25 CFR 115.106 - Assets of members of the Agua Caliente Band of Mission Indians.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., expended, exchanged, deposited, disposed of, invested, and reinvested by the Director, Palm Springs Office... Springs Office, under the Act of October 17, 1968, supra, shall be of such a nature as will afford...

25 CFR 115.106 - Assets of members of the Agua Caliente Band of Mission Indians.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., expended, exchanged, deposited, disposed of, invested, and reinvested by the Director, Palm Springs Office... Springs Office, under the Act of October 17, 1968, supra, shall be of such a nature as will afford...

Geology of the platanares geothermal area, Departamento de Copan, Honduras

USGS Publications Warehouse

Heiken, G.; Ramos, N.; Duffield, W.; Musgrave, J.; Wohletz, K.; Priest, S.; Aldrich, J.; Flores, W.; Ritchie, A.; Goff, F.; Eppler, D.; Escobar, C.

1991-01-01

Platanares is located 16 km west of Santa Rosa de Copan, Honduras, along the Quebrada del Agua Caliente. The thermal manifestations are along faults in tuffs, tuffaceous sedimentary rocks, and lavas of the Padre Miguel Group. These tuffs are silicified near the faults, are fractured, and may provide the fracture permeability necessary for the hydrothermal system. Tuffs are overlain by a wedge of terrace gravels up to 60 m thick. Quaternary conglomerates of the Quebrada del Agua Caliente are cemented by silica sinter. The Platanares area contains numerous faults, all of which appear to be extensional. There are four groups of faults (N80/sup 0/E to N70/sup 0/W, N30/sup 0/ to 60/sup 0/W, N40/sup 0/ to 65/sup 0/E, and N00/sup 0/ to 05/sup 0/W). All hot springs at this site are located along faults that trend mostly northwest and north. Twenty-eight spring groups were described over an area of 0.2 km/sup 2/; half were boiling. Based on surface temperatures and flow rates, between 0.7 and 1.0 MW thermal energy is estimated for the area. The increased temperature of the stream flowing through the thermal area indicates that several megawatts of thermal energy are being added to the stream. We recommend that a dipole-dipole resistivity line be run along the Quebrada del Agua Caliente to identify zones of fracture permeability associated with buried faults and hot water reservoirs within those fault zones. A thermal gradient corehole should be drilled at Platanares to test temperatures, lithologies, and permeability of the hydrothermal system.

Mineralogy, structural control and age of the Incachule Sb epithermal veins, the Cerro Aguas Calientes collapse caldera, Central Puna

NASA Astrophysics Data System (ADS)

Salado Paz, Natalia; Petrinovic, Iván; Do Campo, Margarita; Brod, José Affonso; Nieto, Fernando; da Silva Souza, Valmir; Wemmer, Klauss; Payrola, Patricio; Ventura, Roberto

2018-03-01

The Incachule Sb epithermal veins is located near to the N-E rim of the Cerro Aguas Calientes collapse caldera (17.5-10.8 Ma), in the geologic province of Puna, Salta- Argentina. It is hosted in Miocene felsic volcanic rocks with continental arc signature. The district includes twelve vein systems with mineralization of Sb occurring in hydrothermal breccias and stockwork. The veins are composed of quartz-sulfide with pyrite, stibnite and arsenopyrite. All around the veins, wall rocks are variably altered to clay minerals and sulfates in an area of around 2.5 km wide by more than 7 km long. The hydrothermal alterations recognized are: silicic, phyllic and argillic. The veins are characterized by high contents of Sb, As, and Tl and intermediate contents of Pb-Zn-Cu, and traces of Ag and Au. Homogenization and ice-melting temperatures of fluid inclusions vary from 125 °C to 189 °C and -2.4 °C to -0.8 °C. The isotopic data indicated a range of δ34S -3.04‰ to +0.72‰ consistent with a magmatic source for sulfur. We present the firsts K-Ar ages for hydrothermal illite/smectite mixed layers (I/SR1, 60% illite layers) and illite that constrain the age of the ore deposit (8.5-6.7 ± 0.2 Ma). The data shown here, let characterized the Incachule district as a shallow low sulfidation epithermal system hosted in a collapse caldera. Our data also indicate that mineralization is structurally controlled by a fault system related to the 10.3 Ma collapse of Aguas Calientes caldera. The interpreted local stress field is consistent with the regional one.

Procedures for Computing Site Seismicity

DTIC Science & Technology

1994-02-01

Fourth World Conference on Earthquake Engineering, Santiago, Chile , 1969. Schnabel, P.B., J. Lysmer, and H.B. Seed (1972). SHAKE, a computer program for...This fault system is composed of the Elsinore and Whittier fault zones, Agua Caliente fault, and Earthquake Valley fault. Five recent earthquakes of

75 FR 13297 - Southeastern Lincoln County Habitat Conservation Plan, Lincoln County, NV

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-19

... development), flood control activities (within the City of Caliente), maintenance of Lincoln County roads and... library locations: (1) Clark County Library, 1401 E. Flamingo Road, Las Vegas, NV 89119; (702) 507-3400...- administered land. Proposed covered activities include: (1) Planned land development and maintenance activities...

Hot Binaries: Observational Results

DTIC Science & Technology

2010-01-01

interferométrico sobre binarias calientes y estrellas múltiples, desde las primeras inter- ferometŕıas oculares hasta recientes catastros de “speckle” y...óptica adaptativa. Se discute la multiplicidad fraccionaria de cúmulos, campos y “runaway” de estrellas O. ABSTRACT Interferometric work on hot binary

Enhancing Command Communications and Innovation with SAINT:Semantics, Adaptation, and Influence in Networked Teams

DTIC Science & Technology

2009-02-01

can be quickly reused to face new analytic tasks. Other humanities projects like Monk and Nema have also recently adopted Meandre. The evolutionary...keynote], Congresso Mexicano dc Com- putation Evolutiva (CONCEV), Aguas Calientes, Mexico, May, 2005. Evolutionary Tools for Human-Innovation and

77 FR 74652 - Combined Notice of Filings #1

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-17

...-1521-001; ER12-1522-001; ER12- 1626-001; ER10-2605-004. Applicants: Agua Caliente Solar, LLC, Alta Wind VII, LLC, Alta Wind IX, LLC, Topaz Solar Farms LLC, Yuma Cogeneration Associates. Description...: Midwest Independent Transmission System Operator, Inc. Description: SA 2431 Glacial Ridge Wind-GRE...

Sedimentology of the Simmler and Vaqueros formations in the Caliente Range-Carrizo Plain area, California

USGS Publications Warehouse

Bartow, J. Alan

1974-01-01

The Simmler and Vaqueros Formations in the Caliente Range-Carrizo Plain area make up a large part of the thick Tertiary sedimentary sequence that was .deposited in a basin which lay along the southwest side of the present-day San Andreas fault. The evolution of this basin during Oligocene and early Miocene time and the relationship of its sedimentary record to the tectonic history is an important chapter in the Tertiary history of California. The Simmler Formation, of provincial Oligocene to early Miocene age, unconformably overlies basement rocks and an Upper Cretaceous-lower Tertiary marine sequence. It consists of a sandstone facies, which is mostly a variegated sequence of sandstone and mudstone occurring in fining-upward cycles, and a conglomerate facies, which occurs around the southwest and southeast margins of the basin. The conformably overlying Vaqueros Formation, of provincial early to middle Miocene age, is subdivided from base upward ,into the Quail Canyon Sandstone, Soda Lake Shale, and Painted Rock Sandstone Members. The Vaqueros intertongues eastward, southeastward, and northward with the continental Caliente Formation and is conformably overlain by the Monterey Shale. In the Caliente Range, northeast of major thrust faults, the Vaqueros may reach a thickness of 8,700 feet (2,650 m). Around the margin of the basin, the formation is much thinner--locally only 200 feet (60 m) thick--and is generally undivided. The Quail Canyon Sandstone Member is composed of cross-bedded or planar-stratified sandstone. The Soda Lake Shale Member consists mostly of siltstone and platy shale with a few thin sandstone interbeds. The Painted Rock Sandstone Member, the thickest and coarsest member, consists mostly of large lenticular bodies of thick-bedded coarse-grained sandstone and thinner units of siltstone. Petrology and paleocurrent studies indicate that, in a given subarea, the Simmler and Vaqueros Formations were derived from the same source terrane and that the sediments were usually transported in the same general direction. Crystalline basement terranes to the north and south were the primary sources, but the Upper Cretaceous-lower Tertiary marine sequence made substantial contributions along the southwest side of the basin. The sandstone facies of the Simmler Formation is interpreted as an alluvial plain depositional complex formed by through-flowing low-sinuosity streams, and the conglomerate facies is interpreted as alluvial fan deposits. The Vaqueros Formation in the Caliente Range forms a transgressive-regressive sequence. The Quail Canyon Sandstone and lowermost Soda Lake Shale Members represent the transgressive phase, are interpreted as beach-nearshore and offshore deposits, and are locally the marine equivalents of the upper part of the Simmler conglomerate facies. The remainder of the Soda Lake Shale Member and the Painted Rock Sandstone Member represent the regressive phase and are interpreted as a complex of deltaic and shelf-slope deposits that prograded over basinal shales and turbidites. The reconstructed basin history began in the Oligocene with alluvial plain sedimentation in an area of relatively low relief. This was interrupted in the early Miocene (ca. 25 m.y. B.P.) by the beginning of a period of crustal extension, probably related to the first interaction of the Pacific and North American plates, resulting in the formation of a rapidly subsiding marine basin. This crustal extension was followed by a period of north-south compression in the Pliocene and Pleistocene, which caused the thick accumulation of sediments in the basin to be folded and thrust over the thinner basin-margin section. The Red Hills-Chimineas-Russell fault trend, along which Cretaceous granitic and Precambrian(?) gneissic rocks had been juxtaposed in Cretaceous time, was reactivated in the Pliocene, when 8 to 9 miles (13-14.5 km) of additional right-lateral slip occurred, The pattern of north-south thrusting and rig

75 FR 30110 - Unblocking of Specially Designated National and Blocked Persons Pursuant to the Foreign Narcotics...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-28

..., 1999. The Act provides a statutory framework for the President to impose sanctions against significant... identified by the President. In addition, the Secretary of the Treasury consults with the Attorney General... Tecnologico, Tijuana, Baja California, Mexico; Calle Geiser 101, Colonia Colinas de Agua Caliente, Tijuana...

PLUTONIUM/HIGH-LEVEL VITRIFIED WASTE BDBE DOSE CALCULATION

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

D.C. Richardson

2003-03-19

In accordance with the Nuclear Waste Policy Amendments Act of 1987, Yucca Mountain was designated as the site to be investigated as a potential repository for the disposal of high-level radioactive waste. The Yucca Mountain site is an undeveloped area located on the southwestern edge of the Nevada Test Site (NTS), about 100 miles northwest of Las Vegas. The site currently lacks rail service or an existing right-of-way. If the Yucca Mountain site is found suitable for the repository, rail service is desirable to the Office of Civilian Waste Management (OCRWM) Program because of the potential of rail transportation tomore » reduce costs and to reduce the number of shipments relative to highway transportation. A Preliminary Rail Access Study evaluated 13 potential rail spur options. Alternative routes within the major options were also developed. Each of these options was then evaluated for potential land use conflicts and access to regional rail carriers. Three potential routes having few land use conflicts and having access to regional carriers were recommended for further investigation. Figure 1-1 shows these three routes. The Jean route is estimated to be about 120 miles long, the Carlin route to be about 365 miles long, and Caliente route to be about 365 miles long. The remaining ten routes continue to be monitored and should any of the present conflicts change, a re-evaluation of that route will be made. Complete details of the evaluation of the 13 routes can be found in the previous study. The DOE has not identified any preferred route and recognizes that the transportation issues need a full and open treatment under the National Environmental Policy Act. The issue of transportation will be included in public hearings to support development of the Environmental Impact Statement (EIS) proceedings for either the Monitored Retrievable Storage Facility or the Yucca Mountain Project or both.« less

76 FR 56790 - Notice of Intent To Prepare an Amendment to the Caliente Resource Management Plan and Associated...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-14

... Delta Water Conservation District, and ARC Vineyards, LLC to purchase the following public lands... Kaweah Delta Water Conservation District, is described as: Mount Diablo Meridian T. 17 S., R. 28 E, Sec... suitable for management by other agencies (e.g., for conservation purposes) or land tenure adjustment in...

77 FR 3759 - Notice of Effectiveness of Exempt Wholesale Generator Status

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-25

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Notice of Effectiveness of Exempt Wholesale Generator Status Docket Nos. Agua Caliente Solar, LLC EG12-1-000 Windpower Partners 1993, L.P EG12-2-000 South Chestnut LLC EG12-3-000 Sandy Creek Energy Associates, L.P..... EG12-4-000 AES New Creek...

77 FR 7600 - Notice of Segregation of Public Lands in the State of Arizona for the Restoration Design Energy...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-13

...--Agua Caliente Solar Energy Zone in Yuma County, AZ AGENCY: Bureau of Land Management, Interior. ACTION... of protecting potential sites for future solar energy development while they are being analyzed in... public lands corresponds with the analysis of these same public lands as a proposed Solar Energy Zone...

Prevalence of bovine subclinical mastitis, its etiology and diagnosis of antibiotic resistance of dairy farms in four municipalities of a tropical region of Mexico.

PubMed

Olivares-Pérez, Jaime; Kholif, Ahmed Eid; Rojas-Hernández, Saul; Elghandour, Mona Mohamed Mohamed Yasseen; Salem, Abdelfattah Zeidan Mohamed; Bastida, Adrian Zaragoza; Velázquez-Reynoso, David; Cipriano-Salazar, Moisés; Camacho-Díaz, Luis Miguel; Alonso-Fresán, María Uxúa; DiLorenzo, Nicolas

2015-12-01

A region-wide survey was conducted in the tropical area of Tierra Caliente, State of Guerrero, Mexico to estimate the prevalence of subclinical bovine mastitis (SCM), distribution of mastitis pathogens, and in vitro antimicrobial susceptibility of different mastitis pathogens in dairy farms. In total, 1036 quarter milk samples were obtained from 259 cows at 87 different dairy farms. Collected quarter milk samples were submitted for California Mastitis Test (CMT), bacteriological examination, and testing for antimicrobial susceptibility. Overall prevalence of SCM in the studied area was 20.5 %. Prevalence in the different regions was as follows: 28 % in Arcelia municipality, 21 % in Tlalchapa municipality, 19.4 % in Pungarabato municipality, and 14.3 % in Finch Cutzamala municipality. Of all positive isolates, 97.5 % were Gram-negative bacteria. Moreover, of all positive isolates, 37.5 % were Proteus vulgaris, 25 % Salmonella spp., 12.5 % Enterobacter aerogenes, and 10 % Escherichia coli. Klebsiella pneumonia and E. coli were sensitive for netilmicin antimicrobial. However, E. coli was sensitive for pefloxacin and gentamicin with a sensitivity for pefloxacin for E. aerogenes, while Staphylococci were sensitive for gentamicin and dicloxacillin. It could be concluded that practices such as the implementation of mastitis control programs, improved milking hygiene together with an intramammary treatment with netilmicin, pefloxacin, and gentamicin antimicrobials should be considered for mastitis prevention in the study area of Tierra Caliente, in the tropical area of Guerrero, Mexico.

Telegraph Canyon Creek, City of Chula Vista, San Diego County, California. Detailed Report for Flood Control. Volume 2. Technical Appendixes.

DTIC Science & Technology

1983-07-01

occurred within 40 miles of’ the site. Most of these earthquakes appear to be related to activity on the Elsinore, Agua Caliente, and offshore faults. The...device would be required by the Sweetwater Authority to prevent contamination of potable water lines. TELEGRAPH CANYON CREEK - - Recommended Plant List A

Charters, Constitutions and By-Laws of the Indian Tribes of North America, Part VII: The Indian Tribes of California.

ERIC Educational Resources Information Center

Fay, George E., Comp.

The publication, Part VII of a series, includes the charters, constitutions, articles of association or community organization, and by-laws of California Indians on 16 reservations and rancherias. Legal documents from the following groups are provided: Hoopa, Me-Wuk, and Paiute Indians; the Agua Caliente Band of Mission Indians; the Mission Creek…

Design and installation of a Prototype Geohazard Monitoring System near Machu Picchu, Peru

NASA Astrophysics Data System (ADS)

Bulmer, M. H.; Farquhar, T.

2010-09-01

The town of Machu Picchu, Peru, serves the >700 000 tourists visiting Machu Picchu annually. It has grown threefold in population in the past two decades. Due to the limited low-lying ground, construction is occurring on the unstable valley slopes. Slopes range from <10° on the valley floor to >70° in the surrounding mountains. The town has grown on a delta formed at the confluence of the Alcamayo, Aguas Calientes and Vilcanota Rivers. Geohazards in and around the town of particular concern are 1) large rocks falling onto the town and/or the rail line, 2) flash flooding by any one of its three rivers, and 3) mudflows and landslides. A prototype early warning system that could monitor weather, river flow and slope stability was installed along the Aguas Calientes River in 2009. This has a distributed modular construction allowing components to be installed, maintained, salvaged, and repaired by local technicians. A diverse set of candidate power, communication and sensor technologies was evaluated. Most of the technologies had never been deployed in similar terrain, altitude or weather. The successful deployment of the prototype proved that it is technically feasible to develop early warning capacity in the town.

Changes in long-term eruption dynamics at Santiaguito, Guatemala: Observations from seismic data

NASA Astrophysics Data System (ADS)

Lamb, O. D.; Lavallée, Y.; De Angelis, S.; Lamur, A.; Hornby, A. J.; von Aulock, F. W.; Kendrick, J. E.; Chigna, G.; Rietbrock, A.

2016-12-01

Santiaguito (Guatemala) is an ideal laboratory for the study of the eruption dynamics of long-lived silicic eruptions. Here we present seismic observations of ash-and-gas explosions recorded between November 2014 and June 2016 during a multi-disciplinary experiment by the University of Liverpool. The instruments, deployed around the active dome complex between 0.5 to 7 km from the vent, included 5 broadband and 6 short-period seismometers, as well as 5 infrasound sensors. The geophysical data is complemented by thermal images, optical images from a UAV, and geochemical measurements of erupted material. Regular, small-to-moderate sized explosions from the El Caliente dome at Santiaguito have been common since at least the early 1970s. However, in 2015, a shift in character took place in terms of the regularity and magnitude of the explosions. Explosions became larger and less regular, and often accompanied by pyroclastic density currents. The larger explosions have caused a major morphological change at the vent, as a rubble-filled vent was replaced by a crater of 150 m depth. This shift in behaviour likely represents a change in the eruptive mechanism in the upper conduit beneath the Caliente vent, possibly triggered by processes at a greater depth in the volcanic system. This experiment represents a unique opportunity to use multi-disciplinary research to help understand the long-term eruptive dynamics of lava dome eruptions. Our observations may have implications for hazard assessment not only at Santiaguito, but at many other volcanic systems worldwide.

Lack of Microbial Diversity in an Extreme Mars Analog Setting: Poás Volcano, Costa Rica.

PubMed

Hynek, Brian M; Rogers, Karyn L; Antunovich, Monique; Avard, Geoffroy; Alvarado, Guillermo E

2018-04-24

The Poás volcano in Costa Rica has been studied as a Mars geochemical analog environment, since both the style of hydrothermal alteration present and the alteration mineralogy are consistent with Mars' relict hydrothermal systems. The site hosts an active volcano, with high-temperature fumaroles (up to 980°C) and an ultra-acidic lake. This lake, Laguna Caliente, is one of the most dynamic environments on Earth, with frequent phreatic eruptions, temperatures ranging from near-ambient to almost boiling, a pH range of -1 to 1.5, and a wide range of chemistries and redox potential. Martian acid-sulfate hydrothermal systems were likely similarly dynamic and equally challenging to life. The microbiology existing within Laguna Caliente was characterized for the first time, with sampling taking place in November, 2013. The diversity of the microbial community was surveyed via extraction of environmental DNA from fluid and sediment samples followed by Illumina sequencing of the 16S rRNA gene. The microbial diversity was limited to a single species of the bacterial genus Acidiphilium. This organism likely gets its energy from oxidation of reduced sulfur in the lake, including elemental sulfur. Given Mars' propensity for sulfur and acid-sulfate environments, this type of organism is of significant interest to the search for past or present life on the Red Planet. Key Words: Mars astrobiology-Acid-sulfate hydrothermal systems-Extremophiles-Acidic-High temperature-Acidiphilium bacteria. Astrobiology 18, xxx-xxx.

Agua Caliente Wind/Solar Project at Whitewater Ranch

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

Hooks, Todd; Stewart, Royce

2014-12-16

Agua Caliente Band of Cahuilla Indians (ACBCI) was awarded a grant by the Department of Energy (DOE) to study the feasibility of a wind and/or solar renewable energy project at the Whitewater Ranch (WWR) property of ACBCI. Red Mountain Energy Partners (RMEP) was engaged to conduct the study. The ACBCI tribal lands in the Coachella Valley have very rich renewable energy resources. The tribe has undertaken several studies to more fully understand the options available to them if they were to move forward with one or more renewable energy projects. With respect to the resources, the WWR property clearly hasmore » excellent wind and solar resources. The DOE National Renewable Energy Laboratory (NREL) has continued to upgrade and refine their library of resource maps. The newer, more precise maps quantify the resources as among the best in the world. The wind and solar technology available for deployment is also being improved. Both are reducing their costs to the point of being at or below the costs of fossil fuels. Technologies for energy storage and microgrids are also improving quickly and present additional ways to increase the wind and/or solar energy retained for later use with the network management flexibility to provide power to the appropriate locations when needed. As a result, renewable resources continue to gain more market share. The transitioning to renewables as the major resources for power will take some time as the conversion is complex and can have negative impacts if not managed well. While the economics for wind and solar systems continue to improve, the robustness of the WWR site was validated by the repeated queries of developers to place wind and/or solar there. The robust resources and improving technologies portends toward WWR land as a renewable energy site. The business case, however, is not so clear, especially when the potential investment portfolio for ACBCI has several very beneficial and profitable alternatives.« less

Long-term variations in explosion dynamics at Santiaguito volcano

NASA Astrophysics Data System (ADS)

Lamb, Oliver; De Angelis, Silvio; Lavallée, Yan; Lamur, Anthony; Hornby, Adrian; Von Aulock, Felix; Kendrick, Jackie; Chigna, Gustavo; Rietbrock, Andreas

2017-04-01

Here we present two years of seismic and infrasound observations of ash-and-gas explosions recorded during an ongoing multi-disciplinary experiment at the Santiaguito lava dome complex, Guatemala. Due to the occurrence of regular explosive activity since the early 1970's, the volcano is an ideal laboratory for the study of the eruption dynamics of long-lived silicic eruptions. The instrument network, deployed between 0.5 and 7 km from the active vent, includes 5 broadband and 6 short-period seismometers, as well as 5 infrasound sensors. Seismo-acoustic data are complemented by thermal infrared imagery, visual observations from an unmanned aerial vehicle, and geochemical measurements of eruptive products. In mid-2015, a major shift in activity took place at Santiaguito. Vulcanian explosions became more energetic and less regular, and were often accompanied by pyroclastic density currents. Important morphological changes were observed at the active El Caliente dome, as the lava-filled crater was excavated by a sequence of vigorous explosions to a depth of at least 150 m. Variations in the relative arrival times of seismic and infrasound signals suggest a significant deepening of the explosion initiation point inside the conduit. This shift in behaviour likely represents a change in the eruptive mechanism in the upper conduit beneath El Caliente, possibly triggered by disequilibrium at a greater depth in the volcanic system. Our observations suggest a reactivation of the deep magmatic system at Santiaguito, with little precursory activity. The results of this multi-parameteric monitoring experiment have specific implications for hazard assessment at Santiaguito, and contributes to understanding the processes that control changes in eruptive regime at lava dome volcanoes.

West Magnesia Canyon Channel, City of Rancho Mirage, Riverside County, California. Detailed Project Report. Rancho Mirage Flood Control. Technical Appendixes.

DTIC Science & Technology

1983-12-01

Maximum Site site length Earthquake Accelerations Fault (miles) (miles) (Magnitude) in Bedrock (g)* Agua Caliente 32 50 7.25 0.13 Calico-Newberry 56 50...disturbed samples of representative materials were - obtained for laboratory testing. Seventeen inr- situ density tests were * conducted in the excavated...disturbed samples of representative materials were obtained for - --.-- laboratory testing. Four in- situ density tests were conducted in the trenches by the

Field Surveys, IOC Valleys. Volume III, Part I. Cultural Resources Survey, Dry Lake Valley, Nevada.

DTIC Science & Technology

1981-08-01

and from* Catherine Fowler, Great Basin ethnographer and bibliographer. Personnel from Facilitators, Inc. and HDR provided information on contemporary...Caliente (see Figure 1-6 above). Together with Muleshoe Valley to the north, it occupies a surficially closel trough in the Basin and Range physiographic...province of the Great Basin (Eakin, ; Fenneman, 1931). It is bounded on the east by the Burnt Springs, Ely, Highland, and aristol ranges. The Chief

A late Holocene paleoenvironmental reconstruction from Agua Caliente, southern Belize, linked to regional climate variability and cultural change at the Maya polity of Uxbenká

NASA Astrophysics Data System (ADS)

Walsh, Megan K.; Prufer, Keith M.; Culleton, Brendan J.; Kennett, Douglas J.

2014-07-01

We report high-resolution macroscopic charcoal, pollen and sedimentological data for Agua Caliente, a freshwater lagoon located in southern Belize, and infer a late Holocene record of human land-use/climate interactions for the nearby prehistoric Maya center of Uxbenká. Land-use activities spanning the initial clearance of forests for agriculture through the drought-linked Maya collapse and continuing into the historic recolonization of the region are all reflected in the record. Human land alteration in association with swidden agriculture is evident early in the record during the Middle Preclassic starting ca. 2600 cal yr BP. Fire slowly tapered off during the Late and Terminal Classic, consistent with the gradual political demise and depopulation of the Uxbenká polity sometime between ca. 1150 and 950 cal yr BP, during a period of multiple droughts evident in a nearby speleothem record. Fire activity was at its lowest during the Maya Postclassic ca. 950-430 cal yr BP, but rose consistent with increasing recolonization of the region between ca. 430 cal yr BP and present. These data suggest that this environmental record provides both a proxy for 2800 years of cultural change, including colonization, growth, decline, and reorganization of regional populations, and an independent confirmation of recent paleoclimate reconstructions from the same region.

Metagenomic analysis of microbial community of an Amazonian geothermal spring in Peru.

PubMed

Paul, Sujay; Cortez, Yolanda; Vera, Nadia; Villena, Gretty K; Gutiérrez-Correa, Marcel

2016-09-01

Aguas Calientes (AC) is an isolated geothermal spring located deep into the Amazon rainforest (7°21'12″ S, 75°00'54″ W) of Peru. This geothermal spring is slightly acidic (pH 5.0-7.0) in nature, with temperatures varying from 45 to 90 °C and continually fed by plant litter, resulting in a relatively high degree of total organic content (TOC). Pooled water sample was analyzed at 16S rRNA V3-V4 hypervariable region by amplicon metagenome sequencing on Illumina HiSeq platform. A total of 2,976,534 paired ends reads were generated which were assigned into 5434 numbers of OTUs. All the resulting 16S rRNA fragments were then classified into 58 bacterial phyla and 2 archaeal phyla. Proteobacteria (88.06%) was found to be the highest represented phyla followed by Thermi (6.43%), Firmicutes (3.41%) and Aquificae (1.10%), respectively. Crenarchaeota and Euryarchaeota were the only 2 archaeal phyla detected in this study with low abundance. Metagenomic sequences were deposited to SRA database which is available at NCBI with accession number SRX1809286. Functional categorization of the assigned OTUs was performed using PICRUSt tool. In COG analysis "Amino acid transport and metabolism" (8.5%) was found to be the highest represented category whereas among predicted KEGG pathways "Metabolism" (50.6%) was the most abundant. This is the first report of a high resolution microbial phylogenetic profile of an Amazonian hot spring.

Telegraph Canyon Creek, City of Chula Vista, San Diego County, California. Detailed Report for Flood Control. Volume 1. Main Report.

DTIC Science & Technology

1983-07-01

SECURITY CLASS. (of chi* report) Los Angeles District, Corps of Engineers Ucasfe P.O. Box 2711, Los Angeles, CA 90053 15&. DEL SI F1CATION/OWNGRAOI...greater potential for the possible occurrence of a large earthquake include the Whittier-Elsinore, Agua Caliente, San Jacinto, and the San Andreas...about 900,000 motor vehicles used within the county. 2.20 Air contaminants monitored within the San Diego Bay air basin include carbon monoxide (CO

Geologic map of the Lockwood Valley Quadrangle, Ventura County, California

USGS Publications Warehouse

Kellogg, Karl S.

2001-01-01

The Lockwood Valley quadrangle is located in the western Transverse Ranges of California, about 10 km southwest of Frazier Park. It includes the western flank of Frazier Mountain, southern Lockwood Valley, and a region of the Los Padres National Forest near northern Piru Creek. The oldest rocks are mostly biotite augen gneiss, in the hanging wall of the Frazier Mountain thrust and in a large body south of the thrust. A U-Pb zircon age for the gneiss is 1690+5 Ma (W. Premo, unpublished data). Two Cretaceous intrusive rocks are named the quartz monzonite of Sheep Creek and the coarse-grained granodiorite of Lockwood Peak. A U-Pb zircon age on the latter is 76.05+0.22 Ma (W. Premo, unpublished data). The northeastern edge of a large Eocene marine basin, comprising the sandstones, shales, and conglomerates of the Juncal Formation, occupies the southwestern 25 percent of the quadrangle. Miocene fluvial rocks, including coarse boulder conglomerates, sandstones, and shale, of the Caliente Formation crop out mostly in the northwestern part of the quadrangle. Commercially exploitable Lockwood Clay unconformably overlies the Caliente, which, in turn, is overlain by the mostly fluvial Pliocene Quatal Formation. Two major south-directed thrusts, the Frazier Mountain thrust and the South Frazier Mountain thrust, place crystalline rocks over Miocene and Pliocene sedimentary rocks. The South Frazier Mountain thrust is transected by the newly recognized, north-directed Lockwood Peak reverse fault. In addition, the newly recognized south-directed Yellowjacket thrust displaces rocks of the Pliocene Quatal Formation.

Identification of the seismogenic source of the 1875 Cucuta earthquake on the basis of a combination of neotectonic, paleoseismologic and historic seismicity studies

NASA Astrophysics Data System (ADS)

Rodríguez, Luz; Diederix, Hans; Torres, Eliana; Audemard, Franck; Hernández, Catalina; Singer, André; Bohórquez, Olga; Yepez, Santiago

2018-03-01

An interesting variety of field evidence that collectively cover the three branches of Earthquake Geology: Neotectonics, Paleoseismology and Historical seismicity, has been collected in the border area between Venezuela and Colombia, near the town of San José de Cúcuta, as part of a study aimed at establishing the seismic source of the great Cucuta Earthquake, that occurred on May 18th, 1875, and that caused heavy losses of life and destruction on both sides of the border, between the Department of Norte de Santander in Colombia and Táchira state in Venezuela. This region is affected by the activity of several cross-border fault systems that converge in the zone of the so-called Pamplona Indenter. Among these seismic sources, the potential candidates of this destructive seismic event in 1875 are those related to the Boconó Fault System, of the northwestern foothills of the Mérida Andes and in particular it's most northwestern expression, the Aguas Calientes Fault System, as suggested by previous research carried out by FUNVISIS for the Venezuelan oil industry in the late 80s. In order to confirm whether this was the responsible system for the earthquake or not, the following studies were carried out: 1) In Neotectonics, a detailed binational surface mapping of the active faults of this system was carried out. This system consists of three branches referred to in this paper as: the North, Central and South branch respectively; 2) In Paleoseismology, two trenches were excavated. The first trench was excavated across the South branch and the second one across the North branch, which confirmed fault activity during the Holocene epoch; 3) In historical seismicity the direct coseismic surface effects that occurred in the epicentral area of the earthquake were assessed. All evidence collected and integrated in these three lines of research, made it possible to conclude that the Central branch of the Aguas Calientes fault system is the most likely candidate to have been the cause of this seismic event.

Letter Report: Yucca Mountain Environmental Monitoring Systems Initiative - Air Quality Scoping Study for Pahranagat National Wildlife Refuge, Lincoln County, Nevada

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

J. Englebrecht; I. Kavouras; D. Campbell

2008-08-01

The Desert Research Institute (DRI) is performing a scoping study as part of the U.S. Department of Energy's Yucca Mountain Environmental Monitoring Systems Initiative (EMSI). The main objective is to obtain baseline air quality information for Yucca Mountain and an area surrounding the Nevada Test Site (NTS). Air quality and meteorological monitoring and sampling equipment housed in a mobile trailer (shelter) is collecting data at eight sites outside the NTS, including Ash Meadows National Wildlife Refuge (NWR), Pahranagat NWR, Beatty, Rachel, Caliente, Crater Flat, and Tonopah Airport, and at four sites on the NTS (Engelbrecht et al., 2007a-d). The trailermore » is stationed at any one site for approximately eight weeks at a time. This letter report provides a summary of air quality and meteorological data on completion of the site's sampling program.« less

Letter Report Yucca Mountain Environmental Monitoring Systems Initiative - Air Quality Scoping Study for Pahranagat National Wildlife Refuge, Lincoln County, Nevada

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

J. Engelbrecht; I. Kavouras; D. Campbell

2009-04-02

The Desert Research Institute (DRI) is performing a scoping study as part of the U.S. Department of Energy's Yucca Mountain Environmental Monitoring Systems Initiative (EMSI). The main objective is to obtain baseline air quality information for Yucca Mountain and an area surrounding the Nevada Test Site (NTS). Air quality and meteorological monitoring and sampling equipment housed in a mobile trailer (shelter) is collecting data at eight sites outside the NTS, including Ash Meadows National Wildlife Refuge (NWR), Pahranagat NWR, Beatty, Rachel, Caliente, Crater Flat, and Tonopah Airport, and at four sites on the NTS (Engelbrecht et al., 2007a-d). The trailermore » is stationed at any one site for approximately eight weeks at a time. This letter report provides a summary of air quality and meteorological data on completion of the site's sampling program.« less

Letter Report Yucca Mountain Environmental Monitoring Systems Initiative - Air Quality Scoping Study for Tonopah Airport, Nye County, Nevada

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

J. Engelbrecht; I. Kavouras; D. Campbell

2009-04-02

The Desert Research Institute (DRI) is performing a scoping study as part of the U.S. Department of Energy's Yucca Mountain Environmental Monitoring Systems Initiative (EMSI). The main objective is to obtain baseline air quality information for Yucca Mountain and an area surrounding the Nevada Test Site (NTS). Air quality and meteorological monitoring and sampling equipment housed in a mobile trailer (shelter) is collecting data at eight sites outside the NTS, including Ash Meadows National Wildlife Refuge (NWR), Tonopah Airport, Beatty, Rachel, Caliente, Pahranagat NWR, Crater Flat, and the Tonopah Airport, and at four sites on the NTS (Engelbrecht et al.,more » 2007a-d). The trailer is stationed at any one site for approximately eight weeks at a time. This letter report provides a summary of air quality and meteorological data, on completion of the site's sampling program.« less

Letter Report: Yucca Mountain Environmental Monitoring Systems Initiative - Air Quality Scoping Study for Tonopah Airport, Nye County, Nevada

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

J. Engelbrecht; I. Kavouras; D Campbell

2008-08-01

The Desert Research Institute (DRI) is performing a scoping study as part of the U.S. Department of Energy's Yucca Mountain Environmental Monitoring Systems Initiative (EMSI). The main objective is to obtain baseline air quality information for Yucca Mountain and an area surrounding the Nevada Test Site (NTS). Air quality and meteorological monitoring and sampling equipment housed in a mobile trailer (shelter) is collecting data at eight sites outside the NTS, including Ash Meadows National Wildlife Refuge (NWR), Tonopah Airport, Beatty, Rachel, Caliente, Pahranagat NWR, Crater Flat, and the Tonopah Airport, and at four sites on the NTS (Engelbrecht et al.,more » 2007a-d). The trailer is stationed at any one site for approximately eight weeks at a time. This letter report provides a summary of air quality and meteorological data, on completion of the site's sampling program.« less

Progradational sequences in Miocene shoreline deposits, southeastern Caliente Range, California

USGS Publications Warehouse

Clifton, H. Edward

1981-01-01

An exceptionally well exposed marine-nonmarine transition in middle Miocene strata exists in the southeastern Caliente Range, California. About 50 individual progradational sequences form a succession that ranges in thickness from approximately 1000 m (where predominantly nonmarine) to more than 2500 m (where predominantly marine). Paleogreographic evidence in basalt flows near the top of the succession and in overlying fluvial deposists indicates that these middle Miocene strata were deposited across a north-northwest trending shoreline.A complete progradational sequence typically is several meters to a few tens of meters thick and includes strata that represent three intertonguing stratigraphic units. Individual sequences generally rest on a thin gravel deposit interpreted as a transgressive lag on an erosional surface. The gravel is overlain by structureless siltstone or fine-grained sandstone deposited at water depths where the rate of faunal mixing exceeded that of production of structures by physical processes. These rocks grade upward into bedded fine sandstone deposited closer to shore where physical processes exceeded bioturbation. Crossbedded lenses of coarse sand or fine gravel in the upper part of this facies suggest the presence of failry long-period surface waves. The bedded fine sandstone is sharply overlain by a crossbedded coarse sandstone facies that is interpreted as a combined offshore bar-rip channel-surf zone assemblage. Cross-strata dip dominantly offshore, suggesting substantial deposition from rip currents. A secondary, shore=parallel mode of cross-strata direction suggests longshore currents produced by surface waves from the northwest. The crossbedded coarse-grained sandstone grades upward into planar-bedded medium-grained sandstone that is interpreted as a beach foreshore. This facies grades upward through structureless medium-grained sandstone into nonmarine or lagoonal red and green mudstone of the Caliente Formation.The middle Miocene succession was deposited in a subsiding basin that was otherwise remarkably stable tectonically; the position of the strand line differed no more than a few kilometers through a period of 1 to 3 m.y. The average duration of the transgressive-regressive cycles, a few tens of thousands of years, together with their distribution in groups of three or four in the lower two-thirds of the succession, is consistent with the pattern of long-term climatic cycles produced by periodicity of the earth's solar orbit and may be related to eustatic sea level changes attendant to the development of the Antarctic ice cap. Changes in the pattern of progradation in the upper part of the succession and nearby basaltic eruptions may hav been precursors to the onset of movement along the San Andreas fault in this area 12-14 m.y. ago.

Late Miocene ignimbrites at the southern Puna-northern Sierras Pampeanas border (˜27°S): Stratigraphic correlation

NASA Astrophysics Data System (ADS)

Montero-López, Carolina; Guzmán, Silvina; Barrios, Fabiola

2015-10-01

New field observations and petrographic and geochemical data of pyroclastic deposits exposed along the Las Papas valley (border between southern Puna and northern Sierras Pampeanas, Argentina) and further north, lead us to propose a new stratigraphic correlation and classification of the late Miocene volcanism in this area. We redefine the Las Papas, Las Juntas, Aguada Alumbrera and Rosada ignimbrites and define the Agua Caliente and Del Medio ignimbrites. The whole set of ignimbrites are rhyolites and less frequently dacites of calc-alkaline affinity. In the present contribution we divide ignimbrites into the Agua Negra and Rincón groups, based mainly on their geochemical signature. The Agua Negra Group is formed by the Las Papas and Las Juntas ignimbrites, indurated and welded, lithic-rich, with crystal-poor pumices and crystal-rich matrix. The Rincón Group comprises the Agua Caliente, Aguada Alumbrera, Rosada and Del Medio ignimbrites, with variable welding degrees, lithic and crystal content. The greater enrichment of crystals in the matrix in comparison with the crystal content in pumices indicates significant elutriation during flow transport and thus volume estimations are to be considered lower bounds for the actual erupted volume. The total minimum estimated volume for the ignimbrites of the Agua Negra and Rincón groups is 2.8 km3 (2.3 km3 DRE). Field relationships and new analytical data indicate that the different acid ignimbrites that crop out in this small area are related to at least two different magma chambers. The widespread Quaternary volcanism in this area covers the older deposits, thus making it difficult to recognize the volcanic centers that produced these late Miocene ignimbrites.

Geographic distribution of genetic diversity in populations of Rio Grande Chub Gila pandora

USGS Publications Warehouse

Galindo, Rene; Wilson, Wade; Caldwell, Colleen A.

2016-01-01

In the southwestern United States (US), the Rio Grande chub (Gila pandora) is state-listed as a fish species of greatest conservation need and federally listed as sensitive due to habitat alterations and competition with non-native fishes. Characterizing genetic diversity, genetic population structure, and effective number of breeders will assist with conservation efforts by providing a baseline of genetic metrics. Genetic relatedness within and among G. pandora populations throughout New Mexico was characterized using 11 microsatellite loci among 15 populations in three drainage basins (Rio Grande, Pecos, Canadian). Observed heterozygosity (HO) ranged from 0.71–0.87 and was similar to expected heterozygosity (0.75–0.87). Rio Ojo Caliente (Rio Grande) had the highest allelic richness (AR = 15.09), while Upper Rio Bonito (Pecos) had the lowest allelic richness (AR = 6.75). Genetic differentiation existed among all populations with the lowest genetic variation occurring within the Pecos drainage. STRUCTURE analysis revealed seven genetic clusters. Populations of G. pandora within the upper Rio Grande drainage (Rio Ojo Caliente, Rio Vallecitos, Rio Pueblo de Taos) had high levels of admixture with Q-values ranging from 0.30–0.50. In contrast, populations within the Pecos drainage (Pecos River and Upper Rio Bonito) had low levels of admixture (Q = 0.94 and 0.87, respectively). Estimates of effective number of breeders (N b ) varied from 6.1 (Pecos: Upper Rio Bonito) to 109.7 (Rio Grande: Rio Peñasco) indicating that populations in the Pecos drainage are at risk of extirpation. In the event that management actions are deemed necessary to preserve or increase genetic diversity of G. pandora, consideration must be given as to which populations are selected for translocation.

Developing an Early Warning System for Machu Picchu Pueblo, Peru.

NASA Astrophysics Data System (ADS)

Bulmer, Mark; Farquhar, Tony

2010-05-01

The town of Machu Picchu, Peru, is linked to Ollantaytambo and Cusco by rail and serves as the main station for the 400,000+ tourists visiting Machu Picchu. Due to the tourist industry the town grown threefold in population in the past two decades. Today, due to the limited availability of low-lying ground, construction is occurring higher up on the unstable valley slopes. The town is located at 2000 m asl while the surrounding peaks rise to over 4000 m asl. Slopes range from < 10° on the valley floor to > 70° in the surrounding granite mountains. The town has grown on the downstream right bank of the Vilcanota River, at the confluence of the Alcamayo and the Aguas Calientes Rivers. Broadly, a dry winter season runs from May to August with a rainy summer season running from October to March. The rainy months provide around 80% of the annual rainfall average, which ranges from 1,600 to 2,300 mm. Seasonal temperature variations are considered modest. An assessment of the geohazards in and around the town has been undertaken. Those of particular concern to the town are 1) large rocks falling onto the town and/or the rail line, 2) flash flooding by any one of its three rivers, and 3) mudflows and landslides. To improve the existing municipal warning system a prototype early warning system incorporating suitable technologies that could monitor weather, river flow and slope satability was installed along the Aguas Calientes River in 2009. This has a distributed modular construction allowing most components to be installed, maintained, swapped, salvaged, repaired and/or replaced by local technicians. A diverse set of candidate power, communication and sensor technologies was deployed and evaluated. Most of the candidate technologies had never been deployed in similar terrain, altitude or weather. The successful deployment of the prototype proved that it is technically feasible to develop early warning capacity in the town.

Multispectral Observations of Explosive Gas Emissions from Santiaguito, Guatemala

NASA Astrophysics Data System (ADS)

Carn, S. A.; Watson, M.; Thomas, H.; Rodriguez, L. A.; Campion, R.; Prata, F. J.

2016-12-01

Santiaguito volcano, Guatemala, has been persistently active for decades, producing frequent explosions from its actively growing lava dome. Repeated release of volcanic gases contains information about conduit processes during the cyclical explosions at Santiaguito, but the composition of the gas phase and the amount of volatiles released in each explosion remains poorly constrained. In addition to its persistent activity, Santiaguito offers an exceptional opportunity to investigate lava dome degassing processes since the upper surface of the active lava dome can be viewed from the summit of neighboring Santa Maria. In January 2016 we conducted multi-spectral observations of Santiaguito's explosive eruption plumes and passive degassing from multiple perspectives as part of the first NSF-sponsored `Workshop on Volcanoes' instrument deployment. Gas measurements included open-path Fourier-Transform infrared (OP-FTIR) spectroscopy from the Santa Maria summit, coincident with ultraviolet (UV) and infrared (IR) camera and UV Differential Optical Absorption Spectroscopy (DOAS) from the El Mirador site below Santiaguito's active Caliente lava dome. Using the OP-FTIR in passive mode with the Caliente lava dome as the source of IR radiation, we were able to collect IR spectra at high temporal resolution prior to and during two explosions of Santiaguito on 7-8 January, with volcanic SO2 and H2O emissions detected. UV and IR camera data provide constraints on the total SO2 burden in the emissions (and potentially the volcanic ash burden), which coupled with the FTIR gas ratios provides new constraints on the mass and composition of volatiles driving explosions at Santiaguito. All gas measurements indicate significant volatile release during explosions with limited degassing during repose periods. In this presentation we will present ongoing analysis of the unique Santiaguito gas dataset including estimation of the total volatile mass released in explosions and an intercomparison of SO2 amounts recorded by the UV and IR instruments.

Structural geology and stress history of the Platanares geothermal site, Honduras: implications on the tectonics of the northwestern Caribbean plate boundary

NASA Astrophysics Data System (ADS)

Aldrich, M. J.; Adams, Andrew I.; Escobar, Carlos

1991-03-01

The structural geology of the Platanares geothermal site in western Honduras, located about 25 km south of the northern boundary of the Caribbean plate, is the result of post Early Miocene extensional deformation. Normal faults, many with listric geometries, are numerous throughout the area. Strike-slip faulting has mostly occurred on reactived normal faults. Analysis of the fault slip data shows an older minimum principal stress, σ 3, oriented approximately N-S and a contemporary σ 3 tensional and oriented ENE-WSW. The analysis suggests that σ 3 has rotated clockwise since the Early Miocene although some of the change in orientation of σ 3 might reflect counterclockwise rotation of the crust about a vertical axis. The σ 1 and σ 2 stress axes apparently switched recently, with the σ 3 axis remaining unchanged. These results are consistent with a tectonic model in which the east-drifting Caribbean plate is pinned against North America by the subducting Cocos plate (Malfait and Dinkleman, 1972) and the northern and southern margins of the Caribbean plate are broad, mobile zones that are undergoing counterclockwise and clockwise rotations respectively (Gose, 1985). The majority of the hot springs at Platanares lie along Quebrada del Agua Caliente. Fractures control the movement of the geothermal waters. Hot springs occur along joints and faults and, in places, hot water flows laterally along bedding planes. If the fractures also control the movement of water at depth then the source reservoir of the geothermal waters may be located northeast of the principal hot spring areas along the quebrada since the majority of the faults dip in that direction. However, if the fault that seems to have controlled the development of Quebrada del Agua Caliente is vertical as inferred then the main reservoir may lie directly beneath this drainage.

Variability among strains of Aspergillus section Nigri with capacity to degrade tannic acid isolated from extreme environments.

PubMed

Lara-Victoriano, F; Veana, F; Hernández-Castillo, F D; Aguilar, C N; Reyes-Valdés, M H; Rodríguez-Herrera, R

2017-01-01

Tannins are polyphenolic compounds that cause astringent flavor and turbidity in food. Tannase is an enzyme that catalyzes the hydrolysis of tannins and is used in food industry. This study was conducted to determine the genetic variability and the tannase alleles variation in fungal strains isolated from soil and plants at five extreme areas of Coahuila, México. Two screening assays under 1 and 20 % of tannic acid were performed, with the isolations. In these assays, it was possible to identify 756 and 128 fungal strains, respectively. The major fungal variability was observed in "Cuatro Ciénegas" with 26 strains. The microorganisms were distributed in 11 groups, which correspond to Aspergillus section Nigri. AN7 and AN1 groups showed the major number of isolates from "Paila" and "Cuatro Ciénegas" locations, respectively. In the last location, the major diversity and specific richness were found. But in "Ojo Caliente," tannase allele conservations were observed.

Geologic Map of the Eastern Three-Quarters of the Cuyama 30' x 60' Quadrangle, California

USGS Publications Warehouse

Kellogg, Karl S.; Minor, Scott A.; Cossette, Pamela M.

2008-01-01

The map area encompasses a large part of the western Transverse Ranges and southern Coast Ranges of southern California. The San Andreas fault (SAF) cuts the northern part of the map. The area south of the SAF, about 80 percent of the map area, encompasses several distinct tectonic blocks bounded by major thrust or reverse faults, including the Santa Ynez fault, Big Pine fault (and structurally continuous Pine Mountain fault), Tule Creek fault, Nacimiento fault, Ozena fault, Munson Creek fault, Morales fault, and Frazier Mountain Thrust System. Movement on these faults is as old as Miocene and some faults may still be active. In addition, the Paleocene Sawmill Mountain Thrust south of the SAF and the Pastoria Thrust north of the SAF place Cretaceous and older crystalline rocks above Pelona Schist (south of the SAF) and Rand Schist (north of the SAF). South of the SAF, each tectonic block contains a unique stratigraphy, reflecting either large-scale movement on bounding faults or different depositional environments within each block. On Mount Pinos and Frazier Mountain, intrusive and metamorphic rocks as old as Mesoproterozoic, but including voluminous Cretaceous granitoid rocks, underlie or are thrust above non-marine sedimentary rocks as old as Miocene. Elsewhere, marine and non-marine sedimentary rocks are as old as Cretaceous, dominated by thick sequences of both Eocene and Cretaceous marine shales and sandstones. Middle Miocene to early Oligocene volcanic rocks crop out in the Caliente Hills (part of Caliente Formation) and south of Mount Pinos (part of the Plush Ranch Formation). Fault-bounded windows of Jurassic Franciscan Complex ophiolitic rocks are evident in the southwest corner of the area. North of the SAF, marine and non-marine sedimentary rocks as old as Eocene and Miocene volcanic rocks overlie a crystalline basement complex. Basement rocks include Cretaceous intrusive rocks that range from monzogranite to diorite, and Jurassic to late Paleozoic intrusive and metamorphic rocks. The Jurassic to late Paleozoic intrusive rocks include diorite, gabbro, and ultramafic rocks, and the metasedimentary rocks include marble, quartzite, schist, and gneiss.

Heritage plaza parking lots improvement project- Solar PV installation

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

Hooks, Todd

The Agua Caliente Band of Cahuilla Indians (ACBCI or the “Tribe”) installed a 79.95 kW solar photovoltaic (PV) system to offset the energy usage costs of the Tribal Education and Family Services offices located at the Tribe's Heritage Plaza office building, 90I Tahquitz Way, Palm Springs, CA, 92262 (the "Project"). The installation of the Solar PV system was part of the larger Heritage Plaza Parking Lot Improvements Project and mounted on the two southern carport shade structures. The solar PV system will offset 99% of the approximately 115,000 kWh in electricity delivered annually by Southern California Edison (SCE) to themore » Tribal Education and Family Services offices at Heritage Plaza, reducing their annual energy costs from approximately $22,000 annually to approximately $200. The total cost of the proposed solar PV system is $240,000.« less

Geology, geochemistry, geochronology, and economic potential of Neogene volcanic rocks in the Laguna Pedernal and Salar de Aguas Calientes segments of the Archibarca lineament, northwest Argentina

NASA Astrophysics Data System (ADS)

Richards, J. P.; Jourdan, F.; Creaser, R. A.; Maldonado, G.; DuFrane, S. A.

2013-05-01

This study presents new geochemical, geochronological, isotopic, and mineralogical data, combined with new geological mapping for a 2400 km2 area of Neogene volcanic rocks in northwestern Argentina near the border with Chile, between 25°10‧S and 25°45‧S. The area covers the zone of intersection between the main axis of the Cordillera Occidental and a set of NW-SE-trending structures that form part of the transverse Archibarca lineament. This lineament has localized major ore deposits in Chile (e.g., the late Eocene La Escondida porphyry Cu deposit) and large volcanic centers such as the active Llullaillaco and Lastarría volcanoes on the border between Chile and Argentina, and the Neogene Archibarca, Antofalla, and Cerro Galán volcanoes in Argentina. Neogene volcanic rocks in the Laguna Pedernal and Salar de Aguas Calientes areas are mostly high-K calc-alkaline in composition, and range from basaltic andesites, through andesites and dacites, to rhyolites. Magmatic temperatures and oxidation states, estimated from mineral compositions, range from ~ 1000 °C and ∆FMQ ≈ 1.0-1.5 in andesites, to ~ 850 °C and ∆FMQ ≈ 1.5-2.0 in dacites and rhyolites. The oldest rocks consist of early-middle Miocene andesite-dacite plagioclase-pyroxene-phyric lava flows and ignimbrites, with 40Ar/39Ar ages ranging from 17.14 ± 0.10 Ma to 11.76 ± 0.27 Ma. Their major and trace element compositions are typical of the Andean Central Volcanic Zone, and show strong crustal contamination trends for highly incompatible elements such as Cs, Rb, Th, and U. These rocks are geochemically grouped as sub-suite 1. This widespread intermediate composition volcanism was followed in the middle-late Miocene by a period of more focused rhyodacitic flow-dome complex formation. These felsic rocks are characterized by less extreme enrichments in highly incompatible elements, and increasing depletion of heavy rare earth elements. These rocks are geochemically grouped as sub-suite 2. The youngest rocks in this sub-suite show the highest La/Yb ratios, and are characterized by abundant hornblende phenocrysts (not commonly seen in other rocks from the area). In the Pliocene-Pleistocene, there was a return to more typical andesite-dacite volcanism, with geochemical characteristics similar to the early-middle Miocene lavas, and are also grouped in sub-suite 1. Finally, extensional tectonics in the Quaternary led to localized outpouring of mafic (basaltic andesitic to andesitic) monogenetic lava flows and cones. One particularly large flow, the Vega Aguas Calientes lava flow, covers approximately 90 km2, and samples form two groupings, with affinities similar to the least-evolved samples from sub-suites 1 and 2 (sub-groups BA1 and BA2, respectively). Nd and Sr isotopic compositions indicate moderate to strong crustal contamination, especially in more felsic rocks, and extend from 87Sr/86Sr (0.706) and εNd (- 2.4), values typical of Central Volcanic Zone rocks, to more evolved compositions (0.709 and - 6.8, respectively) typical of large-volume ignimbrites of the Altiplano-Puna Volcanic Complex and Cerro Galán. The latter compositions are thought to be derived by extensive interaction between mantle-derived arc magmas and Paleozoic granitoid rocks that form much of the crustal column in this region. The distinctive mineralogy and geochemistry of the sub-suite 2 middle-late Miocene rhyodacitic flow-dome complexes indicate that these magmas had higher water content than both the earlier and later sub-suite 1 andesites-dacites. They were erupted during a period of tectonic quiescence following the Quechua orogenic phase, and geophysical evidence suggests that they were proximally derived from a large upper crustal magma chamber which partially collapsed to form a trap-door caldera. Strong fumarolic alteration associated with the youngest of these felsic volcanoes, Cerro Abra Grande, suggests the potential for the existence of epithermal-type mineralization within the volcanic edifice, or porphyry-type mineralization at depth.

Provenance, Offset Equivalent and Palinspastic Reconstruction of the Miocene Cajon Valley Formation, Southern California

NASA Astrophysics Data System (ADS)

Stang, Dallon Michael

Petrographic, conglomerate and detrital-zircon analyses of formations in southern California can determine consanguineous petrofacies and lithofacies that help constrain paleotectonic and paleogeographic reconstructions of the southwestern United States. Arkosic sandstone of the lower Middle Miocene Cajon Valley formation is exposed on the southwest edge of the Mojave block and juxtaposed against Mesozoic and Paleozoic rocks by the San Andreas fault (SAf). Early work in Cajon Valley referred to the formation as Punchbowl, due to its similar appearance to the Punchbowl Formation at Devil's Punchbowl (northwest along the SAf). However, paleontological work placed Cajon Valley strata in the Hemingfordian-Barstovian (18-14 Ma), as opposed to the Clarendonian-Hemphillian (13-9 Ma) Punchbowl Formation. Since the Cajon Valley formation was deposited prior to being truncated by the San Andreas fault, the 2400m-thick, laterally extensive subaerial deposits likely were deposited across what is now the fault trace. Restoring 310 km of dextral slip on the SAf system should indicate the location of offset equivalent sandstone. Restoration of slip on the SAf system places Cajon Valley adjacent to the Caliente and La Panza Ranges, east of San Luis Obispo. Although analysis of detrital zircon from Cenozoic sandstone throughout southern California has been crucial in establishing paleodrainage areas, detrital zircon from the Cajon Valley and equivalent formations had not been analyzed prior to this study. Paleocurrents measured throughout the Cajon Valley formation indicate a source to the NE, in the Mojave Desert. Sandstone samples analyzed in thin section using the Gazzi-Dickinson method of point-counting are homogeneously arkosic, with slight compositional variability, making differentiation of the Cajon Valley formation and potential offset equivalents problematic. However, Branch Canyon Sandstone and Santa Margarita Formation samples are compositionally the best match for the Cajon Valley formation. Detrital-zircon ages were determined from the Cajon Valley formation and related strata. These data are slightly more variable than sandstone composition, with distinct age peaks at 85-90 Ma, 150 Ma and 250 Ma. These ages correlate with batholiths in the SW Mojave Desert. Of the nine samples from six formations collected as potential offset equivalents, Branch Canyon and Santa Margarita samples are most similar to Cajon Valley samples, in terms of both detrital-zircon ages and sandstone composition. Based on 310km of post-Miocene offset on the San Andreas fault system, the Cajon Valley formation restores adjacent to shallow-marine sandstone of the Santa Margarita Formation and Branch Canyon Sandstone Member of the Monterey Formation in the Caliente and La Panza ranges. Cajon Valley sandstone is interpreted to represent a Miocene fluvial system on a coastal plain, flowing toward a delta on a narrow continental shelf.

Examining Severe Drought-Induced Vegetation Change and its Influence on Water Resources

NASA Astrophysics Data System (ADS)

White, A. B.; Springer, E. P.; Vivoni, E. R.

2007-12-01

A "global-change-type" drought that occurred in the southwestern U.S. from 2000 to 2003, accompanied by increased temperatures and bark beetle infestations, induced large-scale woodland overstory mortality, the consequent redistribution of water, radiation, and nutrients, as well as modification of the ecosystem phenology. Our objectives in this research are to examine these vegetation changes in detail and to determine whether they translated to changes in hydrological processes. We chose the Rio Ojo Caliente, a subbasin of the Rio Grande, as a study site since a significant portion of the woodland ecosystem (piñon-juniper) was affected. Examining a remotely-sensed vegetation index (1-km AVHRR NDVI from 1989 to 2006), there is an increasing trend in the mean NDVI from 1989 to 1998 (pre-drought period), a decreasing trend from 1999 to 2003 (drought period), and a dramatic increasing trend from 2004 to 2006 (post-drought period) in which the mean NDVI rebounds to pre- drought magnitudes. Streamflow records from 1932 to 2006 show the watershed to be primarily spring snowmelt-driven, although monsoonal summer precipitation also plays a significant role. We compare the temporal variability in the streamflow to the NDVI, including the mean, anomalies from the mean, and seasonally- based duration curves, and find significant correlations (correlation coefficient ρ = -0.61) between the streamflow and NDVI at approximately a three-month lag (NDVI lagging streamflow). In analyzing the three phases of the drought, the correlation is slightly stronger during the pre-drought (ρ = -0.64) and drought (ρ = -0.65) periods, yet markedly stronger during the post-drought period (ρ = -0.74). This suggests that the coupling between vegetation water use and streamflow is tighter after the drought. This may be attributable to the reduction in the less-responsive overstory (pinñon mortality) and increase in the more-responsive understory (grasses and shrubs exploiting newly available resources). Temporal patterns in gauge-based precipitation (frozen and unfrozen) and air temperature, and spatial-temporal patterns in PRISM precipitation, air temperature, and a soil moisture index are also compared to the NDVI. While the vegetation composition was altered to a great degree in the Rio Ojo Caliente Basin, the system rapidly recovered both photosynthetically and hydrologically during the post-drought wet period, although the dynamic between vegetation water use and streamflow was slightly altered. The aim of this research is to explore the consequences of a severe drought married with elevated temperatures on vegetation and water resources. As the intensity and frequency of droughts are expected to increase in the southwestern U.S. with rising temperatures (IPCC 2007), this research contributes to our knowledge of ecosystem and hydrologic response to the changing climate.

Salud Para Su Corazon-NCLR: a comprehensive Promotora outreach program to promote heart-healthy behaviors among hispanics.

PubMed

Balcazar, Hector; Alvarado, Matilde; Hollen, Mary Luna; Gonzalez-Cruz, Yanira; Hughes, Odelinda; Vazquez, Esperanza; Lykens, Kristine

2006-01-01

This article describes results of year-1 implementation of the Salud Para Su Corazón (Health For Your Heart)-National Council of la Raza (NCLR) promotora (lay health worker) program for promoting heart-healthy behaviors among Latinos. Findings of this community outreach initiative include data from promotora pledges and self-skill behaviors, cardiovascular disease risk factors of Latino families, family heart-health education delivery, and program costs associated with promotora time. Participation included 29 trained promotoras serving 188 families from three NCLR affiliates in Escondido, California; Chicago, Illinois; and Ojo Caliente, New Mexico. Using several evaluation tools, the results showed that the promotora approach worked based on evidence obtained from the following indicators: changes in promotora's pre-post knowledge and performance skills, progress toward their pledge goals following training, recruiting and teaching families, providing follow-up, and organizing or participating in community events. Strengths and limitations of the promotora model approach are also discussed.

Geologic map and digital database of the Apache Canyon 7.5' quadrangle, Ventura and Kern counties, California

USGS Publications Warehouse

Stone, Paul; Cossette, P.M.

2000-01-01

The Apache Canyon 7.5-minute quadrangle is located in southwestern California about 55 km northeast of Santa Barbara and 65 km southwest of Bakersfield. This report presents the results of a geologic mapping investigation of the Apache Canyon quadrangle that was carried out in 1997-1999 as part of the U.S. Geological Survey's Southern California Areal Mapping Project. This quadrangle was chosen for study because it is in an area of complex, incompletely understood Cenozoic stratigraphy and structure of potential importance for regional tectonic interpretations, particularly those involving the San Andreas fault located just northwest of the quadrangle and the Big Pine fault about 10 km to the south. In addition, the quadrangle is notable for its well-exposed sequences of folded Neogene nonmarine strata including the Caliente Formation of Miocene age from which previous workers have collected and described several biostratigraphically significant land-mammal fossil assemblages. During the present study, these strata were mapped in detail throughout the quadrangle to provide an improved framework for possible future paleontologic investigations. The Apache Canyon quadrangle is in the eastern part of the Cuyama 30-minute by 60-minute quadrangle and is largely part of an erosionally dissected terrain known as the Cuyama badlands at the east end of Cuyama Valley. Most of the Apache Canyon quadrangle consists of public lands in the Los Padres National Forest.

Mechanical constraints on the triggering of vulcanian explosions at Santiaguito volcano, Guatemala

NASA Astrophysics Data System (ADS)

Hornby, Adrian; Lavallée, Yan; Collinson, Amy; Neuberg, Jurgen; De Angelis, Silvio; Kendrick, Jackie; Lamur, Anthony

2016-04-01

Gas- and ash explosions at Santiaguito volcano occur at regular 20-200 minute intervals, exiting through arcuate fractures in the summit dome of the Caliente vent. Infrasound, ground deformation and seismic monitoring collected during a long term monitoring survey conducted by the University of Liverpool have constrained a stable, repeatable source for these explosions. The explosions maintain similar magnitudes and (low) erupted mass throughout examined period. Ground deformation reveals stable ~25 minute inflation-deflation cycles, which culminate in either explosions or passive outgassing. Inversion of infrasound sources has revealed that faster inflation rates during the final minutes before peak inflation lead to explosions. These explosions fragment a consistently small-volume pressurized, gas-rich domain within magma located below a denser, lower permeability magma plug. Rapid decompression of this gas-rich domain occurs through fracturing and faulting, creating a highly permeable connection with atmospheric pressures near to the dome surface. We surmise that the dominant fracture mode at these shallow depths is tensile due to the volumetric strain exerted by a pressurising source below the magma plug, however a component of shear is also detected during explosive events. Fractures may either propagate downwards from the dome surface (due to greater magma stiffness and lower confining pressure) or upwards from the gas-rich domain (due to higher strain rates at the deformation source in the case of viscous deformation). In order to constrain the origin and evolution of these fractures we have conducted Brazilian tensile stress tests on lavas from the Caliente vent at strain rates from 10-3-10-5, porosities 3-30% and temperatures 20-800 °C. Across the expected conduit temperature range (750-800 °C) the dome material becomes highly sensitive to strain rate, showing a range of response from elastic failure to viscous flow. The total strain accommodated prior to failure shows a non-linear increase as viscous deformation becomes more important (i.e. temperature is increased or strain rate decreased). This allows us to constrain timescales for fracture propagation for given temperature-strain rate scenarios. We use these results, together with monitoring data and the results of numerical modelling to compare the probability of fractures propagating from the top-down or bottom-up prior to explosions at Santiaguito. Thus, we shed light on the triggers and signals leading to vulcanian explosions, which may be widely applicable to vulcanian explosions at active volcanoes.

The Rail Alignment Environmental Impact Statement: An Update

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

R. Sweeney

2005-01-20

On July 23,2002, the President of the United States signed into law a joint resolution of the United States Congress designating the Yucca Mountain site in Nye County, Nevada, for development as a geologic repository for the disposal of spent nuclear fuel and high-level radioactive waste. If the US. Nuclear Regulatory Commission authorizes construction of the repository and receipt and possession of spent nuclear fuel and high-level radioactive at Yucca Mountain, the U.S. Department of Energy (DOE) would be responsible for transporting these materials to the Yucca Mountain repository as part of its obligation under the Nuclear Waste Policy Act.more » Part of the site recommendation decision included the analysis of a nation-wide shipping campaign to the proposed repository site. The ''Final Environmental Impact Statement for a Geologic Repository for the Disposal of Spent Nuclear Fuel and High-Level Radioactive Waste at Yucca Mountain, Nye County, Nevada'' (February 2002) (Repository EIS) evaluated the potential impacts of the transportation of 70,000 Metric Tons of Heavy Metal spent nuclear fuel and high-level radioactive waste from 77 locations around the nation to the potential repository in Nevada over a 24 year shipping campaign. In the Repository EIS, DOE identified mostly rail as its preferred mode of transportation, both nationally and in the State of Nevada. In December 2003, based on public comments and the environmental analyses in the Repository EIS, DOE identified a preference for the Caliente rail corridor in Nevada. On April 8, 2004, DOE issued a Record of Decision (ROD) on the Mode of Transportation and Nevada Rail Corridor for the Disposal of Spent Nuclear Fuel and High-Level Radioactive Waste at Yucca Mountain, Nye County, Nevada. In this ROD, the DOE announced that it had decided to select the mostly rail scenario analyzed in the Repository EIS as the transportation mode both on a national basis and in the State of Nevada. Under the mostly rail scenario, the DOE would rely on a combination of rail, truck and possibly barge to transport to the repository site at Yucca Mountain up to 70,000 MTHM of spent nuclear fuel and high-level radioactive waste, with most of the spent nuclear fuel and high-level radioactive waste being transported by rail. This will ultimately require construction of a rail line in Nevada to the repository. In addition, the DOE has decided to select the Caliente rail corridor in which to examine potential alignments within which to construct that rail line. A corridor is a strip of land, approximately 400 meters (0.25 miles) wide, that encompasses one of several possible routes through which DOE could build a rail line. An alignment is the specific location of a rail line in a corridor, and would likely be 60 meters [200 feet] or less in width. Also on April 8, 2004, DOE issued a Notice of Intent to Prepare an Environmental Impact Statement for the Alignment, Construction, and Operation of a Rail Line to a Geologic Repository at Yucca Mountain, Nye County, NV. In the Notice of Intent, the Department announced its intent to prepare a Rail Alignment EIS to assist in selecting a possible alignment for construction of a rail line that would connect the repository at Yucca Mountain to an existing main rail line in Nevada. The Rail Alignment EIS also would consider the potential construction and operation of a rail-to-truck intermodal transfer facility, proposed to be located at the confluence of an existing mainline railroad and a highway, to support legal-weight truck transportation until the rail system is fully operational. This corridor is approximately 513 kilometers (319 miles) long and would cost an estimated $880 million (2001 dollars). Should DOE decide to build the Caliente corridor, it may be the longest rail line built in the United States since the Transcontinental Railroad was constructed in 1869. Some of the challenges in building this rail corridor are steep grades (the corridor crosses over 7 mountain ranges), isolated terrain, possible tunnels, and stakeholder acceptance.« less

Soda Lake-Painted Rock(!) Petroleum System in the Cuyama Basin, California, U.S.A.

USGS Publications Warehouse

Lillis, Paul G.

1994-01-01

The Cuyama basin, located in the central California Coast Ranges, was formed by extension during early Miocene time and was filled with a variety of nonmarine, marginal marine, and neritic to bathyal marine sediments. Low sulfur oil is produced primarily from the lower Miocene Painted Rock Sandstone Member of the Vaqueros Formation along a structural trend parallel to the Russell fault, which was active from 23 to 5 Ma. A major fold and thrust belt beginning about 3 Ma formed the Caliente and Sierra Madre ranges and partially obscures the Miocene extensional basin. Stable carbon isotope and biomarker data indicate that the lower Miocene Soda Lake Shale Member of the Vaqueros Formation is the predominant source rock for the oil in the Cuyama area. Burial and thermal history modeling shows that oil generation began in middle-late Miocene time and that oil migrated into existing traps. Younger traps that formed in the overthrust are barren of oil because migration occurred prior to the development of the fold and thrust belt or because subthrust oil was unable to migrate into the overthrust.

Hydrological Alterations Due to Climate-Induced Regional Vegetation Change

NASA Astrophysics Data System (ADS)

White, A. B.; Vivoni, E. R.; Springer, E. P.

2010-12-01

An extended, severe drought in the southwestern U.S. from 2000 to 2003 was accompanied by increased temperatures and bark beetle infestations, inducing the large-scale mortality of woody overstory (Pinus edulis). The consequential redistribution of water, radiation, and nutrient availability modified the ecosystem phenology, species composition, and forced the ecosystem to transition into a new state. We hypothesize that the hydrological processes in the ecosystem were also altered due to the mortality. Thus, our objective is to investigate changes in the soil-vegetation-atmosphere continuum at the watershed scale. The Rio Ojo Caliente Basin is a subbasin of the Upper Rio Grande, located mostly in New Mexico, and is approximately 1,000 km2. Examining a remotely-sensed vegetation index (1-km AVHRR NDVI from 1990 to 2006), there is an increasing trend in the NDVI from 1989 to 1999 (pre-mortality period), a decreasing trend from 2000 to 2003 (mortality period), and a dramatic increasing trend from 2004 to 2006 (post-mortality period) in which the NDVI rebounds to nearly pre-mortality magnitudes. This pattern exists across varying spatial scales (plot to watershed to region) and signifies a profound alteration in the ecosystem, for while the vegetation composition was altered to a great degree, the system rapidly returned to a homeostatic state balancing resource supply and use during the post-mortality period. To investigate hydrological changes due to the mortality, we employ a physically-based, distributed hydrologic model, tRIBS (TIN-based Real-Time Integrated Basin Simulator) for the Rio Ojo Caliente Basin. STATSGO 1-km soils data, 10-meter National Elevation Dataset DEMs, Carson National Forest vegetation species data, and MM5-downscaled NCEP/NCAR Reanalysis-I meteorologic data are used as model inputs. A combination of MODIS and AVHRR remote-sensing data, values from the literature, and field data from a long-term, pi {n}on-juniper (PJ) observation site in Los Alamos, New Mexico, are used to represent the mortality event and generate spatio-temporally dynamic vegetation parameters. We use the phenological mean computed over the pre-mortality period on a monthly to bimonthly basis, depending on the vegetation parameter, to reconstruct a ``no mortality’’ scenario, and compare this to the ``mortality’’ scenario. Basin-averaged and elevational transect output are examined, including: moisture content throughout the soil column, groundwater flux and recharge, evapotranspiration, and surface heat fluxes. The aim of this research is to explore the consequences of a severe drought married with elevated temperatures on vegetation and water resources. As the intensity and frequency of droughts are expected to increase in the southwestern U.S. with rising temperatures, this research contributes to our knowledge of ecosystem and hydrologic response to the changing climate.

Multireaction equilibrium geothermometry: A sensitivity analysis using data from the Lower Geyser Basin, Yellowstone National Park, USA

USGS Publications Warehouse

King, Jonathan M.; Hurwitz, Shaul; Lowenstern, Jacob B.; Nordstrom, D. Kirk; McCleskey, R. Blaine

2016-01-01

A multireaction chemical equilibria geothermometry (MEG) model applicable to high-temperature geothermal systems has been developed over the past three decades. Given sufficient data, this model provides more constraint on calculated reservoir temperatures than classical chemical geothermometers that are based on either the concentration of silica (SiO2), or the ratios of cation concentrations. A set of 23 chemical analyses from Ojo Caliente Spring and 22 analyses from other thermal features in the Lower Geyser Basin of Yellowstone National Park are used to examine the sensitivity of calculated reservoir temperatures using the GeoT MEG code (Spycher et al. 2013, 2014) to quantify the effects of solute concentrations, degassing, and mineral assemblages on calculated reservoir temperatures. Results of our analysis demonstrate that the MEG model can resolve reservoir temperatures within approximately ±15°C, and that natural variation in fluid compositions represents a greater source of variance in calculated reservoir temperatures than variations caused by analytical uncertainty (assuming ~5% for major elements). The analysis also suggests that MEG calculations are particularly sensitive to variations in silica concentration, the concentrations of the redox species Fe(II) and H2S, and that the parameters defining steam separation and CO2 degassing from the liquid may be adequately determined by numerical optimization. Results from this study can provide guidance for future applications of MEG models, and thus provide more reliable information on geothermal energy resources during exploration.

SRTM Perspective View with Landsat Overlay: Caliente Range and Cuyama Valley, California

NASA Technical Reports Server (NTRS)

2001-01-01

Before the arrival of Europeans, California's Cuyama Valley was inhabited by Native Americans who were culturally and politically tied to the Chumash tribes of coastal Santa Barbara County. Centuries later, the area remains the site of noted Native American rock art paintings. In the 1800s, when Europeans established large cattle and horse-breeding ranches in the valley, the early settlers reported the presence of small villages along the Cuyama River. This perspective view looks upstream toward the southeast through the Cuyama Valley. The Caliente Range, with maximum elevations of 1,550 meters (5,085 feet), borders the valley on the left. The Cuyama River, seen as a bright meandering line on the valley floor, enters the valley from headwaters more than 2,438 meters (8,000 feet) above sea level near Mount Abel and flows 154 kilometers (96 miles) before emptying into the Pacific Ocean. The river's course has been determined in large part by displacement along numerous faults.

Today, the Cuyama Valley is the home of large ranches and small farms. The area has a population of 1,120 and is more than an hour and a half drive from the nearest city in the county.

This image was generated by draping an enhanced Landsat satellite image over elevation data from the Shuttle Radar Topography Mission (SRTM). Landsat has been providing visible and infrared views of the Earth since 1972. SRTM elevation data matches the 30-meter resolution of most Landsat images and will substantially help in analyses of the large and growing Landsat image archive. For visualization purposes, topographic heights displayed in this image are exaggerated two times. Colors approximate natural colors.

The elevation data used in this image was acquired by SRTM aboard the Space Shuttle Endeavour, launched on February 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on Endeavour in 1994. SRTM was designed to collect three-dimensional measurements of Earth's land surface. To collect the 3-D SRTM data, engineers added a mast 60 meters (about 200 feet)long, installed additional C-band and X-band antennas, and improved tracking and navigation devices. The mission is a cooperative project between the NASA, the National Imagery and Mapping Agency (NIMA) of the U.S. Department of Defense, and the German and Italian space agencies. It is managed by NASA's Jet Propulsion Laboratory, Pasadena, Calif, for NASA's Earth Science Enterprise, Washington, D.C. JPL is a division of the California Institute of Technology in Pasadena.

Location (Center): 34.97 deg. North lat., 119.70 deg. West lon. View: Southeast Scale: Scale Varies in this Perspective Date Acquired: February 16, 2000 SRTM, December 14, 1984 Landsat

Investigation of lineaments on Skylab and ERTS images of Peninsular Ranges, Southwestern California

NASA Technical Reports Server (NTRS)

Merifield, P. M. (Principal Investigator); Lamar, D. L.

1974-01-01

The author has identified the following significant results. Northwest trending faults such as the Elsinore and San Jacinto are prominently displayed on Skylab and ERTS images of the Peninsular Ranges, southern California. Northeast, north-south, and west-north-west trending lineaments and faults are also apparent on satellite imagery. Several of the lineaments represent previously unmapped faults. Other lineaments are due to erosion along foliation directions and sharp bends in basement rock contacts rather than faulting. The northeast trending Thing Valley fault appears to be offset by the south branch of the Elsinore fault near Agua Caliente Hot Springs. Larger horizontal displacement along the Elsinore fault further northwest may be distributed along several faults which branch from the Elsinore fault in the Peninsular Ranges. The northeast and west-northwest trending faults are truncated by the major northwest trending faults and appear to be restricted to basement terrane. Limited data on displacement direction suggests that the northeast and west-northwest trending faults formed in response to an earlier period of east-northeast, west-southwest crustal shortening. Such a stress system is consistent with the plate tectonic model of a subduction zone parallel to the continental margin suggested in the late Mesozoic and early Tertiary.

Deformational and erosional history for the Abiquiu and contiguous area, north-central New Mexico: Implications for formation of the Abiquiu embayment and a discussion of new geochronological and geochemical analysis

USGS Publications Warehouse

Maldonado, Florian; Miggins, Daniel P.; Budahm, James R.

2013-01-01

Geologic mapping, age determinations, and geochemistry of rocks exposed in the Abiquiu area of the Abiquiu embayment of the Rio Grande rift, north-central New Mexico, provide data to determine fault-slip and incision rates. Vertical-slip rates for faults in the area range from 16 m/m.y. to 42 m/m.y., and generally appear to decrease from the eastern edge of the Colorado Plateau to the Abiquiu embayment. Incision rates calculated for the period ca. 10 to ca. 3 Ma indicate rapid incision with rates that range from 139 m/m.y. on the eastern edge of the Colorado Plateau to 41 m/m.y. on the western part of the Abiquiu embayment.The Abiquiu area is located along the margin of the Colorado Plateau–Rio Grande rift and lies within the Abiquiu embayment, a shallow, early extensional basin of the Rio Grande rift. Cenozoic rocks include the Eocene El Rito Formation, Oligocene Ritito Conglomerate, Oligocene–Miocene Abiquiu Formation, and Miocene Chama–El Rito and Ojo Caliente Sandstone Members of the Tesuque Formation (Santa Fe Group). Volcanic rocks include the Lobato Basalt (Miocene; ca. 15–8 Ma), El Alto Basalt (Pliocene; ca. 3 Ma), and dacite of the Tschicoma Formation (Pliocene; ca. 2 Ma). Quaternary deposits consist of inset axial and side-stream deposits of the ancestral Rio Chama (Pleistocene in age), landslide and pediment alluvium and colluvium, and Holocene main and side-stream channel and floodplain deposits of the modern Rio Chama. The predominant faults are Tertiary normal high-angle faults that displace rocks basinward.A low-angle fault, referred to as the Abiquiu fault, locally separates an upper plate composed of the transitional zone of the Ojo Caliente Sandstone and Chama–El Rito Members from a lower plate consisting of the Abiquiu Formation or the Ritito Conglomerate. The upper plate is distended into blocks that range from about 0.1 km to 3.5 km long that may represent a larger sheet that has been broken up and partly eroded.Geochronology (40Ar/39Ar) from fifteen volcanic and intrusive rocks resolves discrete volcanic episodes in the Abiquiu area: (1) emplacement of Early and Late Miocene basaltic dikes at 20 Ma and ca. 10 Ma; (2) extensive Late Miocene–age lava flows at 9.5 Ma, 7.9 Ma, and 5.6 Ma; and (3) extensive basaltic eruptions during the early Pliocene at 2.9 Ma and 2.4 Ma. Clasts of biotite- and hornblende-rich trachyandesites and trachydacites from the base of the Abiquiu Formation are dated at ca. 27 Ma, possibly derived from the Latir volcanic field. The most-mafic magmas are interpreted to be generated from a similar lithospheric mantle during rifting, but variations in composition are correlated with partial melting at different depths, which is correlated with thinning of the crust due to extensional processes.

Workshops on Volcanoes at Santiaguito (Guatemala): A community effort to inform and highlight the outstanding science opportunities at an exceptional laboratory volcano

NASA Astrophysics Data System (ADS)

Johnson, J. B.; Escobar-Wolf, R. P.; Pineda, A.

2016-12-01

Santiaguito is one of Earth's most reliable volcanic spectacles and affords opportunity to investigate dome volcanism, including hourly explosions, pyroclastic flows, block lava flows, and sporadic paroxysmal eruptions. The cubic km dome, active since 1922, comprises four coalescing structures. Lava effusion and explosions are ideally observed from a birds-eye perspective at the summit of Santa Maria volcano (1200 m above and 2700 km from the active Caliente vent). Santiaguito is also unstable and dangerous. Thousands of people in farms and local communities are exposed to hazards from frequent lahars, pyroclastic flows, and potentially large sector-style dome collapses. In January 2016 more than 60 volcano scientists, students, postdocs, and observatory professionals traveled to Santiaguito to participate in field study and discussion about the science and hazards of Santiaguito. The event facilitated pre- and syn-workshop field experiments, including deployment of seismic, deformation, infrasound, multi-spectral gas and thermal sensing, UAV reconnaissance, photogrammetry, and petrologic and rheologic sampling. More than 55 participants spent the night on the 3770-m summit of Santa Maria to partake in field observations. The majority of participants also visited lahar and pyroclastic flow-impacted regions south of the volcano. A goal of the workshop was to demonstrate how multi-disciplinary observations are critical to elucidate volcano eruption dynamics. Integration of geophysical and geochemical observation, and open exchange of technological advances, is vital to achieve the next generation of volcano discovery. Toward this end data collected during the workshop are openly shared within the broader volcanological community. Another objective of the workshop was to bring attention to an especially hazardous and little-studied volcanic system. The majority of workshop attendees had not visited the region and their participation was hoped to seed future collaboration and study in Guatemala. This presentation highlights both the multi-disciplinary science and scientists' experiences at Santiaguito and argues for future similar meetings at other open-vent volcanoes.

Late Holocene Sediment Study From Santa María del Oro Crater Lake, Nayarit, México, Using Environmental Magnetism

NASA Astrophysics Data System (ADS)

Vazquez, G.; Ortega, B.; Rodriguez, A.

2007-05-01

The lake is located near the Pacific coast of Mexico, at the western end of the Trans Mexican Volcanic Belt. It is a deep lake (ca. 65 m) with steep sides and only a small bay (Agua Caliente) has shallower water (ca. 12 m). Four parallel cores between 4 and 9 m long were recovered in March 2002 from this shallower area. Sediments are characterized by alternated laminations (few millimeters to 2 cm) of sand, brown silt, green silt, reddish silt, ochre silt, and peat. The 14-C dated sequence spans the last ca. 2,600 yrs. Given this age, it is possible that each set of laminations represent annual sedimentation cycles. The record is a potential high- resolution archive of environmental and climatic variability for western Mexico for late Holocene. Magnetic measurements of susceptibility along the cores show a high variability in the concentration of magnetic mineralogy. Different magnetic and non-magnetic properties show two sets of facies in relation to its magnetic mineralogy; one group composed by sand, brown silt, green silt and peat has the magnetite and Ti-magnetite as the principal magnetic phase; the second group, composed by reddish and ochre silt, has a low Ti magnetite component and siderite, as the principal paramagnetic component. The effects of climatic variations such as the drought occurred in the archeological Classic period (100 - 900 dC), the Medieval Warm Period (950 - 1350 dC), the Little Ice Age (1400 - 1800 dC), and the droughts over the last 700 years, documented in sites along central Mexico, are recognized in the magnetic mineralogy of Santa Maria del Oro.

A geochemical and geophysical approach to derive a conceptual circulation model of CO2-rich mineral waters: A case study of Vilarelho da Raia, northern Portugal

NASA Astrophysics Data System (ADS)

Marques, J. M.; Santos, Monteiro; Graça, R. C.; Castro, R.; Aires-Barros, L.; Mendes Victor, L. A.

2001-11-01

The Vilarelho da Raia-Chaves region, located in northern Portugal adjacent to the Spanish border, is characterized by both hot and cold CO2-rich mineral waters issuing from springs and drilled wells. The present paper updates the conceptual circulation model of the Vilarelho da Raia cold CO2-rich mineral waters. Vilarelho da Raia mineral waters, dominated by Na and HCO3 ions, have formed mainly by interaction with CO2 of deep-seated mantle origin. The δ18O, δ2H and 3H values indicate that these waters are the result of meteoric waters infiltrating into Larouco Mountain, NW of Vilarelho da Raia, circulating at shallow depths in granitic rocks and moving into Vilarelho da Raia area. The conceptual geochemical and geophysical circulation model indicates that the hot and cold CO2-rich mineral waters of Chaves (76 °C) and Vilarelho da Raia (17 °C) should be considered manifestations of similar but not the same geohydrological systems. Résumé. La région de Vilarelho da Raia - Chaves, située au Portugal près de la frontière Espagnole, est caractérisée par des eaux carbogazeuses, chaudes et froides, émergeant à des sources et dans des puits. Ce travail constitue une mise au point du modèle conceptuel de circulation des eaux minérales carbogazeuses froides de Vilarelho da Raia. Les eaux minérales de Vilarelho da Raia, dans lesquelles les ions Na and HCO3 sont dominants, résultent principalement d'interactions avec du CO2 d'origine mantellique. Les δ18O, les δ2H, et les teneurs en 3H indiquent que ces eaux proviennent de l'infiltration d'eaux météoriques dans le Mont Larouco au NW de Vilarelho da Raia, circulant à faible profondeur dans les granites en direction de la région de Vilarelho da Raia. Le modèle de circulation géochimique et géophysique conduit à penser que les eaux minérales carbogazeuses chaudes et froides de Chaves (76 °C) et de Vilarelho da Raia (17 °C) doivent être considérées comme des manifestations de systèmes hydrogéologiques similaires, mais non identiques. Resumen. La región de Vilarelho-Chaves está situada en el Norte de Portugal, junto a la frontera con España. Se caracteriza por la existencia de aguas minerales calientes y frías enriquecidas en CO2, que descargan mediante manantiales y pozos. El artículo tiene como objetivo la actualización del modelo conceptual de flujo de las aguas frías de Vilarelho de Raia, que son ricas en CO2. Dichas aguas se han formado fundamentalmente por la interacción con el CO2 procedente del manto profundo, y son del tipo bicarbonatado sódico. Los valores de δ18O, δ2H y 3H indican que proceden de la infiltración de agua meteórica en la Montaña Larouco -al Noroeste de Vilarelho de Raia-, que circulan a poca profundidad en un medio formado por de rocas graníticas y se mueven hacia el área de Vilarelho de Raia. El modelo conceptual de flujo, basado en datos geoquímicos y geofísicos, indica que las aguas minerales calientes de Chaves (76 °C) y las frías de Vilarelho de Raia (17 °C), ambas enriquecidas en CO2, no deben ser consideradas como manifestaciones de un único sistema hidrogeológico, sino de dos similares.

Espectroscopía Espacial en el IR-Lejano

NASA Astrophysics Data System (ADS)

Goicoechea, Javier R.; Cernicharo, J.

Debido a la opacidad atmosférica, el dominio IR--lejano del espectro electromagnético ha sido la última ventana en ser utilizada por la Astrofísica Molecular. El potencial que supone abrir este nuevo rango de frecuencias a través de la espectroscopía molecular ha comenzado a ser explotado con el Infrared Space Observatory (ISO). La sensibilidad de la instrumentación embarcada en dicho satélite no tiene comparación alguna con las escasas misiones espaciales, o a bordo de aviones, realizadas con anterioridad a su lanzamiento. En particular, casi todo el rango operativo de ISO en el IR--lejano no había sido explorado. El espectro IR--lejano de las fuentes más representativas de la galaxia era desconocido y los principales emisores de radiación, las moléculas, estaban por identificar. Las observaciones en el IR--lejano están especialmente indicadas para el estudio del gas caliente en las nubes moleculares del medio interestelar y en el interior de las envolturas circunestelares alrededor de estrellas evolucionadas. Algunas de estas fuentes; Sgr B2 en el Centro Galáctico y las Proto--Nebulosas Planetarias, constituyen uno de los objetos más paradigmáticos en nuestra comprensión de la complejidad química de La Galaxia. En esta contribución se presentan los resultados espectroscópicos más importantes de algunas de estas fuentes astronómicas.

Catalog of crater lakes from Costa Rica

NASA Astrophysics Data System (ADS)

Ramirez, C. J.; Mora-Amador, R.; González, G.

2010-12-01

Costa Rica has a diversity of volcanic crater lakes that can be classified into two groups: hot and cold lakes. The country contains at least 5% of the world's hot lakes. Costa Rica has 2 hot hyperacidic lakes, both of them on active volcanoes, the Rincón de la Vieja (38.0°C, pH = 0 - 1) and the Poás Laguna Caliente (36.1°C - 56°C, pH = 0.55 - 0.74), nowadays the Poás hot lake is the most active crater lake in the world, with more than 200 eruptions only on 2010. One of the most studied cold crater lakes is Irazú (13°C, pH = 3.5), that used to contain bubbling and clear areas of upwelling involving CO2 liberation and subaqueous fumaroles with temperatures up to 50°C, but since 2005 the lake presents an important descend until April 2010 when it disappeared. On February 9, 2003, Irazú's lake underwent a drastic change of color, from clear green to mustard with reddish loops, similar to the color of the waters of Lake Nyos after the gas burst of August 1986. Other studied cold lakes include Botos, Chato, and Tenorio, all at the summit of Quaternary volcanoes as well as Barva and Danta, located in recent pyroclastic cones. Some cold lakes are located in Holocene maar-type explosion craters, among them are Congo, Bosque Alegre, Hule, and Río Cuarto. These last two have undergone repeated rapid reddish color changes over the last 10 years, in association with fish kills and the liberation of apparently sulfurous scents. On March 2010, University of Costa Rica was the host of the 7th Workshop on Volcanic Lakes, part of the Commission of Volcanic Lakes of the IAVCEI, 51 participants from 14 countries attended the workshop; they presented 27 talks and 17 posters, also they visited and sample 4 of the lakes mentioned above (Botos, Irazú, Río Cuarto and Hule). Level of Study: 1: few or no data, 2: regular, 3: acceptable

Superficial alteration mineralogy in active volcanic systems: An example of Poás volcano, Costa Rica

NASA Astrophysics Data System (ADS)

Rodríguez, Alejandro; van Bergen, Manfred J.

2017-10-01

The alteration mineralogy in the crater area of Poás volcano (Costa Rica) has been studied to constrain acid fluid-rock interaction processes and conditions relevant for the formation of sulphate-bearing mineral assemblages found on the surface of Mars. Individual sub-environments, which include the hyperacid lake (Laguna Caliente), ephemeral hot springs, fumarole vents and areas affected by acid rain and/or spray from the lake, are marked by distinct secondary mineral associations, with sulphates commonly as prevailing component. The sulphates occur in a wide mineralogical diversity comprising gypsum/anhydrite, various polyhydrated Al-sulphates, alunite-jarosite group minerals, halotrichite-, voltaite- and copiapite-group minerals, epsomite and römerite. Depending on the sub-environment, they are variably associated with clay minerals (kaolinite-group and smectite-group), zeolites, SiO2-polymorphs, Fe-(hydro)oxides, Ti-oxides, native sulphur, sulphides, chlorides, fluorides, phosphates and carbonates. Geochemical modelling was performed to identify mechanisms responsible for the formation of the secondary minerals found in the field, and to predict their possible stability under conditions not seen at the surface. The results indicate that the appearance of amorphous silica, hematite, anhydrite/gypsum, pyrite, anatase and kaolinite is relatively insensitive to the degree of acidity of the local aqueous system. On the other hand, alunite-jarosite group minerals, elemental sulphur and Al(OH)SO4 only form under acidic conditions (pH < 4). The presence of polyhydrated Mg- and Fe2 +-sulphates is restricted to olivine-bearing rocks exposed to acid rain or brine spray. Modelling suggests that their formation required a repetitive sequence of olivine dissolution and evaporation in an open system involving limited amounts of fluid. The mineral variety in the crater of Poás is remarkably similar to sulphate-bearing assemblages considered to be the product of acid-sulphate alteration on Mars. The analogy suggests that comparable fluid-rock interaction controls operated in Martian volcanic environments.

Equatorial origin for Lower Jurassic radiolarian chert in the Franciscan Complex, San Rafael Mountains, southern California

USGS Publications Warehouse

Hagstrum, J.T.; Murchey, B.L.; Bogar, R.S.

1996-01-01

Lower Jurassic radiolarian chert sampled at two localities in the San Rafael Mountains of southern California (???20 km north of Santa Barbara) contains four components of remanent magnetization. Components A, B???, and B are inferred to represent uplift, Miocene volcanism, and subduction/accretion overprint magnetizations, respectively. The fourth component (C), isolated between 580?? and 680??C, shows a magnetic polarity stratigraphy and is interpreted as a primary magnetization acquired by the chert during, or soon after, deposition. Both sequences are late Pliensbachian to middle Toarcian in age, and an average paleolatitude calculated from all tilt-corrected C components is 1?? ?? 3?? north or south. This result is consistent with deposition of the cherts beneath the equatorial zone of high biologic productivity and is similar to initial paleolatitudes determined for chert blocks in northern California and Mexico. This result supports our model in which deep-water Franciscan-type cherts were deposited on the Farallon plate as it moved eastward beneath the equatorial productivity high, were accreted to the continental margin at low paleolatitudes, and were subsequently distributed northward by strike-slip faulting associated with movements of the Kula, Farallon, and Pacific plates. Upper Cretaceous turbidites of the Cachuma Formation were sampled at Agua Caliente Canyon to determine a constraining paleolatitude for accretion of the Jurassic chert sequences. These apparently unaltered rocks, however, were found to be completely overprinted by the A component of magnetization. Similar in situ directions and demagnetization behaviors observed in samples of other Upper Cretaceous turbidite sequences in southern and Baja California imply that these rocks might also give unreliable results.

Preliminary geologic map of the San Guillermo Mountain Quadrangle, Ventura County, California

USGS Publications Warehouse

Minor, S.A.

1999-01-01

New 1:24,000-scale geologic mapping in the Cuyama 30' x 60' quadrangle, in support of the USGS Southern California Areal Mapping Project (SCAMP), is contributing to a more complete understanding of the stratigraphy, structure, and tectonic evolution of the complex junction area between the NW-striking Coast Ranges and EW-striking western Transverse Ranges. The 1:24,000-scale geologic map of the San Guillermo Mountain quadrangle is one of six contiguous 7 1/2' quadrangle geologic maps in the eastern part of the Cuyama map area being compiled for a more detailed portrayal and reevaluation of geologic structures and rock units shown on previous geologic maps of the area (e.g., Dibblee, 1979). The following observations and interpretations are based on the new San Guillermo Mountain geologic compilation: (1) The new geologic mapping in the northern part of the San Guillermo Mountain quadrangle allows for reinterpretation of fault architecture that bears on potential seismic hazards of the region. Previous mapping had depicted the eastern Big Pine fault (BPF) as a northeast-striking, sinistral strike-slip fault that extends for 30 km northeast of the Cuyama River to its intersection with the San Andreas fault (SAF). In contrast the new mapping indicates that the eastern BPF is a thrust fault that curves from a northeast strike to an east strike, where it is continuous with the San Guillermo thrust fault, and dies out further east about 15 km south of the SAF. This redefined segment of the BPF is a south-dipping, north-directed thrust, with dominantly dip slip components (rakes > 60 deg.), that places Middle Eocene marine rocks (Juncal and Matilija Formations) over Miocene through Pliocene(?) nonmarine rocks (Caliente, Quatal, and Morales Formations). Although a broad northeast-striking fault zone, exhibiting predominantly sinistral components of slip (rakes < 45 deg.), extends to the SAF as previously mapped, the fault zone does not connect to the southwest with the BPF but instead curves into a southwest-directed thrust fault system a short distance north of the BPF. Oligocene to Pliocene(?) nonmarine sedimentary and volcanic rocks of the Plush Ranch, Caliente, and Morales(?) Formations are folded on both sides of this fault zone (informally named the Lockwood Valley fault zone [LVFZ] on the map). South-southeast of the LVFZ overturned folds have southward vergence. Several moderate-displacement (< 50 m), mainly northwest-dipping thrust and reverse faults, exhibiting mostly sinistral-oblique slip, flank and strike parallel to the overturned folds. The fold vergence and thrust direction associated with the LVFZ is opposite to that of the redefined BPF, providing further evidence that the two faults are distinct structures. These revised fault interpretations bring into question earlier estimates of net sinistral strike-slip displacement of as much as 13 km along the originally defined eastern BPF, which assumed structural connection with the LVFZ. Also, despite sparse evidence for repeated Quaternary movement on the LVFZ (e.g., Dibblee, 1982), the potential for a large earthquake involving coseismic slip on both the LVFZ and the central BPF to the southwest may not be as great as once believed. (2) Several generations of Pleistocene and younger dissected alluvial terrace and fan deposits sit at various levels above modern stream channels throughout the quadrangle. These deposits give testimony to the recent uplift and related fault deformation that has occurred in the area. (3) A vast terrane of Eocene marine sedimentary rocks (Juncal and Matilija Formations and Cozy Dell Shale) exposed south of the Big Pine fault forms the southern two-thirds of the San Guillermo Mountain quadrangle. Benthic foraminifers collected from various shale intervals within the Juncal Formation indicate a Middle Eocene age (Ulatisian) for the entire formation (K. McDougall, unpub. data, 1998) and deposition at paleodepths as great as 2,000 m (i.e., lowe

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-17

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

BWI terminal accessibility study.

DOT National Transportation Integrated Search

2001-12-01

This study details the landside accessibility of the BWI airport. The accessibility of the airport is examined from : each of the access facilities. Included in the study are the terminal garage, ESP parking lot, all satellite lots and : terminal cur...

A synthesis of studies of access point density as a risk factor for road accidents.

PubMed

Elvik, Rune

2017-10-01

Studies of the relationship between access point density (number of access points, or driveways, per kilometre of road) and accident frequency or rate (number of accidents per unit of exposure) have consistently found that accident rate increases when access point density increases. This paper presents a formal synthesis of the findings of these studies. It was found that the addition of one access point per kilometre of road is associated with an increase of 4% in the expected number of accidents, controlling for traffic volume. Although studies consistently indicate an increase in accident rate as access point density increases, the size of the increase varies substantially between studies. In addition to reviewing studies of access point density as a risk factor, the paper discusses some issues related to formally synthesising regression coefficients by applying the inverse-variance method of meta-analysis. Copyright © 2017 Elsevier Ltd. All rights reserved.

Measurement of availability and accessibility of food among youth: a systematic review of methodological studies.

PubMed

Gebremariam, Mekdes K; Vaqué-Crusellas, Cristina; Andersen, Lene F; Stok, F Marijn; Stelmach-Mardas, Marta; Brug, Johannes; Lien, Nanna

2017-02-14

Comprehensive and psychometrically tested measures of availability and accessibility of food are needed in order to explore availability and accessibility as determinants and predictors of dietary behaviors. The main aim of this systematic review was to update the evidence regarding the psychometric properties of measures of food availability and accessibility among youth. A secondary objective was to assess how availability and accessibility were conceptualized in the included studies. A systematic literature search was conducted using Medline, Embase, PsycINFO and Web of Science. Methodological studies published between January 2010 and March 2016 and reporting on at least one psychometric property of a measure of availability and/or accessibility of food among youth were included. Two reviewers independently extracted data and assessed study quality. Existing criteria were used to interpret reliability and validity parameters. A total of 20 studies were included. While 16 studies included measures of food availability, three included measures of both availability and accessibility; one study included a measure of accessibility only. Different conceptualizations of availability and accessibility were used across the studies. The measures aimed at assessing availability and/or accessibility in the home environment (n = 11), the school (n = 4), stores (n = 3), childcare/early care and education services (n = 2) and restaurants (n = 1). Most studies followed systematic steps in the development of the measures. The most common psychometrics tested for these measures were test-retest reliability and criterion validity. The majority of the measures had satisfactory evidence of reliability and/or validity. None of the included studies assessed the responsiveness of the measures. The review identified several measures of food availability or accessibility among youth with satisfactory evidence of reliability and/or validity. Findings indicate a need for more studies including measures of accessibility and addressing its conceptualization. More testing of some of the identified measures in different population groups is also warranted, as is the development of more measures of food availability and accessibility in the broader environment such as the neighborhood food environment.

A Randomized Cadaver Study Comparing First-Attempt Success Between Tibial and Humeral Intraosseous Insertions Using NIO Device by Paramedics: A Preliminary Investigation.

PubMed

Szarpak, Lukasz; Truszewski, Zenon; Smereka, Jacek; Krajewski, Paweł; Fudalej, Marcin; Adamczyk, Piotr; Czyzewski, Lukasz

2016-05-01

Medical personnel may encounter difficulties in obtaining intravenous (IV) access during cardiac arrest. The 2015 American Heart Association guidelines and the 2015 European Resuscitation Council guidelines for cardiopulmonary resuscitation (CPR) suggest that rescuers establish intraosseous (IO) access if an IV line is not easily obtainable.The aim of the study was to compare the success rates of the IO proximal tibia and proximal humerus head access performed by paramedics using the New Intraosseous access device (NIO; Persys Medical, Houston, TX, USA) in an adult cadaver model during simulated CPR.In an interventional, randomized, crossover, single-center cadaver study, a semi-automatic spring-load driven NIO access device was investigated. In total, 84 paramedics with less than 5-year experience in Emergency Medical Service participated in the study. The trial was performed on 42 adult cadavers. In each cadaver, 2 IO accesses to the humerus head, and 2 IO accesses to the proximal tibia were obtained.The success rate of the first IO attempt was 89.3% (75/84) for tibial access, and 73.8% (62/84) for humeral access (P = 0.017). The procedure times were significantly faster for tibial access [16.8 (interquartile range, IQR, 15.1-19.9] s] than humeral access [26.7 (IQR, 22.1-30.9) s] (P < 0.001).Tibial IO access is easier and faster to put in place than humeral IO access. Humeral IO access can be an alternative method to tibial IO access. clinicaltrials.gov Identifier: NCT02700867.

How Accessible Are Public Libraries' Web Sites? A Study of Georgia Public Libraries

ERIC Educational Resources Information Center

Ingle, Emma; Green, Ravonne A.; Huprich, Julia

2009-01-01

One issue that public librarians must consider when planning Web site design is accessibility for patrons with disabilities. This article reports a study of Web site accessibility of public libraries in Georgia. The focus of the report is whether public libraries use accessible guidelines and standards in making their Web sites accessible. An…

Storms and flooding in California in December 2005 and January 2006 - a preliminary assessment

USGS Publications Warehouse

Parrett, Charles; Hunrichs, Richard A.

2006-01-01

A series of storms beginning before Christmas 2005 and ending after New Year's Day 2006 produced significant runoff over much of northern California. The storms resulted in an estimated $300 million in damages and Federal disaster declarations in 10 counties. Several precipitation stations in the Sierra Nevada had precipitation totals greater than 20 inches for the period December 24 through January 3, and several stations in the Coastal Range had precipitation totals greater than 18 inches. The peak stream discharges resulting from the storms in the north coast area generally had recurrence intervals in the 10- to 25-year range, although the recurrence interval for peak discharge at one station on Sonoma Creek near Agua Caliente was greater than 100 years. In the San Francisco Bay area, peak discharges also generally had recurrence intervals in the 10- to 25-year range. Further south along the central coast and in southern California, peak discharges had smaller recurrence intervals, in the 2- to 5-year range. Upper Sacramento River tributaries draining from the west had peak flows with recurrence intervals in the 2- to 5-year range, whereas upper tributaries draining from the east side had recurrence intervals in the 5- to 10-year range. Further south, Sacramento River tributaries such as the Yuba and American Rivers had peak discharges with recurrence intervals in the 10- to 25-year range. On the east side of the central Sierra around Lake Tahoe, peak discharges had recurrence intervals in the 10- to 25-year range. Further south in the Sierra, streams draining into the San Joaquin River Basin had flows with recurrence intervals ranging from 2 to 5 years.

Hybrid III-V Silicon Lasers

NASA Astrophysics Data System (ADS)

Bowers, John

2014-03-01

Abstract: A number of important breakthroughs in the past decade have focused attention on Si as a photonic platform. We review here recent progress in this field, focusing on efforts to make lasers, amplifiers, modulators and photodetectors on or in silicon. We also describe optimum quantum well design and distributed feedback cavity design to reduce the threshold and increase the efficiency and power output. The impact active silicon photonic integrated circuits could have on interconnects, telecommunications and on silicon electronics is reviewed. Biography: John Bowers holds the Fred Kavli Chair in Nanotechnology, and is the Director of the Institute for Energy Efficiency and a Professor in the Departments of Electrical and Computer Engineering and Materials at UCSB. He is a cofounder of Aurrion, Aerius Photonics and Calient Networks. Dr. Bowers received his M.S. and Ph.D. degrees from Stanford University and worked for AT&T Bell Laboratories and Honeywell before joining UC Santa Barbara. Dr. Bowers is a member of the National Academy of Engineering and a fellow of the IEEE, OSA and the American Physical Society. He is a recipient of the OSA/IEEE Tyndall Award, the OSA Holonyak Prize, the IEEE LEOS William Streifer Award and the South Coast Business and Technology Entrepreneur of the Year Award. He and coworkers received the EE Times Annual Creativity in Electronics (ACE) Award for Most Promising Technology for the hybrid silicon laser in 2007. Bowers' research is primarily in optoelectronics and photonic integrated circuits. He has published ten book chapters, 600 journal papers, 900 conference papers and has received 54 patents. He has published 180 invited papers and conference papers, and given 16 plenary talks at conferences. As well as Chong Zhang.

Collaborative remembering revisited: Study context access modulates collaborative inhibition and later benefits for individual memory.

PubMed

Abel, Magdalena; Bäuml, Karl-Heinz T

2017-11-01

Collaborating groups typically show reduced recall relative to nominal groups, i.e., to the cumulated non-redundant recall of the same number of people remembering in isolation-a finding termed collaborative inhibition. Motivated by the results of several previous studies, this study examined in two experiments whether access to study context at test influences the effects of collaboration. In both experiments, subjects collaborated in triads or recalled previously studied material in isolation. Experiment 1 applied short versus prolonged retention intervals to vary access to study context at test, whereas Experiment 2 used the list-method directed forgetting task and applied remember versus forget instructions to modulate context access. In both experiments, collaborative inhibition was present when access to study context at test was intact (i.e., after the short delay and the remember instruction) but was eliminated when the access was impaired (i.e., after the prolonged delay and the forget instruction). Also, post-collaborative gains for individual recall were greater when context access was impaired and collaborative inhibition was eliminated. The findings demonstrate a critical role of access to study context at test for collaborative inhibition, indicating that impaired context access may reflect a general boundary condition for the recall impairment. The possible role of context reactivation processes for beneficial effects of social recall is discussed.

Lexical Access in Early Stages of Visual Word Processing: A Single-Trial Correlational MEG Study of Heteronym Recognition

ERIC Educational Resources Information Center

Solomyak, Olla; Marantz, Alec

2009-01-01

We present an MEG study of heteronym recognition, aiming to distinguish between two theories of lexical access: the "early access" theory, which entails that lexical access occurs at early (pre 200 ms) stages of processing, and the "late access" theory, which interprets this early activity as orthographic word-form identification rather than…

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…

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…

Accessible information for people with complex communication needs.

PubMed

Owens, Janet S

2006-09-01

Information can be empowering if it is accessible. While a number of known information access barriers have been reported for the broader group of people with disabilities, specific information issues for people with complex communication needs have not been previously reported. In this consumer-focused study, the accessibility of information design and dissemination practices were discussed by 17 people with complex communication needs; by eight parents, advocates, therapists, and agency representatives in focus groups; and by seven individuals in individual interviews. Participants explored issues and made recommendations for content, including language, visual and audio supports; print accessibility; physical access; and human support for information access. Consumer-generated accessibility guidelines were an outcome of this study.

Extraterrestrial hydrogeology

NASA Astrophysics Data System (ADS)

Baker, Victor R.; Dohm, James M.; Fairén, Alberto G.; Ferré, Ty P. A.; Ferris, Justin C.; Miyamoto, Hideaki; Schulze-Makuch, Dirk

2005-03-01

Subsurface water processes are common for planetary bodies in the solar system and are highly probable for exoplanets (planets outside the solar system). For many solar system objects, the subsurface water exists as ice. For Earth and Mars, subsurface saturated zones have occurred throughout their planetary histories. Earth is mostly clement with the recharge of most groundwater reservoirs from ample precipitation during transient ice- and hot-house conditions, as recorded through the geologic and fossilized records. On the other hand, Mars is mostly in an ice-house stage, which is interrupted by endogenic-driven activity. This activity catastrophically drives short-lived hydrological cycling and associated climatic perturbations. Regional aquifers in the Martian highlands that developed during past, more Earth-like conditions delivered water to the northern plains. Water was also cycled to the South Polar Region during changes in climate induced by endogenic activity and/or by changes in Mars' orbital parameters. Venus very likely had a warm hydrosphere for hundreds of millions of years, before the development of its current extremely hot atmosphere and surface. Subsequently, Venus lost its hydrosphere as solar luminosity increased and a run-away moist greenhouse took effect. Subsurface oceans of water or ammonia-water composition, induced by tidal forces and radiogenic heating, probably occur on the larger satellites Europa, Ganymede, Callisto, Titan, and Triton. Tidal forces operating between some of the small bodies of the outer solar system could also promote the fusion of ice and the stability of inner liquid-water oceans. Les processus de subsurface impliquant l'eau sont communs pour les corps planétaires du système solaire et sont très probables sur les exoplanètes (planètes en dehors du système solaire). Pour plusieurs objets du systèmes solaire, l'eau de subsurface est présente sous forme de glace. Pour la Terre et Mars, les zones saturées de subsurface apparaissent à travers toute leur histoire planétaire. La Terre est particulièrement clémente avec la recharge des réservoirs, avec de amples précipitations, des conditions glaciaires et de fortes chaleurs, comme l'atteste les enregistrements géologiques et paléontologiques. D'un autre côté, Mars se trouve dans une phase essentiellement glaciaire, qui est interrompue par des activités contraintes par les phénomènes endogéniques. Cette activité conduit de manière catastrophique à des cycles hydrologiques et à des perturbations climatiques brutaux. Les aquifères régionaux dans les haute terres martiennes qui se sont formés dans des conditions similaires aux conditions terrestres, alimentent les plaines du Nord. L'eau a également été déplacée vers le Pôle Sud martien durant des changements marqués par une forte activité endogénique et une modification des paramètres de l'orbite de Mars. Venus possèdait vrais emblablement une hydrosphère chaude durant des millions d'année, avant le développement de son atmosphère et sa surface particulièrement chaude. Par après Venus a perdit son hydrosphère alors que la luminosité solaire augmentait et qu'une humidité liée à un effet de serre s'installait. Les océans de subsurface d'eau ou d'eau ammoniacale, induits par les forces de marée et le chauffage radiogénique, apparaissent probablement sur les satellites les plus importants (Europa, Ganymede, Callisto, Titan, Triton). Les forces de marée entre les petits corps externes du système solaire peuvent également occasionner la fusion de glace et la stabilité des océans internes d'eau liquide. Los procesos hídricos subsuperficiales son comunes en cuerpos planetarios del sistema solar y son altamente probables para exoplanetas (planetas fuera del sistema solar). Para muchos cuerpos del sistema solar, el agua subsuperficial existe como hielo. Para la Tierra y Marte han ocurrido zonas saturadas subsuperficiales a través de sus historias planetarias. La Tierra es principalmente generosa con la recarga de la mayoría de reservorios de aguas subterráneas a partir de amplia precipitación reconocida en condiciones transitorias calientes y heladas, tal y como aparece en los registros fósiles y geológicos. Por otro lado, Marte se encuentra principalmente en una etapade cámara de hielo la cual es interrumpida por actividad de tipo endogénico. Esta actividad pone en funcionamiento catastróficamente ciclos hidrológicos de vida corta y perturbaciones climáticas asociadas. Acuíferos regionales en las montañas de Marte que se desarrollaron en el pasado en condiciones similares a la Tierra distribuyen agua a las planicies del norte. El agua ha sido transportada hacia el sur de la región polar durante cambios en el clima inducidos por actividad endogénica y/o cambios en los parámetros orbitales de Marte. Venus muy probablemente tuvo una hidrósfera caliente durante cientos de millones de años, antes de que se desarrollara su atmósfera y superficie actual extremadamente caliente. Subsecuentemente, Venus perdió su hidrósfera a medida que la luminosidad solar aumentó y un efecto de invernadero húmedo escapatorio se llevó a cabo. Océanos subsuperficiales de composición agua o amoniaco-agua, inducidos por fuerzas de marea y calentamiento radiogénico, probablemente ocurren en los satélites más grandes como Europa, Ganimeda, Callisto, Titan y Triton. Las fuerzas de marea que operan entre los cuerpos pequeños del sistema solar externo podrían también promover la fusión de hielo y la estabilidad de líquido interno-aguas de los océanos.

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.

Physical and Visual Accessibilities in Intensive Care Units: A Comparative Study of Open-Plan and Racetrack Units.

PubMed

Rashid, Mahbub; Khan, Nayma; Jones, Belinda

2016-01-01

This study compared physical and visual accessibilities and their associations with staff perception and interaction behaviors in 2 intensive care units (ICUs) with open-plan and racetrack layouts. For the study, physical and visual accessibilities were measured using the spatial analysis techniques of Space Syntax. Data on staff perception were collected from 81 clinicians using a questionnaire survey. The locations of 2233 interactions, and the location and length of another 339 interactions in these units were collected using systematic field observation techniques. According to the study, physical and visual accessibilities were different in the 2 ICUs, and clinicians' primary workspaces were physically and visually more accessible in the open-plan ICU. Physical and visual accessibilities affected how well clinicians' knew their peers and where their peers were located in these units. Physical and visual accessibilities also affected clinicians' perception of interaction and communication and of teamwork and collaboration in these units. Additionally, physical and visual accessibilities showed significant positive associations with interaction behaviors in these units, with the open-plan ICU showing stronger associations. However, physical accessibilities were less important than visual accessibilities in relation to interaction behaviors in these ICUs. The implications of these findings for ICU design are discussed.

Urban Studies: A Study of Bibliographic Access and Control.

ERIC Educational Resources Information Center

Anderson, Barbara E.

This paper analyzes: (1) the bibliographic access to publications in urban studies via printed secondary sources; (2) development and scope of classification systems and of vocabulary control for urban studies; and (3) currently accessible automated collections of bibliographic citations. Urban studies is defined as "an agglomeration of…

Understanding differences in access to water fountains and sugar-sweetened beverages in children׳s environments: a pilot study in high and low deprivation neighbourhoods.

PubMed

Pearson, Amber L; de Latour, Phillip; Kemp, Gabrielle; Findlay, Nohoana; Halim, Angela; Atkinson, Nicola; Chong, Mark; Cameron, Rose; Brown, Courtney; Kim, Grace; Campbell, Paul; Hills, Toby; Jayawant, Aditya; Chae, Matthew; Bhagavan, Chiranth; French, Claire; Jenkin, Gabrielle; Smith, Moira; Signal, Louise

2014-11-01

Access to water fountains and sugar-sweetened beverages (SSBs) in children׳s environments may impact on child obesity and may vary with neighbourhood deprivation. Our pilot analyses of access to water fountains and SSBs in Wellington, New Zealand revealed that water fountain access was high in school environments and low in recreational environments. There were also differences in water fountain and SSB access points by neighbourhood deprivation. The methods piloted in this study could be translated in a larger study, more capable of detecting significant differences in access and allowing for more sophisticated analyses. Such future studies may provide important evidence for the improvement of children׳s health and well-being. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Impact of School Closures on Equity of Access in Chicago

ERIC Educational Resources Information Center

Lee, Jin; Lubienski, Christopher

2017-01-01

This study examines the impact of school closures on the sociospatial distribution of equitable access to schooling following the school closure policy pursued by the Chicago Public Schools in 2013. By examining access in terms of proximity between students and schools, the study estimates the changes in accessibility before and after school…

Availability and Accessibility in an Open Access Institutional Repository: A Case Study

ERIC Educational Resources Information Center

Lee, Jongwook; Burnett, Gary; Vandegrift, Micah; Baeg, Jung Hoon; Morris, Richard

2015-01-01

Introduction: This study explores the extent to which an institutional repository makes papers available and accessible on the open Web by using 170 journal articles housed in DigiNole Commons, the institutional repository at Florida State University. Method: To analyse the repository's impact on availability and accessibility, we conducted…

Individual Public Transportation Accessibility is Positively Associated with Self-Reported Active Commuting.

PubMed

Djurhuus, Sune; Hansen, Henning Sten; Aadahl, Mette; Glümer, Charlotte

2014-01-01

Active commuters have lower risk of chronic disease. Understanding which of the, to some extent, modifiable characteristics of public transportation that facilitate its use is thus important in a public health perspective. The aim of the study was to examine the association between individual public transportation accessibility and self-reported active commuting, and whether the associations varied with commute distance, age, and gender. Twenty-eight thousand nine hundred twenty-eight commuters in The Capital Region of Denmark reported self-reported time spent either walking or cycling to work or study each day and the distance to work or study. Data were obtained from the Danish National Health Survey collected in February to April 2010. Individual accessibility by public transportation was calculated using a multi-modal network in a GIS. Multilevel logistic regression was used to analyze the association between accessibility, expressed as access area, and being an active commuter. Public transport accessibility area based on all stops within walking and cycling distance was positively associated with being an active commuter. Distance to work, age, and gender modified the associations. Residing within 10 km commute distance and in areas of high accessibility was associated with being an active commuter and meeting the recommendations of physical activity. For the respondents above 29 years, individual public transportation accessibility was positively associated with being an active commuter. Women having high accessibility had significantly higher odds of being an active commuter compared to having a low accessibility. For men, the associations were insignificant. This study extends the knowledge about the driving forces of using public transportation for commuting by examining the individual public transportation accessibility. Findings suggest that transportation accessibility supports active commuting and planning of improved public transit accessibility has thus a potential of providing health benefits to commuters.

Access to means of suicide, occupation and the risk of suicide: a national study over 12 years of coronial data.

PubMed

Milner, A; Witt, K; Maheen, H; LaMontagne, A D

2017-04-04

Availability of lethal means is a significant risk factor for suicide. This study investigated whether occupations with greater access to lethal means had higher suicide rates than those without access, and further, whether this relationship differed for females versus males. A retrospective mortality study was conducted across the Australian population over the period 2001 to 2012. Data from the Australian Bureau of Statistics, which collects Census information on occupation for the Australian population, and the National Coroners Information System, which records information on suicide deaths, were combined. Employed suicide records were coded by occupation and work-related access to lethal means. Descriptive analysis and negative binomial regression were used to assess the relationship between access to means and suicide. Persons in occupations with access to firearms, medicines or drugs, and carbon monoxide more frequently used these methods to end their lives than those without access to means. Females employed in occupations with access to means had suicide rates that were 3.02 times greater (95% CI 2.60 to 3.50, p < 0.001) than those employed in occupations without access. Males in occupations with access had suicide rates that were 1.24 times greater than those without access (95% CI 1.16 to 1.33, p < 0.001). Work-related access to means is a risk factor for suicide in the employed population, but is associated with a greater risk for females than males. The findings of this study suggest the importance of controlling access to lethal methods in occupations where these are readily available.

Macroscopic characterisations of Web accessibility

NASA Astrophysics Data System (ADS)

Lopes, Rui; Carriço, Luis

2010-12-01

The Web Science framework poses fundamental questions on the analysis of the Web, by focusing on how microscopic properties (e.g. at the level of a Web page or Web site) emerge into macroscopic properties and phenomena. One research topic on the analysis of the Web is Web accessibility evaluation, which centres on understanding how accessible a Web page is for people with disabilities. However, when framing Web accessibility evaluation on Web Science, we have found that existing research stays at the microscopic level. This article presents an experimental study on framing Web accessibility evaluation into Web Science's goals. This study resulted in novel accessibility properties of the Web not found at microscopic levels, as well as of Web accessibility evaluation processes themselves. We observed at large scale some of the empirical knowledge on how accessibility is perceived by designers and developers, such as the disparity of interpretations of accessibility evaluation tools warnings. We also found a direct relation between accessibility quality and Web page complexity. We provide a set of guidelines for designing Web pages, education on Web accessibility, as well as on the computational limits of large-scale Web accessibility evaluations.

Providers' Access of Imaging Versus Only Reports: A System Log File Analysis.

PubMed

Jung, Hye-Young; Gichoya, Judy Wawira; Vest, Joshua R

2017-02-01

An increasing number of technologies allow providers to access the results of imaging studies. This study examined differences in access of radiology images compared with text-only reports through a health information exchange system by health care professionals. The study sample included 157,256 historical sessions from a health information exchange system that enabled 1,670 physicians and non-physicians to access text-based reports and imaging over the period 2013 to 2014. The primary outcome was an indicator of access of an imaging study instead of access of a text-only report. Multilevel mixed-effects regression models were used to estimate the association between provider and session characteristics and access of images compared with text-only reports. Compared with primary care physicians, specialists had an 18% higher probability of accessing actual images instead of text-only reports (β = 0.18; P < .001). Compared with primary care practice settings, the probability of accessing images was 4% higher for specialty care practices (P < .05) and 8% lower for emergency departments (P < .05). Radiologists, orthopedists, and neurologists accounted for 79% of all the sessions with actual images accessed. Orthopedists, radiologists, surgeons, and pulmonary disease specialists accessed imaging more often than text-based reports only. Consideration for differences in the need to access images compared with text-only reports based on the type of provider and setting of care are needed to maximize the benefits of image sharing for patient care. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

47 CFR 54.807 - Interstate access universal service support.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

Finding Food Deserts: A Comparison of Methods Measuring Spatial Access to Food Stores.

PubMed

Jaskiewicz, Lara; Block, Daniel; Chavez, Noel

2016-05-01

Public health research has increasingly focused on how access to resources affects health behaviors. Mapping environmental factors, such as distance to a supermarket, can identify intervention points toward improving food access in low-income and minority communities. However, the existing literature provides little guidance on choosing the most appropriate measures of spatial access. This study compared the results of different measures of spatial access to large food stores and the locations of high and low access identified by each. The data set included U.S. Census population data and the locations of large food stores in the six-county area around Chicago, Illinois. Six measures of spatial access were calculated at the census block group level and the results compared. The analysis found that there was little agreement in the identified locations of high or low access between measures. This study illustrates the importance of considering the access measure used when conducting research, interpreting results, or comparing studies. Future research should explore the correlation of different measures with health behaviors and health outcomes. © 2015 Society for Public Health Education.

System access control study

DOT National Transportation Integrated Search

1974-06-01

The report presents a summary of a study conducted for the Transportation Systems Center of promising access control techniques which are applicable to an aeronautical satellite system. Several frequency division multiple access (FDMA) and time divis...

[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.

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.

The impact of free access to the scientific literature: a review of recent research.

PubMed

Davis, Philip M; Walters, William H

2011-07-01

The paper reviews recent studies that evaluate the impact of free access (open access) on the behavior of scientists as authors, readers, and citers in developed and developing nations. It also examines the extent to which the biomedical literature is used by the general public. The paper is a critical review of the literature, with systematic description of key studies. Researchers report that their access to the scientific literature is generally good and improving. For authors, the access status of a journal is not an important consideration when deciding where to publish. There is clear evidence that free access increases the number of article downloads, although its impact on article citations is not clear. Recent studies indicate that large citation advantages are simply artifacts of the failure to adequately control for confounding variables. The effect of free access on the general public's use of the primary medical literature has not been thoroughly evaluated. Recent studies provide little evidence to support the idea that there is a crisis in access to the scholarly literature. Further research is needed to investigate whether free access is making a difference in non-research contexts and to better understand the dissemination of scientific literature through peer-to-peer networks and other informal mechanisms.

Sociocultural variables in youth access to tobacco: replication 5 years later.

PubMed

Landrine, H; Klonoff, E A; Campbell, R; Reina-Patton, A

2000-05-01

A prior study presented the only systematic investigation of the role of sociocultural variables in youth access to tobacco. White, black, and Latino girls and boys attempted to purchase cigarettes in the same 72 stores at the same time of day. Results revealed significantly greater sales to girls than to boys and to minorities than to whites. Before concluding that sociocultural variables must be addressed in merchant intervention programs designed to reduce youth access to tobacco, this study must be replicated, particularly in light of the significant decreases in youth access in the past 5 years. This article presents that replication. The stores used in the prior study were selected, and 12 white, black, and Latino girls and boys attempted to purchase cigarettes in those stores at the same time of day. Results Youths' access rate in 1999 (12.7%) was significantly lower than in the prior (1993-1995) study (41%). No effect for minors' gender was found, but the ethnicity effect again emerged: Black and Latino youth were 2.5 times more likely to be sold cigarettes than their white counterparts. Multiple sociocultural variables affect youth access to tobacco when access rates are high, but only youth ethnicity plays a role when access rates are low. Merchant interventions designed to reduce youth access to tobacco must address ethnic issues.

Evaluation of spatial accessibility to primary healthcare using GIS

NASA Astrophysics Data System (ADS)

Jamtsho, S.; Corner, R. J.

2014-11-01

Primary health care is considered to be one of the most important aspects of the health care system in any country, which directly helps in improving the health of the population. Potential spatial accessibility is a very important component of the primary health care system. One technique for studying spatial accessibility is by computing a gravity-based measure within a geographic information system (GIS) framework. In this study, straight-line distances between the associated population clusters and the health facilities and the provider-to-population ratio were used to compute the spatial accessibility of the population clusters for the whole country. Bhutan has been chosen as the case study area because it is quite easy to acquire and process data for the whole country due to its small size and population. The spatial accessibility measure of the 203 sub-districts shows noticeable disparities in health care accessibility in this country with about only 19 sub-districts achieving good health accessibility ranking. This study also examines a number of different health accessibility policy scenarios which can assist in identifying the most effective health policy from amongst many probable planning scenarios. Such a health accessibility measuring system can be incorporated into an existing spatial health system in developing countries to facilitate the proper planning and equitable distribution of health resources.

The impact of free access to the scientific literature: a review of recent research

PubMed Central

Walters, William H

2011-01-01

Objectives: The paper reviews recent studies that evaluate the impact of free access (open access) on the behavior of scientists as authors, readers, and citers in developed and developing nations. It also examines the extent to which the biomedical literature is used by the general public. Method: The paper is a critical review of the literature, with systematic description of key studies. Results: Researchers report that their access to the scientific literature is generally good and improving. For authors, the access status of a journal is not an important consideration when deciding where to publish. There is clear evidence that free access increases the number of article downloads, although its impact on article citations is not clear. Recent studies indicate that large citation advantages are simply artifacts of the failure to adequately control for confounding variables. The effect of free access on the general public's use of the primary medical literature has not been thoroughly evaluated. Conclusions: Recent studies provide little evidence to support the idea that there is a crisis in access to the scholarly literature. Further research is needed to investigate whether free access is making a difference in non-research contexts and to better understand the dissemination of scientific literature through peer-to-peer networks and other informal mechanisms. PMID:21753913

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

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.

Implementation of accessible tourism concept at museums in Jakarta

NASA Astrophysics Data System (ADS)

Wiastuti, R. D.; Adiati, M. P.; Lestari, N. S.

2018-03-01

Accessibility, sustainability and equitable participation by all makeup what is known as Tourism for All. Tourism product must be designed for all people despite the age, gender and ability as one of the requirements to comply the accessible tourism concept. Museum as one of the elements of tourism chain must adhere to accessible tourism concept thus able to be enjoyed for everyone regardless of one’s abilities. The aim of this study is to identify the implementation of accessible tourism concept at the museum in Jakarta and to provide practical accessibility- improvement measures for the museum in Jakarta towards accessible tourism concept. This research is qualitative- explorative research. Jakarta Tourism Board website was used as the main reference to obtain which museum that was selected. Primary data collect from direct field observations and interview. The results outline museum implementation of accessible tourism that classified into five criteria; information, transport, common requirements, universal design, and accessibility. The implication of this study provides recommendations to enhance museums’ accessibility performance expected to be in line with accessible tourism concept.

The pervasive crisis of diminishing radiation therapy access for vulnerable populations in the United States-part 3: Hispanic-American patients.

PubMed

McClelland, Shearwood; Perez, Carmen A

2018-01-01

Health disparities have profoundly affected underrepresented minorities throughout the United States, particularly with regard to access to evidence-based interventions such as surgery or medication. The degree of disparity in access to radiation therapy (RT) for Hispanic-American patients with cancer has not been previously examined in an extensive manner. An extensive literature search was performed using the PubMed database to examine studies investigating disparities in RT access for Hispanic-Americans. A total of 34 studies were found, spanning 10 organ systems. Disparities in access to RT for Hispanic-Americans were most prominently studied in cancers of the breast (15 studies), prostate (4 studies), head and neck (4 studies), and gynecologic system (3 studies). Disparities in RT access for Hispanic-Americans were prevalent regardless of the organ system studied and were compounded by limited English proficiency and/or birth outside of the United States. A total of 26 of 34 studies (77%) involved analysis of a population-based database, such as Surveillance, Epidemiology and End Result (15 studies); Surveillance, Epidemiology and End Result-Medicare (4 studies); National Cancer Database (3 studies); or a state tumor registry (4 studies). Hispanic-Americans in the United States have diminished RT access compared with Caucasian patients but are less likely to experience concomitant disparities in mortality than other underrepresented minorities that experience similar disparities (ie, African-Americans). Hispanic-Americans who are born outside of the United States and/or have limited English proficiency may be more likely to experience substandard RT access. These results underscore the importance of finding nationwide solutions to address such inequalities that hinder Hispanic-Americans and other underrepresented minorities throughout the United States.

A Bibliometric Study of Scholarly Articles Published by Library and Information Science Authors about Open Access

ERIC Educational Resources Information Center

Grandbois, Jennifer; Beheshti, Jamshid

2014-01-01

Introduction: This study aims to gain a greater understanding of the development of open access practices amongst library and information science authors, since their role is integral to the success of the broader open access movement. Method: Data were collected from scholarly articles about open access by library and information science authors…

Widening Access to Higher Education: An Evaluative Case Study of a Foundation Year Alternative to Access

ERIC Educational Resources Information Center

Reddy, Peter A.; Moores, Elisabeth

2008-01-01

Universities are encouraged to widen access to a broad range of applicants, including mature students taking Access qualifications. Admissions tutors can find it difficult to compare and choose between Access and A-level applications, and Access applicants for popular courses may be disadvantaged relative to students with good A-levels. In this…

Impact of Advanced (Open) Access Scheduling on Patients With Chronic Diseases

PubMed Central

Degani, N

2013-01-01

Background The goal of advanced access scheduling is to eliminate wait times for physician visits by ensuring access to same-day appointments, regardless of urgency or health care need. The intent is to reduce delays in access, leading to improvements in clinical care and patient satisfaction, and reductions in the use of urgent care. Objective To evaluate whether implementation of an advanced access scheduling system reduced other types of health service utilization and/or improved clinical measures and patient satisfaction among adults with chronic diseases. Data Sources and Review Methods A literature search was performed on January 29, 2012, for studies published from 1946 (OVID) or 1980 (EMBASE) to January 29, 2012. Systematic reviews, randomized controlled trials, and observational studies were eligible if they evaluated advanced access implementation in adults with chronic diseases and reported health resource utilization, patient outcomes, or patient satisfaction. Results were summarized descriptively. Results One systematic review in a primary care population and 4 observational studies (5 papers) in chronic disease and/or geriatric populations were identified. The systematic review concluded that advanced access did not improve clinical outcomes, but there was no evidence of harm. Findings from the observational studies in chronic disease populations were consistent with those of the systematic review. Advanced access implementation was not consistently associated with changes in clinical outcomes, patient satisfaction, or health service utilization. Limitations All studies were retrospective: 3 studies (4 papers) included historical controls only, and 1 included contemporaneous controls. Findings were inconsistent across studies for a number of outcomes. Conclusions Based on low to very low quality evidence, advanced access did not have a statistically (or clinically) significant impact on health service utilization among patients with diabetes and/or coronary artery disease (CAD). Very low quality evidence showed a significant reduction in the proportion of patients with diabetes and CAD admitted to hospital whose length of stay was greater than 3 days. Evidence was inconsistent for changes in clinical outcomes for patients with diabetes or CAD. Very low quality evidence showed no increase in patient satisfaction with an advanced access scheduling system. Plain Language Summary Timeliness of health care access—reducing wait times and delays for those receiving and providing care—is a key measure of health system quality. However, in international comparison studies, Canada ranked either last or next to last when it came to timely access to regular doctors. Efforts in Ontario to address delays in access have included the implementation of the Advanced Access and Efficiency for Primary Care initiative through the Quality Improvement and Innovation Partnership, later incorporated into Health Quality Ontario. Advanced access is a physician appointment scheduling system that aims to eliminate wait times for physician visits and ensure same-day access for all patients, regardless of urgency or health care need. While it can generally be agreed that timely access to health care is necessary for all patients, same-day access may not always be required. Indeed, advanced access may adversely affect the care of patients with chronic diseases if clinics implement strict same-day appointment rules and patients cannot pre-book follow-up appointments. This review evaluated the effect of advanced access scheduling on clinical outcomes, patient satisfaction, and health service utilization in patients with selected chronic diseases, as part of the Optimizing Chronic Disease Management in the Outpatient (Community) Setting mega-analysis. In patients with diabetes or coronary artery disease, advanced access implementation had little or no impact on acute health care use (hospitalizations, emergency department visits, and/or urgent care visits) and had inconsistent effects on clinical outcomes (blood glucose, low-density lipoprotein [LDL] cholesterol, and blood pressure). Two studies reported reduced monitoring of patients with chronic diseases after implementation of advanced access. Another study reported improved patient management (regular blood glucose and cholesterol testing) after advanced access implementation, but this was attributed to improved provider continuity rather than to reduced appointment wait times. There was no increase in patient satisfaction with the advanced access scheduling system. The quality of the evidence ranged from low to very low. PMID:24133569

Adult Intraosseous Access by Advanced EMTs: A Statewide Non-Inferiority Study.

PubMed

Wolfson, Daniel L; Tandoh, Margaret A; Jindal, Mohit; Forgione, Patrick M; Harder, Valerie S

2017-01-01

Intraosseous (IO) access is increasingly being used as an alternative to peripheral intravenous access, which is often difficult or impossible to establish in critically ill patients in the prehospital setting. Until recently, only Paramedics performed adult IO access. In 2014, Vermont Emergency Medical Services (EMS) expanded the Advanced Emergency Medical Technicians (AEMTs) scope of practice to include IO access in adult patients. This study compares successful IO access in adults performed by AEMTs compared to Paramedics in the prehospital setting. All Vermont EMS patient encounters between January 1, 2013 and November 30, 2015 were examined, and 543 adult patients with a documented IO access insertion attempt were identified. The proportion of successful IO insertions was compared between AEMTs and Paramedics using a Chi-Squared statistic and a non-inferiority test. There was no significant difference in the percentage of successful IO access between AEMTs and Paramedics [95.2% and 95.6%, respectively; P = 0.84]. The confidence interval around this 0.4% difference (95% confidence interval = -4.2, 3.2) was within a pre-specified delta of ±10% indicating non-inferiority of AEMTs compared to Paramedics. This study's finding that successful IO access was not different among AEMTs and Paramedics lends evidence in support of expanding the scope of practice of AEMTs to include establishing IO access in adults.

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

PubMed

Thummapol, Onouma; Park, Tanya; Barton, Sylvia

2018-05-03

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

Use of Mobile Devices to Access Resources Among Health Professions Students: A Systematic Review.

PubMed

Mi, Misa; Wu, Wendy; Qiu, Maylene; Zhang, Yingting; Wu, Lin; Li, Jie

2016-01-01

This systematic review examines types of mobile devices used by health professions students, kinds of resources and tools accessed via mobile devices, and reasons for using the devices to access the resources and tools. The review included 20 studies selected from articles published in English between January 2010 and April 2015, retrieved from PubMed and other sources. Data extracted included participants, study designs, mobile devices used, mobile resources/apps accessed, outcome measures, and advantages of and barriers to using mobile devices. The review indicates significant variability across the studies in terms of research methods, types of mobile programs implemented, resources accessed, and outcomes. There were beneficial effects of using mobile devices to access resources as well as conspicuous challenges or barriers in using mobile devices.

End User Evaluations

NASA Astrophysics Data System (ADS)

Jay, Caroline; Lunn, Darren; Michailidou, Eleni

As new technologies emerge, and Web sites become increasingly sophisticated, ensuring they remain accessible to disabled and small-screen users is a major challenge. While guidelines and automated evaluation tools are useful for informing some aspects of Web site design, numerous studies have demonstrated that they provide no guarantee that the site is genuinely accessible. The only reliable way to evaluate the accessibility of a site is to study the intended users interacting with it. This chapter outlines the processes that can be used throughout the design life cycle to ensure Web accessibility, describing their strengths and weaknesses, and discussing the practical and ethical considerations that they entail. The chapter also considers an important emerging trend in user evaluations: combining data from studies of “standard” Web use with data describing existing accessibility issues, to drive accessibility solutions forward.

Web Accessibility and Accessibility Instruction

ERIC Educational Resources Information Center

Green, Ravonne A.; Huprich, Julia

2009-01-01

Section 508 of the Americans with Disabilities Act (ADA) mandates that programs and services be accessible to people with disabilities. While schools of library and information science (SLIS*) and university libraries should model accessible Web sites, this may not be the case. This article examines previous studies about the Web accessibility of…

Neighbourhood access to open spaces and the physical activity of residents: a national study.

PubMed

Witten, Karen; Hiscock, Rosemary; Pearce, Jamie; Blakely, Tony

2008-09-01

Increasing population levels of physical activity is high on the health agenda in many countries. There is some evidence that neighbourhood access to public open space can increase physical activity by providing easier and more direct access to opportunities for exercise. This national study examines the relationship between travel time access to parks and beaches, BMI and physical activity in New Zealand neighbourhoods. Access to parks and beaches, measured in minutes taken by a car, was calculated for 38,350 neighbourhoods nationally using Geographic Information Systems. Multilevel regression analyses were used to establish the significance of access to these recreational amenities as a predictor of BMI, and levels of physical activity and sedentary behaviour in the 12,529 participants, living in 1178 neighbourhoods, of the New Zealand Health Survey 2002/3. Neighbourhood access to parks was not associated with BMI, sedentary behaviour or physical activity, after controlling for individual-level socio-economic variables, and neighbourhood-level deprivation and urban/rural status. There was some evidence of a relationship between beach access and BMI and physical activity in the expected direction. This study found little evidence of an association between locational access to open spaces and physical activity.

The patient's safety and access to experimental drugs after the termination of clinical trials: regulations and trends.

PubMed

da Silva, Ricardo Eccard; Amato, Angélica Amorim; Sousa, Thiago do Rego; de Carvalho, Marta Rodrigues; Novaes, Maria Rita Carvalho Garbi

2018-05-12

Participants' rights and safety must be guaranteed not only while a clinical trial is being conducted but also when a clinical trial finishes. The criteria for post-trial access to experimental drugs, however, are unclear in various countries. The objectives of this study were (i) to ascertain if there were regulations or guidelines related to patients' access to drugs after the end of clinical trials in the countries selected in the study and (ii) to analyze trends in post-trial access in countries classified by their level of economic development. This study is a retrospective review. The data are from the records of clinical trials from 2014 registered in the World Health Organization's International Clinical Trials Registry Platform (ICTRP) database. Among the countries selected, provision of drugs post-trial is mandatory only in Argentina, Brazil, Chile, Finland, and Peru. The plans for post-trial access tend to be more present in low- and middle-income and upper middle-income countries, in comparison with high-income countries. Studies involving vulnerable populations are 2.53 times more likely to have plans for post-trial access than studies which do not. The guaranteeing of post-trial access remains mandatory in few countries. Considering that individuals seen as vulnerable have been included in clinical trials without plans for post-trial access, stakeholders must discuss the need to develop regulations mandating the guaranteeing of post-trial access in specified situations.

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.

Exploring Situational Factors Shaping Access in a Laptop Program for Socially Disadvantaged Children in India: A Case Study

ERIC Educational Resources Information Center

Padmanabhan, Poornima; Wise, Alyssa Friend

2012-01-01

Low-cost laptop programs attempt to address gaps in access to computers in developing countries. However, the translation of computing access from intention to actuality is mediated by many situational factors. This research presents a case study of how access to a set of laptops donated to a school for socially disadvantaged children in India was…

Individual Public Transportation Accessibility is Positively Associated with Self-Reported Active Commuting

PubMed Central

Djurhuus, Sune; Hansen, Henning Sten; Aadahl, Mette; Glümer, Charlotte

2014-01-01

Background: Active commuters have lower risk of chronic disease. Understanding which of the, to some extent, modifiable characteristics of public transportation that facilitate its use is thus important in a public health perspective. The aim of the study was to examine the association between individual public transportation accessibility and self-reported active commuting, and whether the associations varied with commute distance, age, and gender. Methods: Twenty-eight thousand nine hundred twenty-eight commuters in The Capital Region of Denmark reported self-reported time spent either walking or cycling to work or study each day and the distance to work or study. Data were obtained from the Danish National Health Survey collected in February to April 2010. Individual accessibility by public transportation was calculated using a multi-modal network in a GIS. Multilevel logistic regression was used to analyze the association between accessibility, expressed as access area, and being an active commuter. Results: Public transport accessibility area based on all stops within walking and cycling distance was positively associated with being an active commuter. Distance to work, age, and gender modified the associations. Residing within 10 km commute distance and in areas of high accessibility was associated with being an active commuter and meeting the recommendations of physical activity. For the respondents above 29 years, individual public transportation accessibility was positively associated with being an active commuter. Women having high accessibility had significantly higher odds of being an active commuter compared to having a low accessibility. For men, the associations were insignificant. Conclusion: This study extends the knowledge about the driving forces of using public transportation for commuting by examining the individual public transportation accessibility. Findings suggest that transportation accessibility supports active commuting and planning of improved public transit accessibility has thus a potential of providing health benefits to commuters. PMID:25453030

Exploring accessibility issues of a public building for the mobility impaired. Case study: interstate bus terminal (ISBT), Vijayawada, India.

PubMed

Alagappan, Valliappan; Hefferan, Albert; Parivallal, Aarthi

2018-04-01

Right to access in the built environment creates equal and nondiscriminatory opportunities to a person with disabilities in order to move freely around and interact positively without hindrance and barriers. The objective of the study is to understand the existing accessibility related issues and implementation of guidelines and standards for public buildings. The technical verification using onsite and offsite access audit format for current provision of facilities in the internal and external environment has been carried out with the format prepared in reference to Central Public Works Department (CPWD) accessibility guidelines for mobility impaired and elderly and American Disability Act (ADA) guidelines. The access audit format included parameters like accessibility, safety, security, comfort and convenience and it addresses the barriers faced by wheel chair users, people with crutches, prosthetics and with non-assistive devices. The study addressed accessibility compliance in three zones of the building with initiation from parking area zone, inside the building, and area outside the building premises. The findings highlight the environmental barriers encountered by mobility impaired people and represented graphically in the layout plan and physical effort required to overcome the challenges in the built environment. The overall accessibility compliance is 42% in the interstate bus terminal. Implications for rehabilitation The study identifies the environmental limitations, human and technologically facilitators with the help of Central Public Works Department (CPWD) and American Disability Act (ADA) guidelines (1990). It highlights barriers for mobility-impaired users, by demonstrating in a spatial layout and the means to facilitate easy access with minimal frustration, stress and with less physical effort. It demonstrates the need for preparation of separate guidelines for making the existing types of buildings to be access and disabled-friendly. New accessibility guidelines shall be prepared by incorporating concepts like such as relative accessibility into new bus terminal buildings. Guidelines help the disabled in the process of rehabilitation and develop inclusiveness not rather than alienation.

Two-Step Optimization for Spatial Accessibility Improvement: A Case Study of Health Care Planning in Rural China

PubMed Central

Luo, Jing; Tian, Lingling; Luo, Lei; Yi, Hong

2017-01-01

A recent advancement in location-allocation modeling formulates a two-step approach to a new problem of minimizing disparity of spatial accessibility. Our field work in a health care planning project in a rural county in China indicated that residents valued distance or travel time from the nearest hospital foremost and then considered quality of care including less waiting time as a secondary desirability. Based on the case study, this paper further clarifies the sequential decision-making approach, termed “two-step optimization for spatial accessibility improvement (2SO4SAI).” The first step is to find the best locations to site new facilities by emphasizing accessibility as proximity to the nearest facilities with several alternative objectives under consideration. The second step adjusts the capacities of facilities for minimal inequality in accessibility, where the measure of accessibility accounts for the match ratio of supply and demand and complex spatial interaction between them. The case study illustrates how the two-step optimization method improves both aspects of spatial accessibility for health care access in rural China. PMID:28484707

Two-Step Optimization for Spatial Accessibility Improvement: A Case Study of Health Care Planning in Rural China.

PubMed

Luo, Jing; Tian, Lingling; Luo, Lei; Yi, Hong; Wang, Fahui

2017-01-01

A recent advancement in location-allocation modeling formulates a two-step approach to a new problem of minimizing disparity of spatial accessibility. Our field work in a health care planning project in a rural county in China indicated that residents valued distance or travel time from the nearest hospital foremost and then considered quality of care including less waiting time as a secondary desirability. Based on the case study, this paper further clarifies the sequential decision-making approach, termed "two-step optimization for spatial accessibility improvement (2SO4SAI)." The first step is to find the best locations to site new facilities by emphasizing accessibility as proximity to the nearest facilities with several alternative objectives under consideration. The second step adjusts the capacities of facilities for minimal inequality in accessibility, where the measure of accessibility accounts for the match ratio of supply and demand and complex spatial interaction between them. The case study illustrates how the two-step optimization method improves both aspects of spatial accessibility for health care access in rural China.

Molecular and chemical characterization of vetiver, Chrysopogon zizanioides (L.) Roberty, germplasm.

PubMed

Celestino, R S; Zucchi, M I; Pinheiro, J B; Campos, J B; Pereira, A A; Bianchini, F G; Lima, R N; Arrigoni-Blank, M F; Alves, P B; Blank, A F

2015-08-14

Due to the economic interests in vetiver, Chrysopogon zizanioides (L.) Roberty, molecular and chemical studies are essential to generate information for its sustainable exploitation. The aim of this study was to undertake a molecular and chemical characterization of vetiver accessions of the active germplasm bank of the Universidade Federal de Sergipe. The molecular characteristics of the accessions were studied using amplified fragment length polymorphism markers, with a total of 14 primer combinations that generated 442 loci, allowing us to observe that these accessions have similar genomes. The vetiver accessions were divided into three distinct groups, where accession UFS-VET005 was the most differentiated and accession UFS-VET004 had the lowest essential oil content (0.70%). The content of the chemical constituents of the essential oils was observed to vary, with a predominance of khusimol, which ranged from 18.97 to 25.02%. It was possible to divide the vetiver accessions into two groups based on chemical composition, and these groups do not correlate with the molecular grouping. Therefore, it is necessary to perform molecular and chemical analyses to characterize vetiver accessions.

Quantification of the benefits of access management for Kentucky : final report.

DOT National Transportation Integrated Search

2006-07-01

This report describes the benefits quantification performed for the proposed access management plan for Kentucky. This study evaluates the capacity, safety and economic impacts associated with access management programs. The proposed Kentucky access ...

Impact of access management practices to pedestrian safety.

DOT National Transportation Integrated Search

2017-03-31

This study focused on the impact of access management practices to the safety of pedestrians. Some : of the access management practices considered to impact pedestrian safety included limiting direct : access to and from major streets, locating signa...

Blood Flow in Idealized Vascular Access for Hemodialysis: A Review of Computational Studies.

PubMed

Ene-Iordache, Bogdan; Remuzzi, Andrea

2017-09-01

Although our understanding of the failure mechanism of vascular access for hemodialysis has increased substantially, this knowledge has not translated into successful therapies. Despite advances in technology, it is recognized that vascular access is difficult to maintain, due to complications such as intimal hyperplasia. Computational studies have been used to estimate hemodynamic changes induced by vascular access creation. Due to the heterogeneity of patient-specific geometries, and difficulties with obtaining reliable models of access vessels, idealized models were often employed. In this review we analyze the knowledge gained with the use of computational such simplified models. A review of the literature was conducted, considering studies employing a computational fluid dynamics approach to gain insights into the flow field phenotype that develops in idealized models of vascular access. Several important discoveries have originated from idealized model studies, including the detrimental role of disturbed flow and turbulent flow, and the beneficial role of spiral flow in intimal hyperplasia. The general flow phenotype was consistent among studies, but findings were not treated homogeneously since they paralleled achievements in cardiovascular biomechanics which spanned over the last two decades. Computational studies in idealized models are important for studying local blood flow features and evaluating new concepts that may improve the patency of vascular access for hemodialysis. For future studies we strongly recommend numerical modelling targeted at accurately characterizing turbulent flows and multidirectional wall shear disturbances.

Publishing in Open Access Education Journals: The Authors' Perspectives

ERIC Educational Resources Information Center

Coonin, Bryna; Younce, Leigh M.

2010-01-01

Open access publishing is now an accepted method of scholarly communication. However, the greatest traction for open access publishing thus far has been in the sciences. Penetration of open access publishing has been much slower among the social sciences. This study surveys 309 authors from recent issues of open access journals in education to…

After Access: Underrepresented Students' Postmatriculation Perceptions of College Access Capital

ERIC Educational Resources Information Center

Means, Darris R.; Pyne, Kimberly B.

2016-01-01

This qualitative study explores the perceived impact of college-going capital gained during participation in a college access program. In three, semistructured interviews spanning the first-year college experience, 10 first-year college students who participated in a college access program articulate the value of access programming and also raise…

Self-Directed Digital Learning: When Do Dental Students Study?

PubMed

Jackson, Tate H; Zhong, James; Phillips, Ceib; Koroluk, Lorne D

2018-04-01

The Growth and Development (G&D) curriculum at the University of North Carolina at Chapel Hill School of Dentistry uses self-directed web-based learning modules in the place of lectures and includes scheduled self-study times during the 8 am-5 pm school hours. The aim of this study was to use direct observation to evaluate dental students' access patterns with the self-directed, web-based learning modules in relation to planned self-study time allocated across the curriculum, proximity to course examinations, and course performance. Module access for all 80 students in the DDS Class of 2014 was recorded for date and time across the four G&D courses. Module access data were used to determine likelihood of usage during scheduled time and frequency of usage in three timeframes: >7, 3 to 7, and 0 to 2 days before the final exam. The results showed a statistically significant difference in the likelihood of module access during scheduled time across the curriculum (p<0.0001). Among the students, 64% accessed modules at least once during scheduled time in G&D1, but only 10%, 19%, and 18% in G&D2, G&D3, and G&D4, respectively. For all courses, the proportion of module accesses was significantly higher 0-2 days before an exam compared to the other two timeframes. Module access also differed significantly within each timeframe across all four courses (p<0.001). There was no association between module access and course performance. In this non-traditional, non-lecture, self-directed curriculum, students rarely accessed learning modules during syllabus-budgeted self-study time and accessed modules more frequently as course exams approached.

The relationship between accessibility of healthcare facilities and medical care utilization among the middle-aged and elderly population in Taiwan.

PubMed

Yang, Ya-Ting; Iqbal, Usman; Ko, Hua-Lin; Wu, Chia-Rong; Chiu, Hsien-Tsai; Lin, Yi-Chieh; Lin, Wender; Elsa Hsu, Yi-Hsin

2015-06-01

The purpose of this study was to explore the relationship between accessibility of healthcare facilities and medical care utilization among the middle-aged and elderly population in Taiwan. Cross-sectional study from 2007 Taiwan Longitudinal Study on Ageing (TLSA) survey. Community-based study. A total of 4249 middle-aged and elderly subjects were recruited. None. Outpatient visits within 1 month, and hospitalization, emergency visits as well as to shop in pharmacy stores within 1 year, respectively. Adjusting for important confounding variables, the middle-aged and elderly with National Health Insurance (NHI) and commercial insurance compared with those with NHI alone tended to have outpatient visits. The middle-aged and elderly with longer time to access healthcare facilities were less likely to shop in pharmacy stores compared with those with <30 min. The middle-aged and elderly who perceived inconvenient to access health care tended to shop in pharmacy stores compared with those with perceived convenience. Our study of Taiwan's experience could provide a valuable lesson for countries that are planning to launch universal health insurance system, locate budgets in health care and transportation. The middle-aged and elderly who were facing more challenges in accessing health care, no matter in perceived accessibility or real time to access health care, had less outpatient visits and more drug stores shopping. Strategic policies are needed to improve accessibility in increasing patients' perception on access and escalating convenience of transportation system for improving accessibility. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

When self-destructive thoughts flash through the mind: Failure to meet standards affects the accessibility of suicide-related thoughts.

PubMed

Chatard, Armand; Selimbegović, Leila

2011-04-01

When individuals realize that they fail to attain important standards or expectations, they may be motivated to escape the self, which could lead thoughts of suicide to become more accessible. Six studies examined this hypothesis, mainly derived from escape theory (Baumeister, 1990). The results indicated that whenever individuals realize that they fail to attain an important standard, they experience increased accessibility of suicide-related thoughts (Studies 1-6). In line with the idea that such effects reflect motivations to escape from negative self-awareness, they were especially pronounced when associated with high levels of self-consciousness and escapist motivations (Study 1) and with a large discrepancy between self and standards (Studies 2-4). Moreover, failure to attain standards increased suicide-thought accessibility along with the desire for an altered state of consciousness (Study 5). Finally, increases in suicide-thought accessibility after failure were associated with simultaneous increases in accessibility of general concepts related to escape (Study 6). Implications of these findings for escape and terror management theories are discussed.

An Analysis of Website Accessibility in Higher Education in Indonesia Based on WCAG 2.0 Guidelines

NASA Astrophysics Data System (ADS)

Arasid, W.; Abdullah, A. G.; Wahyudin, D.; Abdullah, C. U.; Widiaty, I.; Zakaria, D.; Amelia, N.; Juhana, A.

2018-02-01

Website accessibility is a simple way to access a website by everyone so that information on the website can be easily understood. This study aims to improve the accessibility of universities’ website to analyze website accessibility problems based on WCAG 2.0 guidelines. This study analyzed 13 universities’ websites in West Java, Indonesia by using TAW as an evaluation tool. The evaluation results were presented in a graph showing the error rate of each university’s website. The same errors that occurred in almost all websites were: non-text content, info and relationships, page title, link purpose, language of page, on input, labels and instructions, parsing, and name, role, value criteria. This study was expected to provide information to the university and to perform as guidelines for website accessibility improvements.

Web accessibility: a longitudinal study of college and university home pages in the northwestern United States.

PubMed

Thompson, Terrill; Burgstahler, Sheryl; Moore, Elizabeth J

2010-01-01

This article reports on a follow-up assessment to Thompson et al. (Proceedings of The First International Conference on Technology-based Learning with Disability, July 19-20, Dayton, Ohio, USA; 2007. pp 127-136), in which higher education home pages were evaluated over a 5-year period on their accessibility to individuals with disabilities. The purpose of this article is to identify trends in web accessibility and long-term impact of outreach and education. Home pages from 127 higher education institutions in the Northwest were evaluated for accessibility three times over a 6-month period in 2004-2005 (Phase I), and again in 2009 (Phase II). Schools in the study were offered varying degrees of training and/or support on web accessibility during Phase I. Pages were evaluated for accessibility using a set of manual checkpoints developed by the researchers. Over the 5-year period reported in this article, significant positive gains in accessibility were revealed on some measures, but accessibility declined on other measures. The areas of improvement are arguably the more basic, easy-to-implement accessibility features, while the area of decline is keyboard accessibility, which is likely associated with the emergence of dynamic new technologies on web pages. Even on those measures where accessibility is improving, it is still strikingly low. In Phase I of the study, institutions that received extensive training and support were more likely than other institutions to show improved accessibility on the measures where institutions improved overall, but were equally or more likely than others to show a decline on measures where institutions showed an overall decline. In Phase II, there was no significant difference between institutions who had received support earlier in the study, and those who had not. Results suggest that growing numbers of higher education institutions in the Northwest are motivated to add basic accessibility features to their home pages, and that outreach and education may have a positive effect on these measures. However, the results also reveal negative trends in accessibility, and outreach and education may not be strong enough to counter the factors that motivate institutions to deploy inaccessible emerging technologies. Further research is warranted toward identifying the motivational factors that are associated with increased and decreased web accessibility, and much additional work is needed to ensure that higher education web pages are accessible to individuals with disabilities.

[Open access to academic scholarship as a public policy resource: a study of the Capes database on Brazilian theses and dissertations].

PubMed

da Silva Rosa, Teresa; Carneiro, Maria José

2010-12-01

Access to scientific knowledge is a valuable resource than can inform and validate positions taken in formulating public policy. But access to this knowledge can be challenging, given the diversity and breadth of available scholarship. Communication between the fields of science and of politics requires the dissemination of scholarship and access to it. We conducted a study using an open-access search tool in order to map existent knowledge on a specific topic: agricultural contributions to the preservation of biodiversity. The present article offers a critical view of access to the information available through the Capes database on Brazilian theses and dissertations.

What do parents perceive are the barriers and facilitators to accessing psychological treatment for mental health problems in children and adolescents? A systematic review of qualitative and quantitative studies.

PubMed

Reardon, Tessa; Harvey, Kate; Baranowska, Magdalena; O'Brien, Doireann; Smith, Lydia; Creswell, Cathy

2017-06-01

A minority of children and adolescents with mental health problems access treatment. The reasons for poor rates of treatment access are not well understood. As parents are a key gatekeeper to treatment access, it is important to establish parents' views of barriers/facilitators to accessing treatment. The aims of this study are to synthesise findings from qualitative and quantitative studies that report parents' perceptions of barriers/facilitators to accessing treatment for mental health problems in children/adolescents. A systematic review and narrative synthesis were conducted. Forty-four studies were included in the review and were assessed in detail. Parental perceived barriers/facilitators relating to (1) systemic/structural issues; (2) views and attitudes towards services and treatment; (3) knowledge and understanding of mental health problems and the help-seeking process; and (4) family circumstances were identified. Findings highlight avenues for improving access to child mental health services, including increased provision that is free to service users and flexible to their needs, with opportunities to develop trusting, supportive relationships with professionals. Furthermore, interventions are required to improve parents' identification of mental health problems, reduce stigma for parents, and increase awareness of how to access services.

Multi-tool accessibility assessment of government department websites:a case-study with JKGAD.

PubMed

Ismail, Abid; Kuppusamy, K S; Nengroo, Ab Shakoor

2017-08-02

Nature of being accessible to all categories of users is one of the primary factors for enabling the wider reach of the resources published through World Wide Web. The accessibility of websites has been analyzed through W3C guidelines with the help of various tools. This paper presents a multi-tool accessibility assessment of government department websites belonging to the Indian state of Jammu and Kashmir. A comparative analysis of six accessibility tools is also presented with 14 different parameters. The accessibility analysis tools used in this study for analysis are aChecker, Cynthia Says, Tenon, wave, Mauve, and Hera. These tools provide us the results of selected websites accessibility status on Web Content Accessibility Guidelines (WCAG) 1.0 and 2.0. It was found that there are variations in accessibility analysis results when using different accessibility metrics to measure the accessibility of websites. In addition to this, we have identified the guidelines which have frequently been violated. It was observed that there is a need for incorporating the accessibility component features among the selected websites. This paper presents a set of suggestions to improve the accessibility status of these sites so that the information and services provided by these sites shall reach a wider spectrum of audience without any barrier. Implications for rehabilitation The following points indicates that this case study of JKGAD websites comes under Rehabilitation focused on Visually Impaired users. Due to the universal nature of web, it should be accessible to all according to WCAG guidelines framed by World Wide Web Consortium. In this paper we have identified multiple accessibility barriers for persons with visual impairment while browsing the Jammu and Kashmir Government websites. Multi-tool analysis has been done to pin-point the potential barriers for persons with visually Impaired. Usability analysis has been performed to check whether these websites are suitable for persons with visual impairment. We provide some valuable suggestions which can be followed by developers and designers to minimize these potential accessibility barriers.Based on aforementioned key points, this article helps the persons with disability especially Visually Impaired Users to access the web resources better with the implementation of identified suggestions.

Using GIS and perceived distance to understand the unequal geographies of healthcare in lower-income urban neighbourhoods.

PubMed

Hawthorne, Timothy L; Kwan, Mei-Po

2012-01-01

Geographers play important roles in public health research, particularly in understanding healthcare accessibility, utilisation, and individual healthcare experiences. Most accessibility studies have benefited from the increased sophistication of geographic information systems (GIS). Some studies have been enhanced with semi-structured in-depth interviews to understand individual experiences of people as they access healthcare. However, few accessibility studies have explicitly utilised individual in-depth interview data in the construction of new GIS accessibility measures. Using mixed methods including GIS analysis and individual data from semi-structured in-depth interviews, we offer satisfaction-adjusted distance as a new way of conceptualising accessibility in GIS. Based on fieldwork in a predominantly lower-income community in Columbus, Ohio (USA), we find many residents felt neighbourhood healthcare facilities offered low-quality care, which suggested an added perceived distance as they attempt to access high-quality healthcare facilities. The satisfaction-adjusted distance measure accounts for the perceived distance some residents feel as they search for high-quality healthcare in lower-income urban neighbourhoods. In moving beyond conventional GIS and re-conceptualising accessibility in this way, we offer a more realistic portrayal of the issues lower-income urban residents face as they attempt to access high-quality healthcare facilities. The work has theoretical implications for conceptualising healthcare accessibility, advances the mixed-methodologies literature, and argues for a more equitable distribution of high-quality healthcare in urban neighbourhoods.

Neighborhood environments: disparities in access to healthy foods in the U.S.

PubMed

Larson, Nicole I; Story, Mary T; Nelson, Melissa C

2009-01-01

Poor dietary patterns and obesity, established risk factors for chronic disease, have been linked to neighborhood deprivation, neighborhood minority composition, and low area population density. Neighborhood differences in access to food may have an important influence on these relationships and health disparities in the U.S. This article reviews research relating to the presence, nature, and implications of neighborhood differences in access to food. A snowball strategy was used to identify relevant research studies (n=54) completed in the U.S. and published between 1985 and April 2008. Research suggests that neighborhood residents who have better access to supermarkets and limited access to convenience stores tend to have healthier diets and lower levels of obesity. Results from studies examining the accessibility of restaurants are less consistent, but there is some evidence to suggest that residents with limited access to fast-food restaurants have healthier diets and lower levels of obesity. National and local studies across the U.S. suggest that residents of low-income, minority, and rural neighborhoods are most often affected by poor access to supermarkets and healthful food. In contrast, the availability of fast-food restaurants and energy-dense foods has been found to be greater in lower-income and minority neighborhoods. Neighborhood disparities in access to food are of great concern because of their potential to influence dietary intake and obesity. Additional research is needed to address various limitations of current studies, identify effective policy actions, and evaluate intervention strategies designed to promote more equitable access to healthy foods.

Women's access needs in maternity care in rural Tasmania, Australia: a mixed methods study.

PubMed

Hoang, Ha; Le, Quynh; Terry, Daniel

2014-03-01

This study investigates (i) maternity care access issues in rural Tasmania, (ii) rural women's challenges in accessing maternity services and (iii) rural women's access needs in maternity services. A mixed-method approach using a survey and semi-structured interviews was conducted. The survey explored women's views of rural maternity services from antenatal to postnatal care, while interviews reinforced the survey results and provided insights into the access issues and needs of women in maternity care. The survey was completed by n=210 women, with a response rate of 35%, with n=22 follow-up interviews being conducted. The survey indicated the majority of rural women believed antenatal education and check-ups and postnatal check-ups should be provided locally. The majority of women surveyed also believed in the importance of having a maternity unit in the local hospital, which was further iterated and clarified within the interviews. Three main themes emerged from the interview data, namely (i) lack of access to maternity services, (ii) difficulties in accessing maternity services, and (iii) rural women's access needs. The study suggested that women's access needs are not fully met in some rural areas of Tasmania. Rural women face many challenges when accessing maternity services, including financial burden and risk of labouring en route. The study supports the claim that the closure of rural maternity units shifts cost and risk from the health care system to rural women and their families. Copyright © 2013 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

The financial impact of health information exchange on emergency department care.

PubMed

Frisse, Mark E; Johnson, Kevin B; Nian, Hui; Davison, Coda L; Gadd, Cynthia S; Unertl, Kim M; Turri, Pat A; Chen, Qingxia

2012-01-01

To examine the financial impact health information exchange (HIE) in emergency departments (EDs). We studied all ED encounters over a 13-month period in which HIE data were accessed in all major emergency departments Memphis, Tennessee. HIE access encounter records were matched with similar encounter records without HIE access. Outcomes studied were ED-originated hospital admissions, admissions for observation, laboratory testing, head CT, body CT, ankle radiographs, chest radiographs, and echocardiograms. Our estimates employed generalized estimating equations for logistic regression models adjusted for admission type, length of stay, and Charlson co-morbidity index. Marginal probabilities were used to calculate changes in outcome variables and their financial consequences. HIE data were accessed in approximately 6.8% of ED visits across 12 EDs studied. In 11 EDs directly accessing HIE data only through a secure Web browser, access was associated with a decrease in hospital admissions (adjusted odds ratio (OR)=0.27; p<0001). In a 12th ED relying more on print summaries, HIE access was associated with a decrease in hospital admissions (OR=0.48; p<0001) and statistically significant decreases in head CT use, body CT use, and laboratory test ordering. Applied only to the study population, HIE access was associated with an annual cost savings of $1.9 million. Net of annual operating costs, HIE access reduced overall costs by $1.07 million. Hospital admission reductions accounted for 97.6% of total cost reductions. Access to additional clinical data through HIE in emergency department settings is associated with net societal saving.

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

The Effects of Implementing Web Accessibility Standards on the Success of Secondary Adolescents

ERIC Educational Resources Information Center

Savi, Christine Opitz; Savenye, Wilhelmina; Rowland, Cynthia

2008-01-01

Web accessibility has become a paramount concern in providing equal access to audiences of all abilities. Unless web accessibility is supported and employed, the internet does not deliver worldwide access as it was intended. This study engaged 60 students in a secondary school setting in order to identify the navigational effectiveness and…

Not All Lexical Access Tasks Are Created Equal: Lexical Development between Three and Five

ERIC Educational Resources Information Center

Isacoff, Nora M.; Stromswold, Karin

2014-01-01

Lexical access tasks are designed to measure efficiency of lexical access, but task demands and methods vary greatly. Many lexical access tasks do not account for confounding factors including competence in other linguistic abilities. In this study, preschoolers were given two lexical access tasks. In the single-category naming (SCN) task,…

AAC menu interface: effectiveness of active versus passive learning to master abbreviation-expansion codes.

PubMed

Gregory, Ellyn; Soderman, Melinda; Ward, Christy; Beukelman, David R; Hux, Karen

2006-06-01

This study investigated the accuracy with which 30 young adults without disabilities learned abbreviation expansion codes associated with specific vocabulary items that were stored in an AAC device with two accessing methods: mouse access and keyboard access. Both accessing methods utilized a specialized computer application, called AAC Menu, which allowed for errorless practice. Mouse access prompted passive learning, whereas keyboard access prompted active learning. Results revealed that participants who accessed words via a keyboard demonstrated significantly higher mastery of abbreviation-expansion codes than those who accessed words via a computer mouse.

The Physical Accessibility of Public Libraries to Users: A GIS Study

ERIC Educational Resources Information Center

Park, Sung Jae

2011-01-01

The purpose of this study is to gain a finer-grained picture and better understanding of the travel patterns of library users, and the activities, demographics, and other factors that affect library access. Previous studies of physical accessibility of public libraries, which have focused on library users' single-destination trips and their travel…

Organizational interventions improving access to community-based primary health care for vulnerable populations: a scoping review.

PubMed

Khanassov, Vladimir; Pluye, Pierre; Descoteaux, Sarah; Haggerty, Jeannie L; Russell, Grant; Gunn, Jane; Levesque, Jean-Frederic

2016-10-10

Access to community-based primary health care (hereafter, 'primary care') is a priority in many countries. Health care systems have emphasized policies that help the community 'get the right service in the right place at the right time'. However, little is known about organizational interventions in primary care that are aimed to improve access for populations in situations of vulnerability (e.g., socioeconomically disadvantaged) and how successful they are. The purpose of this scoping review was to map the existing evidence on organizational interventions that improve access to primary care services for vulnerable populations. Scoping review followed an iterative process. Eligibility criteria: organizational interventions in Organisation for Economic Cooperation and Development (OECD) countries; aiming to improve access to primary care for vulnerable populations; all study designs; published from 2000 in English or French; reporting at least one outcome (avoidable hospitalization, emergency department admission, or unmet health care needs). Main bibliographic databases (Medline, Embase, CINAHL) and team members' personal files. One researcher selected relevant abstracts and full text papers. Theory-driven synthesis: The researcher classified included studies using (i) the 'Patient Centered Access to Healthcare' conceptual framework (dimensions and outcomes of access to primary care), and (ii) the classification of interventions of the Cochrane Effective Practice and Organization of Care. Using pattern analysis, interventions were mapped in accordance with the presence/absence of 'dimension-outcome' patterns. Out of 8,694 records (title/abstract), 39 studies with varying designs were included. The analysis revealed the following pattern. Results of 10 studies on interventions classified as 'Formal integration of services' suggested that these interventions were associated with three dimensions of access (approachability, availability and affordability) and reduction of hospitalizations (four/four studies), emergency department admissions (six/six studies), and unmet healthcare needs (five/six studies). These 10 studies included seven non-randomized studies, one randomized controlled trial, one quantitative descriptive study, and one mixed methods study. Our results suggest the limited breadth of research in this area, and that it will be feasible to conduct a full systematic review of studies on the effectiveness of the formal integration of services to improve access to primary care services for vulnerable populations.

Accessible medical equipment for patients with disabilities in primary care clinics: why is it lacking?

PubMed

Pharr, Jennifer

2013-04-01

Previous research has identified inaccessible medical equipment as a barrier to health care services encountered by people with disabilities. However, no research has been conducted to understand why medical practices lack accessible equipment. The purpose of this study was to examine practice administrators' knowledge of accessible medical equipment and cost of accessible medical equipment to understand why medical practices lack such equipment. Hypotheses were: 1) Practice administrators lacked knowledge about accessible medical equipment and 2) The cost of accessible medical equipment was too great compared to standard equipment for the clinic. This study was a mixed methods survey of primary care practice administrators. The sixty-three participates were members of a medical management organization. Data were collected between December 20, 2011 and January 17, 2012. Proportions, Guttman scalogram, and Spearman's Rho correlation analyses were utilized. For this sample, less than half of the administrators knew that accessible equipment existed and a fourth knew what accessible equipment existed. There was a significant (p < 0.01), positive correlation between knowledge of accessible equipment and pieces of accessible equipment in the clinics. Because less than half of the administrators had ever considered purchasing accessible equipment, it was inconclusive if cost of accessible equipment was too great. Practice administrators' lack of knowledge of accessible medical equipment emphasizes the need not only for more education about the availability of accessible equipment but also about the importance of accessible equipment for their patients with disabilities and for physicians who provide them care. Copyright © 2013 Elsevier Inc. All rights reserved.

RNA-Seq study reveals genetic responses of diverse wild soybean accessions to increased ozone levels.

PubMed

Waldeck, Nathan; Burkey, Kent; Carter, Thomas; Dickey, David; Song, Qijian; Taliercio, Earl

2017-06-29

Ozone is an air pollutant widely known to cause a decrease in productivity in many plant species, including soybean (Glycine max (L.) Merr). While the response of cultivated soybean to ozone has been studied, very little information is available regarding the ozone response of its wild relatives. Ozone-resistant wild soybean accessions were identified by measuring the response of a genetically diverse group of 66 wild soybean (Glycine soja Zucc. and Sieb.) accessions to elevated ozone levels. RNA-Seq analyses were performed on leaves of different ages from selected ozone-sensitive and ozone-resistant accessions that were subjected to treatment with an environmentally relevant level of ozone. Many more genes responded to elevated ozone in the two ozone-sensitive accessions than in the ozone-resistant accessions. Analyses of the ozone response genes indicated that leaves of different ages responded differently to ozone. Older leaves displayed a consistent reduction in expression of genes involved in photosynthesis in response to ozone, while changes in expression of defense genes dominated younger leaf tissue in response to ozone. As expected, there is a substantial difference between the response of ozone-sensitive and ozone-resistant accessions. Genes associated with photosystem 2 were substantially reduced in expression in response to ozone in the ozone-resistant accessions. A decrease in peptidase inhibitors was one of several responses specific to one of the ozone resistant accessions. The decrease in expression in genes associated with photosynthesis confirms that the photosynthetic apparatus may be an early casualty in response to moderate levels of ozone. A compromise of photosynthesis would substantially impact plant growth and seed production. However, the resistant accessions may preserve their photosynthetic apparatus in response to the ozone levels used in this study. Older leaf tissue of the ozone-resistant accessions showed a unique down-regulation of genes associated with endopeptidase inhibitor activity. This study demonstrates the existence of significant diversity in wild soybean for ozone response. Wild soybean accessions characterized in this study can be used by soybean breeders to enhance ozone tolerance of this important food crop.

Trends in communicative access solutions for children with cerebral palsy.

PubMed

Myrden, Andrew; Schudlo, Larissa; Weyand, Sabine; Zeyl, Timothy; Chau, Tom

2014-08-01

Access solutions may facilitate communication in children with limited functional speech and motor control. This study reviews current trends in access solution development for children with cerebral palsy, with particular emphasis on the access technology that harnesses a control signal from the user (eg, movement or physiological change) and the output device (eg, augmentative and alternative communication system) whose behavior is modulated by the user's control signal. Access technologies have advanced from simple mechanical switches to machine vision (eg, eye-gaze trackers), inertial sensing, and emerging physiological interfaces that require minimal physical effort. Similarly, output devices have evolved from bulky, dedicated hardware with limited configurability, to platform-agnostic, highly personalized mobile applications. Emerging case studies encourage the consideration of access technology for all nonverbal children with cerebral palsy with at least nascent contingency awareness. However, establishing robust evidence of the effectiveness of the aforementioned advances will require more expansive studies. © The Author(s) 2014.

Access to inpatient dermatology care in Pennsylvania hospitals.

PubMed

Messenger, Elizabeth; Kovarik, Carrie L; Lipoff, Jules B

2016-01-01

Access to care is a known issue in dermatology, and many patients may experience long waiting periods to see a physician. In this study, an anonymous online survey was sent to all 274 Pennsylvania hospitals licensed by the US Department of Health in order to evaluate current levels of access to inpatient dermatology services. Although the response rate to this survey was limited, the data suggest that access to inpatient dermatology services is limited and may be problematic in hospitals across the United States. Innovation efforts and further studies are needed to address this gap in access to care.

US hospital-based direct access with radiology referral: an administrative case report.

PubMed

Keil, Aaron; Brown, Suzanne Robben

2015-01-01

Legislative gains in the US allow physical therapists to function in expanded scopes of practice including direct access and referral to specialists. The combination of direct access with privileges to order imaging studies directly offers a desirable practice status for many physical therapists, especially in musculoskeletal focused settings. Although direct access is legal in all US jurisdictions, institutional-based physical therapy settings have not embraced these practices. Barriers cited to implementing direct access with advanced practice are concerns over medical and administrative opposition, institutional policies, provider qualifications and reimbursement. This administrative case report describes the process taken to allow therapists to see patients without a referral and to order diagnostic imaging studies at an academic medical center. Nine-month implementation results show 66 patients seen via direct access with 15% referred for imaging studies. Claims submitted to 20 different insurance providers were reimbursed at 100%. While institutional regulations and reimbursement are reported as barriers to direct access, this report highlights the process one academic medical center used to implement direct access and advanced practice radiology referral by updating policies and procedures, identifying advanced competencies and communicating with necessary stakeholder groups. Favorable reimbursement for services is documented.

Ubiquitous Accessibility for People with Visual Impairments: Are We There Yet?

PubMed

Billah, Syed Masum; Ashok, Vikas; Porter, Donald E; Ramakrishnan, I V

2017-05-01

Ubiquitous access is an increasingly common vision of computing, wherein users can interact with any computing device or service from anywhere, at any time. In the era of personal computing, users with visual impairments required special-purpose, assistive technologies, such as screen readers, to interact with computers. This paper investigates whether technologies like screen readers have kept pace with, or have created a barrier to, the trend toward ubiquitous access, with a specific focus on desktop computing as this is still the primary way computers are used in education and employment. Towards that, the paper presents a user study with 21 visually-impaired participants, specifically involving the switching of screen readers within and across different computing platforms, and the use of screen readers in remote access scenarios. Among the findings, the study shows that, even for remote desktop access-an early forerunner of true ubiquitous access-screen readers are too limited, if not unusable. The study also identifies several accessibility needs, such as uniformity of navigational experience across devices, and recommends potential solutions. In summary, assistive technologies have not made the jump into the era of ubiquitous access, and multiple, inconsistent screen readers create new practical problems for users with visual impairments.

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

PubMed

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

2016-01-01

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

Pedestrian Access to Roundabouts: Assessment of Motorists' Yielding to Visually Impaired Pedestrians and Potential Treatments to Improve Access

DOT National Transportation Integrated Search

2006-05-01

This report describes two related studies intended to address double-lane roundabout accessibility issues for visually impaired pedestrians. The first study was conducted on a closed course to evaluate the feasibility of a pavement treatment to alert...

The Effect of Community Uninsurance Rates on Access to Health Care

PubMed Central

Sabik, Lindsay M

2012-01-01

Objective To investigate the effect of local uninsurance rates on access to health care for the uninsured and insured and improve on recent studies by controlling for time-invariant differences across markets. Data Sources Individual-level data from the 1996 and 2003 Community Tracking Study, and market-level data from other sources, including the Area Resource File and the Bureau of Primary Healthcare. Study Design Market-level fixed effects models estimate the effect of changes in uninsurance rates within markets on access to care, measured by whether individuals report forgoing necessary care. Instrumental variables models are also estimated. Principal Findings Increases in the rate of uninsurance are associated with poorer access to necessary care among the uninsured. In contrast with recent evidence, increases in uninsurance had no effect on access to care among the insured. Instrumental variables results are similar, although not statistically significant. Conclusions Changes in rates of insurance coverage are likely to affect access to care for both previously and continuously uninsured. In contrast with earlier studies, there is no evidence of spillover effects on the insured, suggesting that such policy changes may have little effect on access for those who are already insured. PMID:22172046

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

PubMed

Hannah, Chona T; Lê, Quynh

2012-10-01

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

Access to electronic health knowledge in five countries in Africa: a descriptive study.

PubMed

Smith, Helen; Bukirwa, Hasifa; Mukasa, Oscar; Snell, Paul; Adeh-Nsoh, Sylvester; Mbuyita, Selemani; Honorati, Masanja; Orji, Bright; Garner, Paul

2007-05-17

Access to medical literature in developing countries is helped by open access publishing and initiatives to allow free access to subscription only journals. The effectiveness of these initiatives in Africa has not been assessed. This study describes awareness, reported use and factors influencing use of on-line medical literature via free access initiatives. Descriptive study in four teaching hospitals in Cameroon, Nigeria, Tanzania and Uganda plus one externally funded research institution in The Gambia. Survey with postgraduate doctors and research scientists to determine Internet access patterns, reported awareness of on-line medical information and free access initiatives; semi structured interviews with a sub-sample of survey participants to explore factors influencing use. In the four African teaching hospitals, 70% of the 305 postgraduate doctors reported textbooks as their main source of information; 66% had used the Internet for health information in the last week. In two hospitals, Internet cafés were the main Internet access point. For researchers at the externally-funded research institution, electronic resources were their main source, and almost all had used the Internet in the last week. Across all 333 respondents, 90% had heard of PubMed, 78% of BMJ on line, 49% the Cochrane Library, 47% HINARI, and 19% BioMedCentral. HINARI use correlates with accessing the Internet on computers located in institutions. Qualitative data suggested there are difficulties logging into HINARI and that sometimes it is librarians that limit access to passwords. Text books remain an important resource for postgraduate doctors in training. Internet use is common, but awareness of free-access initiatives is limited. HINARI and other initiatives could be more effective with strong institutional endorsement and management to promote and ensure access.

[Stents in dialysis vascular access--do they promise improved high quality prolonged access use].

PubMed

Klein, Osnat; Plotkin, Eleonora; Gritun, Igal; Verner, Myriam; Lehmann, J M; Rathaus, Mauro; Bernheim, Jacques

2008-02-01

The life expectancy of dialysis patients depends, to a large extent, on blood access which provides uninterrupted and efficient treatment. Dialysis access created by a direct anastomosis between artery and vein usually allows normal dialysis for many years. Blood access by a bridge graft between artery and vein functions for a much shorter time and occludes chiefly because of endothelial hyperplasia at the graft vein anastomosis. This type of fistula is created when the veins of the patient are small. During the last few years the dialysis population is increasingly composed of adult and elderly patients suffering from diabetes mellitus, hypertension, dyslipidemias and atheromatous vascular disease so that a relatively large proportion of dialysis accesses are created using a bridge graft. Since we currently do not have the knowledge of how to arrest or delay the processes which lead to access occlusion, attempts are made to implement prophylactic strategies, find stenoses and dilate them before the access fails. Up to date, controlled trials have not succeeded in proving that this method prolongs access use. These trials did not describe the use of stents following dilatation. Between July 2002 and May 2005, 238 angiographies were performed on blood accesses including 179 angioplasties of stenoses. In sixteen patients a stent was deployed during the angioplasty. In ten patients dialysis was performed using the same access up to the end of the study period, an average of 43 months from the creation of the access. Three patients died with a functioning access and in three the access occluded during the period of followup. This study shows that the use of stents following angioplasty of dialysis access stenoses can improve the duration of use of accesses created through grafts.

Predictors of nonfunctional arteriovenous access at hemodialysis initiation and timing of access creation: A registry-based study

PubMed Central

Metzger, Marie; Labeeuw, Michel; Ayav, Carole; Jacquelinet, Christian; Massy, Ziad A.; Stengel, Bénédicte

2017-01-01

Determinants of nonfunctional arteriovenous (AV) access, including timing of AV access creation, have not been sufficiently described. We studied 29 945 patients who had predialysis AV access placement and were included in the French REIN registry from 2005 through 2013. AV access was considered nonfunctional when dialysis began with a catheter. We estimated crude and adjusted odds ratio (OR) with 95% confidence intervals (CI) of nonfunctional versus functional AV access associated with case-mix, facility characteristics, and timing of AV access creation. Analyses were stratified by dialysis start condition (planned or as an emergency) and comorbidity profile. Overall, 18% patients had nonfunctional AV access at hemodialysis initiation. In the group with planned dialysis start, female gender (OR 1.43, 95% CI 1.32–1.56), diabetes (OR 1.28, 95% CI 1.15–1.44), and a higher number of cardiovascular comorbidities (OR 1.27, 95% CI 1.09–1.49, and 1.31, 1.05–1.64, for 3 and >3 cardiovascular comorbidities versus none, respectively) were independent predictors of nonfunctional AV access. A higher percentage of AV access creation at the region level was associated with a lower rate of nonfunctional AV access (OR 0.98, 95% CI 0.98–0.99 per 1% increase). The odds of nonfunctional AV access decreased as time from creation to hemodialysis initiation increased up to 3 months in nondiabetic patients with fewer than 2 cardiovascular comorbidities and 6 months in patients with diabetes or 2 or more such comorbidities. In conclusion, both patient characteristics and clinical practices may play a role in successful AV access use at hemodialysis initiation. Adjusting the timing of AV access creation to patients’ comorbidity profiles may improve functional AV access rates. PMID:28749967

Predictors of nonfunctional arteriovenous access at hemodialysis initiation and timing of access creation: A registry-based study.

PubMed

Alencar de Pinho, Natalia; Coscas, Raphael; Metzger, Marie; Labeeuw, Michel; Ayav, Carole; Jacquelinet, Christian; Massy, Ziad A; Stengel, Bénédicte

2017-01-01

Determinants of nonfunctional arteriovenous (AV) access, including timing of AV access creation, have not been sufficiently described. We studied 29 945 patients who had predialysis AV access placement and were included in the French REIN registry from 2005 through 2013. AV access was considered nonfunctional when dialysis began with a catheter. We estimated crude and adjusted odds ratio (OR) with 95% confidence intervals (CI) of nonfunctional versus functional AV access associated with case-mix, facility characteristics, and timing of AV access creation. Analyses were stratified by dialysis start condition (planned or as an emergency) and comorbidity profile. Overall, 18% patients had nonfunctional AV access at hemodialysis initiation. In the group with planned dialysis start, female gender (OR 1.43, 95% CI 1.32-1.56), diabetes (OR 1.28, 95% CI 1.15-1.44), and a higher number of cardiovascular comorbidities (OR 1.27, 95% CI 1.09-1.49, and 1.31, 1.05-1.64, for 3 and >3 cardiovascular comorbidities versus none, respectively) were independent predictors of nonfunctional AV access. A higher percentage of AV access creation at the region level was associated with a lower rate of nonfunctional AV access (OR 0.98, 95% CI 0.98-0.99 per 1% increase). The odds of nonfunctional AV access decreased as time from creation to hemodialysis initiation increased up to 3 months in nondiabetic patients with fewer than 2 cardiovascular comorbidities and 6 months in patients with diabetes or 2 or more such comorbidities. In conclusion, both patient characteristics and clinical practices may play a role in successful AV access use at hemodialysis initiation. Adjusting the timing of AV access creation to patients' comorbidity profiles may improve functional AV access rates.

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

PubMed

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

2017-10-01

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

Easy access to firearms: juveniles' risks for violent offending and violent victimization.

PubMed

Ruback, R Barry; Shaffer, Jennifer N; Clark, Valerie A

2011-07-01

Keeping firearms at home may increase personal safety but it may also increase the risk of injury. This study uses data from three waves of the National Longitudinal Study of Adolescent Health to assess the extent to which adolescents' easy access to firearms at home increases the risk of violent offending and violent victimization. Access to firearms was higher for males, Whites, and adolescents having two parents, especially fathers. Current access to firearms at home significantly increased the odds of both violent offending and violent victimization, even after controlling for prior access, prior offending, and prior victimization. This relationship persisted into early adulthood; access to firearms still significantly increased the odds of violent offending and violent victimization.

Regional Geologic Map of San Andreas and Related Faults in Carrizo Plain, Temblor, Caliente and La Panza Ranges and Vicinity, California; A Digital Database

USGS Publications Warehouse

Dibblee, T. W.; Digital database compiled by Graham, S. E.; Mahony, T.M.; Blissenbach, J.L.; Mariant, J.J.; Wentworth, C.M.

1999-01-01

This Open-File Report is a digital geologic map database. The report serves to introduce and describe the digital data. There is no paper map included in the Open-File Report. The report includes PostScript and PDF plot files that can be used to plot images of the geologic map sheet and explanation sheet. This digital map database is prepared from a previously published map by Dibblee (1973). The geologic map database delineates map units that are identified by general age, lithology, and clast size following the stratigraphic nomenclature of the U.S. Geological Survey. For descriptions of the units, their stratigraphic relations, and sources of geologic mapping, consult the explanation sheet (of99-14_4b.ps or of99-14_4d.pdf), or the original published paper map (Dibblee, 1973). The scale of the source map limits the spatial resolution (scale) of the database to 1:125,000 or smaller. For those interested in the geology of Carrizo Plain and vicinity who do not use an ARC/INFO compatible Geographic Information System (GIS), but would like to obtain a paper map and explanation, PDF and PostScript plot files containing map images of the data in the digital database, as well as PostScript and PDF plot files of the explanation sheet and explanatory text, have been included in the database package (please see the section 'Digital Plot Files', page 5). The PostScript plot files require a gzip utility to access them. For those without computer capability, we can provide users with the PostScript or PDF files on tape that can be taken to a vendor for plotting. Paper plots can also be ordered directly from the USGS (please see the section 'Obtaining Plots from USGS Open-File Services', page 5). The content and character of the database, methods of obtaining it, and processes of extracting the map database from the tar (tape archive) file are described herein. The map database itself, consisting of six ARC/INFO coverages, can be obtained over the Internet or by magnetic tape copy as described below. The database was compiled using ARC/INFO, a commercial Geographic Information System (Environmental Systems Research Institute, Redlands, California), with version 3.0 of the menu interface ALACARTE (Fitzgibbon and Wentworth, 1991, Fitzgibbon, 1991, Wentworth and Fitzgibbon, 1991). The ARC/INFO coverages are stored in uncompressed ARC export format (ARC/INFO version 7.x). All data files have been compressed, and may be uncompressed with gzip, which is available free of charge over the Internet via links from the USGS Public Domain Software page (http://edcwww.cr.usgs.gov/doc/edchome/ndcdb/public.html). ARC/INFO export files (files with the .e00 extension) can be converted into ARC/INFO coverages in ARC/INFO (see below) and can be read by some other Geographic Information Systems, such as MapInfo via ArcLink and ESRI's ArcView.

Household computer and Internet access: The digital divide in a pediatric clinic population

PubMed Central

Carroll, Aaron E.; Rivara, Frederick P.; Ebel, Beth; Zimmerman, Frederick J.; Christakis, Dimitri A.

2005-01-01

Past studies have noted a digital divide, or inequality in computer and Internet access related to socioeconomic class. This study sought to measure how many households in a pediatric primary care outpatient clinic had household access to computers and the Internet, and whether this access differed by socio-economic status or other demographic information. We conducted a phone survey of a population-based sample of parents with children ages 0 to 11 years old. Analyses assessed predictors of having home access to a computer, the Internet, and high-speed Internet service. Overall, 88.9% of all households owned a personal computer, and 81.4% of all households had Internet access. Among households with Internet access, 48.3% had high speed Internet at home. There were statistically significant associations between parental income or education and home computer ownership and Internet access. However, the impact of this difference was lessened by the fact that over 60% of families with annual household income of $10,000–$25,000, and nearly 70% of families with only a high-school education had Internet access at home. While income and education remain significant predictors of household computer and internet access, many patients and families at all economic levels have access, and might benefit from health promotion interventions using these modalities. PMID:16779012

Access to medical care reported by Asians and Pacific Islanders in a West Coast physician group association.

PubMed

Snyder, R E; Cunningham, W; Nakazono, T T; Hays, R D

2000-06-01

This study examines access to medical care for Asians and Pacific Islanders in the United States, using a survey of patients receiving care provided by a physician group practice association concentrated on the West Coast. Asians and Pacific Islanders who had used their health plan in the past year had worse access to health care than whites, blacks, Hispanics, and Native American or other ethnicities. The odds that Asians reported that they had adequate access ranged from about one quarter to three quarters that of whites, depending on the measure. Cultural differences and associated communication problems may explain the access problems experienced by Asians. Interventions need to be developed to address the problems with access to services, and better translation services may play an important role in improving access to care for Asians. Future studies need to clarify why Asians were more vulnerable to the access problems examined than other ethnic groups that might experience similar barriers.

African Americans' Access to Vocational Rehabilitation Services after Antidiscrimination Legislation

ERIC Educational Resources Information Center

Mwachofi, Ari K.

2008-01-01

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

Case Study in Modeling Accessibility for Online Instruction

ERIC Educational Resources Information Center

Conway, Thomas Hayes

2017-01-01

The purpose of this qualitative multiple case study was to explore how accessibility standards are adapted to create online learning environments that are accessible to people who use assistive technology, or have navigational challenges due to physical or intellectual disabilities. Rogers diffusion of innovation was used as the contextual…

Accessing Digital Libraries: A Study of ARL Members' Digital Projects

ERIC Educational Resources Information Center

Kahl, Chad M.; Williams, Sarah C.

2006-01-01

To ensure efficient access to and integrated searching capabilities for their institution's new digital library projects, the authors studied Web sites of the Association of Research Libraries' (ARL) 111 academic, English-language libraries. Data were gathered on 1117 digital projects, noting library Web site and project access, metadata, and…

A Retrospective Look at Website Accessibility over Time

ERIC Educational Resources Information Center

Hackett, Stephanie; Parmanto, Bambang; Zeng, Xiaoming

2005-01-01

Websites were retrospectively analysed to study the effects that technological advances in web design have had on accessibility for persons with disabilities. A random sample of general websites and a convenience sample of US government websites were studied and compared for the years 1997-2002. Web accessibility barrier (WAB) and complexity…

Geographic access to mammography and its relationship to breast cancer screening and stage at diagnosis: a systematic review

PubMed Central

Khan-Gates, Jenna A.; Ersek, Jennifer L.; Eberth, Jan M.; Adams, Swann A.; Pruitt, Sandi

2016-01-01

Introduction A review was conducted to summarize the current evidence and gaps in the literature on geographic access to mammography and its relationship to breast cancer-related outcomes. Methods Ovid Medline and PubMed were searched for articles published between January 1, 2000 and April 1, 2013 using Medical Subject Headings and key terms representing geographic accessibility and breast cancer-related outcomes. Due to a paucity of breast cancer treatment and mortality outcomes meeting the criteria (N=6), outcomes were restricted to breast cancer screening and stage at diagnosis. Studies included one or more of the following types of geographic accessibility measures: capacity, density, distance and travel time. Study findings were grouped by outcome and type of geographic measure. Results Twenty-one articles met inclusion criteria. Fourteen articles included stage at diagnosis as an outcome, five included mammography utilization, and two included both. Geographic measures of mammography accessibility varied widely across studies. Findings also varied, but most articles found either increased geographic access to mammography associated with increased utilization and decreased late-stage at diagnosis or no statistically significant association. Conclusion The gaps and methodologic heterogeneity in the literature to date limit definitive conclusions about an underlying association between geographic mammography access and breast cancer-related outcomes. Future studies should focus on the development and application of more precise and consistent measures of geographic access to mammography. PMID:26219677

A Qualitative Study of Barriers to Accessing Water, Sanitation and Hygiene for Disabled People in Malawi.

PubMed

White, Sian; Kuper, Hannah; Itimu-Phiri, Ambumulire; Holm, Rochelle; Biran, Adam

2016-01-01

Globally, millions of people lack access to improved water, sanitation and hygiene (WASH). Disabled people, disadvantaged both physically and socially, are likely to be among those facing the greatest inequities in WASH access. This study explores the WASH priorities of disabled people and uses the social model of disability and the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework to look at the relationships between impairments, contextual factors and barriers to WASH access. 36 disabled people and 15 carers from urban and rural Malawi were purposively selected through key informants. The study employed a range of qualitative methods including interviews, emotion mapping, free-listing of priorities, ranking, photo voice, observation and WASH demonstrations. A thematic analysis was conducted using nVivo 10. WASH access affected all participants and comprised almost a third of the challenges of daily living identified by disabled people. Participants reported 50 barriers which related to water and sanitation access, personal and hand hygiene, social attitudes and participation in WASH programs. No two individuals reported facing the same set of barriers. This study found that being female, being from an urban area and having limited wealth and education were likely to increase the number and intensity of the barriers faced by an individual. The social model proved useful for classifying the majority of barriers. However, this model was weaker when applied to individuals who were more seriously disabled by their body function. This study found that body function limitations such as incontinence, pain and an inability to communicate WASH needs are in and of themselves significant barriers to adequate WASH access. Understanding these access barriers is important for the WASH sector at a time when there is a global push for equitable access.

A Qualitative Study of Barriers to Accessing Water, Sanitation and Hygiene for Disabled People in Malawi

PubMed Central

Kuper, Hannah; Itimu-Phiri, Ambumulire; Holm, Rochelle; Biran, Adam

2016-01-01

Globally, millions of people lack access to improved water, sanitation and hygiene (WASH). Disabled people, disadvantaged both physically and socially, are likely to be among those facing the greatest inequities in WASH access. This study explores the WASH priorities of disabled people and uses the social model of disability and the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) framework to look at the relationships between impairments, contextual factors and barriers to WASH access. 36 disabled people and 15 carers from urban and rural Malawi were purposively selected through key informants. The study employed a range of qualitative methods including interviews, emotion mapping, free-listing of priorities, ranking, photo voice, observation and WASH demonstrations. A thematic analysis was conducted using nVivo 10. WASH access affected all participants and comprised almost a third of the challenges of daily living identified by disabled people. Participants reported 50 barriers which related to water and sanitation access, personal and hand hygiene, social attitudes and participation in WASH programs. No two individuals reported facing the same set of barriers. This study found that being female, being from an urban area and having limited wealth and education were likely to increase the number and intensity of the barriers faced by an individual. The social model proved useful for classifying the majority of barriers. However, this model was weaker when applied to individuals who were more seriously disabled by their body function. This study found that body function limitations such as incontinence, pain and an inability to communicate WASH needs are in and of themselves significant barriers to adequate WASH access. Understanding these access barriers is important for the WASH sector at a time when there is a global push for equitable access. PMID:27171520

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

PubMed

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

2013-04-20

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

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.

Measuring and reducing college students' procrastination.

PubMed

Perrin, Christopher J; Miller, Neal; Haberlin, Alayna T; Ivy, Jonathan W; Meindl, James N; Neef, Nancy A

2011-01-01

We examined college students' procrastination when studying for weekly in-class quizzes. Two schedules of online practice quiz delivery were compared using a multiple baseline design. When online study material was made available noncontingently, students usually procrastinated. When access to additional study material was contingent on completing previous study material, studying was more evenly distributed. Overall, the mean gain in percentage correct scores on weekly in-class quizzes relative to pretests was greater during contingent access than during noncontingent access conditions.

Poor Access for African Researchers to African Emergency Care Publications: A Cross-sectional Study

PubMed Central

Bruijns, Stevan R.; Maesela, Mmapeladi; Sinha, Suniti; Banner, Megan

2017-01-01

Introduction Based on relative population size and burden of disease, emergency care publication outputs from low- and middle-income regions are disproportionately lower than those of high-income regions. Ironically, outputs from regions with higher publication rates are often less relevant in the African context. As a result, the dissemination of and access to local research is essential to local researchers, but the cost of this access (actual and cost-wise) remains unknown. The aim of this study was to describe access to African emergency care publications in terms of publisher-based access (open access or subscription) and alternate access (self-archived or author provided), as well as the cost of access. Methods We conducted a retrospective, cross-sectional study using all emergency medicine publications included in Scopus between 2011 and 2015. A sequential search strategy described access to each article, and we calculated mean article charges against the purchasing power parity index (used to describe out-of-pocket expense). Results We included 666 publications from 49 journals, of which 395 (59.3%) were open access. For subscription-based articles, 106 (39.1%) were self-archived, 60 (22.1%) were author-provided, and 105 (38.8%) were inaccessible. Mean article access cost was $36.44, and mean processing charge was $2,319.34. Using the purchasing power parity index it was calculated that equivalent out-of-pocket expenditure for South African, Ghanaian and Tanzanian authors would respectively be $15.77, $10.44 and $13.04 for access, and $1,004.02, $664.36 and $830.27 for processing. Based on this, the corrected cost of a single-unit article access or process charge for South African, Ghanaian and Tanzanian authors, respectively, was 2.3, 3.5 and 2.8 times higher than the standard rate. Conclusion One in six African emergency care publications are inaccessible outside institutional library subscriptions; additionally, the cost of access to publications in low- and middle-income countries appears prohibitive. Publishers should strongly consider revising pricing for more equitable access for researchers from low- and middle-income countries. PMID:29085532

Poor Access for African Researchers to African Emergency Care Publications: A Cross-sectional Study.

PubMed

Bruijns, Stevan R; Maesela, Mmapeladi; Sinha, Suniti; Banner, Megan

2017-10-01

Based on relative population size and burden of disease, emergency care publication outputs from low- and middle-income regions are disproportionately lower than those of high-income regions. Ironically, outputs from regions with higher publication rates are often less relevant in the African context. As a result, the dissemination of and access to local research is essential to local researchers, but the cost of this access (actual and cost-wise) remains unknown. The aim of this study was to describe access to African emergency care publications in terms of publisher-based access (open access or subscription) and alternate access (self-archived or author provided), as well as the cost of access. We conducted a retrospective, cross-sectional study using all emergency medicine publications included in Scopus between 2011 and 2015. A sequential search strategy described access to each article, and we calculated mean article charges against the purchasing power parity index (used to describe out-of-pocket expense). We included 666 publications from 49 journals, of which 395 (59.3%) were open access. For subscription-based articles, 106 (39.1%) were self-archived, 60 (22.1%) were author-provided, and 105 (38.8%) were inaccessible. Mean article access cost was $36.44, and mean processing charge was $2,319.34. Using the purchasing power parity index it was calculated that equivalent out-of-pocket expenditure for South African, Ghanaian and Tanzanian authors would respectively be $15.77, $10.44 and $13.04 for access, and $1,004.02, $664.36 and $830.27 for processing. Based on this, the corrected cost of a single-unit article access or process charge for South African, Ghanaian and Tanzanian authors, respectively, was 2.3, 3.5 and 2.8 times higher than the standard rate. One in six African emergency care publications are inaccessible outside institutional library subscriptions; additionally, the cost of access to publications in low- and middle-income countries appears prohibitive. Publishers should strongly consider revising pricing for more equitable access for researchers from low- and middle-income countries.

Child welfare professionals' determination of when children's access or potential access to loaded firearms constitutes child neglect.

PubMed

Evans, Erin M; Jennissen, Charles A; Oral, Resmiye; Denning, Gerene M

2017-11-01

Pediatric deaths and injuries from access to firearms are a significant public health problem. No studies have examined how experts determine child neglect regarding firearm access in the home. Our study objectives were to identify factors that influenced pediatric experts' finding of firearm-related child neglect and to assess their attitudes toward child access prevention (CAP) laws. A survey was distributed to the American Academy of Pediatrics Section on Child Abuse and Neglect members. Demographics, attitudes regarding CAP laws, and ages (up to 14 years old) at which experts deemed several scenarios as child neglect were determined. Scenarios tested potential versus actual loaded firearm access, presence or absence of a CAP law, and injury versus no injury when the firearm was accessed. One hundred ninety-three surveys were completed. Experts agreed (>95%) that CAP laws were important, even for children up to age 15 years. Although a high percentage considered potential access to a loaded firearm as child neglect, a CAP law significantly increased the percentage for each age. In addition, higher percentages of respondents from states with CAP laws than those without deemed potential access as child neglect for 12- and 14-year-olds. In contrast, if the child had accessed a loaded firearm, there were no significant differences in the high percentages that deemed the scenario as child neglect under any conditions, including with and without a CAP law. Although almost all child neglect experts considered potential and actual access to loaded firearms as child neglect, CAP laws increased the percentage for cases of potential access. Universal CAP laws may help ensure that determinations of child neglect are more consistent across states. The deterrent effect of potential child neglect findings may increase the number of parents securing firearms in ways that prevent child access and reduce firearm-related deaths and injuries. Epidemiologic study, level III.

[Does open access publishing increase the impact of scientific articles? An empirical study in the field of intensive care medicine].

PubMed

Riera, M; Aibar, E

2013-05-01

Some studies suggest that open access articles are more often cited than non-open access articles. However, the relationship between open access and citations count in a discipline such as intensive care medicine has not been studied to date. The present article analyzes the effect of open access publishing of scientific articles in intensive care medicine journals in terms of citations count. We evaluated a total of 161 articles (76% being non-open access articles) published in Intensive Care Medicine in the year 2008. Citation data were compared between the two groups up until April 30, 2011. Potentially confounding variables for citation counts were adjusted for in a linear multiple regression model. The median number (interquartile range) of citations of non-open access articles was 8 (4-12) versus 9 (6-18) in the case of open access articles (p=0.084). In the highest citation range (>8), the citation count was 13 (10-16) and 18 (13-21) (p=0.008), respectively. The mean follow-up was 37.5 ± 3 months in both groups. In the 30-35 months after publication, the average number (mean ± standard deviation) of citations per article per month of non-open access articles was 0.28 ± 0.6 versus 0.38 ± 0.7 in the case of open access articles (p=0.043). Independent factors for citation advantage were the Hirsch index of the first signing author (β=0.207; p=0.015) and open access status (β=3.618; p=0.006). Open access publishing and the Hirsch index of the first signing author increase the impact of scientific articles. The open access advantage is greater for the more highly cited articles, and appears in the 30-35 months after publication. Copyright © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.

Accessible Near-Earth Objects (NEOs)

NASA Technical Reports Server (NTRS)

Barbee, Brent W.

2015-01-01

Near Earth Objects (NEOs) are asteroids and comets whose orbits are in close proximity to Earth's orbit; specifically, they have perihelia less than 1.3 astronomical units. NEOs particularly near Earth asteroids (NEAs) are identified as potential destinations for future human exploration missions. In this presentation I provide an overview of the current state of knowledge regarding the astrodynamical accessibility of NEAs according to NASA's Near Earth Object Human Space Flight Accessible Targets Study (NHATS). I also investigate the extremes of NEA accessibility using case studies and illuminate the fact that a space-based survey for NEOs is essential to expanding the set of known accessible NEAs for future human exploration missions.

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

PubMed

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

2017-08-22

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

Access to Effective Teaching for Disadvantaged Students. NCEE 2014-4001

ERIC Educational Resources Information Center

Isenberg, Eric; Max, Jeffrey; Gleason, Philip; Potamites, Liz; Santillano, Robert; Hock, Heinrich; Hansen, Michael

2013-01-01

Recent federal initiatives emphasize measuring teacher effectiveness and ensuring that disadvantaged students have equal access to effective teachers. This study substantially broadens the existing evidence on access to effective teaching by examining access in 29 geographically dispersed school districts over the 2008-2009 to 2010-2011 school…

7 CFR 1789.160 - Access to information.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 12 2014-01-01 2013-01-01 true Access to information. 1789.160 Section 1789.160... Consultant Services Funded by Borrowers-General § 1789.160 Access to information. The Borrower shall not have rights in nor right of access to the work product of the Consultant. All analyses, studies, opinions...

Website Accessibility for Users with Visual Impairment

ERIC Educational Resources Information Center

Smith, J. A.; Lind, M. R.

2010-01-01

In this web accessibility study of homepages of education departments in post-secondary educational institutions, the 1998 US Section 508 Law regarding webpage accessibility for people with disabilities was addressed. Along with the requirements of this legislation, there are growing demands for web accessibility resulting from age-related visual…

A Quest for Website Accessibility in Higher Education Institutions

ERIC Educational Resources Information Center

Harper, Kelly A.; DeWaters, Jamie

2008-01-01

Researchers increasingly suggest that accessibility remains a prominent issue across the World Wide Web (www). This study raises awareness about issues of access in higher education. This qualitative research design utilized a listserv that invited university based webmasters to use freeware to evaluate the overall accessibility of their…

K-12 Technology Accessibility: The Message from State Governments

ERIC Educational Resources Information Center

Shaheen, Natalie L.; Lazar, Jonathan

2018-01-01

This study examined state education technology plans and technology accessibility statutes to attempt to answer the question--is K-12 instructional technology accessibility discussed in state-level technology accessibility statutes and education technology plans across the 50 United States? When a K-12 school district is planning the construction…

Student Empowerment. The Influence of High Computer Access on Student Empowerment (An Exploratory Study of the Nashville ACOT Site). ACOT Report #1.

ERIC Educational Resources Information Center

Fisher, Charles W.

This study identifies classroom conditions that affect student empowerment and examines the relationship between student empowerment and high computer access (HCA). The study involved observation in two fourth grade classrooms--one week in an ACOT classroom (with high computer access), and one week in a non-ACOT classroom (without high computer…

The pervasive crisis of diminishing radiation therapy access for vulnerable populations in the United States, part 1: African-American patients.

PubMed

McClelland, Shearwood; Page, Brandi R; Jaboin, Jerry J; Chapman, Christina H; Deville, Curtiland; Thomas, Charles R

2017-01-01

African Americans experience the highest burden of cancer incidence and mortality in the United States and have been persistently less likely to receive interventional care, even when such care has been proven superior to conservative management by randomized controlled trials. The presence of disparities in access to radiation therapy (RT) for African American cancer patients has rarely been examined in an expansive fashion. An extensive literature search was performed using the PubMed database to examine studies investigating disparities in RT access for African Americans. A total of 55 studies were found, spanning 11 organ systems. Disparities in access to RT for African Americans were most prominently study in cancers of the breast (23 studies), prostate (7 studies), gynecologic system (5 studies), and hematologic system (5 studies). Disparities in RT access for African Americans were prevalent regardless of organ system studied and often occurred independently of socioeconomic status. Fifty of 55 studies (91%) involved analysis of a population-based database such as Surveillance, Epidemiology and End Result (SEER; 26 studies), SEER-Medicare (5 studies), National Cancer Database (3 studies), or a state tumor registry (13 studies). African Americans in the United States have diminished access to RT compared with Caucasian patients, independent of but often in concert with low socioeconomic status. These findings underscore the importance of finding systemic and systematic solutions to address these inequalities to reduce the barriers that patient race provides in receipt of optimal cancer care.

Community-based interventions for enhancing access to or consumption of fruit and vegetables among five to 18-year olds: a scoping review

PubMed Central

2012-01-01

Background Low fruit and vegetable ( FV) consumption is a key risk factor for morbidity and mortality. Consumption of FV is limited by a lack of access to FV. Enhanced understanding of interventions and their impact on both access to and consumption of FV can provide guidance to public health decision-makers. The purpose of this scoping review is to identify and map literature that has evaluated effects of community-based interventions designed to increase FV access or consumption among five to 18-year olds. Methods The search included 21 electronic bibliographic databases, grey literature, targeted organization websites, and 15 key journals for relevant studies published up to May 2011. Retrieved citations were screened in duplicate for relevance. Data extracted from included studies covered: year, country, study design, target audience, intervention setting, intervention strategies, interventionists, and reported outcomes. Results The search located 19,607 unique citations. Full text relevance screening was conducted on 1,908 studies. The final 289 unique studies included 30 knowledge syntheses, 27 randomized controlled trials, 55 quasi-experimental studies, 113 cluster controlled studies, 60 before-after studies, one mixed method study, and three controlled time series studies. Of these studies, 46 included access outcomes and 278 included consumption outcomes. In terms of target population, 110 studies focused on five to seven year olds, 175 targeted eight to 10 year olds, 192 targeted 11 to 14 year olds, 73 targeted 15 to 18 year olds, 55 targeted parents, and 30 targeted teachers, other service providers, or the general public. The most common intervention locations included schools, communities or community centres, and homes. Most studies implemented multi-faceted intervention strategies to increase FV access or consumption. Conclusions While consumption measures were commonly reported, this review identified a small yet important subset of literature examining access to FV. This is a critically important issue since consumption is contingent upon access. Future research should examine the impact of interventions on direct outcome measures of FV access and a focused systematic review that examines these interventions is also needed. In addition, research on interventions in low- and middle-income countries is warranted based on a limited existing knowledge base. PMID:22931474

The Effects of Promoting Patient Access to Medical Records: A Review

PubMed Central

Ross, Stephen E.; Lin, Chen-Tan

2003-01-01

The Health Insurance Privacy and Portability Act (HIPPA) stipulates that patients must be permitted to review and amend their medical records. As information technology makes medical records more accessible to patients, it may become more commonplace for patients to review their records routinely. This article analyzes the potential benefits and drawbacks of facilitating patient access to the medical record by reviewing previously published research. Previous research includes analysis of clinical notes, surveys of patients and practitioners, and studies of patient-accessible medical records. Overall, studies suggest the potential for modest benefits (for instance, in enhancing doctor-patient communication). Risks (for instance, increasing patient worry or confusion) appear to be minimal in medical patients. The studies, however, were of limited quality and low statistical power to detect the variety of outcomes that may result from implementation of a patient-accessible medical record. The data from these studies lay the foundation for future research. PMID:12595402

He just wants to play: how goals determine the influence of violent computer games on aggression.

PubMed

Denzler, Markus; Häfner, Michael; Förster, Jens

2011-12-01

Generally, the accessibility of goal-related constructs is inhibited upon goal fulfillment. In line with this notion, the current studies explored whether violent computer games may reduce relative accessibility of aggression if the game involves the fulfillment of an aggressive goal. Specifically, in Study 1, participants who watched a trailer for a violent computer game that fulfilled the goal of venting anger showed less relative accessibility of aggression compared to participants who watched the trailer without goal fulfillment. In Study 2, actually playing a violent computer game to vent anger also decreased the relative accessibility of aggression compared to a control condition in which the game was played without such a goal. Lastly, in Study 3, the relative accessibility of aggression was reduced after playing a violent computer game for participants who reported a high general tendency to vent their anger.

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

PubMed

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

2011-01-01

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

Update on Virginia College Access Provider Activity

ERIC Educational Resources Information Center

Corning, Amy; Senechal, Jesse; Hutton, Amy

2015-01-01

In the fall of 2008, the State Council of Higher Education for Virginia (SCHEV) commissioned a research study comparing the college access provider resources in Virginia to the access and academic achievement needs of the state. That study--conducted by researchers from the College of William and Mary and West Carolina University--resulted in the…

Access to Higher Education in Chile: A Public vs. Private Analysis

ERIC Educational Resources Information Center

Espinoza, Oscar; González, Luis Eduardo

2013-01-01

This study analyzes how access to public and private institutions of higher education in Chile has changed as the post-secondary system has become increasingly privatized. It analyses access by young people to higher education from four perspectives: funding type (public/private), gender, family income level, and ethnicity. The study uses…

The Knuckle-Cracker's Dilemma: A Transaction Log Study of OPAC Subject Searching.

ERIC Educational Resources Information Center

Ferl, Terry Ellen; Milsap, Larry

1996-01-01

Researchers studying subject searching distributed an online questionnaire to users who access the University of California's online public access catalog, MELVYL, from public access terminals in the libraries of the University of California at Santa Cruz. This article discusses the results of transaction log analysis, comparison of in-library and…

Accessible Adult Learning in the Health Professions: Interactive Uses of Distance Technology.

ERIC Educational Resources Information Center

Townsend, Elizabeth; Curran-Smith, Janet

This paper describes a study of students' perceptions of the impact of accessibility and interactivity on successful distance education in the Health Professions. The study utilized both quantitative and qualitative data to determine how students perceived issues of accessibility and interactivity affecting their success in distance courses. The…

College Prep and Access from the Perspective of Diversity College Admission Professionals

ERIC Educational Resources Information Center

Bethea, Kathryn A.

2016-01-01

Studies have found that there is a college access gap for students of color in P-16 education. I utilize Perna's (2006) integrated college access model in exploring college admission's knowledge of college preparation in education. The present study uses qualitative questionnaires to measure diversity college admission professionals' (DCAPs)…

Predictors of Health Service Barriers for Older Chinese Immigrants in Canada

ERIC Educational Resources Information Center

Lai, Daniel W. L.; Chau, Shirley B. Y.

2007-01-01

Elderly people from ethnic minority groups often experience different barriers in accessing health services. Earlier studies on access usually focused on types and frequency but failed to address the predictors of service barriers. This study examined access barriers to health services faced by older Chinese immigrants in Canada. Factor analysis…

Non-Selective Lexical Access in Different-Script Bilinguals

ERIC Educational Resources Information Center

Moon, Jihye; Jiang, Nan

2012-01-01

Lexical access in bilinguals is known to be largely non-selective. However, most studies in this area have involved bilinguals whose two languages share the same script. This study aimed to examine bilingual lexical access among bilinguals whose two languages have distinct scripts. Korean-English bilinguals were tested in a phoneme monitoring task…

Systemic barriers accessing HIV treatment among people who inject drugs in Russia: a qualitative study.

PubMed

Sarang, Anya; Rhodes, Tim; Sheon, Nicolas

2013-10-01

Achieving 'universal access' to antiretroviral HIV treatment (ART) in lower income and transitional settings is a global target. Yet, access to ART is shaped by local social condition and is by no means universal. Qualitative studies are ideally suited to describing how access to ART is socially situated. We explored systemic barriers to accessing ART among people who inject drugs (PWID) in a Russian city (Ekaterinburg) with a large burden of HIV treatment demand. We undertook 42 in-depth qualitative interviews with people living with HIV with current or recent experience of injecting drug use. Accounts were analysed thematically, and supplemented here with an illustrative case study. Three core themes were identified: 'labyrinthine bureaucracy' governing access to ART; a 'system Catch 22' created by an expectation that access to ART was conditional upon treated drug use in a setting of limited drug treatment opportunity; and 'system verticalization', where a lack of integration across HIV, tuberculosis (TB) and drug treatment compromised access to ART. Taken together, we find that systemic factors play a key role in shaping access to ART with the potential adverse effects of reproducing treatment initiation delay and disengagement from treatment. We argue that meso-level systemic factors affecting access to ART for PWID interact with wider macro-level structural forces, including those related to drug treatment policy and the social marginalization of PWID. We note the urgent need for systemic and structural changes to improve access to ART for PWID in this setting, including to simplify bureaucratic procedures, foster integrated HIV, TB and drug treatment services, and advocate for drug treatment policy reform.

Spatial accessibility to healthcare services in Shenzhen, China: improving the multi-modal two-step floating catchment area method by estimating travel time via online map APIs.

PubMed

Tao, Zhuolin; Yao, Zaoxing; Kong, Hui; Duan, Fei; Li, Guicai

2018-05-09

Shenzhen has rapidly grown into a megacity in the recent decades. It is a challenging task for the Shenzhen government to provide sufficient healthcare services. The spatial configuration of healthcare services can influence the convenience for the consumers to obtain healthcare services. Spatial accessibility has been widely adopted as a scientific measurement for evaluating the rationality of the spatial configuration of healthcare services. The multi-modal two-step floating catchment area (2SFCA) method is an important advance in the field of healthcare accessibility modelling, which enables the simultaneous assessment of spatial accessibility via multiple transport modes. This study further develops the multi-modal 2SFCA method by introducing online map APIs to improve the estimation of travel time by public transit or by car respectively. As the results show, the distribution of healthcare accessibility by multi-modal 2SFCA shows significant spatial disparity. Moreover, by dividing the multi-modal accessibility into car-mode and transit-mode accessibility, this study discovers that the transit-mode subgroup is disadvantaged in the competition for healthcare services with the car-mode subgroup. The disparity in transit-mode accessibility is the main reason of the uneven pattern of healthcare accessibility in Shenzhen. The findings suggest improving the public transit conditions for accessing healthcare services to reduce the disparity of healthcare accessibility. More healthcare services should be allocated in the eastern and western Shenzhen, especially sub-districts in Dapeng District and western Bao'an District. As these findings cannot be drawn by the traditional single-modal 2SFCA method, the advantage of the multi-modal 2SFCA method is significant to both healthcare studies and healthcare system planning.

Distributed clinical data sharing via dynamic access-control policy transformation.

PubMed

Rezaeibagha, Fatemeh; Mu, Yi

2016-05-01

Data sharing in electronic health record (EHR) systems is important for improving the quality of healthcare delivery. Data sharing, however, has raised some security and privacy concerns because healthcare data could be potentially accessible by a variety of users, which could lead to privacy exposure of patients. Without addressing this issue, large-scale adoption and sharing of EHR data are impractical. The traditional solution to the problem is via encryption. Although encryption can be applied to access control, it is not applicable for complex EHR systems that require multiple domains (e.g. public and private clouds) with various access requirements. This study was carried out to address the security and privacy issues of EHR data sharing with our novel access-control mechanism, which captures the scenario of the hybrid clouds and need of access-control policy transformation, to provide secure and privacy-preserving data sharing among different healthcare enterprises. We introduce an access-control mechanism with some cryptographic building blocks and present a novel approach for secure EHR data sharing and access-control policy transformation in EHR systems for hybrid clouds. We propose a useful data sharing system for healthcare providers to handle various EHR users who have various access privileges in different cloud environments. A systematic study has been conducted on data sharing in EHR systems to provide a solution to the security and privacy issues. In conclusion, we introduce an access-control method for privacy protection of EHRs and EHR policy transformation that allows an EHR access-control policy to be transformed from a private cloud to a public cloud. This method has never been studied previously in the literature. Furthermore, we provide a protocol to demonstrate policy transformation as an application scenario. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

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

PubMed Central

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

2016-01-01

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

The ICF: International Classification of Functioning, Disability and Health (ICF)--a Swiss army knife? Accessibility and disability in a Scandinavian disability magazine (SDM)--a quantitative content analysis.

PubMed

Lundälv, Jörgen; Larsson, Per-Olof; Törnbom, Marie; Sunnerhagen, Katharina Stibrant

2012-11-01

The study describes the extent to which the concept of accessibility and accessibility issues has been reported in a national Scandinavian disability magazine. In this study particular attention is paid to how the compatibility between the various domains of the international classification - International Classification of Functioning, Disability and Health (ICF) - has been covered in the magazine over a decade. Furthermore, other types of descriptions that the magazine has made of accessibility for people with physical disabilities are considered. The study is based on a quantitative content analysis of a total of 326 articles from the Swedish disability magazine (SDM); 450 text pages published during the years 2000-2009. The magazine's coverage has been comprehensive. More than half of the studied texts were news items about various accessibility issues. Every third article can be characterised as a news article or feature article. The most frequently reported of the ICF domains consist of two perspectives: environmental accessibility and civil rights. Public opinion articles in the form of letters to editors and editorials focused on accessibility have a low frequency. Likewise, research reports are few. The study has included a review of illustrations and photographs. The illustrations are generally of high quality, reinforcing the disability message of the article. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

Technological advancements and Internet sexuality: does private access to the Internet influence online sexual behavior?

PubMed

Daneback, Kristian; Månsson, Sven-Axel; Ross, Michael W

2012-08-01

The aim of this study was to investigate whether demographic characteristics and sexual behavior online and offline were associated with private, respectively, nonprivate access to the Internet in a Web sample of people who use the Internet for sexual purposes. A total of 1,913 respondents completed an online questionnaire about Internet sexuality, and 1,614 reported using the Internet for sexual purposes. The majority of these respondents reported having access to an Internet-connected computer no one else had access to (62 percent women and 70 percent men). The results showed that it is possible to differentiate between those who have access to an Internet-connected computer no one else has access to and those who have shared access to an Internet-connected computer. Not only did they differ in demographic characteristics, but also in the sexual activities they engaged in on the Internet. Different patterns were found for women and men. For example, men who had private access to Internet-connected computers were more likely than those who had shared access to seek information about sexual issues. Thus, having access to Internet computers no one else has access to may promote sexual knowledge and health for men. The results of this study along with the technological development implies that in future research, attention should be paid to where and how people access the Internet in relation to online behavior in general and online sexual behavior in particular.

Technological Advancements and Internet Sexuality: Does Private Access to the Internet Influence Online Sexual Behavior?

PubMed Central

Månsson, Sven-Axel; Ross, Michael W.

2012-01-01

Abstract The aim of this study was to investigate whether demographic characteristics and sexual behavior online and offline were associated with private, respectively, nonprivate access to the Internet in a Web sample of people who use the Internet for sexual purposes. A total of 1,913 respondents completed an online questionnaire about Internet sexuality, and 1,614 reported using the Internet for sexual purposes. The majority of these respondents reported having access to an Internet-connected computer no one else had access to (62 percent women and 70 percent men). The results showed that it is possible to differentiate between those who have access to an Internet-connected computer no one else has access to and those who have shared access to an Internet-connected computer. Not only did they differ in demographic characteristics, but also in the sexual activities they engaged in on the Internet. Different patterns were found for women and men. For example, men who had private access to Internet-connected computers were more likely than those who had shared access to seek information about sexual issues. Thus, having access to Internet computers no one else has access to may promote sexual knowledge and health for men. The results of this study along with the technological development implies that in future research, attention should be paid to where and how people access the Internet in relation to online behavior in general and online sexual behavior in particular. PMID:22823598

Electronic doors to education: study of high school website accessibility in Iowa.

PubMed

Klein, David; Myhill, William; Hansen, Linda; Asby, Gary; Michaelson, Susan; Blanck, Peter

2003-01-01

The Americans with Disabilities Act (ADA), and Sections 504 and 508 of the Rehabilitation Act, prohibit discrimination against people with disabilities in all aspects of daily life, including education, work, and access to places of public accommodations. Increasingly, these antidiscrimination laws are used by persons with disabilities to ensure equal access to e-commerce, and to private and public Internet websites. To help assess the impact of the anti-discrimination mandate for educational communities, this study examined 157 website home pages of Iowa public high schools (52% of high schools in Iowa) in terms of their electronic accessibility for persons with disabilities. We predicted that accessibility problems would limit students and others in obtaining information from the web pages as well as limiting ability to navigate to other web pages. Findings show that although many web pages examined included information in accessible formats, none of the home pages met World Wide Web Consortium (W3C) standards for accessibility. The most frequent accessibility problem was lack of alternative text (ALT tags) for graphics. Technical sophistication built into pages was found to reduce accessibility. Implications are discussed for schools and educational institutions, and for laws, policies, and procedures on website accessibility. Copyright 2003 John Wiley & Sons, Ltd.

Access block in NSW hospitals, 1999-2001: does the definition matter?

PubMed

Forero, Roberto; Mohsin, Mohammed; Bauman, Adrian E; Ieraci, Sue; Young, Lis; Phung, Hai N; Hillman, Kenneth M; McCarthy, Sally M; Hugelmeyer, C David

2004-01-19

To estimate the magnitude of access block and its trend over time in New South Wales hospitals, using different definitions of access block, and to explore its association with clinical and non-clinical factors. An epidemiological study using the Emergency Department Information System datasets (1 January 1999 to 31 December 2001) from a sample of 55 NSW hospitals. Prevalence of access block measured by four different definitions; strength of association between access block, type of hospital, year of presentation, mode and time of arrival, triage category (an indicator of urgency), age and sex. Rates of access block (for all four definitions) increased between 1999 and 2001 by 1%-2% per year. There were increases across all regions of NSW, but urban regions in particular. Patients presenting to Principal Referral hospitals and those who arrived at night were more likely to experience access block. After adjusting for triage category and year of presentation, the mode of arrival, time of arrival, type of hospital, age and sex were significantly associated with access block. Access block continues to increase across NSW, whatever the definition used. We recommend that hospitals in NSW and Australia move to the use of one standard definition of access block, as our study suggests there is no significant additional information emerging from the use of multiple definitions.

Evidence that attitude accessibility augments the relationship between speeding attitudes and speeding behavior: a test of the MODE model in the context of driving.

PubMed

Elliott, Mark A; Lee, Emme; Robertson, Jamie S; Innes, Rhona

2015-01-01

According to the MODE model of attitude-to-behavior processes, attitude accessibility augments attitude-behavior correspondence, reflecting an automatic influence of attitudes on behavior. We therefore tested whether attitude accessibility moderates the attitude-behavior relationship in a context that is governed by characteristically automatic behavior, namely driving. In study 1 (correlational design), participants (N=130) completed online questionnaire measures of the valences and accessibilities of their attitudes towards speeding. Two weeks later, online questionnaire measures of subsequent speeding behavior were obtained. Attitude valence was a significantly better predictor of behavior at high (mean+1SD) versus low (mean-1SD) levels of attitude accessibility. In study 2 (experimental design), attitude accessibility was manipulated with a repeated attitude expression task. Immediately after the manipulation, participants (N=122) completed online questionnaire measures of attitude valence and accessibility, and two weeks later, subsequent speeding behavior. Increased attitude accessibility in the experimental (versus control) condition generated an increase in attitude-behavior correspondence. The findings are consistent with the MODE model's proposition that attitudes can exert an automatic influence on behavior. Interventions to reduce speeding could usefully increase the accessibility of anti-speeding attitudes and reduce the accessibility of pro-speeding attitudes. Copyright © 2014 Elsevier Ltd. All rights reserved.

"Where to find those doctors?" A qualitative study on barriers and facilitators in access to and utilization of health care services by Polish migrants in Norway.

PubMed

Czapka, Elżbieta Anna; Sagbakken, Mette

2016-09-01

Poles constitute the largest group of migrants in Norway. Research confirms a steady inflow and a minimal outflow of Polish migrants. One of the key aspects of migrants' structural integration is access to health care services. This study explored barriers to and facilitators of Polish migrants' access to Norwegian health care services. A qualitative interview-based study was carried out between November 2013 and July 2014. The study is part of a larger, ongoing mixed-method study of Polish migrants' access to health care services in Norway. Semi-structured interviews were conducted with 19 Polish migrants in Oslo. The interviews were transcribed, coded, and analyzed. Thematic analysis was performed to identify barriers and facilitators related to the use of Norwegian health care services. Migrants experienced several barriers to and facilitators of access to health care services in Norway. The barriers most often mentioned were problems resulting from insufficient command of the language, related communication problems, and lack of knowledge about navigating the Norwegian health care system. Other barriers related to the organization of the health care system, perceptions of doctors' skills and practices, and attitudes among health personnel. Factors such as having a Polish social network, meeting friendly health personnel, and perceptions of equal treatment of all patients, facilitated access to and use of health care services. The study shows that there are both system- and patient-related barriers to and facilitators of migrants' access to health services in Norway. These findings suggest that successful inclusion of migrants into the Norwegian health system requires regular evaluation of access and utilization of health care services.

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.

Direct access compared with referred physical therapy episodes of care: a systematic review.

PubMed

Ojha, Heidi A; Snyder, Rachel S; Davenport, Todd E

2014-01-01

Evidence suggests that physical therapy through direct access may help decrease costs and improve patient outcomes compared with physical therapy by physician referral. The purpose of this study was to conduct a systematic review of the literature on patients with musculoskeletal injuries and compare health care costs and patient outcomes in episodes of physical therapy by direct access compared with referred physical therapy. Ovid MEDLINE, CINAHL (EBSCO), Web of Science, and PEDro were searched using terms related to physical therapy and direct access. Included articles were hand searched for additional references. Included studies compared data from physical therapy by direct access with physical therapy by physician referral, studying cost, outcomes, or harm. The studies were appraised using the Centre for Evidence-Based Medicine (CEBM) levels of evidence criteria and assigned a methodological score. Of the 1,501 articles that were screened, 8 articles at levels 3 to 4 on the CEBM scale were included. There were statistically significant and clinically meaningful findings across studies that satisfaction and outcomes were superior, and numbers of physical therapy visits, imaging ordered, medications prescribed, and additional non-physical therapy appointments were less in cohorts receiving physical therapy by direct access compared with referred episodes of care. There was no evidence for harm. There is evidence across level 3 and 4 studies (grade B to C CEBM level of recommendation) that physical therapy by direct access compared with referred episodes of care is associated with improved patient outcomes and decreased costs. Primary limitations were lack of group randomization, potential for selection bias, and limited generalizability. Physical therapy by way of direct access may contain health care costs and promote high-quality health care. Third-party payers should consider paying for physical therapy by direct access to decrease health care costs and incentivize optimal patient outcomes.

A team approach to improving colorectal cancer services using administrative health data.

PubMed

Porter, Geoffrey; Urquhart, Robin; Bu, Jingyu; Kendell, Cynthia; Macintyre, Maureen; Dewar, Ron; Kephart, George; Asada, Yukiko; Grunfeld, Eva

2012-01-31

Colorectal cancer (CRC) is the third most commonly diagnosed cancer in Canada and accounts for 11.9% of all cancer-related mortality. Fortunately, previous studies have provided evidence of improved outcomes from access to timely and appropriate health services along the disease trajectory in CRC. As a result, the CIHR/CCNS Team in Access to Colorectal Cancer Services in Nova Scotia (Team ACCESS) was created to build colorectal cancer (CRC) research capacity in Nova Scotia (NS) and to study access to and quality of CRC services along the entire continuum of cancer care. The objectives of this paper are to: 1) provide a detailed description of the methodologies employed across the various studies being conducted by Team ACCESS; 2) demonstrate how administrative health data can be used to evaluate access and quality in CRC services; and 3) provide an example of an interdisciplinary team approach to addressing health service delivery issues. All patients diagnosed with CRC in NS between 2001 and 2005 were identified through the Nova Scotia Cancer Registry (NSCR) and staged using the Collaborative Stage Data Collection System. Using administrative databases that were linked at the patient level, Team ACCESS created a retrospective longitudinal cohort with comprehensive demographic, clinical, and healthcare utilization data. These data were used to examine access to and quality of CRC services in NS, as well as factors affecting access to and quality of care, at various transition points along the continuum of care. Team ACCESS has also implemented integrated knowledge translation strategies targeting policy- and decision- makers. The development of Team ACCESS represents a unique approach to CRC research. We anticipate that the skills, tools, and knowledge generated from our work will also advance the study of other cancer disease sites in NS. Given the increasing prevalence of cancer, and with national and provincial funding agencies promoting collaborative research through increased funding for research team development, the work carried out by Team ACCESS is important in the Canadian context and exemplifies how a team approach is essential to comprehensively addressing issues surrounding not only cancer, but other chronic diseases in Canada.

Trends in access to water supply and sanitation in 31 major sub-Saharan African cities: an analysis of DHS data from 2000 to 2012.

PubMed

Hopewell, Mike R; Graham, Jay P

2014-02-28

By 2050, sub-Saharan Africa's (SSA) urban population is expected to grow from 414 million to over 1.2 billion. This growth will likely increase challenges to municipalities attempting to provide access to water supply and sanitation (WS&S). This study aims to characterize trends in access to WS&S in SSA cities and identify factors affecting those trends. DHS data collected between 2000 and 2012 were used for this analysis of thirty-one cities in SSA. Four categories of household access to WS&S were studied using data from demographic and health surveys--these included: 1) household access to an improved water supply, 2) household's time spent collecting water, 3) household access to improved sanitation, and 4) households reporting to engage in open defecation. An exploratory analysis of these measures was then conducted to assess the relationship of access to several independent variables. Among the 31 cities, there was wide variability in coverage levels and trends in coverage with respect to the four categories of access. The majority of cities were found to be increasing access in the categories of improved water supply and improved sanitation (65% and 83% of cities, respectively), while fewer were making progress in reducing the amount of time spent collecting water and reducing open defecation (50% and 38% of cities, respectively). Additionally, the prevalence of open defecation in study cities was found to be, on average, increasing. Based on DHS data, cities appeared to be making the most progress in gaining access to WS&S along metrics which reflect specified targets of the Millennium Development Goals. Nearly half of the cities, however, did not make progress in reducing open defecation or the time spent collecting water. This may reflect that the MDGs have led to a focus on "improved" services while other measures, potentially more relevant to the extreme poor, are being neglected. This study highlights the need to better characterize access, beyond definitions of improved and unimproved, as well as the need to target resources to cities where changes in WS&S access have stalled, or in some cases regressed.

Access to Strong Opioid Analgesics in the Context of Legal and Regulatory Barriers in Eleven Central and Eastern European Countries.

PubMed

Vranken, Marjolein J M; Mantel-Teeuwisse, Aukje K; Schutjens, Marie-Hélène D B; Scholten, Willem K; Jünger, Saskia; Medic, Dr Rer; Leufkens, Hubert G M

2018-04-06

In 2011-2013, >95% of the global opioid analgesics consumption occurred in three regions, accounting for 15% of the world population. Despite abundant literature on barriers to access, little is known on the correlation between actual access to opioid analgesics and barriers to access, including legal and regulatory barriers. This study aimed to evaluate the correlation between access to strong opioid analgesics and barriers to access in national legislation and regulations in 11 central and eastern European countries that participated in the Access to Opioid Medication in Europe (ATOME) project. Two variables were contrasted to assess their correlation: the country level of access to strong opioid analgesics indicated by the Adequacy of Consumption Measure (ACM) and the number of potential legal and regulatory barriers identified by an external review of legislation and regulations. A linear correlation was evaluated using a squared linear correlation coefficient. Evaluation of the correlation between the ACM and the number of potential barriers produces an R 2 value of 0.023 and a correlation plot trend line gradient of -0.075, indicating no correlation between access to strong opioid analgesics and the number of potential barriers in national legislation and regulations in the countries studied. No correlation was found, which indicates that other factors besides potential legal and regulatory barriers play a critical role in withholding prescribers and patients essential pain medication in the studied countries. More research is needed toward better understanding of the complex interplay of factors that determine access to strong opioid analgesics.

Assessing Impacts on Unplanned Hospitalisations of Care Quality and Access Using a Structural Equation Method: With a Case Study of Diabetes

PubMed Central

Congdon, Peter

2016-01-01

Background: Enhanced quality of care and improved access are central to effective primary care management of long term conditions. However, research evidence is inconclusive in establishing a link between quality of primary care, or access, and adverse outcomes, such as unplanned hospitalisation. Methods: This paper proposes a structural equation model for quality and access as latent variables affecting adverse outcomes, such as unplanned hospitalisations. In a case study application, quality of care (QOC) is defined in relation to diabetes, and the aim is to assess impacts of care quality and access on unplanned hospital admissions for diabetes, while allowing also for socio-economic deprivation, diabetes morbidity, and supply effects. The study involves 90 general practitioner (GP) practices in two London Clinical Commissioning Groups, using clinical quality of care indicators, and patient survey data on perceived access. Results: As a single predictor, quality of care has a significant negative impact on emergency admissions, and this significant effect remains when socio-economic deprivation and morbidity are allowed. In a full structural equation model including access, the probability that QOC negatively impacts on unplanned admissions exceeds 0.9. Furthermore, poor access is linked to deprivation, diminished QOC, and larger list sizes. Conclusions: Using a Bayesian inference methodology, the evidence from the analysis is weighted towards negative impacts of higher primary care quality and improved access on unplanned admissions. The methodology of the paper is potentially applicable to other long term conditions, and relevant when care quality and access cannot be measured directly and are better regarded as latent variables. PMID:27598184

Assessing Impacts on Unplanned Hospitalisations of Care Quality and Access Using a Structural Equation Method: With a Case Study of Diabetes.

PubMed

Congdon, Peter

2016-09-01

Enhanced quality of care and improved access are central to effective primary care management of long term conditions. However, research evidence is inconclusive in establishing a link between quality of primary care, or access, and adverse outcomes, such as unplanned hospitalisation. This paper proposes a structural equation model for quality and access as latent variables affecting adverse outcomes, such as unplanned hospitalisations. In a case study application, quality of care (QOC) is defined in relation to diabetes, and the aim is to assess impacts of care quality and access on unplanned hospital admissions for diabetes, while allowing also for socio-economic deprivation, diabetes morbidity, and supply effects. The study involves 90 general practitioner (GP) practices in two London Clinical Commissioning Groups, using clinical quality of care indicators, and patient survey data on perceived access. As a single predictor, quality of care has a significant negative impact on emergency admissions, and this significant effect remains when socio-economic deprivation and morbidity are allowed. In a full structural equation model including access, the probability that QOC negatively impacts on unplanned admissions exceeds 0.9. Furthermore, poor access is linked to deprivation, diminished QOC, and larger list sizes. Using a Bayesian inference methodology, the evidence from the analysis is weighted towards negative impacts of higher primary care quality and improved access on unplanned admissions. The methodology of the paper is potentially applicable to other long term conditions, and relevant when care quality and access cannot be measured directly and are better regarded as latent variables.

Comparison of perceived and modelled geographical access to accident and emergency departments: a cross-sectional analysis from the Caerphilly Health and Social Needs Study.

PubMed

Fone, David L; Christie, Stephen; Lester, Nathan

2006-04-13

Assessment of the spatial accessibility of hospital accident and emergency departments as perceived by local residents has not previously been investigated. Perceived accessibility may affect where, when, and whether potential patients attend for treatment. Using data on 11,853 respondents to a population survey in Caerphilly county borough, Wales, UK, we present an analysis comparing the accessibility of accident and emergency departments as reported by local residents and drive-time to the nearest accident and emergency department modelled using a geographical information system (GIS). Median drive-times were significantly shorter in the lowest perceived access category and longer in the best perceived access category (p < 0.001). The perceived access and GIS modelled drive-time variables were positively correlated (Spearman's rank correlation coefficient, r = 0.38, p < 0.01). The strongest correlation was found for respondents living in areas in which nearly all households had a car or van (r = 0.47, p < 0.01). Correlations were stronger among respondents reporting good access to public transport and among those reporting a recent accident and emergency attendance for injury treatment compared to other respondents. Correlation coefficients did not vary substantially by levels of household income. Drive-time, road distance and straight-line distance were highly inter-correlated and substituting road distance or straight-line distance as the GIS modelled spatial accessibility measure only marginally decreased the magnitude of the correlations between perceived and GIS modelled access. This study provides evidence that the accessibility of hospital-based health care services as perceived by local residents is related to measures of spatial accessibility modelled using GIS. For studies that aim to model geographical separation in a way that correlates well with the perception of local residents, there may be minimal advantage in using sophisticated measures. Straight-line distance, which can be calculated without GIS, may be as good as GIS-modelled drive-time or distance for this purpose. These findings will be of importance to health policy makers and local planners who seek to obtain local information on access to services through focussed assessments of residents' concerns over accessibility and GIS modelling.

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

PubMed

McClellan, Sean R; Snowden, Lonnie

2015-01-01

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

Open Access Theses in Institutional Repositories: An Exploratory Study of the Perceptions of Doctoral Students

ERIC Educational Resources Information Center

Stanton, Kate Valentine; Liew, Chern Li

2011-01-01

Introduction: We examine doctoral students' awareness of and attitudes to open access forms of publication. Levels of awareness of open access and the concept of institutional repositories, publishing behaviour and perceptions of benefits and risks of open access publishing were explored. Method: Qualitative and quantitative data were collected…

Open Access Publishing: What Authors Want

ERIC Educational Resources Information Center

Nariani, Rajiv; Fernandez, Leila

2012-01-01

Campus-based open access author funds are being considered by many academic libraries as a way to support authors publishing in open access journals. Article processing fees for open access have been introduced recently by publishers and have not yet been widely accepted by authors. Few studies have surveyed authors on their reasons for publishing…

Almost Halfway There: An Analysis of the Open Access Behaviors of Academic Librarians

ERIC Educational Resources Information Center

Mercer, Holly

2011-01-01

Academic librarians are increasingly expected to advocate for scholarly communications reforms such as open access to scholarly publications, yet librarians do not always practice what they preach. Previous research examined librarian attitudes toward open access, whereas this article presents results of a study of open access publishing and…

Remote Access to CD-ROM for the Distant Learner.

ERIC Educational Resources Information Center

Cutright, Patricia; Girrard, Kenneth M.

1991-01-01

A dial-access, multiuser, multiaccess CD-ROM search system with end-user capability was developed to provide Eastern Oregon State College distance education students with access to the information required by their studies. Based on UNIX, the system provides students with access to 12 databases, an e-mail system for messaging, interlibrary loan…

Black and White Women Managers: Access to Opportunity

ERIC Educational Resources Information Center

Hite, Linda M.

2004-01-01

This study explores the differing views of Black and White female managers regarding access to key career opportunities for White women and women of color. Items addressed include access to hiring, promotions, key assignments, salary increases, acknowledgment for work, and mentors. Access to each is described by comparing White women and women of…

Intraosseous anesthesia in hemodynamic studies in children with cardiopathy.

PubMed

Aliman, Ana Cristina; Piccioni, Marilde de Albuquerque; Piccioni, João Luiz; Oliva, José Luiz; Auler Júnior, José Otávio Costa

2011-01-01

Intraosseous (IO) access has been used with good results in emergency situations, when venous access is not available for fluids and drugs infusion. The objective of this study was to evaluate IO a useful technique for anesthesia and fluids infusion during hemodynamic studies and when peripheral intravascular access is unobtainable. The setting was an university hospital hemodynamics unit, and the subjects were twenty one infants with congenital heart disease enrolled for elective hemodynamic study diagnosis. This study compared the effectiveness of IO access in relation to IV access for infusion of anesthetics agents (ketamine, midazolam, and fentanyl) and fluids during hemodynamic studies. The anesthetic induction time, procedure duration, anesthesia recovery time, adequate hydration, and IV and IO puncture complications were compared between groups. The puncture time was significantly smaller in IO group (3.6 min) that in IV group (9.6 min). The anesthetic onset time (56.3 second) for the IV group was faster than IO group (71.3 second). No significant difference between groups were found in relation to hydration (IV group, 315.5 mL vs IO group, 293.2 mL), and anesthesia recovery time (IO group, 65.2 min vs IV group, 55.0 min). The puncture site was reevaluated after 7 and 15 days without signs of infection or other complications. Results showed superiority for IO infusion when considering the puncture time of the procedure. Due to its easy manipulation and efficiency, hydration and anesthesia by IO access was satisfactory for hemodynamic studies without the necessity of other infusion access. Copyright © 2011 Elsevier Editora Ltda. All rights reserved.

Beyond the trigger: The mental health consequences of in-home firearm access among children of gun owners.

PubMed

Kim, Jinho

2018-04-01

The high prevalence of household firearms in the U.S. has ignited a growing body of research seeking to understand its health consequences. While a large number of studies examine the impact of firearm availability on health risks of gun owners in the household, relatively little attention is given to whether and how in-home firearm access may shape psychological outcomes among children of gun owners. This study examined whether and how in-home firearm access is associated with adolescents' depressive symptoms. Given a strong social/cultural association between masculinity and gun possession as well as stark gender differences in perceptions of safety and attitudes toward firearms, this study also investigated whether this association differs for male and female adolescents. Participants were drawn from the National Longitudinal Study of Adolescent to Adult Health (Add Health) (n = 14,013). This study used random- and fixed-effects regression analyses as well as propensity-score matching models in order to reduce the chances of bias due to individual-level heterogeneity. The present study showed that gaining access to guns at home was significantly related to increased depressive symptoms among children of gun owners, even after accounting for both observed and unobserved individual characteristics. Both fixed-effects and propensity-score matching models yielded consistent results. In addition, the observed association between in-home firearm access and depression was more pronounced for female adolescents. Finally, this study found suggestive evidence that the perceptions of safety, especially about school (but not neighborhood), are an important mechanism linking in-home firearm access to adolescent depression. As a substantial proportion of U.S. adolescents reported in-home firearm access, the findings of this study suggest that scholars and policymakers must seriously consider mental as well as physical health consequences related to household access to firearms among children of gun owners. Copyright © 2017 Elsevier Ltd. All rights reserved.

Provider responses to patients controlling access to their electronic health records: a prospective cohort study in primary care.

PubMed

Tierney, William M; Alpert, Sheri A; Byrket, Amy; Caine, Kelly; Leventhal, Jeremy C; Meslin, Eric M; Schwartz, Peter H

2015-01-01

Applying Fair Information Practice principles to electronic health records (EHRs) requires allowing patient control over who views their data. We designed a program that captures patients' preferences for provider access to an urban health system's EHR. Patients could allow or restrict providers' access to all data (diagnoses, medications, test results, reports, etc.) or only highly sensitive data (sexually transmitted infections, HIV/AIDS, drugs/alcohol, mental or reproductive health). Except for information in free-text reports, we redacted EHR data shown to providers according to patients' preferences. Providers could "break the glass" to display redacted information. We prospectively studied this system in one primary care clinic, noting redactions and when users "broke the glass," and surveyed providers about their experiences and opinions. Eight of nine eligible clinic physicians and all 23 clinic staff participated. All 105 patients who enrolled completed the preference program. Providers did not know which of their patients were enrolled, nor their preferences for accessing their EHRs. During the 6-month prospective study, 92 study patients (88 %) returned 261 times, during which providers viewed their EHRs 126 times (48 %). Providers "broke the glass" 102 times, 92 times for patients not in the study and ten times for six returning study patients, all of whom had restricted EHR access. Providers "broke the glass" for six (14 %) of 43 returning study patients with redacted data vs. zero among 49 study patients without redactions (p = 0.01). Although 54 % of providers agreed that patients should have control over who sees their EHR information, 58 % believed restricting EHR access could harm provider-patient relationships and 71 % felt quality of care would suffer. Patients frequently preferred restricting provider access to their EHRs. Providers infrequently overrode patients' preferences to view hidden data. Providers believed that restricting EHR access would adversely impact patient care. Applying Fair Information Practice principles to EHRs will require balancing patient preferences, providers' needs, and health care quality.

Where Are the Women? A Report into Issues Related to Women's Access to Workplace Literacy Programs.

ERIC Educational Resources Information Center

Milton, Marion

A study investigated provision of workplace literacy courses available for women in female-dominated industries and women's access to and participation in those courses. A literature review revealed very little research on the required increased literacy skills in Australia and no previous studies on women's access to workplace literacy courses in…

Acceptance and Adoption of Open Access Publication (OAP) in University Libraries in South East Nigeria

ERIC Educational Resources Information Center

Sambe, Manasseh Tyungu; Raphael, Gabriel Okplogidi

2015-01-01

This study examines the kinds of open access scholarly publication or information resources accepted and adopted by federal university libraries in South East Nigeria. The purpose was to determine the factors that affect open access scholarly publication or information resources acceptance and adoption in university libraries. The study adopted…

The Open Access Availability of Library and Information Science Literature

ERIC Educational Resources Information Center

Way, Doug

2010-01-01

To examine the open access availability of Library and Information Science (LIS) research, a study was conducted using Google Scholar to search for articles from 20 top LIS journals. The study examined whether Google Scholar was able to find any links to full text, if open access versions of the articles were available and where these articles…

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…

Remoteness and Access to Learning Opportunities in the Pacific Region.

ERIC Educational Resources Information Center

Pacific Region Educational Lab., Honolulu, HI.

The Remoteness and Access to Learning Opportunities in the Pacific Region Study was carried out to investigate whether access to learning opportunities (ALO) is related to the remoteness and isolation of many schools in the Pacific region. The study also profiles the conditions of remote and isolated schools and the ALO for Pacific students. Seven…

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

ERIC Educational Resources Information Center

McLachlan, Sarah; Hagger, Martin S.

2010-01-01

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

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

ERIC Educational Resources Information Center

Maas, Ericca

2005-01-01

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

The Searching Behavior of Remote Users: A Study of One Online Public Access Catalog (OPAC).

ERIC Educational Resources Information Center

Kalin, Sally W.

1991-01-01

Describes a study that was conducted to determine whether the searching behavior of remote users of LIAS (Library Information Access System), Pennsylvania State University's online public access catalog (OPAC), differed from those using the OPAC within the library. Differences in search strategies and in user satisfaction are discussed. (eight…

Measuring Confidence Levels of Male and Female Students in Open Access Enabling Courses

ERIC Educational Resources Information Center

Atherton, Mirella

2015-01-01

The study of confidence was undertaken at the University of Newcastle with students selecting science courses at two campuses. The students were enrolled in open access programs and aimed to gain access to undergraduate studies in various disciplines at University. The "third person effect" was used to measure the confidence levels of…

Access to Technology and Readiness to Use It in Learning

ERIC Educational Resources Information Center

Kabonoki, S. K.

2008-01-01

This case study involved 429 distance education diploma students at the University of Botswana. The aim of the study was to find out whether these students had access to MP3 players and other technologies essential in distance learning. Findings show that, contrary to expectations, learners did not have access to MP3 digital audio devices.…

Rebuilding Haiti's Educational Access: A Phenomenological Study of Technology Use in Education Delivery

ERIC Educational Resources Information Center

Sandiford, Gladwyn A.

2013-01-01

There is a lack of access to technology blended with face-to-face instruction and learning in Haiti. Despite this lack of access, some Haitian college students have nevertheless leveraged technology to overcome the obstacles of poverty and obtain a higher education. This phenomenological study explored the lived experiences of 20 adult…

Testing the Digital Divide: Does Access to High-Quality Use of Technology in Schools Affect Student Achievement?

ERIC Educational Resources Information Center

Talley, Gregory Keith

2012-01-01

This study investigates the relationship between access, use of technology and student achievement in public middle schools in Maryland. The objective of this study was to determine whether a digital divide (differences in access and utilization of technology based on student characteristics of race, socioeconomic status, and gender) exists among…

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

PubMed

Mahmud, Aidalina; Aljunid, Syed Mohamed

2018-01-01

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

The burden of rheumatoid arthritis and access to treatment: determinants of access.

PubMed

Lundqvist, J; Kastäng, F; Kobelt, G; Jönsson, B

2008-01-01

As part of the study "The Burden of Rheumatoid Arthritis (RA) and Patient Access to Treatment", this paper reviews the impact on access to RA drugs of the approval processes, pricing and funding decisions and times to market (access) in different countries. In addition, an overview of health technology assessments (HTA) and the economic literature related to RA treatments is provided. The time from approval to market access ranged from immediate to over 500 days in the countries included in the study. A total of 55 HTA reports were identified, 40 of them in the period between 2002 and 2006; 29 were performed by European HTA agencies, 14 in Canada and 7 in the United States. A total of 239 economic evaluations related to RA were identified in a specialized health economic database (HEED).

The association between recreational parks, facilities and childhood obesity: a cross-sectional study of the 2007 National Survey of Children's Health.

PubMed

Alexander, Dayna S; Huber, Larissa R Brunner; Piper, Crystal R; Tanner, Amanda E

2013-05-01

Despite the rising childhood obesity rates, few studies have examined the association between access to recreational parks and facilities and obesity. A cross-sectional study was performed among 42 278 US children who participated in the 2007 National Survey of Children's Health. Access to parks and recreational facilities was self-reported by parents, and body mass index was calculated from parents' self-report of the child's height and weight. Logistic regression was used to obtain ORs and 95% CIs. Since obesity was not a rare occurrence, an OR correction method was used to provide a more reliable estimate of the prevalence ratio (PR). Children with access to parks and facilities had decreased prevalence of obesity as compared to children without access (PR=0.79, 95% CI 0.69 to 0.91). After adjustment for covariates, the magnitude of the association remained unchanged; however, results were no longer statistically significant (PR=0.77, 95% CI 0.55 to 1.07). Race/ethnicity was an effect modifier of the access-obesity relationship (p<0.0001). Among Non-Hispanic White children, there was no strong association (PR=0.89, 95% CI 0.64 to 1.23). However, among Non-Hispanic Black children, those who had access to recreational parks and facilities had 0.40 times the prevalence of obesity as compared to those without access, and this result was statistically significant (95% CI 0.17 to 0.90). This research highlights potential health disparities in childhood obesity due to limited access to recreational parks and facilities. Additional studies are needed to further investigate this association. If confirmed, providing safe, accessible parks and facilities may be one way to combat childhood obesity, particularly among minority children.

Randomized comparison of operator radiation exposure comparing transradial and transfemoral approach for percutaneous coronary procedures: rationale and design of the minimizing adverse haemorrhagic events by TRansradial access site and systemic implementation of angioX - RAdiation Dose study (RAD-MATRIX).

PubMed

Sciahbasi, Alessandro; Calabrò, Paolo; Sarandrea, Alessandro; Rigattieri, Stefano; Tomassini, Francesco; Sardella, Gennaro; Zavalloni, Dennis; Cortese, Bernardo; Limbruno, Ugo; Tebaldi, Matteo; Gagnor, Andrea; Rubartelli, Paolo; Zingarelli, Antonio; Valgimigli, Marco

2014-06-01

Radiation absorbed by interventional cardiologists is a frequently under-evaluated important issue. Aim is to compare radiation dose absorbed by interventional cardiologists during percutaneous coronary procedures for acute coronary syndromes comparing transradial and transfemoral access. The randomized multicentre MATRIX (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX) trial has been designed to compare the clinical outcome of patients with acute coronary syndromes treated invasively according to the access site (transfemoral vs. transradial) and to the anticoagulant therapy (bivalirudin vs. heparin). Selected experienced interventional cardiologists involved in this study have been equipped with dedicated thermoluminescent dosimeters to evaluate the radiation dose absorbed during transfemoral or right transradial or left transradial access. For each access we evaluate the radiation dose absorbed at wrist, at thorax and at eye level. Consequently the operator is equipped with three sets (transfemoral, right transradial or left transradial access) of three different dosimeters (wrist, thorax and eye dosimeter). Primary end-point of the study is the procedural radiation dose absorbed by operators at thorax. An important secondary end-point is the procedural radiation dose absorbed by operators comparing the right or left radial approach. Patient randomization is performed according to the MATRIX protocol for the femoral or radial approach. A further randomization for the radial approach is performed to compare right and left transradial access. The RAD-MATRIX study will probably consent to clarify the radiation issue for interventional cardiologist comparing transradial and transfemoral access in the setting of acute coronary syndromes. Copyright © 2014 Elsevier Inc. All rights reserved.

Flooding in Clark and Lincoln Counties, Nevada, December 2004 and January 2005

USGS Publications Warehouse

Ryan, Roslyn

2006-01-01

Introduction: A regional storm passed through the Las Vegas Valley, Nevada, on December 28-29, 2004, producing up to 2 inches of rain in a 24-hour period. Due to the intense, sustained rainfall, streamflow along Las Vegas Wash was near the record discharges of July 8, 1999. Additional rainfall in December and in January, combined with an early warming trend, resulted in record flooding along Meadow Valley Wash, Muddy River, and Virgin River, January 10-11, 2005 (figs. 1 and 2). On January 7, this warming trend resulted in about a 15?F (degree Fahrenheit) increase over the previous week (fig. 2). This temperature spike, along with further precipitation, caused much of the snow pack in the surrounding mountain ranges to melt and run off into the valleys. These two factors led to the major flood events in Clark and Lincoln Counties during December 2004 and January 2005. Total flood and storm damage for Lincoln County was estimated at $9.4 million and $4.5 million for Clark County (Manning, 2005). Clark County generally is drained by the Las Vegas and Meadow Valley Washes, and the Muddy and Virgin River systems. Las Vegas Valley is drained by Duck Creek, Tropicana Wash (not in fig. 1), Flamingo Wash, Las Vegas Wash, and several smaller tributaries (fig. 1). Water in these drainages generally flows eastward through Las Vegas to Las Vegas Wash and on toward Lake Mead, an impoundment of the Colorado River. The Virgin River originates in southern Utah, flows past Littlefield, AZ, through Mesquite, NV, and into the Overton Arm of Lake Mead. Meadow Valley Wash flows from Ursine, NV, through Caliente, NV, continues southeast through Moapa Valley, and into the Muddy River at Glendale, NV. The Muddy River flows southeast through Moapa Valley into the Overton Arm of Lake Mead (Kane and Wilson, 2000).

Groundwater flow in a closed basin with a saline shallow lake in a volcanic area: Laguna Tuyajto, northern Chilean Altiplano of the Andes.

PubMed

Herrera, Christian; Custodio, Emilio; Chong, Guillermo; Lambán, Luis Javier; Riquelme, Rodrigo; Wilke, Hans; Jódar, Jorge; Urrutia, Javier; Urqueta, Harry; Sarmiento, Alvaro; Gamboa, Carolina; Lictevout, Elisabeth

2016-01-15

Laguna Tuyajto is a small, shallow saline water lake in the Andean Altiplano of northern Chile. In the eastern side it is fed by springs that discharge groundwater of the nearby volcanic aquifers. The area is arid: rainfall does not exceed 200mm/year in the rainiest parts. The stable isotopic content of spring water shows that the recharge is originated mainly from winter rain, snow melt, and to a lesser extent from some short and intense sporadic rainfall events. Most of the spring water outflowing in the northern side of Laguna Tuyajto is recharged in the Tuyajto volcano. Most of the spring water in the eastern side and groundwater are recharged at higher elevations, in the rims of the nearby endorheic basins of Pampa Colorada and Pampa Las Tecas to the East. The presence of tritium in some deep wells in Pampa Colorada and Pampa Las Tecas indicates recent recharge. Gas emission in recent volcanoes increase the sulfate content of atmospheric deposition and this is reflected in local groundwater. The chemical composition and concentration of spring waters are the result of meteoric water evapo-concentration, water-rock interaction, and mainly the dissolution of old and buried evaporitic deposits. Groundwater flow is mostly shallow due to a low permeability ignimbrite layer of regional extent, which also hinders brine spreading below and around the lake. High deep temperatures near the recent Tuyajto volcano explain the high dissolved silica contents and the δ(18)O shift to heavier values found in some of the spring waters. Laguna Tuyajto is a terminal lake where salts cumulate, mostly halite, but some brine transfer to the Salar de Aguas Calientes-3 cannot be excluded. The hydrogeological behavior of Laguna Tuyajto constitutes a model to understand the functioning of many other similar basins in other areas in the Andean Altiplano. Copyright © 2015 Elsevier B.V. All rights reserved.

Nonspherical Radiation Driven Wind Models Applied to Be Stars

NASA Astrophysics Data System (ADS)

Arauxo, F. X.

1990-11-01

ABSTRACT. In this work we present a model for the structure of a radiatively driven wind in the meridional plane of a hot star. Rotation effects and simulation of viscous forces were included in the motion equations. The line radiation force is considered with the inclusion of the finite disk correction in self-consistent computations which also contain gravity darkening as well as distortion of the star by rotation. An application to a typical BlV star leads to mass-flux ratios between equator and pole of the order of 10 and mass loss rates in the range 5.l0 to Mo/yr. Our envelope models are flattened towards the equator and the wind terminal velocities in that region are rather high (1000 Km/s). However, in the region near the star the equatorial velocity field is dominated by rotation. RESUMEN. Se presenta un modelo de la estructura de un viento empujado radiativamente en el plano meridional de una estrella caliente. Se incluyeron en las ecuaciones de movimiento los efectos de rotaci6n y la simulaci6n de fuerzas viscosas. Se consider6 la fuerza de las lineas de radiaci6n incluyendo la correcci6n de disco finito en calculos autoconsistentes los cuales incluyen oscurecimiento gravitacional asi como distorsi6n de la estrella por rotaci6n. La aplicaci6n a una estrella tipica BlV lleva a cocientes de flujo de masa entre el ecuador y el polo del orden de 10 de perdida de masa en el intervalo 5.l0 a 10 Mo/ano. Nuestros modelos de envolvente estan achatados hacia el ecuador y las velocidads terminales del viento en esa regi6n son bastante altas (1000 Km/s). Sin embargo, en la regi6n cercana a la estrella el campo de velocidad ecuatorial esta dominado por la rotaci6n. Key words: STARS-BE -- STARS-WINDS

An evaluation of edge effects in nutritional accessibility and availability measures: a simulation study

PubMed Central

2010-01-01

Background This paper addresses the statistical use of accessibility and availability indices and the effect of study boundaries on these measures. The measures are evaluated via an extensive simulation based on cluster models for local outlet density. We define outlet to mean either food retail store (convenience store, supermarket, gas station) or restaurant (limited service or full service restaurants). We designed a simulation whereby a cluster outlet model is assumed in a large study window and an internal subset of that window is constructed. We performed simulations on various criteria including one scenario representing an urban area with 2000 outlets as well as a non-urban area simulated with only 300 outlets. A comparison is made between estimates obtained with the full study area and estimates using only the subset area. This allows the study of the effect of edge censoring on accessibility measures. Results The results suggest that considerable bias is found at the edges of study regions in particular for accessibility measures. Edge effects are smaller for availability measures (when not smoothed) and also for short range accessibility Conclusions It is recommended that any study utilizing these measures should correct for edge effects. The use of edge correction via guard areas is recommended and the avoidance of large range distance-based accessibility measures is also proposed. PMID:20663199

Thine Own Self: True Self-Concept Accessibility and Meaning in Life

PubMed Central

Schlegel, Rebecca J.; Hicks, Joshua A.; Arndt, Jamie; King, Laura A.

2016-01-01

A number of philosophical and psychological theories suggest the true self is an important contributor to well-being. The present research examined whether the cognitive accessibility of the true self-concept would predict the experience of meaning in life. To ensure that any observed effects were due to the true self-concept rather than the self-concept more generally, we utilized actual self-concept accessibility as a control variable in all studies. True and actual self-concepts were defined as including those traits which are enacted around close others versus most others (Studies 1 through 3) or as traits that refer to “who you really are” vs. “who you are during most of your activities” (Studies 4 and 5), respectively. Studies 1 and 2 showed that individual differences in true self-concept accessibility, but not differences in actual self-concept accessibility, predicted meaning in life. Study 3 showed that priming traits related to the true self led to enhanced meaning in life. Studies 4 and 5 provided correlational and experimental support for the role of true self-concept accessibility in meaning in life, even when traits were defined without reference to social relationships and when state self-esteem and self-reported authenticity were controlled. Implications for the study of the true self-concept and authenticity are discussed. PMID:19159144

REVIEW: Widespread access to predictive models in the motor system: a short review

NASA Astrophysics Data System (ADS)

Davidson, Paul R.; Wolpert, Daniel M.

2005-09-01

Recent behavioural and computational studies suggest that access to internal predictive models of arm and object dynamics is widespread in the sensorimotor system. Several systems, including those responsible for oculomotor and skeletomotor control, perceptual processing, postural control and mental imagery, are able to access predictions of the motion of the arm. A capacity to make and use predictions of object dynamics is similarly widespread. Here, we review recent studies looking at the predictive capacity of the central nervous system which reveal pervasive access to forward models of the environment.

Sociodemographic Differences in Access to Care Among Hispanic Patients Who Are HIV Infected in the United States

PubMed Central

Morales, Leo S.; Cunningham, William E.; Galvan, Frank H.; Andersen, Ronald M.; Nakazono, Terry T.; Shapiro, Martin F.

2004-01-01

This study evaluated associations between sociodemographic factors and access to care, use of highly active antiretroviral therapy, and patients’ ratings of care among Hispanic patients who are HIV infected; we used data from the HIV Cost and Services Utilization Study. Gender, insurance, mode of exposure, and geographic region were associated with access to medical care. Researchers and policymakers should consider sociodemographic factors among Hispanic patients who are HIV positive when designing and prioritizing interventions to improve access to care. PMID:15226129

An Observational Study of Consumers’ Accessing of Nutrition Information in Chain Restaurants

PubMed Central

Agnew, Henry; Brownell, Kelly D.

2009-01-01

In this observational study, we determined how frequently consumers accessed on-premises nutrition information provided at chain restaurants. The number of patrons entering and accessing nutrition information was recorded at 8 locations that were part of 4 major restaurant chains (McDonald's, Burger King, Starbucks, and Au Bon Pain). Only 6 (0.1%) of 4311 patrons accessed on-premises nutrition information before purchasing food. This very small percentage suggests that such information should be more prominently displayed, such as on restaurant menu boards, to help customers make informed decisions. PMID:19299679

An observational study of consumers' accessing of nutrition information in chain restaurants.

PubMed

Roberto, Christina A; Agnew, Henry; Brownell, Kelly D

2009-05-01

In this observational study, we determined how frequently consumers accessed on-premises nutrition information provided at chain restaurants. The number of patrons entering and accessing nutrition information was recorded at 8 locations that were part of 4 major restaurant chains (McDonald's, Burger King, Starbucks, and Au Bon Pain). Only 6 (0.1%) of 4311 patrons accessed on-premises nutrition information before purchasing food. This very small percentage suggests that such information should be more prominently displayed, such as on restaurant menu boards, to help customers make informed decisions.

Access to Triptans for Acute Episodic Migraine: A Qualitative Study.

PubMed

Khan, Sobia; Mascarenhas, Alekhya; Moore, Julia E; Knowles, Sandra; Gomes, Tara

2015-01-01

Our study aims to examine factors related to access of triptans among multiple stakeholder groups. Triptans are a cornerstone of pain management for the acute treatment of migraine, but actual utilization of triptans is lower than ideal. Initial and continued access to triptans may be an important clinical issue in the acute treatment of migraines, but factors affecting access at the patient, provider, and health-care system levels have not been comprehensively explored. A qualitative study was conducted in Ontario, Canada, between August 2013 and January 2014. Three participant groups were recruited to the qualitative study: (1) migraineurs who have experience accessing triptans; (2) physicians, including primary care physicians (PCPs) and neurologists, who have prescribed triptans; and (3) pharmacists who have dispensed triptans. Qualitative data were collected through one-on-one, semi-structured telephone interviews. The framework approach was used for data collection and analysis. Data collected from 19 migraineurs, 6 physicians, and 8 pharmacists were included in the analysis. Study participants discussed various factors that facilitate or hinder access to triptans, which were synthesized into four themes that emerged at the patient, provider, and health-care systems levels: (1) awareness; (2) apathy; (3) advocacy; and (4) affordability. Across all participant groups, awareness of available treatments and coverage policies for those treatments were potential factors relating to timely drug provision. Participants describe apathy in terms of patients' health-seeking behaviors and physicians' lack of concern toward migraine, which were seen as factors that could delay diagnosis and provision of appropriate treatment. Patients engaging in self-advocacy enhanced their ability to seek timely and appropriate provision of triptans at the patient level. At the health-care provider level, pharmacists were identified by patients as advocates for receiving more effective treatments for their migraines; pharmacists also self-identified with the advocate role. The affordability of triptans was a key concern impacting access at the systems level, but coverage limitations (eg, quantity limits) were also described to influence the appropriateness of prescribed migraine treatment. This study fills a gap in knowledge about access to triptans and how this may be impacted by patient, provider, and health-care systems barriers. Overall, our study sheds light on the experiences of prescribing, dispensing, and accessing triptans for migraine treatment, and unveils important information that can impact how patients access these drugs. © 2015 American Headache Society.

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

PubMed

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

2012-09-01

The regionalization of medical services has resulted in improved outcomes and greater compliance with existing guidelines. For certain "time-critical" conditions intimately associated with emergency medicine, early intervention has demonstrated mortality benefits. For these conditions, then, appropriate triage within a regionalized system at first diagnosis is paramount, ideally occurring in the field by emergency medical services (EMS) personnel. Therefore, EMS ground transport access is an important metric in the ongoing evaluation of a regionalized care system for time-critical emergency services. To our knowledge, no studies have demonstrated how methodologies for calculating EMS ground transport access differ in their estimates of access over the same study area for the same resource. This study uses two methodologies to calculate EMS ground transport access to trauma center care in a single study area to explore their manifestations and critically evaluate the differences between the methodologies. Two methodologies were compared in their estimations of EMS ground transport access to trauma center care: a routing methodology (RM) and an as-the-crow-flies methodology (ACFM). These methodologies were adaptations of the only two methodologies that had been previously used in the literature to calculate EMS ground transport access to time-critical emergency services across the United States. The RM and ACFM were applied to the nine Level I and Level II trauma centers within the province of Ontario by creating trauma center catchment areas at 30, 45, 60, and 120 minutes and calculating the population and area encompassed by the catchments. Because the methodologies were identical for measuring air access, this study looks specifically at EMS ground transport access. Catchments for the province were created for each methodology at each time interval, and their populations and areas were significantly different at all time periods. Specifically, the RM calculated significantly larger populations at every time interval while the ACFM calculated larger catchment area sizes. This trend is counterintuitive (i.e., larger catchment should mean higher populations), and it was found to be most disparate at the shortest time intervals (under 60 minutes). Through critical evaluation of the differences, the authors elucidated that the ACFM could calculate road access in areas with no roads and overestimates access in low-density areas compared to the RM, potentially affecting delivery of care decisions. Based on these results, the authors believe that future methodologies for calculating EMS ground transport access must incorporate a continuous and valid route through the road network as well as use travel speeds appropriate to the road segments traveled; alternatively, we feel that variation in methods for calculating road distances would have little effect on realized access. Overall, as more complex models for calculating EMS ground transport access become used, there needs to be a standard methodology to improve and to compare it to. Based on these findings, the authors believe that this should be the RM. © 2012 by the Society for Academic Emergency Medicine.

Output order reflects the cognitive accessibility of goals.

PubMed

Grimes, Carrie E; Nes, Lise Solberg; Waldman, Andrea; Segerstrom, Suzanne C

2012-01-01

Goal accessibility--the ease or speed with which a goal is activated--increases the likelihood that it will be acted on. The present studies validate output order as a measure of goal accessibility that can be applied to goal lists in both laboratory and naturalistic settings. In three studies, output order (the order in which goals are listed in a free-response format) was related to self-reported goal value but was not redundant with it. Furthermore, output order was affected by motivational priming whereas value was not, and order associated with typical student goals (e.g., achievement) compared with atypical goals (e.g., power). Output order is well suited to bring the study of accessibility to naturalistic studies of goals and goal pursuit.

Disparities and access to healthy food in the United States: A review of food deserts literature.

PubMed

Walker, Renee E; Keane, Christopher R; Burke, Jessica G

2010-09-01

Increasingly, studies are focusing on the role the local food environment plays in residents' ability to purchase affordable, healthy and nutritious foods. In a food desert, an area devoid of a supermarket, access to healthy food is limited. We conducted a systematic review of studies that focused on food access and food desert research in the United States. The 31 studies identified utilized 9 measures to assess food access. Results from these studies can be summarized primarily into four major statements. Findings from other countries offer insight into ways, in which future research, policy development and program implementation in the U.S. may continue to be explored. Copyright 2010 Elsevier Ltd. All rights reserved.

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

PubMed Central

2013-01-01

Introduction There is a great health services disparity between urban and rural areas in China. The percentage of people who are unable to access health services due to long travel times increases. This paper takes Donghai County as the study unit to analyse areas with physician shortages and characteristics of the potential spatial accessibility of health services. We analyse how the unequal health services resources distribution and the New Cooperative Medical Scheme affect the potential spatial accessibility of health services in Donghai County. We also give some advice on how to alleviate the unequal spatial accessibility of health services in areas that are more remote and isolated. Methods The shortest traffic times of from hospitals to villages are calculated with an O-D matrix of GIS extension model. This paper applies an enhanced two-step floating catchment area (E2SFCA) method to study the spatial accessibility of health services and to determine areas with physician shortages in Donghai County. The sensitivity of the E2SFCA for assessing variation in the spatial accessibility of health services is checked using different impedance coefficient valuesa. Geostatistical Analyst model and spatial analyst method is used to analyse the spatial pattern and the edge effect of potential spatial accessibility of health services. Results The results show that 69% of villages have access to lower potential spatial accessibility of health services than the average for Donghai County, and 79% of the village scores are lower than the average for Jiangsu Province. The potential spatial accessibility of health services diminishes greatly from the centre of the county to outlying areas. Using a smaller impedance coefficient leads to greater disparity among the villages. The spatial accessibility of health services is greater along highway in the county. Conclusions Most of villages are in underserved health services areas. An unequal distribution of health service resources and the reimbursement policies of the New Cooperative Medical Scheme have led to an edge effect regarding spatial accessibility of health services in Donghai County, whereby people living on the edge of the county have less access to health services. Comprehensive measures should be considered to alleviate the unequal spatial accessibility of health services in areas that are more remote and isolated. PMID:23688278

Limited School Drinking Water Access for Youth.

PubMed

Kenney, Erica L; Gortmaker, Steven L; Cohen, Juliana F W; Rimm, Eric B; Cradock, Angie L

2016-07-01

Providing children and youth with safe, adequate drinking water access during school is essential for health. This study used objectively measured data to investigate the extent to which schools provide drinking water access that meets state and federal policies. We visited 59 middle and high schools in Massachusetts during spring 2012. Trained research assistants documented the type, location, and working condition of all water access points throughout each school building using a standard protocol. School food service directors (FSDs) completed surveys reporting water access in cafeterias. We evaluated school compliance with state plumbing codes and federal regulations and compared FSD self-reports of water access with direct observation; data were analyzed in 2014. On average, each school had 1.5 (standard deviation: .6) water sources per 75 students; 82% (standard deviation: 20) were functioning and fewer (70%) were both clean and functioning. Less than half of the schools met the federal Healthy Hunger-Free Kids Act requirement for free water access during lunch; 18 schools (31%) provided bottled water for purchase but no free water. Slightly over half (59%) met the Massachusetts state plumbing code. FSDs overestimated free drinking water access compared to direct observation (96% FSD reported vs. 48% observed, kappa = .07, p = .17). School drinking water access may be limited. In this study, many schools did not meet state or federal policies for minimum student drinking water access. School administrative staff may not accurately report water access. Public health action is needed to increase school drinking water access. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Access to medication in the Public Health System and equity: populational health surveys in São Paulo, Brazil.

PubMed

Monteiro, Camila Nascimento; Gianini, Reinaldo José; Barros, Marilisa Berti de Azevedo; Cesar, Chester Luiz Galvão; Goldbaum, Moisés

2016-03-01

Since 2003, the access to medication has been increasing in Brazil and particularly in São Paulo. The present study aimed to analyze the access to medication obtained in the public sector and the socioeconomic differences in this access in 2003 and 2008. Also, we explored the difference in access to medication from 2003 to 2008. Data were obtained from two cross-sectional population-based household surveys from São Paulo, Brazil (ISA-Capital 2003 and ISA-Capital 2008). Concentration curve and concentration index were calculated to analyze the associations between socioeconomic factors and access to medication in the public sector. Additionally, the differences between 2003 and 2008 regarding socioeconomic characteristics and access to medication were studied. Access to medication was 89.55% in 2003 and 92.99% in 2008, and the proportion of access to medication did not change in the period. Access in the public sector increased from 26.40% in 2003 to 48.55% in 2008 and there was a decrease in the concentration index between 2003 and 2008 in access to medication in the public sector. The findings indicate an expansion of Brazilian Unified Health System (Sistema Único de Saúde ) users, with the inclusion of people of higher socioeconomic position in the public sector. As the SUS gives more support to people of lower socioeconomic position in terms of medication provision, the SUS tends to equity. Nevertheless, universal coverage for medication and equity in access to medication in the public sector are still challenges for the Brazilian public health system.

Action research to improve methods of delivery and feedback in an Access Grid Room environment

NASA Astrophysics Data System (ADS)

McArthur, Lynne C.; Klass, Lara; Eberhard, Andrew; Stacey, Andrew

2011-12-01

This article describes a qualitative study which was undertaken to improve the delivery methods and feedback opportunity in honours mathematics lectures which are delivered through Access Grid Rooms. Access Grid Rooms are facilities that provide two-way video and audio interactivity across multiple sites, with the inclusion of smart boards. The principal aim was to improve the student learning experience, given the new environment. The specific aspects of the course delivery that the study focused on included presentation of materials and provision of opportunities for interaction between the students and between students and lecturers. The practical considerations in the delivery of distance learning are well documented in the literature, and similar problems arise in the Access Grid Room environment; in particular, those of limited access to face-to-face interaction and the reduction in peer support. The nature of the Access Grid Room classes implies that students studying the same course can be physically situated in different cities, and possibly in different countries. When studying, it is important that students have opportunity to discuss new concepts with others; particularly their peers and their lecturer. The Access Grid Room environment also presents new challenges for the lecturer, who must learn new skills in the delivery of materials. The unique nature of Access Grid Room technology offers unprecedented opportunity for effective course delivery and positive outcomes for students, and was developed in response to a need to be able to interact with complex data, other students and the instructor, in real-time, at a distance and from multiple sites. This is a relatively new technology and as yet there has been little or no studies specifically addressing the use and misuse of the technology. The study found that the correct placement of cameras and the use of printed material and smart boards were all crucial to the student experience. In addition, the inclusion of special tutorial type sessions were necessary to provide opportunities to students for one-on-one discussion with both lecturer and other students. This study contributes to the broader understanding of distance education in general and future Access Grid Room course delivery in particular.

A Matter of Discipline: Open Access, the Humanities, and Art History

ERIC Educational Resources Information Center

Tomlin, Patrick

2009-01-01

Recent events suggest that open access has gained new momentum in the humanities, but the slow and uneven development of open-access initiatives in humanist fields continues to hinder the consolidation of efforts across the university. Although various studies have traced the general origins of the humanities' reticence to embrace open access, few…

Measuring, Rating, Supporting, and Strengthening Open Access Scholarly Publishing in Brazil

ERIC Educational Resources Information Center

Neto, Silvio Carvalho; Willinsky, John; Alperin, Juan Pablo

2016-01-01

This study assesses the extent and nature of open access scholarly publishing in Brazil, one of the world's leaders in providing universal access to its research and scholarship. It utilizes Brazil's Qualis journal evaluation system, along with other relevant data bases to address the association between scholarly quality and open access in the…

Taking the Plunge: Open Access at the "Canadian Journal of Sociology." Case Studies in Open Access Publishing. Number Five

ERIC Educational Resources Information Center

Haggerty, Kevin D.

2008-01-01

Introduction: Presents a personal account of the transfer to open access of the leading Canadian journal of sociology. Background: The Canadian Journal of Sociology had established a strong position, internationally, among sociology journals. However, subscriptions were falling as readers increasingly accessed the resource through libraries and a…

A Comparison of Student Confidence Levels in Open Access and Undergraduate University Courses

ERIC Educational Resources Information Center

Atherton, Mirella

2017-01-01

Confidence levels of students enrolled in open access programs and undergraduate courses were measured at the University of Newcastle. The open access science students aimed to gain access to undergraduate studies in various disciplines at University. The undergraduate students were enrolled in a variety of degrees and were surveyed during their…

Enabling Remote Access to Fieldwork: Gaining Insight into the Pedagogic Effectiveness of "Direct" and "Remote" Field Activities

ERIC Educational Resources Information Center

Stokes, Alison; Collins, Trevor; Maskall, John; Lea, John; Lunt, Paul; Davies, Sarah

2012-01-01

This study considers the pedagogical effectiveness of remote access to fieldwork locations. Forty-one students from across the GEES disciplines (geography, earth and environmental sciences) undertook a fieldwork exercise, supported by two lecturers. Twenty students accessed the field site directly and the remainder accessed the site remotely using…

Disambiguating Form and Lexical Frequency Effects in MEG Responses Using Homonyms

ERIC Educational Resources Information Center

Simon, Dylan Alexander; Lewis, Gwyneth; Marantz, Alec

2012-01-01

We present an MEG study of homonym recognition in reading, identifying effects of a semantic measure of homonym ambiguity. This measure sheds light on two competing theories of lexical access: the "early access" theory, which entails that lexical access occurs at early (pre 200 ms) stages of processing; and the "late access" theory, which…

Elementary School Computer Access, Socioeconomic Status, Ethnicity, and Grade 5 Student Achievement

ERIC Educational Resources Information Center

Barrett, Julie Ann

2013-01-01

Purpose: The purpose of this study was to describe the current school computer access rates of elementary school students and to determine the extent to which school computer access relates to academic achievement among Grade 5 students in the state of Texas. Specifically, the relationship of school computer access to student passing rates on the…

Prevalence of difficult venous access and associated risk factors in highly complex hospitalised patients.

PubMed

Armenteros-Yeguas, Victoria; Gárate-Echenique, Lucía; Tomás-López, Maria Aranzazu; Cristóbal-Domínguez, Estíbaliz; Moreno-de Gusmão, Breno; Miranda-Serrano, Erika; Moraza-Dulanto, Maria Inmaculada

2017-12-01

To estimate the prevalence of difficult venous access in complex patients with multimorbidity and to identify associated risk factors. In highly complex patients, factors like ageing, the need for frequent use of irritant medication and multiple venous catheterisations to complete treatment could contribute to exhaustion of venous access. A cross-sectional study was conducted. 'Highly complex' patients (n = 135) were recruited from March 2013-November 2013. The main study variable was the prevalence of difficult venous access, assessed using one of the following criteria: (1) a history of difficulties obtaining venous access based on more than two attempts to insert an intravenous line and (2) no visible or palpable veins. Other factors potentially associated with the risk of difficult access were also measured (age, gender and chronic illnesses). Univariate analysis was performed for each potential risk factor. Factors with p < 0·2 were then included in multivariable logistic regression analysis. Odds ratios were also calculated. The prevalence of difficult venous access was 59·3%. The univariate logistic regression analysis indicated that gender, a history of vascular access complications and osteoarticular disease were significantly associated with difficult venous access. The multivariable logistic regression showed that only gender was an independent risk factor and the odds ratios was 2·85. The prevalence of difficult venous access is high in this population. Gender (female) is the only independent risk factor associated with this. Previous history of several attempts at catheter insertion is an important criterion in the assessment of difficult venous access. The prevalence of difficult venous access in complex patients is 59·3%. Significant risk factors include being female and a history of complications related to vascular access. © 2017 John Wiley & Sons Ltd.

Evaluation of 19,460 Wheat Accessions Conserved in the Indian National Genebank to Identify New Sources of Resistance to Rust and Spot Blotch Diseases.

PubMed

Kumar, Sundeep; Archak, Sunil; Tyagi, R K; Kumar, Jagdish; Vk, Vikas; Jacob, Sherry R; Srinivasan, Kalyani; Radhamani, J; Parimalan, R; Sivaswamy, M; Tyagi, Sandhya; Yadav, Mamata; Kumari, Jyotisna; Deepali; Sharma, Sandeep; Bhagat, Indoo; Meeta, Madhu; Bains, N S; Chowdhury, A K; Saha, B C; Bhattacharya, P M; Kumari, Jyoti; Singh, M C; Gangwar, O P; Prasad, P; Bharadwaj, S C; Gogoi, Robin; Sharma, J B; Gm, Sandeep Kumar; Saharan, M S; Bag, Manas; Roy, Anirban; Prasad, T V; Sharma, R K; Dutta, M; Sharma, Indu; Bansal, K C

2016-01-01

A comprehensive germplasm evaluation study of wheat accessions conserved in the Indian National Genebank was conducted to identify sources of rust and spot blotch resistance. Genebank accessions comprising three species of wheat-Triticum aestivum, T. durum and T. dicoccum were screened sequentially at multiple disease hotspots, during the 2011-14 crop seasons, carrying only resistant accessions to the next step of evaluation. Wheat accessions which were found to be resistant in the field were then assayed for seedling resistance and profiled using molecular markers. In the primary evaluation, 19,460 accessions were screened at Wellington (Tamil Nadu), a hotspot for wheat rusts. We identified 4925 accessions to be resistant and these were further evaluated at Gurdaspur (Punjab), a hotspot for stripe rust and at Cooch Behar (West Bengal), a hotspot for spot blotch. The second round evaluation identified 498 accessions potentially resistant to multiple rusts and 868 accessions potentially resistant to spot blotch. Evaluation of rust resistant accessions for seedling resistance against seven virulent pathotypes of three rusts under artificial epiphytotic conditions identified 137 accessions potentially resistant to multiple rusts. Molecular analysis to identify different combinations of genetic loci imparting resistance to leaf rust, stem rust, stripe rust and spot blotch using linked molecular markers, identified 45 wheat accessions containing known resistance genes against all three rusts as well as a QTL for spot blotch resistance. The resistant germplasm accessions, particularly against stripe rust, identified in this study can be excellent potential candidates to be employed for breeding resistance into the background of high yielding wheat cultivars through conventional or molecular breeding approaches, and are expected to contribute toward food security at national and global levels.

Evaluation of 19,460 Wheat Accessions Conserved in the Indian National Genebank to Identify New Sources of Resistance to Rust and Spot Blotch Diseases

PubMed Central

Jacob, Sherry R.; Srinivasan, Kalyani; Radhamani, J.; Parimalan, R.; Sivaswamy, M.; Tyagi, Sandhya; Yadav, Mamata; Kumari, Jyotisna; Deepali; Sharma, Sandeep; Bhagat, Indoo; Meeta, Madhu; Bains, N. S.; Chowdhury, A. K.; Saha, B. C.; Bhattacharya, P. M.; Kumari, Jyoti; Singh, M. C.; Gangwar, O. P.; Prasad, P.; Bharadwaj, S. C.; Gogoi, Robin; Sharma, J. B.; GM, Sandeep Kumar; Saharan, M. S.; Bag, Manas; Roy, Anirban; Prasad, T. V.; Sharma, R. K.; Dutta, M.; Sharma, Indu; Bansal, K. C.

2016-01-01

A comprehensive germplasm evaluation study of wheat accessions conserved in the Indian National Genebank was conducted to identify sources of rust and spot blotch resistance. Genebank accessions comprising three species of wheat–Triticum aestivum, T. durum and T. dicoccum were screened sequentially at multiple disease hotspots, during the 2011–14 crop seasons, carrying only resistant accessions to the next step of evaluation. Wheat accessions which were found to be resistant in the field were then assayed for seedling resistance and profiled using molecular markers. In the primary evaluation, 19,460 accessions were screened at Wellington (Tamil Nadu), a hotspot for wheat rusts. We identified 4925 accessions to be resistant and these were further evaluated at Gurdaspur (Punjab), a hotspot for stripe rust and at Cooch Behar (West Bengal), a hotspot for spot blotch. The second round evaluation identified 498 accessions potentially resistant to multiple rusts and 868 accessions potentially resistant to spot blotch. Evaluation of rust resistant accessions for seedling resistance against seven virulent pathotypes of three rusts under artificial epiphytotic conditions identified 137 accessions potentially resistant to multiple rusts. Molecular analysis to identify different combinations of genetic loci imparting resistance to leaf rust, stem rust, stripe rust and spot blotch using linked molecular markers, identified 45 wheat accessions containing known resistance genes against all three rusts as well as a QTL for spot blotch resistance. The resistant germplasm accessions, particularly against stripe rust, identified in this study can be excellent potential candidates to be employed for breeding resistance into the background of high yielding wheat cultivars through conventional or molecular breeding approaches, and are expected to contribute toward food security at national and global levels. PMID:27942031

Using routinely recorded data in the UK to assess outcomes in a randomised controlled trial: The Trials of Access.

PubMed

Powell, G A; Bonnett, L J; Tudur-Smith, C; Hughes, D A; Williamson, P R; Marson, A G

2017-08-23

In the UK, routinely recorded data may benefit prospective studies including randomised controlled trials (RCTs). In an on-going study, we aim to assess the feasibility of access and agreement of routinely recorded clinical and non-clinical data compared to data collected during a RCT using standard prospective methods. This paper will summarise available UK routinely recorded data sources and discuss our experience with the feasibility of accessing routinely recorded data for participants of a RCT before finally proposing recommendations for improving the access and implementation of routinely recorded data in RCTs. Setting: the case study RCT is the Standard and New Antiepileptic Drugs II (SANAD II) trial, a pragmatic, UK, multicentre, phase IV RCT assessing the clinical and cost-effectiveness of antiepileptic drug treatments for newly diagnosed epilepsy. 98 participants have provided written consent to permit the request of routinely recorded data. Study procedures: routinely recorded clinical and non-clinical data were identified and data requested through formal applications from available data holders for the duration that participants have been recruited into SANAD II. The feasibility of accessing routinely recorded data during a RCT is assessed and recommendations for improving access proposed. Secondary-care clinical and socioeconomic data is recorded on a national basis and can be accessed, although there are limitations in the application process. Primary-care data are recorded by a number of organisations on a de-identified basis but access for specific individuals has not been feasible. Access to data recorded by non-clinical sources, including The Department for Work and Pensions and The Driving and Vehicle Licensing Agency, was not successful. Recommendations discussed include further research to assess the attributes of routinely recorded data, an assessment of public perceptions and the development of strategies to collaboratively improve access to routinely recorded data for research. International Standard Randomised Controlled Trials, ISRCTN30294119 . Registered on 3 July 2012. EudraCT No: 2012-001884-64. Registered on 9 May 2012.

Estimating spatial accessibility to facilities on the regional scale: an extended commuting-based interaction potential model

PubMed Central

2011-01-01

Background There is growing interest in the study of the relationships between individual health-related behaviours (e.g. food intake and physical activity) and measurements of spatial accessibility to the associated facilities (e.g. food outlets and sport facilities). The aim of this study is to propose measurements of spatial accessibility to facilities on the regional scale, using aggregated data. We first used a potential accessibility model that partly makes it possible to overcome the limitations of the most frequently used indices such as the count of opportunities within a given neighbourhood. We then propose an extended model in order to take into account both home and work-based accessibility for a commuting population. Results Potential accessibility estimation provides a very different picture of the accessibility levels experienced by the population than the more classical "number of opportunities per census tract" index. The extended model for commuters increases the overall accessibility levels but this increase differs according to the urbanisation level. Strongest increases are observed in some rural municipalities with initial low accessibility levels. Distance to major urban poles seems to play an essential role. Conclusions Accessibility is a multi-dimensional concept that should integrate some aspects of travel behaviour. Our work supports the evidence that the choice of appropriate accessibility indices including both residential and non-residential environmental features is necessary. Such models have potential implications for providing relevant information to policy-makers in the field of public health. PMID:21219597

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.

Barriers to access and minority ethnic carers' satisfaction with social care services in the community: a systematic review of qualitative and quantitative literature

PubMed Central

Greenwood, Nan; Habibi, Ruth; Smith, Raymond; Manthorpe, Jill

2015-01-01

As populations age, the numbers of carers overall and numbers of carers from minority ethnic groups in particular are rising. Evidence suggests that carers from all sections of the community and particularly carers from minority groups often fail to access care services. This may relate to barriers in accessing services and service dissatisfaction. The aim of this systematic review was to identify and summarise minority ethnic carers' perceptions of barriers to accessing community social care services and their satisfaction with these services if accessed. The following databases were searched from their start until July 2013: Social Care Online, Social Policy and Research, Scopus, PsychINFO, HMIC, ASSIA, MEDLINE, Embase, CINAHL Plus and AMED. Thirteen studies met the inclusion criteria. Most investigated either barriers to access or satisfaction levels, although three explored both. Only 4 studies investigated minority ethnic carers' satisfaction with social care, although 12 studies reported perceived barriers to accessing services. Few studies compared minority ethnic carers' perceptions with majority ethnic groups, making it difficult to identify issues specific to minority groups. Most barriers described were potentially relevant to all carers, irrespective of ethnic group. They included attitudinal barriers such as not wanting to involve outsiders or not seeing the need for services and practical barriers such as low awareness of services and service availability. Issues specific to minority ethnic groups included language barriers and concerns about services' cultural or religious appropriateness. Studies investigating satisfaction with services reported a mixture of satisfaction and dissatisfaction. Barriers common to all groups should not be underestimated and a better understanding of the relationship between perceived barriers to accessing services and dissatisfaction with services is needed before the experiences of all carers can be improved. PMID:25135207

Value of doppler ultrasonography in the study of hemodialysis peripheral vascular access dysfunction.

PubMed

Moreno Sánchez, T; Martín Hervás, C; Sola Martínez, E; Moreno Rodríguez, F

2014-01-01

The main objectives of this study were to evaluate the sensitivity and specificity of duplex Doppler ultrasonography in the study of hemodialysis peripheral vascular access dysfunction and to analyze the resistance index and flow in the afferent artery. We prospectively studied 178 patients with 178 peripheral vascular accesses that were dysfunctional in at least three consecutive hemodialysis sessions. Patients underwent duplex Doppler ultrasonography and clinical and laboratory follow-up for three months (provided angiography findings were negative). We calculated the sensitivity, specificity, predictive values, and coefficients of probability. We studied the morphology of the afferent artery, the arteriovenous anastomosis, and the efferent vein, and we measured the resistance index and the flow of the afferent artery, the diameter of the anastomosis, and the flow and peak systolic velocity in the efferent vein. The final sample consisted of 159 patients. The sensitivity, specificity, positive and negative predictive values, and positive and negative coefficients of probability were 0,98 (95% CI: 0,88-1.00), 0,74 (95% CI: 0,66-0,81), 0,96, 0,82, 3.7, and 0,03, respectively. The resistance index was less than 0,5 in 78.5% of the peripheral vascular accesses with normal function and greater than 0,5 in 86.1% of the dysfunctional peripheral vascular accesses. We found aneurysms in 19 of the native peripheral vascular accesses and pseudoaneurysms in 7 of the prosthetic grafts. Inverted flow was seen in 57 peripheral vascular accesses. Duplex Doppler ultrasonography is an efficacious method for detecting and characterizing stenosis and thrombosis in peripheral vascular accesses, and it provides information about the morphology and hemodynamics. Copyright © 2012 SERAM. Published by Elsevier Espana. All rights reserved.

EU accession: A policy window opportunity for nursing?

PubMed

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

2017-03-01

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

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

PubMed

McCann, Terence V; Lubman, Dan I

2012-08-01

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

Structural barriers in access to medical marijuana in the USA-a systematic review protocol.

PubMed

Valencia, Celina I; Asaolu, Ibitola O; Ehiri, John E; Rosales, Cecilia

2017-08-07

There are 43 state medical marijuana programs in the USA, yet limited evidence is available on the demographic characteristics of the patient population accessing these programs. Moreover, insights into the social and structural barriers that inform patients' success in accessing medical marijuana are limited. A current gap in the scientific literature exists regarding generalizable data on the social, cultural, and structural mechanisms that hinder access to medical marijuana among qualifying patients. The goal of this systematic review, therefore, is to identify the aforementioned mechanisms that inform disparities in access to medical marijuana in the USA. This scoping review protocol outlines the proposed study design for the systematic review and evaluation of peer-reviewed scientific literature on structural barriers to medical marijuana access. The protocol follows the guidelines set forth by the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) checklist. The overarching goal of this study is to rigorously evaluate the existing peer-reviewed data on access to medical marijuana in the USA. Income, ethnic background, stigma, and physician preferences have been posited as the primary structural barriers influencing medical marijuana patient population demographics in the USA. Identification of structural barriers to accessing medical marijuana provides a framework for future policies and programs. Evidence-based policies and programs for increasing medical marijuana access help minimize the disparity of access among qualifying patients.

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

PubMed Central

2013-01-01

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

Systemic barriers accessing HIV treatment among people who inject drugs in Russia: a qualitative study

PubMed Central

Sarang, Anya; Rhodes, Tim; Sheon, Nicolas

2013-01-01

Achieving ‘universal access’ to antiretroviral HIV treatment (ART) in lower income and transitional settings is a global target. Yet, access to ART is shaped by local social condition and is by no means universal. Qualitative studies are ideally suited to describing how access to ART is socially situated. We explored systemic barriers to accessing ART among people who inject drugs (PWID) in a Russian city (Ekaterinburg) with a large burden of HIV treatment demand. We undertook 42 in-depth qualitative interviews with people living with HIV with current or recent experience of injecting drug use. Accounts were analysed thematically, and supplemented here with an illustrative case study. Three core themes were identified: ‘labyrinthine bureaucracy’ governing access to ART; a ‘system Catch 22’ created by an expectation that access to ART was conditional upon treated drug use in a setting of limited drug treatment opportunity; and ‘system verticalization’, where a lack of integration across HIV, tuberculosis (TB) and drug treatment compromised access to ART. Taken together, we find that systemic factors play a key role in shaping access to ART with the potential adverse effects of reproducing treatment initiation delay and disengagement from treatment. We argue that meso-level systemic factors affecting access to ART for PWID interact with wider macro-level structural forces, including those related to drug treatment policy and the social marginalization of PWID. We note the urgent need for systemic and structural changes to improve access to ART for PWID in this setting, including to simplify bureaucratic procedures, foster integrated HIV, TB and drug treatment services, and advocate for drug treatment policy reform. PMID:23197431

How Well Does Medicaid Work in Improving Access to Care?

PubMed Central

Long, Sharon K; Coughlin, Teresa; King, Jennifer

2005-01-01

Objective To provide an assessment of how well the Medicaid program is working at improving access to and use of health care for low-income mothers. Data Source/Study Setting The 1997 and 1999 National Survey of America's Families, with state and county information drawn from the Area Resource File and other sources. Study Design Estimate the effects of Medicaid on access and use relative to private coverage and being uninsured, using instrumental variables methods to control for selection into insurance status. Data Collection/Extraction Method This study combines data from 1997 and 1999 for mothers in families with incomes below 200 percent of the federal poverty level. Principal Findings We find that Medicaid beneficiaries' access and use are significantly better than those obtained by the uninsured. Analysis that controls for insurance selection shows that the benefits of having Medicaid coverage versus being uninsured are substantially larger than what is estimated when selection is not accounted for. Our results also indicate that Medicaid beneficiaries' access and use are comparable to that of the low-income privately insured. Once insurance selection is controlled for, access and use under Medicaid is not significantly different from access and use under private insurance. Without controls for insurance selection, access and use for Medicaid beneficiaries is found to be significantly worse than for the low-income privately insured. Conclusions Our results show that the Medicaid program improved access to care relative to uninsurance for low-income mothers, achieving access and use levels comparable to those of the privately insured. Our results also indicate that prior research, which generally has not controlled for selection into insurance coverage, has likely understated the gains of Medicaid relative to uninsurance and overstated the gains of private coverage relative to Medicaid. PMID:15663701

Population-based geographic access to endocrinologists in the United States, 2012.

PubMed

Lu, Hua; Holt, James B; Cheng, Yiling J; Zhang, Xingyou; Onufrak, Stephen; Croft, Janet B

2015-12-07

Increases in population and life expectancy of Americans may result in shortages of endocrinologists by 2020. This study aims to assess variations in geographic accessibility to endocrinologists in the US, by age group at state and county levels, and by urban/rural status, and distance. We used the 2012 National Provider Identifier Registry to obtain office locations of all adult and pediatric endocrinologists in the US. The population with geographic access to an endocrinologist within a series of 6 distance radii, centered on endocrinologist practice locations, was estimated using the US Census 2010 block-level population. We assumed that persons living within the same circular buffer zone of an endocrinologist location have the same geographic accessibility to that endocrinologist. The geographic accessibility (the percentage of the population with geographic access to at least one endocrinologist) and the population-to-endocrinologist ratio for each geographic area were estimated. By using 20 miles as the distance radius, geographic accessibility to at least one pediatric/adult endocrinologist for age groups 0-17, 18-64, and ≥ 65 years was 64.1%, 85.4%, and 82.1%. The overall population-to-endocrinologist ratio within 20 miles was 39,492:1 for children, 29,887:1 for adults aged 18-64 years, and 6,194:1 for adults aged ≥ 65 years. These ratios varied considerably by state, county, urban/rural status, and distance. This study demonstrates that there are geographic variations of accessibility to endocrinologists in the US. The areas with poorer geographic accessibility warrant further study of the effect of these variations on disease prevention, detection, and management of endocrine diseases in the US population. Our findings of geographic access to endocrinologists also may provide valuable information for medical education and health resources allocation.

Open to All? Nationwide Evaluation of High-Priority Web Accessibility Considerations among Higher Education Websites

ERIC Educational Resources Information Center

Kimmons, Royce

2017-01-01

This study seeks to evaluate the basic Priority 1 web accessibility of all college and university websites in the US (n = 3141). Utilizing web scraping and automated content analysis, the study establishes that even in the case of high-priority, simple-to-address accessibility requirements, colleges and universities generally fail to make their…

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

ERIC Educational Resources Information Center

Carlon, Sarah; Carter, Mark; Stephenson, Jennifer

2017-01-01

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

United States Federal Health Care Websites: A Multimethod Evaluation of Website Accessibility for Individuals with Disabilities

ERIC Educational Resources Information Center

Brobst, John L.

2012-01-01

The problem addressed by this study is the observed low levels of compliance with federal policy on website accessibility. The study examines the two key federal policies that promote website accessibility, using a side-by-side policy analysis technique. The analysis examines the Americans with Disabilities Act of 1990 and Section 508 of the…

The Digitally Disadvantaged: Access to Digital Communication Technologies among First Year Students at a Rural South African University

ERIC Educational Resources Information Center

Oyedemi, Toks; Mogano, Saki

2018-01-01

Considering the importance of digital skills in university education, this article reports on a study which examined access to technology among first year students at a rural South African university. The study focused on the digital readiness of students prior to their admission to the university, since many universities provide access to…

Beyond access: a case study on the intersection between accessibility, sustainability, and universal design.

PubMed

Gossett, Andrea; Mirza, Mansha; Barnds, Ann Kathleen; Feidt, Daisy

2009-11-01

A growing emphasis has been placed on providing equal opportunities for all people, particularly people with disabilities, to support participation. Barriers to participation are represented in part by physical space restrictions. This article explores the decision-making process during the construction of a new office building housing a disability-rights organization. The building project featured in this study was developed on the principles of universal design, maximal accessibility, and sustainability to support access and participation. A qualitative case study approach was used involving collection of data through in-depth interviews with key decision-makers; non-participant observations at design meetings; and on-site tours. Qualitative thematic analysis along with the development of a classification system was used to understand specific building elements and the relevant decision processes from which they resulted. Recording and analyzing the design process revealed several key issues including grassroots involvement of stakeholders; interaction between universal design and sustainable design; addressing diversity through flexibility and universality; and segregationist accessibility versus universal design. This case study revealed complex interactions between accessibility, universal design, and sustainability. Two visual models were proposed to understand and analyze these complexities.

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

PubMed

Stellenberg, Ethelwynn L

2015-03-10

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

True or false: do 5-year-olds understand belief?

PubMed

Fabricius, William V; Boyer, Ty W; Weimer, Amy A; Carroll, Kathleen

2010-11-01

In 3 studies (N = 188) we tested the hypothesis that children use a perceptual access approach to reason about mental states before they understand beliefs. The perceptual access hypothesis predicts a U-shaped developmental pattern of performance in true belief tasks, in which 3-year-olds who reason about reality should succeed, 4- to 5-year-olds who use perceptual access reasoning should fail, and older children who use belief reasoning should succeed. The results of Study 1 revealed the predicted pattern in 2 different true belief tasks. The results of Study 2 disconfirmed several alternate explanations based on possible pragmatic and inhibitory demands of the true belief tasks. In Study 3, we compared 2 methods of classifying individuals according to which 1 of the 3 reasoning strategies (reality reasoning, perceptual access reasoning, belief reasoning) they used. The 2 methods gave converging results. Both methods indicated that the majority of children used the same approach across tasks and that it was not until after 6 years of age that most children reasoned about beliefs. We conclude that because most prior studies have failed to detect young children's use of perceptual access reasoning, they have overestimated their understanding of false beliefs. We outline several theoretical implications that follow from the perceptual access hypothesis.

The price of access: capitalization of neighborhood contextual factors

PubMed Central

2013-01-01

Background Studies of neighborhood context on health behavior have not considered that the health benefits of context may be ‘capitalized’ into, or included in, higher housing values. This study examines the associations of better neighborhood context with neighborhood housing values. Methods We use the third wave of Add Health (2000-2001) to estimate the association of neighborhood contextual variables and housing values first across then within income types. This is a census block group-level analysis. Results We find that neighborhood context, especially access to fruit and vegetable outlets, is capitalized into, or associated with, higher housing values. Fast food and convenience store access are associated with lower housing values. Capitalization differs by income quartile of the neighborhood. Even those in the poorest neighborhoods value access to fresh fruits and vegetables, and those in the wealthier neighborhoods value activity resources. All neighborhood incomes types place negative value on fast food access and convenience store access. Conclusions Access to health-related contextual attributes is capitalized into higher housing prices. Access to fresh fruits and vegetables is valued in neighborhoods of all income levels. Modeling these associations by neighborhood income levels helps explain the mixed results in the literature on the built environment in terms of linking health outcomes to access. PMID:23927010

Modeling the effect of accessibility and congestion in location choice.

DOT National Transportation Integrated Search

2012-12-01

This study explores the relationship between accessibility and congestion, and their impacts on property values. Three research questions are addressed: (1) What is the relation between accessibility and congestion both regional and neighborhood leve...

Suppression, accessibility of death-related thoughts, and cultural worldview defense: exploring the psychodynamics of terror management.

PubMed

Arndt, J; Greenberg, J; Solomon, S; Pyszczynski, T; Simon, L

1997-07-01

Previous research has shown that after a mortality-salience (MS) treatment, death thought accessibility and worldview defense are initially low and then increase after a delay, suggesting that a person's initial response to conscious thoughts of mortality is to actively suppress death thoughts. If so, then high cognitive load, by disrupting suppression efforts, should lead to immediate increases in death thought accessibility and cultural worldview defense. Studies 1 and 2 supported this reasoning. Specifically, Study 1 replicated the delayed increase in death accessibility after MS among low cognitive load participants but showed a reversed pattern among participants under high cognitive load. Study 2 showed that, unlike low cognitive load participants, high cognitive load participants exhibited immediate increase in pro-American bias after MS. Study 3 demonstrated that worldview defense in response to MS reduces the delayed increase in death accessibility. Implications of these findings for understanding both terror management processes and psychological defense in general are discussed.

Train users’ perceptions of walking distance to train station and attributes of paratransit service: understanding their association with decision using paratransit or not towards the train station

NASA Astrophysics Data System (ADS)

Syafriharti, R.; Kombaitan, B.; Kusumantoro, I. P.; Syabri, I.

2018-05-01

Access mode is an important factor in public transport systems. Most of the train users from Cicalengka to Padalarang via Bandung use paratransit as access mode. Access modes under this study are only paratransit and walking. This study aims to explore the relationship between access mode choice to the station and the perception about walking distance to station, perception about attributes of paratransit service quality which consist of accessibility, cheapness, comfortable, swiftness, safety, security and easiness. Of all the variables tested, walking distance to the station is the only variable relating to the mode access choice. So, a person will tend to use paratransit when his/her perception of walking distance to station is relatively far away. While perceptions about the quality of paratransit service can not determine whether a person will choose paratransit or not.

An access technology delivery protocol for children with severe and multiple disabilities: a case demonstration.

PubMed

Mumford, Leslie; Lam, Rachel; Wright, Virginia; Chau, Tom

2014-08-01

This study applied response efficiency theory to create the Access Technology Delivery Protocol (ATDP), a child and family-centred collaborative approach to the implementation of access technologies. We conducted a descriptive, mixed methods case study to demonstrate the ATDP method with a 12-year-old boy with no reliable means of access to an external device. Evaluations of response efficiency, satisfaction, goal attainment, technology use and participation were made after 8 and 16 weeks of training with a custom smile-based access technology. At the 16 week mark, the new access technology offered better response quality; teacher satisfaction was high; average technology usage was 3-4 times per week for up to 1 h each time; switch sensitivity and specificity reached 78% and 64%, respectively, and participation scores increased by 38%. This case supports further development and testing of the ATDP with additional children with multiple or severe disabilities.

Ground access to airport study

DOT National Transportation Integrated Search

2001-08-24

The Ground Access to Airport Study for the California Department of Transportation (Department), hereinafter referred to as Caltrans, began in July 2000. The Study's primary purpose was to assist Caltrans in identifying needs and provide tools to imp...

Protecting intellectual property associated with Canadian academic clinical trials--approaches and impact.

PubMed

Ross, Sue; Magee, Laura; Walker, Mark; Wood, Stephen

2012-12-27

Intellectual property is associated with the creative work needed to design clinical trials. Two approaches have developed to protect the intellectual property associated with multicentre trial protocols prior to site initiation. The 'open access' approach involves publishing the protocol, permitting easy access to the complete protocol. The main advantages of the open access approach are that the protocol is freely available to all stakeholders, permitting them to discuss the protocol widely with colleagues, assess the quality and rigour of the protocol, determine the feasibility of conducting the trial at their centre, and after trial completion, to evaluate the reported findings based on a full understanding of the protocol. The main potential disadvantage of this approach is the potential for plagiarism; however if that occurred, it should be easy to identify because of the open access to the original trial protocol, as well as ensure that appropriate sanctions are used to deal with plagiarism. The 'restricted access' approach involves the use of non-disclosure agreements, legal documents that must be signed between the trial lead centre and collaborative sites. Potential sites must guarantee they will not disclose any details of the study before they are permitted to access the protocol. The main advantages of the restricted access approach are for the lead institution and nominated principal investigator, who protect their intellectual property associated with the trial. The main disadvantages are that ownership of the protocol and intellectual property is assigned to the lead institution; defining who 'needs to know' about the study protocol is difficult; and the use of non-disclosure agreements involves review by lawyers and institutional representatives at each site before access is permitted to the protocol, significantly delaying study implementation and adding substantial indirect costs to research institutes. This extra step may discourage sites from joining a trial. It is possible that the restricted access approach may contribute to the failure of well-designed trials without any significant benefit in protecting intellectual property. Funding agencies should formalize rules around open versus restricted access to the study protocol just as they have around open access to results.

Lexical access changes in patients with multiple sclerosis: a two-year follow-up study.

PubMed

Sepulcre, Jorge; Peraita, Herminia; Goni, Joaquin; Arrondo, Gonzalo; Martincorena, Inigo; Duque, Beatriz; Velez de Mendizabal, Nieves; Masdeu, Joseph C; Villoslada, Pablo

2011-02-01

The aim of the study was to analyze lexical access strategies in patients with multiple sclerosis (MS) and their changes over time. We studied lexical access strategies during semantic and phonemic verbal fluency tests and also confrontation naming in a 2-year prospective cohort of 45 MS patients and 20 healthy controls. At baseline, switching lexical access strategy (both in semantic and in phonemic verbal fluency tests) and confrontation naming were significantly impaired in MS patients compared with controls. After 2 years follow-up, switching score decreased, and cluster size increased over time in semantic verbal fluency tasks, suggesting a failure in the retrieval of lexical information rather than an impairment of the lexical pool. In conclusion, these findings underline the significant presence of lexical access problems in patients with MS and could point out their key role in the alterations of high-level communications abilities in MS.

Near-Earth Asteroids 2006 RH120 AND 2009 BD: Proxies for Maximally Accessible Objects?

NASA Technical Reports Server (NTRS)

Barbee, Brent W.; Chodas, Paul W.

2015-01-01

NASA's Near-Earth Object Human Space Flight Accessible Targets Study (NHATS) has identified over 1,400 of the approximately 12,800 currently known near-Earth asteroids (NEAs) as more astrodynamically accessible, round-trip, than Mars. Hundreds of those approximately 1,400 NEAs can be visited round-trip for less change-in-velocity than the lunar surface, and dozens can be visited round-trip for less change-in-velocity than low lunar orbit. How accessible might the millions of undiscovered NEAs be? We probe that question by investigating the hypothesis that NEAs 2006 RH120 and 2009 BD are proxies for the most accessible NEAs we would expect to find, and describing possible future NEA population model studies.

Rural providers' access to online resources: a randomized controlled trial

PubMed Central

Hall, Laura J.; McElfresh, Karen R.; Warner, Teddy D.; Stromberg, Tiffany L.; Trost, Jaren; Jelinek, Devin A.

2016-01-01

Objective The research determined the usage and satisfaction levels with one of two point-of-care (PoC) resources among health care providers in a rural state. Methods In this randomized controlled trial, twenty-eight health care providers in rural areas were stratified by occupation and region, then randomized into either the DynaMed or the AccessMedicine study arm. Study participants were physicians, physician assistants, and nurses. A pre- and post-study survey measured participants' attitudes toward different information resources and their information-seeking activities. Medical student investigators provided training and technical support for participants. Data analyses consisted of analysis of variance (ANOVA), paired t tests, and Cohen's d statistic to compare pre- and post-study effects sizes. Results Participants in both the DynaMed and the AccessMedicine arms of the study reported increased satisfaction with their respective PoC resource, as expected. Participants in both arms also reported that they saved time in finding needed information. At baseline, both arms reported too little information available, which increased to “about right amounts of information” at the completion of the study. DynaMed users reported a Cohen's d increase of +1.50 compared to AccessMedicine users' reported use of 0.82. DynaMed users reported d2 satisfaction increases of 9.48 versus AccessMedicine satisfaction increases of 0.59 using a Cohen's d. Conclusion Participants in the DynaMed arm of the study used this clinically oriented PoC more heavily than the users of the textbook-based AccessMedicine. In terms of user satisfaction, DynaMed users reported higher levels of satisfaction than the users of AccessMedicine. PMID:26807050

Two signs indicative of successful access in nuclear medicine cerebrospinal fluid diversionary shunt studies.

PubMed

Bermo, Mohammed S; Khalatbari, Hedieh; Parisi, Marguerite T

2018-05-08

Successful shunt access is the first step in a properly performed nuclear medicine cerebrospinal fluid (CSF) shunt study. To determine the significance of the radiotracer configuration at the injection site during initial nuclear medicine CSF shunt imaging and the lack of early systemic radiotracer activity as predictors of successful shunt access. With Institutional Review Board approval, three nuclear medicine physicians performed a retrospective review of all consecutive CSF shunt studies performed in children at our institution in 2015. Antecedent nuclear medicine CSF shunt studies in these patients were also assessed and included in the review. The appearance of the reservoir site immediately after radiotracer injection was classified as either figure-of-eight or round/ovoid configuration. The presence or absence of early systemic distribution of the tracer on the 5-min static images was noted and separately evaluated. A total of 98 nuclear medicine ventriculoperitoneal CSF shunt studies were evaluated. Figure-of-eight configuration was identified in 87% of studies and, when present, had 93% sensitivity, 78% specificity, 92% accuracy, 98% positive predictive value (PPV) and 54% negative predictive value (NPV) as a predictor of successful shunt access. Early systemic activity was absent in 89 of 98 studies. Lack of early systemic distribution of the radiotracer had 98% sensitivity, 78% specificity, 96% accuracy, 98% PPV and 78% NPV as a predictor of successful shunt access. Figure-of-eight configuration in conjunction with the absence of early systemic tracer activity had 99% PPV for successful shunt access. Figure-of-eight configuration at the injection site or lack of early systemic radiotracer activity had moderate specificity for successful shunt access. Specificity and PPV significantly improved when both signs were combined in assessment.

Cancer patients' attitudes and experiences of online access to their electronic medical records: A qualitative study.

PubMed

Rexhepi, Hanife; Åhlfeldt, Rose-Mharie; Cajander, Åsa; Huvila, Isto

2018-06-01

Patients' access to their online medical records serves as one of the cornerstones in the efforts to increase patient engagement and improve healthcare outcomes. The aim of this article is to provide in-depth understanding of cancer patients' attitudes and experiences of online medical records, as well as an increased understanding of the complexities of developing and launching e-Health services. The study result confirms that online access can help patients prepare for doctor visits and to understand their medical issues. In contrast to the fears of many physicians, the study shows that online access to medical records did not generate substantial anxiety, concerns or increased phone calls to the hospital.

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

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.

[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.

Access to dental care among 15–64 year old people

PubMed Central

Eslamipour, Faezeh; Heydari, Kamal; Ghaiour, Marzieh; Salehi, Hoda

2018-01-01

INTRODUCTION: The current study aims to study people's access to oral and dental health-care services and their satisfaction with the services provided to them. MATERIALS AND METHODS: A descriptive study with multi-stage sampling was conducted on 1360 people aged 16–64 years residing in Isfahan city, Iran. The required data were collected by a questionnaire which comprised of three main parts: demographic characteristics, patients’ access to oral and dental health-care services and its barriers and participants’ satisfaction with access to services. Data were analyzed by SPSS statistical software. RESULTS: The results showed 40% of participants reported an average level for oral health, and 82% of them did not have any problems regarding access to dental care facilities. The main causes of their dissatisfaction were high cost of services (60%) and insufficient health insurance coverage (40%). About 73% reported that they had to spend 30 min or less to access to a dental health-care facility. In addition, 50% of participants were satisfied with the provided services. The main reported reasons for referring to dentists were oral and dental problems (69%) and regular check-ups (15%). There was no significant relationship between participants’ gender, education level, insurance coverage, and access to dental health-care centers (P > 0.05). CONCLUSION: Most participants were satisfied with access to dental healthcare, but they were dissatisfied with the costs and inadequate insurance coverage. About half of the participants were satisfied with the services provided to them, and the highest level of satisfaction was reported for easy access to health-care centers. PMID:29693027

Insertion side, body position and circuit life during continuous renal replacement therapy with femoral vein access.

PubMed

Kim, In Byung; Fealy, Nigel; Baldwin, Ian; Bellomo, Rinaldo

2011-01-01

Choice of insertion side and patient position during continuous renal replacement therapy (CRRT) with femoral vein vascular access may affect circuit life. We investigated if there is an association between choice of insertion side and body position and its changes and circuit life during CRRT with femoral vein access. We studied 50 patients receiving CRRT via femoral vein access with a sequential retrospective study in a tertiary intensive care unit. We defined two groups: patients with right or left femoral vein access. We then obtained information on age, gender, circuit life, total heparin dose, hemoglobin concentration and coagulation variables (platelet count, international normalized ratio, and activated partial thromboplastin time) and percentage of time each patient spent in the supine, left lying, right lying, and sitting position during treatment. We studied 341 circuits in 50 patients. Mean circuit life was 13.9 h. Of these circuits, 251 (73.6%) were treated with right femoral vein access. Mean circuit life in this group was significantly longer compared with left femoral vein access (15.0 ± 14.3 vs. 10.6 ± 7.4; p = 0.019). Percentage spent in a particular position during CRRT was not significantly different between two groups. On multivariable linear regression analysis, mean circuit life was significantly and positively correlated with right vascular access site (p = 0.03) and lower platelet count (p = 0.03), but not with patient position. Right-sided insertion but not time spent in a particular position significantly affects circuit life during CRRT with femoral vein access. Copyright © 2010 S. Karger AG, Basel.

Social Inequality in Access to Higher Education: Grade Inflation in Private Schools and the Ineffectiveness of Compensatory Education

ERIC Educational Resources Information Center

Neves, Tiago; Ferraz, Hélder; Nata, Gil

2016-01-01

Access to higher education is affected by inequalities worldwide. Here we present a longitudinal study based on large databases of scores in upper secondary education and access to higher education in Portugal. Our findings show how access to higher education builds on and reinforces social inequalities: (1) private, fee-paying secondary schools…

Restricting access to publications from funded research: ethical issues and solutions.

PubMed

Manikandan, S; Vani, N Isai

2010-01-01

India is becoming one of the hubs of clinical research. Commensurate with these advances, the government funding for biomedical research in thrust areas is also increasing. The Indian Council of Medical Research (ICMR), Department of Biotechnology (DBT), Department of Science and Technology (DST) are some of the government organizations which provide financial support for various research projects. The results of the funded research projects are published in various international journals. Most of these journals have an access to paid subscribers only. Hence it is unethical to use the research grants from government (people's money) and not allow the scientific community free access to the results of the study. To tackle such issues, these agencies should sign the Berlin declaration and create open access repositories. A public access policy should be formulated and listed in JULIET. The funding bodies in India should also join Pubmed Central (PMC) to form PMC India so that every investigator who has received grants would submit the full text of the paper published from his study and these can be made freely accessible to everyone. Universities and research institutions should also develop institutional open access repositories. The public access policy has definitive advantages and should be implemented.

Mobile phone interventions for tuberculosis should ensure access to mobile phones to enhance equity - A prospective, observational cohort study in Peruvian shantytowns.

PubMed

Saunders, Matthew J; Wingfield, Tom; Tovar, Marco A; Herlihy, Niamh; Rocha, Claudio; Zevallos, Karine; Montoya, Rosario; Ramos, Eric; Datta, Sumona; Evans, Carlton A

2018-06-04

Mobile phone interventions have been advocated for tuberculosis care, but little is known about access of target populations to mobile phones. We studied mobile phone access amongst patients with tuberculosis, focusing on vulnerable patients and patients who later had adverse treatment outcomes. In a prospective cohort study in Callao, Peru, we recruited and interviewed 2,584 patients with tuberculosis between 2007-2013 and followed them until 2016 for adverse treatment outcomes using national treatment registers. Subsequently, we recruited a further 622 patients between 2016-2017. Data were analysed using logistic regression and by calculating relative risks (RR). Between 2007-2013, the proportion of the general population of Peru without mobile phone access averaged 7.8% but for patients with tuberculosis was 18% (p<0.001). Patients without access were more likely to hold a lower socioeconomic position, suffer from food insecurity and be older than 50 years (all p<0.01). Compared to patients with mobile phone access, patients without access at recruitment were more likely to subsequently have incomplete treatment (20% versus 13%, RR=1.5; p=0.001) or an adverse treatment outcome (29% versus 23% RR=1.3; p=0.006). Between 2016 and 2017, the proportion of patients without access dropped to 8.9% overall, but remained the same (18%) as in 2012 among the poorest third. Access to mobile phones among patients with tuberculosis is insufficient, and rarest in patients who are poorer and later have adverse treatment outcomes. Thus, mobile phone interventions to improve tuberculosis care may be least accessed by the priority populations for whom they are intended. Such interventions should ensure access to mobile phones to enhance equity. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

A study of the effect of ADA accessibility on Kansas roundabouts.

DOT National Transportation Integrated Search

2008-11-01

The Access Board, with authority to enforce provisions of the American Disabilities Act (ADA), initially determined : that roundabouts are not accessible by blind pedestrians and drafted proposed guidelines to require pedestrian : signals at all roun...

Interventions to Improve Access to Primary Care for People Who Are Homeless: A Systematic Review

PubMed Central

2016-01-01

Background People who are homeless encounter barriers to primary care despite having greater needs for health care, on average, than people who are not homeless. We evaluated the effectiveness of interventions to improve access to primary care for people who are homeless. Methods We performed a systematic review to identify studies in English published between January 1, 1995, and July 8, 2015, comparing interventions to improve access to a primary care provider with usual care among people who are homeless. The outcome of interest was access to a primary care provider. The risk of bias in the studies was evaluated, and the quality of the evidence was assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. Results From a total of 4,047 citations, we identified five eligible studies (one randomized controlled trial and four observational studies). With the exception of the randomized trial, the risk of bias was considered high in the remaining studies. In the randomized trial, people who were homeless, without serious mental illness, and who received either an outreach intervention plus clinic orientation or clinic orientation alone, had improved access to a primary care provider compared with those receiving usual care. An observational study that compared integration of primary care and other services for people who are homeless with usual care did not observe any difference in access to a primary care provider between the two groups. A small observational study showed improvement among participants with a primary care provider after receiving an intervention consisting of housing and supportive services compared with the period before the intervention. The quality of the evidence was considered moderate for both the outreach plus clinic orientation and clinic orientation alone, and low to very low for the other interventions. Despite limitations, the literature identified reports of interventions developed to overcome barriers in access to primary care in people who are homeless. The interventions studied are complex and include multiple components that are consistent with proposed dimensions of access to care (availability, affordability, and acceptability). Conclusions Our systematic review of the literature identified various types of interventions that seek to improve access to primary care by attempting to address barriers to care encountered by people who are homeless. Moderate-quality evidence indicates that orientation to clinic services (either alone or combined with outreach) improves access to a primary care provider in adults who are homeless, without serious mental illness, and living in urban centres. PMID:27099645

Interventions to Improve Access to Primary Care for People Who Are Homeless: A Systematic Review.

PubMed

2016-01-01

People who are homeless encounter barriers to primary care despite having greater needs for health care, on average, than people who are not homeless. We evaluated the effectiveness of interventions to improve access to primary care for people who are homeless. We performed a systematic review to identify studies in English published between January 1, 1995, and July 8, 2015, comparing interventions to improve access to a primary care provider with usual care among people who are homeless. The outcome of interest was access to a primary care provider. The risk of bias in the studies was evaluated, and the quality of the evidence was assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. From a total of 4,047 citations, we identified five eligible studies (one randomized controlled trial and four observational studies). With the exception of the randomized trial, the risk of bias was considered high in the remaining studies. In the randomized trial, people who were homeless, without serious mental illness, and who received either an outreach intervention plus clinic orientation or clinic orientation alone, had improved access to a primary care provider compared with those receiving usual care. An observational study that compared integration of primary care and other services for people who are homeless with usual care did not observe any difference in access to a primary care provider between the two groups. A small observational study showed improvement among participants with a primary care provider after receiving an intervention consisting of housing and supportive services compared with the period before the intervention. The quality of the evidence was considered moderate for both the outreach plus clinic orientation and clinic orientation alone, and low to very low for the other interventions. Despite limitations, the literature identified reports of interventions developed to overcome barriers in access to primary care in people who are homeless. The interventions studied are complex and include multiple components that are consistent with proposed dimensions of access to care (availability, affordability, and acceptability). Our systematic review of the literature identified various types of interventions that seek to improve access to primary care by attempting to address barriers to care encountered by people who are homeless. Moderate-quality evidence indicates that orientation to clinic services (either alone or combined with outreach) improves access to a primary care provider in adults who are homeless, without serious mental illness, and living in urban centres.

Efficient Access Control in Multimedia Social Networks

NASA Astrophysics Data System (ADS)

Sachan, Amit; Emmanuel, Sabu

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

Accessibility of antiretroviral therapy in Ghana: convenience of access.

PubMed

Addo-Atuah, Joyce; Gourley, Dick; Gourley, Greta; White-Means, Shelley I; Womeodu, Robin J; Faris, Richard J; Addo, Nii Akwei

2012-01-01

The convenience of accessing antiretroviral therapy (ART) is important for initial access to care and subsequent adherence to ART. We conducted a qualitative study of people living with HIV/AIDS (PLWHA) and ART healthcare providers in Ghana in 2005. The objective of this study was to explore the participants' perceived convenience of accessing ART by PLWHA in Ghana. The convenience of accessing ART was evaluated from the reported travel and waiting times to receive care, the availability, or otherwise, of special considerations, with respect to the waiting time to receive care, for those PLWHA who were in active employment in the formal sector, the frequency of clinic visits before and after initiating ART, and whether the PLWHA saw the same or different providers at each clinic visit (continuity of care). This qualitative study used in-depth interviews based on Yin's case-study research design to collect data from 20 PLWHA and 24 ART healthcare providers as study participants. • Reported travel time to receive ART services ranged from 2 to 12 h for 30% of the PLWHA. • Waiting time to receive care was from 4 to 9 h. • While known government workers, such as teachers, were attended to earlier in some of the centres, this was not a consistent practice in all the four ART centres studied. • The PLWHA corroborated the providers' description of the procedure for initiating and monitoring ART in Ghana. • PLWHA did not see the same provider every time, but they were assured that this did not compromise the continuity of their care. Our study suggests that convenience of accessing ART is important to both PLWHA and ART healthcare providers, but the participants alluded to other factors, including open provider-patient communication, which might explain the PLWHA's understanding of the constraints under which they were receiving care. The current nation-wide coverage of the ART programme in Ghana, however, calls for the replication of this study to identify possible perception changes over time that may need attention. Our study findings can inform interventions to promote access to ART, especially in Africa.

Genetic divergence among Psidium accessions based on single nucleotide polymorphisms developed for Eucalyptus.

PubMed

Costa, S R; Santos, C A F

2017-05-04

The goal of this study was to analyze the genetic divergence among Psidium species accessions based on SNPs developed for Eucalyptus. Fifty-three Psidium accessions, including 47 P. guajava, were genotyped with EUCHIP60K. The dendrogram similarity ranged from 0.58 to 1.00, with a cophenetic value of 0.97. Five groups were identified at dendrogram cut point of 0.7: the first with 44 guava accessions, the second with 1 guava accession, the third with 3 P. guineense accessions, the forth with 2 guava accessions, and the fifth with 3 P. cattleianum accessions. The Bayesian analyses suggested seven subpopulations, with formation of two additional groups with guava accessions. Primers designed with Eucalyptus SNP sequences resulted in reliable Psidium amplicons on 6% polyacrylamide gels. In general, the SNP dendrogram agreed with biological genus structure, since different species were not grouped, indicating that transferability among Myrtaceae genus was possible and reliable.

A Framework for Context Sensitive Risk-Based Access Control in Medical Information Systems

PubMed Central

Choi, Donghee; Kim, Dohoon; Park, Seog

2015-01-01

Since the access control environment has changed and the threat of insider information leakage has come to the fore, studies on risk-based access control models that decide access permissions dynamically have been conducted vigorously. Medical information systems should protect sensitive data such as medical information from insider threat and enable dynamic access control depending on the context such as life-threatening emergencies. In this paper, we suggest an approach and framework for context sensitive risk-based access control suitable for medical information systems. This approach categorizes context information, estimating and applying risk through context- and treatment-based permission profiling and specifications by expanding the eXtensible Access Control Markup Language (XACML) to apply risk. The proposed framework supports quick responses to medical situations and prevents unnecessary insider data access through dynamic access authorization decisions in accordance with the severity of the context and treatment. PMID:26075013

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.

Airport Ground Access Study

DOT National Transportation Integrated Search

1978-03-02

In response to a request by Congress, the FAA and TSC have undertaken a study to determine the extent to which inadequate (off-airport) ground access to airports constrains airport capacity and air travel. Presently, TSC is preparing case studies of ...

Exploring the Relationship between Access Technology and Standardized Test Scores for Youths with Visual Impairments: Secondary Analysis of the National Longitudinal Transition Study 2

ERIC Educational Resources Information Center

Freeland, Amy L.; Emerson, Robert Wall; Curtis, Amy B.; Fogarty, Kieran

2010-01-01

This article presents the findings of a secondary analysis of the National Longitudinal Transition Study 2 that explored the predictive association between training in access technology and performance on the Woodcock-Johnson Tests of Academic Achievement: III. The results indicated that the use of access technology had a limited predictive…

Patient Access Study

DTIC Science & Technology

1998-03-01

guidelines. 14. SUBJECT TERMS Efficiency, health care issues, medical services, military medicine, military standards, Navy, patients , scheduling...Rev. 2-89) Prescribed by ANSI Std. 239-18 299-01 Patient Access Study Sponsor: Assistant Chief for Health Care Operations (MED 03) March 1998...Michelle Dolfini-Reed Derek Shia In today’s highly competitive health care market, patient access to care is the key ingredient to a practice’s

What Is the Impact of Full Access to Technology on the Achievement of the Hispanic Student?

ERIC Educational Resources Information Center

Carr, John E., Jr.

2013-01-01

The problem studied in this research was whether the impact of full access to technology both at home and in school would affect the achievement of Hispanic students. The purpose of this study was to examine the relationship between the access to technology and the achievement of the Hispanic students at a suburban middle school. What are the…

WWC Review of the Report "Looking beyond Enrollment: The Causal Effect of Need-Based Grants on College Access, Persistence, and Graduation." What Works Clearinghouse Single Study Review

ERIC Educational Resources Information Center

What Works Clearinghouse, 2014

2014-01-01

The 2013 study, "Looking Beyond Enrollment: The Causal Effect of Need-Based Grants on College Access, Persistence, and Graduation," examined whether eligibility for the Florida Student Access Grant (FSAG), a need-based grant for low-income students in Florida, affects college enrollment, credit accumulation, persistence over time in…

Limited school drinking water access for youth

PubMed Central

Kenney, Erica L.; Gortmaker, Steven L.; Cohen, Juliana F.W.; Rimm, Eric B.; Cradock, Angie L.

2016-01-01

PURPOSE Providing children and youth with safe, adequate drinking water access during school is essential for health. This study utilized objectively measured data to investigate the extent to which schools provide drinking water access that meets state and federal policies. METHODS We visited 59 middle and high schools in Massachusetts during spring 2012. Trained research assistants documented the type, location, and working condition of all water access points throughout each school building using a standard protocol. School food service directors (FSDs) completed surveys reporting water access in cafeterias. We evaluated school compliance with state plumbing codes and federal regulations and compared FSD self-reports of water access with direct observation; data were analyzed in 2014. RESULTS On average, each school had 1.5 (SD: 0.6) water sources per 75 students; 82% (SD: 20) were functioning, and fewer (70%) were both clean and functioning. Less than half of the schools met the federal Healthy Hunger Free Kids Act requirement for free water access during lunch; 18 schools (31%) provided bottled water for purchase but no free water. Slightly over half (59%) met the Massachusetts state plumbing code. FSDs overestimated free drinking water access compared to direct observation (96% FSD-reported versus 48% observed, kappa=0.07, p=0.17). CONCLUSIONS School drinking water access may be limited. In this study, many schools did not meet state or federal policies for minimum student drinking water access. School administrative staff may not accurately report water access. Public health action is needed to increase school drinking water access. IMPLICATIONS AND CONTRIBUTIONS Adolescents’ water consumption is lower than recommended. In a sample of Massachusetts middle and high schools, about half did not meet federal and state minimum drinking water access policies. Direct observation may improve assessments of drinking water access and could be integrated into routine school food service monitoring protocols. PMID:27235376

Minimizing Spatial Variability of Healthcare Spatial Accessibility-The Case of a Dengue Fever Outbreak.

PubMed

Chu, Hone-Jay; Lin, Bo-Cheng; Yu, Ming-Run; Chan, Ta-Chien

2016-12-13

Outbreaks of infectious diseases or multi-casualty incidents have the potential to generate a large number of patients. It is a challenge for the healthcare system when demand for care suddenly surges. Traditionally, valuation of heath care spatial accessibility was based on static supply and demand information. In this study, we proposed an optimal model with the three-step floating catchment area (3SFCA) to account for the supply to minimize variability in spatial accessibility. We used empirical dengue fever outbreak data in Tainan City, Taiwan in 2015 to demonstrate the dynamic change in spatial accessibility based on the epidemic trend. The x and y coordinates of dengue-infected patients with precision loss were provided publicly by the Tainan City government, and were used as our model's demand. The spatial accessibility of heath care during the dengue outbreak from August to October 2015 was analyzed spatially and temporally by producing accessibility maps, and conducting capacity change analysis. This study also utilized the particle swarm optimization (PSO) model to decrease the spatial variation in accessibility and shortage areas of healthcare resources as the epidemic went on. The proposed method in this study can help decision makers reallocate healthcare resources spatially when the ratios of demand and supply surge too quickly and form clusters in some locations.

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.

Water-chemistry and on-site sulfur-speciation data for selected springs in Yellowstone National Park, Wyoming, 1994-1995

USGS Publications Warehouse

Ball, James W.; Nordstrom, D. Kirk; Cunningham, Kirk M.; Schoonen, Martin A.; Xu, Yong; DeMonge, Jennifer M.

1998-01-01

Forty-two water analyses are reported for samples collected at 8 hot springs and their overflow drainages, two geysers, and two ambient-temperature acid streams in Yellowstone National Park during 1994-95. These water samples were collected and analyzed as part of the initial research investigations on sulfur redox speciation in the hot springs of Yellowstone and to document chemical changes in overflows that affect major ions, redox species, and trace elements. The sulfur redox speciation research is a collaboration between the State University of New York (SUNY) at Stony Brook and the U.S. Geological Survey (USGS). Four hot springs, Ojo Caliente, Azure, Frying Pan, and Angel Terrace, were studied in detail. Analyses were performed adjacent to the sampling site or in an on-site mobile lab truck constructed by the USGS, or later in a USGS laboratory. Water temperature, specific conductance, pH, Eh, D.O., and dissolved H2S were determined adjacent to the sample source at the time of sampling. Alkalinity and F- were determined on-site on the day of sample collection. Thiosulfate and polythionates were determined as soon as possible (minutes to hours later) by ion chromatography (IC). Other major anions (Cl-, SO4 2-, Br-) also were determined on-site by IC within two days of sample collection. Ammonium, Fe(II), and Fe(total) were determined on-site by ultraviolet/visible spectrophotometry within two days of sample collection. Later in the USGS laboratory, densities were determined. Concentrations of Ca, Mg, Li, Na, and K were determined by flame atomic absorption and emission (Na, K) spectrometry. Concentrations of Al, As, B, Ba, Be, Ca, Cd, Co, Cr, Cu, Fe(total), K, Mg, Mn, Na, Ni, Pb, Si, Sr, V, and Zn were determined by inductively-coupled plasma optical emission spectrometry. Trace concentrations of Al and Mg were determined by Zeeman-corrected graphite furnace atomic absorption spectrometry. Three important conclusions from the sampling and analyses are: (1) variability in H2S concentrations can be caused as much by sampling and preservation artifacts as by actual variations in water composition over time, (2) historical determinations of S2O3 2- were subject to overestimation, most likely because of inadequate preservation leading to H2S oxidation, and (3) S2O3 2- is a common constituent of hot spring waters.

Observing changes at Santiaguito Volcano, Guatemala with an Unmanned Aerial Vehicle (UAV)

NASA Astrophysics Data System (ADS)

De Angelis, S.; von Aulock, F.; Lavallée, Y.; Hornby, A. J.; Kennedy, B.; Lamb, O. D.; Kendrick, J. E.

2016-12-01

Santiaguito Volcano (Guatemala) is one of the most active volcanoes in Central America, producing several ash venting explosions per day for almost 100 years. Lahars, lava flows and dome and flank collapses that produce major pyroclastic density currents also present a major hazard to nearby farms and communities. Optical observations of both the vent as well as the lava flow fronts can provide scientists and local monitoring staff with important information on the current state of volcanic activity and hazard. Due to the strong activity, and difficult terrain, unmanned aerial vehicles can help to provide valuable data on the activities of the volcano at a safe distance. We collected a series of images and video footage of the active vent of Caliente and the flow front of the active lava flow and its associated lahar channels, both in May 2015 and in December 2015- January 2016. Images of the crater and the lava flows were used for the reconstruction of 3D terrain models using structure-from-motion. These models can be used to constrain topographical changes and distribution of ballistics via cloud comparisons. The preliminary data of aerial images and videos of the summit crater (during two separate ash venting episodes) and the lava flow fronts indicate the following differences in activity during those two field campaigns: - A recorded explosive event in December 2015 initiates at subparallel linear faults near the centre of the dome, with a later, separate, and more ash-laden burst occurring from an off-centre fracture. - A comparison of the point clouds before and after a degassing explosion shows minor subsidence of the dome surface and the formation of several small craters at the main venting locations. - The lava flow fronts did not advance more than a few meters between May and December 2015. - Damming of river valleys by the lava flows has established new stream channels that have modified established pathways for the recurring lahars, one of the major hazards of Santiaguito volcano. The preliminary results of this study from two fieldtrips to Santiaguito Volcano are exemplary for the plethora of applications of UAVs in the field of volcano monitoring, and we urge funding agencies and legislative bodies to consider the value of these scientific instruments in future decisions and allocation of funding.

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

PubMed Central

Aljunid, Syed Mohamed

2018-01-01

Access to healthcare is essential in the pursuit of universal health coverage. Components of access are availability, accessibility (spatial and non-spatial), affordability and acceptability. Measuring spatial accessibility is common approach to evaluating access to health care. This study aimed to determine the availability and spatial accessibility of subsidised mammogram screening in Peninsular Malaysia. Availability was determined from the number and distribution of facilities. Spatial accessibility was determined using the travel impedance approach to represent the revealed access as opposed to potential access measured by other spatial measurement methods. The driving distance of return trips from the respondent’s residence to the facilities was determined using a mapping application. The travel expenditure was estimated by multiplying the total travel distance by a standardised travel allowance rate, plus parking fees. Respondents in this study were 344 breast cancer patients who received treatment at 4 referral hospitals between 2015 and 2016. In terms of availability, there were at least 6 major entities which provided subsidised mammogram programs. Facilities with mammogram involved with these programs were located more densely in the central and west coast region of the Peninsula. The ratio of mammogram facility to the target population of women aged 40–74 years ranged between 1: 10,000 and 1:80,000. In terms of accessibility, of the 3.6% of the respondents had undergone mammogram screening, their mean travel distance was 53.4 km (SD = 34.5, range 8–112 km) and the mean travel expenditure was RM 38.97 (SD = 24.00, range RM7.60–78.40). Among those who did not go for mammogram screening, the estimated travel distance and expenditure had a skewed distribution with median travel distance of 22.0 km (IQR 12.0, 42.0, range 2.0–340.0) and the median travel cost of RM 17.40 (IQR 10.40, 30.00, range 3.40–240.00). Higher travel impedance was noted among those who lived in sub-urban and rural areas. In summary, availability of mammogram facilities was good in the central and west coast of the peninsula. The overall provider-to-population ratio was lower than recommended. Based on the travel impedance approach used, accessibility to subsidised mammogram screening among the respondents was good in urban areas but deprived in other areas. This study was a preliminary study with limitations. Nonetheless, the evidence suggests that actions have to be taken to improve the accessibility to opportunistic mammogram screening in Malaysia in pursuit of universal health coverage. PMID:29389972

What Remains on Your Mind After You Are Done?: Flexible Regulation of Knowledge Accessibility

PubMed Central

Hedberg, Per H.; Higgins, E. Tory

2011-01-01

The accessibility of stored knowledge has been found to decline over time after activation without further stimulation. A special case is goal pursuit; goal-related knowledge remains accessible until goal completion, and then its accessibility declines rapidly. We hypothesized that after goal completion the decline in accessibility of goal-related knowledge would be especially rapid for strong promotion-focused individuals because their motivation to eagerly advance beyond the status quo would make accessibility of this knowledge an irrelevant detriment. We hypothesized an opposite effect for strongly prevention-predominant individuals because their motivation to vigilantly maintain a satisfactory state would make accessibility of this knowledge continually relevant. The results of two studies supported both these predicted moderators of accessibility change. Indeed, we found that for strongly prevention-predominant participants, knowledge accessibility actually increased over time after goal completion. We discuss how even basic cognitive mechanisms, like changes in accessibility, can be affected by general motivational concerns. PMID:21765541

Concentration of Access to Information and Communication Technologies in the Municipalities of the Brazilian Legal Amazon.

PubMed

de Brito, Silvana Rossy; da Silva, Aleksandra do Socorro; Cruz, Adejard Gaia; Monteiro, Maurílio de Abreu; Vijaykumar, Nandamudi Lankalapalli; da Silva, Marcelino Silva; Costa, João Crisóstomo Weyl Albuquerque; Francês, Carlos Renato Lisboa

2016-01-01

This study fills demand for data on access and use of information and communication technologies (ICT) in the Brazilian legal Amazon, a region of localities with identical economic, political, and social problems. We use the 2010 Brazilian Demographic Census to compile data on urban and rural households (i) with computers and Internet access, (ii) with mobile phones, and (iii) with fixed phones. To compare the concentration of access to ICT in the municipalities of the Brazilian Amazon with other regions of Brazil, we use a concentration index to quantify the concentration of households in the following classes: with computers and Internet access, with mobile phones, with fixed phones, and no access. These data are analyzed along with municipal indicators on income, education, electricity, and population size. The results show that for urban households, the average concentration in the municipalities of the Amazon for computers and Internet access and for fixed phones is lower than in other regions of the country; meanwhile, that for no access and mobile phones is higher than in any other region. For rural households, the average concentration in the municipalities of the Amazon for computers and Internet access, mobile phones, and fixed phones is lower than in any other region of the country; meanwhile, that for no access is higher than in any other region. In addition, the study shows that education and income are determinants of inequality in accessing ICT in Brazilian municipalities and that the existence of electricity in rural households is directly associated with the ownership of ICT resources.

The base rates and factors associated with reported access to firearms in psychiatric inpatients.

PubMed

Kolla, Bhanu Prakash; O'Connor, Stephen S; Lineberry, Timothy W

2011-01-01

The aim of this study was to define whether specific patient demographic groups, diagnoses or other factors are associated with psychiatric inpatients reporting firearms access. A retrospective medical records review study was conducted using information on access to firearms from electronic medical records for all patients 16 years and older admitted between July 2007 and May 2008 at the Mayo Clinic Psychiatric Hospital in Rochester, MN. Data were obtained only on patients providing authorization for record review. Data were analyzed using univariate and multivariate logistic regression analyses accounting for gender, diagnostic groups, comorbid substance use, history of suicide attempts and family history of suicide/suicide attempts. Seventy-four percent (1169/1580) of patients provided research authorization. The ratio of men to women was identical in both research and nonresearch authorization groups. There were 14.6% of inpatients who reported firearms access. In univariate analysis, men were more likely (P<.0001) to report access than women, and a history of previous suicide attempt(s) was associated with decreased access (P=.02). Multiple logistic regression analyses controlling for other factors found females and patients with history of previous suicide attempt(s) less likely to report access, while patients with a family history of suicide or suicide attempts reported increased firearms access. Diagnostic groups were not associated with access on univariate or multiple logistic regression analyses. Men and inpatients with a family history of suicide/suicide attempts were more likely to report firearms access. Clinicians should develop standardized systems of identification of firearms access and provide guidance on removal. Copyright © 2011 Elsevier Inc. All rights reserved.

Concentration of Access to Information and Communication Technologies in the Municipalities of the Brazilian Legal Amazon

PubMed Central

de Brito, Silvana Rossy; da Silva, Aleksandra do Socorro; Cruz, Adejard Gaia; Monteiro, Maurílio de Abreu; Vijaykumar, Nandamudi Lankalapalli; da Silva, Marcelino Silva; Costa, João Crisóstomo Weyl Albuquerque; Francês, Carlos Renato Lisboa

2016-01-01

This study fills demand for data on access and use of information and communication technologies (ICT) in the Brazilian legal Amazon, a region of localities with identical economic, political, and social problems. We use the 2010 Brazilian Demographic Census to compile data on urban and rural households (i) with computers and Internet access, (ii) with mobile phones, and (iii) with fixed phones. To compare the concentration of access to ICT in the municipalities of the Brazilian Amazon with other regions of Brazil, we use a concentration index to quantify the concentration of households in the following classes: with computers and Internet access, with mobile phones, with fixed phones, and no access. These data are analyzed along with municipal indicators on income, education, electricity, and population size. The results show that for urban households, the average concentration in the municipalities of the Amazon for computers and Internet access and for fixed phones is lower than in other regions of the country; meanwhile, that for no access and mobile phones is higher than in any other region. For rural households, the average concentration in the municipalities of the Amazon for computers and Internet access, mobile phones, and fixed phones is lower than in any other region of the country; meanwhile, that for no access is higher than in any other region. In addition, the study shows that education and income are determinants of inequality in accessing ICT in Brazilian municipalities and that the existence of electricity in rural households is directly associated with the ownership of ICT resources. PMID:27035577

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

PubMed

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

2011-06-01

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

Frontage Roads in Texas: Legal Issues, Operational Issues, and Land Use Distinctions

DOT National Transportation Integrated Search

2000-08-01

This research project investigates frontage roads as an element of limited-access highway design. The discussion in this paper reviews legal statutes affecting public access to roadways, summarizes studies on access-right valuation, and considers a v...

Transit and trail connections: assessment of visitor access to National Wildlife Refuges

DOT National Transportation Integrated Search

2010-12-01

The purpose of the study is to characterize the use of transit and non-motorized transportation modes for visitor access to National Wildlife Refuges (NWRs), as well as identify opportunities for and constraints to alternative transportation access. ...

Microsimulation of the Impact of Access Management Practices to Pedestrians

DOT National Transportation Integrated Search

2018-12-31

The study applied microsimulation to analyze the impact of access management (AM) to the operational performances of vehicles and pedestrians. A conceptual model was developed in VISSIM and VISWALK to examine the effect of access and signals density ...

Open access for freight railroads : worthwhile or wasteful disruption, final report.

DOT National Transportation Integrated Search

2009-01-01

This study compares the experience of the freight railroads in North America, Europe and : Australia with required access. Europe and Australia have pursued very different network access : strategies than the United States and Canada. Both the Europe...

Policies to Spur Energy Access. Executive Summary; Volume 1, Engaging the Private Sector in Expanding Access to Electricity; Volume 2, Case Studies to Public-Private Models to Finance Decentralized Electricity Access

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

Walters, Terri; Rai, Neha; Esterly, Sean

Government policy is one of the most important factors in engaging the private sector in providing universal access to electricity. In particular, the private sector is well positioned to provide decentralized electricity products and services. While policy uncertainty and regulatory barriers can keep enterprises and investors from engaging in the market, targeted policies can create opportunities to leverage private investment and skills to expand electricity access. However, creating a sustainable market requires policies beyond traditional electricity regulation. The report reviews the range of policy issues that impact the development and expansion of a market for decentralized electricity services from establishingmore » an enabling policy environment to catalyzing finance, building human capacity, and integrating energy access with development programs. The case studies in this report show that robust policy frameworks--addressing a wide range of market issues--can lead to rapid transformation in energy access. The report highlights examples of these policies in action Bangladesh, Ethiopia, Mali, Mexico, and Nepal.« less

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

PubMed

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

2013-01-01

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

Emerging new practices in technology to support independent community access for people with intellectual and cognitive disabilities.

PubMed

Stock, Steven E; Davies, Daniel K; Wehmeyer, Michael L; Lachapelle, Yves

2011-01-01

The concept of community access is a multidimensional term, which may involve issues related to physical access, knowledge and information, power and control, relationships and communications, advocacy, participation and quality of life [21]. This paper discusses historical and emerging practices and interventions related to physical access to community and community based information for individuals with cognitive disabilities such as intellectual disability, autism or traumatic brain injury. While much societal attention has been paid to features of independent community access for populations such as individuals with hearing, vision or physical disabilities, less attention has focused on independent community access for people with intellectual and other significant cognitive disabilities. Attitudes and actions by families and professional service communities are often mixed for some individuals in this population. The somewhat limited research base in these areas is explored, including a case study review and results from several promising feasibility studies. The paper concludes with comments concerning future prospects and recommendations for improving independent community access for persons with significant cognitive disabilities.

Values, inter-attitudinal structure, and attitude change: value accessibility can increase a related attitude's resistance to change.

PubMed

Blankenship, Kevin L; Wegener, Duane T; Murray, Renee A

2015-12-01

Accessibility is one of the most basic structural properties of an attitude and an important factor to consider in attitude strength. Despite its importance, relatively little work has examined the role of attitude accessibility in an inter-attitudinal context, particularly as it relates to the strength of related attitudes in the network. The present research examines accessibility as a property of one attitude (toward an abstract goal or end-state, that is, a value) that might influence the strength of a different but related attitude (toward a social policy conceptually related to the value). In Study 1, a highly accessible evaluative component of a value increased resistance to change of attitudes and behavioral intentions toward a social policy related to that value. Similarly, a manipulation of value accessibility (Studies 2 and 3) led to increased resistance of attitudes and behavioral intentions toward a social policy related to that value. Implications for the role of accessibility in inter-attitudinal strength are discussed. © 2015 by the Society for Personality and Social Psychology, Inc.

Fixed Route Accessible Bus Service in Connecticut : A Case Study

DOT National Transportation Integrated Search

1981-07-01

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

SSR-based genetic diversity and structure of garlic accessions from Brazil.

PubMed

da Cunha, Camila Pinto; Resende, Francisco Vilela; Zucchi, Maria Imaculada; Pinheiro, José Baldin

2014-10-01

Garlic is a spice and a medicinal plant; hence, there is an increasing interest in 'developing' new varieties with different culinary properties or with high content of nutraceutical compounds. Phenotypic traits and dominant molecular markers are predominantly used to evaluate the genetic diversity of garlic clones. However, 24 SSR markers (codominant) specific for garlic are available in the literature, fostering germplasm researches. In this study, we genotyped 130 garlic accessions from Brazil and abroad using 17 polymorphic SSR markers to assess the genetic diversity and structure. This is the first attempt to evaluate a large set of accessions maintained by Brazilian institutions. A high level of redundancy was detected in the collection (50 % of the accessions represented eight haplotypes). However, non-redundant accessions presented high genetic diversity. We detected on average five alleles per locus, Shannon index of 1.2, HO of 0.5, and HE of 0.6. A core collection was set with 17 accessions, covering 100 % of the alleles with minimum redundancy. Overall FST and D values indicate a strong genetic structure within accessions. Two major groups identified by both model-based (Bayesian approach) and hierarchical clustering (UPGMA dendrogram) techniques were coherent with the classification of accessions according to maturity time (growth cycle): early-late and midseason accessions. Assessing genetic diversity and structure of garlic collections is the first step towards an efficient management and conservation of accessions in genebanks, as well as to advance future genetic studies and improvement of garlic worldwide.

Maternal Health of Undocumented Women With and Without Medicaid Access in Nebraska, 2007-2011.

PubMed

Atkins, Danielle N; Barroso, Cristina S; Anderson, Amy J; Meadows, J Thomas; Lindley, Lisa C

2017-03-01

Four million infants are born in the United States to undocumented mothers. Nebraska granted Medicaid access to undocumented pregnant women from 1996 to 2010 and then discontinued access from 2010 to 2012. However, little is known about the maternal health of these undocumented women. The purpose of this study was to compare maternal health of undocumented women with and without access to Medicaid in Nebraska from 2007 to 2011. A retrospective, longitudinal cohort design was conducted with 2007 to 2011 Nebraska birth certificate data. Study participants were 6,262 undocumented women. Groups of measures were created for demographics, prenatal, pregnancy, and delivery characteristics. Descriptive statistics were calculated and comparisons were conducted between women with and without access to Medicaid using chi-square and Student t tests. More than 60% of undocumented women had access to Medicaid, while 32% had no access to Medicaid. Undocumented women were predominately Hispanic (73.32%) and did not have a high school education (68.77%). The comparison of undocumented women with and without Medicaid revealed that women with Medicaid access had more than adequate prenatal care (17.86% vs. 14.80%) and a higher frequency of infant born with abnormal conditions (6.26% vs. 8.03%). Women without access to Medicaid more often had inadequate prenatal care (10.28% vs. 6.94%) and were obese prior to pregnancy (19.37% vs. 17.37%). Undocumented women who are prenatally obese and lack access to prenatal care may be at increased risk for poor maternal outcomes.

Revealed access to haemodialysis facilities in northeastern Iran: Factors that matter in rural and urban areas.

PubMed

Kiani, Behzad; Bagheri, Nasser; Tara, Ahmad; Hoseini, Benyamin; Tabesh, Hamed; Tara, Mahmood

2017-11-07

Poor access to haemodialysis facilities is associated with high mortality and morbidity rates. This study investigated factors affecting revealed access to the haemodialysis facilities considering patients living in rural and urban areas without any haemodialysis facility (Group A) and those living urban areas with haemodialysis facilities (Group B). This study is based on selfreported Actual Access Time (AAT) to referred haemodialysis facilities and other information regarding travel to haemodialysis facilities from patients. All significant variables on univariate analysis were entered into a univariate general linear model in order to identify factors associated with AAT. Both spatial (driving time and distance) and non-spatial factors (sex, income level, caregivers, transportation mode, education level, ethnicity and personal vehicle ownership) influenced the revealed access identified in Group A. The non-spatial factors for Group B patients were the same as for Group A, but no spatial factor was identified in Group B. It was found that accessibility is strongly underestimated when driving time is chosen as accessibility measure to haemodialysis facilities. Analysis of revealed access determinants provides policymakers with an appropriate decision base for making appropriate decisions and finding solutions to decrease the access time for patients under haemodialysis therapy. Driving time alone is not a good proxy for measuring access to haemodialysis facilities as there are many other potential obstacles, such as women's special travel problems, poor other transportation possibilities, ethnicity disparities, low education levels, low caregiver status and low-income.

Drug-related stigma and access to care among people who inject drugs in Vietnam.

PubMed

Lan, Chiao-Wen; Lin, Chunqing; Thanh, Duong Cong; Li, Li

2018-03-01

There are considerable challenges faced by people with a history of injecting drug use (PWID) in Vietnam, including drug-related stigma and lack of access to healthcare. Seeking and utilising healthcare, as well as harm reduction programs for PWID, are often hampered by drug-related stigma. This study aimed to examine the impacts of drug-related stigma on access to care and utilisation of harm reduction programs among PWID in Vietnam. A cross-sectional study was conducted in two provinces in Vietnam, Phú Thọ and Vinh Phúc. The study participants completed the survey by using Audio Computer-Assisted Self-Interview between late 2014 and early 2015. Linear multiple regression models and logistic regression models were used to assess the relationship among drug-related stigma, access to care and utilisation of harm reduction programs, including methadone maintenance treatment (MMT) and needle exchange programs (NEP). A total of 900 PWID participated in this study. Drug-related stigma was significantly associated with lower level of access to care, but not with utilisation of MMT or NEP. Older age was positively associated with higher levels of access to care. Levels of education were positively correlated with access to care, as well as utilisation of MMT and NEP. This study underscores the need for future interventions to reduce drug-related stigma in society and in health-care settings to improve PWID's utilisation of care services. Special attention should be paid to younger PWID and those with lower levels of education. © 2017 Australasian Professional Society on Alcohol and other Drugs.

Distinct modes of DNA accessibility in plant chromatin.

PubMed

Shu, Huan; Wildhaber, Thomas; Siretskiy, Alexey; Gruissem, Wilhelm; Hennig, Lars

2012-01-01

The accessibility of DNA to regulatory proteins is a major property of the chromatin environment that favours or hinders transcription. Recent studies in flies reported that H3K9me2-marked heterochromatin is accessible while H3K27me3-marked chromatin forms extensive domains of low accessibility. Here we show that plants regulate DNA accessibility differently. H3K9me2-marked heterochromatin is the least accessible in the Arabidopsis thaliana genome, and H3K27me3-marked chromatin also has low accessibility. We see that very long genes without H3K9me2 or H3K27me3 are often inaccessible and generated significantly lower amounts of antisense transcripts than other genes, suggesting that reduced accessibility is associated with reduced recognition of alternative promoters. Low accessibility of H3K9me2-marked heterochromatin and long genes depend on cytosine methylation, explaining why chromatin accessibility differs between plants and flies. Together, we conclude that restriction of DNA accessibility is a local property of chromatin and not necessarily a consequence of microscopically visible compaction.

Wheelchair accessibility to public buildings in the Kumasi metropolis, Ghana.

PubMed

Yarfi, Cosmos; Ashigbi, Evans Y K; Nakua, Emmanuel K

2017-01-01

Accessibility implies making public places accessible to every individual, irrespective of his or her disability or special need, ensuring the integration of the wheelchair user into the society and thereby granting them the capability of participating in activities of daily living and ensuring equality in daily life. This study was carried out to assess the accessibility of the physical infrastructures (public buildings) in the Kumasi metropolis to wheelchairs after the passage of the Ghanaian Disability Law (Act 716, 2006). Eighty-four public buildings housing education facilities, health facilities, ministries, departments and agencies, sports and recreation, religious groups and banks were assessed. The routes, entrances, height of steps, grade of ramps, sinks, entrance to washrooms, toilets, urinals, automated teller machines and tellers' counters were measured and computed. Out of a total of 84 buildings assessed, only 34 (40.5%) of the buildings, 52.3% of the entrances and 87.4% of the routes of the buildings were accessible to wheelchair users. A total of 25% (13 out of 52) of the public buildings with more than one floor were fitted with elevators to connect the different levels of floors. The results of this study show that public buildings in the Kumasi metropolis are not wheelchair accessible. An important observation made during this study was that there is an intention to improve accessibility when buildings are being constructed or renovated, but there are no laid down guidelines as how to make the buildings accessible for wheelchair users.

Application of an access technology delivery protocol to two children with cerebral palsy.

PubMed

Mumford, Leslie; Chau, Tom

2015-07-14

This study further delineates the merits and limitations of the Access Technology Delivery Protocol (ATDP) through its application to two children with severe disabilities. We conducted mixed methods case studies to demonstrate the ATDP with two children with no reliable means of access to an external device. Evaluations of response efficiency, satisfaction, goal attainment, technology use and participation were made after 8 and 16 weeks of training with custom access technologies. After 16 weeks, one child's switch offered improved response efficiency, high teacher satisfaction and increased participation. The other child's switch resulted in improved satisfaction and switch effectiveness but lower overall efficiency. The latter child was no longer using his switch by the end of the study. These contrasting findings indicate that changes to any contextual factors that may impact the user's switch performance should mandate a reassessment of the access pathway. Secondly, it is important to ensure that individuals who will be responsible for switch training be identified at the outset and engaged throughout the ATDP. Finally, the ATDP should continue to be tested with individuals with severe disabilities to build an evidence base for the delivery of response efficient access solutions. Implications for Rehabilitation A data-driven, comprehensive access technology delivery protocol for children with complex communication needs could help to mitigate technology abandonment. Successful adoption of an access technology requires personalized design, training of the technology user, the teaching staff, the caregivers and other communication partners, and integration with functional activities.

Wheelchair accessibility to public buildings in the Kumasi metropolis, Ghana

PubMed Central

Ashigbi, Evans Y.K.

2017-01-01

Background Accessibility implies making public places accessible to every individual, irrespective of his or her disability or special need, ensuring the integration of the wheelchair user into the society and thereby granting them the capability of participating in activities of daily living and ensuring equality in daily life. Objective This study was carried out to assess the accessibility of the physical infrastructures (public buildings) in the Kumasi metropolis to wheelchairs after the passage of the Ghanaian Disability Law (Act 716, 2006). Methods Eighty-four public buildings housing education facilities, health facilities, ministries, departments and agencies, sports and recreation, religious groups and banks were assessed. The routes, entrances, height of steps, grade of ramps, sinks, entrance to washrooms, toilets, urinals, automated teller machines and tellers’ counters were measured and computed. Results Out of a total of 84 buildings assessed, only 34 (40.5%) of the buildings, 52.3% of the entrances and 87.4% of the routes of the buildings were accessible to wheelchair users. A total of 25% (13 out of 52) of the public buildings with more than one floor were fitted with elevators to connect the different levels of floors. Conclusion The results of this study show that public buildings in the Kumasi metropolis are not wheelchair accessible. An important observation made during this study was that there is an intention to improve accessibility when buildings are being constructed or renovated, but there are no laid down guidelines as how to make the buildings accessible for wheelchair users. PMID:29062761

Spatial Access to Primary Care Providers in Appalachia

PubMed Central

Donohoe, Joseph; Marshall, Vince; Tan, Xi; Camacho, Fabian T.; Anderson, Roger T.; Balkrishnan, Rajesh

2016-01-01

Purpose: The goal of this research was to examine spatial access to primary care physicians in Appalachia using both traditional access measures and the 2-step floating catchment area (2SFCA) method. Spatial access to care was compared between urban and rural regions of Appalachia. Methods: The study region included Appalachia counties of Pennsylvania, Ohio, Kentucky, and North Carolina. Primary care physicians during 2008 and total census block group populations were geocoded into GIS software. Ratios of county physicians to population, driving time to nearest primary care physician, and various 2SFCA approaches were compared. Results: Urban areas of the study region had shorter travel times to their closest primary care physician. Provider to population ratios produced results that varied widely from one county to another because of strict geographic boundaries. The 2SFCA method produced varied results depending on the distance decay weight and variable catchment size techniques chose. 2SFCA scores showed greater access to care in urban areas of Pennsylvania, Ohio, and North Carolina. Conclusion: The different parameters of the 2SFCA method—distance decay weights and variable catchment sizes—have a large impact on the resulting spatial access to primary care scores. The findings of this study suggest that using a relative 2SFCA approach, the spatial access ratio method, when detailed patient travel data are unavailable. The 2SFCA method shows promise for measuring access to care in Appalachia, but more research on patient travel preferences is needed to inform implementation. PMID:26906524

The Status of Web Accessibility of Canadian Universities and Colleges: A Charter of Rights and Freedoms Issue

ERIC Educational Resources Information Center

Zaparyniuk, Nicholas; Montgomerie, Craig

2005-01-01

The fundamental ideal that access to education and information as one of our basic human rights must not be neglected in the electronic information age. This ideal however is not being met in the area of postsecondary Web accessibility. This study surveyed 350 postsecondary institutions in Canada to evaluate their level of Web accessibility in…

Cost-effectiveness of population-level expansion of highly active antiretroviral treatment for HIV in British Columbia, Canada: a modelling study.

PubMed

Nosyk, Bohdan; Min, Jeong E; Lima, Viviane D; Hogg, Robert S; Montaner, Julio S G

2015-09-01

Widespread HIV screening and access to highly active antiretroviral treatment (ART) were cost effective in mathematical models, but population-level implementation has led to questions about cost, value, and feasibility. In 1996, British Columbia, Canada, introduced universal coverage of drug and other health-care costs for people with HIV/AIDS and and began extensive scale-up in access to ART. We aimed to assess the cost-effectiveness of ART scale-up in British Columbia compared with hypothetical scenarios of constrained treatment access. Using comprehensive linked population-level data, we populated a dynamic, compartmental transmission model to simulate the HIV/AIDS epidemic in British Columbia from 1997 to 2010. We estimated HIV incidence, prevalence, mortality, costs (in 2010 CAN$), and quality-adjusted life-years (QALYs) for the study period, which was 1997-2010. We calculated incremental cost-effectiveness ratios from societal and third-party-payer perspectives to compare actual practice (true numbers of individuals accessing ART) to scenarios of constrained expansion (75% and 50% probability of accessing ART). We also investigated structural and parameter uncertainty. Actual practice resulted in 263 averted incident cases compared with 75% of observed access and 676 averted cases compared with 50% of observed access to ART. From a third-party-payer perspective, actual practice resulted in incremental cost-effectiveness ratios of $23 679 per QALY versus 75% access and $24 250 per QALY versus 50% access. From a societal perspective, actual practice was cost saving within the study period. When the model was extended to 2035, current observed access resulted in cumulative savings of $25·1 million compared with the 75% access scenario and $65·5 million compared with the 50% access scenario. ART scale-up in British Columbia has decreased HIV-related morbidity, mortality, and transmission. Resulting incremental cost-effectiveness ratios for actual practice, derived within a limited timeframe, were within established cost-effectiveness thresholds and were cost saving from a societal perspective. BC Ministry of Health, National Institute of Drug Abuse at the US National Institutes of Health. Copyright © 2015 Elsevier Ltd. All rights reserved.

A registry-based randomized trial comparing radial and femoral approaches in women undergoing percutaneous coronary intervention: the SAFE-PCI for Women (Study of Access Site for Enhancement of PCI for Women) trial.

PubMed

Rao, Sunil V; Hess, Connie N; Barham, Britt; Aberle, Laura H; Anstrom, Kevin J; Patel, Tejan B; Jorgensen, Jesse P; Mazzaferri, Ernest L; Jolly, Sanjit S; Jacobs, Alice; Newby, L Kristin; Gibson, C Michael; Kong, David F; Mehran, Roxana; Waksman, Ron; Gilchrist, Ian C; McCourt, Brian J; Messenger, John C; Peterson, Eric D; Harrington, Robert A; Krucoff, Mitchell W

2014-08-01

This study sought to determine the effect of radial access on outcomes in women undergoing percutaneous coronary intervention (PCI) using a registry-based randomized trial. Women are at increased risk of bleeding and vascular complications after PCI. The role of radial access in women is unclear. Women undergoing cardiac catheterization or PCI were randomized to radial or femoral arterial access. Data from the CathPCI Registry and trial-specific data were merged into a final study database. The primary efficacy endpoint was Bleeding Academic Research Consortium type 2, 3, or 5 bleeding or vascular complications requiring intervention. The primary feasibility endpoint was access site crossover. The primary analysis cohort was the subgroup undergoing PCI; sensitivity analyses were conducted in the total randomized population. The trial was stopped early for a lower than expected event rate. A total of 1,787 women (691 undergoing PCI) were randomized at 60 sites. There was no significant difference in the primary efficacy endpoint between radial or femoral access among women undergoing PCI (radial 1.2% vs. 2.9% femoral, odds ratio [OR]: 0.39; 95% confidence interval [CI]: 0.12 to 1.27); among women undergoing cardiac catheterization or PCI, radial access significantly reduced bleeding and vascular complications (0.6% vs. 1.7%; OR: 0.32; 95% CI: 0.12 to 0.90). Access site crossover was significantly higher among women assigned to radial access (PCI cohort: 6.1% vs. 1.7%; OR: 3.65; 95% CI: 1.45 to 9.17); total randomized cohort: (6.7% vs. 1.9%; OR: 3.70; 95% CI: 2.14 to 6.40). More women preferred radial access. In this pragmatic trial, which was terminated early, the radial approach did not significantly reduce bleeding or vascular complications in women undergoing PCI. Access site crossover occurred more often in women assigned to radial access. (SAFE-PCI for Women; NCT01406236). Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

A review of accessibility of administrative healthcare databases in the Asia-Pacific region.

PubMed

Milea, Dominique; Azmi, Soraya; Reginald, Praveen; Verpillat, Patrice; Francois, Clement

2015-01-01

We describe and compare the availability and accessibility of administrative healthcare databases (AHDB) in several Asia-Pacific countries: Australia, Japan, South Korea, Taiwan, Singapore, China, Thailand, and Malaysia. The study included hospital records, reimbursement databases, prescription databases, and data linkages. Databases were first identified through PubMed, Google Scholar, and the ISPOR database register. Database custodians were contacted. Six criteria were used to assess the databases and provided the basis for a tool to categorise databases into seven levels ranging from least accessible (Level 1) to most accessible (Level 7). We also categorised overall data accessibility for each country as high, medium, or low based on accessibility of databases as well as the number of academic articles published using the databases. Fifty-four administrative databases were identified. Only a limited number of databases allowed access to raw data and were at Level 7 [Medical Data Vision EBM Provider, Japan Medical Data Centre (JMDC) Claims database and Nihon-Chouzai Pharmacy Claims database in Japan, and Medicare, Pharmaceutical Benefits Scheme (PBS), Centre for Health Record Linkage (CHeReL), HealthLinQ, Victorian Data Linkages (VDL), SA-NT DataLink in Australia]. At Levels 3-6 were several databases from Japan [Hamamatsu Medical University Database, Medi-Trend, Nihon University School of Medicine Clinical Data Warehouse (NUSM)], Australia [Western Australia Data Linkage (WADL)], Taiwan [National Health Insurance Research Database (NHIRD)], South Korea [Health Insurance Review and Assessment Service (HIRA)], and Malaysia [United Nations University (UNU)-Casemix]. Countries were categorised as having a high level of data accessibility (Australia, Taiwan, and Japan), medium level of accessibility (South Korea), or a low level of accessibility (Thailand, China, Malaysia, and Singapore). In some countries, data may be available but accessibility was restricted based on requirements by data custodians. Compared with previous research, this study describes the landscape of databases in the selected countries with more granularity using an assessment tool developed for this purpose. A high number of databases were identified but most had restricted access, preventing their potential use to support research. We hope that this study helps to improve the understanding of the AHDB landscape, increase data sharing and database research in Asia-Pacific countries.

Limited access: gender, occupational composition, and flexible work scheduling.

PubMed

Glauber, Rebecca

2011-01-01

The current study draws on national data to explore differences in access to flexible work scheduling by the gender composition of women's and men's occupations. Results show that those who work in integrated occupations are more likely to have access to flexible scheduling. Women and men do not take jobs with lower pay in return for greater access to flexibility. Instead, jobs with higher pay offer greater flexibility. Integrated occupations tend to offer the greatest access to flexible scheduling because of their structural locations. Part-time work is negatively associated with men's access to flexible scheduling but positively associated with women's access. Women have greater flexibility when they work for large establishments, whereas men have greater flexibility when they work for small establishments.

Inability to access addiction treatment predicts injection initiation among street-involved youth in a Canadian setting.

PubMed

DeBeck, Kora; Kerr, Thomas; Nolan, Seonaid; Dong, Huiru; Montaner, Julio; Wood, Evan

2016-01-06

Preventing injection drug use among vulnerable youth is critical for reducing serious drug-related harms. Addiction treatment is one evidence-based intervention to decrease problematic substance use; however, youth frequently report being unable to access treatment services and the impact of this on drug use trajectories remains largely unexplored. This study examines the relationship between being unable to access addiction treatment and injection initiation among street-involved youth. Data were derived from the At-Risk Youth Study (ARYS), a prospective cohort of street-involved youth aged 14-26 who use illicit drugs, from September 2005 to May 2014. An extended Cox model with time-dependent variables was used to identify factors independently associated with injection initiation. Among 462 participants who were injection naïve at baseline, 97 (21 %) initiated injection drug use over study follow-up and 129 (28 %) reported trying but being unable to access addiction treatment in the previous 6 months at some point during the study period. The most frequently reported reason for being unable to access treatment was being put on a wait list. In a multivariable Cox regression analysis, being unable to access addiction treatment remained independently associated with a more rapid rate of injection initiation (Adjusted Hazard Ratio =2.02; 95 % Confidence Interval: 1.12-3.62), after adjusting for potential confounders. Inability to access addiction treatment was common among our sample and associated with injection initiation. Findings highlight the need for easily accessible, evidence-based addiction treatment for high-risk youth as a means to prevent injection initiation and subsequent serious drug-related harms.

Disparities in internet use among orthopedic outpatients.

PubMed

Walsh, Kenneth P; Rehman, Saqib; Goldhirsh, Jessie

2014-02-01

Internet access has lagged behind for patients with lower incomes and from certain ethnic groups. This study investigated the possible improvement of access to health-related information on the Internet for all patients in an urban outpatient setting, regardless of socioeconomic background. A 28-question survey was completed by 100 orthopedic outpatients evaluating associations between their age, ethnicity, income, or education level and their access to the Internet. The survey also examined how patients used the Internet to obtain information about their medical condition, their privacy concerns when conducting online research, and their use of mobile phones as a primary means of Internet access. The Internet was used by 57% of orthopedic outpatients in this urban setting. Internet access decreased with advancing age but increased with increasing income and education, findings consistent with similar studies. Despite the inability to identify an association between ethnicity and Internet access in this patient population, fewer Latinos (33%) than whites (67%) or African Americans (77%) sought information about their medical condition. Among patients who used a mobile phone as the primary method for online access, 74% were African American or Latino and 26% were white. This difference in mobile phone use for online access suggests that mobile phones have provided ethnic minorities with greater Internet access and thus may have narrowed the digital divide among the races. Copyright 2014, SLACK Incorporated.

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

ERIC Educational Resources Information Center

Collins, Sarah R.

2012-01-01

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

The Architecture of Access: A Grounded Theory on the Nature of Access to Early Childhood Services within a Children's Centre, Derived from Nine Parent Voices

ERIC Educational Resources Information Center

Hayward, Kate; Fletcher, Colin; Whalley, Margy; McKinnon, Eddie; Gallagher, Tracy; Prodger, Angela; Donoyou, Heather; Potts, Judy; Young, Elaine

2013-01-01

This was a collaborative action research study by lead staff, researchers and parents at the Pen Green Centre for Children and their Families in England. The study focuses on the factors enabling access to children's services by nine parents from challenging family contexts. The critical questions were: What enabled some parents to overcome…

Case Study: South Texas Veterans Health Care System’s Communication Center

DTIC Science & Technology

2008-07-14

appropriate access to health care; technical quality is providing world-class care to our veterans; customer satisfaction is ensuring the STVHCS patients and...were not called. These results not only improved access to health care, but also positively affected customer service. 111 Case Study: South Texas...increased waiting times for the patient . With current regulatory requirements calling for improved access to health care services, many hospital and

Web Accessibility of the Higher Education Institute Websites Based on the World Wide Web Consortium and Section 508 of the Rehabilitation Act

ERIC Educational Resources Information Center

Alam, Najma H.

2014-01-01

The problem observed in this study is the low level of compliance of higher education website accessibility with Section 508 of the Rehabilitation Act of 1973. The literature supports the non-compliance of websites with the federal policy in general. Studies were performed to analyze the accessibility of fifty-four sample web pages using automated…

Access to Higher Education

ERIC Educational Resources Information Center

Briscoe, Felecia; De Oliver, Miguel

2006-01-01

This case study researches the degree to which the location and services offered by a multicampus university, geographically situated consistent with the commercial principles of a large mass-market enterprise, facilitate access for educationally underserved groups. First, the necessity of democratizing educational access to an underprivileged…

Extended access to methamphetamine self-administration up-regulates dopamine transporter levels 72 hours after withdrawal in rats.

PubMed

D'Arcy, Christina; Luevano, Joe E; Miranda-Arango, Manuel; Pipkin, Joseph A; Jackson, Jonathan A; Castañeda, Eddie; Gosselink, Kristin L; O'Dell, Laura E

2016-01-01

Previous studies have demonstrated that there are persistent changes in dopamine systems following withdrawal from methamphetamine (METH). This study examined changes in striatal dopamine transporter (DAT), tyrosine hydroxylase (TH) and dopamine receptor 2 (D2) 72 h after withdrawal from METH intravenous self- administration (IVSA). Rats were given limited (1h) or extended (6h) access to METH IVSA (0.05 mg/kg/0.1 ml infusion) for 22 days. Controls did not receive METH IVSA. The rats given extended access to IVSA displayed higher METH intake during the first hour of drug access compared to rats given limited access. Extended access to METH also produced a concomitant increase in striatal DAT levels relative to drug-naïve controls. There were no changes in TH or D2 levels across groups. Previous studies have reported a decrease in striatal DAT levels during protracted periods (>7 days) of withdrawal from METH IVSA. This study extends previous work by showing an increase in striatal DAT protein expression during an earlier time point of withdrawal from this drug. These results are an important step toward understanding the dynamic changes in dopamine systems that occur during different time points of withdrawal from METH IVSA. Copyright © 2015 Elsevier B.V. All rights reserved.

Root Architecture Diversity and Meristem Dynamics in Different Populations of Arabidopsis thaliana

PubMed Central

Aceves-García, Pamela; Álvarez-Buylla, Elena R.; Garay-Arroyo, Adriana; García-Ponce, Berenice; Muñoz, Rodrigo; Sánchez, María de la Paz

2016-01-01

Arabidopsis thaliana has been an excellent model system for molecular genetic approaches to development and physiology. More recently, the potential of studying various accessions collected from diverse habitats has been started to exploit. Col-0 has been the best-studied accession but we now know that several traits show significant divergences among them. In this work, we focused in the root that has become a key system for development. We studied root architecture and growth dynamics of 12 Arabidopsis accessions. Our data reveal a wide variability in root architecture and root length among accessions. We also found variability in the root apical meristem (RAM), explained mainly by cell size at the RAM transition domain and possibly by peculiar forms of organization at the stem cell niche in some accessions. Contrary to Col-0 reports, in some accessions the RAM size not always explains the variations in the root length; indicating that elongated cell size could be more relevant in the determination of root length than the RAM size itself. This study contributes to investigations dealing with understanding the molecular and cellular basis of phenotypic variation, the role of plasticity on adaptation, and the developmental mechanisms that may restrict phenotypic variation in response to contrasting environmental conditions. PMID:27379140

Root Architecture Diversity and Meristem Dynamics in Different Populations of Arabidopsis thaliana.

PubMed

Aceves-García, Pamela; Álvarez-Buylla, Elena R; Garay-Arroyo, Adriana; García-Ponce, Berenice; Muñoz, Rodrigo; Sánchez, María de la Paz

2016-01-01

Arabidopsis thaliana has been an excellent model system for molecular genetic approaches to development and physiology. More recently, the potential of studying various accessions collected from diverse habitats has been started to exploit. Col-0 has been the best-studied accession but we now know that several traits show significant divergences among them. In this work, we focused in the root that has become a key system for development. We studied root architecture and growth dynamics of 12 Arabidopsis accessions. Our data reveal a wide variability in root architecture and root length among accessions. We also found variability in the root apical meristem (RAM), explained mainly by cell size at the RAM transition domain and possibly by peculiar forms of organization at the stem cell niche in some accessions. Contrary to Col-0 reports, in some accessions the RAM size not always explains the variations in the root length; indicating that elongated cell size could be more relevant in the determination of root length than the RAM size itself. This study contributes to investigations dealing with understanding the molecular and cellular basis of phenotypic variation, the role of plasticity on adaptation, and the developmental mechanisms that may restrict phenotypic variation in response to contrasting environmental conditions.

Using Remote Access to Scientific Instrumentation to Create Authentic Learning Activities in Pharmaceutical Analysis

PubMed Central

Albon, Simon P.; Cancilla, Devon A.; Hubball, Harry

2006-01-01

Objectives To pilot test and evaluate a gas chromatography-mass spectrometry (GCMS) case study as a teaching and learning tool. Design A case study incorporating remote access to a GCMS instrument through the Integrated Laboratory Network (ILN) at Western Washington University was developed and implemented. Student surveys, faculty interviews, and examination score data were used to evaluate learning. Assessment While the case study did not impact final examination scores, approximately 70% of students and all faculty members felt the ILN-supported case study improved student learning about GCMS. Faculty members felt the “live” instrument access facilitated more authentic teaching. Students and faculty members felt the ILN should continue to be developed as a teaching tool. Conclusion Remote access to scientific instrumentation can be used to modify case studies to enhance student learning and teaching practice in pharmaceutical analysis. PMID:17149450

Comparison of methods to estimate water access: a pilot study of a GPS-based approach in low resource settings.

PubMed

Pearson, Amber L

2016-09-20

Most water access studies involve self-reported measures such as time spent or simple spatial measures such as Euclidean distance from home to source. GPS-based measures of access are often considered actual access and have shown little correlation with self-reported measures. One main obstacle to widespread use of GPS-based measurement of access to water has been technological limitations (e.g., battery life). As such, GPS-based measures have been limited by time and in sample size. The aim of this pilot study was to develop and test a novel GPS unit, (≤4-week battery life, waterproof) to measure access to water. The GPS-based method was pilot-tested to estimate number of trips per day, time spent and distance traveled to source for all water collected over a 3-day period in five households in south-western Uganda. This method was then compared to self-reported measures and commonly used spatial measures of access for the same households. Time spent collecting water was significantly overestimated using a self-reported measure, compared to GPS-based (p < 0.05). In contrast, both the GIS Euclidean distances to nearest and actual primary source significantly underestimated distances traveled, compared to the GPS-based measurement of actual travel paths to water source (p < 0.05). Households did not consistently collect water from the source nearest their home. Comparisons between the GPS-based measure and self-reported meters traveled were not made, as respondents did not feel that they could accurately estimate distance. However, there was complete agreement between self-reported primary source and GPS-based. Reliance on cross-sectional self-reported or simple GIS measures leads to misclassification in water access measurement. This new method offers reductions in such errors and may aid in understanding dynamic measures of access to water for health studies.

Barriers to accessing biologic treatment for rheumatoid arthritis in Greece: the unseen impact of the fiscal crisis--the Health Outcomes Patient Environment (HOPE) study.

PubMed

Souliotis, Kyriakos; Papageorgiou, Manto; Politi, Anastasia; Ioakeimidis, Dimitrios; Sidiropoulos, Prodromos

2014-01-01

The latest regulatory change in the distribution system of biologic disease-modifying, antirheumatic drugs limited their sale only through the designated pharmacies of the National Organization for Healthcare Services Provision (EOPYY) or the National Health System (NHS) hospitals, adding to the complexity of access to effective treatment for rheumatoid arthritis (RA) in Greece. The aim of this paper was to assess the barriers to access RA treatment, by recording patients', rheumatologists' and EOPYY pharmacists' experiences. One twenty-three patients, 12 rheumatologists and 27 pharmacists from Athens and other urban areas in Greece participated in the study. Three types of standardized questionnaires were used to elicit information from each group of respondents using the method of personal interview for patients and the method of postal survey for doctors and pharmacists. During the last year, 26% of patients encountered problems in accessing their rheumatologist and 49% of patients experienced difficulties in accessing their medication. Ninety-two percent of rheumatologists and 96% of pharmacists confirmed that patients experience difficulties in accessing RA medication. The most commonly reported reasons for reduced access to medical treatment were travel difficulties and long distance from doctor's clinic, as well as delays in booking an appointment. The most frequently reported barriers to access pharmaceutical treatment were difficulties in the prescription process, distance from EOPYY pharmacies and medicine shortages in NHS hospitals. The study showed that RA patients are facing increased barriers to access timely and effective treatment. Redesign of the current system of distribution ensuring the operation of additional points of sale is deemed necessary.

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

PubMed

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

2017-09-21

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

Equity in access to health care in a rural population in Malaysia: A cross-sectional study.

PubMed

Lim, Ka Keat; Sivasampu, Sheamini; Mahmud, Fatihah

2017-04-01

To examine the extent of equity in access to health care, their determinants and reasons of unmet need of a rural population in Malaysia. Exploratory cross-sectional survey administered by trained interviewers among participants of a health screening program. A rural plantation estate in the West Coast of Peninsular Malaysia. One hundred and thirty out of 142 adults above 18 years old who attended the program. Percentages of respondents reporting realised access and unmet need to health care, determinants of both access indicators and reasons for unmet need. Realised access associated with need but not predisposing or enabling factors and unmet need not associated with any variables were considered equitable. A total of 88 (67.7%) respondents had visited a doctor (realised access) in the past 6 months and 24.8% (n = 31) experienced unmet need in the past 12 months. Using logistic regression, realised access was associated with presence of chronic disease (OR 6.97, P < 0.001), whereas unmet need was associated with low education level (OR 6.50, P < 0.05), 'poor' or 'fair' self-assessed health status (OR 6.03, P < 0.05) and highest income group (> RM 2000 per month) (OR 51.27, P < 0.05). Personal choice (67.7%) was more commonly expressed than barriers (54.8%) as reasons for unmet need. The study found equity in realised access and inequity in unmet need among the rural population, the latter associated with education level, subjective health status and income. Despite not being generalisable, the findings highlight the need for a national level study on equity in access before the country reforms its health system. © 2016 National Rural Health Alliance Inc.

Radiation Exposure and Vascular Access in Acute Coronary Syndromes: The RAD-Matrix Trial.

PubMed

Sciahbasi, Alessandro; Frigoli, Enrico; Sarandrea, Alessandro; Rothenbühler, Martina; Calabrò, Paolo; Lupi, Alessandro; Tomassini, Francesco; Cortese, Bernardo; Rigattieri, Stefano; Cerrato, Enrico; Zavalloni, Dennis; Zingarelli, Antonio; Calabria, Paolo; Rubartelli, Paolo; Sardella, Gennaro; Tebaldi, Matteo; Windecker, Stephan; Jüni, Peter; Heg, Dik; Valgimigli, Marco

2017-05-23

It remains unclear whether radial access increases the risk of operator or patient radiation exposure compared to transfemoral access when performed by expert operators. This study sought to determine whether radial access increases radiation exposure. A total of 8,404 patients, with or without ST-segment elevation acute coronary syndrome, were randomly assigned to radial or femoral access for coronary angiography and percutaneous intervention, and collected fluoroscopy time and dose-area product (DAP). RAD-MATRIX is a radiation sub-study of the MATRIX (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of AngioX) trial. We anticipated that 13 or more operators, each wearing a thorax (primary endpoint), wrist, and head (secondary endpoints) lithium fluoride thermoluminescent dosimeter, and randomizing at least 13 patients per access site, were needed to establish noninferiority of radial versus femoral access. Among 18 operators, performing 777 procedures in 767 patients, the noninferiority primary endpoint was not achieved (p value for noninferiority = 0.843). Operator equivalent dose at the thorax (77 μSv) was significantly higher with radial than femoral access (41 μSv; p = 0.02). After normalization of operator radiation dose by fluoroscopy time or DAP, the difference remained significant. Radiation dose at wrist or head did not differ between radial and femoral access. Thorax operator dose did not differ for right radial (84 μSv) compared to left radial access (52 μSv; p = 0.15). In the overall MATRIX population, fluoroscopy time and DAP were higher with radial compared to femoral access: 10 min versus 9 min (p < 0.0001) and 65 Gy·cm 2 versus 59 Gy·cm 2 (p = 0.0001), respectively. Compared to femoral access, radial access is associated with greater operator and patient radiation exposure when performed by expert operators in current practice. Radial operators and institutions should be sensitized towards radiation risks and adopt adjunctive radioprotective measures. (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of AngioX; NCT101433627). Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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

PubMed Central

2012-01-01

Background Despite the emergence of mental health problems during adolescence and early adulthood, many young people encounter difficulties accessing appropriate services. In response to this gap, the Australian Government recently established new enhanced primary care services (headspace) that target young people with emerging mental health problems. In this study, we examine the experience of young people with depression accessing one of these services, with a focus on understanding how they access the service and the difficulties they encounter in the process. Method Individual, in-depth, audio-recorded interviews were used to collect data. Twenty-six young people with depression were recruited from a headspace site in Melbourne, Australia. Interpretative phenomenological analysis was used to analyse the data. Results Four overlapping themes were identified in the data. First, school counsellors as access mediators, highlights the prominent role school counsellors have in facilitating student access to the service. Second, location as an access facilitator and inhibitor. Although the service is accessible by public transport, it is less so to those who do not live near public transport. Third, encountering barriers accessing the service initially. Two main service access barriers were experienced: unfamiliarity with the service, and delays in obtaining initial appointments for ongoing therapy. Finally, the service’s funding model acts as an access facilitator and barrier. While the model provides a low or no cost services initially, it limits the number of funded sessions, and this can be problematic. Conclusions Young people have contrasting experiences accessing the service. School counsellors have an influential role in facilitating access, and its close proximity to public transport enhances access. The service needs to become more prominent in young people’s consciousness, while the appointment system would benefit from providing more timely appointments with therapists. The service’s funding model is important in enabling access initially to young people from low socioeconomic backgrounds, but the government needs to reassess the model for those who require additional support. PMID:22853550

Designing Out the Play: Accessibility and Playfulness in Inclusive Play.

PubMed

Holt, Raymond; Beckett, Angharad

2017-01-01

Play is an important part of child development, yet disabled children are often excluded from the opportunity to play, either due to lack of accessible toys and games, or social pressures. This paper presents a case study reflecting on the development of Button Bash: a switch accessible game intended to encourage inclusive play between disabled and non-disabled children. In particular, the paper focuses on how changes intended to make the game more accessible tended to make it less playful, and reflects on the relationship between playfulness and accessibility.

Vascular Access Creation before Hemodialysis Initiation and Use: A Population-Based Cohort Study

PubMed Central

Al-Jaishi, Ahmed A.; Lok, Charmaine E.; Garg, Amit X.; Zhang, Joyce C.

2015-01-01

Background and objectives In Canada, approximately 17% of patients use an arteriovenous access (fistula or arteriovenous graft) at commencement of hemodialysis, despite guideline recommendations promoting its timely creation and use. It is unclear if this low pattern of use is attributable to the lack of surgical creation or a high nonuse rate. Design, setting, participants, & measurements Using large health care databases in Ontario, Canada, a population-based cohort of adult patients (≥18 years old) who initiated hemodialysis as their first form of RRT between 2001 and 2010 was studied. The aims were to (1) estimate the proportion of patients who had an arteriovenous access created before starting hemodialysis and the proportion who successfully used it at hemodialysis start, (2) test for secular trends in arteriovenous access creation, and (3) estimate the effect of late nephrology referral and patient characteristics on arteriovenous access creation. Results There were 17,183 patients on incident hemodialysis. The mean age was 65.8 years, 60% were men, and 40% were referred late to a nephrologist; 27% of patients (4556 of 17,183) had one or more arteriovenous accesses created, and the median time between arteriovenous access creation and hemodialysis start was 184 days. When late referrals were excluded, 39% of patients (4007 of 10,291) had one or more arteriovenous accesses created, and 27% of patients (2724 of 10,291) used the arteriovenous access. Since 2001, there has been a decline in arteriovenous access creation before hemodialysis initiation. Women, higher numbers of comorbidities, and rural residence were consistently associated with lower rates of arteriovenous access creation. These results persisted even after removing patients with <6 months nephrology care or who had AKI 6 months before starting hemodialysis. Conclusions In Canada, arteriovenous access creation before hemodialysis initiation is low, even among patients followed by a nephrologist. Better understanding of the barriers and influencers of arteriovenous access creation is needed to inform both clinical care and guidelines. PMID:25568219

Vascular access creation before hemodialysis initiation and use: a population-based cohort study.

PubMed

Al-Jaishi, Ahmed A; Lok, Charmaine E; Garg, Amit X; Zhang, Joyce C; Moist, Louise M

2015-03-06

In Canada, approximately 17% of patients use an arteriovenous access (fistula or arteriovenous graft) at commencement of hemodialysis, despite guideline recommendations promoting its timely creation and use. It is unclear if this low pattern of use is attributable to the lack of surgical creation or a high nonuse rate. Using large health care databases in Ontario, Canada, a population-based cohort of adult patients (≥18 years old) who initiated hemodialysis as their first form of RRT between 2001 and 2010 was studied. The aims were to (1) estimate the proportion of patients who had an arteriovenous access created before starting hemodialysis and the proportion who successfully used it at hemodialysis start, (2) test for secular trends in arteriovenous access creation, and (3) estimate the effect of late nephrology referral and patient characteristics on arteriovenous access creation. There were 17,183 patients on incident hemodialysis. The mean age was 65.8 years, 60% were men, and 40% were referred late to a nephrologist; 27% of patients (4556 of 17,183) had one or more arteriovenous accesses created, and the median time between arteriovenous access creation and hemodialysis start was 184 days. When late referrals were excluded, 39% of patients (4007 of 10,291) had one or more arteriovenous accesses created, and 27% of patients (2724 of 10,291) used the arteriovenous access. Since 2001, there has been a decline in arteriovenous access creation before hemodialysis initiation. Women, higher numbers of comorbidities, and rural residence were consistently associated with lower rates of arteriovenous access creation. These results persisted even after removing patients with <6 months nephrology care or who had AKI 6 months before starting hemodialysis. In Canada, arteriovenous access creation before hemodialysis initiation is low, even among patients followed by a nephrologist. Better understanding of the barriers and influencers of arteriovenous access creation is needed to inform both clinical care and guidelines. Copyright © 2015 by the American Society of Nephrology.

The intraosseous have it: A prospective observational study of vascular access success rates in patients in extremis using video review.

PubMed

Chreiman, Kristen M; Dumas, Ryan P; Seamon, Mark J; Kim, Patrick K; Reilly, Patrick M; Kaplan, Lewis J; Christie, Jason D; Holena, Daniel N

2018-04-01

Quick and successful vascular access in injured patients arriving in extremis is crucial to enable early resuscitation and rapid OR transport for definitive repair. We hypothesized that intraosseous (IO) access would be faster and have higher success rates than peripheral intravenous (PIV) or central venous catheters (CVCs). High-definition video recordings of resuscitations for all patients undergoing emergency department thoracotomy from April 2016 to July 2017 were reviewed as part of a quality improvement initiative. Demographics, mechanism of injury, access type, access location, start and stop time, and success of each vascular access attempt were recorded. Times to completion for access types (PIV, IO, CVC) were compared using Kruskal-Wallis test adjusted for multiple comparisons, while categorical outcomes, such as success rates by access type, were compared using χ test or Fisher's exact test. Study patients had a median age of 30 years (interquartile range [IQR], 25-38 years), 92% were male, 92% were African American, and 93% sustained penetrating trauma. A total of 145 access attempts in 38 patients occurred (median, 3.8; SD, 1.4 attempts per patient). There was no difference between duration of PIV and IO attempts (0.63; IQR, 0.35-0.96 vs. 0.39 IQR, 0.13-0.65 minutes, adjusted p = 0.03), but both PIV and IO were faster than CVC attempts (3.2; IQR, 1.72-5.23 minutes; adjusted p < 0.001 for both comparisons). Intraosseous lines had higher success rates than PIVs or CVCs (95% vs. 42% vs. 46%, p < 0.001). Access attempts using IO are as fast as PIV attempts but are more than twice as likely to be successful. Attempts at CVC access in patients in extremis have high rates of failure and take a median of over 3 minutes. While IO access may not completely supplant PIVs and CVCs, IO access should be considered as a first-line therapy for trauma patients in extremis. Therapeutic, level III.

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

PubMed

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

2016-01-01

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

The Indigenous Red Ribbon Storytelling Study: What does it mean for Indigenous peoples living with HIV and a substance use disorder to access antiretroviral therapy in Saskatchewan?

PubMed Central

Nowgesic, Earl; Meili, Ryan; Stack, Sandra; Myers, Ted

2016-01-01

Indigenous peoples living with HIV are less likely than non-Indigenous peoples living with HIV to access antiretroviral therapy; however, there is not enough contextual information surrounding this issue. The Indigenous Red Ribbon Storytelling Study was conducted in part to examine how Indigenous peoples living with HIV construct and understand their experiences accessing antiretroviral therapy. Our study design was critical Indigenous qualitative research, using the Behavioral Model of Health Services Use and community-based participatory research approaches. The study was conducted in partnership with Indigenous and non-Indigenous organizations. Study participants were adults from two Canadian cities. The study methods included 20 individual and two Indigenous sharing circle interviews, six participant observation sessions, a short survey and thematic analysis. Accessing antiretroviral therapy within the context of living with a substance use disorder was an overarching theme. Indigenous peoples living with HIV felt they had to choose between living with their active substance use disorder and accessing antiretroviral therapy. They felt misunderstood as a person living with a substance use disorder and often felt coerced into using antiretroviral therapy. Despite these challenges, they persevered as Indigenous peoples living with HIV and a substance use disorder. Further research on antiretroviral therapy access among Indigenous peoples living with HIV and a substance use disorder, particularly from the perspective of health service providers, is needed. PMID:27867444

The Indigenous Red Ribbon Storytelling Study: What does it mean for Indigenous peoples living with HIV and a substance use disorder to access antiretroviral therapy in Saskatchewan?

PubMed

Nowgesic, Earl; Meili, Ryan; Stack, Sandra; Myers, Ted

2015-01-01

Indigenous peoples living with HIV are less likely than non-Indigenous peoples living with HIV to access antiretroviral therapy; however, there is not enough contextual information surrounding this issue. The Indigenous Red Ribbon Storytelling Study was conducted in part to examine how Indigenous peoples living with HIV construct and understand their experiences accessing antiretroviral therapy. Our study design was critical Indigenous qualitative research, using the Behavioral Model of Health Services Use and community-based participatory research approaches. The study was conducted in partnership with Indigenous and non-Indigenous organizations. Study participants were adults from two Canadian cities. The study methods included 20 individual and two Indigenous sharing circle interviews, six participant observation sessions, a short survey and thematic analysis. Accessing antiretroviral therapy within the context of living with a substance use disorder was an overarching theme. Indigenous peoples living with HIV felt they had to choose between living with their active substance use disorder and accessing antiretroviral therapy. They felt misunderstood as a person living with a substance use disorder and often felt coerced into using antiretroviral therapy. Despite these challenges, they persevered as Indigenous peoples living with HIV and a substance use disorder. Further research on antiretroviral therapy access among Indigenous peoples living with HIV and a substance use disorder, particularly from the perspective of health service providers, is needed.

Patterns of perceived barriers to medical care in older adults: a latent class analysis.

PubMed

Thorpe, Joshua M; Thorpe, Carolyn T; Kennelty, Korey A; Pandhi, Nancy

2011-08-03

This study examined multiple dimensions of healthcare access in order to develop a typology of perceived barriers to healthcare access in community-dwelling elderly. Secondary aims were to define distinct classes of older adults with similar perceived healthcare access barriers and to examine predictors of class membership to identify risk factors for poor healthcare access. A sample of 5,465 community-dwelling elderly was drawn from the 2004 wave of the Wisconsin Longitudinal Study. Perceived barriers to healthcare access were measured using items from the Group Health Association of America Consumer Satisfaction Survey. We used latent class analysis to assess the constellation of items measuring perceived barriers in access and multinomial logistic regression to estimate how risk factors affected the probability of membership in the latent barrier classes. Latent class analysis identified four classes of older adults. Class 1 (75% of sample) consisted of individuals with an overall low level of risk for perceived access problems (No Barriers). Class 2 (5%) perceived problems with the availability/accessibility of healthcare providers such as specialists or mental health providers (Availability/Accessibility Barriers). Class 3 (18%) perceived problems with how well their providers' operations arise organized to accommodate their needs and preferences (Accommodation Barriers). Class 4 (2%) perceived problems with all dimension of access (Severe Barriers). Results also revealed that healthcare affordability is a problem shared by members of all three barrier groups, suggesting that older adults with perceived barriers tend to face multiple, co-occurring problems. Compared to those classified into the No Barriers group, those in the Severe Barrier class were more likely to live in a rural county, have no health insurance, have depressive symptomatology, and speech limitations. Those classified into the Availability/Accessibility Barriers group were more likely to live in rural and micropolitan counties, have depressive symptomatology, more chronic conditions, and hearing limitations. Those in the Accommodation group were more likely to have depressive symptomatology and cognitive limitations. The current study identified a typology of perceived barriers in healthcare access in older adults. The identified risk factors for membership in perceived barrier classes could potentially assist healthcare organizations and providers with targeting polices and interventions designed to improve access in their most vulnerable older adult populations, particularly those in rural areas, with functional disabilities, or in poor mental health.

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

PubMed Central

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

2001-01-01

Objective: This study examined the rates of print journal subscription price increases according to the type of available electronic access. The types of access included: electronic priced separately from the print, combination print with “free online” access, and aggregated, defined here as electronic access purchased as part of a collection. The percentages of print price increases were compared to each other and to that for titles available only in print. The authors were not aware of prior objective research in this area. Methods: The authors analyzed the percentage print price increases of 300 journals over a five-year time period. The titles were grouped according to type of available electronic access. The median and mean percentage print price increases were calculated and plotted for all titles within each group. Results: Using both the median and the mean to look at the percentage print price increases over five years, it was obvious that print prices for journals with electronic access exceeded journals that did not offer an electronic option. Electronic priced separately averaged 3% to 5% higher than print only titles using both measures. Combination print with “free online” access had higher increases from 1996 to 1999, but, in 2000, their percentage increases were about the same as print only titles. The rate of price increases for aggregated titles consistently went down over the past five years. Journals with no electronic option showed the lowest percentage rates of print price increase. Conclusions: The authors' findings reveal that the increases of print prices for their sample of titles were higher if a type of electronic access was offered. According to the results of this study, aggregated collections currently represent the electronic option whose percentage price increase for print prices was lowest. However, the uneven fluctuations in rates of subscription prices revealed that the pricing of journals with electronic access is still evolving. More study is recommended to see if the trends observed in this study are sustained over a longer time period. PMID:11837258

Perceived Ease of Access to Alcohol, Tobacco, and Other Substances in Rural and Urban US Students

PubMed Central

Warren, Jacob C.; Smalley, K. Bryant; Barefoot, K. Nikki

2015-01-01

Introduction Ease of access to substances has been shown to have a direct and significant relationship with substance use for school-aged children. Previous research involving rural samples of middle and high school students reveals that perceived ease of access to substances is a significant predictor of recent use among rural adolescents; however, it is unclear if perceived access to substances varies between rural and urban areas. The purpose of the current study was to examine rural-urban differences in perceived ease of access to alcohol, smoking and chewing tobacco, marijuana, and seven other substances in order to better inform and promote future substance use prevention and programming efforts in rural areas. Methods Data were analyzed from the 2013 Georgia Student Health Survey II, administered in all public and interested private/charter schools in the state of Georgia. A total of 513,909 students (18.2% rural) indicated their perceived ease of access to 11 substances on a 4-point Likert-type scale. Rural-urban differences were investigated using chi-square analysis. Results In general, it appeared the rural-urban differences fell along legal/illicit lines. For middle school students, a significant difference in perceived ease of access was found for each substance, with rural students reporting greater access to smoking tobacco, chewing tobacco, and steroids, and urban students reporting greater access to alcohol, marijuana, cocaine, inhalants, ecstasy, methamphetamine, hallucinogens, and prescription drugs. Rural high school students reported higher access to alcohol, smoking tobacco, chewing tobacco, and steroids, with urban students reporting higher access to marijuana, cocaine, inhalants, ecstasy, and hallucinogens. Perceptions of ease of access more than doubled for each substance in both geographies between middle and high school. Conclusions In summary, the current study found multiple and fairly consistent differences between rural and urban students’ perceived ease of access to a variety of substances, with rural students reporting higher levels of access to legal substances and urban students reporting higher levels of access predominantly to illicit substances. Most troubling were the high levels of perceived access to substances, however, particularly in high school students, with more than half even of rural students reporting at least somewhat easy access to marijuana, and more than 60% of both rural and urban high school students reporting easy access to alcohol. Future research should investigate ways to decrease the perceptions of access to substances in order to prevent use and abuse. PMID:26518286

Social Media Use and Access to Digital Technology in US Young Adults in 2016.

PubMed

Villanti, Andrea C; Johnson, Amanda L; Ilakkuvan, Vinu; Jacobs, Megan A; Graham, Amanda L; Rath, Jessica M

2017-06-07

In 2015, 90% of US young adults with Internet access used social media. Digital and social media are highly prevalent modalities through which young adults explore identity formation, and by extension, learn and transmit norms about health and risk behaviors during this developmental life stage. The purpose of this study was to provide updated estimates of social media use from 2014 to 2016 and correlates of social media use and access to digital technology in data collected from a national sample of US young adults in 2016. Young adult participants aged 18-24 years in Wave 7 (October 2014, N=1259) and Wave 9 (February 2016, N=989) of the Truth Initiative Young Adult Cohort Study were asked about use frequency for 11 social media sites and access to digital devices, in addition to sociodemographic characteristics. Regular use was defined as using a given social media site at least weekly. Weighted analyses estimated the prevalence of use of each social media site, overlap between regular use of specific sites, and correlates of using a greater number of social media sites regularly. Bivariate analyses identified sociodemographic correlates of access to specific digital devices. In 2014, 89.42% (weighted n, 1126/1298) of young adults reported regular use of at least one social media site. This increased to 97.5% (weighted n, 965/989) of young adults in 2016. Among regular users of social media sites in 2016, the top five sites were Tumblr (85.5%), Vine (84.7%), Snapchat (81.7%), Instagram (80.7%), and LinkedIn (78.9%). Respondents reported regularly using an average of 7.6 social media sites, with 85% using 6 or more sites regularly. Overall, 87% of young adults reported access or use of a smartphone with Internet access, 74% a desktop or laptop computer with Internet access, 41% a tablet with Internet access, 29% a smart TV or video game console with Internet access, 11% a cell phone without Internet access, and 3% none of these. Access to all digital devices with Internet was lower in those reporting a lower subjective financial situation; there were also significant differences in access to specific digital devices with Internet by race, ethnicity, and education. The high mean number of social media sites used regularly and the substantial overlap in use of multiple social media sites reflect the rapidly changing social media environment. Mobile devices are a primary channel for social media, and our study highlights disparities in access to digital technologies with Internet access among US young adults by race/ethnicity, education, and subjective financial status. Findings from this study may guide the development and implementation of future health interventions for young adults delivered via the Internet or social media sites. ©Andrea C Villanti, Amanda L Johnson, Vinu Ilakkuvan, Megan A Jacobs, Amanda L Graham, Jessica M Rath. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 07.06.2017.

Social Media Use and Access to Digital Technology in US Young Adults in 2016

PubMed Central

Johnson, Amanda L; Ilakkuvan, Vinu; Jacobs, Megan A; Graham, Amanda L; Rath, Jessica M

2017-01-01

Background In 2015, 90% of US young adults with Internet access used social media. Digital and social media are highly prevalent modalities through which young adults explore identity formation, and by extension, learn and transmit norms about health and risk behaviors during this developmental life stage. Objective The purpose of this study was to provide updated estimates of social media use from 2014 to 2016 and correlates of social media use and access to digital technology in data collected from a national sample of US young adults in 2016. Methods Young adult participants aged 18-24 years in Wave 7 (October 2014, N=1259) and Wave 9 (February 2016, N=989) of the Truth Initiative Young Adult Cohort Study were asked about use frequency for 11 social media sites and access to digital devices, in addition to sociodemographic characteristics. Regular use was defined as using a given social media site at least weekly. Weighted analyses estimated the prevalence of use of each social media site, overlap between regular use of specific sites, and correlates of using a greater number of social media sites regularly. Bivariate analyses identified sociodemographic correlates of access to specific digital devices. Results In 2014, 89.42% (weighted n, 1126/1298) of young adults reported regular use of at least one social media site. This increased to 97.5% (weighted n, 965/989) of young adults in 2016. Among regular users of social media sites in 2016, the top five sites were Tumblr (85.5%), Vine (84.7%), Snapchat (81.7%), Instagram (80.7%), and LinkedIn (78.9%). Respondents reported regularly using an average of 7.6 social media sites, with 85% using 6 or more sites regularly. Overall, 87% of young adults reported access or use of a smartphone with Internet access, 74% a desktop or laptop computer with Internet access, 41% a tablet with Internet access, 29% a smart TV or video game console with Internet access, 11% a cell phone without Internet access, and 3% none of these. Access to all digital devices with Internet was lower in those reporting a lower subjective financial situation; there were also significant differences in access to specific digital devices with Internet by race, ethnicity, and education. Conclusions The high mean number of social media sites used regularly and the substantial overlap in use of multiple social media sites reflect the rapidly changing social media environment. Mobile devices are a primary channel for social media, and our study highlights disparities in access to digital technologies with Internet access among US young adults by race/ethnicity, education, and subjective financial status. Findings from this study may guide the development and implementation of future health interventions for young adults delivered via the Internet or social media sites. PMID:28592394

Evaluation of Demonstrations of National School Lunch Program and School Breakfast Program Direct Certification of Children Receiving Medicaid Benefits: Access Evaluation Report

ERIC Educational Resources Information Center

Hulsey, Lara; Gordon, Anne; Leftin, Joshua; Beyler, Nicholas; Schirm, Allen; Smither-Wulsin, Claire; Crumbley, Will

2015-01-01

This report presents findings from the Access Evaluation, a study component that is designed to assess the potential impacts of direct certification-Medicaid (DC-M) on students' access to free school meals by conducting retrospective simulations of DC-M in school year 2011-2012, the year before the demonstration began. For the Access Evaluation,…

Mobile devices and weak ties: a study of vision impairments and workplace access in Bangalore.

PubMed

Pal, Joyojeet; Lakshmanan, Meera

2015-07-01

To explore ways in which social and economic interactions are changed by access to mobile telephony. This is a mixed-methods study of mobile phone use among 52 urban professionals with vision impairments in Bangalore, India. Interviews and survey results indicated that mobile devices, specifically those with adaptive technology software, play a vital role as multi-purpose devices that enable people with disabilities to navigate economically and socially in an environment where accessibility remains a significant challenge. We found that mobile devices play a central role in enabling and sustaining weak ties, but also that these weak ties have important gender-specific implications. We found that women have less access to weak ties than men, which impacts women's access to assistive technology (AT). This has potential implications for women's sense of safety and independence, both of which are strongly related to AT access. Implications for Rehabilitation Adaptive technologies increase individuals' ability to keep in contact with casual connections or weak ties through phone calls or social media. Men tend to have stronger access to weak ties than women in India due to cultural impediments to independent access to public spaces. Weak ties are an important source of assistive technology (AT) due to the high rate of resale of used AT, typically through informal networks.

Genetic diversity analysis of Varronia curassavica Jacq. accessions using ISSR markers.

PubMed

Brito, F A; Nizio, D A C; Silva, A V C; Diniz, L E C; Rabbani, A R C; Arrigoni-Blank, M F; Alvares-Carvalho, S V; Figueira, G M; Montanari Júnior, I; Blank, A F

2016-09-02

Varronia curassavica Jacq. is a medicinal and aromatic plant from Brazil with significant economic importance. Studies on genetic diversity in active germplasm banks (AGB) are essential for conservation and breeding programs. The aim of this study was to analyze the genetic diversity of V. curassavica accessions of the AGB of Medicinal and Aromatic Plants of the Federal University of Sergipe (UFS), using inter-simple sequence repeat molecular markers. Twenty-four primers were tested, and 14 were polymorphic and informative, resulting in 149 bands with 97.98% polymorphism. The UPGMA dendrogram divided the accessions into Clusters I and II. Jaccard similarity coefficients for pair-wise comparisons of accessions ranged between 0.24 and 0.78. The pairs of accessions VCUR-001/VCUR-503, VCUR-001/VCUR-504, and VCUR-104/VCUR-501 showed relatively low similarity (0.24), and the pair of accessions VCUR-402/VCUR- 403 showed medium similarity (0.78). Twenty-eight accessions were divided into three distinct clusters, according to the STRUCTURE analysis. The genetic diversity of V. curassavica in the AGB of UFS is low to medium, and it requires expansion. Accession VCUR-802 is the most suitable for selection in breeding program of this species, since it clearly represents all of the diversity present in the AGB.

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

PubMed

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

2017-11-11

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

Retail Food Store Access in Rural Appalachia: A Mixed Methods Study.

PubMed

Thatcher, Esther; Johnson, Cassandra; Zenk, Shannon N; Kulbok, Pamela

2017-05-01

To describe how characteristics of food retail stores (potential access) and other factors influence self-reported food shopping behavior (realized food access) among low-income, rural Central Appalachian women. Cross-sectional descriptive. Potential access was assessed through store mapping and in-store food audits. Factors influencing consumers' realized access were assessed through in-depth interviews. Results were merged using a convergent parallel mixed methods approach. Food stores (n = 50) and adult women (n = 9) in a rural Central Appalachian county. Potential and realized food access were described across five dimensions: availability, accessibility, affordability, acceptability, and accommodation. Supermarkets had better availability of healthful foods, followed by grocery stores, dollar stores, and convenience stores. On average, participants lived within 10 miles of 3.9 supermarkets or grocery stores, and traveled 7.5 miles for major food shopping. Participants generally shopped at the closest store that met their expectations for food availability, price, service, and atmosphere. Participants' perceptions of stores diverged from each other and from in-store audit findings. Findings from this study can help public health nurses engage with communities to make affordable, healthy foods more accessible. Recommendations are made for educating low-income consumers and partnering with food stores. © 2016 Wiley Periodicals, Inc.

A national study of the association between neighbourhood access to fast-food outlets and the diet and weight of local residents.

PubMed

Pearce, Jamie; Hiscock, Rosemary; Blakely, Tony; Witten, Karen

2009-03-01

Differential locational access to fast-food retailing between neighbourhoods of varying socioeconomic status has been suggested as a contextual explanation for the social distribution of diet-related mortality and morbidity. This New Zealand study examines whether neighbourhood access to fast-food outlets is associated with individual diet-related health outcomes. Travel distances to the closest fast-food outlet (multinational and locally operated) were calculated for all neighbourhoods and appended to a national health survey. Residents in neighbourhoods with the furthest access to a multinational fast-food outlet were more likely to eat the recommended intake of vegetables but also be overweight. There was no association with fruit consumption. Access to locally operated fast-food outlets was not associated with the consumption of the recommended fruit and vegetables or being overweight. Better neighbourhood access to fast-food retailing is unlikely to be a key contextual driver for inequalities in diet-related health outcomes in New Zealand.

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).

Examining correlates of different cigarette access behaviours among Canadian youth: data from the Canadian Youth Smoking Survey (2006).

PubMed

Vu, Mary; Leatherdale, Scott T; Ahmed, Rashid

2011-12-01

Understanding factors associated with youth cigarette access behaviours can provide insight into the development of more effective means of preventing youth from accessing cigarettes. This cross-sectional study used self-reported data collected from 41,886 students in grades 9 to 12 who participated in the 2006-07 Youth Smoking Survey to examine the student- and school-level characteristics that differentiate youth smokers who usually access cigarettes from a social source versus buying their own from retailers. Multi-level regression analyses revealed significant between-school variability in the odds of a smoking student reporting that they usually buy their own cigarettes. Important student-level characteristics associated with how youth usually access their cigarettes included binge drinking and being asked for age or photo identification when purchasing cigarettes from a retailer. Future studies should further explore the school- and student-level characteristics associated with youth cigarette access behaviour. Copyright © 2011 Elsevier Ltd. All rights reserved.

In-home firearm access among US adolescents and the role of religious subculture: Results from a nationally representative study.

PubMed

Stroope, Samuel; Tom, Joshua C

2017-09-01

Religious participation is linked to numerous positive safety outcomes for adolescents. Scant attention, however, has been paid to associations between religious participation and safety risks among adolescents. Using data from Add Health (N = 18,449), a nationally representative school-based sample of US adolescents, this study examines the relationship between adolescents' religious affiliation and easy access to firearms at home. Regression analyses adjust for complex sampling design and compare easy firearm access at home among conservative Protestant adolescents to adolescent firearm access in other religious traditions. Conservative Protestant adolescents have a substantially greater likelihood of easy access to a gun at home compared to adolescents of all other major religious traditions in the United States. Recognizing differences in adolescent firearm access between subcultural groups can help public health interventions more effectively identify and address the needs of vulnerable populations. The paper's conclusion considers suggestions for effective policy and programmatic initiatives. Copyright © 2017 Elsevier Inc. All rights reserved.

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

PubMed

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

2011-04-01

Many individuals who are candidates for thoracic endovascular aortic repair (TEVAR) are found to have iliac artery anatomy and/or disease that preclude transfemoral endovascular access and require retroperitoneal surgical approach through more proximal arteries. This relatively more invasive technique could potentially affect the procedural outcomes. This study compares the retroperitoneal with transfemoral access used for TEVAR in a single center. In this study, 133 consecutive patients (96 men; mean age ± SD: 69.5 ± 14.7 years) who underwent TEVAR between 1994 and 2009 in a single center were retrospectively evaluated. The type of endovascular access was identified in all the patients. The basic demographics, access method, endograft type, 30-day morbidity and mortality rates, as well as procedure recordings including fluoroscopic and procedure duration, estimated blood loss, and duration of hospitalization were compared between the TEVAR procedures performed using a surgical retroperitoneal approach and those using the standard femoral access. Retroperitoneal access was used in 19 (14.3%; 13 women; mean age ± SD: 71 ± 12.2 years) and direct femoral access in 114 (85.7%; 24 women; mean age ± SD: 69 ± 15.4 years) patients. Two of the retroperitoneal accesses were obtained after failure of femoral approach. Techniques that were used included iliac artery conduit (seven patients), aortic artery conduit (eight patients), aortobifemoral artery graft conduit (one patient), and direct sheath introduction through the distal aorta (two patients) or common iliac artery (one patient). Retroperitoneal approach was used more frequently in women (35%) as compared with men (6%) (p = 0.0001). In all, 79% of the retroperitoneal approaches were associated with use of delivery sheath sizes larger than 24F (p = 0.049). TEVAR technical success was 100% with retroperitoneal and 97.3% with femoral access (p > 0.05). Thirty-day mortality rates were 0% and 8.8% and the rates of access artery injury were 5.3% and 4.4% in retroperitoneal and femoral access groups, respectively (p > 0.05). The incidence of retroperitoneal hematoma was significantly higher with retroperitoneal access (21% vs. 2.6%, p = 0.008). Additionally, retroperitoneal access was associated with significant increase in estimated blood loss and duration of hospitalization (p < 0.05). Type of access does not affect TEVAR success and the early mortality rate. Retroperitoneal approach is a valuable alternative technique in cases involving failed or impossible femoral access. However, this approach is associated with higher chances of retroperitoneal bleeding and longer procedural time and duration of hospitalization. Thoracic endografts with smaller delivery systems could minimize the need for this approach in the future. Copyright © 2011 Annals of Vascular Surgery Inc. All rights reserved.

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.

Long-Lasting Insecticide Net Ownership, Access and Use in Southwest Ethiopia: A Community-Based Cross-Sectional Study

PubMed Central

Seyoum, Dinberu; Speybroeck, Niko; Duchateau, Luc; Brandt, Patrick; Rosas-Aguirre, Angel

2017-01-01

Introduction: A large proportion of the Ethiopian population (approximately 68%) lives in malaria risk areas. Millions of long-lasting insecticide treated nets (LLINs) have been distributed as part of the malaria prevention and control strategy in the country. This study assessed the ownership, access and use of LLNs in the malaria endemic southwest Ethiopia. Methods: A community-based cross-sectional study was conducted in southwest Ethiopia during October–November 2015, including 836 households from sixteen villages around Gilgel-Gibe dam area. Indicators of ownership, access and use of LLINs were derived following the Roll Back Malaria (RBM) guidelines. Factors associated with failure for both LLIN access and use were analysed at household level using a multivariate logistic regression model. Results: The proportion of households with at least one LLIN was 82.7% (95% CI: 80.0, 85.1). However, only 68.9% (95% CI: 65.6, 71.9) had enough LLINs to cover all family members (with ≥one LLIN for every two persons). While 75.3% (95% CI: 68.4, 83.0) of the population was estimated to have accessed to LLINs, only 63.8% (95% CI: 62.3, 65.2) reported to have used a LLIN the previous night. The intra-household gap (i.e., households owning at least one LLIN, but unable to cover all family members) and the behavioral gap (i.e., household members who did not sleep under a LLIN despite having access to one) were 16.8% and 10.5%, respectively. Age, marital status and education of household heads, as well as household size and cooking using firewood were associated with the access to enough LLINs within households. Decreased access to LLINs at households was the main determinant for not achieving ≥80% household members sleeping under a LLIN the previous night. Other associated factors were household size and education level of household head. Conclusions: LLIN coverage levels in study villages remain below national targets of 100% for ownership and 80% for use. The access to enough LLINs within the households is the main restriction of LLIN use in the study area. PMID:29077052

Convergence of goals: phylogenetical, morphological, and physiological characterization of tolerance to drought stress in tall fescue (Festuca arundinacea Schreb.).

PubMed

Salehi, Mohammadreza; Salehi, Hassan; xNiazi, Hassan; Ghobadi, Cyrus

2014-03-01

The aim of this study is to find Iranian tall fescue accessions that tolerate drought stress and investigation on phylogenetical, morphological, and physiological characterization of them. For this propose, inter-simple sequence repeats (ISSR) markers were used to examine the genetic variability of accessions from different provinces of Iran. Of 21 primers, 20 primers generated highly reproducible fragments. Using these primers, 390 discernible DNA fragments were produced with 367 (93.95 %) being polymorphic. The polymorphic information content (PIC) values ranged from 0.948 to 0.976, with a mean PIC value of 0.969. Probability identity (PI) and discriminating power (D = 1-PI) among the primers ranged from 0.001 to 0.004 and 0.998 to 0.995, respectively. A binary qualitative data matrix was constructed. Data analyses were performed using the NTSYS software and the similarity values were used to generate a dendrogram via UPGMA. To study the drought stress, plants were irrigated at 25 % FC condition for three times. Fresh leaves were collected to measure physiological characters including: superoxide dismutase, catalase, and peroxidase activities and proline and total chlorophyll content at two times, before and after stress application. Relative water content, fresh and dry weight ratio, survival percentage, and visual quality were evaluated after stress. Morphological and physiological characters were assessed in order to classify accessions as either tolerant or sensitive using Ward's method of Hierarchical cluster analysis in SPSS software. The results of present study demonstrated that the ISSR markers are useful for studying tall fescue genetic diversity. Convergence of morphological and physiological characterizations during drought stress and phylogenetic relationship results showed that accessions can be grouped into four clusters; drought-tolerant accessions that collected from west of Iran, drought-tolerant accessions collected from northwest of Iran, drought semi-tolerant accessions collected from center of Iran, and drought-sensitive accessions collected from north of Iran. Data presented could be used to classify the tall fescue accessions based on suitability of cultivation in the regions studied or the regions with the similar environmental condition.

Long-Lasting Insecticide Net Ownership, Access and Use in Southwest Ethiopia: A Community-Based Cross-Sectional Study.

PubMed

Seyoum, Dinberu; Speybroeck, Niko; Duchateau, Luc; Brandt, Patrick; Rosas-Aguirre, Angel

2017-10-27

Introduction : A large proportion of the Ethiopian population (approximately 68%) lives in malaria risk areas. Millions of long-lasting insecticide treated nets (LLINs) have been distributed as part of the malaria prevention and control strategy in the country. This study assessed the ownership, access and use of LLNs in the malaria endemic southwest Ethiopia. Methods: A community-based cross-sectional study was conducted in southwest Ethiopia during October-November 2015, including 836 households from sixteen villages around Gilgel-Gibe dam area. Indicators of ownership, access and use of LLINs were derived following the Roll Back Malaria (RBM) guidelines. Factors associated with failure for both LLIN access and use were analysed at household level using a multivariate logistic regression model. Results: The proportion of households with at least one LLIN was 82.7% (95% CI: 80.0, 85.1). However, only 68.9% (95% CI: 65.6, 71.9) had enough LLINs to cover all family members (with ≥one LLIN for every two persons). While 75.3% (95% CI: 68.4, 83.0) of the population was estimated to have accessed to LLINs, only 63.8% (95% CI: 62.3, 65.2) reported to have used a LLIN the previous night. The intra-household gap (i.e., households owning at least one LLIN, but unable to cover all family members) and the behavioral gap (i.e., household members who did not sleep under a LLIN despite having access to one) were 16.8% and 10.5%, respectively. Age, marital status and education of household heads, as well as household size and cooking using firewood were associated with the access to enough LLINs within households. Decreased access to LLINs at households was the main determinant for not achieving ≥80% household members sleeping under a LLIN the previous night. Other associated factors were household size and education level of household head. Conclusions: LLIN coverage levels in study villages remain below national targets of 100% for ownership and 80% for use. The access to enough LLINs within the households is the main restriction of LLIN use in the study area.

Ubiquitous Accessibility for People with Visual Impairments: Are We There Yet?

PubMed Central

Billah, Syed Masum; Ashok, Vikas; Porter, Donald E.; Ramakrishnan, IV

2017-01-01

Ubiquitous access is an increasingly common vision of computing, wherein users can interact with any computing device or service from anywhere, at any time. In the era of personal computing, users with visual impairments required special-purpose, assistive technologies, such as screen readers, to interact with computers. This paper investigates whether technologies like screen readers have kept pace with, or have created a barrier to, the trend toward ubiquitous access, with a specific focus on desktop computing as this is still the primary way computers are used in education and employment. Towards that, the paper presents a user study with 21 visually-impaired participants, specifically involving the switching of screen readers within and across different computing platforms, and the use of screen readers in remote access scenarios. Among the findings, the study shows that, even for remote desktop access—an early forerunner of true ubiquitous access—screen readers are too limited, if not unusable. The study also identifies several accessibility needs, such as uniformity of navigational experience across devices, and recommends potential solutions. In summary, assistive technologies have not made the jump into the era of ubiquitous access, and multiple, inconsistent screen readers create new practical problems for users with visual impairments. PMID:28782061

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.

On the Relationship between the Indirectly Measured Attitude Towards Beer and Beer Consumption: The Role of Attitude Accessibility

PubMed Central

Descheemaeker, Mathilde; Spruyt, Adriaan; Hermans, Dirk

2014-01-01

Although some studies have demonstrated that the indirectly measured attitude towards alcohol is related to alcohol use, this relationship has not always been confirmed. In the current study, we attempted to shed light on this issue by investigating whether the predictive validity of an indirect attitude measure is dependent upon attitude accessibility. In a sample of 88 students, the picture-picture naming task, an adaptation of the affective priming paradigm, was used to measure the automatically activated attitude towards beer. Attitude accessibility was measured using a speeded evaluative categorization task. Behavioral measures were the amount of beer poured and drunk during a bogus taste test and the choice between a bottle of beer or water at the end of the experiment. In line with our hypothesis, the indirectly measured attitude towards beer predicted behavior during the taste test only when it was highly accessible. In contrast, this attitude was related to choice behavior irrespective of attitude accessibility. This study confirms that indirect attitude measures can be valuable predictors of alcohol-related behavior, but that it is sometimes necessary to take attitude accessibility into account. PMID:24777156

On the relationship between the indirectly measured attitude towards beer and beer consumption: the role of attitude accessibility.

PubMed

Descheemaeker, Mathilde; Spruyt, Adriaan; Hermans, Dirk

2014-01-01

Although some studies have demonstrated that the indirectly measured attitude towards alcohol is related to alcohol use, this relationship has not always been confirmed. In the current study, we attempted to shed light on this issue by investigating whether the predictive validity of an indirect attitude measure is dependent upon attitude accessibility. In a sample of 88 students, the picture-picture naming task, an adaptation of the affective priming paradigm, was used to measure the automatically activated attitude towards beer. Attitude accessibility was measured using a speeded evaluative categorization task. Behavioral measures were the amount of beer poured and drunk during a bogus taste test and the choice between a bottle of beer or water at the end of the experiment. In line with our hypothesis, the indirectly measured attitude towards beer predicted behavior during the taste test only when it was highly accessible. In contrast, this attitude was related to choice behavior irrespective of attitude accessibility. This study confirms that indirect attitude measures can be valuable predictors of alcohol-related behavior, but that it is sometimes necessary to take attitude accessibility into account.

Racial and Sociodemographic Disparities in Internet Access and eHealth Intervention Utilization Among Veteran Smokers.

PubMed

Calhoun, Patrick S; Wilson, Sarah M; Hicks, Terrell A; Thomas, Shaun P; Dedert, Eric A; Hair, Lauren P; Bastian, Lori A; Beckham, Jean C

2016-09-15

Access to the internet at home may be an important barrier to electronic health (eHealth) smoking cessation interventions. The current study explored possible sociodemographic disparities in access to the internet at home among veteran smokers. Data from participants proactively recruited and enrolled in a randomized smoking cessation effectiveness trial (N = 408) that compared a web-based smoking cessation intervention to Veterans Affairs (VA) usual care were used to examine the demographic attributes of smokers with and without internet access at home. Multivariable logistic regression was used to examine associations between demographic factors and home internet access. Data from patients randomized to the internet arm of the study (N = 205) were used to ascertain correlates of utilization of the intervention website. While the majority of the sample (82 %) endorsed access to the internet at home, veterans who were African-American, older, and not married were significantly less likely to have home internet access. Veterans who were African-American, older, less educated, had longer travel times to the nearest VA facility, and increased nicotine dependence were less likely to access the internet on a daily basis. While several sociodemographic variables (e.g., age, race, education, employment) were related to utilization of a free membership to a commercial, web-based smoking cessation intervention in bivariate analyses, only access to the internet at home was related to use of the smoking cessation site in adjusted results. These results highlight gaps in internet access and use among veterans and additionally underscore the importance of improving accessibility of eHealth interventions for low-income, minority, and socially disadvantaged veteran populations.

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

PubMed

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

2018-05-10

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

Who's Got the Booze? The Role of Access to Alcohol in the Relations Between Social Status and Individual Use.

PubMed

Deutsch, Arielle R; Steinley, Douglas; Sher, Kenneth J; Slutske, Wendy S

2017-09-01

The findings of previous research that examined relationships between popularity and alcohol use in adolescents have been mixed, and few hypotheses have proposed mechanisms for this relationship. The current study expands on previous literature (a) by examining a possible mechanism that can explain the relation between popularity and alcohol use (home access to alcohol) and (b) by using another sociometric measure ("betweenness"), beyond popularity, that may relate more to home alcohol access. Using network-level data from adolescents in 9th-11th grades in eight schools within two in-home waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we examined two sociometric measures of social status: popularity (number of schoolmates who nominated participants as a friend) and betweenness (level of ties participants have to multiple social subgroups within a network). Betweenness, but not popularity, related to later alcohol use. Having home access to alcohol positively related to later alcohol use, and having friends with home access to alcohol negatively related to later alcohol use. Alcohol access was also related to later sociometric status. Friends' alcohol access negatively related to later betweenness, and personal alcohol access moderated other pathways predicting betweenness. Betweenness appears to play a unique role in the association between social status and alcohol use in adolescent social networks. This is potentially tied to specific ways in which adolescents may be able to access alcohol (through home or through friends with access at home). More research is necessary to examine the ways in which multiple sociometric statuses relate to the contexts in which adolescents access and use alcohol.

Eisenhower National Historic Site visitor transportation and access study

DOT National Transportation Integrated Search

2017-11-01

This study evaluates the current shuttle system and Eisenhower National Historic Site, which is currently the sole access to the site. Visitation at Eisenhower has been declining since the site opened, and the study looks at the impacts of this trend...

Access to primary health care for acute vascular events in rural low income settings: a mixed methods study.

PubMed

Ahmed, Shyfuddin; Chowdhury, Muhammad Ashique Haider; Khan, Md Alfazal; Huq, Nafisa Lira; Naheed, Aliya

2017-01-18

Cardiovascular diseases (CVDs) are the leading cause of global mortality. Among the CVDs, acute vascular events (AVE) mainly ischemic heart diseases and stroke are the largest contributors. To achieve 25% reduction in preventable deaths from CVDs by 2025, health systems need to be equipped with extended service coverage in order to provide person-centered care. The overall goal of this proposed study is to assess access to health care in-terms of service availability, care seeking patterns and barriers to access care after AVE in rural Bangladesh. We will consider myocardial infarction (MI) and stroke as acute vascular events. We will conduct a mixed methods study in rural Matlab, Bangladesh. This study will comprise of a) health facility survey, b) structured questionnaire interview and c) qualitative study. We will assess service availabilities by creating an inventory of public and private health facilities. Readiness of the facilities to deliver services for AVE will be assessed through a health facility survey using 'service availability and readiness assessment' (SARA) tools of the World Health Organization (WHO). We will interview survivors of AVE and caregivers (present and accompanied the person during the event) of person who died from AVE for exploring patterns of care seeking during an AVE. For exploring barriers to access care for AVE, we will conduct in-depth interview with survivors of AVE and caregivers of the person who died from AVE. We will also conduct key informant interviews with the service providers at primary health care (PHC) facilities and government high level officials at central health administration of Bangladesh. This study will provide a comprehensive picture of access to primary health care services during acute cardiovascular events as stroke & MI in rural context of Bangladesh. It will explore available service facilities in rural area for management, utilization of services and barriers to access care during an acute emergency. This study will help to generate hypothesis, develop programs and policies for better access to care for AVE in similar rural settings considering barriers of access and improving utilization.

Reducing queues: demand and capacity variations.

PubMed

Eriksson, Henrik; Bergbrant, Ing-Marie; Berrum, Ingela; Mörck, Boel

2011-01-01

The aim of this paper is to investigate how waiting lists or queues could be reduced without adding more resources; and to describe what factors sustain reduced waiting-times. Cases were selected according to successful and sustained queue reduction. The approach in this study is action research. Accessibility improved as out-patient waiting lists for two clinics were reduced. The main success was working towards matching demand and capacity. It has been possible to sustain the improvements. Results should be viewed cautiously. Transferring and generalizing outcomes from this study is for readers to consider. However, accessible healthcare may be possible by paying more attention to existing solutions. The study indicates that queue reduction activities should include acquiring knowledge about theories and methods to improve accessibility, finding ways to monitor varying demand and capacity, and to improve patient processing by reducing variations. Accessibility is considered an important dimension when measuring service quality. However, there are few articles on how clinic staff sustain reduces waiting lists. This paper contributes accessible knowledge to the field.

Primary health-care nurses and Internet health information-seeking: Access, barriers and quality checks.

PubMed

Gilmour, Jean; Strong, Alison; Chan, Helen; Hanna, Sue; Huntington, Annette

2016-02-01

Online information is a critical resource for evidence-based practice and patient education. This study aimed to establish New Zealand nurses' access and evaluation of online health information in the primary care context using a postal questionnaire survey; there were 630 respondents from a random sample of 931 nurses. The majority of respondents were satisfied with work access to online information (84.5%, n = 501) and searched for online information at least several times a week (57.5%, n = 343). The major barrier to online information seeking was insufficient time, but 68 respondents had no work online information access. The level of nursing qualification was significantly correlated with computer confidence and information quality checking. A range of information evaluation approaches was used. Most nurses in study accessed and evaluated Internet information in contrast to the findings of earlier studies, but there were barriers preventing universal integration into practice. © 2014 Wiley Publishing Asia Pty Ltd.

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.

Health information exchange and healthcare utilization.

PubMed

Vest, Joshua R

2009-06-01

Health information exchange (HIE) makes previously inaccessible data available to clinicians, resulting in more complete information. This study tested the hypotheses that HIE information access reduced emergency room visits and inpatient hospitalizations for ambulatory care sensitive conditions among medically indigent adults. HIE access was quantified by how frequently system users' accessed patients' data. Encounter counts were modeled using zero inflated binomial regression. HIE was not accessed for 43% of individuals. Patient factors associated with accessed data included: prior utilization, chronic conditions, and age. Higher levels of information access were significantly associated with increased counts of all encounter types. Results indicate system users were more likely to access HIE for patients for whom the information might be considered most beneficial. Ultimately, these results imply that HIE information access did not transform care in the ways many would expect. Expectations in utilization reductions, however logical, may have to be reevaluated or postponed.

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 impediments to migrants' access to preventive interventions are crucial, to encourage more positive action for those facing the risk of intersectional discrimination.

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.

Barriers to access and minority ethnic carers' satisfaction with social care services in the community: a systematic review of qualitative and quantitative literature.

PubMed

Greenwood, Nan; Habibi, Ruth; Smith, Raymond; Manthorpe, Jill

2015-01-01

As populations age, the numbers of carers overall and numbers of carers from minority ethnic groups in particular are rising. Evidence suggests that carers from all sections of the community and particularly carers from minority groups often fail to access care services. This may relate to barriers in accessing services and service dissatisfaction. The aim of this systematic review was to identify and summarise minority ethnic carers' perceptions of barriers to accessing community social care services and their satisfaction with these services if accessed. The following databases were searched from their start until July 2013: Social Care Online, Social Policy and Research, Scopus, PsychINFO, HMIC, ASSIA, MEDLINE, Embase, CINAHL Plus and AMED. Thirteen studies met the inclusion criteria. Most investigated either barriers to access or satisfaction levels, although three explored both. Only 4 studies investigated minority ethnic carers' satisfaction with social care, although 12 studies reported perceived barriers to accessing services. Few studies compared minority ethnic carers' perceptions with majority ethnic groups, making it difficult to identify issues specific to minority groups. Most barriers described were potentially relevant to all carers, irrespective of ethnic group. They included attitudinal barriers such as not wanting to involve outsiders or not seeing the need for services and practical barriers such as low awareness of services and service availability. Issues specific to minority ethnic groups included language barriers and concerns about services' cultural or religious appropriateness. Studies investigating satisfaction with services reported a mixture of satisfaction and dissatisfaction. Barriers common to all groups should not be underestimated and a better understanding of the relationship between perceived barriers to accessing services and dissatisfaction with services is needed before the experiences of all carers can be improved. © 2014 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd.

76 FR 47529 - Port Access Route Study: In the Waters of Montauk Channel and Block Island Sound

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-05

.... ACTION: Notice of availability of Preliminary Study Recommendations with request for comments. SUMMARY: The Coast Guard announces the availability of Preliminary Study Recommendations of a Port Access Route... study area. Preliminary recommendations indicate that marine transportation safety would be enhanced...

Factors that impact access to ongoing health care for First Nation children with a chronic condition.

PubMed

Coombes, Julieann; Hunter, Kate; Mackean, Tamara; Holland, Andrew J A; Sullivan, Elizabeth; Ivers, Rebecca

2018-06-14

Access to multidisciplinary health care services for First Nation children with a chronic condition is critical for the child's health and well-being, but disparities and inequality in health care systems have been almost impossible to eradicate for First Nation people globally. The objective of this review is to identify the factors that impact access and ongoing care for First Nation children globally with a chronic condition. An extensive systematic search was conducted of nine electronic databases to identify primary studies that explored factors affecting access to ongoing services for First Nation children with a chronic disease or injury. Due to the heterogeneity of included studies the Mixed Method Appraisal Tool (MMAT) was used to assess study quality. A total of six studies from Australia, New Zealand and Canada were identified and included in this review. Four studies applied qualitative approaches using in-depth semi structured interviews, focus groups and community fora. Two of the six studies used quantitative approaches. Facilitators included the utilisation of First Nation liaison workers or First Nation Health workers. Key barriers that emerged included lack of culturally appropriate health care, distance, language and cultural barriers, racism, the lack of incorporation of First Nation workers in services, financial difficulties and transport issues. There are few studies that have identified positive factors that facilitate access to health care for First Nation children. There is an urgent need to develop programs and processes to facilitate access to appropriate health care that are inclusive of the cultural needs of First Nation children.

Airport Access/Egress Systems Study : Volume 1. Text.

DOT National Transportation Integrated Search

1973-09-01

Studies of airport activities and user characteristics at 34 high volume U. S. airports indicate that disbursed trip origins cannot economically justify rapid transit corridor investments dedicated to airport access travel. Generally, airports have t...

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.

Relationship between household access to food and malnutrition in eastern and southern Africa.

PubMed

Mwadime, R K; Baldwin, S L

1994-09-01

This review paper gives an overview of the relationship between household access to food and malnutrition using national level data in the Eastern and Southern Africa Region. The overall prevalence of malnutrition amongst the under-five population have not changed significantly over the decade and, in some cases, have deteriorated. The situation of household access to food differs between economies and production systems, but most households (average of 80%) in the region do not have access to adequate food. A preliminary analysis of the determinants of malnutrition at country level pointed to the importance of: financial access to food (an indicator of household access to food) and; access to safe water (an indicator of household healthy environment), as the most significant variables predicting rates of malnutrition. Several areas for action by governments in the region and for further study within the subject of household access to food are delineated. These are: more clear determination of the relative contribution of household access to food, to the nutritional status of women and children and, improved analysis of indicators of household access to food.

Vascular access complications in patients undergoing percutaneous procedures in hemodynamics: a scoping review.

PubMed

Reich, Rejane; Rabelo-Silva, Eneida Rejane; Santos, Simone Marques Dos; Almeida, Miriam de Abreu

2018-06-07

To map the production of knowledge on vascular access complications in patients undergoing percutaneous procedures in hemodynamic laboratories. Scoping review study. The search strategy was developed in three stages, considering the period from July 2005 to July 2015 in the PubMed, CINAHL, Scopus, and LILACS databases. The collected data were analyzed and summarized in a narrative form. One-hundred twenty-eight publications that made it possible to map the contexts of study of complications, occurrence according to access routes, as well as an understanding of diagnosis and clinical management, were included. Three theme categories were identified: complications; predictive factors; and diagnosis/treatment. Vascular access site complications range according to the access route used. Knowledge of factors that permeate the occurrence of these events may contribute to early detection, planning, and monitoring of the care implemented.

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

PubMed

Scheffler, Elsje; Visagie, Surona; Schneider, Marguerite

2015-06-19

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

Implementing Recommendations From Web Accessibility Guidelines: A Comparative Study of Nondisabled Users and Users With Visual Impairments.

PubMed

Schmutz, Sven; Sonderegger, Andreas; Sauer, Juergen

2017-09-01

The present study examined whether implementing recommendations of Web accessibility guidelines would have different effects on nondisabled users than on users with visual impairments. The predominant approach for making Web sites accessible for users with disabilities is to apply accessibility guidelines. However, it has been hardly examined whether this approach has side effects for nondisabled users. A comparison of the effects on both user groups would contribute to a better understanding of possible advantages and drawbacks of applying accessibility guidelines. Participants from two matched samples, comprising 55 participants with visual impairments and 55 without impairments, took part in a synchronous remote testing of a Web site. Each participant was randomly assigned to one of three Web sites, which differed in the level of accessibility (very low, low, and high) according to recommendations of the well-established Web Content Accessibility Guidelines 2.0 (WCAG 2.0). Performance (i.e., task completion rate and task completion time) and a range of subjective variables (i.e., perceived usability, positive affect, negative affect, perceived aesthetics, perceived workload, and user experience) were measured. Higher conformance to Web accessibility guidelines resulted in increased performance and more positive user ratings (e.g., perceived usability or aesthetics) for both user groups. There was no interaction between user group and accessibility level. Higher conformance to WCAG 2.0 may result in benefits for nondisabled users and users with visual impairments alike. Practitioners may use the present findings as a basis for deciding on whether and how to implement accessibility best.

Preoperative enteral access is not necessary prior to multimodality treatment of esophageal cancer.

PubMed

Jenkins, Thomas K; Lopez, Alexandra N; Sarosi, George A; Ben-David, Kfir; Thomas, Ryan M

2018-04-01

Surgical enteral access prior to multimodality treatment for esophageal cancer is controversial as dysphagia is often used for feeding tube referral. We hypothesized that enteral access before neoadjuvant chemoradiation for esophageal cancer provides no benefit compared to that placed during definitive esophagectomy. Patients undergoing esophagectomy for esophageal malignancy from 2007 - 2014 were retrospectively identified. Clinicopathologic factors were recorded including preoperative enteral access, weight change, nutritional laboratory works, and perioperative complications. Of 156 identified patients, 99 (63.5%) received neoadjuvant chemoradiation and comprised the study cohort. Fifty (50.5%) underwent enteral access (gastrostomy [14], jejunostomy [32], other [4]; "Access Group") prior to chemoradiation followed by esophagectomy and were compared to 49 "No-Access" patients who underwent enteral access during esophagectomy. Clinicopathologic variables were similar between cohorts. The Access and No-Access cohorts had similar reported dysphagia (86% vs 75.5%, respectively; P = .2) and mean preesophagectomy serum albumin (3.9 vs 4 gm/dL, respectively; P = .2). Weight loss ± 6-month periesophagectomy was similar between access versus No-Access cohorts (-11.2% vs -15.4%, respectively; P = .1). Weight loss during this period was likewise similar for patients with dysphagia in the Access (-11%) versus No-Access group (-15.2%, P = .1). No difference in complication rates was noted between Access (64%) and No-Access groups (51%, P = .2). Despite healthcare provider bias, there seems to be no nutritional or perioperative benefit for enteral access before neoadjuvant chemoradiation for esophageal malignancy. Patients with esophageal malignancy should therefore proceed to appropriate neoadjuvant and surgical therapy with enteral access performed during definitive resection or reserved for those with frank obstruction on endoscopy. Published by Elsevier Inc.

Access to Sign Language Interpreters in the Criminal Justice System.

ERIC Educational Resources Information Center

Miller, Katrina R.

2001-01-01

This study surveyed 46 professional sign language interpreters working in criminal justice settings and evaluated 22 cases to evaluate access issues for individuals with hearing impairments. Recommendations to increase the accessibility of interpreting services included providing ongoing awareness training to criminal justice personnel and…

Students' Motivation to Access Academic Advising Services

ERIC Educational Resources Information Center

Henning, Marcus A.

2009-01-01

The interrelationships between motivation for choosing a program of study, intention to access academic advisors, academic difficulty, and actual appointments with academic advisors were based on student self-reports of motivation and intentions. In addition, academic achievement measures and data on student access to academic advisors were…

Integrated molecular and morphological studies of Daucus

USDA-ARS?s Scientific Manuscript database

Ninety-four nuclear orthologs were used to analyze phylogenetic structure in 89 accessions of 13 species and two subspecies of Daucus, and an additional ten accessions of related genera. A near parallel set of accessions were used for morphological analyses of germplasm planted in a common garden in...

Barriers to access to care reported by women living with HIV across 27 countries.

PubMed

Johnson, Margaret; Samarina, Anna; Xi, He; Valdez Ramalho Madruga, José; Hocqueloux, Laurent; Loutfy, Mona; Fournelle, Marie-Josée; Norton, Michael; Van Wyk, Jean; Zachry, Woodie; Martinez, Marisol

2015-01-01

Increased access to successful antiretroviral therapy (ART) is necessary in order to achieve an AIDS-free generation. Importantly, slightly over half of the people living with HIV are women. Small studies have described many barriers to accessing treatment and care among women living with HIV. This cross-sectional, non-interventional, epidemiological study assessed the prevalence of barriers to accessing care for women living with HIV across 27 countries, divided into four global regions. HIV-positive women attending routine clinical visits were offered the opportunity to participate in the study. Data describing the study sites and demographic characteristics of the participating women were collected. Participating women filled out questionnaires including the Barriers to Care Scale (BACS) questionnaire, on which they reported the extent to which they found each of the 12 potential barriers to accessing health care problematic. A total of 1931 women living with HIV were included in the study: 760 from Western Europe and Canada (WEC), 532 from Central and Eastern Europe (CEE), 519 from Latin America (LA), and 120 from China. The mean age of participating women was 40.1 ± 11.4 years. A total of 88.2% were currently taking ART. A total of 81.8% obtained HIV treatment under a government health plan. The most prevalent barrier to care was community HIV/AIDS stigma. Community HIV/AIDS knowledge, lack of supportive/understanding work environments, lack of employment opportunities, and personal financial resources were also highly prevalent barriers to accessing care. These findings indicate that, more than 30 years after the start of the AIDS epidemic, stigma is still a major issue for women living with HIV. Continued efforts are needed to improve community education on HIV/AIDS in order to maximize access to health care among women living with HIV.

Barriers to access to care reported by women living with HIV across 27 countries

PubMed Central

Johnson, Margaret; Samarina, Anna; Xi, He; Valdez Ramalho Madruga, José; Hocqueloux, Laurent; Loutfy, Mona; Fournelle, Marie-Josée; Norton, Michael; Van Wyk, Jean; Zachry, Woodie; Martinez, Marisol

2015-01-01

Increased access to successful antiretroviral therapy (ART) is necessary in order to achieve an AIDS-free generation. Importantly, slightly over half of the people living with HIV are women. Small studies have described many barriers to accessing treatment and care among women living with HIV. This cross-sectional, non-interventional, epidemiological study assessed the prevalence of barriers to accessing care for women living with HIV across 27 countries, divided into four global regions. HIV-positive women attending routine clinical visits were offered the opportunity to participate in the study. Data describing the study sites and demographic characteristics of the participating women were collected. Participating women filled out questionnaires including the Barriers to Care Scale (BACS) questionnaire, on which they reported the extent to which they found each of the 12 potential barriers to accessing health care problematic. A total of 1931 women living with HIV were included in the study: 760 from Western Europe and Canada (WEC), 532 from Central and Eastern Europe (CEE), 519 from Latin America (LA), and 120 from China. The mean age of participating women was 40.1 ± 11.4 years. A total of 88.2% were currently taking ART. A total of 81.8% obtained HIV treatment under a government health plan. The most prevalent barrier to care was community HIV/AIDS stigma. Community HIV/AIDS knowledge, lack of supportive/understanding work environments, lack of employment opportunities, and personal financial resources were also highly prevalent barriers to accessing care. These findings indicate that, more than 30 years after the start of the AIDS epidemic, stigma is still a major issue for women living with HIV. Continued efforts are needed to improve community education on HIV/AIDS in order to maximize access to health care among women living with HIV. PMID:26168817

Where Latin Americans are physically active, and why does it matter? Findings from the IPEN-adult study in Bogota, Colombia; Cuernavaca, Mexico; and Curitiba, Brazil.

PubMed

Salvo, Deborah; Sarmiento, Olga L; Reis, Rodrigo S; Hino, Adriano A F; Bolivar, Manuel A; Lemoine, Pablo D; Gonçalves, Priscilla B; Pratt, Michael

2017-10-01

Latin America (LA) has a unique structural, political, cultural and social environment. This study aimed to identify the places where Latin American adults are physically active; and to determine the association of using public- and restricted-access places with physical activity (PA). We used data from the International PA Environment Network study in Bogota, Colombia (n=1000, accelerometry=249); Cuernavaca, Mexico (n=677, accelerometry=652); and Curitiba, Brazil (n=697, accelerometry=331) (2010-2011). Walking and moderate-to-vigorous PA for leisure were measured with the International Physical Activity Questionnaire. Overall PA and PA within 10-minute bouts were measured with accelerometers. Participants reported use of public- and restricted-access places for PA. Mixed-effects regression models were used to determine the association of using public- and restricted-access places with PA. The streets were the most frequently-reported place for PA, and walking was the most common PA in the studied places. 'Informal', non-exercise-or-sports places (e.g., shopping malls) ranked high for use for PA in Bogota and Cuernavaca. In Curitiba, use of 'formal' places for sports/exercise (e.g., gyms) was more prevalent. Using public-access places was directly related to walking for leisure in all cities, and to additional PA outcomes in Bogota and Cuernavaca. In Cuernavaca and Curitiba, using restricted-access places was also associated with PA. Our study highlights the importance of public-access places for PA in LA. In some contexts, places for social interaction may be as important for PA as places for exercise/sport. Strategies increasing the availability, accessibility and quality of these places may effectively promote PA in LA. Copyright © 2016 Elsevier Inc. All rights reserved.

When access is an issue: exploring barriers to predictive testing for Huntington disease in British Columbia, Canada.

PubMed

Hawkins, Alice K; Creighton, Susan; Hayden, Michael R

2013-02-01

Predictive testing (PT) for Huntington disease (HD) requires several in-person appointments. This requirement may be a barrier to testing so that at risk individuals do not realize the potential benefits of PT. To understand the obstacles to PT in terms of the accessibility of services, as well as exploring mechanisms by which this issue may be addressed, we conducted an interview study of individuals at risk for HD throughout British Columbia, Canada. Results reveal that the accessibility of PT can be a barrier for two major reasons: distance and the inflexibility of the testing process. Distance is a structural barrier, and relates to the time and travel required to access PT, the financial and other opportunity costs associated with taking time away from work and family to attend appointments and the stress of navigating urban centers. The inflexibility of the testing process barrier relates to the emotional and psychological accessibility of PT. The results of the interview study reveal that there are access barriers to PT that deter individuals from receiving the support, information and counseling they require. What makes accessibility of PT services important is not just that it may result in differences in quality of life and care, but because these differences may be addressed with creative and adaptable solutions in the delivery of genetic services. The study findings underscore the need for us to rethink and personalize the way we deliver such services to improve access issues to prevent inequities in the health care system.

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.

Health research needs more comprehensive accessibility measures: integrating time and transport modes from open data.

PubMed

Tenkanen, Henrikki; Saarsalmi, Perttu; Järv, Olle; Salonen, Maria; Toivonen, Tuuli

2016-07-28

In this paper, we demonstrate why and how both temporality and multimodality should be integrated in health related studies that include accessibility perspective, in this case healthy food accessibility. We provide evidence regarding the importance of using multimodal spatio-temporal accessibility measures when conducting research in urban contexts and propose a methodological approach for integrating different travel modes and temporality to spatial accessibility analyses. We use the Helsinki metropolitan area (Finland) as our case study region to demonstrate the effects of temporality and modality on the results. Spatial analyses were carried out on 250 m statistical grid squares. We measured travel times between the home location of inhabitants and open grocery stores providing healthy food at 5 p.m., 10 p.m., and 1 a.m. using public transportation and private cars. We applied the so-called door-to-door approach for the travel time measurements to obtain more realistic and comparable results between travel modes. The analyses are based on open access data and publicly available open-source tools, thus similar analyses can be conducted in urban regions worldwide. Our results show that both time and mode of transport have a prominent impact on the outcome of the analyses; thus, understanding the realities of accessibility in a city may be very different according to the setting of the analysis used. In terms of travel time, there is clear variation in the results at different times of the day. In terms of travel mode, our results show that when analyzed in a comparable manner, public transport can be an even faster mode than a private car to access healthy food, especially in central areas of the city where the service network is dense and public transportation system is effective. This study demonstrates that time and transport modes are essential components when modeling health-related accessibility in urban environments. Neglecting them from spatial analyses may lead to overly simplified or even erroneous images of the realities of accessibility. Hence, there is a risk that health related planning and decisions based on simplistic accessibility measures might cause unwanted outcomes in terms of inequality among different groups of people.

Unequal Access, Unequal Participation: Some Spatial and Socio-Economic Dimensions of the Gender Gap in Education in Africa with Special Reference to Ghana, Zimbabwe and Kenya

ERIC Educational Resources Information Center

Shabaya, Judith; Konadu-Agyemang, Kwadwo

2004-01-01

The question of unequal access to education among males and females appears to be universal in the developing world. However, females in Africa seem to suffer more discrimination in terms of access to education. This study revisits the question of gender disparities in educational access in Africa by analyzing data from recent comparative national…

Access to New Zealand Sign Language interpreters and quality of life for the deaf: a pilot study.

PubMed

Henning, Marcus A; Krägeloh, Christian U; Sameshima, Shizue; Shepherd, Daniel; Shepherd, Gregory; Billington, Rex

2011-01-01

This paper aims to: (1) explore usage and accessibility of sign language interpreters, (2) appraise the levels of quality of life (QOL) of deaf adults residing in New Zealand, and (3) consider the impact of access to and usage of sign language interpreters on QOL. Sixty-eight deaf adults living in New Zealand participated in this study. Two questionnaires were employed: a 12-item instrument about access and use of New Zealand sign language interpreters and the abbreviated version of the World Health Organization Quality of Life questionnaire (WHOQOL-BREF). The results showed that 39% of this sample felt that they were unable to adequately access interpreting services. Moreover, this group scored significantly lower than a comparable hearing sample on all four WHOQOL-BREF domains. Finally, the findings revealed that access to good quality interpreters were associated with access to health services, transport issues, engagement in leisure activities, gaining more information, mobility and living in a healthy environment. These findings have consequences for policy makers and agencies interested in ensuring that there is an equitable distribution of essential services for all groups within New Zealand which inevitably has an impact on the health of the individual.

Femoral Access and Delivery of Continuous Renal Replacement Therapy Dose.

PubMed

Bellomo, Rinaldo; Mårtensson, Johan; Lo, Serigne; Kaukonen, Kirsi-Maija; Cass, Alan; Gallagher, Martin

2016-01-01

The study aims to describe the use of dialysis catheters in critically ill patients treated with continuous renal replacement therapy (CRRT) and to study the impact of femoral versus non-femoral access on CRRT dose. Statistical analysis and predictive modelling of data from the Randomized Evaluation of Normal vs. Augmented Level renal replacement therapy trial. The femoral vein was the first access site in 937 (67%) of 1,399 patients. These patients had higher Acute Physiology and Chronic Health Evaluation and Sequential Organ Failure Assessment scores (p = 0.009) and lower pH (p < 0.001) but similar mortality to patients with non-femoral access (44 vs. 45%; p = 0.63). Lower body weight was independently associated with femoral access placement (OR 0.97, 95% CI 0.96-0.98). Femoral access was associated with a 1.03% lower CRRT dose (p = 0.05), but a 4.20% higher dose was achieved with 13.5 Fr catheters (p = 0.03). Femoral access was preferred in lighter and sicker patients. Catheter gauge had greater impact than catheter site in CRRT dose delivery. Video Journal Club "Cappuccino with Claudio Ronco" at http://www.karger.com/?doi=439581. © 2015 S. Karger AG, Basel.

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

PubMed

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

2016-01-01

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

Transcolonic Perirectal NOTES Access (PNA): A feasibility study with survival in swine model.

PubMed

Oliveira, André L A; Zorron, Ricardo; Oliveira, Flavio M M DE; Santos, Marcelo B Dos; Scheffer, Jussara P; Rios, Marcelo; Antunes, Fernanda

2017-05-01

Transrectal access still has some unsolved issues such as spatial orientation, infection, access and site closure. This study presents a simple technique to perform transcolonic access with survival in a swine model series. A new technique for NOTES perirectal access to perform retroperitoneoscopy, peritoneoscopy, liver and lymphnode biopsies was performed in 6 pigs, using Totally NOTES technique. The specimens were extracted transanally. The flexible endoscope was inserted through a posterior transmural incision and the retrorectal space. Cultures of bacteria were documented for the retroperitoneal space and intra abdominal cavity after 14 days. Rectal site was closed using non-absorbable sutures. There was no bowel cleansing, nor preoperative fasting. The procedures were performed in 6 pigs through transcolonic natural orifice access using available endoscopic flexible instruments. All animals survived 14 days without complications, and cultures were negative. Histopathologic examination of the rectal closure site showed adequate healing of suture line and no micro abscesses. The results of feasibility and safety of experimental Transcolonic NOTES potentially brings new frontiers and future wider applications for minimally invasive surgery. The treatment of colorectal, abdominal and retroperitoneal diseases through a flexible Perirectal NOTES Access (PNA) is a promising new approach.

Perspectives of People Living with HIV on Access to Health Care: Protocol for a Scoping Review.

PubMed

Asghari, Shabnam; Maybank, Allison; Hurley, Oliver; Modir, Hilary; Farrell, Alison; Marshall, Zack; Kendall, Claire; Johnston, Sharon; Hogel, Matthew; Rourke, Sean B; Liddy, Clare

2016-05-18

Strategies to improve access to health care for people living with human immunodeficiency virus (PLHIV) have demonstrated limited success. Whereas previous approaches have been informed by the views of health providers and decision-makers, it is believed that incorporating patient perspectives into the design and evaluations of health care programs will lead to improved access to health care services. We aim to map the literature on the perspectives of PLHIV concerning access to health care services, to identify gaps in evidence, and to produce an evidence-informed research action plan to guide the Living with HIV program of research. This scoping review includes peer-reviewed and grey literature from 1946 to May 2014 using double data extraction. Variations of the search terms "HIV", "patient satisfaction", and "health services accessibility" are used to identify relevant literature. The search strategy is being developed in consultation with content experts, review methodologists, and a librarian, and validated using gold standard studies identified by those stakeholders. The inclusion criteria are (1) the study includes the perspectives of PLHIV, (2) study design includes qualitative, quantitative, or mixed methods, and (3) outcome measures are limited to patient satisfaction, their implied needs, beliefs, and desires in relation to access to health care. The papers are extracted by two independent reviewers, including quality assessment. Data is then collated, summarized, and thematically analyzed. A total of 12,857 references were retrieved, of which 326 documents were identified as eligible in pre-screening, and 64 articles met the inclusion criteria (56% qualitative studies, 38% quantitative studies and 6% mixed-method studies). Only four studies were conducted in Canada. Data synthesis is in progress and full results are expected in June, 2016. This scoping review will record and characterize the extensive body of literature on perspectives of PLHIV regarding access to health care. A literature repository will be developed to assist stakeholders, decision-makers, and PLHIV in developing and implementing patient-oriented health care programs.

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

PubMed Central

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

2015-01-01

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

Factors Involved in Access and Utilization of Adult Hearing Healthcare: A Systematic Review

PubMed Central

Barnett, Margaret; Hixon, Brian; Okwiri, Neville; Irungu, Catherine; Ayugi, John; Thompson, Robin; Shinn, Jennifer B.; Bush, Matthew L.

2016-01-01

Objective/Hypothesis Hearing loss is a public health concern yet hearing healthcare disparities exist and influence utilization of rehabilitation services. The objective of this review was to systematically analyze the published literature on motivators, barriers, and compliance factors affecting adult patient access and utilization of hearing rehabilitation healthcare. Data Sources and Study Eligibility Criteria Pubmed, PsychINFO, CINAHL, Web of Science were searched for relevant articles. Eligible studies were those containing original, peer-reviewed research in English pertaining to factors affecting adult hearing healthcare access and utilization of hearing aids and cochlear implantation. The search encompassed 1990-2015. Study Appraisal and Synthesis Methods Two investigators independently reviewed all articles and extracted data. Specific variables regarding access to care and compliance to recommended care were extracted from each study. Results Thirty articles were reviewed. The factors affecting access and utilization of hearing rehabilitation could be classified into motivators, barriers, and compliance in treatment or device use. The key motivators to seek care include degree of hearing loss, self-efficacy, family support, and self-recognition of hearing loss. The primary barriers to care were financial limitations, stigma of hearing devices, inconvenience, competing chronic health problems, and unrealistic expectations. Compliance is most affected by self-efficacy, education level, and engagement in the rehabilition process. Conclusion Accessing hearing healthcare is complicated by multiple factors. Considering the current climate in healthcare policy and legislation towards improved access of care, a deeper understanding of motivators, barriers and compliance factors can aid in delivery of effective and efficient hearing healthcare. PMID:27545324

Experiences of registered nurses with regard to accessing health information at the point-of-care via mobile computing devices.

PubMed

Ricks, Esmeralda; Benjamin, Valencia; Williams, Margaret

2015-11-19

The volume of health information necessary to provide competent health care today has become overwhelming. Mobile computing devices are fast becoming an essential clinical tool for accessing health information at the point-of-care of patients. This study explored and described how registered nurses experienced accessing information at the point-of-care via mobile computing devices (MCDs). A qualitative, exploratory, descriptive and contextual design was used. Ten in-depth interviews were conducted with purposively sampled registered nurses employed by a state hospital in the Nelson Mandela Bay Municipality (NMBM). Interviews were recorded, transcribed verbatim and analysed using Tesch's data analysis technique. Ethical principles were adhered to throughout the study. Guba's model of trustworthiness was used to confirm integrity of the study. Four themes emerged which revealed that the registered nurses benefited from the training they received by enabling them to develop, and improve, their computer literacy levels. Emphasis was placed on the benefits that the accessed information had for educational purposes for patients and the public, for colleagues and students. Furthermore the ability to access information at the point-of-care was considered by registered nurses as valuable to improve patient care because of the wide range of accurate and readily accessible information available via the mobile computing device. The registered nurses in this study felt that being able to access information at the point-of-care increased their confidence and facilitated the provision of quality care because it assisted them in being accurate and sure of what they were doing.

The provision and impact of online patient access to their electronic health records (EHR) and transactional services on the quality and safety of health care: systematic review protocol.

PubMed

Mold, Freda; Ellis, Beverley; de Lusignan, Simon; Sheikh, Aziz; Wyatt, Jeremy C; Cavill, Mary; Michalakidis, Georgios; Barker, Fiona; Majeed, Azeem; Quinn, Tom; Koczan, Phil; Avanitis, Theo; Gronlund, Toto Anne; Franco, Christina; McCarthy, Mary; Renton, Zoë; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Jones, Simon; Rafi, Imran

2012-01-01

Innovators have piloted improvements in communication, changed patterns of practice and patient empowerment from online access to electronic health records (EHR). International studies of online services, such as prescription ordering, online appointment booking and secure communications with primary care, show good uptake of email consultations, accessing test results and booking appointments; when technologies and business process are in place. Online access and transactional services are due to be rolled out across England by 2015; this review seeks to explore the impact of online access to health records and other online services on the quality and safety of primary health care. To assess the factors that may affect the provision of online patient access to their EHR and transactional services, and the impact of such access on the quality and safety of health care. Two reviewers independently searched 11 international databases during the period 1999-2012. A range of papers including descriptive studies using qualitative or quantitative methods, hypothesis-testing studies and systematic reviews were included. A detailed eligibility criterion will be used to shape study inclusion. A team of experts will review these papers for eligibility, extract data using a customised extraction form and use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument to determine the quality of the evidence and the strengths of any recommendation. Data will then be descriptively summarised and thematically synthesised. Where feasible, we will perform a quantitative meta-analysis. Prospero (International Prospective Register of Systematic Reviews) registration number: crd42012003091.

The media and access issues: content analysis of Canadian newspaper coverage of health policy decisions.

PubMed

Rachul, Christen; Caulfield, Timothy

2015-08-25

Previous studies have demonstrated how the media has an influence on policy decisions and healthcare coverage. Studies of Canadian media have shown that news coverage often emphasizes and hypes certain aspects of high profile health debates. We hypothesized that in Canadian media coverage of access to healthcare issues about therapies and technologies including for rare diseases, the media would be largely sympathetic towards patients, thus adding to public debate that largely favors increased access to healthcare-even in the face of equivocal evidence regarding efficacy. In order to test this hypothesis, we conducted a content analysis of 530 news articles about access to health therapies and technologies from 15 major Canadian newspapers over a 10-year period. Articles were analyzed for the perspectives presented in the articles and the types of reasons or arguments presented either for or against the particular access issue portrayed in the news articles. We found that news media coverage was largely sympathetic towards increasing healthcare funding and ease of access to healthcare (77.4 %). Rare diseases and orphan drugs were the most common issues raised (22.6 %). Patients perspectives were often highlighted in articles (42.3 %). 96.8 % of articles discussed why access to healthcare needs to increase, and discussion that questioned increased access was only included in 33.6 % articles. We found that news media favors a patient access ethos, which may contribute to a difficult policy-making environment.

Perceived and geographic food access and food security status among households with children.

PubMed

Ma, Xiaoguang; Liese, Angela D; Bell, Bethany A; Martini, Lauren; Hibbert, James; Draper, Carrie; Burke, Michael P; Jones, Sonya J

2016-10-01

To examine the association of both perceived and geographic neighbourhood food access with food security status among households with children. This was a cross-sectional study in which participants' perceptions of neighbourhood food access were assessed by a standard survey instrument, and geographic food access was evaluated by distance to the nearest supermarket. Multinomial logistic regression models were used to examine the associations. The Midlands Family Study included 544 households with children in eight counties in South Carolina, USA. Food security status among participants was classified into three categories: food secure (FS), food insecure (FI) and very low food security among children (VLFS-C). Compared with FS households, VLFS-C households had lower odds of reporting easy access to adequate food shopping. VLFS-C households also had lower odds of reporting neighbourhood access to affordable fruits and vegetables compared with FS households and reported worse selection of fruits and vegetables, quality of fruits and vegetables, and selection of low-fat products. FI households had lower odds of reporting fewer opportunities to purchase fast food. None of the geographic access measures was significantly associated with food security status. Caregivers with children who experienced hunger perceived that they had less access to healthy affordable food in their community, even though grocery stores were present. Approaches to improve perceived access to healthy affordable food should be considered as part of the overall approach to improving food security and eliminating child hunger.

The evaluation of radiologic methods for access guidance in percutaneous nephrolithotomy: a systematic review of the literature.

PubMed

Breda, Alberto; Territo, Angelo; Scoffone, Cesare; Seitz, Christian; Knoll, Thomas; Herrmann, Thomas; Brehmer, Mariannhe; Osther, Palle J S; Liatsikos, Evangelos

2017-11-12

Percutaneous nephrolithotomy (PNL) is the treatment of choice for larger and complex renal calculi. First step in performing PNL is to obtain access to the renal cavity using either fluoroscopy or ultrasound (US) guidance or a combination of both. Which guiding method to choose is controversial? A systematic review of the literature was performed comparing image guidance modalities for obtaining access in PNL. Evidence acquisition and synthesis: A PubMed, Scopus and Cochrane search for peer-reviewed studies was performed using the keywords "ultrasound" AND "fluoroscopy" AND "Percutaneous nephrolithotomy". Eligible articles were reviewed according to PRISMA criteria. Two hundred and forty records were identified using the keywords. Of these twelve studies were considered relevant. US guidance seems to be associated with a slightly lower complication rate, which may be related to fewer puncture attempts needed for obtaining access and to better peri-renal organ visualization. On the other hand, US-guidance alone needs the adjunct of fluoroscopy in a significant number of cases for achieving access. Stone free rate (SFR) was comparable between groups. Using US for renal access unequivocally reduces radiation exposure. Current evidence indicates that both fluoroscopy and US guidance may be successfully used for obtaining percutaneous renal access. Combining the image-guiding modalities - US and fluoroscopy - seems to increase outcome in PNL both with regard to success in achieving access and reducing complications. Furthermore, including US in the access strategy of PNL reduces radiation exposure to surgeon and staff as well as patients.

Perceived and Geographic Food Access and Food Security Status among Households with Children

PubMed Central

Ma, Xiaoguang; Liese, Angela D.; Bell, Bethany; Martini, Lauren; Hibbert, James; Draper, Carrie; Jones, Sonya J.

2017-01-01

Objective To examine the association of both perceived and geographic neighborhood food access with food security status among households with children. Design This was a cross-sectional study in which participants’ perceptions of neighborhood food access were assessed by a standard survey instrument, and geographic food access was evaluated by distance to the nearest supermarket. Multinomial logistic regression models were used to examine the associations. Subjects The Midlands Family Study included 544 households with children in eight counties in South Carolina. Food security status among participants was classified into three categories: food secure (FS), food insecure (FI) and very low food security among children (VLFS-C). Results Compared to FS households, VLFS-C households had lower odds of reporting easy access to adequate food shopping. VLFS-C households also had lower odds of reporting neighborhood access to affordable fruits and vegetables compared to FS households and reported worse selection of fruits and vegetables, quality of fruits and vegetables and selection of low-fat products. FI households had lower odds of reporting fewer opportunities to purchase fast food. None of the geographic access measures was significantly associated with food security status. Conclusions Caregivers with children that experienced hunger perceived that they had less access to healthy affordably food in their community, even though grocery stores were present. Approaches to improve perceived access to healthy affordable food should be considered as part of the overall approach to improving food security and eliminating child hunger. PMID:27133939

Development of the public information and communication technology assessment tool.

PubMed

Ripat, Jacquie; Watzke, James; Birch, Gary

2008-09-01

Public information and communication technologies, such as information kiosks, automated banking machines and ticket dispensers, allow people to access services in a convenient and timely manner. However, the development of these technologies has occurred largely without consideration of access by people with disabilities. Inaccessible technical features make operation of a public technology difficult and barriers in the environment create navigational challenges, limiting the opportunity of people with disabilities to use these devices and access the services they provide. This paper describes the development of a tool that individuals, disability advocacy groups, business owners, healthcare providers, and urban planners can use to evaluate the accessibility of public technologies and the surrounding environment. Evaluation results can then be used to develop recommendations and advocate for technical and environmental changes to improve access. Tool development consisted of a review of the literature and key Canadian Standards Association documents, task analysis, and consultation with accessibility experts. Studies of content validity, tool usability, inter-rater and test-retest reliability were conducted in sites across Canada. Accessibility experts verified the content validity of the tool. The current version of the tool has incorporated the findings of a usability study. Initial testing indicated excellent agreement for inter-rater and test-retest reliability scores. Social exclusion can arise when public technologies are not accessible. This newly developed instrument provides detailed information that can be used to advocate for more accessible and inclusive public information and communication technologies.

San Diego Wheelchair Accessible Bus Study

DOT National Transportation Integrated Search

1977-09-01

The study describes the implementation and early operation of a pilot project of fixed route, wheelchair accessible bus service on two routes of the San Diego Transit system. Five buses of the Transit Authority fleet were retrofitted with wheelchair ...

The meaning of computers to a group of men who are homeless.

PubMed

Miller, Kathleen Swenson; Bunch-Harrison, Stacey; Brumbaugh, Brett; Kutty, Rekha Sankaran; FitzGerald, Kathleen

2005-01-01

The purpose of this pilot study was to explore the experience with computers and the meaning of computers to a group of homeless men living in a long-term shelter. This descriptive exploratory study used semistructured interviews with seven men who had been given access to computers and had participated in individually tailored occupation based interventions through a Work Readiness Program. Three themes emerged from analyzing the interviews: access to computers, computers as a bridge to life-skill development, and changed self-perceptions as a result of connecting to technology. Because they lacked computer knowledge and feared failure, the majority of study participants had not sought out computers available through public access. The need for access to computers, the potential use of computers as a medium for intervention, and the meaning of computers to these men who represent the digital divide are described in this study.

Effects of research tool patents on biotechnology innovation in a developing country: A case study of South Korea

PubMed Central

Kang, Kyung-Nam; Ryu, Tae-Kyu; Lee, Yoon-Sik

2009-01-01

Background Concerns have recently been raised about the negative effects of patents on innovation. In this study, the effects of patents on innovations in the Korean biotech SMEs (small and medium-sized entrepreneurs) were examined using survey data and statistical analysis. Results The survey results of this study provided some evidence that restricted access problems have occurred even though their frequency was not high. Statistical analysis revealed that difficulties in accessing patented research tools were not negatively correlated with the level of innovation performance and attitudes toward the patent system. Conclusion On the basis of the results of this investigation in combination with those of previous studies, we concluded that although restricted access problems have occurred, this has not yet deterred innovation in Korea. However, potential problems do exist, and the effects of restricted access should be constantly scrutinized. PMID:19321013

Computer and Internet Interventions to Optimize Listening and Learning for People With Hearing Loss: Accessibility, Use, and Adherence.

PubMed

Ferguson, Melanie; Henshaw, Helen

2015-09-01

The aim of this research forum article was to examine accessibility, use, and adherence to computerized and online interventions for people with hearing loss. Four intervention studies of people with hearing loss were examined: 2 auditory training studies, 1 working memory training study, and 1 study of multimedia educational support. A small proportion (approximately 15%) of participants had never used a computer, which may be a barrier to the accessibility of computer and Internet-based interventions. Computer competence was not a factor in intervention use or adherence. Computer skills and Internet access influenced participant preference for the delivery method of the multimedia educational support program. It is important to be aware of current barriers to computer and Internet-delivered interventions for people with hearing loss. However, there is a clear need to develop and future-proof hearing-related applications for online delivery.

Validity of Assessments of Youth Access to Tobacco: The Familiarity Effect

PubMed Central

Landrine, Hope; Klonoff, Elizabeth A.

2003-01-01

Objectives. We examined the standard compliance protocol and its validity as a measure of youth access to tobacco. Methods. In Study 1, youth smokers reported buying cigarettes in stores where they are regular customers. In Study 2, youths attempted to purchase cigarettes by using the Standard Protocol, in which they appeared at stores once for cigarettes, and by using the Familiarity Protocol, in which they were rendered regular customers by purchasing nontobacco items 4 times and then requested cigarettes during their fifth visit. Results. Sales to youths aged 17 years in the Familiarity Protocol were significantly higher than sales to the same age group in the Standard Protocols (62.5% vs. 6%, respectively). Conclusions. The Standard Protocol does not match how youths obtain cigarettes. Access is low for stranger youths within compliance studies, but access is high for familiar youths outside of compliance studies. PMID:14600057

Effects of research tool patents on biotechnology innovation in a developing country: a case study of South Korea.

PubMed

Kang, Kyung-Nam; Ryu, Tae-Kyu; Lee, Yoon-Sik

2009-03-26

Concerns have recently been raised about the negative effects of patents on innovation. In this study, the effects of patents on innovations in the Korean biotech SMEs (small and medium-sized entrepreneurs) were examined using survey data and statistical analysis. The survey results of this study provided some evidence that restricted access problems have occurred even though their frequency was not high. Statistical analysis revealed that difficulties in accessing patented research tools were not negatively correlated with the level of innovation performance and attitudes toward the patent system. On the basis of the results of this investigation in combination with those of previous studies, we concluded that although restricted access problems have occurred, this has not yet deterred innovation in Korea. However, potential problems do exist, and the effects of restricted access should be constantly scrutinized.

Psychological Processes Underlying Cultivation Effects: Further Tests of Construct Accessibility.

ERIC Educational Resources Information Center

Shrum, L. J.

1996-01-01

Describes a study that tested whether the accessibility of information in memory mediates the cultivation effect (the effect of television viewing on social perceptions), consistent with the availability heuristic. Shows that heavy viewers gave higher frequency estimates (cultivation effect) and responded faster (accessibility effect) than did…

The effects of natural and induced short-term floods on four sugarcane accessions

USDA-ARS?s Scientific Manuscript database

A study was initiated at the USDA/ARS Subtropical Horticulture Research Station, Miami, FL to evaluate the potential for flood tolerance in several accessions from Saccharum barberi (Jeswiet) and S. sinense (Roxb. Amend. Jeswiet) sugarcane genera. The experimental design included 4 accessions, Kewal...

Disentangling Mathematics Target and Access Skills: Implications for Accommodation Assignment Practices

ERIC Educational Resources Information Center

Ketterlin-Geller, Leanne R.; Jamgochian, Elisa M.; Nelson-Walker, Nancy J.; Geller, Joshua P.

2012-01-01

Appropriate assignment of accommodations is predicated on a clear distinction between target skills and access skills. In this study, we examine the agreement between test developer/researchers' and educators' classification of target and access skills as a possible explanatory mechanism for assigning accommodations. Findings indicate that…

The Accessibility of Higher Education in the Russian Regions

ERIC Educational Resources Information Center

Gromov, A. D.; Platonova, D. P.; Semyonov, D. S.; Pyrova, T. L.

2017-01-01

This article provides a comparative analysis of accessibility of higher education across Russian regions in terms of the following three factors: the availability of admission opportunities; financial affordability; and geographic accessibility. The study will be of interest to government agencies in higher education at various levels, analysts…

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

ERIC Educational Resources Information Center

Nunez, Anne-Marie

2009-01-01

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

Open Access Publishing in Indian Premier Research Institutions

ERIC Educational Resources Information Center

Bhat, Mohammad Hanief

2009-01-01

Introduction: Publishing research findings in open access journals is a means of enhancing visibility and consequently increasing the impact of publications. This study provides an overview of open access publishing in premier research institutes of India. Method: The publication output of each institution from 2003 to 2007 was ascertained through…

47 CFR 69.123 - Density pricing zones for special access and switched transport.

Code of Federal Regulations, 2011 CFR

2011-10-01

... switched transport. 69.123 Section 69.123 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED... for special access and switched transport. (a)(1) Incumbent local exchange carriers not subject to... at least 15 percent of that carrier's special access and transport revenues within that study area...

Thus Spake the OPAC User.

ERIC Educational Resources Information Center

Markey, Karen

1983-01-01

Findings of focused-group interviews conducted for OCLC study of library users and online public access catalogs (OPACs) indicate users like OPACs, have problems finding right subject heading, envision features to improve subject access, want access to more than books, and want OPACs to provide new services. Eight references are listed. (EJS)

Correlates of Access to Business Research Databases

ERIC Educational Resources Information Center

Gottfried, John C.

2010-01-01

This study examines potential correlates of business research database access through academic libraries serving top business programs in the United States. Results indicate that greater access to research databases is related to enrollment in graduate business programs, but not to overall enrollment or status as a public or private institution.…

Access and Equity in Higher Education in Antigua and Barbuda

ERIC Educational Resources Information Center

Hewlett-Thomas, Elsie

2009-01-01

Across the international higher education spectrum access represents a significant issue. The literature is replete with analyses of access in various higher education systems. Low and inequitable patterns of participation in higher education are particularly prominent in developing countries. This dissertation is a case study of the higher…

High School Student Information Access and Engineering Design Performance

ERIC Educational Resources Information Center

Mentzer, Nathan

2014-01-01

Developing solutions to engineering design problems requires access to information. Research has shown that appropriately accessing and using information in the design process improves solution quality. This quasi-experimental study provides two groups of high school students with a design problem in a three hour design experience. One group has…

Comparison between different thickness umbrella-shaped expandable radiofrequency electrodes (SuperSlim and CoAccess): Experimental and clinical study

PubMed Central

KODA, MASAHIKO; TOKUNAGA, SHIHO; MATONO, TOMOMITSU; SUGIHARA, TAKAAKI; NAGAHARA, TAKAKAZU; MURAWAKI, YOSHIKAZU

2011-01-01

The purpose of the present study was to compare the size and configuration of the ablation zones created by SuperSlim and CoAccess electrodes, using various ablation algorithms in ex vivo bovine liver and in clinical cases. In the experimental study, we ablated explanted bovine liver using 2 types of electrodes and 4 ablation algorithms (combinations of incremental power supply, stepwise expansion and additional low-power ablation) and evaluated the ablation area and time. In the clinical study, we compared the ablation volume and the shape of the ablation zone between both electrodes in 23 hepatocellular carcinoma (HCC) cases with the best algorithm (incremental power supply, stepwise expansion and additional low-power ablation) as derived from the experimental study. In the experimental study, the ablation area and time by the CoAccess electrode were significantly greater compared to those by the SuperSlim electrode for the single-step (algorithm 1, p=0.0209 and 0.0325, respectively) and stepwise expansion algorithms (algorithm 2, p=0.0002 and <0.0001, respectively; algorithm 3, p= 0.006 and 0.0407, respectively). However, differences were not significant for the additional low-power ablation algorithm. In the clinical study, the ablation volume and time in the CoAccess group were significantly larger and longer, respectively, compared to those in the SuperSlim group (p=0.0242 and 0.009, respectively). Round ablation zones were acquired in 91.7% of the CoAccess group, while irregular ablation zones were obtained in 45.5% of the SuperSlim group (p=0.0428). In conclusion, the CoAccess electrode achieves larger and more uniform ablation zones compared with the SuperSlim electrode, though it requires longer ablation times in experimental and clinical studies. PMID:22977647

Duration to Establish an Emergency Vascular Access and How to Accelerate It: A Simulation-Based Study Performed in Real-Life Neonatal Resuscitation Rooms.

PubMed

Schwindt, Eva M; Hoffmann, Florian; Deindl, Philipp; Waldhoer, Thomas J; Schwindt, Jens C

2018-05-01

To compare the duration to establish an umbilical venous catheter and an intraosseous access in real hospital delivery rooms and as a secondary aim to assess delaying factors during establishment and to provide recommendations to accelerate vascular access in neonatal resuscitation. Retrospective analysis of audio-video recorded neonatal simulation training. Simulation training events in exact replications of actual delivery/resuscitation rooms of 16 hospitals with different levels of care (Austria and Germany). Equipment was prepared the same way as for real clinical events. Medical teams of four to five persons with birth-related background (midwives, nurses, neonatologists, and anesthesiologists) in a realistic team composition. Audio-video recorded mannequin-based simulated resuscitation of an asphyxiated newborn including the establishment of either umbilical venous catheter or intraosseous access. The duration of access establishment (time from decision to first flush/aspiration), preparation (decision to start of procedure), and the procedure itself (start to first flush/aspiration) was significantly longer for umbilical venous catheter than for intraosseous access (overall duration 199 vs 86 s). Delaying factors for umbilical venous catheter establishment were mainly due to the complex approach itself, the multitude of equipment required, and uncertainties about necessary hygiene standards. Challenges in intraosseous access establishment were handling of the unfamiliar material and absence of an intraosseous access kit in the resuscitation room. There was no significant difference between the required duration for access establishment between large centers and small hospitals, but a trend was observed that duration for umbilical venous catheter was longer in small hospitals than in centers. Duration for intraosseous access was similar in both hospital types. Vascular access establishment in neonatal resuscitation could be accelerated by infrastructural improvements and specific training of medical teams. In simulated in situ neonatal resuscitation, intraosseous access is faster to establish than umbilical venous catheter. Future studies are required to assess efficacy and safety of both approaches in real resuscitation settings.

Patient-reported access to primary care in Ontario: effect of organizational characteristics.

PubMed

Muggah, Elizabeth; Hogg, William; Dahrouge, Simone; Russell, Grant; Kristjansson, Elizabeth; Muldoon, Laura; Devlin, Rose Anne

2014-01-01

To describe patient-reported access to primary health care across 4 organizational models of primary care in Ontario, and to explore how access is associated with patient, provider, and practice characteristics. Cross-sectional survey. One hundred thirty-seven randomly selected primary care practices in Ontario using 1 of 4 delivery models (fee for service, established capitation, reformed capitation, and community health centres). Patients included were at least 18 years of age, were not severely ill or cognitively impaired, were not known to the survey administrator, had consenting providers at 1 of the participating primary care practices, and were able to communicate in English or French either directly or through a translator. Patient-reported access was measured by a 4-item scale derived from the previously validated adult version of the Primary Care Assessment Tool. Questions were asked about physician availability during and outside of regular office hours and access to health information via telephone. Responses to the scale were normalized, with higher scores reflecting greater patient-reported access. Linear regressions were used to identify characteristics independently associated with access to care. Established capitation model practices had the highest patient-reported access, although the difference in scores between models was small. Our multilevel regression model identified several patient factors that were significantly (P = .05) associated with higher patient-reported access, including older age, female sex, good-to-excellent self-reported health, less mental health disability, and not working. Provider experience (measured as years since graduation) was the only provider or practice characteristic independently associated with improved patient-reported access. This study adds to what is known about access to primary care. The study found that established capitation models outperformed all the other organizational models, including reformed capitation models, independent of provider and practice variables save provider experience. This suggests that the capitation models might provide better access to care and that it might take time to realize the benefits of organizational reforms.

Circadian Activity Rhythms and Voluntary Ethanol Intake in Male and Female Ethanol-Preferring Rats: Effects of Long-Term Ethanol Access

PubMed Central

Rosenwasser, Alan M.; McCulley, Walter D.; Fecteau, Matthew

2014-01-01

Chronic alcohol (ethanol) intake alters fundamental properties of the circadian clock. While previous studies have reported significant alterations in free-running circadian period during chronic ethanol access, these effects are typically subtle and appear to require high levels of intake. In the present study we examined the effects of long-term voluntary ethanol intake on ethanol consumption and free-running circadian period in male and female, selectively bred ethanol-preferring P and HAD2 rats. In light of previous reports that intermittent access can result in escalated ethanol intake, an initial 2-week water-only baseline was followed by either continuous or intermittent ethanol access (i.e., alternating 15-day epochs of ethanol access and ethanol deprivation) in separate groups of rats. Thus, animals were exposed to either 135 days of continuous ethanol access or to five 15-day access periods alternating with four 15-day periods of ethanol deprivation. Animals were maintained individually in running-wheel cages under continuous darkness throughout the experiment to allow monitoring of free-running activity and drinking rhythms, and 10% (v/v) ethanol and plain water were available continuously via separate drinking tubes during ethanol access. While there were no initial sex differences in ethanol drinking, ethanol preference increased progressively in male P and HAD2 rats under both continuous and intermittent-access conditions, and eventually exceeded that seen in females. Free-running period shortened during the initial ethanol-access epoch in all groups, but the persistence of this effect showed complex dependence on sex, breeding line, and ethanol-access schedule. Finally, while females of both breeding lines displayed higher levels of locomotor activity than males, there was little evidence for modulation of activity level by ethanol access. These results are consistent with previous findings that chronic ethanol intake alters free-running circadian period, and show further that the development of chronobiological tolerance to ethanol may vary by sex and genotype. PMID:25281289

ACCESS - A Science and Engineering Assessment of Space Coronagraph Concepts for the Direct Imaging and Spectroscopy of Exoplanetary Systems

NASA Technical Reports Server (NTRS)

Trauger, John

2008-01-01

Topics include and overview, science objectives, study objectives, coronagraph types, metrics, ACCESS observatory, laboratory validations, and summary. Individual slides examine ACCESS engineering approach, ACCESS gamut of coronagraph types, coronagraph metrics, ACCESS Discovery Space, coronagraph optical layout, wavefront control on the "level playing field", deformable mirror development for HCIT, laboratory testbed demonstrations, high contract imaging with the HCIT, laboratory coronagraph contrast and stability, model validation and performance predictions, HCIT coronagraph optical layout, Lyot coronagraph on the HCIT, pupil mapping (PIAA), shaped pupils, and vortex phase mask experiments on the HCIT.

Evaluation of introduction scenarios for a broadband access network

NASA Astrophysics Data System (ADS)

Bocker, Geert-Jan; Cuthbert, Laurie; Gobbi, Roberta; Inch, Robert; Sara, Lini

1995-02-01

The provision of broadband services at a reasonable cost to residential and small business customers is one of the major challenges facing operators. The introduction of cost-effective systems considering the existing infrastructure is an important study. Within the RACE project 2024 Broadband Access Facilities, the economic and evolution aspects of different introduction scenarios of a broadband access system suitable for providing these services are investigated. This paper presents the final results of this study.

Systematic review of strategies to increase access to health services among children over five in low- and middle-income countries.

PubMed

Bright, Tess; Felix, Lambert; Kuper, Hannah; Polack, Sarah

2018-05-01

The populations of many low- and middle-income countries (LMIC) are young. Despite progress made towards achieving Universal Health Coverage and remarkable health gains, evidence suggests that many children in LMIC are still not accessing needed healthcare services. Delayed or lack of access to health services can lead to a worsening of health and can in turn negatively impact a child's ability to attend school, and future employment opportunities. We conducted a systematic review to assess the effectiveness of interventions aimed at increasing access to health services for children over 5 years in LMIC settings. Four electronic databases were searched in March 2017. Studies were included if they evaluated interventions that aimed to increase: healthcare utilisation, immunisation uptake and compliance with medication/referral. Randomised controlled trials and non-randomised study designs were included in the review. Data extraction included study characteristics, intervention type and measures of access to health services for children above 5 years of age. Study outcomes were classified as positive, negative, mixed or null in terms of their impact on access outcomes. Ten studies met the criteria for inclusion in the review. Interventions were evaluated in Nicaragua (1), Brazil (1), Turkey (1), India (1), China (1), Uganda (1), Ghana (1), Nigeria (1), South Africa (1) and Swaziland (1). Intervention types included education (2), incentives (1), outreach (1), SMS/phone call reminders (2) and multicomponent interventions (4). All evaluations reported positive findings on measured health access outcomes; however, the quality and strength of evidence were mixed. This review provides evidence of the range of interventions that were used to increase healthcare access for children above 5 years old in LMIC. Nevertheless, further research is needed to examine each of the identified intervention types and the influence of contextual factors, with robust study designs. There is also a need to assess the cost-effectiveness of the interventions to inform decision-makers on which are suitable for scale-up in their particular contexts. © 2018 John Wiley & Sons Ltd.

Characteristics of clients who access mobile compared to clinic HIV counselling and testing services: a matched study from Cape Town, South Africa.

PubMed

Meehan, Sue-Ann; Naidoo, Pren; Claassens, Mareli M; Lombard, Carl; Beyers, Nulda

2014-12-20

Studies within sub-Saharan African countries have shown that mobile services increase uptake of HIV counselling and testing (HCT) services when compared to clinics and are able to access different populations, but these have included provider-initiated HCT in clinics. This study aimed to compare the characteristics of clients who self-initiated HCT at either a mobile or a clinic service in terms of demographic and socio-economic variables, also comparing reasons for accessing a particular health service provider. This study took place in eight areas around Cape Town. A matched design was used with one mobile HCT service matched with one or more clinics (offering routine HCT services) within each of the eight areas. Adult clients who self-referred for an HIV test within a specified time period at either a mobile or clinic service were invited to participate in the study. Data were collected between February and April 2011 using a questionnaire. Summary statistics were calculated for each service type within a matched pair and differences of outcomes from pairs were used to calculate effect sizes and 95% confidence intervals. 1063 participants enrolled in the study with 511 from mobile and 552 from clinic HCT services. The proportion of males accessing mobile HCT significantly exceeded that of clinic HCT (p < 0.001). The mean age of participants attending mobile HCT was higher than clinic participants (p = 0.023). No significant difference was found for socio-economic variables between participants, with the exception of access to own piped water (p = 0.029). Participants who accessed mobile HCT were significantly more likely to report that they were just passing, deemed an "opportunistic" visit (p = 0.014). Participants who accessed clinics were significantly more likely to report the service being close to home or work (p = 0.035). An HCT strategy incorporating a mobile HCT service, has a definite role to play in reaching those population groups who do not typically access HCT services at a clinic, especially males and those who take advantage of the opportunity to test. Mobile HCT services can complement clinic services.

Exploring the interaction of activity limitations with context, systems, community and personal factors in accessing public health care services: A presentation of South African case studies.

PubMed

Mji, Gubela; Braathen, Stine H; Vergunst, Richard; Scheffler, Elsje; Kritzinger, Janis; Mannan, Hasheem; Schneider, Marguerite; Swartz, Leslie; Visagie, Surona

2017-02-08

There are many factors that influence access to public health services, such as the context people live in, the existing health services, and personal, cultural and community factors. People with disabilities (activity limitations), through their experience of health services, may offer a particular understanding of the performance of the health services, thus exposing health system limitations more clearly than perhaps any other health service user. This article explores how activity limitations interact with factors related to context, systems, community and personal factors in accessing public health care services in South Africa. We present four case studies of people with disabilities from four low-resource diverse contexts in South Africa (rural, semi-rural, farming community and peri-urban) to highlight challenges of access to health services experienced by people with activity limitations in a variety of contexts. One case study of a person with disabilities was chosen from each study setting to build evidence using an intensive qualitative case study methodology to elucidate individual and household experiences of challenges experienced by people with activity limitations when attempting to access public health services. In-depth interviews were used to collect data, using an interview guide. The analysis was conducted in the form of a thematic analysis using the interview topics as a starting point. First, these four case studies demonstrate that equitable access to health services for people with activity limitations is influenced by a complex interplay of a variety of factors for a single individual in a particular context. Secondly, that while problems with access to public health services are experienced by everyone, people with activity limitations are affected in particular ways making them particularly vulnerable in using public health services. The revitalisation of primary health care and the introduction of national health insurance by the Health Department of South Africa open a window of opportunity for policy makers and policy implementers to revisit and address the areas of access to public health services for people with activity limitations.

A review of accessibility of administrative healthcare databases in the Asia-Pacific region

PubMed Central

Milea, Dominique; Azmi, Soraya; Reginald, Praveen; Verpillat, Patrice; Francois, Clement

2015-01-01

Objective We describe and compare the availability and accessibility of administrative healthcare databases (AHDB) in several Asia-Pacific countries: Australia, Japan, South Korea, Taiwan, Singapore, China, Thailand, and Malaysia. Methods The study included hospital records, reimbursement databases, prescription databases, and data linkages. Databases were first identified through PubMed, Google Scholar, and the ISPOR database register. Database custodians were contacted. Six criteria were used to assess the databases and provided the basis for a tool to categorise databases into seven levels ranging from least accessible (Level 1) to most accessible (Level 7). We also categorised overall data accessibility for each country as high, medium, or low based on accessibility of databases as well as the number of academic articles published using the databases. Results Fifty-four administrative databases were identified. Only a limited number of databases allowed access to raw data and were at Level 7 [Medical Data Vision EBM Provider, Japan Medical Data Centre (JMDC) Claims database and Nihon-Chouzai Pharmacy Claims database in Japan, and Medicare, Pharmaceutical Benefits Scheme (PBS), Centre for Health Record Linkage (CHeReL), HealthLinQ, Victorian Data Linkages (VDL), SA-NT DataLink in Australia]. At Levels 3–6 were several databases from Japan [Hamamatsu Medical University Database, Medi-Trend, Nihon University School of Medicine Clinical Data Warehouse (NUSM)], Australia [Western Australia Data Linkage (WADL)], Taiwan [National Health Insurance Research Database (NHIRD)], South Korea [Health Insurance Review and Assessment Service (HIRA)], and Malaysia [United Nations University (UNU)-Casemix]. Countries were categorised as having a high level of data accessibility (Australia, Taiwan, and Japan), medium level of accessibility (South Korea), or a low level of accessibility (Thailand, China, Malaysia, and Singapore). In some countries, data may be available but accessibility was restricted based on requirements by data custodians. Conclusions Compared with previous research, this study describes the landscape of databases in the selected countries with more granularity using an assessment tool developed for this purpose. A high number of databases were identified but most had restricted access, preventing their potential use to support research. We hope that this study helps to improve the understanding of the AHDB landscape, increase data sharing and database research in Asia-Pacific countries. PMID:27123180

Refugee Students at College and University: Improving Access and Support

NASA Astrophysics Data System (ADS)

Hannah, Janet

1999-03-01

This article summarizes the findings and recommendations of a study into access to, and experience of, colleges of further education and universities by refugees in Sydney, Australia. The study sought to identify examples of institutional good practice which are potentially transferable to other major host countries for refugees in the developed world. It focuses upon the factors influencing the decision to enter college or university, sources and usefulness of information and advice, access courses and special entry schemes, the recognition of prior learning and overseas qualifications and institutional sensitivity and support. It concludes with a series of recommendations for providers of further and higher education to improve access and support for students from refugee backgrounds.

The transferability of safety-driven access management models for application to other sites.

DOT National Transportation Integrated Search

2001-01-01

Several research studies have produced mathematical models that predict the safety impacts of selected access management techniques. Since new models require substantial resources to construct, this study evaluated five existing models with regard to...

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

PubMed

Bustillos, Arnaldo Sanchez; Trigoso, Oswaldo Ortiz

2013-11-01

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

Perceptions of Medicaid Beneficiaries Regarding the Usefulness of Accessing Personal Health Information and Services through a Patient Internet Portal

PubMed Central

Lobach, David F.; Willis, Janese M.; Macri, Jennifer M.; Simo, Jessica; Anstrom, Kevin J.

2006-01-01

Increasing emphasis is being placed on the importance of information technology to improve the safety and quality of healthcare. However, concern is growing that these potential benefits will not be equally distributed across the population because of a widening digital divide along racial and socioeconomic lines. In this pilot study, we surveyed 31 Medicaid beneficiaries to ascertain their interest in and projected use of a healthcare patient Internet portal. We found that most Medicaid beneficiaries (or their parents/guardians) were very interested in accessing personal health information about themselves (or their dependents) online. Additionally, they were interested in accessing healthcare services online. We also found that many Medicaid beneficiaries have Internet access, including a slight majority with access to high-speed Internet connections. Our study revealed significant concern about the privacy of online health information. PMID:17238393

Using Geographic Information Systems (GIS) to Examine Barriers to Healthcare Access for Hispanic and Latino Immigrants in the U.S. South.

PubMed

Edward, Jean; Biddle, Donald J

2017-04-01

Geographic barriers to accessing timely and appropriate primary health care services have been identified as significant social determinants of health that contribute to the growing health inequities among Hispanic and Latino immigrants in the United States. The purpose of this study was to examine the geographic factors that serve as barriers to healthcare access for Hispanic and Latino immigrants in the southern community of Louisville, Kentucky. Accessibility to healthcare services was examined using spatial analysis techniques, a Geographic Information System and geographic data from the U.S. Census Bureau and the Louisville and Jefferson County Information Consortium. Results from this study indicated that physical location, socioeconomic factors, distance, and transportation served as barriers to accessing healthcare services. Findings provide significant implications for future research and policy-based interventions focused on eliminating geographic barriers and promoting social and health equity for the underserved.

High School Students' Self-Reported Use of School Clinics and Nurses.

PubMed

Harper, Christopher R; Liddon, Nicole; Dunville, Richard; Habel, Melissa A

2016-10-01

Access to school health clinics and nurses has been linked with improved student achievement and health. Unfortunately, no studies have examined how many students report using school clinics or nurses and for which services. This study addressed this gap with data from a nationally representative sample of 15- to 25-year-olds. Respondents who reported being in high school were provided a list of services and asked whether they had gone to a school nurse or clinic for any of the listed services. Nearly 90% reported having access to a school clinic or nurse. Among students with access, 65.6% reported using at least one service. Non-White students and younger students were more likely to report having access to a clinic or nurse. These results show many students have access to clinics or nurses and are using these services, although not uniformly for all services. © The Author(s) 2016.

Spatial access to residential care resources in Beijing, China

PubMed Central

2012-01-01

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

Sociotechnical challenges to developing technologies for patient access to health information exchange data

PubMed Central

Ancker, Jessica S; Miller, Melissa C; Patel, Vaishali; Kaushal, Rainu

2014-01-01

Background Providing patients with access to their medical data is widely expected to help educate and empower them to manage their own health. Health information exchange (HIE) infrastructures could potentially help patients access records across multiple healthcare providers. We studied three HIE organizations as they developed portals to give consumers access to HIE data previously exchanged only among healthcare organizations. Objective To follow the development of new consumer portal technologies, and to identify barriers and facilitators to patient access to HIE data. Methods Semistructured interviews of 15 key informants over a 2-year period spanning the development and early implementation of three new projects, coded according to a sociotechnical framework. Results As the organizations tried to develop functionality that fully served the needs of both providers and patients, plans were altered by technical barriers (primarily related to data standardization) and cultural and legal issues surrounding data access. Organizational changes also played an important role in altering project plans. In all three cases, patient access to data was significantly scaled back from initial plans. Conclusions This prospective study revealed how sociotechnical factors previously identified as important in health information technology success and failure helped to shape the evolution of three novel consumer informatics projects. Barriers to providing patients with seamless access to their HIE data were multifactorial. Remedies will have to address technical, organizational, cultural, and other factors. PMID:24064443

Wheelchair accessibility to public buildings in Istanbul.

PubMed

Evcil, A Nilay

2009-03-01

Accessibility to public environment is the human right and basic need of each citizen and is one of the fundamental considerations for urban planning. The aim of this study is to determine the compliance of public buildings in central business districts (CBD) of Istanbul, Turkey, to wheelchair accessibility to the guidelines of the instrument and identify architectural barriers faced by wheelchair users. This is a descriptive study of 26 public buildings in CBD of Istanbul. The instrument used is the adapted Useh, Moyo and Munyonga questionnaire to collect the data from direct observation and measurement. Descriptive statistics of simple percentages and means are used to explain the compliance to the guidelines of the instrument and wheelchair accessibility. The descriptive survey results indicate that wheelchair users experience many accessibility problems in public environment of the most urbanised city (cultural capital of Europe in 2010) in a developing country. It is found that the major architectural barrier is the public transportation items with the lowest mean compliance (25%). Beside this, the most compliant to the instrument is entrance to building items with 79% as mean percentage. It is also found that there is an intention to improve accessibility when building construction period is investigated. This article describes the example of the compliance of public buildings accessibility when the country has legislation, but lacking regulations about accessibility for the wheelchair users.