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 ...

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…

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...

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.

Accessing primary care: a simulated patient study.

PubMed

Campbell, John L; Carter, Mary; Davey, Antoinette; Roberts, Martin J; Elliott, Marc N; Roland, Martin

2013-03-01

Simulated patient, or so-called 'mystery-shopper', studies are a controversial, but potentially useful, approach to take when conducting health services research. To investigate the construct validity of survey questions relating to access to primary care included in the English GP Patient Survey. Observational study in 41 general practices in rural, urban, and inner-city settings in the UK. Between May 2010 and March 2011, researchers telephoned practices at monthly intervals, simulating patients requesting routine, but prompt, appointments. Seven measures of access and appointment availability, measured from the mystery-shopper contacts, were related to seven measures of practice performance from the GP Patient Survey. Practices with lower access scores in the GP Patient Survey had poorer access and appointment availability for five out of seven items measured directly, when compared with practices that had higher scores. Scores on items from the national survey that related to appointment availability were significantly associated with direct measures of appointment availability. Patient-satisfaction levels and the likelihood that patients would recommend their practice were related to the availability of appointments. Patients' reports of ease of telephone access in the national survey were unrelated to three out of four measures of practice call handling, but were related to the time taken to resolve an appointment request, suggesting responders' possible confusion in answering this question. Items relating to the accessibility of care in a the English GP patient survey have construct validity. Patients' satisfaction with their practice is not related to practice call handling, but is related to appointment availability.

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

Accessing primary care: a simulated patient study

PubMed Central

Campbell, John L; Carter, Mary; Davey, Antoinette; Roberts, Martin J; Elliott, Marc N; Roland, Martin

2013-01-01

Background Simulated patient, or so-called ‘mystery-shopper’, studies are a controversial, but potentially useful, approach to take when conducting health services research. Aim To investigate the construct validity of survey questions relating to access to primary care included in the English GP Patient Survey. Design and setting Observational study in 41 general practices in rural, urban, and inner-city settings in the UK. Method Between May 2010 and March 2011, researchers telephoned practices at monthly intervals, simulating patients requesting routine, but prompt, appointments. Seven measures of access and appointment availability, measured from the mystery-shopper contacts, were related to seven measures of practice performance from the GP Patient Survey. Results Practices with lower access scores in the GP Patient Survey had poorer access and appointment availability for five out of seven items measured directly, when compared with practices that had higher scores. Scores on items from the national survey that related to appointment availability were significantly associated with direct measures of appointment availability. Patient-satisfaction levels and the likelihood that patients would recommend their practice were related to the availability of appointments. Patients’ reports of ease of telephone access in the national survey were unrelated to three out of four measures of practice call handling, but were related to the time taken to resolve an appointment request, suggesting responders’ possible confusion in answering this question. Conclusion Items relating to the accessibility of care in a the English GP patient survey have construct validity. Patients’ satisfaction with their practice is not related to practice call handling, but is related to appointment availability. PMID:23561783

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…

Mobile multiple access study

NASA Technical Reports Server (NTRS)

1977-01-01

Multiple access techniques (FDMA, CDMA, TDMA) for the mobile user and attempts to identify the current best technique are discussed. Traffic loading is considered as well as voice and data modulation and spacecraft and system design. Emphasis is placed on developing mobile terminal cost estimates for the selected design. In addition, design examples are presented for the alternative techniques of multiple access in order to compare with the selected technique.

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.

An Imaging Calorimeter for Access-Concept Study

NASA Technical Reports Server (NTRS)

Parnell, T. A.; Adams, James H.; Binns, R. W.; Christl, M. J.; Derrickson, J. H.; Fountain, W. F.; Howell, L. W.; Gregory, J. C.; Hink, P. L.; Israel, M. H.;

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 ...

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.

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...

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

Advanced Cosmic-Ray Composition Experiment for Space Station (ACCESS): ACCESS Accommodation Study Report

NASA Technical Reports Server (NTRS)

Wilson, Thomas L. (Editor); Wefel, John P. (Editor)

1999-01-01

In 1994 NASA Administrator selected the first high-energy particle physics experiment for the Space Station, the Alpha Magnetic Spectrometer (AMS), to place a magnetic spectrometer in Earth orbit and search for cosmic antimatter. A natural consequence of this decision was that NASA would begin to explore cost-effective ways through which the design and implementation of AMS might benefit other promising payload experiments. The first such experiment to come forward was Advanced Cosmic-Ray Composition Experiment for Space Station (ACCESS) in 1996. It was proposed as a new mission concept in space physics to attach a cosmic-ray experiment of weight, volume, and geometry similar to the AMS on the International Space Station (ISS), and replace the latter as its successor when the AMS is returned to Earth. This was to be an extension of NASA's suborbital balloon program, with balloon payloads serving as the precursor flights and heritage for ACCESS. The balloon programs have always been a cost-effective NASA resource since the particle physics instrumentation for balloon and space applications are directly related. The next step was to expand the process, pooling together expertise from various NASA centers and universities while opening up definition of the ACCESS science goals to the international community through the standard practice of peer review. This process is still ongoing, and the accommodation study presented here will discuss the baseline definition of ACCESS as we understand it today.

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…

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.

Access to space study

NASA Technical Reports Server (NTRS)

1994-01-01

This report summarizes the results of a comprehensive NASA in-house study to identify and assess alternate approaches to access to space through the year 2030, and to select and recommend a preferred cause of action. The goals of the study were to identify the best vehicles and transportation architectures to make major reductions in the cost of space transportation (at least 50%), while at the same time increasing safety for flight crews by at least an order of magnitude. In addition, vehicle reliability was to exceed 0.98 percent, and, as important, the robustness, pad time, turnaround time, and other aspects of operability were to be vastly improved. This study examined three major optional architectures: (1) retain and upgrade the Space Shuttle and expendable launch vehicles; (2) develop new expendable vehicles using conventional technologies and transition from current vehicles beginning in 2005; and (3) develop new reusable vehicles using advanced technology, and transition from current vehicles beginning in 2008. The launch-needs, mission model utilized for for the study was based upon today's projection of civil, defense, and commercial mission payload requirements.

76 FR 82291 - Combined Notice of Filings #2

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-30

... 12/30/11. Docket Numbers: ER12-21-002. Applicants: Agua Caliente Solar, LLC. Description: Notice of Change in Status and Request for Expedited Action of Agua Caliente Solar, LLC. Filed Date: 12/20/11...

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…

Next generation communications satellites: Multiple access and network studies

NASA Technical Reports Server (NTRS)

Stern, T. E.; Schwartz, M.; Meadows, H. E.; Ahmadi, H. K.; Gadre, J. G.; Gopal, I. S.; Matsmo, K.

1980-01-01

Following an overview of issues involved in the choice of promising system architectures for efficient communication with multiple small inexpensive Earth stations serving hetergeneous user populations, performance evaluation via analysis and simulation for six SS/TDMA (satellite-switched/time-division multiple access) system architectures is discussed. These configurations are chosen to exemplify the essential alternatives available in system design. Although the performance evaluation analyses are of fairly general applicability, whenever possible they are considered in the context of NASA's 30/20 GHz studies. Packet switched systems are considered, with the assumption that only a part of transponder capacit is devoted to packets, the integration of circuit and packet switched traffic being reserved for further study. Three types of station access are distinguished: fixed (FA), demand (DA), and random access (RA). Similarly, switching in the satellite can be assigned on a fixed (FS) or demand (DS) basis, or replaced by a buffered store-and-forward system (SF) onboard the satellite. Since not all access/switching combinations are practical, six systems are analyzed in detail: three FS SYSTEMS, FA/FS, DA/ES, RA/FS; one DS system, DA/DS; and two SF systems, FA/SF, DA/SF. Results are presented primarily in terms of delay-throughput characteristics.

Global access to surgical care: a modelling study.

PubMed

Alkire, Blake C; Raykar, Nakul P; Shrime, Mark G; Weiser, Thomas G; Bickler, Stephen W; Rose, John A; Nutt, Cameron T; Greenberg, Sarah L M; Kotagal, Meera; Riesel, Johanna N; Esquivel, Micaela; Uribe-Leitz, Tarsicio; Molina, George; Roy, Nobhojit; Meara, John G; Farmer, Paul E

2015-06-01

More than 2 billion people are unable to receive surgical care based on operating theatre density alone. The vision of the Lancet Commission on Global Surgery is universal access to safe, affordable surgical and anaesthesia care when needed. We aimed to estimate the number of individuals worldwide without access to surgical services as defined by the Commission's vision. We modelled access to surgical services in 196 countries with respect to four dimensions: timeliness, surgical capacity, safety, and affordability. We built a chance tree for each country to model the probability of surgical access with respect to each dimension, and from this we constructed a statistical model to estimate the proportion of the population in each country that does not have access to surgical services. We accounted for uncertainty with one-way sensitivity analyses, multiple imputation for missing data, and probabilistic sensitivity analysis. At least 4·8 billion people (95% posterior credible interval 4·6-5·0 [67%, 64-70]) of the world's population do not have access to surgery. The proportion of the population without access varied widely when stratified by epidemiological region: greater than 95% of the population in south Asia and central, eastern, and western sub-Saharan Africa do not have access to care, whereas less than 5% of the population in Australasia, high-income North America, and western Europe lack access. Most of the world's population does not have access to surgical care, and access is inequitably distributed. The near absence of access in many low-income and middle-income countries represents a crisis, and as the global health community continues to support the advancement of universal health coverage, increasing access to surgical services will play a central role in ensuring health care for all. None. Copyright © 2015 Alkire et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd.. All rights reserved.

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…

Modeling spatial accessibility to parks: a national study.

PubMed

Zhang, Xingyou; Lu, Hua; Holt, James B

2011-05-09

Parks provide ideal open spaces for leisure-time physical activity and important venues to promote physical activity. The spatial configuration of parks, the number of parks and their spatial distribution across neighborhood areas or local regions, represents the basic park access potential for their residential populations. A new measure of spatial access to parks, population-weighted distance (PWD) to parks, combines the advantages of current park access approaches and incorporates the information processing theory and probability access surface model to more accurately quantify residential population's potential spatial access to parks. The PWD was constructed at the basic level of US census geography - blocks - using US park and population data. This new measure of population park accessibility was aggregated to census tract, county, state and national levels. On average, US residential populations are expected to travel 6.7 miles to access their local neighborhood parks. There are significant differences in the PWD to local parks among states. The District of Columbia and Connecticut have the best access to local neighborhood parks with PWD of 0.6 miles and 1.8 miles, respectively. Alaska, Montana, and Wyoming have the largest PWDs of 62.0, 37.4, and 32.8 miles, respectively. Rural states in the western and Midwestern US have lower neighborhood park access, while urban states have relatively higher park access. The PWD to parks provides a consistent platform for evaluating spatial equity of park access and linking with population health outcomes. It could be an informative evaluation tool for health professionals and policy makers. This new method could be applied to quantify geographic accessibility of other types of services or destinations, such as food, alcohol, and tobacco outlets.

Accessible Earth: An accessible study abroad capstone for the geoscience curriculum

NASA Astrophysics Data System (ADS)

Bennett, R. A.; Lamb, D. A.

2017-12-01

International capstone field courses offer geoscience-students opportunities to reflect upon their knowledge, develop intercultural competence, appreciate diversity, and recognize themselves as geoscientists on a global scale. Such experiences are often described as pivotal to a geoscientist's education, a right of passage. However, field-based experiences present insurmountable barriers to many students, undermining the goal of inclusive excellence. Nevertheless, there remains a widespread belief that successful geoscientists are those able to traverse inaccessible terrain. One path forward from this apparent dilemma is emerging as we take steps to address a parallel challenge: as we move into the 21st century the geoscience workforce will require an ever increasing range of skills, including analysis, modeling, communication, and computational proficiency. Computer programing, laboratory experimentation, numerical simulation, etc, are inherently more accessible than fieldwork, yet equally valuable. Students interested in pursuing such avenues may be better served by capstone experiences that align more closely with their career goals. Moreover, many of the desirable learning outcomes attributed to field-based education are not unique to immersion in remote inaccessible locations. Affective and cognitive gains may also result from social bonding through extended time with peers and mentors, creative synthesis of knowledge, project-based learning, and intercultural experience. Developing an inclusive course for the geoscience curriculum requires considering all learners, including different genders, ages, physical abilities, familial dynamics, and a multitude of other attributes. The Accessible Earth Study Abroad Program endeavors to provide geoscience students an inclusive capstone experience focusing on modern geophysical observation systems (satellite based observations and permanent networks of ground-based instruments), computational thinking and methods of

Studying "exposure" to firearms: household ownership v access

PubMed Central

Ikeda, R; Dahlberg, L; Kresnow, M; Sacks, J; Mercy, J

2003-01-01

Background: Firearm ownership has often been used to measure access to weapons. However, persons who own a firearm may not have access to it and conversely, persons who do not own a firearm may be able to access one quickly. Objectives: To examine whether using firearm ownership is a reasonable proxy for access by describing the demographic characteristics associated with ownership and access. Methods: Data are from the 1994 Injury Control and Risk Survey, a national, random digit dial survey. Information about household firearm ownership and ready access to a loaded firearm were collected and weighted to provide national estimates. Adjusted odds ratios for three separate models were calculated using logistic regression. Results: A total of 1353 (27.9%) respondents reported both having a firearm in the household and ready access to one. An additional 313 respondents (8.1%) reported having a firearm, but were not able to access these weapons. Another 421 respondents (7.2%) did not have a firearm in or around their home, yet reported being able to retrieve and fire one within 10 minutes. Based on the logistic regression findings, the demographic characteristics of this latter group are quite different from those who report ownership. Those who do not have a firearm, but report ready access to one, are more likely to be ethnic minorities, single, and living in attached homes. Conclusions: Asking only about the presence of a firearm in a household may miss some respondents with ready access to a loaded firearm. More importantly, those who do not own a firearm, but report ready access to one, appear to be qualitatively different from those who report ownership. Caution should be exercised when using measures of ownership as a proxy for access. PMID:12642560

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…

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...

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…

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…

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.

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

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...

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

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.

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.

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.

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.

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

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

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

Access to timely formal dementia care in Europe: protocol of the Actifcare (ACcess to Timely Formal Care) study.

PubMed

Kerpershoek, Liselot; de Vugt, Marjolein; Wolfs, Claire; Jelley, Hannah; Orrell, Martin; Woods, Bob; Stephan, Astrid; Bieber, Anja; Meyer, Gabriele; Engedal, Knut; Selbaek, Geir; Handels, Ron; Wimo, Anders; Hopper, Louise; Irving, Kate; Marques, Maria; Gonçalves-Pereira, Manuel; Portolani, Elisa; Zanetti, Orazio; Verhey, Frans

2016-08-23

Previous findings indicate that people with dementia and their informal carers experience difficulties accessing and using formal care services due to a mismatch between needs and service use. This mismatch causes overall dissatisfaction and is a waste of the scarce financial care resources. This article presents the background and methods of the Actifcare (ACcess to Timely Formal Care) project. This is a European study aiming at best-practice development in finding timely access to formal care for community-dwelling people with dementia and their informal carers. There are five main objectives: 1) Explore predisposing and enabling factors associated with the use of formal care, 2) Explore the association between the use of formal care, needs and quality of life and 3) Compare these across European countries, 4) Understand the costs and consequences of formal care services utilization in people with unmet needs, 5) Determine the major costs and quality of life drivers and their relationship with formal care services across European countries. In a longitudinal cohort study conducted in eight European countries approximately 450 people with dementia and informal carers will be assessed three times in 1 year (baseline, 6 and 12 months). In this year we will closely monitor the process of finding access to formal care. Data on service use, quality of life and needs will be collected. The results of Actifcare are expected to reveal best-practices in organizing formal care. Knowledge about enabling and predisposing factors regarding access to care services, as well as its costs and consequences, can advance the state of the art in health systems research into pathways to dementia care, in order to benefit people with dementia and their informal carers.

A study of institutional spending on open access publication fees in Germany.

PubMed

Jahn, Najko; Tullney, Marco

2016-01-01

Publication fees as a revenue source for open access publishing hold a prominent place on the agendas of researchers, policy makers, and academic publishers. This study contributes to the evolving empirical basis for funding these charges and examines how much German universities and research organisations spent on open access publication fees. Using self-reported cost data from the Open APC initiative, the analysis focused on the amount that was being spent on publication fees, and compared these expenditure with data from related Austrian (FWF) and UK (Wellcome Trust, Jisc) initiatives, in terms of both size and the proportion of articles being published in fully and hybrid open access journals. We also investigated how thoroughly self-reported articles were indexed in Crossref, a DOI minting agency for scholarly literature, and analysed how the institutional spending was distributed across publishers and journal titles. According to self-reported data from 30 German universities and research organisations between 2005 and 2015, expenditures on open access publication fees increased over the years in Germany and amounted to € 9,627,537 for 7,417 open access journal articles. The average payment was € 1,298, and the median was € 1,231. A total of 94% of the total article volume included in the study was supported in accordance with the price cap of € 2,000, a limit imposed by the Deutsche Forschungsgemeinschaft (DFG) as part of its funding activities for open access funding at German universities. Expenditures varied considerably at the institutional level. There were also differences in how much the institutions spent per journal and publisher. These differences reflect, at least in part, the varying pricing schemes in place including discounted publication fees. With an indexing coverage of 99%, Crossref thoroughly indexed the open access journals articles included in the study. A comparison with the related openly available cost data from Austria and

A study of institutional spending on open access publication fees in Germany

PubMed Central

Tullney, Marco

2016-01-01

Publication fees as a revenue source for open access publishing hold a prominent place on the agendas of researchers, policy makers, and academic publishers. This study contributes to the evolving empirical basis for funding these charges and examines how much German universities and research organisations spent on open access publication fees. Using self-reported cost data from the Open APC initiative, the analysis focused on the amount that was being spent on publication fees, and compared these expenditure with data from related Austrian (FWF) and UK (Wellcome Trust, Jisc) initiatives, in terms of both size and the proportion of articles being published in fully and hybrid open access journals. We also investigated how thoroughly self-reported articles were indexed in Crossref, a DOI minting agency for scholarly literature, and analysed how the institutional spending was distributed across publishers and journal titles. According to self-reported data from 30 German universities and research organisations between 2005 and 2015, expenditures on open access publication fees increased over the years in Germany and amounted to € 9,627,537 for 7,417 open access journal articles. The average payment was € 1,298, and the median was € 1,231. A total of 94% of the total article volume included in the study was supported in accordance with the price cap of € 2,000, a limit imposed by the Deutsche Forschungsgemeinschaft (DFG) as part of its funding activities for open access funding at German universities. Expenditures varied considerably at the institutional level. There were also differences in how much the institutions spent per journal and publisher. These differences reflect, at least in part, the varying pricing schemes in place including discounted publication fees. With an indexing coverage of 99%, Crossref thoroughly indexed the open access journals articles included in the study. A comparison with the related openly available cost data from Austria and

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.

Geochemistry of thermal fluids in NW Honduras: New perspectives for exploitation of geothermal areas in the southern Sula graben

NASA Astrophysics Data System (ADS)

Capaccioni, Bruno; Franco, Tassi; Alberto, Renzulli; Orlando, Vaselli; Marco, Menichetti; Salvatore, Inguaggiato

2014-06-01

geothermal sites of the southern Sula graben (Laguna de Agua Caliente and El Olivar) are covered by the Oligocene-Miocene volcano-sedimentary sequences of the Matagalpa formation, possibly acting as efficient impermeable cap rocks. These results significantly differ from those reported by previous studies and emphasize that the southern Sula graben, in particular the El Olivar area, can represent among the investigated thermal springs, the most promising site for the exploitation of a high-enthalpy geothermal field.

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 ...

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.

Enhancing Access to Patient Education Information: A Pilot Usability Study

PubMed Central

Beaudoin, Denise E.; Rocha, Roberto A.; Tse, Tony

2005-01-01

Health care organizations are developing Web-based portals to provide patient access to personal health information and enhance patient-provider communication. This pilot study investigates two navigation models (“serial” and “menu-driven”) for improving access to education materials available through a portal. There was a trend toward greater user satisfaction with the menu-driven model. Model preference was influenced by frequency of Web use. Results should aid in the improvement of existing portals and in the development of new ones. PMID:16779179

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.

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.

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.

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

Access to Healthcare in Russia: A Pilot Study in Ekaterinburg.

PubMed

Antonova, Natalia

2016-06-01

The aim of the study was to analyze accessibility of medical assistance in Russian polyclinics (a case study of the city of Ekaterinburg). The research included an anonymous survey of patients in five polyclinics of Ekaterinburg (N=500) conducted by applying a specially developed standardised interview. The following factors of medical care accessibility were analyzed: the patient's financial status and administrative and managerial resources of medical institutions. Medical aid in polyclinics is provided within the framework of the Compulsory Medical Insurance Programme. 72% of the patients polled, however, had to pay for medical services. In order to pay less for medical services and to obtain services faster patients use informal payments: they either pay their doctors directly (4%) or make gifts (58%). Low-income population groups refuse to pay for medical services or to make gifts to the medical staff. They also tend not to follow their doctors' recommendations. The most significant indicators of the organizational and managerial work of a medical institution which limit accessibility are the following: queues in front of doctors' offices (41%) and difficulties with making appointments (17%). To solve the problem of medical aid accessibility in the Russian state healthcare system, it is necessary to develop information and reference materials for patients available in every polyclinic listing the terms of provision of free medical aid and types of free medical services. The difficulties to obtain medical services could be resolved at the management level by using the material and human resources of the administration of medical institutions. Copyright© by the National Institute of Public Health, Prague 2015.

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.

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

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

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

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

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…

The prehospital intravenous access assessment: a prospective study on intravenous access failure and access delay in prehospital emergency medicine.

PubMed

Prottengeier, Johannes; Albermann, Matthias; Heinrich, Sebastian; Birkholz, Torsten; Gall, Christine; Schmidt, Joachim

2016-12-01

Intravenous access in prehospital emergency care allows for early administration of medication and extended measures such as anaesthesia. Cannulation may, however, be difficult, and failure and resulting delay in treatment and transport may have negative effects on the patient. Therefore, our study aims to perform a concise assessment of the difficulties of prehospital venous cannulation. We analysed 23 candidate predictor variables on peripheral venous cannulations in terms of cannulation failure and exceedance of a 2 min time threshold. Multivariate logistic regression models were fitted for variables of predictive value (P<0.25) and evaluated by the area under the curve (AUC>0.6) of their respective receiver operating characteristic curve. A total of 762 intravenous cannulations were enroled. In all, 22% of punctures failed on the first attempt and 13% of punctures exceeded 2 min. Model selection yielded a three-factor model (vein visibility without tourniquet, vein palpability with tourniquet and insufficient ambient lighting) of fair accuracy for the prediction of puncture failure (AUC=0.76) and a structurally congruent model of four factors (failure model factors plus vein visibility with tourniquet) for the exceedance of the 2 min threshold (AUC=0.80). Our study offers a simple assessment to identify cases of difficult intravenous access in prehospital emergency care. Of the numerous factors subjectively perceived as possibly exerting influences on cannulation, only the universal - not exclusive to emergency care - factors of lighting, vein visibility and palpability proved to be valid predictors of cannulation failure and exceedance of a 2 min threshold.

Sandy Hook : alternative access concept plan and vehicle replacement study

DOT National Transportation Integrated Search

2009-06-01

This study addresses two critical issues of concern to the Sandy Hook Unit of Gateway National : Recreational Area: (1) options for alternative access to Sandy Hook during peak summer season, : particularly when the park is closed to private vehicles...

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.

Harvard Aging Brain Study: Dataset and accessibility.

PubMed

Dagley, Alexander; LaPoint, Molly; Huijbers, Willem; Hedden, Trey; McLaren, Donald G; Chatwal, Jasmeer P; Papp, Kathryn V; Amariglio, Rebecca E; Blacker, Deborah; Rentz, Dorene M; Johnson, Keith A; Sperling, Reisa A; Schultz, Aaron P

2017-01-01

The Harvard Aging Brain Study is sharing its data with the global research community. The longitudinal dataset consists of a 284-subject cohort with the following modalities acquired: demographics, clinical assessment, comprehensive neuropsychological testing, clinical biomarkers, and neuroimaging. To promote more extensive analyses, imaging data was designed to be compatible with other publicly available datasets. A cloud-based system enables access to interested researchers with blinded data available contingent upon completion of a data usage agreement and administrative approval. Data collection is ongoing and currently in its fifth year. Copyright © 2015 Elsevier Inc. All rights reserved.

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…

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

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

Access to Orthopaedic Surgical Care in Northern Tanzania: A Modelling Study.

PubMed

Premkumar, Ajay; Ying, Xiaohan; Mack Hardaker, W; Massawe, Honest H; Mshahaba, David J; Mandari, Faiton; Pallangyo, Anthony; Temu, Rogers; Masenga, Gileard; Spiegel, David A; Sheth, Neil P

2018-04-25

The global burden of musculoskeletal disease and resulting disability is enormous and is expected to increase over the next few decades. In the world's poorest regions, the paucity of information defining and quantifying the current state of access to orthopaedic surgical care is a major problem in developing effective solutions. This study estimates the number of individuals in Northern Tanzania without adequate access to orthopaedic surgical services. A chance tree was created to model the probability of access to orthopaedic surgical services in the Northern Tanzanian regions of Arusha, Kilimanjaro, Tanga, Singida, and Manyara, with respect to four dimensions: timeliness, surgical capacity, safety, and affordability. Timeliness was estimated by the proportion of people living within a 4-h driving distance from a hospital with an orthopaedic surgeon, capacity by comparing number of surgeries performed to the number of surgeries indicated, safety by applying WHO Emergency and Essential Surgical Care infrastructure and equipment checklists, and affordability by approximating the proportion of the population protected from catastrophic out-of-pocket healthcare expenditure. We accounted for uncertainty in our model with one-way and probabilistic sensitivity analyses. Data sources included the Tanzanian National Bureau of Statistics and Ministry of Finance, World Bank, World Health Organization, New Zealand Ministry of Health, Google Corporation, NASA population estimator, and 2015 hospital records from Kilimanjaro Christian Medical Center, Machame Hospital, Nkoroanga Hospital, Mt. Meru Hospital, and Arusha Lutheran Medical Center. Under the most conservative assumptions, more than 90% of the Northern Tanzanian population does not have access to orthopaedic surgical services. There is a near absence of access to orthopaedic surgical care in Northern Tanzania. These findings utilize more precise country and region-specific data and are consistent with prior published

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.

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

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.

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.

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.

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

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.

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.

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

Introduction to the Personal Access Satellite System Study

NASA Technical Reports Server (NTRS)

Sue, Miles K.

1990-01-01

A recent study by the National Telecommunications and Information Administration (NTIA) has concluded that the 21st century will be the age of information in which the telecommunication infrastructure will be vital to the social and economic well being of society. To meet the challenge of the coming age, JPL has been performing studies on a personal access satellite system (PASS) for the 21st century. The PASS study can be traced back to a study in which the technical feasibility and potential applications of a high frequency, low data rate satellite system were identified using small fixed terminals. Herein, the PASS concept is described along with the strawman design. Then the key challenges are identified along with possible solutions. Finally, the plan for the future is summarized from the key results.

A study of innovative features in scholarly open access journals.

PubMed

Björk, Bo-Christer

2011-12-16

The emergence of the Internet has triggered tremendous changes in the publication of scientific peer-reviewed journals. Today, journals are usually available in parallel electronic versions, but the way the peer-review process works, the look of articles and journals, and the rigid and slow publication schedules have remained largely unchanged, at least for the vast majority of subscription-based journals. Those publishing firms and scholarly publishers who have chosen the more radical option of open access (OA), in which the content of journals is freely accessible to anybody with Internet connectivity, have had a much bigger degree of freedom to experiment with innovations. The objective was to study how open access journals have experimented with innovations concerning ways of organizing the peer review, the format of journals and articles, new interactive and media formats, and novel publishing revenue models. The features of 24 open access journals were studied. The journals were chosen in a nonrandom manner from the approximately 7000 existing OA journals based on available information about interesting journals and include both representative cases and highly innovative outlier cases. Most early OA journals in the 1990s were founded by individual scholars and used a business model based on voluntary work close in spirit to open-source development of software. In the next wave, many long-established journals, in particular society journals and journals from regions such as Latin America, made their articles OA when they started publishing parallel electronic versions. From about 2002 on, newly founded professional OA publishing firms using article-processing charges to fund their operations have emerged. Over the years, there have been several experiments with new forms of peer review, media enhancements, and the inclusion of structured data sets with articles. In recent years, the growth of OA publishing has also been facilitated by the availability of open

A Study of Innovative Features in Scholarly Open Access Journals

PubMed Central

2011-01-01

Background The emergence of the Internet has triggered tremendous changes in the publication of scientific peer-reviewed journals. Today, journals are usually available in parallel electronic versions, but the way the peer-review process works, the look of articles and journals, and the rigid and slow publication schedules have remained largely unchanged, at least for the vast majority of subscription-based journals. Those publishing firms and scholarly publishers who have chosen the more radical option of open access (OA), in which the content of journals is freely accessible to anybody with Internet connectivity, have had a much bigger degree of freedom to experiment with innovations. Objective The objective was to study how open access journals have experimented with innovations concerning ways of organizing the peer review, the format of journals and articles, new interactive and media formats, and novel publishing revenue models. Methods The features of 24 open access journals were studied. The journals were chosen in a nonrandom manner from the approximately 7000 existing OA journals based on available information about interesting journals and include both representative cases and highly innovative outlier cases. Results Most early OA journals in the 1990s were founded by individual scholars and used a business model based on voluntary work close in spirit to open-source development of software. In the next wave, many long-established journals, in particular society journals and journals from regions such as Latin America, made their articles OA when they started publishing parallel electronic versions. From about 2002 on, newly founded professional OA publishing firms using article-processing charges to fund their operations have emerged. Over the years, there have been several experiments with new forms of peer review, media enhancements, and the inclusion of structured data sets with articles. In recent years, the growth of OA publishing has also been

A study comparing centralized CD-ROM and decentralized intranet access to MEDLINE

PubMed Central

Darmoni, Stefan J.; Benichou, Jacques; Thirion, Benoit; Hellot, Marie France; Fuss, Jacques

2000-01-01

Objective: The purpose of this study was to evaluate the efficacy of a decentralized intranet access in each medical department as opposed to centralized unique MEDLINE access in the medical library. Design: A two-phase questionnaire to evaluate MEDLINE use was given to junior and senior physicians at Rouen University Hospital (RUH). Phase I (August–October 1996) corresponded to a time period when centralized access was the only means of access available and phase II (August–October 1997) to a time period following the introduction of decentralized intranet access. Results: A total of 168 physicians filled out at least one phase of the questionnaire, among whom 123 (73%) filled out both phases. Use of MEDLINE significantly increased in 1997 (average of 10.2 ± 1.1 searches in three months) versus 1996 (average of 4.9 ± 0.7 searches in three months, P < 0.0001). The aim of searches changed, becoming significantly more care oriented in phase II (P < 0.0001). The number of searches performed by the physicians alone increased (P < 0.0001) and searches performed by the librarian decreased (P < 0.0001) in phase II. The method of searches also changed, as searches by author (P < 0.0001), by journal (P = 0.0042), and by free word (P = 0.0027) increased in phase II. Knowledge of the following concepts of MEDLINE significantly increased: explosion (P < 0.0001), scope note (P < 0.0001), Abridged Index Medicus (AIM) journals (P < 0.0001), Medical Subject Headings (MeSH) qualifier (P < 0.0001), and focus (P < 0.0001). Conclusion: A decentralized intranet access to MEDLINE increased the number of searches and knowledge of this bibliographic database. MEDLINE intranet access modified the purpose and the methods of searching. PMID:10783970

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.

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

'Predatory' open access: a longitudinal study of article volumes and market characteristics.

PubMed

Shen, Cenyu; Björk, Bo-Christer

2015-10-01

A negative consequence of the rapid growth of scholarly open access publishing funded by article processing charges is the emergence of publishers and journals with highly questionable marketing and peer review practices. These so-called predatory publishers are causing unfounded negative publicity for open access publishing in general. Reports about this branch of e-business have so far mainly concentrated on exposing lacking peer review and scandals involving publishers and journals. There is a lack of comprehensive studies about several aspects of this phenomenon, including extent and regional distribution. After an initial scan of all predatory publishers and journals included in the so-called Beall's list, a sample of 613 journals was constructed using a stratified sampling method from the total of over 11,000 journals identified. Information about the subject field, country of publisher, article processing charge and article volumes published between 2010 and 2014 were manually collected from the journal websites. For a subset of journals, individual articles were sampled in order to study the country affiliation of authors and the publication delays. Over the studied period, predatory journals have rapidly increased their publication volumes from 53,000 in 2010 to an estimated 420,000 articles in 2014, published by around 8,000 active journals. Early on, publishers with more than 100 journals dominated the market, but since 2012 publishers in the 10-99 journal size category have captured the largest market share. The regional distribution of both the publisher's country and authorship is highly skewed, in particular Asia and Africa contributed three quarters of authors. Authors paid an average article processing charge of 178 USD per article for articles typically published within 2 to 3 months of submission. Despite a total number of journals and publishing volumes comparable to respectable (indexed by the Directory of Open Access Journals) open access

Accessibility information in New Delhi for "EasenAccess" Android-based app for persons with disability: an observational study.

PubMed

Agarwal, Yashovardhan

2018-06-14

The World Health Organization and the World Bank's "World Report on Disability" reported that over 1 billion people have various kinds of disability worldwide while Indian Census 2011 reported about 26 million in India. The United Nations Convention states, "The Rights of Persons with Disabilities (PwD) include accessibility to Information, Transportation, Environment, Communication Technology and Services". This article takes forward the reason of making the "EasenAccess" (EnA) Android-based app to empower PwD with wheelchair-accessibility information, communication sentences and sending SOS signals with location. A survey of 25 most frequented places in New Delhi by common people and tourist with chosen 12 parameters in comparison the Government of India's survey of 100 most important buildings nationally. A statistical analysis and recommendations about areas for improvement, for the Government of India. EasenAccess helps millions of PwD to enable them with freedom of movement for employment and socio-economic activities to lead an independent lifestyle. EasenAccess increases government's access to information about lacunae, gives them an easy way to tabulate the places where more accessibility needs updating, and helps the government in facilitating information flow to the PwD. Implication for Rehabilitation The Rights of Persons with Disability Act in 2016 covers both the concepts of Universal Design of products, environments and programs; and accessibility. We are exploring with them the ways technology can help bridge the gap between rehabilitation and accessibility. In the higher income countries such as the UK or USA, it is normal for a person to receive training when being given a wheelchair to prevent future injuries. Frequently, even with this, training people develop upper limb injuries, due in part to the high, repetitive loads needed to push a wheelchair. This training is given as part of a package of rehabilitation, which also normally includes

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…

Access site complications and puncture site pain following transradial coronary procedures: a correlational study.

PubMed

Cheng, Ka Yan; Chair, Sek Ying; Choi, Kai Chow

2013-10-01

Transradial coronary angiography (CA) and percutaneous coronary intervention (PCI) are gaining worldwide popularity due to the low incidence of major vascular complications and early mobilization of patients post procedures. Although post transradial access site complications are generally considered as minor in nature, they are not being routinely recorded in clinical settings. To evaluate the incidence of access site complications and level of puncture site pain experienced by patients undergoing transradial coronary procedures and to examine factors associated with access site complications occurrence and puncture site pain severity. A cross-sectional correlational study of 85 Chinese speaking adult patients scheduled for elective transradial CA and or PCI. Ecchymosis, bleeding, hematoma and radial artery occlusion (RAO) were assessed through observation, palpation and plethysmographic signal of pulse oximetry after coronary procedures. Puncture site pain was assessed with a 100mm Visual Analogue Scale. Factors that were related to access site complications and puncture site pain were obtained from medical records. Ecchymosis was the most commonly reported transradial access site complication in this study. Paired t-test showed that the level of puncture site pain at 24 h was significantly (p<0.001) lower than that at 3 h after the procedure. Stepwise multivariable regression showed that female gender and shorter sheath time were found to be significantly associated with bleeding during gradual deflation of compression device. Only longer sheath time was significantly associated with RAO. Female gender and larger volume of compression air were associated with the presence of ecchymosis and puncture site pain at 3 h after procedure, respectively. The study findings suggest that common access site complications post transradial coronary procedures among Chinese population are relatively minor in nature. Individual puncture site pain assessment during the period of

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

Meckel's cave access: anatomic study comparing the endoscopic transantral and endonasal approaches.

PubMed

Van Rompaey, Jason; Suruliraj, Anand; Carrau, Ricardo; Panizza, Benedict; Solares, C Arturo

2014-04-01

Recent advances in endonasal endoscopy have facilitated the surgical access to the lateral skull base including areas such as Meckel's cave. This approach has been well documented, however, few studies have outlined transantral specific access to Meckel's. A transantral approach provides a direct pathway to this region obviating the need for extensive endonasal and transsphenoidal resection. Our aim in this study is to compare the anatomical perspectives obtained in endonasal and transantral approaches. We prepared 14 cadaveric specimens with intravascular injections of colored latex. Eight cadavers underwent endoscopic endonasal transpterygoid approaches to Meckel's cave. Six additional specimens underwent an endoscopic transantral approach to the same region. Photographic evidence was obtained for review. 30 CT scans were analyzed to measure comparative distances to Meckel's cave for both approaches. The endoscopic approaches provided a direct access to the anterior and inferior portions of Meckel's cave. However, the transantral approach required shorter instrumentation, and did not require clearing of the endonasal corridor. This approach gave an anterior view of Meckel's cave making posterior dissection more difficult. A transantral approach to Meckel's cave provides access similar to the endonasal approach with minimal invasiveness. Some of the morbidity associated with extensive endonasal resection could possibly be avoided. Better understanding of the complex skull base anatomy, from different perspectives, helps to improve current endoscopic skull base surgery and to develop new alternatives, consequently, leading to improvements in safety and efficacy.

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.

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

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

Accessibility of School Districts' Web Sites: A Descriptive Study

ERIC Educational Resources Information Center

Bray, Marty; Flowers, Claudia; Gibson, Patricia

2003-01-01

Many school districts (SDs) use the World Wide Web (WWW or Web) to disseminate a wide variety of information about things such as district events, policies, and a wide variety of student information. On-line barriers limit the accessibility of the WWW for persons and students with disabilities and thus can limit their access to vital information.…

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.

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

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

PubMed

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

2010-10-07

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

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

PubMed Central

2010-01-01

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

[A particular anthropometric method for the study of accessibility of a workstation].

PubMed

Molinaro, V; Del Ferraro, S

2008-01-01

One of the main factors which can involve musculo-skeletal disorders is the assumption of awkward postures. These lasts can be caused, in some cases, by a no-suitable collocation of some devices which are indispensable for the work. It is possible to evaluate if the chosen collocation is adequate or not by studying the accessibility of the workstation with a special regard for the accessibility of the devices placed inside the workstation. EN ISO 14738:2002 is a specific standard which has been adopted in Italy as UNI EN ISO 14738:2004. This standard gives some useful requirements, in terms of accessibility, to design a workstation at no-mobile machinery. In this study, the authors have analyzed a check out workstation by following the requirements described in UNI EN ISO 14738:2004. Critical aspects, related to the organization both of the work activities either of the workstation, have been highlighted taking into account standard criteria. Finally the authors make a new design of the check out workstation trying to optimize device collocation in order to reduce awkward postures. The new configuration has been investigated by applying the criteria mentioned in the standard.

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.

Aspirex Thrombectomy in Occluded Dialysis Access: A Retrospective Study

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

Dyer, Jules, E-mail: Jules.Dyer@nhs.net; Rosa, Joao; Chachlani, Menka

PurposeThis study is the first to present the outcomes of the Straub Aspirex device for the salvage of occluded renal dialysis access fistulae.Materials and MethodsThis is a retrospective study, using data from the Renal Unit and Radiology Department database. It included all the patients between 2010 and 2014 who underwent percutaneous mechanical thrombectomy (PMT) treated by JD. Aspirex is an over-the-wire, 6–10 French catheter within which is a rapidly rotating helix which draws thrombus into a window near the tip which it then macerates and removes. Access survival was assessed using the Kaplan–Meier method, and multi-variant analysis was performed usingmore » the Cox proportional hazards model. Significance was considered if p < 0.05.ResultsA total of 27 procedures were performed for 19 patients. 13 had autologous arterio-venous fistulae, and 14 had synthetic (PTFE) arterio-venous grafts. 15 were males, 4 females. 100 % of the patients successfully had a channel of thrombus removed. This resulted in an 81.5 % initial clinical success, with primary patency rates of 53.6, 44.3 and 33 % by days 30, 90 and 480, respectively, without significant difference of any analysed covariates. No major complication (pulmonary embolus, paradoxical cerebral infarction, limb ischaemia or significant haemorrhage) occurred.ConclusionAspirex has rates of patency and complication similar to other PMT devices. No covariant studied affected outcome.« less

Accessibility, Textbooks, and Access Services

ERIC Educational Resources Information Center

Kahler, Janice E.

2017-01-01

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

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…

A study of the bio-accessibility of welding fumes.

PubMed

Berlinger, Balázs; Ellingsen, Dag G; Náray, Miklós; Záray, Gyula; Thomassen, Yngvar

2008-12-01

The respiratory bio-accessibility of a substance is the fraction that is soluble in the respiratory environment and is available for absorption. In the case of respiratory exposure the amount of absorbed substance plays a main role in the biological effects. Extensive bio-accessibility studies have always been an essential requirement for a better understanding of the biological effects of different workplace aerosols, such as welding fumes. Fumes generated using three different welding techniques, manual metal arc (MMA) welding, metal inert gas (MIG) welding, and tungsten inert gas (TIG) welding were investigated in the present study. Each technique was used for stainless steel welding. Welding fumes were collected on PVC membrane filters in batches of 114 using a multiport air sampler. Three different fluids were applied for the solubility study: deionised water and two kinds of lung fluid simulants: lung epithelial lining fluid simulant (Gamble's solution) and artificial lung lining fluid simulant (Hatch's solution). In order to obtain sufficient data to study the tendencies in solubility change with time, seven different leaching periods were used (0.5, 1, 2, 4, 8, 16, 24 h), each of them with three replicates. The effect of dissolution temperature was also studied. The total amounts of selected metals in the three different welding fumes were determined after microwave-assisted digestion with the mixture of aqua regia and hydrofluoric acid. The most obvious observation yielded by the results is that the solubility of individual metals varies greatly depending on the welding technique, the composition of the leaching fluid and leaching time. This study shows that the most reasonable choice as a media for the bio-assessment of solubility might be Hatch's solution by a dissolution time of 24 h.

The Potential for Adaptable Accessible Learning Objects: A Case Study in Accessible Vodcasting

ERIC Educational Resources Information Center

Gkatzidou, Stavroula; Pearson, Elaine

2009-01-01

With the rapid development of wireless networks and mobile technologies and the increasing adoption of mobile learning, the need for "anywhere, anytime and any device" access to information becomes more evident. This has influenced the design of learning objects. The small but developing literature on vodcasting indicates its potential…

Internet and Social Media Access Among Youth Experiencing Homelessness: Mixed-Methods Study.

PubMed

VonHoltz, Lauren A Houdek; Frasso, Rosemary; Golinkoff, Jesse M; Lozano, Alicia J; Hanlon, Alexandra; Dowshen, Nadia

2018-05-22

Youth experiencing homelessness are at a risk for a variety of adverse outcomes. Given the widespread use of the internet and social media, these new technologies may be used to address their needs and for outreach purposes. However, little is known about how this group uses these resources. This study investigated how homeless adolescents use these technologies for general and health-related purposes, whether the scope of their use changes with housing status, and their interest in a website dedicated to youth experiencing homelessness. A convenience sample of youth aged 18 to 21 years was recruited from a youth-specific homeless shelter. All participants completed a 47-item survey, with 10 individuals completing a semistructured interview. Descriptive statistics, exact testing, logistic regression, and generalized estimating equation modeling was performed for quantitative data analysis. Interviews were transcribed verbatim, and NVivo 10 (QSR International) was employed to facilitate double coding and thematic analysis. A total of 87 participants completed the survey with a mean age of 19.4 (SD 1.1) years. While experiencing homelessness, 56% (49/87) accessed the internet at least once a day, with 86% (75/87) accessing once a week. Access to a smartphone was associated with a 3.03 greater odds of accessing the internet and was the most frequently used device (66% of participants, 57/87). While experiencing homelessness, subjects reported a 68% decreased odds in internet access frequency (odds ratio [OR] 0.32, P<.001), 75% decreased odds in spending greater amounts of time on the internet (OR 0.25, P<.001), and an 87% decreased odds of social media use (OR 0.13, P=.01). Ten participants completed the semistructured interview. Several themes were identified, including (1) changes in internet behaviors while experiencing homelessness, (2) health status as a major concern and reason for Internet use, and (3) interest in a website dedicated to youth experiencing

The association between alcohol outlet accessibility and adverse birth outcomes: A retrospective cohort study.

PubMed

Seabrook, J A; Woods, N; Clark, A; de Vrijer, B; Penava, D; Gilliland, J

2018-01-01

Alcohol outlet accessibility is positively associated with alcohol consumption, although this relationship has not been thoroughly examined in pregnant women. The present study examines the relationship between proximity and density of alcohol outlets and risk for low birth weight (LBW: <2,500 grams) and preterm birth (PTB: <37 weeks gestational age), and is the first Canadian study to investigate this association. Maternal accessibility to alcohol outlets was specified using a gravity-type measure of accessibility, which provides the amount of accessibility that a given household has to liquor stores within 30-minutes of their home. All singleton newborns without congenital anomalies that were born between February 2009 and February 2014 at London Health Sciences Centre in London, Ontario, were included in this cohort. The sample consisted of 25,734 live births, of which 5.8% were LBW and 7.6% were PTB. Only 2.0% of women reported alcohol use during pregnancy. Alcohol outlet gravity was positively correlated with the percentage of mothers living in poverty (rs = 0.33, p < 0.001) and in single-parent families (rs = 0.39, p < 0.001), and who self-identify as visible minorities (rs = 0.45, p < 0.001). Alcohol outlet gravity increased the odds that mothers drank alcohol during pregnancy (OR 1.05; 95% CI: 1.02, 1.07), although the association was weak. Furthermore, alcohol outlet gravity did not increase the likelihood of a LBW or PTB infant. Women with high accessibility to alcohol outlets are more likely to consume alcohol during pregnancy, but greater alcohol outlet accessibility does not translate into poor birth outcomes.

[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.

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 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…

Open Access Could Transform Drug Discovery: A Case Study of JQ1.

PubMed

Arshad, Zeeshaan; Smith, James; Roberts, Mackenna; Lee, Wen Hwa; Davies, Ben; Bure, Kim; Hollander, Georg A; Dopson, Sue; Bountra, Chas; Brindley, David

2016-01-01

The cost to develop a new drug from target discovery to market is a staggering $1.8 billion, largely due to the very high attrition rate of drug candidates and the lengthy transition times during development. Open access is an emerging model of open innovation that places no restriction on the use of information and has the potential to accelerate the development of new drugs. To date, no quantitative assessment has yet taken place to determine the effects and viability of open access on the process of drug translation. This need is addressed within this study. The literature and intellectual property landscapes of the drug candidate JQ1, which was made available on an open access basis when discovered, and conventionally developed equivalents that were not are compared using the Web of Science and Thomson Innovation software, respectively. Results demonstrate that openly sharing the JQ1 molecule led to a greater uptake by a wider and more multi-disciplinary research community. A comparative analysis of the patent landscapes for each candidate also found that the broader scientific diaspora of the publically released JQ1 data enhanced innovation, evidenced by a greater number of downstream patents filed in relation to JQ1. The authors' findings counter the notion that open access drug discovery would leak commercial intellectual property. On the contrary, JQ1 serves as a test case to evidence that open access drug discovery can be an economic model that potentially improves efficiency and cost of drug discovery and its subsequent commercialization.

Longitudinal study of health, disease and access to care in rural Victoria: the Crossroads-II study: methods.

PubMed

Glenister, Kristen M; Bourke, Lisa; Bolitho, Leslie; Wright, Sian; Roberts, Stuart; Kemp, William; Rhode, Leigh; Bhat, Ravi; Tremper, Sönke; Magliano, Dianna J; Morgan, Mike; Mariño, Rodrigo; Adam, William; Simmons, David

2018-05-30

High quality, contemporary data regarding patterns of chronic disease is essential for planning by health services, policy makers and local governments, but surprisingly scarce, including in rural Australia. This dearth of data occurs despite the recognition that rural Australians live with high rates of ill health, poor health behaviours and restricted access to health services. Crossroads-II is set in the Goulburn Valley, a rural region of Victoria, Australia 100-300 km north of metropolitan Melbourne. It is primarily an irrigated agricultural area. The aim of the study is to identify changes in the prevalence of key chronic health conditions including the extent of undiagnosed and undermanaged disease, and association with access to care, over a 15 year period. This study is a 15 year follow up from the 2000-2003 Crossroads-I study (2376 households participated). Crossroads-II includes a similar face to face household survey of 3600 randomly selected households across four towns of sizes 6300 to 49,800 (50% sampled in the larger town with the remainder sampled equally from the three smaller towns). Self-reported health, health behaviour and health service usage information is verified and supplemented in a nested sub-study of 900 randomly selected adult participants in 'clinics' involving a range of additional questionnaires and biophysical measurements. The study is expected to run from October 2016 to December 2018. Besides providing epidemiological and health service utilisation information relating to different diseases and their risk factors in towns of different sizes, the results will be used to develop a composite measure of health service access. The importance of access to health services will be investigated by assessing the correlation of this measure with rates of undiagnosed and undermanaged disease at the mesh block level. Results will be shared with partner organisations to inform service planning and interventions to improve health outcomes

Inequity of access to ACE inhibitors in Swedish heart failure patients: a register-based study

PubMed Central

Lindahl, Bertil; Hanning, Marianne; Westerling, Ragnar

2016-01-01

Background Several international studies suggest inequity in access to evidence-based heart failure (HF) care. Specifically, studies of ACE inhibitors (ACEIs) point to reduced ACEI access related to female sex, old age and socioeconomic position. Thus far, most studies have either been rather small, lacking diagnostic data, or lacking the possibility to account for several individual-based sociodemographic factors. Our aim was to investigate differences, which could reflect inequity in access to ACEIs based on sex, age, socioeconomic status or immigration status in Swedish patients with HF. Methods Individually linked register data for all Swedish adults hospitalised for HF in 2005–2010 (n=93 258) were analysed by multivariate regression models to assess the independent risk of female sex, high age, low employment status, low income level, low educational level or foreign country of birth, associated with lack of an ACEI dispensation within 1 year of hospitalisation. Adjustment for possible confounding was made for age, comorbidity, Angiotensin receptor blocker therapy, period and follow-up time. Results Analysis revealed an adjusted OR for no ACEI dispensation for women of 1.31 (95% CI 1.27 to 1.35); for the oldest patients of 2.71 (95% CI 2.53 to 2.91); and for unemployed patients of 1.59 (95% CI 1.46 to 1.73). Conclusions Access to ACEI treatment was reduced in women, older patients and unemployed patients. We conclude that access to ACEIs is inequitable among Swedish patients with HF. Future studies should include clinical data, as well as mortality outcomes in different groups. PMID:26261264

Accessing Suicide-Related Information on the Internet: A Retrospective Observational Study of Search Behavior

PubMed Central

2013-01-01

Background The Internet’s potential impact on suicide is of major public health interest as easy online access to pro-suicide information or specific suicide methods may increase suicide risk among vulnerable Internet users. Little is known, however, about users’ actual searching and browsing behaviors of online suicide-related information. Objective To investigate what webpages people actually clicked on after searching with suicide-related queries on a search engine and to examine what queries people used to get access to pro-suicide websites. Methods A retrospective observational study was done. We used a web search dataset released by America Online (AOL). The dataset was randomly sampled from all AOL subscribers’ web queries between March and May 2006 and generated by 657,000 service subscribers. Results We found 5526 search queries (0.026%, 5526/21,000,000) that included the keyword "suicide". The 5526 search queries included 1586 different search terms and were generated by 1625 unique subscribers (0.25%, 1625/657,000). Of these queries, 61.38% (3392/5526) were followed by users clicking on a search result. Of these 3392 queries, 1344 (39.62%) webpages were clicked on by 930 unique users but only 1314 of those webpages were accessible during the study period. Each clicked-through webpage was classified into 11 categories. The categories of the most visited webpages were: entertainment (30.13%; 396/1314), scientific information (18.31%; 240/1314), and community resources (14.53%; 191/1314). Among the 1314 accessed webpages, we could identify only two pro-suicide websites. We found that the search terms used to access these sites included “commiting suicide with a gas oven”, “hairless goat”, “pictures of murder by strangulation”, and “photo of a severe burn”. A limitation of our study is that the database may be dated and confined to mainly English webpages. Conclusions Searching or browsing suicide-related or pro-suicide webpages was

Accessing suicide-related information on the internet: a retrospective observational study of search behavior.

PubMed

Wong, Paul Wai-Ching; Fu, King-Wa; Yau, Rickey Sai-Pong; Ma, Helen Hei-Man; Law, Yik-Wa; Chang, Shu-Sen; Yip, Paul Siu-Fai

2013-01-11

The Internet's potential impact on suicide is of major public health interest as easy online access to pro-suicide information or specific suicide methods may increase suicide risk among vulnerable Internet users. Little is known, however, about users' actual searching and browsing behaviors of online suicide-related information. To investigate what webpages people actually clicked on after searching with suicide-related queries on a search engine and to examine what queries people used to get access to pro-suicide websites. A retrospective observational study was done. We used a web search dataset released by America Online (AOL). The dataset was randomly sampled from all AOL subscribers' web queries between March and May 2006 and generated by 657,000 service subscribers. We found 5526 search queries (0.026%, 5526/21,000,000) that included the keyword "suicide". The 5526 search queries included 1586 different search terms and were generated by 1625 unique subscribers (0.25%, 1625/657,000). Of these queries, 61.38% (3392/5526) were followed by users clicking on a search result. Of these 3392 queries, 1344 (39.62%) webpages were clicked on by 930 unique users but only 1314 of those webpages were accessible during the study period. Each clicked-through webpage was classified into 11 categories. The categories of the most visited webpages were: entertainment (30.13%; 396/1314), scientific information (18.31%; 240/1314), and community resources (14.53%; 191/1314). Among the 1314 accessed webpages, we could identify only two pro-suicide websites. We found that the search terms used to access these sites included "commiting suicide with a gas oven", "hairless goat", "pictures of murder by strangulation", and "photo of a severe burn". A limitation of our study is that the database may be dated and confined to mainly English webpages. Searching or browsing suicide-related or pro-suicide webpages was uncommon, although a small group of users did access websites that contain

Interfaces to PeptideAtlas: a case study of standard data access systems

PubMed Central

Handcock, Jeremy; Robinson, Thomas; Deutsch, Eric W.; Boyle, John

2012-01-01

Access to public data sets is important to the scientific community as a resource to develop new experiments or validate new data. Projects such as the PeptideAtlas, Ensembl and The Cancer Genome Atlas (TCGA) offer both access to public data and a repository to share their own data. Access to these data sets is often provided through a web page form and a web service API. Access technologies based on web protocols (e.g. http) have been in use for over a decade and are widely adopted across the industry for a variety of functions (e.g. search, commercial transactions, and social media). Each architecture adapts these technologies to provide users with tools to access and share data. Both commonly used web service technologies (e.g. REST and SOAP), and custom-built solutions over HTTP are utilized in providing access to research data. Providing multiple access points ensures that the community can access the data in the simplest and most effective manner for their particular needs. This article examines three common access mechanisms for web accessible data: BioMart, caBIG, and Google Data Sources. These are illustrated by implementing each over the PeptideAtlas repository and reviewed for their suitability based on specific usages common to research. BioMart, Google Data Sources, and caBIG are each suitable for certain uses. The tradeoffs made in the development of the technology are dependent on the uses each was designed for (e.g. security versus speed). This means that an understanding of specific requirements and tradeoffs is necessary before selecting the access technology. PMID:22941959

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

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.

Incorporating information on predicted solvent accessibility to the co-evolution-based study of protein interactions.

PubMed

Ochoa, David; García-Gutiérrez, Ponciano; Juan, David; Valencia, Alfonso; Pazos, Florencio

2013-01-27

A widespread family of methods for studying and predicting protein interactions using sequence information is based on co-evolution, quantified as similarity of phylogenetic trees. Part of the co-evolution observed between interacting proteins could be due to co-adaptation caused by inter-protein contacts. In this case, the co-evolution is expected to be more evident when evaluated on the surface of the proteins or the internal layers close to it. In this work we study the effect of incorporating information on predicted solvent accessibility to three methods for predicting protein interactions based on similarity of phylogenetic trees. We evaluate the performance of these methods in predicting different types of protein associations when trees based on positions with different characteristics of predicted accessibility are used as input. We found that predicted accessibility improves the results of two recent versions of the mirrortree methodology in predicting direct binary physical interactions, while it neither improves these methods, nor the original mirrortree method, in predicting other types of interactions. That improvement comes at no cost in terms of applicability since accessibility can be predicted for any sequence. We also found that predictions of protein-protein interactions are improved when multiple sequence alignments with a richer representation of sequences (including paralogs) are incorporated in the accessibility prediction.

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

PubMed Central

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

2015-01-01

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

Household food access and child malnutrition: results from the eight-country MAL-ED study.

PubMed

Psaki, Stephanie; Bhutta, Zulfiqar A; Ahmed, Tahmeed; Ahmed, Shamsir; Bessong, Pascal; Islam, Munirul; John, Sushil; Kosek, Margaret; Lima, Aldo; Nesamvuni, Cebisa; Shrestha, Prakash; Svensen, Erling; McGrath, Monica; Richard, Stephanie; Seidman, Jessica; Caulfield, Laura; Miller, Mark; Checkley, William

2012-12-13

Stunting results from decreased food intake, poor diet quality, and a high burden of early childhood infections, and contributes to significant morbidity and mortality worldwide. Although food insecurity is an important determinant of child nutrition, including stunting, development of universal measures has been challenging due to cumbersome nutritional questionnaires and concerns about lack of comparability across populations. We investigate the relationship between household food access, one component of food security, and indicators of nutritional status in early childhood across eight country sites. We administered a socioeconomic survey to 800 households in research sites in eight countries, including a recently validated nine-item food access insecurity questionnaire, and obtained anthropometric measurements from children aged 24 to 60 months. We used multivariable regression models to assess the relationship between household food access insecurity and anthropometry in children, and we assessed the invariance of that relationship across country sites. Average age of study children was 41 months. Mean food access insecurity score (range: 0-27) was 5.8, and varied from 2.4 in Nepal to 8.3 in Pakistan. Across sites, the prevalence of stunting (42%) was much higher than the prevalence of wasting (6%). In pooled regression analyses, a 10-point increase in food access insecurity score was associated with a 0.20 SD decrease in height-for-age Z score (95% CI 0.05 to 0.34 SD; p = 0.008). A likelihood ratio test for heterogeneity revealed that this relationship was consistent across countries (p = 0.17). Our study provides evidence of the validity of using a simple household food access insecurity score to investigate the etiology of childhood growth faltering across diverse geographic settings. Such a measure could be used to direct interventions by identifying children at risk of illness and death related to malnutrition.

Household food access and child malnutrition: results from the eight-country MAL-ED study

PubMed Central

2012-01-01

Background Stunting results from decreased food intake, poor diet quality, and a high burden of early childhood infections, and contributes to significant morbidity and mortality worldwide. Although food insecurity is an important determinant of child nutrition, including stunting, development of universal measures has been challenging due to cumbersome nutritional questionnaires and concerns about lack of comparability across populations. We investigate the relationship between household food access, one component of food security, and indicators of nutritional status in early childhood across eight country sites. Methods We administered a socioeconomic survey to 800 households in research sites in eight countries, including a recently validated nine-item food access insecurity questionnaire, and obtained anthropometric measurements from children aged 24 to 60 months. We used multivariable regression models to assess the relationship between household food access insecurity and anthropometry in children, and we assessed the invariance of that relationship across country sites. Results Average age of study children was 41 months. Mean food access insecurity score (range: 0–27) was 5.8, and varied from 2.4 in Nepal to 8.3 in Pakistan. Across sites, the prevalence of stunting (42%) was much higher than the prevalence of wasting (6%). In pooled regression analyses, a 10-point increase in food access insecurity score was associated with a 0.20 SD decrease in height-for-age Z score (95% CI 0.05 to 0.34 SD; p = 0.008). A likelihood ratio test for heterogeneity revealed that this relationship was consistent across countries (p = 0.17). Conclusions Our study provides evidence of the validity of using a simple household food access insecurity score to investigate the etiology of childhood growth faltering across diverse geographic settings. Such a measure could be used to direct interventions by identifying children at risk of illness and death related to

Study of optoelectronic switch for satellite-switched time-division multiple access

NASA Technical Reports Server (NTRS)

Su, Shing-Fong; Jou, Liz; Lenart, Joe

1987-01-01

The use of optoelectronic switching for satellite switched time division multiple access will improve the isolation and reduce the crosstalk of an IF switch matrix. The results are presented of a study on optoelectronic switching. Tasks include literature search, system requirements study, candidate switching architecture analysis, and switch model optimization. The results show that the power divided and crossbar switching architectures are good candidates for an IF switch matrix.

Personal Access Satellite System (PASS) study. Fiscal year 1989 results

NASA Technical Reports Server (NTRS)

Sue, Miles K. (Editor)

1990-01-01

The Jet Propulsion Laboratory is exploring the potential and feasibility of a personal access satellite system (PASS) that will offer the user greater freedom and mobility than existing or currently planned communications systems. Studies performed in prior years resulted in a strawman design and the identification of technologies that are critical to the successful implementation of PASS. The study efforts in FY-89 were directed towards alternative design options with the objective of either improving the system performance or alleviating the constraints on the user terminal. The various design options and system issues studied this year and the results of the study are presented.

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.

Midwives' and women's views on accessing dental care during pregnancy: an Australian qualitative study.

PubMed

Lim, M; Riggs, E; Shankumar, R; Marwaha, P; Kilpatrick, N

2018-04-16

Maternal behaviours during pregnancy are likely to play a significant role in the development of dental caries in children. Although midwives are well placed to discuss oral health and provide information to women, dental attendance by women during pregnancy is minimal. This study aimed to explore midwives' experience of facilitating pregnant women's access to dental care and to document women's experience of receiving dental information and care during pregnancy. Focus groups with midwives and telephone interviews with women who were referred to Monash Health Dental Services were conducted to explore their perspectives and experiences. The qualitative data was thematically analysed. Three focus groups with 13 midwives and telephone interviews with eight women who recently gave birth were conducted. Three key themes were identified: maternal oral health knowledge; barriers to accessing dental information and care during pregnancy; and suggested recommendations. This study highlighted the barriers that exist for midwives to discuss oral health with women and refer women to dental care, and women's experiences of accessing dental care during pregnancy. Ongoing collaboration between the maternity and dental services is required to strengthen midwives' knowledge, confidence and practise in supporting women to access dental care during pregnancy. © 2018 Australian Dental Association.

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

PubMed

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

2016-05-01

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

A Unique, Optically Accessible Flame Tube Facility for Lean Combustor Studies

NASA Technical Reports Server (NTRS)

Hicks, Yolanda R.; Locke, Randy J.; Wey, Chowen C.; Bianco, Jean

1995-01-01

A facility that allows interrogation of combusting flows by advanced diagnostic methods and instrumentation has been developed at the NASA Lewis Research Center. An optically accessible flame tube combustor is described which has high temperature, pressure, and air flow capabilities. The windows in the combustor measure 3.8 cm axially by 5.1 cm radially, providing 67% optical access to the 7.6 cm x 7.6 cm cross section flow chamber. Advanced gas analysis instrumentation is available through a gas chromatography/mass spectrometer system (GC/MS), which has on-line capability for heavy hydrocarbon measurement with resolution to the parts per billion level. The instrumentation allows one to study combusting flows and combustor subcomponents, such as fuel injectors and air swirlers. Planar Laser Induced Fluorescence (PLIF) can measure unstable combustion species, which cannot be obtained with traditional gas sampling. This type of data is especially useful to combustion modellers. The optical access allows measurements to have high spatial and temporal resolution. GC/MS data and PLIF images of OH- are presented from experiments using a lean direct injection (LDI) combustor burning Jet-A fuel at inlet temperatures ranging from 810 K to 866 K, combustor pressures up to 1380 kPa, and equivalence ratios from 0.41 to 0.59.

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…

How automated access verification can help organizations demonstrate HIPAA compliance: A case study.

PubMed

Hill, Linda

2006-01-01

This case study of Sharp HealthCare takes an in depth look at how the organization has embedded security policies into its business process and automated workflow to ensure users are granted only the IT access that is necessary for them to perform their jobs and to ensure patient privacy Some of the most pressing audit and compliance concerns in healthcare organizations today revolve around the need to constantly review and give an account for users' IT access. The need for this at Sharp is exacerbated because of the high rate of change within the organization and the large percentage of non-employee staff such as traveling nurses moving throughout hospital departments on their rotations. By implementing a software solution to verify the accuracy of user access rights or automatically initiate appropriate corrective actions, Sharp is now able to extend the responsibility and accountability for compliance to the most appropriate resources.

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.

Older teen attitudes toward birth control access in pharmacies: a qualitative study.

PubMed

Wilkinson, Tracey A; Miller, Courtney; Rafie, Samantha; Landau, Sharon Cohen; Rafie, Sally

2018-03-01

To examine adolescent attitudes toward accessing contraception through a new pharmacist prescribing model in the State of California. In-depth telephone interviews were conducted in summer 2015 with 30 females ages 18 to 19 in California. Participants were recruited using a social media advertisement. Semi-structured interviews utilized open-ended questions to understand teens' experiences with pharmacies, experiences obtaining contraception, and views on pharmacist prescribing of contraception. Responses were transcribed and qualitatively analyzed using an independent-coder method to identify salient themes. Participants were ethnically diverse and primarily living in suburban areas. All participants had completed high school and many had completed one year of college. Nearly all participants were supportive of California's new law allowing pharmacist prescribing of contraception. Thematic analyses revealed that while participants were satisfied with traditional service providers and valued those relationships, they appreciated the benefit of increased access and convenience of going directly to a pharmacy. Participants expected increased access to contraception in pharmacies would lead to both personal and societal benefits. They expressed concerns regarding parental involvement, as well as confidentiality in the pharmacy environment and with insurance disclosures. Older teens in California are very supportive of pharmacies and pharmacists as direct access points for contraception, but confidentiality concerns were noted. Policy makers and pharmacies can incorporate study findings when designing policies, services, and physical pharmacy spaces to better serve teens. Further research is warranted after pharmacies implement this new service to assess teen utilization and satisfaction as well as outcomes. Several states recently passed legislation enabling pharmacists to prescribe contraception and other states are considering similar legislation. Older teens are

Enhancing healthcare accessibility measurements using GIS: A case study in Seoul, Korea.

PubMed

Kim, Yeeun; Byon, Young-Ji; Yeo, Hwasoo

2018-01-01

With recent aging demographic trends, the needs for enhancing geo-spatial analysis capabilities and monitoring the status of accessibilities of its citizens with healthcare services have increased. The accessibility to healthcare is determined not only by geographic distances to service locations, but also includes travel time, available modes of transportation, and departure time. Having access to the latest and accurate information regarding the healthcare accessibility allows the municipal government to plan for improvements, including expansion of healthcare infrastructure, effective labor distribution, alternative healthcare options for the regions with low accessibilities, and redesigning the public transportation routes and schedules. This paper proposes a new method named, Seoul Enhanced 2-Step Floating Catchment Area (SE2SFCA), which is customized for the city of Seoul, where population density is higher and the average distance between healthcare-service locations tends to be shorter than the typical North American or European cities. The proposed method of SE2SFCA is found to be realistic and effective in determining the weak accessibility regions. It resolves the over-estimation issues of the past, arising from the assignment of high healthcare accessibility for the regions with large hospitals and high density of population and hospitals.

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.

Walker Ranch 3D seismic images

DOE Data Explorer

Robert J. Mellors

2016-03-01

Amplitude images (both vertical and depth slices) extracted from 3D seismic reflection survey over area of Walker Ranch area (adjacent to Raft River). Crossline spacing of 660 feet and inline of 165 feet using a Vibroseis source. Processing included depth migration. Micro-earthquake hypocenters on images. Stratigraphic information and nearby well tracks added to images. Images are embedded in a Microsoft Word document with additional information. Exact location and depth restricted for proprietary reasons. Data collection and processing funded by Agua Caliente. Original data remains property of Agua Caliente.

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...

Neighborhood deprivation and access to fast-food retailing: a national study.

PubMed

Pearce, Jamie; Blakely, Tony; Witten, Karen; Bartie, Phil

2007-05-01

Obesogenic environments may be an important contextual explanation for the growing obesity epidemic, including its unequal social distribution. The objective of this study was to determine whether geographic access to fast-food outlets varied by neighborhood deprivation and school socioeconomic ranking, and whether any such associations differed to those for access to healthier food outlets. Data were collected on the location of fast-food outlets, supermarkets, and convenience stores across New Zealand. The data were geocoded and geographic information systems used to calculate travel distances from each census meshblock (i.e., neighborhood), and each school, to the closest fast-food outlet. Median travel distances are reported by a census-based index of socioeconomic deprivation for each neighborhood, and by a Ministry of Education measure of socioeconomic circumstances for each school. Analyses were repeated for outlets selling healthy food to allow comparisons. At the national level, statistically significant negative associations were found between neighborhood access to the nearest fast-food outlet and neighborhood deprivation (p<0.001) for both multinational fast-food outlets and locally operated outlets. The travel distances to both types of fast food outlet were at least twice as far in the least socially deprived neighborhoods compared to the most deprived neighborhoods. A similar pattern was found for outlets selling healthy food such as supermarkets and smaller food outlets (p<0.001). These relationships were broadly linear with travel distances tending to be shorter in more-deprived neighborhoods. There is a strong association between neighborhood deprivation and geographic access to fast food outlets in New Zealand, which may contribute to the understanding of environmental causes of obesity. However, outlets potentially selling healthy food (e.g., supermarkets) are patterned by deprivation in a similar way. These findings highlight the importance of

Enhancing healthcare accessibility measurements using GIS: A case study in Seoul, Korea

PubMed Central

Kim, Yeeun; Byon, Young-Ji

2018-01-01

With recent aging demographic trends, the needs for enhancing geo-spatial analysis capabilities and monitoring the status of accessibilities of its citizens with healthcare services have increased. The accessibility to healthcare is determined not only by geographic distances to service locations, but also includes travel time, available modes of transportation, and departure time. Having access to the latest and accurate information regarding the healthcare accessibility allows the municipal government to plan for improvements, including expansion of healthcare infrastructure, effective labor distribution, alternative healthcare options for the regions with low accessibilities, and redesigning the public transportation routes and schedules. This paper proposes a new method named, Seoul Enhanced 2-Step Floating Catchment Area (SE2SFCA), which is customized for the city of Seoul, where population density is higher and the average distance between healthcare-service locations tends to be shorter than the typical North American or European cities. The proposed method of SE2SFCA is found to be realistic and effective in determining the weak accessibility regions. It resolves the over-estimation issues of the past, arising from the assignment of high healthcare accessibility for the regions with large hospitals and high density of population and hospitals. PMID:29462194

Usage Trends of Open Access and Local Journals: A Korean Case Study

PubMed Central

Chung, Hosik; Yun, Jungmin; Park, Jin Young; Park, Eunsun; Ahn, Yuri

2016-01-01

Articles from open access and local journals are important resources for research in Korea and the usage trends of these articles are important indicators for the assessment of the current research practice. We analyzed an institutional collection of published papers from 1998 to 2014 authored by researchers from Seoul National University, and their references from papers published between 1998 and 2011. The published papers were collected from Web of Science or Scopus and were analyzed according to the proportion of articles from open access journals. Their cited references from published papers in Web of Science were analyzed according to the proportion of local (South Korean) or open access journals. The proportion of open access papers was relatively stable until 2006 (2.5 ~ 5.2% in Web of Science and 2.7 ~ 4.2% in Scopus), but then increased to 15.9% (Web of Science) or 18.5% (Scopus) in 2014. We analyzed 2,750,485 cited references from 52,295 published papers. We found that the overall proportion of cited articles from local journals was 1.8% and that for open access journals was 3.0%. Citations of open access articles have increased since 2006 to 4.1% in 2011, although the increase in open access article citations was less than for open access publications. The proportion of citations from local journals was even lower. We think that the publishing / citing mismatch is a term to describe this difference, which is an issue at Seoul National University, where the number of published papers at open access or local journals is increasing but the number of citations is not. The cause of this discrepancy is multi-factorial but the governmental / institutional policies, social / cultural issues and authors' citing behaviors will explain the mismatch. However, additional measures are also necessary, such as the development of an institutional citation database and improved search capabilities with respect to local and open access documents. PMID:27195948

Usage Trends of Open Access and Local Journals: A Korean Case Study.

PubMed

Seo, Jeong-Wook; Chung, Hosik; Yun, Jungmin; Park, Jin Young; Park, Eunsun; Ahn, Yuri

2016-01-01

Articles from open access and local journals are important resources for research in Korea and the usage trends of these articles are important indicators for the assessment of the current research practice. We analyzed an institutional collection of published papers from 1998 to 2014 authored by researchers from Seoul National University, and their references from papers published between 1998 and 2011. The published papers were collected from Web of Science or Scopus and were analyzed according to the proportion of articles from open access journals. Their cited references from published papers in Web of Science were analyzed according to the proportion of local (South Korean) or open access journals. The proportion of open access papers was relatively stable until 2006 (2.5 ~ 5.2% in Web of Science and 2.7 ~ 4.2% in Scopus), but then increased to 15.9% (Web of Science) or 18.5% (Scopus) in 2014. We analyzed 2,750,485 cited references from 52,295 published papers. We found that the overall proportion of cited articles from local journals was 1.8% and that for open access journals was 3.0%. Citations of open access articles have increased since 2006 to 4.1% in 2011, although the increase in open access article citations was less than for open access publications. The proportion of citations from local journals was even lower. We think that the publishing / citing mismatch is a term to describe this difference, which is an issue at Seoul National University, where the number of published papers at open access or local journals is increasing but the number of citations is not. The cause of this discrepancy is multi-factorial but the governmental / institutional policies, social / cultural issues and authors' citing behaviors will explain the mismatch. However, additional measures are also necessary, such as the development of an institutional citation database and improved search capabilities with respect to local and open access documents.

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.

Empower: access to medicine - working towards early access.

PubMed

Pearson, Jennifer Bryant; Turgoose, James; Hargrave, James

2015-01-01

Empower: Access to Medicine's contribution will document the founding of Empower: Access to Medicine and tactics used to create a lobbying campaign designed to facilitate the debate around barriers to medical innovation and patient access to medicines. The article will detail the evolution of the campaign's goals and the potential solutions to an expensive and slow system. Specifically the submission will look at the influence that Empower: Access to Medicine had on the Government's thinking and development of an early access scheme.

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.

Increasing access to healthful foods: a qualitative study with residents of low-income communities

PubMed Central

2015-01-01

Background Inadequate access to healthful foods has been identified as a significant barrier to healthful dietary behaviors among individuals who live in low-income communities. The purpose of this study was to gather low-income community members’ opinions about their food purchasing choices and their perceptions of the most effective ways to increase access to healthful foods in their communities. Methods Spanish and English focus groups were conducted in low-income, ethnically-diverse communities. Participants were asked about their knowledge, factors influencing their food purchasing decisions, and their perceptions regarding solutions to increase access to healthful foods. Results A total of 148 people participated in 13 focus groups. The majority of participants were female and ethnically diverse (63% Hispanic, 17% African American, 16% Caucasian, and 4% “other”). More than 75% of the participants reported making less than $1999 USD per month. Participants reported high levels of knowledge and preference for healthful foods. The most important barriers influencing healthful shopping behaviors included high price of healthful food, inadequate geographical access to healthful food, poor quality of available healthful food, and lack of overall quality of the proximate retail stores. Suggested solutions to inadequate access included placement of new chain supermarkets in their communities. Strategies implemented in convenience stores were not seen as effective. Farmers’ markets, with specific stipulations, and community gardens were regarded as beneficial supplementary solutions. Conclusion The results from the focus groups provide important input from a needs assessment perspective from the community, identify gaps in access, and offer potential effective solutions to provide direction for the future. PMID:26222910

Mapping South American Summer Monsoon Changes during Heinrich Event 1 and the LGM: Insights from New Paleolake Records from the Central Andes

NASA Astrophysics Data System (ADS)

Chen, C. Y.; McGee, D.; Quade, J.

2015-12-01

Cave stalagmite records show strong evidence of abrupt changes in summer monsoons during Heinrich events, but we lack rigorous constraints on the amount of wetting or drying occurring in monsoon regions. Studies on shoreline deposits of closed-basin lakes can establish quantitative bounds on water balance changes through mapping-based estimates of lake volume variations. We present new dating constraints on lake level variations in Agua Caliente I and Laguna Loyoques, two closed-basin, high-altitude paleolakes on the Altiplano-Puna plateau of the Central Andes (23.1°S, 67.4°W, 4250 masl). Because this area receives >70% of its total annual precipitation during austral summer, the region is ideally suited to capture a pure response to changes in the South American summer monsoon (SASM). The plateau is home to several small (<40 km2) lakes surrounded by well-preserved paleoshorelines that indicate past wetter conditions. Agua Caliente I is unique, having multiple shorelines encrusted with biologically-mediated calcium carbonate "tufa" deposits. Initial U-Th dating of these massive shoreline tufas reveals that these deposits are dateable to within ±50 to 300 years due to high U concentrations and low initial Th content (as indicated by high 230Th/232Th). Our U-Th dates show that Agua Caliente I was greater in lake surface area during two periods: 17.5-14.5 kyrs BP, coincident with Heinrich Event 1 (HE1), and 24-23 kyrs BP, roughly coincident with the Last Glacial Maximum (LGM). At these times, Agua Caliente I also overflowed into a neighboring lake basin (Loyoques) through an 8-km long southeast-trending stream channel. Thus, during HE1 and the LGM, the lake was ~9 times larger in surface area relative to modern. Hydrologic modeling constrained by paleotemperature estimates is used to provide bounds for these past precipitation changes. We also tentatively explore physical mechanisms linking Heinrich events and the regional hydroclimate by comparing freshwater

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…

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

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

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

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

Building College Access with Families in New Bedford, Massachusetts: A Case Study

ERIC Educational Resources Information Center

Marks, Sue Anne

2012-01-01

This qualitative study was an investigation into improving college access through family engagement with minority and low-income students in an urban school district. Critical theory concepts of cultural capital, field, and habitus, as well as organizational communication theory, formed the theoretical framework that guided a literature review and…

ICT and UD: Preliminary Study for Recommendations to Design Accessible University Courses.

PubMed

Pagliara, Silvio Marcello; Sánchez Utgé, Marta; De Anna, Lucia

2017-01-01

Starting from the Universal Design in the educational context principles, the experiences gained during the FIRB project "Net@ccessibility" and the high-education courses for teachers' specialization on special education, this research will focus on preliminary studies in order to define the recommendations for designing accessible university courses.

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…

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

PubMed

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

2015-01-01

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

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

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

Accessing the Soil Metagenome for Studies of Microbial Diversity▿ †

PubMed Central

Delmont, Tom O.; Robe, Patrick; Cecillon, Sébastien; Clark, Ian M.; Constancias, Florentin; Simonet, Pascal; Hirsch, Penny R.; Vogel, Timothy M.

2011-01-01

Soil microbial communities contain the highest level of prokaryotic diversity of any environment, and metagenomic approaches involving the extraction of DNA from soil can improve our access to these communities. Most analyses of soil biodiversity and function assume that the DNA extracted represents the microbial community in the soil, but subsequent interpretations are limited by the DNA recovered from the soil. Unfortunately, extraction methods do not provide a uniform and unbiased subsample of metagenomic DNA, and as a consequence, accurate species distributions cannot be determined. Moreover, any bias will propagate errors in estimations of overall microbial diversity and may exclude some microbial classes from study and exploitation. To improve metagenomic approaches, investigate DNA extraction biases, and provide tools for assessing the relative abundances of different groups, we explored the biodiversity of the accessible community DNA by fractioning the metagenomic DNA as a function of (i) vertical soil sampling, (ii) density gradients (cell separation), (iii) cell lysis stringency, and (iv) DNA fragment size distribution. Each fraction had a unique genetic diversity, with different predominant and rare species (based on ribosomal intergenic spacer analysis [RISA] fingerprinting and phylochips). All fractions contributed to the number of bacterial groups uncovered in the metagenome, thus increasing the DNA pool for further applications. Indeed, we were able to access a more genetically diverse proportion of the metagenome (a gain of more than 80% compared to the best single extraction method), limit the predominance of a few genomes, and increase the species richness per sequencing effort. This work stresses the difference between extracted DNA pools and the currently inaccessible complete soil metagenome. PMID:21183646

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

PubMed

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

2016-01-01

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

Design study of the accessible focal plane telescope for shuttle

NASA Technical Reports Server (NTRS)

1976-01-01

The design and cost analysis of an accessible focal plane telescope for Spacelab is presented in blueprints, tables, and graphs. Topics covered include the telescope tube, the telescope mounting, the airlock plus Spacelab module aft plate, the instrument adapter, and the instrument package. The system allows access to the image plane with instrumentation that can be operated by a scientist in a shirt sleeve environment inside a Spacelab module.

Advanced access appointments

PubMed Central

Hudec, John C.; MacDougall, Steven; Rankin, Elaine

2010-01-01

ABSTRACT OBJECTIVE To examine the effects of advanced access (same-day physician appointments) on patient and provider satisfaction and to determine its association with other variables such as physician income and patient emergency department use. DESIGN Patient satisfaction survey and semistructured interviews with physicians and support staff; analysis of physician medical insurance billings and patient emergency department visits. SETTING Cape Breton, NS. PARTICIPANTS Patients, physicians, and support staff of 3 comparable family physician practices that had not implemented advanced access and an established advanced access practice. MAIN OUTCOME MEASURES Self-reported provider and patient satisfaction, physician office income, and patients’ emergency department use. RESULTS The key benefits of implementation of advanced access were an increase in provider and patient satisfaction levels, same or greater physician office income, and fewer less urgent (triage level 4) and nonurgent (triage level 5) emergency department visits by patients. CONCLUSION Currently within the Central Cape Breton Region, 33% of patients wait 4 or more days for urgent appointments. Findings from this study can be used to enhance primary care physician practice redesign. This research supports many benefits of transitioning to an advanced access model of patient booking. PMID:20944024

Access to food retail outlets in County Durham, UK: a pragmatic cross-sectional study.

PubMed

Mills, Susanna; Wright, Tim

2015-02-26

Strong links exist between deprivation, obesity, and dietary quality. Increasing interest has focussed on the concept of access to food and so-called food deserts, defined by a policy working group of the UK Low Income Project Team in 1995 as "areas of relative exclusion where people experience physical and economic barriers to accessing healthy food". We aimed to establish the accessibility of food retail outlets in County Durham, a county in north-east England, UK, considering physical access, affordability, and food range and quality. In a pragmatic cross-sectional study in County Durham, we used information from town surveys and food business databases to locate and identify food retail outlets. The prevalence of deprivation, obesity, retail outlets, takeaway outlets, and ratio of retail to takeaway outlets was mapped, to establish local food access, and any associations with deprivation and obesity. The times taken to travel from residences to supermarkets using private car and public transport were also measured. 400 members of the community participated in eight focus groups and commissioned on-street surveys. Focus group transcripts were reviewed alongside the on-street survey responses to identify key issues. Most residents shopped at least weekly for food (n=368, 92%), used a supermarket for their main food shop (372, 93%), travelled for up to 15 min (340, 85%), and used a car for transport (188, 47%). Many survey respondents indicated high levels of satisfaction with food retail outlets (average rating 8·7 out of 10 for agreement with the statement "Overall I am satisfied with the shop where I do my main food shopping"), although financial constraints and transport inconvenience were identified as barriers. Difficulties with food shopping were more widely described in focus groups, and many individuals felt that local shopping provision had declined, with an emergent excess of takeaway outlets. Food retail access was reduced for the disabled, full

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

Intraosseous Vascular Access through the Anterior Mandible – A Cadaver Model Pilot Study

PubMed Central

Goldschalt, Christin; Doll, Sara; Ihle, Brit; Kirsch, Joachim; Mutzbauer, Till Sebastian

2014-01-01

Background Several insertion sites have been described for intraosseous puncture in cases of emergencies when a conventional vascular access cannot be established. This pilot study has been designed to evaluate the feasibility of the mandibular bone for the use of an intraosseous vascular access in a cadaver model. Methodology/Principal Findings 17 dentistry and 16 medical students participating in a voluntary course received a short introduction into the method and subsequently used the battery powered EZ-IO system with a 15 mm cannula for a puncture of the anterior mandible in 33 cadavers. The time needed to perform each procedure was evaluated. India ink was injected into the accesses and during the anatomy course cadavers were dissected to retrace the success or failure of the puncture. Dental students needed 25.5±18.9(mean±standard deviation)s and medical students 33±20.4 s for the procedure (p = 0.18). Floor of mouth extravasation occurred in both groups in 3 cases. Success rates were 82 and 75% (p = 0.93). Conclusions/Significance Despite floor of mouth extravasation of injected fluid into a mandibular intraosseous access might severely complicate this procedure, the anterior mandible may be helpful as an alternative to other intraosseous and intravenous insertion sites when these are not available in medical emergencies. PMID:25405476

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.

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.

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

ERIC Educational Resources Information Center

Parrott, Justin; Lindsay, Beth Daniel

2017-01-01

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

Patient preference for radial versus femoral vascular access for elective coronary procedures: The PREVAS study.

PubMed

Kok, Marlies M; Weernink, Marieke G M; von Birgelen, Clemens; Fens, Anneloes; van der Heijden, Liefke C; van Til, Janine A

2018-01-01

To explore patient preference for vascular access site in percutaneous coronary procedures, the perceived importance of benefits and risks of transradial access (TRA) and transfemoral access (TFA) were assessed. In addition, direct preference for vascular access and preference for shared decision making (SDM) were evaluated. TRA has gained significant ground on TFA during the last decades. Surveys on patient preference have mostly been performed in dedicated TRA trials. In the PREVAS study (Clinicaltrials.gov: NCT02625493) a stated preference elicitation method best-worst scaling (BWS) was used to determine patient preference for six treatment attributes: bleeding, switch of access-site, postprocedural vessel quality, mobilization and comfort, and over-night stay. Based on software-generated treatment scenarios, 142 patients indicated which characteristics they perceived most and least important in treatment choice. Best-minus-Worst scores and attribute importance were calculated. Bleeding risk was considered most important (attribute importance 31.3%), followed by length of hospitalization (22.6%), and mobilization(20.2%). Most patients preferred the approach of their current procedure (85.9%); however, 71.1% of patients with experience with both access routes favored TRA (P < 0.001). Most patients (38.0%) appreciated SDM, balanced between patient and cardiologist. Patients appreciate lower bleeding risk and early ambulation, factors favoring TRA. Previous experience with a single access route has a major impact on preference, while experience with both routes generally resulted in preference for TRA. Most patients prefer balanced SDM. © 2017 The Authors Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc. © 2017 The Authors Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc.

Accessible Earth: Enhancing diversity in the Geosciences through accessible course design

NASA Astrophysics Data System (ADS)

Bennett, R. A.; Lamb, D. A.

2017-12-01

The tradition of field-based instruction in the geoscience curriculum, which culminates in a capstone geological field camp, presents an insurmountable barrier to many disabled students who might otherwise choose to pursue geoscience careers. There is a widespread perception that success as a practicing geoscientist requires direct access to outcrops and vantage points available only to those able to traverse inaccessible terrain. Yet many modern geoscience activities are based on remotely sensed geophysical data, data analysis, and computation that take place entirely from within the laboratory. To challenge the perception of geoscience as a career option only for the non-disabled, we have created the capstone Accessible Earth Study Abroad Program, an alternative to geologic field camp for all students, with a focus on modern geophysical observation systems, computational thinking, data science, and professional development.In this presentation, we will review common pedagogical approaches in geosciences and current efforts to make the field more inclusive. We will review curricular access and inclusivity relative to a wide range of learners and provide examples of accessible course design based on our experiences in teaching a study abroad course in central Italy, and our plans for ongoing assessment, refinement, and dissemination of the effectiveness of our efforts.

Fulfilling an Institutional and Public Good Mission: A Case Study of Access

ERIC Educational Resources Information Center

Batman, Renee F.

2013-01-01

Access to higher education has been and remains a critical issue, yet research typically focuses on students and programs which may overlook the role of the faculty. Through an in-depth case study, the perspectives of tenured and tenure-track faculty at a predominately White, Midwestern land-grant, research institution are described as they relate…

Association of State Access Standards With Accessibility to Specialists for Medicaid Managed Care Enrollees.

PubMed

Ndumele, Chima D; Cohen, Michael S; Cleary, Paul D

2017-10-01

Medicaid recipients have consistently reported less timely access to specialists than patients with other types of coverage. By 2018, state Medicaid agencies will be required by the Center for Medicare and Medicaid Services (CMS) to enact time and distance standards for managed care organizations to ensure an adequate supply of specialist physicians for enrollees; however, there have been no published studies of whether these policies have significant effects on access to specialty care. To compare ratings of access to specialists for adult Medicaid and commercial enrollees before and after the implementation of specialty access standards. We used Consumer Assessment of Healthcare Providers and Systems survey data to conduct a quasiexperimental difference-in-differences (DID) analysis of 20 163 nonelderly adult Medicaid managed care (MMC) enrollees and 54 465 commercially insured enrollees in 5 states adopting access standards, and 37 290 MMC enrollees in 5 matched states that previously adopted access standards. Reported access to specialty care in the previous 6 months. Seven thousand six hundred ninety-eight (69%) Medicaid enrollees and 28 423 (75%) commercial enrollees reported that it was always or usually easy to get an appointment with a specialist before the policy implementation (or at baseline) compared with 11 889 (67%) of Medicaid enrollees in states that had previously implemented access standards. Overall, there was no significant improvement in timely access to specialty services for MMC enrollees in the period following implementation of standard(s) (adjusted difference-in-differences, -1.2 percentage points; 95% CI, -2.7 to 0.1), nor was there any impact of access standards on insurance-based disparities in access (0.6 percentage points; 95% CI, -4.3 to 5.4). There was heterogeneity across states, with 1 state that implemented both time and distance standards demonstrating significant improvements in access and reductions in disparities

Access Barriers to Dental Health Care in Children with Disability. A Questionnaire Study of Parents.

PubMed

Gerreth, Karolina; Borysewicz-Lewicka, Maria

2016-03-01

A patient's with disability everyday life is rife with many limitations such as architectural, transport, information as well as medical, psychological, legal, economic and social barriers. The aim of this study was to evaluate access to dental health care of special-care schoolchildren with intellectual disability on the basis of their parents' opinion. A questionnaire survey was carried out among 264 parents/caregivers of children from eight special-care schools in Poznan (Poland). Close-ended questions concerned children's barriers in access to dental care and parents' satisfaction with their children's dental care. Only 31.8% parents/caregivers did not have any problems with access to dental care and the most commonly reported barrier to obtaining dental care was protracted waiting time for a visit (36.7%). Most commonly, children were treated in dental surgery conditions (90.1%). Only 42.1% respondents were satisfied with their children's dental care. The research revealed that there is a need to improve the access of children with disability to dental care. Hence, it seems to be beneficial to set up specialist dental surgeries in special-care schools which would improve the access of children with disability to prophylaxis as well as dental treatment. © 2015 John Wiley & Sons Ltd.

Video game access, parental rules, and problem behavior: a study of boys with autism spectrum disorder.

PubMed

Engelhardt, Christopher R; Mazurek, Micah O

2014-07-01

Environmental correlates of problem behavior among individuals with autism spectrum disorder remain relatively understudied. The current study examined the contribution of in-room (i.e. bedroom) access to a video game console as one potential correlate of problem behavior among a sample of 169 boys with autism spectrum disorder (ranging from 8 to 18 years of age). Parents of these children reported on (1) whether they had specific rules regulating their child's video game use, (2) whether their child had in-room access to a variety of screen-based media devices (television, computer, and video game console), and (3) their child's oppositional behaviors. Multivariate regression models showed that in-room access to a video game console predicted oppositional behavior while controlling for in-room access to other media devices (computer and television) and relevant variables (e.g. average number of video game hours played per day). Additionally, the association between in-room access to a video game console and oppositional behavior was particularly large when parents reported no rules on their child's video game use. The current findings indicate that both access and parental rules regarding video games warrant future experimental and longitudinal research as they relate to problem behavior in boys with autism spectrum disorder. © The Author(s) 2013.

Informal workers and access to healthcare: a qualitative study of facilitators and barriers to accessing healthcare for beer promoters in the Lao People's Democratic Republic.

PubMed

Sychareun, Vanphanom; Vongxay, Viengnakhone; Thammavongsa, Vassana; Thongmyxay, Souksamone; Phummavongsa, Phouthong; Durham, Jo

2016-04-18

Informal workers often face considerable risks and vulnerabilities as a consequence of their work and employment conditions. The purpose of this study was to examine the interplay between the experience of informal work and access to health, using as an example, female beer promoters employed in the informal economy, in the Lao People's Democratic Republic. In-depth interviews were undertaken with 24 female beer promoters working in beer shops, restaurants and entertainment venues in Vientiane City. The recruitment strategy of snowball sampling was used. Interviews explored the beer promoter's experience of the organization of work, perceived healthcare needs, access to healthcare and insurance, and health seeking practices. The data was analysed thematically and subsequently using Bourdieu's concepts of habitus, capital and field. Most of the beer promoters included in the study were 18 years of age, single, had worked as beer promoters for more than one year and just over half were working to support their higher education. The beer promoters demonstrated a holistic view of health, also viewing good health as contributing to being beautiful - an important attribute in their work. Many reported that their work conditions, including the noisy environment, exposure to second-hand tobacco smoke, long hours on their feet and sexual harassment negatively affected their physical and mental health. Only four participants had any form of health insurance with access to healthcare constrained by individual characteristics, health system factors and the conditions of their informal employment. Drawing on the work of Bourdieu, the study shows how both employment and illness are linked to habitus embodied in everyday practices, access to capital and the position the female beer promoters hold in the social hierarchy in the field of employment.

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

Using a journal availability study to improve access.

PubMed

Shaw-Kokot, J; de la Varre, C

2001-01-01

Identify journal collection access and use factors. University of North Carolina at Chapel Hill's Health Sciences Library patrons. Survey forms and user interactions were monitored once a week for twelve weeks during the fall 1997 semester. The project was based on a 1989 New Mexico State University study and used Kantor's Branching Analysis to measure responses. 80% of reported sought journal articles were found successfully. Along with journal usage data, the library obtained demographic and behavioral information. Journals are the library's most used resource and, even as more electronic journals are offered, print journals continue to make up the majority of the collection. Several factors highlighted the need to study journal availability. User groups indicated that finding journals was problematic, and internal statistics showed people requesting interlibrary loans for owned items. The study looked at success rates, time, and ease of finding journals. A variety of reasons contributed to not finding journals. While overall user reports indicated relatively high success rate and satisfaction, there were problems to be addressed. As the library proceeds in redesigning both the physical space and electronic presence, the collected data have provided valuable direction.

Rural women and violence situation: access and accessibility limits to the healthcare network.

PubMed

Costa, Marta Cocco da; Silva, Ethel Bastos da; Soares, Joannie Dos Santos Fachinelli; Borth, Luana Cristina; Honnef, Fernanda

2017-07-13

To analyze the access and accessibility to the healthcare network of women dwelling in rural contexts undergoing violence situation, as seen from the professionals' speeches. A qualitative, exploratory, descriptive study with professionals from the healthcare network services about coping with violence in four municipalities in the northern region of Rio Grande do Sul. The information derived from interviews, which have been analyzed by thematic modality. (Lack of) information of women, distance, restricted access to transportation, dependence on the partner and (lack of) attention by professionals to welcome women undergoing violence situation and (non)-articulation of the network are factors that limit the access and, as a consequence, they result in the lack of confrontation of this problem. To bring closer the services which integrate the confrontation network of violence against women and to qualify professionals to welcome these situations are factors that can facilitate the access and adhesion of rural women to the services.

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

PubMed Central

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

2016-01-01

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

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.

The availability and accessibility of basic concept vocabulary in AAC software: a preliminary study.

PubMed

McCarthy, Jillian H; Schwarz, Ilsa; Ashworth, Morgan

2017-09-01

Core vocabulary lists obtained through the analyses of children's utterances include a variety of basic concept words. Supporting young children who use augmentative and alternative communication (AAC) to develop their understanding and use of basic concepts is an area of practice that has important ramifications for successful communication in a classroom environment. This study examined the availability of basic concept words across eight frequently used, commercially available AAC language systems, iPad© applications, and symbol libraries used to create communication boards. The accessibility of basic concept words was subsequently examined using two AAC language page sets and two iPad applications. Results reveal that the availability of basic concept words represented within the different AAC language programs, iPad applications, and symbol libraries varied but was limited across programs. However, there is no significant difference in the accessibility of basic concept words across the language program page sets or iPad applications, generally because all of them require sophisticated motor and cognitive plans for access. These results suggest that educators who teach or program vocabulary in AAC systems need to be mindful of the importance of basic concept words in classroom settings and, when possible, enhance the availability and accessibility of these words to users of AAC.

Does Technical Success of Angioplasty in Dysfunctional Hemodialysis Accesses Correlate with Access Patency?

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

Sidhu, Arshdeep; Tan, Kong T.; Noel-Lamy, Maxime

2016-10-15

PurposeTo study if <30 % residual stenosis post angioplasty (PTA) correlates with primary access circuit patency, and if any variables predict technical success.Materials and MethodsA prospective observational study was performed between January 2009 and December 2012, wherein 76 patients underwent 154 PTA events in 56 prosthetic grafts (AVG) and 98 autogenous fistulas (AVF). Data collected included patient age, gender, lesion location and laterality, access type and location, number of prior interventions, and transonic flow rates pre- and postintervention. Impact of technical outcome on access patency was assessed. Univariate logistic regression was used to assess the impact of variables on technical success withmore » significant factors assessed with a multiple variable model.ResultsTechnical success rates of PTA in AVFs and AVGs were 79.6 and 76.7 %, respectively. Technical failures of PTA were associated with an increased risk of patency loss among circuits with AVFs (p < 0.05), but not with AVGs (p = 0.7). In AVFs, primary access patency rates between technical successes and failures at three and 6 months were 74.4 versus 61.9 % (p = 0.3) and 53.8 versus 23.8 % (p < 0.05), respectively. In AVGs, primary access patency rates between technical successes and failures at three and six months were 72.1 versus 53.9 % (p = 0.5) and 33.6 versus 38.5 % (p = 0.8), respectively. Transonic flow rates did not significantly differ among technically successful or failed outcomes at one or three months.ConclusionTechnical failures of PTA had a significant impact on access patency among AVFs with a trend toward poorer access patency within AVGs.« less

Does Technical Success of Angioplasty in Dysfunctional Hemodialysis Accesses Correlate with Access Patency?

PubMed

Sidhu, Arshdeep; Tan, Kong T; Noel-Lamy, Maxime; Simons, Martin E; Rajan, Dheeraj K

2016-10-01

To study if <30 % residual stenosis post angioplasty (PTA) correlates with primary access circuit patency, and if any variables predict technical success. A prospective observational study was performed between January 2009 and December 2012, wherein 76 patients underwent 154 PTA events in 56 prosthetic grafts (AVG) and 98 autogenous fistulas (AVF). Data collected included patient age, gender, lesion location and laterality, access type and location, number of prior interventions, and transonic flow rates pre- and postintervention. Impact of technical outcome on access patency was assessed. Univariate logistic regression was used to assess the impact of variables on technical success with significant factors assessed with a multiple variable model. Technical success rates of PTA in AVFs and AVGs were 79.6 and 76.7 %, respectively. Technical failures of PTA were associated with an increased risk of patency loss among circuits with AVFs (p < 0.05), but not with AVGs (p = 0.7). In AVFs, primary access patency rates between technical successes and failures at three and 6 months were 74.4 versus 61.9 % (p = 0.3) and 53.8 versus 23.8 % (p < 0.05), respectively. In AVGs, primary access patency rates between technical successes and failures at three and six months were 72.1 versus 53.9 % (p = 0.5) and 33.6 versus 38.5 % (p = 0.8), respectively. Transonic flow rates did not significantly differ among technically successful or failed outcomes at one or three months. Technical failures of PTA had a significant impact on access patency among AVFs with a trend toward poorer access patency within AVGs.

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.

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

PubMed

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

2016-02-01

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

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.

National Study of Changes in Community Access to School Physical Activity Facilities: The School Health Policies and Programs Study

PubMed Central

Evenson, Kelly R.; Wen, Fang; Lee, Sarah M.; Heinrich, Katie M.; Eyler, Amy

2016-01-01

Background A Healthy People 2010 developmental objective (22-12) was set to increase the proportion of the nation’s public and private schools that provide access to their physical activity spaces and facilities for all persons outside of normal school hours. The purpose of this study was to describe the prevalence of indoor and outdoor facilities at schools and the availability of those facilities to the public in 2000 and 2006. Methods In 2000 and 2006, the School Health Policies and Programs Study (SHPPS) was conducted in each state and in randomly selected districts, schools, and classrooms. This analysis focused on the school level questionnaire from a nationally representative sample of public and nonpublic elementary, middle, and high schools (n = 921 in 2000 and n = 984 in 2006). Results No meaningful changes in the prevalence of access to school physical activity facilities were found from 2000 to 2006, for youth or adult community sports teams, classes, or open gym. Conclusions These national data indicate a lack of progress from 2000 and 2006 toward increasing the proportion of the nation’s public and private schools that provide access to their physical activity facilities for all persons outside of normal school hours. PMID:20440007

Underage Drinking, Group Identity and Access to Alcohol: A Qualitative Study of Chinese Youths

ERIC Educational Resources Information Center

Yoon, S.; Lam, W. W. T.; Sham, J. T. L.; Lam, T. H.

2017-01-01

Despite substantial research into underage youth's source of alcohol, few studies have examined how they go about obtaining alcohol through various means. This study explored the nature of alcohol access by Chinese adolescents and how their own perceptions around alcohol availability influence them to source alcohol in particular ways. This…

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…

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

NASA Astrophysics Data System (ADS)

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

2013-12-01

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

Expanding Access: An Evaluation of ReadCube Access as an ILL Alternative.

PubMed

Grabowsky, Adelia

2016-01-01

ReadCube Access is a patron-driven, document delivery system that provides immediate access to articles from journals owned by Nature Publishing Group. The purpose of this study was to evaluate the use of ReadCube Access as an interlibrary loan (ILL) alternative for nonsubscribed Nature journals at Auburn University, a research university with a School of Pharmacy and a School of Veterinary Medicine. An analysis of ten months' usage and costs are presented along with the results of a user satisfaction survey. Auburn University Libraries found ReadCube to be an acceptable alternative to ILL for unsubscribed Nature journals and at current levels of use and cost, consider ReadCube to be financially sustainable.

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.

Preliminary access routes and cost study analyses for seven potentially acceptable salt sites: Final report, October 1984

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

Not Available

1987-02-01

This report analyzes highway and railroad access to seven potentially acceptable salt repository sites: Richton Dome and Cypress Creek Dome in Mississippi, Vacherie Dome in Louisiana, Swisher County and Deaf Smith County in Texas, and Davis Canyon and Lavender Canyon in utah. The objectives of the study were to investigate the routing of reasonable access corridors to the sites, describe major characteristics of each route, and estimate the costs for constructing or upgrading highways and railroads. The routes used in the analysis are not necessarily recommended or preferred over other routes, nor do they represent an implied final selection. Detailedmore » engineering studies must be performed for the Davis Canyon and Lavender Canyon highway access before the analyzed routes can be considered to be viable. 20 refs., 7 figs., 3 tabs.« less

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

PubMed

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

2013-11-27

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

[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.

A cross-sectional ecological study of spatial scale and geographic inequality in access to drinking-water and sanitation.

PubMed

Yu, Weiyu; Bain, Robert E S; Mansour, Shawky; Wright, Jim A

2014-11-26

Measuring inequality in access to safe drinking-water and sanitation is proposed as a component of international monitoring following the expiry of the Millennium Development Goals. This study aims to evaluate the utility of census data in measuring geographic inequality in access to drinking-water and sanitation. Spatially referenced census data were acquired for Colombia, South Africa, Egypt, and Uganda, whilst non-spatially referenced census data were acquired for Kenya. Four variants of the dissimilarity index were used to estimate geographic inequality in access to both services using large and small area units in each country through a cross-sectional, ecological study. Inequality was greatest for piped water in South Africa in 2001 (based on 53 areas (N) with a median population (MP) of 657,015; D = 0.5599) and lowest for access to an improved water source in Uganda in 2008 (N = 56; MP = 419,399; D = 0.2801). For sanitation, inequality was greatest for those lacking any facility in Kenya in 2009 (N = 158; MP = 216,992; D = 0.6981), and lowest for access to an improved facility in Uganda in 2002 (N = 56; MP = 341,954; D = 0.3403). Although dissimilarity index values were greater for smaller areal units, when study countries were ranked in terms of inequality, these ranks remained unaffected by the choice of large or small areal units. International comparability was limited due to definitional and temporal differences between censuses. This five-country study suggests that patterns of inequality for broad regional units do often reflect inequality in service access at a more local scale. This implies household surveys designed to estimate province-level service coverage can provide valuable insights into geographic inequality at lower levels. In comparison with household surveys, censuses facilitate inequality assessment at different spatial scales, but pose challenges in harmonising water and sanitation typologies across countries.

Improved access to life insurance after genetic diagnosis of familial hypercholesterolaemia: cross-sectional postal questionnaire study

PubMed Central

Huijgen, Roeland; Homsma, Sietske JM; Hutten, Barbara A; Kindt, Iris; Vissers, Maud N; Kastelein, John JP; van Rijckevorsel, Jan LA

2012-01-01

A decade ago, in the initial stage of genetic testing for familial hypercholesterolaemia (FH) in The Netherlands, it was reported that such screening decreased access to affordable life insurance for mutation carriers. In 2003, in order to improve access to insurance for FH mutation carriers, insurers agreed to underwrite according to a set of guidelines. In this cross-sectional study, we assessed whether access to insurance has improved since the advent of these guidelines. We approached 2825 subjects that had participated in the genetic testing for FH between 1998 and 2003. We compared unconditional acceptance rates before and after FH diagnosis and before and after the guidelines were issued by means of logistic regression analysis. Our study outcome pertains to 414 FH patients who applied for life insurance. Unconditional acceptance of a policy before DNA diagnosis and before the issue of guidelines occurred in 182 out of 255 (71%) cases, versus 27 out of 35 (77%) cases after DNA diagnosis, but before the issue of guidelines. De facto, 107 out of 124 (86%) patients received unconditional acceptance after DNA diagnosis and after the issue of guidelines (P for trend=0.002). Access to life insurance improved for FH patients after molecular diagnosis and it improved even further after the guidelines were issued. Therefore, we argue that limited access to life insurance on the basis of ‘DNA discrimination' is no longer a valid argument against genetic cascade testing for FH, at least not in our country. PMID:22293687

Delivering accessible fieldwork: preliminary findings from a collaborative international study

NASA Astrophysics Data System (ADS)

Stokes, Alison; Atchison, Christopher; Feig, Anthony; Gilley, Brett

2017-04-01

Students with disabilities are commonly excluded from full participation in geoscience programs, and encounter significant barriers when accessing field-learning experiences. In order to increase talent and diversity in the geoscience workforce, more inclusive learning experiences must be developed that will enable all students to complete the requirements of undergraduate degree programs, including fieldwork. We discuss the outcomes of a completely accessible field course developed through the collaborative effort of geoscience education practitioners from the US, Canada and the UK. This unique field workshop has brought together current geoscience academics and students with disabilities to share perspectives on commonly-encountered barriers to learning in the field, and explore methods and techniques for overcoming them. While the student participants had the opportunity to learn about Earth processes while situated in the natural environment, participating geoscience instructors began to identify how to improve the design of field courses, making them fully inclusive of learners with disabilities. The outcomes from this experience will be used to develop guidelines to facilitate future development and delivery of accessible geoscience fieldwork.

Understanding delayed access to antenatal care: a qualitative interview study

PubMed Central

2014-01-01

Background Delayed access to antenatal care ('late booking’) has been linked to increased maternal and fetal mortality and morbidity. The aim of this qualitative study was to understand why some women are late to access antenatal care. Methods 27 women presenting after 19 completed weeks gestation for their first hospital booking appointment were interviewed, using a semi-structured format, in community and maternity hospital settings in South Yorkshire, United Kingdom. Interviews were transcribed verbatim and entered onto NVivo 8 software. An interdisciplinary, iterative, thematic analysis was undertaken. Results The late booking women were diverse in terms of: age (15–37 years); parity (0–4); socioeconomic status; educational attainment and ethnicity. Three key themes relating to late booking were identified from our data: 1) 'not knowing’: realisation (absence of classic symptoms, misinterpretation); belief (age, subfertility, using contraception, lay hindrance); 2) 'knowing’: avoidance (ambivalence, fear, self-care); postponement (fear, location, not valuing care, self-care); and 3) 'delayed’ (professional and system failures, knowledge/empowerment issues). Conclusions Whilst vulnerable groups are strongly represented in this study, women do not always fit a socio-cultural stereotype of a 'late booker’. We report a new taxonomy of more complex reasons for late antenatal booking than the prevalent concepts of denial, concealment and disadvantage. Explanatory sub-themes are also discussed, which relate to psychological, empowerment and socio-cultural factors. These include poor reproductive health knowledge and delayed recognition of pregnancy, the influence of a pregnancy 'mindset’ and previous pregnancy experience, and the perceived value of antenatal care. The study also highlights deficiencies in early pregnancy diagnosis and service organisation. These issues should be considered by practitioners and service commissioners in order to promote

Creating a Culture of Access in Composition Studies

ERIC Educational Resources Information Center

Brewer, Elizabeth; Selfe, Cynthia L.; Yergeau, Melanie

2014-01-01

While the teaching profession has long been committed to the goal of accessibility, the movement toward that goal has proved dismally slow and frustratingly uneven. Consider, for instance, the printed articles and books that so many educators publish. They have not, as yet, taken on the professional responsibility of making sure that all such…

Does improved access to diagnostic imaging results reduce hospital length of stay? A retrospective study

PubMed Central

2010-01-01

Background One year after the introduction of Information and Communication Technology (ICT) to support diagnostic imaging at our hospital, clinicians had faster and better access to radiology reports and images; direct access to Computed Tomography (CT) reports in the Electronic Medical Record (EMR) was particularly popular. The objective of this study was to determine whether improvements in radiology reporting and clinical access to diagnostic imaging information one year after the ICT introduction were associated with a reduction in the length of patients' hospital stays (LOS). Methods Data describing hospital stays and diagnostic imaging were collected retrospectively from the EMR during periods of equal duration before and one year after the introduction of ICT. The post-ICT period was chosen because of the documented improvement in clinical access to radiology results during that period. The data set was randomly split into an exploratory part used to establish the hypotheses, and a confirmatory part. The data was used to compare the pre-ICT and post-ICT status, but also to compare differences between groups. Results There was no general reduction in LOS one year after ICT introduction. However, there was a 25% reduction for one group - patients with CT scans. This group was heterogeneous, covering 445 different primary discharge diagnoses. Analyses of subgroups were performed to reduce the impact of this divergence. Conclusion Our results did not indicate that improved access to radiology results reduced the patients' LOS. There was, however, a significant reduction in LOS for patients undergoing CT scans. Given the clinicians' interest in CT reports and the results of the subgroup analyses, it is likely that improved access to CT reports contributed to this reduction. PMID:20819224

Using a journal availability study to improve access

PubMed Central

Shaw-Kokot, Julia; de la Varre, Claire

2001-01-01

Purpose: Identify journal collection access and use factors. Setting and Subjects: University of North Carolina at Chapel Hill's Health Sciences Library patrons. Methodology: Survey forms and user interactions were monitored once a week for twelve weeks during the fall 1997 semester. The project was based on a 1989 New Mexico State University study and used Kantor's Branching Analysis to measure responses. Result: 80% of reported sought journal articles were found successfully. Along with journal usage data, the library obtained demographic and behavioral information. Discussion and Conclusions: Journals are the library's most used resource and, even as more electronic journals are offered, print journals continue to make up the majority of the collection. Several factors highlighted the need to study journal availability. User groups indicated that finding journals was problematic, and internal statistics showed people requesting interlibrary loans for owned items. The study looked at success rates, time, and ease of finding journals. A variety of reasons contributed to not finding journals. While overall user reports indicated relatively high success rate and satisfaction, there were problems to be addressed. As the library proceeds in redesigning both the physical space and electronic presence, the collected data have provided valuable direction. PMID:11209797

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

Access to green space, physical activity and mental health: a twin study.

PubMed

Cohen-Cline, Hannah; Turkheimer, Eric; Duncan, Glen E

2015-06-01

Increasing global urbanisation has resulted in a greater proportion of the world's population becoming exposed to risk factors unique to urban areas, and understanding these effects on public health is essential. The aim of this study was to examine the association between access to green space and mental health among adult twin pairs. We used a multilevel random intercept model of same-sex twin pairs (4338 individuals) from the community-based University of Washington Twin Registry to analyse the association between access to green space, as measured by the Normalised Difference Vegetation Index and self-reported depression, stress, and anxiety. The main parameter of interest was the within-pair effect for identical (monozygotic, MZ) twins because it was not subject to confounding by genetic or shared childhood environment factors. Models were adjusted for income, physical activity, neighbourhood deprivation and population density. When treating twins as individuals and not as members of a twin pair, green space was significantly inversely associated with each mental health outcome. The association with depression remained significant in the within-pair MZ univariate and adjusted models; however, there was no within-pair MZ effect for stress or anxiety among the models adjusted for income and physical activity. These results suggest that greater access to green space is associated with less depression, but provide less evidence for effects on stress or anxiety. Understanding the mechanisms linking neighbourhood characteristics to mental health has important public health implications. Future studies should combine twin designs and longitudinal data to strengthen causal inference. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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

PubMed Central

2012-01-01

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

Local Music Collections: Strategies for Digital Access, Presentation, and Preservation--A Case Study

ERIC Educational Resources Information Center

Doi, Carolyn

2015-01-01

The Saskatchewan Music Collection (SMC) is a local music collection held at the University of Saskatchewan. This case study examines a project to digitize and present this unique special collection in the online environment. The project aims to facilitate access to the collection, preserve the collection and promote scholarship and interest in the…

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…

Transportation Limitation Access to the Small Islands (Case Study: Banggai Laut Regency)

NASA Astrophysics Data System (ADS)

Sunarti, S.

2018-02-01

Indonesia is as an archipelago and maritime country, the large number of Islands owned and scattered in all directions makes a challenge for the Government in equitable development. Development in Indonesia has not been spread evenly and tends to focus on the big island, while the smaller islands are still far behind and lack of government attention. One of them is the lack of infrastructure especially the access to the small islands. Among the small islands in Indonesia with minimal maritime infrastructure or transportation is Banggai Laut Regency, Central Sulawesi Province. This Regency is a new regency that separate itself from its previous regency that is Banggai Kepulauan Regency in about 4 years ago. For the development of the Banggai Laut Regency, access to reach that regency is quite difficult. Therefore, the aim of this research is to find infrastructure development strategy to support the development of Banggai Laut Regency. The research method used was the concurrent model mixed method. Data collection method was done with primary data through field observation and interview, secondary data through literature and document review. Analytical techniques used are qualitative descriptive and Map Overlay techniques using GIS to describe the characteristics of study areas and spatial relationships between islands. The results of this research conclude that the Banggai Laut Regency requires infrastructure development particularly maritime transportation to enhance accessibility of the community headed to Banggi Laut Regency or headed to another island from the Banggai Laut Regency.

Hemodialysis access - self care

MedlinePlus

Kidney failure - chronic-hemodialysis access; Renal failure - chronic-hemodialysis access; Chronic renal insufficiency - hemodialysis access; Chronic kidney failure - hemodialysis access; Chronic renal failure - hemodialysis access; dialysis - hemodialysis access

Potential impact of public access defibrillators on survival after out of hospital cardiopulmonary arrest: retrospective cohort study

PubMed Central

Pell, Jill P; Sirel, Jane M; Marsden, Andrew K; Ford, Ian; Walker, Nicola L; Cobbe, Stuart M

2002-01-01

Objective To estimate the potential impact of public access defibrillators on overall survival after out of hospital cardiac arrest. Design Retrospective cohort study using data from an electronic register. A statistical model was used to estimate the effect on survival of placing public access defibrillators at suitable or possibly suitable sites. Setting Scottish Ambulance Service. Subjects Records of all out of hospital cardiac arrests due to heart disease in Scotland in 1991-8. Main outcome measures Observed and predicted survival to discharge from hospital. Results Of 15 189 arrests, 12 004 (79.0%) occurred in sites not suitable for the location of public access defibrillators, 453 (3.0%) in sites where they may be suitable, and 2732 (18.0%) in suitable sites. Defibrillation was given in 67.9% of arrests that occurred in possibly suitable sites for locating defibrillators and in 72.9% of arrests that occurred in suitable sites. Compared with an actual overall survival of 744 (5.0%), the predicted survival with public access defibrillators ranged from 942 (6.3%) to 959 (6.5%), depending on the assumptions made regarding defibrillator coverage. Conclusions The predicted increase in survival from targeted provision of public access defibrillators is less than the increase achievable through expansion of first responder defibrillation to non-ambulance personnel, such as police or firefighters, or of bystander cardiopulmonary resuscitation. Additional resources for wide scale coverage of public access defibrillators are probably not justified by the marginal improvement in survival. What is already known on this topicThree quarters of all deaths from acute coronary events occur before the patient reaches a hospitalDefibrillation is an independent predictor of survival from out of hospital cardiac arrestThe probability of a rhythm being amenable to defibrillation declines with timeInterest in providing public access defibrillators to reduce the time to

Accessible Geoscience - Digital Fieldwork

NASA Astrophysics Data System (ADS)

Meara, Rhian

2017-04-01

Accessible Geoscience is a developing field of pedagogic research aimed at widening participation in Geography, Earth and Environmental Science (GEES) subjects. These subjects are often less commonly associated with disabilities, ethnic minorities, low income socio-economic groups and females. While advancements and improvements have been made in the inclusivity of these subject areas in recent years, access and participation of disabled students remains low. While universities are legally obligated to provide reasonable adjustments to ensure accessibility, the assumed incompatibility of GEES subjects and disability often deters students from applying to study these courses at a university level. Instead of making reasonable adjustments if and when they are needed, universities should be aiming to develop teaching materials, spaces and opportunities which are accessible to all, which in turn will allow all groups to participate in the GEES subjects. With this in mind, the Swansea Geography Department wish to enhance the accessibility of our undergraduate degree by developing digital field work opportunities. In the first instance, we intend to digitise three afternoon excursions which are run as part of a 1st year undergraduate module. Each of the field trips will be digitized into English- and Welsh-medium formats. In addition, each field trip will be digitized into British Sign Language (BSL) to allow for accessibility for D/deaf and hard of hearing students. Subtitles will also be made available in each version. While the main focus of this work is to provide accessible fieldwork opportunities for students with disabilities, this work also has additional benefits. Students within the Geography Department will be able to revisit the field trips, to revise and complete associated coursework. The use of digitized field work should not replace opportunities for real field work, but its use by the full cohort of students will begin to "normalize" accessible field

Demand and access to mental health services: a qualitative formative study in Nepal.

PubMed

Brenman, Natassia F; Luitel, Nagendra P; Mall, Sumaya; Jordans, Mark J D

2014-08-02

Nepal is experiencing a significant 'treatment gap' in mental health care. People with mental disorders do not always receive appropriate treatment due to a range of structural and individual issues, including stigma and poverty. The PRIME (Programme for Improving Mental Health Care) programme has developed a mental health care plan to address this issue in Nepal and four other low and middle income countries. This study aims to inform the development of this comprehensive care plan by investigating the perceptions of stakeholders at different levels of the care system in the district of Chitwan in southern Nepal: health professionals, lay workers and community members. It focuses specifically on issues of demand and access to care, and aims to identify barriers and potential solutions for reaching people with priority mental disorders. This qualitative study consisted of key informant interviews (33) and focus group discussions (83 participants in 9 groups) at community and health facility levels. Data were analysed using a framework analysis approach. As well as pragmatic barriers at the health facility level, mental health stigma and certain cultural norms were found to reduce access and demand for services. Respondents perceived the lack of awareness about mental health problems to be a major problem underlying this, even among those with high levels of education or status. They proposed strategies to improve awareness, such as channelling education through trusted and respected community figures, and responding to the need for openness or privacy in educational programmes, depending on the issue at hand. Adapting to local perceptions of stigmatised treatments emerged as another key strategy to improve demand. This study identifies barriers to accessing care in Nepal that reach beyond the health facility and into the social fabric of the community. Stakeholders in PRIME's integrated care plan advocate strategic awareness raising initiatives to improve the reach

Restrictive Access to Books in School Library Media Centers in Georgia. Research Study.

ERIC Educational Resources Information Center

DuPree, Vi

This study sought to determine the extent of restrictive access to books in Georgia school library media centers and to discover by whose authority and for what reason these books might be placed on restrictive shelves. Questionnaires were completed and received from a stratified random sampling of 119 media specialists in high schools, middle or…

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

A national study of neighbourhood access to gambling opportunities and individual gambling behaviour.

PubMed

Pearce, J; Mason, K; Hiscock, R; Day, P

2008-10-01

To investigate associations between neighbourhood accessibility to gambling outlets (non-casino gaming machine locations, sports betting venues and casinos) and individual gambling behaviour in New Zealand. A Geographical Information Systems (GIS) measure of neighbourhood access to gambling venues. Two-level logistic regression models were fitted to examine the effects of neighbourhood access on individual gambling behaviour after controlling for potential individual- and neighbourhood-level confounding factors. 38,350 neighbourhoods across New Zealand. 12,529 respondents of the 2002/03 New Zealand Health Survey. Compared with those living in the quartile of neighbourhoods with the furthest access to a gambling venue, residents living in the quartile of neighbourhoods with the closest access were more likely (adjusted for age, sex, socio-economic status at the individual-level and deprivation, urban/rural status at the neighbourhood-level) to be a gambler (OR 1.60, 95% CI 1.20 to 2.15) or problem gambler (OR 2.70, 95% CI 1.03 to 7.05). When examined independently, neighbourhood access to venues with non-casino gaming machines (gambling: OR 1.67, 95% CI 1.28 to 2.18; problem gambling: OR 2.71, 95% CI 1.45 to 5.07) and sports betting venues (gambling: OR 1.67, 95% CI 1.28 to 2.18; problem gambling: OR 2.71, 95% CI 1.45 to 5.07) were similarly related. Neighbourhood access to opportunities for gambling is related to gambling and problem gambling behaviour, and contributes substantially to neighbourhood inequalities in gambling over and above-individual level characteristics.

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.

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…

Naturalistic study of guideline implementation tool use via evaluation of website access and physician survey.

PubMed

Armstrong, Melissa J; Gronseth, Gary S; Dubinsky, Richard; Potrebic, Sonja; Penfold Murray, Rebecca; Getchius, Thomas S D; Rheaume, Carol; Gagliardi, Anna R

2017-01-13

Clinical guidelines support decision-making at the point-of-care but the onus is often on individual users such as physicians to implement them. Research shows that the inclusion of implementation tools in or with guidelines (GItools) is associated with guideline use. However, there is little research on which GItools best support implementation by individual physicians. The purpose of this study was to investigate naturalistic access and use of GItools produced by the American Academy of Neurology (AAN) to inform future tool development. Website accesses over six months were summarized for eight AAN guidelines and associated GItools published between July 2012 and August 2013. Academy members were surveyed about use of tools accompanying the sport concussion guideline. Data were analyzed using summary statistics and the Chi-square test. The clinician summary was accessed more frequently (29.0%, p < 0.001) compared with the slide presentation (26.8%), patient summary (23.2%) or case study (20.9%), although this varied by guideline topic. For the sport concussion guideline, which was accompanied by a greater variety of GItools, the mobile phone quick reference check application was most frequently accessed, followed by the clinician summary, patient summary, and slide presentation. For the sports concussion guideline survey, most respondents (response rate 21.8%, 168/797) were aware of the guideline (88.1%) and had read the guideline (78.6%). For GItool use, respondents indicated reading the reference card (51.2%), clinician summary (45.2%), patient summary (28.0%), mobile phone application (26.2%), and coach/athletic trainer summary (20.2%). Patterns of sports concussion GItool use were similar between respondents who said they had and had not yet implemented the guideline. Developers faced with resource limitations may wish to prioritize the development of printable or mobile application clinician summaries, which were accessed significantly more than other

Comparative Study of Periodical Literature Indexing: Print versus Electronic Access. Final Report.

ERIC Educational Resources Information Center

Lowry, Charles B.

This 2-year project at the University of Texas at Arlington (UTA) was conducted to determine the feasibility of providing online periodical indexing to the journal holdings of the UTA libraries by demonstrating an extended use of the libraries' NOTIS Online Public Access Catalog (OPAC) to provide better access to local resources. Three approaches…

Gender-Related Barriers and Delays in Accessing Tuberculosis Diagnostic and Treatment Services: A Systematic Review of Qualitative Studies

PubMed Central

Akande, Tokunbo; Shankar, Anita V.; McIntire, Katherine N.; Gounder, Celine R.; Gupta, Amita; Yang, Wei-Teng

2014-01-01

Background. Tuberculosis (TB) remains a significant global public health problem with known gender-related (male versus female) disparities. We reviewed the qualitative evidence (written/spoken narrative) for gender-related differences limiting TB service access from symptom onset to treatment initiation. Methods. Following a systematic process, we searched 12 electronic databases, included qualitative studies that assessed gender differences in accessing TB diagnostic and treatment services, abstracted data, and assessed study validity. Using a modified “inductive coding” system, we synthesized emergent themes within defined barriers and delays limiting access at the individual and provider/system levels and examined gender-related differences. Results. Among 13,448 studies, 28 studies were included. All were conducted in developing countries and assessed individual-level barriers; 11 (39%) assessed provider/system-level barriers, 18 (64%) surveyed persons with suspected or diagnosed TB, and 7 (25%) exclusively surveyed randomly sampled community members or health care workers. Each barrier affected both genders but had gender-variable nature and impact reflecting sociodemographic themes. Women experienced financial and physical dependence, lower general literacy, and household stigma, whereas men faced work-related financial and physical barriers and community-based stigma. Conclusions. In developing countries, barriers limiting access to TB care have context-specific gender-related differences that can inform integrated interventions to optimize TB services. PMID:24900921

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.

[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.

Flow chemistry kinetic studies reveal reaction conditions for ready access to unsymmetrical trehalose analogues.

PubMed

Patel, Mitul K; Davis, Benjamin G

2010-10-07

Monofunctionalization of trehalose, a widely-found symmetric plant disaccharide, was studied in a microreactor to give valuable kinetic insights that have allowed improvements in desymmetrization yields and the development of a reaction sequence for large scale monofunctionalizations that allow access to probes of trehalose's biological function.

Measuring Land Uses Accessibility by Using Fuzzy Majority Gis-Based Multicriteria Decision Analysis Case Study: Malayer City

NASA Astrophysics Data System (ADS)

Taravat, A.; Yari, A.; Rajaei, M.; Mousavian, R.

2014-10-01

Public spaces accessibility has become one of the important factors in urban planning. Therefore, considerable attention has been given to measure accessibility to public spaces on the UK, US and Canada, but there are few studies outside the anglophone world especially in developing countries such as Iran. In this study an attempt has been made to measure objective accessibility to public spaces (parks, school, library and administrative) using fuzzy majority GIS-based multicriteria decision analysis. This method is for defining the priority for distribution of urban facilities and utilities as the first step towards elimination of social justice. In order to test and demonstrate the presented model, the comprehensive plan of Malayer city has been considered for ranking in three objectives and properties in view of index per capital (Green space, sport facilities and major cultural centers like library and access index). The results can be used to inform the local planning process and the GIS approach can be expanded into other local authority domains. The results shows that the distribution of facilities in Malayer city has followed on the base of cost benefit law and the human aspect of resource allocation programming of facilities (from centre to suburbs of the city).

Utilisation of prehospital intravenous access.

PubMed

Bester, B H; Sobuwa, Simpiwe

2014-07-22

To describe the use of intravenous (IV) therapy in the South African (SA) prehopsital setting, and to determine the proportion of prehopsital cannulations considered unnecessary when graded against the South African Triage Score (SATS) chart. The study was conducted in the prehospital emergency medical care setting in the Western Cape Province, SA. Using a descriptive research design, we looked at the report forms of patients treated and transported by personnel currently employed in the public sector, serving the urban and rural areas stipulated by the municipal boundaries. All medical and trauma cases in which establishment of IV access was documented for the month of April 2013 were included. Interhospital transfers, unsuccessful attempts at IV access and intraosseous cannulation were excluded. When graded against the SATS, prophylactic IV access was not justified in 42.3% of the total number of cases (N=149) in which it was established, and therefore added no direct benefit to the continuum of patient care. It is worth noting that 18.8% (n=39) of the IV lines were utilised for fluid administration, as opposed to 9.2% (n=19) for the administration of IV medications. In view of the paucity of studies indicating a direct benefit of out-of-hospital IV intervention, the practice of precautionary, protocol-driven prophylactic establishment of IV access should be evaluated. Current data suggest that in the absence of scientific evidence, IV access should only be initiated when it will benefit the patient immediately, and precautionary IV access, especially in non-injured patients, should be re-evaluated.

Do new and traditional models of primary care differ with regard to access?: Canadian QUALICOPC study.

PubMed

Miedema, Baukje; Easley, Julie; Thompson, Ashley E; Boivin, Antoine; Aubrey-Bassler, Kris; Katz, Alan; Hogg, William E; Breton, Mylaine; Francoeur, Danièle; Wong, Sabrina T; Wodchis, Walter P

2016-01-01

To examine access to primary care in new and traditional models using 2 dimensions of the concept of patient-centred access. An international survey examining the quality and costs of primary health care (the QUALICOPC study) was conducted in 2013 in Canada. This study adopted a descriptive cross-sectional survey method using data from practices across Canada. Each participating practice filled out the Family Physician Survey and the Practice Survey, and patients in each participating practice were asked to complete the Patient Experiences Survey. All 10 Canadian provinces. A total of 759 practices and 7172 patients. Independent t tests were conducted to examine differences between new and traditional models of care in terms of availability and accommodation, and affordability of care. Of the 759 practices, 407 were identified as having new models of care and 352 were identified as traditional. New models of care were distinct with respect to payment structure, opening hours, and having an interdisciplinary work force. Most participating practices were from large cities or suburban areas. There were few differences between new and traditional models of care regarding accessibility and accommodation in primary care. Patients under new models of care reported easier access to other physicians in the same practice, while patients from traditional models reported seeing their regular family physicians more frequently. There was no difference between the new and traditional models of care with regard to affordability of primary care. Patients attending clinics with new models of care reported that their physicians were more involved with them as a whole person than patients attending clinics based on traditional models did. Primary care access issues do not differ strongly between traditional and new models of care; however, patients in the new models of care believed that their physicians were more involved with them as people.

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...

The AAS Working Group on Accessibility and Disability (WGAD) Year 1 Highlights and Database Access

NASA Astrophysics Data System (ADS)

Knierman, Karen A.; Diaz Merced, Wanda; Aarnio, Alicia; Garcia, Beatriz; Monkiewicz, Jacqueline A.; Murphy, Nicholas Arnold

2017-06-01

The AAS Working Group on Accessibility and Disability (WGAD) was formed in January of 2016 with the express purpose of seeking equity of opportunity and building inclusive practices for disabled astronomers at all educational and career stages. In this presentation, we will provide a summary of current activities, focusing on developing best practices for accessibility with respect to astronomical databases, publications, and meetings. Due to the reliance of space sciences on databases, it is important to have user centered design systems for data retrieval. The cognitive overload that may be experienced by users of current databases may be mitigated by use of multi-modal interfaces such as xSonify. Such interfaces would be in parallel or outside the original database and would not require additional software efforts from the original database. WGAD is partnering with the IAU Commission C1 WG Astronomy for Equity and Inclusion to develop such accessibility tools for databases and methods for user testing. To collect data on astronomical conference and meeting accessibility considerations, WGAD solicited feedback from January AAS attendees via a web form. These data, together with upcoming input from the community and analysis of accessibility documents of similar conferences, will be used to create a meeting accessibility document. Additionally, we will update the progress of journal access guidelines and our social media presence via Twitter. We recommend that astronomical journals form committees to evaluate the accessibility of their publications by performing user-centered usability studies.

Underage access to online alcohol marketing content: a YouTube case study.

PubMed

Barry, Adam E; Johnson, Emily; Rabre, Alexander; Darville, Gabrielle; Donovan, Kristin M; Efunbumi, Orisatalabi

2015-01-01

With the proliferation of the Internet and online social media use, alcohol advertisers are now marketing their products through social media sites such as YouTube, Facebook and Twitter. As a result, new recommendations have been made by the Federal Trade Commission concerning the self-regulation of digital marketing strategies, including content management on social and digital media sites. The current study sought to determine whether alcohol companies were implementing the self-imposed mandates that they have developed for online marketing. Specifically, we examined whether alcohol companies were implementing effective strategies that would prevent persons under the minimum legal drinking age in the USA from accessing their content on YouTube. We assessed 16 alcohol brands (beer and liquor) associated with the highest prevalence of past 30 day underage alcohol consumption in the USA. Fictitious YouTube user profiles were created and assigned the ages of 14, 17 and 19. These profiles then attempted to access and view the brewer-sponsored YouTube channels for each of the 16 selected brands. Every underage profile, regardless of age, was able to successfully subscribe to each of the 16 (100%) official YouTube channels. On average, two-thirds of the brands' channels were successfully viewed (66.67%). Alcohol industry provided online marketing content is predominantly accessible to underage adolescents. Thus, brewers are not following some of the self-developed and self-imposed mandates for online advertising by failing to implement effective age-restriction measures (i.e. age gates). © The Author 2014. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Adding a PECS II block for proximal arm arteriovenous access - a randomised study.

PubMed

Quek, K H; Low, E Y; Tan, Y R; Ong, A S C; Tang, T Y; Kam, J W; Kiew, A S C

2018-05-01

Brachial plexus block is often utilised for proximal arm arteriovenous access creation. However, the medial upper arm and axilla are often inadequately anaesthetised, requiring repeated, intraoperative local anaesthetic supplementation, or conversion into general anaesthesia. We hypothesised that the addition of a PECS II block would improve anaesthesia and analgesia for proximal arm arteriovenous access surgery. In this prospective, double-blinded, randomised proof-of-concept study, 36 consenting adults with end-stage renal disease aged between 21 and 90 years received either a combined supraclavicular and PECS II block (Group PECS, n = 18), or combined supraclavicular and sham block (Group SCB, n = 18) for proximal arm arteriovenous access surgery. Primary outcome was whether patients required intraoperative local anaesthetic supplementation by the surgeon. In Group PECS, 33.3% (6/18) needed local anaesthetic supplementation vs. 100% (18/18) in Group SCB. Group SCB had three times (RR 3.0, 95% CI 1.6-5.8; P < 0.001) the risk of requiring intraoperative local anaesthetic supplementation. Group PECS required lower volume of supplemental local anaesthetic compared to Group SCB (0.0 ml, IQR 0.0-6.3 ml vs. 15.0 ml, IQR 7.4-17.8 ml; P < 0.001). Group SCB had twice [RR 2.2, 95% CI 1.1-4.4; (P = 0.019)] the risk of needing additional sedation or analgesia. There were no significant differences between the groups with respect to postoperative visual analogue scale pain scores, time to first rescue analgesia or patient satisfaction. The results suggest that adding a PECS II block to a supraclavicular block improves regional anaesthesia for patients with end-stage renal disease undergoing proximal arm arteriovenous access surgery. © 2018 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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

PubMed

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

2017-01-01

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

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

PubMed Central

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

2013-01-01

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

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...

Robotic percutaneous access to the kidney: comparison with standard manual access.

PubMed

Su, Li-Ming; Stoianovici, Dan; Jarrett, Thomas W; Patriciu, Alexandru; Roberts, William W; Cadeddu, Jeffrey A; Ramakumar, Sanjay; Solomon, Stephen B; Kavoussi, Louis R

2002-09-01

To evaluate the efficiency, accuracy, and safety of robotic percutaneous access to the kidney (PAKY) for percutaneous nephrolithotomy in comparison with conventional manual techniques. We compared the intraoperative access variables (number of access attempts, time to successful access, estimated blood loss, complications) of 23 patients who underwent robotic PAKY with the remote center of motion device (PAKY-RCM) with the same data from a contemporaneous series of 23 patients who underwent conventional manual percutaneous access to the kidney. The PAKY-RCM incorporates a robotic arm and a friction transmission with axial loading system to accurately position and insert a standard 18-gauge needle percutaneously into the kidney. The blood loss during percutaneous access was estimated on a four-point scale (1 = minimal to 4 = large). The color of effluent urine was graded on a four-point scale (1 = clear to 4 = red). The mean target calix width was 13.5 +/- 9.2 mm in the robotic group and 12.2 +/- 4.5 mm in the manual group (P = 0.57). When comparing PAKY-RCM with standard manual techniques, the mean number of attempts was 2.2 +/- 1.6 v 3.2 +/- 2.5 (P = 0.14), time to access was 10.4 +/- 6.5 minutes v 15.1 +/- 8.8 minutes (P = 0.06), estimated blood loss score was 1.3 +/- 0.49 v 1.7 +/- 0.66 (P = 0.14), and color of effluent urine following access was 2.0 +/- 0.90 v 2.1 +/- 0.7 (P = 0.82). The PAKY-RCM was successful in obtaining access in 87% (20 of 23) of cases. The other three patients (13%) required conversion to manual techniques. There were no major intraoperative complications in either group. Robotic PAKY is a feasible, safe, and efficacious method of obtaining renal access for nephrolithotomy. The number of attempts and time to access were comparable to those of standard manual percutaneous access techniques. These findings provide the groundwork for the development of a completely automated robot-assisted percutaneous renal access device.

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.

Barriers to accessing termination of pregnancy in a remote and rural setting: a qualitative study.

PubMed

Heller, R; Purcell, C; Mackay, L; Caird, L; Cameron, S T

2016-09-01

To explore the experiences of women from a remote and rural setting who had a termination of pregnancy (TOP), in relation to any barriers they may have experienced trying to access TOP. Qualitative interview study. Scottish Highlands and Western Isles. Women who had undergone TOP in the Scottish Highlands National Health Service between October 2014 and May 2015. Sixteen semi-structured, audio-recorded telephone interviews were conducted by a researcher with women who had consented to be interviewed at their initial assessment. Six stages of thematic analysis were followed to explore themes in and across participant accounts. Themes derived from interview transcripts. Four themes emerged relating to barriers to access and experience: (1) the impact of travel for TOP, (2) temporal factors unique to this population and how they affected women, (3) the attitude of health professionals, notably general practitioners, as a result of local culture, and (4) stigma surrounding TOP and the expectation that abortion will be traumatising. Women in remote and rural areas experience barriers to accessing TOP. Prompt referrals, more providers of TOP and tackling stigma associated with TOP could make delivery of this service more equitable and improve women's journey through TOP. Women in remote and rural areas of Scotland face multiple barriers to accessing termination of pregnancy. © 2016 Royal College of Obstetricians and Gynaecologists.

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.

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.

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

ERIC Educational Resources Information Center

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

2012-01-01

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

Knowing, Acting and Being: Epistemological and Ontological Access in a Science Extended Studies Course

ERIC Educational Resources Information Center

Ellery, K.

2011-01-01

Gross participation and throughput rates in higher education institutions in South Africa indicate an inequitable and poorly functioning system. This interpretive study argues for an approach that enhances epistemological and ontological access and examines how an intervention that includes an overt approach in dealing with the nature of science,…

Disability and access to health care - a community based descriptive study.

PubMed

Maart, Soraya; Jelsma, Jennifer

2014-01-01

The World Disability Report highlighted the need for adequate access to health and medical rehabilitation services for those with disability. Participants in a large community based survey in a low-income area were asked questions relating to their use of health related services. Using random, cluster sampling a representative sample of 1083 households in a deprived area of Cape Town were approached and 152 people with disability were interviewed. Those with disability were more likely to be male (χ² = 4.24, p = 0.03) and unemployed (χ² = 66.89, p > 0.001) compared to those without disability. The percentages reporting unmet needs were respectively: 54% for home-based care; 34.5% for assistive devices, 28.9% for medical rehabilitation services; and 2.5% for health services. Those over 65 years of age were less likely to have had the medical rehabilitation that they required (χ² = 8.00, p = 0.018). There were fewer respondents with sensory and language disorders but these groups reported proportionately more unmet needs. The main problems with accessing services included inadequate finances (71%) and transport problems (72%). It is recommended that all efforts be expended to extend appropriate rehabilitation services, including home based-care and appliances to those identified as having disability, particularly to those older than 65 years. In addition, the services need to be affordable and accessible in terms of suitable transport, particularly in the light of the high unemployment rate and the large number of respondents with mobility problems. Implications for Rehabilitation People with disability may be the most in need of additional health related care and the least able to access it. Transport and financial considerations were found to limit the ability to access appropriate care. Rehabilitation and health services need to reach out through home-based care and appropriate forms of rehabilitation delivery to ensure that those who are most in need

Optical Access Networks

NASA Astrophysics Data System (ADS)

Zheng, Jun; Ansari, Nirwan

2005-06-01

Call for Papers: Optical Access Networks With the wide deployment of fiber-optic technology over the past two decades, we have witnessed a tremendous growth of bandwidth capacity in the backbone networks of today's telecommunications infrastructure. However, access networks, which cover the "last-mile" areas and serve numerous residential and small business users, have not been scaled up commensurately. The local subscriber lines for telephone and cable television are still using twisted pairs and coaxial cables. Most residential connections to the Internet are still through dial-up modems operating at a low speed on twisted pairs. As the demand for access bandwidth increases with emerging high-bandwidth applications, such as distance learning, high-definition television (HDTV), and video on demand (VoD), the last-mile access networks have become a bandwidth bottleneck in today's telecommunications infrastructure. To ease this bottleneck, it is imperative to provide sufficient bandwidth capacity in the access networks to open the bottleneck and thus present more opportunities for the provisioning of multiservices. Optical access solutions promise huge bandwidth to service providers and low-cost high-bandwidth services to end users and are therefore widely considered the technology of choice for next-generation access networks. To realize the vision of optical access networks, however, many key issues still need to be addressed, such as network architectures, signaling protocols, and implementation standards. The major challenges lie in the fact that an optical solution must be not only robust, scalable, and flexible, but also implemented at a low cost comparable to that of existing access solutions in order to increase the economic viability of many potential high-bandwidth applications. In recent years, optical access networks have been receiving tremendous attention from both academia and industry. A large number of research activities have been carried out or

Optical Access Networks

NASA Astrophysics Data System (ADS)

Zheng, Jun; Ansari, Nirwan; Jersey Inst Ansari, New; Jersey Inst, New

2005-04-01

Call for Papers: Optical Access Networks With the wide deployment of fiber-optic technology over the past two decades, we have witnessed a tremendous growth of bandwidth capacity in the backbone networks of today's telecommunications infrastructure. However, access networks, which cover the "last-mile" areas and serve numerous residential and small business users, have not been scaled up commensurately. The local subscriber lines for telephone and cable television are still using twisted pairs and coaxial cables. Most residential connections to the Internet are still through dial-up modems operating at a low speed on twisted pairs. As the demand for access bandwidth increases with emerging high-bandwidth applications, such as distance learning, high-definition television (HDTV), and video on demand (VoD), the last-mile access networks have become a bandwidth bottleneck in today's telecommunications infrastructure. To ease this bottleneck, it is imperative to provide sufficient bandwidth capacity in the access networks to open the bottleneck and thus present more opportunities for the provisioning of multiservices. Optical access solutions promise huge bandwidth to service providers and low-cost high-bandwidth services to end users and are therefore widely considered the technology of choice for next-generation access networks. To realize the vision of optical access networks, however, many key issues still need to be addressed, such as network architectures, signaling protocols, and implementation standards. The major challenges lie in the fact that an optical solution must be not only robust, scalable, and flexible, but also implemented at a low cost comparable to that of existing access solutions in order to increase the economic viability of many potential high-bandwidth applications. In recent years, optical access networks have been receiving tremendous attention from both academia and industry. A large number of research activities have been carried out or

Optical Access Networks

NASA Astrophysics Data System (ADS)

Zheng, Jun; Ansari, Nirwan

2005-05-01

Call for Papers: Optical Access Networks With the wide deployment of fiber-optic technology over the past two decades, we have witnessed a tremendous growth of bandwidth capacity in the backbone networks of today's telecommunications infrastructure. However, access networks, which cover the "last-mile" areas and serve numerous residential and small business users, have not been scaled up commensurately. The local subscriber lines for telephone and cable television are still using twisted pairs and coaxial cables. Most residential connections to the Internet are still through dial-up modems operating at a low speed on twisted pairs. As the demand for access bandwidth increases with emerging high-bandwidth applications, such as distance learning, high-definition television (HDTV), and video on demand (VoD), the last-mile access networks have become a bandwidth bottleneck in today's telecommunications infrastructure. To ease this bottleneck, it is imperative to provide sufficient bandwidth capacity in the access networks to open the bottleneck and thus present more opportunities for the provisioning of multiservices. Optical access solutions promise huge bandwidth to service providers and low-cost high-bandwidth services to end users and are therefore widely considered the technology of choice for next-generation access networks. To realize the vision of optical access networks, however, many key issues still need to be addressed, such as network architectures, signaling protocols, and implementation standards. The major challenges lie in the fact that an optical solution must be not only robust, scalable, and flexible, but also implemented at a low cost comparable to that of existing access solutions in order to increase the economic viability of many potential high-bandwidth applications. In recent years, optical access networks have been receiving tremendous attention from both academia and industry. A large number of research activities have been carried out or

Public Access and Open Access: Is There a Difference? | Poster

Cancer.gov

By Robin Meckley, Contributing Writer, and Tracie Frederick, Guest Writer Open access and public access—are they different concepts or are they the same? What do they mean for the researchers at NCI at Frederick? “Open-access (OA) literature is digital, online, free of charge, and free of most copyright and licensing restrictions. What makes it possible is the Internet and the consent of the author or copyright-holder,” according to an open access website maintained by Peter Suber, director, Harvard Open Access Project.

Moving toward a universally accessible web: Web accessibility and education.

PubMed

Kurt, Serhat

2017-12-08

The World Wide Web is an extremely powerful source of information, inspiration, ideas, and opportunities. As such, it has become an integral part of daily life for a great majority of people. Yet, for a significant number of others, the internet offers only limited value due to the existence of barriers which make accessing the Web difficult, if not impossible. This article illustrates some of the reasons that achieving equality of access to the online world of education is so critical, explores the current status of Web accessibility, discusses evaluative tools and methods that can help identify accessibility issues in educational websites, and provides practical recommendations and guidelines for resolving some of the obstacles that currently hinder the achievability of the goal of universal Web access.

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...

Demand and access to mental health services: a qualitative formative study in Nepal

PubMed Central

2014-01-01

Background Nepal is experiencing a significant ‘treatment gap’ in mental health care. People with mental disorders do not always receive appropriate treatment due to a range of structural and individual issues, including stigma and poverty. The PRIME (Programme for Improving Mental Health Care) programme has developed a mental health care plan to address this issue in Nepal and four other low and middle income countries. This study aims to inform the development of this comprehensive care plan by investigating the perceptions of stakeholders at different levels of the care system in the district of Chitwan in southern Nepal: health professionals, lay workers and community members. It focuses specifically on issues of demand and access to care, and aims to identify barriers and potential solutions for reaching people with priority mental disorders. Methods This qualitative study consisted of key informant interviews (33) and focus group discussions (83 participants in 9 groups) at community and health facility levels. Data were analysed using a framework analysis approach. Results As well as pragmatic barriers at the health facility level, mental health stigma and certain cultural norms were found to reduce access and demand for services. Respondents perceived the lack of awareness about mental health problems to be a major problem underlying this, even among those with high levels of education or status. They proposed strategies to improve awareness, such as channelling education through trusted and respected community figures, and responding to the need for openness or privacy in educational programmes, depending on the issue at hand. Adapting to local perceptions of stigmatised treatments emerged as another key strategy to improve demand. Conclusions This study identifies barriers to accessing care in Nepal that reach beyond the health facility and into the social fabric of the community. Stakeholders in PRIME’s integrated care plan advocate strategic

Riociguat in patients with chronic thromboembolic pulmonary hypertension: results from an early access study.

PubMed

McLaughlin, Vallerie V; Jansa, Pavel; Nielsen-Kudsk, Jens E; Halank, Michael; Simonneau, Gérald; Grünig, Ekkehard; Ulrich, Silvia; Rosenkranz, Stephan; Gómez Sánchez, Miguel A; Pulido, Tomás; Pepke-Zaba, Joanna; Barberá, Joan Albert; Hoeper, Marius M; Vachiéry, Jean-Luc; Lang, Irene; Carvalho, Francine; Meier, Christian; Mueller, Katharina; Nikkho, Sylvia; D'Armini, Andrea M

2017-12-28

Following positive results from the Phase III CHEST-1 study in patients with inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH), the Phase IIIb CTEPH early access study (EAS) was designed to assess the safety and tolerability of riociguat in real-world clinical practice, as well as to provide patients with early access to riociguat before launch. Riociguat is approved for the treatment of inoperable and persistent/recurrent CTEPH. We performed an open-label, uncontrolled, single-arm, early access study in which 300 adult patients with inoperable or persistent/recurrent CTEPH received riociguat adjusted from 1 mg three times daily (tid) to a maximum of 2.5 mg tid. Patients switching from unsatisfactory prior pulmonary arterial hypertension (PAH)-targeted therapy (n = 84) underwent a washout period of at least 3 days before initiating riociguat. The primary aim was to assess the safety and tolerability of riociguat, with World Health Organization functional class and 6-min walking distance (6MWD) as exploratory efficacy endpoints. In total, 262 patients (87%) completed study treatment and entered the safety follow-up (median treatment duration 47 weeks). Adverse events were reported in 273 patients (91%). The most frequently reported serious adverse events were syncope (6%), right ventricular failure (3%), and pneumonia (2%). There were five deaths, none of which was considered related to study medication. The safety and tolerability of riociguat was similar in patients switched from other PAH-targeted therapies and those who were treatment naïve. In patients with data available, mean ± standard deviation 6MWD had increased by 33 ± 42 m at Week 12 with no clinically relevant differences between the switched and treatment-naïve subgroups. Riociguat was well tolerated in patients with CTEPH who were treatment naïve, and in those who were switched from other PAH-targeted therapies. No new safety signals were

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.

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.

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2016-05-16

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

Vascular access for home haemodialysis.

PubMed

Al Shakarchi, Julien; Day, C; Inston, N

2018-03-01

Home haemodialysis has been advocated due to improved quality of life. However, there are very little data on the optimum vascular access for it. A retrospective cohort study was carried on all patients who initiated home haemodialysis between 2011 and 2016 at a large university hospital. Access-related hospital admissions and interventions were used as primary outcome measures. Our cohort consisted of 74 patients. On initiation of home haemodialysis, 62 individuals were using an arteriovenous fistula as vascular access, while the remaining were on a tunnelled dialysis catheter. Of the 12 patients who started on a tunnelled dialysis catheter, 5 were subsequently converted to either an arteriovenous fistula ( n = 4) or an arteriovenous graft ( n = 1). During the period of home haemodialysis use, four arteriovenous fistula failed or thrombosed with patients continuing on home haemodialysis using an arteriovenous graft ( n = 3) or a tunnelled dialysis catheter ( n = 1). To maintain uninterrupted home haemodialysis, interventional rates were 0.32 per arteriovenous fistula/arteriovenous graft access-year and 0.4 per tunnelled dialysis catheter access-year. Hospital admission rates for patients on home haemodialysis were 0.33 per patient-year. Our study has shown that home haemodialysis can be safely and independently performed at home within a closely managed home haemodialysis programme. The authors also advocate the use of arteriovenous fistulas for this cohort of patients due to both low complication and intervention rates.

10 CFR 25.15 - Access permitted under “Q” or “L” access authorization.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Access permitted under âQâ or âLâ access authorization. 25.15 Section 25.15 Energy NUCLEAR REGULATORY COMMISSION ACCESS AUTHORIZATION Access Authorizations § 25.15 Access permitted under “Q” or “L” access authorization. (a) A “Q” access authorization permits an...

10 CFR 25.15 - Access permitted under “Q” or “L” access authorization.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Access permitted under âQâ or âLâ access authorization. 25.15 Section 25.15 Energy NUCLEAR REGULATORY COMMISSION ACCESS AUTHORIZATION Access Authorizations § 25.15 Access permitted under “Q” or “L” access authorization. (a) A “Q” access authorization permits an...

10 CFR 25.15 - Access permitted under “Q” or “L” access authorization.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Access permitted under âQâ or âLâ access authorization. 25.15 Section 25.15 Energy NUCLEAR REGULATORY COMMISSION ACCESS AUTHORIZATION Access Authorizations § 25.15 Access permitted under “Q” or “L” access authorization. (a) A “Q” access authorization permits an...

10 CFR 25.15 - Access permitted under “Q” or “L” access authorization.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Access permitted under âQâ or âLâ access authorization. 25.15 Section 25.15 Energy NUCLEAR REGULATORY COMMISSION ACCESS AUTHORIZATION Access Authorizations § 25.15 Access permitted under “Q” or “L” access authorization. (a) A “Q” access authorization permits an...

Optical Access Networks

NASA Astrophysics Data System (ADS)

Zheng, Jun; Ansari, Nirwan

2005-03-01

Call for Papers: Optical Access Networks With the wide deployment of fiber-optic technology over the past two decades, we have witnessed a tremendous growth of bandwidth capacity in the backbone networks of today's telecommunications infrastructure. However, access networks, which cover the "last-mile" areas and serve numerous residential and small business users, have not been scaled up commensurately. The local subscriber lines for telephone and cable television are still using twisted pairs and coaxial cables. Most residential connections to the Internet are still through dial-up modems operating at a low speed on twisted pairs. As the demand for access bandwidth increases with emerging high-bandwidth applications, such as distance learning, high-definition television (HDTV), and video on demand (VoD), the last-mile access networks have become a bandwidth bottleneck in today's telecommunications infrastructure. To ease this bottleneck, it is imperative to provide sufficient bandwidth capacity in the access networks to open the bottleneck and thus present more opportunities for the provisioning of multiservices. Optical access solutions promise huge bandwidth to service providers and low-cost high-bandwidth services to end users and are therefore widely considered the technology of choice for next-generation access networks. To realize the vision of optical access networks, however, many key issues still need to be addressed, such as network architectures, signaling protocols, and implementation standards. The major challenges lie in the fact that an optical solution must be not only robust, scalable, and flexible, but also implemented at a low cost comparable to that of existing access solutions in order to increase the economic viability of many potential high-bandwidth applications. In recent years, optical access networks have been receiving tremendous attention from both academia and industry. A large number of research activities have been carried out or

7 CFR 54.13 - Accessibility and refrigeration of products; access to establishments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Accessibility and refrigeration of products; access to establishments. 54.13 Section 54.13 Agriculture Regulations of the Department of Agriculture (Continued...) Regulations Service § 54.13 Accessibility and refrigeration of products; access to establishments. (a) The...

7 CFR 54.13 - Accessibility and refrigeration of products; access to establishments.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 3 2011-01-01 2011-01-01 false Accessibility and refrigeration of products; access to establishments. 54.13 Section 54.13 Agriculture Regulations of the Department of Agriculture (Continued...) Regulations Service § 54.13 Accessibility and refrigeration of products; access to establishments. (a) The...

7 CFR 54.13 - Accessibility and refrigeration of products; access to establishments.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 3 2012-01-01 2012-01-01 false Accessibility and refrigeration of products; access to establishments. 54.13 Section 54.13 Agriculture Regulations of the Department of Agriculture (Continued...) Regulations Service § 54.13 Accessibility and refrigeration of products; access to establishments. (a) The...

7 CFR 54.13 - Accessibility and refrigeration of products; access to establishments.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 3 2013-01-01 2013-01-01 false Accessibility and refrigeration of products; access to establishments. 54.13 Section 54.13 Agriculture Regulations of the Department of Agriculture (Continued...) Regulations Service § 54.13 Accessibility and refrigeration of products; access to establishments. (a) The...

7 CFR 54.13 - Accessibility and refrigeration of products; access to establishments.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 3 2014-01-01 2014-01-01 false Accessibility and refrigeration of products; access to establishments. 54.13 Section 54.13 Agriculture Regulations of the Department of Agriculture (Continued...) Regulations Service § 54.13 Accessibility and refrigeration of products; access to establishments. (a) The...

Optical Access Networks

NASA Astrophysics Data System (ADS)

Zheng, Jun; Ansari, Nirwan

2005-02-01

Call for Papers: Optical Access Networks With the wide deployment of fiber-optic technology over the past two decades, we have witnessed a tremendous growth of bandwidth capacity in the backbone networks of today's telecommunications infrastructure. However, access networks, which cover the "last-mile" areas and serve numerous residential and small business users, have not been scaled up commensurately. The local subscriber lines for telephone and cable television are still using twisted pairs and coaxial cables. Most residential connections to the Internet are still through dial-up modems operating at a low speed on twisted pairs. As the demand for access bandwidth increases with emerging high-bandwidth applications, such as distance learning, high-definition television (HDTV), and video on demand (VoD), the last-mile access networks have become a bandwidth bottleneck in today's telecommunications infrastructure. To ease this bottleneck, it is imperative to provide sufficient bandwidth capacity in the access networks to open the bottleneck and thus present more opportunities for the provisioning of multiservices. Optical access solutions promise huge bandwidth to service providers and low-cost high-bandwidth services to end users and are therefore widely considered the technology of choice for next-generation access networks. To realize the vision of optical access networks, however, many key issues still need to be addressed, such as network architectures, signaling protocols, and implementation standards. The major challenges lie in the fact that an optical solution must be not only robust, scalable, and flexible, but also implemented at a low cost comparable to that of existing access solutions in order to increase the economic viability of many potential high-bandwidth applications. In recent years, optical access networks have been receiving tremendous attention from both academia and industry. A large number of research activities have been carried out or

Improving access to electronic health records for people with intellectual disability: a qualitative study.

PubMed

van Dooren, Kate; Lennox, Nick; Stewart, Madeline

2013-01-01

People with intellectual disability represent ~2-3% of the Australian population and experience elevated rates of mortality and morbidity compared with the general population. People with intellectual disability, and their families and carers, must keep track of extensive medical information while also managing turnover of paid staff, general practitioners and other health professionals, making them beneficiaries of Australia's new eHealth record system. Although they are key users, there is a lack of knowledge about the accessibility of the system for individuals with intellectual disability, or those responsible for managing their health information. This is a missed opportunity to improve the lives of an already overlooked group. This study aimed to identify the facilitators and barriers to registering for an eHealth record network for people with intellectual disability and those supporting them to manage their health information. We interviewed potential users of eHealth records, including four people with intellectual disability, three family members and two residential support workers. Our findings suggest that decision-makers involved in the roll-out of the eHealth record networks should incorporate 'reasonable accommodations' to improve accessibility for people with intellectual disability and those who support them to manage their health information. This includes identifying and eliminating the barriers to accessibility of eHealth records and taking appropriate measures to promote access to individuals with intellectual disability. People with intellectual disability and the people who support them are a diverse group with a range of abilities. The translation of their views into practice will help to improve the eHealth system for this and other vulnerable population groups.

Assessment method of accessibility conditions: how to make public buildings accessible?

PubMed

Andrade, Isabela Fernandes; Ely, e Vera Helena Moro Bins

2012-01-01

The enforcement of accessibility today has faced several difficulties, such as intervention in historic buildings that now house public services and cultural activities, such as town halls, museums and theaters and should allow access, on equal terms to all people. The paper presents the application of a method for evaluating the spatial accessibility conditions and their results. For this, we sought to support the theoretical foundation about the main issue involved and legislation. From the method used--guided walks--it was possible to identify the main barriers to accessibility in historic buildings. From the identified barriers, possible solutions are presented according to the four components of accessibility: spatial orientation, displacement, use and communication. It is hoped also that the knowledge gained in this research contributes to an improvement of accessibility legislation in relation to the listed items.

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.

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.

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.

[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.

A comparison of Percutaneous femoral access in Endovascular Repair versus Open femoral access (PiERO): study protocol for a randomized controlled trial.

PubMed

Vierhout, Bastiaan P; Saleem, Ben R; Ott, Alewijn; van Dijl, Jan Maarten; de Kempenaer, Ties D van Andringa; Pierie, Maurice E N; Bottema, Jan T; Zeebregts, Clark J

2015-09-14

Access for endovascular repair of abdominal aortic aneurysms (EVAR) is obtained through surgical cutdown or percutaneously. The only devices suitable for percutaneous closure of the 20 French arteriotomies of the common femoral artery (CFA) are the Prostar(™) and Proglide(™) devices (Abbott Vascular). Positive effects of these devices seem to consist of a lower infection rate, and shorter operation time and hospital stay. This conclusion was published in previous reports comparing techniques in patients in two different groups (cohort or randomized). Access techniques were never compared in one and the same patient; this research simplifies comparison because patient characteristics will be similar in both groups. Percutaneous access of the CFA is compared to surgical cutdown in a single patient; in EVAR surgery, access is necessary in both groins in each patient. Randomization is performed on the introduction site of the larger main device of the endoprosthesis. The contralateral device of the endoprosthesis is smaller. When we use this type of randomization, both groups will contain a similar number of main and contralateral devices. Preoperative nose cultures and perineal cultures are obtained, to compare colonization with postoperative wound cultures (in case of a surgical site infection). Furthermore, patient comfort will be considered, using VAS-scores (Visual analog scale). Punch biopsies of the groin will be harvested to retrospectively compare skin of patients who suffered a surgical site infection (SSI) to patients who did not have an SSI. The PiERO trial is a multicenter randomized controlled clinical trial designed to show the consequences of using percutaneous access in EVAR surgery and focuses on the occurrence of surgical site infections. NTR4257 10 November 2013, NL44578.042.13.

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…

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

PubMed

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

2014-03-01

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

Optical Access Networks

NASA Astrophysics Data System (ADS)

Zheng, Jun; Ansari, Nirwan

2005-01-01

Call for Papers: Optical Access Networks

Guest Editors Jun Zheng, University of Ottawa Nirwan Ansari, New Jersey Institute of Technology

Submission Deadline: 1 June 2005

Background

What Rural Women Want the Public Health Community to Know About Access to Healthful Food: A Qualitative Study, 2011.

PubMed

Carnahan, Leslie R; Zimmermann, Kristine; Peacock, Nadine R

2016-04-28

Living in a rural food desert has been linked to poor dietary habits. Understanding community perspectives about available resources and feasible solutions may inform strategies to improve food access in rural food deserts. The objective of our study was to identify resources and solutions to the food access problems of women in rural, southernmost Illinois. Fourteen focus groups with women (n = 110 participants) in 4 age groups were conducted in a 7-county region as part of a community assessment focused on women's health. We used content analysis with inductive and deductive approaches to explore food access barriers and facilitators. Similar to participants in previous studies, participants in our study reported insufficient local food sources, which they believe contributed to poor dietary habits, high food prices, and the need to travel for healthful food. Participants identified existing local activities and resources that help to increase access, such as home and community gardens, food pantries, and public transportation, as well as local solutions, such as improving nutrition education and public transportation options. Multilevel and collaborative strategies and policies are needed to address food access barriers in rural communities. At the individual level, education may help residents navigate geographic and economic barriers. Community solutions include collaborative strategies to increase availability of healthful foods through traditional and nontraditional food sources. Policy change is needed to promote local agriculture and distribution of privately grown food. Understanding needs and strengths in rural communities will ensure responsive and effective strategies to improve the rural food environment.

What Rural Women Want the Public Health Community to Know About Access to Healthful Food: A Qualitative Study, 2011

PubMed Central

Zimmermann, Kristine; Peacock, Nadine R.

2016-01-01

Introduction Living in a rural food desert has been linked to poor dietary habits. Understanding community perspectives about available resources and feasible solutions may inform strategies to improve food access in rural food deserts. The objective of our study was to identify resources and solutions to the food access problems of women in rural, southernmost Illinois. Methods Fourteen focus groups with women (n = 110 participants) in 4 age groups were conducted in a 7-county region as part of a community assessment focused on women’s health. We used content analysis with inductive and deductive approaches to explore food access barriers and facilitators. Results Similar to participants in previous studies, participants in our study reported insufficient local food sources, which they believe contributed to poor dietary habits, high food prices, and the need to travel for healthful food. Participants identified existing local activities and resources that help to increase access, such as home and community gardens, food pantries, and public transportation, as well as local solutions, such as improving nutrition education and public transportation options. Conclusion Multilevel and collaborative strategies and policies are needed to address food access barriers in rural communities. At the individual level, education may help residents navigate geographic and economic barriers. Community solutions include collaborative strategies to increase availability of healthful foods through traditional and nontraditional food sources. Policy change is needed to promote local agriculture and distribution of privately grown food. Understanding needs and strengths in rural communities will ensure responsive and effective strategies to improve the rural food environment. PMID:27126555

Accessing Electronic Journals.

ERIC Educational Resources Information Center

McKay, Sharon Cline

1999-01-01

Discusses issues librarians need to consider when providing access to electronic journals. Topics include gateways; index and abstract services; validation and pay-per-view; title selection; integration with OPACs (online public access catalogs)or Web sites; paper availability; ownership versus access; usage restrictions; and services offered…

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…

Is open access sufficient? A review of the quality of open-access nursing journals.

PubMed

Crowe, Marie; Carlyle, Dave

2015-02-01

The present study aims to review the quality of open-access nursing journals listed in the Directory of Open Access Journals that published papers in 2013 with a nursing focus, written in English, and were freely accessible. Each journal was reviewed in relation to their publisher, year of commencement, number of papers published in 2013, fee for publication, indexing, impact factor, and evidence of requirements for ethics and disclosure statements. The quality of the journals was assessed by impact factors and the requirements for indexing in PubMed. A total of 552 were published in 2013 in the 19 open-access nursing journals that met the inclusion criteria. No journals had impact factors listed in Web of Knowledge, but three had low Scopus impact factors. Only five journals were indexed with PubMed. The quality of the 19 journals included in the review was evaluated as inferior to most subscription-fee journals. Mental health nursing has some responsibility to the general public, and in particular, consumers of mental health services and their families, for the quality of papers published in open-access journals. The way forward might involve dual-platform publication or a process that enables assessment of how research has improved clinical outcomes. © 2014 Australian College of Mental Health Nurses Inc.

A global assessment of market accessibility and market influence for global environmental change studies

NASA Astrophysics Data System (ADS)

Verburg, Peter H.; Ellis, Erle C.; Letourneau, Aurelien

2011-07-01

Markets influence the global patterns of urbanization, deforestation, agriculture and other land use systems. Yet market influence is rarely incorporated into spatially explicit global studies of environmental change, largely because consistent global data are lacking below the national level. Here we present the first high spatial resolution gridded data depicting market influence globally. The data jointly represent variations in both market strength and accessibility based on three market influence indices derived from an index of accessibility to market locations and national level gross domestic product (purchasing power parity). These indices show strong correspondence with human population density while also revealing several distinct and useful relationships with other global environmental patterns. As market influence grows, the need for high resolution global data on market influence and its dynamics will become increasingly important to understanding and forecasting global environmental change.

Accessing memory

DOEpatents

Yoon, Doe Hyun; Muralimanohar, Naveen; Chang, Jichuan; Ranganthan, Parthasarathy

2017-09-26

A disclosed example method involves performing simultaneous data accesses on at least first and second independently selectable logical sub-ranks to access first data via a wide internal data bus in a memory device. The memory device includes a translation buffer chip, memory chips in independently selectable logical sub-ranks, a narrow external data bus to connect the translation buffer chip to a memory controller, and the wide internal data bus between the translation buffer chip and the memory chips. A data access is performed on only the first independently selectable logical sub-rank to access second data via the wide internal data bus. The example method also involves locating a first portion of the first data, a second portion of the first data, and the second data on the narrow external data bus during separate data transfers.

Barriers and facilitators to parents seeking and accessing professional support for anxiety disorders in children: qualitative interview study.

PubMed

Reardon, Tessa; Harvey, Kate; Young, Bridget; O'Brien, Doireann; Creswell, Cathy

2018-01-25

Anxiety disorders are among the most common mental health disorders experienced by children, but only a minority of these children access professional help. Understanding the difficulties parents face seeking support for child anxiety disorders could inform targeted interventions to improve treatment access. The aims of the study were to identify barriers and facilitators to seeking and accessing professional support for child anxiety disorders, and ways to minimise these barriers. A qualitative interview study was conducted with parents of 16 children (aged 7-11 years) with anxiety disorders identified through screening in schools. Barriers and facilitators were identified in relation to four distinct stages in the help-seeking process: parents recognising the anxiety difficulty, parents recognising the need for professional support, parents contacting professionals, and families receiving professional support. Barriers and facilitators at each stage related to the child's difficulties, the role of the parent, and parent perceptions of professionals and services. Findings illustrate the need (1) for readily available tools to help parents and professionals identify clinically significant anxiety in children, (2) to ensure that families and professionals can easily access guidance on the help-seeking process and available support, and (3) to ensure existing services offer sufficient provision for less severe difficulties that incorporates direct support for parents.

AEROSAT Access Control Summary

DOT National Transportation Integrated Search

1976-10-01

The report consists of three basic sections. Section 2 is a discussion of the communications concepts germane to AEROSAT access control. It defines and reviews the principles of multiplexing, multiple access, demand access, and access control and rel...

Aerosat Access Control Summary

DOT National Transportation Integrated Search

1976-10-01

The report consists of three basic sections. Section 2 is a discussion of the communications concepts germane to AEROSAT access control. It defines and reviews the principles of multiplexing, multiple access, demand access, and access control and rel...

Crucial design issues for special access technology; a Delphi study.

PubMed

O'Rourke, Pearl; Ekins, Ray; Timmins, Bernard; Timmins, Fiona; Long, Siobhan; Coyle, Eugene

2014-01-01

To develop and demonstrate a method to involve professional users of assistive technology (AT) in the development process of customisable products. Employing the ideas of user participation and mass customisation, this research addresses the need for reduced product costs and optimised product flexibility. An adaptable six-question Delphi study was developed to establish consensus among AT professionals on design issues relating to a specified AT domain requiring innovation. The study is demonstrated for the special access technology (SAT) domain. A modified morphological matrix structures the application of the study results to the product design process. Fourteen professionals from the Republic of Ireland and the UK participated. Consensus was reached on prevalent parts of SAT that malfunction, primary reasons for SAT malfunction, characteristics of clients associated with SAT selection, client needs regarding SAT use and training, desirable traits of SAT and clinicians' frustrations with SAT. The study revealed a range of problems related to SAT, highlighting the complexities of successful SAT adoption. The questions led to differentiated insights and enabled design solution conceptualisation from various perspectives. The approach was found to help facilitate efficient generation and application of professional users' knowledge during the design process of customisable AT.

Transparency of Biobank Access in Canada: An Assessment of Industry Access and the Availability of Information on Access Policies and Resulting Research.

PubMed

Gibson, Shannon G; Axler, Renata E; Lemmens, Trudo

2017-12-01

A key issue impacting public trust in biobanks is how these resources are utilized, including who is given access to biobank data and samples. To assess the conditions under which researchers are given access to Canadian biobanks, we reviewed websites and contacted Canadian biobanks to determine the availability of information on access policies and procedures; research resulting from access biobank data and samples; and conditions on private industry access to biobanks. We also conducted expert interviews with key Canadian stakeholders ( n = 11) to obtain their perspectives on biobank transparency and access policies. Among 21 Canadian biobanks, there was wide variation in the access information made publicly available, and the majority of these allowed access by industry applicants. Biobanks should be governed by the principles of transparency, accountability, and accessibility, and attention must be given to the conditions around the commercialization of biobank-based research.

[Accessible Rural Housing.

ERIC Educational Resources Information Center

Baker, Nick, Ed.

1995-01-01

This issue of the quarterly newsletter "Rural Exchange" provides information and resources on accessible rural housing for the disabled. "Accessible Manufactured Housing Could Increase Rural Home Supply" (Nick Baker) suggests that incorporation of access features such as lever door handles and no-step entries into manufactured housing could help…

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.

Developing an agenda for research about policies to improve access to healthy foods in rural communities: a concept mapping study

PubMed Central

2014-01-01

Background Policies that improve access to healthy, affordable foods may improve population health and reduce health disparities. In the United States most food access policy research focuses on urban communities even though residents of rural communities face disproportionately higher risk for nutrition-related chronic diseases compared to residents of urban communities. The purpose of this study was to (1) identify the factors associated with access to healthy, affordable food in rural communities in the United States; and (2) prioritize a meaningful and feasible rural food policy research agenda. Methods This study was conducted by the Rural Food Access Workgroup (RFAWG), a workgroup facilitated by the Nutrition and Obesity Policy Research and Evaluation Network. A national sample of academic and non-academic researchers, public health and cooperative extension practitioners, and other experts who focus on rural food access and economic development was invited to complete a concept mapping process that included brainstorming the factors that are associated with rural food access, sorting and organizing the factors into similar domains, and rating the importance of policies and research to address these factors. As a last step, RFAWG members convened to interpret the data and establish research recommendations. Results Seventy-five participants in the brainstorming exercise represented the following sectors: non-extension research (n = 27), non-extension program administration (n = 18), “other” (n = 14), policy advocacy (n = 10), and cooperative extension service (n = 6). The brainstorming exercise generated 90 distinct statements about factors associated with rural food access in the United States; these were sorted into 5 clusters. Go Zones were established for the factors that were rated highly as both a priority policy target and a priority for research. The highest ranked policy and research priorities include strategies designed to

Developing an agenda for research about policies to improve access to healthy foods in rural communities: a concept mapping study.

PubMed

Johnson, Donna B; Quinn, Emilee; Sitaker, Marilyn; Ammerman, Alice; Byker, Carmen; Dean, Wesley; Fleischhacker, Sheila; Kolodinsky, Jane; Pinard, Courtney; Pitts, Stephanie B Jilcott; Sharkey, Joseph

2014-06-12

Policies that improve access to healthy, affordable foods may improve population health and reduce health disparities. In the United States most food access policy research focuses on urban communities even though residents of rural communities face disproportionately higher risk for nutrition-related chronic diseases compared to residents of urban communities. The purpose of this study was to (1) identify the factors associated with access to healthy, affordable food in rural communities in the United States; and (2) prioritize a meaningful and feasible rural food policy research agenda. This study was conducted by the Rural Food Access Workgroup (RFAWG), a workgroup facilitated by the Nutrition and Obesity Policy Research and Evaluation Network. A national sample of academic and non-academic researchers, public health and cooperative extension practitioners, and other experts who focus on rural food access and economic development was invited to complete a concept mapping process that included brainstorming the factors that are associated with rural food access, sorting and organizing the factors into similar domains, and rating the importance of policies and research to address these factors. As a last step, RFAWG members convened to interpret the data and establish research recommendations. Seventy-five participants in the brainstorming exercise represented the following sectors: non-extension research (n = 27), non-extension program administration (n = 18), "other" (n = 14), policy advocacy (n = 10), and cooperative extension service (n = 6). The brainstorming exercise generated 90 distinct statements about factors associated with rural food access in the United States; these were sorted into 5 clusters. Go Zones were established for the factors that were rated highly as both a priority policy target and a priority for research. The highest ranked policy and research priorities include strategies designed to build economic viability in

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

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…

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.

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

PubMed

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

2010-01-01

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

[Three-dimensional finite element analysis of the upper cervical-defected incisor with labial access or lingual access].

PubMed

Su, Fan; Zhao, Ying; Su, Qin

2013-08-01

To evaluate the stress distribution of the cervical-defected incisor with labial or lingual endodontic access with finite element analysis (FEA), and to explore the advantage of resistance in labial endodontic access. 3-D finite element models of upper cervical-defected incisor were established using cone-beam CT (CBCT), Mimics Catia, and Ansys software. The subjects were categorized according to the two endodontic accesses and three restorative ways, which were composite resin, glass fiber-reinforced composite resin and glass fiber-reinforced post-crown. All the models were loaded.The von Mises stress values and distribution were recorded and analyzed with Ansys 10.0 software. In this study, direct composite resin restoration showed no significant difference between the labial and lingual access. In glass fiber-reinforced composite resin, labial access could transfer the stress concentration area. It could reduce the incidence of fracture of the cervical lesion but increase the incidence of root fracture. Post-crown restoration could obviously reduce the incidence of fracture of the cervical lesion. When the cervical-defected incisor is restored with composite resin, labial and lingual accesses can be considered. Labial access with glass fiber-reinforced composite resin or post-crown restoration is a good choice.

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.

Assessment of the vaccine industry in Iran in context of accession to WTO: a survey study

PubMed Central

2012-01-01

Background The vaccine industry is one of the most important health-related industries. It can be affected by accession to the World Trade Organization (WTO) because of probable dramatic changes in the business environment. Iran has already initiated accession negotiations. Purpose of the study In this paper, we investigate the position of, challenges to, and opportunities for vaccine manufacturing in Iran with regard to accession to the WTO. Methods This is a qualitative and cross sectional study. To collect information, we designed a questionnaire and interviewed some of the vaccine industry’s key opinion leaders in Iran. Before the interviews were conducted, the questionnaires were sent to these individuals by email. Results According to the interviewees, the country’s main challenges with regard to accession to the WTO are the lack of firm internal intellectual property (IP) rules, not being recognized as pre-qualified by the World Health Organization (WHO), the use of old equipment, and a lack of cooperation with global vaccine companies. Major conclusions Iran’s local vaccine industry, with a long history and international reputation that could be used as an advantage, is faced with several challenges, such as problems with keeping up with Current Good Manufacturing Practice (cGMP), a lack of adequate and meaningful investment in research and development (R&D), and limitations on private sector participation in the production of vaccines. Gradual privatization of the industry, improved international relations, utilization of the R&D power of small hi-tech companies, consistent education of human resources, and modernization of infrastructures and equipment are among the suggested solutions. PMID:23351841

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…

Progress report on CCIR studies for guaranteeing access to the geostationary satellite orbit

NASA Astrophysics Data System (ADS)

Reinhart, E. E.

Overall responsibility for preparing a report on the technical information necessary for the World Administrative Radio Conference to be held in the spring of 1984 is vested in the Interim Working Party (IWP) 4/1. The various approaches being considered by the IWP 4/1 to guarantee orbital access are described, along with the criteria that the party has proposed for evaluating and comparing the approaches. These approaches include the following: a regional detailed long-term (10-20 years) a priori allotment plan, a periodically revised (3-5 years) regional detailed allotment plan, a regional or subregional allotment plan with guaranteed access, guaranteed access by means of multilateral coordination, and coordination procedures and technical factors that are revised periodically.

Demystifying Remote Access

ERIC Educational Resources Information Center

Howe, Grant

2009-01-01

With money tight, more and more districts are considering remote access as a way to reduce expenses and budget information technology costs more effectively. Remote access allows staff members to work with a hosted software application from any school campus without being tied to a specific physical location. Each school can access critical…

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…

A participatory study of teenagers and young adults views on access and participation in cancer research.

PubMed

Taylor, Rachel M; Solanki, Anita; Aslam, Natasha; Whelan, Jeremy S; Fern, Lorna A

2016-02-01

The purpose of this study was to elicit young people's views on access and participation in cancer research. Eight young people aged 18-25 years with a previous cancer diagnosis aged 15-24 participated in a one day workshop utilising participatory methodology. The workshop consisted of four exercises: role play/scene setting; focus group examining thoughts and opinions of research access and participation; individual reflection on access to different types of research; and creative interpretation of the workshop. Further consultation with 222 young people with cancer was conducted using an electronic survey. Three themes emerged: • Patient choice: Young people thought it was their right to know all options about available research. Without knowledge of all available studies they would be unable to make an informed choice about participation. • Role of healthcare professionals as facilitators/barriers: Young people suggested non-clinical healthcare professionals such as social workers and youth support coordinators may be more suited to approaching young people about participation in psychosocial and health services research. • Value of the research: The what, when and how information was delivered was key in relaying the value of the study and assisting young people in their decision to participate. Further consultation showed approximately 70% wanted to find out about all available research. However, one third trusted healthcare professionals to decide which research studies to inform them of. Effective ways to support healthcare professionals approaching vulnerable populations about research are needed to ensure young people are empowered to make informed choices about research participation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Differing perspectives on parent access to their child's electronic medical record during neonatal intensive care hospitalization: a pilot study.

PubMed

Chung, Rebecca K; Kim, Una Olivia; Basir, Mir Abdul

2018-04-01

To improve informed medical decision-making, principles for family-centered neonatal care recommend that parents have access to their child's medical record on an ongoing basis during neonatal intensive unit care (NICU) hospitalization. Currently, many NICUs do not allow independent parent access to their child's electronic medical record (EMR) during hospitalization. We undertook a cross-sectional survey pilot study of medical professionals and parents to explore opinions regarding this practice. Inclusion criteria: 18-years old, English-literate, legal guardian of patients admitted to the NICU for 14 days. NICU medical professionals included physicians, nurse practitioners, nurses, and respiratory therapists. Medical professionals believed parent access would make their work more difficult, increase time documenting and updating families, making them more liable to litigation and hesitant to chart sensitive information. However, parents felt that they lacked control over their child's care and desired direct access to the EMR. Parents believed this would improve accuracy of their child's medical chart, and increase advocacy and understanding of their child's illness. NICU parents and medical professionals have differing perspectives on independent parental access to their child's EMR. More research is needed to explore the potential of independent parental EMR access to further improve family-centered neonatal care.

New Insights into Dialysis Vascular Access: What Is the Optimal Vascular Access Type and Timing of Access Creation in CKD and Dialysis Patients?

PubMed

Woo, Karen; Lok, Charmaine E

2016-08-08

Optimal vascular access planning begins when the patient is in the predialysis stages of CKD. The choice of optimal vascular access for an individual patient and determining timing of access creation are dependent on a multitude of factors that can vary widely with each patient, including demographics, comorbidities, anatomy, and personal preferences. It is important to consider every patient's ESRD life plan (hence, their overall dialysis access life plan for every vascular access creation or placement). Optimal access type and timing of access creation are also influenced by factors external to the patient, such as surgeon experience and processes of care. In this review, we will discuss the key determinants in optimal access type and timing of access creation for upper extremity arteriovenous fistulas and grafts. Copyright © 2016 by the American Society of Nephrology.

Private forest landowner attitudes toward off-highway vehicle access: A Minnesota case study

Treesearch

Dennis R. Becker; Grant L. Wilson; Stephanie A. Snyder

2010-01-01

Off-highway vehicle (OHV) riding has increased dramatically in the past decade, creating challenges for finding suitable places to ride, particularly where access to public lands is limited. This research examines the attitudes and willingness of private forest and seasonal recreation landowners to provide OHV access. A series of focus groups was conducted to inform a...

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…

Access to health care and employment status of people with disabilities in South India, the SIDE (South India Disability Evidence) study.

PubMed

Gudlavalleti, Murthy Venkata S; John, Neena; Allagh, Komal; Sagar, Jayanthi; Kamalakannan, Sureshkumar; Ramachandra, Srikrishna S

2014-11-01

Data shows that people with disability are more disadvantaged in accessing health, education and employment opportunities compared to people without a disability. There is a lack of credible documented evidence on health care access and barriers to access from India. The South India Disability Evidence (SIDE) Study was undertaken to understand the health needs of people with disabilities, and barriers to accessing health services. The study was conducted in one district each in two States (Andhra Pradesh and Karnataka) in 2012. Appropriate age and sex-matched people without a disability were recruited to compare with people with disability who were identified through a population-based survey and available government disability records by trained key informants. These people were then examined by a medical team to confirm the diagnosis. Investigators administered questionnaire schedules to people with and without a disability to harness information on employment and health service access, utilization and barriers. A total of 839 people with disabilities and 1153 age and sex matched people without a disability, aged 18 years or more were included. People with disability had significantly lower employment rates. On univariate analysis, people with disability (18.4%) needed to visit a hospital significantly more often in the preceding year compared to people without a disability (8.8%) (X2- 40.0562; P < =0.001). However adjusted odds ratios did not show a statistically significant difference. Significant differences were also observed with respect to past hospitalization. People with disabilities had 4.6 times higher risk of suffering from diabetes and 5.8 times higher risk of suffering from depression compared to people without a disability and the risk was significantly higher in males compared to females with disability. People with disability faced significantly more barriers to accessing health services compared to people without a disability. Barriers

Variation in geographic access to chemotherapy by definitions of providers and service locations: a population-based observational study.

PubMed

Schroeder, Mary C; Chapman, Cole G; Nattinger, Matthew C; Halfdanarson, Thorvardur R; Abu-Hejleh, Taher; Tien, Yu-Yu; Brooks, John M

2016-07-18

An aging population, with its associated rise in cancer incidence and strain on the oncology workforce, will continue to motivate patients, healthcare providers and policy makers to better understand the existing and growing challenges of access to chemotherapy. Administrative data, and SEER-Medicare data in particular, have been used to assess patterns of healthcare utilization because of its rich information regarding patients, their treatments, and their providers. To create measures of geographic access to chemotherapy, patients and oncologists must first be identified. Others have noted that identifying chemotherapy providers from Medicare claims is not always straightforward, as providers may report multiple or incorrect specialties and/or practice in multiple locations. Although previous studies have found that specialty codes alone fail to identify all oncologists, none have assessed whether various methods of identifying chemotherapy providers and their locations affect estimates of geographic access to care. SEER-Medicare data was used to identify patients, physicians, and chemotherapy use in this population-based observational study. We compared two measures of geographic access to chemotherapy, local area density and distance to nearest provider, across two definitions of chemotherapy provider (identified by specialty codes or billing codes) and two definitions of chemotherapy service location (where chemotherapy services were proven to be or possibly available) using descriptive statistics. Access measures were mapped for three representative registries. In our sample, 57.2 % of physicians who submitted chemotherapy claims reported a specialty of hematology/oncology or medical oncology. These physicians were associated with 91.0 % of the chemotherapy claims. When providers were identified through billing codes instead of specialty codes, an additional 50.0 % of beneficiaries (from 23.8 % to 35.7 %) resided in the same ZIP code as a chemotherapy

Health Care Access among Deaf People

ERIC Educational Resources Information Center

Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

2016-01-01

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

Access to emergency care services: a transversal ecological study about Brazilian emergency health care network.

PubMed

Rocha, T A H; da Silva, N C; Amaral, P V; Barbosa, A C Q; Rocha, J V M; Alvares, V; de Almeida, D G; Thumé, E; Thomaz, E B A F; de Sousa Queiroz, R C; de Souza, M R; Lein, A; Toomey, N; Staton, C A; Vissoci, J R N; Facchini, L A

2017-12-01

Studies of health geography are important in the planning and allocation of emergency health services. The geographical distribution of health facilities is an important factor in timely and quality access to emergency services; therefore, the present study analyzed the emergency health care network in Brazil, focusing the analysis at the roles of small hospitals (SHs). Cross-sectional ecological study. Data were collected from 9429 hospitals of which 3524 were SHs and 5905 were high-complexity centers (HCCs). For analytical purposes, we considered four specialties when examining the proxies of emergency care capability: adult, pediatrics, neonatal, and obstetric. We analyzed the spatial distribution of hospitals, identifying municipalities that rely exclusively on SHs and the distance of these cities from HCCs. More than 14 and 30 million people were at least 120 km away from HCCs with an adult intensive care unit (ICU) and pediatric ICU, respectively. For neonatal care distribution, 12% of the population was more than 120 km away from a health facility with a neonatal ICU. The maternities situation is different from other specialties, where 81% of the total Brazilian population was within 1 h or less from such health facilities. Our results highlighted a polarization in distribution of Brazilian health care facilities. There is a concentration of hospitals in urban areas more developed and access gaps in rural areas and the Amazon region. Our results demonstrate that the distribution of emergency services in Brazil is not facilitating access to the population due to geographical barriers associated with great distances. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Medicines access programs to cancer medicines in Australia and New Zealand: An exploratory study.

PubMed

Grover, Piyush; Babar, Zaheer-Ud-Din; Oehmen, Raoul; Vitry, Agnes

2018-03-01

Medicines Access Programs (MAP) offer access to publicly unfunded medicines at the discretion of pharmaceutical companies. Limited literature is available on their extent and scope in Australia and New Zealand. This study aims to identify MAPs for cancer medicines that were operational in 2014-15 in Australia and New Zealand and describe their characteristics. A preliminary list of MAPs was sent to hospital pharmacists in Australia and New Zealand to validate and collect further information. Pharmaceutical companies were contacted directly to provide information regarding MAPs offered. Key stakeholders were interviewed to identify issues with MAPs. Fifty-one MAPs were identified covering a range of indications. The majority of MAPs were provided free of charge to the patient for medicines that were registered or in the process of being registered but were not funded. Variability in the number of MAPs across institutions and characteristics was observed. Australia offered more MAPs than New Zealand. Only two of 17 pharmaceutical companies contacted agreed to provide information on their MAPs. Eight stakeholder interviews were conducted. This identified that while MAPs are widely operational there is lack of clinical monitoring, inequity to access, operational issues and lack of transparency. Our results suggest a need for a standardised and mandated policy to mitigate issues with MAPs. Copyright © 2017 Elsevier B.V. All rights reserved.

Air pollution and general practitioner access and utilization: a population based study in Sarnia, 'Chemical Valley,' Ontario

PubMed Central

2011-01-01

Background Health impacts of poor environmental quality have been identified in studies around the world and in Canada. While many of the studies have identified associations between air pollution and mortality or morbidity, few have focused on the role of health care as a potential moderator of impacts. This study assessed the determinants of health care access and utilization in the context of ambient air pollution in Sarnia, Ontario, Canada. Methods Residents of Sarnia participated in a Community Health Study administered by phone, while several ambient air pollutants including nitrogen dioxide (NO2), sulphur dioxide (SO2) and the volatile organic compounds benzene, toluene, ethylbenzene, mp- and o-xylene (BTEX) were monitored across the city. Land Use Regression models were used to estimate individual exposures to the measured pollutants and logistic regression models were utilized to assess the relative influence of environmental, socioeconomic and health related covariates on general practitioner access and utilization outcomes. Results The results show that general practitioner use increased with levels of exposure to nitrogen dioxide (NO2- Odds Ratio [OR]: 1.16, p < 0.05) and sulphur dioxide (SO2- OR: 1.61, p < 0.05). Low household income was a stronger predictor of having no family doctor in areas exposed to high concentrations of NO2 and SO2. Respondents without regular care living in high pollution areas were also more likely to report travelling or waiting for care in excess of 20 minutes (OR: 3.28, p < 0.05) than their low exposure counterparts (OR: 1.11, p > 0.05). Conclusions This study provides evidence for inequitable health care access and utilization in Sarnia, with particular relevance to its situation as a sentinel high exposure environment. Levels of exposure to pollution appears to influence utilization of health care services, but poor access to primary health care services additionally burden certain groups in Sarnia, Ontario, Canada. PMID

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.

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.

Open Access Alternatives

ERIC Educational Resources Information Center

Tenopir, Carol

2004-01-01

Open access publishing is a hot topic today. But open access publishing can have many different definitions, and pros and cons vary with the definitions. Open access publishing is especially attractive to companies and small colleges or universities that are likely to have many more readers than authors. A downside is that a membership fee sounds…

[Analysis on accessibility of urban park green space: the case study of Shenyang Tiexi District].

PubMed

Lu, Ning; Li, Jun-Ying; Yan, Hong-Wei; Shi, Tuo; Li, Ying

2014-10-01

The accessibility of urban park green space is an important indicator to reflect how much the natural service supplied by parks could be enjoyed by citizens conveniently and fairly. This paper took Shenyang Tiexi District as an example to evaluate the accessibility of urban park green space based on QuickBird imagery and GIS software, with four modes of transportation, walking, non-motor vehicle, motor vehicle and public transport being considered. The research compared and analyzed the distribution of the accessible area and the accessible people of park green space. The result demonstrated that park green space in Shenyang Tiexi District was not enough and the distribution was not even. To be precise, the accessibility in southwest part and central part was relatively good, that in marginal sites was worse, and that in east part and north part was the worst. Furthermore, the accessibility based on different modes of transportation varied a lot. The accessibility of motor vehicle was the best, followed by non-motor vehicle and public transport, and walking was the worst. Most of the regions could be reached within 30 minutes by walking, 15 minutes by non-motor vehicle and public transport, and 10 minutes by motor vehicle. This paper had a realistic significance in terms of further, systematic research on the green space spatial pattern optimization.

Accessibility | NREL

Science.gov Websites

electronic and information technologies accessible to individuals with disabilities in accordance with Section 508 of the Rehabilitation Act (29 U.S.C. 794d), as amended in 1998. Contact us with feedback or concerns related to the accessibility of this website.

A USANS/SANS study of the accessibility of pores in the Barnett Shale to methane and water

USGS Publications Warehouse

Ruppert, Leslie F.; Sakurovs, Richard; Blach, Tomasz P.; He, Lilin; Melnichenko, Yuri B.; Mildner, David F.; Alcantar-Lopez, Leo

2013-01-01

Shale is an increasingly important source of natural gas in the United States. The gas is held in fine pores that need to be accessed by horizontal drilling and hydrofracturing techniques. Understanding the nature of the pores may provide clues to making gas extraction more efficient. We have investigated two Mississippian Barnett Shale samples, combining small-angle neutron scattering (SANS) and ultrasmall-angle neutron scattering (USANS) to determine the pore size distribution of the shale over the size range 10 nm to 10 μm. By adding deuterated methane (CD4) and, separately, deuterated water (D2O) to the shale, we have identified the fraction of pores that are accessible to these compounds over this size range. The total pore size distribution is essentially identical for the two samples. At pore sizes >250 nm, >85% of the pores in both samples are accessible to both CD4 and D2O. However, differences in accessibility to CD4 are observed in the smaller pore sizes (~25 nm). In one sample, CD4 penetrated the smallest pores as effectively as it did the larger ones. In the other sample, less than 70% of the smallest pores (4, but they were still largely penetrable by water, suggesting that small-scale heterogeneities in methane accessibility occur in the shale samples even though the total porosity does not differ. An additional study investigating the dependence of scattered intensity with pressure of CD4 allows for an accurate estimation of the pressure at which the scattered intensity is at a minimum. This study provides information about the composition of the material immediately surrounding the pores. Most of the accessible (open) pores in the 25 nm size range can be associated with either mineral matter or high reflectance organic material. However, a complementary scanning electron microscopy investigation shows that most of the pores in these shale samples are contained in the organic components. The neutron scattering results indicate that the pores are

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.

The experience of foot problems and decisions to access foot care in patients with rheumatoid arthritis: a qualitative study.

PubMed

Wilson, Oonagh; Kirwan, John; Dures, Emma; Quest, Enid; Hewlett, Sarah

2017-01-01

Although foot problems are common in rheumatoid arthritis (RA), the consequences of foot problems from the patient perspective have not been fully explored. The aims of this study were to explore the experience of foot problems and decisions to access foot care services or not in patients with RA. Semi structured, one-to-one interviews with patients recruited from 2 UK rheumatology units, purposively sampled for self-reported foot problems and a range of personal/disease characteristics. Inductive thematic analysis was used, with rigour provided by multiple independent analysers. Emerging themes were discussed and agreed by all authors. Twelve patients participated: 7 female; mean age 56 years (29-72); mean disease duration 12 years (2-27), 5 had accessed foot care services. The 'Impact' of foot problems was substantial and formed the underpinning theme, comprising three organising themes: 'Foot symptoms'; 'Consequences'; and 'Cost'. Foot symptoms such as pain and numbness required self-management, and affected daily life (walking, working) leading to social and emotional costs. The global theme, 'Decision to access foot care or not', also comprised three organising themes: 'Access perceived unnecessary' (no problem, can cope); 'Access hindered by patients' perception'; and 'Access supported by patient and clinician'. Decisions to access foot care or not were complex and influenced by patient beliefs regarding possible treatments and how to access these, and hindered by patient perceptions that their feet were ignored by rheumatology clinicians. Positive experience of foot care encouraged continued utilisation but negative experiences contributed to patients' decisions to discontinue foot care services. Foot problems are important issues for patients and impact on many aspects of their physical, social and emotional lives. Patients who had accessed foot care services prioritised their foot problems as an important health care need. However, for others who would

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

PubMed

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

2014-11-01

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

Access Barriers to Dental Health Care in Children with Disability. A Questionnaire Study of Parents

ERIC Educational Resources Information Center

Gerreth, Karolina; Borysewicz-Lewicka, Maria

2016-01-01

Background: A patient's with disability everyday life is rife with many limitations such as architectural, transport, information as well as medical, psychological, legal, economic and social barriers. The aim of this study was to evaluate access to dental health care of special-care schoolchildren with intellectual disability on the basis of…

Online Public Access Catalog User Studies: A Review of Research Methodologies, March 1986-November 1989.

ERIC Educational Resources Information Center

Seymour, Sharon

1991-01-01

Review of research methodologies used in studies of online public access catalog (OPAC) users finds that a variety of research methodologies--e.g., surveys, transaction log analysis, interviews--have been used with varying degrees of expertise. It is concluded that poor research methodology resulting from limited training and resources limits the…

Open access publishing: a study of current practices in orthopaedic research.

PubMed

Sabharwal, Sanjeeve; Patel, Nirav; Johal, Karanjeev

2014-06-01

Open access (OA) publications have changed the paradigm of dissemination of scientific research. Their benefits to low-income countries underline their value; however, critics question exorbitant publication fees as well as their effect on the peer review process and research quality. This study reports on the prevalence of OA publishing in orthopaedic research and compares benchmark citation indices as well as evidence quality derived from OA journals with conventional subscription based orthopaedic journals. All 63 orthopaedic journals listed in ISI's Web of Knowledge Journal Citation Report (JCR) were examined. Bibliometric data attributed to each journal for the year 2012 was acquired from the JCR. Studies that fulfilled the criteria of level I evidence were identified for each journal within PubMed. Individual journal websites were reviewed to identify their open access policy. A total of 38 (60.3 %) journals did not offer any form of OA publishing; however, 20 (31.7 %) hybrid journals were identified which offered authors the choice to publish their work as OA if a publication fee was paid. Only five (8 %) journals published all their articles as OA. There was variability amongst the different publication fees for OA articles. Journals that published OA articles did not differ from subscription based journals on the basis of 2012 impact factor, citation number, self citation proportion or the volume of level I evidence published (p > 0.05). OA journals are present in orthopaedic research, though in small numbers. Over a third of orthopaedic journals catalogued in the ISI Web of Knowledge JCR® are hybrid journals that provide authors with the opportunity to publish their articles as OA after a publication fee is paid. This study suggests equivalent importance and quality of articles between OA and subscription based orthopaedic journals based on bibliometric data and the volume of level I evidence produced. Orthopaedic researchers must recognize the

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

PubMed Central

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

2013-01-01

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

"It's Easy to Get Fags": A Qualitative Study of Disadvantaged Young People's Perspectives on Cigarette Availability and Access.

PubMed

Tjelta, Thomas; Ritchie, Deborah; Amos, Amanda

2017-11-07

Reducing young people's access to cigarettes is a key element of smoking prevention policies. This article explores how young people source cigarettes following the increase in the UK minimum age of sale from 16 to 18 years. Semi-structured individual, paired and triadic interviews with 60 disadvantaged young people aged between 12 and 17. Participants were recruited from clubs and voluntary organizations offering advice and support to disadvantaged young people. Most participants said they sourced cigarettes from shops, but understandings of "buying cigarettes from shops" included using intermediaries for proxy purchases. Access from social sources was contingent on reciprocation, and blackmarket sources were avoided. The distinction between potential and actual sources reflected participants concerns about their presentation of self. Those who bought cigarettes directly from shops accrued status and power in negotiating social hierarchies. Participants therefore highlighted their smoking related competencies, that is, ability to secure regular retail access to tobacco, while downplaying the significant difficulties they experienced. The presentational dimension of youth cigarette access highlights a need for caution in associating self-reported changes in young people's cigarette sources straightforwardly with access policies. The conflation of direct retail purchases with proxy purchases, and the interrelationship between commercial and social cigarette sources also raises issues for interpreting data on "usual" cigarette sources from national surveys. Findings suggest that some young people may still be both reliant on making retail cigarette purchases following the increase in the age of sale in the United Kingdom, and experiencing significant difficulties making these. This study highlights the self-presentational dimension of youth cigarette access in a particular community context, and the important distinction between the apparent range of sources

77 FR 49367 - Final Flood Elevation Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-16

... County. Verde Creek confluence. Approximately 500 feet +2593 downstream of the Agua Caliente Wash... Pima County. Tanque Verde Road. Approximately 0.4 mile +2624 upstream of East Tanque Verde Road. Agua...

Widening Access, Widening Participation, Widening Success: An Indian Case Study

ERIC Educational Resources Information Center

Thornton, Mary

2006-01-01

Multiple deprivations are widespread in rural India. Literacy levels remain stubbornly low, albeit gradually improving. Caste, class, religion, gender, age and disability all impact on access to education, participation and successful completion. The education of girls remains problematic given the higher value attached to sons, especially in…

Patients’ perceptions of access to primary care

PubMed Central

Premji, Kamila; Ryan, Bridget L.; Hogg, William E.; Wodchis, Walter P.

2018-01-01

Abstract Objective To gain a more comprehensive understanding of patients’ perceptions of access to their primary care practice and how these relate to patient characteristics. Design Cross-sectional study. Setting Ontario. Participants Adult primary care patients in Ontario (N = 1698) completing the Quality and Costs of Primary Care (QUALICOPC) Patient Experiences Survey. Main outcome measures Responses to 11 access-related survey items, analyzed both individually and as a Composite Access Score (CAS). Results The mean (SD) CAS was 1.78 (0.16) (the highest possible CAS was 2 and the lowest was 1). Most patients (68%) waited more than 1 day for their appointment. By far most (96%) stated that it was easy to obtain their appointment and that they obtained that appointment as soon as they wanted to (87%). There were no statistically significant relationships between CAS and sex, language fluency, income, education, frequency of emergency department use, or chronic disease status. A higher CAS was associated with being older and being born in Canada, better self-reported health, and increased frequency of visits to a doctor. Conclusion Despite criticisms of access to primary care, this study found that Ontario patients belonging to primary care practices have favourable impressions of their access. There were few statistically significant relationships between patient characteristics and access, and these relationships appeared to be weak. PMID:29540392

Policies of Access and Quality of Higher Education in China and Kenya: A Comparative Study

ERIC Educational Resources Information Center

Malechwanzi, J. Muthiani; Shen, Hong; Mbeke, Caroline

2016-01-01

This paper traces the development and current situations of higher education in China and Kenya. This paper calls for rethinking on how to address increasing demand for access and quality through creating a conducive environment for learning and researching for both students and faculties. The paper presents a comparative study where China has…

Access Denied

ERIC Educational Resources Information Center

Villano, Matt

2008-01-01

Building access control (BAC)--a catchall phrase to describe the systems that control access to facilities across campus--has traditionally been handled with remarkably low-tech solutions: (1) manual locks; (2) electronic locks; and (3) ID cards with magnetic strips. Recent improvements have included smart cards and keyless solutions that make use…

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…

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…

Linear Time Algorithms to Restrict Insider Access using Multi-Policy Access Control Systems

PubMed Central

Mell, Peter; Shook, James; Harang, Richard; Gavrila, Serban

2017-01-01

An important way to limit malicious insiders from distributing sensitive information is to as tightly as possible limit their access to information. This has always been the goal of access control mechanisms, but individual approaches have been shown to be inadequate. Ensemble approaches of multiple methods instantiated simultaneously have been shown to more tightly restrict access, but approaches to do so have had limited scalability (resulting in exponential calculations in some cases). In this work, we take the Next Generation Access Control (NGAC) approach standardized by the American National Standards Institute (ANSI) and demonstrate its scalability. The existing publicly available reference implementations all use cubic algorithms and thus NGAC was widely viewed as not scalable. The primary NGAC reference implementation took, for example, several minutes to simply display the set of files accessible to a user on a moderately sized system. In our approach, we take these cubic algorithms and make them linear. We do this by reformulating the set theoretic approach of the NGAC standard into a graph theoretic approach and then apply standard graph algorithms. We thus can answer important access control decision questions (e.g., which files are available to a user and which users can access a file) using linear time graph algorithms. We also provide a default linear time mechanism to visualize and review user access rights for an ensemble of access control mechanisms. Our visualization appears to be a simple file directory hierarchy but in reality is an automatically generated structure abstracted from the underlying access control graph that works with any set of simultaneously instantiated access control policies. It also provide an implicit mechanism for symbolic linking that provides a powerful access capability. Our work thus provides the first efficient implementation of NGAC while enabling user privilege review through a novel visualization approach. This

Montreal Archive of Sleep Studies: an open-access resource for instrument benchmarking and exploratory research.

PubMed

O'Reilly, Christian; Gosselin, Nadia; Carrier, Julie; Nielsen, Tore

2014-12-01

Manual processing of sleep recordings is extremely time-consuming. Efforts to automate this process have shown promising results, but automatic systems are generally evaluated on private databases, not allowing accurate cross-validation with other systems. In lacking a common benchmark, the relative performances of different systems are not compared easily and advances are compromised. To address this fundamental methodological impediment to sleep study, we propose an open-access database of polysomnographic biosignals. To build this database, whole-night recordings from 200 participants [97 males (aged 42.9 ± 19.8 years) and 103 females (aged 38.3 ± 18.9 years); age range: 18-76 years] were pooled from eight different research protocols performed in three different hospital-based sleep laboratories. All recordings feature a sampling frequency of 256 Hz and an electroencephalography (EEG) montage of 4-20 channels plus standard electro-oculography (EOG), electromyography (EMG), electrocardiography (ECG) and respiratory signals. Access to the database can be obtained through the Montreal Archive of Sleep Studies (MASS) website (http://www.ceams-carsm.ca/en/MASS), and requires only affiliation with a research institution and prior approval by the applicant's local ethical review board. Providing the research community with access to this free and open sleep database is expected to facilitate the development and cross-validation of sleep analysis automation systems. It is also expected that such a shared resource will be a catalyst for cross-centre collaborations on difficult topics such as improving inter-rater agreement on sleep stage scoring. © 2014 European Sleep Research Society.

The unethical focus on access: a study of medical ethics and the waiting-time guarantee.

PubMed

Karlberg, H I; Brinkmo, B-M

2009-03-01

All civilized societies favour ethical principles of equity. In healthcare, these principles generally focus on needs for medical care. Methods for establishing priorities among such needs are instrumental in this process. In this study, we analysed whether rules on access to healthcare, waiting-time guarantees, conflict with ethical principles of distributive justice. We interviewed directors, managers and other decision-makers of various healthcare providers of hospitals, primary care organizations and purchasing offices. We also conducted focus group interviews with professionals from a number of distinct medical areas. Our informants and their co-workers were reasonably familiar with the ethical platforms for priority-setting established by the Swedish parliament, giving the sickest patients complete priority. However, to satisfy the waiting-time guarantees, the informants often had to make priority decisions contrary to the ethical principles by favouring access before needs to keep waiting times within certain limits. The common opinion was that the waiting-time guarantee leads to crowding-out effects, overruling the ethical principles based on needs. For more than a decade, the interpretation in Sweden of the equitable principle based on medical needs has been distorted through political decisions, leading to healthcare providers giving priority to access rather than needs for care.

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

Rapid Access Real-Time device and Rapid Access software: new tools in the armamentarium of capsule endoscopy.

PubMed

Spada, Cristiano; Riccioni, Maria Elena; Costamagna, Guido

2007-07-01

Small bowel capsule endoscopy represents a significant advance in the investigation of the small bowel, allowing direct visualization of this section of the gastrointestinal system. More recently, new video capsules have been released, specifically designed to investigate the esophagus and the colon. In June 2006, Given Imaging Ltd received marketing clearance from the US FDA for the Rapid Access Real-Time (RT) and Rapid Access software. The Rapid Access RT is a handheld device that enables real-time viewing during capsule endoscopy procedures. To date, the clinical benefits of this device are unknown as studies on the Rapid Access RT system have not yet been published. However, it appears that the Rapid Access RT system may reduce the examination and reading time, and may impact significantly in cases where it is important to know the precise localization of the capsule (during PillCam ESO ingestion procedures, PillCam Colon examinations or when delayed gastric transit is suspected) or in case of severe gastrointestinal bleeding (when a therapeutic procedure is required urgently).

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...

Obstacles to the Access, Use and Transfer of Information from Archives: A RAMP Study.

ERIC Educational Resources Information Center

Duchein, Michel

This publication reviews means of access to information contained in the public archives (current administrative documents and archival records) and private archives (manuscripts of personal or family origin) of many countries and makes recommendations for improving access to archival information. Sections describe: (1) the origin and development…

Accessibility to Ontario Universities.

ERIC Educational Resources Information Center

Davis, Christine K.

Accessibility to a college education in Ontario, Canada, was assessed by studying the pattern of acceptances and rejections of various choices made by unregistered college applicants. Study concerns included: total offers to programs of choice from any college and from an Ontario college only; offers by institution type and program type for first…

Methodology and Results of the Near-Earth Object (NEO) Human Space Flight (HSF) Accessible Targets Study (NHATS)

NASA Technical Reports Server (NTRS)

Barbee, Brent W.; Mink, Ronald G.; Adamo, Daniel R.; Alberding, Cassandra M.

2011-01-01

Near-Earth Asteroids (NEAs) have been identified by the Administration as potential destinations for human explorers during the mid-2020s. Planning such ambitious missions requires selecting potentially accessible targets from the growing known population of 8,008 NEAs. NASA is therefore conducting the Near-Earth Object (NEO) Human Space Flight (HSF) Accessible Targets Study (NHATS), in which the trajectory opportunities to all known NEAs are being systematically evaluated with respect to a set of defined constraints. While the NHATS algorithms have identified hundreds of NEAs which satisfy purposely inclusive trajectory constraints, only a handful of them offer truly attractive mission opportunities in the time frame of greatest interest. In this paper we will describe the structure of the NHATS algorithms and the constraints utilized in the study, present current study results, and discuss various mission design considerations for future human space flight missions to NEAs.

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.

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…

Open Access

ERIC Educational Resources Information Center

Suber, Peter

2012-01-01

The Internet lets us share perfect copies of our work with a worldwide audience at virtually no cost. We take advantage of this revolutionary opportunity when we make our work "open access": digital, online, free of charge, and free of most copyright and licensing restrictions. Open access is made possible by the Internet and copyright-holder…

Access to MISR Aerosol Data and Imagery for the GoMACCS Field Study

NASA Astrophysics Data System (ADS)

Ritchey, N.; Watkinson, T.; Davis, J.; Walter, J.; Protack, S.; Matthews, J.; Smyth, M.; Rheingans, B.; Gaitley, B.; Ferebee, M.; Haberer, S.

2006-12-01

NASA Langley Atmospheric Science Data Center (ASDC) and NASA Jet Propulsion Laboratory (JPL) Multi- angle Imaging SpectroRadiometer (MISR) teams collaborated to provide special data products and images in an innovative approach for the Gulf of Mexico Atmospheric Composition and Climate Study (GoMACCS) field campaign. GoMACCS was an intensive field study focused on providing a better understanding of the sources and atmospheric processes responsible for the formation and distribution of ozone and aerosols in the atmosphere and the influence that these species have on the radiative forcing of regional and global climate, as well as their impact on human health and regional haze. The study area encompassed Texas and the northwestern Gulf of Mexico. Numerous U. S. Government agencies, universities and commercial entities participated in the field campaign which occurred August through September 2006. Aerosol and meteorological measurements were provided by a network of instruments on land, buoys and ships, by airborne in situ and remote instruments, and by satellite retrievals. MISR's role in GoMACCS was to provide satellite retrievals of aerosols and cloud properties and imagery as quickly as possible after data acquisition. The diverse group of scientific participants created unique opportunities for ASDC and MISR to develop special data products and images that were easily accessible by all participants. Examples of the data products, images and access methods as well as the data and imagery flow will be presented. Additional information about ASDC and MISR is available from the following web sites, http://eosweb.larc.nasa.gov and http://www-misr.jpl.nasa.gov/.

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…

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

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.

The Mission Accessibility of Near-Earth Asteroids

NASA Technical Reports Server (NTRS)

Barbee, Brent W.; Abell, P. A.; Adamo, D. R.; Mazanek, D. D.; Johnson, L. N.; Yeomans, D. K.; Chodas, P. W.; Chamberlin, A. B.; Benner, L. A. M.; Taylor, P.;

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

PubMed

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

2018-04-01

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

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.…

Web Accessibility and Guidelines

NASA Astrophysics Data System (ADS)

Harper, Simon; Yesilada, Yeliz

Access to, and movement around, complex online environments, of which the World Wide Web (Web) is the most popular example, has long been considered an important and major issue in the Web design and usability field. The commonly used slang phrase ‘surfing the Web’ implies rapid and free access, pointing to its importance among designers and users alike. It has also been long established that this potentially complex and difficult access is further complicated, and becomes neither rapid nor free, if the user is disabled. There are millions of people who have disabilities that affect their use of the Web. Web accessibility aims to help these people to perceive, understand, navigate, and interact with, as well as contribute to, the Web, and thereby the society in general. This accessibility is, in part, facilitated by the Web Content Accessibility Guidelines (WCAG) currently moving from version one to two. These guidelines are intended to encourage designers to make sure their sites conform to specifications, and in that conformance enable the assistive technologies of disabled users to better interact with the page content. In this way, it was hoped that accessibility could be supported. While this is in part true, guidelines do not solve all problems and the new WCAG version two guidelines are surrounded by controversy and intrigue. This chapter aims to establish the published literature related to Web accessibility and Web accessibility guidelines, and discuss limitations of the current guidelines and future directions.

Identifying strategies to improve access to credible and relevant information for public health professionals: a qualitative study

PubMed Central

LaPelle, Nancy R; Luckmann, Roger; Simpson, E Hatheway; Martin, Elaine R

2006-01-01

Background Movement towards evidence-based practices in many fields suggests that public health (PH) challenges may be better addressed if credible information about health risks and effective PH practices is readily available. However, research has shown that many PH information needs are unmet. In addition to reviewing relevant literature, this study performed a comprehensive review of existing information resources and collected data from two representative PH groups, focusing on identifying current practices, expressed information needs, and ideal systems for information access. Methods Nineteen individual interviews were conducted among employees of two domains in a state health department – communicable disease control and community health promotion. Subsequent focus groups gathered additional data on preferences for methods of information access and delivery as well as information format and content. Qualitative methods were used to identify themes in the interview and focus group transcripts. Results Informants expressed similar needs for improved information access including single portal access with a good search engine; automatic notification regarding newly available information; access to best practice information in many areas of interest that extend beyond biomedical subject matter; improved access to grey literature as well as to more systematic reviews, summaries, and full-text articles; better methods for indexing, filtering, and searching for information; and effective ways to archive information accessed. Informants expressed a preference for improving systems with which they were already familiar such as PubMed and listservs rather than introducing new systems of information organization and delivery. A hypothetical ideal model for information organization and delivery was developed based on informants' stated information needs and preferred means of delivery. Features of the model were endorsed by the subjects who reviewed it. Conclusion

Catalog Use Studies--Since the Introduction of Online Interactive Catalogs: Impact on Design for Subject Access.

ERIC Educational Resources Information Center

Cochrane, Pauline A.; Markey, Karen

1983-01-01

This review of the transition from library card catalogs to online public access catalogs (OPAC) (1981-1982) discusses methods employed by online catalog use studies (self-administered questionnaires, OPAC transaction logs, focused-group interviews, feature analysis, online search and retrieval experiments) and new directions for OPAC research…

Access to scientific publications: the scientist's perspective.

PubMed

Voronin, Yegor; Myrzahmetov, Askar; Bernstein, Alan

2011-01-01

Scientific publishing is undergoing significant changes due to the growth of online publications, increases in the number of open access journals, and policies of funders and universities requiring authors to ensure that their publications become publicly accessible. Most studies of the impact of these changes have focused on the growth of articles available through open access or the number of open-access journals. Here, we investigated access to publications at a number of institutes and universities around the world, focusing on publications in HIV vaccine research--an area of biomedical research with special importance to the developing world. We selected research papers in HIV vaccine research field, creating: 1) a first set of 50 most recently published papers with keywords "HIV vaccine" and 2) a second set of 200 articles randomly selected from those cited in the first set. Access to the majority (80%) of the recently published articles required subscription, while cited literature was much more accessible (67% freely available online). Subscriptions at a number of institutions around the world were assessed for providing access to subscription-only articles from the two sets. The access levels varied widely, ranging among institutions from 20% to 90%. Through the WHO-supported HINARI program, institutes in low-income countries had access comparable to that of institutes in the North. Finally, we examined the response rates for reprint requests sent to corresponding authors, a method commonly used before internet access became widespread. Contacting corresponding authors with requests for electronic copies of articles by email resulted in a 55-60% success rate, although in some cases it took up to 1.5 months to get a response. While research articles are increasingly available on the internet in open access format, institutional subscriptions continue to play an important role. However, subscriptions do not provide access to the full range of HIV vaccine

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

Access to and utilisation of GP services among Burmese migrants in London: a cross-sectional descriptive study.

PubMed

Aung, Nyein Chan; Rechel, Bernd; Odermatt, Peter

2010-10-12

An estimated 10,000 Burmese migrants are currently living in London. No studies have been conducted on their access to health services. Furthermore, most studies on migrants in the United Kingdom (UK) have been conducted at the point of service provision, carrying the risk of selection bias. Our cross-sectional study explored access to and utilisation of General Practice (GP) services by Burmese migrants residing in London. We used a mixed-method approach: a quantitative survey using self-administered questionnaires was complemented by qualitative in-depth interviews for developing the questionnaire and triangulating the findings of the survey. Overall, 137 questionnaires were received (a response rate of 57%) and 11 in-depth interviews conducted. The main outcome variables of the study included GP registration, barriers towards registration, GP consultations, barriers towards consultations, and knowledge on entitlements to health care. Quantitative data were analysed using descriptive statistics, association tests, and a multivariate analysis using logistic regression. The qualitative information was analysed using content analysis. The respondents were young, of roughly equal gender (51.5% female), well educated, and had a fair level of knowledge on health services in the UK. Although the GP registration rate was relatively high (80%, 109 out of 136), GP service utilisation during the last episode of illness, at 56.8% (54 out of 95), was low. The statistical analysis showed that age being younger than 35 years, lacking prior overseas experience, having an unstable immigration status, having a shorter duration of stay, and resorting to self-medication were the main barriers hindering Burmese migrants from accessing primary health care services. These findings were corroborated by the in-depth interviews. Our study found that having formal access to primary health care was not sufficient to ensure GP registration and health care utilisation. Some respondents faced

Mind the gap: An empirical study of post-trial access in HIV biomedical prevention trials.

PubMed

Haire, Bridget; Jordens, Christopher

2015-08-01

The principle of providing post-trial access for research participants to successful products of that research is widely accepted and has been enshrined in various declarations and guidelines. While recent ethical guidelines recognise that the responsibility to provide post-trial access extends to sponsors, regulators and government bodies as well as to researchers, it is the researchers who have the direct duty of care to participants. Researchers may thus need to act as advocates for trial participants, especially where government bodies, sponsors, and regulatory bodies have complex interests vested in decisions about whether or not new interventions are made available, how, and to whom. This paper provides an empirical account of post-trial access in the context of HIV prevention research. It describes both access to the successful products of research and the provision antiretroviral drugs for trial participants who acquire HIV. First, we provide evidence that, in the current system, there is considerable variation in the duration and timeliness of access. We then argue that by analysing the difficulties faced by researchers to this point, and their efforts to meet this obligation, much can be learned about how to secure post-trial access in HIV biomedical preventions trials. While researchers alone have a limited obligation, their advocacy on behalf of trial participants may be necessary to call the other parties to account. © 2013 John Wiley & Sons Ltd.

ART access-related barriers faced by HIV-positive persons linked to care in southern Ghana: a mixed method study.

PubMed

Ankomah, Augustine; Ganle, John Kuumuori; Lartey, Margaret Yaa; Kwara, Awewura; Nortey, Priscilla Awo; Okyerefo, Michael Perry Kweku; Laar, Amos Kankponang

2016-12-07

Timely and enduring access to antiretroviral therapy (ART) by HIV-infected individuals has been shown to substantially reduce HIV transmission risk, HIV-related morbidity and mortality. However, there is evidence that in addition to limited supply of antiretrovirals (ARVs) and linkage to ART in many low-income countries, HIV+ persons often encounter barriers in accessing ART-related services even in contexts where these services are freely available. In Ghana, limited research evidence exists regarding the barriers HIV+ persons already linked to ART face. This paper explores ART access-related barriers that HIV+ persons linked to care in southern Ghana face. A mixed method study design, involving a cross-sectional survey and qualitative in-depth interviews, was conducted to collect data from four healthcare providers and a total of 540 adult HIV+ persons receiving ART at four treatment centres in Ghana. We used univariate analysis to generate descriptive tabulations for key variables from the survey. Data from qualitative in-depth interviews were thematically analysed. Results from the survey and in-depth interviews were brought together to illuminate the challenges of the HIV+ persons. All (100%) the HIV+ persons interviewed were ARV-exposed and linked to ART. Reasons for taking ARVs ranged from beliefs that they will suppress the HIV virus, desire to maintain good health and prolong life, and desire to prevent infection in unborn children, desire both to avoid death and to become good therapeutic citizens (abide by doctors' advice). Despite this, more than half of the study participants (63.3%) reported seven major factors as barriers hindering access to ART. These were high financial costs associated with accessing and receiving ART (26%), delays associated with receiving care from treatment centres (24%), shortage of drugs and other commodities (23%), stigma (8.8%), fear of side effects of taking ARVs (7.9%), job insecurity arising from regular leave of absence

Insurance + Access ≠ Health Care: Typology of Barriers to Health Care Access for Low-Income Families

PubMed Central

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

2007-01-01

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

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.

The geographic accessibility of pharmacies in Nova Scotia.

PubMed

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

2013-01-01

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

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…

Power System Trade Studies for the Lunar Surface Access Module

NASA Technical Reports Server (NTRS)

Kohout, Lisa, L.

2008-01-01

A Lunar Lander Preparatory Study (LLPS) was undertaken for NASA's Lunar Lander Pre-Project in 2006 to explore a wide breadth of conceptual lunar lander designs. Civil servant teams from nearly every NASA center responded with dozens of innovative designs that addressed one or more specific lander technical challenges. Although none of the conceptual lander designs sought to solve every technical design issue, each added significantly to the technical database available to the Lunar Lander Project Office as it began operations in 2007. As part of the LLPS, a first order analysis was performed to identify candidate power systems for the ascent and descent stages of the Lunar Surface Access Module (LSAM). A power profile by mission phase was established based on LSAM subsystem power requirements. Using this power profile, battery and fuel cell systems were modeled to determine overall mass and volume. Fuel cell systems were chosen for both the descent and ascent stages due to their low mass. While fuel cells looked promising based on these initial results, several areas have been identified for further investigation in subsequent studies, including the identification and incorporation of peak power requirements into the analysis, refinement of the fuel cell models to improve fidelity and incorporate ongoing technology developments, and broadening the study to include solar power.

Atomic memory access hardware implementations

DOEpatents

Ahn, Jung Ho; Erez, Mattan; Dally, William J

2015-02-17

Atomic memory access requests are handled using a variety of systems and methods. According to one example method, a data-processing circuit having an address-request generator that issues requests to a common memory implements a method of processing the requests using a memory-access intervention circuit coupled between the generator and the common memory. The method identifies a current atomic-memory access request from a plurality of memory access requests. A data set is stored that corresponds to the current atomic-memory access request in a data storage circuit within the intervention circuit. It is determined whether the current atomic-memory access request corresponds to at least one previously-stored atomic-memory access request. In response to determining correspondence, the current request is implemented by retrieving data from the common memory. The data is modified in response to the current request and at least one other access request in the memory-access intervention circuit.

Neighborhood Environment and Disparities in Health Care Access Among Urban Medicare Beneficiaries With Diabetes: A Retrospective Cohort Study.

PubMed

Ryvicker, Miriam; Sridharan, Sridevi

2018-01-01

Older adults' health is sensitive to variations in neighborhood environment, yet few studies have examined how neighborhood factors influence their health care access. This study examined whether neighborhood environmental factors help to explain racial and socioeconomic disparities in health care access and outcomes among urban older adults with diabetes. Data from 123 233 diabetic Medicare beneficiaries aged 65 years and older in New York City were geocoded to measures of neighborhood walkability, public transit access, and primary care supply. In 2008, 6.4% had no office-based "evaluation and management" (E&M) visits. Multilevel logistic regression indicated that this group had greater odds of preventable hospitalization in 2009 (odds ratio = 1.31; 95% confidence interval: 1.22-1.40). Nonwhites and low-income individuals had greater odds of a lapse in E&M visits and of preventable hospitalization. Neighborhood factors did not help to explain these disparities. Further research is needed on the mechanisms underlying these disparities and older adults' ability to navigate health care. Even in an insured population living in a provider-dense city, targeted interventions may be needed to overcome barriers to chronic illness care for older adults in the community.

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

Communicating the Open Access Message: A Case Study from Ireland

ERIC Educational Resources Information Center

Lawton, Aoife

2016-01-01

Since 2009, Open Access (OA) Week has been celebrated worldwide in October each year. It is an opportunity for librarians to engage with the research community and demonstrate the value that they bring to their organisations in the area of disseminating scholarly output. Although thousands of events have been held since the inception of OA Week, a…

Selecting Lentil Accessions for Global Selenium Biofortification.

PubMed

Thavarajah, Dil; Abare, Alex; Mapa, Indika; Coyne, Clarice J; Thavarajah, Pushparajah; Kumar, Shiv

2017-08-26

The biofortification of lentil ( Lens culinaris Medikus.) has the potential to provide adequate daily selenium (Se) to human diets. The objectives of this study were to (1) determine how low-dose Se fertilizer application at germination affects seedling biomass, antioxidant activity, and Se uptake of 26 cultivated lentil genotypes; and (2) quantify the seed Se concentration of 191 lentil wild accessions grown in Terbol, Lebanon. A germination study was conducted with two Se treatments [0 (control) and 30 kg of Se/ha] with three replicates. A separate field study was conducted in Lebanon for wild accessions without Se fertilizer. Among cultivated lentil accessions, PI533690 and PI533693 showed >100% biomass increase vs. Se addition significantly increased seedling Se uptake, with the greatest uptake (6.2 µg g -1 ) by PI320937 and the least uptake (1.1 µg g -1 ) by W627780. Seed Se concentrations of wild accessions ranged from 0 to 2.5 µg g -1 ; accessions originating from Syria (0-2.5 µg g -1 ) and Turkey (0-2.4 µg g -1 ) had the highest seed Se. Frequency distribution analysis revealed that seed Se for 63% of accessions was between 0.25 and 0.75 µg g -1 , and thus a single 50 g serving of lentil has the potential to provide adequate dietary Se (20-60% of daily recommended daily allowance). As such, Se application during plant growth for certain lentil genotypes grown in low Se soils may be a sustainable Se biofortification solution to increase seed Se concentration. Incorporating a diverse panel of lentil wild germplasm into Se biofortification programs will increase genetic diversity for effective genetic mapping for increased lentil seed Se nutrition and plant productivity.

Selecting Lentil Accessions for Global Selenium Biofortification

PubMed Central

Thavarajah, Dil; Abare, Alex; Mapa, Indika; Coyne, Clarice J.; Thavarajah, Pushparajah; Kumar, Shiv

2017-01-01

The biofortification of lentil (Lens culinaris Medikus.) has the potential to provide adequate daily selenium (Se) to human diets. The objectives of this study were to (1) determine how low-dose Se fertilizer application at germination affects seedling biomass, antioxidant activity, and Se uptake of 26 cultivated lentil genotypes; and (2) quantify the seed Se concentration of 191 lentil wild accessions grown in Terbol, Lebanon. A germination study was conducted with two Se treatments [0 (control) and 30 kg of Se/ha] with three replicates. A separate field study was conducted in Lebanon for wild accessions without Se fertilizer. Among cultivated lentil accessions, PI533690 and PI533693 showed >100% biomass increase vs. controls. Se addition significantly increased seedling Se uptake, with the greatest uptake (6.2 µg g−1) by PI320937 and the least uptake (1.1 µg g−1) by W627780. Seed Se concentrations of wild accessions ranged from 0 to 2.5 µg g−1; accessions originating from Syria (0–2.5 µg g−1) and Turkey (0–2.4 µg g−1) had the highest seed Se. Frequency distribution analysis revealed that seed Se for 63% of accessions was between 0.25 and 0.75 µg g−1, and thus a single 50 g serving of lentil has the potential to provide adequate dietary Se (20–60% of daily recommended daily allowance). As such, Se application during plant growth for certain lentil genotypes grown in low Se soils may be a sustainable Se biofortification solution to increase seed Se concentration. Incorporating a diverse panel of lentil wild germplasm into Se biofortification programs will increase genetic diversity for effective genetic mapping for increased lentil seed Se nutrition and plant productivity. PMID:28846602

Strategies of arteriovenous dialysis access.

PubMed

Weiswasser, Jonathan M; Kellicut, Dwight; Arora, Subodh; Sidawy, Anton N

2004-03-01

Surgical management of the patient who requires hemodialysis access, while continuing to demand more attention from the vascular surgeon, suffers from discrepancies of approach and strategy. With the increase in incidence of dialysis dependent renal failure among our population, many have attempted to present a uniform, logical strategy with which the vascular surgeon can most effectively treat the hemodialysis patient in the long term. Most notably, the multidisciplinary Dialysis Outcomes Quality Initiative (DOQI) guidelines present the surgeon with a rough outline of hemodialysis access insertion strategy, and it has become nationally recognized as an acceptable summary of treatment strategy and goals. The decision as to the most appropriate surgical access to offer a patient depends on immediate need for hemodialysis, history and physical examination findings, and suitability of available veins in the extremity. While percutaneous, catheter based access affords the luxury of immediate access, these devices suffer from several complicating factors, such as infection, and damage to large, proximal veins. For long-term access, the autogenous access, while perhaps less successful in the immediate short term, is always the preferred access type given its favorable longevity. The surgeons should focus on sites distally on the extremity, reserving proximal sites for potential future access insertions should the primary access fail. In the absence of suitable vein, prosthetic access may be considered. When both the upper and lower aspects of both upper extremities have been exhausted, the surgeon should consider access insertion elsewhere, such as the lower extremity.

Why build limited access highways?.

DOT National Transportation Integrated Search

1991-01-01

This report first explains what a limited access highway is, then describes the benefits and advantages of limited access highways. As compared with highways with no control of access, limited access highways (especially those with full control) have...

Barriers to patient portal access among veterans receiving home-based primary care: a qualitative study.

PubMed

Mishuris, Rebecca G; Stewart, Max; Fix, Gemmae M; Marcello, Thomas; McInnes, D Keith; Hogan, Timothy P; Boardman, Judith B; Simon, Steven R

2015-12-01

Electronic, or web-based, patient portals can improve patient satisfaction, engagement and health outcomes and are becoming more prevalent with the advent of meaningful use incentives. However, adoption rates are low, particularly among vulnerable patient populations, such as those patients who are home-bound with multiple comorbidities. Little is known about how these patients view patient portals or their barriers to using them. To identify barriers to and facilitators of using My HealtheVet (MHV), the United States Department of Veterans Affairs (VA) patient portal, among Veterans using home-based primary care services. Qualitative study using in-depth semi-structured interviews. We conducted a content analysis informed by grounded theory. Fourteen Veterans receiving home-based primary care, surrogates of two of these Veterans, and three home-based primary care (HBPC) staff members. We identified five themes related to the use of MHV: limited knowledge; satisfaction with current HBPC care; limited computer and Internet access; desire to learn more about MHV and its potential use; and value of surrogates acting as intermediaries between Veterans and MHV. Despite their limited knowledge of MHV and computer access, home-bound Veterans are interested in accessing MHV and using it as an additional point of care. Surrogates are also potential users of MHV on behalf of these Veterans and may have different barriers to and benefits from use. © 2014 John Wiley & Sons Ltd.

36 CFR 9.32 - Access.

Code of Federal Regulations, 2013 CFR

2013-07-01

... MANAGEMENT Non-Federal Oil and Gas Rights § 9.32 Access. (a) No access on, across or through lands or waters... access is by foot, pack animal, or designated road. Persons using designated roads for access to such a...

36 CFR 9.32 - Access.

Code of Federal Regulations, 2012 CFR

2012-07-01

... MANAGEMENT Non-Federal Oil and Gas Rights § 9.32 Access. (a) No access on, across or through lands or waters... access is by foot, pack animal, or designated road. Persons using designated roads for access to such a...

36 CFR 9.32 - Access.

Code of Federal Regulations, 2010 CFR

2010-07-01

... MANAGEMENT Non-Federal Oil and Gas Rights § 9.32 Access. (a) No access on, across or through lands or waters... access is by foot, pack animal, or designated road. Persons using designated roads for access to such a...

36 CFR 9.32 - Access.

Code of Federal Regulations, 2014 CFR

2014-07-01

... MANAGEMENT Non-Federal Oil and Gas Rights § 9.32 Access. (a) No access on, across or through lands or waters... access is by foot, pack animal, or designated road. Persons using designated roads for access to such a...

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.

Anatomy of open access publishing: a study of longitudinal development and internal structure

PubMed Central

2012-01-01

Background Open access (OA) is a revolutionary way of providing access to the scholarly journal literature made possible by the Internet. The primary aim of this study was to measure the volume of scientific articles published in full immediate OA journals from 2000 to 2011, while observing longitudinal internal shifts in the structure of OA publishing concerning revenue models, publisher types and relative distribution among scientific disciplines. The secondary aim was to measure the share of OA articles of all journal articles, including articles made OA by publishers with a delay and individual author-paid OA articles in subscription journals (hybrid OA), as these subsets of OA publishing have mostly been ignored in previous studies. Methods Stratified random sampling of journals in the Directory of Open Access Journals (n = 787) was performed. The annual publication volumes spanning 2000 to 2011 were retrieved from major publication indexes and through manual data collection. Results An estimated 340,000 articles were published by 6,713 full immediate OA journals during 2011. OA journals requiring article-processing charges have become increasingly common, publishing 166,700 articles in 2011 (49% of all OA articles). This growth is related to the growth of commercial publishers, who, despite only a marginal presence a decade ago, have grown to become key actors on the OA scene, responsible for 120,000 of the articles published in 2011. Publication volume has grown within all major scientific disciplines, however, biomedicine has seen a particularly rapid 16-fold growth between 2000 (7,400 articles) and 2011 (120,900 articles). Over the past decade, OA journal publishing has steadily increased its relative share of all scholarly journal articles by about 1% annually. Approximately 17% of the 1.66 million articles published during 2011 and indexed in the most comprehensive article-level index of scholarly articles (Scopus) are available OA through journal

Enhancing Digital Access to Learning Materials for Canadians with Perceptual Disabilities: A Pilot Study. Research Report

ERIC Educational Resources Information Center

Lockerby, Christina; Breau, Rachel; Zuvela, Biljana

2006-01-01

By exploring the experiences of participants with DAISY (Digital Accessible Information System) Talking Books, the study reported in this article not only discovered how people who are blind, visually impaired, and/or print-disabled read DAISY books, but also identified participants' perceptions of DAISY as being particularly useful in their…

Negative Evidence in Language Classroom Activities: A Study of Its Availability and Accessibility to Language Learners.