eap Gene as novel target for specific identification of Staphylococcus aureus.

PubMed

Hussain, Muzaffar; von Eiff, Christof; Sinha, Bhanu; Joost, Insa; Herrmann, Mathias; Peters, Georg; Becker, Karsten

2008-02-01

The cell surface-associated extracellular adherence protein (Eap) mediates adherence of Staphylococcus aureus to host extracellular matrix components and inhibits inflammation, wound healing, and angiogenesis. A well-characterized collection of S. aureus and non-S. aureus staphylococcal isolates (n = 813) was tested for the presence of the Eap-encoding gene (eap) by PCR to investigate the use of the eap gene as a specific diagnostic tool for identification of S. aureus. Whereas all 597 S. aureus isolates were eap positive, this gene was not detectable in 216 non-S. aureus staphylococcal isolates comprising 47 different species and subspecies of coagulase-negative staphylococci and non-S. aureus coagulase-positive or coagulase-variable staphylococci. Furthermore, non-S. aureus isolates did not express Eap homologs, as verified on the transcriptional and protein levels. Based on these data, the sensitivity and specificity of the newly developed PCR targeting the eap gene were both 100%. Thus, the unique occurrence of Eap in S. aureus offers a promising tool particularly suitable for molecular diagnostics of this pathogen.

Recommendations to Facilitate Expanded Access to Investigational Therapies for Seriously Ill Patients

PubMed Central

Jerome, Rebecca N.; Edwards, Terri L.; Boswell, Haley C.; Bernard, Gordon R.; Harris, Paul A.; Pulley, Jill M.

2015-01-01

When clinical trial enrollment is not an option for seriously ill patients whose illnesses have not responded to approved treatment options, those patients and their physicians may consider gaining access to investigational therapies through a pathway established by the Food and Drug Administration (FDA) called expanded access. However, recent events have highlighted the challenging dynamics involved in accessing investigational therapies through expanded access that include a complex interplay of factors involving the patient, physician, drug company, FDA, and, increasingly, social media. The authors offer several potential strategies to streamline what is otherwise an arduous process for all involved. (1) The drug company should prospectively determine whether it will establish an expanded access program for specific drugs. (2) A central clearinghouse for companies should support registration of expanded access drugs for suitable patients. (3) The determination of whether a patient fits criteria would be made by an independent review board of clinicians. (4) An independent coordinating center is needed; academic health centers are ideally suited for that role. (5) Adequate financing of the costs of therapy need to be in place to make expanded access a reality, given frequent lack of payor coverage for therapies. (6) Further enhancement of regulatory pathways, approaches, or rules would promote expanded access. (7) Patients should explicitly acknowledge the limited data available. (8) There should be a shared, secure, technical platform to facilitate expanded access. All the authors’ strategies present important prospects for improving treatment options for the most seriously ill patients. PMID:26445080

The Costs of an Enhanced Employee Assistance Program (EAP) Intervention.

ERIC Educational Resources Information Center

French, Michael T.; Dunlap, Laura J.; Zarkin, Gary A.; Karuntzos, Georgia T.

1998-01-01

This study estimates the economic costs of an enhanced Employee Assistance Program (EAP) intervention at a large midwestern EAP that serves 90 worksites. Results specify developmental and implementation costs and provide benchmark cost estimated for other EAPs that may be considering enhanced services. (SLD)

Nonnegative definite EAP and ODF estimation via a unified multi-shell HARDI reconstruction.

PubMed

Cheng, Jian; Jiang, Tianzi; Deriche, Rachid

2012-01-01

In High Angular Resolution Diffusion Imaging (HARDI), Orientation Distribution Function (ODF) and Ensemble Average Propagator (EAP) are two important Probability Density Functions (PDFs) which reflect the water diffusion and fiber orientations. Spherical Polar Fourier Imaging (SPFI) is a recent model-free multi-shell HARDI method which estimates both EAP and ODF from the diffusion signals with multiple b values. As physical PDFs, ODFs and EAPs are nonnegative definite respectively in their domains S2 and R3. However, existing ODF/EAP estimation methods like SPFI seldom consider this natural constraint. Although some works considered the nonnegative constraint on the given discrete samples of ODF/EAP, the estimated ODF/EAP is not guaranteed to be nonnegative definite in the whole continuous domain. The Riemannian framework for ODFs and EAPs has been proposed via the square root parameterization based on pre-estimated ODFs and EAPs by other methods like SPFI. However, there is no work on how to estimate the square root of ODF/EAP called as the wavefuntion directly from diffusion signals. In this paper, based on the Riemannian framework for ODFs/EAPs and Spherical Polar Fourier (SPF) basis representation, we propose a unified model-free multi-shell HARDI method, named as Square Root Parameterized Estimation (SRPE), to simultaneously estimate both the wavefunction of EAPs and the nonnegative definite ODFs and EAPs from diffusion signals. The experiments on synthetic data and real data showed SRPE is more robust to noise and has better EAP reconstruction than SPFI, especially for EAP profiles at large radius.

EMPLOYER CHOICES IN EAP DESIGN AND WORKSITE SERVICES.

PubMed

McCann, Bernard; Azzone, Vanessa; Merrick, Elizabeth L; Hiatt, Deirdre; Hodgkin, Dominic; Horgan, Constance M

2010-01-01

In today's complex private healthcare market, employers have varied preferences for particular features of behavioral health products such as Employee Assistance Programs (EAPs). Factors which may influence these preferences include: establishment size, type of organization, industry, workplace substance abuse regulations, and structure of health insurance benefits. This study of 103 large employer purchasers from a single managed behavioral healthcare organization investigated the impact of such variables on the EAP features that employers select to provide to workers and their families. Our findings indicate that for this group of employers, preferences for the type and delivery mode of EAP counseling services are fairly universal, while number of sessions provided and choices for EAP-provided worksite activities are much more varied, and may be more reflective of the diverse characteristics, organizational missions and workplace culture found among larger employers in the US.

Wirelessly Controllable Inflated Electroactive Polymer (EAP) Reflectors

NASA Technical Reports Server (NTRS)

Bao, Xiaoqi; Bar-Cohen, Yoseph; Chang, Zensheu; Sherrit, Stewart; Badescu, Mircea

2005-01-01

Inflatable membrane reflectors are attractive for deployable, large aperture, lightweight optical and microwave systems in micro-gravity space environment. However, any fabrication flaw or temperature variation may results in significant aberration of the surface. Even for a perfectly fabricated inflatable membrane mirror with uniform thickness, theory shows it will form a Hencky curve surface but a desired parabolic or spherical surface. Precision control of the surfaceshape of extremely flexible membrane structures is a critical challenge for the success of this technology. Wirelessly controllable inflated reflectors made of electroactive polymers (EAP) are proposed in this paper. A finite element model was configured to predict the behavior of the inflatable EAP membranes under pre-strains, pressures and distributed electric charges on the surface. To explore the controllability of the inflatable EAP reflectors, an iteration algorism was developed to find the required electric actuation for correcting the aberration of the Hencky curve to the desired parabolic curve. The correction capability of the reflectors with available EAP materials was explored numerically and is presented in this paper.

Honing EAP Learners' Public Speaking Skills by Analyzing TED Talks

ERIC Educational Resources Information Center

Leopold, Lisa

2016-01-01

Despite the importance of public speaking skills for English for Academic Purposes (EAP) students' academic and professional success, few EAP textbooks incorporate authentic, professional speech models. Thus, many EAP instructors have turned to TED talks for dynamic speech models. Yet a single TED talk may be too long for viewing in class and may…

EMPLOYER CHOICES IN EAP DESIGN AND WORKSITE SERVICES

PubMed Central

McCann, Bernard; Azzone, Vanessa; Merrick, Elizabeth L.; Hiatt, Deirdre; Hodgkin, Dominic; Horgan, Constance M.

2011-01-01

SUMMARY In today’s complex private healthcare market, employers have varied preferences for particular features of behavioral health products such as Employee Assistance Programs (EAPs). Factors which may influence these preferences include: establishment size, type of organization, industry, workplace substance abuse regulations, and structure of health insurance benefits. This study of 103 large employer purchasers from a single managed behavioral healthcare organization investigated the impact of such variables on the EAP features that employers select to provide to workers and their families. Our findings indicate that for this group of employers, preferences for the type and delivery mode of EAP counseling services are fairly universal, while number of sessions provided and choices for EAP-provided worksite activities are much more varied, and may be more reflective of the diverse characteristics, organizational missions and workplace culture found among larger employers in the US. PMID:22768017

Self-Disclosure as a Predictor of EAP Supervisory Utilization

NASA Technical Reports Server (NTRS)

Donohoe, Timothy L.; Johnson, James T.; Taquino, Maurice A.

1999-01-01

The value of Employee Assistance Programs (EAPS) has been cited in a variety of published papers and articles. An important managerial element relative to the assessment and referral of troubled employees has been supervisory training. There has been numerous studies highlighting the various factors and circumstances associated with supervisory behavior and EAP referrals. The inclusion of emotional awareness factors in EAP supervisory utilization has not been thoroughly investigated, although frequently found in the literature as a training and development objective for managers in business and education. The present study sought to determine what role supervisory denial and anxiety avoidance plays in confrontation of troubled employees and if admission of specific, internal emotional events is a characteristic among EAP utilizing supervisors.

14 CFR 120.115 - Employee Assistance Program (EAP).

Code of Federal Regulations, 2014 CFR

2014-01-01

... (CONTINUED) AIR CARRIERS AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS DRUG AND ALCOHOL TESTING PROGRAM Drug Testing Program Requirements § 120.115 Employee Assistance Program (EAP). (a... the employee and supervisor EAP training in the employer's drug testing program. [Doc. No. FAA-2008...

EAP and LLNP Students: Common Problems and Strategies

ERIC Educational Resources Information Center

Nguyen, Thi Minh Phuong

2010-01-01

As English learners originate from many cultural and language backgrounds, they come to class with different circumstances. This paper examines the backgrounds, common problems and solutions for English for Academic Purposes (EAP) students and Language, Literacy, and Numeracy Programme (LLNP) students. EAP students are from Meridian International…

Optimizing Depression Care: Opportunities for the EAP.

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

Kreuch, Tony J.

Depression is a major workplace concern with significant impact on employee productivity, attendance and “presenteeism” and often affects the company bottom line in areas such as cost impact, employee morale, worker turnover and affected families. However, despite the frequent challenge of depression in the workplace, EAPs are often not well-equipped to fully address these employees. Often, the individual will either be directed to a 24 hour call center or seen briefly onsite by an EAP professional and referred to a treating provider without a full assessment or comprehensive approach. Diagnostic practices may be informal without use of validated tools andmore » without a full assessment of risk or identification of appropriate level of care. However, the EAP may be ideally placed within an organization to have a significant positive impact on this condition. This article will summarize my recommendations regarding EAP strategies for optimizing assessment and care for employees who are struggling with depression. I will also briefly review a working model for the assessment and treatment of depression that we have developed at my company using best practices and a collaborative model for tracking outcomes.« less

46 CFR 16.401 - Employee Assistance Program (EAP).

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Employee Assistance Program (EAP). 16.401 Section 16.401 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN CHEMICAL TESTING Employee Assistance Programs § 16.401 Employee Assistance Program (EAP). The employer shall provide an...

Extracellular adherence protein (Eap) from Staphylococcus aureus does not function as a superantigen.

PubMed

Haggar, A; Flock, J-I; Norrby-Teglund, A

2010-08-01

Extracellular adherence protein (Eap) from Staphylococcus aureus has been reported to have strong anti-inflammatory properties, which make Eap a potential anti-inflammatory agent. However, Eap has also been demonstrated to trigger T-cell activation and to share structural homology with superantigens. In this study, we focused on whether Eap fulfilled the definition criteria for a superantigen. We demonstrate that T-cell activation by Eap is dependent on both major histocompatibility complex class II and intercellular adhesion molecule type 1, that cellular processing is required for Eap to elicit T-cell proliferation, and that the kinetics of proliferation resemble the profile of a conventional antigen and not that of a superantigen.

The Staphylococcus aureus extracellular adherence protein (Eap) adopts an elongated but structured conformation in solution.

PubMed

Hammel, Michal; Nemecek, Daniel; Keightley, J Andrew; Thomas, George J; Geisbrecht, Brian V

2007-12-01

The extracellular adherence protein (Eap) of Staphylococcus aureus participates in a wide range of protein-protein interactions that facilitate the initiation and dissemination of Staphylococcal disease. In this report, we describe the use of a multidisciplinary approach to characterize the solution structure of full-length Eap. In contrast to previous reports suggesting that a six-domain isoform of Eap undergoes multimerization, sedimentation equilibrium analytical ultracentrifugation data revealed that a four-domain isoform of Eap is a monomer in solution. In vitro proteolysis and solution small angle X-ray scattering studies both indicate that Eap adopts an extended conformation in solution, where the linkers connecting sequential EAP modules are solvent exposed. Construction of a low-resolution model of full-length Eap using a combination of ab initio deconvolution of the SAXS data and rigid body modeling of the EAP domain crystal structure suggests that full-length Eap may present several unique concave surfaces capable of participating in ligand binding. These results also raise the possibility that such surfaces may be held together by additional interactions between adjacent EAP modules. This hypothesis is supported by a comparative Raman spectroscopic analysis of full-length Eap and a stoichiometric solution of the individual EAP modules, which indicates the presence of additional secondary structure and a greater extent of hydrogen/deuterium exchange protection in full-length Eap. Our results provide the first insight into the solution structure of full-length Eap and an experimental basis for interpreting the EAP domain crystal structures within the context of the full-length molecule. They also lay a foundation for future studies into the structural and molecular bases of Eap-mediated protein-protein interactions with its many ligands.

The extracellular adherence protein (Eap) of Staphylococcus aureus acts as a proliferation and migration repressing factor that alters the cell morphology of keratinocytes.

PubMed

Eisenbeis, Janina; Peisker, Henrik; Backes, Christian S; Bur, Stephanie; Hölters, Sebastian; Thewes, Nicolas; Greiner, Markus; Junker, Christian; Schwarz, Eva C; Hoth, Markus; Junker, Kerstin; Preissner, Klaus T; Jacobs, Karin; Herrmann, Mathias; Bischoff, Markus

2017-02-01

Staphyloccocus aureus is a major human pathogen and a common cause for superficial and deep seated wound infections. The pathogen is equipped with a large arsenal of virulence factors, which facilitate attachment to various eukaryotic cell structures and modulate the host immune response. One of these factors is the extracellular adherence protein Eap, a member of the "secretable expanded repertoire adhesive molecules" (SERAM) protein family that possesses adhesive and immune modulatory properties. The secreted protein was previously shown to impair wound healing by interfering with host defense and neovascularization. However, its impact on keratinocyte proliferation and migration, two major steps in the re-epithelialization process of wounds, is not known. Here, we report that Eap affects the proliferation and migration capacities of keratinocytes by altering their morphology and adhesive properties. In particular, treatment of non-confluent HaCaT cell cultures with Eap resulted in cell morphology changes as well as a significant reduction in cell proliferation and migration. Eap-treated HaCaT cells changed their appearance from an oblong via a trapezoid to an astral-like shape, accompanied by decreases in cell volume and cell stiffness, and exhibited significantly increased cell adhesion. Eap had a similar influence on endothelial and cancer cells, indicative for a general effect of Eap on eukaryotic cell morphology and functions. Specifically, Eap was found to interfere with growth factor-stimulated activation of the mitogen-activated protein kinase (MAPK) pathway that is known to be responsible for cell shape modulation, induction of proliferation and migration of epithelial cells. Western blot analyses revealed that Eap blocked the phosphorylation of extracellular signal-regulated kinase 1 and 2 (Erk1/2) in keratinocyte growth factor (KGF)-stimulated HaCaT cells. Together, these data add another antagonistic mechanism of Eap in wound healing, whereby the

The Staphylococcus aureus extracellular adherence protein (Eap) adopts an elongated but structured conformation in solution

PubMed Central

Hammel, Michal; Němeček, Daniel; Keightley, J. Andrew; Thomas, George J.; Geisbrecht, Brian V.

2007-01-01

The extracellular adherence protein (Eap) of Staphylococcus aureus participates in a wide range of protein–protein interactions that facilitate the initiation and dissemination of Staphylococcal disease. In this report, we describe the use of a multidisciplinary approach to characterize the solution structure of full-length Eap. In contrast to previous reports suggesting that a six-domain isoform of Eap undergoes multimerization, sedimentation equilibrium analytical ultracentrifugation data revealed that a four-domain isoform of Eap is a monomer in solution. In vitro proteolysis and solution small angle X-ray scattering studies both indicate that Eap adopts an extended conformation in solution, where the linkers connecting sequential EAP modules are solvent exposed. Construction of a low-resolution model of full-length Eap using a combination of ab initio deconvolution of the SAXS data and rigid body modeling of the EAP domain crystal structure suggests that full-length Eap may present several unique concave surfaces capable of participating in ligand binding. These results also raise the possibility that such surfaces may be held together by additional interactions between adjacent EAP modules. This hypothesis is supported by a comparative Raman spectroscopic analysis of full-length Eap and a stoichiometric solution of the individual EAP modules, which indicates the presence of additional secondary structure and a greater extent of hydrogen/deuterium exchange protection in full-length Eap. Our results provide the first insight into the solution structure of full-length Eap and an experimental basis for interpreting the EAP domain crystal structures within the context of the full-length molecule. They also lay a foundation for future studies into the structural and molecular bases of Eap-mediated protein–protein interactions with its many ligands. PMID:18029416

A place for marriage and family services in employee assistance programs (EAPs): a survey of EAP client problems and needs.

PubMed

Shumway, Sterling T; Wampler, Richard S; Dersch, Charette; Arredondo, Rudy

2004-01-01

Marriage and family services have not been widely recognized as part of employee assistance programs (EAP), although family and relational problems are widely cited as sources of problems on the job. EAP clients (N = 800, 97% self-referred) indicated how much family, psychological/emotional, drug, alcohol, employment-related, legal, and medical problems troubled them and the need for services in each area. Psychological/emotional (66%) and family (65%) problem areas frequently were rated "considerable" or "extreme." Both areas were rated as "considerable" or "extreme" by 48.6% of participants. In view of the evidence that marriage and family services can be effective with both family and psychological/emotional problems, professionals who are competent to provide such services have much to offer EAP programs.

Progress toward EAP actuators for biomimetic social robots

NASA Astrophysics Data System (ADS)

Hanson, D.

2013-04-01

Social robotics and artificial intelligence have progressed steadily in recent years, appearing in a variety of useful applications and products as well as breakthrough research. However, limitations in conventional motors continue to limit the possibilities of bio-inspired robotics. Such motors are needed for locomotion, grasping and manipulation, and social expressions and gestures. EAP actuators, being more like biological muscle in key regards, could revolutionize the hardware for such robots, if made robust, powerful, and manufacturable at reasonable prices. The author presents a survey of the progress and opportunities for EAP actuators in these fields, and discusses the latest work of his team in developing and manufacturing social robots that could benefit from EAP actuators.

Final quality of life and safety data for patients with metastatic castration-resistant prostate cancer treated with cabazitaxel in the UK Early Access Programme (EAP) (NCT01254279).

PubMed

Bahl, Amit; Masson, Susan; Malik, Zafar; Birtle, Alison J; Sundar, Santhanam; Jones, Rob J; James, Nicholas D; Mason, Malcolm D; Kumar, Satish; Bottomley, David; Lydon, Anna; Chowdhury, Simon; Wylie, James; de Bono, Johann S

2015-12-01

To compile the safety profile and quality of life (QoL) data for patients with metastatic castration-resistant prostate cancer (mCRPC) treated with cabazitaxel in the UK Early Access Programme (UK EAP). A total of 112 patients participated at 12 UK cancer centres. All had mCRPC with disease progression during or after docetaxel. Patients received cabazitaxel 25 mg/m(2) every 3 weeks with prednisolone 10 mg daily for up to 10 cycles. Safety assessments were performed before each cycle and QoL was recorded at alternate cycles using the EQ-5D-3L questionnaire and visual analogue scale (VAS). The safety profile was compiled after completion of the UK EAP and QoL measures were analysed to record trends. No formal statistical analysis was carried out. The incidences of neutropenic sepsis (6.3%), grade 3 and 4 diarrhoea (4.5%) and grade 3 and 4 cardiac toxicity (0%) were low. Neutropenic sepsis episodes, though low, occurred only in patients who did not receive prophylactic granulocyte-colony stimulating factor. There were trends towards improved VAS and EQ-5D-3L pain scores during treatment. The UK EAP experience indicates that cabazitaxel might improve QoL in mCRPC and represents an advance and a useful addition to the armamentarium of treatment for patients whose disease has progressed during or after docetaxel. In view of the potential toxicity, careful patient selection is important. © 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd.

Platform based design of EAP transducers in Danfoss PolyPower A/S

NASA Astrophysics Data System (ADS)

Sarban, Rahimullah; Gudlaugsson, Tómas V.

2013-04-01

Electroactive Polymer (EAP) has gained increasing focus, in research communities, in last two decades. Research within the field of EAP has, so far, been mainly focused on material improvements, characterization, modeling and developing demonstrators. As the EAP technology matures, the need for a new area of research namely product development emerges. Product development can be based on an isolated design and production for a single product or platform design where a product family is developed. In platform design the families of products exploits commonality of platform modules while satisfying a variety of different market segments. Platform based approach has the primary benefit of being cost efficient and short lead time to market when new products emerges. Products development based on EAP technology is challenging both technologically as well as from production and processing point of view. Both the technological and processing challenges need to be addressed before a successful implementation of EAP technology into products. Based on this need Danfoss PolyPower A/S has, in 2011, launched a EAP platform project in collaboration with three Danish universities and three commercial organizations. The aim of the project is to develop platform based designs and product family for the EAP components to be used in variety of applications. This paper presents the structure of the platform project as a whole and specifically the platform based designs of EAP transducers. The underlying technologies, essential for EAP transducers, are also presented. Conceptual design and solution for the concepts are presented as well.

EAP Service Use in a Managed Behavioral Health Care Organization: From the Employee Perspective.

PubMed

Merrick, Elizabeth L; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M; McCann, Bernard

2011-01-01

Contemporary employee assistance program (EAP) services are typically provided in broad-brush programs delivered by large external vendors in a network model. Yet research has not kept pace with EAP evolution, including in terms of how EAP clients themselves view services. We surveyed a random sample of EAP service users from a national provider (361 respondents). About one-third of respondents reported getting help for workplace issues. Most learned about the EAP through employer communications such as the company website. The large majority reported that the EAP helped them "a lot" or "some," suggesting they valued this benefit.

What Do We Want EAP Teaching Materials for?

ERIC Educational Resources Information Center

Harwood, Nigel

2005-01-01

This paper explores the various anti-textbook arguments in the literature to determine their relevance to the field of EAP. I distinguish between what I call a "strong" and a "weak" anti-textbook line, then review the corpus-based studies which compare the language EAP textbooks teach with corpora of the language academic writers use. After…

1H, 15N, and 13C resonance assignments of the third domain from the S. aureus innate immune evasion protein Eap.

PubMed

Herrera, Alvaro I; Ploscariu, Nicoleta T; Geisbrecht, Brian V; Prakash, Om

2018-04-01

Staphylococcus aureus is a widespread and persistent pathogen of humans and livestock. The bacterium expresses a wide variety of virulence proteins, many of which serve to disrupt the host's innate immune system from recognizing and clearing bacteria with optimal efficiency. The extracellular adherence protein (Eap) is a multidomain protein that participates in various protein-protein interactions that inhibit the innate immune response, including both the complement system (Woehl et al in J Immunol 193:6161-6171, 2014) and Neutrophil Serine Proteases (NSPs) (Stapels et al in Proc Natl Acad Sci USA 111:13187-13192, 2014). The third domain of Eap, Eap3, is an ~ 11 kDa protein that was recently shown to bind complement component C4b (Woehl et al in Protein Sci 26:1595-1608, 2017) and therefore play an essential role in inhibiting the classical and lectin pathways of complement (Woehl et al in J Immunol 193:6161-6171, 2014). Since structural characterization of Eap3 is still incomplete, we acquired a series of 2D and 3D NMR spectra of Eap3 in solution. Here we report the backbone and side-chain 1 H, 15 N, and 13 C resonance assignments of Eap3 and its predicted secondary structure via the TALOS-N server. The assignment data have been deposited in the BMRB data bank under accession number 27087.

Early access programs: Benefits, challenges, and key considerations for successful implementation

PubMed Central

Patil, Sanjaykumar

2016-01-01

Early access programs, (EAPs) are adopted by an increasing number of pharma companies due to several benefits offered by these programs. EAPs offer ethical, compliant, and controlled mechanisms of access to investigational drugs outside of the clinical trial space and before the commercial launch of the drug, to patients with life-threatening diseases having no treatment options available. In addition to the development of positive relationships with key opinion leaders (KOL), patients, advocacy groups and regulators, the data captured from the implementation of EAPs supports in the formulation of global commercialization strategies. This white paper outlines various circumstances to be considered for the implementation of EAPs named patient programs, the regulatory landscape, the benefits and challenges associated with implementing these programs and the key considerations for their successful implementation. PMID:26955570

EAP Service Use in a Managed Behavioral Health Care Organization: From the Employee Perspective

PubMed Central

Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M.; McCann, Bernard

2011-01-01

SUMMARY Contemporary employee assistance program (EAP) services are typically provided in broad-brush programs delivered by large external vendors in a network model. Yet research has not kept pace with EAP evolution, including in terms of how EAP clients themselves view services. We surveyed a random sample of EAP service users from a national provider (361 respondents). About one-third of respondents reported getting help for workplace issues. Most learned about the EAP through employer communications such as the company website. The large majority reported that the EAP helped them “a lot” or “some,” suggesting they valued this benefit. PMID:21966281

EAP's Response to Personal Stress and Productivity: Implications for Occupational Social Work.

ERIC Educational Resources Information Center

Ramanathan, Chathapuram S.

1992-01-01

Used pretest-posttest design to investigate influence of employee assistance program (EAP) on employee stress and productivity at time of initial contact with EAP and two and four months later. Findings from 47 employees who used EAP services revealed that, although personal stress and employee productivity were related, employee assistance…

Iranian English for Academic Purposes (EAP) Stakeholders' Attitudes toward Using the Internet in EAP Courses for Civil Engineering Students: Promises and Challenges

ERIC Educational Resources Information Center

Atai, Mahmood Reza; Dashtestani, Reza

2013-01-01

English for academic purposes (EAP) has established itself as a considerable part of English as a foreign language (EFL) instruction in Iranian universities. Considering the Internet as a major educational source in EAP reading courses, it is highly important that the stakeholders have positive attitudes toward it and be aware of promises and…

Transfer Climate and EAP Education: Students Perceptions of Challenges to Learning Transfer

ERIC Educational Resources Information Center

James, Mark Andrew

2010-01-01

This study examined the applicability of the construct transfer climate in EAP education. In an EAP setting, transfer climate can be viewed as the support for learning transfer from an EAP course that students perceive in mainstream academic courses. The research question was as follows: What can a transfer climate perspective reveal about…

Beyond Needs Analysis: Soft Systems Methodology for Meaningful Collaboration in EAP Course Design

ERIC Educational Resources Information Center

Tajino, Akira; James, Robert; Kijima, Kyoichi

2005-01-01

Designing an EAP course requires collaboration among various concerned stakeholders, including students, subject teachers, institutional administrators and EAP teachers themselves. While needs analysis is often considered fundamental to EAP, alternative research methodologies may be required to facilitate meaningful collaboration between these…

Fostering Transformative Practitioners for Critical EAP: Possibilities and Challenges

ERIC Educational Resources Information Center

Morgan, Brian

2009-01-01

In this article, I explore the often difficult transfer of theory to practice in respect to promoting the conceptual role of transformative intellectual/practitioner through a pre-service "social issues project" for future EAP and ESL teachers. Following an examination of more established role options in EAP (e.g. technician, reflective…

The Impact of EAP Study on the Academic Experiences of International Postgraduate Students in Australia

ERIC Educational Resources Information Center

Terraschke, Agnes; Wahid, Ridwan

2011-01-01

EAP courses usually not only aim to improve students' level of English but also to convey useful academic study skills and introduce students to the common genres of their discipline. These are extra skills and information other international students do not have ready access to. Yet, few studies have focused on how the academic experiences of…

A Case for Faculty Involvement in EAP Placement Testing

ERIC Educational Resources Information Center

James, Cindy; Templeman, Elizabeth

2009-01-01

The EAP placement procedure at Thompson Rivers University (TRU) involves multiple measures to assess the language skills of incoming students, some of which are facilitated and all of which are assessed by ESL faculty. In order to determine the effectiveness of this comprehensive EAP placement process and the effect of the faculty factor, a…

The Spatial Politics of Gender in EAP Classroom Practice

ERIC Educational Resources Information Center

Appleby, Roslyn

2009-01-01

This paper explores some of the challenges faced by EAP teachers as they address gender issues that arise when teaching in a non-Western cultural context. It draws on interviews with four Australian teachers regarding their experiences in delivering EAP programs in East Timor as part of an international aid effort, and focuses on critical…

Going "social" to access experimental and potentially life-saving treatment: an assessment of the policy and online patient advocacy environment for expanded access.

PubMed

Mackey, Tim K; Schoenfeld, Virginia J

2016-02-02

Social media is fundamentally altering how we access health information and make decisions about medical treatment, including for terminally ill patients. This specifically includes the growing phenomenon of patients who use online petitions and social media campaigns in an attempt to gain access to experimental drugs through expanded access pathways. Importantly, controversy surrounding expanded access and "compassionate use" involves several disparate stakeholders, including patients, manufacturers, policymakers, and regulatory agencies-all with competing interests and priorities, leading to confusion, frustration, and ultimately advocacy. In order to explore this issue in detail, this correspondence article first conducts a literature review to describe how the expanded access policy and regulatory environment in the United States has evolved over time and how it currently impacts access to experimental drugs. We then conducted structured web searches to identify patient use of online petitions and social media campaigns aimed at compelling access to experimental drugs. This was carried out in order to characterize the types of communication strategies utilized, the diseases and drugs subject to expanded access petitions, and the prevalent themes associated with this form of "digital" patient advocacy. We find that patients and their families experience mixed results, but still gravitate towards the use of online campaigns out of desperation, lack of reliable information about treatment access options, and in direct response to limitations of the current fragmented structure of expanded access regulation and policy currently in place. In response, we discuss potential policy reforms to improve expanded access processes, including advocating greater transparency for expanded access programs, exploring use of targeted economic incentives for manufacturers, and developing systems to facilitate patient information about existing treatment options. This includes

Refreshable Braille displays using EAP actuators

NASA Astrophysics Data System (ADS)

Bar-Cohen, Yoseph

2010-04-01

Refreshable Braille can help visually impaired persons benefit from the growing advances in computer technology. The development of such displays in a full screen form is a great challenge due to the need to pack many actuators in small area without interferences. In recent years, various displays using actuators such as piezoelectric stacks have become available in commercial form but most of them are limited to one line Braille code. Researchers in the field of electroactive polymers (EAP) investigated methods of using these materials to form full screen displays. This manuscript reviews the state of the art of producing refreshable Braille displays using EAP-based actuators.

Refreshable Braille Displays Using EAP Actuators

NASA Technical Reports Server (NTRS)

Bar-Cohen, Yoseph

2010-01-01

Refreshable Braille can help visually impaired persons benefit from the growing advances in computer technology. The development of such displays in a full screen form is a great challenge due to the need to pack many actuators in small area without interferences. In recent years, various displays using actuators such as piezoelectric stacks have become available in commercial form but most of them are limited to one line Braille code. Researchers in the field of electroactive polymers (EAP) investigated methods of using these materials to form full screen displays. This manuscript reviews the state of the art of producing refreshable Braille displays using EAP-based actuators..

78 FR 27115 - Draft Guidance for Industry on Expanded Access to Investigational Drugs for Treatment Use...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-09

... a more transparent process by increasing awareness and knowledge of expanded access programs and the... regulations. Consistent with the goal of making expanded access processes more transparent, FDA is providing... (IRB) review and approval required for individual patient expanded access?'' In the draft guidance, FDA...

sae is essential for expression of the staphylococcal adhesins Eap and Emp.

PubMed

Harraghy, Niamh; Kormanec, Jan; Wolz, Christiane; Homerova, Dagmar; Goerke, Christiane; Ohlsen, Knut; Qazi, Saara; Hill, Philip; Herrmann, Mathias

2005-06-01

Eap and Emp are two Staphylococcus aureus adhesins initially described as extracellular matrix binding proteins. Eap has since emerged as being important in adherence to and invasion of eukaryotic cells, as well as being described as an immunomodulator and virulence factor in chronic infections. This paper describes the mapping of the transcription start point of the eap and emp promoters. Moreover, using reporter-gene assays and real-time PCR in defined regulatory mutants, environmental conditions and global regulators affecting expression of eap and emp were investigated. Marked differences were found in expression of eap and emp between strain Newman and the 8325 derivatives SH1000 and 8325-4. Moreover, both genes were repressed in the presence of glucose. Analysis of expression of both genes in various regulatory mutants revealed that sarA and agr were involved in their regulation, but the data suggested that there were additional regulators of both genes. In a sae mutant, expression of both genes was severely repressed. sae expression was also reduced in the presence of glucose, suggesting that repression of eap and emp in glucose-containing medium may, in part, be a consequence of a decrease in expression of sae.

EAP artificial muscle actuators for bio-inspired intelligent social robotics (Conference Presentation)

NASA Astrophysics Data System (ADS)

Hanson, David F.

2017-04-01

Bio-inspired intelligent robots are coming of age in both research and industry, propelling market growth for robots and A.I. However, conventional motors limit bio-inspired robotics. EAP actuators and sensors could improve the simplicity, compliance, physical scaling, and offer bio-inspired advantages in robotic locomotion, grasping and manipulation, and social expressions. For EAP actuators to realize their transformative potential, further innovations are needed: the actuators must be robust, fast, powerful, manufacturable, and affordable. This presentation surveys progress, opportunities, and challenges in the author's latest work in social robots and EAP actuators, and proposes a roadmap for EAP actuators in bio-inspired intelligent robotics.

Model-free and analytical EAP reconstruction via spherical polar Fourier diffusion MRI.

PubMed

Cheng, Jian; Ghosh, Aurobrata; Jiang, Tianzi; Deriche, Rachid

2010-01-01

How to estimate the diffusion Ensemble Average Propagator (EAP) from the DWI signals in q-space is an open problem in diffusion MRI field. Many methods were proposed to estimate the Orientation Distribution Function (ODF) that is used to describe the fiber direction. However, ODF is just one of the features of the EAP. Compared with ODF, EAP has the full information about the diffusion process which reflects the complex tissue micro-structure. Diffusion Orientation Transform (DOT) and Diffusion Spectrum Imaging (DSI) are two important methods to estimate the EAP from the signal. However, DOT is based on mono-exponential assumption and DSI needs a lot of samplings and very large b values. In this paper, we propose Spherical Polar Fourier Imaging (SPFI), a novel model-free fast robust analytical EAP reconstruction method, which almost does not need any assumption of data and does not need too many samplings. SPFI naturally combines the DWI signals with different b-values. It is an analytical linear transformation from the q-space signal to the EAP profile represented by Spherical Harmonics (SH). We validated the proposed methods in synthetic data, phantom data and real data. It works well in all experiments, especially for the data with low SNR, low anisotropy, and non-exponential decay.

Fast and Analytical EAP Approximation from a 4th-Order Tensor.

PubMed

Ghosh, Aurobrata; Deriche, Rachid

2012-01-01

Generalized diffusion tensor imaging (GDTI) was developed to model complex apparent diffusivity coefficient (ADC) using higher-order tensors (HOTs) and to overcome the inherent single-peak shortcoming of DTI. However, the geometry of a complex ADC profile does not correspond to the underlying structure of fibers. This tissue geometry can be inferred from the shape of the ensemble average propagator (EAP). Though interesting methods for estimating a positive ADC using 4th-order diffusion tensors were developed, GDTI in general was overtaken by other approaches, for example, the orientation distribution function (ODF), since it is considerably difficult to recuperate the EAP from a HOT model of the ADC in GDTI. In this paper, we present a novel closed-form approximation of the EAP using Hermite polynomials from a modified HOT model of the original GDTI-ADC. Since the solution is analytical, it is fast, differentiable, and the approximation converges well to the true EAP. This method also makes the effort of computing a positive ADC worthwhile, since now both the ADC and the EAP can be used and have closed forms. We demonstrate our approach with 4th-order tensors on synthetic data and in vivo human data.

Evaluate Your EAP: Can It Help Support Employee Rights Legislation?

ERIC Educational Resources Information Center

Ryan, Katherine C.

1997-01-01

Employee assistance programs (EAPs) are emerging as an efficient way to address employee rights, particularly in light of the Americans with Disabilities Act and the Family and Medical Leave Act. Well-managed EAPs help maintain a healthy, motivated, productive workforce, show effort to provide reasonable accommodation of employee needs, and may…

Exploring Teacher Beliefs in Teaching EAP at Low Proficiency Levels

ERIC Educational Resources Information Center

Alexander, Olwyn

2012-01-01

Teaching English for Academic Purposes (EAP) requires teachers experienced in Communicative Language Teaching (CLT) to acquire additional skills, abilities and approaches. Beliefs about CLT teaching may not be appropriate for teaching EAP, especially to low level learners. Making teachers aware of their beliefs is the first step in helping them to…

Integrating CALL into an Iranian EAP Course: Constraints and Affordances

ERIC Educational Resources Information Center

Mehran, Parisa; Alizadeh, Mehrasa

2015-01-01

Iranian universities have recently displayed a growing interest in integrating Computer-Assisted Language Learning (CALL) into teaching/learning English. The English for Academic Purposes (EAP) context, however, is not keeping pace with the current changes since EAP courses are strictly text-based and exam-oriented, and little research has thus…

How Often Are Drugs Made Available Under the Food and Drug Administration's Expanded Access Process Approved?

PubMed

McKee, Amy E; Markon, André O; Chan-Tack, Kirk M; Lurie, Peter

2017-10-01

In this review of individual patient expanded-access requests to the Center for Drug Evaluation and Research for the period Fiscal Year 2010 to Fiscal Year 2014, we evaluated the number of applications received and the number allowed to proceed. We also evaluated whether drugs and certain biologics obtained under expanded access went on to be approved by the Food and Drug Administration. Finally, we considered concerns that adverse events occurring during expanded access might place sponsors at risk for legal liability. Overall, 98% of individual patient expanded-access requests were allowed to proceed. During the study period, among drugs without a previous approval for any indication or dosage form, 24% of unique drugs (ie, multiple applications for access to the same drug were considered to relate to 1 unique drug), and 20% of expanded-access applications received marketing approval by 1 year after initial submission; 43% and 33%, respectively, were approved by 5 years after initial submission. A search of 3 legal databases and a database of news articles did not appear to identify any product liability cases arising from the use of a product in expanded access. Our analyses seek to give physicians and patients a realistic perspective on the likelihood of a drug's approval as well as certain information regarding the product liability risks for commercial sponsors when providing expanded access to investigational drugs. The US Food and Drug Administration (FDA)'s expanded-access program maintains a careful balance between authorizing patient access to potentially beneficial drugs and protecting them from drugs that may have unknown risks. At the same time, the agency wishes to maintain the integrity of the clinical trials process, ultimately the best way to get safe and effective drugs to patients. © 2017, The American College of Clinical Pharmacology.

Electroactive Polymer (EAP) Actuators for Future Humanlike Robots

NASA Technical Reports Server (NTRS)

Bar-Cohen, Yoseph

2009-01-01

Human-like robots are increasingly becoming an engineering reality thanks to recent technology advances. These robots, which are inspired greatly by science fiction, were originated from the desire to reproduce the human appearance, functions and intelligence and they may become our household appliance or even companion. The development of such robots is greatly supported by emerging biologically inspired technologies. Potentially, electroactive polymer (EAP) materials are offering actuation capabilities that allow emulating the action of our natural muscles for making such machines perform lifelike. There are many technical issues related to making such robots including the need for EAP materials that can operate as effective actuators. Beside the technology challenges these robots also raise concerns that need to be addressed prior to forming super capable robots. These include the need to prevent accidents, deliberate harm, or their use in crimes. In this paper, the potential EAP actuators and the challenges that these robots may pose will be reviewed.

Electroactive polymer (EAP) actuators for future humanlike robots

NASA Astrophysics Data System (ADS)

Bar-Cohen, Yoseph

2009-03-01

Human-like robots are increasingly becoming an engineering reality thanks to recent technology advances. These robots, which are inspired greatly by science fiction, were originated from the desire to reproduce the human appearance, functions and intelligence and they may become our household appliance or even companion. The development of such robots is greatly supported by emerging biologically inspired technologies. Potentially, electroactive polymer (EAP) materials are offering actuation capabilities that allow emulating the action of our natural muscles for making such machines perform lifelike. There are many technical issues related to making such robots including the need for EAP materials that can operate as effective actuators. Beside the technology challenges these robots also raise concerns that need to be addressed prior to forming super capable robots. These include the need to prevent accidents, deliberate harm, or their use in crimes. In this paper, the potential EAP actuators and the challenges that these robots may pose will be reviewed.

IL17 Mediates Pelvic Pain in Experimental Autoimmune Prostatitis (EAP)

PubMed Central

Murphy, Stephen F.; Schaeffer, Anthony J.; Done, Joseph; Wong, Larry; Bell-Cohn, Ashlee; Roman, Kenny; Cashy, John; Ohlhausen, Michelle; Thumbikat, Praveen

2015-01-01

Chronic pelvic pain syndrome (CPPS) is the most common form of prostatitis, accounting for 90–95% of all diagnoses. It is a complex multi-symptom syndrome with unknown etiology and limited effective treatments. Previous investigations highlight roles for inflammatory mediators in disease progression by correlating levels of cytokines and chemokines with patient reported symptom scores. It is hypothesized that alteration of adaptive immune mechanisms results in autoimmunity and subsequent development of pain. Mouse models of CPPS have been developed to delineate these immune mechanisms driving pain in humans. Using the experimental autoimmune prostatitis (EAP) in C57BL/6 mice model of CPPS we examined the role of CD4+T-cell subsets in the development and maintenance of prostate pain, by tactile allodynia behavioral testing and flow cytometry. In tandem with increased CD4+IL17A+ T-cells upon EAP induction, prophylactic treatment with an anti-IL17 antibody one-day prior to EAP induction prevented the onset of pelvic pain. Therapeutic blockade of IL17 did not reverse pain symptoms indicating that IL17 is essential for development but not maintenance of chronic pain in EAP. Furthermore we identified a cytokine, IL7, to be associated with increased symptom severity in CPPS patients and is increased in patient prostatic secretions and the prostates of EAP mice. IL7 is fundamental to development of IL17 producing cells and plays a role in maturation of auto-reactive T-cells, it is also associated with autoimmune disorders including multiple sclerosis and type-1 diabetes. More recently a growing body of research has pointed to IL17’s role in development of neuropathic and chronic pain. This report presents novel data on the role of CD4+IL17+ T-cells in development and maintenance of pain in EAP and CPPS. PMID:25933188

IL17 Mediates Pelvic Pain in Experimental Autoimmune Prostatitis (EAP).

PubMed

Murphy, Stephen F; Schaeffer, Anthony J; Done, Joseph; Wong, Larry; Bell-Cohn, Ashlee; Roman, Kenny; Cashy, John; Ohlhausen, Michelle; Thumbikat, Praveen

2015-01-01

Chronic pelvic pain syndrome (CPPS) is the most common form of prostatitis, accounting for 90-95% of all diagnoses. It is a complex multi-symptom syndrome with unknown etiology and limited effective treatments. Previous investigations highlight roles for inflammatory mediators in disease progression by correlating levels of cytokines and chemokines with patient reported symptom scores. It is hypothesized that alteration of adaptive immune mechanisms results in autoimmunity and subsequent development of pain. Mouse models of CPPS have been developed to delineate these immune mechanisms driving pain in humans. Using the experimental autoimmune prostatitis (EAP) in C57BL/6 mice model of CPPS we examined the role of CD4+T-cell subsets in the development and maintenance of prostate pain, by tactile allodynia behavioral testing and flow cytometry. In tandem with increased CD4+IL17A+ T-cells upon EAP induction, prophylactic treatment with an anti-IL17 antibody one-day prior to EAP induction prevented the onset of pelvic pain. Therapeutic blockade of IL17 did not reverse pain symptoms indicating that IL17 is essential for development but not maintenance of chronic pain in EAP. Furthermore we identified a cytokine, IL7, to be associated with increased symptom severity in CPPS patients and is increased in patient prostatic secretions and the prostates of EAP mice. IL7 is fundamental to development of IL17 producing cells and plays a role in maturation of auto-reactive T-cells, it is also associated with autoimmune disorders including multiple sclerosis and type-1 diabetes. More recently a growing body of research has pointed to IL17's role in development of neuropathic and chronic pain. This report presents novel data on the role of CD4+IL17+ T-cells in development and maintenance of pain in EAP and CPPS.

The crystal structures of EAP domains from Staphylococcus aureus reveal an unexpected homology to bacterial superantigens.

PubMed

Geisbrecht, Brian V; Hamaoka, Brent Y; Perman, Benjamin; Zemla, Adam; Leahy, Daniel J

2005-04-29

The Eap (extracellular adherence protein) of Staphylococcus aureus functions as a secreted virulence factor by mediating interactions between the bacterial cell surface and several extracellular host proteins. Eap proteins from different Staphylococcal strains consist of four to six tandem repeats of a structurally uncharacterized domain (EAP domain). We have determined the three-dimensional structures of three different EAP domains to 1.8, 2.2, and 1.35 A resolution, respectively. These structures reveal a core fold that is comprised of an alpha-helix lying diagonally across a five-stranded, mixed beta-sheet. Comparison of EAP domains with known structures reveals an unexpected homology with the C-terminal domain of bacterial superantigens. Examination of the structure of the superantigen SEC2 bound to the beta-chain of a T-cell receptor suggests a possible ligand-binding site within the EAP domain (Fields, B. A., Malchiodi, E. L., Li, H., Ysern, X., Stauffacher, C. V., Schlievert, P. M., Karjalainen, K., and Mariuzza, R. (1996) Nature 384, 188-192). These results provide the first structural characterization of EAP domains, relate EAP domains to a large class of bacterial toxins, and will guide the design of future experiments to analyze EAP domain structure/function relationships.

A Corpus-Based EAP Course for NNS Doctoral Students: Moving from Available Specialized Corpora to Self-Compiled Corpora

ERIC Educational Resources Information Center

Lee, David; Swales, John

2006-01-01

This paper presents a discussion of an experimental, innovative course in corpus-informed EAP for doctoral students. Participants were given access to specialized corpora of academic writing and speaking, instructed in the tools of the trade (web- and PC-based concordancers) and gradually inducted into the skills needed to best exploit the data…

On the impact of self-clearing on electroactive polymer (EAP) actuators

NASA Astrophysics Data System (ADS)

Ahmed, Saad; Ounaies, Zoubeida; Lanagan, Michael T.

2017-10-01

Electroactive polymer (EAP)-based actuators have large potential for a wide array of applications; however, their practical implementation is still a challenge because of the requirement of high driving voltage, which most often leads to premature defect-driven electrical breakdown. Polymer-based capacitors have the ability to clear defects with partial electrical breakdown and subsequent removal of a localized electrode section near the defect. In this study, this process, which is known as self-clearing, is adopted for EAP technologies. We report a methodical approach to self-clear an EAP, more specifically P(VDF-TrFE-CTFE) terpolymer, to delay premature defect-driven electrical breakdown of the terpolymer actuators at high operating electric fields. Breakdown results show that electrical breakdown strength is improved up to 18% in comparison to a control sample after self-clearing. Furthermore, the electromechanical performance in terms of blocked force and free displacement of P(VDF-TrFE-CTFE) terpolymer-based bending actuators are examined after self-clearing and precleared samples show improved blocked force, free displacement and maximum sustainable electric field compared to control samples. The study demonstrates that controlled self-clearing of EAPs improves the breakdown limit and reliability of the EAP actuators for practical applications without impeding their electromechanical performance.

Fast and Analytical EAP Approximation from a 4th-Order Tensor

PubMed Central

Ghosh, Aurobrata; Deriche, Rachid

2012-01-01

Generalized diffusion tensor imaging (GDTI) was developed to model complex apparent diffusivity coefficient (ADC) using higher-order tensors (HOTs) and to overcome the inherent single-peak shortcoming of DTI. However, the geometry of a complex ADC profile does not correspond to the underlying structure of fibers. This tissue geometry can be inferred from the shape of the ensemble average propagator (EAP). Though interesting methods for estimating a positive ADC using 4th-order diffusion tensors were developed, GDTI in general was overtaken by other approaches, for example, the orientation distribution function (ODF), since it is considerably difficult to recuperate the EAP from a HOT model of the ADC in GDTI. In this paper, we present a novel closed-form approximation of the EAP using Hermite polynomials from a modified HOT model of the original GDTI-ADC. Since the solution is analytical, it is fast, differentiable, and the approximation converges well to the true EAP. This method also makes the effort of computing a positive ADC worthwhile, since now both the ADC and the EAP can be used and have closed forms. We demonstrate our approach with 4th-order tensors on synthetic data and in vivo human data. PMID:23365552

Controllable Curved Mirrors Made from Single-Layer EAP Films

NASA Technical Reports Server (NTRS)

Bao, Xiaoqi; Bar-Cohen, Yoseph; Sherrit, Stewart

2004-01-01

A document proposes that lightweight, deployable, large-aperture, controllable curved mirrors made of reflectively coated thin electroactive-polymer (EAP) films be developed for use in spaceborne microwave and optical systems. In these mirrors, the EAP films would serve as both structures and actuators. EAPs that are potentially suitable for such use include piezoelectric, electrostrictive, ferroelectric, and dielectric polymers. These materials exhibit strains proportional to the squares of applied electric fields. Utilizing this phenomenon, a curved mirror according to the proposal could be made from a flat film, upon which a nonuniform electrostatic potential (decreasing from the center toward the edge) would be imposed to obtain a required curvature. The effect would be analogous to that of an old-fashioned metalworking practice in which a flat metal sheet is made into a bowl by hammering it repeatedly, the frequency of hammer blows decreasing with distance from the center. In operation, the nonuniform electrostatic potential could be imposed by use of an electron gun. Calculations have shown that by use of a single- layer film made of a currently available EAP, it would be possible to control the focal length of a 2-m-diameter mirror from infinity to 1.25 m.

Discourse Itineraries in an EAP Classroom: A Collaborative Critical Literacy Praxis

ERIC Educational Resources Information Center

Chun, Christian Wai

2010-01-01

This classroom ethnography documents the developing critical literacy pedagogy of an English for Academic Purposes (EAP) instructor over the course of several terms. My research, which involved extensive collaboration with the EAP instructor, explores how specific classroom practices and discourses are enacted and mediated through dialogic…

The role of the EAP in the identification and treatment of substance abuse.

PubMed

Kramer, R M

1998-12-01

Employee Assistance Programs (EAPs) are cost-effective strategies for employers to contain the substantial direct and indirect costs of substance abuse in the workplace. EAPs offer prevention, early detection, assessment of referral, and after-care programs to help stem the enormous costs of substance abuse in the workplace. Most effective employer substance abuse programs integrate drug-testing and EAP services to ensure a well coordinated, cost-effective program.

An EAP Program and Students' Success at a Canadian University

ERIC Educational Resources Information Center

Keefe, Karin; Shi, Ling

2017-01-01

Many universities have instituted intensive English for Academic Purposes (EAP) programs to support international students. This qualitative study used interviews to gain insights into the experiences of 8 non-native English speaking (NNES) students who completed an EAP program before they enrolled in disciplinary courses at a Canadian university.…

Teaching Writing within the Disciplines: A Viable Approach for English for Academic Purposes (EAP) Instructors

ERIC Educational Resources Information Center

Leopold, Lisa

2011-01-01

This case study of an adjunct-model English for Academic Purposes (EAP) writing course linked to a policy-analysis course describes an effective approach for putting "specificity" into practice in EAP curriculum design. The rationale for interdisciplinary collaboration, the positive learning outcomes from the EAP writing course, the…

EAP recordings in ineraid patients--correlations with psychophysical measures and possible implications for patient fitting.

PubMed

Zimmerling, Martin J; Hochmair, Erwin S

2002-04-01

Objective measurements can be helpful for cochlear implant fitting of difficult populations, as for example very young children. One method, the recording of the electrically evoked compound action potential (EAP), measures the nerve recruitment in the cochlea in response to stimulation through the implant. For coding strategies implemented at a moderate stimulation rate of 250 pps per channel, useful correlations between EAP data and psychophysical data have been already found. With new systems running at higher rates, it is important to check these correlations again. This study investigates the correlations between psychophysical data and EAP measures calculated from EAP amplitude growth functions. EAP data were recorded in 12 Ineraid subjects. Additionally, behavioral thresholds (THR) and maximum acceptable loudness levels (MAL) were determined for stimulation rates of 80 pps and 2,020 pps for each electrode. Useful correlations between EAP data and psychophysical data were found at the low stimulation rate (80 pps). However, at the higher stimulation rate (2,020 pps) correlations were not significant. They were improved substantially, however, by introducing a factor that corrected for disparities due to temporal integration. Incorporation of this factor, which controls for the influence of the stimulation rate on the threshold, improved the correlations between EAP measures recorded at 80 pps and psychophysical MALs measured at 2,020 pps to better than r = 0.70. EAP data as such can only be used to predict behavioral THRs or MCLs at low stimulation rates. To cope with temporal integration effects at higher stimulation rates, EAP data must be rate corrected. The introduction of a threshold-rate-factor is a promising way to achieve that goal. Further investigations need to be performed.

Antibody response to the extracellular adherence protein (Eap) of Staphylococcus aureus in healthy and infected individuals.

PubMed

Joost, Insa; Jacob, Susanne; Utermöhlen, Olaf; Schubert, Uwe; Patti, Joseph M; Ong, Mei-Fang; Gross, Jürgen; Justinger, Christoph; Renno, Jörg H; Preissner, Klaus T; Bischoff, Markus; Herrmann, Mathias

2011-06-01

The extracellular adherence protein (Eap) from Staphylococcus aureus has been suggested as a vaccine candidate and for therapeutic use due to its immunomodulating and antiangiogenic properties; however, little is known about anti-Eap antibodies in humans. We determined anti-Eap antibody titers by enzyme-linked immunosorbent assay and Western blot and measured serum samples from 92 patients with proven S. aureus infections and 93 healthy controls. The functionality of antibodies was assessed by a phagocytosis assay using Eap-coated fluorescent microspheres. Antibodies were detected in all human samples, but not in mice. Patients showed significantly higher titers than controls [immunoglobulin M (IgM), P=0.007; IgG, P<0.0001]. Patients with deep or severe infections showed higher titers than those with superficial or mild disease. Eap alone was sufficient to promote phagocytosis by peripheral blood mononuclear cell and granulocytes that was moderately enhanced in the presence of human serum, but no correlation was found with the levels of anti-Eap antibodies. Anti-Eap antibodies are prevalent in all tested humans and correlate with the severity of S. aureus infection; however, they do not seem to provide protection against invasive infections. Before considering Eap for therapy or as a vaccine candidate, further studies are warranted to assess the impact of the interference between Eap and its specific antibodies. © 2011 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

EAP: Employee Assistance Programs in the Public Schools. Reference & Resource Series.

ERIC Educational Resources Information Center

Hacker, Carol

Employee assistance programs (EAP's) have been set up by many businesses and organizations to help employees resolve their personal problems so they can maintain or resume an acceptable job performance level. So far, only a few public school districts have considered or implemented such programs. This monograph examines EAP's in general and…

Expanding access to sterile syringes through pharmacies: assessment of New York's Expanded Syringe Access Program.

PubMed

Tesoriero, James M; Battles, Haven B; Klein, Susan J; Kaufman, Erin; Birkhead, Guthrie S

2009-01-01

To investigate the evolution of pharmacist practices, attitudes, and experiences with the Expanded Syringe Access Program (ESAP), which permits over-the-counter sale of syringes by registered pharmacies in New York State. Longitudinal study. New York State in 2002 and 2006. 506 (2002) and 682 (2006) managing pharmacists (response rates approximately 70%) at ESAP-registered pharmacies (n = 346 in both years). Mailed surveys (2002 and 2006). Pharmacist practices, attitudes, and experiences with ESAP over time. Approximately 75% of pharmacists reported that ESAP had facilitated timely/emergency access to syringes, and more than 90% in each year reported no problems or very few problems administering ESAP. The practice of placing additional requirements on the sale of syringes decreased from 2002 (51.4%) to 2006 (45.1%), while a 55% increase in syringe sales was reported between 2002 (43.3/month) and 2006 (67.1/month). The sale of sharps containers also increased between 2002 (85.2%) and 2006 (92.8%). Community independent pharmacies and those located outside New York City generally expressed more favorable attitudes and experiences with ESAP, although these differences decreased over time. Pharmacy-based syringe access is a viable harm-reduction alternative in the fight against blood-borne diseases, with ESAP now equaling the number of syringes being distributed by syringe exchange programs in New York State. Continued education/training is necessary to increase participation in ESAP and to further reduce barriers to ESAP use.

Obtaining i.v. fosfomycin through an expanded-access protocol.

PubMed

Frederick, Corey M; Burnette, Jennifer; Aragon, Laura; Gauthier, Timothy P

2016-08-15

One hospital's experience with procuring i.v. fosfomycin via an expanded-access protocol to treat a panresistant infection is described. In mid-2014, a patient at a tertiary care institution had an infection caused by a gram-negative pathogen expressing notable drug resistance. Once it was determined by the infectious diseases (ID) attending physician that i.v. fosfomycin was a possible treatment for this patient, the ID pharmacist began the process of drug procurement. The research and ID pharmacists completed an investigational new drug (IND) application, which required patient-specific details and contributions from the ID physician. After obtaining approval of the IND, an Internet search identified a product vendor in the United Kingdom, who was then contacted to begin the drug purchasing and acquisition processes. Authorization of the transaction required signatures from key senior hospital administrators, including the chief financial officer and the chief operating officer. Approximately 6 days after beginning the acquisition process, the research pharmacist arranged for the wholesaler to expedite product delivery. The ID pharmacist contacted the wholesaler's shipping company at the U.S. Customs Office, providing relevant contact information to ensure that any unexpected circumstances could be quickly addressed. The product arrived at the U.S. Customs Office 8 days after beginning the acquisition process and was held in the U.S. Customs Office for 2 days. The patient received the first dose of i.v. fosfomycin 13 days after starting the expanded-access protocol process. I.V. fosfomycin was successfully procured through an FDA expanded-access protocol by coordinating efforts among ID physicians, pharmacists, and hospital executives. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

What lies beneath? Diffusion EAP-based study of brain tissue microstructure.

PubMed

Zucchelli, Mauro; Brusini, Lorenza; Andrés Méndez, C; Daducci, Alessandro; Granziera, Cristina; Menegaz, Gloria

2016-08-01

Diffusion weighted magnetic resonance signals convey information about tissue microstructure and cytoarchitecture. In the last years, many models have been proposed for recovering the diffusion signal and extracting information to constitute new families of numerical indices. Two main categories of reconstruction models can be identified in diffusion magnetic resonance imaging (DMRI): ensemble average propagator (EAP) models and compartmental models. From both, descriptors can be derived for elucidating the underlying microstructural architecture. While compartmental models indices directly quantify the fraction of different cell compartments in each voxel, EAP-derived indices are only a derivative measure and the effect of the different microstructural configurations on the indices is still unclear. In this paper, we analyze three EAP indices calculated using the 3D Simple Harmonic Oscillator based Reconstruction and Estimation (3D-SHORE) model and estimate their changes with respect to the principal microstructural configurations. We take advantage of the state of the art simulations to quantify the variations of the indices with the simulation parameters. Analysis of in-vivo data correlates the EAP indices with the microstructural parameters obtained from the Neurite Orientation Dispersion and Density Imaging (NODDI) model as a pseudo ground truth for brain data. Results show that the EAP derived indices convey information on the tissue microstructure and that their combined values directly reflect the configuration of the different compartments in each voxel. Copyright © 2016 Elsevier B.V. All rights reserved.

Androids: application of EAP as artificial muscles to entertainment industry

NASA Technical Reports Server (NTRS)

Hanson, D.; Pioggia, G.; Bar-Cohen, Yoseph; de Rossi, D.

2001-01-01

The classic movie Metropolis (1926), which is nowadays considered a cinema milestone, has shown the possibility to build robots called androids that are science and fiction run together to realize a dream: the human-like robot. In that movie, Dr. Rotwang transforms a simple and cold calculating robot into the body of a beautiful woman. Robots have often been depicted as metal creatures with cold steel bodies, but there is no reason why metals should be the only kind of material for construction of robots. The authors examined the issues related to applying electroactive polymers materials (EAP) to the entertainment industry. EAP are offering attractive characteristics with the potential to produce more realistic models of living creatures at significantly lower cost. This paper seeks to elucidate how EAP might infiltrate and ultimately revolutionize entertainment, showing some applicative examples.

Academic Literacies: Providing a Space for the Socio-Political Dynamics of EAP

ERIC Educational Resources Information Center

Turner, Joan

2012-01-01

This article highlights the potential of academic literacies as a theoretical framework for EAP, encompassing not only work on texts, but the wider, socio-political, geopolitical, and institutional contexts and practices in and with which EAP operates. An academic literacies approach foregrounds social practices, and one particular practice, that…

Collaborative Academic Projects on Social Network Sites to Socialize EAP Students into Academic Communities of Practice

ERIC Educational Resources Information Center

Dashtestani, Reza

2018-01-01

Learning English for academic purposes (EAP) can help university students promote their academic literacy through socializing them into academic communities of practice. This study examined the impact of the use of collaborative projects on three social network sites on EAP students' attitudes towards EAP and academic content learning. Three…

The possible physical mechanism for the EAP-SR co-action

NASA Astrophysics Data System (ADS)

Gong, Zhiqiang; Feng, Guolin; Dogar, Muhammad Mubashar; Huang, Gang

2017-11-01

The anomalous characteristics of summer precipitation and atmospheric circulation in the East Asia-West Pacific Region (EA-WP) associated with the co-action of East Asia/Pacific teleconnection-Silk Road teleconnection (EAP-SR) are investigated in this study. The compositions of EAP-SR phase anomalies can be expressed as pattern I (+ +), pattern II (+ -), pattern III (- -), and pattern IV (- +) using EAP and SR indices. It is found that the spatial distribution of summer precipitation anomalies in EA-WP corresponding to pattern I (III) shows a tripole structure in the meridional direction and a zonal dipole structure in the subtropical region, while pattern II (IV) presents a tripole pattern in meridional direction with compressed and continuous anomalies in the zonal direction over the subtropical region. The similar meridional and zonal structures are also found in the geopotential height anomalies at 500-hPa, as well as wind anomalies and moisture convergence at 850-hPa. Finally, a schematic mechanism for the EAP-SR co-action upon the summer precipitation in EA-WP is built: (1) Pattern I (III) exhibits that the negative (positive) sea surface temperature (SST) anomalies over tropical East Pacific may cause the enhanced (weakened) convective activity dominating the West Pacific, trigger the positive (negative) EAP teleconnection and produce more (less) precipitation. Besides, the negative (positive) SST anomalies over the Indonesia Maritime Continent (IMC) may further weaken (strengthen) anomalous downward (upward) motion over the South China Sea (SCS), cause negative (positive) geopotential height anomalies at the middle troposphere and surrounding regions through the function of the tropical Hadley circulation. Then the negative (positive) geopotential height anomalies could motivate the positive (negative) EAP teleconnection through the northward propagation of wave-activity perturbation. Meanwhile, a positive (negative) geopotential height anomalous pattern

Insertional inactivation of Eap in Staphylococcus aureus strain Newman confers reduced staphylococcal binding to fibroblasts.

PubMed

Hussain, Muzaffar; Haggar, Axana; Heilmann, Christine; Peters, Georg; Flock, Jan-Ingmar; Herrmann, Mathias

2002-06-01

To initiate invasive infection, Staphylococcus aureus must adhere to host substrates, such as the extracellular matrix or eukaryotic cells, by virtue of different surface proteins (adhesins). Recently, we identified a 60-kDa cell-secreted extracellular adherence protein (Eap) of S. aureus strain Newman with broad-spectrum binding characteristics (M. Palma, A. Haggar, and J. I. Flock, J. Bacteriol. 181:2840-2845, 1999), and we have molecularly confirmed Eap to be an analogue of the previously identified major histocompatibility complex class II analog protein (Map) (M. Hussain, K. Becker, C. von Eiff, G. Peter, and M. Herrmann, Clin. Diagn. Lab. Immunol. 8:1281-1286, 2001). Previous analyses of the Eap/Map function performed with purified protein did not allow dissection of its precise role in the complex situation of the staphylococcal whole cell presenting several secreted and wall-bound adhesins. Therefore, the role of Eap was investigated by constructing a stable eap::ermB deletion in strain Newman and by complementation of the mutant. Patterns of extracted cell surface proteins analyzed both by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and by Western ligand assays with various adhesive matrix molecules clearly confirmed the absence of Eap in the mutant. However, binding and adhesion tests using whole staphylococcal cells demonstrated that both the parent and mutant strains bound equally well to fibronectin- and fibrinogen-coated surfaces, possibly due to their recognition by other staphylococcal adhesins. Furthermore, Eap mediated staphylococcal agglutination of both wild-type and mutant cells. In contrast, the mutant adhered to a significantly lesser extent to cultured fibroblasts (P < 0.001) than did the wild type, while adherence was restorable upon complementation. Furthermore, adherence to both epithelial cells (P < 0.05) and fibroblasts (not significant) could be blocked with antibodies against Eap, whereas preimmune serum was not active

Anisotropic D-EAP Electrodes and their Application in Spring Roll Actuators

NASA Astrophysics Data System (ADS)

Fang, Xiaomeng

Electroactive polymers (EAPs) exhibit shape change when subjected to an electric field. They are lightweight, soft, and inexpensive, while they are easy to process, shape, and tune to offer a broad range of mechanical and electrical properties. Dielectric electroactive polymers (DEAP) constitute a class of EAPs with great potential. D-EAPs consist of physically or chemically cross-linked macromolecular networks and are mechanically isotopic. Therefore, in most actuator applications that require directional electromechanical response, it is necessary to use other complex means to direct the stress/strain in the preferred direction. In this work, a simple carbon nanotube (CNT) based electrode for D-EAP actuators is demonstrated that vastly improves directional strain response originating from the mechanical anisotropy of the electrode material. Using this novel approach, the mechanical anisotropy, defined as the ratio of initial modulus in fiber direction and that in cross-fiber direction, of the CNT electroded VHB actuators, ranges from 7.9 to 11.2. Hence, the CNT-VHB flat film actuators show high directed linear actuation strain in cross-fiber direction of greater than 25% meanwhile almost no strain in fiber direction at a relatively low electric field (120 V mum-1). The morphology of the CNT sheets has critical influence on their mechanical properties and resultant actuator performance. The results demonstrate the efficacy of microcombing and selective laser etching processes to improve the CNT fiber alignment to produce pure unidirectional strain of 33% at a relatively moderate electric field. Unidirectional D-EAP composite laminates using polyurethane and polyamide monofilaments are also employed in spring roll actuators to investigate their directional mechanical and electromechanical properties. While CNT electroded D-EAP spring roll actuators were found to have about the same performance as actuators with carbon grease electrodes (6.5% strain in CNT

The Effective Use of EAPs: Retrenchment Leads to Emphasis on Helping Troubled Employees.

ERIC Educational Resources Information Center

Pogue, Gregory

1994-01-01

During a period of retrenchment, colleges and universities are increasingly developing employee assistance programs (EAPs) to help personnel cope with personal and work-related problems. Successful EAPs have top management commitment, have written policies and procedure, focus on employee performance, provide professional assistance, involve the…

Extended Nonfiction Readers for EAP Programs

ERIC Educational Resources Information Center

Fitzsimmons-Doolan, Shannon; Davis, Jessica; Stoller, Fredricka L.; Crawford, William

2012-01-01

Content-based instruction course designers have many important decisions to make when developing courses for postsecondary English for academic purposes (EAP) students. One important consideration revolves around deciding if students would benefit most from the use of sustained content (Murphy & Stoller, 2001) or a topical approach (Brinton,…

Measuring the bending of asymmetric planar EAP structures

NASA Astrophysics Data System (ADS)

Weiss, Florian M.; Zhao, Xue; Thalmann, Peter; Deyhle, Hans; Urwyler, Prabitha; Kovacs, Gabor; Müller, Bert

2013-04-01

The geometric characterization of low-voltage dielectric electro-active polymer (EAP) structures, comprised of nanometer thickness but areas of square centimeters, for applications such as artificial sphincters requires methods with nanometer precision. Direct optical detection is usually restricted to sub-micrometer resolution because of the wavelength of the light applied. Therefore, we propose to take advantage of the cantilever bending system with optical readout revealing a sub-micrometer resolution at the deflection of the free end. It is demonstrated that this approach allows us to detect bending of rather conventional planar asymmetric, dielectric EAP-structures applying voltages well below 10 V. For this purpose, we built 100 μm-thin silicone films between 50 nm-thin silver layers on a 25 μm-thin polyetheretherketone (PEEK) substrate. The increase of the applied voltage in steps of 50 V until 1 kV resulted in a cantilever bending that exhibits only in restricted ranges the expected square dependence. The mean laser beam displacement on the detector corresponded to 6 nm per volt. The apparatus will therefore become a powerful mean to analyze and thereby improve low-voltage dielectric EAP-structures to realize nanometer-thin layers for stack actuators to be incorporated into artificial sphincter systems for treating severe urinary and fecal incontinence.

The cellular RNA-binding protein EAP recognizes a conserved stem-loop in the Epstein-Barr virus small RNA EBER 1.

PubMed Central

Toczyski, D P; Steitz, J A

1993-01-01

EAP (EBER-associated protein) is an abundant, 15-kDa cellular RNA-binding protein which associates with certain herpesvirus small RNAs. We have raised polyclonal anti-EAP antibodies against a glutathione S-transferase-EAP fusion protein. Analysis of the RNA precipitated by these antibodies from Epstein-Barr virus (EBV)- or herpesvirus papio (HVP)-infected cells shows that > 95% of EBER 1 (EBV-encoded RNA 1) and the majority of HVP 1 (an HVP small RNA homologous to EBER 1) are associated with EAP. RNase protection experiments performed on native EBER 1 particles with affinity-purified anti-EAP antibodies demonstrate that EAP binds a stem-loop structure (stem-loop 3) of EBER 1. Since bacterially expressed glutathione S-transferase-EAP fusion protein binds EBER 1, we conclude that EAP binding is independent of any other cellular or viral protein. Detailed mutational analyses of stem-loop 3 suggest that EAP recognizes the majority of the nucleotides in this hairpin, interacting with both single-stranded and double-stranded regions in a sequence-specific manner. Binding studies utilizing EBER 1 deletion mutants suggest that there may also be a second, weaker EAP-binding site on stem-loop 4 of EBER 1. These data and the fact that stem-loop 3 represents the most highly conserved region between EBER 1 and HVP 1 suggest that EAP binding is a critical aspect of EBER 1 and HVP 1 function. Images PMID:8380232

Teachers' Voice vs. Students' Voice: A Needs Analysis Approach to English for Acadmic Purposes (EAP) in Iran

ERIC Educational Resources Information Center

Eslami, Zohreh R.

2010-01-01

EAP plays a highly important role in countries where English is used mainly for academic purposes. However, EAP programs have been developed without conducting a systematic needs analysis from both the students' and instructors' perspective. The purpose of this study is to describe the perception that EAP students and instructors have of the…

Matching Students to Opportunity: Expanding College Choice, Access, and Quality

ERIC Educational Resources Information Center

Kelly, Andrew P., Ed.; Howell, Jessica S., Ed.; Sattin-Bajaj, Carolyn, Ed.

2016-01-01

"Matching Students to Opportunity" expands on the discussion of a critical issue in college access and success: the match between prospective students and the colleges in which they enroll. Research indicates that ensuring a good match significantly increases a student's chance of graduating. The contributors to this volume argue that…

Response to "Expanding Access to Learning with Mobile Digital Devices"

ERIC Educational Resources Information Center

Vanek, Jen

2017-01-01

In his article "Expanding Access to Learning with Mobile Digital Devices" (EJ1150752), Jeff Carter recommended a balanced perspective when measuring the potential of mobile learning to redefine teaching and learning for adults with basic skills needs. In response to Carter's article, the author makes some recommendations that she thinks…

EAP as artificial muscles - progress and challenges

NASA Technical Reports Server (NTRS)

Bar-Cohen, Yoseph

2004-01-01

During the last decade and a half new polymers have emerged that respond to electrical stimulation with a significant shape or size change. This capability of electroactive polymer (EAP) materials is attracting the attention of engineers and scientists from many different disciplines.

The extracellular adherence protein (Eap) of Staphylococcus aureus inhibits wound healing by interfering with host defense and repair mechanisms.

PubMed

Athanasopoulos, Athanasios N; Economopoulou, Matina; Orlova, Valeria V; Sobke, Astrid; Schneider, Darius; Weber, Holger; Augustin, Hellmut G; Eming, Sabine A; Schubert, Uwe; Linn, Thomas; Nawroth, Peter P; Hussain, Muzaffar; Hammes, Hans-Peter; Herrmann, Mathias; Preissner, Klaus T; Chavakis, Triantafyllos

2006-04-01

Staphylococcus aureus is a major human pathogen interfering with host-cell functions. Impaired wound healing is often observed in S aureus-infected wounds, yet, the underlying mechanisms are poorly defined. Here, we identify the extracellular adherence protein (Eap) of S aureus to be responsible for impaired wound healing. In a mouse wound-healing model wound closure was inhibited in the presence of wild-type S aureus and this effect was reversible when the wounds were incubated with an isogenic Eap-deficient strain. Isolated Eap also delayed wound closure. In the presence of Eap, recruitment of inflammatory cells to the wound site as well as neovascularization of the wound were prevented. In vitro, Eap significantly reduced intercellular adhesion molecule 1 (ICAM-1)-dependent leukocyte-endothelial interactions and diminished the consequent activation of the proinflammatory transcription factor nuclear factor kappaB (NFkappaB) in leukocytes associated with a decrease in expression of tissue factor. Moreover, Eap blocked alphav-integrin-mediated endothelial-cell migration and capillary tube formation, and neovascularization in matrigels in vivo. Collectively, the potent anti-inflammatory and antiangiogenic properties of Eap provide an underlying mechanism that may explain the impaired wound healing in S aureus-infected wounds. Eap may also serve as a lead compound for new anti-inflammatory and antiangiogenic therapies in several pathologies.

21 CFR 312.305 - Requirements for all expanded access uses.

Code of Federal Regulations, 2010 CFR

2010-04-01

... options; (iii) The criteria for patient selection or, for an individual patient, a description of the... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Requirements for all expanded access uses. 312.305 Section 312.305 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

Extracting quantitative measures from EAP: a small clinical study using BFOR.

PubMed

Hosseinbor, A Pasha; Chung, Moo K; Wu, Yu-Chien; Fleming, John O; Field, Aaron S; Alexander, Andrew L

2012-01-01

The ensemble average propagator (EAP) describes the 3D average diffusion process of water molecules, capturing both its radial and angular contents, and hence providing rich information about complex tissue microstructure properties. Bessel Fourier orientation reconstruction (BFOR) is one of several analytical, non-Cartesian EAP reconstruction schemes employing multiple shell acquisitions that have recently been proposed. Such modeling bases have not yet been fully exploited in the extraction of rotationally invariant q-space indices that describe the degree of diffusion anisotropy/restrictivity. Such quantitative measures include the zero-displacement probability (P(o)), mean squared displacement (MSD), q-space inverse variance (QIV), and generalized fractional anisotropy (GFA), and all are simply scalar features of the EAP. In this study, a general relationship between MSD and q-space diffusion signal is derived and an EAP-based definition of GFA is introduced. A significant part of the paper is dedicated to utilizing BFOR in a clinical dataset, comprised of 5 multiple sclerosis (MS) patients and 4 healthy controls, to estimate P(o), MSD, QIV, and GFA of corpus callosum, and specifically, to see if such indices can detect changes between normal appearing white matter (NAWM) and healthy white matter (WM). Although the sample size is small, this study is a proof of concept that can be extended to larger sample sizes in the future.

Counseling and the Bystander-Equity Model of Supervisory Helping Behavior: Directions for EAP Research.

ERIC Educational Resources Information Center

Gerstein, Lawrence H.; Bayer, Gregory A.

1991-01-01

Discusses contribution of Bystander-Equity Model of Supervisory Helping Behavior to pursuit of employee assistance program (EAP) research based on traditions of field of counseling. Offers structure for pursuing empirical and applied activities in EAP settings. Encourages counseling researchers and practitioners to respond to challenge of working…

Isolation and characterization of a bacteriophage phiEap-2 infecting multidrug resistant Enterobacter aerogenes

PubMed Central

Li, Erna; Wei, Xiao; Ma, Yanyan; Yin, Zhe; Li, Huan; Lin, Weishi; Wang, Xuesong; Li, Chao; Shen, Zhiqiang; Zhao, Ruixiang; Yang, Huiying; Jiang, Aimin; Yang, Wenhui; Yuan, Jing; Zhao, Xiangna

2016-01-01

Enterobacter aerogenes (Enterobacteriaceae) is an important opportunistic pathogen that causes hospital-acquired pneumonia, bacteremia, and urinary tract infections. Recently, multidrug-resistant E. aerogenes have been a public health problem. To develop an effective antimicrobial agent, bacteriophage phiEap-2 was isolated from sewage and its genome was sequenced because of its ability to lyse the multidrug-resistant clinical E. aerogenes strain 3-SP. Morphological observations suggested that the phage belongs to the Siphoviridae family. Comparative genome analysis revealed that phage phiEap-2 is related to the Salmonella phage FSL SP-031 (KC139518). All of the structural gene products (except capsid protein) encoded by phiEap-2 had orthologous gene products in FSL SP-031 and Serratia phage Eta (KC460990). Here, we report the complete genome sequence of phiEap-2 and major findings from the genomic analysis. Knowledge of this phage might be helpful for developing therapeutic strategies against E. aerogenes. PMID:27320081

Isolation and characterization of a bacteriophage phiEap-2 infecting multidrug resistant Enterobacter aerogenes.

PubMed

Li, Erna; Wei, Xiao; Ma, Yanyan; Yin, Zhe; Li, Huan; Lin, Weishi; Wang, Xuesong; Li, Chao; Shen, Zhiqiang; Zhao, Ruixiang; Yang, Huiying; Jiang, Aimin; Yang, Wenhui; Yuan, Jing; Zhao, Xiangna

2016-06-20

Enterobacter aerogenes (Enterobacteriaceae) is an important opportunistic pathogen that causes hospital-acquired pneumonia, bacteremia, and urinary tract infections. Recently, multidrug-resistant E. aerogenes have been a public health problem. To develop an effective antimicrobial agent, bacteriophage phiEap-2 was isolated from sewage and its genome was sequenced because of its ability to lyse the multidrug-resistant clinical E. aerogenes strain 3-SP. Morphological observations suggested that the phage belongs to the Siphoviridae family. Comparative genome analysis revealed that phage phiEap-2 is related to the Salmonella phage FSL SP-031 (KC139518). All of the structural gene products (except capsid protein) encoded by phiEap-2 had orthologous gene products in FSL SP-031 and Serratia phage Eta (KC460990). Here, we report the complete genome sequence of phiEap-2 and major findings from the genomic analysis. Knowledge of this phage might be helpful for developing therapeutic strategies against E. aerogenes.

A study of metalized electrode self-clearing in electroactive polymer (EAP) based actuators

NASA Astrophysics Data System (ADS)

Ahmed, Saad; Ounaies, Zoubeida

2016-04-01

Electroactive polymer (EAP) based technologies have shown promise in areas such as artificial muscles, actuator, aerospace, medical and soft robotics. Still challenges remain such as low induced forces and defects-driven electrical breakdown, which impede the practical implementation of this technology. Multilayered or stacked configuration can address the low induced force issue whereas self-clearing can be a technique to improve breakdown limit of EAP based actuators. Self-clearing refers to the partial local breakdown of dielectric medium due to the presence of impurities, which in turn results in the evaporation of some of the metalized electrode. After this evaporation, the impurity is cleared and any current path would be safely cut off, which means the actuator continues to perform. It is a widely studied concept in the capacitor community, while it has not been studied much for EAP technologies. In this paper we report a systematic approach to precondition a silver-metalized electroactive polymer (EAP), more specifically P(VDF-TrFE-CTFE) terpolymer, using self-clearing concept. First, we show improvement in the dielectric breakdown strength of EAP based unimorph actuators after pre-clearing the impurities using low electric field (lower than dielectric breakdown of the terpolymer). Inspired by this improvement, we used Weibull statistics to systematically estimate the self-clearing/ preconditioning field needed to clear the defects. Then electrical breakdown experiments are conducted with and without preconditioning the samples to investigate its effect on the breakdown strength of the sample.

Electroactive Polymer (EAP) Actuation of Mechanisms and Robotic Devices

NASA Technical Reports Server (NTRS)

Bar-Cohen, Y.; Leary, S.; Harrison, J.; Smith, J.

1999-01-01

Actuators are responsible to the operative capability of manipulation systems and robots. In recent years, electroactive polymers (EAP) have emerged as potential alternative to conventional actuators.

Computer Literacy in Learning Academic English: Iranian EAP Students' and Instructors' Attitudes and Perspectives

ERIC Educational Resources Information Center

Alavi, Seyed Mohammad; Borzabadi, Davood; Dashtestani, Reza

2016-01-01

This study aimed to analyze perceptions of Iranian English for Academic Purposes (EAP) students on their computer literacy levels. A total of 641 undergraduate students of civil engineering and 34 EAP instructors participated in the study. Data collection instruments included questionnaires and semi-structured interviews. Findings confirmed that…

Integrated employee assistance program/managed behavioral health care benefits: relationship with access and client characteristics.

PubMed

Levy Merrick, Elizabeth S; Hodgkin, Dominic; Horgan, Constance M; Hiatt, Deirdre; McCann, Bernard; Azzone, Vanessa; Zolotusky, Galina; Ritter, Grant; Reif, Sharon; McGuire, Thomas G

2009-11-01

This study examined service user characteristics and determinants of access for enrollees in integrated EAP/behavioral health versus standard managed behavioral health care plans. A national managed behavioral health care organization's claims data from 2004 were used. Integrated plan service users were more likely to be employees rather than dependents, and to be diagnosed with adjustment disorder. Logistic regression analyses found greater likelihood in integrated plans of accessing behavioral health services (OR 1.20, CI 1.17-1.24), and substance abuse services specifically (OR 1.23, CI 1.06-1.43). Results are consistent with the concept that EAP benefits may increase access and address problems earlier.

Converging the capabilities of EAP artificial muscles and the requirements of bio-inspired robotics

NASA Astrophysics Data System (ADS)

Hanson, David F.; White, Victor

2004-07-01

The characteristics of Electro-actuated polymers (EAP) are typically considered inadequate for applications in robotics. But in recent years, there has been both dramatic increases in EAP technological capbilities and reductions in power requirements for actuating bio-inspired robotics. As the two trends continue to converge, one may anticipate that dramatic breakthroughs in biologically inspired robotic actuation will result due to the marraige of these technologies. This talk will provide a snapshot of how EAP actuator scientists and roboticists may work together on a common platform to accelerate the growth of both technologies. To demonstrate this concept of a platform to accelerate this convergence, the authors will discuss their work in the niche application of robotic facial expression. In particular, expressive robots appear to be within the range of EAP actuation, thanks to their low force requirements. Several robots will be shown that demonstrate realistic expressions with dramatically decreased force requirements. Also, detailed descriptions will be given of the engineering innovations that have enabled these robotics advancements-most notably, Structured-Porosity Elastomer Materials (SPEMs). SPEM manufacturing techniques create delicate cell-structures in a variety of elastomers that maintain the high elongation characteristics of the mother material, but because of the porisity, behave as sponge-materials, thus lower the force required to emulate facial expressions to levels output by several extant EAP actuators.

Integrated Employee Assistance Program/Managed Behavioral Healthcare Benefits: Relationship with Access and Client Characteristics

PubMed Central

Merrick, Elizabeth S. Levy; Hodgkin, Dominic; Horgan, Constance M.; Hiatt, Deirdre; McCann, Bernard; Azzone, Vanessa; Zolotusky, Galina; Ritter, Grant; Reif, Sharon; McGuire, Thomas G.

2009-01-01

This study examined service user characteristics and determinants of access for enrollees in integrated EAP/behavioral health versus standard managed behavioral health care plans. A national managed behavioral health care organization’s claims data from 2004 were used. Integrated plan service users were more likely to be employees rather than dependents, and to be diagnosed with adjustment disorder. Logistic regression analyses found greater likelihood in integrated plans of accessing behavioral health services (OR 1.20, CI 1.17–1.24), and substance abuse services specifically (OR 1.23, CI 1.06–1.43). Results are consistent with the concept that EAP benefits may increase access and address problems earlier. PMID:19690952

The anchorless adhesin Eap (extracellular adherence protein) from Staphylococcus aureus selectively recognizes extracellular matrix aggregates but binds promiscuously to monomeric matrix macromolecules.

PubMed

Hansen, Uwe; Hussain, Muzaffar; Villone, Daniela; Herrmann, Mathias; Robenek, Horst; Peters, Georg; Sinha, Bhanu; Bruckner, Peter

2006-05-01

Besides a number of cell wall-anchored adhesins, the majority of Staphylococcus aureus strains produce anchorless, cell wall-associated proteins, such as Eap (extracellular adherence protein). Eap contains four to six tandem repeat (EAP)-domains. Eap mediates diverse biological functions, including adherence and immunomodulation, thus contributing to S. aureus pathogenesis. Eap binding to host macromolecules is unusually promiscuous and includes matrix or matricellular proteins as well as plasma proteins. The structural basis of this promiscuity is poorly understood. Here, we show that in spite of the preferential location of the binding epitopes within triple helical regions in some collagens there is a striking specificity of Eap binding to different collagen types. Collagen I, but not collagen II, is a binding substrate in monomolecular form. However, collagen I is virtually unrecognized by Eap when incorporated into banded fibrils. By contrast, microfibrils containing collagen VI as well as basement membrane-associated networks containing collagen IV, or aggregates containing fibronectin bound Eap as effectively as the monomeric proteins. Therefore, Eap-binding to extracellular matrix ligands is promiscuous at the molecular level but not indiscriminate with respect to supramolecular structures containing the same macromolecules. In addition, Eap bound to banded fibrils after their partial disintegration by matrix-degrading proteinases, including matrix metalloproteinase 1. Therefore, adherence to matrix suprastructures by S. aureus can be supported by inflammatory reactions.

Expanding Access to Quality Pre-K Is Sound Public Policy

ERIC Educational Resources Information Center

Barnett, W. Steven

2013-01-01

In 2013, preschool education received more attention in the media and public policy circles than it has for some time, in part because of a series of high-profile proposals to expand access to quality pre-K. The scientific basis for these proposed expansions of quality pre-K is impressive. This paper brings to bear the full weight of the evidence…

14 CFR 120.115 - Employee Assistance Program (EAP).

Code of Federal Regulations, 2012 CFR

2012-01-01

... (CONTINUED) AIR CARRIERS AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS DRUG AND ALCOHOL TESTING PROGRAM Drug Testing Program Requirements § 120.115 Employee Assistance Program (EAP). (a... employer's drug testing plan submitted to the FAA for approval. ...

14 CFR 120.115 - Employee Assistance Program (EAP).

Code of Federal Regulations, 2011 CFR

2011-01-01

... (CONTINUED) AIR CARRIERS AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS DRUG AND ALCOHOL TESTING PROGRAM Drug Testing Program Requirements § 120.115 Employee Assistance Program (EAP). (a... employer's drug testing plan submitted to the FAA for approval. ...

14 CFR 120.115 - Employee Assistance Program (EAP).

Code of Federal Regulations, 2013 CFR

2013-01-01

... (CONTINUED) AIR CARRIERS AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS DRUG AND ALCOHOL TESTING PROGRAM Drug Testing Program Requirements § 120.115 Employee Assistance Program (EAP). (a... employer's drug testing plan submitted to the FAA for approval. ...

14 CFR 120.115 - Employee Assistance Program (EAP).

Code of Federal Regulations, 2010 CFR

2010-01-01

... (CONTINUED) AIR CARRIERS AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS DRUG AND ALCOHOL TESTING PROGRAM Drug Testing Program Requirements § 120.115 Employee Assistance Program (EAP). (a... employer's drug testing plan submitted to the FAA for approval. ...

Access to Investigational Drugs: FDA Expanded Access Programs or "Right-to-Try" Legislation?

PubMed

Holbein, M E Blair; Berglund, Jelena P; Weatherwax, Kevin; Gerber, David E; Adamo, Joan E

2015-10-01

The Food and Drug Administration Expanded Access (EA) program and "Right-to-Try" legislation aim to provide seriously ill patients who have no other comparable treatment options to gain access to investigational drugs and biological agents. Physicians and institutions need to understand these programs to respond to questions and requests for access. FDA EA programs and state and federal legislative efforts to provide investigational products to patients by circumventing FDA regulations were summarized and compared. The FDA EA program includes Single Patient-Investigational New Drug (SP-IND), Emergency SP-IND, Intermediate Sized Population IND, and Treatment IND. Approval rates for all categories exceed 99%. Approval requires FDA and Institutional Review Board (IRB) approval, and cooperation of the pharmaceutical partner is essential. "Right-to-Try" legislation bypasses some of these steps, but provides no regulatory or safety oversight. The FDA EA program is a reasonable option for patients for whom all other therapeutic interventions have failed. The SP-IND not only provides patient access to new drugs, but also maintains a balance between immediacy and necessary patient protection. Rather than circumventing existing FDA regulations through proposed legislation, it seems more judicious to provide the knowledge and means to meet the EA requirements. © 2015 Wiley Periodicals, Inc.

Examining the Use of Web-Based Tests for Testing Academic Vocabulary in EAP Instruction

ERIC Educational Resources Information Center

Dashtestani, Reza

2015-01-01

Interest in Web-based and computer-assisted language testing is growing in the field of English for academic purposes (EAP). In this study, four groups of undergraduate EAP students (n = 120), each group consisted of 30 students, were randomly selected from four different disciplines, i.e. biology, political sciences, psychology, and law. The four…

Beliefs on Learning and Teaching Language Components: The Case of Iranian EAP and EFL Learners

ERIC Educational Resources Information Center

Parsi, Gholamreza

2017-01-01

The present study intended to investigate the possible difference between EAP and EFL learners' beliefs concerning learning and teaching of language components, namely, vocabulary, pronunciation and grammar. Furthermore, this study examined the association between EAP and EFL learners' beliefs and their language components' development. To this…

Receptivity to Learner-Driven Feedback in EAP

ERIC Educational Resources Information Center

Maas, Clare

2017-01-01

There is still debate surrounding what constitutes the most effective feedback on EFL learners' writing, particularly in English for Academic Purposes (EAP) settings. Unanswered questions are found in the literature on topics such as the best formats for feedback, the role of technology, authors' authority over written texts, and ways of helping…

EAP actuators aid the quest for the 'Holy Braille' of tactile displays

NASA Astrophysics Data System (ADS)

Runyan, Noel; Blazie, Deane

2010-04-01

The authors present the worldwide need for electronic Braille displays to promote literacy among the blind. The use of of EAP's to produce Braille displays is encouraged and detailed descriptions of the technology of Braille are presented. Prior art is covered since the early 1950's through present day displays based mostly on piezoelectric technologies. EAP's offer the promise of the "Holy Braille", the ability to display a full page of Braille electronically. Details on "how not to make a Braille display" are covered in prior art.

Interaction between the Staphylococcus aureus extracellular adherence protein Eap and its subdomains with platelets.

PubMed

Palankar, Raghavendra; Binsker, Ulrike; Haracska, Bianca; Wesche, Jan; Greinacher, Andreas; Hammerschmidt, Sven

2018-04-18

S. aureus associated bacteremia can lead to severe infections with high risk of mortality (e.g. sepsis, infective endocarditis). Many virulence factors and adhesins of S. aureus are known to directly interact with platelets. Extracellular adherence protein, Eap, one of the most important virulence factors in S. aureus mediated infections is a multi-tandem domain protein and has been shown to interact with almost all cell types in the human circulatory system. By using amine reactive fluorescent N-hydroxysuccinimidyl (NHS)-ester dyes and by direct detection with primary fluorescently conjugated anti-histidine (His-tag) antibodies against detect N-terminal His6, we show Eap subdomain Eap D 3 D 4 specifically interacts and rapidly activates human platelets. Furthermore, we validate our finding by using site directed directional immobilization of Eap D 3 D 4 through N-terminal His 6 on nickel (II)-nitrilotriacetic acid (Ni-NTA) functionalized bacteriomimetic microbead arrays to visualize real-time platelet activation through calcium release assay. These methods offer an easily adoptable protocols for screening of S.aureus derived virulence factors and adhesins with platelets. Copyright © 2018 Elsevier GmbH. All rights reserved.

Access to Investigational Drugs: FDA Expanded Access Programs or “Right‐to‐Try” Legislation?

PubMed Central

Berglund, Jelena P.; Weatherwax, Kevin; Gerber, David E.; Adamo, Joan E.

2015-01-01

Abstract Purpose The Food and Drug Administration Expanded Access (EA) program and “Right‐to‐Try” legislation aim to provide seriously ill patients who have no other comparable treatment options to gain access to investigational drugs and biological agents. Physicians and institutions need to understand these programs to respond to questions and requests for access. Methods FDA EA programs and state and federal legislative efforts to provide investigational products to patients by circumventing FDA regulations were summarized and compared. Results The FDA EA program includes Single Patient‐Investigational New Drug (SP‐IND), Emergency SP‐IND, Intermediate Sized Population IND, and Treatment IND. Approval rates for all categories exceed 99%. Approval requires FDA and Institutional Review Board (IRB) approval, and cooperation of the pharmaceutical partner is essential. “Right‐to‐Try” legislation bypasses some of these steps, but provides no regulatory or safety oversight. Conclusion The FDA EA program is a reasonable option for patients for whom all other therapeutic interventions have failed. The SP‐IND not only provides patient access to new drugs, but also maintains a balance between immediacy and necessary patient protection. Rather than circumventing existing FDA regulations through proposed legislation, it seems more judicious to provide the knowledge and means to meet the EA requirements. PMID:25588691

EAP viewpoint on unpublished data from paediatric clinical trials.

PubMed

Schrier, L; Illy, K; Valiulis, A; Wyder, C; Stiris, T

2018-02-01

European children and paediatricians rely heavily on the fair, complete and timely publication of data obtained from paediatric randomised controlled trials (RCTs). Selective publication and reporting of paediatric RCTs is common practice. Industry-sponsored trials are more likely to remain unpublished, and take longer to get published compared with trials sponsored by others. However, also academic sponsors contribute to inefficiencies in publishing clinical data. Publication bias violates the ethical obligation that investigators have towards study participants, leads to considerable inefficiencies in research and a waste of financial and human resources, and has the potential to distort evidence for treatment approaches. The European Academy of Paediatrics (EAP) therefore actively supports initiatives that increase the public dissemination of paediatric clinical trial data. The EAP will raise awareness about the guidelines for Good Publication Practice among European paediatricians and subspecialty societies.

The structure of EAP-groups and self-autopermutable subgroups.

PubMed

Housieni, Shima; Moghaddam, Mohammad Reza Rajabzadeh

2014-01-01

A subgroup H of a given group G is said to be autopermutable, if HH(α) = H(α)H for all α ∈ Aut(G). We also call H a self-autopermutable subgroup of G, when HH(α) = H(α)H implies that H(α) = H. Moreover, G is said to be EAP-group, if every subgroup of G is autopermutable. One notes that if α runs over the inner automorphisms of the group, one obtains the notions of conjugate-permutability, self-conjugate-permutability, and ECP-groups, which were studied by Foguel in 1997, Li and Meng in 2007, and Xu and Zhang in 2005, respectively. In the present paper, we determine the structure of a finite EAP-group when its centre is of index 4 in G. We also show that self-autopermutability and characteristic properties are equivalent for nilpotent groups.

Exploring Reading Comprehension Needs of Iranian EAP Students of Health Information Management (HIM): A Triangulated Approach

ERIC Educational Resources Information Center

Atai, Mahmood Reza; Nazari, Ogholgol

2011-01-01

Discipline-based English for Academic Purposes (EAP) reading programs in Iran are designed to fill the gap between the students' general English reading competence and their ability to read authentic discipline-specific texts. This study attempted to assess target and present reading comprehension needs of EAP students of Health Information…

EAP Curriculum Alignment and Social Acculturation: Student Perceptions

ERIC Educational Resources Information Center

Tweedie, M. Gregory; Kim, Marcia

2015-01-01

The role of English as a second language (ESL) teachers and instruction as factors in student social and psychological acculturation is widely acknowledged. However, the function of English for Academic Purposes (EAP) is less well known in this regard, because research has focused largely on academic acculturation. This qualitative study…

PANATIKI: A Network Access Control Implementation Based on PANA for IoT Devices

PubMed Central

Sanchez, Pedro Moreno; Lopez, Rafa Marin; Gomez Skarmeta, Antonio F.

2013-01-01

Internet of Things (IoT) networks are the pillar of recent novel scenarios, such as smart cities or e-healthcare applications. Among other challenges, these networks cover the deployment and interaction of small devices with constrained capabilities and Internet protocol (IP)-based networking connectivity. These constrained devices usually require connection to the Internet to exchange information (e.g., management or sensing data) or access network services. However, only authenticated and authorized devices can, in general, establish this connection. The so-called authentication, authorization and accounting (AAA) services are in charge of performing these tasks on the Internet. Thus, it is necessary to deploy protocols that allow constrained devices to verify their credentials against AAA infrastructures. The Protocol for Carrying Authentication for Network Access (PANA) has been standardized by the Internet engineering task force (IETF) to carry the Extensible Authentication Protocol (EAP), which provides flexible authentication upon the presence of AAA. To the best of our knowledge, this paper is the first deep study of the feasibility of EAP/PANA for network access control in constrained devices. We provide light-weight versions and implementations of these protocols to fit them into constrained devices. These versions have been designed to reduce the impact in standard specifications. The goal of this work is two-fold: (1) to demonstrate the feasibility of EAP/PANA in IoT devices; (2) to provide the scientific community with the first light-weight interoperable implementation of EAP/PANA for constrained devices in the Contiki operating system (Contiki OS), called PANATIKI. The paper also shows a testbed, simulations and experimental results obtained from real and simulated constrained devices. PMID:24189332

PANATIKI: a network access control implementation based on PANA for IoT devices.

PubMed

Moreno Sanchez, Pedro; Marin Lopez, Rafa; Gomez Skarmeta, Antonio F

2013-11-01

Internet of Things (IoT) networks are the pillar of recent novel scenarios, such as smart cities or e-healthcare applications. Among other challenges, these networks cover the deployment and interaction of small devices with constrained capabilities and Internet protocol (IP)-based networking connectivity. These constrained devices usually require connection to the Internet to exchange information (e.g., management or sensing data) or access network services. However, only authenticated and authorized devices can, in general, establish this connection. The so-called authentication, authorization and accounting (AAA) services are in charge of performing these tasks on the Internet. Thus, it is necessary to deploy protocols that allow constrained devices to verify their credentials against AAA infrastructures. The Protocol for Carrying Authentication for Network Access (PANA) has been standardized by the Internet engineering task force (IETF) to carry the Extensible Authentication Protocol (EAP), which provides flexible authentication upon the presence of AAA. To the best of our knowledge, this paper is the first deep study of the feasibility of EAP/PANA for network access control in constrained devices. We provide light-weight versions and implementations of these protocols to fit them into constrained devices. These versions have been designed to reduce the impact in standard specifications. The goal of this work is two-fold: (1) to demonstrate the feasibility of EAP/PANA in IoT devices; (2) to provide the scientific community with the first light-weight interoperable implementation of EAP/PANA for constrained devices in the Contiki operating system (Contiki OS), called PANATIKI. The paper also shows a testbed, simulations and experimental results obtained from real and simulated constrained devices.

Directions for Development of the Field of Electroactive Polymer (EAP)

NASA Technical Reports Server (NTRS)

Bar-Cohen, Yoseph

2011-01-01

In last few years, the rate of development and advances in the field of EAP has accelerated significantly and it is increasingly getting closer to the point of finding them used in commercial products. Substantial development has been reported in the understanding of their drive mechanisms and the parameters that control their electro-activation behavior. Further, efforts are being made to develop mass production techniques with greatly improved actuation capability and operation durability. The recent efforts to develop energy harvesting techniques, haptic interfacing (including refreshable braille displays), and toys are further increasing the likelihood of finding niches for these materials. In this paper, the author sought to examine the potential directions for the future development of the field of EAP in relation to the state-of-the-art.

Directions for development of the field of electroactive polymer (EAP)

NASA Astrophysics Data System (ADS)

Bar-Cohen, Yoseph

2011-04-01

In last few years, the rate of development and advances in the field of EAP has accelerated significantly and it is increasingly getting closer to the point of finding them used in commercial products. Substantial development has been reported in the understanding of their drive mechanisms and the parameters that control their electro-activation behavior. Further, efforts are being made to develop mass production techniques with greatly improved actuation capability and operation durability. The recent efforts to develop energy harvesting techniques, haptic interfacing (including refreshable braille displays), and toys are further increasing the likelihood of finding niches for these materials. In this paper, the author sought to examine the potential directions for the future development of the field of EAP in relation to the state-of-the-art.

Strain-specific induction of experimental autoimmune prostatitis (EAP) in mice.

PubMed

Jackson, Christopher M; Flies, Dallas B; Mosse, Claudio A; Parwani, Anil; Hipkiss, Edward L; Drake, Charles G

2013-05-01

Prostatitis, a clinical syndrome characterized by pelvic pain and inflammation, is common in adult males. Although several induced and spontaneous murine models of prostatitis have been explored, the role of genetic background on induction has not been well-defined. Using a standard methodology for the induction of experimental autoimmune prostatitis (EAP), we investigated both acute and chronic inflammation on several murine genetic backgrounds. In our colony, nonobese diabetic (NOD) mice evinced spontaneous prostatitis that was not augmented by immunization with rat prostate extract (RPE). In contrast, the standard laboratory strain Balb/c developed chronic inflammation in response to RPE immunization. Development of EAP in other strains was variable. These data suggest that Balb/c mice injected with RPE may provide a useful model for chronic prostatic inflammation. Copyright © 2012 Wiley Periodicals, Inc.

Strain-Specific Induction of Experimental Autoimmune Prostatitis (EAP) in Mice

PubMed Central

Jackson, Christopher M.; Flies, Dallas B.; Mosse, Claudio A.; Parwani, Anil; Hipkiss, Edward L.; Drake, Charles G.

2013-01-01

BACKGROUND Prostatitis, a clinical syndrome characterized by pelvic pain and inflammation, is common in adult males. Although several induced and spontaneous murine models of prostatitis have been explored, the role of genetic background on induction has not been well-defined. METHODS Using a standard methodology for the induction of experimental autoimmune prostatitis (EAP), we investigated both acute and chronic inflammation on several murine genetic backgrounds. RESULTS In our colony, nonobese diabetic (NOD) mice evinced spontaneous prostatitis that was not augmented by immunization with rat prostate extract (RPE). In contrast, the standard laboratory strain Balb/c developed chronic inflammation in response to RPE immunization. Development of EAP in other strains was variable. CONCLUSIONS These data suggest that Balb/c mice injected with RPE may provide a useful model for chronic prostatic inflammation. PMID:23129407

Effects of EAP follow-up on prevention of relapse among substance abuse clients.

PubMed

Foote, A; Erfurt, J C

1991-05-01

Clients entering an employee assistance program (EAP) of a large manufacturing plant in 1985 who were assessed as having an alcohol or drug abuse problem (N = 325) were randomized into an experimental "special follow-up" group and a control "regular care" group. The regular care group received follow-up only as needed (following the usual practice of the EAP), while a follow-up counselor was hired to make routine contacts with the special follow-up group. Study intake continued through 1985, and follow-up continued through the end of 1986. Data collected on study subjects included EAP participation data, absenteeism, number of hospitalizations, health care claims paid and disability claims paid. The major study hypothesis was that EAP clients randomly allocated to special follow-up would show better results than regular care clients (i.e., would have fewer relapses, better job attendance and lower health benefit utilization during the follow-up year). The follow-up intervention was incompletely implemented due to a variety of organizational problems. Differences between the two groups on the six outcome measures were not statistically significant, although clients in the special follow-up group did show better results than clients in the regular care group on the three measures related to substance abuse. Differences on these three measures were marginally significant in regression analyses after controlling for the effects of number of follow-up visits, age, race and chronicity.

Promoting Reflection on Science, Technology, and Society among Engineering Students through an EAP Online Learning Environment

ERIC Educational Resources Information Center

Arno-Macia, Elisabet; Rueda-Ramos, Carmen

2011-01-01

With the new European framework, as EAP lecturers in an engineering college, we are reappraising our teaching and the position of our courses. From the perspective of engineering education in the 21st century, we believe that EAP teaching can focus not only on language and communication needs, but also on developing critical thinking about science…

Learner Corpora: The Missing Link in EAP Pedagogy

ERIC Educational Resources Information Center

Gilquin, Gaetanelle; Granger, Sylviane; Paquot, Magali

2007-01-01

This article deals with the place of learner corpora, i.e. corpora containing authentic language data produced by learners of a foreign/second language, in English for academic purposes (EAP) pedagogy and sets out to demonstrate that they have a valuable contribution to make to the field. Following an initial brief introduction to corpus-based…

An Analysis of Curriculum Renewal in EAP Context

ERIC Educational Resources Information Center

Yurekli, Aynur

2012-01-01

This study aims at describing the new approach to English for Academic Purposes (EAP) teaching based on the results of the curriculum renewal conducted for the freshman "Academic Skills in English" courses (ENG 101 and ENG 102) with reference to the Faculty of Computer Sciences. The study is based on the results of the needs analysis…

Human-like robots as platforms for electroactive polymers (EAP)

NASA Astrophysics Data System (ADS)

Bar-Cohen, Yoseph

2008-03-01

Human-like robots, which have been a science fiction for many years, are increasingly becoming an engineering reality thanks to many technology advances in recent years. Humans have always sought to imitate the human appearance, functions and intelligence and as the capability progresses they may become our household appliance or even companion. Biomimetic technologies are increasingly becoming common tools to support the development of such robots. As artificial muscles, electroactive polymers (EAP) are offering important actuation capability for making such machines lifelike. The current limitations of EAP are hampering the possibilities that can be adapted in such robots but progress is continually being made. As opposed to other human made machines and devices, this technology raises various questions and concerns that need to be addressed. These include the need to prevent accidents, deliberate harm, or their use in crimes. In this paper the state-of-the-art and the challenges will be reviewed.

Expanding Access

ERIC Educational Resources Information Center

Roach, Ronald

2007-01-01

There is no question that the United States lags behind most industrialized nations in consumer access to broadband Internet service. For many policy makers and activists, this shortfall marks the latest phase in the struggle to overcome the digital divide. To remedy this lack of broadband affordability and availability, one start-up firm--with…

A 2-year cohort study on the impact of an Employee Assistance Programme (EAP) on depression and suicidal thoughts in male Japanese workers.

PubMed

Nakao, Mutsuhiro; Nishikitani, Mariko; Shima, Satoru; Yano, Eiji

2007-11-01

Depression and suicide-related behaviours are important issues for workers, and the number of Japanese companies contracting with the Employee Assistance Programme (EAP) to promote employees' mental health has recently increased. However, no longitudinal studies have reported that the EAP maintains or improves the overall level of depression among employees qualitatively. Thus, we attempted to assess the impact of the EAP on depression and suicide-related behaviours in the workplace. A cohort study was conducted on 283 male Japanese employees aged 22-38 years at a Japanese information-technology company introducing the EAP. Because the privacy policy of the EAP service made it difficult to perform a randomised design in the workplace, 22 men working at an affiliated company without the EAP were used as a reference group. All the subjects completed the 17-item Hamilton Depression Scale (HAM-D) and Job Content Questionnaire (JCQ) consisting of job demands, control, and social support before the EAP was introduced to establish a baseline and after 2 years. In the EAP group, the total HAM-D scores significantly decreased after the 2-year study period (P=0.0011); the changes in the scores of the five HAM-D items (i.e., suicidal thoughts, agitation, psychomotor retardation, guilt, and depressed mood) were significant. Specifically, 19 (86%) of the 22 workers with a positive response to the suicidal thoughts item (i.e., score >or= 1) at baseline reported that they no longer had suicidal thoughts (i.e., score=0) after the 2 year study period. No significant changes were observed in the reference group. The three JCQ scores were not significantly different between the baseline and after the 2 year study period in both groups. Although further studies are needed, EAPs may be a promising strategy for maintaining the good mental health of workers.

Enhancing the Quality of EAP Writing through Overt Teaching

ERIC Educational Resources Information Center

Wee, Roselind; Sim, Jacqueline; Jusoff, Kamaruzaman

2009-01-01

This paper examines how overt teaching is instrumental in reducing subject-verb agreement (SVA) errors of Malaysian EAP learners which in turn improves the quality of their writing. The researchers used overt teaching of these grammatical items, that is, SVA and investigated how this method has significantly benefitted the learners who were second…

The challenges that employees who abuse substances experience when returning to work after completion of employee assistance programme (EAP).

PubMed

Soeker, Shaheed; Matimba, Tandokazi; Machingura, Last; Msimango, Henry; Moswaane, Bobo; Tom, Sinazo

2015-01-01

Employee assistance programs (EAPs) are responsible for helping employees cope with problems such as: mental distress, alcoholism and other drug dependencies, marital and financial difficulties--in short, the whole host of personal and family troubles endemic to the human condition. The study explored the challenges that employees who abuse substances experience when returning to work after the completion of an employee assistance program. The study used a qualitative exploratory descriptive research design. Three male participants and two key informants participated in the study. One semi structured interview was conducted with each one of the participants and one semi structured interview with the key informants. Four themes emerged: 1) Loss of one's worker role identity, 2) Negative influences of the community continues to effect the success of EAP, 3) EAP as a vehicle for change and, 4) Healthy occupations strengthen EAP. This study portrayed the following: how substance abuse effect the worker role of individuals employed in the open labor market, the challenges and facilitators experienced by employees who abuse substances when returning to their previous work roles and how occupation based interventions can be incorporated in EAP programs. Occupational therapists could use the health promotion approach, work simplification, energy conservation techniques and ergonomic analysis techniques.

The Impact of an EAP Course on Postgraduate Writing

ERIC Educational Resources Information Center

Storch, Neomy; Tapper, Joanna

2009-01-01

This study assessed the impact of completing an English for Academic Purposes (EAP) course on the writing of postgraduate learners. We begin this paper by describing a course offered for credit to postgraduate international students at a university in Australia, and then report on a large-scale study (n = 69) which investigated the improvement (if…

Medical Negligence Determinations, the "Right to Try," and Expanded Access to Innovative Treatments.

PubMed

Meyerson, Denise

2017-09-01

This article considers the issue of expanded access to innovative treatments in the context of recent legislative initiatives in the United Kingdom and the United States. In the United Kingdom, the supporters of legislative change argued that the common law principles governing medical negligence are a barrier to innovation. In an attempt to remove this perceived impediment, two bills proposed that innovating doctors sued for negligence should be able to rely in their defence on the fact that their decision to innovate was "responsible." A decision to innovate would be regarded as responsible if it followed a specified process. Although these changes to the law of medical negligence were not passed, this article argues that the idea of a process-based approach was sound. In the United States, a number of states have passed "Right to Try" laws that permit doctors to prescribe and companies to provide investigational products without the need for FDA approval. These laws do not purport to and nor are they able to alter the obligations of individuals and companies under federal law. They are consequently unlikely to achieve their stated aim of expanding access to investigational products. This article argues that they nevertheless have a cogent rationale in so far as they highlight the need for rights-based reform to federal regulations governing access.

Simulation/Gaming in the EAP Writing Class: Benefits and Drawbacks.

ERIC Educational Resources Information Center

Salies, Tania Gastao

2002-01-01

Describes an integrated use of simulation/gaming in an English for Academic Purposes (EAP) class, analyzes benefits and drawbacks, and suggest how the technique could apply to other specific contexts. Explains how international students ran a simulation on gun control; discusses the debriefing process; and considers motivation, metacognitive…

Implementing long-term EAP follow-up with clients and family members to help prevent relapse-With implications for primary prevention.

PubMed

Foote, A; Googins, B; Moriarty, M; Sandonato, C; Nadolski, J; Jefferson, C

1994-12-01

This paper reports on a study in progress which involves (a) regular post-treatment contact by employee assistance program (EAP) staff with employees who seek help through the EAP, and (b) contact with a family member or other support person designated by the employee. The contacts are designed to provide support for maintenance of therapeutic gains, assistance in adjusting to current life situations, and early identification and prevention of relapse. The study will evaluate the process of initiating these contacts and will examine their effectiveness at reducing relapse. Factors associated with implementing these services in an EAP context are discussed.

A Promising Tool for Helping Vulnerable Workers? An Exploration of the Use of Employee Assistance Programs (EAPs) to Help Low-Wage Workers on College Campuses

ERIC Educational Resources Information Center

Hahn, Andrew B.

2005-01-01

Employee assistance programs, or EAPs, are an employee benefit designed to help workers meet their work and family needs. However, questions have been raised about the design, utilization, and scale of services that EAPs make possible for low-wage workers. This article explores whether on college campuses an EAP benefit can simultaneously meet the…

Diagnosing EAP Writing Ability Using the Reduced Reparameterized Unified Model

ERIC Educational Resources Information Center

Kim, Youn-Hee

2011-01-01

Despite the increasing interest in and need for test information for use in instructional practice and student learning, there have been few attempts to systematically link a diagnostic approach to English for academic purposes (EAP) writing instruction and assessment. In response to this need for research, this study examined the extent to which…

Impaired Job Performance and Critical Incidents: Factors Influencing Supervisory EAP Referrals.

ERIC Educational Resources Information Center

Harley, David A.

Relatively little empirical research has been done on the supervisory referral of employees to employee assistance programs (EAPs). Inclusion of constructive confrontation (supervisory referral) into program standards and its continued promotion as a "central strategy" of program theory and operation calls for critical investigation of…

Survival analysis to explore the characteristics of employee assistance program (EAP) referrals that remain employed.

PubMed

Macdonald, S; Albert, W; Maynard, M; French, P

1989-02-01

This study examined characteristics of referrals to employee assistance programs (EAP) associated with subsequent termination of employment. As well, relationships between characteristics of the referrals and program characteristics were explored. Longitudinal data were collected at several time periods for 163 referrals to EAPs from five organizations. Survival analysis was conducted to determine which variables were associated with termination of employment. Females, cohabitating couples, and employees who worked for the organization for 5 or more years were most likely to remain employed. One interesting finding was that people with alcohol problems were significantly more likely to be formal referrals.

The Margins as "Third Space": EAP Teacher Professionalism in Canadian Universities

ERIC Educational Resources Information Center

MacDonald, Jennifer

2016-01-01

Teachers of English for Academic Purposes (EAP) in the Canadian university setting often experience professional marginalization in terms of lack of status, clarity of mandate, or administrative home within their institutions. Despite having broadly benefited the ESL/EAL sector in Canada, traditional trait-focused professionalization efforts have…

Investing in Our Children: A Plan to Expand Access to Preschool and Child Care

ERIC Educational Resources Information Center

Brown, Cynthia G.; Cooper, Donna; Herman, Juliana; Lazarín, Melissa; Linden, Michael; Post, Sasha; Tanden, Neera

2013-01-01

This issue brief presents a plan to expand educational opportunities and care for children ages 0-5 years old by investing significant federal dollars to: (1) Make high-quality preschool universally accessible to all 3- and 4-year-old children; and (2) Enable more lower-income families to afford child care for children ages 0-3 years old. These…

Bimonthly 24 h infusion of high-dose 5-fluorouracil vs EAP regimen in patients with advanced gastric cancer. A randomized phase II study.

PubMed

Popov, I P; Jelić, S B; Krivokapić, Z V; Jezdić, S D; Pesko, P M; Micev, M T; Babić, D R

2008-01-01

To investigate the activity and toxicity of high dose (HD) infusional 5-FU in comparison to EAP regimen as first-line chemotherapy in patients with advanced gastric cancer. Histologically confirmed measurable advanced gastric cancer, age < 72 yr, ECOG performance status 0-2, no prior chemo- and radiotherapy, adequate organ functions. EAP arm: doxorubicin (40 mg/m(2)), etoposide (360 mg/m(2)), and cisplatin (80 mg/m(2)) every 28 d; HD 5-FU arm: 5-FU 2.6 g/m(2) 24 h infusion, biweekly. Sixty patients were randomized. Patient characteristics (arms EAP/HD 5-FU): Median age 57/55 yr, median PS 1/1, LAD (patients) 3/8, M1 (patients) 27/22. Median number of cycles (range): EAP arm 4 (2-8), HD 5-FU arm 2 (1-8). Worst toxicity per cycle (grade 3 and 4 in%): Neutropenia 20/3, thrombocytopenia 9/0, anemia 9/13, diarrhea 3/10, nausea 17/7, vomiting 10/0 for EAP and HD 5-FU arms, respectively. All patients were eligible for response in both arms. Confirmed response rate (95%CI): EAP arm 34% [16-50%]/HD 5-FU arm 10% (0-21%), no change: 46/40%, progression of disease: 20/50, respectively. Overall survival (range): EAP arm A 7 mo [3-27], HD 5-FU arm 6 mo (4-25). Infusional HD 5-FU showed a low incidence of severe toxicity. But given the low efficacy of 5-FU in the dosage we applied in the study, it cannot be recommended as a single treatment for further studies. Assessment of higher dose intensity and/or dose density of 5-FU, with introduction of other active drugs in combination, could be an option for further studies.

Mapping the transcription start points of the Staphylococcus aureus eap, emp, and vwb promoters reveals a conserved octanucleotide sequence that is essential for expression of these genes.

PubMed

Harraghy, Niamh; Homerova, Dagmar; Herrmann, Mathias; Kormanec, Jan

2008-01-01

Mapping the transcription start points of the eap, emp, and vwb promoters revealed a conserved octanucleotide sequence (COS). Deleting this sequence abolished the expression of eap, emp, and vwb. However, electrophoretic mobility shift assays gave no evidence that this sequence was a binding site for SarA or SaeR, known regulators of eap and emp.

Bessel Fourier orientation reconstruction: an analytical EAP reconstruction using multiple shell acquisitions in diffusion MRI.

PubMed

Hosseinbor, Ameer Pasha; Chung, Moo K; Wu, Yu-Chien; Alexander, Andrew L

2011-01-01

The estimation of the ensemble average propagator (EAP) directly from q-space DWI signals is an open problem in diffusion MRI. Diffusion spectrum imaging (DSI) is one common technique to compute the EAP directly from the diffusion signal, but it is burdened by the large sampling required. Recently, several analytical EAP reconstruction schemes for multiple q-shell acquisitions have been proposed. One, in particular, is Diffusion Propagator Imaging (DPI) which is based on the Laplace's equation estimation of diffusion signal for each shell acquisition. Viewed intuitively in terms of the heat equation, the DPI solution is obtained when the heat distribution between temperatuere measurements at each shell is at steady state. We propose a generalized extension of DPI, Bessel Fourier Orientation Reconstruction (BFOR), whose solution is based on heat equation estimation of the diffusion signal for each shell acquisition. That is, the heat distribution between shell measurements is no longer at steady state. In addition to being analytical, the BFOR solution also includes an intrinsic exponential smootheing term. We illustrate the effectiveness of the proposed method by showing results on both synthetic and real MR datasets.

A New Outlook on EAP Literacies: General and Specific English Territories

ERIC Educational Resources Information Center

Zohrabi, Mohammad

2010-01-01

In designing an EAP (English for Academic Purposes) course it is necessary that we consider several factors: students' objectives, needs, levels and interests, course and institution's goals, and availability of resources. In this paper it is strived to elucidate the differences between EGP (English for General purposes) and ESP (English for…

Investigating the Application of Needs Analysis on EAP Business Administration Materials

ERIC Educational Resources Information Center

Mohammed, Saifalislam Abdalla Hajahmed

2016-01-01

This study is conducted to investigate the application of needs analysis in developing EAP materials for business administration students in two Sudanese universities. The subjects are 2 head departments of English language. To collect data, the researcher uses interview and content analysis. The study adopts the descriptive approach. The data of…

Various design approaches to achieve electric field-driven segmented folding actuation of electroactive polymer (EAP) sheets

NASA Astrophysics Data System (ADS)

Ahmed, Saad; Hong, Jonathan; Zhang, Wei; Kopatz, Jessica; Ounaies, Zoubeida; Frecker, Mary

2018-03-01

Electroactive polymer (EAPs) based technologies have shown promise in areas such as artificial muscles, aerospace, medical and soft robotics. In this work, we demonstrate ways to harness on-demand segmented folding actuation from pure bending of relaxor-ferroelectric P(VDF-TrFE-CTFE) based films, using various design approaches, such as `stiffener' and `notch' based approaches. The in-plane actuation of the P(VDF-TrFE-CTFE) is converted into bending actuation using unimorph configurations, where one passive substrate layer is attached to the active polymer. First, we experimentally show that placement of thin metal strips as stiffener in between active EAPs and passive substrates leads to segmented actuation as opposed to pure bending actuation; stiffeners made of different materials, such as nickel, copper and aluminum, are studied which reveals that a higher Young's modulus favors more pronounced segmented actuation. Second, notched samples are prepared by mounting passive substrate patches of various materials on top of the passive layers of the unimorph EAP actuators. Effect of notch materials, size of the notches and position of the notches on the folding actuation are studied. The motion of the human finger inspires a finger-like biomimetic actuator, which is realized by assigning multiple notches on the structure; finite element analysis (FEA) is also performed using COMSOL Multiphysics software for the notched finger actuator. Finally, a versatile soft-gripper is developed using the notched approach to demonstrate the capability of a properly designed EAP actuator to hold objects of various sizes and shapes.

Surfactant protein A (SP-A)-mediated clearance of Staphylococcus aureus involves binding of SP-A to the staphylococcal adhesin eap and the macrophage receptors SP-A receptor 210 and scavenger receptor class A.

PubMed

Sever-Chroneos, Zvjezdana; Krupa, Agnieszka; Davis, Jeremy; Hasan, Misbah; Yang, Ching-Hui; Szeliga, Jacek; Herrmann, Mathias; Hussain, Muzafar; Geisbrecht, Brian V; Kobzik, Lester; Chroneos, Zissis C

2011-02-11

Staphylococcus aureus causes life-threatening pneumonia in hospitals and deadly superinfection during viral influenza. The current study investigated the role of surfactant protein A (SP-A) in opsonization and clearance of S. aureus. Previous studies showed that SP-A mediates phagocytosis via the SP-A receptor 210 (SP-R210). Here, we show that SP-R210 mediates binding and control of SP-A-opsonized S. aureus by macrophages. We determined that SP-A binds S. aureus through the extracellular adhesin Eap. Consequently, SP-A enhanced macrophage uptake of Eap-expressing (Eap(+)) but not Eap-deficient (Eap(-)) S. aureus. In a reciprocal fashion, SP-A failed to enhance uptake of Eap(+) S. aureus in peritoneal Raw264.7 macrophages with a dominant negative mutation (SP-R210(DN)) blocking surface expression of SP-R210. Accordingly, WT mice cleared infection with Eap(+) but succumbed to sublethal infection with Eap- S. aureus. However, SP-R210(DN) cells compensated by increasing non-opsonic phagocytosis of Eap(+) S. aureus via the scavenger receptor scavenger receptor class A (SR-A), while non-opsonic uptake of Eap(-) S. aureus was impaired. Macrophages express two isoforms: SP-R210(L) and SP-R210(S). The results show that WT alveolar macrophages are distinguished by expression of SP-R210(L), whereas SR-A(-/-) alveolar macrophages are deficient in SP-R210(L) expressing only SP-R210(S). Accordingly, SR-A(-/-) mice were highly susceptible to both Eap(+) and Eap(-) S. aureus. The lungs of susceptible mice generated abnormal inflammatory responses that were associated with impaired killing and persistence of S. aureus infection in the lung. In conclusion, alveolar macrophage SP-R210(L) mediates recognition and killing of SP-A-opsonized S. aureus in vivo, coordinating inflammatory responses and resolution of S. aureus pneumonia through interaction with SR-A.

Arrays of EAP micro-actuators for single-cell stretching applications

NASA Astrophysics Data System (ADS)

Akbari, S.; Niklaus, M.; Shea, H.

2010-04-01

Mechanical stimuli are critical for the development and maintenance of most tissues such as muscles, cartilage, bones and blood vessels. The commercially available cell culture systems replicating the in vivo environment are typically based on simple membrane cell-stretching equipment, which can only measure the average response of large colonies of cells over areas of greater than one cm2. We present here the conceptual design and the complete fabrication process of an array of 128 Electro-Active Polymer (EAP) micro-actuators which are uni-axially stretched and hence used to impose unidirectional strain on single cells, make it feasible to do experiments on the cytomechanics of individual cells. The Finite Element Method is employed to study the effect of different design parameters on achievable strain, leading to the optimized design. Compliant gold electrodes are deposited by low-energy ion implantation on both sides of a PDMS membrane, as this technique allows making electrodes that support large strain with minimal stiffening of the elastomer. The membrane is bonded to a rigid support, leading to an array of 100×100 μm2 EAP actuators.

Expanding the Role of Nurse Practitioners: Effects on Rural Access to Care for Injured Workers

ERIC Educational Resources Information Center

Sears, Jeanne M.; Wickizer, Thomas M.; Franklin, Gary M.; Cheadle, Allen D.; Berkowitz, Bobbie

2008-01-01

Context: A 3-year pilot program to expand the role of nurse practitioners (NPs) in the Washington State workers' compensation system was implemented in 2004 (SHB 1691), amid concern about disparities in access to health care for injured workers in rural areas. SHB 1691 authorized NPs to independently perform most functions of an attending…

Reading and Writing as Academic Literacy in EAP Program of Indonesian Leaners

ERIC Educational Resources Information Center

Solikhah, Imroatus

2015-01-01

This study investigates academic literacy imposed in reading and writing for academic purposes in the EAP program. This study uses descriptive design elaborating data from curriculum documents and interviews. Involving 45 participants from IAIN Surakarta and Veteran University, data were analyzed using constant-comparison and inductive analysis…

The Pronunciation Component in Teaching EAP in Cameroonian Universities: Some Proposals

ERIC Educational Resources Information Center

Safotso, Gilbert Tagne

2016-01-01

In Cameroonian universities, EAP is generally seen as a marginalised unit, and its teaching is abandoned to part-time secondary school teachers, or doctorate students who have little or no knowledge of the subject. Most of the time, these teachers do not know the real objective of the subject, and do not master it. In some universities, each…

Bryostatin Effects on Cognitive Function and PKCɛ in Alzheimer's Disease Phase IIa and Expanded Access Trials.

PubMed

Nelson, Thomas J; Sun, Miao-Kun; Lim, Chol; Sen, Abhik; Khan, Tapan; Chirila, Florin V; Alkon, Daniel L

2017-01-01

Bryostatin 1, a potent activator of protein kinase C epsilon (PKCɛ), has been shown to reverse synaptic loss and facilitate synaptic maturation in animal models of Alzheimer's disease (AD), Fragile X, stroke, and other neurological disorders. In a single-dose (25 μg/m2) randomized double-blind Phase IIa clinical trial, bryostatin levels reached a maximum at 1-2 h after the start of infusion. In close parallel with peak blood levels of bryostatin, an increase of PBMC PKCɛ was measured (p = 0.0185) within 1 h from the onset of infusion. Of 9 patients with a clinical diagnosis of AD, of which 6 received drug and 3 received vehicle within a double-blind protocol, bryostatin increased the Mini-Mental State Examination (MMSE) score by +1.83±0.70 unit at 3 h versus -1.00±1.53 unit for placebo. Bryostatin was well tolerated in these AD patients and no drug-related adverse events were reported. The 25 μg/m2 administered dose was based on prior clinical experience with three Expanded Access advanced AD patients treated with bryostatin, in which return of major functions such as swallowing, vocalization, and word recognition were noted. In one Expanded Access patient trial, elevated PKCɛ levels closely tracked cognitive benefits in the first 24 weeks as measured by MMSE and ADCS-ADL psychometrics. Pre-clinical mouse studies showed effective activation of PKCɛ and increased levels of BDNF and PSD-95. Together, these Phase IIa, Expanded Access, and pre-clinical results provide initial encouragement for bryostatin 1 as a potential treatment for AD.

How fish swim: flexible fin thrusters as an EAP platform

NASA Astrophysics Data System (ADS)

Lauder, George V.

2007-04-01

Fish are capable of remarkable locomotor performance and use their fins extensively for both propulsion and maneuvering. Recent interest in using fishes as inspiration for the design of a new generation of autonomous underwater vehicles has prompted both new experimental studies of fish locomotor function and efforts to use electroactive polymers (EAP) as actuators in fish-inspired propulsive devices. The fins of fishes allow precise control over body position and vectoring of thrust during propulsion and maneuvering. Recent experimental studies of fish locomotion have revealed that fins exhibit much greater flexibility than previously suspected and that there is considerable deformation of the fin surface during locomotion. The fins of the large group known as ray-finned fishes are supported by fin rays, which have a bilaminar structure that allows active curvature control of the ray and fin surface by the fin musculature. Fish have up to seven different fins, and these fins may interact with each other hydrodynamically during locomotion. Fish fins provide an excellent test platform for the use of electroactive polymer actuators as the frequency of movement is typically less than 5 Hz, and fin muscle strains typically range from 2 to 10%. Recent developments of biorobotic fish pectoral fins actuated with EAP are reviewed.

Multimodal Genre Systems in EAP Writing Pedagogy: Reflecting on a Needs Analysis

ERIC Educational Resources Information Center

Molle, Daniella; Prior, Paul

2008-01-01

This article reports on a genre-based needs analysis for a graduate course in English for academic purposes (EAP) at a large public U.S. university. In particular, it describes the theoretical reconceptualizations of genre analysis that the data provoked. Using ethnographic methods, an investigation of academic genres in several classrooms in…

Parametric dictionary learning for modeling EAP and ODF in diffusion MRI.

PubMed

Merlet, Sylvain; Caruyer, Emmanuel; Deriche, Rachid

2012-01-01

In this work, we propose an original and efficient approach to exploit the ability of Compressed Sensing (CS) to recover diffusion MRI (dMRI) signals from a limited number of samples while efficiently recovering important diffusion features such as the ensemble average propagator (EAP) and the orientation distribution function (ODF). Some attempts to sparsely represent the diffusion signal have already been performed. However and contrarly to what has been presented in CS dMRI, in this work we propose and advocate the use of a well adapted learned dictionary and show that it leads to a sparser signal estimation as well as to an efficient reconstruction of very important diffusion features. We first propose to learn and design a sparse and parametric dictionary from a set of training diffusion data. Then, we propose a framework to analytically estimate in closed form two important diffusion features: the EAP and the ODF. Various experiments on synthetic, phantom and human brain data have been carried out and promising results with reduced number of atoms have been obtained on diffusion signal reconstruction, thus illustrating the added value of our method over state-of-the-art SHORE and SPF based approaches.

Reflections on the GUN CONTROL Simulation: Pedagogical Implications for EAP Writing Classes

ERIC Educational Resources Information Center

Salies, Tania Gastao

2007-01-01

This article critically reflects on the GUN CONTROL simulation (Salies, 1994a) by retaking ideas advanced by Salies (2002) and applying them to the context of English for Academic Purposes (EAP) writing classes in Brazil. It examines how controlled practice relates to learners' performance on the first draft in a simulation-based content unit…

Improving Students' Report Writing Quality in an EAP Context: Group versus Individual

ERIC Educational Resources Information Center

Ali, Holi Ibrahim Holi

2012-01-01

This paper looks into report writing quality on both individual and group bases in an EAP context. A total of 100 EFL students at post foundation level in a University College in Oman, and 15 EFL teachers were selected randomly. Questionnaires were administered to investigate their perceptions and experiences with report writing quality on…

Expanded access to naloxone among firefighters, police officers, and emergency medical technicians in Massachusetts.

PubMed

Davis, Corey S; Ruiz, Sarah; Glynn, Patrick; Picariello, Gerald; Walley, Alexander Y

2014-08-01

Naloxone is a medication that reverses respiratory depression from opioid overdose if given in time. Paramedics routinely administer naloxone to opioid overdose victims in the prehospital setting, and many states are moving to increase access to the medication. Several jurisdictions have expanded naloxone administration authority to nonparamedic first responders, and others are considering that step. We report here on policy change in Massachusetts, where several communities have equipped emergency medical technicians, law enforcement officers, and firefighters with naloxone.

EAP-based critical incident stress management: utilization of a practice-based assessment of incident severity level in responding to workplace trauma.

PubMed

DeFraia, Gary S

2013-01-01

Central to the field of trauma psychology is assessment of the impact of critical incidents on individuals, as measured by individual symptoms of stress. Accordingly, the trauma literature reflects a proliferation of clinical impact of event scales. Workplace incidents however, affect not only individual employees, but also work organizations, requiring a multi-level response. Critical incident stress management (CISM) is the most prevalent multi-level incident response strategy utilized by organizations, often through specialized CISM units operating within their employee assistance programs (EAPs). While EAP-based CISM units seeks to support both individuals and organizations, studies focused on individual stress dominate the literature, mirroring assessment scales that tend to emphasize clinical as opposed to organizational practice. This research contributes to less-prevalent studies exploring incident characteristics as disruptive to organizations, rather than clinical symptoms as disruptive to individuals. To measure incident disruption, an EAP-based CISM unit developed a critical incident severity scale. By analyzing this unit's extensive practice database, this exploratory study examines how critical incident severity level varies among various types of incidents. Employing the methodology of clinical data mining, this practice-based research generates evidence-informed practice recommendations in the areas of EAP-based CISM intake assessment, organizational consultation and incident response planning.

A Study of Culturally Responsive Teaching Practices of Adult ESOL and EAP Teachers

ERIC Educational Resources Information Center

Rhodes, Christy M.

2013-01-01

The purpose of this study was to examine how frequently adult education English for Speakers of Other Languages (ESOL) and English for Academic Purposes (EAP) teachers in Florida used specific culturally responsive teaching practices and how important they believed those practices were to their teaching. Using Ginsberg and Wlodkowski's…

75 FR 11189 - Expanded Access to Direct-Acting Antiviral Agents for the Treatment of Chronic Hepatitis C...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-10

...] Expanded Access to Direct-Acting Antiviral Agents for the Treatment of Chronic Hepatitis C Infection in... hepatitis C (CHC) infection in patients with unmet medical need. This public hearing is being held to obtain.... Background A. CHC In the United States, hepatitis C virus infection causes 20 percent of all cases of acute...

The Multimodalities of Globalization: Teaching a YouTube Video in an EAP Classroom

ERIC Educational Resources Information Center

Chun, Christian W.

2012-01-01

This article examines the ways in which a multimodal text--a YouTube video on globalization and business--was mediated in two English for Academic Purposes (EAP) classrooms, and how these mediations shaped the instructor's and her students' meaning-making in specific ways. I first explore the complex multimodal discourses involved with this…

Surfactant Protein A (SP-A)-mediated Clearance of Staphylococcus aureus Involves Binding of SP-A to the Staphylococcal Adhesin Eap and the Macrophage Receptors SP-A Receptor 210 and Scavenger Receptor Class A*

PubMed Central

Sever-Chroneos, Zvjezdana; Krupa, Agnieszka; Davis, Jeremy; Hasan, Misbah; Yang, Ching-Hui; Szeliga, Jacek; Herrmann, Mathias; Hussain, Muzafar; Geisbrecht, Brian V.; Kobzik, Lester; Chroneos, Zissis C.

2011-01-01

Staphylococcus aureus causes life-threatening pneumonia in hospitals and deadly superinfection during viral influenza. The current study investigated the role of surfactant protein A (SP-A) in opsonization and clearance of S. aureus. Previous studies showed that SP-A mediates phagocytosis via the SP-A receptor 210 (SP-R210). Here, we show that SP-R210 mediates binding and control of SP-A-opsonized S. aureus by macrophages. We determined that SP-A binds S. aureus through the extracellular adhesin Eap. Consequently, SP-A enhanced macrophage uptake of Eap-expressing (Eap+) but not Eap-deficient (Eap−) S. aureus. In a reciprocal fashion, SP-A failed to enhance uptake of Eap+ S. aureus in peritoneal Raw264.7 macrophages with a dominant negative mutation (SP-R210(DN)) blocking surface expression of SP-R210. Accordingly, WT mice cleared infection with Eap+ but succumbed to sublethal infection with Eap- S. aureus. However, SP-R210(DN) cells compensated by increasing non-opsonic phagocytosis of Eap+ S. aureus via the scavenger receptor scavenger receptor class A (SR-A), while non-opsonic uptake of Eap− S. aureus was impaired. Macrophages express two isoforms: SP-R210L and SP-R210S. The results show that WT alveolar macrophages are distinguished by expression of SP-R210L, whereas SR-A−/− alveolar macrophages are deficient in SP-R210L expressing only SP-R210S. Accordingly, SR-A−/− mice were highly susceptible to both Eap+ and Eap− S. aureus. The lungs of susceptible mice generated abnormal inflammatory responses that were associated with impaired killing and persistence of S. aureus infection in the lung. In conclusion, alveolar macrophage SP-R210L mediates recognition and killing of SP-A-opsonized S. aureus in vivo, coordinating inflammatory responses and resolution of S. aureus pneumonia through interaction with SR-A. PMID:21123169

Constraining the parameters of the EAP sea ice rheology from satellite observations and discrete element model

NASA Astrophysics Data System (ADS)

Tsamados, Michel; Heorton, Harry; Feltham, Daniel; Muir, Alan; Baker, Steven

2016-04-01

The new elastic-plastic anisotropic (EAP) rheology that explicitly accounts for the sub-continuum anisotropy of the sea ice cover has been implemented into the latest version of the Los Alamos sea ice model CICE. The EAP rheology is widely used in the climate modeling scientific community (i.e. CPOM stand alone, RASM high resolution regional ice-ocean model, MetOffice fully coupled model). Early results from sensitivity studies (Tsamados et al, 2013) have shown the potential for an improved representation of the observed main sea ice characteristics with a substantial change of the spatial distribution of ice thickness and ice drift relative to model runs with the reference visco-plastic (VP) rheology. The model contains one new prognostic variable, the local structure tensor, which quantifies the degree of anisotropy of the sea ice, and two parameters that set the time scale of the evolution of this tensor. Observations from high resolution satellite SAR imagery as well as numerical simulation results from a discrete element model (DEM, see Wilchinsky, 2010) have shown that these individual floes can organize under external wind and thermal forcing to form an emergent isotropic sea ice state (via thermodynamic healing, thermal cracking) or an anisotropic sea ice state (via Coulombic failure lines due to shear rupture). In this work we use for the first time in the context of sea ice research a mathematical metric, the Tensorial Minkowski functionals (Schroeder-Turk, 2010), to measure quantitatively the degree of anisotropy and alignment of the sea ice at different scales. We apply the methodology on the GlobICE Envisat satellite deformation product (www.globice.info), on a prototype modified version of GlobICE applied on Sentinel-1 Synthetic Aperture Radar (SAR) imagery and on the DEM ice floe aggregates. By comparing these independent measurements of the sea ice anisotropy as well as its temporal evolution against the EAP model we are able to constrain the

Designing and Evaluating an EAP Reading Textbook: English for Political Science and Economics

ERIC Educational Resources Information Center

Sauzier-Uchida, Emi

2009-01-01

This study aims to report an attempt to design and organise a content-based EAP reading course in political science and economics at a university in Japan, and to shed some light on learners' actual practices and preferences through the use of survey- and interview-based research participated in by 438 students. A principal axis of this project…

Expanding oral care opportunities: direct access care provided by dental hygienists in the United States.

PubMed

Naughton, Doreen K

2014-06-01

Dental hygienists expand access to oral care in the United States. Many Americans have access to oral health care in traditional dental offices however millions of Americans have unmet dental needs. For decades dental hygienists have provided opportunities for un-served and under-served Americans to receive preventive services in a variety of alternate delivery sites, and referral to licensed dentists for dental care needs. Publications, state practice acts, state public health departments, the American Dental Hygienists' Association, and personal interviews of dental hygiene practitioners were accessed for information and statistical data. Dental hygienists in 36 states can legally provide direct access care. Dental hygienists are providing preventive services in a variety of settings to previously un-served and under-served Americans, with referral to dentists for dental needs. Dental hygienists have provided direct access to care in the United States for decades. The exact number of direct access providers in the United States is unknown. Limited research and anecdotal information demonstrate that direct access care has facilitated alternate entry points into the oral health systems for thousands of previously un-served and underserved Americans. Older adults, persons with special needs, children in schools, pregnant women, minority populations, rural populations, and others have benefited from the availability of many services provided by direct access dental hygienists. Legislatures and private groups are becoming increasingly aware of the impact that direct access has made on the delivery of oral health care. Many factors continue to drive the growth of direct access care. Additional research is needed to accumulate qualitative and quantitative outcome data related to direct access care provided by dental hygienists and other mid level providers of oral health services. Copyright © 2014 Elsevier Inc. All rights reserved.

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

Relationship between University Level and Employment of Language-Learning Strategies: A Study of EAP Learners

ERIC Educational Resources Information Center

Ghafournia, Narjes

2014-01-01

This study scrutinized the relationship between utilizing language-learning strategies and university levels in reading-comprehension process of language learners in Iran. The participants comprised 406 EAP students at three university levels. The findings reflected significant differences among the students in implementing learning strategies.…

Social costs of expanding access to evidence-based supported employment: concepts and interpretive review of evidence.

PubMed

Salkever, David

2013-02-01

A recent policy analysis argued that expanding access to evidence-based supported employment can provide savings in major components of social costs. This article extends the scope of this policy analysis by placing the argument within a recently developed economic framework for social cost-effectiveness analysis that defines a program's social cost impact as its effect on net consumption of all goods and services. A total of 27 studies over the past two decades are reviewed to synthesize evidence of the social cost impacts of expanding access to the individual placement and support model of supported employment (IPS-SE). Most studies have focused primarily on agency costs of providing IPS-SE services, cost offsets when clients shift from "traditional" rehabilitation to IPS-SE, and impacts on clients' earnings. Because costs and cost offsets are similar in magnitude, incremental costs of expanding services to persons who would otherwise receive traditional services are probably small or even negative. The population served by an expansion could be sizable, but the feasibility of a policy targeting IPS-SE expansion in this way has yet to be demonstrated. IPS-SE has positive impacts on competitive job earnings, but these may not fully translate into social cost offsets. Additional empirical support is needed for the argument that large-scale expansion would yield substantial mental health treatment cost offsets. Other gaps in evidence of policy impacts include take-up rate estimates, cost impact estimates from longer-term studies (exceeding two years), and longer-term studies of whether IPS-SE prevents younger clients from becoming recipients of Supplemental Security Income or Social Security Disability Insurance

Biomimetic actuators using electroactive polymers (EAP) as artificial muscles

NASA Technical Reports Server (NTRS)

Bar-Cohen, Yoseph

2006-01-01

Evolution has resolved many of nature's challenges leading to lasting solutions with maximal performance and effective use of resources. Nature's inventions have always inspired human achievements leading to effective materials, structures, tools, mechanisms, processes, algorithms, methods, systems and many other benefits. The field of mimicking nature is known as Biomimetics and one of its topics includes electroactive polymers that gain the moniker artificial muscles. Integrating EAP with embedded sensors, self-repair and many other capabilities that are used in composite materials can add greatly to the capability of smart biomimetic systems. Such development would enable fascinating possibilities potentially turning science fiction ideas into engineering reality.

Biologically Inspired Technology Using Electroactive Polymers (EAP)

NASA Technical Reports Server (NTRS)

Bar-Cohen, Yoseph

2006-01-01

Evolution allowed nature to introduce highly effective biological mechanisms that are incredible inspiration for innovation. Humans have always made efforts to imitate nature's inventions and we are increasingly making advances that it becomes significantly easier to imitate, copy, and adapt biological methods, processes and systems. This brought us to the ability to create technology that is far beyond the simple mimicking of nature. Having better tools to understand and to implement nature's principles we are now equipped like never before to be inspired by nature and to employ our tools in far superior ways. Effectively, by bio-inspiration we can have a better view and value of nature capability while studying its models to learn what can be extracted, copied or adapted. Using electroactive polymers (EAP) as artificial muscles is adding an important element to the development of biologically inspired technologies.

We strongly support childhood immunisation-statement from the European Academy of Paediatrics (EAP).

PubMed

Dornbusch, Hans Juergen; Hadjipanayis, Adamos; Del Torso, Stefano; Mercier, Jean-Christophe; Wyder, Corinne; Schrier, Lenneke; Ross-Russell, Robert; Stiris, Tom; Ludvigsson, Jonas F

2017-05-01

The eradication of smallpox and the elimination of several other infectious diseases from much of the world has provided convincing evidence that vaccines are among the most effective interventions for promoting health. The current scepticism about immunisation among members of the new US administration carries a risk of decreasing immunisation rates also in Europe. While only a small minority of the population are strongly anti-vaccine, their public activities have significantly influenced an uncertainty among the general population about both the safety of and the necessity for vaccination. Therefore, the EAP calls for greater publically available, scientifically supported information on vaccination, particularly targeted at health care providers, for the further development of electronically based immunisation information systems (IIS). We further call on all European countries to work together both in legislative and public health arenas in order to increase vaccination coverage among the paediatric population. In the interest of children and their parents, the EAP expresses its strong support for childhood immunisation and recommended vaccination schedules. We are prepared to work with governments and media and share the extensive evidence demonstrating the effectiveness and safety of vaccines.

Final results from the large sunitinib global expanded-access trial in metastatic renal cell carcinoma.

PubMed

Gore, M E; Szczylik, C; Porta, C; Bracarda, S; Bjarnason, G A; Oudard, S; Lee, S-H; Haanen, J; Castellano, D; Vrdoljak, E; Schöffski, P; Mainwaring, P; Hawkins, R E; Crinò, L; Kim, T M; Carteni, G; Eberhardt, W E E; Zhang, K; Fly, K; Matczak, E; Lechuga, M J; Hariharan, S; Bukowski, R

2015-06-30

We report final results with extended follow-up from a global, expanded-access trial that pre-regulatory approval provided sunitinib to metastatic renal cell carcinoma (mRCC) patients, ineligible for registration-directed trials. Patients ⩾18 years received oral sunitinib 50 mg per day on a 4-weeks-on-2-weeks-off schedule. Safety was assessed regularly. Tumour measurements were scheduled per local practice. A total of 4543 patients received sunitinib. Median treatment duration and follow-up were 7.5 and 13.6 months. Objective response rate was 16% (95% confidence interval (CI): 15-17). Median progression-free survival (PFS) and overall survival (OS) were 9.4 months (95% CI: 8.8-10.0) and 18.7 months (95% CI: 17.5-19.5). Median PFS in subgroups of interest: aged ⩾65 years (33%), 10.1 months; Eastern Cooperative Oncology Group performance status ⩾2 (14%), 3.5 months; non-clear cell histology (12%), 6.0 months; and brain metastases (7%), 5.3 months. OS was strongly associated with the International Metastatic Renal-Cell Carcinoma Database Consortium prognostic model (n=4065). The most common grade 3/4 treatment-related adverse events were thrombocytopenia (10%), fatigue (9%), and asthenia, neutropenia, and hand-foot syndrome (each 7%). Final analysis of the sunitinib expanded-access trial provided a good opportunity to evaluate the long-term side effects of a tyrosine kinase inhibitor used worldwide in mRCC. Efficacy and safety findings were consistent with previous results.

Doing more for less: identifying opportunities to expand public sector access to safe abortion in South Africa through budget impact analysis.

PubMed

Lince-Deroche, Naomi; Harries, Jane; Constant, Deborah; Morroni, Chelsea; Pleaner, Melanie; Fetters, Tamara; Grossman, Daniel; Blanchard, Kelly; Sinanovic, Edina

2018-02-01

To estimate the costs of public-sector abortion provision in South Africa and to explore the potential for expanding access at reduced cost by changing the mix of technologies used. We conducted a budget impact analysis using public sector abortion statistics and published cost data. We estimated the total costs to the public health service over 10 years, starting in South Africa's financial year 2016/17, given four scenarios: (1) holding service provision constant, (2) expanding public sector provision, (3) changing the abortion technologies used (i.e. the method mix), and (4) expansion plus changing the method mix. The public sector performed an estimated 20% of the expected total number of abortions in 2016/17; 26% and 54% of all abortions were performed illegally or in the private sector respectively. Costs were lowest in scenarios where method mix shifting occurred. Holding the proportion of abortions performed in the public-sector constant, shifting to more cost-effective service provision (more first-trimester services with more medication abortion and using the combined regimen for medical induction in the second trimester) could result in savings of $28.1 million in the public health service over the 10-year period. Expanding public sector provision through elimination of unsafe abortions would require an additional $192.5 million. South Africa can provide more safe abortions for less money in the public sector through shifting the methods provided. More research is needed to understand whether the cost of expanding access could be offset by savings from averting costs of managing unsafe abortions. South Africa can provide more safe abortions for less money in the public sector through shifting to more first-trimester methods, including more medication abortion, and shifting to a combined mifepristone plus misoprostol regimen for second trimester medical induction. Expanding access in addition to method mix changes would require additional funds. Copyright

The Construction of EAP Textbooks in Chinese Context from the Perspective of Eco-Education Theory

ERIC Educational Resources Information Center

Dali, Ning

2017-01-01

The increase of international exchange in education triggers strong demand for learning English language skills in various academic disciplines among Chinese students, which brings up a wide implementation of EAP (English for academic purposes) learning in universities in China. However, the teaching and learning result do not seem to be as…

Changing International Student and Business Staff Perceptions of In-Sessional EAP: Using the CEM Model

ERIC Educational Resources Information Center

Sloan, Diane; Porter, Elizabeth

2010-01-01

This article addresses the question of whether the existing approach to EAP delivery implemented at the University of Northumbria is supporting the learning needs of the international student body. In addressing this the article documents the background, research and preliminary findings relating to provision of an in-sessional English for…

The gefitinib long-term responder (LTR)--a cancer stem-like cell story? Insights from molecular analyses of German long-term responders treated in the IRESSA expanded access program (EAP).

PubMed

Gottschling, Sandra; Herpel, Esther; Eberhardt, Wilfried E E; Heigener, David F; Fischer, Jürgen R; Köhne, Claus-Henning; Kortsik, Cornelius; Kuhnt, Thomas; Muley, Thomas; Meister, Michael; Bischoff, Helge G; Klein, Peter; Moldenhauer, Ines; Schnabel, Philipp A; Thomas, Michael; Penzel, Roland

2012-07-01

In selected patients with advanced non-small cell lung cancer (NSCLC) the EGFR (epidermal growth factor receptor) tyrosine kinase inhibitor (TKI) gefitinib (IRESSA) shows response rates of ≥ 70% and a significant prolongation of progression free survival (PFS). However, cogent biomarkers predicting long-term response to EGFR-TKIs are yet lacking. Cancer stem-like cells (CSC) are thought to play a pivotal role in tumor regeneration and appear to be influenced by the EGFR-pathway. This makes them a promising candidate for predicting long-term response to EGFR-TKIs. We analyzed pre-therapeutic tissue specimens of a rare and specific subset of previously treated German patients with advanced NSCLC who experienced ≥ 3 year response to gefitinib within the International IRESSA EAP. 11/20 identified long-term responders (LTRs) had appropriate tissue specimens available. Those were analyzed for EGFR and k-ras (Kirsten rat sarcoma) mutations, EGFR and c-met (met proto-oncogene) amplifications and protein expression of EGFR, E-cadherin/vimentin and the CSC antigens CD133 and BCRP1 (breast cancer resistance protein 1). The results were compared to primary resistant patients (RPs) and intermediate responders (IRs) showing a median response of 8.6 months. Each group consisted of 6 women and 5 men, with 1 squamous cell carcinoma (SCC) and 10 adenocarcinoma (AC). Along the LTRs, all but the SCC had EGFR mutations, whereas the RPs had no EGFR, but k-ras mutations in 5/11 cases. 8/11 IRs had EGFR and 3/11 k-ras mutations, of which 2 occurred concomitantly. One patient of each group had an EGFR and/or c-met amplification. EGFR and E-cadherin/vimentin expression was not different between the groups, whereas CD133 was expressed only in 4/10 LTRs and BCRP1 predominantly in responders. The LTRs showed a substantially longer mean PFS to previous therapies, a substantially lower number of metastatic sites and almost exclusively pulmonary or pleural metastasis. LTRs display established

Vocabulary Learning Strategies Used by EAP Learners: The Case of the Students of Social Sciences

ERIC Educational Resources Information Center

Haghi, Eshrat Bazarmaj; Pasand, Parastou Gholami

2013-01-01

The significance of using language learning strategies in general and vocabulary learning strategies in particular is quite clear to both language learners and language specialists. Being familiar with and making use of a range of different vocabulary learning strategies is a great aid for EAP learners in dealing with unknown words. The present…

Understanding Test-Takers' Perceptions of Difficulty in EAP Vocabulary Tests: The Role of Experiential Factors

ERIC Educational Resources Information Center

Oruç Ertürk, Nesrin; Mumford, Simon E.

2017-01-01

This study, conducted by two researchers who were also multiple-choice question (MCQ) test item writers at a private English-medium university in an English as a foreign language (EFL) context, was designed to shed light on the factors that influence test-takers' perceptions of difficulty in English for academic purposes (EAP) vocabulary, with the…

Moderating Top-Down Policy Impact and Supporting EAP Curricular Renewal: Exploring the Potential of Diagnostic Assessment

ERIC Educational Resources Information Center

Fox, Janna D.

2009-01-01

A Canadian university required a new admissions policy in order to increase the fairness of procedures for second language (L2) international students, admitted provisionally to the university with mandatory language course requirements. This necessitated reform of the English for Academic Purposes (EAP) curriculum, but there was no agreement…

Expanding Medicaid Access without Expanding Medicaid: Why Did Some Nonexpansion States Continue the Primary Care Fee Bump?

PubMed

Wilk, Adam S; Evans, Leigh C; Jones, David K

2018-02-01

Six states that have rejected the Patient Protection and Affordable Care Act's (ACA) Medicaid expansion nonetheless extended the primary care "fee bump," by which the federal government increased Medicaid fees for primary care services up to 100 percent of Medicare fees during 2013-14. We conducted semistructured interviews with leaders in five of these states, as well as in three comparison states, to examine why they would continue a provision of the ACA that moderately expands access at significant state expense while rejecting the expansion and its large federal match, focusing on relevant economic, political, and procedural factors. We found that fee bump extension proposals were more successful where they were dissociated from major national policy debates, actionable with the input of relatively few stakeholder entities, and well aligned with preexisting policy-making structures and decision trends. Republican proposals to cap or reduce federal funding for Medicaid, if enacted, would compel states to contain program costs. In this context, states' established decision-making processes for updating Medicaid fee schedules, which we elucidate in this study, may shape the future of the Medicaid program. Copyright © 2018 by Duke University Press 2018.

JASPAR 2014: an extensively expanded and updated open-access database of transcription factor binding profiles

PubMed Central

Mathelier, Anthony; Zhao, Xiaobei; Zhang, Allen W.; Parcy, François; Worsley-Hunt, Rebecca; Arenillas, David J.; Buchman, Sorana; Chen, Chih-yu; Chou, Alice; Ienasescu, Hans; Lim, Jonathan; Shyr, Casper; Tan, Ge; Zhou, Michelle; Lenhard, Boris; Sandelin, Albin; Wasserman, Wyeth W.

2014-01-01

JASPAR (http://jaspar.genereg.net) is the largest open-access database of matrix-based nucleotide profiles describing the binding preference of transcription factors from multiple species. The fifth major release greatly expands the heart of JASPAR—the JASPAR CORE subcollection, which contains curated, non-redundant profiles—with 135 new curated profiles (74 in vertebrates, 8 in Drosophila melanogaster, 10 in Caenorhabditis elegans and 43 in Arabidopsis thaliana; a 30% increase in total) and 43 older updated profiles (36 in vertebrates, 3 in D. melanogaster and 4 in A. thaliana; a 9% update in total). The new and updated profiles are mainly derived from published chromatin immunoprecipitation-seq experimental datasets. In addition, the web interface has been enhanced with advanced capabilities in browsing, searching and subsetting. Finally, the new JASPAR release is accompanied by a new BioPython package, a new R tool package and a new R/Bioconductor data package to facilitate access for both manual and automated methods. PMID:24194598

JASPAR 2014: an extensively expanded and updated open-access database of transcription factor binding profiles.

PubMed

Mathelier, Anthony; Zhao, Xiaobei; Zhang, Allen W; Parcy, François; Worsley-Hunt, Rebecca; Arenillas, David J; Buchman, Sorana; Chen, Chih-yu; Chou, Alice; Ienasescu, Hans; Lim, Jonathan; Shyr, Casper; Tan, Ge; Zhou, Michelle; Lenhard, Boris; Sandelin, Albin; Wasserman, Wyeth W

2014-01-01

JASPAR (http://jaspar.genereg.net) is the largest open-access database of matrix-based nucleotide profiles describing the binding preference of transcription factors from multiple species. The fifth major release greatly expands the heart of JASPAR-the JASPAR CORE subcollection, which contains curated, non-redundant profiles-with 135 new curated profiles (74 in vertebrates, 8 in Drosophila melanogaster, 10 in Caenorhabditis elegans and 43 in Arabidopsis thaliana; a 30% increase in total) and 43 older updated profiles (36 in vertebrates, 3 in D. melanogaster and 4 in A. thaliana; a 9% update in total). The new and updated profiles are mainly derived from published chromatin immunoprecipitation-seq experimental datasets. In addition, the web interface has been enhanced with advanced capabilities in browsing, searching and subsetting. Finally, the new JASPAR release is accompanied by a new BioPython package, a new R tool package and a new R/Bioconductor data package to facilitate access for both manual and automated methods.

L'E.A.P. ou l'anglais enseigne dans les etudes superieures. Un guide pour le debutant (E.A.P. or English for Academic Purposes: A Guide for the Beginner).

ERIC Educational Resources Information Center

Roe, Peter J.

1981-01-01

Addresses those readers who are not familiar with EAP, offering an introductory discussion of its objectives and methods, in two parts. Devotes the first part to the needs that justify an EAP approach, and the second to its methodology, with particular attention to interdisciplinary, task-oriented instruction. Societe Nouvelle Didier Erudition, 40…

The effect of employee assistance plan benefits on the use of outpatient behavioral health care.

PubMed

Hodgkin, Dominic; Merrick, Elizabeth L; Hiatt, Deirdre; Horgan, Constance M; McGuire, Thomas G

2010-12-01

Nearly half of all US workers have access to an employee assistance plan (EAP). At the same time, most large US employers also purchase health benefits for their employees, and these benefits packages typically include behavioral health services. There is some potential overlap in services covered by the EAP and the health plan, and some employers choose to purchase the two jointly as an 'integrated product'. It is not clear whether EAP services substitute for outpatient behavioral health care services covered by the health plan. To evaluate how the number of EAP visits covered affects the use of regular outpatient behavioral health care (number of visits, and total spending), in an integrated product setting. Analysis of claims, eligibility and benefits data for 26,464 users of behavioral health care for the year 2005. For both EAP and regular behavioral health care, the individuals were enrolled with Managed Health Network (MHN), a large national specialty insurance plan. Multivariate regression analyses were performed to investigate the determinants of the number of regular outpatient visits, and spending for regular outpatient care. To address skewness in the dependent variables, the estimation used generalized linear models with a log link. A limited instrumental variable analysis was used to test for endogeneity of the number of EAP visits covered. Nearly half the enrollees in this sample were in employer plans that allowed 4-5 EAP visits per treatment episode, and 31% were allowed 3 EAP visits per year. Having an EAP visit allowance of 4-5 sessions per episode predicts fewer regular outpatient visits, compared with having an allowance of 3 sessions per year. More generous EAP allowances also reduce payments for outpatient care, with one exception. Greater availability of EAP benefits appears to reduce utilization of regular outpatient care, supporting the idea that the two types of care are to some extent perceived as substitutes. One limitation of this

Expanding Audio Access to Mathematics Expressions by Students with Visual Impairments via MathML. Research Report. ETS RR-17-13

ERIC Educational Resources Information Center

Frankel, Lois; Brownstein, Beth; Soiffer, Neil

2017-01-01

This report describes the pilot conducted in the final phase of a project, Expanding Audio Access to Mathematics Expressions by Students With Visual Impairments via MathML, to provide easy-to-use tools for authoring and rendering secondary-school algebra-level math expressions in synthesized speech that is useful for students with blindness or low…

Determinants of access to experimental antiretroviral drugs in an Italian cohort of patients with HIV: a multilevel analysis.

PubMed

Girardi, Enrico; Scognamiglio, Paola; Angeletti, Claudio; Gori, Andrea; Buonfrate, Dora; Arlotti, Massimo; Mazzarello, Giovanni; Castagna, Antonella; Andreoni, Massimo; d'Arminio Monforte, Antonella; Antinori, Andrea; Ippolito, Giuseppe

2012-02-15

Identification of the determinants of access to investigational drugs is important to promote equity and scientific validity in clinical research. We aimed to analyze factors associated with the use of experimental antiretrovirals in Italy. We studied participants in the Italian Cohort of Antiretroviral-Naive Patients (ICoNA). All patients 18 years or older who had started cART (≥ 3 drugs including at least two NRTI) after their enrolment and during 1997-2007 were included in this analysis. We performed a random effect logistic regression analysis to take into account clustering observations within clinical units. The outcome variable was the use of an experimental antiretroviral, defined as an antiretroviral started before commercial availability, in any episode of therapy initiation/change. Use of an experimental antiretroviral obtained through a clinical trial or an expanded access program (EAP) was also analyzed separately. A total of 9,441 episodes of therapy initiation/change were analyzed in 3,752 patients. 392 episodes (360 patients) involved an experimental antiretroviral. In multivariable analysis, factors associated with the overall use of experimental antiretrovirals were: number of experienced drugs (≥ 8 drugs versus "naive": adjusted odds ratio [AOR] = 3.71) or failed antiretrovirals(3-4 drugs and ≥ 5 drugs versus 0-2 drugs: AOR = 1.42 and 2.38 respectively); calendar year (AOR = 0.80 per year) and plasma HIV-RNA copies/ml at therapy change (≥ 4 log versus < 2 log: AOR = 1.55). The probability of taking an experimental antiretroviral through a trial was significantly lower for patients suffering from liver co-morbidity(AOR = 0.65) and for those who experienced 3-4 drugs (vs naive) (AOR = 0.55), while it increased for multi-treated patients(AOR = 2.60). The probability to start an experimental antiretroviral trough an EAP progressively increased with the increasing number of experienced and of failed drugs and also increased for patients with

Pre and Post Test Evaluations of Students in the Needs-Analysis Based EAP Course at Undergraduate Level

ERIC Educational Resources Information Center

Nafissi, Zohreh; Rezaeipanah, Fariba; Monsefi, Roya

2017-01-01

Iran's education system is exam-based and to gain admission to universities at undergraduate, graduate, and postgraduate levels, candidates have to sit a competitive examination. For this reason, developing an EAP course which prepares the candidates for these examinations is of crucial importance. The present study attempted to develop an EAP…

Designing and Delivering an e-Presessional Course in EAP for the 21st First Century International Student

ERIC Educational Resources Information Center

Watson, Julie; White, Steven

2012-01-01

Summer pre-sessional courses in English for academic purposes (EAP), which prepare growing numbers of international students for degree programmes at UK universities, are facing greater challenges in how to provide the physical space and human resources for their effective and efficient delivery. The affordances of the internet now make other…

Expanding Access and Usage of NASA Near Real-Time Imagery and Data

NASA Astrophysics Data System (ADS)

Cechini, M.; Murphy, K. J.; Boller, R. A.; Schmaltz, J. E.; Thompson, C. K.; Huang, T.; McGann, J. M.; Ilavajhala, S.; Alarcon, C.; Roberts, J. T.

2013-12-01

In late 2009, the Land Atmosphere Near-real-time Capability for EOS (LANCE) was created to greatly expand the range of near real-time data products from a variety of Earth Observing System (EOS) instruments. Since that time, NASA's Earth Observing System Data and Information System (EOSDIS) developed the Global Imagery Browse Services (GIBS) to provide highly responsive, scalable, and expandable imagery services that distribute near real-time imagery in an intuitive and geo-referenced format. The GIBS imagery services provide access through standards-based protocols such as the Open Geospatial Consortium (OGC) Web Map Tile Service (WMTS) and standard mapping file formats such as the Keyhole Markup Language (KML). Leveraging these standard mechanisms opens NASA near real-time imagery to a broad landscape of mapping libraries supporting mobile applications. By easily integrating with mobile application development libraries, GIBS makes it possible for NASA imagery to become a reliable and valuable source for end-user applications. Recently, EOSDIS has taken steps to integrate near real-time metadata products into the EOS ClearingHOuse (ECHO) metadata repository. Registration of near real-time metadata allows for near real-time data discovery through ECHO clients. In kind with the near real-time data processing requirements, the ECHO ingest model allows for low-latency metadata insertion and updates. Combining with the ECHO repository, the fast visual access of GIBS imagery can now be linked directly back to the source data file(s). Through the use of discovery standards such as OpenSearch, desktop and mobile applications can connect users to more than just an image. As data services, such as OGC Web Coverage Service, become more prevalent within the EOSDIS system, applications may even be able to connect users from imagery to data values. In addition, the full resolution GIBS imagery provides visual context to other GIS data and tools. The NASA near real-time imagery

Processfolio: Uniting Academic Literacies and Critical Emancipatory Action Research for Practitioner-Led Inquiry into EAP Writing Assessment

ERIC Educational Resources Information Center

Pearson, Jayne

2017-01-01

This article reports on the design and implementation of an alternative form of writing assessment in a UK English for Academic Purposes (EAP) pre-sessional course. The assessment, termed processfolio, was a response to research inquiry into how writing assessment in a local context negated student agency and inculcated disempowering models of…

Syringe Disposal among Injection Drug Users in Harlem and the Bronx during the New York State Expanded Syringe Access Demonstration Program

ERIC Educational Resources Information Center

Cleland, Charles M.; Deren, Sherry; Fuller, Crystal M.; Blaney, Shannon; McMahon, James M.; Tortu, Stephanie; Des Jarlais, Don C.; Vlahov, David

2007-01-01

Effective January 1, 2001, New York State enacted the Expanded Syringe Access Demonstration Program (ESAP), allowing syringes to be sold in pharmacies without a prescription or dispensed through doctors, hospitals, and clinics to adults. A concern in the assessment of ESAP is its effects on syringe disposal practices. Syringe use data regarding…

Promises to keep. An evaluator's perspective on employee assistance programs.

PubMed

Albert, W C; Smythe, P C; Brook, R C

1985-01-01

This paper presents a critical review of the rapidly expanding literature concerning employee assistance programs (EAPs). Several essential features of EAPs are identified and the assumptions underlying these components are examined. The latter section of this report offers some tentative suggestions for correcting this situation so that the EAP movement will no longer suffer from the lack of a firm database upon which to build more coherent and defensible theories and programs.

Biophysical modelling of phytoplankton communities from first principles using two-layered spheres: Equivalent Algal Populations (EAP) model.

PubMed

Robertson Lain, L; Bernard, S; Evers-King, H

2014-07-14

There is a pressing need for improved bio-optical models of high biomass waters as eutrophication of coastal and inland waters becomes an increasing problem. Seasonal boom conditions in the Southern Benguela and persistent harmful algal production in various inland waters in Southern Africa present valuable opportunities for the development of such modelling capabilities. The phytoplankton-dominated signal of these waters additionally addresses an increased interest in Phytoplankton Functional Type (PFT) analysis. To these ends, an initial validation of a new model of Equivalent Algal Populations (EAP) is presented here. This paper makes a first order comparison of two prominent phytoplankton Inherent Optical Property (IOP) models with the EAP model, which places emphasis on explicit bio-physical modelling of the phytoplankton population as a holistic determinant of inherent optical properties. This emphasis is shown to have an impact on the ability to retrieve the detailed phytoplankton spectral scattering information necessary for PFT applications and to successfully simulate reflectance across wide ranges of physical environments, biomass, and assemblage characteristics.

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.

Technology-Enhanced Language Learning (Tell): An Update and a Principled Framework for English for Academic Purposes (EAP) Courses

ERIC Educational Resources Information Center

Chau, Juliana; Lee, Alfred

2014-01-01

The range and number of technologies currently available have yielded both opportunities and challenges for language educators. This study aims to review recent technology-enhanced language learning (TeLL) research, and to examine their potential relevance to EAP pedagogy, curricula, assessment and instruction. The results of this study show TeLL…

Expanded Access Protocol (EAP) Using the CliniMACS® Device for Pediatric Haplocompatible Donor Stem Cell Transplant

ClinicalTrials.gov

2017-11-22

Acute Lymphoblastic Leukemia; Acute Myeloid Leukemia; Chronic Myeloid Leukemia; Myelodysplastic Syndrome; Lymphomas; Bone Marrow Failure; Hemoglobinopathy; Immune Deficiency; Osteopetrosis; Cytopenias; Leukocyte Disorders; Anemia Due to Intrinsic Red Cell Abnormality

Safety and efficacy results of the advanced renal cell carcinoma sorafenib expanded access program in North America.

PubMed

Stadler, Walter M; Figlin, Robert A; McDermott, David F; Dutcher, Janice P; Knox, Jennifer J; Miller, Wilson H; Hainsworth, John D; Henderson, Charles A; George, Jeffrey R; Hajdenberg, Julio; Kindwall-Keller, Tamila L; Ernstoff, Marc S; Drabkin, Harry A; Curti, Brendan D; Chu, Luis; Ryan, Christopher W; Hotte, Sebastien J; Xia, Chenghua; Cupit, Lisa; Bukowski, Ronald M

2010-03-01

The Advanced Renal Cell Carcinoma Sorafenib (ARCCS) program made sorafenib available to patients with advanced renal cell carcinoma (RCC) before regulatory approval. In this nonrandomized, open-label expanded access program, 2504 patients from the United States and Canada were treated with oral sorafenib 400 mg twice daily. Safety and efficacy were explored overall and in subgroups of patients including those with no prior therapy, nonclear cell (nonclear cell) RCC, brain metastases, prior bevacizumab treatment, and elderly patients. Sorafenib was approved for RCC 6 months after study initiation, at which time patients with no prior therapy or with nonclear cell RCC could enroll in an extension protocol for continued assessment for a period of 6 months. The most common grade > or =2 drug-related adverse events were hand-foot skin reaction (18%), rash (14%), hypertension (12%), and fatigue (11%). In the 1891 patients evaluable for response, complete response was observed in 1 patient, partial response in 67 patients (4%), and stable disease for at least 8 weeks in 1511 patients (80%). Median progression-free survival in the extension population was 36 weeks (95% confidence interval [CI], 33-45 weeks; censorship rate, 56%); median overall survival in the entire population was 50 weeks (95% CI, 46-52 weeks; censorship rate, 63%). The efficacy and safety results were similar across the subgroups. Sorafenib 400 mg twice daily demonstrated activity and a clinically acceptable toxicity profile in all patient subsets enrolled in the ARCCS expanded access program (clinicaltrials.gov identifier: NCT00111020).

[Employee assistance program].

PubMed

Shima, Satoru; Tanaka, Katsutoshi; Ohba, Sayo

2002-03-01

Recently the EAP has received much attention in Japan. The first EAP service in the US was conducted by employees who had recovered from alcohol problems. In the early days EAP providers focused on addiction, but mainly after 1980 they expanded their service areas to include mental health, marital problems, legal problems and financial problems. In Japan the EAP was first received attention as a counseling resource outside the workplace where employees could seek professional help confidentially, but the main reasons why this system now interests employers are as a risk-management tool and an outsourcing of mental health services, since the growing number of mental health cases in the workplace has been a big issue for employers. Two movements have also contributed to more recognition of the EAP: one is guidelines on compensation for mental health cases in the workplace and the other is guidelines on mental health promotion in the workplace. There are four types of EAP systems: internal EAP, external EAP, combination EAP, and consortium EAP. EAP core technology consists of 8 functions including problem identification, Crisis intervention, Short-term intervention, Consultation with work organization leader. The literature on cost-benefit analysis of the EAP is very limited. Although the available data suggest that the EAP is highly cost-effective, further studies are needed with the sufficient statistical quality. In Japan the most important issues in the EAP are the standardization and quality assurance of EAP services. For this purpose development of a good educational system for EAP professionals is needed.

Impact of Employee Assistance Services on Depression, Anxiety, and Risky Alcohol Use: A Quasi-Experimental Study.

PubMed

Richmond, Melissa K; Pampel, Fred C; Wood, Randi C; Nunes, Ana P

2016-07-01

To test the impact of Employee Assistance Programs (EAPs) on reducing employee depression, anxiety, and risky alcohol use, and whether improvements in clinical symptoms lead to improved work outcomes. The study used a prospective, quasi-experimental design with propensity score matching. Participants (n = 344) came from 20 areas of state government. EAP (n = 156) and non-EAP (n = 188) employees were matched on baseline demographic, psychosocial, and work-related characteristics that differentiate EAP from non-EAP users. Follow-up surveys were collected 2 to 12 months later (M = 6.0). EAP significantly reduced symptoms of depression and anxiety, but not at-risk alcohol use. EAP reductions in depression and anxiety mediated EAP-based reductions in absenteeism and presenteeism. EAPs provide easy-to-access work-based services that are effective at improving employee mental health.

Effects of expanded and standard captions on deaf college students' comprehension of educational videos.

PubMed

Stinson, Michael S; Stevenson, Susan

2013-01-01

Twenty-two college students who were deaf viewed one instructional video with standard captions and a second with expanded captions, in which key terms were expanded in the form of vocabulary definitions, labeled illustrations, or concept maps. The students performed better on a posttest after viewing either type of caption than on a pretest; however, there was no difference in comprehension between standard and expanded captions. Camtasia recording software enabled examination of the extent to which the students accessed the expanded captions. The students accessed less than 20% of the available expanded captions. Thus, one explanation for the lack of difference in comprehension between the standard and expanded captions is that the students did not access the expanded captions sufficiently. Despite limited use of the expanded captions, the students stated, when interviewed, that they considered these captions beneficial in learning from the instructional video.

The Use of Discourse Analysis To Enhance ESP Teacher Knowledge: An Example Using Aviation English.

ERIC Educational Resources Information Center

Sullivan, Patricia; Girginer, Handan

2002-01-01

Provides an example of one process used by a teacher-researcher to increase and expand the use of relevant materials, knowledgeable teachers, and teamwork with subject matter professionals in English for academic purposes' (EAP) programs. The study was conducted for an EAP program in a civil aviation school in Turkey. (Author/VWL)

Efficacy and Safety of Pembrolizumab in Patients Enrolled in KEYNOTE-030 in the United States: An Expanded Access Program.

PubMed

Gangadhar, Tara C; Hwu, Wen-Jen; Postow, Michael A; Hamid, Omid; Daud, Adil; Dronca, Roxana; Joseph, Richard; O'Day, Steven J; Hodi, F S; Pavlick, Anna C; Kluger, Harriet; Oxborough, Romina P; Yang, Aiming; Gazdoiu, Mihaela; Kush, Debra A; Ebbinghaus, Scot; Salama, April K S

KEYNOTE-030 (ClinicalTrials.gov ID, NCT02083484) was a global expanded access program that allowed access to pembrolizumab, an antiprogrammed death 1 antibody, for patients with advanced melanoma before its regulatory approval. Patients with unresectable stage III/IV melanoma that progressed after standard-of-care therapy, including ipilimumab and, if BRAF mutant, a BRAF inhibitor, were eligible to receive pembrolizumab 2 mg/kg every 3 weeks. Response was assessed by immune-related response criteria by investigator review. Adverse events (AEs) were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. In the United States, 979 patients enrolled between April and September 2014. Of the 947 evaluable patients, 621 (65.6%) remained on treatment and transitioned to receive commercial pembrolizumab following approval by the Food and Drug Administration, whereas 326 (34.4%) discontinued, most commonly for disease progression (39.6%) or death (26.4%). Objective response rate was 14.5% (95% confidence interval, 12.2%-16.8%) in the treated population (n=947) and 22.1% (95% confidence interval, 18.8%-25.5%) in patients who had ≥1 response assessment reported (n=619). Twelve patients achieved complete response. One hundred eighty-one (19.1%) patients experienced ≥1 treatment-related AE, most commonly general disorders (8.0%), skin/subcutaneous tissue disorders (7.3%), and gastrointestinal disorders (6.4%); 29 (3.1%) patients experienced ≥1 grade 3/4 treatment-related AE. Immune-mediated AEs were also reported. There were no treatment-related deaths. The safety and efficacy observed in this expanded access program were consistent with those previously reported for similar populations and support the use of pembrolizumab for patients with advanced melanoma.

Access to Ophthalmologists in States Where Optometrists Have Expanded Scope of Practice.

PubMed

Stein, Joshua D; Kapoor, Kapil G; Tootoo, Joshua L; Li, Ruiyang; Wagner, Alan; Andrews, Chris; Miranda, Marie Lynn

2018-01-01

As the United States considers how to best structure its health care services, specialty care availability is receiving increased focus. This study assesses whether patients lack reasonable access to ophthalmologists in states where optometrists have been granted expanded scope of practice. To determine the estimated travel time (ETT) to the nearest ophthalmologist office for persons residing in states that have expanded scope of practice for optometrists, and to quantify ETT to the nearest ophthalmologist for Medicare beneficiaries who received surgical care from optometrists in those states between 2008 and 2014. This study used data from the 2010 US census, a 2016 American Academy of Ophthalmology member database, and a data set of claims data for a random sample of 20% of beneficiaries enrolled in Medicare nationwide from 2008 to 2014 (n=14 063 725). Combining these sources with geographic information systems analysis, the ETT to the nearest ophthalmologist office was calculated for every resident of Kentucky, Oklahoma, and New Mexico. This study also assessed ETT to the nearest ophthalmologist for Medicare beneficiaries in those states who had received surgery from an optometrist from 2008 to 2014. Data analyses were conducted from July 2016 to July 2017. The proportion of residents of Kentucky, Oklahoma, and New Mexico who live within an ETT of 10, 30, 45, 60, or 90 minutes of the nearest ophthalmologist office. The study included 4 339 367 Kentucky residents, 3 751 351 Oklahoma residents, and 2 059 179 New Mexico residents. Of these, 5 140 547 (50.6%) were female. Racial/ethnic composition included 7 154 847 people (70.5%) who were white, 640 608 (6.3%) who were black, and 1 418 246 (14.0%) who were Hispanic. The mean (SD) age was 37.8 (22.8) years. More than 75% of residents in the 3 states lived within an ETT of 30 minutes to the nearest ophthalmology office, and 94% to 99% of residents lived within an ETT of 60 minutes to the

Expanding Access to Malaria Diagnosis through Retail Shops in Western Kenya: What Do Shop Workers Think?

PubMed

Rusk, Andria; Goodman, Catherine; Naanyu, Violet; Koech, Beatrice; Obala, Andrew; O'Meara, Wendy Prudhomme

2013-01-01

Background. The common symptoms of malaria reduce the specificity of clinical diagnosis. Presumptive treatment is conventional but can lead to overdiagnosis of malaria, delay of appropriate treatment, overprescription of antimalarials, and drug resistance. Routine use of diagnostic tests can address many of these concerns. Though treatment is often procured from retailers, there is low availability of rapid diagnostic tests for malaria (MRDTs), a simple, inexpensive, and accurate diagnostic solution. We know little about the challenges to expanding access to diagnostics through these outlets. Methods. To understand the perceptions of the benefits and challenges to selling rapid diagnostic tests for malaria, we conducted focus group discussions with antimalarial retailers who serve the residents of the Webuye Health and Demographic Surveillance Site in western Kenya. Results. Medicine retailers perceived MRDTs to be beneficial to their customers and businesses but also included cost, fear of the tests, risks of self-treatment, and regulatory concerns among the challenges to using and selling MRDTs. Conclusion. MRDTs represent a viable approach to increase access to malaria diagnostic testing. Medicine retailers are eager for MRDTs to be made available to them. However, certain challenges remain to implementation in retail outlets and should be addressed in advance.

Early Intervention: Expanding Access to Higher Education.

ERIC Educational Resources Information Center

Mitchell, Kevin, Ed.

2000-01-01

"The ERIC Review" announces research results, publications, and new programs relevant to each issue's theme topic. This issue focuses on early intervention and its role in making higher education accessible to all students, especially those who are traditionally underrepresented or at risk. An introductory section contains one article,…

Higher Education In Michigan: Overcoming Challenges to Expand Access

ERIC Educational Resources Information Center

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

2008-01-01

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

Pembrolizumab for advanced melanoma: experience from the Spanish Expanded Access Program.

PubMed

González-Cao, M; Arance, A; Piulats, J M; Marquez-Rodas, I; Manzano, J L; Berrocal, A; Crespo, G; Rodriguez, D; Perez-Ruiz, E; Berciano, M; Soria, A; Castano, A G; Espinosa, E; Montagut, C; Alonso, L; Puertolas, T; Aguado, C; Royo, M A; Blanco, R; Rodríguez, J F; Muñoz, E; Mut, P; Barron, F; Martin-Algarra, S

2017-06-01

The programmed death (PD-1) inhibitor pembrolizumab has been recently approved for the treatment of advanced melanoma. We evaluated the clinical activity of pembrolizumab in melanoma patients treated under the Spanish Expanded Access Program. Advanced melanoma patients who failed to previous treatment lines were treated with pembrolizumab 2 mg/kg every three weeks. Patients with brain metastases were not excluded if they were asymptomatic. Data were retrospectively collected from 21 centers in the Spanish Melanoma Group. Sixty-seven advanced melanoma patients were analyzed. Most patients were stage M1c (73.1%), had high LDH levels (55.2%) and had ECOG PS 1 or higher (59.7%). For cutaneous melanoma patients, median overall survival was 14.0 months; the 18-month overall survival rate was 47.1%. Overall response rate was 27%, including three patients with complete responses (6.5%). Median response duration was not reached, with 83.3% of responses ongoing (3.5 m+ to 20.4 m+). From ten patients included with brain metastases, four (40%) had an objective response, two (20%) of them achieved a complete response. Significant prognostic factors for overall survival were LDH level, ECOG PS and objective response. There were no serious adverse events. Although this was a heavily pretreated cohort, pembrolizumab activity at the approved dose and schedule was confirmed in the clinical setting with long-term responders, also including patients with brain metastases.

Association of PPP1R13L and CD3EAP polymorphisms with risk and survival of non-small cell lung cancer in Chinese non-smoking females

PubMed Central

Feng, Xu; Fang, Xue; Xia, Lingzi; Ren, Yangwu; Li, Xuelian; Quan, Xiaowei; Zhou, Baosen

2017-01-01

PPP1R13L and CD3EAP were confirmed to play important roles in transcription and apoptosis. SNPs in PPP1R13L and CD3EAP may be associated with lung cancer risk and survival. This study investigated the association of PPP1R13L rs1005165 and CD3EAP rs967591 with non-small cell lung cancer (NSCLC) risk and survival in Chinese non-smoking females. 442 NSCLC cases and 480 cancer-free controls were conducted in the case-control study, and 283 cases were in cohort study. Genotype was determined by Taqman real-time PCR. The statistical analyses were performed by SPSS 22.0 software. We found that rs1005165 and rs967591 were significantly associated with NSCLC risk in Chinese non-smoking females. For rs1005165, compared with homozygous wild CC genotype, carriers of CT or TT genotype had lower risk of NSCLC (adjusted ORs were 0.675 and 0.713, 95% CI were 0.461-0.988 and 0.525-0.968, respectively), adjusted OR for dominant model was 0.702, 95% CI was 0.526-0.937. For rs967591, AA genotype (adjusted OR = 0.721, 95% CI = 0.532-0.978) and at least one A allele (GA+AA) (adjusted OR = 0.716, 95% CI = 0.536-0.956) were significantly correlated with lower risk of NSCLC, compared with GG genotype. But we didn’t find correlation between the two SNPs and survival time in Chinese non-smoking NSCLC females. In general, we found PPP1R13L rs1005165 and CD3EAP rs967591 might be associated with lower NSCLC risk in Chinese non-smoking females, but no significant relationship was found with NSCLC survival. PMID:29108262

Expanding Access to Malaria Diagnosis through Retail Shops in Western Kenya: What Do Shop Workers Think?

PubMed Central

Koech, Beatrice; Obala, Andrew; O'Meara, Wendy Prudhomme

2013-01-01

Background. The common symptoms of malaria reduce the specificity of clinical diagnosis. Presumptive treatment is conventional but can lead to overdiagnosis of malaria, delay of appropriate treatment, overprescription of antimalarials, and drug resistance. Routine use of diagnostic tests can address many of these concerns. Though treatment is often procured from retailers, there is low availability of rapid diagnostic tests for malaria (MRDTs), a simple, inexpensive, and accurate diagnostic solution. We know little about the challenges to expanding access to diagnostics through these outlets. Methods. To understand the perceptions of the benefits and challenges to selling rapid diagnostic tests for malaria, we conducted focus group discussions with antimalarial retailers who serve the residents of the Webuye Health and Demographic Surveillance Site in western Kenya. Results. Medicine retailers perceived MRDTs to be beneficial to their customers and businesses but also included cost, fear of the tests, risks of self-treatment, and regulatory concerns among the challenges to using and selling MRDTs. Conclusion. MRDTs represent a viable approach to increase access to malaria diagnostic testing. Medicine retailers are eager for MRDTs to be made available to them. However, certain challenges remain to implementation in retail outlets and should be addressed in advance. PMID:23766923

Biophysical modelling of phytoplankton communities from first principles using two-layered spheres: Equivalent Algal Populations (EAP) model: erratum.

PubMed

Lain, Lisl Robertson; Bernard, Stewart; Matthews, Mark W

2016-11-28

We regret that the Rrs spectra shown for the EAP modelled high biomass validation in Fig. 7 [Opt. Express, 22, 16745 (2014)] are incorrect. They are corrected here. The closest match of modelled to measured effective diameter is for a generalised 16 μm dinoflagellate population and not a 12 μm one as previously stated. These corrections do not affect the discussion or the conclusions of the paper.

Traditions of the Sun, One Model for Expanding Audience Access

NASA Astrophysics Data System (ADS)

Hawkins, I.; Paglierani, R.

2006-12-01

The Internet is a powerful tool with which to expand audience access, bringing students, teachers and the public to places and resources they might not otherwise visit or make use of. We will present Traditions of the Sun, an experiential Web site that invites exploration of the world's ancient observatories with special emphasis on Chaco Culture National Historic Park in the Four Corners region of the US and several sites in the Yucatan Peninsula in Mexico. Traditions of the Sun includes resources in English and Spanish along with a unique trilingual on-line book, "Traditions of the Sun, A Photographic Journal," containing explanatory text in Yucatec Maya as well. Traditions of the Sun offers rich opportunities for virtual visits to ancient sites used for solar observing while learning about current NASA research on the Sun and indigenous solar practices within a larger historical and cultural context. The site contains hundreds of photographs, historic images and rich multimedia to help tell the story of the Sun-Earth Connection. Visitors to the site can zoom in on the great Mayan cities of Chichen Itza, Uxmal, Dzibilchaltun, and Mayapan to learn about Mayan astronomy, history, culture, and science. They can also visit Chaco Canyon to watch sunrise over Pueblo Bonito on the summer solstice, take a virtual reality tour of the great kiva at Casa Rinconada or see panoramic vistas from Fajada Butte, an area which, for preservation purposes, is restricted to the public. Traditions of the Sun provides one model of how exploration and discovery can come to life for both formal and informal audiences via the Internet. Traditions of the Sun is a collaborative project between NASA's Sun-Earth Connection Education Forum, the National Park Service, Instituto National de Antropologia e Historia, Universidad Nacional Autonoma de Mexico, and Ideum.

Health and federal budgetary effects of increasing access to antiretroviral medications for HIV by expanding Medicaid.

PubMed

Kahn, J G; Haile, B; Kates, J; Chang, S

2001-09-01

OBJECTIVES. This study modeled the health and federal fiscal effects of expanding Medicaid for HIV-infected people to improve access to highly active antiretroviral therapy. A disease state model of the US HIV epidemic, with and without Medicaid expansion, was used. Eligibility required a CD4 cell count less than 500/mm3 or viral load greater than 10,000, absent or inadequate medication insurance, and annual income less than $10,000. Two benefits were modeled, "full" and "limited" (medications, outpatient care). Federal spending for Medicaid, Medicare, AIDS Drug Assistance Program, Supplemental Security Income, and Social Security Disability Insurance were assessed. An estimated 38,000 individuals would enroll in a Medicaid HIV expansion. Over 5 years, expansion would prevent an estimated 13,000 AIDS diagnoses and 2600 deaths and add 5,816 years of life. Net federal costs for all programs are $739 million (full benefits) and $480 million (limited benefits); for Medicaid alone, the costs are $1.43 and $1.17 billion, respectively. Results were sensitive to awareness of serostatus, highly active antiretroviral therapy cost, and participation rate. Strategies for federal cost neutrality include Medicaid HIV drug price reductions as low as 9% and private insurance buy-ins. Expansion of the Medicaid eligibility to increase access to antiretroviral therapy would have substantial health benefits at affordable costs.

Expanding access to high-cost medicines through the E2 access program in Thailand: effects on utilisation, health outcomes and cost using an interrupted time-series analysis.

PubMed

Sruamsiri, Rosarin; Wagner, Anita K; Ross-Degnan, Dennis; Lu, Christine Y; Dhippayom, Teerapon; Ngorsuraches, Surachat; Chaiyakunapruk, Nathorn

2016-03-17

In 2008, the Thai government introduced the 'high-cost medicines E2 access program' as a part of the National List of Essential Medicines to increase patient access to medicines, improve clinical outcomes and make medicines more affordable. Our objective was to examine whether the 'high-cost medicines E2 access program' achieved its goals. Interrupted time-series design study. 3 tertiary hospitals in different regions of Thailand, January 2006 to December 2012. Patients with target acute and chronic disease diagnoses who newly met E2 program criteria for selected study medicines. High-cost medicines E2 access program. Level and trend changes over time in the proportions of eligible patients who received the indicated E2 medicines and who improved clinically, as well as in costs of treatment. A total of 2024 patients were included in utilisation analyses and 1375 patients with selected acute diseases contributed to analyses of clinical outcome. After 1 year of the E2 program implementation, the percentage of eligible patients receiving the indicated E2 program medicines increased significantly (relative change 12.7% (95% CI 4.4% to 21.0%), especially among those insured by the government's universal coverage scheme (relative change 19.9% (95% CI 9.5% to 30.5%)). The increase in the proportion of clinically improved patients with acute conditions was not significant (relative change 6.2% (95% CI -1.9% to 15.1%)). Quarterly healthcare costs per patient dropped significantly (relative change -13.5% (95% CI -26.9% to -1.7%)). In the study hospitals, the E2 access program seems to have facilitated patient access to specialty medicines, may have contributed to improved health outcomes, and decreased treatment costs. Routine monitoring is needed to assess effects of expanding the programme, including effects on quality of care and financial sustainability. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence

Expanding the repertoire of microsatellite markers for polymorphism studies in Indian accessions of mung bean (Vigna radiata L. Wilczek).

PubMed

Shrivastava, Divya; Verma, Priyanka; Bhatia, Sabhyata

2014-09-01

Limited availability of validated, polymorphic microsatellite markers in mung bean (Vigna radiata), an important food legume of India, has been a major hurdle towards its improvement and higher yield. The present study was undertaken in order to develop a new set of microsatellite markers and utilize them for the analysis of genetic diversity within mung bean accessions from India. A GA/CT enriched library was constructed from V. radiata which resulted in 1,250 putative recombinant clones of which 850 were sequenced. SSR motifs were identified and their flanking sequences were utilized to design 328 SSR primer pairs. Of these, 48 SSR markers were employed for assessing genetic diversity among 76 mung bean accessions from various geographical locations in India. Two hundred and thirty four alleles with an average of 4.85 alleles per locus were detected at 48 loci. The polymorphic information content (PIC) per locus varied from 0.1 to 0.88 (average: 0.49 per locus). The observed and expected heterozygosities ranged from 0.40 to 0.95 and 0.40 to 0.81 respectively. Based on Jaccard's similarity matrix, a dendrogram was constructed using the unweighted pair-group method with arithmetic averages (UPGMA) analysis which revealed that one accession from Bundi, Rajasthan was clustered out separately while remaining accessions were grouped into two major clusters. The markers generated in this study will help in expanding the repertoire of the available SSR markers thereby facilitating analysis of genetic diversity, molecular mapping and ultimately broadening the scope for genetic improvement of this legume.

Closed-loop control of a core free rolled EAP actuator

NASA Astrophysics Data System (ADS)

Sarban, Rahimullah; Oubaek, Jakob; Jones, Richard W.

2009-03-01

Tubular dielectric electro-active polymer actuators, also referred as tubular InLastors, have many possible applications. One of the most obvious is as a positioning push-type device. This work examines the feedback closed-loop control of a core-free tubular InLastor fabricated from sheets of PolyPowerTM, an EAP material developed by Danfoss PolyPower A/S, which uses a silicone elastomer in conjunction with smart compliant electrode technology. This is part of an ongoing study to develop a precision positioning feedback control system for this device. Initially proportional and integral (PI) control is considered to provide position control of the tubular InLastor. Control of the tubular Inlastors require more than conventional control, used for linear actuators, because the InLastors display highly nonlinear static voltage-strain and voltage-force characteristics as well as dynamic hysteresis and time-dependent strain behavior. In an attempt to overcome the nonlinear static voltage-strain characteristics of the Inlastors and for improving the dynamic performance of the controlled device, a gain scheduling algorithm is then integrated into the PI controlled system.

AtomDB: Expanding an Accessible and Accurate Atomic Database for X-ray Astronomy

NASA Astrophysics Data System (ADS)

Smith, Randall

Since its inception in 2001, the AtomDB has become the standard repository of accurate and accessible atomic data for the X-ray astrophysics community, including laboratory astrophysicists, observers, and modelers. Modern calculations of collisional excitation rates now exist - and are in AtomDB - for all abundant ions in a hot plasma. AtomDB has expanded beyond providing just a collisional model, and now also contains photoionization data from XSTAR as well as a charge exchange model, amongst others. However, building and maintaining an accurate and complete database that can fully exploit the diagnostic potential of high-resolution X-ray spectra requires further work. The Hitomi results, sadly limited as they were, demonstrated the urgent need for the best possible wavelength and rate data, not merely for the strongest lines but for the diagnostic features that may have 1% or less of the flux of the strong lines. In particular, incorporation of weak but powerfully diagnostic satellite lines will be crucial to understanding the spectra expected from upcoming deep observations with Chandra and XMM-Newton, as well as the XARM and Athena satellites. Beyond incorporating this new data, a number of groups, both experimental and theoretical, have begun to produce data with errors and/or sensitivity estimates. We plan to use this to create statistically meaningful spectral errors on collisional plasmas, providing practical uncertainties together with model spectra. We propose to continue to (1) engage the X-ray astrophysics community regarding their issues and needs, notably by a critical comparison with other related databases and tools, (2) enhance AtomDB to incorporate a large number of satellite lines as well as updated wavelengths with error estimates, (3) continue to update the AtomDB with the latest calculations and laboratory measurements, in particular velocity-dependent charge exchange rates, and (4) enhance existing tools, and create new ones as needed to

OPACs: The User and Subject Access.

ERIC Educational Resources Information Center

Carson, Elizabeth

1985-01-01

This survey of the literature reveals user and professional opinions of changes in subject access features available for online public access catalogs. Highlights include expanded access to fields already incorporated into traditional MARC record, access to context of the record, and design of the user interface. Twenty-four references are cited.…

Expanding global access to radiotherapy.

PubMed

Atun, Rifat; Jaffray, David A; Barton, Michael B; Bray, Freddie; Baumann, Michael; Vikram, Bhadrasain; Hanna, Timothy P; Knaul, Felicia M; Lievens, Yolande; Lui, Tracey Y M; Milosevic, Michael; O'Sullivan, Brian; Rodin, Danielle L; Rosenblatt, Eduardo; Van Dyk, Jacob; Yap, Mei Ling; Zubizarreta, Eduardo; Gospodarowicz, Mary

2015-09-01

Radiotherapy is a critical and inseparable component of comprehensive cancer treatment and care. For many of the most common cancers in low-income and middle-income countries, radiotherapy is essential for effective treatment. In high-income countries, radiotherapy is used in more than half of all cases of cancer to cure localised disease, palliate symptoms, and control disease in incurable cancers. Yet, in planning and building treatment capacity for cancer, radiotherapy is frequently the last resource to be considered. Consequently, worldwide access to radiotherapy is unacceptably low. We present a new body of evidence that quantifies the worldwide coverage of radiotherapy services by country. We show the shortfall in access to radiotherapy by country and globally for 2015-35 based on current and projected need, and show substantial health and economic benefits to investing in radiotherapy. The cost of scaling up radiotherapy in the nominal model in 2015-35 is US$26·6 billion in low-income countries, $62·6 billion in lower-middle-income countries, and $94·8 billion in upper-middle-income countries, which amounts to $184·0 billion across all low-income and middle-income countries. In the efficiency model the costs were lower: $14·1 billion in low-income, $33·3 billion in lower-middle-income, and $49·4 billion in upper-middle-income countries-a total of $96·8 billion. Scale-up of radiotherapy capacity in 2015-35 from current levels could lead to saving of 26·9 million life-years in low-income and middle-income countries over the lifetime of the patients who received treatment. The economic benefits of investment in radiotherapy are very substantial. Using the nominal cost model could produce a net benefit of $278·1 billion in 2015-35 ($265·2 million in low-income countries, $38·5 billion in lower-middle-income countries, and $239·3 billion in upper-middle-income countries). Investment in the efficiency model would produce in the same period an even

Expanding the Enzyme Universe: Accessing Non-Natural Reactions by Mechanism-Guided Directed Evolution

PubMed Central

Renata, Hans; Wang, Z. Jane

2015-01-01

High selectivities and exquisite control over reaction outcomes entice chemists to use biocatalysts in organic synthesis. However, many useful reactions are not accessible because they are not in nature’s known repertoire. We will use this review to outline an evolutionary approach to engineering enzymes to catalyze reactions not found in nature. We begin with examples of how nature has discovered new catalytic functions and how such evolutionary progressions have been recapitulated in the laboratory starting from extant enzymes. We then examine non-native enzyme activities that have been discovered and exploited for chemical synthesis, emphasizing reactions that do not have natural counterparts. The new functions have mechanistic parallels to the native reaction mechanisms that often manifest as catalytic promiscuity and the ability to convert from one function to the other with minimal mutation. We present examples of how non-natural activities have been improved by directed evolution, mimicking the process used by nature to create new catalysts. Examples of new enzyme functions include epoxide opening reactions with non-natural nucleophiles catalyzed by a laboratory-evolved halohydrin dehalogenase, cyclopropanation and other carbene transfer reactions catalyzed by cytochrome P450 variants, and non-natural modes of cyclization by a modified terpene synthase. Lastly, we describe discoveries of non-native catalytic functions that may provide future opportunities for expanding the enzyme universe. PMID:25649694

Expanding Your Laboratory by Accessing Collaboratory Resources

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

Hoyt, David W.; Burton, Sarah D.; Peterson, Michael R.

2004-03-01

The Environmental Molecular Sciences Laboratory (EMSL) in Richland, Washington, is the home of a research facility setup by the United States Department of Energy (DOE). The facility is atypical because it houses over 100 cutting-edge research systems for the use of researchers all over the United States and the world. Access to the lab is requested through a peer-review proposal process and the scientists who use the facility are generally referred to as ‘users’. There are six main research facilities housed in EMSL, all of which host visiting researchers. Several of these facilities also participate in the EMSL Collaboratory, amore » remote access capability supported by EMSL operations funds. Of these, the High-Field Magnetic Resonance Facility (HFMRF) and Molecular Science Computing Facility (MSCF) have a significant number of their users performing remote work. The HFMRF in EMSL currently houses 12 NMR spectrometers that range in magnet field strength from 7.05T to 21.1T. Staff associated with the NMR facility offers scientific expertise in the areas of structural biology, solid-state materials/catalyst characterization, and magnetic resonance imaging (MRI) techniques. The way in which the HFMRF operates, with a high level of dedication to remote operation across the full suite of High-Field NMR spectrometers, has earned it the name “Virtual NMR Facility”. This review will focus on the operational aspects of remote research done in the High-Field Magnetic Resonance Facility and the computer tools that make remote experiments possible.« less

Integrated employee assistance program/managed behavioral health plan utilization by persons with substance use disorders.

PubMed

Merrick, Elizabeth S Levy; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M; Greenfield, Shelly F; McCann, Bernard

2011-04-01

New federal parity and health reform legislation, promising increased behavioral health care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral health care (MBHC) organization's integrated EAP/MBHC product (N = 1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan, and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of the clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the front end of treatment and is often only one component of treatment episodes. Copyright © 2011 Elsevier Inc. All rights reserved.

Ipilimumab retreatment in patients with pretreated advanced melanoma: the expanded access programme in Italy

PubMed Central

Chiarion-Sileni, V; Pigozzo, J; Ascierto, P A; Simeone, E; Maio, M; Calabrò, L; Marchetti, P; De Galitiis, F; Testori, A; Ferrucci, P F; Queirolo, P; Spagnolo, F; Quaglino, P; Carnevale Schianca, F; Mandalà, M; Di Guardo, L; Del Vecchio, M

2014-01-01

Background: Retreatment with ipilimumab has been shown to re-establish disease control in some patients with disease progression. Here, we report the efficacy and safety of retreatment with ipilimumab 3 mg kg−1 among patients participating in an expanded access programme in Italy. Methods: Patients who achieved disease control during induction therapy were retreated with ipilimumab upon progression (3 mg kg−1 every 3 weeks for up to four doses), providing they had not experienced toxicity that precluded further dosing. Tumour assessments were conducted after retreatment, and patients were monitored throughout for adverse events. Results: Of 855 patients treated with ipilimumab, 51 were retreated upon disease progression. Of these, 28 (55%) regained disease control upon retreatment and 42% were alive 2 years after the first induction dose of ipilimumab; median overall survival was 21 months. Eleven patients (22%) had a treatment-related adverse event of any grade during retreatment. These were generally mild-to-moderate and resolved within a median of 4 days. No new types of toxicity were reported. Conclusions: For patients who meet predefined criteria, retreatment with ipilimumab is generally well tolerated and can translate into clinical benefit. This strategy should be compared with other therapeutic options in randomised controlled trials. PMID:24619072

The effect of Employee Assistance Programs use on healthcare utilization.

PubMed

Zarkin, G A; Bray, J W; Qi, J

2000-04-01

To estimate the effect of Employee Assistance Program (EAP) use on healthcare utilization as measured by health claims. A unique data set that combines individual-level information on EAP utilization, demographic information, and health insurance claims from 1991 to 1995 for all employees of a large midwestern employer. Using "fixed-effect" econometric models that control for unobserved differences between individuals' propensities to use healthcare resources and the EAP, we perform our analyses in two steps. First, for those employees who visited the EAP, we test whether post-EAP claims differ from pre-EAP claims. Second, we combine claims data of individuals who went to an EAP with those of individuals who did not use an EAP to test whether differences in utilization exist between EAP users and nonusers. From the EAP we obtained the date of first EAP contact for all employees who used the service, and from the company's human resources department we obtained limited demographic data on all employees. We obtained healthcare utilization claims data on all employees and their dependents from the company's two healthcare plans: a fee-for-service (FFS) plan and a health maintenance organization (HMO) plan. We found that going to an EAP substantially increases both the probability of an alcohol, drug abuse, or mental health (ADM) claim and the number of ADM claims in the same quarter as EAP contact. The increased probability of an ADM claim persists for approximately 11 quarters after the initial contact, while the increased ADM charges persist for approximately six quarters after the initial EAP contact. Our results strongly suggest that the EAP is able to identify behavioral and other health problems that may affect workplace performance and prompt EAP users to access ADM and other healthcare. Consistent with the stated goals of many EAPs, including the one examined in this study, this process should improve individuals' health, family functioning, and workplace

The effect of Employee Assistance Programs use on healthcare utilization.

PubMed Central

Zarkin, G A; Bray, J W; Qi, J

2000-01-01

OBJECTIVE: To estimate the effect of Employee Assistance Program (EAP) use on healthcare utilization as measured by health claims. DATA SOURCES: A unique data set that combines individual-level information on EAP utilization, demographic information, and health insurance claims from 1991 to 1995 for all employees of a large midwestern employer. STUDY DESIGN: Using "fixed-effect" econometric models that control for unobserved differences between individuals' propensities to use healthcare resources and the EAP, we perform our analyses in two steps. First, for those employees who visited the EAP, we test whether post-EAP claims differ from pre-EAP claims. Second, we combine claims data of individuals who went to an EAP with those of individuals who did not use an EAP to test whether differences in utilization exist between EAP users and nonusers. DATA COLLECTION METHODS: From the EAP we obtained the date of first EAP contact for all employees who used the service, and from the company's human resources department we obtained limited demographic data on all employees. We obtained healthcare utilization claims data on all employees and their dependents from the company's two healthcare plans: a fee-for-service (FFS) plan and a health maintenance organization (HMO) plan. PRINCIPAL FINDINGS: We found that going to an EAP substantially increases both the probability of an alcohol, drug abuse, or mental health (ADM) claim and the number of ADM claims in the same quarter as EAP contact. The increased probability of an ADM claim persists for approximately 11 quarters after the initial contact, while the increased ADM charges persist for approximately six quarters after the initial EAP contact. CONCLUSIONS: Our results strongly suggest that the EAP is able to identify behavioral and other health problems that may affect workplace performance and prompt EAP users to access ADM and other healthcare. Consistent with the stated goals of many EAPs, including the one examined in

EFFECTS: an expanded access program of everolimus for patients with subependymal giant cell astrocytoma associated with tuberous sclerosis complex.

PubMed

Fogarasi, Andras; De Waele, Liesbeth; Bartalini, Gabriella; Jozwiak, Sergiusz; Laforgia, Nicola; Verhelst, Helene; Petrak, Borivoj; Pedespan, Jean-Michel; Witt, Olaf; Castellana, Ramon; Crippa, Stefania; Gislimberti, Gabriella; Gyorsok, Zsuzsanna

2016-08-08

Everolimus, a mammalian target of rapamycin (mTOR) inhibitor, has been shown to be effective and safe in the treatment of subependymal giant cell astrocytoma (SEGA) associated with tuberous sclerosis complex (TSC). The Everolimus For Fast Expanded aCcess in TSC SEGA (EFFECTS) study was designed to provide everolimus access to patients with SEGA associated with TSC and to mainly assess the safety and also efficacy of everolimus in a real-world setting. EFFECTS was a phase 3b, open-label, noncomparative, multicenter, expanded access study. Eligible patients were ≥ 3 years of age, with a definite diagnosis of TSC, and with at least one SEGA lesion identified by MRI or CT scan. Patients received once daily everolimus (dose adjusted to attain a trough level of 5-15 ng/mL). Safety evaluation was the primary objective and included collection of adverse events (AEs) and serious AEs, with their severity and relationship to everolimus. Efficacy evaluation, which was the secondary objective, was based on the best overall response as per medical judgment. Of the 120 patients enrolled, 100 (83.3%) completed the study. Median age of patients was 11 years (range, 1-47). Median daily dose of everolimus was 5.82 mg (range, 2.0-11.8). Median duration of exposure was 56.5 weeks (range, 0.3-130). The overall incidence of AEs was 74.2%. Aphthous stomatitis (18 [15.0%]), pyrexia (18 [15.0%]), bronchitis (11 [9.2%]), and stomatitis (10 [8.3%]) were the most common AEs reported. Overall, 25 patients had grade 3 AEs; most frequent was stomatitis (4 [3.3%]). Grade 4 AEs were reported in three (2.5%) patients. A total of 62 (51.7%) patients had suspected drug-related AEs, of which 15 (12.5%) were of grade 3 or 4. In eight (6.7%) patients, AEs led to drug discontinuation. With regard to efficacy, 81 (67.5%) patients had a partial response, 35 (29.2%) had a stable disease, and one (0.8%) had progressive disease. The response was unknown in three (2.5%) patients. This study confirms the

Adams National Historical Park expanded transit service evaluation

DOT National Transportation Integrated Search

2009-12-01

In 2005 and 2006, Adams National Historical Park piloted expanded shuttle service, with the aim of promoting car-free access for its visitors. This report evaluates the 2006 season of operation. Adams National Historical Park (NHP) is located approxi...

Experience in production of (68)Ga-DOTA-NOC for clinical use under an Expanded Access IND.

PubMed

Green, Mark A; Mathias, Carla J; Fletcher, James W

2016-10-01

[(68)Ga]Ga-DOTA-NOC was produced under an Expanded Access IND for 174 clinical PET/CT studies to evaluate patients with neuroendocrine tumors. Production employed either the TiO2-based Eckert & Ziegler (EZAG) (68)Ge/(68)Ga-generator (with fractionated elution), or the SiO2-based ITG (68)Ge/(68)Ga-generator. In both cases, [(68)Ga]Ga-DOTA-NOC was reliably produced, without pre-synthesis purification of the(68)Ga generator eluate, using readily-implemented manual synthesis procedures. [(68)Ga]Ga-DOTA-NOC radiochemical purity averaged 99.2±0.4%. Administered (68)Ga dose averaged 181±22 MBq, and administered peptide mass averaged 43.2±5.2µg (n=47) and 23.9±5.7µg (n=127), respectively, using the EZAG and ITG generators. At dose expiration, (68)Ge breakthrough in the final product averaged 2.7×10(-7)% and 5.4×10(-5%) using the EZAG and ITG generators, respectively. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

PubMed Central

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

2013-01-01

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

Exposing the Dynamic Nature and Potential Role of Student Attribution Processes on English for Academic Purposes Achievement in Higher Education

ERIC Educational Resources Information Center

Chang, Heejin; Windsor, Angela; Helwig, Lindsay

2017-01-01

The aim of this study is to investigate the reasons that English for Academic Purposes (EAP) students in the Open Access College at the University of Southern Queensland give to explain their success in a course of study. It will examine how students' internal and external attributions change while studying EAP. The data has been gathered through…

Data Basin: Expanding Access to Conservation Data, Tools, and People

NASA Astrophysics Data System (ADS)

Comendant, T.; Strittholt, J.; Frost, P.; Ward, B. C.; Bachelet, D. M.; Osborne-Gowey, J.

2009-12-01

Mapping and spatial analysis are a fundamental part of problem solving in conservation science, yet spatial data are widely scattered, difficult to locate, and often unavailable. Valuable time and resources are wasted locating and gaining access to important biological, cultural, and economic datasets, scientific analysis, and experts. As conservation problems become more serious and the demand to solve them grows more urgent, a new way to connect science and practice is needed. To meet this need, an open-access, web tool called Data Basin (www.databasin.org) has been created by the Conservation Biology Institute in partnership with ESRI and the Wilburforce Foundation. Users of Data Basin can gain quick access to datasets, experts, groups, and tools to help solve real-world problems. Individuals and organizations can perform essential tasks such as exploring and downloading from a vast library of conservation datasets, uploading existing datasets, connecting to other external data sources, create groups, and produce customized maps that can be easily shared. Data Basin encourages sharing and publishing, but also provides privacy and security for sensitive information when needed. Users can publish projects within Data Basin to tell more complete and rich stories of discovery and solutions. Projects are an ideal way to publish collections of datasets, maps and other information on the internet to reach wider audiences. Data Basin also houses individual centers that provide direct access to data, maps, and experts focused on specific geographic areas or conservation topics. Current centers being developed include the Boreal Information Centre, the Data Basin Climate Center, and proposed Aquatic and Forest Conservation Centers.

Do Hospitals Support Second Victims? Collective Insights From Patient Safety Leaders in Maryland.

PubMed

Edrees, Hanan H; Morlock, Laura; Wu, Albert W

2017-09-01

Second victims-defined as health care providers who are emotionally traumatized after a patient adverse event-may not receive needed emotional support. Although most health care organizations have an employee assistance program (EAP), second victims may be reluctant to access this service because of worries about confidentiality. A study was conducted to describe the extent to which organizational support for second victims is perceived as desirable by patient safety officers in acute care hospitals in Maryland and to identify existing support programs. Semistructured interviews (using existing and newly developed questions) were conducted with 43 patient safety representatives from 38 of the 46 acute care hospitals in Maryland (83% response rate). All but one of the responding hospitals offered EAP services to their employees, but there were gaps in the services provided related to timeliness, EAP staff's ability to relate to clinical providers, and physical accessibility. There were no valid measures in place to assess the effectiveness of EAP services. Participants identified a need for peer support, both for the second victim and potentially for individuals who provide that support. Six (16%) of the 38 hospitals had second victim support programs, which varied in structure, accessibility, and outcomes, while an additional 5 hospitals (13%) were developing such a program. Patient safety officers thought their organizations should reevaluate the support currently provided by their EAPs, and consider additional peer support mechanisms. Future research is needed to evaluate the effectiveness of these programs. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

The Effect of Employee Assistance Plan Benefits on the Use of Outpatient Behavioral Health Care

PubMed Central

Hodgkin, Dominic; Merrick, Elizabeth L.; Hiatt, Deirdre; Horgan, Constance M.; McGuire, Thomas G.

2011-01-01

Many US workers have access both to an employee assistance plan (EAP) and to employer health insurance that includes behavioral health services. We examine whether EAP services substitute for outpatient behavioral health care services covered by the health plan, in settings where the employer has purchased both products jointly. We analyze administrative data for 26,464 patients enrolled with a managed behavioral health organization in 2005. General linear models are used to predict visits and spending for regular outpatient care. We also use instrumental variable analysis to test for endogeneity of the number of EAP visits covered. Having more generous EAP coverage predicts fewer regular outpatient visits, and lower spending for outpatient care. This supports the idea that the two types of care are to some extent perceived as substitutes, although patients also appear to perceive that EAP services offer something distinct from regular outpatient care. PMID:21368341

Expanding Educational Access in Eastern Turkey: A New Initiative

ERIC Educational Resources Information Center

O'Dwyer, John; Aksit, Necmi; Sands, Margaret

2010-01-01

The Eastern Anatolian project extends opportunity and access to quality education. The study examines the selection and learning systems adopted within the framework of gender equity, family background and higher order skills. Performance data on a range of selection measures and the initial programme are analysed. Results show that selection was…

Expanding Access to HCV Treatment - Extension for Community Healthcare Outcomes (ECHO) Project: Disruptive Innovation in Specialty Care

PubMed Central

Arora, Sanjeev; Kalishman, Summers; Thornton, Karla; Dion, Denise; Murata, Glen; Deming, Paulina; Parish, Brooke; Brown, John; Komaromy, Miriam; Colleran, Kathleen; Bankhurst, Arthur; Katzman, Joanna; Harkins, Michelle; Curet, Luis; Cosgrove, Ellen; Pak, Wesley

2013-01-01

The Extension for Community Healthcare Outcomes (ECHO) Model was developed by the University of New Mexico Health Sciences Center (UNMHSC) as a platform to deliver complex specialty medical care to underserved populations through an innovative educational model of team-based inter-disciplinary development. Using state-of-the-art telehealth technology, best practice protocols, and case based learning, ECHO trains and supports primary care providers to develop knowledge and self-efficacy on a variety of diseases. As a result, they can deliver best practice care for complex health conditions in communities where specialty care is unavailable. ECHO was first developed for the management of hepatitis C virus (HCV), optimal management of which requires consultation with multi-disciplinary experts in medical specialties, mental health and substance abuse. Few practitioners, particularly in rural and underserved areas, have the knowledge to manage its emerging treatment options, side effects, drug toxicities and treatment-induced depression. In addition data was obtained from observation of ECHO weekly clinics and database of ECHO clinic participation and patient presentations by clinical provider, evaluation of the ECHO program incorporates annual survey integrated into the ECHO annual meeting and routine surveys of community providers about workplace learning, personal and professional experiences, systems and environmental factors associated with professional practice, self-efficacy, facilitators and barriers to ECHO. The initial survey data show a significant improvement in provider knowledge, self-efficacy and professional satisfaction through participation in ECHO HCV clinics. Clinicians reported a moderate to major benefit from participation. We conclude that ECHO expands access to best practice care for underserved populations, builds communities of practice to enhance professional development and satisfaction of primary care clinicians, and expands sustainable

Evolutionary Action score of TP53 (EAp53) identifies high risk mutations associated with decreased survival and increased distant metastases in head and neck cancer

PubMed Central

Neskey, David M.; Osman, Abdullah A.; Ow, Thomas J.; Katsonis, Panagiotis; McDonald, Thomas; Hicks, Stephanie C.; Hsu, Teng-Kuei; Pickering, Curtis R.; Ward, Alexandra; Patel, Ameeta; Yordy, John S.; Skinner, Heath D.; Giri, Uma; Sano, Daisuke; Story, Michael D.; Beadle, Beth M.; El-Naggar, Adel K.; Kies, Merrill S.; William, William N.; Caulin, Carlos; Frederick, Mitchell; Kimmel, Marek; Myers, Jeffrey N.; Lichtarge, Olivier

2015-01-01

TP53 is the most frequently altered gene in head and neck squamous cell carcinoma (HNSCC) with mutations occurring in over two third of cases, but the prognostic significance of these mutations remains elusive. In the current study, we evaluated a novel computational approach termed Evolutionary Action (EAp53) to stratify patients with tumors harboring TP53 mutations as high or low risk, and validated this system in both in vivo and in vitro models. Patients with high risk TP53 mutations had the poorest survival outcomes and the shortest time to the development of distant metastases. Tumor cells expressing high risk TP53 mutations were more invasive and tumorigenic and they exhibited a higher incidence of lung metastases. We also documented an association between the presence of high risk mutations and decreased expression of TP53 target genes, highlighting key cellular pathways that are likely to be dysregulated by this subset of p53 mutations which confer particularly aggressive tumor behavior. Overall, our work validated EAp53 as a novel computational tool that may be useful in clinical prognosis of tumors harboring p53 mutations. PMID:25634208

Atezolizumab in Platinum-treated Locally Advanced or Metastatic Urothelial Carcinoma: Clinical Experience from an Expanded Access Study in the United States.

PubMed

Pal, Sumanta Kumar; Hoffman-Censits, Jean; Zheng, Hanzhe; Kaiser, Constanze; Tayama, Darren; Bellmunt, Joaquim

2018-05-01

Atezolizumab (anti-programmed death-ligand 1) was approved in the USA, Europe, and elsewhere for treatment-naive and platinum-treated locally advanced/metastatic urothelial carcinoma (mUC). To report efficacy and safety from an atezolizumab expanded access study. This single-arm, open-label study enrolled 218 patients at 36 US sites. Key eligibility criteria included progression during/following ≥1 platinum-based chemotherapy for mUC or in perioperative setting (progression within 12 mo) and Eastern Cooperative Oncology Group performance status (ECOG PS) 0-2. Patients received atezolizumab1200mg intravenously every 3 wk until loss of clinical benefit, unacceptable toxicity, consent withdrawal, decision to discontinue, death, atezolizumab commercial availability, or study closure. Key end points reported herein included Response Evaluation Criteria in Solid Tumors v1.1 objective response rate and duration, disease control rate (DCR; response or stable disease), and safety. All patients received prior systemic therapy (68% mUC; 27% adjuvant; and 26% neoadjuvant). At baseline, 57% of 214 treated patients had ECOG PS ≥1, 19% had hemoglobin <10g/dl, and 25% had liver metastases. Median treatment duration was 9 wk (interquartile range [IQR], 6-12 wk). Median follow-up duration was 2.3 mo (IQR, 1.6-3.4 mo) overall and 2.7 mo (IQR, 2.0-3.5 mo) in patients not known to have died. Seventeen of 114 evaluable patients (15%) had objective responses (16 ongoing at study termination). DCR was 49%. Treatment-related adverse events (mostly fatigue) occurred in 98 of 214 treated patients. The benefit/risk profile of atezolizumab was consistent with that observed in previous studies, despite pretreatment and poor prognostic factors. These results suggest a potential role for atezolizumab in a broader patient range than typically eligible for phase 1-3 studies. In this expanded access study, atezolizumab was active and tolerable in a range of patients with platinum

The effect of code expanding optimizations on instruction cache design

NASA Technical Reports Server (NTRS)

Chen, William Y.; Chang, Pohua P.; Conte, Thomas M.; Hwu, Wen-Mei W.

1991-01-01

It is shown that code expanding optimizations have strong and non-intuitive implications on instruction cache design. Three types of code expanding optimizations are studied: instruction placement, function inline expansion, and superscalar optimizations. Overall, instruction placement reduces the miss ratio of small caches. Function inline expansion improves the performance for small cache sizes, but degrades the performance of medium caches. Superscalar optimizations increases the cache size required for a given miss ratio. On the other hand, they also increase the sequentiality of instruction access so that a simple load-forward scheme effectively cancels the negative effects. Overall, it is shown that with load forwarding, the three types of code expanding optimizations jointly improve the performance of small caches and have little effect on large caches.

Synthetic biology to access and expand nature’s chemical diversity

PubMed Central

Smanski, Michael J.; Zhou, Hui; Claesen, Jan; Shen, Ben; Fischbach, Michael; Voigt, Christopher A.

2016-01-01

Bacterial genomes encode the biosynthetic potential to produce hundreds of thousands of complex molecules with diverse applications, from medicine to agriculture and materials. Economically accessing the potential encoded within sequenced genomes promises to reinvigorate waning drug discovery pipelines and provide novel routes to intricate chemicals. This is a tremendous undertaking, as the pathways often comprise dozens of genes spanning as much as 100+ kiliobases of DNA, are controlled by complex regulatory networks, and the most interesting molecules are made by non-model organisms. Advances in synthetic biology address these issues, including DNA construction technologies, genetic parts for precision expression control, synthetic regulatory circuits, computer aided design, and multiplexed genome engineering. Collectively, these technologies are moving towards an era when chemicals can be accessed en mass based on sequence information alone. This will enable the harnessing of metagenomic data and massive strain banks for high-throughput molecular discovery and, ultimately, the ability to forward design pathways to complex chemicals not found in nature. PMID:26876034

Expanding access to off-grid rural electrification in Africa: An analysis of community-based micro-grids in Kenya

NASA Astrophysics Data System (ADS)

Kirubi, Charles Gathu

lead to elite capture. Experiences from different micro-grid settings illustrate the manner in which a coincidence of interest between the elites and the rest of members and access to external support can create incentives and mechanisms to enable community-wide access to scarce services, hence mitigating elite capture. Moreover, access to external support was found to increase the likelihood of participation for the relatively poor households. The policy-relevant message from this research is two-fold. In rural areas with suitable sites for micro-hydro power, the potential for community micro-grids appear considerable to the extent that this option would seem to represent "the road not taken" as far as policies and initiatives aimed at expanding RE are concerned in Kenya and other African countries with comparable settings. However, local participatory initiatives not complimented by external technical assistance run a considerable risk of locking rural households into relatively more costly and poor-quality services. By taking advantage of existing and/or building a dense network of local organizations, including micro-finance agencies, the government and development partners can make available to local communities the necessary support---financial, technical or regulatory---essential for efficient design of micro-grids in addition to facilitating equitable distribution of electricity benefits.

Use of spring-roll EAP actuator applied as end-effector of a hyper-redundant robot

NASA Astrophysics Data System (ADS)

Errico, Gianmarco; Fava, Victor; Resta, Ferruccio; Ripamonti, Francesco

2015-04-01

This paper presents a hyper-redundant continuous robot used to perform work in places which humans can not reach. This type of robot is generally a bio-inspired solution, it is composed by a lot of flexible segments driven by multiple actuators and its dynamics is described by a lot degrees of freedom. In this paper a model composed of some rigid links connected to each other by revolution joint is presented. In each link a torsional spring is added in order to simulate the resistant torque between the links and the interactions among the cables and the robot during the relative rotation. Moreover a type of EAP actuator, called spring roll, is used as the end-effector of the robot. Through a suitable sensor, such as a camera, the spring roll allows to track a target and it closes the control loop on the robot to follow it.

Ring vaccination with rVSV-ZEBOV under expanded access in response to an outbreak of Ebola virus disease in Guinea, 2016: an operational and vaccine safety report.

PubMed

Gsell, Pierre-Stéphane; Camacho, Anton; Kucharski, Adam J; Watson, Conall H; Bagayoko, Aminata; Nadlaou, Séverine Danmadji; Dean, Natalie E; Diallo, Abdourahamane; Diallo, Abdourahmane; Honora, Djidonou A; Doumbia, Moussa; Enwere, Godwin; Higgs, Elizabeth S; Mauget, Thomas; Mory, Diakite; Riveros, Ximena; Oumar, Fofana Thierno; Fallah, Mosoka; Toure, Alhassane; Vicari, Andrea S; Longini, Ira M; Edmunds, W J; Henao-Restrepo, Ana Maria; Kieny, Marie Paule; Kéïta, Sakoba

2017-12-01

In March, 2016, a flare-up of Ebola virus disease was reported in Guinea, and in response ring vaccination with the unlicensed rVSV-ZEBOV vaccine was introduced under expanded access, the first time that an Ebola vaccine has been used in an outbreak setting outside a clinical trial. Here we describe the safety of rVSV-ZEBOV candidate vaccine and operational feasibility of ring vaccination as a reactive strategy in a resource-limited rural setting. Approval for expanded access and compassionate use was rapidly sought and obtained from relevant authorities. Vaccination teams and frozen vaccine were flown to the outbreak settings. Rings of contacts and contacts of contacts were defined and eligible individuals, who had given informed consent, were vaccinated and followed up for 21 days under good clinical practice conditions. Between March 17 and April 21, 2016, 1510 individuals were vaccinated in four rings in Guinea, including 303 individuals aged between 6 years and 17 years and 307 front-line workers. It took 10 days to vaccinate the first participant following the confirmation of the first case of Ebola virus disease. No secondary cases of Ebola virus disease occurred among the vaccinees. Adverse events following vaccination were reported in 47 (17%) 6-17 year olds (all mild) and 412 (36%) adults (individuals older than 18 years; 98% were mild). Children reported fewer arthralgia events than adults (one [<1%] of 303 children vs 81 [7%] of 1207 adults). No severe vaccine-related adverse events were reported. The results show that a ring vaccination strategy can be rapidly and safely implemented at scale in response to Ebola virus disease outbreaks in rural settings. WHO, Gavi, and the World Food Programme. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

ExpandED Options: Learning beyond High School Walls

ERIC Educational Resources Information Center

ExpandED Schools, 2014

2014-01-01

Through ExpandED Options by TASC, New York City high school students get academic credit for learning career-related skills that lead to paid summer jobs. Too many high school students--including those most likely to drop out--are bored or see classroom learning as irrelevant. ExpandED Options students live the connection between mastering new…

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.

The role of auxiliary nurse-midwives and community health volunteers in expanding access to medical abortion in rural Nepal.

PubMed

Puri, Mahesh; Tamang, Anand; Shrestha, Prabhakar; Joshi, Deepak

2015-02-01

Medical abortion was introduced in Nepal in 2009, but rural women's access to medical abortion services remained limited. We conducted a district-level operations research study to assess the effectiveness of training 13 auxiliary nurse-midwives as medical abortion providers, and 120 female community health volunteers as communicators and referral agents for expanding access to medical abortion for rural women. Interviews with service providers and women who received medical abortion were undertaken and service statistics were analysed. Compared to a neighbouring district with no intervention, there was a significant increase in the intervention area in community health volunteers' knowledge of the legal conditions for abortion, the advantages and disadvantages of medical abortion, safe places for an abortion, medical abortion drugs, correct gestational age for home use of medical abortion, and carrying out a urine pregnancy test. In a one-year period in 2011-12, the community health volunteers did pregnancy tests for 584 women and referred 114 women to the auxiliary nurse-midwives for abortion; 307 women in the intervention area received medical abortion services from auxiliary nurse-midwives. There were no complications that required referral to a higher-level facility except for one incomplete abortion. Almost all women who opted for medical abortion were happy with the services provided. The study demonstrated that auxiliary nurse-midwives can independently and confidently provide medical abortion safely and effectively at the sub-health post level, and community health volunteers are effective change agents in informing women about medical abortion. Copyright © 2015 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Higher Education: In Search of Access and Scholarship.

ERIC Educational Resources Information Center

Walker, David A.

This report presents a brief historical review of how American higher education has attempted to develop potential by adhering to the foundations of its educational mission: access and scholarship. Higher education has accomplished its mission by expanding in areas such as diversity in enrollment and educational legislation to provide access to…

Syringe disposal among injection drug users in Harlem and the Bronx during the New York State Expanded Syringe Access Demonstration Program.

PubMed

Cleland, Charles M; Deren, Sherry; Fuller, Crystal M; Blaney, Shannon; McMahon, James M; Tortu, Stephanie; Des Jarlais, Don C; Vlahov, David

2007-04-01

Effective January 1, 2001, New York State enacted the Expanded Syringe Access Demonstration Program (ESAP), allowing syringes to be sold in pharmacies without a prescription or dispensed through doctors, hospitals, and clinics to adults. A concern in the assessment of ESAP is its effects on syringe disposal practices. Syringe use data regarding the last injection episode were combined from three projects (N = 1,030) recruiting injection drug users. Disposal of syringes by methods known to be safe decreased significantly over time after the implementation of ESAP. Syringes obtained either from syringe exchange programs or ESAP sources were more likely to be disposed of safely than syringes obtained from other sources. Efforts to enlist pharmacists and others involved in ESAP implementation to encourage safe disposal are needed. More detailed information on disposal practices is needed to capture the continuum from least to most safe practices and variation within individuals.

Expanding Access, Participation, and Success in International Baccalaureate Programmes: Year 1 Documentation Report

ERIC Educational Resources Information Center

Corcoran, Thomas B.; Gerry, Gail B.

2010-01-01

In fall 2009, the Bill and Melinda Gates Foundation funded a three-year project (IB Access Project) with International Baccalaureate (IB) to increase participation of minority students and students in poverty in the Middle Years Programme (MYP) and Diploma Programme (DP). The IB Access Project seeks to do four things: (1) Improve teacher practice…

Awakening Tiger: India’s Quest for Expanded Influence in the World

DTIC Science & Technology

2008-03-01

media.csis/pubs/sam98. pdf (accessed June 3, 2007). 2 Lisa Curtis. “India’s Expanding Role in Asia: Adapting to Rising Power Status,” Heritage Foundation...Backgrounder No. 2008 (February 20, 2007), http://www.heritage.org/Research/AsiaandthePacific/upload/bg_2008. pdf (accessed May 29, 2007). 3...Growth,” Indian Council for Research on International Economic Relations, New Delhi Working Papers Number 122 (2004). http://www.icrier.org/ pdf /wp122. pdf

Employee Assistance on the Campus: Considerations for Student Personnel Administrators.

ERIC Educational Resources Information Center

Ansley, James A.

1983-01-01

Suggests that student personnel services could be expanded to provide employee assistance programs for college faculty and staff. Outlines steps to implement an EAP including planning, organizing, budgeting, staffing, directing, and evaluating. Suggests more effective use of campus resources to preserve human resources. (JAC)

Card Access Know-How.

ERIC Educational Resources Information Center

College Planning & Management, 2000

2000-01-01

Provides tips for expanding a school's card access system and making it more productive for all concerned. Tips include the use of electronic locks for better security; the need for state-of-the-art card reader system to save money in the long run; selecting vendors to one that manufactures, installs, and supports the card system; and having…

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

PubMed

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

2013-01-01

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

Tissue Expander Overfilling: Achieving New Dimensions of Customization in Breast Reconstruction.

PubMed

Treiser, Matthew D; Lahair, Tracy; Carty, Matthew J

2016-02-01

Overfill of tissue expanders is a commonly used modality to achieve customized dimensions in breast reconstruction. Little formal study of the dynamics of hyperexpansion of these devices has been performed to date, however. Overfill trials were performed using both Natrelle 133 MV and Mentor 8200 tissue expanders of indicated capacities ranging from 250 to 800 mL. Each expander was initially filled to its indicated capacity with normal water and then injected in regular increments to 400% overfill. Measurements of each expander's width, height, and projection were made at indicated capacity and with each successive incremental overfill injection, and these results were then recorded, collated, and analyzed. Over the first 50% overfill, all expanders demonstrated a logarithmic increase in projection (mean increase, 143 ± 9%) while maintaining essentially stable base dimensions. Overfill levels in excess of 50% were accompanied by linear increases in height, width, and projection, during which projection approached, but never equaled, base dimensions. Stress versus strain analyses demonstrated nonlinear biomechanical dynamics during the first 50% overfill, followed by standard elastic dynamics up to 400% overfill. At no point during the study, did expander tensions outstrip elastic properties, thereby explaining the lack of device rupture. Through overfilling, tunable geometries of tissue expanders can be accessed that may provide for increasing customization of reconstructions, particularly at overfill volumes up to 50% over indicated capacity. This study should serve to guide tissue expander selection and fill volumes that surgeons may implement in obtaining ideal reconstructed breast shapes.

Technology for People, Not Disabilities: Ensuring Access and Inclusion

ERIC Educational Resources Information Center

Foley, Alan; Ferri, Beth A.

2012-01-01

The potential of technology to connect people and provide access to education, commerce, employment and entertainment has never been greater or more rapidly changing. Communication technologies and new media promise to "revolutionize our lives" by breaking down barriers and expanding access for disabled people. Yet, it is also true that technology…

Expanding Discourse Options through Computer-Mediated Communication: Guiding Learners toward Autonomy

ERIC Educational Resources Information Center

Abraham, Lee B.; Williams, Lawrence

2011-01-01

This article proposes a multiliteracies-based pedagogical framework for the analysis of computer-mediated discourse (CMD) in order to give students increased access to expanded discourse options that are available in online communication environments and communities (i.e., beyond the classroom). Through the analysis of excerpts and a corpus of…

Italian Nivolumab Expanded Access Program in Nonsquamous Non-Small Cell Lung Cancer Patients: Results in Never-Smokers and EGFR-Mutant Patients.

PubMed

Garassino, Marina Chiara; Gelibter, Alain Jonathan; Grossi, Francesco; Chiari, Rita; Soto Parra, Hector; Cascinu, Stefano; Cognetti, Francesco; Turci, Daniele; Blasi, Livio; Bengala, Carmelo; Mini, Enrico; Baldini, Editta; Quadrini, Silvia; Ceresoli, Giovanni Luca; Antonelli, Paola; Vasile, Enrico; Pinto, Carmine; Fasola, Gianpiero; Galetta, Domenico; Macerelli, Marianna; Giannarelli, Diana; Lo Russo, Giuseppe; de Marinis, Filippo

2018-05-03

Nivolumab is the first checkpoint inhibitor approved for the treatment of nonsquamous NSCLC. We report results from the nivolumab Italian expanded access program focusing on never-smokers and patients with EGFR-mutant nonsqamous NSCLC. Nivolumab (3 mg/kg intravenously every 2 weeks) was administered upon physicians' request to patients who had relapsed after one or more prior systemic treatments for stage IIIB/IV nonsquamous NSCLC. Efficacy and safety were evaluated in patients who received at least one dose of nivolumab. Of 1588 patients with nonsquamous NSCLC, 305 (19.2%) were never-smokers. EGFR status was available for 1395 patients. Of the 102 patients (6.4%) with EGFR mutation-positive tumors, 51 (50%) were never-smokers. The objective response rate was significantly higher in patients with wild-type EGFR than patients with EGFR-mutant tumors (19.6% versus 8.8% [p = 0.007]), in former and current smokers than in never-smokers (21.5% versus 9.2% [p = 0.0001]), and in never-smokers with wild-type EGFR than in never-smokers with mutant EGFR (11.0% versus 1.9% [p = 0.04]). There was no significant difference in objective response rate between smokers with wild-type EGFR and smokers with mutant EGFR (22.0% versus 20.6%). There was no statistically significant difference in median progression-free survival or in median overall survival. The median overall survival times were 11 months in patients with EGFR wild-type tumors versus 8.3 months in patients with EGFR-mutant tumors, 11.6 months in smokers versus 10.0 months in never-smokers, 11.0 months in never-smokers with EGFR wild-type tumors versus 5.6 months in never-smokers with EGFR-mutant tumors, and 14.1 months in smokers with EGFR-mutant tumors versus 11.3 months in smokers with EGFR wild-type tumors. The data on the Italian expanded access program in populations with nonsquamous NSCLC suggest that subgroups of patients could benefit differently from nivolumab according to their EGFR mutational status and

Access to Higher Education in Egypt: Examining Trends by University Sector

ERIC Educational Resources Information Center

Buckner, Elizabeth

2013-01-01

Access to higher education in Egypt is expanding in both the public and private sectors. Using a nationally representative sample from the Survey of Young People in Egypt, this article is able to disaggregate patterns of access by both demographic group and university sector. Findings suggest that access in the public sector is governed strongly…

Evaluating the Impact of Expanded Practice Dental Hygienists in Oregon: An Outcomes Assessment.

PubMed

Bell, Kathryn P; Coplen, Amy E

2016-06-01

Currently the dental hygiene practice model in Oregon includes the Expanded Practice Dental Hygienist (EPDH), which allows dental hygienists with an Expanded Practice Permit (EPP) to provide care to limited access populations without the supervision of a dentist. The number and types of services provided by EPDH practitioners is thus far undocumented. The purpose of this study is to conduct an outcomes assessment of EPDH practitioners in order to quantify the impact, defined by count of services, on the access to care crisis in Oregon. A 16 question confidential survey was developed and approved by the Pacific University institutional review board. The mail-based survey was sent to 181 EPDHs in Oregon in November 2011 (all EPDHs except pilot testers and one author). A second mailing was sent to non-respondents. Data were analyzed using descriptive statistics and chi-square analysis in SPSS. The response rate was 39% (n=71). Approximately 41% (n=29) of the respondents were currently using their EPP to provide care to limited access patients with an additional 21% (n=15) planning to start their own expanded practice. The majority of practicing EPDHs provide care in residential care facilities (n=21) and in school settings (n=13). Of the current practicing EPP holders, 76% practice ≤10 hours per week, and 66% make <$10,000 per year. Total services reported in an average month from all responding EPDH practitioners were: 254 adult prophylaxes, 1,003 child prophylaxes, 106 adult fluorides, 901 child fluorides and 1,994 fluoride varnishes, among many other preventive procedures. To a limited extent, the amount and type of services provided by EPDHs has now been quantified, and EPDHs are making an impact on the access to care crisis in Oregon. Continued outcomes assessment is needed to further quantify the impact of EPDHs. Copyright © 2016 The American Dental Hygienists’ Association.

Evaluating the impact of expanded practice dental hygienists in Oregon: an outcomes assessment.

PubMed

Bell, Kathryn P; Coplen, Amy E

2015-02-01

Currently the dental hygiene practice model in Oregon includes the Expanded Practice Dental Hygienist (EPDH), which allows dental hygienists with an Expanded Practice Permit (EPP) to provide care to limited access populations without the supervision of a dentist. The number and types of services provided by EPDH practitioners is thus far undocumented. The purpose of this study is to conduct an outcomes assessment of EPDH practitioners in order to quantify the impact, defined by count of services, on the access to care crisis in Oregon. A 16 question confidential survey was developed and approved by the Pacific University institutional review board. The mail-based survey was sent to 181 EPDHs in Oregon in November 2011 (all EPDHs except pilot testers and one author). A second mailing was sent to non-respondents. Data were analyzed using descriptive statistics and chi-square analysis in SPSS. The response rate was 39% (n = 71). Approximately 41% (n = 29) of the respondents were currently using their EPP to provide care to limited access patients with an additional 21% (n = 15) planning to start their own expanded practice. The majority of practicing EPDHs provide care in residential care facilities (n = 21) and in school settings (n=13). Of the current practicing EPP holders, 76% practice ≤ 10 hours per week, and 66% make < $10,000 per year. Total services reported in an average month from all responding EPDH practitioners were: 254 adult prophylaxes, 1,003 child prophylaxes, 106 adult fluorides, 901 child fluorides and 1,994 fluoride varnishes, among many other preventive procedures. To a limited extent, the amount and type of services provided by EPDHs has now been quantified, and EPDHs are making an impact on the access to care crisis in Oregon. Continued outcomes assessment is needed to further quantify the impact of EPDHs. Copyright © 2015 The American Dental Hygienists’ Association.

Pore-expanded SBA-15 sulfonic acid silicas for biodiesel synthesis.

PubMed

Dacquin, J P; Lee, A F; Pirez, C; Wilson, K

2012-01-07

Here we present the first application of pore-expanded SBA-15 in heterogeneous catalysis. Pore expansion over the range 6-14 nm confers a striking activity enhancement towards fatty acid methyl ester (FAME) synthesis from triglycerides (TAG), and free fatty acid (FFA), attributed to improved mass transport and acid site accessibility. This journal is © The Royal Society of Chemistry 2012

Continuous diffusion signal, EAP and ODF estimation via Compressive Sensing in diffusion MRI.

PubMed

Merlet, Sylvain L; Deriche, Rachid

2013-07-01

In this paper, we exploit the ability of Compressed Sensing (CS) to recover the whole 3D Diffusion MRI (dMRI) signal from a limited number of samples while efficiently recovering important diffusion features such as the Ensemble Average Propagator (EAP) and the Orientation Distribution Function (ODF). Some attempts to use CS in estimating diffusion signals have been done recently. However, this was mainly an experimental insight of CS capabilities in dMRI and the CS theory has not been fully exploited. In this work, we also propose to study the impact of the sparsity, the incoherence and the RIP property on the reconstruction of diffusion signals. We show that an efficient use of the CS theory enables to drastically reduce the number of measurements commonly used in dMRI acquisitions. Only 20-30 measurements, optimally spread on several b-value shells, are shown to be necessary, which is less than previous attempts to recover the diffusion signal using CS. This opens an attractive perspective to measure the diffusion signals in white matter within a reduced acquisition time and shows that CS holds great promise and opens new and exciting perspectives in diffusion MRI (dMRI). Copyright © 2013 Elsevier B.V. All rights reserved.

A balloon-expandable sheath facilitates transfemoral TAVR in patients with peripheral vascular disease and tortuosity.

PubMed

Goldsweig, Andrew M; Faheem, Osman; Cleman, Michael W; Forrest, John K

2015-06-01

We sought to perform transcatheter aortic valve replacement (TAVR) via the transfemoral approach in patients with peripheral arterial disease (PAD), small caliber ileofemoral vessels and vascular tortuosity. For patients with increased surgical risk, TAVR is associated with a higher 1-year survival rate than surgical aortic valve replacement (SAVR). Transfemoral vascular access for TAVR results in superior outcomes versus procedures performed via other routes in terms of mortality, morbidity and healthcare economics. In many patients, the ability to safely perform the procedure via the transfemoral approach is limited by narrow, diseased and tortuous ileofemoral vasculature. We employed the SoloPath Balloon Expandable TransFemoral Access System (Terumo Med. Corp., Tokyo, Japan) to perform transfemoral TAVR in five patients with PAD, small caliber ileofemoral vessels and vascular tortuosity. We report our experience using this balloon-expandable sheath during 5 cases of transfemoral TAVR in patients with inhospitable ileofemoral vasculature of mean diameter ⩽ 5.8 mm. The unexpanded sheath's malleable structure and hydrophilic coating permitted deployment despite severe stenoses and tortuosity. Subsequent inflation to 18 Fr facilitated successful TAVR. Postprocedural angiography demonstrated no significant vascular access complications. In one case, the entire procedure was performed percutaneously, without common femoral artery surgical cutdown. The SoloPath sheath system permits transfemoral TAVR in patients with PAD small caliber ileofemoral vessels and vascular tortuosity. The transfemoral balloon-expandable sheath allowed these patients to avoid the increased morbidity and mortality risks associated with direct aortic or transapical access. © The Author(s), 2015.

Thoughts on Access, Differentiation, and Implementation of a Multicultural Curriculum

ERIC Educational Resources Information Center

Cavilla, Derek

2014-01-01

Identification of gifted students from diverse and underserved communities is traditionally low; however, there are ways to expand identification methods in order to make access to gifted education programs more equitable. Creation and implementation of multi-faceted and multi-dimensional assessments as well as tiered access into gifted education…

76 FR 76158 - Agency Information Collection Activities; Proposed Collection; Comment Request; RCRA Expanded...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-06

... contents of the docket, and to access those documents in the public docket that are available..., including through the use of appropriate automated electronic, mechanical, or other technological collection... as State, local, or Tribal governments. Title: RCRA Expanded Public Participation. ICR numbers: EPA...

Expanding Learning, Enriching Learning: Portraits of Five Programs. Stories from the Field

ERIC Educational Resources Information Center

Browne, Daniel; Syed, Sarosh; Mendels, Pamela

2013-01-01

These "Stories From the Field" describe five Wallace-funded programs working to expand learning and enrichment for disadvantaged children, so they can benefit from the types of opportunities their wealthier counterparts have access to, from homework help to swimming classes. The report details each program's approach, successes and…

Affordable antiretroviral drugs for the under-served markets: how to expand equitable access against the backdrop of challenging scenarios?

PubMed

Dionisio, Daniele; Cao, Yunzhen; Hongzhou, Lu; Kraisintu, Krisana; Messeri, Daniela

2006-01-01

Threats by enforced Intellectual Property (IP) rights to equitable HIV treatment access by poor populations are impending. India and China's policy directions in the field will be crucial in ultimately affecting the affordability and accessibility of antiretroviral (ARV) therapy in the under-served markets. These directions, together with the exploitation level of IP-bound flexibilities and the evolutionary modelling in partnerships and trade agreements between research-based and generic pharmaceutical industry, will also affect the outcomes of self-sufficiency efforts now at their beginning in the developing world as far as domestic manufacturing of generic ARV drugs is concerned. This paper explores key issues, implications and interaction dynamics across these challenging scenarios while attempting to provide equitable solution glimpses into the near future. Access-oriented long-term drug policy strategies entitled to pass muster of governments, research-based as well as generic industries in both developed and developing countries are needed if equitable access to affordable ARV treatments by poor people has to be achieved despite enforced IP rights. Predictable dynamics between western multinationals and transitional country generic corporations let regard IP-bound Voluntary License flexibilities as a fitting measure into just mentioned needs especially if substantial incentives to generic corporations are concurrently secured. Efforts to equitably expand ARV drug access through exploiting IP opportunities should encompass attainment of self-sufficiency in domestic drug manufacturing whenever basic requirements are in place in the developing world as a whole. A credible industrial potential would act, indeed, as a boosting factor for drawing branded drug producers into technology transfer agreements, the terms of which would let all contractors enjoy substantial advantages. These perspectives consistently bind up with the foreseeable long-term trade and drug

Access to Experimental Cancer Drugs

Cancer.gov

An experimental drug has been tested in the lab and with animals and approved for testing in people by the FDA, but can’t yet be advertised, sold, or prescribed. Experimental drugs may be available through clinical trials or expanded access programs - learn more about these programs and how to talk to your doctor.

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.

Tissue Expander Overfilling: Achieving New Dimensions of Customization in Breast Reconstruction

PubMed Central

Treiser, Matthew D.; Lahair, Tracy

2016-01-01

Introduction: Overfill of tissue expanders is a commonly used modality to achieve customized dimensions in breast reconstruction. Little formal study of the dynamics of hyperexpansion of these devices has been performed to date, however. Methods: Overfill trials were performed using both Natrelle 133 MV and Mentor 8200 tissue expanders of indicated capacities ranging from 250 to 800 mL. Each expander was initially filled to its indicated capacity with normal water and then injected in regular increments to 400% overfill. Measurements of each expander’s width, height, and projection were made at indicated capacity and with each successive incremental overfill injection, and these results were then recorded, collated, and analyzed. Results: Over the first 50% overfill, all expanders demonstrated a logarithmic increase in projection (mean increase, 143 ± 9%) while maintaining essentially stable base dimensions. Overfill levels in excess of 50% were accompanied by linear increases in height, width, and projection, during which projection approached, but never equaled, base dimensions. Stress versus strain analyses demonstrated nonlinear biomechanical dynamics during the first 50% overfill, followed by standard elastic dynamics up to 400% overfill. At no point during the study, did expander tensions outstrip elastic properties, thereby explaining the lack of device rupture. Conclusions: Through overfilling, tunable geometries of tissue expanders can be accessed that may provide for increasing customization of reconstructions, particularly at overfill volumes up to 50% over indicated capacity. This study should serve to guide tissue expander selection and fill volumes that surgeons may implement in obtaining ideal reconstructed breast shapes. PMID:27014541

A Universal Good: Expanding Voluntary, Early Learning Opportunities for Illinois' Young Children.

ERIC Educational Resources Information Center

Noble, Sean

This report was written to stimulate discussion about the potential and need for expanding access to voluntary, high-quality early childhood care and education programs in Illinois. The report compiles 13 short articles pertaining to early learning as follows: (1) "Ready to Succeed: Preparing Children for School, and for Life"; (2)…

Expanded Learning Time and Opportunities: Key Principles, Driving Perspectives, and Major Challenges

ERIC Educational Resources Information Center

Blyth, Dale A.; LaCroix-Dalluhn, Laura

2011-01-01

If expanded learning is going to make a real difference, then three key principles must inform how communities overcome challenges and assure equitable access to learning opportunities. Much of today's debate is framed in the language of formal education systems--students, classrooms, schools--even though part of the expansion seeks to engage a…

Enhancing Access to Information: Designing Catalogs for the 21st Century.

ERIC Educational Resources Information Center

Tyckoson, David A., Ed.

This book addresses the problem of when a library has limited catalog access, and explores various technological methods to expand the catalog beyond its traditional boundaries. Fourteen chapters describe catalog projects in individual libraries: (1) "Enhancing Access to Information: Building Catalogs for the Future" (David A. Tyckoson);…

Utilizing Remote Real-Time Videoconferencing to Expand Access to Cancer Genetic Services in Community Practices: A Multicenter Feasibility Study.

PubMed

Bradbury, Angela; Patrick-Miller, Linda; Harris, Diana; Stevens, Evelyn; Egleston, Brian; Smith, Kyle; Mueller, Rebecca; Brandt, Amanda; Stopfer, Jill; Rauch, Shea; Forman, Andrea; Kim, Rebecca; Fetzer, Dominique; Fleisher, Linda; Daly, Mary; Domchek, Susan

2016-02-01

Videoconferencing has been used to expand medical services to low-access populations and could increase access to genetic services at community sites where in-person visits with genetic providers are not available. To evaluate the feasibility of, patient feedback of, and cognitive and affective responses to remote two-way videoconferencing (RVC) telegenetic services at multiple sociodemographically diverse community practices without access to genetic providers. Patients at 3 community sites in 2 US states outside the host center completed RVC pretest (visit 1, V1) and post-test (visit 2, V2) genetic counseling for cancer susceptibility. Surveys evaluated patient experiences, knowledge, satisfaction with telegenetic and cancer genetics services, anxiety, depression, and cancer worry. A total of 82 out of 100 (82.0%) approached patients consented to RVC services. A total of 61 out of 82 patients (74%) completed pretest counseling and 41 out of 61 (67%) proceeded with testing and post-test counseling. A total of 4 out of 41 (10%) mutation carriers were identified: BRCA2, MSH2, and PMS2. Patients reported many advantages (eg, lower travel burden and convenience) and few disadvantages to RVC telegenetic services. Most patients reported feeling comfortable with the video camera--post-V1: 52/57 (91%); post-V2: 39/41 (95%)--and that their privacy was respected--post-V1: 56/57 (98%); post-V2: 40/41 (98%); however, some reported concerns that RVC might increase the risk of a confidentiality breach of their health information--post-V1: 14/57 (25%); post-V2: 12/41 (29%). While the majority of patients reported having no trouble seeing or hearing the genetic counselor--post-V1: 47/57 (82%); post-V2: 39/41 (95%)--51 out of 98 (52%) patients reported technical difficulties. Nonetheless, all patients reported being satisfied with genetic services. Compared to baseline, knowledge increased significantly after pretest counseling (+1.11 mean score, P=.005); satisfaction with

The Ins and Outs of Access Control.

ERIC Educational Resources Information Center

Longworth, David

1999-01-01

Presents basic considerations when school districts plan to acquire an access-control system for their education facilities. Topics cover cards and readers, controllers, software, automation, card technology, expandability, price, specification of needs beyond the canned specifications already supplied, and proper usage training to cardholders.…

ExpandED Schools National Demonstration: Lessons for Scale and Sustainability

ERIC Educational Resources Information Center

Russell, Christina A.; Hildreth, Jeanine L.; Stevens, Pamela

2016-01-01

The ExpandED Schools model for expanded learning is designed to transform schools by changing the use of time, both as experienced by students in learning and by teachers in instruction. The model is grounded in the belief that strategically adding time to the school day can enhance skills and knowledge and broaden horizons by engaging students in…

Expanding federal funding to community health centers slows decline in access for low-income adults.

PubMed

McMorrow, Stacey; Zuckerman, Stephen

2014-06-01

To identify the impact of the Health Center Growth Initiative on access to care for low-income adults. Data on federal funding for health centers are from the Bureau of Primary Health Care's Uniform Data System (2000-2007), and individual-level measures of access and use are derived from the National Health Interview Survey (2001-2008). We estimate person-level models of access and use as a function of individual- and market-level characteristics. By using market-level fixed effects, we identify the effects of health center funding on access using changes within markets over time. We explore effects on low-income adults and further examine how those effects vary by insurance coverage. We calculate health center funding per poor person in a health care market and attach this information to individual observations on the National Health Interview Survey. Health care markets are defined as hospital referral regions. Low-income adults in markets with larger funding increases were more likely to have an office visit and to have a general doctor visit. These results were stronger for uninsured and publicly insured adults. Expansions in federal health center funding had some mitigating effects on the access declines that were generally experienced by low-income adults over this time period. © Health Research and Educational Trust.

Expanded Endonasal Endoscopic Approach for Resection of an Infrasellar Craniopharyngioma.

PubMed

Abou-Al-Shaar, Hussam; Blitz, Ari M; Rodriguez, Fausto J; Ishii, Masaru; Gallia, Gary L

2016-11-01

Craniopharyngiomas are uncommon benign locally aggressive epithelial tumors mostly located in the sellar and suprasellar regions. An infrasellar origin of these tumors is rare. The authors report a 22-year-old male patient with a purely infrasellar adamantinomatous craniopharyngioma centered in the nasopharynx with extension into the posterior nasal septum, sphenoid sinus, and clivus. Gross total resection was achieved using an expanded endonasal endoscopic transethmoidal, transsphenoidal, transpterygoid, and transclival approach. Follow-up at one year demonstrated no evidence of disease recurrence. Infrasellar craniopharyngioma should be included in the differential diagnosis of sinonasal masses even in the absence of sellar extension. Expanded endonasal endoscopic approaches provide excellent access to and visualization of such lesions and may obviate the need for postoperative radiotherapy when gross total resection is achieved. Copyright © 2016 Elsevier Inc. All rights reserved.

Individual and neighborhood-level factors associated with non-prescription counseling in pharmacies participating in the New York State Expanded Syringe Access Program (ESAP)

PubMed Central

Rivera, Alexis V; Blaney, Shannon; Crawford, Natalie D; White, Kellee; Stern, Rachel J; Amesty, Silvia; Fuller, Crystal

2013-01-01

Objective To determine the individual- and neighborhood-level predictors of frequent non-prescription in-pharmacy counseling. Design Cross-sectional survey Setting 130 pharmacies registered in the Expanded Syringe Access Program (ESAP) in New York City. Participants 477 pharmacists, non-pharmacist owner/managers, and technicians/clerks. Main outcome measures Frequent counseling on medical conditions, health insurance, and other products. Results Technicians were less likely than pharmacists to provide frequent counseling on medical conditions or health insurance. In terms of neighborhood-level characteristics, pharmacies in areas of high employment disability were less likely to provide frequent health insurance counseling and pharmacies in areas with higher deprivation were more likely to provide counseling on other products. Conclusion ESAP pharmacy staff is a frequent source of non-prescription counseling for their patients/customers in disadvantaged neighborhoods of NYC. These findings suggest that ESAP pharmacy staff may be amenable to providing relevant counseling services to injection drug using syringe customers and warrants further investigation. PMID:20833615

Blood expression profiles of fragile X premutation carriers identify candidate genes involved in neurodegenerative and infertility phenotypes.

PubMed

Mateu-Huertas, Elisabet; Rodriguez-Revenga, Laia; Alvarez-Mora, Maria Isabel; Madrigal, Irene; Willemsen, Rob; Milà, Montserrat; Martí, Eulàlia; Estivill, Xavier

2014-05-01

Male premutation carriers presenting between 55 and 200 CGG repeats in the Fragile-X-associated (FMR1) gene are at risk of developing Fragile X Tremor/Ataxia Syndrome (FXTAS), and females undergo Premature Ovarian Failure (POF1). Here, we have evaluated gene expression profiles from blood in male FMR1 premutation carriers and detected a strong deregulation of genes enriched in FXTAS relevant biological pathways, including inflammation, neuronal homeostasis and viability. Gene expression profiling distinguished between control individuals, carriers with FXTAS and carriers without FXTAS, with levels of expanded FMR1 mRNA being increased in FXTAS patients. In vitro studies in a neuronal cell model indicate that expression levels of expanded FMR1 5'-UTR are relevant in modulating the transcriptome. Thus, perturbations of the transcriptome may be an interplay between the CGG expansion size and FMR1 expression levels. Several deregulated genes (DFFA, BCL2L11, BCL2L1, APP, SOD1, RNF10, HDAC5, KCNC3, ATXN7, ATXN3 and EAP1) were validated in brain samples of a FXTAS mouse model. Downregulation of EAP1, a gene involved in the female reproductive system physiology, was confirmed in female carriers. Decreased levels were detected in female carriers with POF1 compared to those without POF1, suggesting that EAP1 levels contribute to ovarian insufficiency. In summary, gene expression profiling in blood has uncovered mechanisms that may underlie different pathological aspects of the premutation. A better understanding of the transcriptome dynamics in relation with expanded FMR1 mRNA expression levels and CGG expansion size may provide mechanistic insights into the disease process and a more accurate FXTAS diagnosis to the myriad of phenotypes associated with the premutation. Copyright © 2014. Published by Elsevier Inc.

Expandable stents.

PubMed

Nesbitt, J C; Carrasco, H

1996-05-01

Expandable metallic stents are effective in selected patients with malignant or benign airway stenoses. When used for malignant lesions, the primary purpose of the stent is to improve the quality of life; stents are usually chosen for palliation of symptoms in recognition of the low likelihood of success for other therapy. For patients with benign stenoses, the stents provide a permanent source of structural support to alleviate the narrowed segment. The advantages of the expandable metallic stents are as follows: (1) they can be inserted through an endotracheal tube or under local anesthesia with relative simplicity under fluoroscopic guidance; (2) they do not impair the drainage of sputum because ciliary movement is not interrupted; (3) over a period of a few weeks, the meshwork is gradually covered with mucosa as the stent becomes incorporated into the airway wall; (4) ventilation usually is not impaired if the metallic mesh stent covers another nonstenosed bronchus, because the interstices of the stent are nonobstructive; and (5) they are dynamic and continue to expand over time, particularly if concurrent treatment achieves an effect on the lesion that caused stenosis. Disadvantages of the expandable stent include (1) they often are only temporarily effective for tracheobronchial stenosis due to intraluminal tumor or granulation tissue, both of which can grow between the wires; (2) they are considered permanent stents because removal is difficult; and (3) they can be poorly positioned during placement or can become displaced by progressive migration after placement, and they cannot be repositioned. A relative contraindication to insertion is an inflammatory process or infection that can predispose to granulation formation, particularly at the points of maximal contact pressure of the stent to the airway mucosa. In the presence of inflammation, it may be better to use a silicone prosthesis until the inflammatory process subsides and fibrosis occurs. Granulation

Expanding Federal Funding to Community Health Centers Slows Decline in Access for Low-Income Adults

PubMed Central

McMorrow, Stacey; Zuckerman, Stephen

2014-01-01

Objective To identify the impact of the Health Center Growth Initiative on access to care for low-income adults. Data Sources Data on federal funding for health centers are from the Bureau of Primary Health Care's Uniform Data System (2000–2007), and individual-level measures of access and use are derived from the National Health Interview Survey (2001–2008). Study Design We estimate person-level models of access and use as a function of individual- and market-level characteristics. By using market-level fixed effects, we identify the effects of health center funding on access using changes within markets over time. We explore effects on low-income adults and further examine how those effects vary by insurance coverage. Data Collection We calculate health center funding per poor person in a health care market and attach this information to individual observations on the National Health Interview Survey. Health care markets are defined as hospital referral regions. Principal Findings Low-income adults in markets with larger funding increases were more likely to have an office visit and to have a general doctor visit. These results were stronger for uninsured and publicly insured adults. Conclusions Expansions in federal health center funding had some mitigating effects on the access declines that were generally experienced by low-income adults over this time period. PMID:24344818

Congress Expands Access to Postsecondary Education and Training for Low-Income Adults

ERIC Educational Resources Information Center

Duke, Amy-Ellen; Strawn, Julie

2007-01-01

On September 7, 2007, Congress enacted H.R. 2669, the College Cost Reduction and Access Act, which will raise the maximum Pell Grant to $5,400 over five years and halve interest rates on subsidized student loans. The act is part of the budget reconciliation process, which secured billions of dollars for increasing Pell Grants and for reducing…

Expanding College Access for Urban Youth: What Schools and Colleges Can Do

ERIC Educational Resources Information Center

Howard, Tyrone C., Ed.; Tunstall, Jonli, Ed.; Flennaugh, Terry K., Ed.

2016-01-01

This timely book demonstrates why there needs to be a more thoughtful and collaborative effort on the part of K-12 schools, as well as institutions of higher education, to provide better college access to students from low-income communities. Building on a 10-year case study of a successful school-university partnership, the authors examine the…

MoodHacker Mobile Web App With Email for Adults to Self-Manage Mild-to-Moderate Depression: Randomized Controlled Trial.

PubMed

Birney, Amelia J; Gunn, Rebecca; Russell, Jeremy K; Ary, Dennis V

2016-01-26

-up calls to subjects reporting current suicidal ideation and/or severe depression symptoms. At 6-week follow-up, significant effects were found on depression, behavioral activation, negative thoughts, knowledge, work productivity, work absence, and workplace distress. MoodHacker yielded significant effects on depression symptoms, work productivity, work absence, and workplace distress for those who reported access to an EAP, but no significant effects on these outcome measures for those without EAP access. Participants in the treatment arm used the MoodHacker app an average of 16.0 times (SD 13.3), totaling an average of 1.3 hours (SD 1.3) of use between pretest and 6-week follow-up. Significant effects on work absence in those with EAP access persisted at 10-week follow-up. This randomized effectiveness trial found that the MoodHacker app produced significant effects on depression symptoms (partial eta(2) = .021) among employed adults at 6-week follow-up when compared to subjects with access to relevant depression Internet sites. The app had stronger effects for individuals with access to an EAP (partial eta(2) = .093). For all users, the MoodHacker program also yielded greater improvement on work absence, as well as the mediating factors of behavioral activation, negative thoughts, and knowledge of depression self-care. Significant effects were maintained at 10-week follow-up for work absence. General attenuation of effects at 10-week follow-up underscores the importance of extending program contacts to maintain user engagement. This study suggests that light-touch, CBT-based mobile interventions like MoodHacker may be appropriate for implementation within EAPs and similar environments. In addition, it seems likely that supporting MoodHacker users with guidance from counselors may improve effectiveness for those who seek in-person support. ClinicalTrials.gov NCT02335554; https://clinicaltrials.gov/ct2/show/NCT02335554 (Archived by WebCite at http://www.webcitation.org/6dGXKWjWE).

MoodHacker Mobile Web App With Email for Adults to Self-Manage Mild-to-Moderate Depression: Randomized Controlled Trial

PubMed Central

Gunn, Rebecca; Russell, Jeremy K; Ary, Dennis V

2016-01-01

exception of safety-related follow-up calls to subjects reporting current suicidal ideation and/or severe depression symptoms. Results At 6-week follow-up, significant effects were found on depression, behavioral activation, negative thoughts, knowledge, work productivity, work absence, and workplace distress. MoodHacker yielded significant effects on depression symptoms, work productivity, work absence, and workplace distress for those who reported access to an EAP, but no significant effects on these outcome measures for those without EAP access. Participants in the treatment arm used the MoodHacker app an average of 16.0 times (SD 13.3), totaling an average of 1.3 hours (SD 1.3) of use between pretest and 6-week follow-up. Significant effects on work absence in those with EAP access persisted at 10-week follow-up. Conclusions This randomized effectiveness trial found that the MoodHacker app produced significant effects on depression symptoms (partial eta2 = .021) among employed adults at 6-week follow-up when compared to subjects with access to relevant depression Internet sites. The app had stronger effects for individuals with access to an EAP (partial eta2 = .093). For all users, the MoodHacker program also yielded greater improvement on work absence, as well as the mediating factors of behavioral activation, negative thoughts, and knowledge of depression self-care. Significant effects were maintained at 10-week follow-up for work absence. General attenuation of effects at 10-week follow-up underscores the importance of extending program contacts to maintain user engagement. This study suggests that light-touch, CBT-based mobile interventions like MoodHacker may be appropriate for implementation within EAPs and similar environments. In addition, it seems likely that supporting MoodHacker users with guidance from counselors may improve effectiveness for those who seek in-person support. Trial Registration ClinicalTrials.gov NCT02335554; https://clinicaltrials.gov/ct2

What Expands in an Expanding Universe?

PubMed

Pacheco, José A De Freitas

2015-01-01

In the present investigation, the possible effects of the expansion of the Universe on systems bonded either by gravitational or electromagnetic forces, are reconsidered. It will be shown that the acceleration (positive or negative) of the expanding background, is the determinant factor affecting planetary orbits and atomic sizes. In the presently accepted cosmology (ΛCDM) all bonded systems are expanding at a decreasing rate that tends to be zero as the universe enters in a de Sitter phase. It is worth mentioning that the estimated expansion rates are rather small and they can be neglected for all practical purposes.

Does Access Equal Retention? The Experiences of Long-Term English Learners in Higher Education

ERIC Educational Resources Information Center

Wonder, Kelly

2011-01-01

Through this longitudinal, phenomenological study, I examined the experiences of (H)Mong Long Term English Learners (LTEL) conditionally admitted to Midwest State University through the English for Academic Success Program (EAP). Over the course of six years, I interviewed participants regarding their academic and social experiences during…

Expandable space frames

NASA Technical Reports Server (NTRS)

Schoen, A. H. (Inventor)

1973-01-01

Expandable space frames having essentially infinite periodicity limited only by practical considerations, are described. Each expandable space frame comprises a plurality of hinge joint assemblies having arms that extend outwardly in predetermined symmetrically related directions from a central or vertex point. The outer ends of the arms form one part of a hinge point. The outer expandable space frame also comprises a plurality of struts. The outer ends of the struts from the other part of the hinged joint. The struts interconnect the plurality of hinge point in sychronism, the spaceframes can be expanded or collapsed. Three-dimensional as well as two-dimensional spaceframes of this general nature are described.

Gaining Access or Losing Ground? Socioeconomically Disadvantaged Students in Undergraduate Engineering, 1994-2003

ERIC Educational Resources Information Center

Lundy-Wagner, Valerie C.; Veenstra, Cindy P.; Orr, Marisa K.; Ramirez, Nichole M.; Ohland, Matthew W.; Long, Russell A.

2014-01-01

Expanding access to engineering for underrepresented groups has by and large focused on ethnicity/race and gender, with little understanding of socioeconomic disadvantages. In this study, we use economic, human, and cultural capital theories to frame and then describe access to undergraduate engineering degree programs and bachelor's degrees.…

Improving Access to Hospice Care: Informing the Debate

PubMed Central

CARLSON, MELISSA D.A.; MORRISON, R. SEAN; BRADLEY, ELIZABETH H.

2015-01-01

The most frequently cited policy solution for improving access to hospice care for patients and families is to expand hospice eligibility criteria under the Medicare Hospice Benefit. However, the substantial implications of such a policy change have not been fully articulated or evaluated. This paper seeks to identify and describe the implications of expanding Medicare Hospice Benefit eligibility on the nature of hospice care, the cost of hospice care to the Medicare program, and the very structure of hospice and palliative care delivery in the United States. The growth in hospice has been dramatic and the central issue facing policymakers and the hospice industry is defining the appropriate target population for hospice care. As policymakers and the hospice industry discuss the future of hospice and potential changes to the Medicare Hospice Benefit, it is critical to clearly delineate the options—and the implications and challenges of each option—for improving access to hospice care for patients and families. PMID:18363486

Community Conversations: An Approach for Expanding and Connecting Opportunities for Employment for Adolescents with Disabilities

ERIC Educational Resources Information Center

Trainor, Audrey A.; Carter, Erik W.; Swedeen, Beth; Pickett, Kelly

2012-01-01

Although early work experiences can impart a number of benefits to adolescents with disabilities, few students have meaningful access to these opportunities. The authors examined "community conversations" to build capacity and interest in expanding employment opportunities. Events were held in seven different communities and used the…

Long-term implications of observing an expanding cosmological civilization

NASA Astrophysics Data System (ADS)

Olson, S. Jay

2018-01-01

Suppose that advanced civilizations, separated by a cosmological distance and time, wish to maximize their access to cosmic resources by rapidly expanding into the universe. How does the presence of one limit the expansionistic ambitions of another, and what sort of boundary forms between their expanding domains? We describe a general scenario for any expansion speed, separation distance and time. We then specialize to a question of particular interest: What are the future prospects for a young and ambitious civilization if they can observe the presence of another at a cosmological distance? We treat cases involving the observation of one or two expanding domains. In the single-observation case, we find that almost any plausible detection will limit one's future cosmic expansion to some extent. Also, practical technological limits to expansion speed (well below the speed of light) play an interesting role. If a domain is visible at the time one embarks on cosmic expansion, higher practical limits to expansion speed are beneficial only up to a certain point. Beyond this point, a higher speed limit means that gains in the ability to expand are more than offset by the first-mover advantage of the observed domain. In the case of two visible domains, it is possible to be `trapped' by them if the practical speed limit is high enough and their angular separation in the sky is large enough, i.e. one's expansion in any direction will terminate at a boundary with the two visible civilizations. Detection at an extreme cosmological distance has surprisingly little mitigating effect on our conclusions.

Ad Hoc Access Gateway Selection Algorithm

NASA Astrophysics Data System (ADS)

Jie, Liu

With the continuous development of mobile communication technology, Ad Hoc access network has become a hot research, Ad Hoc access network nodes can be used to expand capacity of multi-hop communication range of mobile communication system, even business adjacent to the community, improve edge data rates. For mobile nodes in Ad Hoc network to internet, internet communications in the peer nodes must be achieved through the gateway. Therefore, the key Ad Hoc Access Networks will focus on the discovery gateway, as well as gateway selection in the case of multi-gateway and handover problems between different gateways. This paper considers the mobile node and the gateway, based on the average number of hops from an average access time and the stability of routes, improved gateway selection algorithm were proposed. An improved gateway selection algorithm, which mainly considers the algorithm can improve the access time of Ad Hoc nodes and the continuity of communication between the gateways, were proposed. This can improve the quality of communication across the network.

Expanding Access to Injectable Contraception: Results From Pilot Introduction of Subcutaneous Depot Medroxyprogesterone Acetate (DMPA-SC) in 4 African Countries

PubMed Central

Stout, Anna; Wood, Siri; Barigye, George; Kaboré, Alain; Siddo, Daouda; Ndione, Ida

2018-01-01

PATH partnered with the United Nations Population Fund (UNFPA) and country ministries of health (MOHs) to coordinate pilot introductions of subcutaneous depot medroxyprogesterone acetate (subcutaneous DMPA or DMPA-SC, brand name Sayana Press) in Burkina Faso, Niger, Senegal, and Uganda from July 2014 through June 2016 in order to expand the range of methods available to women, particularly in remote locations. The pilot introductions aimed to answer key questions that would inform decisions about future investments in DMPA-SC and scaling up product availability and service-delivery innovations nationally. These questions included the extent to which DMPA-SC would appeal to first-time users of modern contraception, as well as adolescent girls and young women; whether DMPA-SC would add value to family planning programs or simply replace DMPA-IM or other modern methods; and the trends in injectables use when introducing DMPA-SC (or any injectable) at the community level for the first time. We implemented a multicountry monitoring system to track key indicators, including the number of doses administered by category of user (e.g., new users, by client age group) or delivery channel. Providers generally collected these data using their national programs' standard family planning registers. Data were analyzed for cumulative information and to examine trends over time using Microsoft Power Query for Excel and Tableau. Across the 4 countries, nearly half a million DMPA-SC doses were administered and approximately 135,000 first-time users of modern contraception were reached. Furthermore, 44% of the doses administered in 3 of the countries with data were to adolescent girls and young women under age 25. Switching from DMPA-IM to DMPA-SC was not widespread, ranging from 7% in Burkina Faso to 16% in Uganda. Results from these pilot introductions demonstrate that DMPA-SC has the potential to expand community-level access to injectables, maximize task-sharing strategies, and

Expanding Access to Early Head Start: State Initiatives for Infants & Toddlers at Risk

ERIC Educational Resources Information Center

Colvard, Jamie; Schmit, Stephanie

2012-01-01

The federal Early Head Start (EHS) program was created in 1994 to address the comprehensive needs of children under age 3 in low-income families and vulnerable low-income pregnant women. In addition to early learning opportunities, EHS's comprehensive early childhood development programs provide children and families with access to a range of…

A Baccalaureate Education Curriculum to Prepare Dental Hygienists for Expanded Public Health Practice.

PubMed

Rowley, Lisa J; Stein, Susan M

2016-06-01

A baccalaureate dental hygiene education program was intentionally designed and implemented to prepare dental hygienists to work in expanded public health practice. Expanded practice dental hygienists (EPDH) in Oregon practice without the supervision of a dentist to provide dental hygiene services for underserved patients with limited access to dental care. Ten competencies were identified for the successful EPDH, and then these competencies were incorporated into the curriculum of a baccalaureate dental hygiene program. When recent graduates of the innovative program were surveyed, results indicated that they felt well prepared for expanded practice, they had a high level of interest in working as an EPDH, and all were planning to apply for an expanded practice permit. Two graduates and their unique contributions to individuals in need are profiled. Intentional preparation of dental hygienists for expanded public health roles suggested the need for a baccalaureate curriculum designed specifically for that purpose. Advocacy and collaboration among educators, legislators, and administrators in Oregon led to the development and implementation of such an innovative dental hygiene education program at Pacific University. Graduates are likely to pursue opportunities working as EPDHs. Further research will document the viability of this purposefully designed curriculum to prepare dental hygienists to help meet the public need for optimal oral health. Copyright © 2016 Elsevier Inc. All rights reserved.

Functionalized expanded porphyrins

DOEpatents

Sessler, Jonathan L; Pantos, Patricia J

2013-11-12

Disclosed are functionalized expanded porphyrins that can be used as spectrometric sensors for high-valent actinide cations. The disclosed functionalized expanded porphyrins have the advantage over unfunctionalized systems in that they can be immobilized via covalent attachment to a solid support comprising an inorganic or organic polymer or other common substrates. Substrates comprising the disclosed functionalized expanded porphyrins are also disclosed. Further, disclosed are methods of making the disclosed compounds (immobilized and free), methods of using them as sensors to detect high valent actinides, devices that comprise the disclosed compounds, and kits.

Research of Ad Hoc Networks Access Algorithm

NASA Astrophysics Data System (ADS)

Xiang, Ma

With the continuous development of mobile communication technology, Ad Hoc access network has become a hot research, Ad Hoc access network nodes can be used to expand capacity of multi-hop communication range of mobile communication system, even business adjacent to the community, improve edge data rates. When the ad hoc network is the access network of the internet, the gateway discovery protocol is very important to choose the most appropriate gateway to guarantee the connectivity between ad hoc network and IP based fixed networks. The paper proposes a QoS gateway discovery protocol which uses the time delay and stable route to the gateway selection conditions. And according to the gateway discovery protocol, it also proposes a fast handover scheme which can decrease the handover time and improve the handover efficiency.

Pharmacy clients' attitudes to expanded pharmacist prescribing and the role of agency theory on involved stakeholders.

PubMed

Hoti, Kreshnik; Hughes, Jeffery; Sunderland, Bruce

2011-02-01

To examine the views of regular pharmacy clients on pharmacist prescribing and employ agency theory in considering the relationship between the stakeholders involved. Computer assisted telephone interviews were conducted with 400 pharmacy clients recruited around Australia. Potential respondents were identified using a random number generation function in Microsoft Excel. Data were analysed with SPSS version 17 using one-way analysis of variance, principal component analysis and linear regression. The relationships between the main stakeholders involved were explored using agency theory. A total of 1153 answered calls recruited 400 consenting pharmacy clients. Most respondents (71%) trusted pharmacists adopting an expanded role in prescribing, however the majority (66%) supported this only after a diagnosis had been made by a doctor. Those who accepted pharmacist diagnosing and prescribing preferred that this was limited to pain management and antibiotics. Most respondents (64%) considered that expanded pharmacist prescribing would improve their access to prescription medicines, although those over 65 years of age were less supportive than younger respondents. Factors which contributed positively to clients' perception of trust in an expanded prescribing role for pharmacists were identified, and improved access to medicines was found to be the strongest predictor (P < 0.0001). Most pharmacy clients trusted pharmacists adopting an expanded prescribing role, but preferred that this was limited to doctors performing the initial diagnosis. Agency theory would conceptualize the introduction of pharmacist prescribers, as disrupting the principal (patient) agent (doctor) relationship. Its introduction would best be facilitated by careful change management. © 2011 The Authors. IJPP © 2011 Royal Pharmaceutical Society.

Building the Case: Changing Consumer Perceptions of the Value of Expanded Community Pharmacist Services.

PubMed

Steckowych, Kathryn; Smith, Marie; Spiggle, Susan; Stevens, Andrew; Li, Hao

2018-01-01

The role of the community pharmacist has traditionally been a medication dispenser; however, community pharmacists' responsibilities must expand to include more direct patient care services in order to transform primary care practice. Use case-based scenarios to (1) determine factors that contribute to positive and negative consumer perceptions of expanded community pharmacist patient care roles, (2) identify facilitators and barriers that contribute to consumer perceptions of the value of expanded community pharmacist patient care services, and (3) develop a successful approach and strategies for increasing consumer advocacy for the value of expanded community pharmacist patient care services. Two consumer focus groups used scenario-based guided discussions and Likert scale questionnaires to elicit consumer reactions, facilitators, and barriers to expanded community pharmacist services. Convenience, timeliness, and accessibility were common positive reactions across all 3 scenarios. Team approach to care and trust were viewed as major facilitators. Participant concerns included uncertainty about pharmacist training and qualifications, privacy, pharmacists' limited bandwidth to accept new tasks, and potential increased patient costs. Common barriers to service uptake included a lack of insurance payment and physician preference to provide the services. Consumer unfamiliarity with non-traditional community pharmacist services is likely an influencer of consumers' hesitancy to utilize such services; therefore, an opportunity exists to engage consumers and advocacy organizations in supporting expanded community pharmacist roles. This study can inform consumers, advocates, community pharmacists, primary care providers, and community-based organizations on methods to shape consumer perceptions on the value of community pharmacist expanded services.

Time to Grow: Year Two Report on ExpandED Schools. A TASC Report

ERIC Educational Resources Information Center

Traill, Saskia; Brohawn, Katie

2014-01-01

An analysis of data from the second year of The After-School Corporation's (TASC's) national demonstration of an expanded school day for elementary and middle school students shows that ExpandED Schools improved school culture, decreased rates of students' chronic absenteeism and helped students develop positive learning habits and attitudes.…

Financial Aid: A Broken Bridge to College Access?

ERIC Educational Resources Information Center

Long, Bridget Terry; Riley, Erin

2007-01-01

In this article, Bridget Terry Long and Erin Riley argue that in recent years, U.S. financial aid policy has shifted its emphasis from expanding college access for low-income students toward defraying the costs for middle- and upper-income families. They explain how loans, merit-based aid, and education tax breaks are increasingly replacing…

The "Magic" of Wireless Access in the Library

ERIC Educational Resources Information Center

Balas, Janet L.

2006-01-01

It seems that the demand for public access computers grows exponentially every time a library network is expanded, making it impossible to ever have enough computers available for patrons. One solution that many libraries are implementing to ease the demand for public computer use is to offer wireless technology that allows patrons to bring in…

Reasons to temper enthusiasm about open access nursing journals.

PubMed

de Jong, Gideon

2017-04-01

Open access is a relatively new phenomenon within nursing science. Several papers from various nursing journals have been published recently on the disadvantages of the traditional model of purchasing proprietary fee-based databases to access scholarly information. Just few nursing scholars are less optimistic about the possible benefits of open access nursing journals. A critical reflection on the merits and pitfalls of open access journals along insights from the literature and personal opinion. Two arguments are discussed, providing justification for tempering enthusiasm about open access journals. First, only research groups with sufficient financial resources can publish in open access journals. Second, open access has conflicting incentives, where the aim is to expand production at the expense of publishing quality articles; a business model that fits well into a neoliberal discourse. There are valid reasons to criticise the traditional publishers for the excessive costs of a single article, therefore preventing the dissemination of scholarly nursing information. On the contrary, the business model of open access publishers is no less imbued with the neoliberal tendency of lining the pockets.

After Access: Divergent Learning Profiles in Vietnam and India

ERIC Educational Resources Information Center

Rolleston, Caine; James, Zoe

2015-01-01

In recent decades, both India and Vietnam have successfully expanded access to schooling to near-universal levels and have shifted their focus to quality-oriented policy reform. Yet, international and national evidence shows strongly contrasting learning profiles for children within the two systems. Simple indicators of numeracy suggest similar…

An evaluation of substance misuse treatment providers used by an employee assistance program.

PubMed

Miller, N A

1992-05-01

Structural measures of access, continuity, and quality of substance misuse treatment services were compared in 30 fee-for-service (FFS) facilities and nine health maintenance organizations (HMOs). Probit models related effects of the provider system (FFS or HMO) and the system's structural characteristics to 243 employees' access to and outcomes from treatment. Access was decreased in Independent Practice Association (IPA)/network HMOs and in all facilities which did not employ an addictionologist or provide coordinated treatment services. When bivariate correlations were examined, both use of copayments and imposing limits to the levels of treatment covered were negatively related to access, while a facility's provision of ongoing professional development was positively associated with access. These correlations did not remain significant in the multivariate probits. Receiving treatment in a staff model HMO and facing limits to the levels of treatment covered were negatively associated with attaining sufficient progress, while receiving treatment in a facility which provided ongoing professional development was positively related to progress: these effects did not remain significant in multivariate analyses. Implications for employee assistance program (EAP) staff in their role as case managers and for EAP staff and employers in their shared role as purchasers of treatment are discussed.

On-line atomic data access

NASA Astrophysics Data System (ADS)

Schultz, David R.; Nash, Jeffrey K.

1996-07-01

The need for atomic data is one which continues to expand in a wide variety of applications including fusion energy, astrophysics, laser-produced plasma research, and plasma processing. Modern computer database and communications technology enables this data to be placed on-line and obtained by users over the INTERNET. Presented here is a summary of the observations and conclusions regarding such on-line atomic data access derived from a forum held at the Tenth APS Topical Conference on Atomic Processes in Plasmas.

Beyond the Yellow Bus: Promising Practices for Maximizing Access to Opportunity through Innovations in Student Transportation

ERIC Educational Resources Information Center

Vincent, Jeffrey M.; Makarewicz, Carrie; Miller, Ruth; Ehrman, Julia; McKoy, Deborah L.

2014-01-01

Access to safe, affordable, and convenient transportation shapes the 'geography of opportunity' for many children and youth. This study looks at how ?localities acrossthe country are implementing new and innovative alternative approaches to student transportation that expand regionaltransportation access for K-12 students, improve…

Library Media Centers: Accessibility Issues in Rural Missouri

ERIC Educational Resources Information Center

Cox, John E.; Lynch, Debra M.

2006-01-01

Based on a study by Cox (2004), this article deals with the needs of students with visual, hearing, and orthopedic impairments in terms of full access to school library media centers. Fictitious vignettes of student concerns as well as possible answers and thought-provoking questions expand Cox's rural Missouri-based study to a much wider audience…

The Future of Accessibility in International Higher Education

ERIC Educational Resources Information Center

Alphin, Henry C., Jr., Ed.; Chan, Roy Y., Ed.; Lavine, Jennie, Ed.

2017-01-01

Education is the foundation to almost all successful lives, and it is important that a high level of schooling be available on a global scale. Studying the trends in accessibility in education will allow educators to improve their own teaching techniques, as well as expand their influence to more remote areas in the world. "The Future of…

Expanding access to naloxone for family members: The Massachusetts experience.

PubMed

Bagley, Sarah M; Forman, Leah S; Ruiz, Sarah; Cranston, Kevin; Walley, Alexander Y

2018-05-01

The Massachusetts Department of Public Health Overdose Education and Naloxone Distribution Program provides overdose education and naloxone rescue kits to people at risk for overdose and bystanders, including family members. Using Massachusetts Department of Public Health data, the aims are to: (i) describe characteristics of family members who receive naloxone; (ii) identify where family members obtain naloxone; and (iii) describe characteristics of rescues by family members. We conducted a retrospective review using program enrollee information collected on a standardised form between 2008 and 2015. We calculated descriptive statistics, including demographics, current substance use, enrolment location, history of witnessed overdoses and rescue attempt characteristics. We conducted a stratified analysis comparing family members who used drugs with those who did not. Family members were 27% of total program enrollees (n = 10 883/40 801). Family members who reported substance use (n = 4679) were 35.6 years (mean), 50.6% female, 76.3% non-Hispanic white, 75.6% had witnessed an overdose, and they obtained naloxone most frequently at HIV prevention programs. Family members who did not report substance use (n = 6148) were 49.2 years (mean), 73.8% female, 87.9% non-Hispanic white, 35.3% had witnessed an overdose, and they obtained naloxone most frequently at community meetings. Family members were responsible for 20% (n = 860/4373) of the total rescue attempts. The Massachusetts experience demonstrates that family members can be active participants in responding to the overdose epidemic by rescuing family members and others. Targeted intervention strategies for families should be included in efforts to expand overdose education and naloxone in Massachusetts. © 2017 Australasian Professional Society on Alcohol and other Drugs.

Comparison of self-expandable and balloon-expanding stents for hybrid ductal stenting in hypoplastic left heart complex.

PubMed

Goreczny, Sebastian; Qureshi, Shakeel A; Rosenthal, Eric; Krasemann, Thomas; Nassar, Mohamed S; Anderson, David R; Morgan, Gareth J

2017-07-01

We aimed to compare the procedural and mid-term performance of a specifically designed self-expanding stent with balloon-expandable stents in patients undergoing hybrid palliation for hypoplastic left heart syndrome and its variants. The lack of specifically designed stents has led to off-label use of coronary, biliary, or peripheral stents in the neonatal ductus arteriosus. Recently, a self-expanding stent, specifically designed for use in hypoplastic left heart syndrome, has become available. We carried out a retrospective cohort comparison of 69 neonates who underwent hybrid ductal stenting with balloon-expandable and self-expanding stents from December, 2005 to July, 2014. In total, 43 balloon-expandable stents were implanted in 41 neonates and more recently 47 self-expanding stents in 28 neonates. In the balloon-expandable stents group, stent-related complications occurred in nine patients (22%), compared with one patient in the self-expanding stent group (4%). During follow-up, percutaneous re-intervention related to the ductal stent was performed in five patients (17%) in the balloon-expandable stent group and seven patients (28%) in self-expanding stents group. Hybrid ductal stenting with self-expanding stents produced favourable results when compared with the results obtained with balloon-expandable stents. Immediate additional interventions and follow-up re-interventions were similar in both groups with complications more common in those with balloon-expandable stents.

Access Based Cost Estimation for Beddown Analysis

DTIC Science & Technology

2006-03-23

logic. This research expands upon the existing research by using Visual Basic for Applications ( VBA ) to further customize and streamline the...methods with the use of VBA . Calculations are completed in either underlying Form VBA code or through global modules accessible throughout the...query and SQL referencing. Attempts were made where possible to align data structures with possible external sources to minimize import errors and

The Expanded Owens Valley Solar Array

NASA Astrophysics Data System (ADS)

Gary, Dale E.; Hurford, G. J.; Nita, G. M.; White, S. M.; Tun, S. D.; Fleishman, G. D.; McTiernan, J. M.

2011-05-01

The Expanded Owens Valley Solar Array (EOVSA) is now under construction near Big Pine, CA as a solar-dedicated microwave imaging array operating in the frequency range 1-18 GHz. The solar science to be addressed focuses on the 3D structure of the solar corona (magnetic field, temperature and density), on the sudden release of energy and subsequent particle acceleration, transport and heating, and on space weather phenomena. The project will support the scientific community by providing open data access and software tools for analysis of the data, to exploit synergies with on-going solar research in other wavelengths. The New Jersey Institute of Technology (NJIT) is expanding OVSA from its previous complement of 7 antennas to a total of 15 by adding 8 new antennas, and will reinvest in the existing infrastructure by replacing the existing control systems, signal transmission, and signal processing with modern, far more capable and reliable systems based on new technology developed for the Frequency Agile Solar Radiotelescope (FASR). The project will be completed in time to provide solar-dedicated observations during the upcoming solar maximum in 2013 and beyond. We provide an update on current status and our preparations for exploiting the data through modeling and data analysis tools. This research is supported by NSF grants AST-0908344, and AGS-0961867 and NASA grant NNX10AF27G to New Jersey Institute of Technology.

Access to Schooling in a Post-Apartheid South Africa: Linking Concepts to Context

NASA Astrophysics Data System (ADS)

Fataar, Aslam

1997-07-01

This paper focuses on the policy issue of expanding schooling in a post-apartheid South Africa. The Project of placing about two million children of school-going age in school is viewed as central to the rebuilding of South Africa. The paper argues that this project should be located within the peculiar history of this country's educational underdevelopment. Challenging the constraining influence of the New Right context should be central in conceptualising the provision of expanded school access. Access policy should be based on a notion of educational development that is linked to the overall socioeconomic development of this society. The view is promoted in this paper that a policy of quantitative expansion of schooling should not ignore the quality of such schooling.

Proceedings of the Mobile Satellite System Architectures and Multiple Access Techniques Workshop

NASA Technical Reports Server (NTRS)

Dessouky, Khaled

1989-01-01

The Mobile Satellite System Architectures and Multiple Access Techniques Workshop served as a forum for the debate of system and network architecture issues. Particular emphasis was on those issues relating to the choice of multiple access technique(s) for the Mobile Satellite Service (MSS). These proceedings contain articles that expand upon the 12 presentations given in the workshop. Contrasting views on Frequency Division Multiple Access (FDMA), Code Division Multiple Access (CDMA), and Time Division Multiple Access (TDMA)-based architectures are presented, and system issues relating to signaling, spacecraft design, and network management constraints are addressed. An overview article that summarizes the issues raised in the numerous discussion periods of the workshop is also included.

Newly available technologies present expanding opportunities for scientific and technical information exchange

NASA Technical Reports Server (NTRS)

Tolzman, Jean M.

1993-01-01

The potential for expanded communication among researchers, scholars, and students is supported by growth in the capabilities for electronic communication as well as expanding access to various forms of electronic interchange and computing capabilities. Increased possibilities for information exchange, collegial dialogue, collaboration, and access to remote resources exist as high-speed networks, increasingly powerful workstations, and large, multi-user computational facilities are more frequently linked and more commonly available. Numerous writers speak of the telecommunications revolution and its impact on the development and dissemination of knowledge and learning. One author offers the phrase 'Scholarly skywriting' to represent a new form of scientific communication that he envisions using electronic networks. In the United States (U.S.), researchers associated with the National Science Foundation (NSF) are exploring 'nationwide collaboratories' and 'digital collaboration.' Research supported by the U.S. National Aeronautics and Space Administration (NASA) points to a future where workstations with built-in audio, video monitors, and screen sharing protocols are used to support collaborations with colleagues located throughout the world. Instruments and sensors located worldwide will produce data streams that will be brought together, analyzed, and distributed as new findings. Researchers will have access to machines that can supply domain-specific information in addition to locator and directory assistance. New forms of electronic journals will emerge and provide opportunities for researchers and scientists to exchange information electronically and interactively in a range of structures and formats. Ultimately, the wide-scale use of these technologies in the dissemination of research results and the stimulation of collegial dialogue will change the way we represent and express our knowledge of the world. A new paradigm will evolve--perhaps a truly worldwide

Community Impact of Pharmacy-Randomized Intervention to Improve Access to Syringes and Services for Injection Drug Users

ERIC Educational Resources Information Center

Crawford, Natalie D.; Amesty, Silvia; Rivera, Alexis V.; Harripersaud, Katherine; Turner, Alezandria; Fuller, Crystal M.

2014-01-01

Objectives: In an effort to reduce HIV transmission among injection drug users (IDUs), New York State deregulated pharmacy syringe sales in 2001 through the Expanded Syringe Access Program by removing the requirement of a prescription. With evidence suggesting pharmacists' ability to expand their public health role, a structural, pharmacy-based…

Brazil's National Program for Improving Primary Care Access and Quality (PMAQ)

PubMed Central

Harris, Matthew J.; Rocha, Marcia Gomes

2017-01-01

Despite some remarkable achievements, there are several challenges facing Brazil's Family Health Strategy (FHS), including expanding access to primary care and improving its quality. These concerns motivated the development of the National Program for Improving Primary Care Access and Quality (PMAQ). Although voluntary, the program now includes nearly 39 000 FHS teams in the country and has led to a near doubling of the federal investment in primary care in its first 2 rounds. In this article, we introduce the PMAQ and advance several recommendations to ensure that it continues to improve primary care access and quality in Brazil. PMID:28252498

Expanding the role of nonclinical personnel in the OR.

PubMed

Hemingway, Maureen; Freehan, Marion; Morrissey, Lisa

2010-06-01

Ideally, quality health care should be accessible, affordable, and equitable. Working toward these goals in the OR necessitates examining and redesigning work processes and nursing workflow to make better use of the education and skills of perioperative nurses and assistive personnel. This article describes a pilot project undertaken in the OR at Massachusetts General Hospital, Boston, to identify tasks that took nurses away from direct patient care and to better incorporate assistive personnel into the workflow to increase nurses' contact with patients. The pilot program resulted in an expanded role for assistive personnel and more direct patient contact for nurses. Copyright 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Efficacy and safety of ipilimumab 3mg/kg in patients with pretreated, metastatic, mucosal melanoma.

PubMed

Del Vecchio, Michele; Di Guardo, Lorenza; Ascierto, Paolo A; Grimaldi, Antonio M; Sileni, Vanna Chiarion; Pigozzo, Jacopo; Ferraresi, Virginia; Nuzzo, Carmen; Rinaldi, Gaetana; Testori, Alessandro; Ferrucci, Pier F; Marchetti, Paolo; De Galitiis, Federica; Queirolo, Paola; Tornari, Elena; Marconcini, Riccardo; Calabrò, Luana; Maio, Michele

2014-01-01

Mucosal melanoma is an extremely rare and aggressive malignancy that often remains undetected until it reaches an advanced stage, when effective treatment options are limited. The activity and safety of ipilimumab were assessed in an Expanded Access Programme (EAP) that included patients with metastatic, mucosal melanoma. Ipilimumab was available upon physician request for patients aged ⩾16years with stage III (unresectable) or IV skin, ocular or mucosal melanoma, who had failed or did not tolerate previous treatments and had no other therapeutic option available. Patients received ipilimumab 3mg/kg every 3weeks for four doses. Patients with stable disease or an objective response to ipilimumab were eligible for retreatment upon disease progression. Tumour assessments were conducted at baseline and week 12 using immune-related response criteria. Patients were monitored for adverse events (AEs), including immune-related AEs, within 3 to 4days of each scheduled visit. Of 855 patients participating in the EAP in Italy, 71 (8%) had metastatic, mucosal melanoma. With a median follow-up of 21.8months, the response rate was 12% and the immune-related disease control rate was 36%. Median progression-free survival and overall survival were 4.3 and 6.4months, respectively. In total, 34% of patients reported treatment-related AEs of any grade, which were grade 3 or 4 in 9% of patients. AEs were generally manageable as per protocol-specific guidelines. Ipilimumab may be a feasible treatment option in pretreated patients with metastatic mucosal melanoma, and warrants further investigation in prospective clinical trials. Copyright © 2013 Elsevier Ltd. All rights reserved.

Employee Attitudes toward an Internal Employee Assistance Program.

ERIC Educational Resources Information Center

Harlow, Kirk C.

1998-01-01

Surveys employees (N=16,603) who had used a large multinational company's employee assistance program (EAP), adult dependents who had used the EAP, employees who had not used the EAP, and adult dependents who had not used the EAP. Findings indicate that EAP users viewed the EAP more positively than nonusers. (Author/MKA)

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

ERIC Educational Resources Information Center

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

2013-01-01

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

Providing Internet Access to the Ohio Career Information System for All Residents: A Feasibility Study.

ERIC Educational Resources Information Center

Lewis, Morgan V.

Expanded Internet access to the Ohio Career Information System (OCIS) would provide adults in Ohio who need to or wish to make career changes with the best available information about occupations, education and training programs, and financial aid. In order to determine the feasibility of improving access without cost to users, an advisory group,…

Expander for Thin-Wall Tubing

NASA Technical Reports Server (NTRS)

Pessin, R.

1983-01-01

Tool locally expands small-diameter tubes. Tube expander locally expands and deforms tube: Compressive lateral stress induced in elastomeric sleeve by squeezing axially between two metal tool parts. Adaptable to situations in which tube must have small bulge for mechanical support or flow control.

The Pathways to Advancement Project: How States Can Expand Postsecondary Educational Opportunities for Working Adults. Issue Brief

ERIC Educational Resources Information Center

Mazzeo, Christopher; Strawn, Julie; Roberts, Brandon

2009-01-01

The Pathways to Advancement initiative was launched by the National Governors Association Center for Best Practices (NGA Center) to help governors and their policy advisors examine options and develop strategies for expanding working adults' access to and completion of postsecondary education. In September 2003, the NGA Center issued a request for…

Expanding Learning in the Workplace: Making More of Individual and Organisational Potential. A NIACE Policy Discussion Paper.

ERIC Educational Resources Information Center

Unwin, Lorna; Fuller, Alison

Ways of expanding workplace learning in the United Kingdom by making better use of individual and organizational potential were examined. The analysis focused on the following issues: ways of fostering, improving, and increasing learning in the workplace; ways of enhancing access to and participation in workplace learning; ways of making workplace…

Predicting likelihood of seeking help through the employee assistance program among salaried and union hourly employees.

PubMed

Delaney, W; Grube, J W; Ames, G M

1998-03-01

This research investigated belief, social support and background predictors of employee likelihood to use an Employee Assistance Program (EAP) for a drinking problem. An anonymous cross-sectional survey was administered in the home. Bivariate analyses and simultaneous equations path analysis were used to explore a model of EAP use. Survey and ethnographic research were conducted in a unionized heavy machinery manufacturing plant in the central states of the United States. A random sample of 852 hourly and salaried employees was selected. In addition to background variables, measures included: likelihood of going to an EAP for a drinking problem, belief the EAP can help, social support for the EAP from co-workers/others, belief that EAP use will harm employment, and supervisor encourages the EAP for potential drinking problems. Belief in EAP efficacy directly increased the likelihood of going to an EAP. Greater perceived social support and supervisor encouragement increased the likelihood of going to an EAP both directly and indirectly through perceived EAP efficacy. Black and union hourly employees were more likely to say they would use an EAP. Males and those who reported drinking during working hours were less likely to say they would use an EAP for a drinking problem. EAP beliefs and social support have significant effects on likelihood to go to an EAP for a drinking problem. EAPs may wish to focus their efforts on creating an environment where there is social support from coworkers and encouragement from supervisors for using EAP services. Union networks and team members have an important role to play in addition to conventional supervisor intervention.

Employing human rights frameworks to realize access to an HIV cure.

PubMed

Meier, Benjamin Mason; Gelpi, Adriane; Kavanagh, Matthew M; Forman, Lisa; Amon, Joseph J

2015-01-01

The scale of the HIV pandemic - and the stigma, discrimination and violence that surrounded its sudden emergence - catalyzed a public health response that expanded human rights in principle and practice. In the absence of effective treatment, human rights activists initially sought to protect individuals at high risk of HIV infection. With advances in antiretroviral therapy, activists expanded their efforts under international law, advocating under the human right to health for individual access to treatment. As a clinical cure comes within reach, human rights obligations will continue to play a key role in political and programmatic decision-making. Building upon the evolving development and implementation of the human right to health in the global response to HIV, we outline a human rights research agenda to prepare for HIV cure access, investigating the role of human rights law in framing 1) resource allocation, 2) international obligations, 3) intellectual property and 4) freedom from coercion. The right to health is widely recognized as central to governmental, intergovernmental and non-governmental responses to the pandemic and critical both to addressing vulnerability to infection and to ensuring universal access to HIV prevention, treatment, care and support. While the advent of an HIV cure will raise new obligations for policymakers in implementing the right to health, the resolution of past debates surrounding HIV prevention and treatment may inform claims for universal access.

Aiding troubled employees: the prevalence, cost, and characteristics of employee assistance programs in the United States.

PubMed

Hartwell, T D; Steele, P; French, M T; Potter, F J; Rodman, N F; Zarkin, G A

1996-06-01

Employee assistance programs (EAPs) are job-based programs designed to identify and assist troubled employees. This study determines the prevalence, cost, and characteristics of these programs in the United States by worksite size, industry, and census region. A stratified national probability sample of more than 6400 private, nonagricultural US worksites with 50 or more full-time employees was contacted with a computer-assisted telephone interviewing protocol. More than 3200 worksites responded and were eligible, with a response rate of 90%. Approximately 33% of all private, nonagricultural worksites with 50 or more full-time employees currently offer EAP services to their employees, an 8.9% increase over 1985. These programs are more likely to be found in larger worksites and in the communications/utilities/transportation industries. The most popular model is an external provider, and the median annual cost per eligible employee for internal and external programs was $21.83 and $18.09, respectively. EAPs are becoming a more prevalent point of access to health care for workers with personal problems such as substance abuse, family problems, or emotional distress.

The extent of problematic alcohol and other drug use within selected South African workplaces.

PubMed

Harker Burnhams, Nadine; Dada, Siphokazi; Linda, Betty; Myers, Bronwyn; Parry, Charles

2013-09-30

The use of alcohol and other drugs (AODs) in the workplace has a major impact on the health and productivity of the workforce globally. Yet information on this issue is limited in South Africa (SA). To describe the nature and extent of AOD problems in selected workplace settings in SA. Secondary data analysis was conducted on a large dataset compiled by an Employee Assistance Programme (EAP) service provider in SA. As part of an EAP risk audit, assessments for AOD-related problems were completed for each employee accessing EAP services (n=10 428) between 2005 and 2011. Data on the socio-demographic profiles, AOD use and impact of AOD use on the work performance of employees were analysed. Findings indicate that employed men are more likely to experience alcohol-related problems than women, the latter demonstrating a higher percentage of drug-related problems. The majority of referrals to the EAPs emanate from the public, industrial and financial sectors. AOD-related problems were also found to significantly impact on employee work performance. The study begins to address the knowledge gap on the extent of AOD use in SA workplaces and points to the need for further investigations into the exact nature of AOD use. In addition, the study highlights the need for intervention programmes and policies suited to the workplace.

Expanding the reach of probiotics through social enterprises.

PubMed

Reid, G; Kort, R; Alvarez, S; Bourdet-Sicard, R; Benoit, V; Cunningham, M; Saulnier, D M; van Hylckama Vlieg, J E T; Verstraelen, H; Sybesma, W

2018-05-25

The rapid rise in microbiome and probiotic science has led to estimates of product creation and sales exceeding $50 billion within five years. However, many people do not have access to affordable products, and regulatory agencies have stifled progress. The objective of a discussion group at the 2017 meeting of the International Scientific Association for Probiotics and Prebiotics was to identify mechanisms to confer the benefits of probiotics to a larger portion of the world's population. Three initiatives, built around fermented food, were discussed with different methods of targeting populations that face enormous challenges of malnutrition, infectious disease, poverty and violent conflict. As new candidate probiotic strains emerge, and the market diversifies towards more personalised interventions, manufacturing processes will need to evolve. Information dissemination through scientific channels and social media is projected to provide consumers and healthcare providers with rapid access to clinical results, and to identify the nearest location of sites making new and affordable probiotic food and supplements. This rapid translation of science to individual well-being will not only expand the beneficiaries of probiotics, but also fuel new social enterprises and economic business models.

Pharmacy staff characteristics associated with support for pharmacy-based HIV-testing in pharmacies participating in the New York State Expanded Access Syringe Exchange Program

PubMed Central

Amesty, Silvia; Blaney, Shannon; Crawford, Natalie D.; Rivera, Alexis V.; Fuller, Crystal

2013-01-01

Objective To determine support of in-pharmacy HIV-testing among pharmacy staff and the individual-level characteristics associated with in-pharmacy HIV testing support. Design Descriptive, nonexperimental, cross-sectional study. Setting New York City (NYC) during January 2008 to March 2009. Intervention 131 pharmacies registered in the Expanded Syringe Access Program (ESAP) completed a survey. Participants 480 pharmacy staff, including pharmacists, owners/managers, and technicians/clerks. Main outcome measures Support of in-pharmacy HIV testing. Results Support of in-pharmacy HIV testing is high among pharmacy staff (79.4%). Pharmacy staff that supported in-pharmacy vaccinations were significantly more likely to support in-pharmacy HIV testing. Pharmacy staff that think that selling syringes to IDUs causes the community to be littered with dirty syringes were significantly less likely to support in-pharmacy HIV testing. Conclusion Support for in-pharmacy HIV testing is high among our sample of ESAP pharmacy staff actively involved in non-prescription syringe sales. These findings suggest that active ESAP pharmacy staff may be amenable to providing HIV counseling and testing to injection drug users and warrants further investigation. PMID:22825227

Medicaid expansion and access to care among cancer survivors: a baseline overview.

PubMed

Tarazi, Wafa W; Bradley, Cathy J; Harless, David W; Bear, Harry D; Sabik, Lindsay M

2016-06-01

Medicaid expansion under the Affordable Care Act facilitates access to care among vulnerable populations, but 21 states have not yet expanded the program. Medicaid expansions may provide increased access to care for cancer survivors, a growing population with chronic conditions. We compare access to health care services among cancer survivors living in non-expansion states to those living in expansion states, prior to Medicaid expansion under the Affordable Care Act. We use the 2012 and 2013 Behavioral Risk Factor Surveillance System to estimate multiple logistic regression models to compare inability to see a doctor because of cost, having a personal doctor, and receiving an annual checkup in the past year between cancer survivors who lived in non-expansion states and survivors who lived in expansion states. Cancer survivors in non-expansion states had statistically significantly lower odds of having a personal doctor (adjusted odds ratio [AOR] 0.76, 95 % confidence interval [CI] 0.63-0.92, p < 0.05) and higher odds of being unable to see a doctor because of cost (AOR 1.14, 95 % CI 0.98-1.31, p < 0.10). Statistically significant differences were not found for annual checkups. Prior to the passage of the Affordable Care Act, cancer survivors living in expansion states had better access to care than survivors living in non-expansion states. Failure to expand Medicaid could potentially leave many cancer survivors with limited access to routine care. Existing disparities in access to care are likely to widen between cancer survivors in Medicaid non-expansion and expansion states.

Expanding access to high-quality plain-language patient education information through context-specific hyperlinks

PubMed Central

Ancker, Jessica S.; Mauer, Elizabeth; Hauser, Diane; Calman, Neil

2016-01-01

Medical records, which are increasingly directly accessible to patients, contain highly technical terms unfamiliar to many patients. A federally qualified health center (FQHC) sought to help patients interpret their records by embedding context-specific hyperlinks to plain-language patient education materials in its portal. We assessed the impact of this innovation through a 3-year retrospective cohort study. A total of 12,877 (10% of all patients) in this safety net population had used the MPC links. Black patients, Latino patients comfortable using English, and patients covered by Medicaid were more likely to use the informational hyperlinks than other patients. The positive association with black race and Latino ethnicity remained statistically significant in multivariable models that controlled for insurance type. We conclude that many of the sociodemographic factors associated with the digital divide do not present barriers to accessing context-specific patient education information once in the portal. In fact, this type of highly convenient plain-language patient education may provide particular value to patients in traditionally disadvantaged groups. PMID:28269821

Advanced expander test bed program

NASA Technical Reports Server (NTRS)

Masters, A. I.; Mitchell, J. C.

1991-01-01

The Advanced Expander Test Bed (AETB) is a key element in NASA's Chemical Transfer Propulsion Program for development and demonstration of expander cycle oxygen/hydrogen engine technology component technology for the next space engine. The AETB will be used to validate the high-pressure expander cycle concept, investigate system interactions, and conduct investigations of advanced missions focused components and new health monitoring techniques. The split-expander cycle AETB will operate at combustion chamber pressures up to 1200 psia with propellant flow rates equivalent to 20,000 lbf vacuum thrust.

Provisional Admission Practices: Blending Access and Support to Facilitate Student Success

ERIC Educational Resources Information Center

Nichols, Andrew Howard; Clinedinst, Melissa

2013-01-01

This report examines provisional admission as an initiative that can expand four-year college access and success for students from economically disadvantaged backgrounds. Provisional admission policies and programs enable students to enroll at an institution under specific conditions. Students are often required to meet certain academic…

Alcohol & drug abuse: Revisiting employee assistance programs and substance use problems in the workplace: key issues and a research agenda.

PubMed

Merrick, Elizabeth S Levy; Volpe-Vartanian, Joanna; Horgan, Constance M; McCann, Bernard

2007-10-01

This column describes employee assistance program (EAPs) and identifies key issues for contemporary EAPs. These programs began as occupational alcohol programs and have evolved into more comprehensive resources. To better understand contemporary EAPs, the authors suggest a research agenda that includes descriptive studies to provide an up-to-date picture of services; investigations of how contemporary EAPs address substance use problems, including management consultation for early identification; further study of EAPs' effects on outcomes, such as productivity and work group outcomes; examination of the relationship between EAPs and other workplace resources; further examination of influences on EAP utilization; and development and testing of EAP performance measures.

Equity and Access in Charter Schools: Identifying Issues and Solutions

ERIC Educational Resources Information Center

Marshall, David T.

2017-01-01

School choice exists in American public schooling, even where official school choice policy is absent. Parents with means can elect to live in neighborhoods zoned for desirable schools, whereas parents without means are locked out of that opportunity. In their ideal, charter schools have the ability to expand access to desirable schools to…

Helping Farmers Access Farmland: New Jersey's New Land Link Website

ERIC Educational Resources Information Center

Schilling, Brian J.; Marxen, Lucas J.; Everett, Jeffrey C.; Miller, Camille L.; Kimmel, David A.; Cook, Justine C.

2015-01-01

Access to land is a common obstacle for beginning farmers and established farmers seeking to expand their operations. Particularly in urban-influenced areas, leasing farmland is often more financially feasible than fee ownership. Locating available land or the right leasing situation, however, can be difficult. NJ Land Link (http://njlandlink.org)…

Tissue Expander versus Tissue Expander and Latissimus Flap in Morbidly Obese Breast Reconstruction Patients

PubMed Central

Adams, Robert L.; Chandler, Robert G.; Parks, Joseph

2015-01-01

Background: Immediate postmastectomy breast reconstruction in morbidly obese patients represents a challenge because neither prosthetic nor abdominal-based options may be suitable. Methods: This study compared a previously published cohort of immediate prosthetic reconstruction of 346 patients (511 breasts) of whom 49 patients (67 breasts) were morbidly obese (defined as a body mass index > 35) with a morbidly obese patient population whose breasts were reconstructed immediately following postmastectomy with latissimus flap and tissue expander (21 patients and 22 breasts) in the same time period. The preoperative risk factors of mastectomy such as tobacco use, diabetes, and prior radiation and the postoperative complications of mastectomy such as skin necrosis, seroma, and prosthesis loss were examined. The explantation of the tissue expander provided a defined endpoint of reconstruction failure. Results: The average body mass index in the tissue expander/implant group and in the latissimus flap plus tissue expander/implant group was 40.9 and 40.1, respectively. The risk profile of diabetes and tobacco use was similar in both groups. Fifteen of the 67 breasts (22.3%) of the tissue expander/implant group and 15 of the 23 breasts (65.2%) of the latissimus flap group had received prior radiation. The prosthesis loss was 13 of 67 breasts (19.4%) that had tissue-expander–alone reconstruction and 1 of 22 (4.8%) in the latissimus group that had tissue expander reconstruction. Modification of donor-site incision and skin-island location in the latissimus group of patients can minimize scar deformity. Conclusion: The loss rate in immediate postmastectomy reconstruction in morbidly obese patients with latissimus flap plus tissue expander was substantially lower than the loss rate in those with breast reconstructed with tissue expander alone. PMID:25878934

Employee Assistance Programs.

ERIC Educational Resources Information Center

Levine, Hermine Zagat

1985-01-01

The author reports company responses to a questionnaire concerning employee assistance programs (EAP). Answers concern EAP structure, staff training, use of outside consultant, services provided by EAPs, program administration, employee confidence in EAPs, advertising the program, program philosophy, problems encountered by EAP users, coverage and…

Expandable Lunar Habitat (X-Hab)

NASA Image and Video Library

2010-09-23

Expandable Lunar Habitat (X-Hab).ILC Dover, under contract by NASA Langley Research Center, and in cooperation with NASA Johnson Space Center has designed and manufactured an expandable lunar habitat. This cylindrical habitat, or Expandable Lunar Habitat (X-Hab) is a hybrid system with two hard end caps and a deployable softgoods section in the center.

Short paths in expander graphs

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

Kleinberg, J.; Rubinfeld, R.

Graph expansion has proved to be a powerful general tool for analyzing the behavior of routing algorithms and the interconnection networks on which they run. We develop new routing algorithms and structural results for bounded-degree expander graphs. Our results are unified by the fact that they are all based upon, and extend, a body of work asserting that expanders are rich in short, disjoint paths. In particular, our work has consequences for the disjoint paths problem, multicommodify flow, and graph minor containment. We show: (i) A greedy algorithm for approximating the maximum disjoint paths problem achieves a polylogarithmic approximation ratiomore » in bounded-degree expanders. Although our algorithm is both deterministic and on-line, its performance guarantee is an improvement over previous bounds in expanders. (ii) For a multicommodily flow problem with arbitrary demands on a bounded-degree expander, there is a (1 + {epsilon})-optimal solution using only flow paths of polylogarithmic length. It follows that the multicommodity flow algorithm of Awerbuch and Leighton runs in nearly linear time per commodity in expanders. Our analysis is based on establishing the following: given edge weights on an expander G, one can increase some of the weights very slightly so the resulting shortest-path metric is smooth - the min-weight path between any pair of nodes uses a polylogarithmic number of edges. (iii) Every bounded-degree expander on n nodes contains every graph with O(n/log{sup O(1)} n) nodes and edges as a minor.« less

Advanced expander test bed engine

NASA Technical Reports Server (NTRS)

Mitchell, J. P.

1992-01-01

The Advanced Expander Test Bed (AETB) is a key element in NASA's Space Chemical Engine Technology Program for development and demonstration of expander cycle oxygen/hydrogen engine and advanced component technologies applicable to space engines as well as launch vehicle upper stage engines. The AETB will be used to validate the high pressure expander cycle concept, study system interactions, and conduct studies of advanced mission focused components and new health monitoring techniques in an engine system environment. The split expander cycle AETB will operate at combustion chamber pressures up to 1200 psia with propellant flow rates equivalent to 20,000 lbf vacuum thrust.

Emulation of Equal Open Access and Competition Creation in the Wireline Telecommunications Local and Last Mile Market Segments

ERIC Educational Resources Information Center

Van Epps, Daniel L.

2013-01-01

Expanded telecommunications was deemed a serious need for end users. The "Local Market" and "Last Mile" market segments have largely consolidated into "natural utilities". Competition and access problems occur if new providers enter the local market and desire competitive access and service to end users. Local and…

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.

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

PubMed Central

Choi, Donghee; Kim, Dohoon; Park, Seog

2015-01-01

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

Effect of expansions in state Medicaid eligibility on access to care and the use of emergency department services for adult Medicaid enrollees.

PubMed

Ndumele, Chima D; Mor, Vincent; Allen, Susan; Burgess, James F; Trivedi, Amal N

2014-06-01

Medicaid enrollees typically report worse access to care than other insured populations. Expansions in Medicaid through less restrictive income eligibility requirements and the resulting influx of new enrollees may further erode access to care for those already enrolled in Medicaid. To assess the effect of previous Medicaid expansions on self-reported access to care and the use of emergency department services by Medicaid enrollees. Quasi-experimental difference-in-differences design among 1714 adult Medicaid enrollees in 10 states that expanded Medicaid between June 1, 2000, and October 1, 2009, and 5097 Medicaid enrollees in 14 bordering control states that did not expand Medicaid. Self-reported access to care and annualized emergency department use. Among states expanding their Medicaid program for adults, the mean income eligibility level increased from 82.6% to 144.2% of the federal poverty level. Income eligibility in matched control states remained constant at 77.1% of the federal poverty level. The proportion of adults reporting being enrolled in Medicaid increased from 7.2% to 8.8% in expansion states and from 6.1% to 6.4% in matched control states. In Medicaid program expansion states, the proportion of Medicaid enrollees reporting poor access to care declined from 8.5% before the expansion to 7.3% after the expansion. In matched control states, the proportion of Medicaid enrollees reporting poor access to care remained constant at 5.3%. The proportion of enrollees reporting any emergency department use decreased from 41.2% to 40.1% in expansion states and from 37.3% to 36.1% in matched control states. In the period following expansions, newly eligible enrollees reported poorer access to care than previously enrolled beneficiaries, although the overall difference between groups did not reach statistical significance. We found no evidence that expanding the number of individuals eligible for Medicaid coverage eroded perceived access to care or increased

Effect of egg albumen protein addition on physicochemical properties and nanostructure of gelatin from fish skin.

PubMed

Cai, Luyun; Feng, Jianhui; Peng, Xichun; Regenstein, Joe M; Li, Xiuxia; Li, Jianrong; Zhao, Wei

2016-12-01

The physicochemical properties and nanostructure of mixtures of egg albumen protein (EAP) and gelatin from under-utilised grass carp ( Ctenopharyngodon idella ) skins were studied. The gelatin with 1% EAP had an acceptable gel strength. The addition of 5% EAP significantly increased the melting and gelling temperatures of gelatin gels. Additionally, the colour turned white and the crystallinity was higher in gelatin gels with gradient concentrations of EAP (1, 3, and 5%). Gelatin with 5% EAP had the highest G' values while gelatin with 1% EAP had the lowest G' values. Atomic force microscopy showed the heterogeneous nanostructure of fish gelatin, and a simple coacervate with a homogeneous distribution was only observed with the addition of 1% EAP, indicating interaction between gelatin and EAP. These results showed that EAP effect fish gelatin's physicochemical and nanostructure properties and has potential applications in foods and pharmaceuticals.

Managing the Nuclear Fuel Cycle: Policy Implications of Expanding Global Access to Nuclear Power

DTIC Science & Technology

2007-11-01

critical aspect of the nuclear fuel cycle for the United States, where longstanding nonproliferation policy discouraged commercial nuclear fuel...perhaps the most critical question in this decade for strengthening the nuclear nonproliferation regime: how can access to sensitive fuel cycle...process can take advantage of the slight difference in atomic mass between 235U and 238U. The typical enrichment process requires about 10 lbs of uranium

Expanding the endoscopic transpterygoid corridor to the petroclival region: anatomical study and volumetric comparative analysis.

PubMed

Freeman, Jacob L; Sampath, Raghuram; Quattlebaum, Steven Craig; Casey, Michael A; Folzenlogen, Zach A; Ramakrishnan, Vijay R; Youssef, A Samy

2017-07-21

OBJECTIVE The endoscopic endonasal transmaxillary transpterygoid (TMTP) approach has been the gateway for lateral skull base exposure. Removal of the cartilaginous eustachian tube (ET) and lateral mobilization of the internal carotid artery (ICA) are technically demanding adjunctive steps that are used to access the petroclival region. The gained expansion of the deep working corridor provided by these maneuvers has yet to be quantified. METHODS The TMTP approach with cartilaginous ET removal and ICA mobilization was performed in 5 adult cadaveric heads (10 sides). Accessible portions of the petrous apex were drilled during the following 3 stages: 1) before ET removal, 2) after ET removal but before ICA mobilization, and 3) after ET removal and ICA repositioning. Resection volumes were calculated using 3D reconstructions generated from thin-slice CT scans obtained before and after each step of the dissection. RESULTS The average petrous temporal bone resection volumes at each stage were 0.21 cm 3 , 0.71 cm 3 , and 1.32 cm 3 (p < 0.05, paired t-test). Without ET removal, inferior and superior access to the petrous apex was limited. Furthermore, without ICA mobilization, drilling was confined to the inferior two-thirds of the petrous apex. After mobilization, the resection was extended superiorly through the upper extent of the petrous apex. CONCLUSIONS The transpterygoid corridor to the petroclival region is maximally expanded by the resection of the cartilaginous ET and mobilization of the paraclival ICA. These added maneuvers expanded the deep window almost 6 times and provided more lateral access to the petroclival region with a maximum volume of 1.5 cm 3 . This may result in the ability to resect small-to-moderate sized intradural petroclival lesions up to that volume. Larger lesions may better be approached through an open transcranial approach.

Maintenance of Access as Demand for Substance Use Disorder Treatment Grows

PubMed Central

Frakt, Austin B.; Trafton, Jodie; Pizer, Steven D.

2015-01-01

Due to the Affordable Care Act and other recent laws and regulations, funding for substance use disorder (SUD) treatment is on the rise. In the 2000s, the Veterans Health Administration (VA) implemented several initiatives that increased funding for SUD treatment during a period of growth in demand for it. A key question is whether access to and intensity of treatment kept pace or declined. Using VA SUD treatment funding data and patient-level records to construct performance measures, we studied the relationship between funding and access during the VA expansion. Overall, we observed an increase in access to and intensity of VA SUD care associated with increased funding. The VA was able to increase funding for and expand the population to which it offered SUD treatment without diminishing internal access and intensity. PMID:25795602

2015 Relaunch as Open Access Pediatric Neurology Briefs.

PubMed

Millichap, John J; Millichap, J Gordon

2015-01-01

Pediatric Neurology Briefs (PNB) has been published monthly since 1987 as a continuing education service designed to expedite and facilitate review of current medical literature concerning pediatric neurology. In 2015, PNB is relaunched as an open access, peer-reviewed, journal with an expanded editorial board. PNB has a new website and content management system capable of organizing peer-review and providing improved indexing, DOI assignment, and online full-text article view. Digitization of back issues, archiving, and inclusion in PubMed are future goals. The new online open access PNB aims to reach more physicians, researchers, and other healthcare providers with highlights of the latest advances in pediatric neurology and commentaries by specialists in the field.

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

Employing human rights frameworks to realize access to an HIV cure

PubMed Central

Meier, Benjamin Mason; Gelpi, Adriane; Kavanagh, Matthew M; Forman, Lisa; Amon, Joseph J

2015-01-01

Introduction The scale of the HIV pandemic – and the stigma, discrimination and violence that surrounded its sudden emergence – catalyzed a public health response that expanded human rights in principle and practice. In the absence of effective treatment, human rights activists initially sought to protect individuals at high risk of HIV infection. With advances in antiretroviral therapy, activists expanded their efforts under international law, advocating under the human right to health for individual access to treatment. Discussion As a clinical cure comes within reach, human rights obligations will continue to play a key role in political and programmatic decision-making. Building upon the evolving development and implementation of the human right to health in the global response to HIV, we outline a human rights research agenda to prepare for HIV cure access, investigating the role of human rights law in framing 1) resource allocation, 2) international obligations, 3) intellectual property and 4) freedom from coercion. Conclusions The right to health is widely recognized as central to governmental, intergovernmental and non-governmental responses to the pandemic and critical both to addressing vulnerability to infection and to ensuring universal access to HIV prevention, treatment, care and support. While the advent of an HIV cure will raise new obligations for policymakers in implementing the right to health, the resolution of past debates surrounding HIV prevention and treatment may inform claims for universal access. PMID:26568056

Funding, coverage, and access under Thailand's universal health insurance program: an update after ten years.

PubMed

Damrongplasit, Kannika; Melnick, Glenn

2015-04-01

In 2001, Thailand implemented a universal coverage program by expanding government-funded health coverage to uninsured citizens and limited their out-of-pocket payments to 30 Baht per encounter and, in 2006, eliminated out-of-pocket payments entirely. Prior research covering the early years of the program showed that the program effectively expanded coverage while a more recent paper of the early effects of the program found that improved access from the program led to a reduction in infant mortality. We expand and update previous analyses of the effects of the 30 Baht program on access and out-of-pocket payments. We analyze national survey and governmental budgeting data through 2011 to examine trends in health care financing, coverage and access, including out-of-pocket payments. By 2011, only 1.64 % of the population remained uninsured in Thailand (down from 2.61 % in 2009). While government funding increased 75 % between 2005 and 2010, budgetary requests by health care providers exceeded approved amounts in many years. The 30 Baht program beneficiaries paid zero out-of-pocket payments for both outpatient and inpatient care. Inpatient and outpatient contact rates across all insurance categories fell slightly over time. Overall, the statistical results suggest that the program is continuing to achieve its goals after 10 years of operation. Insurance coverage is now virtually universal, access has been more or less maintained, government funding has continued to grow, though at rates below requested levels and 30 Baht patients are still guaranteed access to care with limited or no out-of-pocket costs. Important issues going forward are the ability of the government to sustain continued funding increases while minimizing cost sharing.

Improving Information Access through Technology: A Plan for Louisiana's Public Libraries.

ERIC Educational Resources Information Center

Jaques, Thomas F.

Strengthening technology in Louisiana's public libraries will support equitable and convenient access to electronic information resources for all citizens at library sites, in homes, and in business. The plan presented in this document is intended to enhance and expand technology in the state's public libraries. After discussion of the crucial…

When are food deserts? Integrating time into research on food accessibility.

PubMed

Widener, Michael J; Shannon, Jerry

2014-11-01

The food desert concept is used as a means for defining regions as having inadequate spatial and socioeconomic access to vendors selling nutritious foods. This primarily aggregate-level and static method for understanding the food environment is commonly used by researchers and policy makers seeking to improve health outcomes of those affected by reduced access. However, recent research findings have brought the association between living in a food desert and adverse health outcomes into question. In this viewpoint, we put forward the idea that the food desert concept, and food accessibility research more generally, should be expanded to include a temporal component, and note potential avenues for future research. Copyright © 2014 Elsevier Ltd. All rights reserved.

Beyond the Yellow Bus: Promising Practices for Maximizing Access to Opportunity through Innovations in Student Transportation. Policy Brief 2014

ERIC Educational Resources Information Center

Center for Cities & Schools, 2014

2014-01-01

Access to safe, affordable, and convenient transportation shapes the "geography of opportunity" for many children and youth. This study looks at how ?localities across the country are implementing new and innovative alternative approaches to student transportation that expand regional transportation access for K-12 students, improve…

42 CFR 405.718 - Expedited appeals process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Part A § 405.718 Expedited appeals process. (a) Conditions for use of expedited appeals process (EAP). A party may use the EAP to request court review in place of an administrative law judge (ALJ..., with the request for the EAP. (b) Content of the request for EAP. The request for the EAP: (1) Alleges...

Improving access to emergency contraception under the Scottish Sexual Health Strategy: can rates of unintended pregnancy be reduced?

PubMed

McGowan, James G

2013-09-01

Unintended pregnancy is a global sexual health problem. Outcomes of unintended pregnancy include unwanted childbirth and abortion, which may be associated with negative physical and psychosocial health implications for women. In Scotland, the Scottish Sexual Health Strategy has the stated goal of improving the sexual health of the people of Scotland. One aim of the Strategy is to reduce rates of unintended pregnancy and one policy designed to achieve this is 'widening access to emergency contraception'. This paper examines the success of this policy with reference to the implicit link it makes between expanding access to emergency contraception and increasing its effective use, aiming thereby to reduce rates of unintended pregnancy. Since there is evidence that previous policies and strategies expanding access to emergency contraception have failed to reduce such rates, alternative approaches to achieve a reduction in unintended pregnancies are discussed.

Access & Equity for All Students: LGBT Student Needs. Commission Report 08-22

ERIC Educational Resources Information Center

California Postsecondary Education Commission, 2008

2008-01-01

Access and equity for all students in California colleges and universities have always been high priorities of the California Postsecondary Education Commission. The Commission has conducted research, gathered data, and made recommendations to expand opportunities and improve outcomes for all students in the state's postsecondary systems.…

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

PubMed

Kirby, James B; Sharma, Ravi

2017-12-01

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

Expanding Access to Secondary Schooling in Sub-Saharan Africa: Key Planning and Finance Issues. Create Pathways to Access. Research Monograph No. 8

ERIC Educational Resources Information Center

Lewin, Keith M.

2007-01-01

This paper makes the case for managed expansion of secondary schooling in Sub-Saharan Africa. The great majority of secondary age African children remain excluded from access to good quality secondary schooling. Increasing numbers are graduating from primary schools where enrolments are rapidly growing as a result of successful Education for All…

42 CFR 405.853 - Expedited appeals process.

Code of Federal Regulations, 2010 CFR

2010-10-01

....853 Expedited appeals process. (a) Conditions for use of expedited appeals process (EAP). A party may use the EAP set forth in § 405.718 of this chapter to request court review in place of the ALJ hearing... the request for an EAP. (b) Content of the request for EAP. The request for an EAP: (1) Alleges that...

Beyond open access: open discourse, the next great equalizer.

PubMed

Dayton, Andrew I

2006-08-30

The internet is expanding the realm of scientific publishing to include free and open public debate of published papers. Journals are beginning to support web posting of comments on their published articles and independent organizations are providing centralized web sites for posting comments about any published article. The trend promises to give one and all access to read and contribute to cutting edge scientific criticism and debate.

End-user searching: impetus for an expanding information management and technology role for the hospital librarian.

PubMed Central

Klein, M S; Ross, F

1997-01-01

Using the results of the 1993 Medical Library Association (MLA) Hospital Libraries Section survey of hospital-based end-user search services, this article describes how end-user search services can become an impetus for an expanded information management and technology role for the hospital librarian. An end-user services implementation plan is presented that focuses on software, hardware, finances, policies, staff allocations and responsibilities, educational program design, and program evaluation. Possibilities for extending end-user search services into information technology and informatics, specialized end-user search systems, and Internet access are described. Future opportunities are identified for expanding the hospital librarian's role in the face of changing health care management, advances in information technology, and increasing end-user expectations. PMID:9285126

Silicon microfabricated beam expander

NASA Astrophysics Data System (ADS)

Othman, A.; Ibrahim, M. N.; Hamzah, I. H.; Sulaiman, A. A.; Ain, M. F.

2015-03-01

The feasibility design and development methods of silicon microfabricated beam expander are described. Silicon bulk micromachining fabrication technology is used in producing features of the structure. A high-precision complex 3-D shape of the expander can be formed by exploiting the predictable anisotropic wet etching characteristics of single-crystal silicon in aqueous Potassium-Hydroxide (KOH) solution. The beam-expander consist of two elements, a micromachined silicon reflector chamber and micro-Fresnel zone plate. The micro-Fresnel element is patterned using lithographic methods. The reflector chamber element has a depth of 40 µm, a diameter of 15 mm and gold-coated surfaces. The impact on the depth, diameter of the chamber and absorption for improved performance are discussed.

[Comparison of two access portals of an employee assistance program at an insurance corporation targeted to reduce stress levels of employees].

PubMed

Burnus, M; Benner, V; Kirchner, D; Drabik, A; Stock, St

2012-03-01

Support programmes for stress reduction were offered independently in two departments (650 employees in total) of an insurance group. Both departments, referred to as comparison group 1 and 2 (CG1 and CG2), offered an Employee Assistance Programme (EAP) featuring individual consultations. The employees were addressed through different channels of communication, such as staff meetings, superiors and email. In CG1, a staff adviser additionally called on all employees at their workplace and showed them a brief relaxing technique in order to raise awareness of stress reduction. By contacting employees personally it was also intended to reduce the inhibition threshold for the following individual talks. In CG2 individual talks were done face-to-face, whereas CG1 used telephone counselling. By using the new access channel with an additional personal contact at the workplace, an above average percentage of employees in CG1 could be motivated to participate in the following talks. The rate of participants was five times as high as in CG1, with lower costs for the consultation in each case.

Revisiting Employee Assistance Programs and Substance Use Problems in the Workplace: Key Issues and a Research Agenda

PubMed Central

Levy Merrick, Elizabeth S.; Volpe-Vartanian, Joanna; Horgan, Constance M.; McCann, Bernard

2012-01-01

This column describes employee assistance program (EAPs) and identifies key issues for contemporary EAPs. These programs began as occupational alcohol programs and have evolved into more comprehensive resources. To better understand contemporary EAPs, the authors suggest a research agenda at includes descriptive studies to provide an up-to-date picture of services; investigations of how contemporary EAPs address substance use problems, including management consultation for early identification; further study of EAPs’ effects on outcomes, such as productivity and work group outcomes; examination of the relationship between EAPs and other workplace resources; further examination of influences on EAP utilization; and development and testing of EAP performance measures. PMID:17914000

Patient Protection and Affordable Care Act Medicaid expansion and gains in health insurance coverage and access among cancer survivors.

PubMed

Nikpay, Sayeh S; Tebbs, Margaret G; Castellanos, Emily H

2018-04-17

The Patient Protection and Affordable Care Act extends Medicaid coverage to millions of low-income adults, including many survivors of cancer who were unable to purchase affordable health insurance coverage in the individual health insurance market. Using data from the 2011 to 2015 Behavioral Risk Factor Surveillance System, the authors compared changes in coverage and health care access measures for low-income cancer survivors in states that did and did not expand Medicaid. The study population of 17,381 individuals included adults aged 18 to 64 years, and was predominantly female, white, and unmarried. The authors found a relative reduction in the uninsured rate of 11.7 percentage points and a relative increase in the probability of having a personal physician of 5.8 percentage points. Stratifying by whether states expanded Medicaid by 2015, the authors found that relative gains in coverage and access were larger among those individuals residing in states with expanded Medicaid compared with those residing in nonexpansion states. The results of the current study suggest that the Patient Protection and Affordable Care Act Medicaid expansion has improved coverage and access for cancer survivors. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

Maintenance of access as demand for substance use disorder treatment grows.

PubMed

Frakt, Austin B; Trafton, Jodie; Pizer, Steven D

2015-08-01

Due to the Affordable Care Act and other recent laws and regulations, funding for substance use disorder (SUD) treatment is on the rise. In the 2000s, the Veterans Health Administration (VA) implemented several initiatives that increased funding for SUD treatment during a period of growth in demand for it. A key question is whether access to and intensity of treatment kept pace or declined. Using VA SUD treatment funding data and patient-level records to construct performance measures, we studied the relationship between funding and access during the VA expansion. Overall, we observed an increase in access to and intensity of VA SUD care associated with increased funding. The VA was able to increase funding for and expand the population to which it offered SUD treatment without diminishing internal access and intensity. Published by Elsevier Inc.

Teacher Placement into Immigrant English Learner Classrooms: Limiting Access in Comprehensive High Schools

ERIC Educational Resources Information Center

Dabach, Dafney Blanca

2015-01-01

This qualitative study examined how secondary teachers were assigned to teach courses intended to expand English learners' (ELs') access to academic subjects. Theoretically, this research extends the "contexts of reception" framework from immigration studies into the educational realm by investigating how teachers--as one important…

Expanding P450 catalytic reaction space through evolution and engineering

PubMed Central

McIntosh, John A.; Farwell, Christopher C.; Arnold, Frances H.

2014-01-01

Advances in protein and metabolic engineering have led to wider use of enzymes to synthesize important molecules. However, many desirable transformations are not catalyzed by any known enzyme, driving interest in understanding how new enzymes can be created. The cytochrome P450 enzyme family, whose members participate in xenobiotic metabolism and natural products biosynthesis, catalyzes an impressive range of difficult chemical reactions that continues to grow as new enzymes are characterized. Recent work has revealed that P450-derived enzymes can also catalyze useful reactions previously accessible only to synthetic chemistry. The evolution and engineering of these enzymes provides an excellent case study for how to genetically encode new chemistry and expand biology’s reaction space. PMID:24658056

Advanced expander test bed program

NASA Technical Reports Server (NTRS)

Riccardi, D. P.; Mitchell, J. C.

1993-01-01

The Advanced Expander Test Bed (AETB) is a key element in NASA's Space Chemical Engine Technology Program for development and demonstration of expander cycle oxygen/hydrogen engine and advanced component technologies applicable to space engines as well as launch vehicle upper stage engines. The AETB will be used to validate the high-pressure expander cycle concept, investigate system interactions, and conduct investigations of advanced mission focused components and new health monitoring techniques in an engine system environment. The split expander cycle AETB will operate at combustion chamber pressures up to 1200 psia with propellant flow rates equivalent to 20,000 lbf vacuum thrust. Contract work began 27 Apr. 1990. During 1992, a major milestone was achieved with the review of the final design of the oxidizer turbopump in Sep. 1992.

Expanding Access to BRCA1/2 Genetic Counseling with Telephone Delivery: A Cluster Randomized Trial

PubMed Central

Butler, Karin M.; Schwartz, Marc D.; Mandelblatt, Jeanne S.; Boucher, Kenneth M.; Pappas, Lisa M.; Gammon, Amanda; Kohlmann, Wendy; Edwards, Sandra L.; Stroup, Antoinette M.; Buys, Saundra S.; Flores, Kristina G.; Campo, Rebecca A.

2014-01-01

Background The growing demand for cancer genetic services underscores the need to consider approaches that enhance access and efficiency of genetic counseling. Telephone delivery of cancer genetic services may improve access to these services for individuals experiencing geographic (rural areas) and structural (travel time, transportation, childcare) barriers to access. Methods This cluster-randomized clinical trial used population-based sampling of women at risk for BRCA1/2 mutations to compare telephone and in-person counseling for: 1) equivalency of testing uptake and 2) noninferiority of changes in psychosocial measures. Women 25 to 74 years of age with personal or family histories of breast or ovarian cancer and who were able to travel to one of 14 outreach clinics were invited to participate. Randomization was by family. Assessments were conducted at baseline one week after pretest and post-test counseling and at six months. Of the 988 women randomly assigned, 901 completed a follow-up assessment. Cluster bootstrap methods were used to estimate the 95% confidence interval (CI) for the difference between test uptake proportions, using a 10% equivalency margin. Differences in psychosocial outcomes for determining noninferiority were estimated using linear models together with one-sided 97.5% bootstrap CIs. Results Uptake of BRCA1/2 testing was lower following telephone (21.8%) than in-person counseling (31.8%, difference = 10.2%, 95% CI = 3.9% to 16.3%; after imputation of missing data: difference = 9.2%, 95% CI = -0.1% to 24.6%). Telephone counseling fulfilled the criteria for noninferiority to in-person counseling for all measures. Conclusions BRCA1/2 telephone counseling, although leading to lower testing uptake, appears to be safe and as effective as in-person counseling with regard to minimizing adverse psychological reactions, promoting informed decision making, and delivering patient-centered communication for both rural and urban women. PMID:25376862

Interactive Exploration for Continuously Expanding Neuron Databases.

PubMed

Li, Zhongyu; Metaxas, Dimitris N; Lu, Aidong; Zhang, Shaoting

2017-02-15

This paper proposes a novel framework to help biologists explore and analyze neurons based on retrieval of data from neuron morphological databases. In recent years, the continuously expanding neuron databases provide a rich source of information to associate neuronal morphologies with their functional properties. We design a coarse-to-fine framework for efficient and effective data retrieval from large-scale neuron databases. In the coarse-level, for efficiency in large-scale, we employ a binary coding method to compress morphological features into binary codes of tens of bits. Short binary codes allow for real-time similarity searching in Hamming space. Because the neuron databases are continuously expanding, it is inefficient to re-train the binary coding model from scratch when adding new neurons. To solve this problem, we extend binary coding with online updating schemes, which only considers the newly added neurons and update the model on-the-fly, without accessing the whole neuron databases. In the fine-grained level, we introduce domain experts/users in the framework, which can give relevance feedback for the binary coding based retrieval results. This interactive strategy can improve the retrieval performance through re-ranking the above coarse results, where we design a new similarity measure and take the feedback into account. Our framework is validated on more than 17,000 neuron cells, showing promising retrieval accuracy and efficiency. Moreover, we demonstrate its use case in assisting biologists to identify and explore unknown neurons. Copyright © 2017 Elsevier Inc. All rights reserved.

Expanding state laws and a growing role for pharmacists in vaccination services.

PubMed

Schmit, Cason D; Penn, Matthew S

Gaps in vaccination coverage leave populations vulnerable to illnesses. Since the 1990s, there has been a growing movement to improve vaccination access by giving pharmacists the authority to administer vaccines according to state laws. Understanding the variation of pharmacist vaccination laws over time is critical to understanding the effect of improving access to vaccination services. We identified relevant statutes and regulations with the use of Westlaw legal databases. A 4-stage coding process identified 220 legal variables of pharmacist vaccination authority. Each jurisdiction's laws were coded against these 220 legal variables. The resulting legal dataset was then evaluated to determine whether jurisdictions expanded or restricted pharmacist vaccination authorities over time. From 1971 to 2016, jurisdictions made 627 changes to statutes and regulations relating to pharmacist vaccination authority. There were 85 expansions, 3 restrictions, and 22 regulatory clarifications. Eight changes were deemed to be unclear, and 479 changes did not substantively alter the scope of pharmacist vaccination authority. Collectively, the laws in 50 states and DC paint a clear picture: the scope of pharmacists' vaccination authority is expanding. Jurisdictions are allowing pharmacists to administer more vaccines to younger patients with less direct prescriber oversight. This clear expansion of pharmacist vaccination authority stands in contrast to the reservations expressed by some physician groups for pharmacists as vaccination providers. However, laws in some states still do not permit pharmacists to vaccinate according to the Advisory Committee on Immunization Practices recommendations. Copyright © 2017 American Pharmacists Association®. All rights reserved.

Employee assistance program services for intimate partner violence and client satisfaction with these services.

PubMed

Pollack, Keshia M; McKay, Tasseli; Cumminskey, Chris; Clinton-Sherrod, A Monique; Lindquist, Christine H; Lasater, Beth M; Walters, Jennifer L Hardison; Krotki, Karol; Grisso, Jeane Ann

2010-08-01

To describe intimate partner violence (IPV) services available through employee assistance programs (EAPs) and determine women's satisfaction with these services. A mixed-methods study consisting of semistructured telephone interviews with 28 EAPs about IPV-related services and a national web-based survey of 1765 women regarding their interactions with EAPs when seeking IPV-related assistance. Data were collected in the fall of 2008. EAPs provide fairly extensive services to individuals experiencing IPV. Satisfaction with EAP services for IPV was significantly associated with annual income and the type of help received from the EAP, but not with type of IPV experienced. EAP representatives described challenges with accurately identifying IPV victims and women expressed concerns with confidentiality. Future efforts to enhance the ability of EAPs to respond effectively to IPV should address confidentially and strengthen how IPV-related assistance is delivered.

Impacts of extension access and cooperative membership on technology adoption and household welfare.

PubMed

Wossen, Tesfamicheal; Abdoulaye, Tahirou; Alene, Arega; Haile, Mekbib G; Feleke, Shiferaw; Olanrewaju, Adetunji; Manyong, Victor

2017-08-01

This paper examines the impacts of access to extension services and cooperative membership on technology adoption, asset ownership and poverty using household-level data from rural Nigeria. Using different matching techniques and endogenous switching regression approach, we find that both extension access and cooperative membership have a positive and statistically significant effect on technology adoption and household welfare. Moreover, we find that both extension access and cooperative membership have heterogeneous impacts. In particular, we find evidence of a positive selection as the average treatment effects of extension access and cooperative membership are higher for farmers with the highest propensity to access extension and cooperative services. The impact of extension services on poverty reduction and of cooperatives on technology adoption is significantly stronger for smallholders with access to formal credit than for those without access. This implies that expanding rural financial markets can maximize the potential positive impacts of extension and cooperative services on farmers' productivity and welfare.

Aiding troubled employees: the prevalence, cost, and characteristics of employee assistance programs in the United States.

PubMed Central

Hartwell, T D; Steele, P; French, M T; Potter, F J; Rodman, N F; Zarkin, G A

1996-01-01

OBJECTIVES: Employee assistance programs (EAPs) are job-based programs designed to identify and assist troubled employees. This study determines the prevalence, cost, and characteristics of these programs in the United States by worksite size, industry, and census region. METHODS: A stratified national probability sample of more than 6400 private, nonagricultural US worksites with 50 or more full-time employees was contacted with a computer-assisted telephone interviewing protocol. More than 3200 worksites responded and were eligible, with a response rate of 90%. RESULTS: Approximately 33% of all private, nonagricultural worksites with 50 or more full-time employees currently offer EAP services to their employees, an 8.9% increase over 1985. These programs are more likely to be found in larger worksites and in the communications/utilities/transportation industries. The most popular model is an external provider, and the median annual cost per eligible employee for internal and external programs was $21.83 and $18.09, respectively. CONCLUSIONS: EAPs are becoming a more prevalent point of access to health care for workers with personal problems such as substance abuse, family problems, or emotional distress. PMID:8659653

Equity in access to fortified maize flour and corn meal

PubMed Central

Zamora, Gerardo; De-Regil, Luz Maria

2014-01-01

Mass fortification of maize flour and corn meal with a single or multiple micronutrients is a public health intervention that aims to improve vitamin and mineral intake, micronutrient nutritional status, health, and development of the general population. Micronutrient malnutrition is unevenly distributed among population groups and is importantly determined by social factors, such as living conditions, socioeconomic position, gender, cultural norms, health systems, and the socioeconomic and political context in which people access food. Efforts trying to make fortified foods accessible to the population groups that most need them require acknowledgment of the role of these determinants. Using a perspective of social determinants of health, this article presents a conceptual framework to approach equity in access to fortified maize flour and corn meal, and provides nonexhaustive examples that illustrate the different levels included in the framework. Key monitoring areas and issues to consider in order to expand and guarantee a more equitable access to maize flour and corn meal are described. PMID:24329609

Newly available technologies present expanding opportunities for scientific and technical information exchange

NASA Astrophysics Data System (ADS)

Tolzman, Jean M.

1993-03-01

The potential for expanded communication among researchers, scholars, and students is supported by growth in the capabilities for electronic communication as well as expanding access to various forms of electronic interchange and computing capabilities. Research supported by the National Aeronautics and Space Administration points to a future where workstations with audio and video monitors and screen-sharing protocols are used to support collaborations with colleagues located throughout the world. Instruments and sensors all over the world will produce data streams that will be brought together and analyzed to produce new findings, which in turn can be distributed electronically. New forms of electronic journals will emerge and provide opportunities for researchers and scientists to electronically and interactively exchange information in a wide range of structures and formats. Ultimately, the wide-scale use of these technologies in the dissemination of research results and the stimulation of collegial dialogue will change the way we represent and express our knowledge of the world. A new paradigm will evolve-perhaps a truly worldwide 'invisible college'.

Newly available technologies present expanding opportunities for scientific and technical information exchange

NASA Technical Reports Server (NTRS)

Tolzman, Jean M.

1993-01-01

The potential for expanded communication among researchers, scholars, and students is supported by growth in the capabilities for electronic communication as well as expanding access to various forms of electronic interchange and computing capabilities. Research supported by the National Aeronautics and Space Administration points to a future where workstations with audio and video monitors and screen-sharing protocols are used to support collaborations with colleagues located throughout the world. Instruments and sensors all over the world will produce data streams that will be brought together and analyzed to produce new findings, which in turn can be distributed electronically. New forms of electronic journals will emerge and provide opportunities for researchers and scientists to electronically and interactively exchange information in a wide range of structures and formats. Ultimately, the wide-scale use of these technologies in the dissemination of research results and the stimulation of collegial dialogue will change the way we represent and express our knowledge of the world. A new paradigm will evolve-perhaps a truly worldwide 'invisible college'.

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

PubMed

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

2007-01-01

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

Approaches used by employee assistance programs to address perpetration of intimate partner violence.

PubMed

Walters, Jennifer L Hardison; Pollack, Keshia M; Clinton-Sherrod, Monique; Lindquist, Christine H; McKay, Tasseli; Lasater, Beth M

2012-01-01

Employee Assistance Programs (EAPs) are workplace resources available to employees with problems impacting work performance. EAPs are well-positioned to address intimate partner violence (IPV), a major public health problem with workplace impacts. A purposeful sample of 28 EAPs across the United States was surveyed to identify policies and programs to address IPV, including perpetration. Most EAPs did not report having standardized approaches for addressing IPV perpetration. EAPs also described significant barriers to identifying IPV perpetrators, with the majority relying on self-disclosure on the part of the perpetrator when contacting the EAP. These results suggest that many EAPs--even when interacting with employees who present with issues known to correlate with IPV--are missing a potential opportunity to assess and intervene with IPV perpetrators.

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

Ends versus means: the role of markets in expanding access to contraceptives.

PubMed

Hanson, K; Kumaranayake, L; Thomas, I

2001-06-01

Achieving and sustaining universal access to contraceptives are key policy goals of interventions supplying contraceptive commodities. Donor support for contraceptive supplies is substantial and many public and national programmes rely on donated and subsidized supplies of contraceptives. Sustainability of programme benefits is a concern to both national governments and donor agencies. At the same time, market-based provision of contraceptives has become a major source of contraceptives for individuals in a number of countries. While the goals or 'ends' of policy are to increase and sustain universal access to contraceptives, there is debate about the role of markets and their negative impacts on equity and universality. There is also concern that while public programmes supplying free contraceptives may, in the medium-term, achieve high coverage, they may hamper the achievement of long-term sustainability and the development of commercial markets. This paper focuses on the tension between the public health and market paradigms, and uses economic analysis as a framework in order to examine the relative roles or 'means' for subsidized public and commercial private sector supply of contraceptives. The review of the theory and evidence focuses on the trade-offs between public sector and market provision of contraceptives, examining the role for the public sector given the potential for market failures, the impact of public provision on the development of markets, and the role of price in demand. However, because of the potential conflict between these policy objectives, we argue that strategies to deliver contraceptives should be based on the specific characteristics of the context. In particular four variables (contraceptive prevalence rates, HIV prevalence, income level of country, size and geographic spread of private sector development) are important in characterizing this context, and these are highlighted in a matrix of programme priorities. Public choices need

Sierra Stars Observatory Network: An Accessible Global Network

NASA Astrophysics Data System (ADS)

Williams, Richard; Beshore, Edward

2011-03-01

The Sierra Stars Observatory Network (SSON) is a unique partnership among professional observatories that provides its users with affordable high-quality calibrated image data. SSON comprises observatories in the Northern and Southern Hemisphere and is in the process of expanding to a truly global network capable of covering the entire sky 24 hours a day in the near future. The goal of SSON is to serve the needs of science-based projects and programs. Colleges, universities, institutions, and individuals use SSON for their education and research projects. The mission of SSON is to promote and expand the use of its facilities among the thousands of colleges and schools worldwide that do not have access to professional-quality automated observatory systems to use for astronomy education and research. With appropriate leadership and guidance educators can use SSON to help teach astronomy and do meaningful scientific projects. The relatively small cost of using SSON for this type of work makes it affordable and accessible for educators to start using immediately. Remote observatory services like SSON need to evolve to better support education and research initiatives of colleges, institutions and individual investigators. To meet these needs, SSON is developing a sophisticated interactive scheduling system to integrate among the nodes of the observatory network. This will enable more dynamic observations, including immediate priority interrupts, acquiring moving objects using ephemeris data, and more.

Ras Labs.-CASIS-ISS NL experiment for synthetic muscle: resistance to ionizing radiation

NASA Astrophysics Data System (ADS)

Rasmussen, Lenore; Sandberg, Eric; Albers, Leila N.; Rodriguez, Simone; Gentile, Charles A.; Meixler, Lewis D.; Ascione, George; Hitchner, Robert; Taylor, James; Hoffman, Dan; Cylinder, David; Moy, Leon; Mark, Patrick S.; Prillaman, Daniel L.; Nordarse, Robert; Menegus, Michael J.; Ratto, Jo Ann; Thellen, Christopher; Froio, Danielle; Furlong, Cosme; Razavi, Payam; Valenza, Logan; Hablani, Surbhi; Fuerst, Tyler; Gallucci, Sergio; Blocher, Whitney; Liffland, Stephanie

2016-04-01

In anticipation of deep space travel, new materials are being explored to assist and relieve humans in dangerous environments, such as high radiation, extreme temperature, and extreme pressure. Ras Labs Synthetic Muscle - electroactive polymers (EAPs) that contract and expand at low voltages - which mimic the unique gentle-yet-strong nature of human tissue, is a potential asset to manned space travel through protective gear and human assist robotics and for unmanned space exploration through deep space. Generation 3 Synthetic Muscle was proven to be resistant to extreme temperatures, and there were indications that these materials may also be radiation resistant. The purpose of the Ras Labs-CASIS-ISS Experiment is to test the radiation resistivity of the third and fourth generation of these EAPs, as well as to make them even more radiation resistant or radiation hardened. On Earth, exposure of the Generation 3 and Generation 4 EAPs to a Cs-137 radiation source for 47.8 hours with a total dose of 305.931 kRad of gamma radiation was performed at the US Department of Energy's Princeton Plasma Physics Laboratory (PPPL) at Princeton University, followed by pH, peroxide, Shore Hardness Durometry, and electroactivity testing to determine the inherent radiation resistivity of these contractile EAPs and to determine whether the EAPs could be made even more radiation resistant through the application of appropriate additives and coatings. The on Earth preliminary tests determined that selected Ras Labs EAPs were not only inherently radiation resistant, but with the appropriate coatings and additives, could be made even more radiation resistant. Gforce testing to over 10 G's was performed at US Army's ARDEC Labs, with excellent results, in preparation for space flight to the International Space Station National Laboratory (ISS-NL). Selected samples of Generation 3 and Generation 4 Synthetic Muscle™, with various additives and coatings, were launched to the ISS-NL on April

Ras Labs-CASIS-ISS NL experiment for synthetic muscle returned to Earth: resistance to ionizing radiation

NASA Astrophysics Data System (ADS)

Rasmussen, Lenore; Albers, Leila N.; Rodriguez, Simone; Gentile, Charles; Meixler, Lewis D.; Ascione, George; Hitchner, Robert; Taylor, James; Hoffman, Dan; Cylinder, David; Gaza, Ramona; Moy, Leon; Mark, Patrick S.; Prillaman, Daniel L.; Nodarse, Robert; Menegus, Michael J.; Ratto, Jo Ann; Thellen, Christopher T.; Froio, Danielle; Valenza, Logan; Poirier, Catherine; Sinkler, Charles; Corl, Dylan; Hablani, Surbhi; Fuerst, Tyler; Gallucci, Sergio; Blocher, Whitney; Liffland, Stephanie

2017-04-01

In anticipation of deep space travel, new materials are being explored to assist and relieve humans in dangerous environments, such as high radiation, extreme temperature, and extreme pressure. Ras Labs Synthetic Muscle™ - electroactive polymers (EAPs) that contract and expand at low voltages - which mimic the unique gentle-yet-strong nature of human tissue, is a potential asset to manned space travel through protective gear and human assist robotics and for unmanned space exploration through deep space. Gen 3 Synthetic Muscle™ was proven to be resistant to extreme temperatures, and there were indications that these materials would also be radiation resistant. The purpose of the Ras Labs-CASIS-ISS Experiment was to test the radiation resistivity of the third and fourth generation of these EAPs, as well as to make them even more radiation resistant. On Earth, exposure of the Generation 3 and Generation 4 EAPs to a Cs-137 radiation source for 47.8 hours with a total dose of 305.931 kRad of gamma radiation was performed at the US Department of Energy's Princeton Plasma Physics Laboratory (PPPL) at Princeton University, followed by pH, peroxide, Shore Hardness durometer, and electroactivity testing to determine the inherent radiation resistivity of these contractile EAPs, and to determine whether the EAPs could be made even more radiation resistant through the application of appropriate additives and coatings. The on Earth preliminary tests determined that selected Ras Labs EAPs were not only inherently radiation resistant, but with the appropriate coatings and additives, could be made even more radiation resistant. G-force testing to over 10 G's was performed at US Army's ARDEC Labs, with excellent results, in preparation for space flight to the International Space Station National Laboratory (ISS-NL). Selected samples of Generation 3 and Generation 4 Synthetic Muscle™, with various additives and coatings, were launched to the ISS-NL on April 14, 2015 on the

Axicabtagene Ciloleucel Expanded Access Study

ClinicalTrials.gov

2018-05-29

Relapsed/Refractory Diffuse Large B Cell Lymphoma; Relapsed/Refractory Primary Mediastinal B Cell Lymphoma; Relapsed/Refractory Transformed Follicular Lymphoma; Relapsed/Refractory High-Grade B-Cell Lymphoma

Caring for Pregnant Women with Opioid Use Disorder in the USA: Expanding and Improving Treatment.

PubMed

Saia, Kelley A; Schiff, Davida; Wachman, Elisha M; Mehta, Pooja; Vilkins, Annmarie; Sia, Michelle; Price, Jordana; Samura, Tirah; DeAngelis, Justin; Jackson, Clark V; Emmer, Sawyer F; Shaw, Daniel; Bagley, Sarah

Opioid use disorder in the USA is rising at an alarming rate, particularly among women of childbearing age. Pregnant women with opioid use disorder face numerous barriers to care, including limited access to treatment, stigma, and fear of legal consequences. This review of opioid use disorder in pregnancy is designed to assist health care providers caring for pregnant and postpartum women with the goal of expanding evidence-based treatment practices for this vulnerable population. We review current literature on opioid use disorder among US women, existing legislation surrounding substance use in pregnancy, and available treatment options for pregnant women with opioid use disorder. Opioid agonist treatment (OAT) remains the standard of care for treating opioid use disorder in pregnancy. Medically assisted opioid withdrawal ("detoxification") is not recommended in pregnancy and is associated with high maternal relapse rates. Extended release naltrexone may confer benefit for carefully selected patients. Histories of trauma and mental health disorders are prevalent in this population; and best practice recommendations incorporate gender-specific, trauma-informed, mental health services. Breastfeeding with OAT is safe and beneficial for the mother-infant dyad. Further research investigating options of OAT and the efficacy of opioid antagonists in pregnancy is needed. The US health care system can adapt to provide quality care for these mother-infant dyads by expanding comprehensive treatment services and improving access to care.

A cross-sectional survey on the attitudes and interests of rural population towards expanded pharmacist prescribing in India.

PubMed

Khan, Muhammad Umair; Arief, Mohammad; Ahmad, Akram; Malik, Sadiqa; Gogoi, Lakhya Jyoti; Kalita, Manabendra; Saleem, Fahad; Hassali, Mohamed Azmi Ahmad

2017-04-01

Background Shortage of qualified medical doctors and little or no access to basic medicines and medical facilities are the major rural health concerns in India. Expanding the role of pharmacists to provide prescribing services could improve rural health outcomes. Objective To assess the attitudes of rural population towards pharmacist prescribing and their interest in using expanded pharmacist prescribing services. Setting Rural population of Assam, India. Methods A descriptive, cross-sectional survey was conducted for a period of 2 months from March to April 2016 in the State of Assam, India. A multi-stage sampling was used to recruit (n = 410) eligible participants. Main outcome measure Rural population attitudes towards, and interests in using, pharmacist prescribing services. Results The attitudes of participants were generally positive towards pharmacist prescribing. A large proportion of participants (81.5%) agreed that pharmacists should have a prescribing role in rural India. Participants indicated their interest in using expanded pharmacist prescribing services, with greater interests in receiving medications in emergency situations (79.7%) and getting a treatment plan for their medical problem (75.6%). Participants with low income and tertiary education had better attitudes and showed more interest towards expanded pharmacist prescribing services (p < 0.05). Conclusions Most participants had positive attitudes towards pharmacist prescribing and were interested in using expanded pharmacist prescribing services.

[Trimming with argon plasma of self-expanding metal stents: report of 7 cases].

PubMed

Jury, Gastón; Amieva, Leandro; López, Fagalde Rafael; Jury, Rubén

2014-06-01

The use of self-expandable enteral stents for palliation of malignant stenosis may present the complication of concealing the ampulla of Vater behind the metallic mesh. Anchoring in the duodenal wall (distal or partial migration) may also be a complication of biliary metallic stents and therefore may cause difficulty in gaining access to the biliary tract. In these cases of difficult access, a fenestration on the prosthesis ( biliary or enteral) can be created to allow reaching the obstructed biliary tract by means of argon plasma (AP). Were retrospectively analysed 7 cases. Under endoscopic vision, AP was directed to filgurate and cut 6 biliary prosthesis and a duodenal stent. Fulguration and cut of biliary stent was performed in 5 cases of distal partial migration and cholangitis. In one case of obstruction caused by distal migration inside the duodenal stent light, cutting of the biliary stent was performed. A window was created in the enteral prosthesis in order to access the ampulla of Vater and place a biliary tract prosthesis. All cases were resolved successfully and without complications. We conclude that the use of AP to fulgurate and cut nitinol prosthesis was effective and presented no complications in this series.

Levels of substance use and willingness to use the Employee Assistance Program.

PubMed

Reynolds, G Shawn; Lehman, Wayne E K

2003-01-01

Individuals with drinking and drug problems may become particularly reluctant to seek help. To remove barriers to services, more needs to be understood about factors that influence help-seeking decisions. It was hypothesized that certain social psychological influences (attitudes, group cohesion, trust in management) might buffer a reluctance to use services provided by an external Employee Assistance Program (EAP). A random sampling of municipal employees (n = 793) completed anonymous questionnaires that assessed willingness to use the EAP, individual drinking and drug use, attitudes toward policy, work group cohesion, and trust in management. Data from the questionnaires were analyzed with multivariate regression analyses to examine the interacting effects of substance abuse and proposed moderators (gender, race, awareness of the EAP, perceptions of policy, cohesion) on willingness to use the EAP. The results demonstrated that although substance abusers were less willing to use the EAP than were nonusers, substance abusers who were aware of the EAP, who had favorable attitudes toward policy, and who did not tolerate coworker substance abuse were as willing to use the EAP as were nonusers. The results also showed that employees with greater awareness of the EAP, support for policy, and perceptions of work group cohesion reported significantly greater willingness to use the EAP than did employees with relatively less awareness of the EAP, policy support, and cohesion. Workplace prevention efforts that are designed to increase the use of EAP services should intentionally target the workplace environment and social context. Creating the awareness and favorability of the EAP, policy, and work group cohesion might buffer substance abusers' reluctance to seek help.

Bigelow Expandable Activity Module (BEAM) Monitoring System

NASA Technical Reports Server (NTRS)

Wells, Nathan

2017-01-01

What is Bigelow Expandable Activity Module (BEAM)? The Bigelow Expandable Activity Module (BEAM) is an expandable habitat technology demonstration on ISS; increase human-rated inflatable structure Technology Readiness Level (TRL) to level 9. NASA managed ISS payload project in partnership with Bigelow Aerospace. Launched to ISS on Space X 8 (April 8th, 2016). Fully expanded on May 28th, 2016. Jeff Williams/Exp. 48 Commander first entered BEAM on June 5th, 2016.

Environmental Assessment Expanded Ponnequin Wind Energy Project Weld County, Colorado

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

N /A

1999-03-02

The U.S.Department of Energy (DOE) has considered a proposal from the State of Colorado, Office of Energy Conservation (OEC), for funding construction of the Expanded Ponnequin Wind Project in Weld County, Colorado. OEC plans to enter into a contracting arrangement with Public Service Company of Colorado (PSCO) for the completion of these activities. PSCo, along with its subcontractors and business partners, are jointly developing the Expanded Ponnequin Wind Project. DOE completed an environmental assessment of the original proposed project in August 1997. Since then, the geographic scope and the design of the project changed, necessitating additional review of the projectmore » under the National Environmental Policy Act. The project now calls for the possible construction of up to 48 wind turbines on State and private lands. PSCo and its partners have initiated construction of the project on private land in Weld County, Colorado. A substation, access road and some wind turbines have been installed. However, to date, DOE has not provided any funding for these activities. DOE, through its Commercialization Ventures Program, has solicited applications for financial assistance from state energy offices, in a teaming arrangement with private-sector organizations, for projects that will accelerate the commercialization of emerging renewable energy technologies. The Commercialization Ventures Program was established by the Renewable Energy and Energy Efficiency Technology Competitiveness Act of 1989 (P.L. 101-218) as amended by the Energy Policy Act of 1992 (P.L. 102-486). The Program seeks to assist entry into the marketplace of newly emerging renewable energy technologies, or of innovative applications of existing technologies. In short, an emerging renewable energy technology is one which has already proven viable but which has had little or no operational experience. The Program is managed by the Department of Energy, Office of Energy Efficiency and Renewable

A Rapidly Expanding Bose-Einstein Condensate: An Expanding Universe in the Lab

NASA Astrophysics Data System (ADS)

Eckel, S.; Kumar, A.; Jacobson, T.; Spielman, I. B.; Campbell, G. K.

2018-04-01

We study the dynamics of a supersonically expanding, ring-shaped Bose-Einstein condensate both experimentally and theoretically. The expansion redshifts long-wavelength excitations, as in an expanding universe. After expansion, energy in the radial mode leads to the production of bulk topological excitations—solitons and vortices—driving the production of a large number of azimuthal phonons and, at late times, causing stochastic persistent currents. These complex nonlinear dynamics, fueled by the energy stored coherently in one mode, are reminiscent of a type of "preheating" that may have taken place at the end of inflation.

Market-Based Higher Education: Does Colorado's Voucher Model Improve Higher Education Access and Efficiency?

ERIC Educational Resources Information Center

Hillman, Nicholas W.; Tandberg, David A.; Gross, Jacob P. K.

2014-01-01

In 2004, Colorado introduced the nation's first voucher model for financing public higher education. With state appropriations now allocated to students, rather than institutions, state officials expect this model to create cost efficiencies while also expanding college access. Using difference-in-difference regression analysis, we find limited…

Disparate British Breast Reconstruction Utilization: Is Universal Coverage Sufficient to Ensure Expanded Care?

PubMed Central

Offodile, Anaeze C.

2016-01-01

Summary: Our intent is to improve the understanding of the ability of healthcare providers to deliver high-quality care as we approach an era of universal coverage. We adopted 2 unique vantage points in this article: (1) the mandated coverage for immediate breast reconstruction (IBR) surgery as a microcosmic surrogate for universal coverage overall and (2) we then scrutinized the respective IBR utilization rates in a contemporaneous system of 2 healthcare delivery models in the United Kingdom, that is, the public National Health Service trust versus private-sector hospitals. A literature review was performed for IBR rates across public trust and private-sector hospitals in the United Kingdom. The IBR rate among public trust hospitals was 17% compared with 43% in the private sector. In the trust hospital setting, the enactment of 2 government mandates, intended to increase the access to cancer care, seemed to fall short in maximizing the ability of surgical practitioners to deliver quality care to patients. Among women who did not receive IBR, 65% felt that they had received the sufficient amount of information to appropriately inform their decision. In addition, only 46% of this same cohort reported a consultation with a reconstructive surgeon preoperatively. Private-sector hospitals delivered better IBR care because of the likely presence of infrastructure and financial incentives for physicians. These results serve as a call for a better alignment between policy initiatives designed to expand care access and the perogatives of physicians to ensure an optimized delivery of the expanded care such policy mandates. PMID:27482486

Job Satisfaction among Employee Assistance Professionals: A National Study.

ERIC Educational Resources Information Center

Sweeney, Anthony P.; Hohenshil, Thomas H.; Fortune, Jimmie C.

2002-01-01

Study examines job satisfaction in a national sample of employee assistance program (EAP) professionals. Data were collected from 210 EAP professionals through mailed surveys. Results indicate that respondents employed by external EAP organizations were more satisfied with their jobs than those who were employed by internal EAPs. (Contains 20…

Organizational Hierarchy, Employee Status, and Use of Employee Assistance Programs.

ERIC Educational Resources Information Center

Gerstein, Lawrence; And Others

1993-01-01

Examined role of organizational hierarchy and staff status in number of Employee Assistance Program (EAP) referrals made by potential helpers and relationship of these variables to personal EAP use among 157 supervisors and 232 employees. Supervisors suggested more EAP referrals than did employees. Middle level staff received EAP services more…

Highly Cited Occupational Therapy Articles in the Science Citation Index Expanded and Social Sciences Citation Index: A Bibliometric Analysis.

PubMed

Brown, Ted; Gutman, Sharon A; Ho, Yuh-Shan; Fong, Kenneth N K

A bibliometric analysis was completed of highly cited occupational therapy literature and authors published from 1991 to 2014 and accessible in the Science Citation Index Expanded (SCI-Expanded) and Social Sciences Citation Index (SSCI) databases. Data were obtained from the SCI-Expanded and SSCI. Articles referenced >100 times were categorized as highly cited articles (HCA). Of 6,486 articles found, 31 were categorized as HCA. The American Journal of Occupational Therapy published the largest number of HCA (n = 8; 26%). The 31 HCA were distributed across seven countries: United States (20 articles), Canada (3), United Kingdom (3), Australia (2), the Netherlands (1), New Zealand (1), and Sweden (1). The three authors with the highest Y-index were S. J. Page, F. Clark, and W. Dunn. A latency period of 4 to 5 yr post-publication appears to be needed for a journal article to gain citations. Copyright © 2017 by the American Occupational Therapy Association, Inc.

A Review of Research Methods Used to Examine Employee Assistance Program Delivery Options.

ERIC Educational Resources Information Center

Csiernik, Rick

1995-01-01

This review of literature on Employee Assistance Programs (EAPs) focuses on EAP delivery options. More than half of the 48 studies reviewed used a case study approach. EAPs provided by on-staff professionals were the most frequently discussed delivery option, although this is not the most dominant form of EAP provision. (SLD)

Employee assistance programs: a workplace resource to address intimate partner violence.

PubMed

Pollack, Keshia M; Austin, Whitney; Grisso, Jeane Ann

2010-04-01

Intimate partner violence (IPV) is a major public health problem with significant impact on the workplace. Employee assistance programs (EAPs) are a confidential benefit to assist employees and their families with a variety of problems that may negatively affect their job performance. The purpose of this systematic review is to study the extant literature to identify articles that have explored the role of EAPs in addressing IPV. We searched Medline, PsychINFO, and Cumulative Index of Nursing and Allied Health Literature (CINAHL) for English-language papers that have explored how EAPs can address IPV. Articles published through 2008 were included. Our review yielded nine articles, mostly from EAP-centered journals. Nearly all of the studies were published before the year 2000 and primarily describe the need for EAPs to be more engaged in preventing violence against women. Most of the studies were commentaries, often using case reports to support recommendations on how EAPs could address IPV. Results from the two intervention studies revealed close connections between EAP clients being treated for alcoholism and IPV perpetration and the effectiveness of a standardized tool to identify EAP clients experiencing IPV. Research in this area is in its infancy, and more studies are needed to inform the formulation of evidence-based policies and programs that guide the role of EAPs in addressing IPV. The lack of research on how EAPs address IPV is alarming, as many employers state that they often refer employees affected by IPV to the EAP for assistance.

Establishment of mouse expanded potential stem cells

PubMed Central

Gao, Xuefei; Antunes, Liliana; Yu, Yong; Zhu, Zhexin; Wang, Juexuan; Kolodziejczyk, Aleksandra A.; Campos, Lia S.; Wang, Cui; Yang, Fengtang; Zhong, Zhen; Fu, Beiyuan; Eckersley-Maslin, Melanie A.; Woods, Michael; Tanaka, Yosuke; Chen, Xi; Wilkinson, Adam C.; Bussell, James; White, Jacqui; Ramirez-Solis, Ramiro; Reik, Wolf; Göttgens, Berthold; Teichmann, Sarah A.; Tam, Patrick P. L.; Nakauchi, Hiromitsu; Zou, Xiangang; Lu, Liming; Liu, Pentao

2018-01-01

Mouse embryonic stem cells derived from the epiblast1 contribute to the somatic lineages and the germline but are excluded from the extra-embryonic tissues that are derived from the trophectoderm and the primitive endoderm2 upon reintroduction to the blastocyst. Here we report that cultures of expanded potential stem cells can be established from individual eight-cell blastomeres, and by direct conversion of mouse embryonic stem cells and induced pluripotent stem cells. Remarkably, a single expanded potential stem cell can contribute both to the embryo proper and to the trophectoderm lineages in a chimaera assay. Bona fide trophoblast stem cell lines and extra-embryonic endoderm stem cells can be directly derived from expanded potential stem cells in vitro. Molecular analyses of the epigenome and single-cell transcriptome reveal enrichment for blastomere-specific signature and a dynamic DNA methylome in expanded potential stem cells. The generation of mouse expanded potential stem cells highlights the feasibility of establishing expanded potential stem cells for other mammalian species. PMID:29019987

Who purchases nonprescription syringes? Characterizing customers of the Expanded Syringe Access Program (ESAP).

PubMed

Battles, Haven B; Rowe, Kirsten A; Ortega-Peluso, Christina; Klein, Susan J; Tesoriero, James M

2009-11-01

This study represents the first attempt in the USA to survey pharmacy nonprescription syringe customers at their point of purchase. We surveyed 62 individuals purchasing nonprescription syringes in seven pharmacies located in NYC and Albany, NY, USA. Three quarters of respondents purchased for illicit use, and 36% purchased for medical use, with differences found by race and gender. Half got their syringes from pharmacies "most of the time." Half had ever been refused a syringe purchase in a NYS pharmacy, with men, Blacks, and Hispanics reporting higher levels of refusals than women or whites. Two thirds reported syringe reuse but very few reported sharing. While approximately one quarter safely obtained and disposed of syringes "most of the time," two thirds used both safe and unsafe methods. Pharmacy-based syringe access programs are essential in areas not served by syringe exchanges.

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

PubMed

Keil, Aaron; Brown, Suzanne Robben

2015-01-01

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

The influence of passband limitation on the waveform of extracellular action potential.

PubMed

Mizuhiki, Takashi; Inaba, Kiyonori; Setogawa, Tsuyoshi; Toda, Koji; Ozaki, Shigeru; Shidara, Muneteka

2012-03-01

The duration of the extracellular action potential (EAP) in single neuronal recording has often been used as a clue to infer biochemical, physiological or functional substrate of the recorded neurons, e.g. neurochemical type. However, when recording a neuronal activity, the high-pass filter is routinely used to achieve higher signal-to-noise ratio. Signal processing theory predicts that passband limitation stretches the waveform of discrete brief impulse. To examine whether the duration of filtered EAP could be the reliable measure, we investigated the influence of high-pass filter both by simulation and unfiltered unit recording data from monkey dorsal raphe. Consistent with the findings in recent theoretical study, the unfiltered EAPs displayed the sharp wave without following bumps. The duration of unfiltered EAP was not correlated with that of filtered EAP. Thus the duration of original EAP cannot be estimated from filtered EAP. It is needed to reexamine the EAP duration measured for classifying the neurons whose activities were recorded under the passband limitation in the related studies. Copyright © 2011 Elsevier Ireland Ltd and the Japan Neuroscience Society. All rights reserved.

Evaluation of an employee assistance program.

PubMed

Nadolski, J N; Sandonato, C E

1987-01-01

The objective of the EAP effectiveness study was to determine the effectiveness of the EAP counseling services. The results demonstrate that employees who received help from the company's EAP subsequently improved their work performance. Although these results cannot be generalized to other EAPs, the results are encouraging and point toward a need for more research in this area.

Increasing access to care for Brazos Valley, Texas: a rural community of solution.

PubMed

Garney, Whitney R; Drake, Kelly; Wendel, Monica L; McLeroy, Kenneth; Clark, Heather R; Ryder, Byron

2013-01-01

Compared with their urban counterparts, rural populations face substantial disparities in terms of health care and health outcomes, particularly with regard to access to health services. To address ongoing inequities, community perspectives are increasingly important in identifying health issues and developing local solutions that are effective and sustainable. This article has been developed by both academic and community representatives and presents a brief case study of the evolution of a regional community of solution (COS) servicing a 7-county region called the Brazos Valley, Texas. The regional COS gave rise to multiple, more localized COSs that implemented similar strategies designed to address access to care within rural communities. The regional COS, known as the Brazos Valley Health Partnership, was a result of a 2002 health status assessment that revealed that rural residents face poorer access to health services and their care is often fragmented. Their localized strategy, called a health resource center, was created as a "one-stop shop" where multiple health and social service providers could be housed to deliver services to rural residents. Initially piloted in Madison County, the resource center model was expanded into Burleson, Grimes, and Leon Counties because of community buy-in at each of these sites. The resource center concept allowed service providers, who previously were able to offer services only in more populous areas, to expand into the rural communities because of reduced overhead costs. The services provided at the health resource centers include transportation, information and referral, and case management along with others, depending on the location. To ensure successful ongoing operations and future planning of the resource centers, local oversight bodies known as health resource commissions were organized within each of the rural communities to represent local COSs. Through collaboration with local entities, these partnerships have

Child Health and Access to Medical Care

PubMed Central

Leininger, Lindsey; Levy, Helen

2016-01-01

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

HIPAA's Individual Right of Access to Genomic Data: Reconciling Safety and Civil Rights.

PubMed

Evans, Barbara J

2018-01-04

In 2014, the United States granted individuals a right of access to their own laboratory test results, including genomic data. Many observers feel that this right is in tension with regulatory and bioethical standards designed to protect the safety of people who undergo genomic testing. This commentary attributes this tension to growing pains within an expanding federal regulatory program for genetic and genomic testing. The Genetic Information Nondiscrimination Act of 2008 expanded the regulatory agenda to encompass civil rights and consumer safety. The individual access right, as it applies to genomic data, is best understood as a civil-rights regulation. Competing regulatory objectives-safety and civil rights-were not successfully integrated during the initial rollout of genomic civil-rights regulations after 2008. Federal law clarifies how to prioritize safety and civil rights when the two come into conflict, although with careful policy design, the two need not collide. This commentary opens a dialog about possible solutions to advance safety and civil rights together. Copyright © 2017 American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

NASA Expands BEAM’s Mission

NASA Image and Video Library

2017-12-05

The mission of the Bigelow Expandable Activity Module (BEAM) on the International Space Station has been, well, expanded. After more than a year and a half on orbit providing performance data on expandable habitat technologies, NASA and Bigelow Aerospace have reached agreement to extend the life of the privately-owned module. For a minimum of three more years, BEAM will be a more operational element of the station used in crew activities and on board storage, allowing time to gather more data on the technology’s structural integrity, thermal stability, and resistance to space debris, radiation and microbial growth. _______________________________________ FOLLOW THE SPACE STATION! Twitter: https://twitter.com/Space_Station Facebook: https://www.facebook.com/ISS Instagram: https://instagram.com/iss/

Education for All: An Expanded Vision. World Conference on Education for All (Jomtien, Thailand, March 5-9, 1990). Monograph II. Roundtable Themes II.

ERIC Educational Resources Information Center

Fordham, Paul

This seven-chapter monograph elaborates on five components of an expanded vision of basic education. It presents material that deals with aspects of these components: universalizing access and promoting equity, focusing on learning, broadening the means and scope of basic education, enhancing the environment for learning, and strengthening…

How the affordable care act and mental health parity and addiction equity act greatly expand coverage of behavioral health care.

PubMed

Beronio, Kirsten; Glied, Sherry; Frank, Richard

2014-10-01

The Patient Protection and Affordable Care Act (ACA) will expand coverage of mental health and substance use disorder benefits and federal parity protections to over 60 million Americans. The key to this expansion is the essential health benefit provision in the ACA that requires coverage of mental health and substance use disorder services at parity with general medical benefits. Other ACA provisions that should improve access to treatment include requirements on network adequacy, dependent coverage up to age 26, preventive services, and prohibitions on annual and lifetime limits and preexisting exclusions. The ACA offers states flexibility in expanding Medicaid (primarily to childless adults, not generally eligible previously) to cover supportive services needed by those with significant behavioral health conditions in addition to basic benefits at parity. Through these various new requirements, the ACA in conjunction with Mental Health Parity and Addiction Equity Act (MHPAEA) will expand coverage of behavioral health care by historic proportions.

Design and validation of new genotypic tools for easy and reliable estimation of HIV tropism before using CCR5 antagonists.

PubMed

Poveda, Eva; Seclén, Eduardo; González, María del Mar; García, Federico; Chueca, Natalia; Aguilera, Antonio; Rodríguez, Jose Javier; González-Lahoz, Juan; Soriano, Vincent

2009-05-01

Genotypic tools may allow easier and less expensive estimation of HIV tropism before prescription of CCR5 antagonists compared with the Trofile assay (Monogram Biosciences, South San Francisco, CA, USA). Paired genotypic and Trofile results were compared in plasma samples derived from the maraviroc expanded access programme (EAP) in Europe. A new genotypic approach was built to improve the sensitivity to detect X4 variants based on an optimization of the webPSSM algorithm. Then, the new tool was validated in specimens from patients included in the ALLEGRO trial, a multicentre study conducted in Spain to assess the prevalence of R5 variants in treatment-experienced HIV patients. A total of 266 specimens from the maraviroc EAP were tested. Overall geno/pheno concordance was above 72%. A high specificity was generally seen for the detection of X4 variants using genotypic tools (ranging from 58% to 95%), while sensitivity was low (ranging from 31% to 76%). The PSSM score was then optimized to enhance the sensitivity to detect X4 variants changing the original threshold for R5 categorization. The new PSSM algorithms, PSSM(X4R5-8) and PSSM(SINSI-6.4), considered as X4 all V3 scoring values above -8 or -6.4, respectively, increasing the sensitivity to detect X4 variants up to 80%. The new algorithms were then validated in 148 specimens derived from patients included in the ALLEGRO trial. The sensitivity/specificity to detect X4 variants was 93%/69% for PSSM(X4R5-8) and 93%/70% for PSSM(SINSI-6.4). PSSM(X4R5-8) and PSSM(SINSI-6.4) may confidently assist therapeutic decisions for using CCR5 antagonists in HIV patients, providing an easier and rapid estimation of tropism in clinical samples.

Screw expander for light duty diesel engines

NASA Technical Reports Server (NTRS)

1983-01-01

Preliminary selection and sizing of a positive displacement screw compressor-expander subsystem for a light-duty adiabatic diesel engine; development of a mathematical model to describe overall efficiencies for the screw compressor and expander; simulation of operation to establish overall efficiency for a range of design parameters and at given engine operating points; simulation to establish potential net power output at light-duty diesel operating points; analytical determination of mass moments of inertia for the rotors and inertia of the compressor-expander subsystem; and preparation of engineering layout drawings of the compressor and expander are discussed. As a result of this work, it was concluded that the screw compressor and expander designed for light-duty diesel engine applications are viable alternatives to turbo-compound systems, with acceptable efficiencies for both units, and only a moderate effect on the transient response.

Open Access Journal Policies: A Systematic Analysis of Radiology Journals.

PubMed

Narayan, Anand; Lobner, Katie; Fritz, Jan

2018-02-01

The open access movement has pushed for greater access to scientific knowledge by expanding access to scientific journal articles. There is limited information about the extent to which open access policies have been adopted by radiology journals. We performed a systematic analysis to ascertain the proportion of radiology journals with open access options. A search was performed with the assistance of a clinical informationist. Full and mixed English-language diagnostic and interventional radiology Web of Science journals (impact factors > 1.0) were included. Nuclear medicine, radiation oncology, physics, and solicitation-only journals were excluded. Primary outcome was open access option (yes or no) with additional outcomes including presence or absence of embargo, complete or partial copyright transfer, publication fees, and self-archiving policies. Secondary outcomes included journal citations, journal impact factors, immediacy, Eigenfactor, and article influence scores. Independent double readings were performed with differences resolved by consensus, supplemented by contacting editorial staff at each journal. In all, 125 journals were identified; review yielded 49 journals (39%, mean impact factor of 2.61). Thirty-six of the journals had open access options (73.4%), and four journals were exclusively open access (8.2%). Twelve-month embargoes were most commonly cited (90.6%) with 28.6% of journals stating that they did not require a complete transfer of copyright. Prices for open access options ranged from $750 to $4,000 (median $3,000). No statistically significant differences were found in journal impact measures comparing journals with open access options to journals without open access options. Diagnostic and interventional radiology journals have widely adopted open access options with a few radiology journals being exclusively open access. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Staphylococcus aureus secretes a unique class of neutrophil serine protease inhibitors

PubMed Central

Stapels, Daphne A. C.; Ramyar, Kasra X.; Bischoff, Markus; von Köckritz-Blickwede, Maren; Milder, Fin J.; Ruyken, Maartje; Eisenbeis, Janina; McWhorter, William J.; Herrmann, Mathias; van Kessel, Kok P. M.; Geisbrecht, Brian V.; Rooijakkers, Suzan H. M.

2014-01-01

Neutrophils are indispensable for clearing infections with the prominent human pathogen Staphylococcus aureus. Here, we report that S. aureus secretes a family of proteins that potently inhibits the activity of neutrophil serine proteases (NSPs): neutrophil elastase (NE), proteinase 3, and cathepsin G. The NSPs, but not related serine proteases, are specifically blocked by the extracellular adherence protein (Eap) and the functionally orphan Eap homologs EapH1 and EapH2, with inhibitory-constant values in the low-nanomolar range. Eap proteins are together essential for NSP inhibition by S. aureus in vitro and promote staphylococcal infection in vivo. The crystal structure of the EapH1/NE complex showed that Eap molecules constitute a unique class of noncovalent protease inhibitors that occlude the catalytic cleft of NSPs. These findings increase our insights into the complex pathogenesis of S. aureus infections and create opportunities to design novel treatment strategies for inflammatory conditions related to excessive NSP activity. PMID:25161283

Factors that influence the use and perceptions of employee assistance programs at six worksites.

PubMed

French, M T; Dunlap, L J; Roman, P M; Steele, P D

1997-10-01

Employee assistance programs (EAPs) have gained significant importance in contemporary worksites. This article uses data from 6 case studies to examine several research questions regarding the relationship between worker demographic (e.g., gender, job tenure, and marital status), substance use, and workplace policies and the actual and potential use of the company EAP. Unlike in most of the existing literature, the authors did not find that gender, marital status, or job dissatisfaction are statistically related to actual or potential EAP use at most worksites. However, job tenure and some substance use behaviors were related to actual EAP use in a positive and statistically significant way. Another important finding, underlying the credible integration of EAPs into worksite culture, is the positive and robust relationship between employee trust and confidence in the EAP and actual use. The results of our study both reinforce some long-established principles in the EAP field and encourage further consideration of other beliefs.

The Affordable Care Act and Expanded Insurance Eligibility Among Nonelderly Adult Cancer Survivors

PubMed Central

Hill, Steven C.; Bernard, Didem; Yabroff, K. Robin

2015-01-01

Background: Cancer survivors may face barriers to accessing health insurance and experience financial hardship because of medical expenditures. We examined potential improvements in access to insurance for cancer survivors through adult Medicaid expansions and premium tax credits in the new insurance marketplaces under the Affordable Care Act (ACA). Methods: Eligibility for Medicaid and premium tax credits was simulated for cancer survivors age 18 to 64 years in the 2008 to 2010 Medical Expenditure Panel Survey using a detailed deterministic model. Financial hardship was determined as: 1) delays or unmet need for medical, prescription, or dental care because of cost or insurance issues and/or 2) family out-of-pocket medical spending that was 20% or more of gross income. Descriptive analyses were stratified by whether the state of residence chose to expand Medicaid by January 2015. All statistical tests were two-sided. Results: Overall, 14.7% of 9.44 million cancer survivors were uninsured, with 18% reporting financial hardship. Under the ACA, 19% overall, 30% of the uninsured, and 39% of those reporting financial hardship would be Medicaid eligible. An additional 10% would be eligible for premium tax credits, with the remainder able to participate in the Marketplace without tax credits. However, 21% of uninsured cancer survivors in states not expanding Medicaid would be ineligible for assistance with coverage. Conclusions: Under the ACA, many of the uninsured and a larger proportion of survivors facing financial hardship will be eligible for Medicaid or premium tax credits in the Marketplaces. ACA implementation will dramatically enhance insurance availability and is likely to reduce financial hardship for vulnerable cancer survivors. PMID:26134034

Expanding the enzyme universe: accessing non-natural reactions by mechanism-guided directed evolution.

PubMed

Renata, Hans; Wang, Z Jane; Arnold, Frances H

2015-03-09

High selectivity and exquisite control over the outcome of reactions entice chemists to use biocatalysts in organic synthesis. However, many useful reactions are not accessible because they are not in nature's known repertoire. In this Review, we outline an evolutionary approach to engineering enzymes to catalyze reactions not found in nature. We begin with examples of how nature has discovered new catalytic functions and how such evolutionary progression has been recapitulated in the laboratory starting from extant enzymes. We then examine non-native enzyme activities that have been exploited for chemical synthesis, with an emphasis on reactions that do not have natural counterparts. Non-natural activities can be improved by directed evolution, thus mimicking the process used by nature to create new catalysts. Finally, we describe the discovery of non-native catalytic functions that may provide future opportunities for the expansion of the enzyme universe. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Characterization of Sugar Concentration Among Edible Podded Accessions in the USDA Phaseolus vulgaris Germplasm Collection

USDA-ARS?s Scientific Manuscript database

The objective is to gain knowledge regarding variation in sugar and flavor content among a sample of dry bean and green pod-type accessions from the USDA Phaseolus Germplasm Core Collection, Pullman, WA. The results could be used to market product quality and offer unique opportunities to expand ma...

The impact of employee assistance services on workplace outcomes: Results of a prospective, quasi-experimental study.

PubMed

Richmond, Melissa K; Pampel, Fred C; Wood, Randi C; Nunes, Ana P

2017-04-01

Employee Assistance Programs (EAPs) are widely used to help employees experiencing personal or work-related difficulties that impact work productivity. However, rigorous research on the effectiveness of programs to improve work-related outcomes is lacking. The current study represents a major advance in EAP research by using a prospective, quasi-experimental design with a large and diverse employee base. Using propensity scores calculated from demographic, social, work-related, and psychological variables collected on baseline surveys, we matched 156 employees receiving EAP to 188 non-EAP employees. Follow-up surveys were collected from 2 to 12 months post-baseline (M = 6.0). At follow-up, EAP employees had significantly greater reductions in absenteeism (b = -.596, p = .001) and presenteeism (b = -.217, p = .038), but not workplace distress (b = -.079, p = .448), than did non-EAP employees. Tests of moderation of baseline alcohol use, depression, anxiety, and productivity indicate that for the most part, the program works equally well for all groups. However, EAP did more to reduce absenteeism for those who began with lower severity of depression and anxiety at baseline. Results provide the scientific rigor needed to demonstrate EAP impact on improved work outcomes. In the first study of its kind, findings confirm the value of EAPs to help employees address personal and work-related concerns that are affecting job performance. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Employed women with alcohol problems who seek help from employee assistance programs. Description and comparisons.

PubMed

Blum, T C; Roman, P M; Harwood, E M

1995-01-01

After a brief description of employee assistance programs (EAP), we present data collected from 6,400 employees from 84 worksites who used the services of EAPs, a portion of whom were assessed by the EAP as having alcohol-related problems and/or received scores on the Alcohol Dependence Scale (ADS) indicative of a potential alcohol-related problem. In addition, data were collected at intake from the EAP administrators, and employment status of the employee clients was assessed 18 to 24 months later. These data indicate that EAPs are effective in sustaining the employment of most women with alcohol-related problems who seek services from EAPs and that EAPs' goal of early intervention is especially realized among women with alcohol problems. Other conclusions include: women with alcohol problems do not enter EAPs through routes that are strikingly different from those of men; many of the gender differences that are revealed are associated with job status differences; employed women with alcohol problems are detached from nuclear families, with markedly low rates of current marriage; even when married, spouses are less likely to play a role in the referral of women with alcohol problems than the spouses of the men; and, there is no clear indication that women are the target of any form of discrimination in the process of EAP utilization. However, women are considerably more likely to have less adequate insurance coverage, according to the EAP administrators' assessment reported at client intake, than their male counterparts, leading to treatment choices that may be less than appropriate.

Employee assistance program services for alcohol and other drug problems: implications for increased identification and engagement in treatment.

PubMed

Jacobson, Jodi M; Sacco, Paul

2012-01-01

Fourteen million U.S. workers meet the diagnostic criteria for substance dependence, costing millions in lost productivity. Prior research suggests that employees who follow through with their Employee Assistance Program's (EAP) recommendations are more likely to participate and remain engaged in alcohol and other drug (AOD) treatment programs. This study identified rates of lifetime EAP service use for AOD problems and compared adults who reported using EAP services for AOD problems with those who used services other than EAP. Researchers analyzed a subset of participants from the National Epidemiologic Survey of Alcohol and Related Conditions who reported having received help for an AOD problem (NESARC, 2001-2002). Statistical analyses tested for differences in sociodemographic variables, lifetime mental health and substance abuse disorders, and health disability between EAP services users and users of other types of services. Among adults who sought services for AOD problems (n= 2,272), 7.58% (n= 166) reported using EAP services for these problems at some point during their lives. Major depressive disorder (lifetime), a drug use disorder (lifetime), and Black race/ethnicity were associated with a greater likelihood that someone would seek EAP services for help with their AOD problem. Results provide a foundation for researchers to understand who uses EAP services for AOD problems. Health and mental health professionals should increase their knowledge of EAP services to improve continuity of care for employees with AOD problems. EAPs are in a unique position to reach out to vulnerable employees in the workplace and engage them in treatment. Copyright © American Academy of Addiction Psychiatry.

Employee assistance programs: a worldwide perspective.

PubMed

Burgess, K M; O'Donnell, W J; Bennett, A A; von Vietinghoff-Scheel, K

1997-08-01

Once limited to U.S. corporations, employee assistance programs (EAPs) are now spreading around the world. The authors review global EAP trends and identify similarities and differences among EAPs in North America, Europe, Central and South America, the Asia-Pacific region, and the Caribbean. Through affiliations between international professional associations and services to multinational corporations, the EAP field is quietly creating globalized behavioral health services.

[Reconstruction in plastic surgery using osmotic tissue expanders].

PubMed

Gronovich, Yoav; Binenboym, Rami; Retchkiman, Meir; Eizenman, Nirit; Lotan, Adi; Stuchiner, Barak; Tuchman, Izhak

2015-03-01

Tissue expander is a major reconstructive modality. Its main disadvantages include: long and inconvenient period of inflation with temporary deformity of the surrounding tissue. Osmotic expander was developed in order to eliminate some of these limitations. It is a self-filling device which absorbs fluids in order to achieve tissue expansion faster. We present our experience with 28 consecutive cases of tissue reconstruction using osmotic expanders. We wish to emphasize the main advantages and limitations of this device. The present study was launched in May 2008, until April 2014, for twenty eight patients, median age 26 years with reconstructions using an osmotic expander (total of 35 expanders). The reasons for using tissue expander included large congenital nevi (75%) and scars. In all of the cases, the operative and post-operative management was uneventful. During the expansion period, there were 2 outpatient clinical visits. The average expansion time was 9 weeks. In 11% (three patients) there was partial extrusion of the expander. In all other cases there were no complications and the final aesthetic results were satisfying. Osmotic expander is an advanced modality for tissue reconstruction. The final shape and size are precisely predictable. Its initial small size allows for a small surgical incision and short overall operating time. The expansion period is shorter and more convenient for the patient. Its main disadvantage includes the inability to control the filling rate and the need to remove the expander in case of damage to the overlying tissue. Osmotic expander is a reliable tool for tissue expansion. It allows for a satisfying aesthetic result in a shorter period of time and with less inconvenience to the patient.

Health benefits, costs, and cost-effectiveness of earlier eligibility for adult antiretroviral therapy and expanded treatment coverage: a combined analysis of 12 mathematical models.

PubMed

Eaton, Jeffrey W; Menzies, Nicolas A; Stover, John; Cambiano, Valentina; Chindelevitch, Leonid; Cori, Anne; Hontelez, Jan A C; Humair, Salal; Kerr, Cliff C; Klein, Daniel J; Mishra, Sharmistha; Mitchell, Kate M; Nichols, Brooke E; Vickerman, Peter; Bakker, Roel; Bärnighausen, Till; Bershteyn, Anna; Bloom, David E; Boily, Marie-Claude; Chang, Stewart T; Cohen, Ted; Dodd, Peter J; Fraser, Christophe; Gopalappa, Chaitra; Lundgren, Jens; Martin, Natasha K; Mikkelsen, Evelinn; Mountain, Elisa; Pham, Quang D; Pickles, Michael; Phillips, Andrew; Platt, Lucy; Pretorius, Carel; Prudden, Holly J; Salomon, Joshua A; van de Vijver, David A M C; de Vlas, Sake J; Wagner, Bradley G; White, Richard G; Wilson, David P; Zhang, Lei; Blandford, John; Meyer-Rath, Gesine; Remme, Michelle; Revill, Paul; Sangrujee, Nalinee; Terris-Prestholt, Fern; Doherty, Meg; Shaffer, Nathan; Easterbrook, Philippa J; Hirnschall, Gottfried; Hallett, Timothy B

2013-12-10

New WHO guidelines recommend ART initiation for HIV-positive persons with CD4 cell counts ≤500 cells/µL, a higher threshold than was previously recommended. Country decision makers must consider whether to further expand ART eligibility accordingly. We used multiple independent mathematical models in four settings-South Africa, Zambia, India, and Vietnam-to evaluate the potential health impact, costs, and cost-effectiveness of different adult ART eligibility criteria under scenarios of current and expanded treatment coverage, with results projected over 20 years. Analyses considered extending eligibility to include individuals with CD4 ≤500 cells/µL or all HIV-positive adults, compared to the previous recommendation of initiation with CD4 ≤350 cells/µL. We assessed costs from a health system perspective, and calculated the incremental cost per DALY averted ($/DALY) to compare competing strategies. Strategies were considered 'very cost-effective' if the $/DALY was less than the country's per capita gross domestic product (GDP; South Africa: $8040, Zambia: $1425, India: $1489, Vietnam: $1407) and 'cost-effective' if $/DALY was less than three times per capita GDP. In South Africa, the cost per DALY averted of extending ART eligibility to CD4 ≤500 cells/µL ranged from $237 to $1691/DALY compared to 2010 guidelines; in Zambia, expanded eligibility ranged from improving health outcomes while reducing costs (i.e. dominating current guidelines) to $749/DALY. Results were similar in scenarios with substantially expanded treatment access and for expanding eligibility to all HIV-positive adults. Expanding treatment coverage in the general population was therefore found to be cost-effective. In India, eligibility for all HIV-positive persons ranged from $131 to $241/DALY and in Vietnam eligibility for CD4 ≤500 cells/µL cost $290/DALY. In concentrated epidemics, expanded access among key populations was also cost-effective. Earlier ART eligibility is estimated

24 CFR 3285.502 - Expanding rooms.

Code of Federal Regulations, 2010 CFR

2010-04-01

... DEVELOPMENT MODEL MANUFACTURED HOME INSTALLATION STANDARDS Optional Features § 3285.502 Expanding rooms. The support and anchoring systems for expanding rooms must be installed in accordance with designs provided by the home manufacturer or prepared by a registered professional engineer or registered architect, in...

Electroactive Polymers as Artificial Muscles - Reality and Challenges

NASA Technical Reports Server (NTRS)

Bar-Cohen, Y.

2001-01-01

Electroactive Polymers (EAPs) are emerging as effective displacement actuators. These materials offer the closest resemblance of biological muscle potentially enabling unique capabilities changing the paradigm about robots construction. Under a NASA task, several EAP driven mechanisms were developed including dust wiper, gripper, and robotic arm EAP are inducing a low actuation force limiting the applications that can use their current capability. In recognition of this limitation a series of international forums were established including SPIE conference, Webhub, Newsletter, and Newsgroup. A challenge was posed to the EAP community to have an arm wrestling between robot that is equipped with EAP actuators and human.

Employee assistance programs: an employer's guide to emerging liability issues.

PubMed

Parliman, G C; Edwards, E L

1992-01-01

Increasing numbers of employers are implementing employee assistance programs (EAPs) designed to assist employees with personal issues that affect their work performance. Studies show that EAPs can dramatically increase employee productivity, but the benefits from EAPs have been accompanied by a less welcome development: lawsuits filed against employers by employees who allege that they suffered harm in the course of obtaining services through their employers' EAPs. Although the potential for liability will always exist, the employer that adheres to certain guidelines will be able to minimize its risk and make its EAP well worth the investment.

Employee assistance programs in the new millennium.

PubMed

Masi, Dale A

2005-01-01

This article presents an overall view of Employee Assistance Programs (EAPs). Beginning with the history, this article describes various models and essential ingredients of EAPs. It then discusses current trends including integration with Work/Life, web-based services, EAP accreditation, and the growth of international programs. Several issues are discussed including the need for licensing done nationally rather than by states and the effect the lack of substance abuse and brief counseling education has had on the delivery of EAP services. Future directions for EAPs emphasize the importance of quality assurance and the development of performance measurements, performance guarantees, and outcome measurements. The formation of the Alliance for Employee Assistance Advancement, an organization of organizations, completes the description and shows a new direction for EAPs in the next millennium.

The role of tablets in accessing information throughout undergraduate medical education in Botswana.

PubMed

Witt, Rachel E; Kebaetse, Masego B; Holmes, John H; Littman-Quinn, Ryan; Ketshogileng, Dineo; Antwi, Cynthia; Kovarik, Carrie; Nkomazana, Oathokwa

2016-04-01

Mobile learning (mLearning) uses wireless networks and mobile devices to expand physician trainees' and healthcare providers' access to and exchange of medical information. Opportunities to increase implementation and expand use of mobile devices to support health care information access and delivery in Africa are vast, but the rapid growth of mLearning has caused project implementation to outpace objective measurement of impact. This study makes a contribution to the existing body of literature regarding mLearning implementation in Africa through its focus on the use of smart devices (tablets) in undergraduate medical education and medical students' perceptions of the effects on their learning environment. The population of this prospective mixed-methods study consisted of 82 undergraduate medical students (45 third year and 37 fourth year) at the University of Botswana Faculty of Medicine. They received tablets in the earliest phase of the mLearning project implementation (between November 2012 and January 2013), when they were in the third and fourth year of their medical training. Usage of the tablets was assessed both quantitatively and qualitatively, through both application usage tracking and focus groups. Based on application usage data and coding and analysis of focus group discussions, undergraduate medical students indicated that tablets were useful in their medical education, allowing them continual access to information and opportunities for communication. Participants noted that the primary barrier to use of tablets was the lack of mobile cellular Internet beyond the Wi-Fi zones at the training sites. Moreover, participants offered suggestions for improvements to the implementation process. Even in resource-limited settings where Internet access can be unreliable and intermittent, the adoption of tablets can have benefits to medical education by providing consistent access to extensive and current medical information resources. This study highlights

24 CFR 3285.502 - Expanding rooms.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 5 2011-04-01 2011-04-01 false Expanding rooms. 3285.502 Section 3285.502 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued... DEVELOPMENT MODEL MANUFACTURED HOME INSTALLATION STANDARDS Optional Features § 3285.502 Expanding rooms. The...

Patterns of Student Enrolment and Attrition in Australian Open Access Online Education: A Preliminary Case Study

ERIC Educational Resources Information Center

Greenland, Steven J.; Moore, Catherine

2014-01-01

Swinburne University of Technology has experienced tremendous growth in open access online learning and as such is typical of the many Australian institutions that have ventured into online tertiary education. While research in online education continues to expand, comparatively little investigates students' enrolment and attrition. This research…

Data Rescue in Collaboration with Federal Open Access Efforts

NASA Astrophysics Data System (ADS)

Avila, R.

2017-12-01

The recent calls to rescue scientific data is a real opportunity to collaborate with federal agencies which have been spending years managing research data and making it secure. The 2013 memos from the White House Office of Science and Technology Policy and Office of Management and Budget have spurred innovation across federal agencies to make publicly funded data accessible. Now is the time for stakeholders to take advantage of the groundwork laid by federal government, support the work to expand data sharing, thereby encouraging open science.

Expanding Notions of Digital Access: Parents' Negotiation of School-Based Technology Initiatives in New Immigrant Communities

ERIC Educational Resources Information Center

Noguerón-Liu, Silvia

2017-01-01

Initiatives to integrate technology in schools are continuously increasing, with efforts to bridge the "homework gap" and provide technology access in low-income households. However, it is critical to include nondominant parents in technology adoption decisions in order to avoid mirroring past patterns of inequality in home-school…

Increasing Need-Based Grant Aid Is the Most Efficient Way To Expand College Access. Illuminations: Highlighting Important Research in Postsecondary Education Access. New Agenda Series.

ERIC Educational Resources Information Center

Lumina Foundation for Education, 2004

2004-01-01

This two-page summary offers an overview of a "New Agenda Series" publication relating to need-based grant aid. The federal and state governments share the responsibility for providing access to postsecondary education. They do this through direct appropriations, student financial aid programs and other support for research and educational…

The Use of Enhanced Appointment Access Strategies by Medical Practices.

PubMed

Rodriguez, Hector P; Knox, Margae; Hurley, Vanessa; Rittenhouse, Diane R; Shortell, Stephen M

2016-06-01

Strategies to enhance appointment access are being adopted by medical practices as part of patient-centered medical home (PCMH) implementation, but little is known about the use of these strategies nationally. We examine practice use of open access scheduling and after-hours care. Data were analyzed from the Third National Study of Physician Organizations (NSPO3) to examine which enhanced appointment access strategies are more likely to be used by practices with more robust PCMH capabilities and with greater external incentives. Logistic regression estimated the effect of PCMH capabilities and external incentives on practice use of open access scheduling and after-hours care. Physician organizations with >20% primary care physicians (n=1106). PCMH capabilities included team-based care, health information technology capabilities, quality improvement orientation, and patient experience orientation. External incentives included public reporting, pay-for-performance (P4P), and accountable care organization participation. A low percentage of practices (19.8%) used same-day open access scheduling, while after-hours care (56.1%) was more common. In adjusted analyses, system-owned practices and practices with greater use of team-based care, health information technology capabilities, and public reporting were more likely to use open access scheduling. Accountable care organization-affiliated practices and practices with greater use of public reporting and P4P were more likely to provide after-hours care. Open access scheduling may be most effectively implemented by practices with robust PCMH capabilities. External incentives appear to influence practice adoption of after-hours care. Expanding open access scheduling and after-hours care will require distinct policies and supports.

Medication coverage for lawmakers may worsen access for everyone else.

PubMed

Taglione, Michael S; Boozary, Andrew; Persaud, Nav

2018-03-01

Despite numerous recommendations for universal public coverage of prescription drugs in Canada based on evidence that millions of Canadians cannot afford medications, no province or territory has adopted first dollar coverage for all residents. However, one group unaffected by the lack of public coverage are lawmakers. Lawmakers receive excellent drug coverage plans for themselves and their immediate families. Evidence suggests that lawmakers' decisions are influenced by their personal circumstances; in this case, they are insulated from the effects of poor access to medications by their drug coverage plans. In contrast, a patchwork system of 46 programs across Canada provides some drug coverage to vulnerable populations. Reducing the disparity in prescription drug access between Canadian lawmakers and the public may promote progress towards better medication access for everyone. This could be achieved either by reducing lawmaker coverage or improving upon the public patchwork system. Since the goal should be to improve the overall access of medications for all Canadians, lawmakers included, the latter method is preferred. A universal drug plan with first dollar coverage could replace the current patchwork system and expand coverage to all Canadians. Copyright © 2017 Elsevier Inc. All rights reserved.

Meeting commentary: Santa Fe Group Salon Expanding Oral Healthcare for America's Seniors, September 28-30, 2016.

PubMed

Wilentz, Joan B; Kleinman, Dushanka V; Alfano, Michael C

2017-04-01

A meeting to explore ways to expand access to oral health care for seniors-possibly by expanding a dental benefit in Medicare-was convened in Arlington, VA, by the Santa Fe Group. Four factors motivated the meeting: PRACTICAL IMPLICATIONS: The model Medicare dental benefit presented generated much discussion. There was agreement that any dental benefit must attract participating dentists. Agreement was also reached on the importance of public demonstration projects to further establish cost savings from dental care for patients with comorbid diseases, the need to collaborate with nondental advocacy and policy groups to establish that overall health benefits for seniors are gained by adding oral health care, and the necessity of oral health literacy campaigns working directly at the community level with the general public and others, including educators and the media, as well as with policy makers and providers from all health fields and at all levels of professional training. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

Free-piston reciprocating cryogenic expander utilizing phase controller

NASA Astrophysics Data System (ADS)

Cha, Jeongmin; Park, Jiho; Kim, Kyungjoong; Jeong, Sangkwon

2017-02-01

In a free-piston expander which eliminates mechanical linkages, a prescribed behaviour of the free-piston movement is the key to an expander performance. In this paper, we have proposed an idea of reducing complexity of the free-piston expander. It is to replace both multiple solenoid valves and reservoirs that are indispensable in a previous machine with a combination of a single orifice-reservoir assembly. It functions as a phase controller like that of a pulse tube refrigerator so that it generates time-delay of pressure variation between the warm-end and the reservoir resulting in the intended expansion of the cold-end volume down to the pre-set reservoir pressure. The modeling of this unique free-piston reciprocating expander utilizing phase controller is developed to understand and predict the performance of the new-type expander. Additionally, the operating parameters are analysed at the specified conditions to enable one to develop a more efficient free-piston type cryogenic expander.

Action potential propagation recorded from single axonal arbors using multi-electrode arrays.

PubMed

Tovar, Kenneth R; Bridges, Daniel C; Wu, Bian; Randall, Connor; Audouard, Morgane; Jang, Jiwon; Hansma, Paul K; Kosik, Kenneth S

2018-04-11

We report the presence of co-occurring extracellular action potentials (eAPs) from cultured mouse hippocampal neurons among groups of planar electrodes on multi-electrode arrays (MEAs). The invariant sequences of eAPs among co-active electrode groups, repeated co-occurrences and short inter-electrode latencies are consistent with action potential propagation in unmyelinated axons. Repeated eAP co-detection by multiple electrodes was widespread in all our data records. Co-detection of eAPs confirms they result from the same neuron and allows these eAPs to be isolated from all other spikes independently of spike sorting algorithms. We averaged co-occurring events and revealed additional electrodes with eAPs that would otherwise be below detection threshold. We used these eAP cohorts to explore the temperature sensitivity of action potential propagation and the relationship between voltage-gated sodium channel density and propagation velocity. The sequence of eAPs among co-active electrodes 'fingerprints' neurons giving rise to these events and identifies them within neuronal ensembles. We used this property and the non-invasive nature of extracellular recording to monitor changes in excitability at multiple points in single axonal arbors simultaneously over several hours, demonstrating independence of axonal segments. Over several weeks, we recorded changes in inter-electrode propagation latencies and ongoing changes in excitability in different regions of single axonal arbors. Our work illustrates how repeated eAP co-occurrences can be used to extract physiological data from single axons with low electrode density MEAs. However, repeated eAP co-occurrences leads to over-sampling spikes from single neurons and thus can confound traditional spike-train analysis.

The mechanism of growth of the low-frequency East Asia-Pacific teleconnection and the triggering role of tropical intraseasonal oscillation

NASA Astrophysics Data System (ADS)

Wang, Jiabao; Wen, Zhiping; Wu, Renguang; Guo, Yuanyuan; Chen, Zesheng

2016-06-01

The East Asia-Pacific (EAP) pattern is a well-known meridional teleconnection over East Asia during boreal summer. In this study, the mechanism for growth of the EAP on intraseasonal timescale is investigated through a vorticity budget. It is found that the beta-effect and high-frequency transient eddies have primary contributions to the growth of the low-frequency EAP. The former leads to a westward shift of disturbances associated with the low-frequency EAP and the latter favors an amplification of disturbances, respectively. The interaction between low-frequency disturbances and zonal flow has a damping effect by dragging disturbances eastward. The impact of boreal summer intraseasonal oscillation (BSISO) on the triggering of the low-frequency EAP is also examined in this study based on observational analysis and a linear model experiment. It is shown that an elongated anomalous convection band located in the vicinity of Philippines associated with the dominant mode of BSISO has a significant impact on the initiation of low-frequency EAP via Rossby wave propagation, whereas anomalous convection located over the North Indian Ocean has a limited impact. Based on the results of present study, the low-frequency EAP could be a self-sustained mode, and the BSISO plays a substantial role in triggering the low-frequency EAP.

Enhancing Ocean Research Data Access

NASA Astrophysics Data System (ADS)

Chandler, Cynthia; Groman, Robert; Shepherd, Adam; Allison, Molly; Arko, Robert; Chen, Yu; Fox, Peter; Glover, David; Hitzler, Pascal; Leadbetter, Adam; Narock, Thomas; West, Patrick; Wiebe, Peter

2014-05-01

The Biological and Chemical Oceanography Data Management Office (BCO-DMO) works in partnership with ocean science investigators to publish data from research projects funded by the Biological and Chemical Oceanography Sections and the Office of Polar Programs Antarctic Organisms & Ecosystems Program at the U.S. National Science Foundation. Since 2006, researchers have been contributing data to the BCO-DMO data system, and it has developed into a rich repository of data from ocean, coastal and Great Lakes research programs. While the ultimate goal of the BCO-DMO is to ensure preservation of NSF funded project data and to provide open access to those data, achievement of those goals is attained through a series of related phases that benefits from active collaboration and cooperation with a large community of research scientists as well as curators of data and information at complementary data repositories. The BCO-DMO is just one of many intermediate data management centers created to facilitate long-term preservation of data and improve access to ocean research data. Through partnerships with other data management professionals and active involvement in local and global initiatives, BCO-DMO staff members are working to enhance access to ocean research data available from the online BCO-DMO data system. Continuing efforts in use of controlled vocabulary terms, development of ontology design patterns and publication of content as Linked Open Data are contributing to improved discovery and availability of BCO-DMO curated data and increased interoperability of related content available from distributed repositories. We will demonstrate how Semantic Web technologies (e.g. RDF/XML, SKOS, OWL and SPARQL) have been integrated into BCO-DMO data access and delivery systems to better serve the ocean research community and to contribute to an expanding global knowledge network.

Effect of Bending Stiffness of the Electroactive Polymer Element on the Performance of a Hybrid Actuator System (HYBAS)

NASA Technical Reports Server (NTRS)

Xu, Tian-Bing; Su, Ji; Jiang, Xiaoning; Rehrig, Paul W.; Zhang, Shujun; Shrout, Thomas R.; Zhang, Qiming

2006-01-01

An electroactive polymer (EAP)-ceramic hybrid actuation system (HYBAS) was developed recently at NASA Langley Research Center. This paper focuses on the effect of the bending stiffness of the EAP component on the performance of a HYBAS, in which the actuation of the EAP element can match the theoretical prediction at various length/thickness ratios for a constant elastic modulus of the EAP component. The effects on the bending stiffness of the elastic modulus and length/thickness ratio of the EAP component were studied. A critical bending stiffness to keep the actuation of the EAP element suitable for a rigid beam theory-based modeling was found for electron irradiated P(VDF-TrFE) copolymer. For example, the agreement of experimental data and theoretical modeling for a HYBAS with the length/thickness ratio of EAP element at 375 times is demonstrated. However, the beam based theoretical modeling becomes invalid (i.e., the profile of the HYBAS movement does not follow the prediction of theoretical modeling) when the bending stiffness is lower than a critical value.

Influence of Medical Insurance Under the Affordable Care Act on Access to Pain Management of the Trauma Patient.

PubMed

Wiznia, Daniel H; Zaki, Theodore; Maisano, Julianna; Kim, Chang-Yeon; Halaszynski, Thomas M; Leslie, Michael P

The Affordable Care Act intended to "extend affordable coverage" and "ensure access" for vulnerable patient populations. This investigation examined whether the type of insurance (Medicaid, Medicare, Blue Cross, cash pay) carried by trauma patients influences access to pain management specialty care. Investigators phoned 443 board-certified pain specialists, securing office visits with 235 pain physicians from 8 different states. Appointments for pain management were for a patient who sustained an ankle fracture requiring surgery and experiencing difficulty weaning off opioids. Offices were phoned 4 times assessing responses to the 4 different payment methodologies. Fifty-three percent of pain specialists contacted (235 of 443) were willing to see new patients to manage pain medication. Within the 53% of positive responses, 7.2% of physicians scheduled appointments for Medicaid patients, compared with 26.8% for cash-paying patients, 39.6% for those with Medicare, and 41.3% with Blue Cross (P < 0.0001). There were no differences in appointment access between states that had expanded Medicaid eligibility for low-income adults versus states that had not expanded Medicaid eligibility. Neither Medicaid nor Medicare reimbursement levels for new patient visits correlated with ability to schedule an appointment or influenced wait times. Access to pain specialists for management of pain medication in the postoperative trauma patient proved challenging. Despite the Affordable Care Act, Medicaid patients still experienced curtailed access to pain specialists and confronted the highest incidence of barriers to receiving appointments.

Information Management and Employee Assistance Program Imperatives.

ERIC Educational Resources Information Center

Bickerton, Richard

1987-01-01

The ALMACA Clearinghouse for Employee Assistance Program (EAP) Information collects and disseminates EAP-specific data to provide subscribers with information to maintain their own competence and to improve upon the understanding and use of EAP practices and procedures. (JOW)

Theoretical Study on Nano-Catalyst Burn Rate

DTIC Science & Technology

2014-11-26

the adsorbed system EAP +surface and the adsorption state, with a positive value of Eads being thermodynamically favorable: Eads = (Esurface + EAP ... EAP +surface, (1) The interaction between the TiO2 surfaces and the AP molecules has been analyzed by

U.S. Physicians’ Views on Financing Options to Expand Health Insurance Coverage: A National Survey

PubMed Central

Woolhandler, Steffie; Bose-Kolanu, Anjali; Germann, Antonio; Bor, David H.; Himmelstein, David U.

2009-01-01

BACKGROUND Physician opinion can influence the prospects for health care reform, yet there are few recent data on physician views on reform proposals or access to medical care in the United States. OBJECTIVE To assess physician views on financing options for expanding health care coverage and on access to health care. DESIGN AND PARTICIPANTS Nationally representative mail survey conducted between March 2007 and October 2007 of U.S. physicians engaged in direct patient care. MEASUREMENTS Rated support for reform options including financial incentives to induce individuals to purchase health insurance and single-payer national health insurance; rated views of several dimensions of access to care. MAIN RESULTS 1,675 of 3,300 physicians responded (50.8%). Only 9% of physicians preferred the current employer-based financing system. Forty-nine percent favored either tax incentives or penalties to encourage the purchase of medical insurance, and 42% preferred a government-run, taxpayer-financed single-payer national health insurance program. The majority of respondents believed that all Americans should receive needed medical care regardless of ability to pay (89%); 33% believed that the uninsured currently have access to needed care. Nearly one fifth of respondents (19.3%) believed that even the insured lack access to needed care. Views about access were independently associated with support for single-payer national health insurance. CONCLUSIONS The vast majority of physicians surveyed supported a change in the health care financing system. While a plurality support the use of financial incentives, a substantial proportion support single payer national health insurance. These findings challenge the perception that fundamental restructuring of the U.S. health care financing system receives little acceptance by physicians. PMID:19184240

The Affordable Care Act and Expanded Insurance Eligibility Among Nonelderly Adult Cancer Survivors.

PubMed

Davidoff, Amy J; Hill, Steven C; Bernard, Didem; Yabroff, K Robin

2015-09-01

Cancer survivors may face barriers to accessing health insurance and experience financial hardship because of medical expenditures. We examined potential improvements in access to insurance for cancer survivors through adult Medicaid expansions and premium tax credits in the new insurance marketplaces under the Affordable Care Act (ACA). Eligibility for Medicaid and premium tax credits was simulated for cancer survivors age 18 to 64 years in the 2008 to 2010 Medical Expenditure Panel Survey using a detailed deterministic model. Financial hardship was determined as: 1) delays or unmet need for medical, prescription, or dental care because of cost or insurance issues and/or 2) family out-of-pocket medical spending that was 20% or more of gross income. Descriptive analyses were stratified by whether the state of residence chose to expand Medicaid by January 2015. All statistical tests were two-sided. Overall, 14.7% of 9.44 million cancer survivors were uninsured, with 18% reporting financial hardship. Under the ACA, 19% overall, 30% of the uninsured, and 39% of those reporting financial hardship would be Medicaid eligible. An additional 10% would be eligible for premium tax credits, with the remainder able to participate in the Marketplace without tax credits. However, 21% of uninsured cancer survivors in states not expanding Medicaid would be ineligible for assistance with coverage. Under the ACA, many of the uninsured and a larger proportion of survivors facing financial hardship will be eligible for Medicaid or premium tax credits in the Marketplaces. ACA implementation will dramatically enhance insurance availability and is likely to reduce financial hardship for vulnerable cancer survivors. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

The effects of mandatory health insurance on equity in access to outpatient care in Indonesia.

PubMed

Hidayat, Budi; Thabrany, Hasbullah; Dong, Hengjin; Sauerborn, Rainer

2004-09-01

This paper examines the effects of mandatory health insurance on access and equity in access to public and private outpatient care in Indonesia. Data from the second round of the 1997 Indonesian Family Life Survey were used. We adopted the concentration index as a measure of equity, and this was calculated from actual data and from predicted probability of outpatient-care use saved from a multinomial logit regression. The study found that a mandatory insurance scheme for civil servants (Askes) had a strongly positive impact on access to public outpatient care, while a mandatory insurance scheme for private employees (Jamsostek) had a positive impact on access to both public and private outpatient care. The greatest effects of Jamsostek were observed amongst poor beneficiaries. A substantial increase in access will be gained by expanding insurance to the whole population. However, neither Askes nor Jamsostek had a positive impact on equity. Policy implications are discussed.

Understanding access to healthcare among Indigenous peoples: A comparative analysis of biomedical and postcolonial perspectives.

PubMed

Horrill, Tara; McMillan, Diana E; Schultz, Annette S H; Thompson, Genevieve

2018-03-25

As nursing professionals, we believe access to healthcare is fundamental to health and that it is a determinant of health. Therefore, evidence suggesting access to healthcare is problematic for many Indigenous peoples is concerning. While biomedical perspectives underlie our current understanding of access, considering alternate perspectives could expand our awareness of and ability to address this issue. In this paper, we critique how access to healthcare is understood through a biomedical lens, how a postcolonial theoretical lens can extend that understanding, and the subsequent implications this alternative view raises for the nursing profession. Drawing on peer-reviewed published and gray literature concerning healthcare access and Indigenous peoples to inform this critique, we focus on the underlying theoretical lens shaping our current understanding of access. A postcolonial analysis provides a way of understanding healthcare as a social space and social relationship, presenting a unique perspective on access to healthcare. The novelty of this finding is of particular importance for the profession of nursing, as we are well situated to influence these social aspects, improving access to healthcare services broadly, and among Indigenous peoples specifically. © 2018 The Authors Nursing Inquiry published by John Wiley & Sons Ltd.

Expanded Schools: Developing Mindsets to Support Academic Success. Research Brief

ERIC Educational Resources Information Center

ExpandED Schools, 2014

2014-01-01

The national demonstration of ExpandED Schools, The After-School Corporation's (TASC) expanded learning model, was launched in 2011-12 in New York City, Baltimore, and New Orleans. The ExpandED Schools demonstration is being evaluated by Policy Studies Associates (PSA) and is rolling out at a time when there is heightened awareness among…

EDITORIAL: Electroactive polymer materials

NASA Astrophysics Data System (ADS)

Bar-Cohen, Yoseph; Kim, Kwang J.; Ryeol Choi, Hyouk; Madden, John D. W.

2007-04-01

Imitating nature's mechanisms offers enormous potential for the improvement of our lives and the tools we use. This field of the study and imitation of, and inspiration from, nature's methods, designs and processes is known as biomimetics. Artificial muscles, i.e. electroactive polymers (EAPs), are one of the emerging technologies enabling biomimetics. Polymers that can be stimulated to change shape or size have been known for many years. The activation mechanisms of such polymers include electrical, chemical, pneumatic, optical and magnetic. Electrical excitation is one of the most attractive stimulators able to produce elastic deformation in polymers. The convenience and practicality of electrical stimulation and the continual improvement in capabilities make EAP materials some of the most attractive among activatable polymers (Bar-Cohen Y (ed) 2004 Electroactive Polymer (EAP) Actuators as Artificial Muscles—Reality, Potential and Challenges 2nd edn, vol PM136 (Bellingham, WA: SPIE Press) pp 1-765). As polymers, EAP materials offer many appealing characteristics that include low weight, fracture tolerance and pliability. Furthermore, they can be configured into almost any conceivable shape and their properties can be tailored to suit a broad range of requirements. These capabilities and the significant change of shape or size under electrical stimulation while being able to endure many cycles of actuation are inspiring many potential possibilities for EAP materials among engineers and scientists in many different disciplines. Practitioners in biomimetics are particularly excited about these materials since they can be used to mimic the movements of animals and insects. Potentially, mechanisms actuated by EAPs will enable engineers to create devices previously imaginable only in science fiction. For many years EAP materials received relatively little attention due to their poor actuation capability and the small number of available materials. In the last fifteen

Amplatzer vascular plug for arteriovenous hemodialysis access occlusion: initial experience.

PubMed

Bui, J T; Gaba, R C; Knuttinen, M G; West, D L; Owens, C A

2009-01-01

The Amplatzer Vascular Plug (AVP; AGA Medical, Golden Valley, MN) is a recently developed self-expanding metallic device indicated for peripheral vascular embolizations. Herein, we describe use of this device in the treatment of vascular complications related to arteriovenous hemodialysis fistulas and grafts. This HIPAA compliant retrospective study was approved by the institutional review board with informed consent waived. Six patients with problematic arteriovenous access underwent access occlusion using the AVP. Procedure indications included vascular steal syndrome in five patients, and enlarging vascular aneurysms in one patient. Contraindications for surgical correction were determined by the referring surgeon. AVP embolizations were performed using devices oversized by 50% introduced through vascular sheaths positioned within vein segments just beyond the arteriovenous anastomoses. Noninvasive evaluation of the involved extremity was performed pre- and post-embolization in addition to clinical follow-up examinations. Measured outcomes included success of angiographic occlusion, improvement in distal arterial flow, AVP number, AVP diameter, time to access occlusion, and clinical symptomatic improvement. Technical success was 100%, with complete arteriovenous access occlusion accomplished in all cases, with an average of 1.5 AVPs used per patient. Mean time to access occlusion was 19.3 minutes. Angiographic improvement in distal arterial flow was immediately evident and resolution of clinical symptoms occurred in all patients, with mean long-term follow-up of 16 months. No procedure-related complications were encountered. The Amplatzer Vascular Plug provides a minimally invasive and efficacious method for embolization of problematic arteriovenous hemodialysis access.

Preparing marriage and family therapy students to become employee assistance professionals*.

PubMed

Smith, T A; Salts, C J; Smith, C W

1989-10-01

While the number of Employee Assistance Programs (EAPs) has grown tremendously, opportunities for marriage and family therapists in EAP settings have not been adequately described. This paper addresses issues pertinent to training Marriage and Family Therapy (MFT) students to develop the skills needed to become EAP professionals. Qualifications for becoming an EAP professional are described and suggestions are made as to how these skills may be taught within the framework of an academically based MFT training program.

Workplace substance abuse prevention and help seeking: comparing team-oriented and informational training.

PubMed

Bennett, J B; Lehman, W E

2001-07-01

Employees fail to seek help for alcohol or drug (AOD) abuse because of unhealthy work climates, stigma, and distrust in Employee Assistance Programs (EAPs). To address such problems, the authors randomly assigned groups of municipal employees (N = 260) to 2 types of training: a 4-hr informational review of EAPs and policy and an 8-hr training that embedded messages about AOD reduction in the context of team building and stress management. Pre- and posttraining and 6-month follow-up surveys assessed change. Group privacy regulation, EAP trust, help seeking, and peer encouragement increased for team training. Stigma of substance users decreased for information training. EAP/policy knowledge increased for both groups. A control group showed little change. Help seeking and peer encouragement also predicted EAP utilization. Integrating both team and informational training may be the most effective for improving help seeking and EAP utilization.

Cost of employee assistance programs: comparison of national estimates from 1993 and 1995.

PubMed

French, M T; Zarkin, G A; Bray, J W; Hartwell, T D

1999-02-01

The cost and financing of mental health services is gaining increasing importance with the spread of managed care and cost-cutting measures throughout the health care system. The delivery of mental health services through structured employee assistance programs (EAPs) could be undermined by revised health insurance contracts and cutbacks in employer-provided benefits at the workplace. This study uses two recently completed national surveys of EAPs to estimate the costs of providing EAP services during 1993 and 1995. EAP costs are determined by program type, worksite size, industry, and region. In addition, information on program services is reported to determine the most common types and categories of services and whether service delivery changes have occurred between 1993 and 1995. The results of this study will be useful to EAP managers, mental health administrators, and mental health services researchers who are interested in the delivery and costs of EAP services.

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

PubMed Central

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

2015-01-01

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

Expanding rural access to mental health care through online postgraduate nurse practitioner education.

PubMed

Kverno, Karan; Kozeniewski, Kate

2016-12-01

Workforce shortages in mental health care are especially relevant to rural communities. People often turn to their primary care providers for mental healthcare services, yet primary care providers indicate that more education is needed to fill this role. Rural primary care nurse practitioners (NPs) are ideal candidates for educational enhancement. Online programs allow NPs to continue living and working in their communities while developing the competencies to provide comprehensive and integrated mental healthcare services. This article presents a review of current online postgraduate psychiatric mental health NP (PMHNP) options. Website descriptions of online PMHNP programs were located using keywords: PMHNP or psychiatric nurse practitioner, postgraduate or post-master's, and distance or online. Across the United States, 15 online postgraduate certificate programs were located that are designed for primary care NPs seeking additional PMHNP specialization. For rural primary care NPs who are ready, willing, and able, a postgraduate PMHNP specialty certificate can be obtained online in as few as three to four semesters. The expected outcome is a cadre of dually credentialed NPs capable of functioning in an integrated role and of increasing rural access to comprehensive mental healthcare services. ©2016 American Association of Nurse Practitioners.

Suicide trends in an expanding mental health service in Auckland.

PubMed

Argyle, Nick

2010-10-01

Suicide is a global health priority. It is important to analyse the effects of investment in mental health services on suicide rates. This paper presents and discusses recent changes in suicide rates and diagnostic mix among clients of the mental health service in Auckland during a time of service growth. Details of suicides among current clients were analysed for the years 1993 to 2006, comparing the periods 1993-1999 and 2000-2006. These periods were compared with the local population and national figures. The local population suicide rate decreased significantly with the rate among clients increasing slightly so the proportion occurring among clients increased (up to 31%). There was an increase in non-psychotic diagnoses. As access to services expands the proportion of suicides that occur in known clients will paradoxically increase. Service expansion may have contributed to the falling population suicide rate in Auckland.

State Employee Assistance Programs: Organization and Services.

ERIC Educational Resources Information Center

Kemp, Donna R.

1985-01-01

Describes a study conducted to determine how many state governments had established employee assistance programs (EAPs). Results concerned how state EAPs are organized, services provided, cost of programs, what dollars or productive benefits were calculated, and what problems have been encountered by state EAPs. (CT)

Assistance Programs: A Timely Solution for the Adult Education Setting.

ERIC Educational Resources Information Center

Burns, Shannon M.

1998-01-01

Discusses the use of formal employee assistance programs (EAPs) with adult students who have personal problems that could affect their school performance. Looks at the differences between EAPs and traditional counseling services: EAPs have a written assistance policy; they institutionalize consistency; they are confidential. (JOW)

Equity and Access to Higher Education in the Context of Educational Expansion and Differentiation in China

ERIC Educational Resources Information Center

Jia, Qiong

2013-01-01

Internationally, higher education has expanded greatly since the closing decades of the twentieth century. China was no exception. This study is intended to examine the status quo of issues relating to equity and access to higher education in the context of educational expansion and differentiation in China. Two research questions are addressed in…

Confidentiality and the employee assistance program professional.

PubMed

Mistretta, E F; Inlow, L B

1991-02-01

During the last two decades EAPs have offered employees confidential assessment, counseling, and referral. Many occupational health nurses have taken on the role of EAP professional or function as the liaison between the EAP counselor and the employee. The occupational health nurse involved in any EAP issue must adhere to the standards of confidentiality. The federal and state laws, company policy, and professional codes of ethics regarding these clients must be clearly understood, especially related to the issue of confidentiality.

PROPOSED STANDARD TO GREATLY EXPAND PUBLIC ACCESS AND EXPLORATION OF TOXICITY DATA: EVALUATION OF STRUCTURE DATA FILE FORMAT

EPA Science Inventory

PROPOSED ST ANDARD TO GREA TL Y EXP AND PUBLIC ACCESS AND EXPLORATION OF TOXICITY DATA: EVALUATION OF STRUCTURE DATA FILE FORMAT

The ability to assess the potential toxicity of environmental, pharmaceutical, or industrial chemicals based on chemical structure in...

Extracurricular Activity Participation in High School: Mechanisms Linking Participation to Math Achievement and 4-Year College Attendance

ERIC Educational Resources Information Center

Morris, David S.

2016-01-01

Extracurricular activity participation (EAP) has been positively linked with increased academic achievement and college attendance. However, the mechanisms linking EAP to educational outcomes are poorly understood. Using the Education Longitudinal Study of 2002 (ELS), this study contributes to our understanding of the relationship between EAP and…

The Organization as Client: Broadening the Concept of Employee Assistance Programs.

ERIC Educational Resources Information Center

Googins, Bradley; Davidson, Bruce N.

1993-01-01

Notes that many employee assistance programs (EAPs) are broadening their function to address rapidly changing human and social issues of environments in which they operate, refocusing practice to include organization as the client. Discusses traditional EAP practice, evolution of EAPs, changes confronting corporations, and alternative model in…

More and Better Learning: Year Three Report on the National Demonstration of ExpandED Schools. A TASC Report