Maryland Early Head Start Initiative

ERIC Educational Resources Information Center

Center for Law and Social Policy, Inc. (CLASP), 2012

2012-01-01

Since 2000, Maryland has provided state supplemental funds to Head Start and Early Head Start (EHS) programs to improve access. Local EHS programs may use funds, through child care partnerships, to extend the EHS day or year. Maryland's approach to building on EHS includes: (1) Increase the capacity of existing Head Start and EHS programs to…

Putting Children and Families First: Head Start Programs in 2010. Brief No. 10

ERIC Educational Resources Information Center

Schmit, Stephanie; Ewen, Danielle

2012-01-01

Since its creation in 1965, Head Start has provided high quality early education and comprehensive support services to three- and four-year-olds in poor families. In addition to early learning opportunities, Head Start's comprehensive early childhood development program provides children and families with access to a range of services such as…

Where We Stand: Early Childhood Education.

ERIC Educational Resources Information Center

American Federation of Teachers, Washington, DC.

This document details the position of the American Federation of Teachers (AFT) regarding universal access to early childhood education as represented in a resolution of the AFT convention in 2003. The document points out that the lack of access to high-quality preschool programs is a major problem affecting nearly every working family, and as the…

The Director's Discretionary Early Release Science Program for JWST

NASA Astrophysics Data System (ADS)

Levenson, Nancy A.; Sembach, Kenneth

2018-06-01

We will introduce the Director's Discretionary Early Release Science (DD-ERS) Program for the James Webb Space Telescope (JWST). These programs will educate and inform the community about JWST's instruments and capabilities, providing open access to early observations, and science-enabling products that the DD-ERS teams produce. During this session, we will provide updates on JWST status, and the 13 selected teams will give an overview of their planned observations and future work.

The Effects of Smart Start on Young Children with Disabilities & Their Families. Final Report.

ERIC Educational Resources Information Center

Porter, Patricia; Munn, Duncan; Buysse, Virginia; Tyndall, Sabrina

Smart Start, North Carolina's early childhood initiative, seeks to improve early childhood programs and ensure that all North Carolina children enter school healthy and ready to learn. This study evaluated outcomes related to Smart Start program inclusion of young children with disabilities: (1) access to inclusive programming; (2) quality of…

Learning Together: A Study of Six B.A. Completion Cohort Programs in Early Care and Education. Year 2 Report. Research Report

ERIC Educational Resources Information Center

Whitebook, Marcy; Sakai, Laura; Kipnis, Fran; Bellm, Dan; Almaraz, Mirella

2010-01-01

Interest in expanding access to higher education has been driven by concerns about ethnic and linguistic stratification within the early childhood workforce, and building a pipeline for diversifying the early care and education (ECE) field's leadership. "Cohort" B.A. completion programs, which target small groups of adults working in ECE…

Key Principles in Providing Integrated Behavioral Health Services for Young Children and Their Families: The "Starting Early Starting Smart" Experience.

ERIC Educational Resources Information Center

Hanson, Lori, Comp.; Deere, David, Comp.; Lee, Carol Amundson, Comp.; Lewin, Amy, Comp.; Seval, Carolyn, Comp.

This paper describes the Starting Early Starting Smart (SESS) project, an early intervention program that has been developed in the context of the national, multi-site program and evaluation. The emphasis in SESS is on the integration of behavioral health services into easily accessible, non-threatening settings where caregivers naturally and…

34 CFR 303.405 - Access rights.

Code of Federal Regulations, 2014 CFR

2014-07-01

... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES Procedural Safeguards Confidentiality of Personally Identifiable Information and Early... review any early intervention records relating to their children that are collected, maintained, or used...

34 CFR 303.405 - Access rights.

Code of Federal Regulations, 2012 CFR

2012-07-01

... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES Procedural Safeguards Confidentiality of Personally Identifiable Information and Early... review any early intervention records relating to their children that are collected, maintained, or used...

34 CFR 303.405 - Access rights.

Code of Federal Regulations, 2013 CFR

2013-07-01

... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES Procedural Safeguards Confidentiality of Personally Identifiable Information and Early... review any early intervention records relating to their children that are collected, maintained, or used...

Access for All: Collaboration for Comprehensive Child Care for Deaf and Hearing Preschoolers and Their Families. Project Access. Final Report.

ERIC Educational Resources Information Center

Solit, Gail A.

This final report presents activities and accomplishments of a three-year outreach project to link programs and agencies serving deaf and hard of hearing children and their families with child care programs in their communities. Each year project staff provided training in establishing integrated early childhood programming and child care for at…

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.

Inequality in Preschool Quality? Community-Level Disparities in Access to High-Quality Learning Environments

ERIC Educational Resources Information Center

Bassok, Daphna; Galdo, Eva

2016-01-01

In recent years, unequal access to high-quality preschool has emerged as a growing public policy concern. Because of data limitations, it is notoriously difficult to measure disparities in access to early learning opportunities across communities and particularly challenging to quantify gaps in access to "high-quality" programs. Research…

76 FR 25311 - Applications for New Awards; Technology and Media Services for Individuals With Disabilities...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-04

... educational media in early learning programs and elementary and secondary schools that are not accessible to... account the media most commonly used in school districts and early learning programs across the nation... DEPARTMENT OF EDUCATION Applications for New Awards; Technology and Media Services for Individuals...

Promoting Early Intervention Referral through a Randomized Controlled Home-Visiting Program

ERIC Educational Resources Information Center

Schwarz, Donald F.; O'Sullivan, Ann L.; Guinn, Judith; Mautone, Jennifer A.; Carlson, Elyse C.; Zhao, Huaqing; Zhang, Xuemei; Esposito, Tara L.; Askew, Megan; Radcliffe, Jerilynn

2012-01-01

The MOM Program is a randomized, controlled trial of an intervention to promote mothers' care for the health and development of their children, including accessing early intervention (EI) services. Study aims were to determine whether, relative to controls, this intervention increased receipt of and referral to EI services. Mothers (N = 302)…

Learning to Thrive: Building Diverse Scientists’ Access to Community and Resources through the BRAINS Program

PubMed Central

Margherio, Cara; Horner-Devine, M. Claire; Mizumori, Sheri J. Y.; Yen, Joyce W.

2016-01-01

BRAINS: Broadening the Representation of Academic Investigators in NeuroScience is a National Institutes of Health–funded, national program that addresses challenges to the persistence of diverse early-career neuroscientists. In doing so, BRAINS aims to advance diversity in neuroscience by increasing career advancement and retention of post-PhD, early-career neuroscientists from underrepresented groups (URGs). The comprehensive professional development program is structured to catalyze conversations specific to URGs in neuroscience and explicitly addresses factors known to impact persistence such as a weak sense of belonging to the scientific community, isolation and solo status, inequitable access to resources that impact career success, and marginalization from informal networks and mentoring relationships. While we do not yet have data on the long-term impact of the BRAINS program on participants’ career trajectory and persistence, we introduce the BRAINS program theory and report early quantitative and qualitative data on shorter-term individual impacts within the realms of career-advancing behaviors and career experiences. These early results suggest promising, positive career productivity, increased self-efficacy, stronger sense of belonging, and new perspectives on navigating careers for BRAINS participants. We finish by discussing recommendations for future professional development programs and research designed to broaden participation in the biomedical and life sciences. PMID:27587858

A Mixed-Methods Study of Early Intervention Implementation in the Commonwealth of Pennsylvania: Supports, Services, and Policies for Young Children with Developmental Delays and Disabilities

ERIC Educational Resources Information Center

Mattern, Janet A.

2015-01-01

Participation in high quality early intervention programs is critical for eligible young children who experience atypical development for their future academic success. High quality programs promote access to services, incorporate instructional strategies that encourage children's participation, and advocate public policy that supports…

Immediately Outcomes of Lower-Income Participants in Minnesota's Universal Access Early Childhood Family Education. Early Childhood Family Education (ECFC) Evaluation Series; Changing Times, Changing Families-Phase II.

ERIC Educational Resources Information Center

Mueller, Marsha R.

The Minnesota Early Childhood Family Education (ECFE) program is a voluntary public school family support and education program for parents of children from birth to kindergarten, and is offered in 360 school districts and the four tribal schools. An evaluation was conducted to learn what types of immediate outcomes could be expected for…

Urban High School Students' Experiences in an Afterschool College Readiness Program

ERIC Educational Resources Information Center

Parikh, Sejal B.

2013-01-01

This transcendental phenomenological investigation examined urban students' experiences in Gaining Early Awareness and Readiness for Undergraduate Programs (GEAR UP), an afterschool college readiness program. The federally funded program provides low-income and minority students information and access to services that lead to increased…

Dual Enrollment Programs. What Works Clearinghouse Intervention Report

ERIC Educational Resources Information Center

What Works Clearinghouse, 2017

2017-01-01

"Dual enrollment" programs allow high school students to take college courses and earn college credits while still attending high school. Such programs, also referred to as "dual credit" or early college programs, are designed to boost college access and degree attainment, especially for students typically underrepresented in…

Prekindergarten: Four Selected States Expanded Access by Relying on Schools and Existing Providers of Early Education and Care to Provide Services. Report to Congressional Requesters. GAO-04-852

ERIC Educational Resources Information Center

Shaul, Marnie S.

2004-01-01

For nearly 40 years, the federal government has helped provide early childhood development for children of low-income families through Head Start and other programs. This study examined how Georgia, New Jersey, New York, and Oklahoma expanded their preschool programs for at-risk students to serve more children, focusing on: how programs were…

Evaluating the Influence of an Urban High School Reform Effort on College Readiness and Access Outcomes: A Quasiexperimental Cohort Study

ERIC Educational Resources Information Center

Sondergeld, Toni A.; Fischer, John M.; Samel, Arthur N.; Knaggs, Christine M.

2013-01-01

It is widely accepted that postsecondary education has become a necessity for US youth. College access, however, has been found not to be equal for all. As a result, federally funded college-readiness programs, such as Gaining Early Awareness and Readiness for Undergraduate Programs (GEAR UP), have been established to increase the numbers of…

Webcam Delivery of the Lidcombe Program for Early Stuttering: A Phase I Clinical Trial

ERIC Educational Resources Information Center

O'Brian, Sue; Smith, Kylie; Onslow, Mark

2014-01-01

Purpose: The Lidcombe Program is an operant treatment for early stuttering shown with meta-analysis to have a favorable odds ratio. However, many clients are unable to access the treatment because of distance and lifestyle factors. In this Phase I trial, we explored the potential efficacy, practicality, and viability of an Internet webcam Lidcombe…

Staff Training Tips: Focusing on Early Childhood Education and Services.

ERIC Educational Resources Information Center

2003

This document collects 15 brief guides to staff training in inclusive early childhood education settings. Guides offer examples of successful programs, research findings, and practical tips. Titles are: (1) "Giving Families Better Access to Early Intervention Services"; (2) "Creating Integrated Classrooms that Work"; (3) "Seamless Transition…

Global Access Programs: A Collaborative Approach for Effective Implementation and Management.

PubMed

Ainge, Debra; Aitken, Suzanne; Corbett, Mark; De-Keyzer, David

Global access programs (GAPs) provide access to medicinal products for patients with serious medical conditions and no commercially available treatment options. Providing early access to medicines can be challenging for a pharmaceutical company. The demand for a GAP often occurs at a time when other activities are the prime focus, such as delivery of pivotal clinical trials or gaining of marketing authorization. Furthermore, the skills, experience, and infrastructure necessary to implement and manage a successful GAP vary significantly from those required for regular clinical trial execution, and the regulatory environment presents its own challenges, with regulations often poorly defined and with considerable inter-country variation. This article considers the triggers for early access requests and examines the need for companies to develop a global strategy for GAPs in order to respond appropriately to requests for early access. It also provides a comprehensive overview of the processes for GAP set-up, implementation, management, and closure, along with the considerations affecting the type and scope of GAP, such as demand, regulatory feasibility, license status of the product, drug pricing structure, company strategy, costs, and product supply. Also discussed is the need for appropriate personnel to implement and manage the GAP, and when to consider collaboration with an external GAP provider. In summary, GAPs require careful and efficient planning and management, from set-up to closure. Well-run GAPs provide an ethical and regulatory-compliant pathway for access of new treatments to patients with serious conditions and an unmet medical need.

Redefining Leadership: Lessons from an Early Education Leadership Development Initiative

ERIC Educational Resources Information Center

Douglass, Anne

2018-01-01

This study examined how experienced early educators developed as change agents in the context of a leadership development program. Unlike in many other professions, experienced early educators lack opportunities to grow throughout their careers and access the supports they need to lead change in their classrooms, organizations, the profession, and…

Structured Analysis/Design - LSA Task 101, Early Logistic Support Analysis Strategy, Subtask 101.2.1, Develop Early LSA Strategy

DTIC Science & Technology

1990-07-01

replacing "logic diagrams" or "flow charts") to aid in coordinating the functions to be performed by a computer program and its associated Inputs...ADDRESS (City, State, and ZIP Code) 10. SOURCE OF FUNDING NUMBERS PROGRAM PROJECT ITASK IWORK UNIT ELEMENT NO. NO. NO. ACCESSION NO. 11. TITLE...the analysis. Both the logical model and detailed procedures are used to develop the application software programs which will be provided to Government

Screening for autism spectrum disorder in underserved communities: Early childcare providers as reporters.

PubMed

Janvier, Yvette M; Harris, Jill F; Coffield, Caroline N; Louis, Barbara; Xie, Ming; Cidav, Zuleyha; Mandell, David S

2016-04-01

Early diagnosis of autism typically is associated with earlier access to intervention and improved outcomes. Daycares and preschools largely have been ignored as possible venues for early identification. This may be especially important for minority children in the United States who are typically diagnosed with autism later than White children, limiting their access to early specialized interventions and possibly resulting in poorer outcomes. Early childcare providers within underserved communities completed autism screening tools for a sample of low-risk young children (n = 967) in their programs. Early childcare providers returned screening tools for 90% of the children for whom parental consent had been received. A total of 14% of children screened positive for autism spectrum disorder and 3% of the sample met criteria for autism spectrum disorder. Among those who screened positive, 34% were lost to follow-up. Findings suggest that early childcare providers can effectively screen young children for autism spectrum disorder in preschool/daycare settings, thus improving access to early diagnosis and reducing potential healthcare disparities among underserved populations. © The Author(s) 2015.

Inter-association task force recommendations on emergency preparedness and management of sudden cardiac arrest in high school and college athletic programs: a consensus statement.

PubMed

Drezner, Jonathan A; Courson, Ron W; Roberts, William O; Mosesso, Vincent N; Link, Mark S; Maron, Barry J

2007-03-01

To assist high school and college athletic programs prepare for and respond to sudden cardiac arrest (SCA). This consensus statement summarizes our current understanding of SCA in young athletes, defines the necessary elements for emergency preparedness, and establishes uniform treatment protocols for the management of SCA. SCA is the leading cause of death in young athletes. The increasing presence of and timely access to automated external defibrillators (AEDs) at sporting events provides a means of early defibrillation and the potential for effective secondary prevention of sudden cardiac death. An Inter-Association Task Force was sponsored by the National Athletic Trainers' Association to develop consensus recommendations on emergency preparedness and management of SCA in athletes. Comprehensive emergency planning is needed for high school and college athletic programs to ensure an efficient and structured response to SCA. Essential elements of an emergency action plan include establishing an effective communication system, training of anticipated responders in cardiopulmonary resuscitation and AED use, access to an AED for early defibrillation, acquisition of necessary emergency equipment, coordination and integration of onsite responder and AED programs with the local emergency medical services system, and practice and review of the response plan. Prompt recognition of SCA, early activation of the emergency medical services system, the presence of a trained rescuer to initiate cardiopulmonary resuscitation, and access to early defibrillation are critical in the management of SCA. In any collapsed and unresponsive athlete, SCA should be suspected and an AED applied as soon as possible for rhythm analysis and defibrillation if indicated.

Videoteleconferencing Early Child Anxiety Treatment: A Case Study of the Internet-Delivered PCIT CALM (I-CALM) Program

PubMed Central

Cooper-Vince, Christine E.; Chou, Tommy; Furr, Jami M.; Puliafico, Anthony C.; Comer, Jonathan S.

2017-01-01

Anxiety disorders are one of the most prevalent and impairing classes of mental health difficulties affecting young children. Though the vast majority of supported programs for child anxiety focus on youth ages 7 years and up, preliminary support has emerged for exposure-based adaptations of parent-coaching interventions, i.e., the Parent Child Interaction Therapy (PCIT) CALM Program, to address anxiety disorders in early childhood. Despite these advances, low rates of community service use and accessibility persist. The increased ubiquity of Internet access has positioned videoteleconferencing (VTC) as a powerful tool to overcome traditional barriers to care. The present case study details the VTC delivery of the PCIT CALM Program in the treatment of a 6 year-old boy presenting with generalized anxiety disorder and separation anxiety disorder. This case provides qualitative support for the feasibility of delivering integrated real-time parent coaching and exposure therapy to address early childhood anxiety disorders via VTC. The remission of the patient’s anxiety across treatment sessions suggests that the telehealth format may be a useful modality for the delivery of early childhood anxiety treatment. The technical considerations for the delivery of VTC therapy as well as the implications for treatment are discussed. PMID:29104931

Early Childhood Education Workforce Supply: A Report to the General Assembly on Public Act 05-245. Report

ERIC Educational Resources Information Center

Connecticut Department of Higher Education (NJ1), 2006

2006-01-01

Public Act 05-245 called for the establishment of a committee to assess pathways to baccalaureate degree programs in early childhood education; make recommendations to increase access to initial certification in early childhood or child development; and make recommendations for strengthening articulation between two-year and four-year early…

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)…

Cancer early detection program based on awareness and clinical breast examination: Interim results from an urban community in Mumbai, India.

PubMed

Gadgil, Anita; Sauvaget, Catherine; Roy, Nobhojit; Muwonge, Richard; Kantharia, Surita; Chakrabarty, Anuradha; Bantwal, Kanchan; Haldar, Indrani; Sankaranarayanan, Rengaswamy

2017-02-01

Indian women with breast cancer are usually diagnosed in advanced stages leading to poor survival. Improving breast awareness and increasing access to early diagnosis and adequate treatment has been advocated for breast cancer control. We implemented a program to increase awareness on breast cancer and access to its early detection in an occupational health care scheme in Mumbai, India. Breast awareness brochures were mailed annually between June 2013 and June 2016 to a cohort of 22,500 eligible women aged 30-69 years old receiving universal health care from an occupational health care scheme comprising of primary health centres and a referral secondary care hospital in Mumbai. Women with suspected breast cancers were provided with diagnostic investigations and treatment. Socio-demographic information and tumour characteristics were compared between the breast awareness pre-intervention period (Jan 2005-May 2013) and the breast awareness intervention period after four rounds of mailers (June 2013-June 2016). The proportion of women with early tumours and axillary lymph node negative cancers increased from 74% to 81% and 46% to 53% respectively, between the two periods. While the proportion of patients receiving breast conserving surgery increased from 39% to 51%, the proportion receiving chemotherapy decreased from 84% to 56%. Interim results following efforts to improve breast awareness and access to care in a cohort of women in an occupational health care scheme indicate early detection and more conservative treatment of breast cancers. Creating awareness and improving access to care may result in cancer down-staging. Copyright © 2016 Elsevier Ltd. All rights reserved.

Supporting Immigrant Families' Access to Prekindergarten

ERIC Educational Resources Information Center

Gelatt, Julia; Adams, Gina; Huerta, Sandra

2014-01-01

In recent years, many states have expanded their state-funded prekindergarten programs, drawing on evidence that public investments in early childhood education bring substantial returns in children's educational trajectories and a more skilled future workforce. Evidence also suggests that returns to early education may be larger for children of…

Pennsylvania's Pre-Kindergarten Crisis: A Crime Prevention Tragedy.

ERIC Educational Resources Information Center

2003

Noting that at-risk children who attend high quality early childhood care and pre-kindergarten programs are less likely to commit delinquent or criminal behaviors than children denied access to such programs, this report presents information on the effectiveness of such programs for preventing crime and argues that Pennsylvania can prevent crime…

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

PubMed

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

2017-03-01

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

Inter-association Task Force recommendations on emergency preparedness and management of sudden cardiac arrest in high school and college athletic programs: a consensus statement.

PubMed

Drezner, Jonathan A; Courson, Ron W; Roberts, William O; Mosesso, Vincent N; Link, Mark S; Maron, Barry J

2007-01-01

To assist high school and college athletic programs prepare for and respond to a sudden cardiac arrest (SCA). This consensus statement summarizes our current understanding of SCA in young athletes, defines the necessary elements for emergency preparedness, and establishes uniform treatment protocols for the management of SCA. Sudden cardiac arrest is the leading cause of death in young athletes. The increasing presence of and timely access to automated external defibrillators (AEDs) at sporting events provides a means of early defibrillation and the potential for effective secondary prevention of sudden cardiac death. An Inter-Association Task Force was sponsored by the National Athletic Trainers' Association to develop consensus recommendations on emergency preparedness and management of SCA in athletes. Comprehensive emergency planning is needed for high school and college athletic programs to ensure an efficient and structured response to SCA. Essential elements of an emergency action plan include establishment of an effective communication system, training of anticipated responders in cardiopulmonary resuscitation and AED use, access to an AED for early defibrillation, acquisition of necessary emergency equipment, coordination and integration of on-site responder and AED programs with the local emergency medical services system, and practice and review of the response plan. Prompt recognition of SCA, early activation of the emergency medical services system, the presence of a trained rescuer to initiate cardiopulmonary resuscitation, and access to early defibrillation are critical in the management of SCA. In any collapsed and unresponsive athlete, SCA should be suspected and an AED applied as soon as possible for rhythm analysis and defibrillation if indicated.

Inter Association Task Force recommendations on emergency preparedness and management of sudden cardiac arrest in high school and college athletic programs: a consensus statement.

PubMed

Drezner, Jonathan A; Courson, Ron W; Roberts, William O; Mosesso, Vincent N; Link, Mark S; Maron, Barry J

2007-01-01

To assist high school and college athletic programs prepare for and respond to a sudden cardiac arrest (SCA). This consensus statement summarizes our current understanding of SCA in young athletes, defines the necessary elements for emergency preparedness, and establishes uniform treatment protocols for the management of SCA. Sudden cardiac arrest is the leading cause of death in young athletes. The increasing presence of and timely access to automated external defibrillators (AEDs) at sporting events provides a means of early defibrillation and the potential for effective secondary prevention of sudden cardiac death. An Inter-Association Task Force was sponsored by the National Athletic Trainers' Association to develop consensus recommendations on emergency preparedness and management of SCA in athletes. Comprehensive emergency planning is needed for high school and college athletic programs to ensure an efficient and structured response to SCA. Essential elements of an emergency action plan include establishing an effective communication system, training of anticipated responders in cardiopulmonary resuscitation and AED use, access to an AED for early defibrillation, acquisition of necessary emergency equipment, coordination, and integration of on-site responder and AED programs with the local emergency medical services system, and practice and review of the response plan. Prompt recognition of SCA, early activation of the emergency medical services system, the presence of a trained rescuer to initiate cardiopulmonary resuscitation, and access to early defibrillation are critical in the management of SCA. In any collapsed and unresponsive athlete, SCA should be suspected and an AED applied as soon as possible for rhythm analysis and defibrillation if indicated.

Inter-association task force recommendations on emergency preparedness and management of sudden cardiac arrest in high school and college athletic programs: a consensus statement.

PubMed

Drezner, Jonathan A; Courson, Ron W; Roberts, William O; Mosesso, Vincent N; Link, Mark S; Maron, Barry J

2007-04-01

To assist high school and college athletic programs prepare for and respond to a sudden cardiac arrest (SCA). This consensus statement summarizes our current understanding of SCA in young athletes, defines the necessary elements for emergency preparedness, and establishes uniform treatment protocols for the management of SCA. Sudden cardiac arrest is the leading cause of death in young athletes. The increasing presence of and timely access to automated external defibrillators (AEDs) at sporting events provides a means of early defibrillation and the potential for effective secondary prevention of sudden cardiac death. An Inter-Association Task Force was sponsored by the National Athletic Trainers' Association to develop consensus recommendations on emergency preparedness and management of SCA in athletes. Comprehensive emergency planning is needed for high school and college athletic programs to ensure an efficient and structured response to SCA. Essential elements of an emergency action plan include establishing an effective communication system, training of anticipated responders in cardiopulmonary resuscitation and AED use, access to an AED for early defibrillation, acquisition of necessary emergency equipment, coordination and integration of onsite responder and AED programs with the local emergency medical services system, and practice and review of the response plan. Prompt recognition of SCA, early activation of the emergency medical services system, the presence of a trained rescuer to initiate cardiopulmonary resuscitation, and access to early defibrillation are critical in the management of SCA. In any collapsed and unresponsive athlete, SCA should be suspected and an AED applied as soon as possible for rhythm analysis and defibrillation if indicated.

Inter-Association Task Force Recommendations on Emergency Preparedness and Management of Sudden Cardiac Arrest in High School and College Athletic Programs: A Consensus Statement

PubMed Central

Drezner, Jonathan A; Courson, Ron W; Roberts, William O; Mosesso, Vincent N; Link, Mark S; Maron, Barry J

2007-01-01

Objective: To assist high school and college athletic programs prepare for and respond to a sudden cardiac arrest (SCA). This consensus statement summarizes our current understanding of SCA in young athletes, defines the necessary elements for emergency preparedness, and establishes uniform treatment protocols for the management of SCA. Background: Sudden cardiac arrest is the leading cause of death in young athletes. The increasing presence of and timely access to automated external defibrillators (AEDs) at sporting events provides a means of early defibrillation and the potential for effective secondary prevention of sudden cardiac death. An Inter-Association Task Force was sponsored by the National Athletic Trainers' Association to develop consensus recommendations on emergency preparedness and management of SCA in athletes. Recommendations: Comprehensive emergency planning is needed for high school and college athletic programs to ensure an efficient and structured response to SCA. Essential elements of an emergency action plan include establishment of an effective communication system, training of anticipated responders in cardiopulmonary resuscitation and AED use, access to an AED for early defibrillation, acquisition of necessary emergency equipment, coordination and integration of on-site responder and AED programs with the local emergency medical services system, and practice and review of the response plan. Prompt recognition of SCA, early activation of the emergency medical services system, the presence of a trained rescuer to initiate cardiopulmonary resuscitation, and access to early defibrillation are critical in the management of SCA. In any collapsed and unresponsive athlete, SCA should be suspected and an AED applied as soon as possible for rhythm analysis and defibrillation if indicated. PMID:17597956

Early Learning Theories Made Visible

ERIC Educational Resources Information Center

Beloglovsky, Miriam; Daly, Lisa

2015-01-01

Go beyond reading about early learning theories and see what they look like in action in modern programs and teacher practices. With classroom vignettes and colorful photographs, this book makes the works of Jean Piaget, Erik Erikson, Lev Vygotsky, Abraham Maslow, John Dewey, Howard Gardner, and Louise Derman-Sparks visible, accessible, and easier…

Accessing Programs for Infants, Toddlers, and Preschoolers with Disabilities.

ERIC Educational Resources Information Center

Horne, Richard, Ed.

1990-01-01

Intended for use by parents of infants, toddlers and preschoolers, this guide presents, in question and answer format, basic information about early intervention and special education services. Questions about services for the period from birth through 2 years include the following: "What are early intervention services?""What is an…

If We Build It, Will They Come? Fielding Dreams of College Access

ERIC Educational Resources Information Center

Bruna, Katherine Richardson; Farley, Jennifer; McNelly, Carla A.; Sellers, Debra M.; Johnson, Roberta

2017-01-01

This article describes the ISU 4U Promise, an innovative college access and affordability initiative. Through this early-commitment partnership program between Iowa State University and Des Moines Public Schools, youth from two urban elementary schools are eligible for tuition awards when they enroll as undergraduates at Iowa State University.…

Early detection of cervical cancer according to the discourses of primary care midwives in Segovia, Spain.

PubMed

Otero, Laura; Sanz, Belén; Blasco, Teresa

2011-10-01

To analyze the discourses of primary care midwives on access to and utilization of the Cervical Cancer Prevention Program. A qualitative study was conducted in an area of low population density with a high proportion of rural population in Segovia, Spain, between 2008 and 2009. Semi-structured interviews were carried out. Ten primary care midwives were interviewed covering the 16 basic health districts of the city. Data analysis was based on grounded theory methodology. Access to and utilization of the Cervical Cancer Prevention Program was associated with attendance to midwife visits, women's experiences with cervical smears and their perception of risk of cervical cancer. Geographic distance to the health center, difficult access to immigrant women who have no health insurance, and being unaware of the program offered are some of the perceived barriers. Social exclusion is also perceived as a barrier of access to and utilization of the program. The recommendation to participate in the program made by the primary care physician was identified as the main facilitator. The midwives perceived inequalities in access to and utilization of the Cervical Cancer Prevention Program that are associated to individual characteristics of women, and contextual characteristics such as the geographical environment where they live and Program's infrastructure. There is inequality of access to care of underrepresented groups of women such as immigrant women and those residing in rural areas.

Colorado GEAR UP Program Design and Its Effect on Student Perceptions of Postsecondary Education

ERIC Educational Resources Information Center

Mendelsberg, Scott

2012-01-01

Gaining Early Awareness and Readiness for Undergraduate Programs (GEAR UP) is a federal program aimed at equalizing access to higher education for low-income students. GEAR UP, created in 1998, attempts to provide information and support about higher education to students beginning no later than the seventh grade while promoting lasting…

Selective College Admission: What Are We Willing to Give Up?

ERIC Educational Resources Information Center

Chimes, Michael

2003-01-01

As teachers and students consider the heated conversations over selective college admission, including a loud cry to end or curtail early application programs, the author urges admission offices to consider that greater access to the most selective schools must involve a redistribution of precious resources. A smaller percentage of early admits…

An Effective Approach to Developing Function-Based Interventions in Early Childhood Classrooms

ERIC Educational Resources Information Center

Wood, Brenna K.; Ferro, Jolenea B.

2014-01-01

Due to the unique features of early childhood classrooms, teachers routinely modify the social and physical environment to support children with mild to moderate challenges. Yet despite their access to behavioral consultants, school-based prekindergarten programs are more likely to expel young children from their classroom settings compared with…

Perspectives in Early Childhood Education: Belize, Brazil, Mexico, El Salvador and Peru

ERIC Educational Resources Information Center

McConnell-Farmer, Judith Lynne; Cook, Pamela R.; Farmer, M. W.

2012-01-01

Early childhood education (ECE) provision is becoming a growing priority. During the past twenty years, Latin America has shown a growing recognition in the provision of educational programs for young children, birth to age eight, is essential. Urban and rural populations intimated in 2009, that many countries utilizing equitable access to…

No Teachers Left Behind: An Exploration of Preschool Teacher Preparation Programs in Massachusetts

ERIC Educational Resources Information Center

O'Brien, Ellen J.

2012-01-01

Recognizing the importance of early childhood education for young children, states are planning and implementing initiatives to assure greater access to high-quality, elementary-school based preschool. In the field of early childhood education the leading professional organizations, such as the National Association for the Education of Young…

Preschool Inclusion: Key Findings from Research and Implications for Policy

ERIC Educational Resources Information Center

Lawrence, Sharmila; Smith, Sheila; Banerjee, Rashida

2016-01-01

A recent policy statement issued by the U.S. Department of Health and Human Services (HHS) and U.S. Department of Education (DOE) on early childhood inclusion presents extensive recommendations for state and local actions that could improve young children's access to high quality inclusive early childhood programs (HHS/DOE, 2015). This brief…

SCI Hospital in Home Program: Bringing Hospital Care Home for Veterans With Spinal Cord Injury.

PubMed

Madaris, Linda L; Onyebueke, Mirian; Liebman, Janet; Martin, Allyson

2016-01-01

The complex nature of spinal cord injury (SCI) and the level of care required for health maintenance frequently result in repeated hospital admissions for recurrent medical complications. Prolonged hospitalizations of persons with SCI have been linked to the increased risk of hospital-acquired infections and development or worsening pressure ulcers. An evidence-based alternative for providing hospital-level care to patients with specific diagnoses who are willing to receive that level of care in the comfort of their home is being implemented in a Department of Veterans Affairs SCI Home Care Program. The SCI Hospital in Home (HiH) model is similar to a patient-centered interdisciplinary care model that was first introduced in Europe and later tested as part of a National Demonstration and Evaluation Study through Johns Hopkins School of Medicine and School of Public Health. This was funded by the John A. Hartford Foundation and the Department of Veterans Affairs. The objectives of the program are to support veterans' choice and access to patient-centered care, reduce the reliance on inpatient medical care, allow for early discharge, and decrease medical costs. Veterans with SCI who are admitted to the HiH program receive daily oversight by a physician, daily visits by a registered nurse, access to laboratory services, oxygen, intravenous medications, and nursing care in the home setting. In this model, patients may typically access HiH services either as an "early discharge" from the hospital or as a direct admit to the program from the emergency department or SCI clinic. Similar programs providing acute hospital-equivalent care in the home have been previously implemented and are successfully demonstrating decreased length of stay, improved patient access, and increased patient satisfaction.

GEAR UP: Providing Opportunities or Conflict?

ERIC Educational Resources Information Center

Walsh, Rachael

2008-01-01

Since 1965 the federal government has attempted to provide low socioeconomic status students with equal access to postsecondary education through the Higher Education Act and its multiplicative programmatic efforts. Implemented as one such program in 1998, the Gaining Early Awareness and Readiness for Undergraduate Programs, or GEAR UP, has been…

The Law of Primacy and the Utility of a Jet Transition Course

ERIC Educational Resources Information Center

Stephenson, Ross L., Jr.; Ziskal, Wayne

2015-01-01

Regional jet carriers have established Pilot Pathway Programs providing partnership opportunities with collegiate aviation programs in order to fashion pilot training at the undergraduate level. These partnerships provide aviation students early screening for employment with regional airlines and provide the university needed access to airline…

76 FR 17128 - Agency Information Collection Request. 60-Day Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-28

.... Proposed Project: The Children's Health Insurance Program Reauthorization Act (CHIPRA) 10-State Evaluation... into how the Children's Health Insurance Program (CHIP) has evolved since its early years, what impacts on children's coverage and access to care have occurred, and what new issues have arisen as a result...

78 FR 15009 - Extension of Deadline; Gaining Early Awareness and Readiness for Undergraduate Programs (GEAR UP...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-08

... official version of this document is the document published in the Federal Register. Free Internet access... free, at 1- 800-877-8339. Accessible Format: Individuals with disabilities can obtain this document in... Document Format (PDF). To use PDF, you must have Adobe Acrobat Reader, which is available free at this site...

Early Contact, Language Access, and Honoring Every Culture: A Framework for Student Success

ERIC Educational Resources Information Center

Gallegos, Rosemary

2017-01-01

Rosemary Gallegos is superintendent of the New Mexico School for the Deaf (NMSD). Her 30+ years of service to NMSD include teaching, instructional supervision, special education compliance, and cultivating NMSD's statewide Birth-3 and outreach programs. Gallegos's goal is to ensure all deaf and hard of hearing children in New Mexico have access to…

Development and Testing of a Conceptual Model Regarding Men’s Access to Health Care

PubMed Central

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

2016-01-01

Epidemiologic data suggest men often experience excessive morbidity and early mortality, possibly compromising family and community health over the lifespan. Moreover, the negative financial/economic consequences affected by poor male health outcomes also has been of great concern in the United States and abroad. Early and consistent access to preventative health care may improve health outcomes; however, men are far less likely to access these services. The purpose of this study was to understand what factors preclude men from accessing health care. We surveyed 485 participants using a 58-item online survey built from a conceptual model previously developed by the researchers using hegemonic masculinity theory, the theory of normative contentment, and the health belief model. For men, three items significantly (ps < .05) predicted whether they had seen a health care provider in the past year: “I/Men do not access healthcare because I do not think there is anything wrong with me,” “My health is only about me,” and “I/Men do not access healthcare because most men in my family do not access healthcare.” Other correlations of practical significance also were noted. Results suggest gender norms and masculine ideals may play a primary role in how men access preventative health care. Future programming targeting males should consider barriers and plan programs that are gender-sensitive in addition to being gender-specific. Clinical implications are discussed. PMID:27698256

Evaluation of a DVD-Based Self-Help Program in Highly Socially Anxious Individuals--Pilot Study

ERIC Educational Resources Information Center

Mall, Anna K.; Mehl, Annette; Kiko, Sonja; Kleindienst, Nikolaus; Salize, Hans-Joachim; Hermann, Christiane; Hoffmann, Torsten; Bohus, Martin; Steil, Regina

2011-01-01

High social anxiety is a risk factor for the incidence of social anxiety disorder (SAD). Early diagnosis and intervention may prevent more severe psychiatric courses. Self-help programs may be a convenient, accessible, and effective intervention. This study examined the efficacy of a newly developed self-help program for SAD in individuals with…

[Programs of early detection of breast cancer and access of mammography in Spain].

PubMed

Luengo, S; Azcona, B; Lázaro, P; Madero, R

1997-05-24

We studied availability to mammography among Spanish women aged 40 to 70 years, variation in use of the mammography by autonomous community, and the situation and importance of breast cancer screening programs among other factors, in the access to mammography. A cross-sectional population survey was conducted in 1994 in a sample of 3,218 women. A questionnaire was used to collect data on the variable access (receipt of at least one mammogram in the last 2 years) as well as different access-related variables. Information on breast cancer screening programs was collected by contacting the responsible institutions. We considered that a program had total coverage if it included all the municipalities in the province and partial if it did not include all municipalities. Twenty-eight percent of women had performed a mammogram. This proportion varied among autonomous communities (AACC) from 11.5 to 73.8%. Breast cancer screening programs existed in 8 AACC. The multivariant analysis revealed an association between access to mammography and the existence of a screening program, especially when the later had total coverage (OR = 7.64; 95% CI = 5.24-11.10). An association was also found between access to mammography and physician-related factors, place of residence and attitudes of women toward mammography. Less than one third of women aged 40-70 have performed a mammography in the last 2 years, and this proportion varies among AACC. Gynecologist visits and the existence of breast cancer screening programs are fundamental factors in the access to mammography in Spain.

Access to Quality Early Childhood Care and Education. Background Paper for the Quality Child Care Think Tank. Draft.

ERIC Educational Resources Information Center

Brandon, Richard N.; Smith, Diana

This background paper discusses the current system of child care finance in Washington State and analyzes options for improvement. It describes prominent characteristics of the early childhood care and education system, findings relating program quality to staff/child ratios and staff educational levels, characteristics of quality, parent…

"Dosage" Effects on Developmental Progress during Early Childhood Intervention: Accessible Metrics for Real-Life Research and Advocacy

ERIC Educational Resources Information Center

Bagnato, Stephen J.; Suen, Hoi K.; Fevola, Antonio V.

2011-01-01

The accountability movement in education, in general, and early childhood intervention (ECI), specifically, have fueled the debate about the quality, benefits, and limitations of various types of publicly funded ECI and human service programs (PEW Charitable Trusts, 2008; National Research Council/National Academy of Sciences, 2009) not only in…

Conceptualizing Child and Family Outcomes of Early Intervention Services for Children with ASD and Their Families

ERIC Educational Resources Information Center

Noyes-Grosser, Donna M.; Rosas, Scott R.; Goldman, Alyssa; Elbaum, Batya; Romanczyk, Ray; Callahan, Emily H.

2013-01-01

State early intervention programs (EIPs) have been encouraged to develop and implement comprehensive outcomes measurement systems. As the number of children with autism spectrum disorders (ASD) and their families receiving services in state EIPs increases, disability-specific outcomes data are needed to better understand issues of access, costs,…

Early College and Dual Enrollment Challenges: Inroads and Impediments to Access

ERIC Educational Resources Information Center

Howley, Aimee; Howley, Marged D.; Howley, Craig B.; Duncan, Tom

2013-01-01

In recent years, some school reformers have come to see early college and dual enrollment as mechanisms for increasing the academic engagement and performance of a range of students beyond those exhibiting high academic achievement or ability. Despite purported benefits, research on the dynamics of such programs is limited. This case study adds to…

Learning to Thrive: Building Diverse Scientists' Access to Community and Resources through the BRAINS Program.

PubMed

Margherio, Cara; Horner-Devine, M Claire; Mizumori, Sheri J Y; Yen, Joyce W

2016-01-01

Broadening the Representation of Academic Investigators in NeuroScience is a National Institutes of Health-funded, national program that addresses challenges to the persistence of diverse early-career neuroscientists. In doing so, BRAINS aims to advance diversity in neuroscience by increasing career advancement and retention of post-PhD, early-career neuroscientists from underrepresented groups (URGs). The comprehensive professional development program is structured to catalyze conversations specific to URGs in neuroscience and explicitly addresses factors known to impact persistence such as a weak sense of belonging to the scientific community, isolation and solo status, inequitable access to resources that impact career success, and marginalization from informal networks and mentoring relationships. While we do not yet have data on the long-term impact of the BRAINS program on participants' career trajectory and persistence, we introduce the BRAINS program theory and report early quantitative and qualitative data on shorter-term individual impacts within the realms of career-advancing behaviors and career experiences. These early results suggest promising, positive career productivity, increased self-efficacy, stronger sense of belonging, and new perspectives on navigating careers for BRAINS participants. We finish by discussing recommendations for future professional development programs and research designed to broaden participation in the biomedical and life sciences. © 2016 C. Margherio et al. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Early Exposure to Research: Outcomes of the ASTER Certification Program

ERIC Educational Resources Information Center

Griffard, Phyllis Baudoin; Golkowska, Krystyna

2013-01-01

This paper discusses a novel structure for providing a high-impact, first year experience for science students. ASTER (Access to Science Through Experience in Research) is an extracurricular certification program designed to introduce our students to the research culture via seminar attendance, journal clubs, book clubs, and lab visits.…

A Program Showcase: Ludeteca Movil

ERIC Educational Resources Information Center

Kalinowski, Michael

2008-01-01

This article describes a program that offers low-income children ages 2 to 12 years a space to grow and learn by providing access to toys, books, and educational materials. It is funded by donations of money, toys, and educational materials. The World Organization for Early Childhood Education (OMEP) Mobile Toy Library started in Paraguay in 2001…

Scaling up Quality in Early Childhood Programs: New Jersey's Story

ERIC Educational Resources Information Center

Lauter, Nancy; Rice, Cynthia

2008-01-01

Preschool systems changed significantly in New Jersey in 1998 when the State's Supreme Court required the poorest school districts to implement high quality, intensive preschool programs for all three- and four-year-olds. Since the first year of implementation in 1999, New Jersey's Abbott districts have been providing preschoolers with access to…

Early Commitment Financial Aid Programs: Promises, Practices, and Policies

ERIC Educational Resources Information Center

Blanco, Cheryl D.

2005-01-01

Student financial assistance has long been a means to promote access to postsecondary education and attainment of college degrees. Numerous types of financial aid programs have proliferated over the years, including a relatively new concept that specifically targets high-risk, low-income students, focusing not just on getting them to go to college…

45 CFR 149.610 - Secretary's authority to reopen and revise a reimbursement determination.

Code of Federal Regulations, 2012 CFR

2012-10-01

... REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Disclosure of Data Inaccuracies § 149.610 Secretary's authority to reopen and revise a reimbursement...

45 CFR 149.610 - Secretary's authority to reopen and revise a reimbursement determination.

Code of Federal Regulations, 2013 CFR

2013-10-01

... REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Disclosure of Data Inaccuracies § 149.610 Secretary's authority to reopen and revise a reimbursement...

45 CFR 149.610 - Secretary's authority to reopen and revise a reimbursement determination.

Code of Federal Regulations, 2014 CFR

2014-10-01

... REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Disclosure of Data Inaccuracies § 149.610 Secretary's authority to reopen and revise a reimbursement...

The Role of Access to Head Start and Quality Ratings for Spanish-Speaking Dual Language Learners’ (DLLs) Participation in Early Childhood Education

PubMed Central

2014-01-01

Data from the Head Start Impact Study (N = 4,442) were used to test for differences between Spanish-speaking Dual Language Learners (DLLs) and monolingual English-speaking children in: (1) Head Start attendance rates when randomly assigned admission; and (2) quality ratings of other early childhood education (ECE) programs attended when not randomly assigned admission to Head Start. Logistic regressions showed that Spanish-speaking DLL children randomly assigned a spot in Head Start were more likely than monolingual-English learners to attend. Further, Spanish-speaking DLLs not randomly assigned a spot in Head Start were more likely to attend higher-quality ECE centers than non-DLL children. Policy implications are discussed, suggesting that, if given access, Spanish-speaking DLL families will take advantage of quality ECE programs. PMID:25018585

An overview of Compassionate Use Programs in the European Union member states.

PubMed

Balasubramanian, Gayathri; Morampudi, Suman; Chhabra, Pankdeep; Gowda, Arun; Zomorodi, Behsad

2016-11-01

The past decade witnessed rapid development of novel drugs and therapeutic biological agents. The marketing authorization for novel therapies is often time consuming and distressing for patients. Earlier clinical trials were the only way to access new drugs under development. However, not every patient meets the enrolment criteria, and participation is difficult for patients with life-threatening, long-lasting or seriously debilitating diseases like rare diseases. Early access programs like "Compassionate Use Program (CUP)" have generated alternative channels for such patients. The European Medical Agency provides regulations and recommendations for compassionate use, upon which every European Union (EU) member state has developed its own rules and regulations. Despite previous reviews and studies, the available information is limited and gaps exist. This literature review explores CUP in 28 EU member states. Data was collected through literature review and use of country-specific search terms from the healthcare domain. Data sources were not limited to databases and articles published in journals, but also included grey literature. The results implied that CUP was present in 20 EU member states (71%). Of 28 EU states, 18 (∼64%) had nationalized regulations and processes were well-defined. Overall, this review identified CUP and its current status and legislation in 28 EU member states. The established legislation for CUP in the EU member states suggest their willingness to adopt processes that facilitate earlier and better access to new medicines. Further research and periodic reviews are warranted to understand the contemporary and future regulatory trends in early access programs.

Delivering Science on Day One

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

Williams, Timothy J.

2016-03-01

While benchmarking software is useful for testing the performance limits and stability of Argonne National Laboratory’s new Theta supercomputer, there is no substitute for running real applications to explore the system’s potential. The Argonne Leadership Computing Facility’s Theta Early Science Program, modeled after its highly successful code migration program for the Mira supercomputer, has one primary aim: to deliver science on day one. Here is a closer look at the type of science problems that will be getting early access to Theta, a next-generation machine being rolled out this year.

Preschool Inclusion: Key Findings from Research and Implications for Policy. Child Care and Early Education Research Connections

ERIC Educational Resources Information Center

Lawrence, Sharmila; Smith, Sheila; Banerjee, Rashida

2016-01-01

A recent policy statement issued by the U.S. Department of Health and Human Services (HHS) and U.S. Department of Education (DOE) on early childhood inclusion presents extensive recommendations for state and local actions that could improve young children's access to high quality inclusive preschool programs (HHS/DOE, 2015). This brief builds on…

A Conceptual Model for Youth-Led Programs as a Promising Approach to Early Childhood Care and Education

ERIC Educational Resources Information Center

Ponguta, Liliana Angelica; Rasheed, Muneera Abdul; Reyes, Chin Regina; Yousafzai, Aisha Khizar

2018-01-01

The international community has set forth global targets that include calls for universal access to high-quality early childhood care and education (ECCE), as indicated in the United Nations' Sustainable Development Goals. One major impediment to achieving this target is the lack of a skilled workforce. In this paper, we argue the case for…

Evaluation of genetic variability among "Early Mature" Juglans regia using microsatellite markers and morphological traits.

PubMed

Ebrahimi, Aziz; Zarei, Abdolkarim; Zamani Fardadonbeh, Mojtaba; Lawson, Shaneka

2017-01-01

Limiting the juvenile phase and reducing tree size are the two main challenges for breeders to improve most fruit crops. Early maturation and dwarf cultivars have been reported for many fruit species. "Early mature" and low vigor walnut genotypes were found among seedlings of Persian walnut. Nine microsatellite markers were used to evaluate genetic diversity among "Early Mature" Persian walnut accessions and provide a comparison with "normal growth" accessions. Six maturation related characteristics were also measured in "Early Mature" samples. Phenotypic traits and diversity indices showed relatively high levels of genetic diversity in "Early Mature" seedlings and indicated high differentiation between individuals. Seedling height, the most diverse phenotypic trait, has an important role in the clustering of "Early Mature" accessions. The "Early Mature" type had higher number of alleles, number of effective allele, and Shannon index compared to the "Normal Growth" group. The two types of studied walnuts had different alleles, with more than half of produced alleles specific to a specific group. "Early Mature" and "Normal Growth" walnuts had 27 and 17 private alleles, respectively. Grouping with different methods separated "Early Mature" and "Normal Growth" samples entirely. The presence of moderate to high genetic diversity in "Early Mature" walnuts and high genetic differentiation with "Normal Growth" walnuts, indicated that "Early Mature" walnuts were more diverse and distinct from "Normal Growth" samples. Moreover, our results showed SSR markers were useful for differentiating between "Early Mature" and "Normal Growth" walnuts. A number of identified loci have potential in breeding programs for identification of "Early Mature" walnuts at the germination phase.

From Car Park to Children's Park: A Childcare Centre in Development. Working Papers in Early Childhood Development.

ERIC Educational Resources Information Center

Wunschel, Gerda

This working paper describes the development of a child care center in Berlin, Germany, focusing on how the program's pedagogical principles support children's learning, how respect for diversity is integrated in everyday practice, and how program quality and accessibility are defined within a multicultural context. Chapter 1 describes the…

Generating Cultural Capital? Impacts of Artists-in-Residence on Teacher Professional Learning

ERIC Educational Resources Information Center

Hunter, Mary Ann; Baker, William; Nailon, Di

2014-01-01

In 2008, the Australian Government established the Artist-in-Residence (AiR) program as a four-year $5.2m initiative to improve young people's access to quality arts education. Managed by State and Territory Government Education and Arts Departments, the program funded professional artists-in-residence in schools, early childhood centres and…

Putting It All Together: Guiding Principles for Quality After-School Programs Serving Preteens

ERIC Educational Resources Information Center

Metz, Rachel A.; Goldsmith, Julie; Arbreton, Amy J. A.

2008-01-01

Successfully navigating early adolescence depends, in large part, on the availability of safe and engaging activities and supportive relationships with adults, yet many preteens have limited access to positive supports and opportunities such as high-quality after-school programs that could put them on a path to success. Funders, policymakers and…

Learning to Thrive: Building Diverse Scientists' Access to Community and Resources through the BRAINS Program

ERIC Educational Resources Information Center

Margherio, Cara; Horner-Devine, M. Claire; Mizumori, Sheri J. Y.; Yen, Joyce W.

2016-01-01

BRAINS: Broadening the Representation of Academic Investigators in NeuroScience is a National Institutes of Health-funded, national program that addresses challenges to the persistence of diverse early-career neuroscientists. In doing so, BRAINS aims to advance diversity in neuroscience by increasing career advancement and retention of post-PhD,…

Early Achievements in Service Integration: What We Can Learn from No Wrong Door Startups.

ERIC Educational Resources Information Center

Washington State Dept. of Social and Health Services, Olympia. Office of Research and Data Analysis.

The Washington State Department of Social and Health Services (DSHS) was created as an umbrella agency, to bring together state human service programs, so that people could get comprehensive assistance with many, often interrelated needs. Efforts were made to co-locate various service program offices to make access to various services easier.…

Limited access to special education services for school-aged children with developmental delay.

PubMed

Twardzik, Erica; Smit, Ellen; Hatfield, Bridget; Odden, Michelle C; Dixon-Ibarra, Alicia; MacDonald, Megan

2018-01-01

Current policy in Oregon limits eligibility of children diagnosed with developmental delay for school-based services. Due to eligibility definitions, children with developmental delay may face additional barriers transitioning from early intervention/early childhood special education into school-based special education services. Examine the relationship between enrollment in school-based special education programs given a change in primary disability diagnosis. Logistic regression models were fit for children who enrolled in early intervention/early childhood special education services with a primary disability diagnosis of developmental delay and changed primary disability diagnosis before third grade (n=5076). Odds of enrollment in future special education were greater in children with a change in primary disability diagnosis after the age of five in comparison to children that had a change in primary disability diagnosis before the age of five, while adjusting for demographic characteristics (adjusted odds ratio: 2.37, 95% CI 1.92, 2.92). Results suggest that children who are diagnosed with a developmental delay and exit early childhood special education due to maximum age of eligibility are more likely to enroll in special education compared to children without a gap in service access. Gaps in service access during early development are associated with the need for supportive services later on in life. Copyright © 2017 Elsevier Ltd. All rights reserved.

Making Pre-Kindergarten Work for Low-Income Working Families. CLASP Child Care and Early Education Series. Policy Paper No. 1

ERIC Educational Resources Information Center

Schumacher, Rachel; Hamm, Katie; Ewen, Danielle

2007-01-01

A growing number of state leaders believe that it is essential to expand high-quality early learning and development opportunities for all young children before they reach kindergarten. A key component of this strategy is providing access to voluntary, high-quality pre-kindergarten programs, especially for low-income children. Over the last few…

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

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

Kollar, William

2013-07-01

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

Community Voices: California Preschool Directors Speak on Policy Options. Working Paper 07-1

ERIC Educational Resources Information Center

Fuller, Bruce; Gesicki, Kathryn; Sweo, Thea; Jung, Sunyoung

2007-01-01

California continues to widen access to local child care and preschool programs--albeit in fits and starts--for a variety of families. About 65% of all four year-olds statewide now attend a preschool center. Government spends $3.6 billion on early care and education programs statewide, including a three-fold increase in state spending since 1996.…

Improved access and cycle time with an "in-house" patient-centered teleglaucoma program versus traditional in-person assessment.

PubMed

Arora, Sourabh; Rudnisky, Chris J; Damji, Karim F

2014-05-01

To compare access time and cycle time between an "in-house" teleglaucoma program and in-person glaucoma consultation. This was a prospective comparative study of 71 patients seen through the teleglaucoma program (eligible patients were glaucoma suspects or early-stage open-angle glaucoma) and 63 patients seen via a traditional in-person exam with a physician present. Access time was calculated as the time from the patient being referred to the date of a booked visit for either a teleglaucoma or in-person exam. Cycle time was defined as the time from registration until departure during the visit to the hospital; it was calculated for the subset of patients from each study group who completed activity logs on the day of their visit. The mean access time was significantly shorter for patients seen through teleglaucoma compared with in-person exam: 45±22 days (range, 13-121 days) (n=68) versus 88±47 days (range, 27-214 days) (n=63), respectively (p<0.0001). The cycle time was also reduced for patients seen through teleglaucoma, compared with in-person assessment: 78±20 min (range, 40-130 min) (n=39) versus 115±44 min (range, 51-216 min) (n=39), respectively (p<0.001). The mean percentage time spent in the waiting room was also significantly reduced for patients seen through teleglaucoma versus in-person assessments: 19±13% versus 41±24% (n=39), respectively (p<0.01). Teleglaucoma improves access to care and is a more efficient way of managing glaucoma suspects and patients with early-stage glaucoma compared with in-person assessment.

Effectiveness of an oral health program in improving the knowledge and competencies of head start staff.

PubMed

Chinn, Courtney Hugh

2011-01-01

Head Start and Early Head Start (HS/EHS) programs have partnered with the American Academy of Pediatric Dentistry to promote oral health and increase access to dental homes. Preparing HS/EHS staff for issues related to pediatric oral health promises to improve effectiveness of this collaboration. This paper's purpose was to describe the Columbia Head Start Oral Health Program (C-HSOHP) and changes in HS/EHS staff pediatric oral health knowledge and competencies after participating in C-HSOHP. Four HS/EHS grantees in New York City engaged in the 2008-09 C-HSOHP. A convenience sample of 61 staff completed pre- and postself assessments of knowledge and competencies. Significant paired mean improvements were found for staff-reported level of preparation to explain dental issues during pregnancy, the tooth decay process, and preparing parents for their child's first dental visit. Significant improvements were found in staff confidence in teaching parents about children's oral health issues, referring for pediatric dental services, and talking to a dentist about a concern. The Columbia Head Start Oral Health Program was effective in improving Head Start/Early Head Start staff self-confidence and self-perceived preparedness in teaching parents about oral health, applying oral health knowledge to HS/EHS programs, communicating with dental professionals, and improving access to pediatric dental services.

Association of Access to Publicly Funded Family Planning Services With Adolescent Birthrates in California Counties

PubMed Central

Chabot, Marina J.; Navarro, Sandy; Swann, Diane; Darney, Philip; Thiel de Bocanegra, Heike

2014-01-01

Objectives. We examined the association of adolescent birthrates (ABRs) with access to and receipt of publicly funded family planning services in California counties provided through 2 state programs: Medi-Cal, California’s Medicaid program, and the Family Planning, Access, Care, and Treatment (Family PACT) program. Methods. Our key data sources included the California Health Interview Survey and California Women’s Health Survey, Medi-Cal and Family PACT claims data, and the Birth Statistical Master File. We constructed a linear regression analysis measuring the relationship of access to and receipt of family planning services with ABRs when controlling for counties’ select covariates. Results. The regression analysis indicated that a higher access rate to Family PACT in a county was associated with a lower ABR (B = −0.19; P < .01) when controlling for unemployment rate, percentage of foreign-born adolescents, and percentage of adult low-income births. Conclusions. Efforts to reduce ABRs, specifically in counties that had persistently high rates are critical to achieving a healthy future for the state and the nation. Family PACT played a crucial role in helping adolescents avoid unintended and early childbearing. PMID:24354841

Accessing Programs for Infants, Toddlers, and Preschoolers with Disabilities: A Parent's Guide = Programas para Infantes y Ninos Pre-escolares con Discapacidades: Guia para Padres de Familia. Update.

ERIC Educational Resources Information Center

Kupper, Lisa, Ed.

This parent's guide (presented in both English and Spanish) is intended to help families access services for young children with special needs. It is presented in the form of questions and answers arranged in three parts. Part I presents 12 questions and answers about early intervention services for infants and toddlers (ages birth through 2…

Preventing anxiety problems in children with Cool Little Kids Online: study protocol for a randomised controlled trial.

PubMed

Morgan, Amy J; Rapee, Ronald M; Tamir, Elli; Goharpey, Nahal; Salim, Agus; McLellan, Lauren F; Bayer, Jordana K

2015-11-05

Anxiety disorders are the most common type of mental health problem and begin early in life. Early intervention to prevent anxiety problems in young children who are at risk has the potential for long-term impact. The 'Cool Little Kids' parenting group program was previously established to prevent anxiety disorders in young children at risk because of inhibited temperament. This group program was efficacious in two randomised controlled trials and has recently been adapted into an online format. 'Cool Little Kids Online' was developed to widen and facilitate access to the group program's preventive content. A pilot evaluation of the online program demonstrated its perceived utility and acceptability among parents. This study aims to evaluate the efficacy of Cool Little Kids Online in a large randomised controlled trial. Parents of young children who are 3-6 years old and who have an inhibited temperament will be recruited (n = 385) and randomly assigned to either immediate access to Cool Little Kids Online or delayed access after a waiting period of 24 weeks. The online program contains eight modules that help parents address key issues in the development of anxiety problems in inhibited children, including children's avoidant coping styles, overprotective parenting behaviours, and parents' own fears and worries. Intervention participants will be offered clinician support when requested. The primary outcome will be change in parent-reported child anxiety symptoms. Secondary outcomes will be child internalising symptoms, child and family life interference due to anxiety, over-involved/protective parenting, plus child anxiety diagnoses assessed by using a new online diagnostic tool. Assessments will take place at baseline and 12 and 24 weeks after baseline. This trial expands upon previous research on the Cool Little Kids parenting group program and will evaluate the efficacy of online delivery. Online delivery of the program could result in an easily accessible evidence-based resource to help families with young children at temperamental risk for anxiety disorders. Australian New Zealand Clinical Trials Registry 12615000217505 (registered 5 March 2015).

Contributions of an artistic educational program for older people with early dementia: an exploratory qualitative study.

PubMed

Ullán, Ana M; Belver, Manuel H; Badía, Marta; Moreno, Carmen; Garrido, Eugenio; Gómez-Isla, José; Gonzalez-Ingelmo, Elena; Delgado, Juan; Serrano, Isabel; Herrero, Carmen; Manzanera, Paloma; Tejedor, Laura

2013-07-01

To describe a contemporary artistic educational program based on photographic cyanotype techniques and to present the results of the program carried out with older people with early dementia. We determined whether these people could participate in the program, their viewpoint about it, and what this program could contribute to their experience. Twenty-one people diagnosed with mild or moderate dementia participated in a series of artistic education workshops. While conducting the workshops, participant observation was carried out, and the participants' engagement was assessed. Upon completing the series, five focus groups were held with the participants with dementia, and another focus group with their professional caretakers. We observed the participants' high level of commitment to the activity and their interest in learning new things. We also observed the participants' satisfaction during the creative process and with their results. The artistic activities not only reinforced the feelings of capacity of the participants with early dementia but also transmitted a positive image of them. Dementia was not an obstacle to participation in the program, which was an opportunity for creativity, learning, enjoyment, and communication for people with dementia. In the authors' opinion, facilitating access to art and artistic education to people with early dementia can contribute to enforcing their rights and to improving the care system.

Early life disruption to the ghrelin system with over-eating is resolved in adulthood in male rats.

PubMed

Sominsky, Luba; Ziko, Ilvana; Nguyen, Thai-Xinh; Andrews, Zane B; Spencer, Sarah J

2017-02-01

Early life overweight is a significant risk factor for developmental programming of adult obesity due to changes in the availability of metabolic factors crucial for the maturation of brain appetite-regulatory circuitry. The appetite-stimulating hormone, ghrelin, has been recently identified as a major regulator of the establishment of hypothalamic feeding pathways. Ghrelin exists in circulation in two major forms, as acylated and des-acylated ghrelin. While most research has focused on acyl ghrelin, the role of neonatal des-acyl ghrelin in metabolic programming is currently unknown. Here we assessed the influences of early life overfeeding on the ghrelin system, including acyl and des-acyl ghrelin's ability to access the hypothalamus in male rats. Our data show that early life overfeeding influences the ghrelin system short-term, leading to an acute reduction in circulating des-acyl ghrelin and increased expression of the growth hormone secretagogue receptor (GHSR) in the arcuate nucleus of the hypothalamus (ARC). These changes are associated with increased neuronal activation in response to exogenous acyl, but not des-acyl, ghrelin in the ARC and the paraventricular nucleus of the hypothalamus (PVN). Interestingly, while we observed no differences in the accessibility of the ARC to acyl or des-acyl ghrelin, less exogenous acyl ghrelin reaches the PVN in the neonatally overfed. Importantly, the influences of neonatal overfeeding on the ghrelin system were not maintained into adulthood. Therefore, while early life overfeeding results in excess body weight and stimulates acute changes in the brain's sensitivity to metabolic signals, this developmental mal-programming is at least partially alleviated in adulthood. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

PubMed

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

2018-03-01

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

A model for community-based pediatric oral heath: implementation of an infant oral care program.

PubMed

Ramos-Gomez, Francisco J

2014-01-01

The Affordable Care Act (ACA) mandates risk assessments, preventive care, and evaluations based on outcomes. ACA compliance will require easily accessible, cost-effective care models that are flexible and simple to establish. UCLA has developed an Infant Oral Care Program (IOCP) in partnership with community-based organizations that is an intervention model providing culturally competent perinatal and infant oral care for underserved, low-income, and/or minority children aged 0-5 and their caregivers. In collaboration with the Venice Family Clinic's Simms/Mann Health and Wellness Center, UCLA Pediatrics, Women, Infants, and Children (WIC), and Early Head Start and Head Start programs, the IOCP increases family-centered care access and promotes early utilization of dental services in nontraditional, primary care settings. Emphasizing disease prevention, management, and care that is sensitive to cultural, language, and oral health literacy challenges, IOCP patients achieve better oral health maintenance "in health" not in "disease modality". IOCP uses interprofessional education to promote pediatric oral health across multiple disciplines and highlights the necessity for the "age-one visit". This innovative clinical model facilitates early intervention and disease management. It sets a new standard of minimally invasive dental care that is widely available and prevention focused, with high retention rates due to strong collaborations with the community-based organizations serving these vulnerable, high-risk children.

45 CFR 149.500 - Appeals.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Appeals. 149.500 Section 149.500 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Appeals § 149.500 Appeals. (a) An adverse reimbursement determination...

45 CFR 149.315 - Reimbursement conditioned upon available funds.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Reimbursement conditioned upon available funds. 149.315 Section 149.315 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods...

45 CFR 149.500 - Appeals.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Appeals. 149.500 Section 149.500 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Appeals § 149.500 Appeals. (a) An adverse reimbursement determination...

45 CFR 149.315 - Reimbursement conditioned upon available funds.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Reimbursement conditioned upon available funds. 149.315 Section 149.315 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods...

45 CFR 149.105 - Transition provision.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Transition provision. 149.105 Section 149.105 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reinsurance Amounts § 149.105 Transition provision. For...

45 CFR 149.105 - Transition provision.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Transition provision. 149.105 Section 149.105 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reinsurance Amounts § 149.105 Transition provision. For...

Implementing a Healthy Food Distribution Program: A Supply Chain Strategy to Increase Fruit and Vegetable Access in Underserved Areas.

PubMed

DeFosset, Amelia R; Kwan, Allison; Rizik-Baer, Daniel; Gutierrez, Luis; Gase, Lauren N; Kuo, Tony

2018-05-24

Increasing access to fresh produce in small retail venues could improve the diet of people in underserved communities. However, small retailers face barriers to stocking fresh produce. In 2014, an innovative distribution program, Community Markets Purchasing Real and Affordable Foods (COMPRA), was launched in Los Angeles with the aim of making it more convenient and profitable for small retailers to stock fresh produce. Our case study describes the key processes and lessons learned in the first 2 years of implementing COMPRA. Considerable investments in staff capacity and infrastructure were needed to launch COMPRA. Early successes included significant week-to-week increases in the volume of produce distributed. Leveraging partnerships, maintaining a flexible operational and funding structure, and broadly addressing store owners' needs contributed to initial gains. We describe key challenges and next steps to scaling the program. Lessons learned from implementing COMPRA could inform other jurisdictions considering supply-side approaches to increase access to healthy food.

Telemedicine Use in Rural Native American Communities in the Era of the ACA: a Systematic Literature Review.

PubMed

Kruse, Clemens Scott; Bouffard, Shelby; Dougherty, Michael; Parro, Jenna Stewart

2016-06-01

Native American communities face serious health disparities and, living in rural areas, often lack regular access to healthcare services as compared to other Americans. Since the early 1970's, telecommunication technology has been explored as a means to address the cost and quality of, as well as access to, healthcare on rural reservations. This systematic review seeks to explore the use of telemedicine in rural Native American communities using the framework of cost, quality, and access as promulgated by the Affordable Care Act of 2010 and urge additional legislation to increase its use in this vulnerable population. As a systematic literature review, this study analyzes 15 peer-reviewed articles from four databases using the themes of cost, quality, and access. The theme of access was referenced most frequently in the reviewed literature, indicating that access to healthcare may be the biggest obstacle facing widespread adoption of telemedicine programs on rural Native American reservations. The use of telemedicine mitigates the costs of healthcare, which impede access to high-quality care delivery and, in some cases, deters prospective patients from accessing healthcare at all. Telemedicine offers rural Native American communities a means of accessing healthcare without incurring high costs. With attention to reimbursement policies, educational services, technological infrastructure, and culturally competent care, telemedicine has the potential to decrease costs, increase quality, and increase access to healthcare for rural Native American patients. While challenges facing the implementation of telemedicine programs exist, there is great potential for it to improve healthcare delivery in rural Native American communities. Public policy that increases funding for programs that help to expand access to healthcare for Native Americans will improve outcomes because of the increase in access.

Determinants of mortality and nondeath losses from an antiretroviral treatment service in South Africa: implications for program evaluation.

PubMed

Lawn, Stephen D; Myer, Landon; Harling, Guy; Orrell, Catherine; Bekker, Linda-Gail; Wood, Robin

2006-09-15

The scale-up of antiretroviral treatment (ART) services in resource-limited settings requires a programmatic model to deliver care to large numbers of people. Understanding the determinants of key outcome measures--including death and nondeath losses--would assist in program evaluation and development. Between September 2002 and August 2005, all in-program (pretreatment and on-treatment) deaths and nondeath losses were prospectively ascertained among treatment-naive adults (n=1235) who were enrolled in a community-based ART program in South Africa. At study censorship, 927 patients had initiated ART after a median of 34 days after enrollment in the program. One hundred twenty-one (9.8%) patients died. Mortality rates were 33.3 (95% CI, 25.5-43.0), 19.1 (95% CI, 14.4-25.2), and 2.9 (95% CI, 1.8-4.8) deaths/100 person-years in the pretreatment interval, during the first 4 months of ART (early deaths), and after 4 months of ART (late deaths), respectively. Pretreatment and early treatment deaths together accounted for 87% of deaths, and were independently associated with advanced immunodeficiency at enrollment. Late deaths were comparatively few and were only associated with the response to ART at 4 months. Nondeath program losses (loss to follow-up, 2.3%; transfer-out, 1.9%; relocation, 0.7%) were not associated with immune status and were evenly distributed during the study period. Loss to follow-up and late mortality rates were low, reflecting good cohort retention and treatment response. However, the extremely high pretreatment and early mortality rates indicate that patients are enrolling in ART programs with far too advanced immunodeficiency. Causes of late access to the ART program, such as delays in health care access, health system delays, or inappropriate treatment criteria, need to be addressed.

Implementing a Mobility Program to Minimize Post-Intensive Care Syndrome.

PubMed

Hopkins, Ramona O; Mitchell, Lorie; Thomsen, George E; Schafer, Michele; Link, Maggie; Brown, Samuel M

2016-01-01

Immobility in the intensive care unit (ICU) is associated with neuromuscular weakness, post-intensive care syndrome, functional limitations, and high costs. Early mobility-based rehabilitation in the ICU is feasible and safe. Mobility-based rehabilitation varied widely across 5 ICUs in 1 health care system, suggesting a need for continuous training and evaluation to maintain a strong mobility-based rehabilitation program. Early mobility-based rehabilitation shortens ICU and hospital stays, reduces delirium, and increases muscle strength and the ability to ambulate. Long-term effects include increased ability for self-care, faster return to independent functioning, improved physical function, and reduced hospital readmission and death. Factors that influence early mobility-based rehabilitation include having an interdisciplinary team; strong unit leadership; access to physical, occupational, and respiratory therapists; a culture focused on patient safety and quality improvement; a champion of early mobility; and a focus on measuring performance and outcomes.

Early life adversities or high fat diet intake reduce cognitive function and alter BDNF signaling in adult rats: Interplay of these factors changes these effects.

PubMed

Arcego, Danusa Mar; Krolow, Rachel; Lampert, Carine; Toniazzo, Ana Paula; Berlitz, Carolina; Lazzaretti, Camilla; Schmitz, Felipe; Rodrigues, André Felipe; Wyse, Angela T S; Dalmaz, Carla

2016-05-01

Environmental factors, like early exposure to stressors or high caloric diets, can alter the early programming of central nervous system, leading to long-term effects on cognitive function, increased vulnerability to cognitive decline and development of psychopathologies later in life. The interaction between these factors and their combined effects on brain structure and function are still not completely understood. In this study, we evaluated long-term effects of social isolation in the prepubertal period, with or without chronic high fat diet access, on memory and on neurochemical markers in the prefrontal cortex of rats. We observed that early social isolation led to impairment in short-term and working memory in adulthood, and to reductions of Na(+),K(+)-ATPase activity and the immunocontent of phospho-AKT, in prefrontal cortex. Chronic exposure to a high fat diet impaired short-term memory (object recognition), and decreased BDNF levels in that same brain area. Remarkably, the association of social isolation with chronic high fat diet rescued the memory impairment on the object recognition test, as well as the changes in BDNF levels, Na(+),K(+)-ATPase activity, MAPK, AKT and phospho-AKT to levels similar to the control-chow group. In summary, these findings showed that a brief social isolation period and access to a high fat diet during a sensitive developmental period might cause memory deficits in adulthood. On the other hand, the interplay between isolation and high fat diet access caused a different brain programming, preventing some of the effects observed when these factors are separately applied. Copyright © 2016 ISDN. Published by Elsevier Ltd. All rights reserved.

45 CFR 149.700 - Change of ownership requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 149.700 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Change of Ownership Requirements § 149.700... liability for health benefits, the existing sponsor agreement is automatically assigned to the new owner. (e...

45 CFR 149.300 - General reimbursement rules.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false General reimbursement rules. 149.300 Section 149.300 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.300 General reimbursement...

45 CFR 149.325 - Requirements for eligibility of claims.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 149.325 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.325 Requirements for eligibility of claims. A claim may be submitted only if it represents costs for health...

45 CFR 149.325 - Requirements for eligibility of claims.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Section 149.325 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.325 Requirements for eligibility of claims. A claim may be submitted only if it represents costs for health...

45 CFR 149.300 - General reimbursement rules.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false General reimbursement rules. 149.300 Section 149.300 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.300 General reimbursement...

45 CFR 149.700 - Change of ownership requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 149.700 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Change of Ownership Requirements § 149.700... liability for health benefits, the existing sponsor agreement is automatically assigned to the new owner. (e...

Students Training for Academic Readiness (STAR): Year Four Evaluation Report

ERIC Educational Resources Information Center

Rainey, Katharine; Maloney, Catherine; Sheehan, Daniel; Lopez, Omar

2011-01-01

The federal Gaining Early Awareness and Readiness for Undergraduate Programs, or GEAR UP, project strives to equalize low-income students' access to higher education by increasing their participation in rigorous coursework, providing expanded opportunities for low-income students and parents to learn about postsecondary educational opportunities…

Students Training for Academic Readiness (STAR): Year Two Evaluation Report

ERIC Educational Resources Information Center

Maloney, Catherine; Sheehan, Daniel; Rainey, Katie; Whipple, Allyson

2008-01-01

The federal Gaining Early Awareness and Readiness for Undergraduate Programs, or GEAR UP, project strives to equalize low-income students' access to higher education by increasing their participation in rigorous coursework, providing expanded opportunities for low-income students and parents to learn about postsecondary educational opportunities…

Supporting Online Learners: Blending High-Tech with High-Touch

ERIC Educational Resources Information Center

Dolan, Sean; Donohue, Chip; Holstrom, Lisa; Pernell, Latonia; Sachdev, Anu

2009-01-01

Effective and easily accessible student support services are essential to the success of adult learners. A student-centered approach is especially important in the design and delivery of online courses, professional certificates, and degree programs for early childhood professionals. A student-first approach is essential for non-traditional adult…

Family Fun Nights: Collaborative Parent Education Accessible for Diverse Learning Abilities

ERIC Educational Resources Information Center

Knowles, Christen; Harris, Anne; Van Norman, Renee

2017-01-01

Quality early childhood education programs have a responsibility to provide enriched educational services to preschool students paired with parent support, education, and outreach. Pearl Buck Preschool, a non-profit organization devoted to the delivery of preschool services for children of parents with intellectual disabilities or learning…

Students Training for Academic Readiness (STAR): Year Four Evaluation Report. Executive Summary

ERIC Educational Resources Information Center

Texas Center for Educational Research, 2011

2011-01-01

The federal Gaining Early Awareness and Readiness for Undergraduate Programs, or GEAR UP, project strives to equalize low-income students' access to higher education by increasing their participation in rigorous coursework, providing expanded opportunities for low-income students and parents to learn about postsecondary educational opportunities…

45 CFR 149.600 - Sponsor's duty to report data inaccuracies.

Code of Federal Regulations, 2014 CFR

2014-10-01

... HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Disclosure of Data Inaccuracies § 149.600 Sponsor's duty to report data inaccuracies. A sponsor is required to disclose any data... 45 Public Welfare 1 2014-10-01 2014-10-01 false Sponsor's duty to report data inaccuracies. 149...

45 CFR 149.600 - Sponsor's duty to report data inaccuracies.

Code of Federal Regulations, 2012 CFR

2012-10-01

... HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Disclosure of Data Inaccuracies § 149.600 Sponsor's duty to report data inaccuracies. A sponsor is required to disclose any data... 45 Public Welfare 1 2012-10-01 2012-10-01 false Sponsor's duty to report data inaccuracies. 149...

eLearning: What Students Can Teach Us

ERIC Educational Resources Information Center

Donohue, Chip; Fox, Selena; LaBonte, Monica

2004-01-01

Online courses, credentials, and degree programs in early childhood education have become a significant way to deliver teacher education and professional development. Online students have many choices and can access training and courses with few, if any, limitations of times and distance. Much has been written about how to design and deliver…

The National Home Visiting Coalition: A History of Collaboration

ERIC Educational Resources Information Center

Callahan, Jane; Gavaghan, Bridget; Howard, Karen; Kelley, Melissa L.; Schwartz, Marvin; Walzer, Sarah

2010-01-01

The Home Visiting Coalition represents more than 75 organizations working together to articulate the effectiveness of home visiting to a range of policymakers and stakeholders in the early childhood field. Despite varying program goals and service delivery strategies, the Coalition participants share a commitment to expanding access to…

45 CFR 149.520 - Review of appeals.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Review of appeals. 149.520 Section 149.520 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Appeals § 149.520 Review of appeals. (a) In conducting...

45 CFR 149.340 - Rule for insured plans.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Rule for insured plans. 149.340 Section 149.340 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.340 Rule for insured plans...

45 CFR 149.340 - Rule for insured plans.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Rule for insured plans. 149.340 Section 149.340 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.340 Rule for insured plans...

45 CFR 149.330 - Content of claims.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Content of claims. 149.330 Section 149.330 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.330 Content of claims. Each...

45 CFR 149.345 - Use of information provided.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Use of information provided. 149.345 Section 149.345 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.345 Use of information...

45 CFR 149.520 - Review of appeals.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Review of appeals. 149.520 Section 149.520 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Appeals § 149.520 Review of appeals. (a) In conducting...

45 CFR 149.345 - Use of information provided.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Use of information provided. 149.345 Section 149.345 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.345 Use of information...

45 CFR 149.600 - Sponsor's duty to report data inaccuracies.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Sponsor's duty to report data inaccuracies. 149.600 Section 149.600 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Disclosure of Data Inaccuracies...

45 CFR 149.330 - Content of claims.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Content of claims. 149.330 Section 149.330 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.330 Content of claims. Each...

45 CFR 149.335 - Documentation of costs of actual claims involved.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Documentation of costs of actual claims involved. 149.335 Section 149.335 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods...

45 CFR 149.335 - Documentation of costs of actual claims involved.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Documentation of costs of actual claims involved. 149.335 Section 149.335 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods...

45 CFR 149.600 - Sponsor's duty to report data inaccuracies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Sponsor's duty to report data inaccuracies. 149.600 Section 149.600 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Disclosure of Data Inaccuracies...

Students Training for Academic Readiness (STAR): Year Two Evaluation Report. Executive Summary

ERIC Educational Resources Information Center

Maloney, Catherine; Sheehan, Daniel; Rainey, Katie; Whipple, Allyson

2008-01-01

The federal Gaining Early Awareness and Readiness for Undergraduate Programs, or GEAR UP, project strives to equalize low-income students' access to higher education by increasing their participation in rigorous coursework, providing expanded opportunities for low-income students and parents to learn about postsecondary educational opportunities…

Students Training for Academic Readiness (STAR): Year One Evaluation Report. Executive Summary

ERIC Educational Resources Information Center

Maloney, Catherine; Caranikas-Walker, Fanny; Sheehan, Daniel

2007-01-01

The federal Gaining Early Awareness and Readiness for Undergraduate Programs, or GEAR UP, strives to equalize low-income students' access to higher education by increasing their participation in rigorous coursework, providing expanded opportunities for low-income students and parents to learn about postsecondary educational opportunities and…

Fulfilling the Promise of Preschool for All: Insights into Issues Affecting Access for Selected Immigrant Groups in Chicago

ERIC Educational Resources Information Center

Adams, Gina; McDaniel, Marla

2009-01-01

Preschool for All (PFA) is a part-day (2.5 hours for up to five days a week) early childhood education program for 3- and 4-year-olds in Illinois. The program is voluntary to families and is designed to be a high-quality preschool option for all children--especially those at risk of academic failure. PFA was implemented in 2006 and is free to…

It's not as simple as it sounds: Problems and solutions in accessing and using administrative child welfare data for evaluating the impact of early childhood interventions☆

PubMed Central

Green, Beth L.; Ayoub, Catherine; Dym Bartlett, Jessica; Furrer, Carrie; Von Ende, Adam; Chazan-Cohen, Rachel; Klevens, Joanne; Nygren, Peggy

2015-01-01

In recent years, there has been increasing interest in using administrative data collected by state child welfare agencies as a source of information for research and evaluation. The challenges of obtaining access to and using these data, however, have not been well documented. This study describes the processes used to access child welfare records in six different states and the approach to combining and using the information gathered to evaluate the impact of the Early Head Start program on children's involvement with the child welfare system from birth through age eleven. We provide “lessons learned” for researchers who are attempting to use this information, including being prepared for long delays in access to information, the need for deep understanding of how child welfare agencies record and code information, and for considerable data management work for translating agency records into analysis-ready datasets. While accessing and using this information is not easy, and the data have a number of limitations, we suggest that the benefits can outweigh the challenges and that these records can be a useful source of information for policy-relevant child welfare research. PMID:26744551

Early Experience with Technology-Based Eye Care Services (TECS): A Novel Ophthalmologic Telemedicine Initiative.

PubMed

Maa, April Y; Wojciechowski, Barbara; Hunt, Kelly J; Dismuke, Clara; Shyu, Jason; Janjua, Rabeea; Lu, Xiaoqin; Medert, Charles M; Lynch, Mary G

2017-04-01

The aging population is at risk of common eye diseases, and routine eye examinations are recommended to prevent visual impairment. Unfortunately, patients are less likely to seek care as they age, which may be the result of significant travel and time burdens associated with going to an eye clinic in person. A new method of eye-care delivery that mitigates distance barriers and improves access was developed to improve screening for potentially blinding conditions. We present the quality data from the early experience (first 13 months) of Technology-Based Eye Care Services (TECS), a novel ophthalmologic telemedicine program. With TECS, a trained ophthalmology technician is stationed in a primary care clinic away from the main hospital. The ophthalmology technician follows a detailed protocol that collects information about the patient's eyes. The information then is interpreted remotely. Patients with possible abnormal findings are scheduled for a face-to-face examination in the eye clinic. Any patient with no known ocular disease who desires a routine eye screening examination is eligible. Technology-Based Eye Care Services was established in 5 primary care clinics in Georgia surrounding the Atlanta Veterans Affairs hospital. Four program operation metrics (patient satisfaction, eyeglass remakes, disease detection, and visit length) and 2 access-to-care metrics (appointment wait time and no-show rate) were tracked. Care was rendered to 2690 patients over the first 13 months of TECS. The program has been met with high patient satisfaction (4.95 of 5). Eyeglass remake rate was 0.59%. Abnormal findings were noted in 36.8% of patients and there was >90% agreement between the TECS reading and the face-to-face findings of the physician. TECS saved both patient (25% less) and physician time (50% less), and access to care substantially improved with 99% of patients seen within 14 days of contacting the eye clinic, with a TECS no-show rate of 5.2%. The early experience with TECS has been promising. Tele-ophthalmology has the potential to improve operational efficiency, reduce cost, and significantly improve access to care. Although further study is necessary, TECS shows potential to help prevent avoidable vision loss. Published by Elsevier Inc.

Early Detection of Prostate Cancer with New Nanoparticle-Based Ultrasound Contrast Agents Targeted to PSMA

DTIC Science & Technology

2017-08-01

Universities Grant Program 2014 Mentor, Minority Access to Research Careers (MARC) program, Emory University 2014 2014/05 ZCA1 SRLB-J (M1) S Quantitative ...AUGUST 2017 TYPE OF REPORT: ANNUAL PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 DISTRIBUTION...and should not be construed as an official Department of the Army position, policy or decision unless so designated by other documentation. REPORT

Dentists' partnership of Michigan's Calhoun County: a care model for uninsured populations.

PubMed

Higbea, Raymond J; Palumbo, Charles H; Pearl, Samantha A; Byrne, Mary Jo; Wise, Jill

2013-09-01

Community leaders in Calhoun County, Michigan, identified access to dental care as an acute local need and in early 2007 organized Calhoun County Dentists' Partnership. A group of stakeholders developed a program centered on local dentists who donated a designated number of office visits per month to care for uninsured county residents. Residents enrolled in the program were required to attend an oral health class; receive a dental screening, cleaning, and dental x-rays by a dental hygienist; and complete a designated number of hours of community service before seeing a dentist. Since the program's 2007 inception, approximately 4,000 people have received dental services valued at approximately $510,000. In turn, program participants provided more than 57,000 hours of community service. The program is credited with reducing the number of patients presenting to a local hospital emergency department for dental pain by 70 percent between 2006 and 2012. Similar programs are now under way in thirteen other communities in the Midwest, which shows that such local initiatives, volunteerism, and community organization can address dental care access needs.

Mediating Access to Headsprout® Early Reading for Children with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Plavnick, Joshua B.; Thompson, Julie L.; Englert, Carol Sue; Mariage, Troy; Johnson, Katie

2016-01-01

Many children with autism spectrum disorder (ASD) require instructional programs that simultaneously address academic content, interfering behavior, and potential gaps in prerequisite skills for a given curriculum. This study examined the impact of an intervention package consisting of contingent reinforcement and match-to-sample training on the…

Teacher Attitudes & Beliefs toward Inclusion of Students with Disabilities in Early Childhood Programs: Impacts on Assessment Outcomes

ERIC Educational Resources Information Center

Maiorca-Nunez, Jessica

2017-01-01

Evidence suggests preschool age students with disabilities (SWD) benefit from inclusive settings. Inclusive education has positive impacts on students' social-emotional, language, and cognitive skills. Yet, preschool age SWD continue to have limited access to inclusive education, and research suggests numerous reasons, including teacher practice.…

45 CFR 149.510 - Content of request for appeal.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Content of request for appeal. 149.510 Section 149.510 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Appeals § 149.510 Content of request for appeal. The...

45 CFR 149.510 - Content of request for appeal.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Content of request for appeal. 149.510 Section 149.510 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Appeals § 149.510 Content of request for appeal. The...

45 CFR 149.610 - Secretary's authority to reopen and revise a reimbursement determination.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Secretary's authority to reopen and revise a reimbursement determination. 149.610 Section 149.610 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Disclosure...

45 CFR 149.510 - Content of request for appeal.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Content of request for appeal. 149.510 Section 149.510 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Appeals § 149.510 Content of request for appeal. The...

45 CFR 149.610 - Secretary's authority to reopen and revise a reimbursement determination.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Secretary's authority to reopen and revise a reimbursement determination. 149.610 Section 149.610 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Disclosure...

Toward a Renewed Focus. Literacy in Early Language Programs

ERIC Educational Resources Information Center

Met, Mimi

2013-01-01

This article promotes literacy as a a powerful tool for learning new language. Although learners frequently think of comprehensible input as language that is heard, comprehensible input from print can also be accessed. Research has shown that reading has a powerful impact on language learning: much of the vocabulary that educated adults know has…

Web-Based Psychoeducation Program for Caregivers of First-Episode of Psychosis: An Experience of Chinese Population in Hong Kong.

PubMed

Chan, Sherry K W; Tse, Samson; Sit, Harrison Long Tin; Hui, Christy L M; Lee, Edwin H M; Chang, Wing C; Chen, Eric Y H

2016-01-01

Caregivers of patients with first-episode psychosis are often with little knowledge about the illness and experience more burden of care. Psychoeducation to caregivers has shown to be effective in improving outcomes of patients and possibly reduce stress of the caregivers. This has been recommended as one of the key psychosocial interventions for specific early intervention for psychosis service. However, the accessibility of the service, high case load of the health care professionals and self-stigma of caregivers are often the barriers of implementation of these programs in the real world. Incorporating the convenience of information access via internet and the concept of self-management approach, an interactive internet-based self-help psychoeducation program (iPEP) (www.ipep.hk) for the caregivers of patients with psychosis was established targeting the caregivers of patients with psychosis at early stage in Hong Kong. It provides a comprehensive online resource center in both written and video format on knowledge about psychosis, skills of care, and information of local resources. It also has a forum facilitate information exchange between healthcare professionals and the caregivers, allowing for self-management. Over 800 caregivers have joined the program as members. The evaluation of the subset of the members/users of the iPEP suggested that the iPEP program has been well received and appreciated by the caregivers of patients with first episode psychosis locally. It can potentially serve as a platform for future development of specific manual-based psychoeducation program for caregivers targeting at the needs of different groups.

Web-Based Psychoeducation Program for Caregivers of First-Episode of Psychosis: An Experience of Chinese Population in Hong Kong

PubMed Central

Chan, Sherry K. W.; Tse, Samson; Sit, Harrison Long Tin; Hui, Christy L. M.; Lee, Edwin H. M.; Chang, Wing C.; Chen, Eric Y. H.

2016-01-01

Caregivers of patients with first-episode psychosis are often with little knowledge about the illness and experience more burden of care. Psychoeducation to caregivers has shown to be effective in improving outcomes of patients and possibly reduce stress of the caregivers. This has been recommended as one of the key psychosocial interventions for specific early intervention for psychosis service. However, the accessibility of the service, high case load of the health care professionals and self-stigma of caregivers are often the barriers of implementation of these programs in the real world. Incorporating the convenience of information access via internet and the concept of self-management approach, an interactive internet-based self-help psychoeducation program (iPEP) (www.ipep.hk) for the caregivers of patients with psychosis was established targeting the caregivers of patients with psychosis at early stage in Hong Kong. It provides a comprehensive online resource center in both written and video format on knowledge about psychosis, skills of care, and information of local resources. It also has a forum facilitate information exchange between healthcare professionals and the caregivers, allowing for self-management. Over 800 caregivers have joined the program as members. The evaluation of the subset of the members/users of the iPEP suggested that the iPEP program has been well received and appreciated by the caregivers of patients with first episode psychosis locally. It can potentially serve as a platform for future development of specific manual-based psychoeducation program for caregivers targeting at the needs of different groups. PMID:28082935

Grassroots Engagement: Securing Support for Science Communication Training Programs Created by Graduate Students for Graduate Students

NASA Astrophysics Data System (ADS)

Rohde, J. A.

2016-12-01

The need for science communication and outreach is widely recognized throughout the scientific community. Yet, at present, graduate students and early career scientists have, at best, widely variable access to opportunities to train in science communication techniques and to hone their outreach skills. In 2010, a small group of graduate students at the University of Washington led a grassroots effort to increase their own access to communication and outreach training by creating "The Engage Program." They developed a novel, interdisciplinary curriculum focused on storytelling, public speaking and improvisation, design, and the distillation of complex topics to clear and accessible forms. These entrepreneurial students faced (real or perceived) barriers to building this program, including the pressure to hide or dampen their enthusiasm from advisors and mentors, ignorance of university structures, and lack of institutional support. They overcame these barriers and secured institutional champions and funding, partnered with Town Hall Seattle to create a science speaker series, and developed a student leadership structure to ensure long-term sustainability of the program. Additionally, they crowdfunded an evaluation of the program's effectiveness in order demonstrate the benefits of such training to the scientific careers of the students. Here we present our key strategies for overcoming barriers to support, and compare them with several similar grassroots graduate-student led public communication programs from other institutions.

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

ERIC Educational Resources Information Center

Solomyak, Olla; Marantz, Alec

2009-01-01

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

Development of an internet version of the Lidcombe Program of early stuttering intervention: A trial of Part 1.

PubMed

Van Eerdenbrugh, Sabine; Packman, Ann; Onslow, Mark; O'brian, Sue; Menzies, Ross

2018-04-01

There is evidence that access to treatment for early stuttering is not available for all who need it. An internet version of the Lidcombe Program for early stuttering (Internet-LP) has been developed to deal with this shortfall. The LP is suitable for such development because it is delivered by parents in the child's everyday environment, with training by a speech-language pathologist. A Phase I trial of Internet-LP Part 1, comprising parent training, is reported here. Eight parents of pre-schoolers who stutter were recruited and six completed the trial. Post-trial assessment indicated that the parents scored well for identifying and measuring stuttering and for knowledge about conducting practice sessions, including how to present verbal contingencies during practice sessions. The results prompted minor adjustments to Part 1 and guided the construction of Part 2, which instructs parents during the remainder of the treatment process.

Does SCHIP Spell Better Dental Care Access for Children? An Early Look at New Initiatives. Occasional Paper Number 50. Assessing the New Federalism: An Urban Institute Program To Assess Changing Social Policies.

ERIC Educational Resources Information Center

Almeida, Ruth; Hill, Ian; Kenney, Genevieve

Dental disease is one of the most prevalent illnesses facing children in the United States today. Eighty percent of untreated dental disease in permanent teeth is found in roughly 25 percent of 5- to 17-year old children, most of whom come from low-income and other vulnerable populations. The State Children's Health Insurance Program (SCHIP)…

An online self-care education program to support patients after total laryngectomy: feasibility and satisfaction.

PubMed

Cnossen, Ingrid C; van Uden-Kraan, Cornelia F; Eerenstein, Simone E J; Jansen, Femke; Witte, Birgit I; Lacko, Martin; Hardillo, José A; Honings, Jimmie; Halmos, Gyorgy B; Goedhart-Schwandt, Noortje L Q; de Bree, Remco; Leemans, C René; Verdonck-de Leeuw, Irma M

2016-03-01

The purpose of this study was to investigate the feasibility of an online self-care education program supporting early rehabilitation of patients after total laryngectomy (TLPs) and factors associated with satisfaction. Health care professionals (HCPs) were invited to participate and to recruit TLPs. TLPs were informed on the self-care education program "In Tune without Cords" (ITwC) after which they gained access. A study specific survey was used (at baseline T0 and postintervention T1) on TLPs' uptake. Usage, satisfaction (general impression, willingness to use, user-friendliness, satisfaction with self-care advice and strategies, Net Promoter Score (NPS)), sociodemographic, and clinical factors were analyzed. HCPs of 6 out of 9 centers (67% uptake rate) agreed to participate and recruited TLPs. In total, 55 of 75 TLPs returned informed consent and the baseline T0 survey and were provided access to ITwC (73% uptake rate). Thirty-eight of these 55 TLPs used ITwC and completed the T1 survey (69% usage rate). Most (66%) TLPs were satisfied (i.e., score ≥7 (scale 1-10) on 4 survey items) with the self-care education program (mean score 7.2, SD 1.1). NPS was positive (+5). Satisfaction with the self-care education program was significantly associated with (higher) educational level and health literacy skills (P = .004, P = .038, respectively). No significant association was found with gender, age, marital status, employment status, Internet use, Internet literacy, treatment modality, time since total laryngectomy, and quality of life. The online self-care education program ITwC supporting early rehabilitation was feasible in clinical practice. In general, TLPs were satisfied with the program.

45 CFR 149.330 - Content of claims.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Content of claims. 149.330 Section 149.330 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.330 Content of claims. Each claim on its face must include the information...

Global Vision, Local Reality: Transforming Pre-Primary Teacher Training in Tanzania

ERIC Educational Resources Information Center

Wilinski, Bethany; Nguyen, Cuong Huy; Landgraf, Jessica M.

2016-01-01

Global attention to early childhood education (ECE) has led to an increased focus on ECE teacher training as a critical component of providing young children with access to high-quality ECE programs. In this paper, we ask how Tanzanian stakeholders at different levels of implementation experienced and responded to efforts to build capacity in…

Speech and Language Disorders in Children: Implications for the Social Security Administration's Supplemental Security Income Program

ERIC Educational Resources Information Center

Rosenbaum, Sara, Ed.; Simon, Patti, Ed.

2016-01-01

Speech and language are central to the human experience; they are the vital means by which people convey and receive knowledge, thoughts, feelings, and other internal experiences. Acquisition of communication skills begins early in childhood and is foundational to the ability to gain access to culturally transmitted knowledge, organize and share…

An Examination of the Psychometric Properties of the Pediatric Symptom Checklist with Children Enrolled in Medicaid

ERIC Educational Resources Information Center

Boothroyd, Roger Alan; Armstrong, Mary

2010-01-01

The federal Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program requires mental health screening of Medicaid-eligible children as part of primary care medical assessments. However, decisions related to selection of a screening tool remain with the states. States need access to brief, cost effective, easily administered screening…

Picture This: Young Quechua Children's Reactions to Imported Picture Books in Ayacucho, Peru

ERIC Educational Resources Information Center

Eck, Jennifer Rowse

2017-01-01

Practitioners in ECE consider picture books an effective instructional tool in early childhood programming in the developed regions of the world. However, many young children from marginalized populations in the developing world have little to no access to them and thus, the effect that picture books could have upon their emergent literacy…

45 CFR 149.600 - Sponsor's duty to report data inaccuracies.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Sponsor's duty to report data inaccuracies. 149.600 Section 149.600 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Disclosure of Data Inaccuracies § 149.600 Sponsor's duty to report data...

Access to High Quality Early Care and Education: Readiness and Opportunity Gaps in America. CEELO Policy Report

ERIC Educational Resources Information Center

Nores, Milagros; Barnett, W. Steven

2014-01-01

A substantial body of research establishes that high quality preschool education can enhance cognitive and social development with long-term benefits for later success in school, the economy, and society more broadly. Such programs have been found to have particularly large benefits for children who are economically disadvantaged. Such children…

Play School: Where Children and Families Learn and Grow Together

ERIC Educational Resources Information Center

McDermott, Lori Berger

2012-01-01

A growing body of national research confirms that significant levels of learning and growth occur during early childhood, and that it is important, from a public policy perspective, to increase access to quality programs and services that support the development of skills and attitudes children need to succeed. Clearly, no one-size-fits-all…

Early Childhood Behavioral Health Integration in Pediatric Primary Care: Serving Refugee Families in the Healthy Steps Program

ERIC Educational Resources Information Center

Buchholz, Melissa; Fischer, Collette; Margolis, Kate L.; Talmi, Ayelet

2016-01-01

Primary care settings are optimal environments for providing comprehensive, family-centered care to young children and their families. Primary care clinics with integrated behavioral health clinicians (BHCs) are well-positioned to build trust and create access to care for marginalized and underserved populations. Refugees from around the world are…

45 CFR 149.115 - Cost threshold and cost limit.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Cost threshold and cost limit. 149.115 Section 149.115 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reinsurance Amounts § 149.115 Cost threshold and cost limit. The following cost threshold...

45 CFR 149.115 - Cost threshold and cost limit.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Cost threshold and cost limit. 149.115 Section 149.115 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reinsurance Amounts § 149.115 Cost threshold and cost limit. The following cost threshold...

45 CFR 149.115 - Cost threshold and cost limit.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Cost threshold and cost limit. 149.115 Section 149.115 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reinsurance Amounts § 149.115 Cost threshold and cost limit. The following cost threshold...

45 CFR 149.115 - Cost threshold and cost limit.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Cost threshold and cost limit. 149.115 Section 149.115 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reinsurance Amounts § 149.115 Cost threshold and cost limit. The following cost threshold...

An early stage evaluation of the Supporting Program for Obstetric Care Underserved Areas in Korea.

PubMed

Na, Baeg Ju; Kim, Hyun Joo; Lee, Jin Yong

2014-06-01

"The Supporting Program for Obstetric Care Underserved Areas (SPOU)" provides financial aids to rural community (or district) hospitals to reopen prenatal care and delivery services for regions without obstetrics and gynecology clinics or hospitals. The purpose of this study was to evaluate the early stage effect of the SPOU program. The proportion of the number of birth through SPOU was calculated by each region. Also survey was conducted to investigate the extent of overall satisfaction, elements of dissatisfaction, and suggestions for improvement of the program; 209 subjects participated from 7 to 12 December, 2012. Overall, 20% of pregnant women in Youngdong (71 cases) and Gangjin (106 cases) used their community (or district) hospitals through the SPOU whereas Yecheon (23 cases) was 8%; their satisfaction rates were high. Short distance and easy accessibility was the main reason among women choosing community (or district) hospital whereas the reasons of not selecting the community (or district) hospital were favor of the outside hospital's facility, system, and trust in the medical staffs. The SPOU seems to be currently effective at an early stage. However, to successfully implement this program, the government should make continuous efforts to recruit highly qualified medical staffs and improve medical facility and equipment.

Breeding of Acrocomia aculeata using genetic diversity parameters and correlations to select accessions based on vegetative, phenological, and reproductive characteristics.

PubMed

Coser, S M; Motoike, S Y; Corrêa, T R; Pires, T P; Resende, M D V

2016-10-17

Macaw palm (Acrocomia aculeata) is a promising species for use in biofuel production, and establishing breeding programs is important for the development of commercial plantations. The aim of the present study was to analyze genetic diversity, verify correlations between traits, estimate genetic parameters, and select different accessions of A. aculeata in the Macaw Palm Germplasm Bank located in Universidade Federal de Viçosa, to develop a breeding program for this species. Accessions were selected based on precocity (PREC), total spathe (TS), diameter at breast height (DBH), height of the first spathe (HFS), and canopy area (CA). The traits were evaluated in 52 accessions during the 2012/2013 season and analyzed by restricted estimation maximum likelihood/best linear unbiased predictor procedures. Genetic diversity resulted in the formation of four groups by Tocher's clustering method. The correlation analysis showed it was possible to have indirect and early selection for the traits PREC and DBH. Estimated genetic parameters strengthened the genetic variability verified by cluster analysis. Narrow-sense heritability was classified as moderate (PREC, TS, and CA) to high (HFS and DBH), resulting in strong genetic control of the traits and success in obtaining genetic gains by selection. Accuracy values were classified as moderate (PREC and CA) to high (TS, HFS, and DBH), reinforcing the success of the selection process. Selection of accessions for PREC, TS, and HFS by the rank-average method permits selection gains of over 100%, emphasizing the successful use of the accessions in breeding programs and obtaining superior genotypes for commercial plantations.

Health promotion in schools: a multi-method evaluation of an Australian School Youth Health Nurse Program.

PubMed

Banfield, Michelle; McGorm, Kelly; Sargent, Ginny

2015-01-01

Health promotion provides a key opportunity to empower young people to make informed choices regarding key health-related behaviours such as tobacco and alcohol use, sexual practices, dietary choices and physical activity. This paper describes the evaluation of a pilot School Youth Health Nurse (SYHN) Program, which aims to integrate a Registered Nurse into school communities to deliver health promotion through group education and individual sessions. The evaluation was guided by the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework. The objectives were to explore: 1) whether the Program was accessible to the high school students; 2) the impacts of the Program on key stakeholders; 3) which factors affected adoption of the Program; 4) whether implementation was consistent with the Program intent; and 5) the long-term sustainability of the Program. Research included retrospective analysis of Program records, administration of a survey of student experiences and interviews with 38 stakeholders. This evaluation provided evidence that the SYHN Program is reaching students in need, is effective, has been adopted successfully in schools, is being implemented as intended and could be maintained with sustained funding. The nurses deliver an accessible and acceptable primary health care service, focused on health promotion, prevention and early intervention. After some initial uncertainty about the scope and nature of the role, the nurses are a respected source of health information in the schools, consulted on curriculum development and contributing to whole-of-school health activities. Findings demonstrate that the SYHN model is feasible and acceptable to the students and schools involved in the pilot. The Program provides health promotion and accessible primary health care in the school setting, consistent with the Health Promoting Schools framework.

Webcam delivery of the Lidcombe program for early stuttering: a phase I clinical trial.

PubMed

O'Brian, Sue; Smith, Kylie; Onslow, Mark

2014-06-01

The Lidcombe Program is an operant treatment for early stuttering shown with meta-analysis to have a favorable odds ratio. However, many clients are unable to access the treatment because of distance and lifestyle factors. In this Phase I trial, we explored the potential efficacy, practicality, and viability of an Internet webcam Lidcombe Program service delivery model. Participants were 3 preschool children who stuttered and their parents, all of whom received assessment and treatment using webcam in their homes with no clinic attendance. At 6 months post-Stage 1 completion, all children were stuttering below 1.0% syllables stuttered. The webcam intervention was acceptable to the parents and appeared to be practical and viable, with only occasional audiovisual problems. At present, there is no reason to doubt that a webcam-delivered Lidcombe Program will be shown with clinical trials to have comparable efficacy with the clinic version. Webcam-delivered Lidcombe Program intervention is potentially efficacious, is practical and viable, and requires further exploration with comparative clinical trials and a qualitative study of parent and caregiver experiences.

MS PHD'S: A successful model for reaching underrepresented minorities (URM) students through virtual platforms

NASA Astrophysics Data System (ADS)

Scott, O.; Johnson, A.; Williamson, V.; Ricciardi, L.; Jearld, A., Jr.; Guzman, W. I.

2014-12-01

To successfully recruit and retain underrepresented minority (URM) students and early career scientists, many programs supplement traditional curricular activities with multiple online platforms, establishing "virtual communities" that are free and easily accessible. These virtual communities offer readily sustainable opportunities to facilitate communication across a wide range of cultural lines and socioeconomic levels thereby broadening participation and inclusivity in STEM. Established in 2003, the Minorities Striving and Pursuing Higher Degrees of Success (MS PHD'S) in Earth System Science Professional Development Program has successfully used virtual community tools such as a listserv, community forum, social media, and VoIP technologies, to extend the face-to-face activities of the program and support the advancement of URM students and early career scientists in STEM. The use of multiple facets of virtual community by MS PHD'S participants supports and encourages "real life" interactions and mentorship, facilitates networking and professional development, and maintains continuity of shared networks. The program is now in its ninth cohort and supports 213 participants. To date, 54 participants have completed their PhD and another 61 are currently enrolled in doctoral programs.

Training in Parent Consultation Skills for Primary Care Practitioners in Early Intervention in the Pre-School Context.

ERIC Educational Resources Information Center

Crisante, Lea

2003-01-01

Describes the implementation of a brief behavioral intervention, based on the Triple P-Positive Parenting Program, by 13 pre-school practitioners with 39 parents. The results point to the role of primary care practitioners in providing services in settings that are easily accessed by parents, thus increasing the availability of support to parents…

A century of meteorological observations at Fort Valley Experimental Forest: A cooperative observer program success story

Treesearch

Daniel P. Huebner; Susan D. Olberding; Byron Peterson; Dino DeSimone

2008-01-01

Meteorological observations at Fort Valley Experimental Forest began with its establishment as early silvicultural research made heavy use of meteorological data. The Fort Valley weather data represent the longest climatological record for northern Arizona with records dating back to 1909. Importance of long-term meteorological records and access to the weather record...

A century of meteorological observations at Fort Valley Experimental Forest: A cooperative observer program success story (P-53)

Treesearch

Daniel P. Huebner; Susan D. Olberding; Byron Peterson; Dino DeSimone

2008-01-01

Meteorological observations at Fort Valley Experimental Forest began with its establishment as early silvicultural research made heavy use of meteorological data. The Fort Valley weather data represent the longest climatological record for northern Arizona with records dating back to 1909. Importance of long term meteorological records and access to the weather record...

Early Childhood Interventionists' Perceptions of the Child Abuse Prevention and Treatment Act: Provider Characteristics and Organizational Climate

ERIC Educational Resources Information Center

Herman-Smith, Robert L.

2013-01-01

Research Findings: A 2003 amendment to the Child Abuse Prevention and Treatment Act (CAPTA) required states to develop plans to ensure that children younger than the age of 3 years who are victims of substantiated abuse or neglect have access to developmental screenings. Programs authorized under Part C of the Individuals with Disabilities…

My-Peer Toolkit [1.0]: Developing an Online Resource for Planning and Evaluating Peer-Based Youth Programs

ERIC Educational Resources Information Center

Hildebrand, Janina; Lobo, Roanna; Hallett, Jonathan; Brown, Graham; Maycock, Bruce

2012-01-01

Peer-based youth services provided by small non-profit community organisations have grown in number over the past two decades in response to an increasing need for informal, youth-friendly, accessible and confidential early intervention services. However, gaps in the evidence base and a general lack of evaluation capacity of service providers…

A Parent's Guide to Accessing Programs for Infants, Toddlers, and Preschoolers with Handicaps.

ERIC Educational Resources Information Center

Valdivieso, Carol; And Others

The guide is intended to help parents of young children with special needs identify early intervention services (for children birth through age 2) and special education services (for children ages 3 through 5). Part 1 answers typical questions of parents of infants including: What should I do if I think my child has special needs? What are early…

The Promise and the Reality: Exploring Virtual Schooling in Rural Juristictions

ERIC Educational Resources Information Center

Barbour, Michael K.

2011-01-01

The history of online learning at the K-12 level is almost as long as its history at the post-secondary level, with the first virtual school programs beginning in the early 1990s. While these opportunities were designed as a way to provide rural students with access to more specialized courses, as opportunities have become organized into virtual…

Early Access Program Using Alpha 1 Antitrypsin Infusion for Patients With Steroid Refractory Acute GvHD After Hematopoietic Stem Cell Transplantation (HSCT)

ClinicalTrials.gov

2017-05-29

SR aGvHD; Acute-graft-versus-host Disease; Steroid Refractory Acute Graft Versus Host Disease; Graft-versus-host-disease; Graft Vs Host Disease; Alpha 1-Antitrypsin Deficiency; Alpha-1 Proteinase Inhibitor; Alpha-1 Protease Inhibitor Deficiency; Acute Graft-Versus-Host Reaction Following Bone Marrow Transplant

Early childhood caries in Indigenous communities

PubMed Central

Irvine, JD; Holve, S; Krol, D; Schroth, R

2011-01-01

The oral health of Indigenous children of Canada (First Nations, Inuit and Métis) and the United States (American Indian and Alaska Native) is a major child health issue. This is exemplified by the high prevalence of early childhood caries (ECC) with resulting adverse health effects, as well as high rates and costs of restorative and surgical treatments under general anesthesia. ECC is an infectious disease that is influenced by multiple factors, including socioeconomic determinants, and requires a combination of approaches for improvement. The present statement includes recommendations for oral health preventive and clinical care for young infants and pregnant women by primary health care providers, community-based health promotion initiatives, oral health workforce and access issues, and advocacy for community water fluoridation and fluoride varnish program access. Further community-based research on the epidemiology, prevention, management and microbiology of ECC in Indigenous communities would be beneficial. PMID:22654547

Early childhood caries in indigenous communities.

PubMed

2011-06-01

The oral health of Indigenous children of Canada (First Nations, Inuit, and Métis) and the United States (American Indian, Alaska Native) is a major child health issue: there is a high prevalence of early childhood caries (ECC) and resulting adverse health effects in this community, as well as high rates and costs of restorative and surgical treatments under general anesthesia. ECC is an infectious disease that is influenced by multiple factors, including socioeconomic determinants, and requires a combination of approaches for improvement. This statement includes recommendations for preventive oral health and clinical care for young infants and pregnant women by primary health care providers, community-based health-promotion initiatives, oral health workforce and access issues, and advocacy for community water fluoridation and fluoride-varnish program access. Further community-based research on the epidemiology, prevention, management, and microbiology of ECC in Indigenous communities would be beneficial.

Early childhood caries in Indigenous communities: A joint statement with the American Academy of Pediatrics.

PubMed

Irvine, Jd; Holve, S; Krol, D; Schroth, R

2011-06-01

The oral health of Indigenous children of Canada (First Nations, Inuit and Métis) and the United States (American Indian and Alaska Native) is a major child health issue. This is exemplified by the high prevalence of early childhood caries (ECC) with resulting adverse health effects, as well as high rates and costs of restorative and surgical treatments under general anesthesia. ECC is an infectious disease that is influenced by multiple factors, including socioeconomic determinants, and requires a combination of approaches for improvement. The present statement includes recommendations for oral health preventive and clinical care for young infants and pregnant women by primary health care providers, community-based health promotion initiatives, oral health workforce and access issues, and advocacy for community water fluoridation and fluoride varnish program access. Further community-based research on the epidemiology, prevention, management and microbiology of ECC in Indigenous communities would be beneficial.

Overview of States' Use of Telehealth for the Delivery of Early Intervention (IDEA Part C) Services.

PubMed

Cason, Jana; Behl, Diane; Ringwalt, Sharon

2012-01-01

Early intervention (EI) services are designed to promote the development of skills and enhance the quality of life of infants and toddlers who have been identified as having a disability or developmental delay, enhance capacity of families to care for their child with special needs, reduce future educational costs, and promote independent living (NECTAC, 2011). EI services are regulated by Part C of the Individuals with Disabilities Education Improvement Act (IDEA); however, personnel shortages, particularly in rural areas, limit access for children who qualify. Telehealth is an emerging delivery model demonstrating potential to deliver EI services effectively and efficiently, thereby improving access and ameliorating the impact of provider shortages in underserved areas. The use of a telehealth delivery model facilitates inter-disciplinary collaboration, coordinated care, and consultation with specialists not available within a local community. A survey sent by the National Early Childhood Technical Assistance Center (NECTAC) to IDEA Part C coordinators assessed their utilization of telehealth within states' IDEA Part C programs. Reimbursement for provider type and services and barriers to implement a telehealth service delivery model were identified. Representatives from 26 states and one jurisdiction responded to the NECTAC telehealth survey. Of these, 30% (n=9) indicated that they are either currently using telehealth as an adjunct service delivery model (n=6) or plan to incorporate telehealth within the next 1-2 years (n=3). Identified telehealth providers included developmental specialists, teachers of the Deaf/Hard of Hearing (DHH), speech-language pathologists, occupational therapists, physical therapists, behavior specialists, audiologists, and interpreters. Reimbursement was variable and included use of IDEA Part C funding, Medicaid, and private insurance. Expressed barriers and concerns for the implementation of telehealth as a delivery model within Part C programming included security issues (40%; n=11); privacy issues (44%; n=12); concerns about quality of services delivered via telehealth (40%; n=11); and lack of evidence to support the effectiveness of a telehealth service delivery model within IDEA Part C programming (3%; n=1). Reimbursement policy and billing processes and technology infrastructure were also identified as barriers impacting the implementation of telehealth programming. Provider shortages impact the quantity and quality of services available for children with disabilities and developmental delay, particularly in rural areas. While many states are incorporating telehealth within their Early Intervention (IDEA Part C) services in order to improve access and overcome personnel shortages, barriers persist. Policy development, education of stakeholders, research, utilization of secure and private delivery platforms, and advocacy may facilitate more widespread adoption of telehealth within IDEA Part C programs across the country.

Overview of States’ Use of Telehealth for the Delivery of Early Intervention (IDEA Part C) Services

PubMed Central

Cason, Jana; Behl, Diane; Ringwalt, Sharon

2012-01-01

Background: Early intervention (EI) services are designed to promote the development of skills and enhance the quality of life of infants and toddlers who have been identified as having a disability or developmental delay, enhance capacity of families to care for their child with special needs, reduce future educational costs, and promote independent living (NECTAC, 2011). EI services are regulated by Part C of the Individuals with Disabilities Education Improvement Act (IDEA); however, personnel shortages, particularly in rural areas, limit access for children who qualify. Telehealth is an emerging delivery model demonstrating potential to deliver EI services effectively and efficiently, thereby improving access and ameliorating the impact of provider shortages in underserved areas. The use of a telehealth delivery model facilitates inter-disciplinary collaboration, coordinated care, and consultation with specialists not available within a local community. Method: A survey sent by the National Early Childhood Technical Assistance Center (NECTAC) to IDEA Part C coordinators assessed their utilization of telehealth within states’ IDEA Part C programs. Reimbursement for provider type and services and barriers to implement a telehealth service delivery model were identified. Results: Representatives from 26 states and one jurisdiction responded to the NECTAC telehealth survey. Of these, 30% (n=9) indicated that they are either currently using telehealth as an adjunct service delivery model (n=6) or plan to incorporate telehealth within the next 1–2 years (n=3). Identified telehealth providers included developmental specialists, teachers of the Deaf/Hard of Hearing (DHH), speech-language pathologists, occupational therapists, physical therapists, behavior specialists, audiologists, and interpreters. Reimbursement was variable and included use of IDEA Part C funding, Medicaid, and private insurance. Expressed barriers and concerns for the implementation of telehealth as a delivery model within Part C programming included security issues (40%; n=11); privacy issues (44%; n=12); concerns about quality of services delivered via telehealth (40%; n=11); and lack of evidence to support the effectiveness of a telehealth service delivery model within IDEA Part C programming (3%; n=1). Reimbursement policy and billing processes and technology infrastructure were also identified as barriers impacting the implementation of telehealth programming. Conclusions: Provider shortages impact the quantity and quality of services available for children with disabilities and developmental delay, particularly in rural areas. While many states are incorporating telehealth within their Early Intervention (IDEA Part C) services in order to improve access and overcome personnel shortages, barriers persist. Policy development, education of stakeholders, research, utilization of secure and private delivery platforms, and advocacy may facilitate more widespread adoption of telehealth within IDEA Part C programs across the country. PMID:25945202

A Report On Eight Early-Stage State And Regional Projects Testing Value-Based Payment

PubMed Central

Conrad, Douglas; Grembowski, David; Gibbons, Claire; Marcus-Smith, Miriam; Hernandez, Susan E.; Chang, Judy; Renz, Anne; Lau, Bernard; Cruz, Erin dela

2014-01-01

To help contain health care spending and improve the quality of care, practitioners and policy makers are trying to move away from fee-for-service toward value-based payment, which links providers’ reimbursement to the value, rather than the volume, of services delivered. With funding from the Robert Wood Johnson Foundation, eight grantees across the country are designing and implementing value-based payment reform projects. For example, in Salem, Oregon, the Physicians Choice Foundation is testing “Program Oriented Payments,” which include incentives for providers who follow a condition-specific program of care designed to meet goals set jointly by patient and provider. In this article we describe the funding rationale and the specific objectives, strategies, progress, and early stages of implementation of the eight projects. We also share some early lessons and identify prerequisites for success, such as ensuring that providers have broad and timely access to data so they can meet patients’ needs in cost-effective ways. PMID:23650332

Public Education and Targeted Outreach to Underserved Women Through the National Breast and Cervical Cancer Early Detection Program

PubMed Central

Levano, Whitney; Miller, Jacqueline W.; Leonard, Banning; Bellick, Linda; Crane, Barbara E.; Kennedy, Stephenie K.; Haslage, Natalie M.; Hammond, Whitney; Tharpe, Felicia S.

2015-01-01

The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) was established to provide low-income, uninsured, and underinsured women access to cancer screening and diagnostic services with the goal of increasing the early detection and prevention of breast and cervical cancer. Although this is a valuable resource for women who might not have the means to get screened otherwise, providing services at no cost, by itself, does not guarantee uptake of screening services. Public education and targeted outreach facilitate the critical link between public service programs and the communities they serve. The purpose of public education and outreach in the NBCCEDP is to increase the number of women who use breast and cervical cancer screening services by raising awareness, providing education, addressing barriers, and motivating women to complete screening exams and follow-up. Effective strategies focus on helping to remove structural, physical, interpersonal, financial, and cultural barriers; educate women about the importance of screening and inform women about the services available to them. This article provides an overview of the importance of public education and targeted outreach activities for cancer screening through community-based programs including examples from NBCCEDP grantees that highlight successes, challenges, and solutions, encountered when conducting these types of interventions. PMID:25099902

Life after the ban: an assessment of US syringe exchange programs' attitudes about and early experiences with federal funding.

PubMed

Green, Traci C; Martin, Erika G; Bowman, Sarah E; Mann, Marita R; Beletsky, Leo

2012-05-01

We aimed to determine whether syringe exchange programs (SEPs) currently receive or anticipate pursuing federal funding and barriers to funding applications following the recent removal of the long-standing ban on using federal funds for SEPs. We conducted a telephone-administered cross-sectional survey of US SEPs. Descriptive statistics summarized responses; bivariate analyses examined differences in pursuing funding and experiencing barriers by program characteristics. Of the 187 SEPs (92.1%) that responded, 90.9% were legally authorized. Three received federal funds and 116 intended to pursue federal funding. Perceived federal funding barriers were common and included availability and accessibility of funds, legal requirements such as written police support, resource capacity to apply and comply with funding regulations, local political and structural organization, and concern around altering program culture. Programs without legal authorization, health department affiliation, large distribution, or comprehensive planning reported more federal funding barriers. Policy implementation gaps appear to render federal support primarily symbolic. In practice, funding opportunities may not be available to all SEPs. Increased technical assistance and legal reform could improve access to federal funds, especially for SEPs with smaller capacity and tenuous local support.

A review of interventions to prevent pregnancy.

PubMed

Dryfoos, J G

1990-01-01

Of more developed nations, the US is unique in its problem with high rates of teen pregnancy. At the heart of our failure to check teen pregnancy may lie the country's poor sexual climate, a lack of government commitment, poor health system performance, local barriers to the provision of quality sex education, and/or lack of access to contraception. Potential solutions to reduce teen pregnancy are equally wide-ranging. Programs may aim to provide better and more health and sex education, improve decision making skills, improve access to contraception and abortion, improve life opportunities as alternatives to pregnancies, restructure welfare, and/or encourage youths to refrain from premarital sex. This essay presents and discusses major prevention efforts which seem to have the highest probability of reducing pregnancy rates, and especially childbearing rates among young, unmarried teens. Literature on program successes, agency reports, and program observations are reviewed, and include programs of sex education and skills enhancement, those helping sexually active youths become better contraceptors, and those which offer life option alternatives. In the area of improving access to contraception, school-based clinics, condom distribution, and other male-oriented programs are covered. Major social structural change is, however, called for with a view to promoting equity in education, housing, and jobs. Short of such change, interventions may target school-based populations, as well as community centers to reach dropouts. Early intervention and collaboration to bolster health, social, and recreational services for children and adolescents is urged.

Crisis-Affected Populations and Tuberculosis.

PubMed

Zenner, Dominik

2017-01-01

By definition, humanitarian crises can severely affect human health, directly through violence or indirectly through breakdown of infrastructure or lack of provision for basic human needs, such as safe shelter, food, clean water, and suitable clothing. After the initial phase, these indirect effects are the most important determinants of morbidity and mortality in humanitarian emergencies, and infectious diseases are among the most significant causes of ill health. Tuberculosis (TB) incidence in humanitarian emergencies varies depending on a number of factors, including the country background epidemiology, but will be elevated compared with precrisis levels. TB morbidity and mortality are associated with access to appropriate care and medications, and will also be elevated due to barriers to access to diagnosis and appropriate treatment, including robust TB drug supplies. While reestablishment of TB control is challenging in the early phases, successful treatment programs have been previously established, and the WHO has issued guidance on establishing such successful programs. Such programs should be closely linked to other health programs and established in close collaboration with the country's national treatment program. Individuals who flee the emergency also have a higher TB risk and can face difficulties accessing care en route to or upon arrival in host countries. These barriers, often associated with treatment delays and worse outcomes, can be the result of uncertainties around legal status, other practical challenges, or lack of health care worker awareness. It is important to recognize and mitigate these barriers with an increasing number of tools now available and described.

Starting Now: A Policy Vision for Supporting the Healthy Growth and Development of Every California Baby

ERIC Educational Resources Information Center

Bell, Adrienne; French, Isabel; Lee, Stacy; Lempert, Ted; Rogers, Kendra; Rothermel, Angela; Silva, Amy

2017-01-01

Too often in California, children (especially children of color, foster youth, and those growing up in poverty) lack the components critical for a healthy early life. For example, as few as 3% of families that might benefit from voluntary home visiting have access to home visiting programs, 32% of children entering foster care are under the age of…

Longitudinal Change in the Use of Services in Autism Spectrum Disorder: Understanding the Role of Child Characteristics, Family Demographics, and Parent Cognitions

ERIC Educational Resources Information Center

Siller, Michael; Reyes, Nuri; Hotez, Emily; Hutman, Ted; Sigman, Marian

2014-01-01

The aim of this study was to identify child characteristics, family demographics, and parent cognitions that may affect access to early intervention, special education, and related services. The sample included 70 families of young children with autism spectrum disorders. All parents were enrolled in a short education program, providing them with…

New Haven Promise: An Early Look at College Preparation, Access, and Enrollment of New Haven Public School Students (2010-2013). Brief

ERIC Educational Resources Information Center

Gonzalez, Gabriella C.; Bozick, Robert; Daugherty, Lindsay; Scherer, Ethan; Singh, Reema; Suárez, Mónica Jacobo; Ryan, Sarah; Schweig, Jonathan

2013-01-01

In New Haven, stakeholders looking to enhance the city's economic development, attract more residents, reduce crime and incarceration, and improve residents' quality of life embarked on a new scholarship program that seeks to build a college-going culture for local students and the community as an avenue to achieve these goals. Recognizing that…

Astrobiology Drilling Program of the NASA Astrobiology Institute

NASA Astrophysics Data System (ADS)

Runnegar, B.

2004-12-01

Access to unweathered and uncontaminated samples of the least altered, oldest, sedimentary rocks is essential for understanding the early history of life on Earth and the environments in which it may have existed. For this reason, the NASA Astrobiology Institute (NAI) has embarked on two international programs, a series of Field Workshops aimed at making the most important surface samples available to investigators, and the Astrobiology Drilling Program (ADP), which serves to provide access to fresh subsurface samples when the scientific objectives require them. The Astrobiology Drilling Program commenced in Western Australia in 2003 with the initiation of its first project, the Archean Biosphere Drilling Project (ABDP). Funding for the ABDP came mainly from the Japanese Government through Kagoshima University and from NASA through the NAI Team at Pennsylvania State University, but significant technical and logistic support was provided by the Geological of Western Australia and, to a lesser extent, by the University of Western Australia. Six diamond drill cores totalling 1.4 km were obtained from astrobiologically important successions in the 3.3-3.5 Ga-old Pilbara Craton of northern Western Australia. Drilling in 2004 also occurred in Western Australia. The Deep Time Drilling Project (DTDP), a spin-off from the NAI's Mission to Early Earth Focus Group, completed one long hole, aimed mainly at fossil biomolecules (biomarkers) and other geochemical indicators of early life. The DTDP and the ABDP also jointly drilled two other important holes 2004, one through the oldest known erosion surface (and possible soil profile). The other intersected well-preserved middle Archean sediments. These efforts parallel other drilling initiatives within the wider astrobiological community that are taking place in Western Australia, South Africa, Spain, and arctic Canada. The ADP is managed by the NAI through a Steering Committee appointed by the NAI Director. Samples of cores obtained through ADP projects are available to the whole community, following a one year embargo, upon application to project PIs and the ADP Steering Committee.

PubMed Central

GIUNTINI, G.; NICASTRO, R.; CIABOTTI, A.; BRUSCHINI, L.; BERRETTINI, S.

2016-01-01

SUMMARY The implementation of regional protocols for newborn hearing screening and early audiologic diagnosis represent the first step of the entire diagnostic, rehabilitative and prosthetic programme for children with permanent hearing impairment. The maximum benefit of early diagnosis can indeed be obtained only by prompt rehabilitation aimed at fostering the child's communicative, linguistic and cognitive development. Within the framework of the CMM 2013 project of the Ministry of Health entitled "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children", the problems concerning the promotion of the global development of children with PHI throughan early rehabilitation project based on shared knowledge and scientific evidence. In this project, our specific aim was to define the features and modes of access to a precise and specialised rehabilitation project for the small hearing-impaired child within three months from audiologic diagnosis. Three main recommendations relative to assessment and rehabilitation aspects of early care emerged from the study. PMID:27054391

Advancing Early Childhood Development: from Science to Scale 1

PubMed Central

Black, Maureen M; Walker, Susan P; Fernald, Lia C H; Andersen, Christopher T; DiGirolamo, Ann M; Lu, Chunling; McCoy, Dana C; Fink, Günther; Shawar, Yusra R; Shiffman, Prof Jeremy; Devercelli, Amanda E; Wodon, Quentin T; Vargas-Barón, Emily; Grantham-McGregor, Sally

2018-01-01

Early childhood development programmes vary in coordination and quality, with inadequate and inequitable access, especially for children younger than 3 years. New estimates, based on proxy measures of stunting and poverty, indicate that 250 million children (43%) younger than 5 years in low-income and middle-income countries are at risk of not reaching their developmental potential. There is therefore an urgent need to increase multisectoral coverage of quality programming that incorporates health, nutrition, security and safety, responsive caregiving, and early learning. Equitable early childhood policies and programmes are crucial for meeting Sustainable Development Goals, and for children to develop the intellectual skills, creativity, and wellbeing required to become healthy and productive adults. In this paper, the first in a three part Series on early childhood development, we examine recent scientific progress and global commitments to early childhood development. Research, programmes, and policies have advanced substantially since 2000, with new neuroscientific evidence linking early adversity and nurturing care with brain development and function throughout the life course. PMID:27717614

A Pilot Study Promoting Participation of Families with Limited Resources in Early Autism Intervention

PubMed Central

Carr, Themba; Lord, Catherine

2016-01-01

Background Relatively little research about autism early intervention has occurred in families of low socioeconomic status. Barriers to participation for under-resourced families (i.e., families with low incomes or limited education), pose a significant problem. The purpose of this pilot study was to apply empirically supported methods promoting participation of families with low-income and low-education levels to an established intervention for children with autism spectrum disorder (ASD). Method Participant recruitment specifically targeted families whose income was equal to or below two times the federal poverty line and whose caregiver(s) had no more than two years of college attendance. An evidence-based intervention was modified to be more accessible to participating families. Adaptations focused on decreasing access barriers, decreasing attrition, and promoting positive change within families. Success of the program was measured quantitatively and qualitatively. Results Twenty-seven families were referred to the project, 13 of which did not meet eligibility requirements. Eight families enrolled, maintained participation for the majority of the project and provided positive qualitative feedback of their experiences. Project and treatment attrition were calculated at 62% and 12.5%, respectively. Treatment attendance was high, but length of time to complete treatment was greatly influenced by the number of session cancellations. Conclusions The exploratory project demonstrated that practical modifications to standard early intervention protocols can promote engagement in families with limited resources. Recommendations for programs seeking to implement interventions in under-resourced communities are discussed. PMID:27019670

Measuring the effectiveness and impact of an open innovation platform.

PubMed

Carroll, Glenn P; Srivastava, Sanjay; Volini, Adam S; Piñeiro-Núñez, Marta M; Vetman, Tatiana

2017-05-01

Today, most pharmaceutical companies complement their traditional R&D models with some variation on the Open Innovation (OI) approach in an effort to better access global scientific talent, ideas and hypotheses. Traditional performance indicators that measure economic returns from R&D through commercialization are often not applicable to the practical assessment of these OI approaches, particularly within the context of early drug discovery. This leaves OI programs focused on early R&D without a standard assessment framework from which to evaluate overall performance. This paper proposes a practical dashboard for such assessment, encompassing quantitative and qualitative elements, to enable decision-making and improvement of future performance. The use of this dashboard is illustrated using real-time data from the Lilly Open Innovation Drug Discovery (OIDD) program. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Distance learning in toxicology: Australia's RMIT program

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

Ahokas, Jorma; Donohue, Diana; Rix, Colin

2005-09-01

RMIT University was the first to offer a comprehensive Masters of Toxicology in Australasia 19 years ago. In 2001 the program was transformed into two stages, leading to a Graduate Diploma and Master of Applied Science in Toxicology. Now, these programs are fully online and suitable for graduates living and working anywhere in the world. The modular distance-learning courses are specifically designed to equip students with essential skills for entering fields such as chemical and drug evaluation; risk assessment of chemicals in the workplace; environmental and food toxicology. RMIT's online course delivery system has made it possible to deliver themore » toxicology programs, both nationally and internationally. The learning material and interactive activities (tests and quizzes, discussion boards, chat sessions) use Blackboard and WebBoard, each with a different educational function. Students log in to a Learning Hub to access their courses. The Learning Hub enables students to extend their learning beyond the classroom to the home, workplace, library and any other location with Internet access. The teaching staff log in to the Learning Hub to maintain and administer the online programs and courses which they have developed and/or which they teach. The Learning Hub is also a communication tool for students and staff, providing access to email, a diary and announcements. The early experience of delivering a full toxicology program online is very positive. However this mode of teaching continues to present many interesting technical, educational and cultural challenges, including: the design and presentation of the material; copyright issues; internationalisation of content; interactive participation; and the assessment procedures.« less

Exercise programming and counseling preferences of breast cancer survivors during or after radiation therapy.

PubMed

Karvinen, Kristina H; Raedeke, Thomas D; Arastu, Hyder; Allison, Ron R

2011-09-01

To explore exercise programming and counseling preferences and exercise-related beliefs in breast cancer survivors during and after radiation therapy, and to compare differences based on treatment and insurance status. Cross-sectional survey. Ambulatory cancer center in a rural community in eastern North Carolina. 91 breast cancer survivors during or after radiation therapy. The researchers administered the questionnaire to participants. Exercise programming and counseling preferences and exercise beliefs moderated by treatment status (on-treatment, early, and late survivors) and insurance status (Medicaid, non-Medicaid). Chi-square analyses indicated that fewer Medicaid users were physically active and reported health benefits as an advantage of exercise compared to non-Medicaid users (p < 0.05). In addition, more Medicaid users preferred exercise programming at their cancer center compared to non-Medicaid users (p < 0.05). More on-treatment and early survivors listed health benefits as advantages to exercise, but fewer indicated weight control as an advantage compared to late survivors (p < 0.05). Early survivors were more likely than on-treatment survivors to indicate that accessible facilities would make exercising easier for them (p < 0.05). Medicaid users are less active, less likely to identify health benefits as an advantage for exercising, and more likely to prefer cancer center-based exercise programming compared to non-Medicaid users. In addition, on-treatment and early survivors are more likely to list health benefits and less likely to indicate weight control as advantages of exercising compared to late survivors. The low activity levels of Medicaid users may be best targeted by providing cancer center-based exercise programming. Exercise interventions may be most effective if tailored to the unique needs of treatment status.

Response to Early Intensive Behavioral Intervention for autism--an umbrella approach to issues critical to treatment individualization.

PubMed

Fava, Leonardo; Strauss, Kristin

2014-12-01

Integrating knowledge across the disciplines of genetics, neurological, and behavioral science targets, so far, early identification of children with autism and thus early access to intervention. Cross-discipline collaboration might be substantially improve treatment efficacy via individualized treatment based on the child and family needs, consistency across treatment providers and careful planning of skill curricula, setting and techniques. This paper documents the current state of five main issues critical to treatment individualization where cross-discipline collaboration is warranted: (1) developmental timing, (2) treatment intensity, (3) heterogeneity in treatment response, (4) program breath and flexibility, and (5) formats of treatment provision. Copyright © 2014 ISDN. Published by Elsevier Ltd. All rights reserved.

NASA's commercial space program - Initiatives for the future

NASA Technical Reports Server (NTRS)

Rose, James T.; Stone, Barbara A.

1990-01-01

NASA's commercial development of the space program aimed at the stimulation and assistance of expanded private sector involvement and investment in civil space activities is discussed, focusing on major new program initiatives and their implementation. NASA's Centers for the Commercial Development of Space (CCDS) program, composed of competitively selected consortia of universities, industries, and government involved in early research and testing phases of potentially commercially viable technologies is described. The 16 centers concentrate on seven different technical areas such as automation and robotics; remote sensing; life sciences; and space power, propulsion, and structures. Private sector participation, CCDS technology development, government and commercially supplied access to space in support of CCDS programs, CCDS hardware development, and CCDS spinoffs are discussed together with various cooperative and reimbursable agreements between NASA and the private sector.

Effects of weaning age and diet on growth and carcass characteristics in steers.

PubMed

Fluharty, F L; Loerch, S C; Turner, T B; Moeller, S J; Lowe, G D

2000-07-01

Two experiments were conducted to determine the effects of diet on growth of steers weaned at approximately 100 vs 205 d of age. In Exp. 1, a 2 x 2 x 2 factorial experiment was conducted using 78 Angus crossbred cow-calf pairs. The factors examined were age at weaning (early, at 103+/-3 d [EW] vs normal, at 203+/-3 d [NW]), feeding strategy (ad libitum vs postweaning programmed intake), and dietary CP concentration (100 vs 120% of NRC [1984] recommended levels). Early-weaned calves had a greater (P < .001) ADG than NW calves from 103 to 203 d and reached market weight at 385 d vs 418 d for NW calves (P < .001). Likewise, steers offered feed for ad libitum consumption reached market weight at 394 d, compared with 409 d for programmed-intake steers (P < .05). In Exp. 2, 64 Angus crossbred steers were either weaned at 93+/-3 d and fed one of four diets, weaned at 210+/-3 d without access to creep feed, or weaned at 210+/-3 d with access to creep feed for 60 d prior to weaning. Early-weaned calves were heavier (P < .01) than NW calves at 210 d if fed either 100 or 90% concentrate diets, and they had greater (P < .001) backfat thickness at 210 d but no difference (P > .10) in longissimus muscle area compared to EW calves fed a 60% concentrate diet. At slaughter, 80 to 100% of steers on all treatments graded low Choice or higher. Feeding high-concentrate diets to EW beef calves accelerated growth rate and fat deposition early in the feeding period and may be a way to provide young cattle for a high-quality beef market.

Early Entry for Youth into the Ocean Science Pipeline Through Ocean Science School Camp and Summer Camp Programs: A Key Strategy for Enhancing Diversity in the Ocean Sciences

NASA Astrophysics Data System (ADS)

Crane, N. L.; Wasser, A.; Weiss, T.; Sullivan, M.; Jones, A.

2004-12-01

Educators, policymakers, employers and other stakeholders in ocean and other geo-science fields face the continuing challenge of a lack of diversity in these fields. A particular challenge for educators and geo-science professionals promoting ocean sciences is to create programs that have broad access, including access for underrepresented youth. Experiential learning in environments such as intensive multi-day science and summer camps can be a critical captivator and motivator for young people. Our data suggest that youth, especially underrepresented youth, may benefit from exposure to the oceans and ocean science through intensive, sustained (eg more than just an afternoon), hands-on, science-based experiences. Data from the more than 570 youth who have participated in Camp SEA Lab's academically based experiential ocean science camp and summer programs provide compelling evidence for the importance of such programs in motivating young people. We have paid special attention to factors that might play a role in recruiting and retaining these young people in ocean science fields. Over 50% of program attendees were underrepresented youth and on scholarship, which gives us a closer look at the impact of such programs on youth who would otherwise not have the opportunity to participate. Both cognitive (knowledge) and affective (personal growth and motivation) indicators were assessed through surveys and questionnaires. Major themes drawn from the data for knowledge growth and personal growth in Camp SEA Lab youth attendees will be presented. These will be placed into the larger context of critical factors that enhance recruitment and retention in the geo-science pipeline. Successful strategies and challenges for involving families and broadening access to specialized programs such as Camp SEA Lab will also be discussed.

A situational analysis of breast cancer early detection services in Trinidad and Tobago.

PubMed

Badal, Kimberly; Rampersad, Fidel; Warner, Wayne A; Toriola, Adetunji T; Mohammed, Hamish; Scheffel, Harold-Alexis; Ali, Rehanna; Moosoodeen, Murrie; Konduru, Siva; Russel, Adaila; Haraksingh, Rajini

2018-01-01

A situational analysis of breast cancer (BC) early detection services was carried out to investigate whether Trinidad and Tobago (T&T) has the framework for successful organized national screening. An online survey was designed to assess the availability, accessibility, quality control and assurance (QC&A), and monitoring and evaluation (M&E) mechanisms for public and private BC early detection. A focus group with local radiologists (n = 3) was held to identify unaddressed challenges and make recommendations for improvement. Major public hospitals offer free detection services with wait times of 1-6 months for an appointment. Private institutions offer mammograms for TTD$240 (USD$37) at minimum with same day service. Both sectors report a lack of trained staff. Using 1.2 mammograms per 10,000 women ≥40 years as sufficient, the public sector's rate of 0.19 mammograms per 10,000 women ≥40 years for screening and diagnosis is inadequate. Program M&E mechanisms, QC&A guidelines for machinery use, delays in receipt of pathology reports, and unreliable drug access are further unaddressed challenges. T&T must first strengthen its human and physical resources, implement M&E and QC&A measures, strengthen cancer care, and address other impediments to BC early detection before investing in nationally organized BC screening.

Immigration, health care access, and recent cancer tests among Mexican-Americans in California.

PubMed

Breen, Nancy; Rao, Sowmya R; Meissner, Helen I

2010-08-01

Immigrants' lower rates of cancer testing may be due to lack of fluency in English and other skills and knowledge about navigating US health care markets, lack of access to health services, or both. We analyzed 9,079 Mexican-American respondents to the 2001 California Health Interview Survey (CHIS) grouped as born in the US, living in the US 10 or more years, or living in the US less than 10 years. The CHIS provides the largest Mexican-American sample in a US survey. Access to care meant having health insurance coverage and a usual source of care. English proficiency meant the respondent took the interview in English. Multivariate logistic regression was used to predict outcomes. Respondents reporting more time in the US were more likely to report access to medical care and to report getting a cancer screening exam. Regardless of time in the US, respondents reporting access had similar test rates. Regression results indicate that time in the US and primary language were not significant relative to use of cancer screening tests, but access to care was. Cancer screening tests that are covered by Every Woman Counts, California's breast and cervical cancer early detection program, had smaller gaps among groups than colorectal cancer screening which is not covered by a program. California is the only state with a survey able to monitor changes in small population groups. Understanding barriers specific to subgroups is key to developing appropriate policy and interventions to increase use of cancer screening exams.

Astronauts Bob Behnken and Eric Boe walk the Crew Access Arm at

NASA Image and Video Library

2017-08-30

Astronauts Bob Behnken, left, and Eric Boe walk down the Crew Access Arm being built by SpaceX for Launch Complex 39A at NASA’s Kennedy Space Center in Florida. The access arm will be installed on the launch pad, providing a bridge between the launch tower it’s the Fixed Service Structure, as noted below, and SpaceX’s Dragon 2 spacecraft for astronauts flying to the International Space Station on the company’s Falcon 9 rocket as part of NASA’s Commercial Crew Program. The access arm is being readied for installation in early 2018. It will be installed 70 feet higher than the former space shuttle access arm on the launch pad’s Fixed Service Structure. SpaceX continues to modify the historic launch site from its former space shuttle days, removing more than 500,000 pounds of steel from the pad structure, including the Rotating Service Structure that was once used for accessing the payload bay of the shuttle. SpaceX also is using the modernized site to launch commercial payloads, as well as cargo resupply missions to and from the International Space Station for NASA. The first SpaceX launch from the historic Apollo and space shuttle site was this past February. NASA’s Commercial Crew Program is working with private companies, Boeing and SpaceX, with a goal of once again flying people to and from the International Space Station, launching from the United States.

Dental Therapists as New Oral Health Practitioners: Increasing Access for Underserved Populations.

PubMed

Brickle, Colleen M; Self, Karl D

2017-09-01

The development of dental therapy in the U.S. grew from a desire to find a workforce solution for increasing access to oral health care. Worldwide, the research that supports the value of dental therapy is considerable. Introduction of educational programs in the U.S. drew on the experiences of programs in New Zealand, Australia, Canada, and the United Kingdom, with Alaska tribal communities introducing dental health aide therapists in 2003 and Minnesota authorizing dental therapy in 2009. Currently, two additional states have authorized dental therapy, and two additional tribal communities are pursuing the use of dental therapists. In all cases, the care provided by dental therapists is focused on communities and populations who experience oral health care disparities and have historically had difficulties in accessing care. This article examines the development and implementation of the dental therapy profession in the U.S. An in-depth look at dental therapy programs in Minnesota and the practice of dental therapy in Minnesota provides insight into the early implementation of this emerging profession. Initial results indicate that the addition of dental therapists to the oral health care team is increasing access to quality oral health care for underserved populations. As evidence of dental therapy's success continues to grow, mid-level dental workforce legislation is likely to be introduced by oral health advocates in other states. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

“It’s Like a Phantom Disease”: Patient Perspectives on Access to Treatment for Chagas Disease in the United States

PubMed Central

Forsyth, Colin J.; Hernandez, Salvador; Flores, Carmen A.; Roman, Mario F.; Nieto, J. Maribel; Marquez, Grecia; Sequeira, Juan; Sequeira, Harry; Meymandi, Sheba K.

2018-01-01

Abstract. Chagas disease (CD) affects > 6 million people globally, including > 300,000 in the United States. Although early detection and etiological treatment prevents chronic complications from CD, < 1% of U.S. cases have been diagnosed and treated. This study explores access to etiological treatment from the perspective of patients with CD. In semi-structured interviews with 50 Latin American–born patients of the Center of Excellence for Chagas Disease at the Olive View–UCLA Medical Center, we collected demographic information and asked patients about their experiences managing the disease and accessing treatment. Patients were highly marginalized, with 63.4% living below the U.S. poverty line, 60% lacking a high school education, and only 12% with private insurance coverage. The main barriers to accessing health care for CD were lack of providers, precarious insurance coverage, low provider awareness, transportation difficulties, and limited time off. Increasing access to diagnosis and treatment will not only require a dramatic increase in provider and public education, but also development of programs which are financially, linguistically, politically, and geographically accessible to patients. PMID:29380723

Cyber Fundamental Exercises

DTIC Science & Technology

2013-03-01

the /bin, /sbin, /etc, /var/log, /home, /proc, /root, /dev, /tmp, and /lib directories • Describe the purpose of the /etc/shadow and /etc/ passwd ...UNLIMITED 19 2.6.2 /etc/ passwd and /etc/shadow The /etc/shadow file didn’t exist on early Linux distributions. Originally only root could access the...etc/ passwd file, which stored user names, user configuration information, and passwords. However, when common programs such as ls running under

NIST Mechanisms for Disseminating Measurements

PubMed Central

Gills, T. E.; Dittman, S.; Rumble, J. R.; Brickenkamp, C. S.; Harris, G. L.; Trahey, N. M.

2001-01-01

The national responsibilities assigned to the National Bureau of Standards (NBS) early in the last century for providing measurement assistance and service are carried out today by the four programs that comprise the National Institute of Standards and Technology (NIST) Office of Measurement Services (OMS). They are the Calibration Program (CP), the Standard Reference Materials Program (SRMP), the Standard Reference Data Program (SRDP), and the Weights and Measures Program (W&MP). Organized when the U.S. Congress changed the NBS name to NIST, the OMS facilitates access to the measurement and standards activities of NIST laboratories and programs through the dissemination of NIST products, data, and services. A brief historical introduction followed by a perspective of pivotal measurement developments from 1901 to the present and concluding with a look to the future of NIST measurement services in the next decade of the new millennium are presented for each OMS program. PMID:27500025

Working with and promoting early career scientists within a larger community

NASA Astrophysics Data System (ADS)

Pratt, K.

2017-12-01

For many scientific communities, engaging early career researchers is critical for success. These young scientists (graduate students, postdocs, and newly appointed professors) are actively forming collaborations and instigating new research programs. They also stand to benefit hugely from being part of a scientific community, gaining access to career development activities, becoming part of strong collaborator networks, and achieving recognition in their field of study — all of which will help their professional development. There are many ways community leaders can work proactively to support and engage early career scientists, and it it is often a community manager's job to work with leadership to implement such activities. In this presentation, I will outline ways of engaging early career scientists at events and tailored workshops, of promoting development of their leadership skills, and of creating opportunities for recognizing early career scientists within larger scientific communities. In this talk, I will draw from my experience working with the Deep Carbon Observatory Early Career Scientist Network, supported by the Alfred P. Sloan Foundation.

[Advances in early childhood development: from neurons to big scale programs].

PubMed

Pérez-Escamilla, Rafael; Rizzoli-Córdoba, Antonio; Alonso-Cuevas, Aranzazú; Reyes-Morales, Hortensia

Early childhood development (ECD) is the basis of countries' economic and social development and their ability to meet the Sustainable Development Goals (SDGs). Gestation and the first three years of life are critical for children to have adequate physical, psychosocial, emotional and cognitive development for the rest of their lives. Nurturing care and protection of children during gestation and early childhood are necessary for the development of trillions of neurons and trillions of synapses necessary for development. ECD requires access to good nutrition and health services from gestation, responsive caregiving according to the child's developmental stage, social protection and child welfare, and early stimulation and learning opportunities. Six actions are recommended to improve national ECD programs: expand political will and funding; create a supportive, evidence-based policy environment; build capacity through inter-sectoral coordination; ensure fair and transparent governance of programs and services; increase support for multidisciplinary research; and promote the development of leaders. Mexico has made significant progress under the leadership of the Health Ministry, but still faces significant challenges. The recent creation of a national inter-sectoral framework to enable ECD with support of international organizations and the participation of civil society organizations can help overcome these challenges. Copyright © 2017 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

Understanding the unique experiences, perspectives and sexual and reproductive health needs of very young adolescents: Somali refugees in Ethiopia.

PubMed

Ortiz-Echevarria, Luis; Greeley, Meghan; Bawoke, Tenaw; Zimmerman, Linnea; Robinson, Courtland; Schlecht, Jennifer

2017-01-01

Kobe Refugee camp hosts roughly 39,000 refugees displaced from Somalia during the 2011-2012 Horn of Africa Crisis. Sexual and reproductive health, as with the greater issues of health and well-being for adolescents displaced from this crisis remain largely unknown and neglected. In 2013, the Women's Refugee Commission, Johns Hopkins University, and International Medical Corps in Ethiopia, implemented qualitative and quantitative research to explore the factors and risks that impact the health of very young adolescents (VYAs), those 10-14 years of age, in this setting. This paper presents findings from the qualitative effort. Focus group discussions (FGD), incorporating community mapping and photo elicitation activities, were conducted with 10-12 and 13-14 year-olds to obtain information about their own perspectives, experiences and values. FGDs were also implemented with 15-16 year-olds and adults, to consider their perspectives on the sexual and reproductive health needs and risks of VYAs. This research identified several factors that were found to influence the health and well-being of VYAs in Kobe refugee camp, including newfound access to education and security, combined with gender divisions and parental communication around early SRH and puberty that remained intact from traditional Somali culture. Girls were found to face an additional risk of child marriage and early pregnancy exacerbated since displacement, which significantly limited their ability to access education and achieve future aspirations. Findings from this study could help to inform future programs in Kobe and similar contexts involving long-term displacement from conflict, focusing on the health and development needs of VYAs. Future programs should consider the determinants of positive VYA health and development, including access to education, gender equity, and safety.By better understanding the unique experiences, perspectives and needs of VYAs, practitioners, policy makers and donors can invest in the individual and community assets that reinforce positive behaviors established in early adolescence, in order to achieve long-term SRH impacts.

Integrating care for frequent users of emergency departments: implementation evaluation of a brief multi-organizational intensive case management intervention.

PubMed

Kahan, Deborah; Leszcz, Molyn; O'Campo, Patricia; Hwang, Stephen W; Wasylenki, Donald A; Kurdyak, Paul; Wise Harris, Deborah; Gozdzik, Agnes; Stergiopoulos, Vicky

2016-04-27

Addressing the needs of frequent users of emergency departments (EDs) is a health system priority in many jurisdictions. This study describes stakeholder perspectives on the implementation of a multi-organizational brief intervention designed to support integration and continuity of care for frequent ED users with mental health and addictions problems, focusing on perceived barriers and facilitators to early implementation in a large urban centre. Coordinating Access to Care from Hospital Emergency Departments (CATCH-ED) is a brief case management intervention bridging hospital, primary and community care for frequent ED users experiencing mental illness and addictions. To examine barriers and facilitators to early implementation of this multi-organizational intervention, between July and October 2012, 47 stakeholders, including direct service providers, managers and administrators participated in 32 semi-structured qualitative interviews and one focus group exploring their experience with the intervention and factors that helped or hindered successful early implementation. Qualitative data were analyzed using thematic analysis. Stakeholders valued the intervention and its potential to support continuity of care for this population. Service delivery system factors, including organizational capacity and a history of collaborative relationships across the healthcare continuum, and support system factors, such as training and supervision, emerged as key facilitators of program implementation. Operational challenges included early low program referral rates, management of a multi-organizational initiative, variable adherence to the model among participating organizations, and scant access to specialty psychiatric resources. Factors contributing to these challenges included lack of dedicated staff in the ED and limited local system capacity to support this population, and insufficient training and technical assistance available to participating organizations. A multi-organizational brief intervention is an acceptable model to support integration of hospital, primary and community care for frequent ED users. The study highlights the importance of early implementation evaluation to identify potential solutions to implementation barriers that may be applicable to many jurisdictions.

Mbd3/NuRD controls lymphoid cell fate and inhibits tumorigenesis by repressing a B cell transcriptional program

PubMed Central

Hamey, Fiona K.; Errami, Youssef

2017-01-01

Differentiation of lineage-committed cells from multipotent progenitors requires the establishment of accessible chromatin at lineage-specific transcriptional enhancers and promoters, which is mediated by pioneer transcription factors that recruit activating chromatin remodeling complexes. Here we show that the Mbd3/nucleosome remodeling and deacetylation (NuRD) chromatin remodeling complex opposes this transcriptional pioneering during B cell programming of multipotent lymphoid progenitors by restricting chromatin accessibility at B cell enhancers and promoters. Mbd3/NuRD-deficient lymphoid progenitors therefore prematurely activate a B cell transcriptional program and are biased toward overproduction of pro–B cells at the expense of T cell progenitors. The striking reduction in early thymic T cell progenitors results in compensatory hyperproliferation of immature thymocytes and development of T cell lymphoma. Our results reveal that Mbd3/NuRD can regulate multilineage differentiation by constraining the activation of dormant lineage-specific enhancers and promoters. In this way, Mbd3/NuRD protects the multipotency of lymphoid progenitors, preventing B cell–programming transcription factors from prematurely enacting lineage commitment. Mbd3/NuRD therefore controls the fate of lymphoid progenitors, ensuring appropriate production of lineage-committed progeny and suppressing tumor formation. PMID:28899870

Life After the Ban: An Assessment of US Syringe Exchange Programs’ Attitudes About and Early Experiences With Federal Funding

PubMed Central

Martin, Erika G.; Bowman, Sarah E.; Mann, Marita R.; Beletsky, Leo

2012-01-01

Objectives. We aimed to determine whether syringe exchange programs (SEPs) currently receive or anticipate pursuing federal funding and barriers to funding applications following the recent removal of the long-standing ban on using federal funds for SEPs. Methods. We conducted a telephone-administered cross-sectional survey of US SEPs. Descriptive statistics summarized responses; bivariate analyses examined differences in pursuing funding and experiencing barriers by program characteristics. Results. Of the 187 SEPs (92.1%) that responded, 90.9% were legally authorized. Three received federal funds and 116 intended to pursue federal funding. Perceived federal funding barriers were common and included availability and accessibility of funds, legal requirements such as written police support, resource capacity to apply and comply with funding regulations, local political and structural organization, and concern around altering program culture. Programs without legal authorization, health department affiliation, large distribution, or comprehensive planning reported more federal funding barriers. Conclusions. Policy implementation gaps appear to render federal support primarily symbolic. In practice, funding opportunities may not be available to all SEPs. Increased technical assistance and legal reform could improve access to federal funds, especially for SEPs with smaller capacity and tenuous local support. PMID:22420810

Computer assisted screening, correction, and analysis of historical weather measurements

NASA Astrophysics Data System (ADS)

Burnette, Dorian J.; Stahle, David W.

2013-04-01

A computer program, Historical Observation Tools (HOB Tools), has been developed to facilitate many of the calculations used by historical climatologists to develop instrumental and documentary temperature and precipitation datasets and makes them readily accessible to other researchers. The primitive methodology used by the early weather observers makes the application of standard techniques difficult. HOB Tools provides a step-by-step framework to visually and statistically assess, adjust, and reconstruct historical temperature and precipitation datasets. These routines include the ability to check for undocumented discontinuities, adjust temperature data for poor thermometer exposures and diurnal averaging, and assess and adjust daily precipitation data for undercount. This paper provides an overview of the Visual Basic.NET program and a demonstration of how it can assist in the development of extended temperature and precipitation datasets using modern and early instrumental measurements from the United States.

Community Targets for JWST's Early Release Science Program: Evaluation of Transiting Exoplanet WASP-63b.

NASA Astrophysics Data System (ADS)

Kilpatrick, Brian; Cubillos, Patricio; Bruno, Giovanni; Lewis, Nikole K.; Stevenson, Kevin B.; Wakeford, Hannah; Blecic, Jasmina; Burrows, Adam Seth; Deming, Drake; Heng, Kevin; Line, Michael R.; Madhusudhan, Nikku; Morley, Caroline; Waldmann, Ingo P.; Transiting Exoplanet Early Release Science Community

2017-06-01

We present observations of the Hubble Space Telescope (HST) ``A Preparatory Program to Identify the Single Best Transiting Exoplanet for JWST Early Release Science" for WASP-63b, one of the community targets proposed for the James Webb Space Telescope (JWST) Early Release Science (ERS) program. A large collaboration of transiting exoplanet scientists identified a set of ``community targets" which meet a certain set of criteria for ecliptic latitude, period, host star brightness, well constrained orbital parameters, and strength of spectroscopic features. WASP-63b was one of the targets identified as a potential candidate for the ERS program. It is presented as an inflated planet with a large signal. It will be accessible to JWST approximately six months after the planned start of Cycle 1/ERS in April 2019 making it an ideal candidate should there be any delays in the JWST timetable. Here, we observe WASP-63b to evaluate its suitability as the best target to test the capabilities of JWST. Ideally, a clear atmosphere will be best suited for bench marking the instruments ability to detect spectroscopic features. We can use the strength of the water absorption feature at 1.4 μm as a way to determine the presence of obscuring clouds/hazes. The results of atmospheric retrieval are presented along with a discussion on the suitability of WASP-63b as the best target to be observed during the ERS Program.

Recent Coverage of Early Childhood Education Approaches in Open Access Early Childhood Journals

ERIC Educational Resources Information Center

Keskin, Burhanettin

2016-01-01

A content analysis of the coverage of the major approaches to early childhood education in the early childhood research journals, published between 2010 and 2014, that are early childhood research oriented and have free online access were investigated. Among 21 journals in early childhood education, two journals were selected for the content…

Indicators of Access to Early Childhood Services in the Mississippi Delta. Rural Early Childhood Report No. 5

ERIC Educational Resources Information Center

Shores, Elizabeth F.; Barbaro, Erin; Barbaro, Michael C.; Flenner, Michelle; Bell, Lynn

2007-01-01

The Early Childhood Atlas facilitates spatial analysis in early childhood services research for the promotion of greater quality and accessibility of early care and education. The Atlas team collects and geocodes federal, state and nongovernmental datasets about early childhood services, integrating selected data elements into its online mapmaking…

A flexible approach to training veterinarians in public health: an overview and early assessment of the DVM/MPH dual-degree program at the University of Minnesota.

PubMed

Minicucci, Larissa A; Hanson, Kate A; Olson, Debra K; Hueston, William D

2008-01-01

As a result of the growing need for public-health veterinarians, novel educational programs are essential to train future public-health professionals. The University of Minnesota School of Public Health, in collaboration with the College of Veterinary Medicine, initiated a dual DVM/MPH program in 2002. This program provides flexibility by combining distance learning and on-campus courses offered through a summer public-health institute. MPH requirements are completed through core courses, elective courses in a focus area, and an MPH project and field experience. Currently, more than 100 students representing 13 veterinary schools are enrolled in the program. The majority of initial program graduates have pursued public-practice careers upon completion of the program. Strengths of the Minnesota program design include accessibility and an environment to support multidisciplinary training. Continued assessment of program graduates will allow for evaluation and adjustment of the program in the coming years.

Accelerating Science with the NERSC Burst Buffer Early User Program

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

Bhimji, Wahid; Bard, Debbie; Romanus, Melissa

NVRAM-based Burst Buffers are an important part of the emerging HPC storage landscape. The National Energy Research Scientific Computing Center (NERSC) at Lawrence Berkeley National Laboratory recently installed one of the first Burst Buffer systems as part of its new Cori supercomputer, collaborating with Cray on the development of the DataWarp software. NERSC has a diverse user base comprised of over 6500 users in 700 different projects spanning a wide variety of scientific computing applications. The use-cases of the Burst Buffer at NERSC are therefore also considerable and diverse. We describe here performance measurements and lessons learned from the Burstmore » Buffer Early User Program at NERSC, which selected a number of research projects to gain early access to the Burst Buffer and exercise its capability to enable new scientific advancements. To the best of our knowledge this is the first time a Burst Buffer has been stressed at scale by diverse, real user workloads and therefore these lessons will be of considerable benefit to shaping the developing use of Burst Buffers at HPC centers.« less

Children’s Environmental Health in the Digital Era: Understanding Early Screen Exposure as a Preventable Risk Factor for Obesity and Sleep Disorders

PubMed Central

Wolf, Candice; Wolf, Seth; Weiss, Miriam; Nino, Gustavo

2018-01-01

The quantity, accessibility and focus on child-targeted programming has exponentially increased since it entered American households in the early 1900s. It may have started with the television (TV), but technology has evolved and now fits in our pockets; as of 2017, 95% of American families own a smartphone. Availability and child-tailored content has subsequently led to a decrease in the age at initial screen exposure. The negative effects that accompany the current culture of early screen exposure are extensive and need to be considered as technology continues to enter the home and inundate social interactions. Increased levels of early screen exposure have been associated with decreased cognitive abilities, decreased growth, addictive behavior, poor school performance, poor sleep patterns, and increased levels of obesity. Research on the adverse effects of early screen exposure is mounting, but further epidemiological studies are still needed to inform prevention and regulation policies. PMID:29473855

Children's Environmental Health in the Digital Era: Understanding Early Screen Exposure as a Preventable Risk Factor for Obesity and Sleep Disorders.

PubMed

Wolf, Candice; Wolf, Seth; Weiss, Miriam; Nino, Gustavo

2018-02-23

The quantity, accessibility and focus on child-targeted programming has exponentially increased since it entered American households in the early 1900s. It may have started with the television (TV), but technology has evolved and now fits in our pockets; as of 2017, 95% of American families own a smartphone. Availability and child-tailored content has subsequently led to a decrease in the age at initial screen exposure. The negative effects that accompany the current culture of early screen exposure are extensive and need to be considered as technology continues to enter the home and inundate social interactions. Increased levels of early screen exposure have been associated with decreased cognitive abilities, decreased growth, addictive behavior, poor school performance, poor sleep patterns, and increased levels of obesity. Research on the adverse effects of early screen exposure is mounting, but further epidemiological studies are still needed to inform prevention and regulation policies.

Cancer screening promotion among medically underserved Asian American women: integration of research and practice.

PubMed

Yu, Mei-yu; Seetoo, Amy D; Hong, Oi Saeng; Song, Lixin; Raizade, Rekha; Weller, Adelwisa L Agas

2002-01-01

Mammography and Pap smear tests are known to be effective early detection measures for breast and cervical cancers, respectively, but Asian Americans are reluctant to make visits for routine preventive care. Quantitative and qualitative research conducted by the Healthy Asian Americans Project (HAAP) between 1996 and 1999 indicated that Asian residents in southeastern Michigan, like the general Asian population in the US, underutilized early cancer screening programs due to cultural, psychosocial, linguistic, and economic barriers. This article reports how the HAAP's research findings guided the Michigan Breast and Cervical Cancer Control Program (BCCCP) promotion (conducted from 2000 to 2001 among medically underserved Asian women residing in southeastern Michigan), and how evaluation of the HAAP's BCCCP promotion will direct future research and health promotion programs. The article presents strategies used to improve access to cancer screening programs for diverse Asian sub-groups as well as outcomes of the 2-year HAAP's BCCCP promotion among the target population. Discussion regarding lessons and experiences gained from integration of research and practice has implications on design and implementation of the cancer screening promotion for the rapidly increasing Asian American population as well as other medically underserved minority populations in the US.

Resident-Assisted Montessori Programming (RAMP): training persons with dementia to serve as group activity leaders.

PubMed

Camp, Cameron J; Skrajner, Michael J

2004-06-01

The purpose of this study was to determine the effects of an activity implemented by means of Resident-Assisted Montessori Programming (RAMP). Four persons with early-stage dementia were trained to serve as leaders for a small-group activity played by nine persons with more advanced dementia. Assessments of leaders' ability to learn the procedures of leading a group, as well as their satisfaction with this role, were taken, as were measures of players' engagement and affect during standard activities programming and RAMP activities. Leaders demonstrated the potential to fill the role of group activity leader effectively, and they expressed a high level of satisfaction with this role. Players' levels of positive engagement and pleasure during the RAMP activity were higher than during standard group activities. This study suggests that to the extent that procedural learning is available to persons with early-stage dementia, especially when they are assisted with external cueing, these individuals can successfully fill the role of volunteers when working with persons with more advanced dementia. This can provide a meaningful social role for leaders and increase access to high quality activities programming for large numbers of persons with dementia. Copyright 2004 The Gerontological Society of America

Factors affecting orthopedic residency selection: a cross-sectional survey

PubMed Central

Strelzow, Jason; Petretta, Robert; Broekhuyse, Henry M.

2017-01-01

Background Annually, orthopedic residency programs rank and recruit the best possible candidates. Little evidence exists identifying factors that potential candidates use to select their career paths. Recent literature from nonsurgical programs suggests hospital, social and program-based factors influence program selection. We sought to determine what factors influence the choice of an orthopedic career and a candidate’s choice of orthopedic residency program. Methods We surveyed medical student applicants to orthopedic programs and current Canadian orthopedic surgery residents (postgraduate year [PGY] 1–5). The confidential online survey focused on 3 broad categories of program selection: educational, program cohesion and noneducation factors. Questions were graded on a Likert Scale and tailed for mean scores. Results In total, 139 residents from 11 of 17 Canadian orthopedic programs (49% response rate) and 23 medical student applicants (88% response rate) completed our survey. Orthopedic electives and mandatory rotations were reported by 71% of participants as somewhat or very important to their career choice. Collegiality among residents (4.70 ± 0.6), program being the “right fit” (4.65 ± 0.53) and current resident satisfaction with their chosen program (4.63 ±0.66) were ranked with the highest mean scores on a 5-point Likert scale. Conclusion There are several modifiable factors that residency programs may use to attract applicants, including early availability of clerkship rotations and a strong mentorship environment emphasizing both resident–resident and resident–staff cohesion. Desirable residency programs should develop early access to surgical and operative skills. These must be balanced with a continued emphasis on top-level orthopedic training. PMID:28327273

Factors affecting orthopedic residency selection: a cross-sectional survey.

PubMed

Strelzow, Jason; Petretta, Robert; Broekhuyse, Henry M

2017-06-01

Annually, orthopedic residency programs rank and recruit the best possible candidates. Little evidence exists identifying factors that potential candidates use to select their career paths. Recent literature from nonsurgical programs suggests hospital, social and program-based factors influence program selection. We sought to determine what factors influence the choice of an orthopedic career and a candidate's choice of orthopedic residency program. We surveyed medical student applicants to orthopedic programs and current Canadian orthopedic surgery residents (postgraduate year [PGY] 1-5). The confidential online survey focused on 3 broad categories of program selection: educational, program cohesion and noneducation factors. Questions were graded on a Likert Scale and tailed for mean scores. In total, 139 residents from 11 of 17 Canadian orthopedic programs (49% response rate) and 23 medical student applicants (88% response rate) completed our survey. Orthopedic electives and mandatory rotations were reported by 71% of participants as somewhat or very important to their career choice. Collegiality among residents (4.70 ± 0.6), program being the "right fit" (4.65 ± 0.53) and current resident satisfaction with their chosen program (4.63 ±0.66) were ranked with the highest mean scores on a 5-point Likert scale. There are several modifiable factors that residency programs may use to attract applicants, including early availability of clerkship rotations and a strong mentorship environment emphasizing both resident-resident and resident-staff cohesion. Desirable residency programs should develop early access to surgical and operative skills. These must be balanced with a continued emphasis on top-level orthopedic training.

Empower: access to medicine - working towards early access.

PubMed

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

2015-01-01

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

Application of modern tools and techniques to maximize engineering productivity in the development of orbital operations plans for the space station progrm

NASA Technical Reports Server (NTRS)

Manford, J. S.; Bennett, G. R.

1985-01-01

The Space Station Program will incorporate analysis of operations constraints and considerations in the early design phases to avoid the need for later modifications to the Space Station for operations. The application of modern tools and administrative techniques to minimize the cost of performing effective orbital operations planning and design analysis in the preliminary design phase of the Space Station Program is discussed. Tools and techniques discussed include: approach for rigorous analysis of operations functions, use of the resources of a large computer network, and providing for efficient research and access to information.

Evaluation of the novel respiratory virus surveillance program: Pediatric Early Warning Sentinel Surveillance (PEWSS).

PubMed

Armour, Patricia A; Nguyen, Linh M; Lutman, Michelle L; Middaugh, John P

2013-01-01

Infections caused by respiratory viruses are associated with recurrent epidemics and widespread morbidity and mortality. Routine surveillance of these pathogens is necessary to determine virus activity, monitor for changes in circulating strains, and plan for public health preparedness. The Southern Nevada Health District in Las Vegas, Nevada, recruited five pediatric medical practices to serve as sentinel sites for the Pediatric Early Warning Sentinel Surveillance (PEWSS) program. Sentinel staff collected specimens throughout the year from ill children who met the influenza-like illness case definition and submitted specimens to the Southern Nevada Public Health Laboratory for molecular testing for influenza and six non-influenza viruses. Laboratory results were analyzed and reported to the medical and general communities in weekly bulletins year-round. PEWSS data were also used to establish viral respiratory seasonal baselines and in influenza vaccination campaigns. The surveillance program was evaluated using the Centers for Disease Control and Prevention's (CDC's) Updated Guidelines for Evaluating Public Health Surveillance Systems. PEWSS met three of six program usefulness criteria and seven of nine surveillance system attributes, which exceeded the CDC Guidelines evaluation criteria for a useful and complete public health surveillance program. We found that PEWSS is a useful and complete public health surveillance system that is simple, flexible, accessible, and stable.

Using Benefit-Cost Analysis to Scale Up Early Childhood Programs through Pay-for-Success Financing

PubMed Central

Temple, Judy A.; Reynolds, Arthur J.

2016-01-01

Increasing access to high-quality preschool programs is a high priority at local, state, and federal levels. Recently, two initiatives to expand preschool programming in Illinois and Utah have used funds from private investors to scale up existing programs. Private-sector social impact investors provide funding to nonprofit or public preschool providers to increase the number of children served. If the measured outcomes from preschool participation meet pre-determined goals, then the estimated government cost savings arising from these preschool interventions are used to repay the investors. Social impact investing with a “Pay for Success” contract can help budget-constrained governments expand proven or promising preventive interventions without the need to increase taxes. Cost-benefit analysis plays a crucial role in helping to identify which social, educational or health interventions are suitable for this type of innovative financing. Cost-benefit analysts are needed to design the structure of the success payments that the government will make to the private investors. This paper describes social impact borrowing as a new method for financing public services, outlines the contribution of cost-benefit analysis, and discusses the innovative use of social impact financing to promote scaling up of the evidence-based Child Parent Centers and other early childhood programs. PMID:27882288

The psychosocial effects of the Li-Fraumeni Education and Early Detection (LEAD) program on individuals with Li-Fraumeni syndrome.

PubMed

Ross, Jessica; Bojadzieva, Jasmina; Peterson, Susan; Noblin, Sarah Jane; Yzquierdo, Rebecca; Askins, Martha; Strong, Louise

2017-09-01

In the past 5 years, new screening protocols have been developed that provide improved cancer screening options for individuals with Li-Fraumeni syndrome (LFS). Very little has been published on the psychosocial impact of these screening protocols. The goals of this study were to determine how participation in screening impacts individuals psychosocially, to examine the benefits and drawbacks of screening, and to evaluate possible barriers to continued screening. We performed a qualitative study consisting of semistructured phone interviews conducted from December 2015 to February 2016 with 20 individuals attending the LFS screening program at MD Anderson Cancer Center. Data analysis showed that benefits of screening include early detection, peace of mind, centralized screening, knowledge providing power, and screening making LFS seem more livable. Perceived drawbacks included logistical issues, difficulty navigating the system, screening being draining, and significant negative emotional reactions such as anxiety, fear, and skepticism. Regardless of the emotions that were present, 100% of participants planned on continuing screening in the program. Our data indicate that the perceived benefits of screening outweigh the drawbacks of screening. Individuals in this screening program appeared to have improved psychosocial well-being because of their access to the screening program.Genet Med advance online publication 16 March 2017.

Evaluation of the Novel Respiratory Virus Surveillance Program: Pediatric Early Warning Sentinel Surveillance (PEWSS)

PubMed Central

Nguyen, Linh M.; Lutman, Michelle L.; Middaugh, John P.

2013-01-01

Objectives Infections caused by respiratory viruses are associated with recurrent epidemics and widespread morbidity and mortality. Routine surveillance of these pathogens is necessary to determine virus activity, monitor for changes in circulating strains, and plan for public health preparedness. The Southern Nevada Health District in Las Vegas, Nevada, recruited five pediatric medical practices to serve as sentinel sites for the Pediatric Early Warning Sentinel Surveillance (PEWSS) program. Methods Sentinel staff collected specimens throughout the year from ill children who met the influenza-like illness case definition and submitted specimens to the Southern Nevada Public Health Laboratory for molecular testing for influenza and six non-influenza viruses. Results Laboratory results were analyzed and reported to the medical and general communities in weekly bulletins year-round. PEWSS data were also used to establish viral respiratory seasonal baselines and in influenza vaccination campaigns. The surveillance program was evaluated using the Centers for Disease Control and Prevention's (CDC's) Updated Guidelines for Evaluating Public Health Surveillance Systems. PEWSS met three of six program usefulness criteria and seven of nine surveillance system attributes, which exceeded the CDC Guidelines evaluation criteria for a useful and complete public health surveillance program. Conclusion We found that PEWSS is a useful and complete public health surveillance system that is simple, flexible, accessible, and stable. PMID:23997308

Lunar Orbit Insertion Targeting and Associated Outbound Mission Design for Lunar Sortie Missions

NASA Technical Reports Server (NTRS)

Condon, Gerald L.

2007-01-01

This report details the Lunar Orbit Insertion (LOI) arrival targeting and associated mission design philosophy for Lunar sortie missions with up to a 7-day surface stay and with global Lunar landing site access. It also documents the assumptions, methodology, and requirements validated by TDS-04-013, Integrated Transit Nominal and Abort Characterization and Sensitivity Study. This report examines the generation of the Lunar arrival parking orbit inclination and Longitude of the Ascending Node (LAN) targets supporting surface missions with global Lunar landing site access. These targets support the Constellation Program requirement for anytime abort (early return) by providing for a minimized worst-case wedge angle [and an associated minimum plane change delta-velocity (V) cost] between the Crew Exploration Vehicle (CEV) and the Lunar Surface Access Module (LSAM) for an LSAM launch anytime during the Lunar surface stay.

Reperfusion therapy of myocardial infarction in Mexico: A challenge for modern cardiology.

PubMed

Martínez-Sánchez, Carlos; Arias-Mendoza, Alexandra; González-Pacheco, Héctor; Araiza-Garaygordobil, Diego; Marroquín-Donday, Luis Alfonso; Padilla-Ibarra, Jorge; Sierra-Fernández, Carlos; Altamirano-Castillo, Alfredo; Álvarez-Sangabriel, Amada; Azar-Manzur, Francisco Javier; Briseño-de la Cruz, José Luis; Mendoza-García, Salvador; Piña-Reyna, Yigal; Martínez-Ríos, Marco Antonio

Mexico has been positioned as the country with the highest mortality attributed to myocardial infarction among the members of the Organization for Economic Cooperation and Development. This rate responds to multiple factors, including a low rate of reperfusion therapy and the absence of a coordinated system of care. Primary angioplasty is the reperfusion method recommended by the guidelines, but requires multiple conditions that are not reached at all times. Early pharmacological reperfusion of the culprit coronary artery and early coronary angiography (pharmacoinvasive strategy) can be the solution to the logistical problem that primary angioplasty rises. Several studies have demonstrated pharmacoinvasive strategy as effective and safe as primary angioplasty ST-elevation myocardial infarction, which is postulated as the choice to follow in communities where access to PPCI is limited. The Mexico City Government together with the National Institute of Cardiology have developed a pharmaco-invasive reperfusion treatment program to ensure effective and timely reperfusion in STEMI. The model comprises a network of care at all three levels of health, including a system for early pharmacological reperfusion in primary care centers, a digital telemedicine system, an inter-hospital transport network to ensure primary angioplasty or early percutaneous coronary intervention after fibrinolysis and a training program with certification of the health care personal. This program intends to reduce morbidity and mortality associated with myocardial infarction. Copyright © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

Which Way is Up? Lessons Learned from Space Shuttle Sensorimotor Research

NASA Technical Reports Server (NTRS)

Wood, S. J.; Reschke, M. F.; Harm, D. L.; Paloski, W. H.; Bloomberg, J. J.

2011-01-01

The Space Shuttle Program provided the opportunity to examine sensorimotor adaptation to space flight in unprecedented numbers of astronauts, including many over multiple missions. Space motion sickness (SMS) severity was highly variable across crewmembers. SMS generally lasted 2-3 days in-flight with approximately 1/3 of crewmembers experiencing moderate to severe symptoms, and decreased incidence in repeat flyers. While SMS has proven difficult to predict from susceptibility to terrestrial analogs, symptoms were alleviated by medications, restriction of early activities, maintaining familiar orientation with respect to the visual environment and maintaining contact cues. Adaptive changes were also reflected by the oculomotor and perceptual disturbances experienced early inflight and by the perceptual and motor coordination problems experienced during re-entry and landing. According to crew self-reports, systematic head movements performed during reentry, as long as paced within one's threshold for motion tolerance, facilitated the early readaptation process. The Shuttle provided early postflight crew access to document the initial performance decrements and time course of recovery. These early postflight measurements were critical to inform the program of risks associated with extending the duration of Shuttle missions. Neurological postflight deficits were documented using a standardized subjective rating by flight surgeons. Computerized dynamic posturography was also implemented as a quantitative means of assessing sensorimotor function to support crew return-to-duty assessments. Towards the end of the Shuttle Program, more emphasis has been placed on mapping physiological changes to functional performance. Future commercial flights will benefit from pre-mission training including exposures to launch and entry G transitions and sensorimotor adaptability assessments. While SMS medication usage will continue to be refined, non-pharmacological countermeasures (e.g., sensory aids) will have both space and Earth-based applications. Early postflight field tests are recommended to provide the evidence base for best practices for future commercial flight programs. Learning Objective: Overview of the Space Shuttle Program regarding adaptive changes in sensorimotor function, including what was learned from research, what was implemented for medical operations, and what is recommended for commercial flights.

77 FR 6113 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-07

... FEDERAL COMMUNICATIONS COMMISSION [DA 12-15] Video Programming and Accessibility Advisory.... SUMMARY: This document announces the next meeting of the Video Programming Accessibility Advisory... Commission regarding the provision of video description, access to emergency programming, and access to user...

Newborn screening 50 years later: access issues faced by adults with PKU

PubMed Central

Berry, Susan A.; Brown, Christine; Grant, Mitzie; Greene, Carol L.; Jurecki, Elaina; Koch, Jean; Moseley, Kathryn; Suter, Ruth; van Calcar, Sandra C.; Wiles, Judy; Cederbaum, Stephen

2013-01-01

Fifty years after the implementation of universal newborn screening programs for phenylketonuria, the first disease identified through newborn screening and considered a success story of newborn screening, a cohort of adults with phenylketonuria treated from birth provides valuable information about effects of long-term treatment for inborn errors of metabolism in general, and phenylketonuria specifically. For phenylketonuria, newborn screening allows early implementation of the phenylalanine-restricted diet, eliminating the severe neurocognitive and neuromotor impairment associated with untreated phenylketonuria. However, executive function impairments and psychiatric problems are frequently reported even for those treated early and continuously with the phenylalanine-restricted diet alone. Moreover, a large percentage of adults with phenylketonuria are reported as lost to follow-up by metabolic clinics. While a group of experts identified by the National Institutes of Health convenes to update treatment guidelines for phenylketonuria, we explore individual patient, social, and economic factors preventing >70% of adult phenylketonuria patients in the United States from accessing treatment. As more conditions are identified through newborn screening, factors affecting access to treatment grow in importance, and we must continue to be vigilant in assessing and addressing factors that affect patient treatment outcomes and not just celebrate amelioration of the most severe manifestations of disease. Genet Med 2013:15(8):591–599 PMID:23470838

Newborn screening 50 years later: access issues faced by adults with PKU.

PubMed

Berry, Susan A; Brown, Christine; Grant, Mitzie; Greene, Carol L; Jurecki, Elaina; Koch, Jean; Moseley, Kathryn; Suter, Ruth; van Calcar, Sandra C; Wiles, Judy; Cederbaum, Stephen

2013-08-01

Fifty years after the implementation of universal newborn screening programs for phenylketonuria, the first disease identified through newborn screening and considered a success story of newborn screening, a cohort of adults with phenylketonuria treated from birth provides valuable information about effects of long-term treatment for inborn errors of metabolism in general, and phenylketonuria specifically. For phenylketonuria, newborn screening allows early implementation of the phenylalanine-restricted diet, eliminating the severe neurocognitive and neuromotor impairment associated with untreated phenylketonuria. However, executive function impairments and psychiatric problems are frequently reported even for those treated early and continuously with the phenylalanine-restricted diet alone. Moreover, a large percentage of adults with phenylketonuria are reported as lost to follow-up by metabolic clinics. While a group of experts identified by the National Institutes of Health convenes to update treatment guidelines for phenylketonuria, we explore individual patient, social, and economic factors preventing >70% of adult phenylketonuria patients in the United States from accessing treatment. As more conditions are identified through newborn screening, factors affecting access to treatment grow in importance, and we must continue to be vigilant in assessing and addressing factors that affect patient treatment outcomes and not just celebrate amelioration of the most severe manifestations of disease.

Disambiguating Form and Lexical Frequency Effects in MEG Responses Using Homonyms

ERIC Educational Resources Information Center

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

2012-01-01

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

Evaluation of an online training program in eating disorders for health professionals in Australia.

PubMed

Brownlow, Rachel S; Maguire, Sarah; O'Dell, Adrienne; Dias-da-Costa, Catia; Touyz, Stephen; Russell, Janice

2015-01-01

Early detection and treatment of eating disorders is instrumental in positive health outcomes for this serious public health concern. As such, workforce development in screening, diagnosis and early treatment of eating disorders is needed. Research has demonstrated both high rates of failure to accurately diagnose and treat cases early and low levels of perceived access to training in eating disorders by health professionals-representing an urgent need for clinician training in this area. However, significant barriers to the access of evidence-based training programs exist, including availability, cost and time, particularly when large geographic distances are involved. Online learning presents a solution to workforce challenges, as it can be delivered anywhere, at a fraction of the cost of traditional training, timing is user controlled, and a growing body of research is demonstrating it as effective as face-to-face training. The Centre for Eating and Dieting Disorders in Australia has developed an Online Training Program In Eating Disorders, to educate health professionals in the nature, identification, assessment and management of eating disorders. The aim of the current study was to evaluate the ability of this online learning course to improve clinician levels of knowledge, skill and confidence to treat eating disorders. As well as its effect on stigmatised beliefs about eating disorders known to effect treatment delivery. One-hundred-eighty-seven health professionals participated in the program. A pre training questionnaire and a post training evaluation examined participants' levels of knowledge, skill and confidence to treat eating disorders, as well attitudes and beliefs about people with eating disorders. Significant improvements in knowledge, skill, and confidence to treat eating disorders was found between pre and post program assessment in health professionals who completed the course, along with a significant decrease in stigmatised beliefs about eating disorders. The results of this study demonstrated that the online training program was an effective tool in increasing health professionals' level of knowledge, skill and confidence to treat people with eating disorders. The results also demonstrated that online training reduced health professionals' personal bias towards people with eating disorders. Limitations of this study include the use of self-report measures rather than observation of the health professional in clinical practice. As a result, it is not possible to make determinations regarding the translation of these results to clinical settings. The findings of this study suggest that online training programs may present an innovative solution to the considerable workforce development challenges faced by clinicians needing training in eating disorders.

Equal Access to Early Childhood Education in South Korea Using the Geographic Information System

ERIC Educational Resources Information Center

Lee, Jin; Jang, Youn Joo

2017-01-01

While the importance of early childhood education is well documented, scant attention is afforded to the access to institutions for early childhood education. Uneven distribution of institutions for early childhood education in segregated metropolitan areas can cause inequality of educational opportunity. By using the Geographic Information System…

Hormone-dependent control of developmental timing through regulation of chromatin accessibility

PubMed Central

Uyehara, Christopher M.; Nystrom, Spencer L.; Niederhuber, Matthew J.; Leatham-Jensen, Mary; Ma, Yiqin; Buttitta, Laura A.

2017-01-01

Specification of tissue identity during development requires precise coordination of gene expression in both space and time. Spatially, master regulatory transcription factors are required to control tissue-specific gene expression programs. However, the mechanisms controlling how tissue-specific gene expression changes over time are less well understood. Here, we show that hormone-induced transcription factors control temporal gene expression by regulating the accessibility of DNA regulatory elements. Using the Drosophila wing, we demonstrate that temporal changes in gene expression are accompanied by genome-wide changes in chromatin accessibility at temporal-specific enhancers. We also uncover a temporal cascade of transcription factors following a pulse of the steroid hormone ecdysone such that different times in wing development can be defined by distinct combinations of hormone-induced transcription factors. Finally, we show that the ecdysone-induced transcription factor E93 controls temporal identity by directly regulating chromatin accessibility across the genome. Notably, we found that E93 controls enhancer activity through three different modalities, including promoting accessibility of late-acting enhancers and decreasing accessibility of early-acting enhancers. Together, this work supports a model in which an extrinsic signal triggers an intrinsic transcription factor cascade that drives development forward in time through regulation of chromatin accessibility. PMID:28536147

NASA Lunar Sample Education Disk Program - Space Rocks for Classrooms, Museums, Science Centers and Libraries

NASA Astrophysics Data System (ADS)

Allen, J. S.

2009-12-01

NASA is eager for students and the public to experience lunar Apollo rocks and regolith soils first hand. Lunar samples embedded in plastic are available for educators to use in their classrooms, museums, science centers, and public libraries for education activities and display. The sample education disks are valuable tools for engaging students in the exploration of the Solar System. Scientific research conducted on the Apollo rocks has revealed the early history of our Earth-Moon system. The rocks help educators make the connections to this ancient history of our planet as well as connections to the basic lunar surface processes - impact and volcanism. With these samples educators in museums, science centers, libraries, and classrooms can help students and the public understand the key questions pursued by missions to Moon. The Office of the Curator at Johnson Space Center is in the process of reorganizing and renewing the Lunar and Meteorite Sample Education Disk Program to increase reach, security and accountability. The new program expands the reach of these exciting extraterrestrial rocks through increased access to training and educator borrowing. One of the expanded opportunities is that trained certified educators from science centers, museums, and libraries may now borrow the extraterrestrial rock samples. Previously the loan program was only open to classroom educators so the expansion will increase the public access to the samples and allow educators to make the critical connections of the rocks to the exciting exploration missions taking place in our solar system. Each Lunar Disk contains three lunar rocks and three regolith soils embedded in Lucite. The anorthosite sample is a part of the magma ocean formed on the surface of Moon in the early melting period, the basalt is part of the extensive lunar mare lava flows, and the breccias sample is an important example of the violent impact history of the Moon. The disks also include two regolith soils and orange glass from a pyroclastic deposit. The loan program also includes Meteorite Disks containing six meteorites that will help educators share the early history of the solar system with students and the public. Educators may borrow either lunar or meteorite disks through Johnson Space Center Curatorial Office. In trainings provided by the NASA Aerospace Education Services Program specialists, educators certified to borrow the disk learn about education resources, the proper use of the samples, and the special security for care and shipping of the disks. The Lunar and Meteorite Sample Education Disk Program is set up to bridge to new education programs that will carry NASA exploration to more people. Getting Space Rocks out to the public and connecting the public to the current space exploration missions is the focus the NASA disk loan program.

Astronomy4Kids: Extending STEM learning to the youngest student through an online educational outreach program

NASA Astrophysics Data System (ADS)

Pearson, Richard L.; Pearson, Sarah R.

2017-06-01

Astronomy4Kids is an online video series aimed at filling the void of effective and engaging education tools within early childhood learning. Much discussion and research has been conducted on the significance of early learning, with general trends showing significant benefits to early introductions to language, mathematics, and general science concepts. Ultimately, when ideas are introduced to a child at a young age, that child is better prepared for when the concept is re-introduced in its entirety later. National agencies—such as the AAS and NSF—have implemented Science, Technology, Engineering, and Math (STEM) initiatives to expand learning in these areas. However, despite these many resources, the education outreach available to the youngest learners (under the age of 8 or those from pre-school to about 2nd-grade) is seriously lacking. Astronomy4Kids was created to bridge this gap and provide succinct, creative-learning videos following the principles of Fred Rogers, the founder of preschool education video. We present ways to incorporate the freely accessible YouTube videos within various classroom ages and discuss how to use simple activities to promote physics, astronomy, and math learning. Current development, video statistics, and future work will be discussed. The freely accessible videos can be found at www.astronomy4kids.net.

OPENWIDE: an innovative oral health program for non-dental health and human services providers.

PubMed

Wolfe, Stanton H; Huebner, Colleen E

2004-05-01

Emerging awareness of the nature and severity of oral diseases and disorders and their serious impact on overall health and well-being, combined with a nationwide crisis in access to oral health care for populations with the most and worst disease, makes it imperative that non-dental health and childcare professionals engage more fully in oral health promotion and disease prevention. OPENWIDE is a comprehensive training program designed to help achieve this goal. The Connecticut Department of Public Health has trained more than 2,000 individuals during the first year of the OPENWIDE program. This article reports on successes and impediments to training and implementation encountered in the early stages of OPENWIDE and makes recommendations to improve the curriculum and its delivery to families and children.

Nga Kaitaunaki Kohungahunga (Early Childhood Development Unit). Annual Report for July 1, 1991-June 30, 1992.

ERIC Educational Resources Information Center

Early Childhood Development Unit, Wellington (New Zealand).

The Early Childhood Development Unit, a government agency located in Aotearoa, New Zealand, promotes and encourages the development and provision of quality, accessible, and culturally appropriate early childhood services. The Unit operates in six activity or output areas. First, to increase access to early childhood education, in 1991-92 the unit…

Lessons from Early Medicaid Expansions Under Health Reform: Interviews with Medicaid Officials

PubMed Central

Sommers, Benjamin D; Arntson, Emily; Kenney, Genevieve M; Epstein, Arnold M

2013-01-01

Background The Affordable Care Act (ACA) dramatically expands Medicaid in 2014 in participating states. Meanwhile, six states have already expanded Medicaid since 2010 to some or all of the low-income adults targeted under health reform. We undertook an in-depth exploration of these six “early-expander” states—California, Connecticut, the District of Columbia, Minnesota, New Jersey, and Washington—through interviews with high-ranking Medicaid officials. Methods We conducted semi-structured interviews with 11 high-ranking Medicaid officials in six states and analyzed the interviews using qualitative methods. Interviews explored enrollment outreach, stakeholder involvement, impact on beneficiaries, utilization and costs, implementation challenges, and potential lessons for 2014. Two investigators independently analyzed interview transcripts and iteratively refined the codebook until reaching consensus. Results We identified several themes. First, these expansions built upon pre-existing state-funded insurance programs for the poor. Second, predictions about costs and enrollment were challenging, indicating the uncertainty in projections for 2014. Other themes included greater than anticipated need for behavioral health services in the expansion population, administrative challenges of expansions, and persistent barriers to enrollment and access after expanding eligibility—though officials overall felt the expansions increased access for beneficiaries. Finally, political context—support or opposition from stakeholders and voters—plays a critical role in shaping the success of Medicaid expansions. Conclusions Early Medicaid expansions under the ACA offer important lessons to federal and state policymakers as the 2014 expansions approach. While the context of each state’s expansion is unique, key shared experiences were significant implementation challenges and opportunities for expanding access to needed services. PMID:24834369

Sorghum Landrace Collections from Cooler Regions of the World Exhibit Magnificent Genetic Differentiation and Early Season Cold Tolerance.

PubMed

Maulana, Frank; Weerasooriya, Dilooshi; Tesso, Tesfaye

2017-01-01

Cold temperature is an important abiotic stress affecting sorghum production in temperate regions. It reduces seed germination, seedling emergence and seedling vigor thus limiting the production of the crop both temporally and spatially. The objectives of this study were (1) to assess early season cold temperature stress response of sorghum germplasm from cooler environments and identify sources of tolerance for use in breeding programs, (2) to determine population structure and marker-trait association among these germplasms for eventual development of marker tools for improving cold tolerance. A total of 136 sorghum accessions from cooler regions of the world were phenotyped for seedling growth characteristics under cold temperature imposed through early planting. The accessions were genotyped using 67 simple sequence repeats markers spanning all ten linkage groups of sorghum, of which 50 highly polymorphic markers were used in the analysis. Genetic diversity and population structure analyses sorted the population into four subpopulations. Several accessions distributed in all subpopulations showed either better or comparable level of tolerance to the standard cold tolerance source, Shan qui red. Association analysis between the markers and seedling traits identified markers Xtxp 34, Xtxp 88, and Xtxp 319 as associated with seedling emergence, Xtxp 211 and Xtxp 304 with seedling dry weight, and Xtxp 20 with seedling height. The markers were detected on chromosomes previously found to harbor QTLs associated with cold tolerance in sorghum. Once validated these may serve as genomic tools in marker-assisted breeding or for screening larger pool of genotypes to identify additional sources of cold tolerance.

Sorghum Landrace Collections from Cooler Regions of the World Exhibit Magnificent Genetic Differentiation and Early Season Cold Tolerance

PubMed Central

Maulana, Frank; Weerasooriya, Dilooshi; Tesso, Tesfaye

2017-01-01

Cold temperature is an important abiotic stress affecting sorghum production in temperate regions. It reduces seed germination, seedling emergence and seedling vigor thus limiting the production of the crop both temporally and spatially. The objectives of this study were (1) to assess early season cold temperature stress response of sorghum germplasm from cooler environments and identify sources of tolerance for use in breeding programs, (2) to determine population structure and marker-trait association among these germplasms for eventual development of marker tools for improving cold tolerance. A total of 136 sorghum accessions from cooler regions of the world were phenotyped for seedling growth characteristics under cold temperature imposed through early planting. The accessions were genotyped using 67 simple sequence repeats markers spanning all ten linkage groups of sorghum, of which 50 highly polymorphic markers were used in the analysis. Genetic diversity and population structure analyses sorted the population into four subpopulations. Several accessions distributed in all subpopulations showed either better or comparable level of tolerance to the standard cold tolerance source, Shan qui red. Association analysis between the markers and seedling traits identified markers Xtxp34, Xtxp88, and Xtxp319 as associated with seedling emergence, Xtxp211 and Xtxp304 with seedling dry weight, and Xtxp20 with seedling height. The markers were detected on chromosomes previously found to harbor QTLs associated with cold tolerance in sorghum. Once validated these may serve as genomic tools in marker-assisted breeding or for screening larger pool of genotypes to identify additional sources of cold tolerance. PMID:28536596

Assessing the effectiveness of Australian early childhood education and care experiences: study protocol.

PubMed

Tayler, Collette; Cloney, Daniel; Adams, Ray; Ishimine, Karin; Thorpe, Karen; Nguyen, Thi Kim Cuc

2016-04-21

In Australia, 61.5 % of children aged 3-4 attend Early Childhood Education and Care (ECEC) programs. Children's experiences within these programs vary widely and impact directly on educational wellbeing and social development. Research has shown that higher quality programs enhance children's learning and developmental outcomes, foster social participation and have long-lasting effects on their productivity as adults. Quality matters, yet we do not know what components of ECEC result in a quality program. Effective Early Educational Experiences (E4Kids) is a 5-year longitudinal study designed to identify and assess the impact of mainstream ECEC programs and program components on children's learning, development, social inclusion and well-being. E4Kids sets out to measure quality ECEC; identify components that add value and positively impact children's outcomes; evaluate the effects of child, family, community and environment characteristics on programs; and provide evidence on how best to invest in ECEC. E4Kids follows a sample of 2,494 children who have experienced a variety of approved care programs (long day care, kindergarten, family day care and occasional care), as well as 157 children who have not accessed such programs. Children are tracked to the first point of National Assessment Program - Literacy and Numeracy (NAPLAN) testing at Year 3. The study presents a multi-level design in which ECEC programs were sampled from two states - Queensland and Victoria - then randomly sampled from two greater metropolitan regions and two regional and remote locations. Parents, centre directors, educators and carers complete questionnaires to provide information on demographics and children's progress. Data collected also include the make-up and organisation of ECEC programs and schools children attended. The quality of adult-child interactions is directly assessed using the Classroom Assessment Scoring System (CLASS) and direct testing of children's cognitive abilities and achievements is undertaken over 3 years and linked with NAPLAN scores. Findings from the E4Kids study have the potential to influence the quality of ECEC available in Australia by providing up-to-date evidence on the impact of ECEC programs and program components to inform future policy decisions and research.

Yakima Tributary Access and Habitat Program, 2002-2003 Annual Report.

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

Myra, D.; Ready, C.

2003-12-01

The Yakima Tributary Access and Habitat Program (YTAHP) was organized to restore salmonid passage to Yakima tributaries that historically supported salmonids and to improve habitat in areas where access is restored. This program intends to (a) screen unscreened diversion structures to prevent fish entrainment into artificial waterways; (b) provide for fish passage at man-made barriers, such as diversion dams, culverts, siphons and bridges; and (c) provide information and assistance to landowners interested in to contributing to the improvement of water quality, water reliability and stream habitat. The YTAHP developed from a number of groups actively engaged in watershed management, and/ormore » habitat restoration within the Yakima River Basin. These groups include the Washington State Fish and Wildlife (WDFW), Kittitas County Conservation District (KCCD), North Yakima Conservation District (NYCD), Kittitas County Water Purveyors (KCWP), and Ahtanum Irrigation District (AID). The US Bureau of Reclamation (Reclamation) and Yakama Nation (YN) both participated in the development of the objectives of YTAHP. Other entities that will be involved during permitting or project review may include the YN, the federal Natural Resources Conservation Service (NRCS), the US Fish and Wildlife Service (USFWS), the National Marine Fisheries Service (NMFS), and US Army Corps of Engineers (COE). The objectives of YTAHP are listed below and also include subtasks detailed in the report: (1) Conduct Early Action Projects; (2) Review Strategic Plan; (3) Restore Access, including stream inventory, prioritization, implementation; and (4) Provide opportunities to improve habitat and conserve resources. The BPA YTAHP funding supported activities of the program which are described in this report. These activities are primarily related to objective 1 (conduct early action projects) and parts of objectives 2-4. The work supported by YTAHP funding will support a series of scheduled projects and be made larger by complementary funding through NRSC EQIP, Irrigation Efficiencies, WA State Salmon Recovery Funding Board and other local, state and federal programs. Projects completed FY-03: The Cooke Creek siphon and screen/bypass was completed on time and within budget. The Rosbach Farms project was completed in cooperation with the NRCS Environmental Quality Incentives Program and the KCCD's Irrigation Efficiencies Program. Tributary survey teams were trained and surveys of tributaries in Yakima and Kittitas counties commenced in December of 2002. By the end of September 2003 Cowiche Creek in Yakima County was completed as well as Coleman, Reecer, Currier, Dry, Cabin, Indian, and Jack Creeks in Kittitas County. A screen was installed on the Hernandez/Ringer diversion in cooperation with the NRCS office in Kittitas County. YTAHP submitted six applications to the Salmon Recovery Funding Board and three were selected and funded. Another Salmon Recovery Funding Board project awarded in 2000 to the Yakama Nation was transferred to the KCCD. Two miles of fencing of riparian zones on the north fork Ahtanum was completed by the North Yakima Conservation District in cooperation with the Department of Natural Resources and the Ahtanum Irrigation District and funded by US fish and Wildlife as part of YTAHP's outreach partnering. Completion of this year's effort has provided significant inroads to working on the private lands in two counties which will be vital to future efforts by YTAHP and others to protect and enhance Yakima River Basin habitat. 2003 saw the migration of the WEB site from MWH to the Kittitas County Conservation District and can be accessed at www.kccd.net.« less

Sucrose exposure in early life alters adult motivation and weight gain.

PubMed

Frazier, Cristianne R M; Mason, Peggy; Zhuang, Xiaoxi; Beeler, Jeff A

2008-09-17

The cause of the current increase in obesity in westernized nations is poorly understood but is frequently attributed to a 'thrifty genotype,' an evolutionary predisposition to store calories in times of plenty to protect against future scarcity. In modern, industrialized environments that provide a ready, uninterrupted supply of energy-rich foods at low cost, this genetic predisposition is hypothesized to lead to obesity. Children are also exposed to this 'obesogenic' environment; however, whether such early dietary experience has developmental effects and contributes to adult vulnerability to obesity is unknown. Using mice, we tested the hypothesis that dietary experience during childhood and adolescence affects adult obesity risk. We gave mice unlimited or no access to sucrose for a short period post-weaning and measured sucrose-seeking, food consumption, and weight gain in adulthood. Unlimited access to sucrose early in life reduced sucrose-seeking when work was required to obtain it. When high-sugar/high-fat dietary options were made freely-available, however, the sucrose-exposed mice gained more weight than mice without early sucrose exposure. These results suggest that early, unlimited exposure to sucrose reduces motivation to acquire sucrose but promotes weight gain in adulthood when the cost of acquiring palatable, energy dense foods is low. This study demonstrates that early post-weaning experience can modify the expression of a 'thrifty genotype' and alter an adult animal's response to its environment, a finding consistent with evidence of pre- and peri-natal programming of adult obesity risk by maternal nutritional status. Our findings suggest the window for developmental effects of diet may extend into childhood, an observation with potentially important implications for both research and public policy in addressing the rising incidence of obesity.

The Attached Payload Facility Program: A Family of In-Space Commercial Facilities for Technology, Science and Industry

NASA Technical Reports Server (NTRS)

Avery, Don E.; Kaszubowski, Martin J.; Kearney, Michael E.; Howard, Trevor P.

1996-01-01

It is anticipated that as the utilization of space increases in both the government and commercial sec tors the re will be a high degree of interest in materials and coatings research as well as research in space environment definition, deployable structures, multi-functional structures and electronics. The International Space Station (ISS) is an excellent platform for long-term technology development because it provides large areas for external attached payloads, power and data capability, and ready access for experiment exchange and return. An alliance of SPACEHAB, MicroCraft, Inc. and SpaceTec, Inc. has been formed to satisfy this research need through commercial utilization of the capabilities of ISS. The alliance will provide a family of facilities designed to provide low-cost, reliable access to space for experimenters. This service would start as early as 1997 and mature to a fully functional attached facility on ISS by 2001. The alliances facilities are based on early activities by NASA, Langley Research Center (LaRC) to determine the feasibility of a Material Exposure Facility (MEF).

Preparing the Fleet for the F-35B

DTIC Science & Technology

2012-02-06

from forward sites, a similar argument was made in the early 1970s by the “ plank holders” of the AV-8B program. vi In the Spring of 2010, USMC...Flying Shame.” Such press caused significant concern in the USMC’s leadership to attempt and mitigate possible risk in the operation of the aircraft...www.armedforcesjournal.com/2010/10/4765181/ (accessed January 14, 2012). Sack, Kevin and Allan C. Miller. “An Abundance of Crash-Causing Glitches.” Los Angeles

Lunar and Meteorite Sample Education Disk Program - Space Rocks for Classrooms, Museums, Science Centers, and Libraries

NASA Technical Reports Server (NTRS)

Allen, Jaclyn; Luckey, M.; McInturff, B.; Huynh, P.; Tobola, K.; Loftin, L.

2010-01-01

NASA is eager for students and the public to experience lunar Apollo samples and meteorites first hand. Lunar rocks and soil, embedded in Lucite disks, are available for educators to use in their classrooms, museums, science centers, and public libraries for education activities and display. The sample education disks are valuable tools for engaging students in the exploration of the Solar System. Scientific research conducted on the Apollo rocks reveals the early history of our Earth-Moon system and meteorites reveal much of the history of the early solar system. The rocks help educators make the connections to this ancient history of our planet and solar system and the basic processes accretion, differentiation, impact and volcanism. With these samples, educators in museums, science centers, libraries, and classrooms can help students and the public understand the key questions pursued by many NASA planetary missions. The Office of the Curator at Johnson Space Center is in the process of reorganizing and renewing the Lunar and Meteorite Sample Education Disk Program to increase reach, security and accountability. The new program expands the reach of these exciting extraterrestrial rocks through increased access to training and educator borrowing. One of the expanded opportunities is that trained certified educators from science centers, museums, and libraries may now borrow the extraterrestrial rock samples. Previously the loan program was only open to classroom educators so the expansion will increase the public access to the samples and allow educators to make the critical connections to the exciting exploration missions taking place in our solar system. Each Lunar Disk contains three lunar rocks and three regolith soils embedded in Lucite. The anorthosite sample is a part of the magma ocean formed on the surface of Moon in the early melting period, the basalt is part of the extensive lunar mare lava flows, and the breccias sample is an important example of the violent impact history of the Moon. The disks also include two regolith soils and orange glass from a pyroclastic deposit. Each Meteorite Disk contains two ordinary chondrites, one carbonaceous chondrite, one iron, one stony iron, and one achondrite. These samples will help educators share the early history of the solar system with students and the public. Educators may borrow either lunar or meteorite disks and the accompanying education materials through the Johnson Space Center Curatorial Office. In trainings provided by the NASA Aerospace Education Services Program specialists, educators certified to borrow the disk learn about education resources, the proper use of the samples, and the special security for care and shipping of the disks. The Lunar and Meteorite Sample Education Disk Program will take NASA exploration to more people. Getting Space Rocks out to the public and inspiring the public about new space exploration is the focus of the NASA disk loan program.

Inequities in access to inpatient rehabilitation after stroke: an international scoping review.

PubMed

Lynch, Elizabeth A; Cadilhac, Dominique A; Luker, Julie A; Hillier, Susan L

2017-12-01

Background Inequities in accessing inpatient rehabilitation after stroke have been reported in many countries and impact on patient outcomes. Objective To explore variation in international recommendations regarding which patients should receive inpatient rehabilitation after stroke and to describe reported access to rehabilitation. Methods A scoping review was conducted to identify clinical guidelines with recommendations regarding which patients should access inpatient rehabilitation after stroke, and data regarding the proportion of patients accessing stroke rehabilitation. Four bibliographic databases and grey literature were searched. Results Twenty-eight documents were included. Selection criteria for post-acute inpatient rehabilitation were identified for 14 countries or regions and summary data on the proportion of patients receiving inpatient rehabilitation were identified for 14 countries. In Australia, New Zealand, and the United Kingdom, it is recommended that all patients with stroke symptoms should access rehabilitation, whereas guidelines from the United States, Canada, and Europe did not consistently recommend rehabilitation for people with severe stroke. Access to inpatient rehabilitation ranged from 13% in Sweden to 57% in Israel. Differences in availability of early supported discharge/home rehabilitation programs and variations in reporting methods may influence the ability to reliably compare access to rehabilitation between regions. Conclusion Recommendations regarding which patients with moderate and severe strokes should access ongoing rehabilitation are inconsistent. Clinical practice guidelines from different countries regarding post-stroke rehabilitation do not always reflect the evidence regarding the likely benefits to people with stroke. Inequity in access to rehabilitation after stroke is an international issue.

Life Course Associations between Victimization and Aggression: Distinct and Cumulative Contributions

PubMed Central

Logan-Greene, Patricia; Nurius, Paula S.; Hooven, Carole; Thompson, Elaine Adams

2014-01-01

The connections between early maltreatment and later aggression are well established in the literature, however gaps remain in our understanding of developmental processes. This study investigates the cascading lifecourse linkages between victimization experiences from childhood through early adulthood andlater aggressive behavior. The diverse, at-risk sample is of particular importance to child and adolescent specialists, as it represents highly vulnerable youth accessible through conventional school settings. In addition to direct pathways from proximal life periods, path analysis revealed significant indirect mediated pathways through which earlier life victimizationcontributes to aggressive behaviors in later life periods as well as revictimization. Multivariateregressions support theorized cumulative effects of multi-form victimization as well as distinct contributions of victimization domains (emotional, witnessing, physical, property, and sexual) in explaining aggressive behavior.Consistent with theorizing about the developmental impact of early maltreatment, results bolster the importance of interrupting pathways from victimization to revictimization and later aggression. Findings are evaluated in light of implications for early identification and prevention programming. PMID:26190899

Life Course Associations between Victimization and Aggression: Distinctive and Cumulative Contributions

PubMed Central

Logan-Greene, Patricia; Nurius, Paula S.; Hooven, Carole; Thompson, Elaine Adams

2014-01-01

The connections between early maltreatment and later aggression are well established in the literature, however gaps remain in our understanding of developmental processes. This study investigates the cascading life course linkages between victimization experiences from childhood through early adulthood and later aggressive behavior. The diverse, at-risk sample is of particular importance to child and adolescent specialists, as it represents highly vulnerable youth accessible through conventional school settings. In addition to direct pathways from proximal life periods, path analysis revealed significant indirect mediated pathways through which earlier life victimization contributes to aggressive behaviors in later life periods as well as revictimization. Multivariate regressions support theorized cumulative effects of multi-form victimization as well as distinct contributions of victimization domains (emotional, witnessing, physical, property, and sexual) in explaining aggressive behavior. Consistent with theorizing about the developmental impact of early maltreatment, results bolster the importance of interrupting pathways from victimization to revictimization and later aggression. Findings are evaluated in light of implications for early identification and prevention programming. PMID:26190900

A 35-year-old pregnant woman presenting with sudden cardiac arrest secondary to peripartum cardiomyopathy.

PubMed

Nelson, Matthew; Moorhead, Amy; Yost, Dana; Whorton, Adrian

2012-01-01

We present a case of successful resuscitation from cardiac arrest after 25 minutes of ventricular fibrillation (VF) secondary to peripartum cardiomyopathy. This case highlights a rare disease, but also, more importantly, the successful use of the five links of survival: early access to 9-1-1, early cardiopulmonary resuscitation (CPR), early defibrillation, early advanced life support, and postresuscitative care. We also demonstrate the importance of high-quality resuscitation practices in order to achieve a successful outcome. Manual compressions can be performed at a guidelines-compliant rate. With training, users are able to achieve high compression fractions. Pre/post shock delays can be minimized to further increase compression fraction. Nationally, CPR interruptions are often long. We recommend closer attention to uninterrupted 2-minute cycles of CPR, minimizing delays in CPR through training, and a focus on a closely choreographed approach. User review of transthoracic impedance feedback data should play a vital role in a cardiac arrest quality-improvement program.

SPIRALE: early warning optical space demonstrator

NASA Astrophysics Data System (ADS)

Galindo, D.; Carucci, A.

2004-11-01

Thanks to its global coverage, its peacetime capabilities and its availability, ballistic missiles Early Warning (EW) space systems are identified as a key node of a global missile defence system. Since the Gulf war in 1991, several feasibility studies of such an Early Warning system have been conducted in France. The main conclusions are first that the most appropriate concept is to use infra-red (IR) sensors on geo- stationary orbit satellites and second that the required satellite performances are achievable and accessible to European industries, even if technological developments are necessary. Besides that, it was recommended to prepare the development of the EW operational system, by demonstrating its achievable performances on the basis of collected background images and available target IR signatures. This is the objective of the "EW optical space demonstrator", also named SPIRALE (this a French acronym which stands for "Preparatory IR Program for EW"). A contract has been awarded early 2004, by DGA/SPOTI (French Armament Procurement Agency), to EADS Astrium France, with a significant participation of Alcatel Space, to perform this demonstration.

Impact of Educational Intervention Concerning Awareness and Behaviors Relating to Avian Influenza (H5N1) in a High-Risk Population in Vietnam

PubMed Central

Manabe, Toshie; Thuy, Pham Thi Phuong; Can, Vu Van; Takasaki, Jin; Huyen, Dinh Thi Thanh; Chau, Nguyen Thi My; Shimbo, Takuro; Ha, Bui Thi Thu; Izumi, Shinyu; Hanh, Tran Thuy; Chau, Ngo Quy; Kudo, Koichiro

2011-01-01

Background Early initiation of treatment is essential for treatment of avian influenza A/H5N1 viral infection in humans, as the disease can lead to rapid development of severe pneumonia which can result in death. Contact with infected poultry is known to be a significant risk factor for contraction of H5N1 infection. However, handling and encountering poultry are a part of most peoples' daily lives, especially in rural communities in Vietnam where epidemic outbreaks among poultry have been continuously reported. Enhancing proper knowledge relating to H5N1 and to the importance of early initiation of treatment are crucial. The aim of this study was to develop an effective educational program to enhance awareness of H5N1 and motivate people to access to health care earlier when H5N1 infection is suspected or likely. Methodology and Principal Findings A study was conducted in two agricultural communities (intervention and control groups) in the Ninh Binh province in Vietnam, where epidemic outbreaks of avian influenza have recently occurred in birds. A unique educational intervention was developed and provided to the intervention group, and no intervention was provided to the control group. A knowledge, attitude and practice (KAP) survey was conducted in both groups with a face-to-face interview by trained local healthcare workers at time points before and after the educational intervention. KAP scores were compared between the different time points and between the groups. How educational intervention influenced awareness relating to H5N1 and accessibility of healthcare in the population was analyzed. The study indicated an increased awareness of H5N1 and increased reliance on local health care workers. Conclusions The novel educational program which was developed for this study impacted awareness of H5N1, and resulted in more people seeking early access to healthcare, and also resulted in earlier medical intervention for patients with H5N1 avian influenza infection in Vietnam. PMID:21887303

Equal Access to Early Learning. Cantigny Conference Report (Chicago, Illinois, June 5-7, 2001).

ERIC Educational Resources Information Center

National Black Child Development Inst., Inc., Washington, DC.

Despite a growing acknowledgement that the United States needs to invest more in the early care and education needs of children, the country lacks a common vision for a comprehensive approach to an early childhood care and education system. The Equal Access to Early Learning Conference, sponsored by the National Black Child Development Institute…

Teen pregnancy: a public health issue or political football?

PubMed

Clark, M P

1996-08-01

Politicians in the US have made adolescent parents the scapegoat of changing cultural patterns by suggesting punitive solutions to nonmarital births rather than addressing underlying causes of premature child-bearing. It is known that the percentages of young people of all races and all social classes reporting early, nonmarital sexual intercourse have increased dramatically, while adolescent fertility rates peaked in the 1950s. Improved access to contraception and abortion caused a decline in teen pregnancy and birth rates from 1970 to 1986. During 1986-91, service providers could not match growing demand, and the birth rate increased 25%. Increased rates of sexual activity have also led to increases in the incidence of sexually transmitted diseases (STDs) and HIV/AIDS among adolescents. This situation was exacerbated by Reagan and Bush policies, which reduced funding for services to adolescents and supported abstinence-only sex education courses. The concern voiced by policy-makers today centers on nonmarital childbearing by low-income adolescents who will rely on public assistance to survive. A proper response to this situation would involve the following policy actions: 1) mandating comprehensive sexuality education from kindergarten through high school, 2) funding mentoring programs, 3) improving economic and educational opportunities, 4) expanding STD and HIV/AIDS prevention programs, 5) increasing access to confidential health services (including mental health care and substance abuse treatment), 6) expanding child sexual abuse prevention and intervention programs, and 7) increasing access to and acceptability of teen contraceptive usage and abortion.

43 CFR 17.550 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Program accessibility: Existing facilities....550 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or... its existing facilities or every part of a facility accessible to and usable by handicapped persons...

49 CFR 28.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 1 2011-10-01 2011-10-01 false Program accessibility: Existing facilities. 28.150....150 Program accessibility: Existing facilities. (a) General. The Department shall operate each program... Department to make each of its existing facilities accessible to and usable by individuals with handicaps; (2...

76 FR 2686 - Video Programming and Emergency Access Advisory Committee; Announcement of Establishment and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-14

... FEDERAL COMMUNICATIONS COMMISSION [DA 10-2320] Video Programming and Emergency Access Advisory... appointment of members of the Video Programming and Emergency Access Advisory Committee (``Committee'' or... change of the Committee's popular name to the Video Programming Accessibility Advisory Committee (``VPAAC...

Welfare Reform: DOT Has Made Progress in Implementing the Job Access Program but Has Not Evaluated the Impact. Testimony before the Committee on Transportation and Infrastructure, Subcommittee on Highways and Transit, U.S. House of Representatives.

ERIC Educational Resources Information Center

Hecker, JayEtta Z.

A series of reviews of the Department of Transportation's (DOT's) Job Access and Reverse Commute (Job Access) Program explored DOT's and grantees' challenges in implementing the Job Access program and the status of DOT's program evaluation efforts. DOT and grantees faced significant challenges in implementing the Job Access program. DOT's process…

Palliative Care in Advanced Cancer Patients: How and When?

PubMed Central

Yennurajalingam, Sriram

2012-01-01

Cancer patients develop severe physical and psychological symptoms as a result of their disease and treatment. Their families commonly suffer great emotional distress as a result of caregiving. Early palliative care access can improve symptom control and quality of life and reduce the cost of care. Preliminary results show that early palliative care access can also extend survival. Unfortunately, only a minority of cancer centers in the U.S. have the two most important resources for palliative care delivery: outpatient palliative care centers and inpatient palliative care units. In this article, we use a case presentation to discuss the impact of early palliative care access in light of the currently available evidence, and we recommend ways to improve early access to palliative care through education and research. PMID:22252934

Contemporary programs in support of traditional ways: Inuit perspectives on community freezers as a mechanism to alleviate pressures of wild food access in Nain, Nunatsiavut.

PubMed

Organ, Jennifer; Castleden, Heather; Furgal, Chris; Sheldon, Tom; Hart, Catherine

2014-11-01

Rapid socio-cultural, economic, and environmental changes are challenging wild food access and thus food security for Inuit in the Canadian Arctic. In response to the continued value and practice of harvesting wild foods, communities are establishing "wild food support" initiatives. This study evaluated how one such initiative, a community freezer, in Nain, Nunatsiavut supported wild food access for community members. Data were collected through: interviews and focus groups with users, freezer managers, and active harvesters; participant observation; and document analysis. Results indicated that the community freezer supported socio-cultural, economic and local access to wild foods. However, there were issues associated with supply, dependency, social exclusion, and tension between feasibility and traditional values and practices. Communities, governments, and policymakers are urged to consider social and physical location as factors when investing in and monitoring such initiatives. The Nunatsiavut Government and the Nain Inuit Community Government have since worked together to modify this early freezer initiative due, in part, to this study's findings. Copyright © 2014 Elsevier Ltd. All rights reserved.

Promoting Children's Sustainable Access to Early Schooling in Africa: Reflections on the Roles of Parents in Their Children's Early Childhood Care and Education

ERIC Educational Resources Information Center

Ngwaru, Jacob Marriote

2014-01-01

Sub-Saharan Africa has predominantly rural populations unable to offer children sustainable access to early literacy and childhood care and education. Children's literacy development starts very early in life through participation and experiences in the home and preschool. My research in rural Zimbabwe, Kenya, Uganda, and Tanzania shows that the…

47 CFR 76.1003 - Program access proceedings.

Code of Federal Regulations, 2014 CFR

2014-10-01

... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Access to Cable Programming § 76.1003 Program access proceedings. (a) Complaints. Any multichannel video programming distributor aggrieved by conduct... multichannel video programming distributor intending to file a complaint under this section must first notify...

47 CFR 76.1003 - Program access proceedings.

Code of Federal Regulations, 2012 CFR

2012-10-01

... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Access to Cable Programming § 76.1003 Program access proceedings. (a) Complaints. Any multichannel video programming distributor aggrieved by conduct... multichannel video programming distributor intending to file a complaint under this section must first notify...

47 CFR 76.1003 - Program access proceedings.

Code of Federal Regulations, 2013 CFR

2013-10-01

... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Access to Cable Programming § 76.1003 Program access proceedings. (a) Complaints. Any multichannel video programming distributor aggrieved by conduct... multichannel video programming distributor intending to file a complaint under this section must first notify...

47 CFR 76.1003 - Program access proceedings.

Code of Federal Regulations, 2010 CFR

2010-10-01

... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Access to Cable Programming § 76.1003 Program access proceedings. (a) Complaints. Any multichannel video programming distributor aggrieved by conduct... multichannel video programming distributor intending to file a complaint under this section must first notify...

47 CFR 76.1003 - Program access proceedings.

Code of Federal Regulations, 2011 CFR

2011-10-01

... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Access to Cable Programming § 76.1003 Program access proceedings. (a) Complaints. Any multichannel video programming distributor aggrieved by conduct... multichannel video programming distributor intending to file a complaint under this section must first notify...

Barriers and Facilitators of Mentoring for Trainees and Early Career Investigators in Rheumatology Research: Current State, Identification of Needs, and Road Map to an Inter-Institutional Adult Rheumatology Mentoring Program.

PubMed

Ogdie, Alexis; Sparks, Jeffrey A; Angeles-Han, Sheila T; Bush, Kathleen; Castelino, Flavia V; Golding, Amit; Jiang, Yihui; Kahlenberg, J Michelle; Kim, Alfred H J; Lee, Yvonne C; Machireddy, Kirthi; Ombrello, Michael J; Shah, Ami A; Wallace, Zachary S; Nigrovic, Peter A; Makris, Una E

2018-03-01

To determine perceived barriers and facilitators to effective mentoring for early career rheumatology investigators and to develop a framework for an inter-institutional mentoring program. Focus groups or interviews with rheumatology fellows, junior faculty, and mentors were conducted, audiorecorded, and transcribed. Content analysis was performed using NVivo software. Themes were grouped into categories (e.g., mentor-mentee relationship, barriers, and facilitators of a productive relationship). Rheumatology fellows and early career investigators were also surveyed nationwide to identify specific needs to be addressed through an inter-institutional mentoring program. Twenty-five individuals participated in focus groups or interviews. Attributes of the ideal mentee-mentor relationship included communication, accessibility, regular meetings, shared interests, aligned goals, and mutual respect. The mentee should be proactive, efficient, engaged, committed, focused, accountable, and respectful of the mentor's time. The mentor should support/promote the mentee, shape the mentee's goals and career plan, address day-to-day questions, provide critical feedback, be available, and have team leadership skills. Barriers included difficulty with career path navigation, gaining independence, internal competition, authorship, time demands, funding, and work-life balance. Facilitators of a successful relationship included having a diverse network of mentors filling different roles, mentor-mentee relationship management, and confidence. Among 187 survey respondents, the primary uses of an inter-institutional mentoring program were career development planning and oversight, goal-setting, and networking. In this mixed-methods study, tangible factors for optimizing the mentor-mentee relationship were identified and will inform the development of an adult rheumatology inter-institutional mentoring program. © 2017, American College of Rheumatology.

45 CFR 1214.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Program accessibility: Discrimination prohibited... PROGRAMS OR ACTIVITIES CONDUCTED BY ACTION § 1214.149 Program accessibility: Discrimination prohibited... of, be excluded from participation in, or otherwise be subjected to discrimination under any program...

76 FR 19356 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-07

... FEDERAL COMMUNICATIONS COMMISSION [DA 11-390] Video Programming and Accessibility Advisory.... SUMMARY: This document announces the next meeting of the Video Programming Accessibility Advisory... Internet programming previously captioned on television, video description of television programming...

Achieving Developmental Synchrony in Young Children With Hearing Loss

PubMed Central

Mellon, Nancy K.; Ouellette, Meredith; Greer, Tracy; Gates-Ulanet, Patricia

2009-01-01

Children with hearing loss, with early and appropriate amplification and intervention, demonstrate gains in speech, language, and literacy skills. Despite these improvements many children continue to exhibit disturbances in cognitive, behavioral, and emotional control, self-regulation, and aspects of executive function. Given the complexity of developmental learning, educational settings should provide services that foster the growth of skills across multiple dimensions. Transdisciplinary intervention services that target the domains of language, communication, psychosocial functioning, motor, and cognitive development can promote academic and social success. Educational programs must provide children with access to the full range of basic skills necessary for academic and social achievement. In addition to an integrated curriculum that nurtures speech, language, and literacy development, innovations in the areas of auditory perception, social emotional learning, motor development, and vestibular function can enhance student outcomes. Through ongoing evaluation and modification, clearly articulated curricular approaches can serve as a model for early intervention and special education programs. The purpose of this article is to propose an intervention model that combines best practices from a variety of disciplines that affect developmental outcomes for young children with hearing loss, along with specific strategies and approaches that may help to promote optimal development across domains. Access to typically developing peers who model age-appropriate skills in language and behavior, small class sizes, a co-teaching model, and a social constructivist perspective of teaching and learning, are among the key elements of the model. PMID:20150187

Insider Threat - Material Control and Accountability Mitigation

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

Powell, Danny H; Elwood Jr, Robert H; Roche, Charles T

2011-01-01

The technical objectives of nuclear safeguards are (1) the timely detection of diversion of significant quantities of nuclear material from peaceful uses to the manufacture of nuclear weapons or other nuclear explosive devices or for purposes unknown and (2) the deterrence of such diversion by the risk of early detection. The safeguards and security program must address both outsider threats and insider threats. Outsider threats are primarily addressed by the physical protection system. Insider threats can be any level of personnel at the site including passive or active insiders that could attempt protracted or abrupt diversion. This could occur bymore » an individual acting alone or by collusion between an individual with material control and accountability (MC&A) responsibilities and another individual who has responsibility or control within both the physical protection and the MC&A systems. The insider threat is one that must be understood and incorporated into the safeguards posture. There have been more than 18 documented cases of theft or loss of plutonium or highly enriched uranium. The insider has access, authority, and knowledge, as well as a set of attributes, that make him/her difficult to detect. An integrated safeguards program is designed as a defense-in-depth system that seeks to prevent the unauthorized removal of nuclear material, to provide early detection of any unauthorized attempt to remove nuclear material, and to rapidly respond to any attempted removal of nuclear material. The program is also designed to support protection against sabotage, espionage, unauthorized access, compromise, and other hostile acts that may cause unacceptable adverse impacts on national security, program continuity, the health and safety of employees, the public, or the environment. Nuclear MC&A play an essential role in the capabilities of an integrated safeguards system to deter and detect theft or diversion of nuclear material. An integrated safeguards system with compensating mitigation can decrease the risk of an insider performing a malicious act without detection.« less

Remote population-based intervention for disruptive behavior at age four: study protocol for a randomized trial of Internet-assisted parent training (Strongest Families Finland-Canada).

PubMed

McGrath, Patrick J; Sourander, Andre; Lingley-Pottie, Patricia; Ristkari, Terja; Cunningham, Charles; Huttunen, Jukka; Filbert, Katharine; Aromaa, Minna; Corkum, Penny; Hinkka-Yli-Salomäki, Susanna; Kinnunen, Malin; Lampi, Katja; Penttinen, Anne; Sinokki, Atte; Unruh, Anita; Vuorio, Jenni; Watters, Carolyn

2013-10-21

Oppositional Defiant Disorder (ODD) is characterized by angry and noncompliant behaviour. It is the most common disruptive behaviour disorder (DBD), with prevalence estimates of 6-9% for preschoolers and is closely linked to several long-term difficulties, including disorders of conduct, mood, anxiety, impulse-control, and substance abuse. ODD in children is related to parental depression, family dysfunction, and impairments in parental work performance. Children displaying early DBDs exhibit more symptoms of greater severity, more frequent offences, and commit more serious crimes later in life. The goal of the Strongest Families Finland Canada (SFFC) Smart Website intervention research program is to develop and evaluate an affordable, accessible, effective secondary prevention parent training program for disruptive behaviour in preschoolers to prevent the negative sequelae of ODD. Strongest Families is an 11-session program with two booster sessions that focuses on teaching skills to: strengthen parent-child relationships; reinforce positive behaviour; reduce conflict; manage daily transitions; plan for potentially problematic situations; promote emotional regulation and pro-social behaviour and decrease antisocial behaviour. This protocol paper describes an ongoing population-based randomized controlled trial (RCT) of high-risk 4 year-olds attending well-child clinics in Turku, Finland and environs to examine the effectiveness of the Strongest Families Smart Website intervention compared to an Education Control condition. Randomization consists of a 1:1 ratio for intervention versus the education group, stratified by the child's sex. The participants randomized to the intervention group receive access to the Strongest Families Smart Website and weekly telephone coaching sessions. The participants randomized to the Education Control condition receive access to a static website with parenting tips. Children are followed using parental and daycare teacher measures at 6 and 12 months after randomization. The Strongest Families Smart Website intervention is hypothesized to improve parenting skills, reduce child disruptive behaviour, reduce parental distress and improve family functioning. These results will likely inform subsequent investigations, public policy, and early treatment of childhood disruptive behaviour problems. ClinicalTrials.gov # NCT01750996.

Remote population-based intervention for disruptive behavior at age four: study protocol for a randomized trial of Internet-assisted parent training (Strongest Families Finland-Canada)

PubMed Central

2013-01-01

Background Oppositional Defiant Disorder (ODD) is characterized by angry and noncompliant behaviour. It is the most common disruptive behaviour disorder (DBD), with prevalence estimates of 6-9% for preschoolers and is closely linked to several long-term difficulties, including disorders of conduct, mood, anxiety, impulse-control, and substance abuse. ODD in children is related to parental depression, family dysfunction, and impairments in parental work performance. Children displaying early DBDs exhibit more symptoms of greater severity, more frequent offences, and commit more serious crimes later in life. The goal of the Strongest Families™ Finland Canada (SFFC) Smart Website intervention research program is to develop and evaluate an affordable, accessible, effective secondary prevention parent training program for disruptive behaviour in preschoolers to prevent the negative sequelae of ODD. Strongest Families is an 11-session program with two booster sessions that focuses on teaching skills to: strengthen parent–child relationships; reinforce positive behaviour; reduce conflict; manage daily transitions; plan for potentially problematic situations; promote emotional regulation and pro-social behaviour and decrease antisocial behaviour. Methods/design This protocol paper describes an ongoing population-based randomized controlled trial (RCT) of high-risk 4 year-olds attending well-child clinics in Turku, Finland and environs to examine the effectiveness of the Strongest Families Smart Website intervention compared to an Education Control condition. Randomization consists of a 1:1 ratio for intervention versus the education group, stratified by the child’s sex. The participants randomized to the intervention group receive access to the Strongest Families Smart Website and weekly telephone coaching sessions. The participants randomized to the Education Control condition receive access to a static website with parenting tips. Children are followed using parental and daycare teacher measures at 6 and 12 months after randomization. Discussion The Strongest Families Smart Website intervention is hypothesized to improve parenting skills, reduce child disruptive behaviour, reduce parental distress and improve family functioning. These results will likely inform subsequent investigations, public policy, and early treatment of childhood disruptive behaviour problems. Trial registration ClinicalTrials.gov # NCT01750996 PMID:24139323

50 CFR 648.60 - Sea scallop access area program requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

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

50 CFR 648.60 - Sea scallop access area program requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

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

50 CFR 648.60 - Sea scallop area access program requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

50 CFR 648.60 - Sea scallop access area program requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

50 CFR 648.60 - Sea scallop area access program requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

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

ERIC Educational Resources Information Center

Means, Darris R.; Pyne, Kimberly B.

2016-01-01

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

The Resilience Activation Framework: A conceptual model of how access to social resources promotes adaptation and rapid recovery in post-disaster settings

PubMed Central

Abramson, David M.; Grattan, Lynn M.; Mayer, Brian; Colten, Craig E.; Arosemena, Farah A.; Rung, Ariane; Lichtveld, Maureen

2014-01-01

A number of governmental agencies have called for enhancing citizen’s resilience as a means of preparing populations in advance of disasters, and as a counter-balance to social and individual vulnerabilities. This increasing scholarly, policy and programmatic interest in promoting individual and communal resilience presents a challenge to the research and practice communities: to develop a translational framework that can accommodate multi-disciplinary scientific perspectives into a single, applied model. The Resilience Activation Framework provides a basis for testing how access to social resources, such as formal and informal social support and help, promotes positive adaptation or reduced psychopathology among individuals and communities exposed to the acute collective stressors associated with disasters, whether manmade, natural, or technological in origin. Articulating the mechanisms by which access to social resources activate and sustain resilience capacities for optimal mental health outcomes post-disaster can lead to the development of effective preventive and early intervention programs. PMID:24870399

The resilience activation framework: a conceptual model of how access to social resources promotes adaptation and rapid recovery in post-disaster settings.

PubMed

Abramson, David M; Grattan, Lynn M; Mayer, Brian; Colten, Craig E; Arosemena, Farah A; Bedimo-Rung, Ariane; Lichtveld, Maureen

2015-01-01

A number of governmental agencies have called for enhancing citizens' resilience as a means of preparing populations in advance of disasters, and as a counterbalance to social and individual vulnerabilities. This increasing scholarly, policy, and programmatic interest in promoting individual and communal resilience presents a challenge to the research and practice communities: to develop a translational framework that can accommodate multidisciplinary scientific perspectives into a single, applied model. The Resilience Activation Framework provides a basis for testing how access to social resources, such as formal and informal social support and help, promotes positive adaptation or reduced psychopathology among individuals and communities exposed to the acute collective stressors associated with disasters, whether human-made, natural, or technological in origin. Articulating the mechanisms by which access to social resources activate and sustain resilience capacities for optimal mental health outcomes post-disaster can lead to the development of effective preventive and early intervention programs.

Access to and coverage of renal replacement therapy in minorities and ethnic groups in Venezuela.

PubMed

Bellorin-Font, Ezequiel; Pernalete, Nidia; Meza, Josefina; Milanes, Carmen Luisa; Carlini, Raul G

2005-08-01

Access to and coverage of renal replacement therapy in minorities and ethnic groups in Venezuela. Numerous studies have documented the presence of racial and minority disparities regarding the impact of renal disease and access to renal replacement therapy (RRT). This problem is less well documented in Latin America. Venezuela, like most countries in the region, is subject to severe constraints in the allocation of resources for high-cost chronic diseases, which limits the access of patients with chronic kidney disease to RRT. Although access to health care is universal, there is both a deficit in coverage and disparity in the access to RRT, largely as a result of socioeconomic limitations and budget constrains. With current rising trends of the incidence of end-stage renal disease (ESRD) and costs of medical technology, the long-term goal of complete RRT coverage will become increasingly out of reach. Current evidence suggests that prevention of progression of renal disease is possible at relatively low cost and broad coverage. Based on this evidence, the Ministry of Health has redesigned its policy with respect to renal disease based on 4 elements: 1. Prevention by means of early detection and referral to multidisciplinary health teams, as well as promotion of health habits in the community. 2. Prevention of progression of renal disease by pharmacologic and nonpharmacologic means. 3. An increase in the rate of coverage and reduction of disparities in the access to dialysis. 4. An increase in the rates of renal transplantation through better organ procurement programs and reinforcement of transplant centers. However, the projected increase in the number of patients with ESKD receiving RRT will represent a serious burden to the health care system. Therefore, implementation of these policies will require the involvement of international agencies as well as an adequate partnership between nephrologists and health care planners, so that meeting the increasing demands of ESKD programs may be balanced with other priorities of our national health system.

29 CFR 4907.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE PENSION BENEFIT GUARANTY CORPORATION § 4907.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by handicapped...

PoLAR Voices: Informing Adult Learners about the Science and Story of Climate Change in the Polar Regions Through Audio Podcast

NASA Astrophysics Data System (ADS)

Quinney, A.; Murray, M. S.; Gobroski, K. A.; Topp, R. M.; Pfirman, S. L.

2015-12-01

The resurgence of audio programming with the advent of podcasting in the early 2000s spawned a new medium for communicating advances in science, research, and technology. To capitalize on this informal educational outlet, the Arctic Institute of North America partnered with the International Arctic Research Center, the University of Alaska Fairbanks, and the UA Museum of the North to develop a podcast series called PoLAR Voices for the Polar Learning and Responding (PoLAR) Climate Change Education Partnership. PoLAR Voices is a public education initiative that uses creative storytelling and novel narrative structures to immerse the listener in an auditory depiction of climate change. The programs will feature the science and story of climate change, approaching topics from both the points of view of researchers and Arctic indigenous peoples. This approach will engage the listener in the holistic story of climate change, addressing both scientific and personal perspectives, resulting in a program that is at once educational, entertaining and accessible. Feedback is being collected at each stage of development to ensure the content and format of the program satisfies listener interests and preferences. Once complete, the series will be released on thepolarhub.org and on iTunes. Additionally, blanket distribution of the programs will be accomplished via radio broadcast in urban, rural and remote areas, and in multiple languages to increase distribution and enhance accessibility.

Supporting Dynamic Spectrum Access in Heterogeneous LTE+ Networks

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

Luiz A. DaSilva; Ryan E. Irwin; Mike Benonis

As early as 2014, mobile network operators’ spectral capac- ity is expected to be overwhelmed by the demand brought on by new devices and applications. With Long Term Evo- lution Advanced (LTE+) networks likely as the future one world 4G standard, network operators may need to deploy a Dynamic Spectrum Access (DSA) overlay in Heterogeneous Networks (HetNets) to extend coverage, increase spectrum efficiency, and increase the capacity of these networks. In this paper, we propose three new management frameworks for DSA in an LTE+ HetNet: Spectrum Accountability Client, Cell Spectrum Management, and Domain Spectrum Man- agement. For these spectrum managementmore » frameworks, we define protocol interfaces and operational signaling scenar- ios to support cooperative sensing, spectrum lease manage- ment, and alarm scenarios for rule adjustment. We also quan- tify, through integer programs, the benefits of using DSA in an LTE+ HetNet, that can opportunistically reuse vacant TV and GSM spectrum. Using integer programs, we consider a topology using Geographic Information System data from the Blacksburg, VA metro area to assess the realistic benefits of DSA in an LTE+ HetNet.« less

[Subcutaneously inserted central intravascular devices in the pediatric oncology patient: can we minimize their infection].

PubMed

Tardáguila, A R; Del Cañizo, A; Santos, M M; Fanjul, M; Corona, C; Zornoza, M; Parente, A; Carrera, N; Beléndez, C; Cerdá, J; Saavedra, J; Molina, E; García-Casillas, M A; Peláez, D

2011-10-01

Long-term indwelling central venous access devices are frequently used in pediatric patients. Their main complication is infection, that can even mean their removal. We try to identify the risk factors really involved in this complication and in their removal. We have made a retrospective review of 120 oncologic pediatric patients who received a central venous device between 2003 and 2009. We searched for epidemiologic, clinic, microbiologic and surgical risk factors. We made a comparative data analysis among: GROUP A, children who suffered device infection, GROUP B the others. Group A was divided into early infection (first month after implantation)/late infection, removed/not removed. Data were analized with statistical program SPSS. 29 suffered from leukemia, 19 from lymphoma and the main part, 72, from solid tumour. 31% experienced infection (GROUP A), being early in the 36% of them. 16% had to be withdrawn. Data analysis revealed statistical association with the age (p=0.015) and with the reception of chemiotherapic treatment the week before the surgical insertion. The rest of the studied factors did not revealed a real association, but could be guess a relationship among infection and leukemia, subclavian catheters, those patients whose deviced was introduced using a guide over a previous catheter and also transplanted. Related to early infection the only associateon founded was with the subclavian access (p=0.018). In conclusion, in our serie long-term central venous access infection was more frequent in the younger patients and also in those who had received chemotherapy the week before the catheter implantation. The tendency towards infection in leukemia, transplanted and subclavian carriers has to be studied in a prospective way with a larger number of oncologic children.

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

PubMed

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

2018-05-08

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

50 CFR 550.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 50 Wildlife and Fisheries 11 2012-10-01 2012-10-01 false Program accessibility: Discrimination... Program accessibility: Discrimination prohibited. Except as otherwise provided in § 550.150, no qualified... discrimination under any program or activity conducted by the agency. ...

A program to respond to otitis media in remote Australian Aboriginal communities: a qualitative investigation of parent perspectives.

PubMed

Jones, Caroline; Sharma, Mridula; Harkus, Samantha; McMahon, Catherine; Taumoepeau, Mele; Demuth, Katherine; Mattock, Karen; Rosas, Lee; Wing, Raelene; Pawar, Sulabha; Hampshire, Anne

2018-03-06

Indigenous infants and children in Australia, especially in remote communities, experience early and chronic otitis media (OM) which is difficult to treat and has lifelong impacts in health and education. The LiTTLe Program (Learning to Talk, Talking to Learn) aimed to increase infants' access to spoken language input, teach parents to manage health and hearing problems, and support children's school readiness. This paper aimed to explore caregivers' views about this inclusive, parent-implemented early childhood program for 0-3 years in an Aboriginal community health context. Data from in-depth, semi-structured interviews with 9 caregivers of 12 children who had participated in the program from one remote Aboriginal community in the Northern Territory are presented. Data were analysed thematically. Caregivers provided overall views on the program. In addition, three key areas of focus in the program are also presented here: speech and language, hearing health, and school readiness. Caregivers were positive about the interactive speech and language strategies in the program, except for some strategies which some parents found alien or difficult: such as talking slowly, following along with the child's topic, using parallel talk, or baby talk. Children's hearing was considered by caregivers to be important for understanding people, enjoying music, and detecting environmental sounds including signs of danger. Caregivers provided perspectives on the utility of sign language and its benefits for communicating with infants and young children with hearing loss, and the difficulty of getting young community children to wear a conventional hearing aid. Caregivers were strongly of the opinion that the program had helped prepare children for school through familiarising their child with early literacy activities and resources, as well as school routines. But caregivers differed as to whether they thought the program should have been located at the school itself. The caregivers generally reported positive views about the LiTTLe Program, and also drew attention to areas for improvement. The perspectives gathered may serve to guide other cross-sector collaborations across health and education to respond to OM among children at risk for OM-related disability in speech and language development.

22 CFR 1005.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE INTER-AMERICAN FOUNDATION § 1005.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by...

12 CFR 794.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL CREDIT UNION ADMINISTRATION § 794.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by handicapped...

50 CFR 550.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY MARINE MAMMAL COMMISSION § 550.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by...

28 CFR 39.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF JUSTICE § 39.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by...

24 CFR 9.152 - Program accessibility: alterations of Property Disposition Program multifamily housing facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... of Property Disposition Program multifamily housing facilities. 9.152 Section 9.152 Housing and Urban... URBAN DEVELOPMENT § 9.152 Program accessibility: alterations of Property Disposition Program multifamily...) in such a project shall be accessible for persons with hearing or vision impairments. If state or...

24 CFR 9.152 - Program accessibility: alterations of Property Disposition Program multifamily housing facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... of Property Disposition Program multifamily housing facilities. 9.152 Section 9.152 Housing and Urban... URBAN DEVELOPMENT § 9.152 Program accessibility: alterations of Property Disposition Program multifamily...) in such a project shall be accessible for persons with hearing or vision impairments. If state or...

49 CFR 807.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 807... CONDUCTED BY THE NATIONAL TRANSPORTATION SAFETY BOARD § 807.150 Program accessibility: Existing facilities... not— (1) Necessarily require the agency to make each of its existing facilities accessible to and...

76 FR 57989 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-19

... FEDERAL COMMUNICATIONS COMMISSION [DA 11-1527] Video Programming and Accessibility Advisory.... SUMMARY: This document announces the next meeting of the Video Programming Accessibility Advisory... Commission regarding video description, and the delivery of video description, access to emergency...

Hand Society and Matching Program Web Sites Provide Poor Access to Information Regarding Hand Surgery Fellowship.

PubMed

Hinds, Richard M; Klifto, Christopher S; Naik, Amish A; Sapienza, Anthony; Capo, John T

2016-08-01

The Internet is a common resource for applicants of hand surgery fellowships, however, the quality and accessibility of fellowship online information is unknown. The objectives of this study were to evaluate the accessibility of hand surgery fellowship Web sites and to assess the quality of information provided via program Web sites. Hand fellowship Web site accessibility was evaluated by reviewing the American Society for Surgery of the Hand (ASSH) on November 16, 2014 and the National Resident Matching Program (NRMP) fellowship directories on February 12, 2015, and performing an independent Google search on November 25, 2014. Accessible Web sites were then assessed for quality of the presented information. A total of 81 programs were identified with the ASSH directory featuring direct links to 32% of program Web sites and the NRMP directory directly linking to 0%. A Google search yielded direct links to 86% of program Web sites. The quality of presented information varied greatly among the 72 accessible Web sites. Program description (100%), fellowship application requirements (97%), program contact email address (85%), and research requirements (75%) were the most commonly presented components of fellowship information. Hand fellowship program Web sites can be accessed from the ASSH directory and, to a lesser extent, the NRMP directory. However, a Google search is the most reliable method to access online fellowship information. Of assessable programs, all featured a program description though the quality of the remaining information was variable. Hand surgery fellowship applicants may face some difficulties when attempting to gather program information online. Future efforts should focus on improving the accessibility and content quality on hand surgery fellowship program Web sites.

Early ACCESS Procedural Safeguards Manual for Parents (Parental Rights in Early Intervention)

ERIC Educational Resources Information Center

Iowa Department of Education, 2006

2006-01-01

Early ACCESS is a partnership between families and their young children with special needs (birth to age three) and providers from the Iowa Departments of Education, Public Health, and Human Services and the University of Iowa Child Health Specialty Clinics, and other community agencies. The purpose of this partnership is to work together to…

The Role of Maternal Depression in Accessing Early Intervention Services for Children with Developmental Delay

ERIC Educational Resources Information Center

Colgan, Siobhan Eileen

2012-01-01

This study investigated the relationship between maternal depression and children's access to early intervention services among a sample of children with developmental delay at age two who were determined to be eligible for early intervention services, were full term and of normal birth weight, and were not previously identified with any special…

75 FR 34941 - Review of the Commission's Program Access Rules and Examination of Programming Tying Arrangements

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-21

... Commission's Program Access Rules and Examination of Programming Tying Arrangements AGENCY: Federal... Program Access Rules and Examination of Programming Tying Arrangements, MB Docket No. 07-198, FCC 10-17... information collection is contained in Sections 4(i), 303(r), and 628 of the Communications Act of 1934, as...

Algorithm for optimal dialysis access timing.

PubMed

Heaf, J G

2007-02-01

Acute initiation of dialysis is associated with increased morbidity due to access and uremia complications. It is frequent despite early referral and regular out-patient control. We studied factors associated with end-stage renal disease (ESRD) progression in order to optimize the timing of dialysis access (DA). In a retrospective longitudinal study (Study 1), the biochemical and clinical course of 255 dialysis and 64 predialysis patients was registered to determine factors associated with dialysis-free survival (DFS). On the basis of these results an algorithm was developed to predict timely DA, defined as >6 weeks and <26 weeks before dialysis initiation, with too late placement weighted twice as harmful as too early. The algorithm was validated in a prospective study (Study 2) of 150 dialysis and 28 predialysis patients. Acute dialysis was associated with increased 90-day hospitalization (17.9 vs. 9.0 days) and mortality (14% vs. 6%). P-creatinine and p-urea were poor indicators of DFS. At any level of p-creatinine, DFS was shorter with lower creatinine clearance and vice versa. Patients with systemic renal disease had a significantly shorter DFS than primary renal disease, due to faster GFR loss and earlier dialysis initiation. Short DFS was seen with hypoalbuminemia and cachexia; these patients were recommended early DA. The following algorithm was used to time DA (units: 1iM and ml/min/1.73 m2): P-Creatinine - 50 x GFR + (100 if Systemic Renal Disease) >200. Use of the algorithm was associated with earlier dialysis placement and a fall in acute dialysis requirements from 50% to 23%. The incidence of too early DA was unchanged (7% vs. 9%), and was due to algorithm non-application. The algorithm failed to predict imminent dialysis in 10% of cases, primarily due to acute exacerbation of stable uremia. Dialysis initiation was advanced by approximately one month. A predialysis program based on early dialysis planning and GFR-based DA timing may reduce the requirement for acute dialysis initiation and patient morbidity and mortality, at the cost of slightly earlier dialysis initiation.

Cognitive advantages and disadvantages in early and late bilinguals.

PubMed

Pelham, Sabra D; Abrams, Lise

2014-03-01

Previous research has documented advantages and disadvantages of early bilinguals, defined as learning a 2nd language by school age and using both languages since that time. Relative to monolinguals, early bilinguals manifest deficits in lexical access but benefits in executive function. We investigated whether becoming bilingual after childhood (late bilinguals) can produce the cognitive advantages and disadvantages typical of early bilinguals. Participants were 30 monolingual English speakers, 30 late English-Spanish bilinguals, and 30 early Spanish-English bilinguals who completed a picture naming task (lexical access) and an attentional network task (executive function). Late and early bilinguals manifested equivalent cognitive effects in both tasks, demonstrating lexical access deficits and executive function benefits. These findings provide support for the hypothesis that cognitive effects associated with bilingualism arise as the result of proficient, habitual use of 2 languages and not of developmental changes associated with becoming bilingual during childhood.

The effects of paid maternity leave: Evidence from Temporary Disability Insurance.

PubMed

Stearns, Jenna

2015-09-01

This paper investigates the effects of a large-scale paid maternity leave program on birth outcomes in the United States. In 1978, states with Temporary Disability Insurance (TDI) programs were required to start providing wage replacement benefits to pregnant women, substantially increasing access to antenatal and postnatal paid leave for working mothers. Using natality data, I find that TDI paid maternity leave reduces the share of low birth weight births by 3.2 percent, and the estimated treatment-on-the-treated effect is over 10 percent. It also decreases the likelihood of early term birth by 6.6 percent. Paid maternity leave has particularly large impacts on the children of unmarried and black mothers. Copyright © 2015 Elsevier B.V. All rights reserved.

Cancer initiatives in developing countries.

PubMed

Mellstedt, H

2006-06-01

The coming decades will bring dramatic increases in morbidity and mortality from cancer in the developing world. The burden of cancer is increasing globally, with an expected 20 million new cases per year in 2020, half of which will be in low- and middle-income countries. Despite an already overwhelming burden of health problems, developing countries must somehow address this cancer pandemic and their alarming share of cancer illness. Many large-scale and innovative worldwide initiatives have been launched in the fight against cancer. These programs represent colossal efforts to expand resources for health education among people and healthcare workers in developing countries and to increase awareness of cancer prevention. Many novel evidence-based and culturally-relevant programs are being implemented for screening and early prevention of common cancers. Several key initiatives are supporting clinical research, guideline development, oncology training, and appropriate technology transfer, such as access to electronic medical literature. Treatment programs are expanding access and quality of radiologic and pharmacologic therapies for cancer. These initiatives represent an unprecedented level of and cooperation among international agencies, governmental and nongovernmental organizations, international foundations, scientific societies, local institutions, and industry. This review examines the scope of need in response to the increasing burden of cancer in the developing world and major initiatives that have been created to respond to these needs.

Lessons Learned From the Implementation of Brighter Bites: A Food Co-op to Increase Access to Fruits and Vegetables and Nutrition Education Among Low-Income Children and Their Families.

PubMed

Sharma, Shreela V; Chow, Joanne; Pomeroy, Michael; Raber, Margaret; Salako, David; Markham, Christine

2017-04-01

Food co-op models have gained popularity as a mechanism for offering affordable, quality produce. We describe the challenges, successes, and lessons learned from implementation of a school-based program using a food co-op model combined with nutrition education to improve access to and intake of fresh fruits and vegetables among low-income children and their families. Brighter Bites is a 16-week intervention comprising of fresh produce deliveries, recipe demonstrations, and nutrition education. A mixed-methods approach was used comprising survey and focus group data collected from Brighter Bites staff, parents, and teachers. Descriptive statistics and frequencies were computed for the survey data collected. Brighter Bites was implemented across 9 schools, serving a total of 1530 predominantly low-income families in the 2013-2014 school year. Brighter Bites distributed an average 60.2 servings of fresh fruits and vegetables per family per week. Lessons learned included the importance of leveraging existing infrastructure of food banks and schools to implement the program, early school and parent engagement, and incorporating strategies to track and optimize engagement. Clear expectations and reliable partnerships are keys to the delivery of the Brighter Bites program. © 2017, American School Health Association.

Increasing access and support for emergency management higher education programs.

PubMed

Cwiak, Carol L

2014-01-01

The number of emergency management higher education programs has grown dramatically since 1994 when the FEMA Higher Education Program was created to propagate and support such growth. Data collected annually since 2007 from emergency management higher education programs shows that these programs face some consistent challenges. These challenges were coupled with annual data on program access and support indicators via dimensional analysis to answer the questions: To what extent are the challenges linked to a lack of access or support? If there is linkage, what can be gleaned from these linkages that can help address the challenges through improving access and support? The analysis showed that lack of access to funding and resources, and lack of support from partner organizations, has an impact on emergency management higher education. Discussion of that impact is followed with detailed recommendations that are focused on strengthening both internal and external access and support relationships for emergency management higher education programs.

28 CFR 41.56 - General requirement concerning program accessibility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false General requirement concerning program accessibility. 41.56 Section 41.56 Judicial Administration DEPARTMENT OF JUSTICE IMPLEMENTATION OF EXECUTIVE... Determining Discriminatory Practices Program Accessibility § 41.56 General requirement concerning program...

32 CFR 1699.149 - Program accessibility: discrimination prohibited.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 6 2012-07-01 2012-07-01 false Program accessibility: discrimination prohibited... SERVICE SYSTEM ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY SELECTIVE SERVICE SYSTEM § 1699.149 Program accessibility: discrimination prohibited. Except as...

45 CFR 606.50 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Program accessibility: Discrimination prohibited... SCIENCE FOUNDATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL SCIENCE FOUNDATION § 606.50 Program accessibility: Discrimination prohibited...

46 CFR 507.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 9 2012-10-01 2012-10-01 false Program accessibility: Discrimination prohibited. 507... MARITIME COMMISSION § 507.149 Program accessibility: Discrimination prohibited. Except as otherwise... in, or otherwise be subjected to discrimination under any program or activity conducted by the agency. ...

49 CFR 28.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 1 2014-10-01 2014-10-01 false Program accessibility: Discrimination prohibited... § 28.149 Program accessibility: Discrimination prohibited. Except as otherwise provided in § 28.150, no... otherwise be subjected to discrimination under any program or activity conducted by the Department. ...

32 CFR 1699.149 - Program accessibility: discrimination prohibited.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Program accessibility: discrimination prohibited... CONDUCTED BY SELECTIVE SERVICE SYSTEM § 1699.149 Program accessibility: discrimination prohibited. Except as... participation in, or otherwise be subject to discrimination under any program or activity conducted by the...

49 CFR 28.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Program accessibility: Discrimination prohibited... § 28.149 Program accessibility: Discrimination prohibited. Except as otherwise provided in § 28.150, no... otherwise be subjected to discrimination under any program or activity conducted by the Department. ...

45 CFR 2104.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... FINE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE COMMISSION OF FINE ARTS § 2104.150 Program accessibility: Existing facilities. (a) General... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...

45 CFR 2104.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... FINE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE COMMISSION OF FINE ARTS § 2104.150 Program accessibility: Existing facilities. (a) General... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...

45 CFR 2104.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... FINE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE COMMISSION OF FINE ARTS § 2104.150 Program accessibility: Existing facilities. (a) General... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...

45 CFR 2104.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... FINE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE COMMISSION OF FINE ARTS § 2104.150 Program accessibility: Existing facilities. (a) General... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...

45 CFR 2104.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... FINE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE COMMISSION OF FINE ARTS § 2104.150 Program accessibility: Existing facilities. (a) General... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...

34 CFR 1200.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 4 2011-07-01 2011-07-01 false Program accessibility: Discrimination prohibited. 1200...) NATIONAL COUNCIL ON DISABILITY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL COUNCIL ON DISABILITY § 1200.149 Program accessibility: Discrimination...

A Mixed Methods Evaluation of Early Childhood Abuse Prevention Within Evidence-Based Home Visiting Programs.

PubMed

Matone, M; Kellom, K; Griffis, H; Quarshie, W; Faerber, J; Gierlach, P; Whittaker, J; Rubin, D M; Cronholm, P F

2018-05-31

Objectives In this large scale, mixed methods evaluation, we determined the impact and context of early childhood home visiting on rates of child abuse-related injury. Methods Entropy-balanced and propensity score matched retrospective cohort analysis comparing children of Pennsylvania Nurse-Family Partnership (NFP), Parents As Teachers (PAT), and Early Head Start (EHS) enrollees and children of Pennsylvania Medicaid eligible women from 2008 to 2014. Abuse-related injury episodes were identified in medical assistance claims with ICD-9 codes. Weighted frequencies and logistic regression odds of injury within 24 months are presented. In-depth interviews with staff and clients (n = 150) from 11 programs were analyzed using a modified grounded theory approach. Results The odds of a healthcare encounter for early childhood abuse among clients were significantly greater than comparison children (NFP: 1.32, 95% CI [1.08, 1.62]; PAT: 4.11, 95% CI [1.60, 10.55]; EHS: 3.15, 95% CI [1.41, 7.06]). Qualitative data illustrated the circumstances of and program response to client issues related to child maltreatment, highlighting the role of non-client caregivers. All stakeholders described curricular content aimed at prevention (e.g. positive parenting) with little time dedicated to addressing current or past abuse. Clients who reported a lack of abuse-related content supposed their home visitor's assumption of an absence of risk in their home, but were supportive of the introduction of abuse-related content. Approach, acceptance, and available resources were mediators of successfully addressing abuse. Conclusions for Practice Home visiting aims to prevent child abuse among high-risk families. Adequate home visitor capacity to proactively assess abuse risk, deliver effective preventive curriculum with fidelity to caregivers, and access appropriate resources is necessary.

The Ares I Crew Launch Vehicle: Human Space Access for the Moon and Beyond

NASA Technical Reports Server (NTRS)

Cook, Stephen A.

2008-01-01

The National Aeronautics and Space Administration (NASA)'s Constellation Program is depending on the Ares Projects to deliver the crew launch capabilities needed to send human explorers to the Moon and beyond. The Ares Projects continue to make progress toward design, component testing, and early flight testing of the Ares I crew launch vehicle (Figure 1), the United States first new human-rated launch vehicle in over 25 years. Ares I will provide the core space launch capabilities the United States needs to continue providing crew and cargo access to the International Space Station (ISS), maintaining the U.S. pioneering tradition as a spacefaring nation, and enabling cooperative international ventures to the Moon and beyond. This paper will discuss programmatic, design, fabrication, and testing progress toward building this new launch vehicle.

South Florida Information Access (SOFIA) metadata for the U.S. Geological Survey Greater Everglades place-based studies

USGS Publications Warehouse

Stapleton, Jo Anne; Sonenshein, Roy

2004-01-01

Beginning in 1995 the U.S. Geological Survey (USGS) funded scientific research to support the restoration of the Greater Everglades area and to supply decision makers and resource mangers with sound data on which to base their actions. However, none of the research and resulting data is useful if it can?t be discovered, can?t be assessed for utility in an application, can?t be accessed, or is in an undetermined format. The decision was made early in the USGS Place-Based Studies (PBS) program to create a ?one-stop? entry for information and data about USGS research results. To facilitate the discovery process some mechanism was needed to allow standardized queries about data. The FGDC metadata standard has been used to document the South Florida PBS data from the beginning.

Teleglaucoma: improving access and efficiency for glaucoma care.

PubMed

Kassam, Faazil; Yogesan, Kanagasingam; Sogbesan, Enitan; Pasquale, Louis R; Damji, Karim F

2013-01-01

Teleglaucoma is the application of telemedicine for glaucoma. We review and present the current literature on teleglaucoma; present our experience with teleglaucoma programs in Alberta, Canada and Western Australia; and discuss the challenges and opportunities in this emerging field. Teleglaucoma is a novel area that was first explored a little over a decade ago and early studies highlighted the technical challenges of delivering glaucoma care remotely. Advanced technologies have since emerged that show great promise in providing access to underserviced populations. Additionally, these technologies can improve the efficiency of healthcare systems burdened with an increasing number of patients with glaucoma, and a limited supply of ophthalmologists. Additional benefits of teleglaucoma systems include e-learning and e-research. Further work is needed to fully validate and study the cost and comparative effectiveness of this approach relative to traditional models of healthcare.

Teleglaucoma: Improving Access and Efficiency for Glaucoma Care

PubMed Central

Kassam, Faazil; Yogesan, Kanagasingam; Sogbesan, Enitan; Pasquale, Louis R.; Damji, Karim F.

2013-01-01

Teleglaucoma is the application of telemedicine for glaucoma. We review and present the current literature on teleglaucoma; present our experience with teleglaucoma programs in Alberta, Canada and Western Australia; and discuss the challenges and opportunities in this emerging field. Teleglaucoma is a novel area that was first explored a little over a decade ago and early studies highlighted the technical challenges of delivering glaucoma care remotely. Advanced technologies have since emerged that show great promise in providing access to underserviced populations. Additionally, these technologies can improve the efficiency of healthcare systems burdened with an increasing number of patients with glaucoma, and a limited supply of ophthalmologists. Additional benefits of teleglaucoma systems include e-learning and e-research. Further work is needed to fully validate and study the cost and comparative effectiveness of this approach relative to traditional models of healthcare. PMID:23741133

Standalone Internet speech restructuring treatment for adults who stutter: A phase I study.

PubMed

Erickson, Shane; Block, Susan; Menzies, Ross; O'Brian, Sue; Packman, Ann; Onslow, Mark

2016-08-01

This Phase I trial reports the results of a clinician-free Internet speech restructuring treatment for adults who stutter. The program consists of nine phases with concepts loosely based on the Camperdown Program. Twenty adults who stutter were recruited. They were given unlimited access to the program for 6 months. Primary outcome measures were the percentage of syllables stuttered and self-reported severity ratings. Five participants accessed all phases of the program, while another five accessed more than half the phases. The remaining 10 accessed between one and four phases. Four of five participants who accessed all phases reduced their stuttering frequency by more than 50% and an additional two participants who accessed more than half the phases also achieved similar reductions. These results were confirmed by self-reports of stuttering severity. Stuttering reductions were largely commensurate with the amount of the program accessed. As with other clinician-free programs in related health areas, maintaining adherence to the program's procedures was a significant issue. Nonetheless, this novel approach to treating stuttering has the potential to be a viable alternative for some clients and may help to address the significant access and relapse issues that affect treatment provision for adults who stutter.

36 CFR 1208.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... OR ACTIVITIES CONDUCTED BY THE NATIONAL ARCHIVES AND RECORDS ADMINISTRATION § 1208.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by individuals with...

45 CFR 2490.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by individuals with handicaps...

31 CFR 17.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Program accessibility: Discrimination... DEPARTMENT OF THE TREASURY § 17.149 Program accessibility: Discrimination prohibited. Except as otherwise... participation in, or otherwise be subjected to discrimination under any program or activity conducted by the...

Home visitation programs: An untapped opportunity for the delivery of early childhood obesity prevention

PubMed Central

Salvy, Sarah-Jeanne; de la Haye, Kayla; Galama, Titus; Goran, Michael I.

2016-01-01

Background Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: 1) short duration and low intensity; 2) late timing of implementation, when children are already overweight or obese; 3) intervention delivery limiting their accessibility and sustainability; and 4) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. Objective This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. Conclusion The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (1) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health due to socio-economic and structural conditions; (2) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (3) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention. PMID:27911984

Home visitation programs: an untapped opportunity for the delivery of early childhood obesity prevention.

PubMed

Salvy, S-J; de la Haye, K; Galama, T; Goran, M I

2017-02-01

Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: (i) short duration and low intensity; (ii) late timing of implementation, when children are already overweight or obese; (iii) intervention delivery limiting their accessibility and sustainability; and (iv) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (i) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health because of socio-economic and structural conditions; (ii) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (iii) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention. © 2016 World Obesity Federation.

Single-incision laparoscopic distal gastrectomy for early gastric cancer through a homemade single port access device.

PubMed

Jiang, Zhi-Wei; Zhang, Shu; Wang, Gang; Zhao, Kun; Liu, Jiang; Ning, Li; Li, Jieshou

2015-01-01

We presented a series of single-incision laparoscopic distal gastrectomies for early gastric cancer patients through a type of homemade single port access device and some other conventional laparoscopic instruments. A single-incision laparoscopic distal gastrectomy with D1 + α lymph node dissection was performed on a 46 years old male patient who had an early gastric cancer. This single port access device has facilitated the conventional laparoscopic instruments to accomplish the surgery and we made in only 6 minutes. Total operating time for this surgery was 240 minutes. During the operation, there were about 100 milliliters of blood loss, and 17 lymph-nodes were retrieved. This homemade single port access device shows its superiority in economy and convenience for complex single-incision surgeries. Single-incision laparoscopic distal gastrectomy for early gastric cancer can be conducted by experienced laparoscopic surgeons. Fully take advantage of both SILS and fast track surgery plan can bring to successful surgeries with minimal postoperative pain, quicker mobilization, early recovery of intestinal function, and better cosmesis effect for the patients.

Nutritional programming of coenzyme Q: potential for prevention and intervention?

PubMed

Tarry-Adkins, Jane L; Fernandez-Twinn, Denise S; Chen, Jian-Hua; Hargreaves, Iain P; Martin-Gronert, Malgorzata S; McConnell, Josie M; Ozanne, Susan E

2014-12-01

Low birth weight and rapid postnatal growth increases risk of cardiovascular-disease (CVD); however, underlying mechanisms are poorly understood. Previously, we demonstrated that rats exposed to a low-protein diet in utero that underwent postnatal catch-up growth (recuperated) have a programmed deficit in cardiac coenzyme Q (CoQ) that was associated with accelerated cardiac aging. It is unknown whether this deficit occurs in all tissues, including those that are clinically accessible. We investigated whether aortic and white blood cell (WBC) CoQ is programmed by suboptimal early nutrition and whether postweaning dietary supplementation with CoQ could prevent programmed accelerated aging. Recuperated male rats had reduced aortic CoQ [22 d (35±8.4%; P<0.05); 12 m (53±8.8%; P<0.05)], accelerated aortic telomere shortening (P<0.01), increased DNA damage (79±13% increase in nei-endonucleaseVIII-like-1), increased oxidative stress (458±67% increase in NAPDH-oxidase-4; P<0.001), and decreased mitochondrial complex II-III activity (P<0.05). Postweaning dietary supplementation with CoQ prevented these detrimental programming effects. Recuperated WBCs also had reduced CoQ (74±5.8%; P<0.05). Notably, WBC CoQ levels correlated with aortic telomere-length (P<0.0001) suggesting its potential as a diagnostic marker of vascular aging. We conclude that early intervention with CoQ in at-risk individuals may be a cost-effective and safe way of reducing the global burden of CVDs. © FASEB.

The Refugee Crisis and the Rights of Children: Perspectives on Community-Based Resettlement Programs.

PubMed

Alipui, Nicholas; Gerke, Nicole

2018-03-01

We are currently facing one of the largest and most complex refugee crises in modern times. Conflict and natural disasters have resulted in 22.5 million refugees worldwide, more than half are children. As the world struggles to respond to this massive displacement of people, how is this affecting child refugees' development and what is being done about it? In this commentary, we explore answers to these central questions. First, we review the situation of child refugees in numbers, exploring their geographic concentration. Second, we review child refugees' access to basic services, including early childhood development, with a special emphasis on community-based programs and initiatives that have proven to be particularly effective in addressing the needs of resettled child refugees. We find in particular that early childhood development activities in emergency contexts have seen remarkable improvements with critical benefits for the development of the youngest child refugees. Our aim is to bring attention to the particular difficulties child refugees must endure and to highlight those practices and approaches that are helping child refugees reach their full potential. © 2018 Wiley Periodicals, Inc.

Existing and Emerging Payment and Delivery Reforms in Cardiology

PubMed Central

Farmer, Steven A.; Darling, Margaret L.; George, Meaghan; Casale, Paul N.; Hagan, Eileen; McClellan, Mark B.

2017-01-01

IMPORTANCE Recent health care reforms aim to increase patient access, reduce costs, and improve health care quality as payers turn to payment reform for greater value. Cardiologists need to understand emerging payment models to succeed in the evolving payment landscape. We review existing payment and delivery reforms that affect cardiologists, present 4 emerging examples, and consider their implications for clinical practice. OBSERVATIONS Public and commercial payers have recently implemented payment reforms and new models are evolving. Most cardiology models are modified fee-for-service or address procedural or episodic care, but population models are also emerging. Although there is widespread agreement that payment reform is needed, existing programs have significant limitations and the adoption ofnew programs has been slow. New payment reforms address some of these problems, but many details remain undefined. CONCLUSIONS AND RELEVANCE Early payment reforms were voluntary and cardiologists’ participation is variable. However, conventional fee-for-service will become less viable, and enrollment in new payment models will be unavoidable. Early participation in new payment models will allow clinicians to develop expertise in new care pathways during a period of relatively lower risk. PMID:27851858

Reflections of Computing Experiences in a Steel Factory in the Early 1960s

NASA Astrophysics Data System (ADS)

Järvinen, Pertti

We can best see many things from a historical perspective. What were the first pioneers doing in the information technology departments of Finnish manufacturing companies? In early 1960s, I had a special chance to work in a steel industry that had long traditions to use rather advanced tools and methods to intensify their productivity. The first computer in our company had such novel properties as movable disk packs making a direct access of stored data possible. In this paper, we describe the following issues and innovations in some depth. These include (a) transitioning from the punched card machines to a new computer era, (b) using advanced programming language to intensify production of new computer software, (c) drawing pictures by using a line printer, (d) supporting steel making with mathematical software, (e) storing executable programs to the disk memory and calling and moving them from there to the core memory for running, and (f) building a simple report generator. I will also pay attention to the breakthrough in those innovations and in this way demonstrate how some computing solutions were growing at that time.

Synergy Between Individual and Institutional Capacity Building: Examples from the NASA DEVELOP National Program

NASA Astrophysics Data System (ADS)

Ross, K. W.; Childs-Gleason, L. M.; Favors, J.; Rogers, L.; Ruiz, M. L.; Allsbrook, K. N.

2016-12-01

The NASA DEVELOP National Program seeks to simultaneously build capacity to use Earth observations in early career and transitioning professionals while building capacity with institutional partners to apply Earth observations in conducting operations, making decisions, or informing policy. Engaging professionals in this manner lays the foundation of the NASA DEVELOP experience and provides a fresh perspective into institutional challenges. This energetic engagement of people in the emerging workforce elicits heightened attention and greater openness to new resources and processes from project partners. This presentation will describe how NASA DEVELOP provides over 350 opportunities for individuals to engage with over 140 partners per year. It will discuss how the program employs teaming approaches, logistical support, and access to science expertise to facilitate increased awareness and use of NASA geospatial information. It will conclude with examples of how individual/institutional capacity building synergies have led to useful capacity building outcomes.

Data Integration Support for Data Served in the OPeNDAP and OGC Environments

NASA Technical Reports Server (NTRS)

McDonald, Kenneth R.; Wharton, Stephen W. (Technical Monitor)

2006-01-01

NASA is coordinating a technology development project to construct a gateway between system components built upon the Open-source Project for a Network Data AcceSs Protocol (OPeNDAP) and those made available made available via interfaces specified by the Open Geospatial Consortium (OGC). This project is funded though the Advanced Collaborative Connections for Earth-Sun System Science (ACCESS) Program and is a NASA contribution to the Committee on Earth Satellites (CEOS) Working Group on Information Systems and Services (WGISS). The motivation for the project is the set of data integration needs that have been expressed by the Coordinated Enhanced Observing Period (CEOP), an international program that is addressing the study of the global water cycle. CEOP is assembling a large collection in situ and satellite data and mode1 results from a wide variety of sources covering 35 sites around the globe. The data are provided by systems based on either the OPeNDAP or OGC protocols but the research community desires access to the full range of data and associated services from a single client. This presentation will discuss the current status of the OPeNDAP/OGC Gateway Project. The project is building upon an early prototype that illustrated the feasibility of such a gateway and which was demonstrated to the CEOP science community. In its first year as an ACCESS project, the effort has been has focused on the design of the catalog and data services that will be provided by the gateway and the mappings between the metadata and services provided in the two environments.

Familial hypercholesterolemia in the Czech Republic: more than 17 years of systematic screening within the MedPed project.

PubMed

Vrablík, M; Vaclová, M; Tichý, L; Soška, V; Bláha, V; Fajkusová, L; Češka, R; Šatný, M; Freiberger, T

2017-04-05

Familial hypercholesterolemia (FH) is the most common autosomal dominant disorder. It is characterized by a decrease in LDL cholesterol catabolism and an early clinical manifestation of atherosclerotic vessel damage. The aim of the MedPed (Make early diagnosis to Prevent early deaths) project is an early diagnosis of FH patients in order to profit from early treatment and prevent cardiovascular events. Till November 30, 2016 The Czech National MedPed Database has registered 7,001 FH patients from 5,223 different families that is 17.4 % of expected patients in the Czech Republic considering 1:250 FH prevalence. The improvement in diagnostic accuracy, patient cooperation and above all familial cascade screening is enabled by FH mutation detection using the modern technology of next-generation sequencing. FH still remain undiagnosed even though the Czech Republic is one of the most successful countries with respect to FH detection. The opportunities of international collaboration and experience sharing within international programs (e.g. EAS FHSC, ScreenPro FH etc.) will improve the detection of FH patients in the future and enable even more accessible and accurate genetic diagnostics.

Building a Communication, Education, an Outreach Program for the ShakeAlert National Earthquake Early Warning Program - Recommendations for Public Alerts Via Cell Phones

NASA Astrophysics Data System (ADS)

DeGroot, R. M.; Long, K.; Strauss, J. A.

2017-12-01

The United States Geological Survey (USGS) and its partners are developing the ShakeAlert Earthquake Early Warning System for the West Coast of the United States. To be an integral part of successful implementation, ShakeAlert engagement programs and materials must integrate with and leverage broader earthquake risk programs. New methods and products for dissemination must be multidisciplinary, cost effective, and consistent with existing hazards education and communication efforts. The ShakeAlert Joint Committee for Communication, Education, and Outreach (JCCEO), is identifying, developing, and cultivating partnerships with ShakeAlert stakeholders including Federal, State, academic partners, private companies, policy makers, and local organizations. Efforts include developing materials, methods for delivery, and reaching stakeholders with information on ShakeAlert, earthquake preparedness, and emergency protective actions. It is essential to develop standards to ensure information communicated via the alerts is consistent across the public and private sector and achieving a common understanding of what actions users take when they receive a ShakeAlert warning. In February 2017, the JCCEO convened the Warning Message Focus Group (WMFG) to provide findings and recommendations to the Alliance for Telecommunications Industry Solutions on the use of earthquake early warning message content standards for public alerts via cell phones. The WMFG represents communications, education, and outreach stakeholders from various sectors including ShakeAlert regional coordinators, industry, emergency managers, and subject matter experts from the social sciences. The group knowledge was combined with an in-depth literature review to ensure that all groups who could receive the message would be taken into account. The USGS and the participating states and agencies acknowledge that the implementation of ShakeAlert is a collective effort requiring the participation of hundreds of stakeholders committed to ensuring public accessibility.

"Get Real--We Can't Afford Kindergarten": A Study of Parental Perceptions of Early Years Services

ERIC Educational Resources Information Center

Garvis, Susanne; Pendergast, Donna; Kanasa, Harry

2012-01-01

The Australian Early Childhood Universal Access Agreement stipulates all children three and a half years of age and older access to 15 hours of a quality early childhood education programme. While most states and territories in Australia have a 90% or higher attendance rate, in 2010, in Queensland the attendance rate was a comparative 40%. This…

32 CFR 147.19 - The three standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) The investigation standard for“Q” access authorizations and for access to top secret (including top secret Special Access Programs) and Sensitive Compartmented Information; (c) The reinvestigation standard... authorizations and for access to confidential and secret (including all secret-level Special Access Programs not...

Sea-change or change challenge? Health information access in developing countries: The U.S. National Library of Medicine experience.

PubMed

Royall, J; Lyon, B

2011-09-01

Health professionals in developing countries want access to information to help them make changes in health care and contribute to medical research. However, they face challenges of technology limitations, lack of training, and, on the village level, culture and language. This report focuses on the U.S. National Library of Medicine experience with access: for the international medical/scientific community to health information which has been published by researchers in developing countries; for scientists and clinicians in developing countries to their own literature and to that of their colleagues around the world; for medical librarians who are a critical conduit for students, faculty, researchers, and, increasingly, the general public; and for the front line workers at the health center in the village at the end of the line. The fundamental question of whether or not information communication technology can make a difference in access and subsequently in health is illustrated by an anecdote regarding an early intervention in Africa in 1992. From that point, we examine programs to improve access involving malaria researchers, medical journal editors, librarians, and medical students working with local health center staff in the village. Although access is a reality, the positive change in health that the information technology intervention might produce often remains a mirage. Information and technology are not static elements in the equation for better access. They must function together, creating a dialectic in which they transform and inform one another and those whom their combination touches.

47 CFR 79.109 - Activating accessibility features.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ACCESSIBILITY OF VIDEO PROGRAMMING Apparatus § 79.109 Activating accessibility features. (a) Requirements... video programming transmitted in digital format simultaneously with sound, including apparatus designed to receive or display video programming transmitted in digital format using Internet protocol, with...

Examining negative effects of early life experiences on reproductive and sexual health among female sex workers in Tijuana, Mexico.

PubMed

Oza, Karishma K; Silverman, Jay G; Bojorquez, Ietza; Strathdee, Steffanie A; Goldenberg, Shira M

2015-02-01

To explore experiences during childhood and adolescence that influenced reproductive and sexual health among women who had entered the sex industry in adolescence. A qualitative study was conducted using information provided by 25 female sex workers (FSWs) from Tijuana, Mexico, who reported entering the sex industry when younger than 18 years. In-depth, semi-structured interviews were conducted with all participants between January 31, 2011, and July 8, 2011. Four interrelated themes that shaped health experiences-early sexual abuse, early illicit drug use, ongoing violence, and limited access to reproductive and sexual health care-were identified. Participants reporting these experiences were at risk of unintended teenaged pregnancy, spontaneous abortion or stillbirth, and untreated sexually transmitted infections. Programs and policies that address social, structural, and individual vulnerabilities during adolescence and adulthood are required to promote reproductive and sexual health among FSWs in Tijuana, Mexico. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

From research to policy and practice: the School of the 21st Century.

PubMed

Zigler, Edward; Finn-Stevenson, Matia

2007-04-01

Current education reform policies focus on raising academic achievement and ensuring that all students have access to high-quality education. Because the achievement gap is apparent even before children enter school, the authors believe that education reform must encompass the early childhood years. The current dialogue about universal preschool presents an opportunity to address the need for a national system for early care and education. The authors believe this system should provide quality child care and preschool experiences for all children and embrace a whole-child approach that nurtures not only cognitive development but physical and mental health and social-emotional behaviors that are also important to successful schooling. The School of the 21st Century provides an example of an effective early care and education system using the public schools. The authors' work with the School of the 21st Century shows that schools can provide high-quality, developmentally appropriate care and that these programs benefit later school performance. 2007 APA, all rights reserved

Examining negative effects of early life experiences on reproductive and sexual health among female sex workers in Tijuana, Mexico

PubMed Central

Oza, Karishma K.; Silverman, Jay G.; Bojorquez, Ietza; Strathdee, Steffanie A.; Goldenberg, Shira M.

2014-01-01

Objective To explore experiences during childhood and adolescence that influenced reproductive and sexual health among women who had entered the sex industry in adolescence. Methods A qualitative study was conducted using information provided by 25 female sex workers (FSWs) from Tijuana, Mexico, who reported entering the sex industry when younger than 18 years. In-depth, semi-structured interviews were conducted with all participants between January 31, 2011, and July 8, 2011. Results Four interrelated themes that shaped health experiences—early sexual abuse, early illicit drug use, ongoing violence, and limited access to reproductive and sexual health care—were identified. Participants reporting these experiences were at risk of unintended teenaged pregnancy, spontaneous abortion or stillbirth, and untreated sexually transmitted infections. Conclusion Programs and policies that address social, structural, and individual vulnerabilities during adolescence and adulthood are required to promote reproductive and sexual health among FSWs in Tijuana, Mexico. PMID:25458416

Family and child-care provider influences on preschool children's fruit, juice, and vegetable consumption.

PubMed

Nicklas, T A; Baranowski, T; Baranowski, J C; Cullen, K; Rittenberry, L; Olvera, N

2001-07-01

Children's intakes of fruit, juice, and vegetables (FJV) do not meet the recommended minimum of five daily servings, placing them at increased risk for development of cancer and other diseases. Because children's food preferences and practices are initiated early in life (e.g., 2-5 years of age), early dietary intervention programs may have immediate nutritional benefit, as well as reduce chronic disease risk when learned healthful habits and preferences are carried into adulthood. Families and child-care settings are important social environments within which food-related behaviors among young children are developed. FJV preferences, the primary predictor of FJV consumption in children, are influenced by availability, variety, and repeated exposure. Caregivers (parents and child-care providers) can influence children's eating practices by controlling availability and accessibility of foods, meal structure, food modeling, food socialization practices, and food-related parenting style. Much remains to be learned about how these influences and practices affect the development of FJV preferences and consumption early in life.

Informing a culturally appropriate approach to oral health and dental care for pre-school refugee children: a community participatory study

PubMed Central

2014-01-01

Background Pre-school children in families of recently settled refugees often have very high rates of early childhood caries (ECC). ECC is associated with a high level of morbidity and is largely preventable, however effective culturally appropriate models of care are lacking. This study aimed to provide a deeper understanding of the refugee experience related to early oral health by exploring pre-school refugee families (i) understanding of ECC and child oral health, (ii) experiences of accessing dental services and (iii) barriers and enablers for achieving improved oral health. The knowledge gained will be critical to the development of effective early oral health programs in refugee children. Methods Community based participatory qualitative methodology using focus groups of resettled refugee families and community refugee nurse interviews. A community reference group was established and a bi-lingual community research associate was employed. Transcripts were analysed for thematic content using NVivo software. Results There were 44 participants: eight focus groups (nine countries of origin) and five interviews. Emergent themes were (i) the major influence of parents’ previous experience, including their beliefs about deciduous (baby) teeth, traditional feeding practices and poverty; and a consequent lack of understanding of the importance of early oral health and early dental caries, (ii) the burden of resettlement including prioritising, parenting, learning about new foods and how to assimilate into the community, and (iii) refugees’ difficulties in accessing both information and dental services, and the role of schools in addressing these issues. An Opportunities for Change Model was proposed. Conclusions The main implication of the study is the demonstration of how enhanced understanding of the refugee experience can inform improvement in early oral prevention and treatment. The community participatory methodology of the study provided a basis for cross-cultural understanding and has already assisted in translating the findings and raising awareness in the provision of targeted refugee oral health services. PMID:24923308

Informing a culturally appropriate approach to oral health and dental care for pre-school refugee children: a community participatory study.

PubMed

Nicol, Pam; Al-Hanbali, Arwa; King, Nigel; Slack-Smith, Linda; Cherian, Sarah

2014-06-13

Pre-school children in families of recently settled refugees often have very high rates of early childhood caries (ECC). ECC is associated with a high level of morbidity and is largely preventable, however effective culturally appropriate models of care are lacking. This study aimed to provide a deeper understanding of the refugee experience related to early oral health by exploring pre-school refugee families (i) understanding of ECC and child oral health, (ii) experiences of accessing dental services and (iii) barriers and enablers for achieving improved oral health. The knowledge gained will be critical to the development of effective early oral health programs in refugee children. Community based participatory qualitative methodology using focus groups of resettled refugee families and community refugee nurse interviews. A community reference group was established and a bi-lingual community research associate was employed. Transcripts were analysed for thematic content using NVivo software. There were 44 participants: eight focus groups (nine countries of origin) and five interviews. Emergent themes were (i) the major influence of parents' previous experience, including their beliefs about deciduous (baby) teeth, traditional feeding practices and poverty; and a consequent lack of understanding of the importance of early oral health and early dental caries, (ii) the burden of resettlement including prioritising, parenting, learning about new foods and how to assimilate into the community, and (iii) refugees' difficulties in accessing both information and dental services, and the role of schools in addressing these issues. An Opportunities for Change Model was proposed. The main implication of the study is the demonstration of how enhanced understanding of the refugee experience can inform improvement in early oral prevention and treatment. The community participatory methodology of the study provided a basis for cross-cultural understanding and has already assisted in translating the findings and raising awareness in the provision of targeted refugee oral health services.

Implementing the first regional hospice palliative care program in Ontario: the Champlain region as a case study.

PubMed

Pereira, José; Contant, Jocelyne; Barton, Gwen; Klinger, Christopher

2016-07-26

Regionalization promotes planning and coordination of services across settings and providers to meet population needs. Despite the potential advantages of regionalization, no regional hospice palliative care program existed in Ontario, Canada, as of 2010. This paper describes the process and early results of the development of the first regional hospice palliative care program in Ontario. The various activities and processes undertaken and the formal agreements, policies and documents are described. A participative approach, started in April 2009, was used. It brought together over 26 health service providers, including residential hospices, a palliative care unit, community and hospital specialist consultation teams, hospitals, community health and social service agencies (including nursing), individual health professionals, volunteers, patients and families. An extensive stakeholder and community vetting process was undertaken that included work groups (to explore key areas such as home care, the hospital sector, hospice and palliative care unit beds, provision of care in rural settings, e-health and education), a steering committee and input from over 320 individuals via e-mail and town-halls. A Transitional Leadership Group was elected to steer the implementation of the Regional Program over the summer of 2010. This group established the by-laws and details regarding the governance structure of the Regional Program, including its role, responsibilities, reporting structures and initial performance indicators that the Local Health Integration Network (LHIN) approved. The Regional Program was formally established in November 2010 with a competency-based Board of 14 elected members to oversee the program. Early work involved establishing standards and performance indicators for the different sectors and settings in the region, and identifying key clinical needs such as the establishment of more residential hospice capacity in Ottawa and a rural framework to ensure access for citizens in rural and remote regions. Challenges encountered are explored as are the process enablers and facilitators. The paper views the development and implementation process from the perspectives of several frameworks and models related to change management. Following on several initial achievements, the long term success of the Regional Program will depend on consolidating the early gains and demonstrating changes based on key measurable outcomes.

Conceptual Model for Quality of Life among Adults With Congenital or Early Deafness

PubMed Central

Kushalnagar, P; McKee, M; Smith, SR; Hopper, M; Kavin, D; Atcherson, SR

2015-01-01

Background A conceptual model of health-related quality of life (QoL) is needed to describe key themes that impact perceived QoL in adults with congenital or early deafness. Objective: To revise University of Washington Center for Disability Policy and Research's conceptual model of health promotion and QoL, with suggestions for applying the model to improving programs or services that target deaf adults with early deafness. Methods Purposive and theoretical sampling of 35 adults who were born or became deaf early was planned in a 1-year study. In-depth semi-structured interviews probed deaf adult participants' perceptions about quality of life as a deaf individual. Data saturation was reached at the 17th interview with 2 additional interviews for validation, resulting in a total sample of 19 deaf adults. Coding and thematic analysis were conducted to develop the conceptual model. Results Our conceptual model delineates the relationships between health status (self-acceptance, coping with limitations), intrinsic (functional communication skills, navigating barriers/self-advocacy, resilience) and extrinsic (acceptance by others, access to information, educating others) factors in their influence on deaf adult quality of life outcomes at home, college, work, and in the community. Conclusions Findings demonstrate the need for the programs and services to consider not only factors intrinsic to the deaf individual but also extrinsic factors in enhancing perceived quality of life outcomes among people with a range of functional hearing and language preferences, including American Sign Language. PMID:24947577

Conceptual model for quality of life among adults with congenital or early deafness.

PubMed

Kushalnagar, Poorna; McKee, Michael; Smith, Scott R; Hopper, Melinda; Kavin, Denise; Atcherson, Samuel R

2014-07-01

A conceptual model of health-related quality of life (QoL) is needed to describe key themes that impact perceived QoL in adults with congenital or early deafness. To revise University of Washington Center for Disability Policy and Research's conceptual model of health promotion and QoL, with suggestions for applying the model to improving programs or services that target deaf adults with early deafness. Purposive and theoretical sampling of 35 adults who were born or became deaf early was planned in a 1-year study. In-depth semi-structured interviews probed deaf adult participants' perceptions about quality of life as a deaf individual. Data saturation was reached at the 17th interview with 2 additional interviews for validation, resulting in a total sample of 19 deaf adults. Coding and thematic analysis were conducted to develop the conceptual model. Our conceptual model delineates the relationships between health status (self-acceptance, coping with limitations), intrinsic (functional communication skills, navigating barriers/self-advocacy, resilience) and extrinsic (acceptance by others, access to information, educating others) factors in their influence on deaf adult quality of life outcomes at home, college, work, and in the community. Findings demonstrate the need for the programs and services to consider not only factors intrinsic to the deaf individual but also extrinsic factors in enhancing perceived quality of life outcomes among people with a range of functional hearing and language preferences, including American Sign Language. Copyright © 2014 Elsevier Inc. All rights reserved.

Using social impact borrowing to expand preschool through third grade programs in urban public schools.

PubMed

Temple, Judy A; Reynolds, Arthur J

Budget constraints and difficulty raising taxes limit school districts from expanding education programming even when research shows that additional expenditures would generate economic benefits that are greater than costs. Recently, coalitions of private investors, philanthropists, education practitioners, and government finance analysts have emerged to create opportunities to expand education services that promise high rates of social net benefits without raising taxes or reducing other expenditures. These collaborators have a strong interest in obtaining careful estimates of educational program effectiveness. We describe the use of social-impact borrowing to increase access to the Child-Parent Center preschool-through-third-grade intervention for at-risk students in the Chicago Public School District. The partners include the city, school district, investors, nonprofit organizations, and a university. The key to the feasibility of social-impact borrowing is the ability to document that early intervention can reduce the need for later special-education services. With the help of private investors and nonprofit organizations, it is possible for public school districts to finance services with funds from private sources and use future cost savings to repay this debt. We discuss how social-impact borrowing is being used in Chicago and in Salt Lake County as the nation's first two instances of using pay-for-performance social-impact borrowing to support early education.

Characteristics of patient portals developed in the context of health information exchanges: early policy effects of incentives in the meaningful use program in the United States.

PubMed

Otte-Trojel, Terese; de Bont, Antoinette; van de Klundert, Joris; Rundall, Thomas G

2014-11-21

In 2014, the Centers for Medicare & Medicaid Services in the United States launched the second stage of its Electronic Health Record (EHR) Incentive Program, providing financial incentives to providers to meaningfully use their electronic health records to engage patients online. Patient portals are electronic means to engage patients by enabling secure access to personal medical records, communication with providers, various self-management tools, and administrative functionalities. Outcomes of patient portals have mainly been reported in large integrated health systems. This may now change as the EHR Incentive Program enables and supports the use of patient portals in other types of health systems. In this paper, we focus on Health Information Exchanges (HIE): entities that facilitate data exchange within networks of independent providers. In response to the EHR Incentive Program, some Health Information Exchanges in the United States are developing patient portals and offering them to their network of providers. Such patient portals hold high value for patients, especially in fragmented health system contexts, due to the portals' ability to integrate health information from an array of providers and give patients one access point to this information. Our aim was to report on the early effects of the EHR incentives on patient portal development by HIEs. Specifically, we describe the characteristics of these portals, identify factors affecting adoption by providers during the 2013-2014 time frame, and consider what may be the primary drivers of providers' adoption of patient portals in the future. We identified four HIEs that were developing patient portals as of spring 2014. We collected relevant documents and conducted interviews with six HIE leaders as well as two providers that were implementing the portals in their practices. We performed content analysis on these data to extract information pertinent to our study objectives. Our findings suggest that there are two primary types of patient portals available to providers in HIEs: (1) portals linked to EHRs of individual providers or health systems and (2) HIE-sponsored portals that link information from multiple providers' EHRs. The decision of providers in the HIEs to adopt either one of these portals appears to be a trade-off between functionality, connectivity, and cost. Our findings also suggest that while the EHR Incentive Program is influencing these decisions, it may not be enough to drive adoption. Rather, patient demand for access to patient portals will be necessary to achieve widespread portal adoption and realization of potential benefits. Optimizing patient value should be the main principle underlying policies intending to increase online patient engagement in the third stage of the EHR Incentive Program. We propose a number of features for the EHR Incentive Program that will enhance patient value and thereby support the growth and sustainability of patient portals provided by Health Information Exchanges.

22 CFR 1600.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Program accessibility: Discrimination prohibited. 1600.149 Section 1600.149 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT... STATES FRIENDSHIP COMMISSION § 1600.149 Program accessibility: Discrimination prohibited. Except as...

47 CFR 1.1849 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 1 2011-10-01 2011-10-01 false Program accessibility: Discrimination... the Federal Communications Commission § 1.1849 Program accessibility: Discrimination prohibited. (a... benefits of, be excluded from participation in, or otherwise be subjected to discrimination under any...

ACCESS 1: Approximation Concepts Code for Efficient Structural Synthesis program documentation and user's guide

NASA Technical Reports Server (NTRS)

Miura, H.; Schmit, L. A., Jr.

1976-01-01

The program documentation and user's guide for the ACCESS-1 computer program is presented. ACCESS-1 is a research oriented program which implements a collection of approximation concepts to achieve excellent efficiency in structural synthesis. The finite element method is used for structural analysis and general mathematical programming algorithms are applied in the design optimization procedure. Implementation of the computer program, preparation of input data and basic program structure are described, and three illustrative examples are given.

Evaluating a community-based early childhood education and development program in Indonesia: study protocol for a pragmatic cluster randomized controlled trial with supplementary matched control group

PubMed Central

2013-01-01

Background This paper presents the study protocol for a pragmatic cluster randomized controlled trial (RCT) with a supplementary matched control group. The aim of the trial is to evaluate a community-based early education and development program launched by the Government of Indonesia. The program was developed in collaboration with the World Bank with a total budget of US$127.7 million, and targets an estimated 738,000 children aged 0 to 6 years living in approximately 6,000 poor communities. The aim of the program is to increase access to early childhood services with the secondary aim of improving school readiness. Methods/Design The study is being conducted across nine districts. The baseline survey contained 310 villages, of which 100 were originally allocated to the intervention arm, 20 originally allocated to a 9-month delay staggered start, 100 originally allocated to an 18-month delay staggered start and 90 allocated to a matched control group (no intervention). The study consists of two cohorts, one comprising children aged 12 to 23 months and the other comprising children aged 48 to 59 months at baseline. The data collection instruments include child observations and task/game-based assessments as well as a questionnaire suite, village head questionnaire, service level questionnaires, household questionnaire, and child caretaker questionnaire. The baseline survey was conducted from March to April 2009, midline was conducted from April to August 2010 and endline conducted early 2013. The resultant participation rates at both the district and village levels were 90%. At the child level, the participation rate was 99.92%. The retention rate at the child level at midline was 99.67%. Discussion This protocol paper provides a detailed record of the trial design including a discussion regarding difficulties faced with compliance to the randomization, compliance to the dispersion schedule of community block grants, and procurement delays for baseline and midline data collections. Considering the execution of the program and the resultant threats to the study, we discuss our analytical plan and intentions for endline data collection. Trials registration Current Controlled Trials ISRCTN76061874 PMID:23953975

Evaluating a community-based early childhood education and development program in Indonesia: study protocol for a pragmatic cluster randomized controlled trial with supplementary matched control group.

PubMed

Pradhan, Menno; Brinkman, Sally A; Beatty, Amanda; Maika, Amelia; Satriawan, Elan; de Ree, Joppe; Hasan, Amer

2013-08-16

This paper presents the study protocol for a pragmatic cluster randomized controlled trial (RCT) with a supplementary matched control group. The aim of the trial is to evaluate a community-based early education and development program launched by the Government of Indonesia. The program was developed in collaboration with the World Bank with a total budget of US$127.7 million, and targets an estimated 738,000 children aged 0 to 6 years living in approximately 6,000 poor communities. The aim of the program is to increase access to early childhood services with the secondary aim of improving school readiness. The study is being conducted across nine districts. The baseline survey contained 310 villages, of which 100 were originally allocated to the intervention arm, 20 originally allocated to a 9-month delay staggered start, 100 originally allocated to an 18-month delay staggered start and 90 allocated to a matched control group (no intervention). The study consists of two cohorts, one comprising children aged 12 to 23 months and the other comprising children aged 48 to 59 months at baseline. The data collection instruments include child observations and task/game-based assessments as well as a questionnaire suite, village head questionnaire, service level questionnaires, household questionnaire, and child caretaker questionnaire. The baseline survey was conducted from March to April 2009, midline was conducted from April to August 2010 and endline conducted early 2013. The resultant participation rates at both the district and village levels were 90%. At the child level, the participation rate was 99.92%. The retention rate at the child level at midline was 99.67%. This protocol paper provides a detailed record of the trial design including a discussion regarding difficulties faced with compliance to the randomization, compliance to the dispersion schedule of community block grants, and procurement delays for baseline and midline data collections. Considering the execution of the program and the resultant threats to the study, we discuss our analytical plan and intentions for endline data collection. Current Controlled Trials ISRCTN76061874.

An eHealth Intervention for Patients in Rural Areas: Preliminary Findings From a Pilot Feasibility Study

PubMed Central

Schrader, Geoffrey; Harris, Melanie; Newman, Lareen; Lynn, Sarah; Peterson, Leigh; Battersby, Malcolm

2014-01-01

Background eHealth facilitation of chronic disease management has potential to increase engagement and effectiveness and extend access to care in rural areas. Objective The objective of this study was to demonstrate the feasibility and acceptability of an eHealth system for the management of chronic conditions in a rural setting. Methods We developed an online management program which incorporated content from the Flinders Chronic Condition Management Program (Flinders Program) and used an existing software platform (goACT), which is accessible by patients and health care workers using either Web-enabled mobile phone or Internet, enabling communication between patients and clinicians. We analyzed the impact of this eHealth system using qualitative and simple quantitative methods. Results The eHealth system was piloted with 8 recently hospitalized patients from rural areas, average age 63 (SD 9) years, each with an average of 5 chronic conditions and high level of psychological distress with an average K10 score of 32.20 (SD 5.81). Study participants interacted with the eHealth system. The average number of logins to the eHealth system by the study participants was 26.4 (SD 23.5) over 29 weeks. The login activity was higher early in the week. Conclusions The pilot demonstrated the feasibility of implementing and delivering a chronic disease management program using a Web-based patient-clinician application. A qualitative analysis revealed burden of illness and low levels of information technology literacy as barriers to patient engagement. PMID:24927511

An eHealth Intervention for Patients in Rural Areas: Preliminary Findings From a Pilot Feasibility Study.

PubMed

Schrader, Geoffrey; Bidargaddi, Niranjan; Harris, Melanie; Newman, Lareen; Lynn, Sarah; Peterson, Leigh; Battersby, Malcolm

2014-06-12

eHealth facilitation of chronic disease management has potential to increase engagement and effectiveness and extend access to care in rural areas. The objective of this study was to demonstrate the feasibility and acceptability of an eHealth system for the management of chronic conditions in a rural setting. We developed an online management program which incorporated content from the Flinders Chronic Condition Management Program (Flinders Program) and used an existing software platform (goACT), which is accessible by patients and health care workers using either Web-enabled mobile phone or Internet, enabling communication between patients and clinicians. We analyzed the impact of this eHealth system using qualitative and simple quantitative methods. The eHealth system was piloted with 8 recently hospitalized patients from rural areas, average age 63 (SD 9) years, each with an average of 5 chronic conditions and high level of psychological distress with an average K10 score of 32.20 (SD 5.81). Study participants interacted with the eHealth system. The average number of logins to the eHealth system by the study participants was 26.4 (SD 23.5) over 29 weeks. The login activity was higher early in the week. The pilot demonstrated the feasibility of implementing and delivering a chronic disease management program using a Web-based patient-clinician application. A qualitative analysis revealed burden of illness and low levels of information technology literacy as barriers to patient engagement.

Early Intervention With Transplantation Recipients to Improve Access to and Knowledge of Palliative Care.

PubMed

Harden, Karen L

2016-08-01

The literature continues to support that patients undergoing hematopoietic stem cell transplantation (HSCT) receive early consultation with palliative care specialists. Nurses can be leaders in this initiative. This quality improvement project was conducted to determine whether patients undergoing HSCT, who were provided an early consultation with palliative care, would report increased knowledge and increased ability to access palliative services. Patients completed a postintervention questionnaire in which the majority of patients reported that they had increased knowledge about palliative care and learned how to access their services. Patient comments were positive about the successful intervention of early palliative care. The palliative care team, however, revealed a different view of the situation, showing that patients were often overwhelmed, anxious, and sometimes did not remember the content of their meetings.

[Breast cancer screening process indicators in Mexico: a case study].

PubMed

Uscanga-Sánchez, Santos; Torres-Mejía, Gabriela; Ángeles-Llerenas, Angélica; Domínguez-Malpica, Raúl; Lazcano-Ponce, Eduardo

2014-01-01

To identify, measure and compare the performance indicators of productivity, effective access and quality service for the early detection breast cancer program in Mexico. By means of a study case based on the 2011 Women Cancer Information System (SICAM), the indicators were measured and compared with the Mexican official standard NOM-041-SSA2-2011 and international standards. The analysis showed insufficient installed capacity (37%), low coverage in screening (15%), diagnostic evaluation (16%), biopsy (44%) and treatment (57%), and very low effectiveness in confirmed cases by the total number of screening mammograms performed (0.04%). There was no information available, from SICAM, to estimate the rest of the indicators proposed. Efficient health information systems are required in order to monitor indicators and generate performance observatories of screening programs.

36 CFR 909.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Program accessibility: Discrimination prohibited. 909.149 Section 909.149 Parks, Forests, and Public Property PENNSYLVANIA AVENUE... CONDUCTED BY THE PENNSYLVANIA AVENUE DEVELOPMENT CORPORATION § 909.149 Program accessibility: Discrimination...

45 CFR 2301.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Program accessibility: Discrimination prohibited. 2301.149 Section 2301.149 Public Welfare Regulations Relating to Public Welfare (Continued) ARCTIC... CONDUCTED BY THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.149 Program accessibility: Discrimination...

45 CFR 2301.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Program accessibility: Discrimination prohibited. 2301.149 Section 2301.149 Public Welfare Regulations Relating to Public Welfare (Continued) ARCTIC... CONDUCTED BY THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.149 Program accessibility: Discrimination...

Economic Impact of the Critical Access Hospital Program on Kentucky's Communities

ERIC Educational Resources Information Center

Ona, Lucia; Davis, Alison

2011-01-01

Context: In 1997, the Medicare Rural Hospital Flexibility Grant Program created the Critical Access Hospital (CAH) Program as a response to the financial distress of rural hospitals. It was believed that this program would reduce the rate of rural hospital closures and improve access to health care services in rural communities. Objective: The…

The International Solar Terrestrial Physics Program: A Model for International Cooperation in Space Research

NASA Astrophysics Data System (ADS)

Acuña, M.

The International Solar Terrestrial Physics Program (ISTP) evolved from the individual plans of US, Japanese and European countries to develop space missions to expand our knowledge of the Sun-Earth connection as a "system". Previous experience with independent missions amply illustrated the critical need for coordinated and simultaneous observations in key regions of Sun-Earth space in order to resolve time-space ambiguities and cause-effect relationships. Mission studies such as the US Origins of Plasmas in the Earth's Neighborhood (OPEN), Geotail in Japan, the Solar Heliospheric Observatory in Europe and the Regatta and other magnetospheric missions in the former Soviert Union, formed the early conceptual elements that eventually led to the ISTP program. The coordinating role developed by the Inter-Agency-Consultative-Group (IACG) integrated by NASA, ESA, ISAS and IKI and demonstrated during the comet Halley apparition in 1986, was continued to include solar-terrestrial research and the mission elements described above. In addition to the space elements, a most important component of the coordination effort was the inclusion of data networks, analysis and planning tools as well as globally accessible data sets by the scientific community at large. This approach enabled the active and direct participation of scientists in developing countries in one of the most comprehensive solar-terrestrial research programs implemented to date. The creation of multiple ISTP data repositories throughout the world has enabled a large number of scientists in developing countries to have direct access to the latest spacecraft observations and a most fruitful interaction with fellow researchers throughout the world. This paper will present a review of the evolution of the ISTP program, its products, analysis tools, data bases, infrastructure and lessons learned applicable to future international collaborative programs.

Clinical outcomes of an early intervention program for preschool children with Autism Spectrum Disorder in a community group setting.

PubMed

Eapen, Valsamma; Crnčec, Rudi; Walter, Amelia

2013-01-07

Available evidence indicates that early intervention programs, such as the Early Start Denver Model (ESDM), can positively affect key outcomes for children with Autism Spectrum Disorder (ASD). However, programs involving resource intensive one-to-one clinical intervention are not readily available or deliverable in the community, resulting in many children with ASD missing out on evidence-based intervention during their early and most critical preschool years. This study evaluated the effectiveness of the ESDM for preschool-aged children with ASD using a predominantly group-based intervention in a community child care setting. Participants were 26 children (21 male) with ASD with a mean age of 49.6 months. The ESDM, a comprehensive early intervention program that integrates applied behaviour analysis with developmental and relationship-based approaches, was delivered by trained therapists during the child's attendance at a child care centre for preschool-aged children with ASD. Children received 15-20 hours of group-based, and one hour of one-to-one, ESDM intervention per week. The average intervention period was ten months. Outcome measures were administered pre- and post-intervention, and comprised a developmental assessment - the Mullen Scales of Early Learning (MSEL); and two parent-report questionnaires - the Social Communication Questionnaire (SCQ) and Vineland Adaptive Behaviours Scales-Second Edition (VABS-II). Statistically significant post-intervention improvements were found in children's performance on the visual reception, receptive language and expressive language domains of the MSEL in addition to their overall intellectual functioning, as assessed by standardised developmental quotients. Parents reported significant increases in their child's receptive communication and motor skills on the VABS-II, and a significant decrease in autism-specific features on the SCQ. These effects were of around medium size, and appeared to be in excess of what may have been expected due to maturation. Nonetheless, these results need to be confirmed in a controlled study. This study suggests community dissemination of the ESDM using predominantly group-based intervention may be an effective intervention. Making the ESDM accessible to the wider ASD community in child care settings has the potential for significant clinical and economic benefits. Further studies are indicated in this area, including those with younger children, and which incorporate a control group and standardised ASD assessments. This trial is registered with the Australian New Zealand Clinical Trials Registry: Registry number ACTRN12612000461897.

Early Patient Access to Medicines: Health Technology Assessment Bodies Need to Catch Up with New Marketing Authorization Methods.

PubMed

Leyens, Lada; Brand, Angela

National and international medicines agencies have developed innovative methods to expedite promising new medicines to the market and facilitate early patient access. Some of these approval pathways are the conditional approval and the adaptive pathways by the European Medicines Agency (EMA); the Promising Innovative Medicine (PIM) designation and the Early Access to Medicines Scheme (EAMS) by the Medicines and Healthcare Products Regulatory Agency (MHRA), as well as the Fast Track, Breakthrough or Accelerated Approval methods by the Food and Drug Administration (FDA). However, at least in Europe, these methods cannot achieve the goal of improving timely access for patients to new medicines on their own; the reimbursement process also has to become adaptive and flexible. In the past 2 years, the effective access (national patient access) to newly approved oncology drugs ranged from 1 to 30 months, with an extremely high variability between European countries. The goal of early patient access in Europe can only be achieved if the national health technology assessment bodies, such as NICE (ENG), HAS (FR), G-BA (DE) or AIFA (IT), provide harmonized, transparent, flexible, conditional and adaptive methods that adopt the level of evidence accepted by the medicines agencies. The efforts from medicines agencies are welcome but will be in vain if health technology assessments do not follow with similar initiatives, and the European 'postcode' lottery will continue. © 2016 S. Karger AG, Basel.

22 CFR 1600.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Program accessibility: New construction and alterations. 1600.151 Section 1600.151 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT... STATES FRIENDSHIP COMMISSION § 1600.151 Program accessibility: New construction and alterations. Each...

22 CFR 1600.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Program accessibility: New construction and alterations. 1600.151 Section 1600.151 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT... STATES FRIENDSHIP COMMISSION § 1600.151 Program accessibility: New construction and alterations. Each...

22 CFR 1600.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 2 2012-04-01 2009-04-01 true Program accessibility: New construction and alterations. 1600.151 Section 1600.151 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT... STATES FRIENDSHIP COMMISSION § 1600.151 Program accessibility: New construction and alterations. Each...

22 CFR 1600.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Program accessibility: New construction and alterations. 1600.151 Section 1600.151 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT... STATES FRIENDSHIP COMMISSION § 1600.151 Program accessibility: New construction and alterations. Each...

19 CFR 201.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 3 2010-04-01 2010-04-01 false Program accessibility: Discrimination prohibited. 201.149 Section 201.149 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.149 Program accessibility: Discrimination...

19 CFR 201.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 3 2010-04-01 2010-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

19 CFR 201.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 3 2012-04-01 2012-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

19 CFR 201.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 3 2014-04-01 2014-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

19 CFR 201.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 3 2012-04-01 2012-04-01 false Program accessibility: Discrimination prohibited. 201.149 Section 201.149 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.149 Program accessibility: Discrimination...

19 CFR 201.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 3 2013-04-01 2013-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

19 CFR 201.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 3 2014-04-01 2014-04-01 false Program accessibility: Discrimination prohibited. 201.149 Section 201.149 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.149 Program accessibility: Discrimination...

19 CFR 201.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 3 2011-04-01 2011-04-01 false Program accessibility: Discrimination prohibited. 201.149 Section 201.149 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.149 Program accessibility: Discrimination...

19 CFR 201.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 3 2013-04-01 2013-04-01 false Program accessibility: Discrimination prohibited. 201.149 Section 201.149 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.149 Program accessibility: Discrimination...

19 CFR 201.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 3 2011-04-01 2011-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

45 CFR 2490.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Program accessibility: Existing facilities. 2490.150 Section 2490.150 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility...

45 CFR 2490.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Program accessibility: Existing facilities. 2490.150 Section 2490.150 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility...

45 CFR 2490.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Program accessibility: Existing facilities. 2490.150 Section 2490.150 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility...

45 CFR 2490.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Program accessibility: Existing facilities. 2490.150 Section 2490.150 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility...

76 FR 66089 - Access Authorization Program for Nuclear Power Plants

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-25

... NUCLEAR REGULATORY COMMISSION [NRC-2011-0245] Access Authorization Program for Nuclear Power... Program for Nuclear Power Plants.'' This guide describes a method that NRC staff considers acceptable to... Regulations (10 CFR), section 73.56, ``Personnel Access Authorization Requirements for Nuclear Power Plants...

45 CFR 2301.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 2301.150 Section 2301.150 Public Welfare Regulations Relating to Public Welfare (Continued) ARCTIC RESEARCH... THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.150 Program accessibility: Existing facilities. (a...

45 CFR 2301.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Program accessibility: Existing facilities. 2301.150 Section 2301.150 Public Welfare Regulations Relating to Public Welfare (Continued) ARCTIC RESEARCH... THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.150 Program accessibility: Existing facilities. (a...

Mass storage systems for data transport in the early space station era 1992-1998

NASA Technical Reports Server (NTRS)

Carper, Richard (Editor); Dalton, John (Editor); Healey, Mike (Editor); Kempster, Linda (Editor); Martin, John (Editor); Mccaleb, Fred (Editor); Sobieski, Stanley (Editor); Sos, John (Editor)

1987-01-01

NASA's Space Station Program will provide a vehicle to deploy an unprecedented number of data producing experiments and operational devices. Peak down link data rates are expected to be in the 500 megabit per second range and the daily data volume could reach 2.4 terabytes. Such startling requirements inspired an internal NASA study to determine if economically viable data storage solutions are likely to be available to support the Ground Data Transport segment of the NASA data system. To derive the requirements for data storage subsystems, several alternative data transport architectures were identified with different degrees of decentralization. Data storage operations at each subsystem were categorized based on access time and retrieval functions, and reduced to the following types of subsystems: First in First out (FIFO) storage, fast random access storage, and slow access with staging. The study showed that industry funded magnetic and optical storage technology has a reasonable probability of meeting these requirements. There are, however, system level issues that need to be addressed in the near term.

Astronomy4Kids: A new, online, STEM-focused, video education outreach program

NASA Astrophysics Data System (ADS)

Pearson, Richard L.; Pearson, Sarah R.

2017-06-01

Recent research indicates significant benefits of early childhood introductions to language, mathematics, and general science concepts. Specifically, a child that is introduced to a concept at a young age is more prepared to receive it in its entirety later. Astronomy4Kids was created to bring science, technology, engineering, and math (STEM) concepts to the youngest learners (those under the age of eight, or those from pre-school to about second-grade). The videos are presented in a succinct, one-on-one manner, and provide a creative learning environment for the viewers. Following the preschool education video principles established by Fred Rogers, we hope to give young children access to an expert astronomer who can explain things simply and sincerely. We believe presenting the material in this manner will make it engaging for even the youngest scholar and available to any interested party. The videos can be freely accessed at www.astronomy4kids.net.

A novel approach for supercapacitors degradation characterization

NASA Astrophysics Data System (ADS)

Oz, Alon; Gelman, Danny; Goren, Emanuelle; Shomrat, Neta; Baltianski, Sioma; Tsur, Yoed

2017-07-01

A novel approach to analyze electrochemical impedance spectroscopy (EIS), based on evolutionary programming, has been utilized to characterize supercapacitors operation mechanism and degradation processes. This approach poses the ability of achieving a comprehensive study of supercapacitors via solely AC measurements. Commercial supercapacitors were examined during accelerated degradation. The microstructure of the electrode-electrolyte interface changes upon degradation; electrolyte parasitic reactions yield the formation of precipitates on the porous surface, which limit the access of the electrolyte ions to the active area and thus reduces performance. EIS analysis using Impedance Spectroscopy Genetic Programming (ISGP) technique enables identifying how the changing microstructure is affecting the operation mechanism of supercapacitors, in terms of each process effective capacitance and time constant. The most affected process is the transport of electrolyte ions at the porous electrode. Their access to the whole active area is hindered, which is shown in our analysis by the decrease of the capacitance gained in the transport and the longer time it takes to penetrate the entire pores depth. Early failure detection is also demonstrated, in a way not readily possible via conventional indicators. ISGP advanced analysis method has been verified using conventional and proven techniques: cyclic voltammetry and post mortem measurements.

Student Perceptions and Acceptance of Mobile Technology in an Undergraduate Nursing Program

PubMed Central

DeCristofaro, Claire; Murphy, Pamela F.; Sims, Archie

2017-01-01

Mobile technology allows healthcare students to access current evidence-based resources. The purpose of this study was to evaluate the student experience of implementing point-of-care (POC) smartphone applications in a first-semester undergraduate nursing program. Teaching methods included using case studies in the laboratory to familiarize students with the apps. At community screening sites, evidence-based guidelines were referenced when students discussed screening results with patients. Surveys were administered prior to implementing this innovation and after the students utilized the apps in direct patient interactions. Survey results were analyzed to evaluate student perceptions and acceptance of mobile technology. Students felt that healthcare smartphone apps were a helpful and convenient way to obtain evidence-based clinical information pertinent to direct care settings. Over 90% of students planned to continue using healthcare smartphone apps. In conclusion, healthcare smartphone apps are a way for students to become comfortable accessing evidence-based clinical resources. It is important to encourage students to use these resources early in the curriculum. Community screenings are an independent health promotion activity which assists in the attainment of health equity and fosters nursing leadership. PMID:28754011

A-21st-century-approach to firefighting in the Western US: How microwave-based seismic networks can change fire suppression from reactive to proactive

NASA Astrophysics Data System (ADS)

Kent, G. M.; Smith, K. D.; Williams, M. C.; Slater, D. E.; Plank, G.; McCarthy, M.; Rojas-Gonzalez, R.; Vernon, F.; Driscoll, N. W.; Hidley, G.

2015-12-01

The Nevada Seismological Laboratory (NSL) at UNR has recently embarked on a bold technical initiative, installing a high-speed (up to 190 Mb/sec) mountaintop-based Internet Protocol (IP) microwave network, enabling a myriad of sensor systems for Multi-Hazard Early Warning detection and response. In the Tahoe Basin, this system is known as AlertTahoe; a similar network has been deployed in north-central Nevada as part of a 5-year-long grant with BLM. The UNR network mirrors the successful HPWREN multi-hazard network run through UCSD; the UNR "Alert" program (Access to Leverage Emergency information in Real Time) has expanded on the original concept by providing a framework for early fire detection and discovery. Both systems do not rely on open-access public Internet services such as those provided by cellular service providers. Instead, they utilize private wireless communication networks to collect data 24/7 in real-time from multiple sensors throughout the system. Utilizing this restricted-access private communication platform enhances system reliability, capability, capacity and versatility for staff and its community of certified users. Both UNR and UCSD fire camera systems are presently being confederated under a common framework to provide end users (e.g., BLM, USFS, CalFire) a unified interface. Earthquake response has been both organizations' primary mission for decades; high-speed IP microwave fundamentally changes the playing field allowing for rapid early detection of wildfires, earthquakes and other natural disasters, greatly improving local and regional disaster response/recovery. For example, networked cameras can be optimally placed for wildfire detection and are significantly less vulnerable due infrastructure hardening and the ability to avoid extreme demands by the public on cellular and other public networks during a crisis. These systems also provide a backup for emergency responders to use when public access communications become overwhelmed or fail during an event. The crowd-sourced fire cameras can be viewed year round through AlertTahoe and AlertSoCal websites with on-demand time-lapse, an integrated real time lightning map, and other useful features.

Foot and Ankle Fellowship Websites: An Assessment of Accessibility and Quality.

PubMed

Hinds, Richard M; Danna, Natalie R; Capo, John T; Mroczek, Kenneth J

2017-08-01

The Internet has been reported to be the first informational resource for many fellowship applicants. The objective of this study was to assess the accessibility of orthopaedic foot and ankle fellowship websites and to evaluate the quality of information provided via program websites. The American Orthopaedic Foot and Ankle Society (AOFAS) and the Fellowship and Residency Electronic Interactive Database (FREIDA) fellowship databases were accessed to generate a comprehensive list of orthopaedic foot and ankle fellowship programs. The databases were reviewed for links to fellowship program websites and compared with program websites accessed from a Google search. Accessible fellowship websites were then analyzed for the quality of recruitment and educational content pertinent to fellowship applicants. Forty-seven orthopaedic foot and ankle fellowship programs were identified. The AOFAS database featured direct links to 7 (15%) fellowship websites with the independent Google search yielding direct links to 29 (62%) websites. No direct website links were provided in the FREIDA database. Thirty-six accessible websites were analyzed for content. Program websites featured a mean 44% (range = 5% to 75%) of the total assessed content. The most commonly presented recruitment and educational content was a program description (94%) and description of fellow operative experience (83%), respectively. There is substantial variability in the accessibility and quality of orthopaedic foot and ankle fellowship websites. Recognition of deficits in accessibility and content quality may assist foot and ankle fellowships in improving program information online. Level IV.

Feeding - Not weeding: A Strategy to Grow More Women Scientists

NASA Astrophysics Data System (ADS)

Pavone, Mary

2004-03-01

In 1990, Dartmouth College, a small, elite liberal arts college in New England, developed a co-curricular initiative to increase the numbers of undergraduate women graduating in SMET (science, math, engineering, and technology). Female attrition from the sciences was several times greater than that of male peers. Women's under-representation has been connected with early socialization, lower self-confidence, lower expectations from parents, teachers, and others; less "tinkering" experience, teaching practices in introductory college SMET courses, and a lack of critical mass. Recognizing that women leave science for varied reasons, a comprehensive and complementary set of programs evolved around the themes of early hands-on research experience, mentoring and networking, role models, access to information, and a sense of community. The cornerstone program of WISP pairs a young woman interested in science with a research faculty member for two terms of a paid, hands-on mentored introduction to research during her first or second year of college. Inquiry-based, active learning in a mentored context results in strengthened science interests, increased confidence, and expanded student vision on the possibilities of a scientific career. Developing early mentoring relationships with faculty and peers, and creating connections with a science community, are important elements for persistence in science. Now a mature and respected program, WISP supports and enhances the overall educational mission of the College by developing and nurturing a pipeline of successful female students interested in pursuing science as a career. WISP has created a positive student culture for research and scholarship that benefits all students and the institution as well.

A Preparatory Program to Identify the Single Best Transiting Exoplanet for JWST Early Release Science

NASA Astrophysics Data System (ADS)

Stevenson, Kevin

2016-10-01

JWST will revolutionize transiting exoplanet atmospheric science due to its capability for continuous, long-duration observations and, compared to existing space-based facilities, its larger collecting area, spectral coverage, and resolution. However, it is unclear precisely how well JWST will perform and which of its myriad instruments and observing modes will be best suited for transiting exoplanet studies. The Early Release Science (ERS) program was devised to provide early and open access to a broad suite of JWST science observations subject to key data analysis challenges so that the community can quickly build experience and develop a list of best observing practices prior to the Cycle 2 proposal deadline. In a recent paper, we identified 12 transiting exoplanets (dubbed community targets) that may be suitable for time-series observations within the ERS program; however, a critical unknown for the most favorable targets is the presence of obscuring clouds. To properly assess each observing mode, it is vital that the selected community target has measurable and identifiable spectroscopic features. We propose HST/WFC3 observations of four exoplanets to identify the single best target by first measuring the size of their 1.4-micron water vapor features. Next, we will perform follow-up Spitzer observations of the top two targets to determine the slopes in their infrared transmission spectra. Together, these measurements will provide the most robust determination of clouds/hazes with the minimum amount of telescope time. Cycle 24 is our final opportunity to identify suitable community targets with cloud-free atmospheres prior to the ERS proposal deadline in mid-2017.

Effectiveness of inpatient and outpatient strategies in increasing referral and utilization of cardiac rehabilitation: a prospective, multi-site study

PubMed Central

2012-01-01

Background Despite the evidence of benefit, cardiac rehabilitation (CR) remains highly underutilized. The present study examined the effect of two inpatient and one outpatient strategy on CR utilization: allied healthcare provider completion of referral (a policy that had been endorsed and approved by the cardiac program leadership in advance; PRE-APPROVED); CR intake appointment booked before hospital discharge (PRE-BOOKED); and early outpatient education provided at the CR program shortly after inpatient discharge (EARLY ED). In this prospective observational study, 2,635 stable cardiac inpatients from 11 Ontario hospitals completed a sociodemographic survey, and clinical data were extracted from charts. One year later, participants were a mailed survey that assessed CR use. Participating inpatient units and CR programs to which patients were referred were coded to reflect whether each of the strategies was used (yes/no). The effect of each strategy on participants’ CR referral and enrollment was examined using generalized estimating equations. Results A total of 1,809 participants completed the post-test survey. Adjusted analyses revealed that the implementation of one of the inpatient strategies was significantly related to greater referral and enrollment (PRE-APPROVED: OR = 1.96, 95%CI = 1.26 to 3.05, and OR = 2.91, 95%CI = 2.20 to 3.85, respectively). EARLY ED also resulted in significantly greater enrollment (OR = 4.85, 95%CI = 2.96 to 7.95). Conclusions These readily-implementable strategies could significantly increase access to and enrollment in CR for the cardiac population. The impact of these strategies on wait times warrants exploration. PMID:23234558

Early Intervention Services in Youth Mental Health

ERIC Educational Resources Information Center

Wade, Darryl; Johnston, Amy; Campbell, Bronwyn; Littlefield, Lyn

2007-01-01

Mental and substance use disorders are leading contributors to the burden of disease among young people in Australia, but young people experience a range of barriers to accessing appropriate treatment for their mental health concerns. The development of early intervention services that provide accessible and effective mental health care has the…

Montessori and Non-Montessori Early Childhood Teachers' Attitudes toward Inclusion and Access

ERIC Educational Resources Information Center

Danner, Natalie; Fowler, Susan A.

2015-01-01

Montessori and non-Montessori general education early childhood teachers were surveyed about their attitudes toward including children with disabilities and providing these students access to the curriculum. Both groups reported similar and positive system-wide supports for inclusion within their schools. Montessori teachers reported having less…

36 CFR 909.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Program accessibility: New construction and alterations. 909.151 Section 909.151 Parks, Forests, and Public Property PENNSYLVANIA AVENUE... CONDUCTED BY THE PENNSYLVANIA AVENUE DEVELOPMENT CORPORATION § 909.151 Program accessibility: New...

Health care leadership development and training: progress and pitfalls

PubMed Central

Sonnino, Roberta E

2016-01-01

Formal training in the multifaceted components of leadership is now accepted as highly desirable for health care leaders. Despite natural leadership instincts, some core leadership competencies (“differentiating competencies”) must be formally taught or refined. Leadership development may begin at an early career stage. Despite the recognized need, the number of comprehensive leadership development opportunities is still limited. Leadership training programs in health care were started primarily as internal institutional curricula, with a limited scope, for the development of faculty or practitioners. More comprehensive national leadership programs were developed in response to the needs of specific cohorts of individuals, such as programs for women, which are designed to increase the ranks of senior women leaders in the health sciences. As some programs reach their 20th year of existence, outcomes research has shown that health care leadership training is most effective when it takes place over time, is comprehensive and interdisciplinary, and incorporates individual/institutional projects allowing participants immediate practical application of their newly acquired skills. The training should envelop all the traditional health care domains of clinical practice, education, and research, so the leader may understand all the activities taking place under his/her leadership. Early career leadership training helps to develop a pipeline of leaders for the future, setting the foundation for further development of those who may chose to pursue significant leadership opportunities later in their career. A combination of early and mid-to-late career development may represent the optimal training for effective leaders. More training programs are needed to make comprehensive leadership development widely accessible to a greater number of potential health care leaders. This paper addresses the skills that health care leaders should develop, the optimal leadership development concepts that must be acquired to succeed as a health care leader today, some resources for where such training may be obtained, and what gaps are still present in today’s system. PMID:29355187

47 CFR 79.2 - Accessibility of programming providing emergency information.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) BROADCAST RADIO SERVICES ACCESSIBILITY OF VIDEO PROGRAMMING Video Programming Owners, Providers, and... of programming providing emergency information. (1) Video programming distributors must make... or by using a method of visual presentation, as described in § 79.1. (2) Video programming...

19 CFR 201.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 3 2010-04-01 2010-04-01 false Program accessibility: New construction and alterations. 201.151 Section 201.151 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES... Activities Conducted by the U.S. International Trade Commission § 201.151 Program accessibility: New...

19 CFR 201.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 3 2011-04-01 2011-04-01 false Program accessibility: New construction and alterations. 201.151 Section 201.151 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES... Activities Conducted by the U.S. International Trade Commission § 201.151 Program accessibility: New...

19 CFR 201.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 3 2014-04-01 2014-04-01 false Program accessibility: New construction and alterations. 201.151 Section 201.151 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES... Activities Conducted by the U.S. International Trade Commission § 201.151 Program accessibility: New...

19 CFR 201.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 3 2012-04-01 2012-04-01 false Program accessibility: New construction and alterations. 201.151 Section 201.151 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES... Activities Conducted by the U.S. International Trade Commission § 201.151 Program accessibility: New...

19 CFR 201.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 3 2013-04-01 2013-04-01 false Program accessibility: New construction and alterations. 201.151 Section 201.151 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES... Activities Conducted by the U.S. International Trade Commission § 201.151 Program accessibility: New...

34 CFR 395.12 - Access to program and financial information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... arrange a convenient time to assist in the interpretation of such financial data. ... 34 Education 2 2010-07-01 2010-07-01 false Access to program and financial information. 395.12... BLIND ON FEDERAL AND OTHER PROPERTY The State Licensing Agency § 395.12 Access to program and financial...

14 CFR 1251.550 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... NONDISCRIMINATION ON BASIS OF HANDICAP Enforcement of Nondiscrimination on the Basis of Handicap in Programs or... activity, when viewed in its entirety, is readily accessible to and usable by individuals with handicaps... accessible to and usable by individuals with handicaps; (2) In the case of historic preservation programs...

14 CFR 1251.550 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... NONDISCRIMINATION ON BASIS OF HANDICAP Enforcement of Nondiscrimination on the Basis of Handicap in Programs or... activity, when viewed in its entirety, is readily accessible to and usable by individuals with handicaps... accessible to and usable by individuals with handicaps; (2) In the case of historic preservation programs...

14 CFR § 1251.550 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... NONDISCRIMINATION ON BASIS OF HANDICAP Enforcement of Nondiscrimination on the Basis of Handicap in Programs or... activity, when viewed in its entirety, is readily accessible to and usable by individuals with handicaps... accessible to and usable by individuals with handicaps; (2) In the case of historic preservation programs...

14 CFR 1251.550 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... NONDISCRIMINATION ON BASIS OF HANDICAP Enforcement of Nondiscrimination on the Basis of Handicap in Programs or... activity, when viewed in its entirety, is readily accessible to and usable by individuals with handicaps... accessible to and usable by individuals with handicaps; (2) In the case of historic preservation programs...

14 CFR 1251.550 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... NONDISCRIMINATION ON BASIS OF HANDICAP Enforcement of Nondiscrimination on the Basis of Handicap in Programs or... activity, when viewed in its entirety, is readily accessible to and usable by individuals with handicaps... accessible to and usable by individuals with handicaps; (2) In the case of historic preservation programs...

75 FR 2583 - Over-the-Road Bus Accessibility Program Grants

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-15

... Transportation Equity Act for the 21st Century (TEA-21). The OTRB Accessibility Program makes funds available to... (TEA-21), Public Law 105-85 as amended by the Safe, Accountable, Flexible, Efficient, Transportation.... transportation system. TEA-21 authorized FTA's OTRB Accessibility Program to assist OTRB operators in complying...

Accessibility and content of individualized adult reconstructive hip and knee/musculoskeletal oncology fellowship web sites.

PubMed

Young, Bradley L; Cantrell, Colin K; Patt, Joshua C; Ponce, Brent A

2018-06-01

Accessible, adequate online information is important to fellowship applicants. Program web sites can affect which programs applicants apply to, subsequently altering interview costs incurred by both parties and ultimately impacting rank lists. Web site analyses have been performed for all orthopaedic subspecialties other than those involved in the combined adult reconstruction and musculoskeletal (MSK) oncology fellowship match. A complete list of active programs was obtained from the official adult reconstruction and MSK oncology society web sites. Web site accessibility was assessed using a structured Google search. Accessible web sites were evaluated based on 21 previously reported content criteria. Seventy-four adult reconstruction programs and 11 MSK oncology programs were listed on the official society web sites. Web sites were identified and accessible for 58 (78%) adult reconstruction and 9 (82%) MSK oncology fellowship programs. No web site contained all content criteria and more than half of both adult reconstruction and MSK oncology web sites failed to include 12 of the 21 criteria. Several programs participating in the combined Adult Reconstructive Hip and Knee/Musculoskeletal Oncology Fellowship Match did not have accessible web sites. Of the web sites that were accessible, none contained comprehensive information and the majority lacked information that has been previously identified as being important to perspective applicants.

Early exposure to media violence and later child adjustment.

PubMed

Fitzpatrick, Caroline; Barnett, Tracie; Pagani, Linda S

2012-05-01

The extent to which early childhood exposure to violent media is associated with subsequent adverse child functioning remains disconcerting. In this study, we examine whether preschool child exposure to what parents generally characterize as violent television programming predicts a range of second-grade mental health outcomes. Participants are from the Quebec Longitudinal Study of Child Development (N = 1786). At 41 and 53 months, parents reported whether the child had viewed television shows and videos consisting of what they judged as violent content. According to parents, children watched on average 1.8 hours of mixed programming per day. Parent-reported child exposure to televised violence was associated with teacher-reported antisocial symptoms (β = 0.180, 95% confidence interval [CI]: 0.026-0.333), emotional distress (β = 0.224, 95% CI: 0.010-0.438), inattention (β = 0.349, 95% CI: 0.048-0.651), and lower global academic achievement (β = -0.127, 95% CI: -0.237-0.017) in second grade. Violent televiewing was also associated with less child-reported academic self-concept (β = -0.175, 95% CI: -0.296-0.053) and intrinsic motivation (β = -0.162, 95% CI: -0.016-0.307) in second grade. Effects remained significant after adjusting for preexisting child and family characteristics such as baseline child aggression. This prospective study suggests risks associated with early childhood violent media exposure for long-term mental health in children. These findings, suggesting diffusive relationships between early childhood violent media exposure and negative socioemotional and academic outcomes, empirically support the notion that access to early childhood violent television represents a threat to population health and should be discouraged by adult caregivers.

Implementing an infant oral care program.

PubMed

Ramos-Gomez, Francisco; Jue, Bonnie; Bonta, C Yolanda

2002-10-01

The American Academy of Pediatric Dentistry, American Dental Association, American Public Health Association, Association of State and Territorial Dental Directors, California Dental Association, and California Society of Pediatric Dentists currently recommend that children receive their first dental evaluation within the first year of life. Providing early care to children from ages 6 months to 5 years offers an opportunity to educate and inform parents about their children's oral health. Anticipatory guidance - counseling of parents by health providers about developmental changes that will occur in their children between health visits - for children's dental health is an important part of preventive care. It may be the most effective way to prevent problems that traditional infectious disease models have failed to address, such as early childhood caries. The model of anticipatory guidance is valuable for dental professionals because it emphasizes prevention of dental problems rather than restorative care. A comprehensive infant oral care program utilizes (1) oral health assessment at regularly scheduled dental visits, (2) risk assessments, (3) counseling sessions with parents during either regular dental visits or additional visits scheduled if a child is deemed at risk, (4) preventive treatment such as the application of fluoride varnish or sealants, and (5) outreach and incentives to reinforce attendance. Facilitating access to early and regular dental care is a crucial part of any effective intervention strategy, and intervention techniques should be tailored to the community being served.

Building a Communication, Education, an Outreach Program for the ShakeAlert National Earthquake Early Warning Program

NASA Astrophysics Data System (ADS)

DeGroot, R. M.; Strauss, J. A.; Given, D. D.; Cochran, E. S.; Burkett, E. R.; Long, K.

2016-12-01

Earthquake Early Warning (EEW) systems can provide as much as tens of seconds of warning to people and automated systems before strong shaking arrives. The United States Geological Survey (USGS) and its partners are developing an EEW system for the West Coast of the United States. To be an integral part of successful implementation, EEW engagement programs and materials must integrate with and leverage broader earthquake risk programs. New methods and products for dissemination must be multidisciplinary, cost effective, and consistent with existing hazards education efforts. Our presentation outlines how the USGS and its partners will approach this effort in the context of the EEW system through the work of a multistate and multiagency committee that participates in the design, implementation, and evaluation of a portfolio of programs and products. This committee, referred to as the ShakeAlert Joint Committee for Communication, Education, and Outreach (ShakeAlert CEO), is working to identify, develop, and cultivate partnerships with EEW stakeholders including Federal, State, academic partners, private companies, policy makers, and local organizations. Efforts include developing materials, methods for delivery, and reaching stakeholders with information on EEW, earthquake preparedness, and emergency protective actions. It is essential to develop standards to ensure information communicated via the EEW alerts is consistent across the public and private sector and achieving a common understanding of what actions users take when they receive an EEW warning. The USGS and the participating states and agencies acknowledge that the implementation of EEW is a collective effort requiring the participation of hundreds of stakeholders committed to ensuring public accessibility.

A phase II clinical trial of a dental health education program delivered by aboriginal health workers to prevent early childhood caries.

PubMed

Blinkhorn, Fiona; Brown, Ngiare; Freeman, Ruth; Humphris, Gerry; Martin, Andrew; Blinkhorn, Anthony

2012-08-21

Early Childhood Caries (ECC) is a widespread problem in Australian Aboriginal communities causing severe pain and sepsis. In addition dental services are difficult to access for many Aboriginal children and trying to obtain care can be stressful for the parents. The control of dental caries has been identified as a key indictor in the reduction of Indigenous disadvantage. Thus, there is a need for new approaches to prevent ECC, which reflect the cultural norms of Aboriginal communities. This is a Phase II single arm trial designed to gather information on the effectiveness of a dental health education program for Aboriginal children aged 6 months, followed over 2 years. The program will deliver advice from Aboriginal Health Workers on tooth brushing, diet and the use of fluoride toothpaste to Aboriginal families. Six waves of data collection will be conducted to enable estimates of change in parental knowledge and their views on the acceptability of the program. The Aboriginal Health Workers will also be interviewed to record their views on the acceptability and program feasibility. Clinical data on the child participants will be recorded when they are 30 months old and compared with a reference population of similar children when the study began. Latent variable modeling will be used to interpret the intervention effects on disease outcome. The research project will identify barriers to the implementation of a family centered Aboriginal oral health strategy, as well as the development of evidence to assist in the planning of a Phase III cluster randomized study. ACTRN12612000712808.

75 FR 20034 - Over-the-Road Bus Accessibility Program Grants: Corrections

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-16

... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Over-the-Road Bus Accessibility... ``Over-the-Road Bus Accessibility Program Grants,'' extends the application deadline, and allows... comply with the terms and conditions of the Special Warranty for the Over-the-Road Bus Accessibility...

The Vanguard Faculty program: research training for complementary and alternative medicine faculty.

PubMed

Connelly, Erin N; Elmer, Patricia J; Morris, Cynthia D; Zwickey, Heather

2010-10-01

The increasing use of complementary and alternative medicine (CAM) treatment is paralleled by a growing demand for an evidence-based approach to CAM practice. In 2007, the Helfgott Research Institute at the National College of Natural Medicine (NCNM), in partnership with Oregon Health & Science University (OHSU), both in Portland, OR, began a National Institutes of Health-funded initiative to increase the quality and quantity of evidence-based medicine (EBM) content in the curricula at NCNM. One key strategy of the Research in Complementary and Alternative Medicine Program (R-CAMP) initiative was to create a faculty development program that included four components: intensive training in EBM; professional skills enhancement; peer and mentored support; and, ultimately, utilization of these skills to incorporate EBM into the curricula. This initiative is centered on a core group of faculty at NCNM, called the Vanguard Faculty, who receives early, intensive training in EBM and works to incorporate this training into classes. Training consists of an intensive, week-long course, monthly group meetings, and periodic individualized meetings. Vanguard Faculty members also receive mentorship and access to resources to pursue individualized faculty development, research or scholarly activities. Early evaluations indicate that this effort has been successful in increasing EBM content in the curricula at NCNM. This article describes the Vanguard Faculty program in an effort to share the successes and challenges of implementing a wide-ranging faculty development and curricular initiative at a complementary and alternative medicine institution.

Access to Employee Wellness Programs and Use of Preventive Care Services Among U.S. Adults.

PubMed

Isehunwa, Oluwaseyi O; Carlton, Erik L; Wang, Yang; Jiang, Yu; Kedia, Satish; Chang, Cyril F; Fijabi, Daniel; Bhuyan, Soumitra S

2017-12-01

There is little research at the national level on access to employee wellness programs and the use of preventive care services. This study examined the use of seven preventive care services among U.S working adults with access to employee wellness programs. The study population comprised 17,699 working adults aged ≥18 years, obtained from the 2015 National Health Interview Survey. Multivariate logistic regression models examined the relationship between access to employee wellness programs and use of seven preventive care services: influenza vaccination, blood pressure check, diabetes check, cholesterol check, Pap smear test, mammogram, and colon cancer screening. Data analysis began in Fall 2016. Overall, 46.6% of working adults reported having access to employee wellness programs in 2015. Working adults with access to employee wellness programs had higher odds of receiving influenza vaccination (OR=1.57, 95% CI=1.43, 1.72, p<0.001), blood pressure check (OR=2.46, 95% CI=2.17, 2.78, p<0.001), diabetes check (OR=1.30, 95% CI=1.12, 1.50, p<0.001), cholesterol check (OR=1.48, 95% CI=1.33, 1.67, p<0.001), and mammogram (OR=1.57, 95% CI=1.24, 1.98, p<0.001). However, there was no significant difference between access to employee wellness programs and the use of Pap smear test and colon cancer screening services. Using a nationally representative sample of individuals, this study found a positive association between access to employee wellness programs and the use of preventive care services. The results support favorable policies to encourage implementing wellness programs in all worksites, especially those with <50 employees. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Final summary report for 1989 inservice inspection (ISI) of SRS (Savannah River Site) 100-P Reactor tank

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

Morrison, J.M.; Loibl, M.W.

1989-12-15

The integrity of the SRS reactor tanks is a key factor affecting their suitability for continued service since, unlike the external piping system and components, the tanks are virtually irreplaceable. Cracking in various areas of the process water piping systems has occurred beginning in 1960 as a result of several degradation mechanisms, chiefly intergranular stress corrosion cracking (IGSCC) and chloride-induced transgranular cracking. IGSCC, currently the primary degradation mechanism, also occurred in the knuckle'' region (tank wall-to-bottom tube sheet transition piece) unique to C Reactor and was eventually responsible for that reactor being deactivated in 1985. A program of visual examinationsmore » of the SRS reactor tanks was initiated in 1968, which used a specially designed immersible periscope. Under that program the condition of the accessible tank welds and associated heat affected zones (HAZ) was evaluated on a five-year frequency. Prior to 1986, the scope of these inspections comprised approximately 20 percent of the accessible weld area. In late 1986 and early 1987 the scope of the inspections was expanded and a 100 percent visual inspection of accessible welds was performed of the P-, L-, and K-Reactor tanks. Supplemental dye penetrant examinations were performed in L Reactor on selected areas which showed visual indications. No evidence of cracking was detected in any of these inspections of the P-, L-, and K-Reactor tanks. 17 refs., 7 figs.« less

Law Enforcement Agency Defibrillation (LEA-D): proceedings of the National Center for Early Defibrillation Police AED Issues Forum.

PubMed

Mosesso, Vincent N; Newman, Mary M; Ornato, Joseph P; Paris, Paul M; Andersen, Leon; Brinsfield, Kathryn; Dunnavant, Gregory R; Frederick, Jay; Groh, William J; Johnston, Steven; Lerner, E Brooke; Murphy, George P; Myerburg, Robert J; Rosenberg, Donald G; Savino, Mitchell; Sayre, Michael R; Sciammarella, Joseph; Schoen, Valerie; Vargo, Philip; van Alem, Anouk; White, Roger D

2002-01-01

Why does LEA-D intervention seem to work in some systems but not others? Panelists agreed that some factors that delay rapid access to treatment, such as long travel distances in rural areas, may represent insurmountable barriers. Other factors, however, may be addressed more readily. These include: absence of a medical response culture, discomfort with the role of medical intervention, insecurity with the use of medical devices, a lack of proactive medical direction, infrequent refresher training, and dependence on EMS intervention. Panelists agreed that successful LEA-D programs possess ten key attributes (Table 6). In the end, the goal remains "early" defibrillation, not "police" defibrillation. It does not matter whether the rescuer wears a blue uniform--or any uniform, for that matter--so long as the defibrillator reaches the victim quickly. If LEA personnel routinely arrive at medical emergencies after other emergency responders or after 8 minutes have elapsed from the time of collapse, an LEA-D program will be unlikely to provide added value. Similarly, if police frequently arrive first, but the department is unwilling or unable to cultivate the attributes of successful LEA-D programs, efforts to improve survival may not be realized. In most communities, however, LEA-D programs have tremendous lifesaving potential and are well worth the investment of time and resources. Law enforcement agencies considering adoption of AED programs should review the frequency with which police arrive first at medical emergencies and LEA response intervals to determine whether AED programs might help improve survival in their communities. It is time for law enforcement agency defibrillation to become the rule, not the exception.

76 FR 26341 - Medicaid Program; Methods for Assuring Access to Covered Medicaid Services

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-06

... Medicare & Medicaid Services 42 CFR Part 447 Medicare Program; Methods for Assuring Access to Covered... Services 42 CFR Part 447 [CMS 2328-P] RIN 0938-AQ54 Medicaid Program; Methods for Assuring Access to... design the procedures for enrolling providers of such care, and to set the methods for establishing...

24 CFR 8.20 - General requirement concerning program accessibility.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false General requirement concerning program accessibility. 8.20 Section 8.20 Housing and Urban Development Office of the Secretary, Department... requirement concerning program accessibility. Except as otherwise provided in §§ 8.21(c)(1), 8.24(a), 8.25...

Evaluation of Access, a Primary Care Program for Indigent Patients: Inpatient and Emergency Room Utilization.

ERIC Educational Resources Information Center

Davidson, Richard A.; Giancola, Angela; Gast, Andrea; Ho, Janice; Waddell, Rhondda

2003-01-01

Evaluated the impact of Accessing Community Care through Eastside Social Services (ACCESS), a program that provided indigent patients with free primary care, on inpatient admissions, emergency room (ER) visits, and subsequent charges. Data on 19 people before and after program enrollment showed significant decreases in ER visits following…

12 CFR 268.707 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Programs and Activities Because of Physical or Mental Disability § 268.707 Program accessibility: Existing facilities. (a) General. The Board shall operate each program or activity so that the program or activity... can demonstrate would result in a fundamental alteration in the nature of a program or activity or in...

12 CFR 268.707 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Programs and Activities Because of Physical or Mental Disability § 268.707 Program accessibility: Existing facilities. (a) General. The Board shall operate each program or activity so that the program or activity... can demonstrate would result in a fundamental alteration in the nature of a program or activity or in...

The Veterans Choice Program (VCP): Program Implementation

DTIC Science & Technology

2017-01-05

Authorized under Section 101 of the Veterans Access, Choice, and Accountability Act of 2014 (VACAA), the Veterans Choice Program (VCP) is a new...country in spring 2014, 1 Congress passed the Veterans Access, Choice, and Accountability Act of 2014 (VACAA, P.L. 113-146, as amended). On August 7...Veterans Choice Program (VCP) Timeline Date Action August 7, 2014 The Veterans Access, Choice, and Accountability Act of 2014 (P.L. 113-146

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

ERIC Educational Resources Information Center

Collins, Sarah R.

2012-01-01

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

A responsive evaluation of an Aboriginal nursing education access program.

PubMed

Curran, Vernon; Solberg, Shirley; LeFort, Sandra; Fleet, Lisa; Hollett, Ann

2008-01-01

Nursing education access programs have been introduced in a number of countries to address the shortage of healthcare providers of Aboriginal descent. An evaluation study of a nursing education access program in Labrador, Canada, was undertaken using a Responsive Evaluation approach. Interviews and focus groups with program stakeholders were conducted. Program effectiveness was influenced by culturally relevant curriculum, experiential and authentic learning opportunities, academic and social support, and the need for partnership building between stakeholders. The authors report key findings resulting from the Responsive Evaluation.

7 CFR 62.206 - Access to program documents and activities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... (CONTINUED) LIVESTOCK, MEAT, AND OTHER AGRICULTURAL COMMODITIES (QUALITY SYSTEMS VERIFICATION PROGRAMS) Quality Systems Verification Programs Definitions Service § 62.206 Access to program documents and... SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS...

Evolution of accesses to information on breast cancer and screening on the Brazilian National Cancer Institute website: an exploratory study.

PubMed

Vasconcellos-Silva, Paulo Roberto; Sormunen, Taina; Craftman, Åsa Gransjön

2018-04-01

Delays in diagnosis due to low Breast Cancer awareness are widespread in Brazil maybe owing to ineffective strategies to raise attention on early diagnosis. As a proxy of collective interest in BC screanning (BCS) we studied the monthly accesses to BC and BCS webpages in INCA's website along 48 months. A log analyzer built a time serie (2006-2009) of BC and BCS monthly means, which oscilations were studied by analysis of variance (ANOVA). We found significant increasing accesses to BC and transient "attention peaks". Enlargement in BC/BCS differences along all period were caused by increasing accesses to BC and decreasing/minor/stable oscillations to SBC pages. These results are consistent with previous reports on increasing interest to BC contrasting with indifference on BCS. In the context of an exploratory study, we discussed some aspects: weakness of a "prevention culture"; lack of confidence in health system and screening programs; "celebrity effect" in the context of media framing; collective perception of risks heightened by perception of social vulnerability. Findings suggest that culture-tailored communication strategies would be necessary to inform Brazilian people about BCS. Future research is needed to study social perceptions and constructions on BC topics.

JASPAR RESTful API: accessing JASPAR data from any programming language.

PubMed

Khan, Aziz; Mathelier, Anthony

2018-05-01

JASPAR is a widely used open-access database of curated, non-redundant transcription factor binding profiles. Currently, data from JASPAR can be retrieved as flat files or by using programming language-specific interfaces. Here, we present a programming language-independent application programming interface (API) to access JASPAR data using the Representational State Transfer (REST) architecture. The REST API enables programmatic access to JASPAR by most programming languages and returns data in eight widely used formats. Several endpoints are available to access the data and an endpoint is available to infer the TF binding profile(s) likely bound by a given DNA binding domain protein sequence. Additionally, it provides an interactive browsable interface for bioinformatics tool developers. This REST API is implemented in Python using the Django REST Framework. It is accessible at http://jaspar.genereg.net/api/ and the source code is freely available at https://bitbucket.org/CBGR/jaspar under GPL v3 license. aziz.khan@ncmm.uio.no or anthony.mathelier@ncmm.uio.no. Supplementary data are available at Bioinformatics online.

The Children and Parents in Focus project: a population-based cluster-randomised controlled trial to prevent behavioural and emotional problems in children.

PubMed

Salari, Raziye; Fabian, Helena; Prinz, Ron; Lucas, Steven; Feldman, Inna; Fairchild, Amanda; Sarkadi, Anna

2013-10-16

There is large body of knowledge to support the importance of early interventions to improve child health and development. Nonetheless, it is important to identify cost-effective blends of preventive interventions with adequate coverage and feasible delivery modes. The aim of the Children and Parents in Focus trial is to compare two levels of parenting programme intensity and rate of exposure, with a control condition to address impact and cost-effectiveness of a universally offered evidence-based parenting programme in the Swedish context. The trial has a cluster randomised controlled design comprising three arms: Universal arm (with access to participation in Triple P - Positive Parenting Program, level 2); Universal Plus arm (with access to participation in Triple P - Positive Parenting Program, level 2 as well as level 3, and level 4 group); and Services as Usual arm. The sampling frame is Uppsala municipality in Sweden. Child health centres consecutively recruit parents of children aged 3 to 5 years before their yearly check-ups (during the years 2013-2017). Outcomes will be measured annually. The primary outcome will be children's behavioural and emotional problems as rated by three informants: fathers, mothers and preschool teachers. The other outcomes will be parents' behaviour and parents' general health. Health economic evaluations will analyse cost-effectiveness of the interventions versus care as usual by comparing the costs and consequences in terms of impact on children's mental health, parent's mental health and health-related quality of life. This study addresses the need for comprehensive evaluation of the long-term effects, costs and benefits of early parenting interventions embedded within existing systems. In addition, the study will generate population-based data on the mental health and well-being of preschool aged children in Sweden. ISRCTN16513449.

A Systematic Review of Land-Based Self-Exclusion Programs: Demographics, Gambling Behavior, Gambling Problems, Mental Symptoms, and Mental Health.

PubMed

Kotter, Roxana; Kräplin, Anja; Pittig, Andre; Bühringer, Gerhard

2018-05-02

Systematic and quantitative reviews on the effects of land-based self-exclusion are scarce. Therefore, the current review aimed to provide a comprehensive summary of (1) the demographic characteristics of land-based self-excluders and changes after exclusion, including (2) gambling behavior, (3) gambling problems, (4) mental symptoms, and (5) mental health. A systematic database and literature search was performed following PRISMA guidelines. Nineteen naturalistic studies met the eligibility criteria. The quality of all included records was rated via adaption of the Newcastle-Ottawa Scale. Results from higher-quality records were more heavily weighted. Self-excluders were predominantly men in their early or middle forties. Changes after exclusion revealed wide ranges in the rates of abstinence (13-81%), rates of gambling reduction (29-92%), and rates of exclusion breaches (8-59%). The records consistently demonstrated significant changes in pathological gambling from before exclusion (61-95%) to after exclusion (13-26%). Up to 73% of self-excluders exhibited symptoms of anxiety, depression, and substance use disorders at program enrollment. Several aspects of mental health improved after exclusion, e.g., quality of life. Problem and pathological gambling are most prevalent in young men, but self-exclusion was most prominent in middle-aged men. The magnitude of effects widely differed between studies despite overall benefits of self-exclusion, and many individuals continued gambling after exclusion. This shortcoming could be minimized using improved access controls and the extension of exclusion to other gambling segments. High rates of pathological gambling and other mental disorders in self-excluders highlight the need for improved early detection and treatment accessibility.

Emerging Early Actions to Bend the Curve in Sub-Saharan Africa's Nutrition Transition.

PubMed

Haggblade, Steven; Duodu, Kwaku G; Kabasa, John D; Minnaar, Amanda; Ojijo, Nelson K O; Taylor, John R N

2016-06-01

Sub-Saharan Africa is the last region to undergo a nutrition transition and can still avoid its adverse health outcomes. The article explores emerging responses to "bend the curve" in sub-Saharan Africa's nutrition transition to steer public health outcomes onto a healthier trajectory. Early responses in 3 countries at different stages of food system transformation are examined: South Africa-advanced, Ghana-intermediate, and Uganda-early. By comparing these with international experience, actions are proposed to influence nutrition and public health trajectories as Africa's food systems undergo rapid structural change. Arising from rapid urbanization and diet change, major public health problems associated with overweight are taking place, particularly in South Africa and among adult women. However, public health responses are generally tepid in sub-Saharan Africa. Only in South Africa have policy makers instituted extensive actions to combat overweight and associated noncommunicable diseases through regulation, education, and public health programs. Elsewhere, in countries in the early and middle stages of transition, public health systems continue to focus their limited resources primarily on undernutrition. Related pressures on the supply side of Africa's food systems are emerging that also need to be addressed. Three types of intervention appear most feasible: maternal and child health programs to simultaneously address short-term undernutrition problems while at the same time helping to reduce future tendencies toward overweigh; regulatory and fiscal actions to limit access to unhealthy foods; and modernization of Africa's agrifood food system through job skills training, marketing reforms, and food industry entrepreneurship. © The Author(s) 2016.

Rationale for New York City's regulations on nutrition, physical activity, and screen time in early child care centers.

PubMed

Nonas, Cathy; Silver, Lynn D; Kettel Khan, Laura; Leviton, Laura

2014-10-16

Childhood obesity is associated with health risks in childhood, and it increases the risk of adult obesity, which is associated with many chronic diseases. Therefore, implementing policies that may prevent obesity at young ages is important. In 2007, the New York City Department of Health and Mental Hygiene implemented new regulations for early childhood centers to increase physical activity, limit screen time, and provide healthful beverage offerings (ie, restrict sugar-sweetened beverages for all children, restrict whole milk for those older than 2 years, restrict juice to beverages that are 100% juice and limit serving of juice to only 6 ounces per day, and make water available and accessible at all times). This article explains why these amendments to the Health Code were created, how information about these changes was disseminated, and what training programs were used to help ensure implementation, particularly in high-need neighborhoods.

Individual Placement And Support Services Boost Employment For People With Serious Mental Illnesses, But Funding Is Lacking.

PubMed

Drake, Robert E; Bond, Gary R; Goldman, Howard H; Hogan, Michael F; Karakus, Mustafa

2016-06-01

The majority of people with serious mental illnesses want to work. Individual placement and support services, an evidence-based supported employment intervention, enables about 60 percent of people with serious mental illnesses who receive the services to gain competitive employment and improve their lives, but the approach does not lead to fewer people on government-funded disability rolls. Yet individual placement and support employment services are still unavailable to a large majority of people with serious mental illnesses in the United States. Disability policies and lack of a simple funding mechanism remain the chief barriers. A recent federal emphasis on early-intervention programs may increase access to employment services for people with early psychosis, but whether these interventions will prevent disability over time is unknown. Project HOPE—The People-to-People Health Foundation, Inc.

Social Support Can Buffer against Stress and Shape Brain Activity

PubMed Central

Hostinar, Camelia E.; Gunnar, Megan R.

2015-01-01

Social support from close relationship partners is an important resource for coping with stress, particularly during childhood. We discuss ethical challenges associated with studying stress and its social buffering in the laboratory, as well as emerging evidence regarding two potential neural substrates for the social buffering of stress: hypothalamic oxytocin activity and activation of areas in the prefrontal cortex associated with effective self-regulation. We also address the role of early-life social experiences in shaping brain development, as well as recommendations for practice and policy that would advance the ethical treatment of children and reduce social inequalities in early-life experiences and opportunities–e.g., investing in programs that prevent child maltreatment and facilitating access to high-quality child care for economically disadvantaged families. We also debate the ethical implications of using oxytocin nasal sprays to simulate the stress-reducing properties of social support and advise waiting for more evidence before recommending their use. PMID:26478822

How to improve the quality of a disease management program for HIV-infected patients using a computerized data system. The Saint-Antoine Orchestra program.

PubMed

Fonquernie, F; Lacombe, K; Vincensini, J P; Boccara, F; Clozel, S; Ayouch Boda, A; Bollens, D; Campa, P; Pacanowski, J; Meynard, J L; Meyohas, M C; Girard, P M

2010-05-01

The emergence of non-AIDS-related events in the HIV-infected population experiencing a longer life expectancy implies the implementation of a comprehensive approach of HIV clinical management through better access to care, prevention, and early diagnosis of co-morbidities. The Orchestra program is a computer-assisted HIV care and support tool implemented since December 2004 in the outpatient clinic of a University Hospital set in Paris, France. The intervention aims at improving access to HIV information care and support specifically targeted five areas of actions: cardiovascular risk factors; gynecological follow-up; anti-hepatitis B virus (HBV) vaccine coverage; sexuality and prevention of sexually transmitted infections; and compliance to antiretrovirals. The impact of this program was examined prospectively on a "before-after" basis after a two-year implementation. In the two-year period, 1717 patients were regularly followed. The level of the database information significantly increased in time (low density lipoprotein (LDL) cholesterol and glycemia were informed in 74% of patients at inclusion versus 95% at two years, and 83% versus 97%, p < 0.001, respectively). The number of targeted interventions was also higher. For eligible women, papanicolaou smears and mammography were prescribed in 52% of cases after intervention, versus 44% at inclusion, p0.04 and 83% versus 50%, p < 0.001, respectively. Indicators of care eventually improved significantly. Initially 72% non-adherent patients declared to be adherent after the intervention ( p < 0.001) and 67% of patients with initial LDL-hypercholesterolemia normalized their LDL level within two years ( p < 0.001). The Orchestra program has provided a unique opportunity to assess and improve prevention and management of co-morbidities in HIV patients.

32 CFR 1906.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2011 CFR

2011-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.149 Program accessibility: Discrimination prohibited...

32 CFR 1906.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2013 CFR

2013-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.149 Program accessibility: Discrimination prohibited...

32 CFR 1906.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2012 CFR

2012-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.149 Program accessibility: Discrimination prohibited...

32 CFR 1906.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2010 CFR

2010-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.149 Program accessibility: Discrimination prohibited...

32 CFR 1906.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2014 CFR

2014-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.149 Program accessibility: Discrimination prohibited...

Designing a community-based lay health advisor training curriculum to address cancer health disparities.

PubMed

Gwede, Clement K; Ashley, Atalie A; McGinnis, Kara; Montiel-Ishino, F Alejandro; Standifer, Maisha; Baldwin, Julie; Williams, Coni; Sneed, Kevin B; Wathington, Deanna; Dash-Pitts, Lolita; Green, B Lee

2013-05-01

Racial and ethnic minorities have disproportionately higher cancer incidence and mortality than their White counterparts. In response to this inequity in cancer prevention and care, community-based lay health advisors (LHAs) may be suited to deliver effective, culturally relevant, quality cancer education, prevention/screening, and early detection services for underserved populations. APPROACH AND STRATEGIES: Consistent with key tenets of community-based participatory research (CBPR), this project engaged community partners to develop and implement a unique LHA training curriculum to address cancer health disparities among medically underserved communities in a tricounty area. Seven phases of curriculum development went into designing a final seven-module LHA curriculum. In keeping with principles of CBPR and community engagement, academic-community partners and LHAs themselves were involved at all phases to ensure the needs of academic and community partners were mutually addressed in development and implementation of the LHA program. Community-based LHA programs for outreach, education, and promotion of cancer screening and early detection, are ideal for addressing cancer health disparities in access and quality care. When community-based LHAs are appropriately recruited, trained, and located in communities, they provide unique opportunities to link, bridge, and facilitate quality cancer education, services, and research.

Improving Medicare coverage of psychological services for older Americans.

PubMed

Karlin, Bradley E; Humphreys, Keith

2007-10-01

Professional psychology's ability to meet older Americans' psychological needs and to simultaneously thrive as a profession will be closely tied to the federal Medicare program over the coming decades. Despite legislative changes in the 1980s providing professional autonomy to psychologists and expanding coverage for mental health services, Medicare coverage policies, reimbursement mechanisms, and organizational traditions continue to limit older Americans' access to psychological services. This article describes how psychologists can influence Medicare coverage policy. Specifically, the authors examine widely unrecognized policy processes and recent political developments and analyze the recent creation of a new Medicare counseling benefit, applying J. W. Kingdon's (1995) well-known model of policy change. These recent developments offer new opportunities for expanding Medicare coverage of psychological services, particularly in the areas of prevention, screening, and early intervention. The article provides an analysis to guide psychologists in engaging in strategic advocacy and incorporating psychological prevention and early intervention services into Medicare. As Medicare policy entrepreneurs, psychologists can improve the well-being of millions of Americans who rely on the national health insurance program and, in so doing, can help shape the future practice of psychology. Copyright 2007 APA, all rights reserved.

A nationwide pharmacy chain responds to the opioid epidemic.

PubMed

Shafer, Emily; Bergeron, Nyahne; Smith-Ray, Renae; Robson, Chester; O'Koren, Rachel

To describe the 3-pronged approach taken by a large national retail pharmacy chain to address the opioid epidemic and associated overdoses. Large national retail pharmacy chain with more than 8200 stores in 50 states. Eight million customer interactions daily through in-store and digital settings. This is a company with a long history of responding to public health crises. Initiated 3 programs to respond to the opioid crisis: 1) provide safe medication disposal kiosks; 2) expand national access to naloxone; and 3) provide education on the risk and avoidance of opioid overdose. Used the RE-AIM framework to evaluate and enhance the quality, speed, and public health impact of the interventions. Not applicable. Early results are safe medication disposal kiosks in more than 43 states, naloxone-dispensing program in 33 states, and patient and support system education using the Opioid Overdose Toolkit from the Substance Abuse and Mental Health Services Administration. The availability of safe drug-disposal kiosks, naloxone dispensing at pharmacies, and patient education are key prevention initiatives to address the opioid epidemic and reduce the increasing national burden of opioid overdose. Early results are quantitatively and qualitatively promising. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Early efforts of blacks in the fight against heart disease and stroke.

PubMed Central

Haywood, L. J.

1999-01-01

This article highlighted the early efforts of some individuals whose vision and dedication helped to set the stage for later progress in the fight against heart disease, who forged links to those who eagerly took up the cause of creating an appropriate place for minority participation in the specialty of cardiovascular diseases, and to contribute to efforts to establish programs for the reduction of morbidity and mortality and for prevention in African Americans. This is only one view of what was an exciting period of fitful progress and controversy. Dr Wilson reviewed the still deplorable state of affairs in regard to minorities and the medical profession in 1986, stating: A meaningful role for minorities will not exist until there is access to academic postgraduate training programs that will lead to faculty positions and research opportunities for minorities to serve as role models for future students. The Association of Academic Minority Physicians was established to foster greater progress in this regard across disciplines. Again, while much has been accomplished, including Donald Wilson's becoming the first African-American dean of a nonminority medical school, much remains to be done as we approach the end of the 20th century. PMID:10628126

Spanish-language community-based mental health treatment programs, policy-required language-assistance programming, and mental health treatment access among Spanish-speaking clients.

PubMed

Snowden, Lonnie R; McClellan, Sean R

2013-09-01

We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California's Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997-2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P < .05). However, the increase was insufficient to significantly reduce language-related disparities. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services.

Spanish-Language Community-Based Mental Health Treatment Programs, Policy-Required Language-Assistance Programming, and Mental Health Treatment Access Among Spanish-Speaking Clients

PubMed Central

McClellan, Sean R.

2013-01-01

Objectives. We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California’s Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Methods. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997–2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. Results. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P < .05). However, the increase was insufficient to significantly reduce language-related disparities. Conclusions. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services. PMID:23865663

32 CFR 1906.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

32 CFR 1906.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

32 CFR 1906.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

32 CFR 1906.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

32 CFR 1906.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

47 CFR 79.2 - Accessibility of programming providing emergency information.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) BROADCAST RADIO SERVICES CLOSED CAPTIONING AND VIDEO DESCRIPTION OF VIDEO PROGRAMMING § 79.2 Accessibility... information. (1) Video programming distributors must make emergency information, as defined in paragraph (a..., as described in § 79.1. (2) Video programming distributors and video programming providers must make...

32 CFR 1699.150 - Program accessibility: existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... SYSTEM ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY SELECTIVE SERVICE SYSTEM § 1699.150 Program accessibility: existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is...

50 CFR 648.262 - Effort-control program for red crab limited access vessels.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Effort-control program for red crab... UNITED STATES Management Measures for the Atlantic Deep-Sea Red Crab Fishery § 648.262 Effort-control program for red crab limited access vessels. (a) General. A vessel issued a limited access red crab permit...

34 CFR 303.11 - Early intervention program.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false Early intervention program. 303.11 Section 303.11... AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND... intervention program. As used in this part, early intervention program means the total effort in a State that...

34 CFR 303.11 - Early intervention program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true Early intervention program. 303.11 Section 303.11... AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND... intervention program. As used in this part, early intervention program means the total effort in a State that...