Sample records for effective access consideration

  1. Organizational context and taxonomy of health care databases.

    PubMed

    Shatin, D

    2001-01-01

    An understanding of the organizational context and taxonomy of health care databases is essential to appropriately use these data sources for research purposes. Characteristics of the organizational structure of the specific health care setting, including the model type, financial arrangement, and provider access, have implications for accessing and using this data effectively. Additionally, the benefit coverage environment may affect the utility of health care databases to address specific research questions. Coverage considerations that affect pharmacoepidemiologic research include eligibility, the nature of the pharmacy benefit, and regulatory aspects of the treatment under consideration.

  2. The Final Barrier: Security Consideration in Restricted Access Reading Rooms.

    ERIC Educational Resources Information Center

    Strassberg, Richard

    1997-01-01

    Examines an effective response to library or archive theft and vandalism of valuable materials: the restricted access reading room. Discusses the need for an alert staff, user identification, restriction of carry-in items, electronic surveillance, record keeping, limits to quantities of collection materials, exiting procedure, photocopying, theft…

  3. Radiation Effects of Commercial Resistive Random Access Memories

    NASA Technical Reports Server (NTRS)

    Chen, Dakai; LaBel, Kenneth A.; Berg, Melanie; Wilcox, Edward; Kim, Hak; Phan, Anthony; Figueiredo, Marco; Buchner, Stephen; Khachatrian, Ani; Roche, Nicolas

    2014-01-01

    We present results for the single-event effect response of commercial production-level resistive random access memories. We found that the resistive memory arrays are immune to heavy ion-induced upsets. However, the devices were susceptible to single-event functional interrupts, due to upsets from the control circuits. The intrinsic radiation tolerant nature of resistive memory makes the technology an attractive consideration for future space applications.

  4. Improving Access To, Quality, and the Effectiveness of Digital Tutoring in K-12 Education

    ERIC Educational Resources Information Center

    Burch, Patricia; Good, Annalee; Heinrich, Carolyn

    2016-01-01

    There is considerable variation in how providers of digital education describe what they do, their services, how students access services, and what is delivered, complicating efforts to accurately assess its impact. We examine program characteristics of digital tutoring providers using rich, longitudinal observational and interview data and then…

  5. Second-Tier Database for Ecosystem Focus, 2002-2003 Annual Report.

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

    Van Holmes, Chris; Muongchanh, Christine; Anderson, James J.

    2003-11-01

    The Second-Tier Database for Ecosystem Focus (Contract 00004124) provides direct and timely public access to Columbia Basin environmental, operational, fishery and riverine data resources for federal, state, public and private entities. The Second-Tier Database known as Data Access in Realtime (DART) integrates public data for effective access, consideration and application. DART also provides analysis tools and performance measures helpful in evaluating the condition of Columbia Basin salmonid stocks.

  6. The Potential of Information: Guidance and Counselling Services for Improving the Access of Adults to Learning Opportunities.

    ERIC Educational Resources Information Center

    Bertelsen, P. H.

    Well-developed information and counseling services not only afford immediate assistance to adult learners, but also generate a significant feedback effect on many other components of the overall system and thus make a considerable contribution to the overall development of adult education. Access to learning and progress in learning should be like…

  7. How To Modify a Trailer for Accessibility (Up to a Point) [and] Accessibility Considerations for Home Buyers. Key Notes.

    ERIC Educational Resources Information Center

    Access Group, Atlanta, GA.

    Two brief fact sheets for people with disabilities provide information on: (1) modifying a trailer to make it accessible for persons with mobility impairments, especially those in wheelchairs, and (2) accessibility considerations for home buyers or home owners with mobility impairments. The first fact sheet identifies inherent problems in…

  8. Synthesizing qualitative and quantitative evidence on non-financial access barriers: implications for assessment at the district level.

    PubMed

    O'Connell, Thomas S; Bedford, K Juliet A; Thiede, Michael; McIntyre, Di

    2015-06-09

    A key element of the global drive to universal health coverage is ensuring access to needed health services for everyone, and to pursue this goal in an equitable way. This requires concerted efforts to reduce disparities in access through understanding and acting on barriers facing communities with the lowest utilisation levels. Financial barriers dominate the empirical literature on health service access. Unless the full range of access barriers are investigated, efforts to promote equitable access to health care are unlikely to succeed. This paper therefore focuses on exploring the nature and extent of non-financial access barriers. We draw upon two structured literature reviews on barriers to access and utilization of maternal, newborn and child health services in Ghana, Bangladesh, Vietnam and Rwanda. One review analyses access barriers identified in published literature using qualitative research methods; the other in published literature using quantitative analysis of household survey data. We then synthesised the key qualitative and quantitative findings through a conjoint iterative analysis. Five dominant themes on non-financial access barriers were identified: ethnicity; religion; physical accessibility; decision-making, gender and autonomy; and knowledge, information and education. The analysis highlighted that non-financial factors pose considerable barriers to access, many of which relate to the acceptability dimension of access and are challenging to address. Another key finding is that quantitative research methods, while yielding important findings, are inadequate for understanding non-financial access barriers in sufficient detail to develop effective responses. Qualitative research is critical in filling this gap. The analysis also indicates that the nature of non-financial access barriers vary considerably, not only between countries but also between different communities within individual countries. To adequately understand access barriers as a basis for developing effective strategies to address them, mixed-methods approaches are required. From an equity perspective, communities with the lowest utilisation levels should be prioritised and the access barriers specific to that community identified. It is, therefore, critical to develop approaches that can be used at the district level to diagnose and act upon access barriers if we are to pursue an equitable path to universal health coverage.

  9. Systemic Effects of Hemodialysis Access.

    PubMed

    Agarwal, Anil K

    2015-11-01

    Patients with advanced chronic kidney disease are at a high risk of cardiovascular events. Patients with end-stage renal disease have a particularly high morbidity and mortality, in part attributed to the complications and dysfunction related to vascular access in this population. Creation of an arteriovenous access for HD is considered standard of care for most patients and has distinct advantages including less likelihood of infections, less need for intervention, and positive impact on survival as compared with usage of a catheter. However, creation of an arteriovenous shunt incites a series of events that significantly impacts cardiovascular and neurohormonal health in both positive and negative ways. This article will review the short- and long-term effects of dialysis access on cardiovascular, neurohormonal, and pulmonary systems as well as a brief review of their effect on survival on HD. Presence of other comorbidities in a patient with dialysis access can amplify these effects, and these considerations are of paramount importance in individualizing the approach to not only the choice of vascular access but also the modality of kidney replacement therapy. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  10. Measuring geographical accessibility to rural and remote health care services: Challenges and considerations.

    PubMed

    Shah, Tayyab Ikram; Milosavljevic, Stephan; Bath, Brenna

    2017-06-01

    This research is focused on methodological challenges and considerations associated with the estimation of the geographical aspects of access to healthcare with a focus on rural and remote areas. With the assumption that GIS-based accessibility measures for rural healthcare services will vary across geographic units of analysis and estimation techniques, which could influence the interpretation of spatial access to rural healthcare services. Estimations of geographical accessibility depend on variations of the following three parameters: 1) quality of input data; 2) accessibility method; and 3) geographical area. This research investigated the spatial distributions of physiotherapists (PTs) in comparison to family physicians (FPs) across Saskatchewan, Canada. The three-steps floating catchment areas (3SFCA) method was applied to calculate the accessibility scores for both PT and FP services at two different geographical units. A comparison of accessibility scores to simple healthcare provider-to-population ratios was also calculated. The results vary considerably depending on the accessibility methods used and the choice of geographical area unit for measuring geographical accessibility for both FP and PT services. These findings raise intriguing questions regarding the nature and extent of technical issues and methodological considerations that can affect GIS-based measures in health services research and planning. This study demonstrates how the selection of geographical areal units and different methods for measuring geographical accessibility could affect the distribution of healthcare resources in rural areas. These methodological issues have implications for determining where there is reduced access that will ultimately impact health human resource priorities and policies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Defense AT&L (Volume 37, Number 2, March-April 2008)

    DTIC Science & Technology

    2008-04-01

    environment. Operational suit- ability is the degree to which a system can be satisfactorily placed in field use, with consideration given to reliability...devise the most effective test-and-evaluation strategy. Whenever possible, the program should be developed and fielded in small increments and provided... ability to control access to design-related informa- tion and availability of technology, and it will raise grave security considerations. Do you develop

  12. Bicycling access and egress to transit : informing the possibilities.

    DOT National Transportation Integrated Search

    2011-04-01

    When effectively integrated with transit services, considerable room exists for bicycling to realize various benefits to communities. A successful marriage between bicycling and transit will likely increase the use and efficiency of both modes. A cor...

  13. Saying what’s on your mind: Working memory effects on sentence production

    PubMed Central

    Slevc, L. Robert

    2011-01-01

    The role of working memory (WM) in sentence comprehension has received considerable interest, but little work has investigated how sentence production relies on memory mechanisms. These three experiments investigated speakers’ tendency to produce syntactic structures that allow for early production of material that is accessible in memory. In Experiment 1, speakers produced accessible information early less often when under a verbal WM load than when under no load. Experiment 2 found the same pattern for given-new ordering, i.e., when accessibility was manipulated by making information given. Experiment 3 addressed the possibility that these effects do not reflect WM mechanisms but rather increased task difficulty by relying on the distinction between verbal and spatial WM: Speakers’ tendency to produce sentences respecting given-new ordering was reduced more by a verbal than by a spatial WM load. These patterns show that accessibility effects do in fact reflect accessibility in verbal WM, and that representations in sentence production are vulnerable to interference from other information in memory. PMID:21767058

  14. Capacity Estimation Model for Signalized Intersections under the Impact of Access Point

    PubMed Central

    Zhao, Jing; Li, Peng; Zhou, Xizhao

    2016-01-01

    Highway Capacity Manual 2010 provides various factors to adjust the base saturation flow rate for the capacity analysis of signalized intersections. No factors, however, is considered for the potential change of signalized intersections capacity caused by the access point closeing to the signalized intersection. This paper presented a theoretical model to estimate the lane group capacity at signalized intersections with the consideration of the effects of access points. Two scenarios of access point locations, upstream or downstream of the signalized intersection, and impacts of six types of access traffic flow are taken into account. The proposed capacity model was validated based on VISSIM simulation. Results of extensive numerical analysis reveal the substantial impact of access point on the capacity, which has an inverse correlation with both the number of major street lanes and the distance between the intersection and access point. Moreover, among the six types of access traffic flows, the access traffic flow 1 (right-turning traffic from major street), flow 4 (left-turning traffic from access point), and flow 5 (left-turning traffic from major street) cause a more significant effect on lane group capacity than others. Some guidance on the mitigation of the negative effect is provided for practitioners. PMID:26726998

  15. 77 FR 3847 - Major Capital Investment Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-25

    ... designed to achieve a ``medium'' cost effectiveness rating to remain eligible for funding while sacrificing other potentially important considerations (such as station locations and/or design features to... access to surrounding development or aesthetically-oriented design features. This would remove a...

  16. What is access to radiation therapy? A conceptual framework and review of influencing factors.

    PubMed

    Sundaresan, Puma; Stockler, Martin R; Milross, Christopher G

    2016-02-01

    Optimal radiation therapy (RT) utilisation rates (RURs) have been defined for various cancer indications through extensive work in Australia and overseas. These benchmarks remain unrealised. The gap between optimal RUR and actual RUR has been attributed to inadequacies in 'RT access'. We aimed to develop a conceptual framework for the consideration of 'RT access' by examining the literature for existing constructs and translating it to the context of RT services. We further aimed to use this framework to identify and examine factors influencing 'RT access'. Existing models of health care access were reviewed and used to develop a multi-dimensional conceptual framework for 'RT access'. A review of the literature was then conducted to identify factors reported to affect RT access and utilisation. The electronic databases searched, the host platform and date range of the databases searched were Ovid MEDLINE, 1946 to October 2014 and PsycINFO via OvidSP,1806 to October 2014. The framework developed demonstrates that 'RT access' encompasses opportunity for RT as well as the translation of this opportunity to RT utilisation. Opportunity for RT includes availability, affordability, adequacy (quality) and acceptability of RT services. Several factors at the consumer, referrer and RT service levels affect the translation of this opportunity for RT to actual RT utilisation. 'Access' is a term that is widely used in the context of health service related research, planning and political discussions. It is a multi-faceted concept with many descriptions. We propose a conceptual framework for the consideration of 'RT access' so that factors affecting RT access and utilisation may be identified and examined. Understanding these factors, and quantifying them where possible, will allow objective evaluation of their impact on RT utilisation and guide implementation of strategies to modify their effects.

  17. Reasoning with alternative explanations in physics: The cognitive accessibility rule

    NASA Astrophysics Data System (ADS)

    Heckler, Andrew F.; Bogdan, Abigail M.

    2018-06-01

    A critical component of scientific reasoning is the consideration of alternative explanations. Recognizing that decades of cognitive psychology research have demonstrated that relative cognitive accessibility, or "what comes to mind," strongly affects how people reason in a given context, we articulate a simple "cognitive accessibility rule", namely that alternative explanations are considered less frequently when an explanation with relatively high accessibility is offered first. In a series of four experiments, we test the cognitive accessibility rule in the context of consideration of alternative explanations for six physical scenarios commonly found in introductory physics curricula. First, we administer free recall and recognition tasks to operationally establish and distinguish between the relative accessibility and availability of common explanations for the physical scenarios. Then, we offer either high or low accessibility explanations for the physical scenarios and determine the extent to which students consider alternatives to the given explanations. We find two main results consistent across algebra- and calculus-based university level introductory physics students for multiple answer formats. First, we find evidence that, at least for some contexts, most explanatory factors are cognitively available to students but not cognitively accessible. Second, we empirically verify the cognitive accessibility rule and demonstrate that the rule is strongly predictive, accounting for up to 70% of the variance of the average student consideration of alternative explanations across scenarios. Overall, we find that cognitive accessibility can help to explain biases in the consideration of alternatives in reasoning about simple physical scenarios, and these findings lend support to the growing number of science education studies demonstrating that tasks relevant to science education curricula often involve rapid, automatic, and potentially predictable processes and outcomes.

  18. Rule of Law in Afghanistan -- Time for a New Approach?

    DTIC Science & Technology

    2009-03-17

    accessed November 7 2008) 139 Gates, Robert M. Afghanistan Command Restructuring Worthy of Consideration. Texarkana , Texas, May 2, 2008 By Donna Miles...products/GAO-08-661 (accessed November 2 2008) Gates, Robert M. Afghanistan Command Restructuring Worthy of Consideration. Texarkana , Texas, May

  19. 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.

  20. Spatially Characterizing Effective Timber Supply

    NASA Technical Reports Server (NTRS)

    Berry, J. K.; Sailor, J.

    1982-01-01

    The structure of a computer-oriented cartographic model for assessing roundwood supply for generation of base load electricity is discussed. The model provides an analytical procedure for coupling spatial information of harvesting economics and owner willingness to sell stumpages. Supply is characterized in terms of standing timber; of accessibility considering various harvesting and hauling factors; and of availability as affected by ownership and residential patterns. Factors governing accessibility to timber include effective harvesting distance to haulic roads as modified by barriers and slopes. Haul distance is expressed in units that take into account the relative ease of travel along various road types to a central processing facility. Areas of accessible timber are grouped into spatial units, termed 'timbersheds', of common access to particular haul road segments that belong to unique 'transport zones'. Timber availability considerations include size of ownership parcels, housing density and excluded areas. The analysis techniques are demonstrated for a cartographic data base in western Massachusetts.

  1. Consideration of What May Influence Student Outcomes on Alternate Assessment.

    ERIC Educational Resources Information Center

    Browder, Diane M.; Fallin, Kathy; Davis, Stephanie; Karvonen, Meagan

    2003-01-01

    This article describes variables that may influence alternate assessment outcomes for students with disabilities and offers recommendations to enhance student achievement. These variables include technical quality, curriculum access, data collection, instructional effectiveness, risk factors, and resources allocated to instruction. Two of four…

  2. Rethinking Canada's Higher Education Policy.

    ERIC Educational Resources Information Center

    Polster, Claire

    2002-01-01

    Rather than a public good that is freely shared, Canadian university research is increasingly privatized and commercialized and thus rendered accessible only to those who can pay for it. The effects include erosion of collegiality, institutional democracy, curiosity-driven basic research, objectivity, and consideration of disadvantaged groups. All…

  3. Operationalisation of the construct of access to dental care: a position paper and proposed conceptual definitions.

    PubMed

    Harris, R V

    2013-06-01

    'Access' is a term readily used in a political and policy context, but one which has not leant itself to measurement of progress towards policy goals or comparisons between health systems. Like 'quality', 'access' is a multi-dimensional construct, but currently often remains a vague and abstract concept which is difficult to translate into something specific, concrete and therefore measureable. The paper describes previous work and identifies a need for a greater consensus and conceptual clarity in the selection of metrics for dental access. The construct of dental access is described as involving the concepts of 1: opportunity for access; 2, realised access (utilisation); 3, equity and 4, outcomes. Proposed conceptual definitions are given and a case made for measuring 'initial utilisation' separately from 'continued utilisation', reflecting modern approaches which distinguish 'entry access' (gaining entry to the dental care system), from the process of gaining access to higher levels of care. Using a distinction between 'entry access' and 'effective access' allows a choice of whether to restrict measurement to mainly supply side considerations, or alternatively to extend the measurement to include whether there is equity in the proportion of patients who are able obtain effective needed interventions. A development of conceptual definitions of dental access could facilitate measurement of progress towards policy goals and operationalisation of the construct.

  4. Trends in communicative access solutions for children with cerebral palsy.

    PubMed

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

    2014-08-01

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

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

    PubMed Central

    2010-01-01

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

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

    PubMed

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

    2002-07-01

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

  7. 77 FR 21553 - Combined Notice of Filings #1

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-10

    .... Description: Revisions to the PJM Tariff & OA re Lost Opportunity Cost for Wind to be effective 6/1/2012... Applicants: Twin Cities Power, LLC. Description: Twin Cities Power, LLC requests authorization under Section 203 of the Federal Power Act and Request for Expedited Consideration. Filed Date: 3/30/12. Accession...

  8. Identity and Access Management and Security in Higher Education.

    ERIC Educational Resources Information Center

    Bruhn, Mark; Gettes, Michael; West, Ann

    2003-01-01

    Discusses the drivers for an identity management system (IdM), components of this system, and its role within a school security strategy, focusing on: basic access management; requirements for access management; middleware support for an access management system; IdM implementation considerations (e.g., access eligibilities, authentication…

  9. Considering Governance for Patient Access to E-Medical Records.

    PubMed

    Day, Karen; Wells, Susan

    2015-01-01

    People having access to their medical records could have a transformative improvement effect on healthcare delivery and use. Our research aimed to explore the concerns and attitudes of giving people electronic access to their medical records through patient portals. We conducted 28 semi-structured interviews with 30 people, asking questions about portal design, organisational implications and governance. We report the findings of the governance considerations raised during the interviews. These revealed that (1) there is uncertainty about the possible design and extent of giving people access to their medical records to view/use, (2) existing policies about patient authentication, proxy, and privacy require modification, and (3) existing governance structures and functions require further examination and adjustment. Future research should include more input from patients and health informaticians.

  10. Current state of web accessibility of Malaysian ministries websites

    NASA Astrophysics Data System (ADS)

    Ahmi, Aidi; Mohamad, Rosli

    2016-08-01

    Despite the fact that Malaysian public institutions have progressed considerably on website and portal usage, web accessibility has been reported as one of the issues deserves special attention. Consistent with the government moves to promote an effective use of web and portal, it is essential for the government institutions to ensure compliance with established standards and guidelines on web accessibility. This paper evaluates accessibility of 25 Malaysian ministries websites using automated tools i.e. WAVE and Achecker. Both tools are designed to objectively evaluate web accessibility in conformance with Web Content Accessibility Guidelines 2.0 (WCAG 2.0) and United States Rehabilitation Act 1973 (Section 508). The findings reported somewhat low compliance to web accessibility standard amongst the ministries. Further enhancement is needed in the aspect of input elements such as label and checkbox to be associated with text as well as image-related elements. This findings could be used as a mechanism for webmasters to locate and rectify errors pertaining to the web accessibility and to ensure equal access of the web information and services to all citizen.

  11. Experimental findings on God as an attachment figure: normative processes and moderating effects of internal working models.

    PubMed

    Granqvist, Pehr; Mikulincer, Mario; Gewirtz, Vered; Shaver, Phillip R

    2012-11-01

    Four studies examined implications of attachment theory for psychological aspects of religion among Israeli Jews. Study 1 replicated previous correlational findings indicating correspondence among interpersonal attachment orientations, attachment to God, and image of God. Studies 2-4 were subliminal priming experiments, which documented both normative and individual-difference effects. Regarding normative effects, findings indicated that threat priming heightened cognitive access to God-related concepts in a lexical decision task (Study 2); priming with "God" heightened cognitive access to positive, secure base-related concepts in the same task (Study 3); and priming with a religious symbol caused neutral material to be better liked (Study 4). Regarding individual differences, interpersonal attachment-related avoidance reduced the normative effects (i.e., avoidant participants had lower implicit access to God as a safe haven and secure base). Findings were mostly independent of level of religiousness. The present experiments considerably extend the psychological literature on connections between attachment constructs and aspects of religion. (c) 2012 APA, all rights reserved.

  12. Allocation of spectral and spatial modes in multidimensional metro-access optical networks

    NASA Astrophysics Data System (ADS)

    Gao, Wenbo; Cvijetic, Milorad

    2018-04-01

    Introduction of spatial division multiplexing (SDM) has added a new dimension in an effort to increase optical fiber channel capacity. At the same time, it can also be explored as an advanced optical networking tool. In this paper, we have investigated the resource allocation to end-users in multidimensional networking structure with plurality of spectral and spatial modes actively deployed in different networking segments. This presents a more comprehensive method as compared to the common practice where the segments of optical network are analyzed independently since the interaction between network hierarchies is included into consideration. We explored the possible transparency from the metro/core network to the optical access network, analyzed the potential bottlenecks from the network architecture perspective, and identified an optimized network structure. In our considerations, the viability of optical grooming through the entire hierarchical all-optical network is investigated by evaluating the effective utilization and spectral efficiency of the network architecture.

  13. A flexible influence of affective feelings on creative and analytic performance.

    PubMed

    Huntsinger, Jeffrey R; Ray, Cara

    2016-09-01

    Considerable research shows that positive affect improves performance on creative tasks and negative affect improves performance on analytic tasks. The present research entertained the idea that affective feelings have flexible, rather than fixed, effects on cognitive performance. Consistent with the idea that positive and negative affect signal the value of accessible processing inclinations, the influence of affective feelings on performance on analytic or creative tasks was found to be flexibly responsive to the relative accessibility of different styles of processing (i.e., heuristic vs. systematic, global vs. local). When a global processing orientation was accessible happy participants generated more creative uses for a brick (Experiment 1), successfully solved more remote associates and insight problems (Experiment 2) and displayed broader categorization (Experiment 3) than those in sad moods. When a local processing orientation was accessible this pattern reversed. When a heuristic processing style was accessible happy participants were more likely to commit the conjunction fallacy (Experiment 3) and showed less pronounced anchoring effects (Experiment 4) than sad participants. When a systematic processing style was accessible this pattern reversed. Implications of these results for relevant affect-cognition models are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  14. Characterization of Educational Resources in e-Learning Systems Using an Educational Metadata Profile

    ERIC Educational Resources Information Center

    Solomou, Georgia; Pierrakeas, Christos; Kameas, Achilles

    2015-01-01

    The ability to effectively administrate educational resources in terms of accessibility, reusability and interoperability lies in the adoption of an appropriate metadata schema, able of adequately describing them. A considerable number of different educational metadata schemas can be found in literature, with the IEEE LOM being the most widely…

  15. The Impact of Mentoring Reconsidered: An Exploration of the Benefits for Student Mentors

    ERIC Educational Resources Information Center

    Raven, Neil

    2015-01-01

    Mentoring represents a widely used outreach intervention amongst higher education institutions. It is also judged to be a "particularly effective" approach in widening access, with a significant amount of attention directed at examining its impact on those being mentored. In contrast, less consideration has been given to the benefits…

  16. Considerations for Realizing the Promise of Educational Gaming Technology

    ERIC Educational Resources Information Center

    Nelson, Nancy J.; Fien, Hank; Doabler, Christian T.; Clarke, Ben

    2016-01-01

    Hope Elementary School recently purchased tablets for all of its students to facilitate the use of technology in the classroom. The principal at Hope Elementary understands that technology can be an efficient and effective way for teachers to access materials and differentiate instruction to support the achievement of all learners. However, some…

  17. Design criteria monograph for metal tanks and tank components

    NASA Technical Reports Server (NTRS)

    1975-01-01

    Significant elements in detail tank design are wall and end structures, weld joints at bulkhead and attachment junctures, and ports and access openings. Additional design considerations are influence and effect of fabrication processes on tank component design, and finally, testing and inspection that are required to establish confidence in tank design.

  18. 75 FR 29587 - Notice of Availability of Revised Model Proposed No Significant Hazards Consideration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-26

    ... available in the Agencywide Documents Access and Management System (ADAMS) under Accession Number ML071420428. Documents: You can access publicly available documents related to this notice using the following..., Maryland. NRC's Agencywide Documents Access and Management System (ADAMS): Publicly available documents...

  19. A pilot program in rural telepsychiatry for deaf and hard of hearing populations.

    PubMed

    Crowe, Teresa; Jani, Suni; Jani, Sushma; Jani, Niranjan; Jani, Raja

    2016-03-01

    Access to mental health care in deaf communities is limited by cultural considerations, availability of translators, and technological considerations. Telepsychiatry can mitigate the deaf community's lack of access to care by allowing for deaf individuals in remote communities access to care with facilities that cater to their needs. Community Behavioral Health, Arundel Lodge, and Gallaudet University worked in conjunction to test three hypotheses: 1.Telepsychiatry will be as effective as traditional face-to-face psychotherapy with deaf adults who have chronic mental illness.2.Patients living in remote locations will report an improvement in accessibility to mental health services.3.Patients who receive telepsychiatry will report a comparable level of satisfaction of services to those receiving traditional services. The patient sample consisted of 24 participants, 13 women, 11 men. Telepsychiatry sessions were scheduled based on each patient's individual treatment plan against a control group who saw their providers face to face. The telepsychiatry and in-person groups were slightly different at baseline. Analysis of the data revealed no significant difference in coping abilities and psychiatric symptoms between those receiving face-to-face psychotherapy and those receiving telepsychiatry. The quality and outcome of care was equal to in-person for the telepsychiatry in deaf patients. Since telepsychiatry does not compromise the quality of care, it is a good means of reaching out to members of the deaf community that cannot readily access mental health resources that meet their needs.

  20. An exploration of multilevel modeling for estimating access to drinking-water and sanitation.

    PubMed

    Wolf, Jennyfer; Bonjour, Sophie; Prüss-Ustün, Annette

    2013-03-01

    Monitoring progress towards the targets for access to safe drinking-water and sanitation under the Millennium Development Goals (MDG) requires reliable estimates and indicators. We analyzed trends and reviewed current indicators used for those targets. We developed continuous time series for 1990 to 2015 for access to improved drinking-water sources and improved sanitation facilities by country using multilevel modeling (MLM). We show that MLM is a reliable and transparent tool with many advantages over alternative approaches to estimate access to facilities. Using current indicators, the MDG target for water would be met, but the target for sanitation missed considerably. The number of people without access to such services is still increasing in certain regions. Striking differences persist between urban and rural areas. Consideration of water quality and different classification of shared sanitation facilities would, however, alter estimates considerably. To achieve improved monitoring we propose: (1) considering the use of MLM as an alternative for estimating access to safe drinking-water and sanitation; (2) completing regular assessments of water quality and supporting the development of national regulatory frameworks as part of capacity development; (3) evaluating health impacts of shared sanitation; (4) using a more equitable presentation of countries' performances in providing improved services.

  1. Does access to improved sanitation reduce childhood diarrhea in rural India?

    PubMed

    Kumar, Santosh; Vollmer, Sebastian

    2013-04-01

    Almost nine million children under 5 years of age die every year. Diarrhea is considered to be the second leading cause of under-five mortality in developing countries. About one out of five deaths is caused by diarrhea. In this paper, we use the newly available data set District Level Household Survey 3 to quantify the impact of access to improved sanitation on diarrheal morbidity for children less than 5 years of age in India. Using propensity score matching, we find that access to improved sanitation reduces the risk of contracting diarrhea by 2.2 percentage points. There is considerable heterogeneity in the impacts of improved sanitation. We find statistically insignificant treatment effects for children in low or middle socioeconomic status households and for girls; however, boys and children in high socioeconomic status households experienced economically significant treatment effects. The magnitude of the treatment effect differs largely by hygiene behavior. Copyright © 2012 John Wiley & Sons, Ltd.

  2. Arteriovenous Vascular Access Selection and Evaluation

    PubMed Central

    MacRae, Jennifer M.; Oliver, Matthew; Clark, Edward; Dipchand, Christine; Hiremath, Swapnil; Kappel, Joanne; Kiaii, Mercedeh; Lok, Charmaine; Luscombe, Rick; Miller, Lisa M.; Moist, Louise

    2016-01-01

    When making decisions regarding vascular access creation, the clinician and vascular access team must evaluate each patient individually with consideration of life expectancy, timelines for dialysis start, risks and benefits of access creation, referral wait times, as well as the risk for access complications. The role of the multidisciplinary team in facilitating access choice is reviewed, as well as the clinical evaluation of the patient. PMID:28270917

  3. Evaluating Microcomputer Access Technology for Use by Visually Impaired Students.

    ERIC Educational Resources Information Center

    Ruconich, Sandra

    1984-01-01

    The article outlines advantages and limitations of five types of access to microcomputer technology for visually impaired students: electronic braille, paper braille, Optacon, synthetic speech, and enlarged print. Additional considerations in access decisions are noted. (CL)

  4. Second-Tier Database for Ecosystem Focus, 2003-2004 Annual Report.

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

    University of Washington, Columbia Basin Research, DART Project Staff,

    2004-12-01

    The Second-Tier Database for Ecosystem Focus (Contract 00004124) provides direct and timely public access to Columbia Basin environmental, operational, fishery and riverine data resources for federal, state, public and private entities essential to sound operational and resource management. The database also assists with juvenile and adult mainstem passage modeling supporting federal decisions affecting the operation of the FCRPS. The Second-Tier Database known as Data Access in Real Time (DART) integrates public data for effective access, consideration and application. DART also provides analysis tools and performance measures for evaluating the condition of Columbia Basin salmonid stocks. These services are critical tomore » BPA's implementation of its fish and wildlife responsibilities under the Endangered Species Act (ESA).« less

  5. A review of earth observation using mobile personal communication devices

    NASA Astrophysics Data System (ADS)

    Ferster, Colin J.; Coops, Nicholas C.

    2013-02-01

    Earth observation using mobile personal communication devices (MPCDs) is a recent advance with considerable promise for acquiring important and timely measurements. Globally, over 5 billion people have access to mobile phones, with an increasing proportion having access to smartphones with capabilities such as a camera, microphone, global positioning system (GPS), data storage, and networked data transfer. Scientists can view these devices as embedded sensors with the potential to take measurements of the Earth's surface and processes. To advance the state of Earth observation using MPCDs, scientists need to consider terms and concepts, from a broad range of disciplines including citizen science, image analysis, and computer vision. In this paper, as a result of our literature review, we identify a number of considerations for Earth observation using MPCDs such as methods of field collection, collecting measurements over broad areas, errors and biases, data processing, and accessibility of data. Developing effective frameworks for mobile data collection with public participation and strategies for minimizing bias, in combination with advancements in image processing techniques, will offer opportunities to collect Earth sensing data across a range of scales and perspectives, complimenting airborne and spaceborne remote sensing measurements.

  6. Techniques for animation of CFD results. [computational fluid dynamics

    NASA Technical Reports Server (NTRS)

    Horowitz, Jay; Hanson, Jeffery C.

    1992-01-01

    Video animation is becoming increasingly vital to the computational fluid dynamics researcher, not just for presentation, but for recording and comparing dynamic visualizations that are beyond the current capabilities of even the most powerful graphic workstation. To meet these needs, Lewis Research Center has recently established a facility to provide users with easy access to advanced video animation capabilities. However, producing animation that is both visually effective and scientifically accurate involves various technological and aesthetic considerations that must be understood both by the researcher and those supporting the visualization process. These considerations include: scan conversion, color conversion, and spatial ambiguities.

  7. Alternative Models of Entrance Exams and Access to Higher Education: The Case of the Czech Republic

    ERIC Educational Resources Information Center

    Konecny, Tomas; Basl, Josef; Myslivecek, Jan; Simonova, Natalie

    2012-01-01

    The study compares the potential effects of a university admission exam model based on program-specific knowledge and an alternative model relying on general study aptitude (GSA) in the context of a strongly stratified educational system with considerable excess of demand over supply of university education. Using results of the "Sonda…

  8. Biosimilars for the management of rheumatoid arthritis: economic considerations.

    PubMed

    Gulácsi, László; Brodszky, Valentin; Baji, Petra; Kim, HoUng; Kim, Su Yeon; Cho, Yu Young; Péntek, Márta

    2015-01-01

    Biologic drugs have proved highly effective for the treatment of immune-mediated inflammatory diseases such as rheumatoid arthritis (RA). These drugs are often considered cost-effective for well-defined RA patient populations not responding adequately to conventional treatment, but are used first-line relatively rarely, partly due to high costs. Furthermore, not all clinically eligible patients can access biologics even as second-line therapy. Recently, there has been a rise in interest in 'biosimilar' drugs that are highly comparable to the 'reference medicinal product' (RMP) in terms of efficacy and safety but may generally be lower in price. This review summarizes the cost burden of RA and considers the potential role of biosimilars in reducing drug costs and increasing patient access to biologics.

  9. Reducing Fatal Opioid Overdose: Prevention, Treatment and Harm Reduction Strategies

    PubMed Central

    Hawk, Kathryn F.; Vaca, Federico E.; D’Onofrio, Gail

    2015-01-01

    The opioid overdose epidemic is a major threat to the public’s health, resulting in the development and implementation of a variety of strategies to reduce fatal overdose [1-3]. Many strategies are focused on primary prevention and increased access to effective treatment, although the past decade has seen an exponential increase in harm reduction initiatives. To maximize identification of opportunities for intervention, initiatives focusing on prevention, access to effective treatment, and harm reduction are examined independently, although considerable overlap exists. Particular attention is given to harm reduction approaches, as increased public and political will have facilitated widespread implementation of several initiatives, including increased distribution of naloxone and policy changes designed to increase bystander assistance during a witnessed overdose [4-7]. PMID:26339206

  10. Traffic Adaptive Energy Efficient and Low Latency Medium Access Control for Wireless Sensor Networks

    NASA Astrophysics Data System (ADS)

    Yadav, Rajesh; Varma, Shirshu; Malaviya, N.

    2008-05-01

    Medium access control for wireless sensor networks has been a very active research area in the recent years. The traditional wireless medium access control protocol such as IEEE 802.11 is not suitable for the sensor network application because these are battery powered. The recharging of these sensor nodes is expensive and also not possible. The most of the literature in the medium access for the sensor network focuses on the energy efficiency. The proposed MAC protocol solves the energy inefficiency caused by idle listening, control packet overhead and overhearing taking nodes latency into consideration based on the network traffic. Simulation experiments have been performed to demonstrate the effectiveness of the proposed approach. The validation of the simulation results of the proposed MAC has been done by comparing it with the analytical model. This protocol has been simulated in Network Simulator ns-2.

  11. Performance model-directed data sieving for high-performance I/O

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

    Chen, Yong; Lu, Yin; Amritkar, Prathamesh

    2014-09-10

    Many scientific computing applications and engineering simulations exhibit noncontiguous I/O access patterns. Data sieving is an important technique to improve the performance of noncontiguous I/O accesses by combining small and noncontiguous requests into a large and contiguous request. It has been proven effective even though more data are potentially accessed than demanded. In this study, we propose a new data sieving approach namely performance model-directed data sieving, or PMD data sieving in short. It improves the existing data sieving approach from two aspects: (1) dynamically determines when it is beneficial to perform data sieving; and (2) dynamically determines how tomore » perform data sieving if beneficial. It improves the performance of the existing data sieving approach considerably and reduces the memory consumption as verified by both theoretical analysis and experimental results. Given the importance of supporting noncontiguous accesses effectively and reducing the memory pressure in a large-scale system, the proposed PMD data sieving approach in this research holds a great promise and will have an impact on high-performance I/O systems.« less

  12. Accessibility Considerations for Hybrid Courses

    ERIC Educational Resources Information Center

    Behling, Kirsten

    2017-01-01

    This chapter explores the central questions and issues that faculty and administrators need to consider when designing and implementing hybrid courses to ensure that all students, including those with disabilities, have equal access. The author offers resources on faculty development programs, accessibility checklists, and online resources on…

  13. [Public control and equity of access to hospitals under non-State public administration].

    PubMed

    Carneiro Junior, Nivaldo; Elias, Paulo Eduardo

    2006-10-01

    To analyze social health organizations in the light of public control and the guarantee of equity of access to health services. Utilizing the case study technique, two social health organizations in the metropolitan region of São Paulo were selected. The analytical categories were equity of access and public control, and these were based on interviews with key informants and technical-administrative reports. It was observed that the overall funding and administrative control of the social health organizations are functions of the state administrator. The presence of a local administrator is important for ensuring equity of access. Public control is expressed through supervisory actions, by means of accounting and financial procedures. Equity of access and public control are not taken into consideration in the administration of these organizations. The central question lies in the capacity of the public authorities to have a presence in implementing this model at the local level, thereby ensuring equity of access and taking public control into consideration.

  14. Affirming Equal Opportunity and Access in the University of California so California Prospers. Higher Education Policy Brief

    ERIC Educational Resources Information Center

    Valliani, Nadia

    2015-01-01

    In 1996, California voters approved Proposition 209--a ban on the consideration of race in the college admissions process at public universities. This policy brief examines the effects of Proposition 209 at the University of California system by analyzing twenty years' of application, admission, and enrollment data. The brief concludes that in…

  15. Subscriptions Are Us: Content, Access, & Collections

    ERIC Educational Resources Information Center

    Thomas, Lisa Carlucci

    2012-01-01

    In a time of increasingly digital distribution, challenging questions arise regarding what people own, what they want to access to, and how they develop and maintain collections. What considerations influence their decision making, as individuals and libraries shift toward more subscription-oriented content? Digital access to e-books and…

  16. The Anxious and Ambivalent Partisan: The Effect of Incidental Anxiety on Partisan Motivated Recall and Ambivalence.

    PubMed

    Groenendyk, Eric

    2016-01-01

    Affective Intelligence Theory (AIT) asserts that anxiety reduces the effect of party identification on candidate preferences (Marcus, Neuman, and MacKuen 2000), but recent studies have raised doubts about this causal claim. Rather than functioning as a moderator of party identification, perhaps anxiety has a direct effect on preferences, or perhaps the relationship is reversed and preferences drive emotions (Ladd and Lenz 2008). Alternatively, Marcus et al.'s measure of anxiety may simply be capturing partisan ambivalence, so the posited relationship is spurious (Lavine, Johnston, and Steenbergen 2012). This paper addresses each of these questions by examining the effect of experimentally induced emotions on the types of considerations that came to mind when a national sample of adult Americans was asked what they liked and disliked about Barack Obama. By directly manipulating anxiety, this experiment avoids the causal ambiguity plaguing this debate and ascertains the true nature of the relationship between anxiety and ambivalence. Consistent with AIT, anxiety led respondents to recall more contemporary considerations, whereas enthusiasm brought to mind more long-standing considerations. Because the political context at the time of the study (fall 2013) was a very tumultuous time for the Obama administration, the increased accessibility of contemporary considerations led Democratic participants to experience more ambivalence in the anxiety condition. This effect was concentrated among those Democrats who were exposed to the most newspaper coverage.

  17. Cost-effectiveness of an improving access to psychological therapies service.

    PubMed

    Mukuria, Clara; Brazier, John; Barkham, Michael; Connell, Janice; Hardy, Gillian; Hutten, Rebecca; Saxon, Dave; Dent-Brown, Kim; Parry, Glenys

    2013-03-01

    Effective psychological therapies have been recommended for common mental health problems, such as depression and anxiety, but provision has been poor. Improving Access to Psychological Therapies (IAPT) may provide a cost-effective solution to this problem. To determine the cost-effectiveness of IAPT at the Doncaster demonstration site (2007-2009). An economic evaluation comparing costs and health outcomes for patients at the IAPT demonstration site with those for comparator sites, including a separate assessment of lost productivity. Sensitivity analyses were undertaken. The IAPT site had higher service costs and was associated with small additional gains in quality-adjusted life-years (QALYs) compared with its comparator sites, resulting in a cost per QALY gained of £29 500 using the Short Form (SF-6D). Sensitivity analysis using predicted EQ-5D scores lowered this to £16 857. Costs per reliable and clinically significant (RCS) improvement were £9440 per participant. Improving Access to Psychological Therapies provided a service that was probably cost-effective within the usual National Institute for Health and Clinical Excellence (NICE) threshold range of £20 000-30 000, but there was considerable uncertainty surrounding the costs and outcome differences.

  18. The ethics of general practice and advertising.

    PubMed

    Colman, R D

    1989-06-01

    UK general practitioners (GPs) are self-employed entrepreneurs running small businesses with commercial considerations. In this situation there is no clear distinction between information, self-promotion and advertising. In response to the growing public demand for more information about medical services, the medical profession should voluntarily accept the notion of soft self-promotion in the form of 'notices' or 'announcements' placed in newspapers. Newspapers are the most effective way of giving easy access to information. The resistance to newspapers may be more concerned with preserving certain medical traditions than consideration of the public interest. The General Medical Council's (GMC's) arguments against soft self-promotion are seen as misguided paternalism, inconsistent and irrational.

  19. Access to and Accessibility of Education: An Analytic and Conceptual Approach to a Multidimensional Issue

    ERIC Educational Resources Information Center

    Stauber, Barbara; Parreira do Amaral, Marcelo

    2015-01-01

    This article presents analytical considerations for the discussion of issues of access to education and inequality. It first sharpens the concept of access and inequality by pointing to the interplay of structure and agency as well as to processes of social differentiation in which differences are constructed. This implies a critical view on…

  20. A primer on intraosseous access: History, clinical considerations, and current devices.

    PubMed

    Burgert, James M

    2016-01-01

    Intraosseous (IO) access is a method recommended by the American Heart Association and the European Resuscitation Council to administer resuscitative drugs and fluids when intravenous (IV) access cannot be rapidly or easily obtained. Many clinicians have limited knowledge or experience with the IO route. The purpose of this review was to provide the reader with a succinct review of the history, clinical considerations, and devices associated with IO access. Narrative review. University-based academic research cell. Not applicable. Not applicable. IO access is a lifesaving bridge to definitive vascular access that may be considered when an IV cannot be rapidly attained and the patient's outcome may be negatively affected without prompt circulatory access. The IO route has few contraindications for use and a low rate of serious complications. Multiple manual and powered devices that may be placed in several anatomic sites are commercially available. All clinicians who provide acute care or respond to cardiovascular emergencies should obtain training and maintain proficiency in placing and using IO devices as the IO route is recommended by the major resuscitation organizations as the preferred route of infusion when rapid, reliable IV access is unavailable.

  1. The College Access Debate: Class Considerations and College Preparation

    ERIC Educational Resources Information Center

    Hodgman, Matthew R.

    2013-01-01

    The college access debate in America remains an important one. Affirmative action policies and practices continue to occupy a significant sub-component of the overall college access discussion. Recent legal debates and policy changes pertaining to affirmative action have encouraged analysis surrounding the overall viability and fairness of these…

  2. The Impact of Coverage Restrictions on Antipsychotic Utilization Among Low-Income Medicare Part D Enrollees.

    PubMed

    Roberto, Pamela N; Brandt, Nicole; Onukwugha, Eberechukwu; Perfetto, Eleanor; Powers, Christopher; Stuart, Bruce

    2017-11-01

    Prior research demonstrates substantial access problems associated with utilization management and formulary exclusions for antipsychotics in Medicaid, but the use and impact of coverage restrictions for these medications in Medicare Part D remains unknown. We assess the effect of coverage restrictions on antipsychotic utilization in Part D by exploiting a unique natural experiment in which low-income beneficiaries are randomly assigned to prescription drug plans with varying levels of formulary generosity. Despite considerable variation in use of coverage restrictions across Part D plans, we find no evidence that these restrictions significantly deter utilization or reduce access to antipsychotics for low-income beneficiaries.

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

    PubMed

    Davis, Philip M; Walters, William H

    2011-07-01

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

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

    PubMed Central

    Walters, William H

    2011-01-01

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

  5. Impact of Socioeconomic Inequality on Access, Adherence, and Outcomes of Antiretroviral Treatment Services for People Living with HIV/AIDS in Vietnam.

    PubMed

    Tran, Bach Xuan; Hwang, Jongnam; Nguyen, Long Hoang; Nguyen, Anh Tuan; Latkin, Noah Reed Knowlton; Tran, Ngoc Kim; Minh Thuc, Vu Thi; Nguyen, Huong Lan Thi; Phan, Huong Thu Thi; Le, Huong Thi; Tran, Tho Dinh; Latkin, Carl A

    2016-01-01

    Ensuring an equal benefit across different patient groups is necessary while scaling up free-of-charge antiretroviral treatment (ART) services. This study aimed to measure the disparity in access, adherence, and outcomes of ART in Vietnam and the effects of socioeconomic status (SES) characteristics on the levels of inequality. A cross-sectional study was conducted in 1133 PLWH in Vietnam. ART access, adherence, and treatment outcomes were self-reported using a structured questionnaire. Wealth-related inequality was calculated using a concentration index, and a decomposition analysis was used to determine the contribution of each SES variable to inequality in access, adherence, and outcomes of ART. Based on SES, minor inequality was found in ART access and adherence while there was considerable inequality in ART outcomes. Poor people were more likely to start treatment early, while rich people had better adherence and overall treatment outcomes. Decomposition revealed that occupation and education played important roles in inequality in ART access, adherence, and treatment outcomes. The findings suggested that health services should be integrated into the ART regimen. Furthermore, occupational orientation and training courses should be provided to reduce inequality in ART access, adherence, and treatment outcomes.

  6. Role of Protein and Amino Acids in Infant and Young Child Nutrition: Considerations for the Development and Delivery of High Quality Complementary Food Supplements.

    PubMed

    Ghosh, Shibani; Kurpad, Anura; Tano-Debrah, Kwaku; Otoo, Gloria E; Aaron, Grant A; Toride, Yasuhiko; Uauy, Ricardo

    2015-01-01

    Prevention of malnutrition in infants and children is multifaceted and requires the following: access to and intake of nutritious food starting at birth with exclusive breastfeeding for the first 6 mo of life, continued breastfeeding in combination with complementary foods from 6-24 mo of age, access to clean drinking water and sanitation, and access to preventive and curative health care (including prenatal). Nutrient-dense complementary foods can improve nutritional status and have long-term benefits; however, in a review of plant-based complementary foods in developing countries, most of them failed to meet many micronutrient requirements. There is need to provide other cost-effective alternatives to increase the quality of the diet during the complementary feeding stage of the lifecycle. This paper provides an overview of the development, testing, efficacy and effectiveness of the delivery of KOKO Plus on the growth and nutritional status of infants 6-24 mo of age.

  7. Access to augmentative and alternative communication: new technologies and clinical decision-making.

    PubMed

    Fager, Susan; Bardach, Lisa; Russell, Susanne; Higginbotham, Jeff

    2012-01-01

    Children with severe physical impairments require a variety of access options to augmentative and alternative communication (AAC) and computer technology. Access technologies have continued to develop, allowing children with severe motor control impairments greater independence and access to communication. This article will highlight new advances in access technology, including eye and head tracking, scanning, and access to mainstream technology, as well as discuss future advances. Considerations for clinical decision-making and implementation of these technologies will be presented along with case illustrations.

  8. Building a generalized distributed system model

    NASA Technical Reports Server (NTRS)

    Mukkamala, Ravi; Foudriat, E. C.

    1991-01-01

    A modeling tool for both analysis and design of distributed systems is discussed. Since many research institutions have access to networks of workstations, the researchers decided to build a tool running on top of the workstations to function as a prototype as well as a distributed simulator for a computing system. The effects of system modeling on performance prediction in distributed systems and the effect of static locking and deadlocks on the performance predictions of distributed transactions are also discussed. While the probability of deadlock is considerably small, its effects on performance could be significant.

  9. Psoriasis treatment considerations in military patients: unique patients, unique drugs.

    PubMed

    Evans, Thomas; Davidson, Nathan; Logemann, Nicholas

    2016-12-01

    Psoriasis is a common dermatologic problem with a chronic and sometimes debilitating course. Psoriasis can impair a service member's ability to perform job-related activities and should certainly be treated; however, use of immunosuppressive treatments can prevent deployment to strategic locations around the world for numerous reasons, such as the need for laboratory monitoring, minimal access to climate-controlled storage, and potential increased risk of exposure to virulent pathogens while on these medications. Similar obstacles can exist for nonmilitary patients who are placed in austere conditions or participate in worldwide travel. Although treatment efficacy, cost, and side-effect profiles are always paramount considerations in deciding on treatment regimens with patients, herein we focus our discussion on a consideration that might be easily overlooked when treating patients in modern society, that being the "logistics" of treatment.

  10. Comparison of Non-Invasive Individual Monitoring of the Training and Health of Athletes with Commercially Available Wearable Technologies

    PubMed Central

    Düking, Peter; Hotho, Andreas; Holmberg, Hans-Christer; Fuss, Franz Konstantin; Sperlich, Billy

    2016-01-01

    Athletes adapt their training daily to optimize performance, as well as avoid fatigue, overtraining and other undesirable effects on their health. To optimize training load, each athlete must take his/her own personal objective and subjective characteristics into consideration and an increasing number of wearable technologies (wearables) provide convenient monitoring of various parameters. Accordingly, it is important to help athletes decide which parameters are of primary interest and which wearables can monitor these parameters most effectively. Here, we discuss the wearable technologies available for non-invasive monitoring of various parameters concerning an athlete's training and health. On the basis of these considerations, we suggest directions for future development. Furthermore, we propose that a combination of several wearables is most effective for accessing all relevant parameters, disturbing the athlete as little as possible, and optimizing performance and promoting health. PMID:27014077

  11. Library Media Center Design Considerations for Physically Disabled Students.

    ERIC Educational Resources Information Center

    Moy, Patricia J.

    Federal legislation ensures that children with physical disabilities should not be denied access to the school library. These children have the same information needs as their peers, and they want equal access to information in the school library media center. To create an accessible and functional school library, many requirements and…

  12. A Comparison of Web Resource Access Experiments: Planning for the New Millennium.

    ERIC Educational Resources Information Center

    Greenberg, Jane

    This paper reports on research that compared five leading experiments that aim to improve access to the growing number of information resources on the World Wide Web. The objective was to identify characteristics of success and considerations for improvement in experiments providing access to Web resources via bibliographic control methods. The…

  13. 17 CFR 9.24 - Petition for stay pending review.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... RELATING TO REVIEW OF EXCHANGE DISCIPLINARY, ACCESS DENIAL OR OTHER ADVERSE ACTIONS Initial Procedure With... the notice of the disciplinary or access denial action has been delivered in accordance with § 9.11 to... disciplinary or access denial action pending consideration by the Commission of the notice of appeal and, if...

  14. The Anxious and Ambivalent Partisan

    PubMed Central

    Groenendyk, Eric

    2016-01-01

    Affective Intelligence Theory (AIT) asserts that anxiety reduces the effect of party identification on candidate preferences (Marcus, Neuman, and MacKuen 2000), but recent studies have raised doubts about this causal claim. Rather than functioning as a moderator of party identification, perhaps anxiety has a direct effect on preferences, or perhaps the relationship is reversed and preferences drive emotions (Ladd and Lenz 2008). Alternatively, Marcus et al.’s measure of anxiety may simply be capturing partisan ambivalence, so the posited relationship is spurious (Lavine, Johnston, and Steenbergen 2012). This paper addresses each of these questions by examining the effect of experimentally induced emotions on the types of considerations that came to mind when a national sample of adult Americans was asked what they liked and disliked about Barack Obama. By directly manipulating anxiety, this experiment avoids the causal ambiguity plaguing this debate and ascertains the true nature of the relationship between anxiety and ambivalence. Consistent with AIT, anxiety led respondents to recall more contemporary considerations, whereas enthusiasm brought to mind more long-standing considerations. Because the political context at the time of the study (fall 2013) was a very tumultuous time for the Obama administration, the increased accessibility of contemporary considerations led Democratic participants to experience more ambivalence in the anxiety condition. This effect was concentrated among those Democrats who were exposed to the most newspaper coverage. PMID:27274573

  15. Access management : transportation policy considerations for a growing Virginia.

    DOT National Transportation Integrated Search

    1998-01-01

    This report analyzes comprehensive highway access management programs and looks at the potential benefits and legal limits to Virginia adopting such a program to replace Virginia's rather limited site specific permitting process. In 1942, Virginia pa...

  16. Accessibility Measures: Formulation Considerations and Current Applications

    DOT National Transportation Integrated Search

    2000-09-01

    This report examines micro-scale and macro-scale factors for inclusion in an ideal accessibility measure. Their potential influence on the evaluation of mode choice and destination choice is discussed. Availability in Texas' major cities is presented...

  17. A longitudinal analysis of cars, transit, and employment outcomes.

    DOT National Transportation Integrated Search

    2015-09-01

    Access to cars and transit can influence individuals ability to reach opportunities such as jobs, health care, and other important : activities. While access to cars and public transit varies considerably across time, space, and across populations...

  18. The ethics of general practice and advertising.

    PubMed Central

    Colman, R D

    1989-01-01

    UK general practitioners (GPs) are self-employed entrepreneurs running small businesses with commercial considerations. In this situation there is no clear distinction between information, self-promotion and advertising. In response to the growing public demand for more information about medical services, the medical profession should voluntarily accept the notion of soft self-promotion in the form of 'notices' or 'announcements' placed in newspapers. Newspapers are the most effective way of giving easy access to information. The resistance to newspapers may be more concerned with preserving certain medical traditions than consideration of the public interest. The General Medical Council's (GMC's) arguments against soft self-promotion are seen as misguided paternalism, inconsistent and irrational. PMID:2746609

  19. Putting a Medical Library Online: Phase III--Remote Access to CD-ROMs.

    ERIC Educational Resources Information Center

    Kittle, Paul

    1989-01-01

    Describes the implementation of a project that provides dial-up access to MEDLINE on remote optical data disk (CD-ROM) using software that enables callers to use programs like Wordstar, Lotus, and dBase. Highlights include networking CD-ROM databases, hardware considerations, advantages and disadvantages of remote access, and future plans. A…

  20. 76 FR 33789 - Florida Power & Light Company, St. Lucie Plant, Unit 1; Notice of Consideration of Issuance of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-09

    ... sign documents and access the E-Submittal server for any proceeding in which it is participating; and... Opportunity for a Hearing and Order Imposing Procedures for Document Access to Sensitive Unclassified Non... Information (SUNSI) is necessary to respond to this notice must request document access by June 20, 2011...

  1. Creating Library Interiors: Planning and Design Considerations.

    ERIC Educational Resources Information Center

    Jones, Plummer Alston, Jr.; Barton, Phillip K.

    1997-01-01

    Examines design considerations for public library interiors: access; acoustical treatment; assignable and nonassignable space; building interiors: ceilings, clocks, color, control, drinking fountains; exhibit space: slotwall display, floor coverings, floor loading, furniture, lighting, mechanical systems, public address, copying machines,…

  2. Architectural Considerations of Fiber-Radio Millimeter-Wave Wireless Access Systems

    NASA Astrophysics Data System (ADS)

    Kitayama, Ken-Ichi

    The architecture of fiber-radio mm-wave wireless access systems critically depends upon the optical mm-wave generation and transport techniques. Four optical mm-wave generation and transport techniques: 1) optical self-heterodyning, 2) external modulation, 3) up- and downconversion, and 4) optical transceiver, will be assessed. From the technical viewpoints, their advantages and disadvantages are discussed. The economical assessment, focusing on the cost of a base station BS ( ), will suggest that the optical transceiver looks the most promising in the long run, but in the near future, however, the external modulation will be cost-effective. The experimental results of 60 GHz testbeds using the external modulation will support the conclusion.

  3. Challenges and gaps for energy planning models in the developing-world context

    NASA Astrophysics Data System (ADS)

    Debnath, Kumar Biswajit; Mourshed, Monjur

    2018-03-01

    Energy planning models (EPMs) support multi-criteria assessments of the impact of energy policies on the economy and environment. Most EPMs originated in developed countries and are primarily aimed at reducing greenhouse gas emissions while enhancing energy security. In contrast, most, if not all, developing countries are predominantly concerned with increasing energy access. Here, we review thirty-four widely used EPMs to investigate their applicability to developing countries and find an absence of consideration of the objectives, challenges, and nuances of the developing context. Key deficiencies arise from the lack of deliberation of the low energy demand resulting from lack of access and availability of supply. Other inadequacies include the lack of consideration of socio-economic nuances such as the prevalence of corruption and resulting cost inflation, the methods for adequately addressing the shortcomings in data quality, availability and adequacy, and the effects of climate change. We argue for further research on characterization and modelling of suppressed demand, climate change impacts, and socio-political feedback in developing countries, and the development of contextual EPMs.

  4. Indoor Athletic Facilities.

    ERIC Educational Resources Information Center

    Fleming, E. Scott

    2000-01-01

    Examines the concept of shared-use facilities to help financially support and meet the demand for athletic facilities. Shared-use considerations are explored including cost sharing of ongoing operations, aesthetics, locker rooms, support facilities, parking and site access, and building access and security. (GR)

  5. Some significant considerations in the planning of sortie missions. [of space transportation system

    NASA Technical Reports Server (NTRS)

    Loftus, J. P., Jr.; Cour-Palais, B. G.; Moore, J. W.; Lohman, R. L.

    1980-01-01

    Opportunities and limitations to be considered in the planning of Space Shuttle/Spacelab sortie missions are discussed. As shown by a simple model of the flow of STS equipment through ground processing and flights under ideal conditions, mission duration is constrained by Orbiter availability, which is determined initially by the Orbiter production schedule and the turnaround time required between missions, and by the usage rate and quantity limitations of mission consumables. Additional considerations affecting mission duration include reductions in crew productivity upon increased mission duration and crew size, spacecraft and experiment degradation, equipment and processing facility cost effectiveness, and requirements for a power extension package, which considerations imply that increased allowable landing weight would make co-manifesting (the combination of Spacelab and deliverable payload missions) more attractive. Advantages related to payload recoverability, human presence, ease of access and the availability of different orbits are also pointed out.

  6. Clinical and financial considerations for implementing an ICU telemedicine program.

    PubMed

    Kruklitis, Robert J; Tracy, Joseph A; McCambridge, Matthew M

    2014-06-01

    As the population in the United States increases and ages, the need to provide high-quality, safe, and cost-effective care to the most critically ill patients will be of great importance. With the projected shortage of intensivists, innovative changes to improve efficiency and increase productivity will be necessary. Telemedicine programs in the ICUs (tele-ICUs) are a successful strategy to improve intensivist access to critically ill patients. Although significant capital and maintenance costs are associated with tele-ICUs, these costs can be offset by indirect financial benefits, such as decreased length of stay. To achieve the positive clinical outcomes desired, tele-ICUs must be carefully designed and implemented. In this article, we discuss the clinical benefits of tele-ICUs. We review the financial considerations, including direct and indirect reimbursement and development and maintenance costs. Finally, we review design and implementation considerations for tele-ICUs.

  7. Impact of Socioeconomic Inequality on Access, Adherence, and Outcomes of Antiretroviral Treatment Services for People Living with HIV/AIDS in Vietnam

    PubMed Central

    Nguyen, Long Hoang; Nguyen, Anh Tuan; Latkin, Noah Reed Knowlton; Tran, Ngoc Kim; Minh Thuc, Vu Thi; Nguyen, Huong Lan Thi; Phan, Huong Thu Thi; Le, Huong Thi; Tran, Tho Dinh; Latkin, Carl A.

    2016-01-01

    Background Ensuring an equal benefit across different patient groups is necessary while scaling up free-of-charge antiretroviral treatment (ART) services. This study aimed to measure the disparity in access, adherence, and outcomes of ART in Vietnam and the effects of socioeconomic status (SES) characteristics on the levels of inequality. Methods A cross-sectional study was conducted in 1133 PLWH in Vietnam. ART access, adherence, and treatment outcomes were self-reported using a structured questionnaire. Wealth-related inequality was calculated using a concentration index, and a decomposition analysis was used to determine the contribution of each SES variable to inequality in access, adherence, and outcomes of ART. Results Based on SES, minor inequality was found in ART access and adherence while there was considerable inequality in ART outcomes. Poor people were more likely to start treatment early, while rich people had better adherence and overall treatment outcomes. Decomposition revealed that occupation and education played important roles in inequality in ART access, adherence, and treatment outcomes Conclusion The findings suggested that health services should be integrated into the ART regimen. Furthermore, occupational orientation and training courses should be provided to reduce inequality in ART access, adherence, and treatment outcomes. PMID:28005937

  8. Variation in Health Technology Assessment and Reimbursement Processes in Europe.

    PubMed

    Akehurst, Ronald L; Abadie, Eric; Renaudin, Noël; Sarkozy, François

    2017-01-01

    It has been suggested that differences in health technology assessment (HTA) processes among countries, particularly within Europe, have led to inequity in patient access to new medicines. To provide an up-to-date snapshot analysis of the present status of HTA and reimbursement systems in select European countries, and to investigate the implications of these processes, especially with regard to delays in market and patient access. HTA and reimbursement processes were assessed through a review of published and gray literature, and through a series of interviews with HTA experts. To quantify the impact of differences among countries, we conducted case studies of 12 products introduced since 2009, including 10 cancer drugs. In addition to the differences in HTA and reimbursement processes among countries, the influence of particular sources of information differs among HTA bodies. The variation in the time from the authorization by the European Medicines Agency to the publication of HTA decisions was considerable, both within and among countries, with a general lack of transparency as to why some assessments take longer than others. In most countries, market access for oncology products can occur outside the HTA process, with sales often preceding HTA decisions. It is challenging even for those with considerable personal experience in European HTA processes to establish what is really happening in market access for new drugs. We recommend that efforts should be directed toward improving transparency in HTA, which should, in turn, lead to more effective processes. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

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

    PubMed

    Park, Hyejin; Cormier, Eileen; Glenna, Gordon

    2016-01-01

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

  10. The influence of motivating operations on generalization probes of specific mands by children with autism.

    PubMed

    Fragale, Christina L; O'Reilly, Mark F; Aguilar, Jeannie; Pierce, Nigel; Lang, Russell; Sigafoos, Jeff; Lancioni, Giulio

    2012-01-01

    We investigated the influence of motivating operations on the generalization of newly taught mands across settings and communication partners for 3 children with autism. Two conditions were implemented prior to generalization probes. In the first condition, participants were given access to a preferred item until they rejected the item (i.e., abolishing operation). In the second condition, the item was not available to participants prior to generalization probes (i.e., establishing operation). The effects of these conditions on the generalization of newly taught mands were evaluated in a multielement design. Results indicated differentiated responding during generalization probes in which more manding with the target mand was observed following the presession no-access condition than in the presession access condition. These results support the consideration of motivating operations when assessing generalization of target mands to various untrained contexts.

  11. 7 CFR 1491.6 - Ranking considerations and proposal selection.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... protection including social, economic, historical and archaeological, and environmental benefits; (4...) system. This score serves as a measure of agricultural viability (access to markets and infrastructure... viability for future generations; and (8) Landowner willingness to allow public access for recreational...

  12. 7 CFR 1491.6 - Ranking considerations and proposal selection.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... protection including social, economic, historical and archaeological, and environmental benefits; (4...) system. This score serves as a measure of agricultural viability (access to markets and infrastructure... viability for future generations; and (8) Landowner willingness to allow public access for recreational...

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

    ERIC Educational Resources Information Center

    Kimmons, Royce

    2017-01-01

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

  14. Using Motion Planning to Determine the Existence of an Accessible Route in a CAD Environment

    ERIC Educational Resources Information Center

    Pan, Xiaoshan; Han, Charles S.; Law, Kincho H.

    2010-01-01

    We describe an algorithm based on motion-planning techniques to determine the existence of an accessible route through a facility for a wheeled mobility device. The algorithm is based on LaValle's work on rapidly exploring random trees and is enhanced to take into consideration the particularities of the accessible route domain. Specifically, the…

  15. Spread-spectrum multiple access using wideband noncoherent MFSK

    NASA Technical Reports Server (NTRS)

    Ha, Tri T.; Pratt, Timothy; Maggenti, Mark A.

    1987-01-01

    Two spread-spectrum multiple access systems which use wideband M-ary frequency shift keying (FSK) (MFSK) as the primary modulation are presented. A bit error rate performance analysis is presented and system throughput is calculated for sample C band and Ku band satellite systems. Sample link analyses are included to illustrate power and adjacent satellite interference considerations in practical multiple access systems.

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

    PubMed Central

    Patil, Sanjaykumar

    2016-01-01

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

  17. Reducing the distance: providing challenging and engaging online postgraduate education in pain management.

    PubMed

    Devonshire, Elizabeth; Henderson, Sarah E

    2012-05-01

    1. Health professionals need access to flexible, high-quality, advanced education in pain management. 2. There are multiple pedagogical distances to be negotiated in the delivery of effective postgraduate education. 3. A critical consideration in the design and delivery of effective online learning for postgraduate education in pain management is how to: actively engage students in the learning process; and encourage students to become lifelong learners. 4. Conceptual frameworks for encouraging student interaction online provide a useful tool in the design of postgraduate online learning activities.

  18. Availability and utilization of opioids for pain management: global issues.

    PubMed

    Manjiani, Deepak; Paul, D Baby; Kunnumpurath, Sreekumar; Kaye, Alan David; Vadivelu, Nalini

    2014-01-01

    Pain can significantly influence an individual's health status and can have serious negative consequences: poor nutrition, decreased appetite, abnormal sleep patterns, fatigue, and impairment of daily living activities. Pain can cause psychological impairment and decrease healing and recovery from injuries and illness. A hallmark of many chronic conditions, pain affects more patients' lives than diabetes mellitus, heart disease, and cancer combined. However, many chronic sufferers do not have access to effective pain management for a variety of reasons, including limited access, restrictions, and personal and cultural biases. This review summarizes issues of access, distribution, and cultural bias with regard to opioid agents and seeks to clarify the challenges related to opioid delivery. The considerable negative physical and mental consequences of chronic pain are discussed for the general and palliative care population. Opioids are an effective treatment for various intractable painful conditions, but problems in global opioid access for safe and rational use in pain management contribute to unnecessary suffering. These problems persist despite increased understanding in recent years of the pathophysiology of pain. Comprehensive guidelines for goal-directed and patient-friendly chronic opiate therapy will potentially enhance the outlook for future chronic pain management. The improvement of pain education in undergraduate and postgraduate training will benefit patients and clinicians. The promise of new medications, along with the utilization of multimodal approaches, has the potential to provide effective pain relief to future generations of sufferers.

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

    PubMed

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

    2017-02-01

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

  20. Operational considerations for the Space Station Life Science Glovebox

    NASA Technical Reports Server (NTRS)

    Rasmussen, Daryl N.; Bosley, John J.; Vogelsong, Kristofer; Schnepp, Tery A.; Phillips, Robert W.

    1988-01-01

    The U.S. Laboratory (USL) module on Space Station will house a biological research facility for multidisciplinary research using living plant and animal specimens. Environmentally closed chambers isolate the specimen habitats, but specimens must be removed from these chambers during research procedures as well as while the chambers are being cleaned. An enclosed, sealed Life Science Glovebox (LSG) is the only locale in the USL where specimens can be accessed by crew members. This paper discusses the key science, engineering and operational considerations and constraints involving the LSG, such as bioisolation, accessibility, and functional versatility.

  1. 47 CFR 8.9 - Other laws and considerations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.9 Other laws and... Internet access service may have to address the needs of emergency communications or law enforcement... provider of broadband Internet access service to address copyright infringement or other unlawful activity. ...

  2. 47 CFR 8.9 - Other laws and considerations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.9 Other laws and... Internet access service may have to address the needs of emergency communications or law enforcement... provider of broadband Internet access service to address copyright infringement or other unlawful activity. ...

  3. 47 CFR 8.9 - Other laws and considerations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.9 Other laws and... Internet access service may have to address the needs of emergency communications or law enforcement... provider of broadband Internet access service to address copyright infringement or other unlawful activity. ...

  4. Access to fertility services by transgender persons: an Ethics Committee opinion.

    PubMed

    2015-11-01

    This statement explores the ethical considerations surrounding the provision of fertility services to transgender individuals and concludes that denial of access to fertility services is not justified. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  5. 47 CFR 8.9 - Other Laws and Considerations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.9 Other Laws and... Internet access service may have to address the needs of emergency communications or law enforcement... provider of broadband Internet access service to address copyright infringement or other unlawful activity. ...

  6. The Ins and Outs of Access Control.

    ERIC Educational Resources Information Center

    Longworth, David

    1999-01-01

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

  7. Realization of the Switching Mechanism in Resistance Random Access Memory™ Devices: Structural and Electronic Properties Affecting Electron Conductivity in a Hafnium Oxide-Electrode System Through First-Principles Calculations

    NASA Astrophysics Data System (ADS)

    Aspera, Susan Meñez; Kasai, Hideaki; Kishi, Hirofumi; Awaya, Nobuyoshi; Ohnishi, Shigeo; Tamai, Yukio

    2013-01-01

    The resistance random access memory (RRAM™) device, with its electrically induced nanoscale resistive switching capacity, has attracted considerable attention as a future nonvolatile memory device. Here, we propose a mechanism of switching based on an oxygen vacancy migration-driven change in the electronic properties of the transition-metal oxide film stimulated by set pulse voltages. We used density functional theory-based calculations to account for the effect of oxygen vacancies and their migration on the electronic properties of HfO2 and Ta/HfO2 systems, thereby providing a complete explanation of the RRAM™ switching mechanism. Furthermore, computational results on the activation energy barrier for oxygen vacancy migration were found to be consistent with the set and reset pulse voltage obtained from experiments. Understanding this mechanism will be beneficial to effectively realizing the materials design in these devices.

  8. Space Commercialization Trends and Consequences for the Workforce

    NASA Astrophysics Data System (ADS)

    Peeters, W.

    2002-01-01

    The major trend we are currently witnessing in space activities is an increasing level of commercialization. This trend is emphasized by: consolidation, mergers and forming strategic alliances. In USA, from the 20 major space companies in the 80's only 3 `prime' ones were left by 1997. A similar effect took place in Europe in the 90's, where at present only primarily 2 major space conglomerates are operating at prime contractor level. Such strategic alliances in the first place result in the creation of end-to-end capabilities, with larger internal R&D and broader access to technologies. Due to the bigger financial volume of such conglomerates there is also better access to new capital and sharing of risks. In a second step, we can at present observe the creation of transatlantic alliances to enter the worldwide market. These trends have a considerable effect on the workforce requirements in industry:

  9. [Chronic noncancer pain and patient education: a place for e-learning?].

    PubMed

    Braillard, Olivia; Cedraschi, Christine; Jesaimani, Ameena; Piguet, Valérie

    2015-06-24

    Chronic non cancerous pain considerably limits the patients' quality of life. Yet, chronic non cancerous pain has a prevalence as high as 25% to 35%, Therapeutic education allows to work on the knowledge and know-how about the disease, the treatment, the management of health resources and health behaviors. E-learning uses new technologies of communication to improve the quality of learning by facilitating access to the resources and favoring the interactivity. It is attractive by its wide accessibility and its limited logistic needs. The level of proof of its efficacy is weak, mainly because of methodological limitations. Some good quality studies are promising, with a positive effect of e-learning programs on pain intensity, disability, autonomy and medication misuse.

  10. Polyphenolic Composition and Antioxidant Activities of 6 New Turmeric (Curcuma Longa L.) Accessions.

    PubMed

    Chinedum, Eleazu; Kate, Eleazu; Sonia, Chukwuma; Ironkwe, Adanma; Andrew, Igwe

    2015-01-01

    The phytochemical composition and antioxidant capacities of 6 new NRCRI turmeric (Curcuma longa L.) accessions (39, 35, 60, 30, 50 and 41) were determined using standard techniques. The moisture contents of the tumeric samples ranged from 15.75 to 47.80% and the curcumin contents of the turmeric samples fell within the range of curcumin obtained from turmeric in other countries of the world. Furthermore, the turmeric accessions contained considerable amounts of antioxidants (measured using 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical and reducing power assays), alkaloids, flavonoids, anthocyanins, and phenolics. There was significant correlation between the anthocyanin contents of the tumeric accessions versus their alkaloid (0.744) and flavonoid contents (0.986) suggesting an additive effect between the anthocyanins and alkaloids in turmeric; significant correlation between the inhibition of the turmeric accessions on DPPH radical versus their flavonoid (0.892) and anthocyanin (0.949) contents and significant correlation between the reducing power of the turmeric accessions versus their flavonoid (0.973) and anthocyanin (0.974) contents suggesting that anthocyanins as flavonoids largely contribute to the antioxidant activities of turmeric. The positive regression recorded between inhibition of DPPH radical by the turmeric accessions and quercetin versus reducing power (R2 = 0.852) suggest that any of these methods could be used to assess the antioxidant activities of tumeric. Finally, the study indicated the potentials of the turmeric accessions especially accessions 30 and 50 as promising sources of antioxidants.

  11. Open Access: "à consommer avec modération"

    NASA Astrophysics Data System (ADS)

    Mahoney, Terence J.

    There is increasing pressure on academics and researchers to publish the results of their investigations in open access journals. Indeed, some funding agencies make open access publishing a basic requirement for funding projects, and the EU is considering taking firm steps in this direction. I argue that astronomy is already one of the most open of disciplines, and that access - both to the general public (in terms of a significantly growing outreach effort) and to developing countries (through efforts to provide computing facilities and Internet access, as well as schemes to provide research centres of limited resources with journals) - is becoming more and more open in a genuine and lasting way. I further argue that sudden switches to more formal kinds of open access schemes could cause irreparable harm to astronomical publishing. Several of the most prestigious astronomical research journals (e.g. MN, ApJ, AJ) have for more than a century met the publishing needs of the research community and continue to adapt successfully to changing demands on the part of that community. The after-effects of abrupt changes in publishing practices - implemented through primarily political concerns - are hard to predict and could be severely damaging. I conclude that open access, in its current acceptation, should be studied with great care and with sufficient time before any consideration is given to its implementation. If forced on the publishing and research communities, open access could well result in much more limited access to properly vetted research results.

  12. Ethical considerations in resource allocation in a cochlear implant program.

    PubMed

    Westerberg, Brian D; Pijl, Sipke; McDonald, Michael

    2008-04-01

    To review processes of resource allocation and the ethical considerations relevant to the fair allocation of a limited number of cochlear implants to increasing numbers of potential recipients. Review of relevant considerations. Tertiary referral hospital. Editorial discussion of the ethical issues of resource allocation. Heterogeneity of audiometric thresholds, self-reported disability of hearing loss, age of the potential cochlear implant recipient, cost-effectiveness, access to resources, compliance with follow-up, social support available to the recipient, social consequences of hearing impairment, and other recipient-related factors. In a publicly funded health care system, there will always be a need for decision-making processes for allocation of finite fiscal resources. All candidates for cochlear implantation deserve fair consideration. However, they are a heterogeneous group in terms of needs and expected outcomes consisting of traditional and marginal candidates, with a wide range of benefit from acoustic amplification. We argue that implant programs should thoughtfully prioritize treatment on the basis of need and potential benefit. We reject queuing on the basis of "first-come, first-served" or on the basis of perceived social worth.

  13. Food insecurity: special considerations for women1234

    PubMed Central

    Cullen, Kimberly A

    2011-01-01

    Food security exists when all people, at all times, have physical, social, and economic access to sufficient, safe, and nutritious food that meets their dietary needs and food preferences for an active and healthy life. Food insecurity is the converse state, is often associated with poverty and low income, and has important implications for the health and nutrition of individuals. Given their contribution to food production and preparation, their role in society as child bearers and caregivers, the increasing number of female-headed households worldwide, and their disproportionately poor economic status, women need special consideration in discussions of food insecurity and its effect on health, nutrition, and behavior. This article reviews the scientific literature on issues related to women and food insecurity. Food insecurity is associated with obesity, anxiety, and depressive symptoms; risky sexual behavior; poor coping strategies; and negative pregnancy outcomes in women, although evidence about the direction and causality of associations is unclear. There is a lack of evidence and understanding of the effects of food insecurity in resource-poor settings, including its effect on weight, nutritional outcomes, and pregnancy outcomes, as well as its effect on progression of diseases such as HIV infection. More research is needed to guide efficient interventions that address food insecurity among women. However, practical experience suggests that both short-term assistance and longer-term strategies that improve livelihoods, address behavioral and coping strategies, acknowledge the mental health components of food insecurity, and attempt to ensure that women have the same economic opportunities, access to land, and economic power as men are important. PMID:22089447

  14. Food insecurity: special considerations for women.

    PubMed

    Ivers, Louise C; Cullen, Kimberly A

    2011-12-01

    Food security exists when all people, at all times, have physical, social, and economic access to sufficient, safe, and nutritious food that meets their dietary needs and food preferences for an active and healthy life. Food insecurity is the converse state, is often associated with poverty and low income, and has important implications for the health and nutrition of individuals. Given their contribution to food production and preparation, their role in society as child bearers and caregivers, the increasing number of female-headed households worldwide, and their disproportionately poor economic status, women need special consideration in discussions of food insecurity and its effect on health, nutrition, and behavior. This article reviews the scientific literature on issues related to women and food insecurity. Food insecurity is associated with obesity, anxiety, and depressive symptoms; risky sexual behavior; poor coping strategies; and negative pregnancy outcomes in women, although evidence about the direction and causality of associations is unclear. There is a lack of evidence and understanding of the effects of food insecurity in resource-poor settings, including its effect on weight, nutritional outcomes, and pregnancy outcomes, as well as its effect on progression of diseases such as HIV infection. More research is needed to guide efficient interventions that address food insecurity among women. However, practical experience suggests that both short-term assistance and longer-term strategies that improve livelihoods, address behavioral and coping strategies, acknowledge the mental health components of food insecurity, and attempt to ensure that women have the same economic opportunities, access to land, and economic power as men are important.

  15. Payer and Pharmaceutical Manufacturer Considerations for Outcomes-Based Agreements in the United States.

    PubMed

    Brown, Joshua D; Sheer, Rich; Pasquale, Margaret; Sudharshan, Lavanya; Axelsen, Kirsten; Subedi, Prasun; Wiederkehr, Daniel; Brownfield, Fred; Kamal-Bahl, Sachin

    2018-01-01

    Considerable interest exists among health care payers and pharmaceutical manufacturers in designing outcomes-based agreements (OBAs) for medications for which evidence on real-world effectiveness is limited at product launch. To build hypothetical OBA models in which both payer and manufacturer can benefit. Models were developed for a hypothetical hypercholesterolemia OBA, in which the OBA was assumed to increase market access for a newly marketed medication. Fixed inputs were drug and outcome event costs from the literature over a 1-year OBA period. Model estimates were developed using a range of inputs for medication effectiveness, medical cost offsets, and the treated population size. Positive or negative feedback to the manufacturer was incorporated on the basis of expectations of drug performance through changes in the reimbursement level. Model simulations demonstrated that parameters had the greatest impact on payer cost and manufacturer reimbursement. Models suggested that changes in the size of the population treated and drug effectiveness had the largest influence on reimbursement and costs. Despite sharing risk for potential product underperformance, manufacturer reimbursement increased relative to having no OBA, if the OBA improved market access for the new product. Although reduction in medical costs did not fully offset the cost of the medication, the payer could still save on net costs per patient relative to having no OBA by tying reimbursement to drug effectiveness. Pharmaceutical manufacturers and health care payers have demonstrated interest in OBAs, and under a certain set of assumptions both may benefit. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  16. Evidence for underuse of effective medical services around the world.

    PubMed

    Glasziou, Paul; Straus, Sharon; Brownlee, Shannon; Trevena, Lyndal; Dans, Leonila; Guyatt, Gordon; Elshaug, Adam G; Janett, Robert; Saini, Vikas

    2017-07-08

    Underuse-the failure to use effective and affordable medical interventions-is common and responsible for substantial suffering, disability, and loss of life worldwide. Underuse occurs at every point along the treatment continuum, from populations lacking access to health care to inadequate supply of medical resources and labour, slow or partial uptake of innovations, and patients not accessing or declining them. The extent of underuse for different interventions varies by country, and is documented in countries of high, middle, and low-income, and across different types of health-care systems, payment models, and health services. Most research into underuse has focused on measuring solutions to the problem, with considerably less attention paid to its global prevalence or its consequences for patients and populations. Although focused effort and resources can overcome specific underuse problems, comparatively little is spent on work to better understand and overcome the barriers to improved uptake of effective interventions, and methods to make them affordable. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Test Design Considerations for Students with Significant Cognitive Disabilities

    ERIC Educational Resources Information Center

    Anderson, Daniel; Farley, Dan; Tindal, Gerald

    2015-01-01

    Students with significant cognitive disabilities present an assessment dilemma that centers on access and validity in large-scale testing programs. Typically, access is improved by eliminating construct-irrelevant barriers, while validity is improved, in part, through test standardization. In this article, one state's alternate assessment data…

  18. 10 CFR 710.7 - Application of the criteria.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... involved in the decision-making process shall consider: the nature, extent, and seriousness of the conduct... decision as to access authorization is a comprehensive, common-sense judgment, made after consideration of... will be made as to access authorization eligibility. (b) To assist in making these determinations, on...

  19. Ah!Help: A generalized on-line help facility

    NASA Technical Reports Server (NTRS)

    Yu, Wong Nai; Mantooth, Charmiane; Soulahakil, Alex

    1986-01-01

    The idea behind the help facility discussed is relatively simple. It is made unique by the fact that it is written in Ada and uses aspects of the language which make information retrieval rapid and simple. Specifically, the DIRECT IO facility allows for random access into the help files. It is necessary to discuss the advantages of random access over sequential access. The mere fact that the program in written in Ada implies a saving in terms of lines of code. This introduces the possibility of eventually adapting the program to run at the microcomputer level, a major consideration . Additionally, since the program uses only standard Ada generics, it is portable to other systems. This is another aspect which must always be taken into consideration in writting any software package in the modern day world of computer programming.

  20. Channel coding and data compression system considerations for efficient communication of planetary imaging data

    NASA Technical Reports Server (NTRS)

    Rice, R. F.

    1974-01-01

    End-to-end system considerations involving channel coding and data compression are reported which could drastically improve the efficiency in communicating pictorial information from future planetary spacecraft. In addition to presenting new and potentially significant system considerations, this report attempts to fill a need for a comprehensive tutorial which makes much of this very subject accessible to readers whose disciplines lie outside of communication theory.

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

    PubMed

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

    2016-02-01

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

  2. Global Strike 2035: Considerations for Enabling Effective Command and Control

    DTIC Science & Technology

    2012-02-16

    reach places .1 Broadly grouped under the moniker Global Strike,2 this family-of-systems capability should mature by 2035 leading to the realization of...and] ‘micro-actors with massive impact,’…[combine] with new technology and new or transfigured ways of war, but the old threats also remain and have...as the Joint Time-Sensitive Targets Manager (JTSTM),38 “operators and analysts [could] access the same dynamic common operating picture…to provide

  3. Secondary stroke prevention services in Canada: a cross-sectional survey and geospatial analysis of resources, capacity and geographic access

    PubMed Central

    Jewett, Lauren; Harroud, Adil; Hill, Michael D.; Côté, Robert; Wein, Theodore; Smith, Eric E.; Gubitz, Gord; Demchuk, Andrew M.; Sahlas, Demetrios J.; Gladstone, David J.; Lindsay, M. Patrice

    2018-01-01

    Background: Rapid assessment and management of transient ischemic attacks and nondisabling strokes by specialized stroke prevention services reduces the risk of recurrent stroke and improves outcomes. In Canada, with its vast geography and with 16.8% of the population living in rural areas, access to these services is challenging, and considerable variation in access to care exists. The purpose of this multiphase study was to identify sites across Canada providing stroke prevention services, evaluate resource capacity and determine geographic access for Canadians. Methods: We developed a Stroke Prevention Services Resource Inventory that contained 22 questions on the organization and delivery of stroke prevention services and quality monitoring. The inventory ran from November 2015 to January 2016 and was administered online. We conducted a geospatial analysis to estimate access by drive times. Considerations were made for hours of operation and access within and across provincial borders. Results: A total of 123 stroke prevention sites were identified, of which 119 (96.7%) completed the inventory. Most (95) are designated stroke prevention or rapid assessment clinics. Of the 119 sites, 68 operate full time, and 39 operate less than 2.5 days per week. A total of 87.3% of the Canadian population has access to a stroke prevention service within a 1-hour drive; however, only 69.2% has access to a service that operates 5-7 days a week. Allowing provincial border crossing improves access (< 6-h drive) for those who are beyond a 6-hour drive within their home province (3.4%). Interpretation: Most Canadians have reasonable geographic access to stroke prevention services. Allowing patients to cross borders improves the existing access for many, particularly some remote communities along the Ontario-Quebec and British Columbia-Alberta borders. PMID:29472251

  4. Helpful advice and hidden expertize: pharmacy users' experiences of community pharmacy accessibility.

    PubMed

    Lindsey, Laura; Husband, Andy; Steed, Liz; Walton, Robert; Todd, Adam

    2017-09-01

    In recent years community pharmacies have emerged as strategically important settings to deliver services aimed at promoting public health. In order to develop evidence-based approaches to public health interventions that exploit the unique accessibility of community pharmacies, it is important to determine how people experience care in this context. This study, therefore, aimed to describe how care is perceived and experienced in community pharmacies with particular focus on community pharmacy access. In-depth semi-structured interviews were used to explore the perceptions and experiences' of people using community pharmacies. A total of 30 participants were interviewed. Themes specifically emerged in relation to community pharmacy access; these fell into four main categories: relationships; time; lack of awareness; and empowerment. The experience of developing a trusting relationship with the pharmacist is an important consideration in the context of community pharmacy accessibility. This could be an important consideration when a person uses a community pharmacy to access a public health service. There is also a perceived lack of awareness among the general public about the extended role of community pharmacy; this is a potential barrier toward people using them. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  5. 75 FR 27368 - Aerotest Operations, Inc., Aerotest Radiography and Research Reactor; Notice of Consideration of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-14

    ...., Aerotest Radiography and Research Reactor; Notice of Consideration of Approval of Transfer and Conforming Amendment, Opportunity for a Hearing, and Order Imposing Procedures for Access to Sensitive Unclassified Non... Manager, Research and Test Reactors Licensing Branch, Division of Policy and Rulemaking, Office of Nuclear...

  6. 22 CFR 212.37 - Procedures for agency consideration of appeals.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Procedures for agency consideration of appeals. 212.37 Section 212.37 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT PUBLIC INFORMATION Access... of the decisions and of the provisions for judicial review of the Agency's denial of the request. (c...

  7. NSF Anticipates Pushing Boundaries on Open-Access Plan

    ERIC Educational Resources Information Center

    Basken, Paul

    2013-01-01

    The National Science Foundation (NSF), in carrying out the Obama administration's new push for greater public access to research published in scientific journals, will consider exclusivity periods shorter than the 12-month standard in the White House directive, as well as trade-offs involving data-sharing and considerations of publishers'…

  8. Information Technology, Campus Libraries, and Patrons with Disabilities: Emerging issues and Access Strategies.

    ERIC Educational Resources Information Center

    Hilton-Chalfen, Danny

    1992-01-01

    Discussion of the potential for academic libraries to provide improved opportunities for patrons with disabilities focuses on access to online information, including online catalogs, campuswide information systems, CD-ROM products, graphical user interfaces, and electronic documents. Other considerations include location of online resources,…

  9. Are CD-ROM LANs a Thing of the Past?

    ERIC Educational Resources Information Center

    Mehta, Apurva

    1996-01-01

    Remote access to full-text and CD-ROM databases using the Internet has advantages over a CD-ROM local area network. Topics include speed, document delivery, multiple platforms, technical support, licensing, copyright, and access to graphics. Considerations of duplication of information, platform compatibility, print versus digital media, back…

  10. Assessment and Documentation Considerations for Postsecondary Students with Learning Disabilities

    ERIC Educational Resources Information Center

    Lindstrom, Jennifer H.; Lindstrom, Will

    2011-01-01

    In order to gain access to accommodations and services at colleges and universities, students with learning disabilities must provide documentation of their disabilities, and as students with learning disabilities access higher education at increasing rates, the need for documentation of their disabilities and its impact becomes even more…

  11. Guantanamo Bay Detainees: Facilities and Factors for Consideration If Detainees Were Brought to the United States

    DTIC Science & Technology

    2012-11-01

    vegetarian or religious diet ); access to educational, occupational, and leisure time programming; access to work opportunities; and basic medical and mental...ADX can provide a religiously observant diet . A full- time chaplain provides for inmates’ religious needs, but BOP officials explained that group

  12. Seeking Legitimacy: The Community College Mission and the Honors College

    ERIC Educational Resources Information Center

    Treat, Tod; Barnard, Thomas C.

    2012-01-01

    The community college mission has been the subject of considerable review and commentary since its conception. Based on traditional concerns of access, a consensus has largely been reached regarding the inclusion of transfer, career, developmental, and community foci within a comprehensive community college. While concerns regarding access and…

  13. Techtalk: Telecommunications for Improving Developmental Education.

    ERIC Educational Resources Information Center

    Caverly, David C.; Broderick, Bill

    1993-01-01

    Explains how to access the Internet, discussing hardware and software considerations, connectivity, and types of access available to users. Describes the uses of electronic mail; TELNET, a method for remotely logging onto another computer; and anonymous File Transfer Protocol (FTP), a method for downloading files from a remote computer. (MAB)

  14. The cultural moral right to a basic minimum of accessible health care.

    PubMed

    Menzel, Paul T

    2011-03-01

    (1) The conception of a cultural moral right is useful in capturing the social-moral realities that underlie debate about universal health care. In asserting such rights, individuals make claims above and beyond their legal rights, but those claims are based on the society's existing commitments and moral culture. In the United States such a right to accessible basic health care is generated by various empirical social facts, primarily the conjunction of the legal requirement of access to emergency care with widely held principles about unfair free riding and just sharing of costs between well and ill. The right can get expressed in social policy through either single-payer or mandated insurance. (2) The same elements that generate this right provide modest assistance in determining its content, the structure and scope of a basic minimum of care. They justify limits on patient cost sharing, require comparative effectiveness, and make cost considerations relevant. They shed light on the status of expensive, marginally life extending, last-chance therapies, as well as life support for PVS patients. They are of less assistance in settling contentious debates about screening for breast and prostate cancer and treatments for infertility and erectile dysfunction, but even there they establish a useful framework for discussion. Scarcity of resources need not be a leading conceptual consideration in discerning a basic minimum. More important are the societal elements that generate the cultural moral right to a basic minimum.

  15. Exploring natural variation of photosynthetic, primary metabolism and growth parameters in a large panel of Capsicum chinense accessions.

    PubMed

    Rosado-Souza, Laise; Scossa, Federico; Chaves, Izabel S; Kleessen, Sabrina; Salvador, Luiz F D; Milagre, Jocimar C; Finger, Fernando; Bhering, Leonardo L; Sulpice, Ronan; Araújo, Wagner L; Nikoloski, Zoran; Fernie, Alisdair R; Nunes-Nesi, Adriano

    2015-09-01

    Collectively, the results presented improve upon the utility of an important genetic resource and attest to a complex genetic basis for differences in both leaf metabolism and fruit morphology between natural populations. Diversity of accessions within the same species provides an alternative method to identify physiological and metabolic traits that have large effects on growth regulation, biomass and fruit production. Here, we investigated physiological and metabolic traits as well as parameters related to plant growth and fruit production of 49 phenotypically diverse pepper accessions of Capsicum chinense grown ex situ under controlled conditions. Although single-trait analysis identified up to seven distinct groups of accessions, working with the whole data set by multivariate analyses allowed the separation of the 49 accessions in three clusters. Using all 23 measured parameters and data from the geographic origin for these accessions, positive correlations between the combined phenotypes and geographic origin were observed, supporting a robust pattern of isolation-by-distance. In addition, we found that fruit set was positively correlated with photosynthesis-related parameters, which, however, do not explain alone the differences in accession susceptibility to fruit abortion. Our results demonstrated that, although the accessions belong to the same species, they exhibit considerable natural intraspecific variation with respect to physiological and metabolic parameters, presenting diverse adaptation mechanisms and being a highly interesting source of information for plant breeders. This study also represents the first study combining photosynthetic, primary metabolism and growth parameters for Capsicum to date.

  16. The effect of charge-introduction mutations on E. coli thioredoxin stability.

    PubMed

    Perez-Jimenez, Raul; Godoy-Ruiz, Raquel; Ibarra-Molero, Beatriz; Sanchez-Ruiz, Jose M

    2005-04-01

    Technological applications of proteins are often hampered by their low-stability and, consequently, the development of procedures for protein stabilization is of considerable biotechnological interest. Here, we use simple electrostatics to determine positions in E. coli thioredoxin at which mutations that introduce new charged residues are expected to lead to stability enhancement. We also obtain the corresponding mutants and characterize their stability using differential scanning calorimetry. The results are interpreted in terms of the accessibility in the native structure of the mutated residues and the potential effect of the mutations on the residual structure of the denatured state.

  17. Specialist clinics in remote Australian Aboriginal communities: where rock art meets rocket science.

    PubMed

    Gruen, Russell; Bailie, Ross

    2004-10-01

    People in remote Aboriginal communities in the Northern Territory have greater morbidity and mortality than other Australians, but face considerable barriers when accessing hospital-based specialist services. The Specialist Outreach Service, which began in 1997, was a novel policy initiative to improve access by providing a regular multidisciplinary visiting specialist services to remote communities. It led to two interesting juxtapositions: that of 'state of the art' specialist services alongside under-resourced primary care in remote and relatively traditional Aboriginal communities; and that of attempts to develop an evidence base for the effectiveness of outreach, while meeting the short-term evaluative requirements of policy-makers. In this essay, first we describe the development of the service in the Northern Territory and its initial process evaluation. Through a Cochrane systematic review we then summarise the published research on the effectiveness of specialist outreach in improving access to tertiary and hospital-based care. Finally we describe the findings of an observational population-based study of the use of specialist services and the impact of outreach to three remote communities over 11 years. Specialist outreach improves access to specialist care and may lessen the demand for both outpatient and inpatient hospital care. Specialist outreach is, however, dependent on well-functioning primary care. According to the way in which outreach is conducted and the service is organised, it can either support primary care or it can hinder primary care and, as a result, reduce its own effectiveness.

  18. Availability and Utilization of Opioids for Pain Management: Global Issues

    PubMed Central

    Manjiani, Deepak; Paul, D. Baby; Kunnumpurath, Sreekumar; Kaye, Alan David; Vadivelu, Nalini

    2014-01-01

    Background Pain can significantly influence an individual's health status and can have serious negative consequences: poor nutrition, decreased appetite, abnormal sleep patterns, fatigue, and impairment of daily living activities. Pain can cause psychological impairment and decrease healing and recovery from injuries and illness. A hallmark of many chronic conditions, pain affects more patients' lives than diabetes mellitus, heart disease, and cancer combined. However, many chronic sufferers do not have access to effective pain management for a variety of reasons, including limited access, restrictions, and personal and cultural biases. Methods This review summarizes issues of access, distribution, and cultural bias with regard to opioid agents and seeks to clarify the challenges related to opioid delivery. The considerable negative physical and mental consequences of chronic pain are discussed for the general and palliative care population. Results Opioids are an effective treatment for various intractable painful conditions, but problems in global opioid access for safe and rational use in pain management contribute to unnecessary suffering. These problems persist despite increased understanding in recent years of the pathophysiology of pain. Conclusions Comprehensive guidelines for goal-directed and patient-friendly chronic opiate therapy will potentially enhance the outlook for future chronic pain management. The improvement of pain education in undergraduate and postgraduate training will benefit patients and clinicians. The promise of new medications, along with the utilization of multimodal approaches, has the potential to provide effective pain relief to future generations of sufferers. PMID:24940131

  19. Features and selection of vascular access devices.

    PubMed

    Sansivero, Gail Egan

    2010-05-01

    To review venous anatomy and physiology, discuss assessment parameters before vascular access device (VAD) placement, and review VAD options. Journal articles, personal experience. A number of VAD options are available in clinical practice. Access planning should include comprehensive assessment, with attention to patient participation in the planning and selection process. Careful consideration should be given to long-term access needs and preservation of access sites. Oncology nurses are uniquely suited to perform a key role in VAD planning and placement. With knowledge of infusion therapy, anatomy and physiology, device options, and community resources, nurses can be key leaders in preserving vascular access and improving the safety and comfort of infusion therapy. Copyright 2010 Elsevier Inc. All rights reserved.

  20. Researching Social Capital in Education: Some Conceptual Considerations Relating to the Contribution of Network Analysis

    ERIC Educational Resources Information Center

    Lee, Moosung

    2010-01-01

    This article discusses conceptual considerations for social capital research in education from a social network perspective. Specifically, the article raises three key conceptual issues that call for further elaboration of concepts of social capital: redefining potential resources as accessible but un-utilized sources of social capital;…

  1. Access to Full-Text Journal Articles: Some Practical Considerations.

    ERIC Educational Resources Information Center

    Racine, Drew

    1992-01-01

    Discusses some of the issues and problems involved in using electronic full-text journals in the University of Texas at Austin libraries. Issues addressed include different standards; subjects represented and the time period covered; hardware considerations; software; printing; skills and training needed for library staff and for users; and costs.…

  2. Filmstrip Techniques for Individualized Instruction. Final Report, May 1963-March 1964.

    ERIC Educational Resources Information Center

    Trow, William H.; Smith, Edgar A.

    With respect to the preparation of filmed program instruction, considerations involved in the choice between slides and filmstrips are discussed. The considerations of revision, quantity, length, storage, recycling, aspect ratio, change time, random access, and continuous repetition are presented. A comparison of the cost of preparing a master of…

  3. Perceptions about Iranian-Kurds' ethnic-inequality in health.

    PubMed

    Yari, Arezoo; Nedjat, Saharnaz; Asadi-Lari, Mohsen; Majdzadeh, Reza

    2017-09-12

    Evidence shows ethnic-inequality is a very effective variable in the Community and individual health associated outcomes. This study focused on gaining a deeper understanding of people's perception on inequality of health in Iranian-Kurds and its determinants. The study was conducted in the three cities of Marivan, Sanandaj (capital of Kurdistan province in Iran) and Tehran (capital of the country). The study was conducted through 34 in-depth interviews and ten focus group discussions with health services users, academic graduates and health delivery service personnel. Consensus on social, mental and physical health inequality did not exist within the study participants. However, there were concerns about differences in healthcare access and utilization. Several participants believed that access to health services and socio-cultural differences of Kurds affected the healthcare utilization. Since, people perceived ethnic-inequality in healthcare access and utilization, ethnicity must be considered as a mandatory stratifier in monitoring health status and a concern during planning health interventions. People's awareness, resources management and allocation are factors requiring more consideration when choosing policy options.

  4. Assessing causality in drug policy analyses: How useful are the Bradford Hill criteria in analysing take-home naloxone programs?

    PubMed

    Olsen, Anna; McDonald, David; Lenton, Simon; Dietze, Paul M

    2018-05-01

    The Bradford Hill criteria for assessing causality are useful in assembling evidence, including within complex policy analyses. In this paper, we argue that the implementation of take-home naloxone (THN) programs in Australia and elsewhere reflects sensible, evidence-based public health policy, despite the absence of randomised controlled trials. However, we also acknowledge that the debate around expanding access to THN would benefit from a careful consideration of causal inference and health policy impact of THN program implementation. Given the continued debate around expanding access to THN, and the relatively recent access to new data from implementation studies, two research groups independently conducted Bradford Hill analyses in order to carefully consider causal inference and health policy impact. Hill's criteria offer a useful analytical tool for interpreting current evidence on THN programs and making decisions about the (un)certainty of THN program safety and effectiveness. © 2017 Australasian Professional Society on Alcohol and other Drugs.

  5. General specifications for the development of a PC-based simulator of the NASA RECON system

    NASA Technical Reports Server (NTRS)

    Dominick, Wayne D. (Editor); Triantafyllopoulos, Spiros

    1984-01-01

    The general specifications for the design and implementation of an IBM PC/XT-based simulator of the NASA RECON system, including record designs, file structure designs, command language analysis, program design issues, error recovery considerations, and usage monitoring facilities are discussed. Once implemented, such a simulator will be utilized to evaluate the effectiveness of simulated information system access in addition to actual system usage as part of the total educational programs being developed within the NASA contract.

  6. Two Dimensional Compressibility of Electrochemically Adsorbed Lead on Silver (111).

    DTIC Science & Technology

    1988-01-28

    PAGE BEFORE COMPLETING FORM REPOR7 4 MS1 2. GOVT ACCESSION NO1 3. RECIPIET’S CATALOG NUMBER Technical Reserach -32C E " :. :)S. TYPE OP REPORT & PERIOD...considerably more difficult, since two 2 dimensional band structure calculations that include the effect of the substrate are necessary. In this paper , we...bulk lead. No additional change in the spacing is observed with potential beyond the the onset of bulk lead deposition. It should be recognized that ,he

  7. Synergy optimization and operation management on syndicate complementary knowledge cooperation

    NASA Astrophysics Data System (ADS)

    Tu, Kai-Jan

    2014-10-01

    The number of multi enterprises knowledge cooperation has grown steadily, as a result of global innovation competitions. I have conducted research based on optimization and operation studies in this article, and gained the conclusion that synergy management is effective means to break through various management barriers and solve cooperation's chaotic systems. Enterprises must communicate system vision and access complementary knowledge. These are crucial considerations for enterprises to exert their optimization and operation knowledge cooperation synergy to meet global marketing challenges.

  8. Variation in Vaccination Data Available at School Entry Across the United States.

    PubMed

    Leslie, Timothy F; Street, Erica J; Delamater, Paul L; Yang, Y Tony; Jacobsen, Kathryn H

    2016-12-01

    To compile substate-level data on US school-age children's vaccination rates. For states that did not have suitable data online, in 2015 we submitted information requests to the state health department and followed up with the state's Freedom of Information Act when necessary. The accessibility, scale, and types of vaccination data varied considerably. Whereas 26 states provided data online, 14 released data only after a Freedom of Information Act request. School or school-district data were available for 24 states, 19 at the county level, 2 at the health department level, and 6 provided no substate-level data. Effective vaccination policy requires a robust understanding of vaccination behavior. Some states make it difficult to access data or provide low-resolution data of limited value for identifying vaccination behavior.

  9. Telerehabilitation Technologies: Accessibility and Usability

    PubMed Central

    Pramuka, Michael; van Roosmalen, Linda

    2009-01-01

    In the fields of telehealth and telemedicine, phone and/or video technologies are key to the successful provision of services such as remote monitoring and visits. How do these technologies affect service accessibility, effectiveness, quality, and usefulness when applied to rehabilitation services in the field of telerehabilitation? To answer this question, we provide a overview of the complex network of available technologies and discuss how they link to rehabilitation applications, services, and practices as well as to the telerehabilitation end-user. This white paper will first present the numerous professional considerations that shape the use of technology in telerehabilitation service and set it somewhat apart from telemedicine. It will then provide an overview of concepts essential to usability analysis; present a summary of various telerehabilitation technologies and their strengths and limitations, and consider how the technologies interface with end users’ clinical needs for service accessibility, effectiveness, quality, and usefulness. The paper will highlight a conceptual framework (including task analyses and usability issues) that underlies a functional match between telerehabilitation technologies, clinical applications, and end-user capabilities for telerehabilitation purposes. Finally, we will discuss pragmatic issues related to user integration of telerehabilitation technology versus traditional face-to-face approaches. PMID:25945165

  10. Constraints to Quality Education and Support for All: A Western Cape Case

    ERIC Educational Resources Information Center

    Dreyer, Lorna M.

    2017-01-01

    In its vision for education, the National Planning Commission (2011:264) of South Africa states that "all children can access and benefit from high quality education" through flexible services which are available, accessible and responsive to the needs of children, and that "specific consideration will be given to the most…

  11. Sex, Pornography, and the Mass Media: How Should Social Studies Teachers Respond?

    ERIC Educational Resources Information Center

    Martinson, David L.

    2007-01-01

    Many people fear that the current explosion in mass media technology is negatively affecting individuals and society via-a-vis considerations related to the accessibility of pornographic materials. The way this accessibility affects young people is of particular concern. In this article, the author addresses these concerns from the legal and…

  12. May I Recruit through Your Agency? Considerations for Researchers of Spousal Caregivers

    ERIC Educational Resources Information Center

    Pote, Steven

    2016-01-01

    Few resources within social science literature provide helpful information related to participant recruitment for research on spousal caregivers of individuals with dementia. Independent researchers with limited resources may not have access to large databases or centers in which access to caregivers is readily available. As a result, these…

  13. Evaluation of high-perimeter electrode designs for deep brain stimulation

    NASA Astrophysics Data System (ADS)

    Howell, Bryan; Grill, Warren M.

    2014-08-01

    Objective. Deep brain stimulation (DBS) is an effective treatment for movement disorders and a promising therapy for treating epilepsy and psychiatric disorders. Despite its clinical success, complications including infections and mis-programing following surgical replacement of the battery-powered implantable pulse generator adversely impact the safety profile of this therapy. We sought to decrease power consumption and extend battery life by modifying the electrode geometry to increase stimulation efficiency. The specific goal of this study was to determine whether electrode contact perimeter or area had a greater effect on increasing stimulation efficiency. Approach. Finite-element method (FEM) models of eight prototype electrode designs were used to calculate the electrode access resistance, and the FEM models were coupled with cable models of passing axons to quantify stimulation efficiency. We also measured in vitro the electrical properties of the prototype electrode designs and measured in vivo the stimulation efficiency following acute implantation in anesthetized cats. Main results. Area had a greater effect than perimeter on altering the electrode access resistance; electrode (access or dynamic) resistance alone did not predict stimulation efficiency because efficiency was dependent on the shape of the potential distribution in the tissue; and, quantitative assessment of stimulation efficiency required consideration of the effects of the electrode-tissue interface impedance. Significance. These results advance understanding of the features of electrode geometry that are important for designing the next generation of efficient DBS electrodes.

  14. Assessment of accessible facilities for disabled passenger movement in aerodrome terminals in Klang Valley

    NASA Astrophysics Data System (ADS)

    Ramli, M. Z.; Hasnol., J. N. E.; Hamid, N. B.; Ismail, N.; Zawawi, M. H.; Zainal, M. Z.

    2017-09-01

    The effectiveness of accessibility in public transport has prompted a great deal of weakness and confines many disabled from moving around unreservedly. As far as the built-up environment is concerned, it is important that it should be barrier-free and adapted to fulfill the needs of all people equally. The consideration of equal accessibility to outdoor environments is still lacking. These cause the problems with poor accessibility, the disabled people face more challenges and difficulties while travelling and using the public transport. Therefore, the aim of the study is to evaluate the performance of accessible facilities for disabled movement in aerodrome terminals in Klang Valley. An assessment rating was developed from an established guideline to assess the disabled facilities provided in the Aerodrome Terminal 1 and Aerodrome Terminal 2 by using manual observation and measurement technique. Based on the results obtained, the facility for disabled people in both aerodrome terminals are moderate. Aerodrome Terminal 1 is averagely 63.46% while for Aerodrome Terminal 2 is 67.31%. Results demonstrated that effort is needed by the respective agencies and there was a demand on re-designing the current facility, so that disabled people will not face any difficulty while traveling through public transport stations or terminals.

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

    PubMed

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

    2015-12-07

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

  16. Socio-economic status influences access to second-line disease modifying treatment in Relapsing Remitting Multiple Sclerosis patients

    PubMed Central

    Dejardin, Olivier; Droulon, Karine; Launoy, Guy; Defer, Gilles

    2018-01-01

    Objective In MS, Socio-Economic status (SES) may influence healthcare and access to disease-modifying treatments (DMTs). Optimising delays to switch patients to a second-line DMT may hamper disease progression most effectively and achieve long term disease control. The objective of this study is to identify the influence of SES on the delay between first and second line DMT in RRMS patients, in Western-Normandy, France. Methods The association between SES and the delay to access a second-line DMT were studied using data from the MS registry of Western-Normandy including 733 patients with a diagnosis of RRMS during the period in question [1982–2011]. We used the European Deprivation Index (EDI), a score with a rank level inversely related to SES. We performed multivariate adjusted Cox models for studying EDI effect on the delay between first and second line DMT. Results No significant influence of SES was observed on delay to access a second-line DMT if first-line DMT exposure time was less than 5 years. After 5 years from initiation of first-line treatment the risk of accessing a second-line DMT is 3 times higher for patients with lower deprivation indices (1st quintile of EDI) ([HR] 3.14 95%CI [1.72–5.72], p-value<0.001) compared to patients with higher values (EDI quintiles 2 to 5). Interpretation In RRMS, a high SES may facilitate access to a second-line DMT a few years after first-line DMT exposure. Greater consideration should also be given to the SES of MS patients as a risk factor in therapeutic healthcare issues throughout medical follow-up. PMID:29390025

  17. Barriers and Facilitators to Deaf Trauma Survivors' Help-Seeking Behavior: Lessons for Behavioral Clinical Trials Research

    ERIC Educational Resources Information Center

    Anderson, Melissa L.; Wolf Craig, Kelly S.; Ziedonis, Douglas M.

    2017-01-01

    Deaf individuals experience significant obstacles to participating in behavioral health research when careful consideration is not given to accessibility during the design of study methodology. To inform such considerations, we conducted an exploratory secondary analysis of a mixed-methods study that originally explored 16 Deaf trauma survivors'…

  18. DeepSurveyCam--A Deep Ocean Optical Mapping System.

    PubMed

    Kwasnitschka, Tom; Köser, Kevin; Sticklus, Jan; Rothenbeck, Marcel; Weiß, Tim; Wenzlaff, Emanuel; Schoening, Timm; Triebe, Lars; Steinführer, Anja; Devey, Colin; Greinert, Jens

    2016-01-28

    Underwater photogrammetry and in particular systematic visual surveys of the deep sea are by far less developed than similar techniques on land or in space. The main challenges are the rough conditions with extremely high pressure, the accessibility of target areas (container and ship deployment of robust sensors, then diving for hours to the ocean floor), and the limitations of localization technologies (no GPS). The absence of natural light complicates energy budget considerations for deep diving flash-equipped drones. Refraction effects influence geometric image formation considerations with respect to field of view and focus, while attenuation and scattering degrade the radiometric image quality and limit the effective visibility. As an improvement on the stated issues, we present an AUV-based optical system intended for autonomous visual mapping of large areas of the seafloor (square kilometers) in up to 6000 m water depth. We compare it to existing systems and discuss tradeoffs such as resolution vs. mapped area and show results from a recent deployment with 90,000 mapped square meters of deep ocean floor.

  19. Bon voyage: an update on safe travel in pregnancy.

    PubMed

    Jones, Claire Ann; Chan, Crystal

    2014-12-01

    Travel in pregnancy is common, particularly as international travel for work and leisure has become more commonplace. Few women are fully aware of the potential risks of travelling while pregnant, particularly the risk of delivering abroad. We describe here the medical risks and the many social, financial, and logistical considerations for travelling during pregnancy. Pertinent considerations include the risks of developing medical complications abroad, immunization considerations, access to obstetrical care in developing countries, travel medical insurance, and airline regulations.

  20. Towards an Approach for an Accessible and Inclusive Virtual Education Using ESVI-AL Project Results

    ERIC Educational Resources Information Center

    Amado-Salvatierra, Hector R.; Hilera, Jose R.

    2015-01-01

    Purpose: This paper aims to present an approach to achieve accessible and inclusive Virtual Education for all, but especially intended for students with disabilities. This work proposes main steps to take into consideration for stakeholders involved in the educational process related to an inclusive e-Learning. Design/methodology/approach: The…

  1. Widening Equity and Retaining Efficiency: Considerations from the IBSA Southern Coalface

    ERIC Educational Resources Information Center

    Akoojee, Salim; Nkomo, Mokubung

    2011-01-01

    Access to higher education is a key challenge of the 21st century state. The link between higher education and personal and socio-economic development has intensified the need for ensuring that greater numbers of citizens have expanded access to and have been provided with quality higher education. The article seeks to explore how initiatives for…

  2. Accessibility Considerations for e-Learning in Ghana

    ERIC Educational Resources Information Center

    Boateng, John Kwame

    2016-01-01

    This paper reports on a study that explored the best ways to design e-learning in order to provide better access for adult learners with disabilities. Two districts from the Central Region of Ghana were selected and two major research questions guided the study. The five-point Likert scale was employed between May and August of 2014. The two…

  3. Policy Considerations for a Student-Loan Refinancing Authority

    ERIC Educational Resources Information Center

    State Council of Higher Education for Virginia, 2016

    2016-01-01

    Access and affordability are the main themes of Goal 1 of The Virginia Plan for Higher Education. Progress toward these goals can be measured by a variety of means, but access and affordability serve as foundational guiding principles as the Commonwealth of Virginia crafts its annual and biennial higher-education budgets. Student-loan debt is but…

  4. A Consideration of the Case for Using Life Story Interviews in the Evaluation of Widening Access Interventions

    ERIC Educational Resources Information Center

    Raven, Neil

    2016-01-01

    Whilst published data sources exist for evaluating interventions aimed at widening higher education access, there is value for practitioners in conducting their own research. However, recognition of the contribution afforded by generating new data raises questions over which research methods to utilise. One method relatively new to widening…

  5. The Impact of Validated, Online Health Education Resources on Patient and Community Members' Satisfaction and Health Behaviour

    ERIC Educational Resources Information Center

    Atack, Lynda; Luke, Robert

    2012-01-01

    Objective: While access to health education information has become easier, the quality of information retrieved from the Internet varies considerably. In response to the need for accessible, quality health information that is tailored to meet individual patient needs, a patient education website, called PEPTalk, was developed. The site houses text…

  6. 76 FR 71914 - Nondiscrimination on the Basis of Disability in Air Travel: Accessibility of Web Sites and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... Disability in Air Travel: Accessibility of Web Sites and Automated Kiosks at U.S. Airports AGENCY: Office of... January 9, 2012. This extension is a result of requests from a number of parties for additional time to... constructive comments for the Department's consideration. The Interactive Travel Services Association requested...

  7. Utilizing College Access & Completion Innovation Funds to Improve Postsecondary Attainment in California

    ERIC Educational Resources Information Center

    Jones, Dennis P.; Ewell, Peter T.

    2009-01-01

    The College Access and Completion Innovation Fund proposed by the Obama administration in the FY 2009-10 budget holds considerable promise as a tool to leverage badly needed change in higher education nationally--and especially in California. It is potentially the most flexible tool among those currently available to promote attainment of…

  8. Will Today's Electronic Journals Be Accessible in the 23rd Century: Issues in Long-Term Archiving (SIG STI, IFP)

    ERIC Educational Resources Information Center

    Lippert, Margaret

    2000-01-01

    This abstract of a planned session on access to scientific and technical journals addresses policy and standard issues related to long-term archives; digital archiving models; economic factors; hardware and software issues; multi-publisher electronic journal content integration; format considerations; and future data migration needs. (LRW)

  9. Reducing heart disease through the vegetarian diet using primary prevention.

    PubMed

    Sticher, Megan A; Smith, Christine B; Davidson, Susan

    2010-03-01

    To evaluate research on the vegetarian diet for its safety, effectiveness in reducing heart disease, special considerations, contraindications, and its association with decreased cardiovascular disease risk. Selected research and evidence-based dietary guidelines found by searching CINAHL, PubMed, Ovid databases, and the World Wide Web. A carefully planned vegetarian diet with adequate supplementation may be effective for primary prevention of heart disease. The vegetarian diet is cost effective, safe, and relatively easy to implement. Improved dietary choices can help improve many chronic conditions. Guidelines for proper nutrition within a vegetarian lifestyle are readily accessible to patients and professionals alike. Referral to a dietitian is an appropriate option in primary care settings.

  10. Student Health Clinics.

    ERIC Educational Resources Information Center

    Jelliffe, James H.; Schipp, Michael K.

    2002-01-01

    Discusses important issues concerning the design of student health clinics, including convenient access, privacy and security, showers and sinks, durability and safety, and special considerations. (EV)

  11. Conductive bridging random access memory—materials, devices and applications

    NASA Astrophysics Data System (ADS)

    Kozicki, Michael N.; Barnaby, Hugh J.

    2016-11-01

    We present a review and primer on the subject of conductive bridging random access memory (CBRAM), a metal ion-based resistive switching technology, in the context of current research and the near-term requirements of the electronics industry in ultra-low energy devices and new computing paradigms. We include extensive discussions of the materials involved, the underlying physics and electrochemistry, the critical roles of ion transport and electrode reactions in conducting filament formation and device switching, and the electrical characteristics of the devices. Two general cation material systems are given—a fast ion chacogenide electrolyte and a lower ion mobility oxide ion conductor, and numerical examples are offered to enhance understanding of the operation of devices based on these. The effect of device conditioning on the activation energy for ion transport and consequent switching speed is discussed, as well as the mechanisms involved in the removal of the conducting bridge. The morphology of the filament and how this could be influenced by the solid electrolyte structure is described, and the electrical characteristics of filaments with atomic-scale constrictions are discussed. Consideration is also given to the thermal and mechanical environments within the devices. Finite element and compact modelling illustrations are given and aspects of CBRAM storage elements in memory circuits and arrays are included. Considerable emphasis is placed on the effects of ionizing radiation on CBRAM since this is important in various high reliability applications, and the potential uses of the devices in reconfigurable logic and neuromorphic systems is also discussed.

  12. Challenges to effective cancer control in China, India, and Russia.

    PubMed

    Goss, Paul E; Strasser-Weippl, Kathrin; Lee-Bychkovsky, Brittany L; Fan, Lei; Li, Junjie; Chavarri-Guerra, Yanin; Liedke, Pedro E R; Pramesh, C S; Badovinac-Crnjevic, Tanja; Sheikine, Yuri; Chen, Zhu; Qiao, You-lin; Shao, Zhiming; Wu, Yi-Long; Fan, Daiming; Chow, Louis W C; Wang, Jun; Zhang, Qiong; Yu, Shiying; Shen, Gordon; He, Jie; Purushotham, Arnie; Sullivan, Richard; Badwe, Rajendra; Banavali, Shripad D; Nair, Reena; Kumar, Lalit; Parikh, Purvish; Subramanian, Somasundarum; Chaturvedi, Pankaj; Iyer, Subramania; Shastri, Surendra Srinivas; Digumarti, Raghunadhrao; Soto-Perez-de-Celis, Enrique; Adilbay, Dauren; Semiglazov, Vladimir; Orlov, Sergey; Kaidarova, Dilyara; Tsimafeyeu, Ilya; Tatishchev, Sergei; Danishevskiy, Kirill D; Hurlbert, Marc; Vail, Caroline; St Louis, Jessica; Chan, Arlene

    2014-04-01

    Cancer is one of the major non-communicable diseases posing a threat to world health. Unfortunately, improvements in socioeconomic conditions are usually associated with increased cancer incidence. In this Commission, we focus on China, India, and Russia, which share rapidly rising cancer incidence and have cancer mortality rates that are nearly twice as high as in the UK or the USA, vast geographies, growing economies, ageing populations, increasingly westernised lifestyles, relatively disenfranchised subpopulations, serious contamination of the environment, and uncontrolled cancer-causing communicable infections. We describe the overall state of health and cancer control in each country and additional specific issues for consideration: for China, access to care, contamination of the environment, and cancer fatalism and traditional medicine; for India, affordability of care, provision of adequate health personnel, and sociocultural barriers to cancer control; and for Russia, monitoring of the burden of cancer, societal attitudes towards cancer prevention, effects of inequitable treatment and access to medicine, and a need for improved international engagement. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. An alternative resource sharing scheme for land mobile satellite services

    NASA Technical Reports Server (NTRS)

    Yan, Tsun-Yee; Sue, Miles K.

    1990-01-01

    A preliminary comparison between the two competing channelization concepts for the Land Mobile Satellite Services (LMSS), namely frequency division (FD) and code division (CD), is presented. Both random access and demand-assigned approaches are considered under these concepts. The CD concept is compared with the traditional FD concept based on the system consideration and a projected traffic model. It is shown that CD is not particularly attractive for the first generation Mobile Satellite Services because of the spectral occupancy of the network bandwidth. However, the CD concept is a viable alternative for future systems such as the personal access satellite system (PASS) in the Ka-band spectrum where spectral efficiency is not of prime concern. The effects of power robbing and voice activity factor are incorporated. It was shown that the traditional rule of thumb of dividing the number of raw channels by the voice activity factor to obtain the effective number of channels is only valid asymptotically as the aggregated traffic approaches infinity.

  14. Wheeling and Banking Strategies for Optimal Renewable Energy Deployment. International Experiences

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

    Heeter, Jenny; Vora, Ravi; Mathur, Shivani

    This paper defines the principles of wheeling (i.e., transmission) tariffs and renewable energy (RE) banking provisions and their role in RE deployment in countries with plans for large-scale RE. It reviews experiences to date in the United States, Mexico, and India and discusses key policy and regulatory considerations for devising more effective wheeling and/or banking provisions for countries with ambitious RE deployment targets. The paper addresses the challenges of competing needs of stakeholders, especially those of RE generators, distribution utilities, and transmission network owners and operators. The importance of wheeling and banking and their effectiveness for financial viability of REmore » deployment is also explored. This paper aims to benefit policymakers and regulators as well as key renewable energy stakeholders. Key lessons for regulators include: creating long-term wheeling and banking policy certainty, considering incentivizing RE through discounted transmission access, and assessing the cost implications of such discounts, as well as expanding access to renewable energy customers.« less

  15. Effect of family break-up and parent divorce on children.

    PubMed

    Connell, H M

    1988-08-01

    Family break-up is a common experience in childhood today, yet reports of its effects on children vary considerably. Variables to be considered are the age, sex and previous experiences of the child as well as the observer's viewpoint (clinician compared with social scientist): the need for well founded research is obvious. Divorce is a process affecting all family members: parent disharmony and quarrels prior to the divorce appear to be more detrimental to a child's adjustment than the separation itself which may represent a relief of tension. Behaviour and emotional problems following divorce relate to litigation regarding custody and access (accusations of sexual abuse during access are not uncommon), and a diminution of living standards. Feelings of rejection, depression, anger and guilt are frequent in the immediate post-divorce period, but settle during the ensuing year. Family counselling, individual work with children (especially explanations for younger ones) and social support in the post-divorce period are suggested as a means of combating long-term, sometimes lifelong, sequelae.

  16. An alternative resource sharing scheme for land mobile satellite services

    NASA Astrophysics Data System (ADS)

    Yan, Tsun-Yee; Sue, Miles K.

    A preliminary comparison between the two competing channelization concepts for the Land Mobile Satellite Services (LMSS), namely frequency division (FD) and code division (CD), is presented. Both random access and demand-assigned approaches are considered under these concepts. The CD concept is compared with the traditional FD concept based on the system consideration and a projected traffic model. It is shown that CD is not particularly attractive for the first generation Mobile Satellite Services because of the spectral occupancy of the network bandwidth. However, the CD concept is a viable alternative for future systems such as the personal access satellite system (PASS) in the Ka-band spectrum where spectral efficiency is not of prime concern. The effects of power robbing and voice activity factor are incorporated. It was shown that the traditional rule of thumb of dividing the number of raw channels by the voice activity factor to obtain the effective number of channels is only valid asymptotically as the aggregated traffic approaches infinity.

  17. Vascular access choice in incident hemodialysis patients: a decision analysis.

    PubMed

    Drew, David A; Lok, Charmaine E; Cohen, Joshua T; Wagner, Martin; Tangri, Navdeep; Weiner, Daniel E

    2015-01-01

    Hemodialysis vascular access recommendations promote arteriovenous (AV) fistulas first; however, it may not be the best approach for all hemodialysis patients, because likelihood of successful fistula placement, procedure-related and subsequent costs, and patient survival modify the optimal access choice. We performed a decision analysis evaluating AV fistula, AV graft, and central venous catheter (CVC) strategies for patients initiating hemodialysis with a CVC, a scenario occurring in over 70% of United States dialysis patients. A decision tree model was constructed to reflect progression from hemodialysis initiation. Patients were classified into one of three vascular access choices: maintain CVC, attempt fistula, or attempt graft. We explicitly modeled probabilities of primary and secondary patency for each access type, with success modified by age, sex, and diabetes. Access-specific mortality was incorporated using preexisting cohort data, including terms for age, sex, and diabetes. Costs were ascertained from the 2010 USRDS report and Medicare for procedure costs. An AV fistula attempt strategy was found to be superior to AV grafts and CVCs in regard to mortality and cost for the majority of patient characteristic combinations, especially younger men without diabetes. Women with diabetes and elderly men with diabetes had similar outcomes, regardless of access type. Overall, the advantages of an AV fistula attempt strategy lessened considerably among older patients, particularly women with diabetes, reflecting the effect of lower AV fistula success rates and lower life expectancy. These results suggest that vascular access-related outcomes may be optimized by considering individual patient characteristics. Copyright © 2015 by the American Society of Nephrology.

  18. An overview of the EASE/ACCESS space construction demonstration

    NASA Technical Reports Server (NTRS)

    Levin, George M.; Ross, Jerry L.; Spring, Sherwood C.

    1988-01-01

    Consideration is given to the development of the Experimental Assembly of Structures in EVA/Assembly Concept for Construction of Erectable Space Structures (EASE/ACCESS) space construction demonstration, which was performed during Space Shuttle mission 61-B. The mission equipment is described and illustrated and the EASE/ACCESS mission management structure is outlined. Simulations of the assembly and disassembly in the NASA neutral buoyancy simulators were used to test the mission plans. In addition, EVA training and crew performance for the mission are discussed.

  19. Translating PrEP effectiveness into public health impact: key considerations for decision-makers on cost-effectiveness, price, regulatory issues, distributive justice and advocacy for access.

    PubMed

    Hankins, Catherine; Macklin, Ruth; Warren, Mitchell

    2015-01-01

    The extraordinary feat of proving the effectiveness of oral pre-exposure prophylaxis (PrEP) in clinical trials in different populations in a variety of settings may prove to have been easier than ensuring it is used well. Decision-makers must make difficult choices to realize the promise of antiretroviral prophylaxis for their countries. This paper outlines key economic, regulatory and distributive justice issues that must be addressed for effective and acceptable PrEP implementation. In considering the role that PrEP can play in combination prevention programmes, decision-makers must determine who can benefit most from PrEP, how PrEP can be provided safely and efficiently, and what kind of health system support will ensure successful implementation. To do this, they need contextualized information on disease burden by population, analyses of how PrEP services might best be delivered, and projections of the human resource and infrastructure requirements for each potential delivery model. There are cost considerations, varying cost-effectiveness results and regulatory challenges. The principles of ethics can inform thorny discussions about who should be prioritized for oral PrEP and how best to introduce it fairly. We describe the cost-effectiveness of PrEP in different populations at higher risk of HIV exposure, its price in low- and middle-income countries, and the current regulatory situation. We explore the principles of ethics that can inform resource allocation decision-making about PrEP anchored in distributive justice, at a time when universal access to antiretroviral treatment remains to be assured. We then highlight the role of advocacy in moving the PrEP agenda forward. The time is ripe now for decisions about whether, how and for whom PrEP should be introduced into a country's HIV response. It has the potential to contribute significantly to high impact HIV prevention if it is tailored to those who can most benefit from it and if current regulatory and pricing barriers can be overcome. Advocacy at all levels can help inform decision-making and push the access agenda to avert HIV infections among those at highest risk of HIV exposure. The benefits will accrue beyond the individual level to slow HIV transmission at the population level.

  20. Child mortality in new industrial localities and opportunities for change: a survey in an Indian steel town.

    PubMed

    Crook, N; Malaker, C R

    1992-10-01

    As Asia becomes increasingly urbanized the effect of new industrial development on child mortality becomes of increasing interest. In India, considerable investment has been made in the social infrastructure of industrial new towns. This survey of Durgapur steel town in West Bengal shows that although the average level of child mortality in the working class population is favourable in comparison with other Indian cities, considerable differentials, that can be related to social, economic and environmental differences within the population, have arisen since the creation of the city in the late 1950s. The paper argues that the undertaking of selective sanitary interventions to improve access to drinking water (in particular) would be administratively feasible in these industrial new towns, of immediate impact, and indeed necessary if the differentials in mortality are to be eliminated.

  1. A panel analysis of the strategic association between information and communication technology and public health delivery.

    PubMed

    Wu, Sarah Jinhui; Raghupathi, Wullianallur

    2012-10-22

    In this exploratory research, we use panel data analysis to examine the correlation between Information and Communication Technology (ICTs) and public health delivery at the country level. The goal of this exploratory research is to examine the strategic association over time between ICTs and country-level public health. Using data from the World Development Indicators, we construct a panel data set of countries of five different income levels and look closely at the period from 2000 to 2008. The panel data analysis allows us to explore this dynamic relationship under the control for unobserved country-specific effects by using a fixed-effects estimation method. In particular,, we examine the association of five ICT factors with five public health indicators: adolescent fertility rate, child immunization coverage, tuberculosis case detected, life expectancy, and adult mortality rate. First, overall ICTs' factors substantially improve a country's public health delivery on the top of wealth effect. Second, among all the ICTs' factors, accessibility is the only one that is associated with improvements in all aspects of public health delivery, while the contributions from the usage, quality, and applications are negligible. ICTs' accessibility factor is associated with a considerable extension to life expectancy and reduced adult mortality rate. Third, all entity-specific factors are significant in each model, indicating that countries' economic development level does influence their public health delivery. Our results indicate that ICT accessibility has a strong association with effective delivery of public health. There are others, but the key strategic applications are eHealth and mHealth. The findings of this study will help government officials and public health policy makers to formulate strategic decisions regarding the best ICT investments and deployment. For example, the study shows that providing accessibility should be a critical focus.

  2. [An application of low-invasive access in ultrasound-guided surgery of liquid formation of the abdominal cavity and retroperitoneal space].

    PubMed

    Demin, D B; Laĭkov, A V; Funygin, M S; Chegodaeva, A A; Solodov, Iu Iu; Butina, K V

    2014-01-01

    The article presents a low-invasive method in the intraoperative ultrasound-guided surgery. The method had several steps: an access (2-3 cm) was made to a liquid formation with the following aspiration of contents, a necrotic detritus was removed through the wound tract using simultaneous ultrasound examination of efficacy of emptying the cavity with drainage. This means allowed the performance of single-stage sanitization and drainage of cavity formations, which contained the liquid and dense necrotic tissues in the lumen. The method was effective, technically workable in any surgical hospital. At the same time, it was economically reasonable, because there wasn't need to buy an additional equipment. The application of the means considerably shortened a hospital stay and the lethality was reduced.

  3. The Challenges of Projecting the Public Health Impacts of Marijuana Legalization in Canada Comment on "Legalizing and Regulating Marijuana in Canada: Review of Potential Economic, Social, and Health Impacts".

    PubMed

    Lake, Stephanie; Kerr, Thomas

    2016-09-10

    A recent editorial in this journal provides a summary of key economic, social, and public health considerations of the forthcoming legislation to legalize, regulate, and restrict access to marijuana in Canada. As our government plans to implement an evidence-based public health framework for marijuana legalization, we reflect and expand on recent discussions of the public health implications of marijuana legalization, and offer additional points of consideration. We select two commonly cited public concerns of marijuana legalization - adolescent usage and impaired driving - and discuss how the underdeveloped and equivocal body of scientific literature surrounding these issues limits the ability to predict the effects of legalization. Finally, we discuss the potential for some potential public health benefits of marijuana legalization - specifically the potential for marijuana to be used as a substitute to opioids and other risky substance use - that have to date not received adequate attention. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  4. Considerations When Including Students with Disabilities in Test Security Policies. NCEO Policy Directions. Number 23

    ERIC Educational Resources Information Center

    Lazarus, Sheryl; Thurlow, Martha

    2015-01-01

    Sound test security policies and procedures are needed to ensure test security and confidentiality, and to help prevent cheating. In this era when cheating on tests draws regular media attention, there is a need for thoughtful consideration of the ways in which possible test security measures may affect accessibility for some students with…

  5. Workshop Report on Deep Mars: Accessing the Subsurface of Mars on Near Term Missions

    NASA Technical Reports Server (NTRS)

    Langhoff, Stephanie R. (Editor)

    2008-01-01

    The workshop encompassed three major themes. The first theme was the scientific objectives of drilling, which center on the search for clues to the existence of past life and to the geological and climate history of Mars. Key questions are where and how deep to drill? Planetary protection issues were stressed as an important consideration in the design of any drilling mission. Secondly, architectures for drilling missions were discussed, including an overview of most of the current drills in operation that would be applicable to drilling on Mars. Considerable emphasis was placed on remote operation and drilling automation technologies. Finally, alternatives to conventional drilling were discussed. These included underground moles, penetrometers, horizontal drilling, impactors, and access to the subsurface from subsurface cavities. Considerable discussion centered on the possible Mars drilling missions that could be performed in both the near and longer term. The workshop participants concluded that useful science could be obtained today using low-cost impactors, with or without a sheperding spacecraft.

  6. Equitable Access for Secondary English Learner Students: Course Taking as Evidence of EL Program Effectiveness

    PubMed Central

    Callahan, Rebecca M.; Shifrer, Dara

    2016-01-01

    Purpose EL education policy has long directed schools to address English learner (EL) students’ linguistic and academic development, and must do so without furthering inequity or segregation (Lau, 1974; Castañeda, 1981). The recent ESSA (2015) reauthorization expresses a renewed focus on evidence of equity, effectiveness, and opportunity to learn. We propose that high school course taking patterns provide evidence of program effectiveness and equity in access. Research Design Using data from the nationally representative Educational Longitudinal Study of 2002 (ELS: 2002), we employ multinomial regression models to predict students’ likelihood of completing two types of high school coursework (basic graduation, college preparatory) by their linguistic status. Findings Despite considerable linguistic, sociodemographic, and academic controls, marked disparities in high school course taking patterns remain, with EL students experiencing significantly less academic exposure. Implications for Policy and Practice Building on McKenzie and Scheurich’s (2004) notion of an equity trap and evidence of a long-standing EL opportunity gap, we suggest that school leaders might use our findings and their own course taking patterns to prompt discussions about the causes and consequences of local EL placement processes. Such discussions have the potential to raise awareness about how educators and school leaders approach educational equity and access, key elements central to the spirit of EL education policy. PMID:27429476

  7. The development of funding recommendations for health technologies at the state level: A South Australian case study.

    PubMed

    Lambert, Robyn; Carter, Drew; Burgess, Naomi; Haji Ali Afzali, Hossein

    2018-04-20

    State governments often face capped budgets that can restrict expenditure on health technologies and their evaluation, yet many technologies are introduced to practice through state-funded institutions such as hospitals, rather than through national evaluation mechanisms. This research aimed to identify the criteria, evidence, and standards used by South Australian committee members to recommend funding for high-cost health technologies. We undertook 8 semi-structured interviews and 2 meeting observations with members of state-wide committees that have a mandate to consider the safety, effectiveness, and cost-effectiveness of high-cost health technologies. Safety and effectiveness were fundamental criteria for decision makers, who were also concerned with increasing consistency in care and equitable access to technologies. Committee members often consider evidence that is limited in quantity and quality; however, they perceive evaluations to be rigorous and sufficient for decision making. Precise standards for safety, effective, and cost-effectiveness could not be identified. Consideration of new technologies at the state level is grounded in the desire to improve health outcomes and equity of access for patients. High quality evidence is often limited. The impact funding decisions have on population health is unclear due to limited use of cost-effectiveness analysis and unclear cost-effectiveness standards. Copyright © 2018 John Wiley & Sons, Ltd.

  8. Evaluating the Effectiveness of Web-based Climate Resilience Decision Support Tools: Insights from Coastal New Jersey

    NASA Astrophysics Data System (ADS)

    Brady, M.; Lathrop, R.; Auermuller, L. M.; Leichenko, R.

    2016-12-01

    Despite the recent surge of Web-based decision support tools designed to promote resiliency in U.S. coastal communities, to-date there has been no systematic study of their effectiveness. This study demonstrates a method to evaluate important aspects of effectiveness of four Web map tools designed to promote consideration of climate risk information in local decision-making and planning used in coastal New Jersey. In summer 2015, the research team conducted in-depth phone interviews with users of one regulatory and three non-regulatory Web map tools using a semi-structured questionnaire. The interview and analysis design drew from a combination of effectiveness evaluation approaches developed in software and information usability, program evaluation, and management information system (MIS) research. Effectiveness assessment results were further analyzed and discussed in terms of conceptual hierarchy of system objectives defined by respective tool developer and user organizations represented in the study. Insights from the interviews suggest that users rely on Web tools as a supplement to desktop and analog map sources because they provide relevant and up-to-date information in a highly accessible and mobile format. The users also reported relying on multiple information sources and comparison between digital and analog sources for decision support. However, with respect to this decision support benefit, users were constrained by accessibility factors such as lack of awareness and training with some tools, lack of salient information such as planning time horizons associated with future flood scenarios, and environmental factors such as mandates restricting some users to regulatory tools. Perceptions of Web tool credibility seem favorable overall, but factors including system design imperfections and inconsistencies in data and information across platforms limited trust, highlighting a need for better coordination between tools. Contributions of the study include user feedback on web-tool system designs consistent with collaborative methods for enhancing usability and a systematic look at effectiveness that includes both user perspectives and consideration of developer and organizational objectives.

  9. Determinants of Women's Education in the Middle East and North Africa: Illustrations from Seven Countries. PHREE Background Paper Series.

    ERIC Educational Resources Information Center

    El-Sanabary, Nagat

    Despite considerable progress by Middle Eastern and North African countries in improving opportunities for women to access and attain education at all levels, much remains to be done. This report focuses on three sets of highly inter-related determinants of access, achievement, and outcome--macro-level societal determinants, school…

  10. The Influence of Water Access in Subjective Well-Being: Some Evidence in Yucatan, Mexico

    ERIC Educational Resources Information Center

    Guardiola, Jorge; Gonzalez-Gomez, Francisco; Grajales, Angel Lendechy

    2013-01-01

    The literature on happiness or subjective well-being has explored the determinants of happiness without taking into consideration the role that water plays. In this paper we attempt to draw attention to water in subjective well-being studies. Approximately one hundred million people do not have access to water. A lack of clean water causes…

  11. The Role of Student Loans in College Access. Research Report.

    ERIC Educational Resources Information Center

    Baum, Sandy

    This paper discusses the role of student loans in college access. Borrowing to pay for education is a sound decision for most students, and student loans are a vital part of college financing policy. There has been a considerable increase in student borrowing, and much of this results from the introduction of the Stafford Loan in 1993. Borrowing…

  12. A Teacher's Perspective on Autonomy and Self-Access: From Theory to Perception to Practice

    ERIC Educational Resources Information Center

    Wichayathian, Nanthiya; Reinders, Hayo

    2018-01-01

    Considerable resources are expended on the development of learner autonomy (LA), and in particular on the provision of self-access facilities as one of the most common ways in which institutions have tried to foster autonomy. Whether the intended outcomes are achieved depends in large part on teachers' agreement with and understanding of the…

  13. 75 FR 43574 - Exelon Generation Company, LLC; PSEG Nuclear, LLC; Notice of Consideration of Issuance of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-26

    ... representative) to digitally sign documents and access the E-Submittal server for any proceeding in which it is....regulations.gov and search for documents filed under Docket ID NRC-2010-0258. Comments may be submitted... 20555-0001, or by fax to RADB at (301) 492-3446. You can access publicly available documents related to...

  14. Market uptake of new antiviral drugs for the treatment of hepatitis C.

    PubMed

    Lettmeier, Beate; Mühlberger, Nikolai; Schwarzer, Ruth; Sroczynski, Gaby; Wright, Davene; Zeuzem, Stefan; Siebert, Uwe

    2008-10-01

    Peginterferon plus ribavirin is the state-of-the-art antiviral therapy for prevention of serious complications of hepatitis C. Our aim was to compare market uptake of and access to these drugs across Europe. We collected launch and sales data for peginterferons for 21 countries in the WHO European region and compared country-specific sales rates. Additionally, we converted sales figures into patient numbers and related those to country-specific hepatitis C prevalence, taking into account genotype distribution, patient characteristics and practice patterns. Peginterferon sales rates differed considerably across countries. The earliest, most rapid and highest adoption rates were in EU founder states, followed by EU members that joined after foundation, and EU non-member states. Most new member states showed a marked increase in sales. By the end of 2005, approximately 308,000 patients had been treated with peginterferons in the 21 countries evaluated. The number of patients ever treated ranged from 16% of prevalent cases in France to less than 1% of cases in Romania, Poland, Greece and Russia. Peginterferon market uptake and access differed considerably across Europe, suggesting unequal access to optimised therapy. Besides budget restrictions, national surveillance and treatment policies should be considered as reasons for market access variation.

  15. End User Evaluations

    NASA Astrophysics Data System (ADS)

    Jay, Caroline; Lunn, Darren; Michailidou, Eleni

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

  16. Authoring Tools

    NASA Astrophysics Data System (ADS)

    Treviranus, Jutta

    Authoring tools that are accessible and that enable authors to produce accessible Web content play a critical role in web accessibility. Widespread use of authoring tools that comply to the W3C Authoring Tool Accessibility Guidelines (ATAG) would ensure that even authors who are neither knowledgeable about nor particularly motivated to produce accessible content do so by default. The principles and techniques of ATAG are discussed. Some examples of accessible authoring tools are described including authoring tool content management components such as TinyMCE. Considerations for creating an accessible collaborative environment are also covered. As part of providing accessible content, the debate between system-based personal optimization and one universally accessible site configuration is presented. The issues and potential solutions to address the accessibility crisis presented by the advent of rich internet applications are outlined. This challenge must be met to ensure that a large segment of the population is able to participate in the move toward the web as a two-way communication mechanism.

  17. Advances in the management of insomnia

    PubMed Central

    Bishop, Todd M.; Marcus, Jonathan A.

    2014-01-01

    Insomnia is highly prevalent and associated with considerable morbidity. Several very efficacious treatments, both pharmacologic and non-pharmacologic, exist for the management of insomnia. New modes of delivery and new formulations of existing sedative-hypnotic medications have been introduced. Novel agents are still being developed and tested to arrive at a hypnotic that has limited side effects while still being efficacious. Innovations with respect to behavioral interventions, which are drastically under-utilized, have focused mainly on making these interventions more widely available through dissemination efforts, briefer formats and more accessible platforms. PMID:24991425

  18. 2010 Northwest Federal Market Assessment Report

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

    Scanlon, Tim; Sandusky, William F.

    The primary intent of this market assessment is to provide insights on the effectiveness of current energy efficiency and renewable energy program offerings available to Federal sites in the region. The level of detail, quality and currency of the data used in this market assessment varies significantly by Federal agency and energy efficiency service provider. Limited access to some Federal sites, limited availability of key points of contact, time/resource constraints, and other considerations limited the total number of Federal agencies and energy efficiency service providers participating in the survey.

  19. Safety and anti-hyperglycemic efficacy of various tea types in mice

    PubMed Central

    Han, Manman; Zhao, Guangshan; Wang, Yijun; Wang, Dongxu; Sun, Feng; Ning, Jingming; Wan, Xiachun; Zhang, Jinsong

    2016-01-01

    Tea, a beverage consumed worldwide, has proven anti-hyperglycemic effects in animal models. Better efficacies of tea beverages are frequently associated with high-dose levels, whose safety attracts considerable attention. Based on the inherent nature of tea catechin oxidation, fresh tea leaves are manufactured into diverse tea types by modulating the oxidation degree of catechins. The present study aimed to assess various tea types for their safety properties and anti-hyperglycemic effects. Mice were allowed free access to tea infusion (1:30, w/v) for one week, and the rare smoked tea caused salient adverse reactions, including hepatic and gastrointestinal toxicities; meanwhile, the widely-consumed green and black teas, unlike the rare yellow tea, suppressed growth in fast-growing healthy mice. When mice were fed a high-fat diet and allowed free access to tea infusion (1:30, w/v) for 25 days, only yellow tea significantly reduced blood glucose. Therefore, various teas showed different safety profiles as well as anti-hyperglycemic efficacy strengths. To achieve an effective and safe anti-hyperglycemic outcome, yellow tea, which effectively suppressed high-fat diet-induced early elevation of hepatic thioredoxin-interacting protein, is an optimal choice. PMID:27531374

  20. Characteristics of psychiatric patients for whom financial considerations affect optimal treatment provision.

    PubMed

    West, Joyce C; Pingitore, David; Zarin, Deborah A

    2002-12-01

    This study assessed characteristics of psychiatric patients for whom financial considerations affected the provision of "optimal" treatment. Psychiatrists reported that for 33.8 percent of 1,228 patients from a national sample, financial considerations such as managed care limitations, the patient's personal finances, and limitations inherent in the public care system adversely affected the provision of optimal treatment. Patients were more likely to have their treatment adversely affected by financial considerations if they were more severely ill, had more than one behavioral health disorder or a psychosocial problem, or were receiving treatment under managed care arrangements. Patients for whom financial considerations affect the provision of optimal treatment represent a population for whom access to treatment may be particularly important.

  1. Vascular Access Procedures

    MedlinePlus

    ... have a personal story about radiology? Share your patient story here Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific content. Related ...

  2. Gender, sexuality and the discursive representation of access and equity in health services literature: implications for LGBT communities

    PubMed Central

    2011-01-01

    Background This article considers how health services access and equity documents represent the problem of access to health services and what the effects of that representation might be for lesbian, gay, bisexual and transgender (LGBT) communities. We conducted a critical discourse analysis on selected access and equity documents using a gender-based diversity framework as determined by two objectives: 1) to identify dominant and counter discourses in health services access and equity literature; and 2) to develop understanding of how particular discourses impact the inclusion, or not, of LGBT communities in health services access and equity frameworks.The analysis was conducted in response to public health and clinical research that has documented barriers to health services access for LGBT communities including institutionalized heterosexism, biphobia, and transphobia, invisibility and lack of health provider knowledge and comfort. The analysis was also conducted as the first step of exploring LGBT access issues in home care services for LGBT populations in Ontario, Canada. Methods A critical discourse analysis of selected health services access and equity documents, using a gender-based diversity framework, was conducted to offer insight into dominant and counter discourses underlying health services access and equity initiatives. Results A continuum of five discourses that characterize the health services access and equity literature were identified including two dominant discourses: 1) multicultural discourse, and 2) diversity discourse; and three counter discourses: 3) social determinants of health (SDOH) discourse; 4) anti-oppression (AOP) discourse; and 5) citizen/social rights discourse. Conclusions The analysis offers a continuum of dominant and counter discourses on health services access and equity as determined from a gender-based diversity perspective. The continuum of discourses offers a framework to identify and redress organizational assumptions about, and ideological commitments to, sexual and gender diversity and health services access and equity. Thus, the continuum of discourses may serve as an important element of a health care organization's access and equity framework for the evaluation of access to good quality care for diverse LGBT populations. More specfically, the analysis offers four important points of consideration in relation to the development of a health services access and equity framework. PMID:21957894

  3. Gender, sexuality and the discursive representation of access and equity in health services literature: implications for LGBT communities.

    PubMed

    Daley, Andrea E; Macdonnell, Judith A

    2011-09-29

    This article considers how health services access and equity documents represent the problem of access to health services and what the effects of that representation might be for lesbian, gay, bisexual and transgender (LGBT) communities. We conducted a critical discourse analysis on selected access and equity documents using a gender-based diversity framework as determined by two objectives: 1) to identify dominant and counter discourses in health services access and equity literature; and 2) to develop understanding of how particular discourses impact the inclusion, or not, of LGBT communities in health services access and equity frameworks.The analysis was conducted in response to public health and clinical research that has documented barriers to health services access for LGBT communities including institutionalized heterosexism, biphobia, and transphobia, invisibility and lack of health provider knowledge and comfort. The analysis was also conducted as the first step of exploring LGBT access issues in home care services for LGBT populations in Ontario, Canada. A critical discourse analysis of selected health services access and equity documents, using a gender-based diversity framework, was conducted to offer insight into dominant and counter discourses underlying health services access and equity initiatives. A continuum of five discourses that characterize the health services access and equity literature were identified including two dominant discourses: 1) multicultural discourse, and 2) diversity discourse; and three counter discourses: 3) social determinants of health (SDOH) discourse; 4) anti-oppression (AOP) discourse; and 5) citizen/social rights discourse. The analysis offers a continuum of dominant and counter discourses on health services access and equity as determined from a gender-based diversity perspective. The continuum of discourses offers a framework to identify and redress organizational assumptions about, and ideological commitments to, sexual and gender diversity and health services access and equity. Thus, the continuum of discourses may serve as an important element of a health care organization's access and equity framework for the evaluation of access to good quality care for diverse LGBT populations. More specfically, the analysis offers four important points of consideration in relation to the development of a health services access and equity framework.

  4. Effects of visitor pressure on understory vegetation in Warsaw forested parks (Poland).

    PubMed

    Sikorski, Piotr; Szumacher, Iwona; Sikorska, Daria; Kozak, Marcin; Wierzba, Marek

    2013-07-01

    Visitor's access to understorey vegetation in park forest stands results in the impoverishment of plant species composition and a reduction in habitat quality. The phenomenon of biotic homogenisation is typical in urban landscapes, but it can proceed differently depending on the scale, a detail that has not been observed in previous studies. This research was carried out in seven Warsaw parks (both public and restricted access). Thirty-four forested areas were randomly selected, some subjected to strong visitors' pressure and some within restricted access areas, free of such impacts. The latter category included woodlands growing in old forest and secondary habitats. Public access to the study areas contributed to the disappearance of some forest species and their replacement by cosmopolitan non-forest species, leading to loss of floristic biodiversity in areas of high ecological importance at the city scale. Some human-induced factors, including soil compaction and changes in soil pH, moisture and capillary volume, were found to cause habitat changes that favoured native non-forest plants. Despite changes in species composition, the taxonomic similarity of understorey vegetation in both categories--public access and restricted access--was comparable. In a distance gradient of measurements taken around selected individual trees, there was found to be significant variation (in light, soil pH and compaction) affecting the quality and quantity of understorey vegetation (including rare species). In conclusion, the protection of rare forest species could be achieved by limiting access to forested areas, particularly in old forest fragments, and we highly recommend its consideration in the proposal of future park restoration plans.

  5. Age and gender considerations for technology-assisted delivery of therapy for substance use disorder treatment: A patient survey of access to electronic devices.

    PubMed

    Antoine, Denis; Heffernan, Sean; Chaudhry, Amina; King, Van; Strain, Eric C

    2016-12-01

    Technology-assisted treatment (TAT) can be an effective supplement to established face-to-face therapy modalities with a growing literature in substance use disorder (SUD) treatment. TAT access, interest, and familiarity are potential limitations to the use and efficacy of these approaches to treatment. 174 participants in outpatient SUD treatment were administered a survey regarding technology device and Internet access, and interest in engaging in TAT SUD counseling (SUDC). The group was dichotomized by mean age and gender to examine potential variations in in these subgroups. Forty-three (43%) of participants were female, and the mean age was 44.8 years, and 89% of participants had Internet access. 83% of participants were interested in TAT for SUD counseling; 81% expected it to be at least "moderately helpful." 34% of participants noted they would choose to continue face-to-face therapy exclusively. 91% of participants had cell phones, but only 50% could access data or the Internet via their handheld device. 80% of participants stated they would be interested in trying SUDC via their phone. Women had a higher preference for computer-based SUDC than men, with gender being significantly correlated with TAT perceive helpfulness. These findings suggest that patients in outpatient SUD treatment have access to resources for TAT implementation, although access was not always readily available. Future research will be needed to determine whether the technology that this population possesses will be able to support the evolving TAT modalities and whether interest in TAT across age and gender groups equalizes over time.

  6. How Philadelphia is Integrating Climate Science and Policy: Changing Capital Planning Processes and Developing Flood-Depth Tools

    NASA Astrophysics Data System (ADS)

    Bhat, C.; Dix, B.; Choate, A.; Wong, A.; Asam, S.; Schultz, P. A.

    2016-12-01

    Policy makers can implement more effective climate change adaptation programs if they are provided with two tools: accessible information on the impacts that they need to prepare for, and clear guidance on how to integrate climate change considerations into their work. This presentation will highlight recent and ongoing efforts at the City of Philadelphia to integrate climate science into their decision-making. These efforts include developing a climate change information visualization tool, climate change risk assessments across the city, and processes to integrate climate change into routine planning and budgeting practices. The goal of these efforts is to make climate change science highly targeted to decision maker needs, non-political, easily accessible, and actionable. While sea level rise inundation maps have been available to communities for years, the maps do not effectively communicate how the design of a building or a piece of infrastructure would need to be modified to protect it. The Philadelphia Flood Risk Viewer is an interactive planning tool that allows Philadelphia to identify projected depths of flooding for any location within the City, for a variety of sea level rise and storm surge scenarios. Users can also determine whether a location is located in a FEMA floodplain. By having access to information on the projected depth of flooding at a given location, the City can determine what flood protection measures may be effective, or even inform the long-term viability of developing a particular area. With an understanding of climate vulnerabilities, cities have the opportunity to make smart, climate-resilient investments with their capital budgets that will yield multiple benefits for years to come. Few, however, have established protocols for doing so. Philadelphia, with support from ICF, developed a guidance document that identifies recommendations for integrating climate change considerations throughout the Capital Program and capital budgeting process. For each recommendation, the guidance also provides supplemental resources and information to make the recommendations actionable. Philadelphia is applying the guidance in their FY 2017 capital planning activities and taking advantage of opportunities to grow stronger in the face of climate change.

  7. Study on the feasibility of provision of distance learning programmes in surgery to Malawi.

    PubMed

    Mains, Edward A A; Blackmur, James P; Dewhurst, David; Ward, Ross M; Garden, O James; Wigmore, Stephen J

    2011-12-01

    Medical educational opportunities and resources are considerably limited in the developing world. The expansion of computing and Internet access means that there exists a potential to provide education to students through distance learning programmes. This study investigated the feasibility of providing distance learning course in surgery in Malawi. The study investigated the user requirements, technical requirements and Internet connections in two teaching hospitals in Malawi. In addition the appropriateness of current course material from the Edinburgh Surgical Sciences Qualification to Malawi trainees was assessed. The study found a high degree of interest from Malawian trainees in distance learning. The provision of basic science modules such as anatomy and physiology and the ability to access journals were considered highly desirable. The current ESSQ course would require extensive re-modelling to make it suitable to an African trainee's requirements. Internet speeds remain slow and access is currently expensive. There is considerable interest in distance learning programmes in Malawi but access to them is limited partly because of slow and expensive Internet access. Understanding the needs of trainees in countries such as Malawi will allow better direction of educational aid and resources to support surgical training. Copyright © 2010 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  8. Scaffolding the design of accessible eLearning content: a user-centered approach and cognitive perspective.

    PubMed

    Catarci, Tiziana; De Giovanni, Loredana; Gabrielli, Silvia; Kimani, Stephen; Mirabella, Valeria

    2008-08-01

    There exist various guidelines for facilitating the design, preparation, and deployment of accessible eLearning applications and contents. However, such guidelines prevalently address accessibility in a rather technical sense, without giving sufficient consideration to the cognitive aspects and issues related to the use of eLearning materials by learners with disabilities. In this paper we describe how a user-centered design process was applied to develop a method and set of guidelines for didactical experts to scaffold their creation of accessible eLearning content, based on a more sound approach to accessibility. The paper also discusses possible design solutions for tools supporting eLearning content authors in the adoption and application of the proposed approach.

  9. High engagement, high quality: A guiding framework for developing empirically informed asynchronous e-learning programs for health professional educators.

    PubMed

    Sinclair, Peter M; Levett-Jones, Tracey; Morris, Amanda; Carter, Ben; Bennett, Paul N; Kable, Ashley

    2017-03-01

    E-learning involves the transfer of skills and knowledge via technology so that learners can access meaningful and authentic educational materials. While learner engagement is important, in the context of healthcare education, pedagogy must not be sacrificed for edu-tainment style instructional design. Consequently, health professional educators need to be competent in the use of current web-based educational technologies so that learners are able to access relevant and engaging e-learning materials without restriction. The increasing popularity of asynchronous e-learning programs developed for use outside of formal education institutions has made this need more relevant. In these contexts, educators must balance design and functionality to deliver relevant, cost-effective, sustainable, and accessible programs that overcome scheduling and geographic barriers for learners. This paper presents 10 guiding design principles and their application in the development of an e-learning program for general practice nurses focused on behavior change. Consideration of these principles will assist educators to develop high quality, pedagogically sound, engaging, and interactive e-learning resources. © 2017 John Wiley & Sons Australia, Ltd.

  10. Brief Communication: Mapping river ice using drones and structure from motion

    NASA Astrophysics Data System (ADS)

    Alfredsen, Knut; Haas, Christian; Tuhtan, Jeffrey A.; Zinke, Peggy

    2018-02-01

    In cold climate regions, the formation and break-up of river ice is important for river morphology, winter water supply, and riparian and instream ecology as well as for hydraulic engineering. Data on river ice is therefore significant, both to understand river ice processes directly and to assess ice effects on other systems. Ice measurement is complicated due to difficult site access, the inherent complexity of ice formations, and the potential danger involved in carrying out on-ice measurements. Remote sensing methods are therefore highly useful, and data from satellite-based sensors and, increasingly, aerial and terrestrial imagery are currently applied. Access to low cost drone systems with quality cameras and structure from motion software opens up a new possibility for mapping complex ice formations. Through this method, a georeferenced surface model can be built and data on ice thickness, spatial distribution, and volume can be extracted without accessing the ice, and with considerably fewer measurement efforts compared to traditional surveying methods. A methodology applied to ice mapping is outlined here, and examples are shown of how to successfully derive quantitative data on ice processes.

  11. Recombinant Human Insulin in Global Diabetes Management – Focus on Clinical Efficacy

    PubMed Central

    Mbanya, Jean Claude; Sandow, Juergen; Landgraf, Wolfgang

    2017-01-01

    Abstract Biosynthetic human insulin and insulin analogues are the mainstay of insulin therapy for both type 1 and type 2 diabetes although access to human insulin at affordable prices remains a global issue. The world is experiencing an exponential rise in the prevalence of diabetes presenting an urgent need to establish effective diabetes therapy in countries burdened by inadequate health care budgets, malnutrition and infectious diseases. Recombinant human insulin has replaced animal insulins and animal-based semisynthetic human insulin thereby available in sufficient quantities and at affordable prices able to provide global access to insulin therapy. In many patients, analog insulins can offer additional clinical benefit, although at a considerably higher price thus severely restricting availability in low income countries. The approval process for recombinant human insulins (i.e. biosimilars) and analogue insulins is highly variable in the developing countries in contrast to Europe and in North America, where it is well established within a strict regulatory framework. This review aims to discuss the future access to human insulin therapy in a global context with an ever increasing burden of diabetes and significant economic implications. PMID:29632602

  12. Wifi-friendly building, enabling wifi signal indoor: an initial study

    NASA Astrophysics Data System (ADS)

    Suherman; Mubarakah, Naemah; Sagala, Romulo S.; Prayitno, Hendra

    2018-03-01

    The 802.11 network (wireless fidelity/WiFi) is the most common wireless infrastructure applied for internet access indoor. Widespread devices and installation simplicity make it better than similar technologies such as 802.16 and other 802.xx series. The access points are the most influential devices for indoor access. However, building indoor architectures contribute to the signal quality. Since WiFi installation in buildings becomes prevalent, the architecture should consider WiFi-friendliness into consideration. The more friendly the building to WiFi signal, the more efficient the 802.11 based wireless infrastructure. This paper present preliminary study how the building, specially the obstacle material, effects the WiFi signal propagation indoor. The study was performed by using ESP8266-based WiFi signal reader, to determine the impact indoor obstacles to WiFi signal propagation. The initial study shows that simple reflecting materials increase signal level about 1.14 dBm. WiFi-friendly building can be achieved by transforming building properties into signal interconnector. A simple photo frame with aluminium sheet insertion increase signal level on the second floor up to 6.56dBm.

  13. Closing the Gap Between Formal and Material Health Care Coverage in Colombia

    PubMed Central

    García, Johnattan

    2016-01-01

    Abstract This paper explores Colombia’s road toward universal health care coverage. Using a policy-based approach, we show how, in Colombia, the legal expansion of health coverage is not sufficient and requires the development of appropriate and effective institutions. We distinguish between formal and material health coverage in order to underscore that, despite the rapid legal expansion of health care coverage, a considerable number of Colombians—especially those living in poor regions of the country—still lack material access to health care services. As a result of this gap between formal and material coverage, an individual living in a rich region has a much better chance of accessing basic health care than an inhabitant of a poor region. This gap between formal and material health coverage has also resulted in hundreds of thousands of citizens filing lawsuits—tutelas—demanding access to medications and treatments that are covered by the health system, but that health insurance companies—also known as EPS— refuse to provide. We explore why part of the population that is formally insured is still unable to gain material access to health care and has to litigate in order to access mandatory health services. We conclude by discussing the current policy efforts to reform the health sector in order to achieve material, universal health care coverage. PMID:28559676

  14. Accessing Secondary Markets as a Capital Source for Energy Efficiency Finance Programs: Program Design Considerations for Policymakers and Administrators

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

    Kramer, C.; Martin, E. Fadrhonc; Thompson, P.

    Estimates of the total opportunity for investment in cost-effective energy efficiency in the United States are typically in the range of several hundred billion dollars (Choi Granade, et al., 2009 and Fulton & Brandenburg, 2012).1,2 To access this potential, many state policymakers and utility regulators have established aggressive energy efficiency savings targets. Current levels of taxpayer and utility bill-payer funding for energy efficiency is only a small fraction of the total investment needed to meet these targets (SEE Action Financing Solutions Working Group, 2013). Given this challenge, some energy efficiency program administrators are working to access private capital sources withmore » the aim of amplifying the funds available for investment. In this context, efficient access to secondary market capital has been advanced as one important enabler of the energy efficiency industry “at scale.”3 The question of what role secondary markets can play in bringing energy efficiency to scale is largely untested despite extensive attention from media, technical publications, advocates, and others. Only a handful of transactions of energy efficiency loan products have been executed to date, and it is too soon to draw robust conclusions from these deals. At the same time, energy efficiency program administrators and policymakers face very real decisions regarding whether and how to access secondary markets as part of their energy efficiency deployment strategy.« less

  15. Nurses' tending instinct as a conduit for men's access to mental health counseling.

    PubMed

    Smith, Jeffrey M; Robertson, Steve

    2006-06-01

    No article has been found melding the phenomenon of nurses' tending instinct and men's mental health counseling access. This theoretical article presents nurses' tending instinct as a viable rationale to support men in utilizing mental health counseling services. Nurses can be the conduit that assists men in accessing mental health counseling when the need arises. An amalgamation of related topics, including nurses' tending instinct, men's illness/injury/disease profile, psychological medicine, and counselor skills, were forged together to unify this innovative theoretical consideration. Implications for nursing practice also were explored.

  16. NNDC Data Services

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

    Tuli, J.K.; Sonzogni,A.

    The National Nuclear Data Center has provided remote access to some of its resources since 1986. The major databases and other resources available currently through NNDC Web site are summarized. The National Nuclear Data Center (NNDC) has provided remote access to the nuclear physics databases it maintains and to other resources since 1986. With considerable innovation access is now mostly through the Web. The NNDC Web pages have been modernized to provide a consistent state-of-the-art style. The improved database services and other resources available from the NNOC site at www.nndc.bnl.govwill be described.

  17. National Computer Security Conference (16th) held at Baltimore Convention Center, Baltimore, Maryland on September 20-23, 1993. Proceedings

    DTIC Science & Technology

    1993-09-23

    answer to the question: Is subject s allowed access type a on object o? An authorization was thus seen as a 3-tuple (s,o,a). This view of access...called trusted in a Bell-LaPadula architecture. Work at Carnegie Mellon University on type enforcement contemporaneous with Denning’s was not addressed in...34Implementation Considerations for the Typed Access Matrix Model in a Distributed Environment," Proceedings of the 15th National Computer Security

  18. A Model of BGA Thermal Fatigue Life Prediction Considering Load Sequence Effects

    PubMed Central

    Hu, Weiwei; Li, Yaqiu; Sun, Yufeng; Mosleh, Ali

    2016-01-01

    Accurate testing history data is necessary for all fatigue life prediction approaches, but such data is always deficient especially for the microelectronic devices. Additionally, the sequence of the individual load cycle plays an important role in physical fatigue damage. However, most of the existing models based on the linear damage accumulation rule ignore the sequence effects. This paper proposes a thermal fatigue life prediction model for ball grid array (BGA) packages to take into consideration the load sequence effects. For the purpose of improving the availability and accessibility of testing data, a new failure criterion is discussed and verified by simulation and experimentation. The consequences for the fatigue underlying sequence load conditions are shown. PMID:28773980

  19. A new harvest operation cost model to evaluate forest harvest layout alternatives

    Treesearch

    Mark M. Clark; Russell D. Meller; Timothy P. McDonald; Chao Chi Ting

    1997-01-01

    The authors develop a new model for harvest operation costs that can be used to evaluate stands for potential harvest. The model is based on felling, extraction, and access costs, and is unique in its consideration of the interaction between harvest area shapes and access roads. The scientists illustrate the model and evaluate the impact of stand size, volume, and road...

  20. Policy Considerations for Enhancing Student Access and Persistence in a World in Which Tuition Keeps Rising

    ERIC Educational Resources Information Center

    Ehrenberg, Ronald G.

    2007-01-01

    The United States no longer leads the world in college completion rates. Inequality in college access rates by income have barely narrowed over the last 25 to 30 years and inequality in college completion rates have narrowed even less. The groups in the population that are growing the most rapidly are those that have historically been…

  1. Robotic Access to Planetary Surfaces Capability Roadmap

    NASA Technical Reports Server (NTRS)

    2005-01-01

    A set of robotic access to planetary surfaces capability developments and supporting infrastructure have been identified. Reference mission pulls derived from ongoing strategic planning. Capability pushes to enable broader mission considerations. Facility and flight test capability needs. Those developments have been described to the level of detail needed for high-level planning. Content and approach. Readiness and metrics. Rough schedule and cost. Connectivity to mission concepts.

  2. 76 FR 39076 - Board of Visitors, Defense Language Institute Foreign Language Center

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-05

    ... floor or speak to any issue under consideration by the Board. Although open to the public, gate access... areas. Public's Accessibility to the Meeting: Pursuant to 5 U.S.C. 552b and 41 CFR 102-3.140 through 102-3.165, and the availability of space, this meeting is open to the public. Seating is on a first-come...

  3. 77 FR 62223 - Board of Visitors Defense Language Institute Foreign Language Center

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-12

    ... floor or speak to any issue under consideration by the Board. Although open to the public, gate access... observations. Public's Accessibility to the Meeting: Pursuant to 5 U.S.C. 552b and 41 CFR 102-3.140 through 102-3.165, and the availability of space, this meeting is open to the public. Seating is on a first come...

  4. Key Considerations in Providing a Free Appropriate Public Education for Youth with Disabilities in Juvenile Justice Secure Care Facilities. Issue Brief

    ERIC Educational Resources Information Center

    Gagnon, Joseph C.; Read, Nicholas W.; Gonsoulin, Simon

    2015-01-01

    Access to high-quality education for youth is critical to their long-term success as adults. Youth in juvenile justice secure care facilities, however, too often do not have access to the high-quality education and related supports and services that they need, particularly youth with disabilities residing in such facilities. This brief discusses…

  5. The need for the use of XACML access control policy in a distributed EHR and some performance considerations.

    PubMed

    Sucurovic, Snezana; Milutinovic, Veljko

    2008-01-01

    The Internet based distributed large scale information systems implements attribute based access control (ABAC) rather than Role Based Access Control (RBAC). The reason is that the Internet is identity less and that ABAC scales better. EXtensible Access Control Markup Language is standardized language for writing access control policies, access control requests and access control responses in ABAC. XACML can provide decentralized administration and credentials distribution. In year 2002 version of CEN ENV 13 606 attributes have been attached to EHCR components and in such a system ABAC and XACML have been easy to implement. This paper presents writing XACML policies in the case when attributes are in hierarchical structure. It is presented two possible solutions to write XACML policy in that case and that the solution when set functions are used is more compact and provides 10% better performances.

  6. Laser power beaming applications and technology

    NASA Astrophysics Data System (ADS)

    Burke, Robert J.; Cover, Ralph A.; Curtin, Mark S.; Dinius, R.; Lampel, Michael C.

    1994-05-01

    Beaming laser energy to spacecraft has important economic potential. It promises significant reduction in the cost of access to space, for commercial and government missions. While the potential payoff is attractive, existing technologies perform the same missions and the keys to market penetration for power beaming are a competitive cost and a schedule consistent with customers' plans. Rocketdyne is considering these questions in the context of a commercial enterprise -- thus, evaluation of the requirements must be done based on market assessments and recognition that significant private funding will be involved. It is in the context of top level business considerations that the technology requirements are being assessed and the program being designed. These considerations result in the essential elements of the development program. Since the free electron laser is regarded as the `long pole in the tent,' this paper summarizes Rocketdyne's approach for a timely, cost-effective program to demonstrate an FEL capable of supporting an initial operating capability.

  7. The economic evaluation of personalised oncology medicines: ethical challenges.

    PubMed

    Lewis, Jan R R; Lipworth, Wendy L; Kerridge, Ian H; Day, Richard O

    2013-10-07

    Insights into the molecular drivers of cancer are providing opportunities for the development of new targeted treatments and more personalised approaches to cancer management. Drugs targeting mutant epidermal growth factor receptors, such as erlotinib and gefitinib, may provide more effective, safer and better tolerated treatment options compared with chemotherapy among appropriately selected patients with advanced non-small cell lung cancer (NSCLC). First-line access to these newer treatments remains unfunded after several considerations by the Pharmaceutical Benefits Advisory Committee and their assessment that these are not cost-effective treatments. We suggest that there may be evidentiary and ethical challenges associated with the assessment of the cost-effectiveness of personalised oncology medicines in Australia, and that a new approach is needed to determine the value and cost-effectiveness of personalised medicine.

  8. Climate change impacts on global food security.

    PubMed

    Wheeler, Tim; von Braun, Joachim

    2013-08-02

    Climate change could potentially interrupt progress toward a world without hunger. A robust and coherent global pattern is discernible of the impacts of climate change on crop productivity that could have consequences for food availability. The stability of whole food systems may be at risk under climate change because of short-term variability in supply. However, the potential impact is less clear at regional scales, but it is likely that climate variability and change will exacerbate food insecurity in areas currently vulnerable to hunger and undernutrition. Likewise, it can be anticipated that food access and utilization will be affected indirectly via collateral effects on household and individual incomes, and food utilization could be impaired by loss of access to drinking water and damage to health. The evidence supports the need for considerable investment in adaptation and mitigation actions toward a "climate-smart food system" that is more resilient to climate change influences on food security.

  9. Primary care access improvement: an empowerment-interaction model.

    PubMed

    Ledlow, G R; Bradshaw, D M; Shockley, C

    2000-05-01

    Improving community primary care access is a difficult and dynamic undertaking. Realizing a need to improve appointment availability, a systematic approach based on measurement, empowerment, and interaction was developed. The model fostered exchange of information and problem solving between interdependent staff sections within a managed care system. Measuring appointments demanded but not available proved to be a credible customer-focused approach to benchmark against set goals. Changing the organizational culture to become more sensitive to changing beneficiary needs was a paramount consideration. Dependent-group t tests were performed to compare the pretreatment and posttreatment effect. The empowerment-interaction model significantly improved the availability of routine and wellness-type appointments. The availability of urgent appointments improved but not significantly; a better prospective model needs to be developed. In aggregate, appointments demanded but not available (empowerment-interaction model) were more than 10% before the treatment and less than 3% with the treatment.

  10. The Role of Socioeconomic Status and Health Care Access in Breast Cancer Screening Compliance Among Hispanics.

    PubMed

    Jadav, Smruti; Rajan, Suja S; Abughosh, Susan; Sansgiry, Sujit S

    2015-01-01

    Considerable disparities in breast cancer screening exist between Hispanic and non-Hispanic white (NHW) women. Identifying and quantifying the factors contributing to these racial-ethnic disparities can help shape interventions and policies aimed at reducing these disparities. This study, for the first time, identified and quantified individual-level sociodemographic and health-related factors that contribute to racial-ethnic disparities in breast cancer screening using the nonlinear Blinder-Oaxaca decomposition method. Analysis of the retrospective pooled cross-sectional Medical Expenditure Panel Survey data from 2000 to 2010 was conducted. Women aged 40 years and older were included in the study. Logistic regressions were used to estimate racial-ethnic disparities in breast cancer screening. Nonlinear Blinder-Oaxaca decomposition method was used to identify and quantify the contribution of each individual-level factor toward racial-ethnic disparities. Based on the unadjusted analyses, Hispanic women had lower odds of receiving mammogram screening (MS) (odds ratio [OR]: 0.74; 95% confidence interval [CI]: 0.69-0.80) and breast cancer screening (OR: 0.75; 95% CI: 0.70-0.81) as compared with NHW women. However, the relationship reversed in adjusted analyses, such that Hispanic women had higher odds of receiving MS (OR: 1.27; 95% CI: 1.16-1.40) and breast cancer screening (OR: 1.28; 95% CI: 1.17-1.40) as compared with NHW women. The Blinder-Oaxaca decomposition estimated that improving insurance status, access to care, education, and income will considerably increase screening rates among Hispanic women. The study projects that improving health care access and health education will considerably increase breast cancer screening compliance among Hispanic women. Policies like the Affordable Care Act, and patient navigation and health education interventions, might considerably reduce screening disparities in the Hispanic population.

  11. Four wave mixing as a probe of the vacuum

    NASA Astrophysics Data System (ADS)

    Tennant, Daniel M.

    2016-06-01

    Much attention has been paid to the quantum structure of the vacuum. Higher order processes in quantum electrodynamics are strongly believed to cause polarization and even breakdown of the vacuum in the presence of strong fields soon to be accessible in high intensity laser experiments. Less explored consequences of strong field electrodynamics include effects from Born-Infeld type of electromagnetic theories, a nonlinear electrodynamics that follows from classical considerations as opposed to coupling to virtual fluctuations. In this article, I will demonstrate how vacuum four wave mixing has the possibility to differentiate between these two types of vacuum responses: quantum effects on one hand and nonlinear classical extensions on the other.

  12. Detrimental effect of interfacial Dzyaloshinskii-Moriya interaction on perpendicular spin-transfer-torque magnetic random access memory

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

    Jang, Peong-Hwa; Lee, Seo-Won, E-mail: swlee-sci@korea.ac.kr, E-mail: kj-lee@korea.ac.kr; Song, Kyungmi

    2015-11-16

    Interfacial Dzyaloshinskii-Moriya interaction in ferromagnet/heavy metal bilayers is recently of considerable interest as it offers an efficient control of domain walls and the stabilization of magnetic skyrmions. However, its effect on the performance of perpendicular spin transfer torque memory has not been explored yet. We show based on numerical studies that the interfacial Dzyaloshinskii-Moriya interaction decreases the thermal energy barrier while increases the switching current. As high thermal energy barrier as well as low switching current is required for the commercialization of spin torque memory, our results suggest that the interfacial Dzyaloshinskii-Moriya interaction should be minimized for spin torque memorymore » applications.« less

  13. Understanding why veterans are reluctant to access help for alcohol problems: Considerations for nurse education.

    PubMed

    Kiernan, Matthew D; Moran, Sandra; Hill, Mick

    2016-12-01

    To effectively engage veterans with substance misuse services, nurses need to understand their unique needs and the potential barriers that prevent them from accessing care. Nurses need to have an understanding and awareness of the cultural sensitivities associated with having been a member of the armed forces. The aim of this study was to investigate the perceived barriers to care amongst those planning, commissioning and delivering services for veterans with substance misuse problems, and to identify and explore subject areas which nurse educators should consider for inclusion in nursing and health education programmes. The findings reported in this paper come from one phase of a larger three phase research project and used an applied qualitative research approached based on methods developed for applied social policy research. The study was undertaken in the north-east of England. The study consisted of a purposive sample of planners, commissioners of services, and service providers in the North East of England. Data was collected using a semi-structured interview schedule. Framework analysis was used to analyse the data. Complexity of services and care, complexity of need and a lack of understanding of veterans were identified as factors that made accessing substance misuse care difficult. To help nurses better understand the unique needs of veterans three educational topics were identified for consideration in pre-registration nurse education: understanding military and veteran culture and the nature of modern warfare, the military 'veteran as institutionalised' hypothesis and stigma. Health and social services can struggle to truly understand the unique needs and experiences of the veteran community. We have identified three broad subject areas that should be considered as the theoretical basis for a veteran specific education programme within pre and post-registration nurse education. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. DeepSurveyCam—A Deep Ocean Optical Mapping System

    PubMed Central

    Kwasnitschka, Tom; Köser, Kevin; Sticklus, Jan; Rothenbeck, Marcel; Weiß, Tim; Wenzlaff, Emanuel; Schoening, Timm; Triebe, Lars; Steinführer, Anja; Devey, Colin; Greinert, Jens

    2016-01-01

    Underwater photogrammetry and in particular systematic visual surveys of the deep sea are by far less developed than similar techniques on land or in space. The main challenges are the rough conditions with extremely high pressure, the accessibility of target areas (container and ship deployment of robust sensors, then diving for hours to the ocean floor), and the limitations of localization technologies (no GPS). The absence of natural light complicates energy budget considerations for deep diving flash-equipped drones. Refraction effects influence geometric image formation considerations with respect to field of view and focus, while attenuation and scattering degrade the radiometric image quality and limit the effective visibility. As an improvement on the stated issues, we present an AUV-based optical system intended for autonomous visual mapping of large areas of the seafloor (square kilometers) in up to 6000 m water depth. We compare it to existing systems and discuss tradeoffs such as resolution vs. mapped area and show results from a recent deployment with 90,000 mapped square meters of deep ocean floor. PMID:26828495

  15. Behavioral health support and online peer communities: international experiences

    PubMed Central

    Harding, Claire

    2016-01-01

    Online peer support communities play an important part in many people’s experience of healthcare. They can be particularly significant in behavioral health/mental health due to the difficulties that people may experience in accessing face to face care for these conditions. There is considerable diversity of practice in service management, target group, and moderation practices of online peer support communities. People using the communities also appear to have diverse aims and experiences. This heterogeneity contributes to a relative lack of data about the value and effectiveness of online peer support in behavioral health, although there is significant research into some aspects of these communities. The digital behavioral health service Big White Wall was launched in the UK in 2007, and in the US in 2015, and is focused on delivering moderated peer support. There are considerable differences in health systems between the two countries, and this has been reflected in different experiences of implementation. The value of online peer support could be maximized if systemic challenges to implementation and adoption were addressed more effectively. PMID:28293613

  16. Measuring User-Created Content: Implications for the ICT Access and Use by Households and Individuals Surveys. OECD Digital Economy Papers, No. 139

    ERIC Educational Resources Information Center

    van Beuzekom, Brigitte

    2008-01-01

    This paper reviews recent measurement work on User-Created Content (UCC) undertaken in OECD countries. It shows that UCC is emerging as a significant area of economic and social activity worthy of consideration for official measurement and discusses the implications for the OECD Model Survey on ICT Access and Use by Households and Individuals.…

  17. Access of Rural Girls to Primary Education in the Third World: State of Art, Obstacles, and Policy Recommendations.

    ERIC Educational Resources Information Center

    Safilios-Rothschild, Constantina

    In the Third World, women's literacy and access to primary education lags behind that of men, and the situation is more accentuated for rural than for urban women. In general, rural women have lower literacy than rural men and than urban women. Because a considerable percentage of girls enrolled in primary school are over 14 years old, marriage,…

  18. Access control and privilege management in electronic health record: a systematic literature review.

    PubMed

    Jayabalan, Manoj; O'Daniel, Thomas

    2016-12-01

    This study presents a systematic literature review of access control for electronic health record systems to protect patient's privacy. Articles from 2006 to 2016 were extracted from the ACM Digital Library, IEEE Xplore Digital Library, Science Direct, MEDLINE, and MetaPress using broad eligibility criteria, and chosen for inclusion based on analysis of ISO22600. Cryptographic standards and methods were left outside the scope of this review. Three broad classes of models are being actively investigated and developed: access control for electronic health records, access control for interoperability, and access control for risk analysis. Traditional role-based access control models are extended with spatial, temporal, probabilistic, dynamic, and semantic aspects to capture contextual information and provide granular access control. Maintenance of audit trails and facilities for overriding normal roles to allow full access in emergency cases are common features. Access privilege frameworks utilizing ontology-based knowledge representation for defining the rules have attracted considerable interest, due to the higher level of abstraction that makes it possible to model domain knowledge and validate access requests efficiently.

  19. The effects of hands-free communication device systems: communication changes in hospital organizations.

    PubMed

    Richardson, Joshua E; Ash, Joan S

    2010-01-01

    To analyze the effects that hands-free communication device (HCD) systems have on healthcare organizations from multiple user perspectives. This exploratory qualitative study recruited 26 subjects from multiple departments in two research sites located in Portland, Oregon: an academic medical center and a community hospital. Interview and observation data were gathered January through March, 2007. Data were analyzed using a grounded theory approach. Because this study was exploratory, data were coded and patterns identified until overall themes 'emerged'. Five themes arose: (1) Communication access-the perception that HCD systems provide fast and efficient communication that supports workflow; (2) Control-social and technical considerations associated with use of an HCD system; (3) Training-processes that should be used to improve use of the HCD system; (4) Organizational change-changes to organizational design and behavior caused by HCD system implementation; and (5) Environment and infrastructure-HCD system use within the context of physical workspaces. HCD systems improve communication access but users experience challenges integrating the system into workflow. Effective HCD use depends on how well organizations train users, adapt to changes brought about by HCD systems, and integrate HCD systems into physical surroundings.

  20. Surveillance and response for high-risk populations: what can malaria elimination programmes learn from the experience of HIV?

    PubMed

    Jacobson, Jerry O; Cueto, Carmen; Smith, Jennifer L; Hwang, Jimee; Gosling, Roly; Bennett, Adam

    2017-01-18

    To eliminate malaria, malaria programmes need to develop new strategies for surveillance and response appropriate for the changing epidemiology that accompanies transmission decline, in which transmission is increasingly driven by population subgroups whose behaviours place them at increased exposure. Conventional tools of malaria surveillance and response are likely not sufficient in many elimination settings for accessing high-risk population subgroups, such as mobile and migrant populations (MMPs), given their greater likelihood of asymptomatic infections, illegal risk behaviours, limited access to public health facilities, and high mobility including extended periods travelling away from home. More adaptive, targeted strategies are needed to monitor transmission and intervention coverage effectively in these groups. Much can be learned from HIV programmes' experience with "second generation surveillance", including how to rapidly adapt surveillance and response strategies to changing transmission patterns, biological and behavioural surveys that utilize targeted sampling methods for specific behavioural subgroups, and methods for population size estimation. This paper reviews the strategies employed effectively for HIV programmes and offers considerations and recommendations for adapting them to the malaria elimination context.

  1. The Challenges Facing Science Data Archiving on Current Mass Storage Systems

    NASA Technical Reports Server (NTRS)

    Peavey, Bernard; Behnke, Jeanne (Editor)

    1996-01-01

    This paper discusses the desired characteristics of a tape-based petabyte science data archive and retrieval system required to store and distribute several terabytes (TB) of data per day over an extended period of time, probably more than 115 years, in support of programs such as the Earth Observing System Data and Information System (EOSDIS). These characteristics take into consideration not only cost effective and affordable storage capacity, but also rapid access to selected files, and reading rates that are needed to satisfy thousands of retrieval transactions per day. It seems that where rapid random access to files is not crucial, the tape medium, magnetic or optical, continues to offer cost effective data storage and retrieval solutions, and is likely to do so for many years to come. However, in environments like EOS these tape based archive solutions provide less than full user satisfaction. Therefore, the objective of this paper is to describe the performance and operational enhancements that need to be made to the current tape based archival systems in order to achieve greater acceptance by the EOS and similar user communities.

  2. Effectiveness of cross-cultural education for medical residents caring for burmese refugees.

    PubMed

    McHenry, Megan Song; Nutakki, Kavitha; Swigonski, Nancy L

    2016-01-01

    Limited resources are available to educate health professionals on cultural considerations and specific healthcare needs of Burmese refugees. The objective of this study was to determine the effectiveness of a module focused on cross-cultural considerations when caring for Burmese refugees. A brief educational module using anonymously tracked pre- and post-intervention, self-administered surveys was developed and studied. The surveys measured pediatric and family medicine residents' knowledge, attitudes, and comfort in caring for Burmese refugees. Paired t-tests for continuous variables and Fisher's exact tests for categorical variables were used to test pre- and post-intervention differences. We included open-ended questions for residents to describe their experiences with the Burmese population. The survey was available to 173 residents. Forty-four pre- and post-intervention surveys were completed (response rate of 25%). Resident comfort in caring for Burmese increased significantly after the module (P = 0.04). Resident knowledge of population-specific cultural information increased regarding ethnic groups (P = 0.004), appropriate laboratory use (P = 0.04), and history gathering (P = 0.001). Areas of improved resident attitudes included comprehension of information from families (P = 0.03) and length of time required with interpreter (P = 0.01). Thematic evaluation of qualitative data highlighted four themes: access to interpreter and resources, verbal communication, nonverbal communication, and relationship building with cultural considerations. A brief intervention for residents has the potential to improve knowledge, attitudes, and comfort in caring for Burmese patients. Interventions focused on cultural considerations in medical care may improve cultural competency when caring for vulnerable patient populations.

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

    PubMed Central

    2010-01-01

    Background Evidence-informed decision making is accepted in Canada and worldwide as necessary for the provision of effective health services. This process involves: 1) clearly articulating a practice-based issue; 2) searching for and accessing relevant evidence; 3) appraising methodological rigor and choosing the most synthesized evidence of the highest quality and relevance to the practice issue and setting that is available; and 4) extracting, interpreting, and translating knowledge, in light of the local context and resources, into practice, program and policy decisions. While the public health sector in Canada is working toward evidence-informed decision making, considerable barriers, including efficient access to synthesized resources, exist. Methods In this paper we map to a previously developed 6 level pyramid of pre-processed research evidence, relevant resources that include public health-related effectiveness evidence. The resources were identified through extensive searches of both the published and unpublished domains. Results Many resources with public health-related evidence were identified. While there were very few resources dedicated solely to public health evidence, many clinically focused resources include public health-related evidence, making tools such as the pyramid, that identify these resources, particularly helpful for public health decisions makers. A practical example illustrates the application of this model and highlights its potential to reduce the time and effort that would be required by public health decision makers to address their practice-based issues. Conclusions This paper describes an existing hierarchy of pre-processed evidence and its adaptation to the public health setting. A number of resources with public health-relevant content that are either freely accessible or requiring a subscription are identified. This will facilitate easier and faster access to pre-processed, public health-relevant evidence, with the intent of promoting evidence-informed decision making. Access to such resources addresses several barriers identified by public health decision makers to evidence-informed decision making, most importantly time, as well as lack of knowledge of resources that house public health-relevant evidence. PMID:20181270

  4. Are telehealth technologies for hypertension care and self-management effective or simply risky and costly?

    PubMed

    McKoy, June; Fitzner, Karen; Margetts, Miranda; Heckinger, Elizabeth; Specker, James; Roth, Laura; Izenberg, Maxwell; Siegel, Molly; McKinney, Shannon; Moss, Gail

    2015-06-01

    Hypertension is a prevalent chronic disease that requires ongoing management and self-care. The disease affects 31% of American adults and contributed to or caused the deaths of 348,000 Americans in 2008, fewer than 50% of whom effectively self-managed the disease. However, self-management is complex, with patients requiring ongoing support and easy access to care. Telehealth may help foster the knowledge and skills necessary for those with hypertension to engage in successful self-management. This paper considers the applicability, efficacy, associated risks, and cost-effectiveness of telehealth for individuals and populations with hypertension. Telehealth is a broad term, encompassing telemedicine and mobile health that is used for physician-patient interactions, diagnostics, care delivery, education, information sharing, monitoring, and reminders. Telemedicine may have considerable utility for people diagnosed with hypertension who have poor access or social barriers that constrain access, but potential risks exist. Telehealth technology is evolving rapidly, even in the absence of fully proven cost-effectiveness and efficacy. Considering the cost of inpatient and emergency department care for patients with hypertension, telehealth is a highly attractive alternative, but there are risks to consider. Incorporating telehealth, which is increasingly characterized by mobile health, can increase both the capacity of health care providers and the reach of patient support, clinical management, and self-care. Telehealth studies need improvement; long-term outcome data on cardiovascular events must be obtained, and robust risk analyses and economic studies are needed to prospectively evaluate the safety and cost savings for hypertension self-management.

  5. Cohesive ARMD Full UAS Integration Strategy

    NASA Technical Reports Server (NTRS)

    Hackenberg, Davis

    2017-01-01

    Introduction / Background; Current Landscape and Future Vision; UAS (Unmanned Aircraft System) Demand and Key Challenges; UAS Airspace Access Pillars and Enablers; Overarching UAS Community Strategy; Long Term Vision Considerations; Recommendations and Next Steps.

  6. Design considerations for a comprehensive regional energy information system. Working paper

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

    Naumann, J.D.; Knobloch, P.C.; Chervany, N.L.

    1974-07-01

    The Regional Energy Information System concerns itself with decision making on sub-state, state, and regional levels in emergencies, for tactical decisions, and long-range strategic policies by both government and industry. Effective access to energy information is critical, and REIS is designed to provide a standardized data base with design goals, constraints, parameters, and schedules. The REIS system is being developed now; many states, the FEA and other agencies are likewise developing energy information systems. Shareability of data must be sought, and both technical and procedural requirements for this are discussed and a plan for action is presented. (GRA)

  7. Radiation Test Challenges for Scaled Commerical Memories

    NASA Technical Reports Server (NTRS)

    LaBel, Kenneth A.; Ladbury, Ray L.; Cohn, Lewis M.; Oldham, Timothy

    2007-01-01

    As sub-100nm CMOS technologies gather interest, the radiation effects performance of these technologies provide a significant challenge. In this talk, we shall discuss the radiation testing challenges as related to commercial memory devices. The focus will be on complex test and failure modes emerging in state-of-the-art Flash non-volatile memories (NVMs) and synchronous dynamic random access memories (SDRAMs), which are volatile. Due to their very high bit density, these device types are highly desirable for use in the natural space environment. In this presentation, we shall discuss these devices with emphasis on considerations for test and qualification methods required.

  8. Ethical Considerations When Using Social Media for Research.

    PubMed

    Hammer, Marilyn J

    2017-07-01

    Because of its adaptation across age groups and populations, social media is being used as a venue for the conduction of research studies. The implications for use of social media to streamline data collection and analyses to understand epidemiologic effects of disease are intriguing. Public access to personalized Internet-based searches and conversations for patients with or at risk for cancer can potentially allow providers to target individuals for earlier interventions and improved outcomes. Although publicly posted, the use of personal information to solicit research participants, implement interventions, or abstract information for research studies raises questions regarding maintaining the ethical conduct of research.

  9. 36 CFR 1237.20 - What are special considerations in the maintenance of audiovisual records?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...-wide, clear captioning standards, procedures, and responsibilities. (e) Maintain current and accessible... records (e.g., for digital files, use file naming conventions), that clarify connections between related...

  10. Research Guidelines in the Era of Large-scale Collaborations: An Analysis of Genome-wide Association Study Consortia

    PubMed Central

    Austin, Melissa A.; Hair, Marilyn S.; Fullerton, Stephanie M.

    2012-01-01

    Scientific research has shifted from studies conducted by single investigators to the creation of large consortia. Genetic epidemiologists, for example, now collaborate extensively for genome-wide association studies (GWAS). The effect has been a stream of confirmed disease-gene associations. However, effects on human subjects oversight, data-sharing, publication and authorship practices, research organization and productivity, and intellectual property remain to be examined. The aim of this analysis was to identify all research consortia that had published the results of a GWAS analysis since 2005, characterize them, determine which have publicly accessible guidelines for research practices, and summarize the policies in these guidelines. A review of the National Human Genome Research Institute’s Catalog of Published Genome-Wide Association Studies identified 55 GWAS consortia as of April 1, 2011. These consortia were comprised of individual investigators, research centers, studies, or other consortia and studied 48 different diseases or traits. Only 14 (25%) were found to have publicly accessible research guidelines on consortia websites. The available guidelines provide information on organization, governance, and research protocols; half address institutional review board approval. Details of publication, authorship, data-sharing, and intellectual property vary considerably. Wider access to consortia guidelines is needed to establish appropriate research standards with broad applicability to emerging forms of large-scale collaboration. PMID:22491085

  11. Effect of prospective reimbursement on nursing home costs.

    PubMed Central

    Coburn, A F; Fortinsky, R; McGuire, C; McDonald, T P

    1993-01-01

    OBJECTIVE. This study evaluates the effect of Maine's Medicaid nursing home prospective payment system on nursing home costs and access to care for public patients. DATA SOURCES/STUDY SETTING. The implementation of a facility-specific prospective payment system for nursing homes provided the opportunity for longitudinal study of the effect of that system. Data sources included audited Medicaid nursing home cost reports, quality-of-care data from state facility survey and licensure files, and facility case-mix information from random, stratified samples of homes and residents. Data were obtained for six years (1979-1985) covering the three-year period before and after implementation of the prospective payment system. STUDY DESIGN. This study used a pre-post, longitudinal analytical design in which interrupted, time-series regression models were estimated to test the effects of prospective payment and other factors, e.g., facility characteristics, nursing home market factors, facility case mix, and quality of care, on nursing home costs. PRINCIPAL FINDINGS. Prospective payment contributed to an estimated $3.03 decrease in total variable costs in the third year from what would have been expected under the previous retrospective cost-based payment system. Responsiveness to payment system efficiency incentives declined over the study period, however, indicating a growing problem in achieving further cost reductions. Some evidence suggested that cost reductions might have reduced access for public patients. CONCLUSIONS. Study findings are consistent with the results of other studies that have demonstrated the effectiveness of prospective payment systems in restraining nursing home costs. Potential policy trade-offs among cost containment, access, and quality assurance deserve further consideration, particularly by researchers and policymakers designing the new generation of case mix-based and other nursing home payment systems. PMID:8463109

  12. Effect of prospective reimbursement on nursing home costs.

    PubMed

    Coburn, A F; Fortinsky, R; McGuire, C; McDonald, T P

    1993-04-01

    This study evaluates the effect of Maine's Medicaid nursing home prospective payment system on nursing home costs and access to care for public patients. The implementation of a facility-specific prospective payment system for nursing homes provided the opportunity for longitudinal study of the effect of that system. Data sources included audited Medicaid nursing home cost reports, quality-of-care data from state facility survey and licensure files, and facility case-mix information from random, stratified samples of homes and residents. Data were obtained for six years (1979-1985) covering the three-year period before and after implementation of the prospective payment system. This study used a pre-post, longitudinal analytical design in which interrupted, time-series regression models were estimated to test the effects of prospective payment and other factors, e.g., facility characteristics, nursing home market factors, facility case mix, and quality of care, on nursing home costs. Prospective payment contributed to an estimated $3.03 decrease in total variable costs in the third year from what would have been expected under the previous retrospective cost-based payment system. Responsiveness to payment system efficiency incentives declined over the study period, however, indicating a growing problem in achieving further cost reductions. Some evidence suggested that cost reductions might have reduced access for public patients. Study findings are consistent with the results of other studies that have demonstrated the effectiveness of prospective payment systems in restraining nursing home costs. Potential policy trade-offs among cost containment, access, and quality assurance deserve further consideration, particularly by researchers and policymakers designing the new generation of case mix-based and other nursing home payment systems.

  13. A Panel Analysis of the Strategic Association Between Information and Communication Technology and Public Health Delivery

    PubMed Central

    Wu, Sarah Jinhui

    2012-01-01

    Background In this exploratory research, we use panel data analysis to examine the correlation between Information and Communication Technology (ICTs) and public health delivery at the country level. Objective The goal of this exploratory research is to examine the strategic association over time between ICTs and country-level public health. Methods Using data from the World Development Indicators, we construct a panel data set of countries of five different income levels and look closely at the period from 2000 to 2008. The panel data analysis allows us to explore this dynamic relationship under the control for unobserved country-specific effects by using a fixed-effects estimation method. In particular,, we examine the association of five ICT factors with five public health indicators: adolescent fertility rate, child immunization coverage, tuberculosis case detected, life expectancy, and adult mortality rate. Results First, overall ICTs’ factors substantially improve a country’s public health delivery on the top of wealth effect. Second, among all the ICTs’ factors, accessibility is the only one that is associated with improvements in all aspects of public health delivery, while the contributions from the usage, quality, and applications are negligible. ICTs’ accessibility factor is associated with a considerable extension to life expectancy and reduced adult mortality rate. Third, all entity-specific factors are significant in each model, indicating that countries’ economic development level does influence their public health delivery. Conclusions Our results indicate that ICT accessibility has a strong association with effective delivery of public health. There are others, but the key strategic applications are eHealth and mHealth. The findings of this study will help government officials and public health policy makers to formulate strategic decisions regarding the best ICT investments and deployment. For example, the study shows that providing accessibility should be a critical focus. PMID:23089193

  14. Open-Access, Low-Magnetic-Field MRI System for Lung Research

    NASA Technical Reports Server (NTRS)

    Mair, Ross W.; Rosen, Matthew S.; Tsai, Leo L.; Walsworth, Ronald L.; Hrovat, Mirko I.; Patz, Samuel; Ruset, Iullian C.; Hersman, F. William

    2009-01-01

    An open-access magnetic resonance imaging (MRI) system is being developed for use in research on orientational/gravitational effects on lung physiology and function. The open-access geometry enables study of human subjects in diverse orientations. This system operates at a magnetic flux density, considerably smaller than the flux densities of typical other MRI systems, that can be generated by resistive electromagnet coils (instead of the more-expensive superconducting coils of the other systems). The human subject inhales air containing He-3 or Xe-129 atoms, the nuclear spins of which have been polarized by use of a laser beam to obtain a magnetic resonance that enables high-resolution gas space imaging at the low applied magnetic field. The system includes a bi-planar, constant-current, four-coil electromagnet assembly and associated electronic circuitry to apply a static magnetic field of 6.5 mT throughout the lung volume; planar coils and associated circuitry to apply a pulsed magnetic-field-gradient for each spatial dimension; a single, detachable radio-frequency coil and associated circuitry for inducing and detecting MRI signals; a table for supporting a horizontal subject; and electromagnetic shielding surrounding the electromagnet coils.

  15. Cyber-physical networking for wireless mesh infrastructures

    NASA Astrophysics Data System (ADS)

    Mannweiler, C.; Lottermann, C.; Klein, A.; Schneider, J.; Schotten, H. D.

    2012-09-01

    This paper presents a novel approach for cyber-physical network control. "Cyber-physical" refers to the inclusion of different parameters and information sources, ranging from physical sensors (e.g. energy, temperature, light) to conventional network information (bandwidth, delay, jitter, etc.) to logical data providers (inference systems, user profiles, spectrum usage databases). For a consistent processing, collected data is represented in a uniform way, analyzed, and provided to dedicated network management functions and network services, both internally and, through an according API, to third party services. Specifically, in this work, we outline the design of sophisticated energy management functionalities for a hybrid wireless mesh network (WLAN for both backhaul traffic and access, GSM for access only), disposing of autonomous energy supply, in this case solar power. Energy consumption is optimized under the presumption of fluctuating power availability and considerable storage constraints, thus influencing, among others, handover and routing decisions. Moreover, advanced situation-aware auto-configuration and self-adaptation mechanisms are introduced for an autonomous operation of the network. The overall objective is to deploy a robust wireless access and backbone infrastructure with minimal operational cost and effective, cyber-physical control mechanisms, especially dedicated for rural or developing regions.

  16. Assessing 15 proposals for promoting innovation and access to medicines globally.

    PubMed

    Hoffman, Steven J; So, Karen

    2014-01-01

    There is widespread recognition that the existing global systems for innovation and access to medicines need reform. Billions of people do not have access to the medicines they need, and market failures prevent new drugs from being developed for diseases that primarily affect the global poor. The World Health Organization's Consultative Expert Working Group on Research and Development: Financing and Coordination (CEWG) analyzed numerous proposals for reform. The aim of this article is to build on these previous inquiries. We conducted a structured analysis that grouped proposals into five broad opportunities for global policy reform to help researchers and decision makers to meaningfully evaluate each proposal in comparison with similar proposals. Proposals were also analyzed along three important dimensions-potential health impact, financial implications, and political feasibility-further facilitating the comparison and application of this information. Upon analysis, no one solution was deemed a panacea, as many (often competing) considerations need to be taken into account. However, some proposals, particularly product development partnership and prizes, appeared more promising and feasible at this time and deserve further attention. More research is needed into the effectiveness of these mechanisms and their transferability across jurisdictions. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  17. UNIX security in a supercomputing environment

    NASA Technical Reports Server (NTRS)

    Bishop, Matt

    1989-01-01

    The author critiques some security mechanisms in most versions of the Unix operating system and suggests more effective tools that either have working prototypes or have been implemented, for example in secure Unix systems. Although no computer (not even a secure one) is impenetrable, breaking into systems with these alternate mechanisms will cost more, require more skill, and be more easily detected than penetrations of systems without these mechanisms. The mechanisms described fall into four classes (with considerable overlap). User authentication at the local host affirms the identity of the person using the computer. The principle of least privilege dictates that properly authenticated users should have rights precisely sufficient to perform their tasks, and system administration functions should be compartmentalized; to this end, access control lists or capabilities should either replace or augment the default Unix protection system, and mandatory access controls implementing multilevel security models and integrity mechanisms should be available. Since most users access supercomputing environments using networks, the third class of mechanisms augments authentication (where feasible). As no security is perfect, the fourth class of mechanism logs events that may indicate possible security violations; this will allow the reconstruction of a successful penetration (if discovered), or possibly the detection of an attempted penetration.

  18. Theoretical Principles of Distance Education.

    ERIC Educational Resources Information Center

    Keegan, Desmond, Ed.

    This book contains the following papers examining the didactic, academic, analytic, philosophical, and technological underpinnings of distance education: "Introduction"; "Quality and Access in Distance Education: Theoretical Considerations" (D. Randy Garrison); "Theory of Transactional Distance" (Michael G. Moore);…

  19. About Maggie's Place.

    ERIC Educational Resources Information Center

    Emmens, Carol E.

    1982-01-01

    Describes "Maggie's Place," the library computer system of the Pikes Peak Library District, Colorado Springs, Colorado, noting its use as an electronic card catalog and community information file, accessibility by home users and library users, and terminal considerations. (EJS)

  20. 47 CFR 54.603 - Competitive bid requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... requester cannot obtain toll-free access to an Internet service provider; (iv) The requested service or... be sold, resold or transferred in consideration of money or any other thing of value; and (vi) If the...

  1. The mechanics of endoscope disinfection.

    PubMed

    Babb, J R; Bradley, C R

    1991-06-01

    The decontamination of flexible fibreoptic endoscopes has considerably improved in recent years. This is mainly due to the introduction of instruments with more accessible channels, the use of automated washer disinfectors and a greater awareness of the problems associated with disinfection. Unfortunately the most widely used and effective disinfectant is 2% glutaraldehyde and this is toxic, irritant and sensitizing. With the implementation of Control of Substances Hazardous to Health legislation, strict environmental controls are required to reduce skin contact and vapour inhalation. Alcohol is probably the most suitable alternative disinfectant at present but it is flammable and cannot be used in automated systems. Other agents are either insufficiently effective or corrosive. Autoclavable or heat tolerant rigid endoscopes are now available but flexible endoscopes will not tolerate heat disinfection temperatures.

  2. Identifying research needs for wheelchair transfers in the built environment.

    PubMed

    Crytzer, Theresa Marie; Cooper, Rory; Jerome, Genevieve; Koontz, Alicia

    2017-02-01

    The purpose of this study is to describe the results of focus groups held during the Independent Wheelchair Transfer (IWT) Workgroup. The aims were to facilitate exchange of ideas on (1) the impact of the built environment on the wheelchair transfer process within the community (i.e. moving from wheelchair to and from other surfaces (e.g. furniture, toilet seat, bath bench, car seat) to participate in daily activities), (2) wheelchair users' needs during transfers in the built environment, and (3) future research directions. Live web-based conferencing using Adobe Connect technology (Clarix Technologies, Inc., Pittsford, NY) was utilized to conduct three focus groups composed of experts in the field of assistive technology. Investigators independently reviewed focus group meeting transcripts and used qualitative methods to identify main themes. Thirty-one experts in assistive technology and related fields participated in focus groups. Nine main themes were found including the effect of transfer skills training, space considerations in the built environment, wheelchair configuration, and the interaction between the built environment, user preferences, and transfer techniques. All groups raised issues about the transfer process in areas of the built environment with limited access, the effect of wheelchair users' transfer techniques, and user preferences during transfers. The area of independent transfers is multi-faceted and several factors require consideration when contemplating environmental changes to improve accessibility for wheelchair users. Obvious opportunity exists for research which could lead to advances in transfer technology, environments, and techniques for wheelchair users. Implications for Rehabilitation Tremendous opportunities for research collaborations in the field of assistive technology: To develop new terminology to describe wheelchair transfers. To improve the design of the built environment for wheelchair users. To investigate wheelchair transfer training techniques.

  3. Tracheostomy: pediatric considerations.

    PubMed

    Deutsch, Ellen S

    2010-08-01

    Pediatric patients for whom tracheotomy is a consideration have different anatomy, medical conditions, and prognoses than adults; even the tracheotomy tubes are different. Indications for pediatric tracheotomy generally include bypassing airway obstruction, providing access for prolonged mechanical ventilation, and facilitating tracheobronchial toilet. Subglottic stenosis is an important indication for tracheotomy in children; its etiology, prevention, and alternative options for management are presented. Discussion includes the benefits, risks, impact on families, techniques for tracheotomy tube changes, and alternatives to tracheotomy, with illustrative photographs and diagrams.

  4. Transition to Office-based Obstetric and Gynecologic Procedures: Safety, Technical, and Financial Considerations.

    PubMed

    Peacock, Lisa M; Thomassee, May E; Williams, Valerie L; Young, Amy E

    2015-06-01

    Office-based surgery is increasingly desired by patients and providers due to ease of access, overall efficiency, reimbursement, and satisfaction. The adoption of office-based surgery requires careful consideration of safety, efficacy, cost, and feasibility within a providers practice. This article reviews the currently available data regarding patient and provider satisfaction as well as practical considerations of staffing, equipment, and supplies. To aid the practitioner, issues of office-based anesthesia and safety with references to currently available national guidelines and protocols are provided. Included is a brief review of billing, coding, and reimbursement. Technical procedural aspects with information and recommendations are summarized.

  5. [Day care and female employment in Mexico: descriptive evidence and policy considerations].

    PubMed

    Knaul, F; Parker, S

    1996-01-01

    "This paper analyzes the supply and organization of public day care in Mexico and presents a series of considerations as to the formulation of future policy. The research concentrates on the evolution of public policies to provide day care to working women in the formal sector through the Mexican Social Security Institute (IMSS). Data on the evolution of female labor force participation, changes in family structure, the supply of day care and patterns of child care arrangements, suggest that access to formal facilities falls short of demand.... Innovative policies for the reorganization and expansion of the provision of day care are presently under consideration." (EXCERPT)

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

    PubMed Central

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

    2017-01-01

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

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

    PubMed

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

    2017-01-01

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

  8. [Network Analyses in Regional Health Care Research: Example of Dermatological Care in the Metropolitan Region of Hamburg].

    PubMed

    Augustin, J; Austermann, J; Erasmi, S

    2016-10-18

    Background: One of the overall objectives of the legislator is to ensure an overall "homogeneous", and easily accessible medical care for the population. The physician-patient ratio can be used to describe the regional health care situation. But this method does not provide information concerning the availability of, for instance, the nearest doctor. Therefore, further parameters such as accessibility must be taken into consideration. For this purpose, network analyses are an appropriate method. The objective of this study is to present methodological tools to evaluate the healthcare situation in the metropolitan region of Hamburg, primarily focusing on accessibility using dermatologists as an example. Methods: Analyzing data of 20 counties, the geographical distribution of N=357 dermatologists and the physician-patient ratio were calculated. In a second step, a network analysis regarding accessibility was performed. In order to calculate accessibility, address data (physicians) were transformed into coordinates, consisting of defined places (N=303) and restrictions (e. g. speed, turn restrictions) of the network. The calculation of population-based accessibility is based on grid cells for the population density. Results: Despite adequacy of the overall medical situation, differences in the availability of the nearest dermatologists in the metropolitan region are remarkable, particularly when use of public transport is taken into consideration. In some counties, over 60% of the population require at least one hour to get to the nearest dermatologist using public transportation. In rural regions within the metropolitan area are particularly affected. Conclusion: The network analysis has shown that the choice and availability of transportation in combination with the location (rural/urban) is essential for health care access. Especially elderly people in rural areas with restricted mobility are at a disadvantage. Therefore, modern health care approaches (e. g. telemedicine) are necessary to optimize the health care situation in rural areas. Network analyses can make a valuable methodological contribution to the analysis of regional health care disparities. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Subjective Probabilities in Household Surveys

    PubMed Central

    Hurd, Michael D.

    2011-01-01

    Subjective probabilities are now collected on a number of large household surveys with the objective of providing data to better understand inter-temporal decision making. Comparison of subjective probabilities with actual outcomes shows that the probabilities have considerable predictive power in situations where individuals have considerable private information such as survival and retirement. In contrast the subjective probability of a stock market gain varies greatly across individuals even though no one has private information and the outcome is the same for everyone. An explanation is that there is considerable variation in accessing and processing information. Further, the subjective probability of a stock market gain is considerably lower than historical averages, providing an explanation for the relatively low frequency of stock holding. An important research objective will be to understand how individuals form their subjective probabilities. PMID:21643535

  10. Baby Doe and the Search for a Quality Life.

    ERIC Educational Resources Information Center

    Powell, T. Hennessy; Hecimovic, Anton

    1985-01-01

    The author reviews quality of life arguments proposed in Baby Doe cases involving severely handicapped infants and views quality of life in terms of six dimensions: educability, relationships, residence, access, technology, and medical considerations. (CL)

  11. Unlocking the Locker Room.

    ERIC Educational Resources Information Center

    St. Clair, Dean

    1996-01-01

    Discusses locker-room design standards and common challenges when complying with the Americans with Disabilities Act. Accessibility and safety considerations for shower, toilet, and locker areas are addressed, as are entrance vestibules, drying and grooming areas, and private dressing rooms. (GR)

  12. Locomotive crashworthiness research : locomotive crew egress evaluation

    DOT National Transportation Integrated Search

    2002-05-01

    The objectives of this study include the identification of aspects of locomotive design and operation related to crew egress or access by rescuers in accidents, with the goal of improving crew survivability. This work identifies the considerations an...

  13. Tracking Bicyclists' Route Choices, Case Study : The Ohio State University

    DOT National Transportation Integrated Search

    2017-08-01

    Bicycles have low access costs and moderate travel speeds, reduce congestion, help protect the environment and bring many health benefits (Clifton & Akar, 2009). Within these considerations, several researchers have explored the factors associated wi...

  14. Mobile health (mHealth) for mental health in Asia: objectives, strategies, and limitations.

    PubMed

    Brian, Rachel M; Ben-Zeev, Dror

    2014-08-01

    Mobile technologies are transforming the way in which we interact with one another, access resources, find information, and conduct business around the world. Harnessing the capabilities of mobile technologies to support health care initiatives worldwide has developed into a new interdisciplinary field called mobile health (mHealth). In the current paper, we review the penetration of mobile technology in Asia, and consider the integration of mobile technologies into the study, diagnoses, and treatment of mental disorders in the region. We outline how mHealth programs could improve mental health literacy, provide greater access to mental health services, extend community-based outreach and engagement, support self-management of illness, and regulate medication distribution. We end with a consideration of the potential barriers and limitations of mHealth for mental health, including funding, language and literacy barriers, power supply considerations, data security, and privacy issues. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Optical fiber cabling technologies for flexible access network

    NASA Astrophysics Data System (ADS)

    Tanji, Hisashi

    2008-07-01

    Fiber-to-the-home (FTTH) outside plant infrastructure should be so designed and constructed as to flexibly deal with increasing subscribers and system evolution to be expected in the future, taking minimization of total cost (CAPEX and OPEX) into consideration. With this in mind, fiber access architectures are reviewed and key technologies on optical fiber and cable for supporting flexible access network are presented. Low loss over wide wavelength (low water peak) and bend-insensitive single mode fiber is a future proof solution. Enhanced separable ribbon facilitates mid-span access to individual fibers in a cable installed, improving fiber utilizing efficiency and flexibility of distribution design. It also contributes to an excellent low PMD characteristic which could be required for video RF overlay system or high capacity long reach metro-access convergence network in the future. Bend-insensitive fiber based cabling technique including field installable connector greatly improves fiber/cable handling in installation and maintenance work.

  16. Supporting open access to clinical trial data for researchers: The Duke Clinical Research Institute-Bristol-Myers Squibb Supporting Open Access to Researchers Initiative.

    PubMed

    Pencina, Michael J; Louzao, Darcy M; McCourt, Brian J; Adams, Monique R; Tayyabkhan, Rehbar H; Ronco, Peter; Peterson, Eric D

    2016-02-01

    There are growing calls for sponsors to increase transparency by providing access to clinical trial data. In response, Bristol-Myers Squibb and the Duke Clinical Research Institute have collaborated on a new initiative, Supporting Open Access to Researchers. The aim is to facilitate open sharing of Bristol-Myers Squibb trial data with interested researchers. Key features of the Supporting Open Access to Researchers data sharing model include an independent review committee that ensures expert consideration of each proposal, stringent data deidentification/anonymization and protection of patient privacy, requirement of prespecified statistical analysis plans, and independent review of manuscripts before submission for publication. We believe that these approaches will promote open science by allowing investigators to verify trial results as well as to pursue interesting secondary uses of trial data without compromising scientific integrity. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Non anti-coagulant factors associated with filter life in continuous renal replacement therapy (CRRT): a systematic review and meta-analysis.

    PubMed

    Brain, Matthew; Winson, Elizabeth; Roodenburg, Owen; McNeil, John

    2017-02-20

    Optimising filter life and performance efficiency in continuous renal replacement therapy has been a focus of considerable recent research. Larger high quality studies have predominantly focussed on optimal anticoagulation however CRRT is complex and filter life is also affected by vascular access, circuit and management factors. We performed a systematic search of the literature to identify and quantify the effect of vascular access, circuit and patient factors that affect filter life and presented the results as a meta-analysis. A systematic review and meta-analysis was performed by searching Pubmed (MEDLINE) and Ovid EMBASE libraries from inception to 29 th February 2016 for all studies with a comparator or independent variable relating to CRRT circuits and reporting filter life. Included studies documented filter life in hours with a comparator other than anti-coagulation intervention. All studies comparing anticoagulation interventions were searched for regression or hazard models pertaining to other sources of variation in filter life. Eight hundred nineteen abstracts were identified of which 364 were selected for full text analysis. 24 presented data on patient modifiers of circuit life, 14 on vascular access modifiers and 34 on circuit related factors. Risk of bias was high and findings are hypothesis generating. Ranking of vascular access site by filter longevity favours: tunnelled semi-permanent catheters, femoral, internal jugular and subclavian last. There is inconsistency in the difference reported between femoral and jugular catheters. Amongst published literature, modality of CRRT consistently favoured continuous veno-venous haemodiafiltration (CVVHD-F) with an associated 44% lower failure rate compared to CVVH. There was a trend favouring higher blood flow rates. There is insufficient data to determine advantages of haemofilter membranes. Patient factors associated with a statistically significant worsening of filter life included mechanical ventilation, elevated SOFA or LOD score, elevations in ionized calcium, elevated platelet count, red cell transfusion, platelet factor 4 (PF-4) antibodies, and elevated fibrinogen. Majority of studies are observational or report circuit factors in sub-analysis. Risk of bias is high and findings require targeted investigations to confirm. The interaction of patient, pathology, anticoagulation, vascular access, circuit and staff factors contribute to CRRT filter life. There remains an ambiguity from published data as to which site and side should be the first choice for vascular access placement and what interaction this has with patient factors and timing. Early consideration of tunnelled semi-permanent access may provide optimal filter life if longer periods of CRRT are anticipated. There remains an absence of robust evidence outside of anti-coagulation strategies despite over 20 years of therapy delivery however trends favour CVVHD-F over CVVH.

  18. Health Access Livelihood Framework Reveals Potential Barriers in the Control of Schistosomiasis in the Dongting Lake Area of Hunan Province, China

    PubMed Central

    McManus, Donald P.; Raso, Giovanna; Utzinger, Jürg; Xiao, Shui-Yuan; Yu, Dong-Bao; Zhao, Zheng-Yuan; Li, Yue-Sheng

    2013-01-01

    Background Access to health care is a major requirement in improving health and fostering socioeconomic development. In the People's Republic of China (P.R. China), considerable changes have occurred in the social, economic, and health systems with a shift from a centrally planned to a socialist market economy. This brought about great benefits and new challenges, particularly for vertical disease control programs, including schistosomiasis. We explored systemic barriers in access to equitable and effective control of schistosomiasis. Methodology Between August 2002 and February 2003, 66 interviews with staff from anti-schistosomiasis control stations and six focus group discussions with health personnel were conducted in the Dongting Lake area, Hunan Province. Additionally, 79 patients with advanced schistosomiasis japonica were interviewed. The health access livelihood framework was utilized to examine availability, accessibility, affordability, adequacy, and acceptability of schistosomiasis-related health care. Principal Findings We found sufficient availability of infrastructure and human resources at most control stations. Many patients with advanced schistosomiasis resided in non-endemic or moderately endemic areas, however, with poor accessibility to disease-specific knowledge and specialized health services. Moreover, none of the patients interviewed had any form of health insurance, resulting in high out-of-pocket expenditure or unaffordable care. Reports on the adequacy and acceptability of care were mixed. Conclusions/Significance There is a need to strengthen health awareness and schistosomiasis surveillance in post-transmission control settings, as well as to reduce diagnostic and treatment costs. Further studies are needed to gain a multi-layered, in-depth understanding of remaining barriers, so that the ultimate goal of schistosomiasis elimination in P.R. China can be reached. PMID:23936580

  19. Prophylactic antibiotic therapy prior to dental treatment for patients with end-stage renal disease.

    PubMed

    Werner, C W; Saad, T F

    1999-01-01

    In the United States, there is a large and growing population of patients undergoing dialysis because of end-stage renal disease (ESRD). These patients present special management considerations for dentists, including antibiotic prophylaxis for the prevention of bacterial endocarditis (BE). ESRD patients, particularly those with an arteriovenous shunt for hemodialysis access, are predisposed to valvular endocarditis. Thus, BE prevention is the primary goal of antibiotic prophylaxis prior to dental or other invasive procedures in these patients. Bacteremia may predispose to infection of synthetic vascular access grafts, although this form of endovascular infection in ESRD patients has not been as well-characterized as BE. Antibiotic prophylaxis may be of some benefit for prevention of synthetic graft infections as well as BE. Poor dentist and physician compliance with BE prophylaxis regimens, as well as errors in dosing, timing, or duration of prophylaxis, have been reported. These problems are of particular concern in the treatment of chronically ill patients. In this article, we review the rationale for prophylactic antibiotic therapy prior to dental procedures in ESRD patients with vascular access. We also elaborate on the current American Heart Association guidelines for BE prophylaxis, and address special considerations for ESRD patients.

  20. A Framework for Integrating Biosimilars Into the Didactic Core Requirements of a Doctor of Pharmacy Curriculum.

    PubMed

    Li, Edward; Liu, Jennifer; Ramchandani, Monica

    2017-04-01

    Biologic drugs approved via the abbreviated United States biosimilar approval pathway are anticipated to improve access to medications by addressing increasing health care expenditures. Surveys of health care practitioners indicate that there is inadequate knowledge and understanding about biosimilars; this must be addressed to ensure safe and effective use of this new category of products. Concepts of biosimilar development, manufacturing, regulation, naming, formulary, and inventory considerations, as well as patient and provider education should be included within the doctor of pharmacy (PharmD) curriculum as preparation for clinical practice. Based on these considerations, we propose that PharmD graduates be required to have knowledge in the following domains regarding biologics and biosimilars: legal definition, development and regulation, state pharmacy practice laws, and pharmacy practice management. We link these general biosimilar concepts to the Accreditation Council for Pharmacy Education (ACPE) Standards 2016 and Center for the Advancement of Pharmacy Education (CAPE) Outcomes 2013, and provide example classroom learning objectives, in-class activities, and assessments to guide implementation.

  1. Methodological proceedings to evaluate the physical accessibility in urban historic sites.

    PubMed

    Ribeiro, Gabriela Sousa; Martins, Laura Bezerra; Monteiro, Circe Maria Gama

    2012-01-01

    Historic urban sites are set by cultural and social diversities, generating multiple activities and use and access to these sites should be available to all people including those with disabilities. Taking into consideration that using the same methodology that was used in different historic sites researches with positive results facilitates replication, we aimed to develop methodological procedures that identify conditions of physical accessibility in open public spaces and access to public buildings in historic urban sites to support proposals about design requirements for improvements to the problems diagnosed and control inadequacies of the physical environment. The study methods and techniques from different areas of knowledge culminated in a proposal built with an emphasis on user participation that could be applied with low cost and in relatively short period of time.

  2. Limited access atrial septal defect closure and the evolution of minimally invasive surgery.

    PubMed

    Izzat, M B; Yim, A P; El-Zufari, M H

    1998-04-01

    While minimizing the "invasiveness" in general surgery has been equated with minimizing "access", what constitutes minimally invasive intra-cardiac surgery remains controversial. Many surgeons doubt the benefits of minimizing access when the need for cardiopulmonary bypass cannot be waived. Recognizing that median sternotomy itself does entail significant morbidity, we investigated the value of alternative approaches to median sternotomy using atrial septal defect closure as our investigative model. We believe that some, but not all minimal access approaches are associated with reduced postoperative morbidity and enhanced recovery. Our current strategy is to use a mini-sternotomy approach in adult patients, whereas conventional median sternotomy remains our standard approach in the pediatric population. Considerable clinical experiences coupled with documented clinical benefits are fundamental before a certain approach is adopted in routine practice.

  3. Endurance Training and Cardiorespiratory Conditioning after Traumatic Brain Injury

    PubMed Central

    Mossberg, Kurt A.; Amonette, William E.; Masel, Brent E.

    2010-01-01

    Objective To examine the importance of cardiorespiratory conditioning after traumatic brain injury (TBI) and provide recommendations for patients recovering from TBI. Method Review of literature assessing the effectiveness of endurance training programs. Main outcomes and results A sedentary lifestyle and lack of endurance are common characteristics of individuals with TBI who have a reduction in peak aerobic capacity of 25-30% compared to healthy sedentary persons. Increased physical activity and exercise training improves cardiorespiratory fitness in many populations with physical and cognitive impairments. Therefore, increasing the endurance and cardiorespiratory fitness of persons with TBI would seem to have important health implications. However, review of the TBI literature reveals that there have been few well-designed, well-controlled studies of physiologic and psychological adaptations of fitness training. Also lacking are long-term follow-up studies of persons with TBI. Conclusions Assessing endurance capacity and cardiorespiratory fitness early in the TBI rehabilitation process merits consideration as a standard of care by professional rehabilitation societies. Also, providing effective, safe and accessible training modalities would seem to be an important consideration for persons with TBI, given the mobility impairments many possess. Long-term follow-up studies are needed to assess the effectiveness of cardiorespiratory training programs on overall morbidity and mortality. PMID:20473091

  4. Traditional and market food access in Arctic Canada is affected by economic factors.

    PubMed

    Lambden, Jill; Receveur, Olivier; Marshall, Joan; Kuhnlein, Harriet V

    2006-09-01

    This study aimed to evaluate the access that Indigenous women have to traditional and market foods in 44 communities across Arctic Canada. This secondary data analysis used a cross-sectional survey of 1771 Yukon First Nations, Dene/Métis and Inuit women stratified by age. Socio-cultural questionnaires were used to investigate food access and chi-square testing was used to ascertain the distribution of subject responses by age and region. There was considerable regional variation in the ability to afford adequate food, with between 40% and 70% saying they could afford enough food. Similarly, regional variation was reflected in the percentage of the population who could afford, or had access to, hunting or fishing equipment. Up to 50% of the responses indicated inadequate access to fishing and hunting equipment, and up to 46% of participants said they could not afford to go hunting or fishing. Affordability of market food and accessibility to hunting and fishing in Arctic Canada were major barriers to Indigenous women's food security.

  5. Pharmaceutical market access in emerging markets: concepts, components, and future.

    PubMed

    Kumar, Anuj; Juluru, Karthaveerya; Thimmaraju, Phani Kishore; Reddy, Jayachandra; Patil, Anand

    2014-01-01

    This article intends to consolidate the concepts of pharmaceutical market access and highlight its growing importance in emerging markets. Market access has gained considerable attention worldwide as countries try to contain their escalating healthcare expenditures amidst the global economic slowdown. This has resulted in governments adopting stricter measures for new product approval. Thus, pharmaceutical companies are finding it increasingly difficult to successfully address the specific challenges posed by various government and regulatory agencies and stakeholders. There is an increasing need to establish market access functions, especially in emerging markets, where the complex, dynamic healthcare landscape confounds product approval and uptake. Moreover, emerging markets are the engines of growth today, and, thus, performing in these markets is critical for the majority of pharmaceutical companies. To address the challenges posed by regulatory agencies and diverse stakeholders, a customized market access strategy is the need of the hour. A market access framework with specific tools and tactics will help companies to plan, implement, and monitor stakeholder engagement activities.

  6. [The global and national context regarding the challenges involved in ensuring adequate access to water for human consumption].

    PubMed

    Augusto, Lia Giraldo da Silva; Gurgel, Idê Gomes Dantas; Câmara Neto, Henrique Fernandes; de Melo, Carlos Henrique; Costa, André Monteiro

    2012-06-01

    The scope of this article is to analyze the challenges involved in ensuring access to water for human consumption taking the international and national context into consideration. Based on the UN declaration that access to safe and clean drinking water is a fundamental human right, vulnerabilities are identified that can consist in restrictions to access to adequate supplies. The distribution of water and the population across the planet, pollution, inadequate policies and management lead to environmental injustice. The iniquity of access to water constitutes the contemporary water crisis. From the 1980s onwards, the transnational water market emerged for private control that occurs at three main levels: surface and underground water sources; bottled water; and public water supply services. The conflicts of the multiple uses of water resources, the market and environmental problems have contributed to rendering the health of the population and ecosystems vulnerable. Adequate public policies are essential to ensure the basic human right to access to safe and clean drinking water.

  7. Agricultural technologies and carbon emissions: evidence from Jordanian economy.

    PubMed

    Ismael, Mohanad; Srouji, Fathi; Boutabba, Mohamed Amine

    2018-04-01

    Theoretically, agriculture can be the victim and the cause of climate change. Using annual data for the period of 1970-2014, this study examines the interaction between agriculture technology factors and the environment in terms of carbon emissions in Jordan. The results provide evidence for unidirectional causality running from machinery, subsidies, and other transfers, rural access to an improved water source and fertilizers to carbon emissions. The results also reveal the existence of bidirectional causality between the real income and carbon emissions. The variance error decompositions highlight the importance of subsidies and machinery in explaining carbon emissions. They also show that fertilizers, the crop and livestock production, the land under cereal production, the water access, the agricultural value added, and the real income have an increasing effect on carbon emissions over the forecast period. These results are important so that policy-makers can build up strategies and take in considerations the indicators in order to reduce carbon emissions in Jordan.

  8. An improved AVC strategy applied in distributed wind power system

    NASA Astrophysics Data System (ADS)

    Zhao, Y. N.; Liu, Q. H.; Song, S. Y.; Mao, W.

    2016-08-01

    Traditional AVC strategy is mainly used in wind farm and only concerns about grid connection point, which is not suitable for distributed wind power system. Therefore, this paper comes up with an improved AVC strategy applied in distributed wind power system. The strategy takes all nodes of distribution network into consideration and chooses the node having the most serious voltage deviation as control point to calculate the reactive power reference. In addition, distribution principles can be divided into two conditions: when wind generators access to network on single node, the reactive power reference is distributed according to reactive power capacity; when wind generators access to network on multi-node, the reference is distributed according to sensitivity. Simulation results show the correctness and reliability of the strategy. Compared with traditional control strategy, the strategy described in this paper can make full use of generators reactive power output ability according to the distribution network voltage condition and improve the distribution network voltage level effectively.

  9. Considerations for a design and operations knowledge support system for Space Station Freedom

    NASA Technical Reports Server (NTRS)

    Erickson, Jon D.; Crouse, Kenneth H.; Wechsler, Donald B.; Flaherty, Douglas R.

    1989-01-01

    Engineering and operations of modern engineered systems depend critically upon detailed design and operations knowledge that is accurate and authoritative. A design and operations knowledge support system (DOKSS) is a modern computer-based information system providing knowledge about the creation, evolution, and growth of an engineered system. The purpose of a DOKSS is to provide convenient and effective access to this multifaceted information. The complexity of Space Station Freedom's (SSF's) systems, elements, interfaces, and organizations makes convenient access to design knowledge especially important, when compared to simpler systems. The life cycle length, being 30 or more years, adds a new dimension to space operations, maintenance, and evolution. Provided here is a review and discussion of design knowledge support systems to be delivered and operated as a critical part of the engineered system. A concept of a DOKSS for Space Station Freedom (SSF) is presented. This is followed by a detailed discussion of a DOKSS for the Lyndon B. Johnson Space Center and Work Package-2 portions of SSF.

  10. Financing the response to AIDS: some fiscal and macroeconomic considerations.

    PubMed

    Haacker, Markus

    2008-07-01

    This article examines the international response to AIDS from a fiscal perspective: first the financing of the international response to AIDS, especially the role of external financing, and second, a more comprehensive perspective on the costs of the national response to AIDS relevant for fiscal policy. The second half of the article focuses on the effectiveness of the response to AIDS. We find that there is little basis for concerns about macroeconomic constraints to scaling up, in light of the moderate scale of AIDS-related aid flows relative to overall aid. Regarding sectoral constraints, the picture is more differentiated. Many countries with high prevalence rates have also achieved high rates of access to treatment, but most of these are middle-income countries. Our econometric analysis credits external aid as a key factor that has enabled higher-prevalence countries to cope with the additional demands for health services. At the same time, gross domestic product per capita and health sector capacities are important determinants of access to treatment.

  11. 9. THIRD IMAGE OF THE PANORAMIC SERIES WITH CONSIDERABLE OVERLAP. ...

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

    9. THIRD IMAGE OF THE PANORAMIC SERIES WITH CONSIDERABLE OVERLAP. A SETTLING TANK, SMOKESTACK FROM THE MILL'S BOILER ROOM, MILL ANNEX AND OTHER MILL OUT BUILDINGS ARE IN THE MIDDLE RIGHT OF THE IMAGE THE SUPERINTENDENTS HOUSE IS IN THE MIDDLE LEFT OF THE IMAGE SPANNING FROM LEFT TO RIGHT IN THE BACKGROUND IS THE TOWN OF BODIE. IN THE FAR BACKGROUND LEFT IS THE ROAD THAT IS THE ACCESS PARK. - Standard Gold Mill, East of Bodie Creek, Northeast of Bodie, Bodie, Mono County, CA

  12. 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.

  13. [Why hospitalize stroke patients in a specialized unit?].

    PubMed

    Jaillard, A; Hommel, M

    1999-01-30

    A PUBLIC HEALTH CHALLENGE: Cerebral vascular events are the third most frequent cause of death in the adult population and the number one cause of disabilities, a public health challenge both in terms of health care service and health care expenditures. Structured health care facilities, particularly specialized hospital units, can lower mortality, limit residual disability and reduce the need for long-term institutionalization. Specialized research and teaching units are paradigmatic of the impact of health care organization. The limited number of such specialized units in France raises important ethical considerations about effective access to health care. Functioning units could be a useful criteria for auditing quality of hospital facilities.

  14. Nano-technology contributions towards the development of high performance radioisotope generators: The future promise to meet the continuing clinical demand.

    PubMed

    Sakr, Tamer M; Nawar, Mohamed F; Fasih, T W; El-Bayoumy, S; Abd El-Rehim, H A

    2017-11-01

    Nanostructured materials attracted considerable attention because of its high surface area to volume ratio resulting from their nano-scale dimensions. This class of sorbents is expected to have a potential impact on enhancement the efficacy of radioisotope generators for diagnostic and therapeutic applications in nuclear medicine. This review provides a summary on the importance of nanostructured materials as effective sorbents for the development of clinical-scale radioisotope generators and outlining the assessment of recent developments, key challenges and promising access to the near future. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Anesthetic Considerations in Robotic-Assisted Gynecologic Surgery

    PubMed Central

    Kaye, Alan D.; Vadivelu, Nalini; Ahuja, Nitin; Mitra, Sukanya; Silasi, Dan; Urman, Richard D.

    2013-01-01

    Background Robotic-assisted surgery has evolved over the past 2 decades with constantly improving technology that assists surgeons in multiple subspecialty disciplines. The surgical requirements of lithotomy and steep Trendelenburg positions, along with the creation of a pneumoperitoneum and lack of direct access to the patient all present management challenges in gynecologic surgery. Patient positioning requirements can have significant physiologic effects and can result in many complications. Methods This review focuses on the anesthetic and surgical implications of robot-assisted technology in gynecologic surgery. Conclusion Good communication among team members and knowledge of the nuances of robotic surgery have the potential to improve patient outcomes, increase efficiency, and reduce complications. PMID:24358000

  16. Improving access to psychological therapies in voice disorders: a cognitive behavioural therapy model.

    PubMed

    Miller, Tracy; Deary, Vincent; Patterson, Jo

    2014-06-01

    The improving access to psychological therapies initiative has highlighted the importance of managing mental health problems effectively, and research has shown excellent outcomes from cognitive behavioural therapy (CBT) interventions. Patients presenting with functional dysphonia will often also describe psychological distress including anxiety, depression and reduced general well-being, and it is felt that effective voice therapy needs to include the management of psychological well-being. The evidence for the use of CBT enhanced voice therapy is limited to date. Recent research has only started to identify the benefits of this approach and questions regarding how to achieve and maintain competence are essential. Voice therapy outcomes are positive and patients receiving CBT with voice therapy have shown more improvement in their general well-being and distress. CBT is a very well evidenced therapy and recommended by The National Institute for Health and Care Excellence (NICE) as the treatment of choice for mental health difficulties and medically unexplained symptoms. Allied health professionals are increasingly being trained to use CBT skills in the management of a number of symptoms/illnesses, and this should be considered for the management of functional dysphonia. However, there is a need for more research and detailed consideration of how therapists should be trained and supervised and how cost-effective this approach may be.

  17. Multiple Phase Transitions in the Culture Dissemination

    NASA Astrophysics Data System (ADS)

    Wang, Bing; Han, Yuexing; Chen, Luonan; Aihara, Kazuyuki

    We study the coevolution process in the Axelrod’s model with the consideration of agents’ abilities to access to the information. With a parameter to control the ability of communication, we observe two kinds of phase transitions both for cultural domains and network fragments, respectively. With the simulation results, we find the relationship between the critical value and the controlled parameter. The results indicate that the powerful ability to access to the information benefits the dissemination of culture in the system.

  18. Conflict, health care and professional perseverance: a qualitative study in the West Bank.

    PubMed

    Sousa, Cindy; Hagopian, Amy

    2011-01-01

    The past three decades have been a time of considerable global conflict, affecting over 50 countries and causing substantial impacts on civilian health. While many effects are direct results of violence, conflict also impinges on health through indirect means. The restricted mobility of health care staff and patients, targeting of health care workers, and stressful working conditions disrupt the ability of health care workers in conflict zones to function effectively. This paper explores the challenges experienced by health care workers in West Bank, Palestine, as well as their strategies of persistence. Research activities included participant observation and interviews with health care providers, which were then analysed for common themes. Results demonstrated that the Israeli military occupation of the West Bank considerably impacts civilians' access to both urgent and preventive care. While attempting to deliver care, providers encountered disruptions, harassment and violence, which interrupted care and contributed to job stress. Professional perseverance was evident, but its influence was limited by enduring constraints. This study thus underscores the importance of accountability to international law regarding the rights of civilians to health care in conflict zones. Health professionals may play a particular role in advocating for just and dignified resolutions to conflicts.

  19. Simulator platform motion -- the need revisited

    DOT National Transportation Integrated Search

    1997-05-13

    The need to provide increased access to flight simulator training for U.S. regional airlines, which historically have been limited by cost considerations in the use of such equipment for pilot recurrent training, is discussed. In light of that need, ...

  20. Integrated deployment architecture for predictive real-time traffic routing incorporating human factors considerations.

    DOT National Transportation Integrated Search

    2014-05-01

    As Advanced Traveler Information Systems (ATIS) are being more widely accessed by drivers, understanding drivers behavioral responses to real-time travel information through ATIS and its consequential benefits are important to the widespread deplo...

  1. Domestic and International Best Practice Case Studies

    DOT National Transportation Integrated Search

    2001-02-01

    Air transportation plays a vital role in the Texas economy. Air passenger/cargo traffic is projected to continue to increase considerably at many of the state's large airports. Ground access to airports is an important function that must be provided ...

  2. Resources and Capabilities of the Department of Veterans Affairs to Provide Timely and Accessible Care to Veterans

    PubMed Central

    Hussey, Peter S.; Ringel, Jeanne S.; Ahluwalia, Sangeeta; Price, Rebecca Anhang; Buttorff, Christine; Concannon, Thomas W.; Lovejoy, Susan L.; Martsolf, Grant R.; Rudin, Robert S.; Schultz, Dana; Sloss, Elizabeth M.; Watkins, Katherine E.; Waxman, Daniel; Bauman, Melissa; Briscombe, Brian; Broyles, James R.; Burns, Rachel M.; Chen, Emily K.; DeSantis, Amy Soo Jin; Ecola, Liisa; Fischer, Shira H.; Friedberg, Mark W.; Gidengil, Courtney A.; Ginsburg, Paul B.; Gulden, Timothy; Gutierrez, Carlos Ignacio; Hirshman, Samuel; Huang, Christina Y.; Kandrack, Ryan; Kress, Amii; Leuschner, Kristin J.; MacCarthy, Sarah; Maksabedian, Ervant J.; Mann, Sean; Matthews, Luke Joseph; May, Linnea Warren; Mishra, Nishtha; Miyashiro, Lisa; Muchow, Ashley N.; Nelson, Jason; Naranjo, Diana; O'Hanlon, Claire E.; Pillemer, Francesca; Predmore, Zachary; Ross, Rachel; Ruder, Teague; Rutter, Carolyn M.; Uscher-Pines, Lori; Vaiana, Mary E.; Vesely, Joseph V.; Hosek, Susan D.; Farmer, Carrie M.

    2016-01-01

    Abstract The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the Department of Veterans Affairs (VA) current and projected health care capabilities and resources. An examination of data from a variety of sources, along with a survey of VA medical facility leaders, revealed the breadth and depth of VA resources and capabilities: fiscal resources, workforce and human resources, physical infrastructure, interorganizational relationships, and information resources. The assessment identified barriers to the effective use of these resources and capabilities. Analysis of data on access to VA care and the quality of that care showed that almost all veterans live within 40 miles of a VA health facility, but fewer have access to VA specialty care. Veterans usually receive care within 14 days of their desired appointment date, but wait times vary considerably across VA facilities. VA has long played a national leadership role in measuring the quality of health care. The assessment showed that VA health care quality was as good or better on most measures compared with other health systems, but quality performance lagged at some VA facilities. VA will require more resources and capabilities to meet a projected increase in veterans' demand for VA care over the next five years. Options for increasing capacity include accelerated hiring, full nurse practice authority, and expanded use of telehealth. PMID:28083424

  3. Achieving household nutrition security in societies in transition: an overview.

    PubMed

    Gopalan, C

    2001-01-01

    The achievement of nutrition security at the household level involves adequacy of food supply at the national level and equitable distribution of food among the population in accordance with their physiological needs. The emergence of globalization and market liberalization and the increasing power of some transnational corporations that are advocating pharmaceutical shortcuts have raised concerns in many developing countries. In order to achieve adequacy of food production, earlier mistakes (such as a reliance on unsustainable new technologies) need to be corrected and the resultant imbalances with respect to food production need to be reversed. Emerging new technologies, including genetic modifications, need to be effectively harnessed and adapted with due consideration to safety and sustainability. There is a need to collect convincing evidence of the efficacy and safety of genetically modified foods before they can gain general public acceptance. Information technology will play an important role in future programmes of food production and developing countries must strive to achieve access to this technology. There is considerable scope and need for the expansion of agro-based industries in villages and townships. This could create job opportunities and could also lead to better production and more effective utilization of local food resources by the community and reduce the present considerable loss of perishable food items. Household nutrition security means more than avoidance of chronic starvation. Policy makers of developing countries should set, as their target in the next century, the achievement of adequate nutrition rather than mere survival.

  4. Ten Steps to Establishing an e-Consultation Service to Improve Access to Specialist Care

    PubMed Central

    Maranger, Julie; Afkham, Amir; Keely, Erin

    2013-01-01

    Abstract There is dissatisfaction among primary care physicians, specialists, and patients with respect to the consultation process. Excessive wait times for receiving specialist services and inefficient communication between practitioners result in decreased access to care and jeopardize patient safety. We created and implemented an electronic consultation (e-consultation) system in Eastern Ontario to address these problems and improve the consultation process. The e-consultation system has passed through the proof-of-concept and pilot study stages and has effectively reduced unnecessary referrals while receiving resoundingly positive feedback from physician-users. Using our experience, we have outlined the 10 steps to developing an e-consultation service. We detail the technical, administrative, and strategic considerations with respect to (1) identifying your partners, (2) choosing your platform, (3) starting as a pilot project, (4) designing your product, (5) ensuring patient privacy, (6) thinking through the process, (7) fostering relationships with your participants, (8) being prepared to provide physician payment, (9) providing feedback, and (10) planning the transition from pilot to permanency. In following these 10 steps, we believe that the e-consultation system and its associated improvements on the consultation process can be effectively implemented in other healthcare settings. PMID:24073898

  5. Game Theory Based Security in Wireless Body Area Network with Stackelberg Security Equilibrium.

    PubMed

    Somasundaram, M; Sivakumar, R

    2015-01-01

    Wireless Body Area Network (WBAN) is effectively used in healthcare to increase the value of the patient's life and also the value of healthcare services. The biosensor based approach in medical care system makes it difficult to respond to the patients with minimal response time. The medical care unit does not deploy the accessing of ubiquitous broadband connections full time and hence the level of security will not be high always. The security issue also arises in monitoring the user body function records. Most of the systems on the Wireless Body Area Network are not effective in facing the security deployment issues. To access the patient's information with higher security on WBAN, Game Theory with Stackelberg Security Equilibrium (GTSSE) is proposed in this paper. GTSSE mechanism takes all the players into account. The patients are monitored by placing the power position authority initially. The position authority in GTSSE is the organizer and all the other players react to the organizer decision. Based on our proposed approach, experiment has been conducted on factors such as security ratio based on patient's health information, system flexibility level, energy consumption rate, and information loss rate. Stackelberg Security considerably improves the strength of solution with higher security.

  6. Testosterone and reproductive effort in male primates

    PubMed Central

    Muller, Martin N.

    2016-01-01

    Considerable evidence suggests that the steroid hormone testosterone mediates major life-history trade-offs in vertebrates, promoting mating effort at the expense of parenting effort or survival. Observations from a range of wild primates support the “Challenge Hypothesis,” which posits that variation in male testosterone is more closely associated with aggressive mating competition than with reproductive physiology. In both seasonally and non-seasonally breeding species, males increase testosterone production primarily when competing for fecund females. In species where males compete to maintain long-term access to females, testosterone increases when males are threatened with losing access to females, rather than during mating periods. And when male status is linked to mating success, and dependent on aggression, high-ranking males normally maintain higher testosterone levels than subordinates, particularly when dominance hierarchies are unstable. Trade-offs between parenting effort and mating effort appear to be weak in most primates, because direct investment in the form of infant transport and provisioning is rare. Instead, infant protection is the primary form of paternal investment in the order. Testosterone does not inhibit this form of investment, which relies on male aggression. Testosterone has a wide range of effects in primates that plausibly function to support male competitive behavior. These include psychological effects related to dominance striving, analgesic effects, and effects on the development and maintenance of the armaments and adornments that males employ in mating competition. PMID:27616559

  7. Understanding decimal proportions: discrete representations, parallel access, and privileged processing of zero.

    PubMed

    Varma, Sashank; Karl, Stacy R

    2013-05-01

    Much of the research on mathematical cognition has focused on the numbers 1, 2, 3, 4, 5, 6, 7, 8, and 9, with considerably less attention paid to more abstract number classes. The current research investigated how people understand decimal proportions--rational numbers between 0 and 1 expressed in the place-value symbol system. The results demonstrate that proportions are represented as discrete structures and processed in parallel. There was a semantic interference effect: When understanding a proportion expression (e.g., "0.29"), both the correct proportion referent (e.g., 0.29) and the incorrect natural number referent (e.g., 29) corresponding to the visually similar natural number expression (e.g., "29") are accessed in parallel, and when these referents lead to conflicting judgments, performance slows. There was also a syntactic interference effect, generalizing the unit-decade compatibility effect for natural numbers: When comparing two proportions, their tenths and hundredths components are processed in parallel, and when the different components lead to conflicting judgments, performance slows. The results also reveal that zero decimals--proportions ending in zero--serve multiple cognitive functions, including eliminating semantic interference and speeding processing. The current research also extends the distance, semantic congruence, and SNARC effects from natural numbers to decimal proportions. These findings inform how people understand the place-value symbol system, and the mental implementation of mathematical symbol systems more generally. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Using local chromatin structure to improve CRISPR/Cas9 efficiency in zebrafish.

    PubMed

    Chen, Yunru; Zeng, Shiyang; Hu, Ruikun; Wang, Xiangxiu; Huang, Weilai; Liu, Jiangfang; Wang, Luying; Liu, Guifen; Cao, Ying; Zhang, Yong

    2017-01-01

    Although the CRISPR/Cas9 has been successfully applied in zebrafish, considerable variations in efficiency have been observed for different gRNAs. The workload and cost of zebrafish mutant screening is largely dependent on the mutation rate of injected embryos; therefore, selecting more effective gRNAs is especially important for zebrafish mutant construction. Besides the sequence features, local chromatin structures may have effects on CRISPR/Cas9 efficiency, which remain largely unexplored. In the only related study in zebrafish, nucleosome organization was not found to have an effect on CRISPR/Cas9 efficiency, which is inconsistent with recent studies in vitro and in mammalian cell lines. To understand the effects of local chromatin structure on CRISPR/Cas9 efficiency in zebrafish, we first determined that CRISPR/Cas9 introduced genome editing mainly before the dome stage. Based on this observation, we reanalyzed our published nucleosome organization profiles and generated chromatin accessibility profiles in the 256-cell and dome stages using ATAC-seq technology. Our study demonstrated that chromatin accessibility showed positive correlation with CRISPR/Cas9 efficiency, but we did not observe a clear correlation between nucleosome organization and CRISPR/Cas9 efficiency. We constructed an online database for zebrafish gRNA selection based on local chromatin structure features that could prove beneficial to zebrafish homozygous mutant construction via CRISPR/Cas9.

  9. Genotype Modulates Age-Related Alterations in Sensitivity to the Aversive Effects of Ethanol: An 8 Inbred Strain Analysis of Conditioned Taste Aversion

    PubMed Central

    Moore, Eileen M.; Forrest, Robert D.; Boehm, Stephen L.

    2012-01-01

    Adolescent individuals display altered behavioral sensitivity to ethanol, which may contribute to the increased ethanol consumption seen in this age-group. However, genetics also exert considerable influence on both ethanol intake and sensitivity. Thus far there is little research assessing the combined influence of developmental and genetic alcohol sensitivities. Sensitivity to the aversive effects of ethanol using a conditioned taste aversion (CTA) procedure was measured during both adolescence (P30) and adulthood (P75) in 8 inbred mouse strains (C57BL/6J, DBA/2J, 129S1/SvImJ, A/J, BALB/cByJ, BTBR T+tf/J, C3H/HeJ, and FVB/NJ). Adolescent and adult mice were water deprived, and subsequently provided with access to 0.9% (v/v) NaCl solution for 1h. Immediately following access mice were administered ethanol (0, 1.5, 2.25, 3g/kg, ip). This procedure was repeated in 72h intervals for a total of 5 CTA trials. Sensitivity to the aversive effects of ethanol was highly dependent upon both strain and age. Within an inbred strain, adolescent animals were consistently less sensitive to the aversive effects of ethanol than their adult counterparts. However, the dose of ethanol required to produce an aversion response differed as a function of both age and strain. PMID:23171343

  10. Testosterone and reproductive effort in male primates.

    PubMed

    Muller, Martin N

    2017-05-01

    Considerable evidence suggests that the steroid hormone testosterone mediates major life-history trade-offs in vertebrates, promoting mating effort at the expense of parenting effort or survival. Observations from a range of wild primates support the "Challenge Hypothesis," which posits that variation in male testosterone is more closely associated with aggressive mating competition than with reproductive physiology. In both seasonally and non-seasonally breeding species, males increase testosterone production primarily when competing for fecund females. In species where males compete to maintain long-term access to females, testosterone increases when males are threatened with losing access to females, rather than during mating periods. And when male status is linked to mating success, and dependent on aggression, high-ranking males normally maintain higher testosterone levels than subordinates, particularly when dominance hierarchies are unstable. Trade-offs between parenting effort and mating effort appear to be weak in most primates, because direct investment in the form of infant transport and provisioning is rare. Instead, infant protection is the primary form of paternal investment in the order. Testosterone does not inhibit this form of investment, which relies on male aggression. Testosterone has a wide range of effects in primates that plausibly function to support male competitive behavior. These include psychological effects related to dominance striving, analgesic effects, and effects on the development and maintenance of the armaments and adornments that males employ in mating competition. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Treating childhood pneumonia in hard-to-reach areas: a model-based comparison of mobile clinics and community-based care.

    PubMed

    Pitt, Catherine; Roberts, Bayard; Checchi, Francesco

    2012-01-10

    Where hard-to-access populations (such as those living in insecure areas) lack access to basic health services, relief agencies, donors, and ministries of health face a dilemma in selecting the most effective intervention strategy. This paper uses a decision mathematical model to estimate the relative effectiveness of two alternative strategies, mobile clinics and fixed community-based health services, for antibiotic treatment of childhood pneumonia, the world's leading cause of child mortality. A "Markov cycle tree" cohort model was developed in Excel with Visual Basic to compare the number of deaths from pneumonia in children aged 1 to 59 months expected under three scenarios: 1) No curative services available, 2) Curative services provided by a highly-skilled but intermittent mobile clinic, and 3) Curative services provided by a low-skilled community health post. Parameter values were informed by literature and expert interviews. Probabilistic sensitivity analyses were conducted for several plausible scenarios. We estimated median pneumonia-specific under-5 mortality rates of 0.51 (95% credible interval: 0.49 to 0.541) deaths per 10,000 child-days without treatment, 0.45 (95% CI: 0.43 to 0.48) with weekly mobile clinics, and 0.31 (95% CI: 0.29 to 0.32) with CHWs in fixed health posts. Sensitivity analyses found the fixed strategy superior, except when mobile clinics visited communities daily, where rates of care-seeking were substantially higher at mobile clinics than fixed posts, or where several variables simultaneously differed substantially from our baseline assumptions. Current evidence does not support the hypothesis that mobile clinics are more effective than CHWs. A CHW strategy therefore warrants consideration in high-mortality, hard-to-access areas. Uncertainty remains, and parameter values may vary across contexts, but the model allows preliminary findings to be updated as new or context-specific evidence becomes available. Decision analytic modelling can guide needed field-based research efforts in hard-to-access areas and offer evidence-based insights for decision-makers.

  12. Role of Polyamines in Parasite Cell Architecture and Function.

    PubMed

    Vannier-Santos, Marcos A; Suarez-Fontes, Ana M

    2017-01-01

    In the absence of accessible, effective vaccines, the fight against parasitic disease relies mostly on chemotherapy. Nevertheless, the considerable side effects, high costs and growing number of refractory cases comprise substantial drawbacks. Thus, the search for new antiparasitic compounds remains a high priority. The polyamine biosynthesis, conversion and transport pathways offer different targets for selective chemotherapy. Polyamine analogues and other antagonists may provide tools in the search for new lead compounds. Light and electron microscopy techniques may encompass valuable approaches to elucidate the possible mechanisms of action of different antiparasitic compounds, allowing the identification of subcellular target compartments, presumably establishing the basis for a more rational drug design and/or planning of therapeutic strategies. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  13. An Evaluation of the Impacts of Changing Firearms Legislation on Australian Female Firearm Homicide Victimization Rates.

    PubMed

    McPhedran, Samara

    2018-05-01

    Reducing lethal violence against women requires comprehensive measures addressing individual, social, economic, cultural, and situational factors. Regarding situational factors, access to weapons-and firearm access in particular-has received notable research attention. However, most study comes from the United States of America, and findings may not apply elsewhere. The current study examines whether changing gun laws in Australia affected female firearm homicide victimization. Female firearm homicide victimization may have been affected; however, no significant impacts were found for male firearm homicide victimization. Findings suggest there may be value in preventing legal access to firearms by persons who have a history of intimate partner violence, although considerable further study is required.

  14. 7 CFR 650.24 - Scenic beauty (visual resource).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... consideration of alternative management and development systems that preserve scenic beauty or improve the... resource values particularly in waste management systems; field borders, field windbreaks, wetland management, access roads, critical area treatment; design and management of ponds, stream margins, odd areas...

  15. CD-ROM Hardware Configurations: Selection and Design.

    ERIC Educational Resources Information Center

    Jaffe, Lee David; Watkins, Steven G.

    1992-01-01

    Presents selection and design considerations to help libraries make informed decisions about hardware configurations of CD-ROM systems. Highlights include CD-ROM configurations, including single drive workstations, daisychains, and jukeboxes; network configurations, including remote access; microcomputer features; CD-ROM drive selection; and…

  16. Synthesis of Literature and Application to Texas Airports

    DOT National Transportation Integrated Search

    2000-02-01

    Air transportation plays a vital role in the Texas economy. Air passenger/cargo traffic is projected to continue to increase considerably at many of the state's large airports. Ground access to airports is an important function that must be provided ...

  17. Decision Analysis for a Sustainable Environment, Economy & Society

    EPA Science Inventory

    Environmental decisions are often made without consideration of the roles that ecosystem services play. Most decision-makers do not currently have access to useful or usable methods and approaches when they are presented with choices that will have significant ecosystem impacts. ...

  18. Decision Analysis For A Sustainable Environment, Economy, & Society

    EPA Science Inventory

    Environmental decisions are often made without consideration of the roles that ecosystem services play. Most decision-makers do not currently have access to useful or usable methods and approaches when they are presented with choices that will have significant ecosystem impacts....

  19. Designing Solar Data Archives: Practical Considerations

    NASA Astrophysics Data System (ADS)

    Messerotti, M.

    The variety of new solar observatories in space and on the ground poses the stringent problem of an efficient storage and archiving of huge datasets. We briefly address some typical architectures and consider the key point of data access and distribution through networking.

  20. "They Put a Library in the Mall!"

    ERIC Educational Resources Information Center

    Johnston, James R.

    1996-01-01

    Describes the experiences of the Joliet Public Library Outlet (Illinois), which was opened in a mall. Highlights include rent, access to the library and increased patronage, criteria for deciding between enclosed and strip malls, other location considerations. funding, and marketing. (AEF)

  1. Digital technology use among disadvantaged Australians: implications for equitable consumer participation in digitally-mediated communication and information exchange with health services.

    PubMed

    Newman, Lareen; Biedrzycki, Kate; Baum, Fran

    2012-05-01

    To present research findings on access to, and use of, digital information and communication technologies (ICTs) by Australians from lower income and disadvantaged backgrounds to determine implications for equitable consumer access to digitally-mediated health services and information. Focus groups were held in 2008-09 with 80 residents from lower income and disadvantaged backgrounds in South Australia, predominantly of working- and family-formation age (25 to 55 years). Qualitative analysis was conducted on a-priori and emergent themes to describe dominant categories. Access to, and use of, computers, the Internet and mobile phones varied considerably in extent, frequency and quality within and across groups due to differences in abilities, resources and life experience. Barriers and facilitators included English literacy (including for native speakers), technological literacy, education, income, housing situation, social connection, health status, employment status, and trust. Many people gained ICT skills by trial and error or help from friends, and only a few from formal programs, resulting in varied skills. The considerable variation in ICT access and use within lower income and disadvantaged groups must be acknowledged and accommodated by health initiatives and services when delivering digitally-mediated consumer-provider interaction, online health information, or online self-management of health conditions. If services require consumers to participate in a digitally-mediated communication exchange, then we suggest they might support skills and technology acquisition, or provide non-ICT alternatives, in order to avoid exacerbating health inequities.

  2. Access to medicines from a health system perspective

    PubMed Central

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

    2013-01-01

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

  3. Pharmaceutical Market Access: current state of affairs and key challenges - results of the Market Access Launch Excellence Inventory (MALEI).

    PubMed

    Koch, Marcus A

    2015-01-01

    To take inventory of the current state of affairs of Market Access Launch Excellence in the life sciences industry. To identify key gaps and challenges for Market Access (MA) and discuss how they can be addressed. To generate a baseline for benchmarking MA launch excellence. An online survey was conducted with pharmaceutical executives primarily working in MA, marketing, or general management. The survey aimed to evaluate MA excellence prerequisites across the product life cycle (rated by importance and level of implementation) and to describe MA activity models in the respective companies. Composite scores were calculated from respondents' ratings and answers. Implementation levels of MA excellence prerequisites generally lagged behind their perceived importance. Item importance and the respective level of implementation correlated well, which can be interpreted as proof of the validity of the questionnaire. The following areas were shown to be particularly underimplemented: 1) early integration of MA and health economic considerations in research and development decision making, 2) developing true partnerships with payers, including the development of services 'beyond the pill', and 3) consideration of human resource and talent management. The concept of importance-adjusted implementation levels as a hybrid parameter was introduced and shown to be a viable tool for benchmarking purposes. More than 70% of respondents indicated that their companies will invest broadly in MA in terms of capital and headcount within the next 3 years. MA (launch) excellence needs to be further developed in order to close implementation gaps across the entire product life cycle. As MA is a comparatively young pharmaceutical discipline in a complex and dynamic environment, this effort will require strategic focus and dedication. The Market Access Launch Excellence Inventory benchmarking tool may help guide decision makers to prioritize their endeavors.

  4. Assessing access to care for transgender and gender nonconforming people: a consideration of diversity in combating discrimination.

    PubMed

    Cruz, Taylor M

    2014-06-01

    Transgender and gender nonconforming people face stigma and discrimination from a wide variety of sources and through numerous social realms. Stigma and discrimination originating from biomedicine and health care provision may impact this group's access to primary care. Such stigma and discrimination may originate not only from direct events and past negative experiences, but also through medicine's role in providing treatments of transitioning, the development of formal diagnoses to provide access to such treatments, and the medical language used to describe this diverse group. This paper examines the postponement of primary curative care among this marginalized group of people by drawing from the National Transgender Discrimination Survey, one of the largest available datasets for this underserved group. This paper also proposes an innovate categorization system to account for differences in self-conceptualization and identity, which has been of considerable concern for transgender and gender nonconforming communities but remains underexplored in social and health research. Results suggest that experience, identity, state of transition, and disclosure of transgender or gender nonconforming status are associated with postponement due to discrimination. Other findings suggest that postponement associated with primary place of seeking care and health insurance has ties to both discrimination and affordability. These findings highlight the importance of combating stigma and discrimination generated from within or experienced at sites of biomedicine or health care provision in improving access to care for this group of people. Improving access to care for all gender variant people requires a critical evaluation of existing research practices and health care provision to ensure that care is tailored as needed to each person's perspective in relation to larger social processes. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. [Improve the accessibility of essential drugs for the populations of one medical region in Burkina Faso].

    PubMed

    Ridde, Valéry; Nitièma, Abdoulaye P; Dadjoari, Moussa

    2005-01-01

    Despite the formulation of the Bamako initiative in 1992 in Burkina Faso, not until 2001 and the launching of a project by a nongovernmental organization was the policy really implemented in a region of the country. One of the goals of this policy is to improve access to health care by using generic essential drugs. The objective of this article is to summarize the results of the evaluation of the project's ability to improve the population's access to drugs. The project lasted three years (2001-2003) and the interventions took place in 41 basic health centres of three districts. According to WHO, improving access to drugs requires consideration of four essential factors: rational use, affordable prices, financial viability, and effectiveness of the distribution. The average number of drugs prescribed per prescription sheet (n = 1061) was 2.4; 93% of the drugs were prescribed by their generic name (international non-proprietary names); 44% of infant diarrheas were treated with oral rehydration salt. National drug prices were respected but not the directives aiming at exempting from payment or subsidizing certain population sub-groups (children, indigents). The average annual cash flow of the basic health centres was 1.2 million F CFA and it increased by 854% compared to the beginning of the project. The cost-recovery scheme for administrative expenses was 106%. The average annual availability of the 10 essential drugs was 89%. Utilization rates increased (0.13 in 1999 to 0.21 in 2003) but not significantly differently than in other basic health centres of the area not supported by the project (p = 0.084). The project succeeded in improving access to these drugs for the overall population but not for the worst-off. The drugs are now geographically available for all and financially accessible for those who can afford to pay. The intervention strategy supported the sustainability of the project's activities but much remains to be done to provide the poorest with access to drugs.

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

    NASA Astrophysics Data System (ADS)

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

    2011-12-01

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

  7. A rapid prototyping/artificial intelligence approach to space station-era information management and access

    NASA Technical Reports Server (NTRS)

    Carnahan, Richard S., Jr.; Corey, Stephen M.; Snow, John B.

    1989-01-01

    Applications of rapid prototyping and Artificial Intelligence techniques to problems associated with Space Station-era information management systems are described. In particular, the work is centered on issues related to: (1) intelligent man-machine interfaces applied to scientific data user support, and (2) the requirement that intelligent information management systems (IIMS) be able to efficiently process metadata updates concerning types of data handled. The advanced IIMS represents functional capabilities driven almost entirely by the needs of potential users. Space Station-era scientific data projected to be generated is likely to be significantly greater than data currently processed and analyzed. Information about scientific data must be presented clearly, concisely, and with support features to allow users at all levels of expertise efficient and cost-effective data access. Additionally, mechanisms for allowing more efficient IIMS metadata update processes must be addressed. The work reported covers the following IIMS design aspects: IIMS data and metadata modeling, including the automatic updating of IIMS-contained metadata, IIMS user-system interface considerations, including significant problems associated with remote access, user profiles, and on-line tutorial capabilities, and development of an IIMS query and browse facility, including the capability to deal with spatial information. A working prototype has been developed and is being enhanced.

  8. Are Age-Related Differences Uniform Across Different Inhibitory Functions?

    PubMed

    Vadaga, Kiran K; Blair, Mervin; Li, Karen Z H

    2016-07-01

    In the current experiment, we examined the relative age-sensitivity of 3 inhibitory functions: access, deletion, and restraint by taking into consideration their underlying control processes: proactive and reactive control. The 3 inhibitory functions were measured using a sequential flanker task. Young (age: 18-35, n = 24) and older adults (age: 60-75, n = 25) first memorized a series of 8 animal words in a fixed order. In the test phase, these stimuli were presented randomly either singly or with flankers and participants responded "yes" or "no" based on the prelearned sequence. In the access trials, flankers were either ahead of the current target or unrelated. In the deletion trials, flankers were previous target items. In the restraint trials, the flanker cues (XXXX) prompted the participants to withhold responses occasionally. Unflanked trials served as the baseline condition. Age-related differences in the magnitude of inhibition effects were largest in restraint, followed by deletion. No age-related differences were observed in access. Our findings suggest that the magnitude of age-related differences in inhibitory functions is contingent on the degree of proactive control recruited by a given inhibitory function. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Root anatomy and canal configuration of the permanent mandibular first molar: clinical implications and recommendations.

    PubMed

    de Pablo, Oliver Valencia; Estevez, Roberto; Heilborn, Carlos; Cohenca, Nestor

    2012-01-01

    Root canal anatomy may present clinicians with a complex clinical challenge that requires diagnostic approaches, access modification, and clinical skills to successfully localize, negotiate, disinfect, and seal the root canal system. This article discusses the clinical implications of endodontic therapy on permanent mandibular first molars. The number of roots on the mandibular first molar is directly related to ethnicity. Canal morphology has a significant effect on treatment protocol: Mesial roots present two canals on a regular basis, adopting 2-2 and 2-1 as the most common configurations. A third canal is present in 2.6% of the population. The most common configuration in the distal root is type I (62.7%), followed by type II (14.5%) and type IV (12.4%). Diagnosis and treatment of complex root canal systems often require specialized training that may be beyond the scope of the average general practitioner. Access modifications are required to find extra roots and/or canals. The instrumentation of the third root requires a different access and small, flexible instruments, given the curvature that is usually present buccally in the apical third. The incidence of isthmuses is 55% in the mesial root and 20% in the distal root. This anatomical configuration should be taken into consideration during endodontic treatment as well as during periapical surgery.

  10. What Indigenous Australian clients value about primary health care: a systematic review of qualitative evidence.

    PubMed

    Gomersall, Judith Streak; Gibson, Odette; Dwyer, Judith; O'Donnell, Kim; Stephenson, Matthew; Carter, Drew; Canuto, Kootsy; Munn, Zachary; Aromataris, Edoardo; Brown, Alex

    2017-08-01

    To synthesise client perceptions of the unique characteristics and value of care provided in Aboriginal Community Controlled Health Organisations (ACCHOs) compared to mainstream/general practitioner services, and implications for improving access to quality, appropriate primary health care for Indigenous Australians. Standardised systematic review methods with modification informed by ethical and methodological considerations in research involving Indigenous Australians. Perceived unique valued characteristics of ACCHOs were: 1) accessibility, facilitated by ACCHOs welcoming social spaces and additional services; 2) culturally safe care; and 3) appropriate care, responsive to holistic needs. Provider-client relationships characterised by shared understanding of clients' needs, Indigenous staff, and relationships between clients who share the same culture, are central to ACCHO clients' perceptions of ACCHOs' unique value. The client perceptions provide insights about how ACCHOs address socio-economic factors that contribute to high levels of chronic disease in Indigenous communities, why mainstream PHC provider care cannot substitute for ACCHO care, and how to improve accessibility and quality of care in mainstream providers. Implications for public health: To increase utilisation of PHC services in Indigenous Australian communities, and help close the gaps between the health status of Indigenous and non-Indigenous Australians, Indigenous community leaders and Australian governments should prioritise implementing effective initiatives to support quality health care provision by ACCHOs. © 2017 The Authors.

  11. Landscaping With Maintenance in Mind.

    ERIC Educational Resources Information Center

    Sorensen, Randy

    2000-01-01

    Examines school ground landscape design that enhances attractive of the school and provides for easier maintenance. Landscape design issues discussed include choice of grass, trees, and shrubs; irrigation; and safety and access. Other considerations for lessening maintenance problems for facility managers are also highlighted. (GR)

  12. Isozyme variation in wild and cultivated pineapple

    USDA-ARS?s Scientific Manuscript database

    Isozyme variation was studied in 161 accessions of pineapple including four species of Ananas and one of Pseudananas. Six enzyme systems (ADH, GPI, PGM, SKDH, TPI, UGPP) involving seven putative loci revealed 35 electromorphs . Considerable variation exists within and between species of Ananas. Sixt...

  13. Some Conditions for Cost Efficiency in Hypermedia.

    ERIC Educational Resources Information Center

    Westland, J. Christopher

    1998-01-01

    Models administrative and operating costs surrounding a hypermedia database and identifies seven conditions for the cost justification of hypermedia. Concludes that cost considerations aside, hypermedia offers significant data retrieval benefits in accessing text, video, still pictures, and sound, and provides substantially better human…

  14. 75 FR 38725 - Service Performance Measurement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-06

    ... of Customer Sastisfaction A. General Considerations B. Rule 3055.91--Consumer Access to Postal Services C. Rule 3055.92--Customer Experience Measurement Surveys D. Rule 3055.93--Mystery Shopper Program... Commission is adopting a final rule on service perfomance measurement and customer satisfaction. The final...

  15. 36 CFR 910.31 - High architectural quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... GENERAL GUIDELINES AND UNIFORM STANDARDS FOR URBAN PLANNING AND DESIGN OF DEVELOPMENT WITHIN THE... the best contemporary design and planning concepts. Great care and sensitivity must be shown in the... provisions for pedestrian and vehicular access. Special design considerations for each coordinated planning...

  16. First-Generation Women and Identity Intersectionality

    ERIC Educational Resources Information Center

    Kouzoukas, Georgia

    2017-01-01

    With a considerable focus to increase America's degree completion rates amongst our diverse population, higher education policymakers and researchers have examined the college access, persistence, and completion rates of first-generation students. However, minimal research has addressed the heterogeneous student population through a gendered or…

  17. The Security Factor in School Renovations.

    ERIC Educational Resources Information Center

    Fickes, Michael

    1998-01-01

    Discusses how one Indiana high school used its renovation as an opportunity to reevaluate the school's security design. Security considerations in the building's external and internal environment include lighting, directional signage, parking, access control technology, and issues regarding the use of closed circuit television. (GR)

  18. Planning for solar access

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

    Heckeroth, S.; McLees, C.

    1997-12-31

    Land use planning is often no more than a strategy for getting the most economic value from a given piece of land while attempting to minimize the expense of mitigating environmental impacts. Because conventional fuels are currently inexpensive, development takes place with little consideration for energy efficiency or solar access. By identifying sites with solar access now, planners and building designers can assure that the south facing roofs and walls of future buildings will receive the solar energy necessary to satisfy the energy needs of their occupants. Planner Ian McHarg outlined scientific methods to map natural determinants including geology, hydrology,more » wildlife, soils, climate, as well as social determinants like population density, energy consumption, and transportation patterns in the late 60s. Overlays of these hand plotted maps gave planners a method of finding the most suitable sites for identified needs but were cost prohibitive for most projects. The affordability of studies done on high speed computers now allows general application of McHargian planning methods. At the time McHarg was developing his planning theory photovoltaics were so expensive their use was restricted to government projects. The low cost of heating with fossil fuels made solar heating expensive by comparison. Today advances in solar technology have made solar electricity and heating competitive with non-renewable energy resources. This paper will show how McHargian planning methods can be effectively used in conjunction with Geographic Information Systems (GIS) to include efficiency and renewable energy access in land use decision making.« less

  19. Evidence-based decision-making within Australia's pharmaceutical benefits scheme.

    PubMed

    Lopert, Ruth

    2009-07-01

    In Australia, most prescription drugs are subsidized through the Pharmaceutical Benefits Scheme (PBS), one of several government programs in which evidence-based decision making is applied to the funding of health technologies. PBS processes are intended to ensure "value for money" for the Australian taxpayer and to support affordable, equitable access to prescription medicines; they are not intended as a mechanism for cost containment. The inclusion of a drug on the national formulary depends on the recommendation of the Pharmaceutical Benefits Advisory Committee (PBAC), which considers not only the comparative effectiveness but also the comparative cost-effectiveness of drugs proposed for listing. While some decisions have been controversial, the PBS retains strong public support. Moreover, evidence does not suggest that the consideration of cost-effectiveness has created a negative environment for the drug industry: Australia has a high penetration of patented medicines, with prices for some recently approved drugs at U.S. levels.

  20. Vaccines for cocaine abuse.

    PubMed

    Orson, Frank M; Kinsey, Berma M; Singh, Rana A K; Wu, Yan; Kosten, Thomas R

    2009-04-01

    Treatments for cocaine abuse have been disappointingly ineffective, especially in comparison with those for some other abused substances. A new approach, using vaccination to elicit specific antibodies to block the access of cocaine to the brain, has shown considerable promise in animal models, and more recently in human trials. The mechanism of action for the antibody effect on cocaine is very likely to be the straightforward and intuitive result of the binding of the drug in circulation by antibodies, thereby reducing its entry into the central nervous system and thus its pharmacological effects. The effectiveness of such antibodies on drug pharmacodynamics is a function of both the quantitative and the qualitative properties of the antibodies, and this combination will determine the success of the clinical applications of anti-cocaine vaccines in helping addicts discontinue cocaine abuse. This review will discuss these issues and present the current developmental status of cocaine conjugate vaccines.

  1. Single and double beta decays in the A=100, A=116 and A=128 triplets of isobars

    NASA Astrophysics Data System (ADS)

    Suhonen, J.; Civitarese, O.

    2014-04-01

    In this paper we analyze the ground-state-to-ground-state two-neutrino double beta (2νββ) decays and single EC and β- decays for the A=100 (100Mo-100Tc-100Ru), A=116 (116Cd-116In-116Sn) and A=128 (128Te-128I-128Xe) triplets of isobars. We use the proton-neutron quasiparticle random-phase approximation (pnQRPA) with realistic G-matrix-derived effective interactions in very large single-particle bases. The purpose is to access the effective value of the axial-vector coupling constant gA in the pnQRPA calculations. We show that the three triplets of isobars represent systems with different characteristics of orbital occupancies and cumulative 2νββ nuclear matrix elements. Our analysis points to a considerably quenched averaged effective value of ≈0.6±0.2 in the pnQRPA calculations.

  2. Medicaid Consent to Sterilization forms: historical, practical, ethical, and advocacy considerations.

    PubMed

    Block-Abraham, Dana; Arora, Kavita S; Tate, Danielle; Gee, Rebekah E

    2015-06-01

    The US government developed a Medicaid Consent to Sterilization form in the mid-1970s to protect vulnerable populations from coerced sterilization. US health care practices have evolved significantly since that time. The form, however, has not changed, and may be preventing access to desired services for the same vulnerable populations it was originally created to protect. This paper discusses the relevant historical, practical use, ethical, and advocacy considerations of the Medicaid sterilization consent form and proposes changes to make the form more pertinent to today's medical environment.

  3. Return to the Moon: NASA's LCROSS AND LRO Missions

    NASA Technical Reports Server (NTRS)

    Morales, Lester

    2012-01-01

    NASA s goals include objectives for robotic and human spaceflight: a) Implement a sustained and affordable human and robotic program to explore the solar system and beyond; b) Extend human presence across the solar system, starting with a human return to the Moon by the year 2020, in preparation for human exploration of Mars and other destinations; c) A lunar outpost is envisioned. Site Considerations: 1) General accessibility of landing site (orbital mechanics) 2) Landing site safety 3) Mobility 4) Mars analog 5) Power 6) Communications 7) Geologic diversity 8) ISRU considerations

  4. Appraisal Skills, Health Literacy and the Patient-Provider Relationship: Considerations as the Health Care Consumer Turns to the Internet to Inform their Care

    PubMed Central

    O’Dell, Rosann

    2012-01-01

    Health care consumers increasingly obtain health information from the Internet to inform their health care; the health care consumer, who also has the role of patient, maintains the right to access information from sources of their choosing for this purpose. However, noteworthy considerations exist including information appraisal skills, health literacy and the patient-provider relationship. Awareness and education are warranted to assist the health care consumer in achieving proficiency as they turn to the Internet for health information. PMID:23569625

  5. Appraisal Skills, Health Literacy and the Patient-Provider Relationship: Considerations as the Health Care Consumer Turns to the Internet to Inform their Care.

    PubMed

    O'Dell, Rosann

    2012-01-01

    Health care consumers increasingly obtain health information from the Internet to inform their health care; the health care consumer, who also has the role of patient, maintains the right to access information from sources of their choosing for this purpose. However, noteworthy considerations exist including information appraisal skills, health literacy and the patient-provider relationship. Awareness and education are warranted to assist the health care consumer in achieving proficiency as they turn to the Internet for health information.

  6. Patient experience of access to primary care: identification of predictors in a national patient survey.

    PubMed

    Kontopantelis, Evangelos; Roland, Martin; Reeves, David

    2010-08-28

    The 2007/8 GP Access Survey in England measured experience with five dimensions of access: getting through on the phone to a practice, getting an early appointment, getting an advance appointment, making an appointment with a particular doctor, and surgery opening hours. Our aim was to identify predictors of patient satisfaction and experience with access to English primary care. 8,307 English general practices were included in the survey (of 8,403 identified). 4,922,080 patients were randomly selected and contacted by post and 1,999,523 usable questionnaires were returned, a response rate of 40.6%. We used multi-level logistic regressions to identify patient, practice and regional predictors of patient satisfaction and experience. After controlling for all other factors, younger people, and people of Asian ethnicity, working full time, or with long commuting times to work, reported the lowest levels of satisfaction and experience of access. For people in work, the ability to take time off work to visit the GP effectively eliminated the disadvantage in access. The ethnic mix of the local area had an impact on a patient's reported satisfaction and experience over and above the patient's own ethnic identity. However, area deprivation had only low associations with patient ratings. Responses from patients in small practices were more positive for all aspects of access with the exception of satisfaction with practice opening hours. Positive reports of access to care were associated with higher scores on the Quality and Outcomes Framework and with slightly lower rates of emergency admission. Respondents in London were the least satisfied and had the worst experiences on almost all dimensions of access. This study identifies a number of patient groups with lower satisfaction, and poorer experience, of gaining access to primary care. The finding that access is better in small practices is important given the increasing tendency for small practices to combine into larger units. Consideration needs to be given to ways of retaining these and other benefits of small practice size when primary care services are reconfigured. Differences between population groups (e.g. younger people, ethnic minorities) may be due to differences in actual care received or different response tendencies of different groups. Further analysis is needed to determine whether case-mix adjustment is required when comparing practices serving different populations.

  7. Access and use of human tissues from the developing world: ethical challenges and a way forward using a tissue trust

    PubMed Central

    2011-01-01

    Background Scientists engaged in global health research are increasingly faced with barriers to access and use of human tissues from the developing world communities where much of their research is targeted. In part, the problem can be traced to distrust of researchers from affluent countries, given the history of 'scientific-imperialism' and 'biocolonialism' reflected in past well publicized cases of exploitation of research participants from low to middle income countries. Discussion To a considerable extent, the failure to adequately engage host communities, the opacity of informed consent, and the lack of fair benefit-sharing have played a significant role in eroding trust. These ethical considerations are central to biomedical research in low to middle income countries and failure to attend to them can inadvertently contribute to exploitation and erode trust. A 'tissue trust' may be a plausible means for enabling access to human tissues for research in a manner that is responsive to the ethical challenges considered. Summary Preventing exploitation and restoring trust while simultaneously promoting global health research calls for innovative approaches to human tissues research. A tissue trust can reduce the risk of exploitation and promote host capacity as a key benefit. PMID:21266076

  8. Biosimilars for the management of inflammatory bowel diseases: economic considerations.

    PubMed

    Gulacsi, Laszlo; Pentek, Marta; Rencz, Fanni; Brodszky, Valentin; Baji, Petra; Vegh, Zsuzsanna; Gecse, Krisztina B; Danese, Silvio; Peyrin-Biroulet, Laurent; Lakatos, Peter L

    2017-04-06

    Biological drugs revolutionized the treatment of inflammatory bowel diseases (IBD) such as Crohn's disease and ulcerative colitis. However, not all clinically eligible patients have access to biologicals, due to significant costs and budget impact. Biosimilars are highly comparable to their originator product in terms of clinical efficacy and safety. Biosimilars are priced 15-75% lower than their reference product, which makes them a less costly alternative and is expected to offer better patients access to biologicals. The total projected cost savings are significant. If the achieved budget savings were used to cover more biological therapy, several additional IBD patients could be treated. Currently, the main barriers to the increasing uptake of biosimilars are the few incentives of the key stakeholders, while physicians' and patients' skepticism towards biosimilars seems to be changing. Over the coming years, biosimilars are expected to gain a growing importance in the treatment of IBD, contributing to a better access to treatment, improving population-level health gain and sustainability of health systems. This review summarizes the results of the literature on the economic considerations of biosimilars in IBD and the role of biosimilar infliximab in the treatment of IBD. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  9. Fluorescence Determination of Tryptophan Side-Chain Accessibility and Dynamics in Triple-Helical Collagen-Like Peptides

    PubMed Central

    Simon-Lukasik, Kristine V.; Persikov, Anton V.; Brodsky, Barbara; Ramshaw, John A. M.; Laws, William R.; Alexander Ross, J. B.; Ludescher, Richard D.

    2003-01-01

    We report tryptophan fluorescence measurements of emission intensity, iodide quenching, and anisotropy that describe the environment and dynamics at X and Y sites in stable collagen-like peptides of sequence (Gly-X-Y)n. About 90% of tryptophans at both sites have similar solvent exposed fluorescence properties and a lifetime of 8.5–9 ns. Analysis of anisotropy decays using an associative model indicates that these long lifetime populations undergo rapid depolarizing motion with a 0.5 ns correlation time; however, the extent of fast motion at the Y site is considerably less than the essentially unrestricted motion at the X site. About 10% of tryptophans at both sites have a shorter (∼3 ns) lifetime indicating proximity to a protein quenching group; these minor populations are immobile on the peptide surface, depolarizing only by overall trimer rotation. Iodide quenching indicates that tryptophans at the X site are more accessible to solvent. Side chains at X sites are more solvent accessible and considerably more mobile than residues at Y sites and can more readily fluctuate among alternate intermolecular interactions in collagen fibrils. This fluorescence analysis of collagen-like peptides lays a foundation for studies on the structure, dynamics, and function of collagen and of triple-helical junctions in gelatin gels. PMID:12524302

  10. Achievable Rate Estimation of IEEE 802.11ad Visual Big-Data Uplink Access in Cloud-Enabled Surveillance Applications.

    PubMed

    Kim, Joongheon; Kim, Jong-Kook

    2016-01-01

    This paper addresses the computation procedures for estimating the impact of interference in 60 GHz IEEE 802.11ad uplink access in order to construct visual big-data database from randomly deployed surveillance camera sensing devices. The acquired large-scale massive visual information from surveillance camera devices will be used for organizing big-data database, i.e., this estimation is essential for constructing centralized cloud-enabled surveillance database. This performance estimation study captures interference impacts on the target cloud access points from multiple interference components generated by the 60 GHz wireless transmissions from nearby surveillance camera devices to their associated cloud access points. With this uplink interference scenario, the interference impacts on the main wireless transmission from a target surveillance camera device to its associated target cloud access point with a number of settings are measured and estimated under the consideration of 60 GHz radiation characteristics and antenna radiation pattern models.

  11. Understanding observed and unobserved health care access and utilization disparities among US Latino adults.

    PubMed

    Vargas Bustamante, Arturo; Fang, Hai; Rizzo, John A; Ortega, Alexander N

    2009-10-01

    This study hypothesizes that differences in health care access and utilization exist across Latino adults (>18 years), with U.S. Latino adults of Mexican ancestry demonstrating the worst patterns of access and utilization. The analyses use the National Health Interview Survey (NHIS) data from 1999 to 2007 (N = 33,908). The authors first estimate the disparities in health care access and utilization among different categories of Latinos. They also implement Blinder-Oaxaca techniques to decompose disparities into observed and unobserved components, comparing Latinos of Mexican ancestry with non-Mexican Latinos. Latinos of Mexican ancestry consistently demonstrate lower health care access and utilization patterns than non-Mexican Latinos. Health insurance and region of residence were the most important factors that explained observable differences. In contrast, language and citizenship status were relatively unimportant. Although a significant share of these disparities may be explained by observed characteristics, disparities because of unobserved heterogeneity among the different Latino cohorts are also considerable.

  12. Access to a Car and the Self-Reported Health and Mental Health of People Aged 65 and Older in Northern Ireland.

    PubMed

    Doebler, Stefanie

    2016-05-01

    This article examines relationships between access to a car and the self-reported health and mental health of older people. The analysis is based on a sample of N = 65,601 individuals aged 65 years and older from the Northern Ireland Longitudinal Study linked to 2001 and 2011 census returns. The findings from hierarchical linear and binary logistic multilevel path models indicate that having no access to a car is related to a considerable health and mental health disadvantage particularly for older people who live alone. Rural-urban health and mental health differences are mediated by access to a car. The findings support approaches that emphasize the importance of autonomy and independence for the well-being of older people and indicate that not having access to a car can be a problem for older people not only in rural but also in intermediate and urban areas, if no sufficient alternative forms of mobility are provided. © The Author(s) 2015.

  13. Mental illness-related stigma in healthcare

    PubMed Central

    Mantler, Ed; Szeto, Andrew

    2017-01-01

    Mental illness-related stigma, including that which exists in the healthcare system and among healthcare providers, creates serious barriers to access and quality care. It is also a major concern for healthcare practitioners themselves, both as a workplace culture issue and as a barrier for help seeking. This article provides an overview of the main barriers to access and quality care created by stigmatization in healthcare, a consideration of contributing factors, and a summary of Canadian-based research into promising practices and approaches to combatting stigma in healthcare environments. PMID:28929889

  14. South East Asia, Differing Socioeconomic Factors, Differing Access to Radiotherapy: The Philippines, a Microcosm.

    PubMed

    Calaguas, Miriam Joy C; Gubat, Johannes A

    2017-04-01

    The accessibility of radiotherapy in Southeast Asia, a region characterized by diversity in both economy and culture, differ widely among its member countries. In most countries, access is not universal and is generally limited by radiotherapy resources and the health-seeking behavior of patients. This in turn relates to the current health policy in place, the practice of radiation oncology, and cultural factors such as religion and family dynamics. Although it is clear that radiotherapy access parallel economic development, it is also affected by different social factors that work to facilitate or impede its improvement. These factors are herein described in relation to the Philippine situation, where there is wide economic disparity, multiple subcultures, and logistical impediments to improving radiotherapy access, reminiscent of the Southeast Asian region. In the face of increasing cancer burden, it becomes increasingly important to improve services and develop new and efficient approaches taking different cultural factors into consideration. Through regional and international cooperation, solutions to the common and complex problem of inequity in radiotherapy access may be developed. Copyright © 2017. Published by Elsevier Inc.

  15. Design Considerations for Post-Acute Care mHealth: Patient Perspectives.

    PubMed

    Sanger, Patrick; Hartzler, Andrea; Lober, William B; Evans, Heather L; Pratt, Wanda

    2014-01-01

    Many current mobile health applications ("apps") and most previous research have been directed at management of chronic illnesses. However, little is known about patient preferences and design considerations for apps intended to help in a post-acute setting. Our team is developing an mHealth platform to engage patients in wound tracking to identify and manage surgical site infections (SSI) after hospital discharge. Post-discharge SSIs are a major source of morbidity and expense, and occur at a critical care transition when patients are physically and emotionally stressed. Through interviews with surgical patients who experienced SSI, we derived design considerations for such a post-acute care app. Key design qualities include: meeting basic accessibility, usability and security needs; encouraging patient-centeredness; facilitating better, more predictable communication; and supporting personalized management by providers. We illustrate our application of these guiding design considerations and propose a new framework for mHealth design based on illness duration and intensity.

  16. High-Payoff Space Transportation Design Approach with a Technology Integration Strategy

    NASA Technical Reports Server (NTRS)

    McCleskey, C. M.; Rhodes, R. E.; Chen, T.; Robinson, J.

    2011-01-01

    A general architectural design sequence is described to create a highly efficient, operable, and supportable design that achieves an affordable, repeatable, and sustainable transportation function. The paper covers the following aspects of this approach in more detail: (1) vehicle architectural concept considerations (including important strategies for greater reusability); (2) vehicle element propulsion system packaging considerations; (3) vehicle element functional definition; (4) external ground servicing and access considerations; and, (5) simplified guidance, navigation, flight control and avionics communications considerations. Additionally, a technology integration strategy is forwarded that includes: (a) ground and flight test prior to production commitments; (b) parallel stage propellant storage, such as concentric-nested tanks; (c) high thrust, LOX-rich, LOX-cooled first stage earth-to-orbit main engine; (d) non-toxic, day-of-launch-loaded propellants for upper stages and in-space propulsion; (e) electric propulsion and aero stage control.

  17. Orthographic and phonological neighborhood effects in handwritten word perception

    PubMed Central

    Goldinger, Stephen D.

    2017-01-01

    In printed-word perception, the orthographic neighborhood effect (i.e., faster recognition of words with more neighbors) has considerable theoretical importance, because it implicates great interactivity in lexical access. Mulatti, Reynolds, and Besner Journal of Experimental Psychology: Human Perception and Performance, 32, 799–810 (2006) questioned the validity of orthographic neighborhood effects, suggesting that they reflect a confound with phonological neighborhood density. They reported that, when phonological density is controlled, orthographic neighborhood effects vanish. Conversely, phonological neighborhood effects were still evident even when controlling for orthographic neighborhood density. The present study was a replication and extension of Mulatti et al. (2006), with words presented in four different formats (computer-generated print and cursive, and handwritten print and cursive). The results from Mulatti et al. (2006) were replicated with computer-generated stimuli, but were reversed with natural stimuli. These results suggest that, when ambiguity is introduced at the level of individual letters, top-down influences from lexical neighbors are increased. PMID:26306881

  18. Allozyme variation in spineless Pejibaye (Bactris gasipaes Kunth)

    USDA-ARS?s Scientific Manuscript database

    Isozyme variation was studied in 161 accessions of pineapple including four species of Ananas and one of Pseudananas. Six enzyme systems (ADH, GPI, PGM, SKDH, TPI, UGPP) involving seven putative loci revealed 35 electromorphs . Considerable variation exists within and between species of Ananas. Sixt...

  19. Extrasensory Perception Research: Difficulties and Implications for Education.

    ERIC Educational Resources Information Center

    McAdams, Elizabeth E.

    In recent years, gradually increased acceptance and heightened attention have been granted to extrasensory perception (ESP) research as a legitimate branch of scientific inquiry. This research holds significant implications for education despite difficulties involved with its consideration. Extrasensory perception, an organism's apparent access to…

  20. 78 FR 43875 - Combined Notice of Filings #1

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-22

    ... that the Commission received the following electric corporate filings: Docket Numbers: EC13-129-000... Expedited Consideration and Confidential Treatment. Filed Date: 7/12/13. Accession Number: 20130712-5183... Commission received the following electric rate filings: Docket Numbers: ER13-1970-000. Applicants: PJM...

  1. 78 FR 11635 - Combined Notice of Filings #1

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-19

    ... that the Commission received the following electric corporate filings: Docket Numbers: EC13-71-000... for Expedited Consideration, Waivers and Confidential Treatment. Filed Date: 2/6/13. Accession Number... following electric rate filings: Docket Numbers: ER13-675-001. Applicants: Catalina Solar, LLC. Description...

  2. 78 FR 16847 - Combined Notice of Filings #2

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-19

    ... that the Commission received the following electric corporate filings: Docket Numbers: EC13-79-000... Expedited Consideration and Confidential Treatment. Filed Date: 3/11/13. Accession Number: 20130311-5080.... ET 4/1/13. Take notice that the Commission received the following electric rate filings: Docket...

  3. 7 CFR 1491.6 - Ranking considerations and proposal selection.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... protection including social, economic, historical and archaeological, and environmental benefits; (4.... This score serves as a measure of agricultural viability (access to markets and infrastructure); and (7) Existence of a farm or ranch succession plan or similar plan established to encourage farm viability for...

  4. 7 CFR 1491.6 - Ranking considerations and proposal selection.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... protection including social, economic, historical and archaeological, and environmental benefits; (4.... This score serves as a measure of agricultural viability (access to markets and infrastructure); and (7) Existence of a farm or ranch succession plan or similar plan established to encourage farm viability for...

  5. 7 CFR 1491.6 - Ranking considerations and proposal selection.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... protection including social, economic, historical and archaeological, and environmental benefits; (4.... This score serves as a measure of agricultural viability (access to markets and infrastructure); and (7) Existence of a farm or ranch succession plan or similar plan established to encourage farm viability for...

  6. SUSTAINABLE WATER DEVELOPMENT PROGRAM FOR RURAL NIGERIA

    EPA Science Inventory

    Rural areas of Sub-Saharan Africa face the most acute water supply challenges in the world. Nigeria, the most populous African country, has considerable populations without basic access to safe drinking water, with over 50% of the country lacking coverage. The village of Adu A...

  7. Human factors and ergonomics in home care: Current concerns and future considerations for health information technology

    PubMed Central

    Or, Calvin K.L.; Valdez, Rupa S.; Casper, Gail R.; Carayon, Pascale; Burke, Laura J.; Brennan, Patricia Flatley; Karsh, Ben-Tzion

    2010-01-01

    Sicker patients with greater care needs are being discharged to their homes to assume responsibility for their own care with fewer nurses available to aid them. This situation brings with it a host of human factors and ergonomic (HFE) concerns, both for the home care nurse and the home dwelling patient, that can affect quality of care and patient safety. Many of these concerns are related to the critical home care tasks of information access, communication, and patient self-monitoring and self-management. Currently, a variety of health information technologies (HITs) are being promoted as possible solutions to those problems, but those same technologies bring with them a new set of HFE concerns. This paper reviews the HFE considerations for information access, communication, and patients self-monitoring and self-management, discusses how HIT can potentially mitigate current problems, and explains how the design and implementation of HIT itself requires careful HFE attention. PMID:19713630

  8. Accession Medical Standards Analysis and Research Activity (AMSARA), 2014 Annual Report

    DTIC Science & Technology

    2016-02-02

    1,318 1.6 280 0.6 275 1.8 20 0.2 Contact dermatitis and other eczema 1,624 2.0 1,148 2.3 275 1.8 196 2.0 Total considerations* 82,398 15,620 Total...125 1.2 50 2.1 45 2.1 Late effects of musculoskeletal and connective tissue injuries 328 2.4 267 2.6 50 2.1 46 2.2 Contact dermatitis and other...Affective psychoses 669 4.2 411 4.1 112 3.1 43 2.0 Contact dermatitis and other eczema 450 2.9 174 1.8 101 2.8 24 1.1 Hearing loss 660 4.2 84 0.8 86

  9. Plantar hyperhidrosis: A review of current management.

    PubMed

    Singh, Sanjay; Kaur, Simranjit; Wilson, Paul

    2016-11-01

    To critically appraise current literature regarding the management of plantar hyperhidrosis in the form of a structured review. A literature search was conducted using various databases and search criteria. The literature reports the use of conservative, medical and surgical treatment modalities for the management of plantar hyperhidrosis. However, long-term follow-up data are rare and some treatment modalities currently available are not fully understood. There is a considerable dearth in the literature on the management of plantar hyperhidrosis. Further study in larger populations with longer follow-up times is critical to access the long-term effects of treatment. Nonetheless, iontophoresis, botulinum toxin injection and lumbar sympathectomy are promising treatment modalities for this disorder.

  10. Applying Pragmatics Principles for Interaction with Visual Analytics.

    PubMed

    Hoque, Enamul; Setlur, Vidya; Tory, Melanie; Dykeman, Isaac

    2018-01-01

    Interactive visual data analysis is most productive when users can focus on answering the questions they have about their data, rather than focusing on how to operate the interface to the analysis tool. One viable approach to engaging users in interactive conversations with their data is a natural language interface to visualizations. These interfaces have the potential to be both more expressive and more accessible than other interaction paradigms. We explore how principles from language pragmatics can be applied to the flow of visual analytical conversations, using natural language as an input modality. We evaluate the effectiveness of pragmatics support in our system Evizeon, and present design considerations for conversation interfaces to visual analytics tools.

  11. High-yields heterologous production of the novel Aspergillus fumigatus elastase inhibitor AFUEI in Aspergillus oryzae.

    PubMed

    Yamashita, Nobuo; Komori, Yumiko; Okumura, Yoshiyuki; Uchiya, Kei-Ichi; Matsui, Takeshi; Nishimura, Akira; Ogawa, Kenji; Nikai, Toshiaki

    2011-08-01

    AFUEI, an elastase inhibitor produced by Aspergillus fumigatus strongly inhibits the elastolytic activity of A. fumigatus etc. To purify AFUEI, we constructed a strain that overproduces AFUEI by introducing the gene encoding AFUEI (Genbank accession no. AB546725) under control of the amyB promoter into the heterologous host Aspergillus oryzae. A. oryzae TF-4 displayed strong elastase inhibitory activity and produced considerably more AFUEI than that of A. fumigatus. Furthermore, AFUEI could be purified using culture broth and single ultrafiltration (UF) treatment, allowing for the effective production of AFUEI for use in clinical trials. Copyright © 2011 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.

  12. Managing Innovation to Maximize Value Along the Discovery-Translation-Application Continuum.

    PubMed

    Waldman, S A; Terzic, A

    2017-01-01

    Success in pharmaceutical development led to a record 51 drugs approved in the past year, surpassing every previous year since 1950. Technology innovation enabled identification and exploitation of increasingly precise disease targets ensuring next generation diagnostic and therapeutic products for patient management. The expanding biopharmaceutical portfolio stands, however, in contradistinction to the unsustainable costs that reflect remarkable challenges of clinical development programs. This annual Therapeutic Innovations issue juxtaposes advances in translating molecular breakthroughs into transformative therapies with essential considerations for lowering attrition and improving the cost-effectiveness of the drug-development paradigm. Realizing the discovery-translation-application continuum mandates a congruent approval, adoption, and access triad. © 2016 ASCPT.

  13. Managing Innovation to Maximize Value Along the Discovery-Translation-Application Continuum

    PubMed Central

    Waldman, SA; Terzic, A

    2017-01-01

    Success in pharmaceutical development led to a record 51 drug approved in the past year, surpassing every previous year since 1950. Technology innovation enabled identification and exploitation of increasingly precise disease targets ensuring a next generation diagnostic and therapeutic products for patient management. The expanding biopharmaceutical portfolio stands however in contradistinction to the unsustainable costs that reflect remarkable challenges of clinical development programs. This annual Therapeutic Innovations issue juxtaposes advances in translating molecular breakthroughs into transformative therapies with essential considerations for lowering attrition and improving the cost-effectiveness of the drug development paradigm. Realizing the discovery-translation-application continuum mandates a congruent approval, adoption and access triad. PMID:27869291

  14. [The treatment of scientific knowledge in the framework of CITES].

    PubMed

    Lanfranchi, Marie-Pierre

    2014-03-01

    Access to scientific knowledge in the context of CITES is a crucial issue. The effectiveness of the text is indeed largely based on adequate scientific knowledge of CITES species. This is a major challenge: more than 30,000 species and 178 member states are involved. The issue of expertise, however, is not really addressed by the Convention. The question was left to the consideration of the COP. Therefore, the COP has created two ad hoc scientific committees: the Plants Committee and the Animals Committee, conferring upon them an ambitious mandate. The article addresses some important issues at stake which are linked to institutional questions, as well as the mixed record after twenty-five years of practice.

  15. Reinforcement magnitude: an evaluation of preference and reinforcer efficacy.

    PubMed

    Trosclair-Lasserre, Nicole M; Lerman, Dorothea C; Call, Nathan A; Addison, Laura R; Kodak, Tiffany

    2008-01-01

    Consideration of reinforcer magnitude may be important for maximizing the efficacy of treatment for problem behavior. Nonetheless, relatively little is known about children's preferences for different magnitudes of social reinforcement or the extent to which preference is related to differences in reinforcer efficacy. The purpose of the current study was to evaluate the relations among reinforcer magnitude, preference, and efficacy by drawing on the procedures and results of basic experimentation in this area. Three children who engaged in problem behavior that was maintained by social positive reinforcement (attention, access to tangible items) participated. Results indicated that preference for different magnitudes of social reinforcement may predict reinforcer efficacy and that magnitude effects may be mediated by the schedule requirement.

  16. The European General Data Protection Regulation: challenges and considerations for iPSC researchers and biobanks

    PubMed Central

    Morrison, Michael; Bell, Jessica; George, Carol; Harmon, Shawn; Munsie, Megan; Kaye, Jane

    2017-01-01

    Increasingly, human induced pluripotent stem cells (iPSC) and their associated genetic and clinical information are being used in a wide range of applications, with large biobanks being established to support and increase their scientific use. The new European General Data Protection Regulations, which comes into effect in 2018, will have implications for biobanks that generate, store and allow research access to iPSC. This paper describes some of the challenges that iPSC biobanks face and suggests some points for the development of appropriate governance structures to address these new requirements. These suggestions also have implications for iPSC research in general. PMID:28976812

  17. Medium Access Control for Opportunistic Concurrent Transmissions under Shadowing Channels

    PubMed Central

    Son, In Keun; Mao, Shiwen; Hur, Seung Min

    2009-01-01

    We study the problem of how to alleviate the exposed terminal effect in multi-hop wireless networks in the presence of log-normal shadowing channels. Assuming node location information, we propose an extension of the IEEE 802.11 MAC protocol that sched-ules concurrent transmissions in the presence of log-normal shadowing, thus mitigating the exposed terminal problem and improving network throughput and delay performance. We observe considerable improvements in throughput and delay achieved over the IEEE 802.11 MAC under various network topologies and channel conditions in ns-2 simulations, which justify the importance of considering channel randomness in MAC protocol design for multi-hop wireless networks. PMID:22408556

  18. Effect of mechanical disruption on the effectiveness of three reactors used for dilute acid pretreatment of corn stover Part 1: chemical and physical substrate analysis

    PubMed Central

    2014-01-01

    Background There is considerable interest in the conversion of lignocellulosic biomass to liquid fuels to provide substitutes for fossil fuels. Pretreatments, conducted to reduce biomass recalcitrance, usually remove at least some of the hemicellulose and/or lignin in cell walls. The hypothesis that led to this research was that reactor type could have a profound effect on the properties of pretreated materials and impact subsequent cellulose hydrolysis. Results Corn stover was dilute-acid pretreated using commercially relevant reactor types (ZipperClave® (ZC), Steam Gun (SG) and Horizontal Screw (HS)) under the same nominal conditions. Samples produced in the SG and HS achieved much higher cellulose digestibilities (88% and 95%, respectively), compared to the ZC sample (68%). Characterization, by chemical, physical, spectroscopic and electron microscopy methods, was used to gain an understanding of the effects causing the digestibility differences. Chemical differences were small; however, particle size differences appeared significant. Sum-frequency generation vibrational spectra indicated larger inter-fibrillar spacing or randomization of cellulose microfibrils in the HS sample. Simons’ staining indicated increased cellulose accessibility for the SG and HS samples. Electron microscopy showed that the SG and HS samples were more porous and fibrillated because of mechanical grinding and explosive depressurization occurring with these two reactors. These structural changes most likely permitted increased cellulose accessibility to enzymes, enhancing saccharification. Conclusions Dilute-acid pretreatment of corn stover using three different reactors under the same nominal conditions gave samples with very different digestibilities, although chemical differences in the pretreated substrates were small. The results of the physical and chemical analyses of the samples indicate that the explosive depressurization and mechanical grinding with these reactors increased enzyme accessibility. Pretreatment reactors using physical force to disrupt cell walls increase the effectiveness of the pretreatment process. PMID:24713111

  19. Dynamic Resource Allocation and Access Class Barring Scheme for Delay-Sensitive Devices in Machine to Machine (M2M) Communications.

    PubMed

    Li, Ning; Cao, Chao; Wang, Cong

    2017-06-15

    Supporting simultaneous access of machine-type devices is a critical challenge in machine-to-machine (M2M) communications. In this paper, we propose an optimal scheme to dynamically adjust the Access Class Barring (ACB) factor and the number of random access channel (RACH) resources for clustered machine-to-machine (M2M) communications, in which Delay-Sensitive (DS) devices coexist with Delay-Tolerant (DT) ones. In M2M communications, since delay-sensitive devices share random access resources with delay-tolerant devices, reducing the resources consumed by delay-sensitive devices means that there will be more resources available to delay-tolerant ones. Our goal is to optimize the random access scheme, which can not only satisfy the requirements of delay-sensitive devices, but also take the communication quality of delay-tolerant ones into consideration. We discuss this problem from the perspective of delay-sensitive services by adjusting the resource allocation and ACB scheme for these devices dynamically. Simulation results show that our proposed scheme realizes good performance in satisfying the delay-sensitive services as well as increasing the utilization rate of the random access resources allocated to them.

  20. [Laparoscopic hysterectomy--brief history, frequency, indications and contraindications].

    PubMed

    Tomov, S; Gorchev, G; Tzvetkov, Ch; Tanchev, L; Iliev, S

    2012-01-01

    Hysterectomy is the most common gynecological operation after Caesarean section and the laparoscopic access to uterus removal is one of the contemporary methods showing slow but steady growth in time. In reference to indications and contraindications for laparoscopic hysterectomy, the following directions emerge as controversial: malignant gynecological tumors, uterus size, and high body mass index. Laparoscopic hysterectomy can be taken into consideration at the first stage of endometrial, cervical and ovarian cancer. If there is doubt about an uterus sarcoma and a laparoscopic access is accomplished, a conversion to abdominal hysterectomy must be done. Obesity and big uteri are not a contrarindication for that minimally-invasive access. Today, laparoscopic hysterectomy is a reasonable alternative to total abdominal and vaginal hysterectomy.

  1. The care of adolescents and young adults with cancer: results of the ESMO/SIOPE survey.

    PubMed

    Saloustros, Emmanouil; Stark, Daniel P; Michailidou, Kyriaki; Mountzios, Giannis; Brugieres, Laurence; Peccatori, Fedro Alessandro; Jezdic, Svetlana; Essiaf, Samira; Douillard, Jean-Yves; Bielack, Stefan

    2017-01-01

    Adolescents and young adults (AYA) with cancer require dedicated clinical management and care. Little is known about the training and practice of European healthcare providers in regard to AYA and the availability of specialised services. A link to an online survey was sent to members of the European Society for Medical Oncology (ESMO) and the European Society for Paediatric Oncology (SIOPE). The link was also sent to ESMO National Representatives and circulated to other European oncology groups. Questions covered the demographics and clinical training of respondents, their definition of AYA, education about AYA cancer, access to specialised clinical and supportive care, research and further education. Data from Europe were analysed by region. Three hundred tweenty two questionnaires were submitted and we focused on data from the 266 European healthcare professionals. Responses revealed considerable variation both within and between countries in the definition of AYA. Over two-thirds of respondents did not have access to specialised centres for AYA (67%), were not aware of research initiatives focusing on AYA with cancer (69%) and had no access to specialist services for managing the late effects of treatment (67%). The majority of the respondents were able to refer AYA patients to professional psychological support and specialised social workers. However, more than half had no access to an age-specialised nurse or specialised AYA education. Overall, 38% of respondents reported that their AYA patients did not have access to fertility specialists. This figure was 76% in Eastern Europe. Lack of specialised AYA care was particularly evident in Eastern and South-Eastern Europe. There is important underprovision and inequity of AYA cancer care across Europe. Improving education and research focused on AYA cancer care should be a priority.

  2. Expanded Access Programs

    PubMed Central

    Van Campen, Luann E.; Garnett, Timothy

    2015-01-01

    Expanded access is a regulatory mechanism by which an investigational drug can be made available outside of a clinical trial to treat patients with serious or life-threatening conditions for which there are no satisfactory treatment options. An expanded access program (EAP) is the formal plan under which preapproval access to an investigational drug can be provided to a group of patients. Although an EAP is a regulated program, the decision to authorize an EAP is the responsibility of the biopharmaceutical sponsor. Because of the significant impact an EAP can have on current patients, drug development, and future patients, we propose that a sponsor’s decision must be based not only on regulatory criteria but also on ethical and practical considerations regarding implementation of an EAP. Such an approach will help ensure that decisions and plans uphold ethical precepts such as fairness, promoting good, and minimizing risk of harm. PMID:29473010

  3. Distributed reservation control protocols for random access broadcasting channels

    NASA Technical Reports Server (NTRS)

    Greene, E. P.; Ephremides, A.

    1981-01-01

    Attention is given to a communication network consisting of an arbitrary number of nodes which can communicate with each other via a time-division multiple access (TDMA) broadcast channel. The reported investigation is concerned with the development of efficient distributed multiple access protocols for traffic consisting primarily of single packet messages in a datagram mode of operation. The motivation for the design of the protocols came from the consideration of efficient multiple access utilization of moderate to high bandwidth (4-40 Mbit/s capacity) communication satellite channels used for the transmission of short (1000-10,000 bits) fixed length packets. Under these circumstances, the ratio of roundtrip propagation time to packet transmission time is between 100 to 10,000. It is shown how a TDMA channel can be adaptively shared by datagram traffic and constant bandwidth users such as in digital voice applications. The distributed reservation control protocols described are a hybrid between contention and reservation protocols.

  4. The promise of telemedicine for chronic neurological disorders: the example of Parkinson's disease.

    PubMed

    Schneider, Ruth B; Biglan, Kevin M

    2017-07-01

    Disparities in access to health care, particularly specialist care, exist worldwide. As the prevalence of chronic neurological disorders increases with ageing populations, access to neurologist care is likely to worsen in many regions if there are no changes to models of care. Telemedicine-defined here as the use of real-time, synchronous videoconferencing to deliver medical care-could be used to improve access to neurologist care for patients with a range of chronic neurological disorders. In Parkinson's disease, several studies have shown the feasibility and potential benefits of telemedicine-delivered care. Further research is needed to establish whether telemedicine can deliver on the promise of improved access to neurologist care and whether telemedicine-delivered care is comparable to in-person care in terms of clinical outcomes. Many barriers to widespread implementation of telemedicine services remain to be addressed, including reimbursement, legal considerations, and technological issues. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Ethical issues of obesity surgery--a health technology assessment.

    PubMed

    Saarni, Samuli I; Anttila, Heidi; Saarni, Suoma E; Mustajoki, Pertti; Koivukangas, Vesa; Ikonen, Tuija S; Malmivaara, Antti

    2011-09-01

    New surgical technologies may challenge societal values, and their adoption may lead to ethical challenges. Despite proven cost-effectiveness, obesity (bariatric) surgery and its public funding have been questioned on ethical arguments relating to, for example, the self-inflicted or non-disease nature of obesity. Our aim was to analyze the ethical issues relevant to bariatric surgery. A comprehensive health technology assessment was conducted on bariatric surgery for morbid obesity using the EUnetHTA method, including a fully integrated ethical analysis. The ethical arguments suggesting that obesity should not be surgically treated because it is self-inflicted were rejected. Medicalization of obesity may have both positive and negative effects that impact the various stakeholders differently, thus being difficult to balance. Informing bariatric surgery patients and actively supporting their autonomy is exceptionally important, as the benefits and harms of both obesity and bariatric surgery are complex, and the outcome depends on how well the patient understands and adheres to the life-long changes in eating habits required. Justice considerations are important in organizing surgical treatment of obesity, as the obese are discriminated against in many ways and obesity is more common in socioeconomically disadvantaged populations who might have problems of access to treatments. Obesity should be treated like other diseases in health care, and obesity surgery rationed like other cost-effective treatments. Positive actions to ensure patient autonomy and just access to surgical treatments may be warranted.

  6. Computerised CBT for depressed adolescents: Randomised controlled trial.

    PubMed

    Smith, Patrick; Scott, Rebecca; Eshkevari, Ertimiss; Jatta, Fatoumata; Leigh, Eleanor; Harris, Victoria; Robinson, Alex; Abeles, Paul; Proudfoot, Judy; Verduyn, Chrissie; Yule, William

    2015-10-01

    Depression in adolescents is a common and impairing problem. Effective psychological therapies for depression are not accessed by most adolescents. Computerised therapy offers huge potential for improving access to treatment. To test the efficacy of Stressbusters, a Computerised-CBT (C-CBT) programme for depression in young people. Multi-site, schools-based, RCT of C-CBT compared to Waiting List, for young people (N = 112; aged 12-16) with significant symptoms of depression, using multiple-informants (adolescents, parents, teachers), with follow-up at 3 and 6 months. Relative to being on a Waiting List, C-CBT was associated with statistically significant and clinically meaningful improvements in symptoms of depression and anxiety according to adolescent self-report; and with a trend towards improvements in depression and anxiety according to parent-report. Improvements were maintained at follow-up. Treatment gains were similar for boys and girls across the participating age range. Treatment effect was partially mediated by changes in ruminative thinking. Teachers rated adolescents as having few emotional or behavioural problems, both before and after intervention. C-CBT had no detectable effect on academic attainment. In the month after intervention, young people who received C-CBT had significantly fewer absences from school than those on the Waiting List. C-CBT shows considerable promise for the treatment of mild-moderate depression in adolescents. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. [Ethylene glycol and propylene glycol ethers - Reproductive and developmental toxicity].

    PubMed

    Starek-Świechowicz, Beata; Starek, Andrzej

    2015-01-01

    Both ethylene and propylene glycol alkyl ethers (EGAEs and PGAEs, respectively) are widely used, mainly as solvents, in industrial and household products. Some EGAEs demonstrate gonadotoxic, embriotoxic, fetotoxic and teratogenic effects in both humans and experimental animals. Due to the noxious impact of these ethers on reproduction and development of organisms EGAEs are replaced for considerably less toxic PGAEs. The data on the mechanisms of testicular, embriotoxic, fetotoxic and teratogenic effects of EGAEs are presented in this paper. Our particular attention was focused on the metabolism of some EGAEs and their organ-specific toxicities, apoptosis of spermatocytes associated with changes in the expression of various genes that code for oxidative stress factors, protein kinases and nuclear hormone receptors. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  8. Tibiopedal access for lower extremity arterial intervention: when to use and how to perform.

    PubMed

    Wiechmann, Bret N

    2014-09-01

    Tibiopedal artery access is being used with increasing frequency as an alternative access to facilitate procedural success in lower extremity arterial intervention. This technique is usually employed in the setting of critical limb ischemia and tibial artery intervention, but it may offer potential practical advantages for popliteal artery and even superficial femoral artery intervention in unique situations. As in all cases of lower extremity arterial intervention, consideration of access is important not only for initial approach to any obstructing lesion but also for exit strategy. The dorsalis pedis artery and posterior tibial artery can be readily accessed if necessary owing to their relatively superficial position in the foot or the ankle, yet their normal diameter and the presence of significant calcification (a common finding in patients with tibial occlusive disease and critical limb ischemia) can pose difficulties as well. In addition, the peroneal artery in the lower leg can be accessed percutaneously; however, its size and depth may present additional challenges. Meticulous attention to detail is paramount in avoiding complications in what may be the only distal vessel supplying the foot. This article describes common techniques in using tibiopedal artery access as a means of alternative access for successful infrainguinal intervention. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Measurement of the potential geographic accessibility from call to definitive care for patient with acute stroke.

    PubMed

    Freyssenge, J; Renard, F; Schott, A M; Derex, L; Nighoghossian, N; Tazarourte, K; El Khoury, C

    2018-01-12

    The World Health Organization refers to stroke, the second most frequent cause of death in the world, in terms of pandemic. Present treatments are only effective within precise time windows. Only 10% of thrombolysis patients are eligible. Late assessment of the patient resulting from admission and lack of knowledge of the symptoms is the main explanation of lack of eligibility. The aim is the measurement of the time of access to treatment facilities for stroke victims, using ambulances (firemen ambulances or EMS ambulances) and private car. The method proposed analyses the potential geographic accessibility of stroke care infrastructure in different scenarios. The study allows better considering of the issues inherent to an area: difficult weather conditions, traffic congestion and failure to respect the distance limits of emergency transport. Depending on the scenario, access times vary considerably within the same commune. For example, between the first and the second scenario for cities in the north of Rhône county, there is a 10 min difference to the nearest Primary Stroke Center (PSC). For the first scenario, 90% of the population is 20 min away of the PSC and 96% for the second scenario. Likewise, depending on the modal vector (fire brigade or emergency medical service), overall accessibility from the emergency call to admission to a Comprehensive Stroke Center (CSC) can vary by as much as 15 min. The setting up of the various scenarios and modal comparison based on the calculation of overall accessibility makes this a new method for calculating potential access to care facilities. It is important to take into account the specific pathological features and the availability of care facilities for modelling. This method is innovative and recommendable for measuring accessibility in the field of health care. This study makes possible to highlight the patients' extension of care delays. Thus, this can impact the improvement of patient care and rethink the healthcare organization. Stroke is addressed here but it is applicable to other pathologies.

  10. Furthering Higher Education Possibilities through Massive Open Online Courses

    ERIC Educational Resources Information Center

    Mesquita, Anabela, Ed.; Peres, Paula, Ed.

    2015-01-01

    In recent years, technological advancements have enabled higher-learning institutions to offer millions of independent learners the opportunity to participate in open-access online courses. As this practice expands, drawing considerable media attention, questions continue to arise regarding pedagogical methodology and the long-term viability of…

  11. Building a High-Tech Library in a Period of Austerity.

    ERIC Educational Resources Information Center

    Bazillion, Richard J.; Scott, Sue

    1991-01-01

    Describes the planning process for designing a new library for Algoma University College (Ontario). Topics discussed include the building committee, library policy, design considerations, an electric system that supports computer technology, library automation, the online public access catalog (OPAC), furnishings and interior environment, and…

  12. 21 CFR 1309.72 - Felony conviction; employer responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... OF MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS OF LIST I CHEMICALS Security Requirements... consideration of employment of persons who will have access to listed chemicals, who have been convicted of a felony offense relating to controlled substances or listed chemicals, or who have, at any time, had an...

  13. 76 FR 73611 - Combined Notice of Filings #1

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-29

    ... that the Commission received the following electric corporate filings: Docket Numbers: EC12-35-000... and Confidential Treatment of Arizona Solar One LLC. Filed Date: 11/18/11. Accession Number: 20111118... Section 203 of the Federal Power Act, and for Expedited Consideration, Confidential Treatment and Waivers...

  14. Budgeting and Funding School Technology: Essential Considerations

    ERIC Educational Resources Information Center

    Ireh, Maduakolam

    2010-01-01

    School districts need adequate financial resources to purchase hardware and software, wire their buildings to network computers and other information and communication devices, and connect to the Internet to provide students, teachers, and other school personnel with adequate access to technology. Computers and other peripherals, particularly,…

  15. Intranets: Considerations for the Information Services Manager.

    ERIC Educational Resources Information Center

    Blackmore, Paul

    1997-01-01

    This article identifies benefits of using Internet technologies in an organization's intranet or internal information system: ease-of-use, one interface, implementation cost, access, information services (flat content and interactive intranets), support desks (via Web services and e-mail), document management. Discusses the impact of intranets on…

  16. To Remodel or To Build?

    ERIC Educational Resources Information Center

    Rosenblum, Todd

    2009-01-01

    The question of remodeling an existing house to make it wheelchair accessible or building a new barrier-free house is a difficult decision. This article presents some initial questions and considerations followed by a list of pros and cons for remodeling an existing house vs. building a new house.

  17. UK Breastfeeding Helpline support: An investigation of influences upon satisfaction

    PubMed Central

    2012-01-01

    Background Helpline services have become an increasingly popular mode of providing community access to information and expert information and advice in the health and welfare sector. This paper reports on data collected from 908 callers to UK-based breastfeeding helplines. Methods A mixed methods design was adopted utilising a structured interview schedule to elicit callers experiences of the help and support received. In this paper we report on a series of multiple regression models undertaken to elicit the variables associated with callers’ ‘overall satisfaction’ with the helpline service. Three models were constructed; 1) caller demographic/call characteristics; 2) attitudes and effectiveness of service characteristics and 3) impact of support on caller wellbeing. Results Overall, 74.6% of callers were very satisfied, and 19.8% were satisfied with the help and support received by the helpline service. The caller demographic/call characteristics found to have a significant relationship with overall satisfaction related to the ease of getting through to the helpline and whether the woman had previously breastfed. Service characteristics associated with overall satisfaction related to whether the information received was helpful and whether the support helped to resolve their issues. The extent to which the volunteer was perceived to have enough time, whether the support had encouraged them to continue breastfeeding, met the caller’s expectations and/or provided the support the caller needed were also significantly associated. Caller outcomes contributing significantly to overall satisfaction concerned callers feeling less stressed, more confident, reassured and determined to continue breastfeeding following the call. Consideration of the effect sizes indicated that key factors associated with overall satisfaction related to: volunteers having sufficient time to deal with the callers’ issues; the information being perceived as helpful; the volunteers providing the support the callers needed; and for callers to feel reassured following the call. Conclusion Overall, these results highlight the value of the breastfeeding helpline(s) in terms of providing rapid, targeted, realistic, practical, and responsive support that provides affirmation and encouragement. The benefits include confidence building and callers feeling reassured and motivated to continue breastfeeding. Care needs to be taken to ensure that helpline support is easily accessible to ensure that callers and their families can access support when needed. This may require consideration of extension to a 24 hour service. PMID:23234293

  18. The impact of visa status and Medicare eligibility on people diagnosed with HIV in Western Australia: a qualitative report.

    PubMed

    Herrmann, Susan; Wardrop, Joan; John, Mina; Gaudieri, Silvana; Lucas, Michaela; Mallal, Simon; Nolan, David

    2012-11-01

    In Australia, temporary visa holders are ineligible for Medicare and subsidised antiretroviral drugs. Additionally, HIV testing is not mandatory for visas unless applicants seek work in the health sector. We sought to understand the impact of HIV and issues of access and adherence to antiretroviral therapy (ART) in people holding temporary visas and permanent residents. Data were gathered from interviews with 22 participants. Information concerning medication adherence, side effects, CD4 T-cell count, viral load and rate of response to generic drugs were collected. The mean age was 33.4 years (±s.d.=6.0), 21 out of 22 were from HIV-prevalent areas in East Africa and Asia, 14 out of 22 were on temporary visas, 12 were ineligible for Medicare, 14 out of 22 were diagnosed during health screening, 19 out of 22 risk exposures were in country of origin, 8 out of 17 were taking generic ART at an average cost of $180 per month, adherence was excellent and self-reported side-effects were relatively infrequent. Participants applying for visa continuations and permanent residency were fearful, believing their HIV serostatus would prejudice their applications. Patients cited belief in ART efficacy, were motivated to maintain therapy and were anxious about lack of access to treatment in their countries of origin. Adherence to antiretroviral drugs in Medicare-ineligible HIV-infected individuals is excellent despite limited access to treatment. The threat of visa non-renewal and the likely failure of applications for permanent residency result in considerable anxiety and confidentiality concerns.

  19. Health in south-eastern Europe: a troubled past, an uncertain future.

    PubMed Central

    Rechel, Bernd; Schwalbe, Nina; McKee, Martin

    2004-01-01

    The political and economic turmoil that occurred in south-eastern Europe in the last decade of the twentieth century left a legacy of physical damage. This aspect of the conflict has received considerable coverage in the media. However, surprisingly less has been reported about the effects of that turmoil on the health of the people living in the region. In an attempt to identify and synthesize data on these effects, we carried out a systematic review and used the results to put together a searchable online database of documents, reports, and published material, the majority of which have not previously been easily accessible (http:// www.lshtm.ac.uk/ecohost/see/index.php). The database covers the period from the early 1990s to 2003 and will be of considerable interest to policy-makers. It contains 762 items, many of them annotated and available for downloading. This paper synthesizes the main findings obtained from the material in the database and emphasizes the need for concerted action to improve the health of people in south-eastern Europe. Furthermore, we also recommend that agencies working in post-conflict situations should invest in developing and maintaining online databases that would be useful to others working in the area. PMID:15500286

  20. Untold stories: biases and selection effects in research with victims of trafficking for sexual exploitation.

    PubMed

    Brunovskis, Anette; Surtees, Rebecca

    2010-01-01

    Recent discussions of trafficking research have included calls for more innovative studies and new methodologies in order to move beyond the current trafficking narrative, which is often based on unrepresentative samples and overly simplified images. While new methods can potentially play a role in expanding the knowledge base on trafficking, this article argues that the solution is not entirely about applying new methods, but as much about using current methods to greater effect and with careful attention to their limitations and ethical constraints. Drawing on the authors' experience in researching trafficking issues in a number of projects over the past decade, the article outlines and exemplifies some of the methodological and ethical issues to be considered and accommodated when conducting research with trafficked persons -- including unrepresentative samples; access to respondents; selection biases by "gatekeepers" and self selection by potential respondents. Such considerations should inform not only how research is undertaken but also how this information is read and understood. Moreover, many of these considerations equally apply when considering the application of new methods within this field. The article maintains that a better understanding of how these issues come into play and inform trafficking research will translate into tools for conducting improved research in this field and, by implication, new perspectives on human trafficking.

  1. Use of mobile devices in community health care: barriers and solutions to implementation.

    PubMed

    Turner, Christopher

    2016-02-01

    Mobile devices allow clinicians to access electronic clinical systems away from traditional base locations. They have contributed to increased productivity and efficiency, and clinical staff also cite benefits to patient care. A selection of NHS trusts have participated in a national pilot to explore the benefits and drawbacks of this technology. Clinical engagement with frontline staff is essential to ensure the staff feel valued, listened to, and fully involved to ensure any change to existing practice is successful. Moreover, the training needs of the workforce require careful consideration. The provision of information technology (IT) support services is fundamental to ensure that staff receive the necessary assistance with any functionality issues they may experience with mobile devices to minimise the effect on clinical practice. Variability in internet connectivity may present as a challenge to clinical staff, and the benefits of complimentary offline working solutions should be considered. Barriers to the successful use of mobile devices should be reported as this may have a negative clinical effect on the safe delivery of patient care. Clinical staff need to be mindful of their obligations in relation to information governance, and should appreciate that the same consideration needs to be given to both paper and electronic records.

  2. Rainwater as a chemical agent of geologic processes; a review

    USGS Publications Warehouse

    Carroll, Dorothy

    1962-01-01

    Chemical analyses of the rainwater collected at several localities are given to show the variations of the principal constitutents. In rock weathering and soil-forming processes, the chemical composition of rainwater has an important effect which has been evaluated for only a few arid areas. In humid regions the important amounts of calcium, magnesium, sodium, and potassium added yearly by rain may be expected to influence the composition of the soil water and thereby the cations in the exchange positions of soil clay minerals. The acquisition of cations by clay minerals may slow down chemical weathering. The stability of soil clay minerals is influenced by the constant accession of cations from rainwater. Conversely, the clay minerals modify the amounts and kinds of cations that are leached out by drainage waters. The stability of micaceous minerals in soils may be partly due to accessions of K +1 ions from rainwater. The pH of rainwater in any area varies considerably and seems to form a seasonal and regional pattern. The recorded pH values range from 3.0 to 9.8.

  3. Beyond information access: Support for complex cognitive activities in public health informatics tools.

    PubMed

    Sedig, Kamran; Parsons, Paul; Dittmer, Mark; Ola, Oluwakemi

    2012-01-01

    Public health professionals work with a variety of information sources to carry out their everyday activities. In recent years, interactive computational tools have become deeply embedded in such activities. Unlike the early days of computational tool use, the potential of tools nowadays is not limited to simply providing access to information; rather, they can act as powerful mediators of human-information discourse, enabling rich interaction with public health information. If public health informatics tools are designed and used properly, they can facilitate, enhance, and support the performance of complex cognitive activities that are essential to public health informatics, such as problem solving, forecasting, sense-making, and planning. However, the effective design and evaluation of public health informatics tools requires an understanding of the cognitive and perceptual issues pertaining to how humans work and think with information to perform such activities. This paper draws on research that has examined some of the relevant issues, including interaction design, complex cognition, and visual representations, to offer some human-centered design and evaluation considerations for public health informatics tools.

  4. Unlocking the genetic diversity of Creole wheats.

    PubMed

    Vikram, Prashant; Franco, Jorge; Burgueño-Ferreira, Juan; Li, Huihui; Sehgal, Deepmala; Saint Pierre, Carolina; Ortiz, Cynthia; Sneller, Clay; Tattaris, Maria; Guzman, Carlos; Sansaloni, Carolina Paola; Ellis, Mark; Fuentes-Davila, Guillermo; Reynolds, Matthew; Sonders, Kai; Singh, Pawan; Payne, Thomas; Wenzl, Peter; Sharma, Achla; Bains, Navtej Singh; Singh, Gyanendra Pratap; Crossa, José; Singh, Sukhwinder

    2016-03-15

    Climate change and slow yield gains pose a major threat to global wheat production. Underutilized genetic resources including landraces and wild relatives are key elements for developing high-yielding and climate-resilient wheat varieties. Landraces introduced into Mexico from Europe, also known as Creole wheats, are adapted to a wide range of climatic regimes and represent a unique genetic resource. Eight thousand four hundred and sixteen wheat landraces representing all dimensions of Mexico were characterized through genotyping-by-sequencing technology. Results revealed sub-groups adapted to specific environments of Mexico. Broadly, accessions from north and south of Mexico showed considerable genetic differentiation. However, a large percentage of landrace accessions were genetically very close, although belonged to different regions most likely due to the recent (nearly five centuries before) introduction of wheat in Mexico. Some of the groups adapted to extreme environments and accumulated high number of rare alleles. Core reference sets were assembled simultaneously using multiple variables, capturing 89% of the rare alleles present in the complete set. Genetic information about Mexican wheat landraces and core reference set can be effectively utilized in next generation wheat varietal improvement.

  5. Emergency Food Assistance in Northern Syria: An Evaluation of Transfer Programs in Idleb Governorate.

    PubMed

    Doocy, Shannon; Tappis, Hannah; Lyles, Emily; Witiw, Joseph; Aken, Vicki

    2017-06-01

    The war in Syria has left millions struggling to survive amidst violent conflict, pervasive unemployment, and food insecurity. Although international assistance funding is also at an all-time high, it is insufficient to meet the needs of conflict-affected populations, and there is increasing pressure on humanitarian stakeholders to find more efficient, effective ways to provide assistance. To evaluate 3 different assistance programs (in-kind food commodities, food vouchers, and unrestricted vouchers) in Idleb Governorate of Syria from December 2014 and March 2015. The evaluation used repeated survey data from beneficiary households to determine whether assistance was successful in maintaining food security at the household level. Shopkeeper surveys and program monitoring data were used to assess the impact on markets at the district/governorate levels and compare the cost-efficiency and cost-effectiveness of transfer modalities. Both in-kind food assistance and voucher programs showed positive effects on household food security and economic measures in Idleb; however, no intervention was successful in improving all outcomes measured. Food transfers were more likely to improve food access and food security than vouchers and unrestricted vouchers. Voucher programs were found to be more cost-efficient than in-kind food assistance, and more cost-effective for increasing household food consumption. Continuation of multiple types of transfer programs, including both in-kind assistance and vouchers, will allow humanitarian actors to remain responsive to evolving access and security considerations, local needs, and market dynamics.

  6. Genotype modulates age-related alterations in sensitivity to the aversive effects of ethanol: an eight inbred strain analysis of conditioned taste aversion.

    PubMed

    Moore, E M; Forrest, R D; Boehm, S L

    2013-02-01

    Adolescent individuals display altered behavioral sensitivity to ethanol, which may contribute to the increased ethanol consumption seen in this age-group. However, genetics also exert considerable influence on both ethanol intake and sensitivity. Currently there is little research assessing the combined influence of developmental and genetic alcohol sensitivities. Sensitivity to the aversive effects of ethanol using a conditioned taste aversion (CTA) procedure was measured during both adolescence (P30) and adulthood (P75) in eight inbred mouse strains (C57BL/6J, DBA/2J, 129S1/SvImJ, A/J, BALB/cByJ, BTBR T(+) tf/J, C3H/HeJ and FVB/NJ). Adolescent and adult mice were water deprived, and subsequently provided with access to 0.9% (v/v) NaCl solution for 1 h. Immediately following access mice were administered ethanol (0, 1.5, 2.25 and 3 g/kg, ip). This procedure was repeated in 72 h intervals for a total of five CTA trials. Sensitivity to the aversive effects of ethanol was highly dependent upon both strain and age. Within an inbred strain, adolescent animals were consistently less sensitive to the aversive effects of ethanol than their adult counterparts. However, the dose of ethanol required to produce an aversion response differed as a function of both age and strain. © 2012 Blackwell Publishing Ltd and International Behavioural and Neural Genetics Society.

  7. A systematic review of social networking sites: innovative platforms for health research targeting adolescents and young adults.

    PubMed

    Park, Bu Kyung; Calamaro, Christina

    2013-09-01

    To review the evidence to determine if social networking sites (SNS) are effective tools for health research in the adolescent and young adult populations. Systematic review of published research articles focused on use of SNS for youth health research. Seventeen articles were selected that met the following criteria: used SNS at any stage of study, participants between 13 and 25 years of age, English language, and both international and national studies. Reviewers categorized selected studies based on the way SNS were used. Utilization of SNS for effectively implementing research with adolescents and young adults include (a) recruitment, (b) intervention, and (c) measurement. Four findings about advantages of using SNS apparent in this review are (a) ease of access to youth, (b) cost effectiveness in recruitment, (c) ease of intervention, and (d) reliable screening venue of mental status and high-risk behaviors. Although this literature review showed relatively minimal research to date on the use of SNS for research targeting adolescents and young adults, the impact of using SNS for health research is of considerable importance for researchers as well as participants. With careful focus, SNS can become a valuable platform to access, recruit, and deliver health interventions in a cost-effective manner to youth populations as well as hard-to-reach minority or underserved populations. The evidence demonstrates the usefulness of SNS as innovative platforms for health promotion among adolescents and young adults. © 2013 Sigma Theta Tau International.

  8. From evidence based bioethics to evidence based social policies.

    PubMed

    Bonneux, Luc

    2007-01-01

    In this issue, Norwegian authors demonstrate that causes of early expulsion out the workforce are rooted in childhood. They reconstruct individual biographies in administrative databases linked by an unique national identification number, looking forward 15 years in early adulthood and looking back 20 years till birth with close to negligible loss to follow up. Evidence based bioethics suggest that it is better to live in a country that allows reconstructing biographies in administrative databases then in countries that forbid access by restrictive legislation based on privacy considerations. The benefits of gained knowledge from existing and accessible information are tangible, particularly for the weak and the poor, while the harms of theoretical privacy invasion have not yet materialised. The study shows once again that disadvantage runs in families. Low parental education, parental disability and unstable marital unions predict early disability pensions and premature expulsion out gainful employment. The effect of low parental education is mediated by low education of the index person. However, in a feast of descriptive studies of socio-economic causes of ill health we still face a famine of evaluative intervention studies. An evidence based social policy should be based on effective interventions that are able to break the vicious circles of disability handed down from generation to generation.

  9. Game Theory Based Security in Wireless Body Area Network with Stackelberg Security Equilibrium

    PubMed Central

    Somasundaram, M.; Sivakumar, R.

    2015-01-01

    Wireless Body Area Network (WBAN) is effectively used in healthcare to increase the value of the patient's life and also the value of healthcare services. The biosensor based approach in medical care system makes it difficult to respond to the patients with minimal response time. The medical care unit does not deploy the accessing of ubiquitous broadband connections full time and hence the level of security will not be high always. The security issue also arises in monitoring the user body function records. Most of the systems on the Wireless Body Area Network are not effective in facing the security deployment issues. To access the patient's information with higher security on WBAN, Game Theory with Stackelberg Security Equilibrium (GTSSE) is proposed in this paper. GTSSE mechanism takes all the players into account. The patients are monitored by placing the power position authority initially. The position authority in GTSSE is the organizer and all the other players react to the organizer decision. Based on our proposed approach, experiment has been conducted on factors such as security ratio based on patient's health information, system flexibility level, energy consumption rate, and information loss rate. Stackelberg Security considerably improves the strength of solution with higher security. PMID:26759829

  10. Same-sex cohabiting elders versus different-sex cohabiting and married elders: effects of relationship status and sex of partner on economic and health outcomes.

    PubMed

    Baumle, Amanda K

    2014-01-01

    In this article, I use pooled data from the 2008-2010 American Community Surveys to examine outcomes for different-sex married, different-sex cohabiting, and same-sex cohabiting elders across several key economic and health indicators, as well as other demographic characteristics. The findings suggest that elders in same-sex cohabiting partnerships differ from those in different-sex marriages and different-sex cohabiting relationships in terms of both financial and health outcomes, and that women in same-sex cohabiting partnerships fare worse than men or women in other couple types. The results indicate that financial implications related to the sex of one's partner might be more predictive of economic and health outcomes in old age, rather than solely access to legal marriage. Nonetheless, findings suggest that individuals in same-sex cohabiting partnerships might experience worse outcomes in old age as a result of cumulative effects across the life course from both the sex of their partner (in the case of female couples) as well as their lack of access to benefits associated with marriage. Accordingly, these findings demonstrate that persons in same-sex cohabiting partnerships require unique policy considerations to address health and economic concerns in old age. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Measuring systems of hard to get objects: problems with analysis of measurement results

    NASA Astrophysics Data System (ADS)

    Gilewska, Grazyna

    2005-02-01

    The problem accessibility of metrological parameters features of objects appeared in many measurements. Especially if it is biological object which parameters very often determined on the basis of indirect research. Accidental component predominate in forming of measurement results with very limited access to measurement objects. Every measuring process has a lot of conditions limiting its abilities to any way processing (e.g. increase number of measurement repetition to decrease random limiting error). It may be temporal, financial limitations, or in case of biological object, small volume of sample, influence measuring tool and observers on object, or whether fatigue effects e.g. at patient. It's taken listing difficulties into consideration author worked out and checked practical application of methods outlying observation reduction and next innovative methods of elimination measured data with excess variance to decrease of mean standard deviation of measured data, with limited aomunt of data and accepted level of confidence. Elaborated methods wee verified on the basis of measurement results of knee-joint width space got from radiographs. Measurements were carried out by indirectly method on the digital images of radiographs. Results of examination confirmed legitimacy to using of elaborated methodology and measurement procedures. Such methodology has special importance when standard scientific ways didn't bring expectations effects.

  12. IDMA-Based MAC Protocol for Satellite Networks with Consideration on Channel Quality

    PubMed Central

    2014-01-01

    In order to overcome the shortcomings of existing medium access control (MAC) protocols based on TDMA or CDMA in satellite networks, interleave division multiple access (IDMA) technique is introduced into satellite communication networks. Therefore, a novel wide-band IDMA MAC protocol based on channel quality is proposed in this paper, consisting of a dynamic power allocation algorithm, a rate adaptation algorithm, and a call admission control (CAC) scheme. Firstly, the power allocation algorithm combining the technique of IDMA SINR-evolution and channel quality prediction is developed to guarantee high power efficiency even in terrible channel conditions. Secondly, the effective rate adaptation algorithm, based on accurate channel information per timeslot and by the means of rate degradation, can be realized. What is more, based on channel quality prediction, the CAC scheme, combining the new power allocation algorithm, rate scheduling, and buffering strategies together, is proposed for the emerging IDMA systems, which can support a variety of traffic types, and offering quality of service (QoS) requirements corresponding to different priority levels. Simulation results show that the new wide-band IDMA MAC protocol can make accurate estimation of available resource considering the effect of multiuser detection (MUD) and QoS requirements of multimedia traffic, leading to low outage probability as well as high overall system throughput. PMID:25126592

  13. Culturally and linguistically diverse population health social marketing campaigns in Australia: a consideration of evidence and related evaluation issues.

    PubMed

    Milat, Andrew J; Carroll, Tom E; Taylor, Jennifer J

    2005-04-01

    This paper describes a review of population health social marketing campaigns targeting culturally and linguistically diverse (CLD) communities in Australia in order to identify characteristics of effective CLD campaigns. Literature on CLD population health social marketing was identified from electronic searches of databases in August 2004. At the same time, the grey literature was examined by searching the Internet and talking to Australian experts in the fields of CLD social marketing and CLD research. Eight studies met the search criteria, four from the published literature. Two studies that employed prepost evaluation designs provided tentative support for the potential efficacy of CLD social marketing strategies. The remaining studies did not allow for causal attribution as they used post-campaign only or process evaluations. Studies did, however, show that CLD communities access campaign-related information from both mainstream and ethnic media channels. In addition, Vietnamese respondents were more likely to access campaign messages through ethnic radio and Chinese respondents through ethnic press. There is insufficient evidence to clearly identify the characteristics of effective CLD campaigns. Campaign evaluation designs used to evaluate social marketing strategies targeting CLD communities in Australia are generally weak, but there is tentative evidence supporting the potential efficacy of these strategies in some Australian settings.

  14. Variation Across U.S. Assisted Living Facilities: Admissions, Resident Care Needs, and Staffing.

    PubMed

    Han, Kihye; Trinkoff, Alison M; Storr, Carla L; Lerner, Nancy; Yang, Bo Kyum

    2017-01-01

    Though more people in the United States currently reside in assisted living facilities (ALFs) than nursing homes, little is known about ALF admission policies, resident care needs, and staffing characteristics. We therefore conducted this study using a nationwide sample of ALFs to examine these factors, along with comparison of ALFs by size. Cross-sectional secondary data analysis using data from the 2010 National Survey of Residential Care Facilities. Measures included nine admission policy items, seven items on the proportion of residents with selected conditions or care needs, and six items on staffing characteristics (e.g., access to licensed nurse, aide training). Facilities (n = 2,301) were divided into three categories by size: small, 4 to 10 beds; medium, 11 to 25 beds; and large, 26 or more beds. Analyses took complex sampling design effects into account to project national U.S. estimates. More than half of ALFs admitted residents with considerable healthcare needs and served populations that required nursing care, such as for transfers, medications, and eating or dressing. Staffing was largely composed of patient care aides, and fewer than half of ALFs had licensed care provider (registered nurse, licensed practical nurse) hours. Smaller facilities tended to have more inclusive admission policies and residents with more complex care needs (more mobility, eating and medication assistance required, short-term memory issues, p < .01) and less access to licensed nurses than larger ALFs (p < .01). This study suggests ALFs are caring for and admitting residents with considerable care needs, indicating potential overlap with nursing home populations. Despite this finding, ALF regulations lag far behind those in effect for nursing homes. In addition, measurement of care outcomes is critically needed to ensure appropriate ALF care quality. As more people choose ALFs, outcome measures for ALFs, which are now unavailable, should be developed to allow for oversight and monitoring of care quality. © 2016 Sigma Theta Tau International.

  15. Qualitative study of physicians' varied uses of biomedical research in the USA

    PubMed Central

    Maggio, Lauren A; Moorhead, Laura L; Willinsky, John M

    2016-01-01

    Objective To investigate the nature of physicians' use of research evidence in experimental conditions of open access to inform training and policy. Design This qualitative study was a component of a larger mixed-methods initiative that provided 336 physicians with relatively complete access to research literature via PubMed and UpToDate, for 1 year via an online portal, with their usage recorded in web logs. Using a semistructured interview protocol, a subset of 38 physician participants were interviewed about their use of research articles in general and were probed about their reasons for accessing specific articles as identified through their web logs. Transcripts were analysed using a general inductive approach. Setting Physician participants were recruited from and registered in the USA. Participants 38 physicians from 16 US states, engaged in 22 medical specialties, possessing more than 1 year of experience postresidency training participated. Results 26 participants attested to the value of consulting research literature within the context of the study by making reference to their roles as clinicians, educators, researchers, learners, administrators and advocates. The physicians reported previously encountering what they experienced as a prohibitive paywall barrier to the research literature and other frustrations with the nature of information systems, such as the need for passwords. Conclusions The findings, against the backdrop of growing open access to biomedical research, indicate that a minority of physicians, at least initially, is likely to seek out and use research and do so in a variety of common roles. Physicians' use of research in these roles has not traditionally been part of their training or part of the considerations for open access policies. The findings have implications for educational and policy initiatives directed towards increasing the effectiveness of this access to and use of research in improving the quality of healthcare. PMID:27872121

  16. Health Technology Assessment, International Reference Pricing, and Budget Control Tools from China's Perspective: What Are the Current Developments and Future Considerations?

    PubMed

    Koh, Liling; Glaetzer, Christoph; Chuen Li, Shu; Zhang, Meng

    2016-05-01

    China is investing considerably in health care reforms to address issues in its health care system. An example is access to innovative drugs, which remains challenging because it is largely dependent on patient self-pay. Recognizing this, the government has invested considerably in its basic medical insurance. As health care expenditure increases, there are growing concerns on budget control. Several health policy tools have been discussed recently such as health technology assessment, international reference pricing, and hospital budget control tools, which can be viewed as addressing the affordability concerns of the government budget. China has also listed her health outcomes goals in "Healthy China 2020" initiative. This article aimed to discuss the "fit-for-purpose" of these tools to address budget concerns and support China in reaching her health outcomes goals. The findings are informed by a panel discussion at ISPOR Asia Pacific 2014, literature review, and authors' experience. This review looks at the current developments in China and the considerations and implications for using these tools by drawing experiences from countries where they are used. These tools are generally used in countries with advanced health care systems. China's health care spending is still below that of countries with advanced health care systems and below World Health Organization recommendation. China has not yet reached the "critical mass" necessary for the effective use of these tools. As China continues its health care reforms, increase in health care spending to balance the health needs of the population would be key. Copyright © 2015. Published by Elsevier Inc.

  17. Pharmacotherapy for alcohol dependence: perceived treatment barriers and action strategies among Veterans Health Administration service providers.

    PubMed

    Harris, Alex H S; Ellerbe, Laura; Reeder, Rachelle N; Bowe, Thomas; Gordon, Adam J; Hagedorn, Hildi; Oliva, Elizabeth; Lembke, Anna; Kivlahan, Daniel; Trafton, Jodie A

    2013-11-01

    Although access to and consideration of pharmacological treatments for alcohol dependence are consensus standards of care, receipt of these medications by patients is generally rare and highly variable across treatment settings. The goal of the present project was to survey and interview the clinicians, managers, and pharmacists affiliated with addiction treatment programs within Veterans Health Administration (VHA) facilities to learn about their perceptions of barriers and facilitators regarding greater and more reliable consideration of pharmacological treatments for alcohol dependence. Fifty-nine participants from 19 high-adopting and 11 low-adopting facilities completed the survey (facility-level response rate = 50%) and 23 participated in a structured interview. The top 4 barriers to increased consideration and use of pharmacotherapy for alcohol dependence were consistent across high- and low-adopting facilities and included perceived low patient demand, pharmacy procedures or formulary restrictions, lack of provider skills or knowledge regarding pharmacotherapy for alcohol dependence, and lack of confidence in treatment effectiveness. Low patient demand was rated as the most important barrier for oral naltrexone and disulfiram, whereas pharmacy or formulary restrictions were rated as the most important barrier for acamprosate and extended-release naltrexone. The 4 strategies rated across low- and high-adopting facilities as most likely to facilitate consideration and use of pharmacotherapy for alcohol dependence were more education to patients about existing medications, more education to health care providers about medications, increased involvement of physicians in treatment for alcohol dependence, and more compelling research on existing medications. This knowledge provides a foundation for designing, deploying, and evaluating targeted implementation efforts.

  18. Planning for Technology: An Administrator's Guide to the Next Century.

    ERIC Educational Resources Information Center

    Day, William C.

    1998-01-01

    Discusses ways for preparing schools for integrating technology, including designing the wiring infrastructure, equipment purchases, furniture needs, and ergonomic considerations. Describes four levels of Internet connectivity access and provides a list of contact names, phone numbers, and Web sites for technology fund information from each state.…

  19. Making Sense of Energy

    ERIC Educational Resources Information Center

    Boohan, Richard

    2014-01-01

    This article describes an approach to teaching about the energy concept that aims to be accessible to students starting in early secondary school, while being scientifically rigorous and forming the foundation for later work. It discusses how exploring thermal processes is a good starting point for a more general consideration of the ways that…

  20. Espey, Huston & Associates Technical Library. A Proposal.

    ERIC Educational Resources Information Center

    Fortine, Suellen

    This proposal for the establishment of a library or information center for an environmental and engineering consulting firm in Texas is divided into two phases--current problems, and future expansion of library service. Major considerations include informational problems of the existing small library facility, i.e., locational and subject access,…

  1. 76 FR 76640 - Telecommunications Act Accessibility Guidelines; Electronic and Information Technology...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-08

    ... benefits and costs, and recommended alternatives. The Board also invites the public to identify any gaps in... guidelines, alternative policies to those presented, and information on benefits and costs. After reviewing... with considerable potential cost in relation to the benefit. Because this requirement potentially would...

  2. Design Considerations for an OPAC Workstation: An Introduction to Specifications and a Model Configuration.

    ERIC Educational Resources Information Center

    Martin, Ron G.

    1989-01-01

    Describes guidelines for an online public access catalog (OPAC) workstation that will support the terminal, printer, and other peripherals. Workstation dimensions, lighting, wire management, printer and paper, acoustical treatment, seating, storage for books and coats, wastebasket, and interior decoration are addressed. Flexibility and simplicity…

  3. An Evaluation of an Automated Approach to Concept-Based Grammar Instruction

    ERIC Educational Resources Information Center

    Lyddon, Paul A.

    2012-01-01

    Acquiring sufficient linguistic proficiency to perform competently in academic and professional contexts generally requires substantial study time beyond what most language programs can offer in the classroom. As such, teachers and students alike would benefit considerably from high quality self-access materials promoting independent learning out…

  4. Digital Technology in the 21st Century: Considerations for Clinical Supervision in Rehabilitation Education

    ERIC Educational Resources Information Center

    Byrne, Andrew M.; Hartley, Michael T.

    2010-01-01

    Technological innovations are increasingly affecting the delivery of clinical supervision. Yet there is limited information on how supervisors can use digital technology to broaden settings in which students record client interviews, enhance evaluation of students' clinical performance, and increase accessibility for students with disabilities.…

  5. 76 FR 20386 - Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-12

    ... series of online investor forms. Investors may access these forms through the SEC Center for Complaints... depends on the number of investors who use the forms each year and the estimated time it takes to complete... techniques or other forms of information technology. Consideration will be given to comments and suggestions...

  6. Realizing the Promises of Mobile Learning

    ERIC Educational Resources Information Center

    Wagner, Ellen D.

    2008-01-01

    This article considers the current status of mobile learning and discusses a number of trends that are driving toward enterprise mobility, a state of technological readiness where users have full access to resources regardless of physical location. Enterprise mobility is discussed as one of several key considerations at the core of a successful…

  7. Inclusive Education and "Barrierefreiheit": Some Social-Epistemological Considerations

    ERIC Educational Resources Information Center

    Horsthemke, Kai

    2017-01-01

    "Barrierefreiheit" is a key term in the German inclusion movement, in education and more generally. Sometimes translated as "accessibility," it refers not just to absence of barriers but to freedom from barriers, which in turn indicates a significant social and ethical component. It signals an active, conscious intervention by…

  8. The Classroom, Board Room, Chat Room, and Court Room: School Computers at the Crossroads.

    ERIC Educational Resources Information Center

    Stewart, Michael

    2000-01-01

    In schools' efforts to maximize technology's benefits, ethical considerations have often taken a back seat. Computer misuse is growing exponentially and assuming many forms: unauthorized data access, hacking, piracy, information theft, fraud, virus creation, harassment, defamation, and discrimination. Integrated-learning activities will help…

  9. Mainstreaming Handicapped Individuals: Parks and Recreation Design Standards Manual.

    ERIC Educational Resources Information Center

    Illinois State Dept. of Conservation, Springfield.

    Intended as a guide for designing and constructing accessible buildings and park facilities for handicapped persons, the manual details design considerations for the following areas: parks and recreation areas, identification signs, parking, trails, picnic areas, furnishings, camp sites, boating, fishing, play and game areas, swimming areas,…

  10. Object-oriented design for accelerator control

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

    Stok, P.D.V. van der; Berk, F. van den; Deckers, R.

    1994-02-01

    An object-oriented design for the distributed computer control system of the accelerator ring EUTERPE is presented. Because of the experimental nature of the ring, flexibility is of the utmost importance. The object-oriented principles have contributed considerably to the flexibility of the design incorporating multiple views, multi-level access and distributed surveillance.

  11. 76 FR 62862 - Notice; Applications and Amendments to Facility Operating Licenses Involving Proposed No...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-11

    ... Operating Licenses Involving Proposed No Significant Hazards Considerations and Containing Sensitive Unclassified Non-Safeguards Information and Order Imposing Procedures for Access to Sensitive Unclassified Non... document. You may submit comments by any one of the following methods: Federal Rulemaking Web Site: Go to...

  12. 77 FR 15813 - Preoperational Testing of Instrument and Control Air Systems

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-16

    ... seismic requirement, ICAS air-dryer testing to meet dew point design requirements, ICAS accumulator check... ensure consideration only for comments received on or before this date. Although a time limit is given... improvements in all published guides are encouraged at any time. ADDRESSES: You may access information and...

  13. Cancer Immunotherapy Using Virus-like Particles | NCI Technology Transfer Center | TTC

    Cancer.gov

    A considerable effort has been devoted to identifying and targeting specific extracellular cancer markers using antibody based therapies. However, diminished access to new cancer cell surface markers has limited the development of corresponding antibodies. NCI Technology Transfer Center is seeking to license cancer immunotherapy using virus-like particles.

  14. Collaborative Language Learning for Professional Adults

    ERIC Educational Resources Information Center

    Mesh, Linda Joy

    2010-01-01

    Institutions of higher education realise the importance of the role of learning organisations in terms of providing personnel training and updating. Yet further consideration should be given to flexible and accessible means for meeting the growing request for continuous learning. Jason Hughes describes an organization's capability to "learn how to…

  15. Great Dismal Swamp National Wildlife Refuge Interagency Assistance Group : transportation observations, considerations and recommendations

    DOT National Transportation Integrated Search

    2014-07-01

    In March 2014, U.S. FWS hosted a Transportation Assistance Group at the Great Dismal Swamp in Virginia. The purpose of the meeting was to identify transportation issues impacting the refuge, ways to improve access to and within the refuge, as well as...

  16. Visual Enhancements: Improving Deaf Students' Transition Skills Using Multimedia Technology.

    ERIC Educational Resources Information Center

    Davis, Cheryl D.

    1999-01-01

    Discusses developments in technology that provide high-quality visual access to transition information and multimedia instruction for learners with deafness. Identifies a variety of considerations in using multimedia products and describes the pros and cons of different media in the context of several multimedia projects. (Author/CR)

  17. Blending Online Learning with Traditional Approaches: Changing Practices

    ERIC Educational Resources Information Center

    Condie, Rae; Livingston, Kay

    2007-01-01

    Considerable claims have been made for the development of e-learning, either as stand-alone programmes or alongside more traditional approaches to teaching and learning, for students across school and tertiary education. National initiatives have improved the position of schools in terms of access to hardware and electronic networking, software…

  18. National Aeronautics and Space Administration's (NASA) Automated Information Security Handbook

    NASA Technical Reports Server (NTRS)

    Roback, E.

    1991-01-01

    The NASA Automated Information Security Handbook provides NASA's overall approach to automated information systems security including discussions of such aspects as: program goals and objectives, assignment of responsibilities, risk assessment, foreign national access, contingency planning and disaster recovery, awareness training, procurement, certification, planning, and special considerations for microcomputers.

  19. An Information Policy for the Information Age.

    ERIC Educational Resources Information Center

    Blake, Virgil; Surprenant, Thomas

    1988-01-01

    Discusses recent federal information policies that pose a threat to access to information. A short-lived policy for protection of sensitive but unclassified information is criticized, and the Computer Security Act of 1987, currently under consideration in Congress, is described. Involvement by the library and information community in developing…

  20. A Measured Approach to Microcomputer Lab Design.

    ERIC Educational Resources Information Center

    Duggan, Brian

    1994-01-01

    Explores design considerations for a functional microcomputer lab, including ergonomics and furnishings; access for the disabled; the use of other media; hardware security; and software security, including virus protection. A summary paragraph comments on the role of planning and forecasting. A bibliography of eight titles for further reading is…

  1. Electronic Books: A Major Publishing Revolution. Part 1: General Considerations and Issues.

    ERIC Educational Resources Information Center

    Hawkins, Donald T.

    2000-01-01

    Discusses electronic books and their impact on the publishing industry. Topics include a history of the book industry; downloadable ebooks; dedicated ebook readers; Web-accessible ebooks; print-on-demand books; advantages and disadvantages; copyright; ebook concerns in libraries, including licensing, lack of standards, bibliographic control, and…

  2. Development of a statewide transportation data warehousing and mining system under the Louisiana transportation information system (LATIS) program : technical summary report.

    DOT National Transportation Integrated Search

    2009-04-01

    Considerable amounts of data are collected by metropolitan and state authorities that : are either not used or accessed and analyzed with difficulty. This situation has been : exacerbated by the recent increase in information from Intelligent Transpo...

  3. Multi-Cultural Considerations for Counselling First Nations Clients

    ERIC Educational Resources Information Center

    Nuttgens, Simon A.; Campbell, Allan J.

    2010-01-01

    Despite evidence that First Nations people experience a disproportionate degree of mental health concerns relative to other Canadians, many within this population do not access Western-based mental health services. In this article we extend a socio-political and historical rationale for attending to key cultural differences when working with First…

  4. Cable in Mass 2.

    ERIC Educational Resources Information Center

    Founders Annex Public Service Project, Inc., Dedham, MA.

    The current (1972) status of cable television (CATV) in Massachusetts is reviewed in this guide. The tone of the guide is oriented toward more citizen participation and public access to CATV operations throughout the state. The legal and technical CATV considerations are briefly discussed. Short illustrated chapters on the possibilities of local…

  5. 77 FR 55781 - Port Access Route Study: The Atlantic Coast from Maine to Florida

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-11

    ... the interim report or submission of additional information for consideration by the workgroup. DATES...) Mail: Docket Management Facility (M-30), U.S. Department of Transportation, West Building Ground Floor... Participation and Request for Comments'' portion of the SUPPLEMENTARY INFORMATION section below for instructions...

  6. Artificial gravity studies and design considerations for Space Station centrifuges

    NASA Technical Reports Server (NTRS)

    Halstead, T. W.; Brown, A. H.; Fuller, C. A.; Oyama, J.

    1984-01-01

    The requirements to and capabilities of a Space Station biological facility centrifuge are discussed on the basis of an assessment of the objectives and subjects of future microgravity biological experiments. It is argued that the facility should be capable of both acute and extended chronic exposure of test subjects and biological materials to altered-g loading. In addition, the experimental approaches and equipment for microgravity studies on a Space Station are outlined. Finally, the engineering requirements of such a centrifuge are examined, with consideration of radial gravity gradients, size, and physical access to animals.

  7. [A father's motherhood... or a mother's fatherhood? Transgender, assisted reproduction and bioethics].

    PubMed

    Alvarez-Díaz, Jorge Alberto

    2009-01-01

    The presence of a transsexual pregnant male in the mass media has made people reassess if transsexuals should have access to assisted reproduction. The bioethical discussion should focus on the future child best interests. This article describes the story of this transsexual man, legally married to a woman in the state of Oregon in the United States. A brief overview of transsexuality and the specific characteristics of this case, with special considerations towards fertility in transsexual people is included. We suggest reflections on what constitutes motherhood and fatherhood and bioethical considerations brought forth by this groundbreaking event.

  8. WORK POTENTIAL OF THE HANDICAPPED—The Physician's Role in Evaluating It

    PubMed Central

    Montero, Jose C.

    1960-01-01

    Even a severe physical defect may not be a handicap on some jobs; even a mild one may be a handicap on others. Physicians considering the employability of a disabled person must not only appraise the person but also must analyze the job. Job analysis must take into consideration the degree of exertion necessary, the emotional demands, working conditions (including accessibility of the place of work, of toilet facilities and the like) and job hazards. Appraisal of the person must include a medical examination, a review of the work history, consideration of socio-economic background, and psychological testing. PMID:14423720

  9. Effects of marine reserves versus nursery habitat availability on structure of reef fish communities.

    PubMed

    Nagelkerken, Ivan; Grol, Monique G G; Mumby, Peter J

    2012-01-01

    No-take marine fishery reserves sustain commercial stocks by acting as buffers against overexploitation and enhancing fishery catches in adjacent areas through spillover. Likewise, nursery habitats such as mangroves enhance populations of some species in adjacent habitats. However, there is lack of understanding of the magnitude of stock enhancement and the effects on community structure when both protection from fishing and access to nurseries concurrently act as drivers of fish population dynamics. In this study we test the separate as well as interactive effects of marine reserves and nursery habitat proximity on structure and abundance of coral reef fish communities. Reserves had no effect on fish community composition, while proximity to nursery habitat only had a significant effect on community structure of species that use mangroves or seagrass beds as nurseries. In terms of reef fish biomass, proximity to nursery habitat by far outweighed (biomass 249% higher than that in areas with no nursery access) the effects of protection from fishing in reserves (biomass 21% lower than non-reserve areas) for small nursery fish (≤ 25 cm total length). For large-bodied individuals of nursery species (>25 cm total length), an additive effect was present for these two factors, although fish benefited more from fishing protection (203% higher biomass) than from proximity to nurseries (139% higher). The magnitude of elevated biomass for small fish on coral reefs due to proximity to nurseries was such that nursery habitats seem able to overrule the usually positive effects on fish biomass by reef reserves. As a result, conservation of nursery habitats gains importance and more consideration should be given to the ecological processes that occur along nursery-reef boundaries that connect neighboring ecosystems.

  10. Effects of Marine Reserves versus Nursery Habitat Availability on Structure of Reef Fish Communities

    PubMed Central

    Nagelkerken, Ivan; Grol, Monique G. G.; Mumby, Peter J.

    2012-01-01

    No-take marine fishery reserves sustain commercial stocks by acting as buffers against overexploitation and enhancing fishery catches in adjacent areas through spillover. Likewise, nursery habitats such as mangroves enhance populations of some species in adjacent habitats. However, there is lack of understanding of the magnitude of stock enhancement and the effects on community structure when both protection from fishing and access to nurseries concurrently act as drivers of fish population dynamics. In this study we test the separate as well as interactive effects of marine reserves and nursery habitat proximity on structure and abundance of coral reef fish communities. Reserves had no effect on fish community composition, while proximity to nursery habitat only had a significant effect on community structure of species that use mangroves or seagrass beds as nurseries. In terms of reef fish biomass, proximity to nursery habitat by far outweighed (biomass 249% higher than that in areas with no nursery access) the effects of protection from fishing in reserves (biomass 21% lower than non-reserve areas) for small nursery fish (≤25 cm total length). For large-bodied individuals of nursery species (>25 cm total length), an additive effect was present for these two factors, although fish benefited more from fishing protection (203% higher biomass) than from proximity to nurseries (139% higher). The magnitude of elevated biomass for small fish on coral reefs due to proximity to nurseries was such that nursery habitats seem able to overrule the usually positive effects on fish biomass by reef reserves. As a result, conservation of nursery habitats gains importance and more consideration should be given to the ecological processes that occur along nursery-reef boundaries that connect neighboring ecosystems. PMID:22675474

  11. Lessons Learned From an Epidemiologist-Led Countywide Community Assessment for Public Health Emergency Response (CASPER) in Oregon.

    PubMed

    Repp, Kimberly K; Hawes, Eva; Rees, Kathleen J; Vorderstrasse, Beth; Mohnkern, Sue

    2018-06-07

    Conducting a large-scale Community Assessment for Public Health Emergency Response (CASPER) in a geographically and linguistically diverse county presents significant methodological challenges that require advance planning. The Centers for Disease Control and Prevention (CDC) has adapted methodology and provided a toolkit for a rapid needs assessment after a disaster. The assessment provides representative data of the sampling frame to help guide effective distribution of resources. This article describes methodological considerations and lessons learned from a CASPER exercise conducted by Washington County Public Health in June 2016 to assess community emergency preparedness. The CDC's CASPER toolkit provides detailed guidance for exercises in urban areas where city blocks are well defined with many single family homes. Converting the exercise to include rural areas with challenging geographical terrain, including accessing homes without public roads, required considerable adjustments in planning. Adequate preparations for vulnerable populations with English linguistic barriers required additional significant resources. Lessons learned are presented from the first countywide CASPER exercise in Oregon. Approximately 61% of interviews were completed, and 85% of volunteers reported they would participate in another CASPER exercise. Results from the emergency preparedness survey will be presented elsewhere. This experience indicates the most important considerations for conducting a CASPER exercise are oversampling clusters, overrecruiting volunteers, anticipating the actual cost of staff time, and ensuring timely language services are available during the event.

  12. Committee Opinion No. 642: Increasing Access to Contraceptive Implants and Intrauterine Devices to Reduce Unintended Pregnancy.

    PubMed

    2015-10-01

    Unintended pregnancy persists as a major public health problem in the United States. Although lowering unintended pregnancy rates requires multiple approaches, individual obstetrician-gynecologists may contribute by increasing access to contraceptive implants and intrauterine devices. Obstetrician-gynecologists should encourage consideration of implants and intrauterine devices for all appropriate candidates, including nulliparous women and adolescents. Obstetrician-gynecologists should adopt best practices for long-acting reversible contraception insertion. Obstetrician-gynecologists are encouraged to advocate for coverage and appropriate payment and reimbursement for every contraceptive method by all payers in all clinically appropriate circumstances.

  13. Caring capacity in the management of the nutrition crisis in infants, young children and women in Nigeria.

    PubMed

    Igbedioh, S O

    1996-01-01

    Nigeria's nutrition crisis has been shown to have a considerable negative impact on infants, young children and women. Available evidence suggests that 'caring capacity' when properly planned and targeted at the most-at-risk can help. Strategies that can achieve this care are increasing women's income and control over income, increasing investment in women's education and improving access to credit facilities. Others are the aggressive promotion of gender-biased labour saving technology, increasing women's access to basic health and family planning services and implementing reforms in land ownership while instituting social security for women.

  14. Data governance frameworks and change management.

    PubMed

    Egelstaff, Richard; Wells, Marilyn

    2013-01-01

    Protecting and preserving data stored in electronic form is important, and ensuring that data is available to the correct access level requires consideration of the characteristics of the data and the purpose to which the data will be used. Important questions therefore are raised about what is the right data and who has the right access level. This is the substance of data governance. This paper will discuss the various aspects of data governance frameworks as it pertains to health care systems. The paper will also explore the changes that confront organisations and individuals as they embrace the requirements of data governance.

  15. Multiple-access phased array antenna simulator for a digital beam-forming system investigation

    NASA Technical Reports Server (NTRS)

    Kerczewski, Robert J.; Yu, John; Walton, Joanne C.; Perl, Thomas D.; Andro, Monty; Alexovich, Robert E.

    1992-01-01

    Future versions of data relay satellite systems are currently being planned by NASA. Being given consideration for implementation are on-board digital beamforming techniques which will allow multiple users to simultaneously access a single S-band phased array antenna system. To investigate the potential performance of such a system, a laboratory simulator has been developed at NASA's Lewis Research Center. This paper describes the system simulator, and in particular, the requirements, design and performance of a key subsystem, the phased array antenna simulator, which provides realistic inputs to the digital processor including multiple signals, noise, and nonlinearities.

  16. Multiple-access phased array antenna simulator for a digital beam forming system investigation

    NASA Technical Reports Server (NTRS)

    Kerczewski, Robert J.; Yu, John; Walton, Joanne C.; Perl, Thomas D.; Andro, Monty; Alexovich, Robert E.

    1992-01-01

    Future versions of data relay satellite systems are currently being planned by NASA. Being given consideration for implementation are on-board digital beamforming techniques which will allow multiple users to simultaneously access a single S-band phased array antenna system. To investigate the potential performance of such a system, a laboratory simulator has been developed at NASA's Lewis Research Center. This paper describes the system simulator, and in particular, the requirements, design, and performance of a key subsystem, the phased array antenna simulator, which provides realistic inputs to the digital processor including multiple signals, noise, and nonlinearities.

  17. Patient empowerment and choice in chronic pain management.

    PubMed

    Barrie, Janette

    Service provision and access to pain services vary considerably in the UK, with only a small percentage of people with chronic pain accessing specialist services. Government policy supports giving patients more choice and control over their care. Empowerment involves ensuring patients have the knowledge, skills, attitudes and self-awareness to improve the quality of their lives. As most healthcare professionals provide care to people with chronic pain at some point, it is their responsibility to prepare patients to make informed decisions about their treatment. Empowering patients to self-manage their chronic pain can lead to improved person-centred outcomes.

  18. An intermediary's perspective of online databases for local governments

    NASA Technical Reports Server (NTRS)

    Jack, R. F.

    1984-01-01

    Numerous public administration studies have indicated that local government agencies for a variety of reasons lack access to comprehensive information resources; furthermore, such entities are often unwilling or unable to share information regarding their own problem-solving innovations. The NASA/University of Kentucky Technology Applications Program devotes a considerable effort to providing scientific and technical information and assistance to local agencies, relying on its access to over 500 distinct online databases offered by 20 hosts. The author presents a subjective assessment, based on his own experiences, of several databases which may prove useful in obtaining information for this particular end-user community.

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

    NASA Astrophysics Data System (ADS)

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

    2017-06-01

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

  20. Collecting behavioural data using the world wide web: considerations for researchers

    PubMed Central

    Rhodes, S; Bowie, D; Hergenrather, K

    2003-01-01

    Objective: To identify and describe advantages, challenges, and ethical considerations of web based behavioural data collection. Methods: This discussion is based on the authors' experiences in survey development and study design, respondent recruitment, and internet research, and on the experiences of others as found in the literature. Results: The advantages of using the world wide web to collect behavioural data include rapid access to numerous potential respondents and previously hidden populations, respondent openness and full participation, opportunities for student research, and reduced research costs. Challenges identified include issues related to sampling and sample representativeness, competition for the attention of respondents, and potential limitations resulting from the much cited "digital divide", literacy, and disability. Ethical considerations include anonymity and privacy, providing and substantiating informed consent, and potential risks of malfeasance. Conclusions: Computer mediated communications, including electronic mail, the world wide web, and interactive programs will play an ever increasing part in the future of behavioural science research. Justifiable concerns regarding the use of the world wide web in research exist, but as access to, and use of, the internet becomes more widely and representatively distributed globally, the world wide web will become more applicable. In fact, the world wide web may be the only research tool able to reach some previously hidden population subgroups. Furthermore, many of the criticisms of online data collection are common to other survey research methodologies. PMID:12490652

  1. Collecting behavioural data using the world wide web: considerations for researchers.

    PubMed

    Rhodes, S D; Bowie, D A; Hergenrather, K C

    2003-01-01

    To identify and describe advantages, challenges, and ethical considerations of web based behavioural data collection. This discussion is based on the authors' experiences in survey development and study design, respondent recruitment, and internet research, and on the experiences of others as found in the literature. The advantages of using the world wide web to collect behavioural data include rapid access to numerous potential respondents and previously hidden populations, respondent openness and full participation, opportunities for student research, and reduced research costs. Challenges identified include issues related to sampling and sample representativeness, competition for the attention of respondents, and potential limitations resulting from the much cited "digital divide", literacy, and disability. Ethical considerations include anonymity and privacy, providing and substantiating informed consent, and potential risks of malfeasance. Computer mediated communications, including electronic mail, the world wide web, and interactive programs will play an ever increasing part in the future of behavioural science research. Justifiable concerns regarding the use of the world wide web in research exist, but as access to, and use of, the internet becomes more widely and representatively distributed globally, the world wide web will become more applicable. In fact, the world wide web may be the only research tool able to reach some previously hidden population subgroups. Furthermore, many of the criticisms of online data collection are common to other survey research methodologies.

  2. Is provision of healthcare sufficient to ensure better access? An exploration of the scope for public-private partnership in India.

    PubMed

    Dutta, Sabitri; Lahiri, Kausik

    2015-04-08

    India's economic growth rate in recent years has been fairly impressive. But, it has been consistently failing to make considerable progress in achieving health related Millennium Development Goal (MDG) targets. Lack of coherence between provisions and utilization becomes the face of the problem. Inadequacies in outreach, access and affordability coupled with escalating healthcare costs have aggravated the problem. Here the application of Public-Private Partnership (PPP) model seems to have enormous potential to ease the impasse. This paper tries to find the gap between the provisions and access in healthcare. The paper attempts to construct a Health Infrastructure Index (HII) and Health Attainment Index (HAI) for different states of India. Considering the presence of regional variations found in health infrastructure and attainment among the states, two states, viz. Maharashtra (MAH) and West Bengal (WB) have been chosen. Then contributions of health programs like Rashtriya Swasthya Bima Yojana (RSBY), National Rural Telemedicine Network (NRTN) and Fair Price Shops (FPS), all PPP initiatives, have been assessed for both the states by carrying out comprehensive benefit-cost analysis. The health infrastructure for population per unit area captures the outreach/delivery issue and the health attainment reveals the true scenario about how far the infrastructure has been accessed by the people; and the gap between the two, as the paper finds, is the root of the problem. The combined effect of RSBY and NRTN will leave both MAH and WB higher benefits in terms of health attainment. The contributions of RSBY and NRTN have been assessed for both the states by carrying out comprehensive benefit-cost analysis. FPS comes up with immense benefits for WB. It is yet to be implemented in MAH. The outreach and access problems arising from deficiencies in infrastructure, human resources and financial ability are expected to be well-addressed by the spread of RSBY and NRTN jointly. The FPS mechanism under PPP initiative can be an effective tool in solving affordability problem by reducing the cost of treatment. © 2015 by Kerman University of Medical Sciences.

  3. Is provision of healthcare sufficient to ensure better access? An exploration of the scope for public-private partnership in India

    PubMed Central

    Dutta, Sabitri; Lahiri, Kausik

    2015-01-01

    Background: India’s economic growth rate in recent years has been fairly impressive. But, it has been consistently failing to make considerable progress in achieving health related Millennium Development Goal (MDG) targets. Lack of coherence between provisions and utilization becomes the face of the problem. Inadequacies in outreach, access and affordability coupled with escalating healthcare costs have aggravated the problem. Here the application of Public-Private Partnership (PPP) model seems to have enormous potential to ease the impasse. Methods: This paper tries to find the gap between the provisions and access in healthcare. The paper attempts to construct a Health Infrastructure Index (HII) and Health Attainment Index (HAI) for different states of India. Considering the presence of regional variations found in health infrastructure and attainment among the states, two states, viz. Maharashtra (MAH) and West Bengal (WB) have been chosen. Then contributions of health programs like Rashtriya Swasthya Bima Yojana (RSBY), National Rural Telemedicine Network (NRTN) and Fair Price Shops (FPS), all PPP initiatives, have been assessed for both the states by carrying out comprehensive benefit-cost analysis. Results: The health infrastructure for population per unit area captures the outreach/delivery issue and the health attainment reveals the true scenario about how far the infrastructure has been accessed by the people; and the gap between the two, as the paper finds, is the root of the problem. The combined effect of RSBY and NRTN will leave both MAH and WB higher benefits in terms of health attainment. The contributions of RSBY and NRTN have been assessed for both the states by carrying out comprehensive benefit-cost analysis. FPS comes up with immense benefits for WB. It is yet to be implemented in MAH. Conclusion: The outreach and access problems arising from deficiencies in infrastructure, human resources and financial ability are expected to be well-addressed by the spread of RSBY and NRTN jointly. The FPS mechanism under PPP initiative can be an effective tool in solving affordability problem by reducing the cost of treatment PMID:26188811

  4. Genetic Characterization of Turkish Snake Melon (Cucumis melo L. subsp. melo flexuosus Group) Accessions Revealed by SSR Markers.

    PubMed

    Solmaz, Ilknur; Kacar, Yildiz Aka; Simsek, Ozhan; Sari, Nebahat

    2016-08-01

    Snake melon is an important cucurbit crop especially in the Southeastern and the Mediterranean region of Turkey. It is consumed as fresh or pickled. The production is mainly done with the local landraces in the country. Turkey is one of the secondary diversification centers of melon and possesses valuable genetic resources which have different morphological characteristics in case of snake melon. Genetic diversity of snake melon genotypes collected from different regions of Turkey and reference genotypes obtained from World Melon Gene Bank in Avignon-France was examined using 13 simple sequence repeat (SSR) markers. A total of 69 alleles were detected, with an average of 5.31 alleles per locus. The polymorphism information content of SSR markers ranged from 0.19 to 0.57 (average 0.38). Based on cluster analysis, two major groups were defined. The first major group included only one accession (61), while the rest of all accessions grouped in the second major group and separated into different sub-clusters. Based on SSR markers, cluster analysis indicated that considerably high genetic variability exists among the examined accessions; however, Turkish snake melon accessions were grouped together with the reference snake melon accessions.

  5. Considerations on private human access to space from an institutional point of view

    NASA Astrophysics Data System (ADS)

    Hufenbach, Bernhard

    2013-12-01

    Private human access to space as discussed in this article addresses two market segments: suborbital flight and crew flights to Low Earth Orbit. The role of entrepreneurs, the technical complexity, the customers, the market conditions as well as the time to market in these two segments differ significantly. Space agencies take currently a very different approach towards private human access to space in both segments. Analysing the outcome of broader inter-agency deliberations on the future of human spaceflight and exploration, performed e.g. in the framework of the International Space Exploration Coordination Group, enables to derive some common general views on this topic. Various documents developed by inter-agency working groups recognise the general strategic importance for enabling private human access to space for ensuring a sustainable future of human spaceflight, although the specific definition of private human access and approaches vary. ESA has performed some reflections on this subject throughout the last 5 years. While it gained through these reflections a good understanding on the opportunities and implications resulting from the development of capabilities and markets for Private Human Access, limited concrete activities have been initiated in relation to this topic as of today.

  6. Operator interface design considerations for a PACS information management system

    NASA Astrophysics Data System (ADS)

    Steinke, James E.; Nabijee, Kamal H.; Freeman, Rick H.; Prior, Fred W.

    1990-08-01

    As prototype PACS grow into fully digital departmental and hospital-wide systems, effective information storage and retrieval mechanisms become increasingly important. Thus far, designers of PACS workstations have concentrated on image communication and display functionality. The new challenge is to provide appropriate operator interface environments to facilitate information retrieval. The "Marburg Model" 1 provides a detailed analysis of the functions, control flows and data structures used in Radiology. It identifies a set of "actors" who perform information manipulation functions. Drawing on this model and its associated methodology it is possible to identify four modes of use of information systems in Radiology: Clinical Routine, Research, Consultation, and Administration. Each mode has its own specific access requirements and views of information. An operator interface strategy appropriate for each mode will be proposed. Clinical Routine mode is the principal concern of PACS primary diagnosis workstations. In a full PACS implementation, such workstations must provide a simple and consistent navigational aid for the on-line image database, a local work list of cases to be reviewed, and easy access to information from other hospital information systems. A hierarchical method of information access is preferred because it provides the ability to start at high-level entities and iteratively narrow the scope of information from which to select subsequent operations. An implementation using hierarchical, nested software windows which fulfills such requirements shall be examined.

  7. International Evidence-Based Medicine Survey of the Veterinary Profession: Information Sources Used by Veterinarians.

    PubMed

    Huntley, Selene J; Dean, Rachel S; Massey, Andrew; Brennan, Marnie L

    2016-01-01

    Veterinarians are encouraged to use evidence to inform their practice, but it is unknown what resources (e.g. journals, electronic sources) are accessed by them globally. Understanding the key places veterinarians seek information can inform where new clinically relevant evidence should most effectively be placed. An international survey was conducted to gain understanding of how veterinary information is accessed by veterinarians worldwide. There were 2137 useable responses to the questionnaire from veterinarians in 78 countries. The majority of respondents (n = 1835/2137, 85.9%) undertook clinical work and worked in a high income country (n = 1576/1762, 89.4%). Respondents heard about the survey via national veterinary organisations or regulatory bodies (31.5%), online veterinary forums and websites (22.7%), regional, discipline-based or international veterinary organisations (22.7%) or by direct invitation from the researchers or via friends, colleagues or social media (7.6%). Clinicians and non-clinicians reportedly used journals most commonly (65.8%, n = 1207/1835; 75.6%, n = 216/286) followed by electronic resources (58.7%, n = 1077/1835; 55.9%, n = 160/286), respectively. Respondents listed a total of 518 journals and 567 electronic sources that they read. Differences in veterinarian preference for resources in developed, and developing countries, were found. The nominated journals most read were the Journal of the American Veterinary Medical Association (12.7% of nominations) for clinicians and the Veterinary Record (5.7%) for non-clinicians. The most accessed electronic resource reported was the Veterinary Information Network (25.6%) for clinicians and PubMed (7.4%) for non-clinicians. In conclusion, a wide array of journals and electronic resources appear to be accessed by veterinarians worldwide. Veterinary organisations appear to play an important role in global communication and outreach to veterinarians and consideration should be given to how these channels could be best utilised for effective dissemination of key research findings.

  8. International Evidence-Based Medicine Survey of the Veterinary Profession: Information Sources Used by Veterinarians

    PubMed Central

    Huntley, Selene J.; Dean, Rachel S.; Massey, Andrew

    2016-01-01

    Veterinarians are encouraged to use evidence to inform their practice, but it is unknown what resources (e.g. journals, electronic sources) are accessed by them globally. Understanding the key places veterinarians seek information can inform where new clinically relevant evidence should most effectively be placed. An international survey was conducted to gain understanding of how veterinary information is accessed by veterinarians worldwide. There were 2137 useable responses to the questionnaire from veterinarians in 78 countries. The majority of respondents (n = 1835/2137, 85.9%) undertook clinical work and worked in a high income country (n = 1576/1762, 89.4%). Respondents heard about the survey via national veterinary organisations or regulatory bodies (31.5%), online veterinary forums and websites (22.7%), regional, discipline-based or international veterinary organisations (22.7%) or by direct invitation from the researchers or via friends, colleagues or social media (7.6%). Clinicians and non-clinicians reportedly used journals most commonly (65.8%, n = 1207/1835; 75.6%, n = 216/286) followed by electronic resources (58.7%, n = 1077/1835; 55.9%, n = 160/286), respectively. Respondents listed a total of 518 journals and 567 electronic sources that they read. Differences in veterinarian preference for resources in developed, and developing countries, were found. The nominated journals most read were the Journal of the American Veterinary Medical Association (12.7% of nominations) for clinicians and the Veterinary Record (5.7%) for non-clinicians. The most accessed electronic resource reported was the Veterinary Information Network (25.6%) for clinicians and PubMed (7.4%) for non-clinicians. In conclusion, a wide array of journals and electronic resources appear to be accessed by veterinarians worldwide. Veterinary organisations appear to play an important role in global communication and outreach to veterinarians and consideration should be given to how these channels could be best utilised for effective dissemination of key research findings. PMID:27458724

  9. Design and methodological considerations of an effectiveness trial of a computer-assisted intervention: an example from the NIDA Clinical Trials Network.

    PubMed

    Campbell, Aimee N C; Nunes, Edward V; Miele, Gloria M; Matthews, Abigail; Polsky, Daniel; Ghitza, Udi E; Turrigiano, Eva; Bailey, Genie L; VanVeldhuisen, Paul; Chapdelaine, Rita; Froias, Autumn; Stitzer, Maxine L; Carroll, Kathleen M; Winhusen, Theresa; Clingerman, Sara; Perez, Livangelie; McClure, Erin; Goldman, Bruce; Crowell, A Rebecca

    2012-03-01

    Computer-assisted interventions hold the promise of minimizing two problems that are ubiquitous in substance abuse treatment: the lack of ready access to treatment and the challenges to providing empirically-supported treatments. Reviews of research on computer-assisted treatments for mental health and substance abuse report promising findings, but study quality and methodological limitations remain an issue. In addition, relatively few computer-assisted treatments have been tested among illicit substance users. This manuscript describes the methodological considerations of a multi-site effectiveness trial conducted within the National Institute on Drug Abuse's (NIDA's) National Drug Abuse Treatment Clinical Trials Network (CTN). The study is evaluating a web-based version of the Community Reinforcement Approach, in addition to prize-based contingency management, among 500 participants enrolled in 10 outpatient substance abuse treatment programs. Several potential effectiveness trial designs were considered and the rationale for the choice of design in this study is described. The study uses a randomized controlled design (with independent treatment arm allocation), intention-to-treat primary outcome analysis, biological markers for the primary outcome of abstinence, long-term follow-up assessments, precise measurement of intervention dose, and a cost-effectiveness analysis. Input from community providers during protocol development highlighted potential concerns and helped to address issues of practicality and feasibility. Collaboration between providers and investigators supports the utility of infrastructures that enhance research partnerships to facilitate effectiveness trials and dissemination of promising, technologically innovative treatments. Outcomes from this study will further the empirical knowledge base on the effectiveness and cost-effectiveness of computer-assisted treatment in clinical treatment settings. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Design and Methodological Considerations of an Effectiveness Trial of a Computer-assisted Intervention: An Example from the NIDA Clinical Trials Network

    PubMed Central

    Campbell, Aimee N. C.; Nunes, Edward V.; Miele, Gloria M.; Matthews, Abigail; Polsky, Daniel; Ghitza, Udi E.; Turrigiano, Eva; Bailey, Genie L.; VanVeldhuisen, Paul; Chapdelaine, Rita; Froias, Autumn; Stitzer, Maxine L.; Carroll, Kathleen M.; Winhusen, Theresa; Clingerman, Sara; Perez, Livangelie; McClure, Erin; Goldman, Bruce; Crowell, A. Rebecca

    2011-01-01

    Computer-assisted interventions hold the promise of minimizing two problems that are ubiquitous in substance abuse treatment: the lack of ready access to treatment and the challenges to providing empirically-supported treatments. Reviews of research on computer-assisted treatments for mental health and substance abuse report promising findings, but study quality and methodological limitations remain an issue. In addition, relatively few computer-assisted treatments have been tested among illicit substance users. This manuscript describes the methodological considerations of a multi-site effectiveness trial conducted within the National Institute on Drug Abuse's (NIDA's) National Drug Abuse Treatment Clinical Trials Network (CTN). The study is evaluating a web-based version of the Community Reinforcement Approach, in addition to prize-based contingency management, among 500 participants enrolled in 10 outpatient substance abuse treatment programs. Several potential effectiveness trial designs were considered and the rationale for the choice of design in this study is described. The study uses a randomized controlled design (with independent treatment arm allocation), intention-to-treat primary outcome analysis, biological markers for the primary outcome of abstinence, long-term follow-up assessments, precise measurement of intervention dose, and a cost-effectiveness analysis. Input from community providers during protocol development highlighted potential concerns and helped to address issues of practicality and feasibility. Collaboration between providers and investigators supports the utility of infrastructures that enhance research partnerships to facilitate effectiveness trials and dissemination of promising, technologically innovative treatments. Outcomes from this study will further the empirical knowledge base on the effectiveness and cost-effectiveness of computer-assisted treatment in clinical treatment settings. PMID:22085803

  11. Evaluating Web accessibility at different processing phases

    NASA Astrophysics Data System (ADS)

    Fernandes, N.; Lopes, R.; Carriço, L.

    2012-09-01

    Modern Web sites use several techniques (e.g. DOM manipulation) that allow for the injection of new content into their Web pages (e.g. AJAX), as well as manipulation of the HTML DOM tree. This has the consequence that the Web pages that are presented to users (i.e. after browser processing) are different from the original structure and content that is transmitted through HTTP communication (i.e. after browser processing). This poses a series of challenges for Web accessibility evaluation, especially on automated evaluation software. This article details an experimental study designed to understand the differences posed by accessibility evaluation after Web browser processing. We implemented a Javascript-based evaluator, QualWeb, that can perform WCAG 2.0 based accessibility evaluations in the two phases of browser processing. Our study shows that, in fact, there are considerable differences between the HTML DOM trees in both phases, which have the consequence of having distinct evaluation results. We discuss the impact of these results in the light of the potential problems that these differences can pose to designers and developers that use accessibility evaluators that function before browser processing.

  12. Rural Veteran Access to Healthcare Services: Investigating the Role of Information and Communication Technologies in Overcoming Spatial Barriers

    PubMed Central

    Schooley, Benjamin L; Horan, Thomas A; Lee, Pamela W; West, Priscilla A

    2010-01-01

    This multimethod pilot study examined patient and practitioner perspectives on the influence of spatial barriers to healthcare access and the role of health information technology in overcoming these barriers. The study included a survey administered to patients attending a Department of Veterans Affairs (VA) health visit, and a focus group with VA care providers. Descriptive results and focus group findings are presented. Spatial distance is a significant factor for many rural veterans when seeking healthcare. For this sample of rural veterans, a range of telephone, computer, and Internet technologies may become more important for accessing care as Internet access becomes more ubiquitous and as younger veterans begin using the VA health system. The focus group highlighted the negative impact of distance, economic considerations, geographic barriers, and specific medical conditions on access to care. Lack of adequate technology infrastructure was seen as an obstacle to utilization. This study discusses the need to consider distance, travel modes, age, and information technology infrastructure and adoption when designing health information technology to care for rural patients. PMID:20697468

  13. Impact of direct drug delivery via gastric access devices.

    PubMed

    Kurien, Matthew; Penny, Hugo; Sanders, David S

    2015-03-01

    Gastric access devices such as nasogastric tubes and gastrostomy tubes are increasingly being used in clinical practice to provide both short- and long-term nutrition support therapy. Increasingly these devices are being utilized to help deliver oral medications, where swallowing is impaired. This concomitant administration of medications and enteral formulas could derive potential benefits in regard to time and cost; however, uncertainty exists regarding potential drug and nutrient interactions and the influence this may have on both safety and efficacy. This article provides an overview of the differing gastric access devices used in clinical practice and evaluates the evidence base for using oral medications via these routes. Alternative methods of drug administration are discussed, alongside common drug nutrient interactions and potential complications. Delivering medications via gastric access devices can be performed safely; however, careful consideration needs to be made regarding tube and patient influences, alongside drug-nutrient interactions. Improving practice in this area in the future necessitates enhancement of an evidence base to substantiate the safety of drug delivery via gastric access devices and improvement in education among healthcare professionals about the potential problems.

  14. The use of a policy dialogue to facilitate evidence-informed policy development for improved access to care: the case of the Winnipeg Central Intake Service (WCIS).

    PubMed

    Damani, Zaheed; MacKean, Gail; Bohm, Eric; DeMone, Brie; Wright, Brock; Noseworthy, Tom; Holroyd-Leduc, Jayna; Marshall, Deborah A

    2016-10-18

    Policy dialogues are critical for developing responsive, effective, sustainable, evidence-informed policy. Our multidisciplinary team, including researchers, physicians and senior decision-makers, comprehensively evaluated The Winnipeg Central Intake Service, a single-entry model in Winnipeg, Manitoba, to improve patient access to hip/knee replacement surgery. We used the evaluation findings to develop five evidence-informed policy directions to help improve access to scheduled clinical services across Manitoba. Using guiding principles of public participation processes, we hosted a policy roundtable meeting to engage stakeholders and use their input to refine the policy directions. Here, we report on the use and input of a policy roundtable meeting and its role in contributing to the development of evidence-informed policy. Our evidence-informed policy directions focused on formal measurement/monitoring of quality, central intake as a preferred model for service delivery, provincial scope, transparent processes/performance indicators, and patient choice of provider. We held a policy roundtable meeting and used outcomes of facilitated discussions to refine these directions. Individuals from our team and six stakeholder groups across Manitoba participated (n = 44), including patients, family physicians, orthopaedic surgeons, surgical office assistants, Winnipeg Central Intake team, and administrators/managers. We developed evaluation forms to assess the meeting process, and collected decision-maker partners' perspectives on the value of the policy roundtable meeting and use of policy directions to improve access to scheduled clinical services after the meeting, and again 15 months later. We analyzed roundtable and evaluation data using thematic analysis to identify key themes. Four key findings emerged. First, participants supported all policy directions, with revisions and key implementation considerations identified. Second, participants felt the policy roundtable meeting achieved its purpose (to engage stakeholders, elicit feedback, refine policy directions). Third, our decision-maker partners' expectations of the policy roundtable meeting were exceeded; they re-affirmed its value and described the refined policy directions as foundational to establishing the vocabulary, vision and framework for improving access to scheduled clinical services in Manitoba. Finally, our adaptation of key design elements was conducive to discussion of issues surrounding access to care. Our policy roundtable process was an effective tool for acquiring broad input from stakeholders, refining policy directions and forming the necessary consensus starting points to move towards evidence-informed policy.

  15. Pharmaceutical Market Access: current state of affairs and key challenges – results of the Market Access Launch Excellence Inventory (MALEI)

    PubMed Central

    Koch, Marcus A.

    2015-01-01

    Objectives To take inventory of the current state of affairs of Market Access Launch Excellence in the life sciences industry. To identify key gaps and challenges for Market Access (MA) and discuss how they can be addressed. To generate a baseline for benchmarking MA launch excellence. Methodology An online survey was conducted with pharmaceutical executives primarily working in MA, marketing, or general management. The survey aimed to evaluate MA excellence prerequisites across the product life cycle (rated by importance and level of implementation) and to describe MA activity models in the respective companies. Composite scores were calculated from respondents’ ratings and answers. Results Implementation levels of MA excellence prerequisites generally lagged behind their perceived importance. Item importance and the respective level of implementation correlated well, which can be interpreted as proof of the validity of the questionnaire. The following areas were shown to be particularly underimplemented: 1) early integration of MA and health economic considerations in research and development decision making, 2) developing true partnerships with payers, including the development of services ‘beyond the pill’, and 3) consideration of human resource and talent management. The concept of importance-adjusted implementation levels as a hybrid parameter was introduced and shown to be a viable tool for benchmarking purposes. More than 70% of respondents indicated that their companies will invest broadly in MA in terms of capital and headcount within the next 3 years. Conclusions MA (launch) excellence needs to be further developed in order to close implementation gaps across the entire product life cycle. As MA is a comparatively young pharmaceutical discipline in a complex and dynamic environment, this effort will require strategic focus and dedication. The Market Access Launch Excellence Inventory benchmarking tool may help guide decision makers to prioritize their endeavors. PMID:29785250

  16. Does comparative effectiveness research promote rationing of cancer care?

    PubMed

    Peppercorn, Jeffrey; Zafar, S Yousuf; Houck, Kevin; Ubel, Peter; Meropol, Neal J

    2014-03-01

    Comparative effectiveness research aims to inform health-care decisions by patients, clinicians, and policy makers. However, questions related to what information is relevant, and how to view the relative attributes of alternative interventions have political, social, and medical considerations. In particular, questions about whether cost is a relevant factor, and whether cost-effectiveness is a desirable or necessary component of such research, have become increasingly controversial as the area has gained prominence. Debate has emerged about whether comparative effectiveness research promotes rationing of cancer care. At the heart of this debate are questions related to the role and limits of patient autonomy, physician discretion in health-care decision making, and the nature of scientific knowledge as an objective good. In this article, we examine the role of comparative effectiveness research in the USA, UK, Canada, and other health-care systems, and the relation between research and policy. As we show, all health systems struggle to balance access to cancer care and control of costs; comparative effectiveness data can clarify choices, but does not itself determine policy or promote rationing of care. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. [Clinical orientation and thought on several problems in post-marketed reassessment of traditional Chinese medicine].

    PubMed

    Wang, Xin; Su, Xia; Yu, Jie; Xie, Yanming; Wang, Yongyan

    2011-10-01

    The post-marketed reassessment is an important link to ensure the safety and effectiveness of traditional chinese medicine. It is also the expansion and stretch of new drug evaluation. Through the systematic, standard, rigorous post-marketed reassessment, the enterprise can full access to drugs after listing the efficacy and safety information, evaluate the interests and risk of the drug and provide the scientific basis for the drug use. It can also provide timely, scientific technology basis for government health decisions, the enterprise marketing decision and public health security. This paper mainly discussed the thought on clinical orientation of traditional chinese medicine in the post-marketed reassessment and how to reach the goal through systematic consideration and overall plan.

  18. Empirical analysis of the effects of cyber security incidents.

    PubMed

    Davis, Ginger; Garcia, Alfredo; Zhang, Weide

    2009-09-01

    We analyze the time series associated with web traffic for a representative set of online businesses that have suffered widely reported cyber security incidents. Our working hypothesis is that cyber security incidents may prompt (security conscious) online customers to opt out and conduct their business elsewhere or, at the very least, to refrain from accessing online services. For companies relying almost exclusively on online channels, this presents an important business risk. We test for structural changes in these time series that may have been caused by these cyber security incidents. Our results consistently indicate that cyber security incidents do not affect the structure of web traffic for the set of online businesses studied. We discuss various public policy considerations stemming from our analysis.

  19. Consideration of probability of bacterial growth for Jovian planets and their satellites

    NASA Technical Reports Server (NTRS)

    Taylor, D. M.; Berkman, R. M.; Divine, N.

    1974-01-01

    Environmental parameters affecting growth of bacteria are compared with current atmospheric models for Jupiter and Saturn, and with the available physical data for their satellites. Different zones of relative probability of growth are identified for Jupiter and Saturn. Of the more than two dozen satellites, only the largest (Io, Europa, Ganymede, Callisto, and Titan) are found to be interesting biologically. Titan's atmosphere may produce a substantial greenhouse effect providing increased surface temperatures. Models predicting a dense atmosphere are compatible with microbial growth for a range of pressures at Titan's surface. For Titan's surface the probability of growth would be enhanced if: (1) the surface is entirely or partially liquid; (2) volcanism is present; or (3) access to internal heat sources is significant.

  20. Latin-American guidelines for opioid use in chronic nononcologic pain.

    PubMed

    Lara-Solares, Argelia; Aguayo Zamora, Carlos; Amescua García, César; Garcia, João Batista Santos; Berenguel Cook, María Del Rosario; Bonilla Sierra, Patricia; Campos Kraychete, Durval; Flores Cantisani, José Alberto; Guerrero, Carlos; Guillén Núñez, María Del Rocío; Hernández Castro, John Jairo; Hernández Ortíz, Andrés; Jreige Iskandar, Aziza; Lech, Osvandré; Macías Guerra, Jacqueline; Ramírez Samayoa, Gerardo; Rangel Morillo, Edwin; Rico Pazos, María Antonieta; Sempértegui Gallegos, Manuel

    2017-05-01

    Latin-American experts in the use of opioids in patients with chronic nononcologic pain (CNOP) have updated existing recommendations to current Latin-American reality. Several key opinion leaders from Latin America participated in a face-to-face meeting in Guatemala (April 2015) to discuss the use of opioids in CNOP. Subgroups of experts worked on specific topics, reviewed the literature and shaped the final manuscript. The expert panel developed guidelines taking into consideration the utility of both opioid and nonopioid analgesics and factors pertaining to their efficacy, safety, adherence, administration and risks for abuse/addiction. Latin-American guidelines for the use of opioids in CNOP should improve pain relief and patients' quality of life by increasing access to these effective agents.

  1. Reinforcement Magnitude: An Evaluation of Preference and Reinforcer Efficacy

    PubMed Central

    Trosclair-Lasserre, Nicole M; Lerman, Dorothea C; Call, Nathan A; Addison, Laura R; Kodak, Tiffany

    2008-01-01

    Consideration of reinforcer magnitude may be important for maximizing the efficacy of treatment for problem behavior. Nonetheless, relatively little is known about children's preferences for different magnitudes of social reinforcement or the extent to which preference is related to differences in reinforcer efficacy. The purpose of the current study was to evaluate the relations among reinforcer magnitude, preference, and efficacy by drawing on the procedures and results of basic experimentation in this area. Three children who engaged in problem behavior that was maintained by social positive reinforcement (attention, access to tangible items) participated. Results indicated that preference for different magnitudes of social reinforcement may predict reinforcer efficacy and that magnitude effects may be mediated by the schedule requirement. PMID:18595284

  2. Euthanasia: a reply to Bartels and Otlowski.

    PubMed

    Prichard, Jeremy

    2012-03-01

    This article counters arguments made by Bartels and Otlowski in 2010 regarding euthanasia. It suggests that the authors over-emphasised the importance of individual autonomy in its bearing on the euthanasia debate. Drawing on literature concerning elder abuse as well as the "mercy-killing" cases reviewed by Bartels and Otlowski, the article contends that legalising euthanasia may increase the risk that some patients are pressured, inadvertently or deliberately, to request access. Safeguards to detect and deter pressure may be of limited effectiveness against such pressure. Regarding slippery slope arguments, the article discusses the potential for an Australian euthanasia system to eventually be extended in scope to encompass mental suffering. The article encourages consideration of long-term potentialities, including changes in macro-economic conditions.

  3. [Mercosur's regional health agenda: architecture and themes].

    PubMed

    Queiroz, Luisa Guimaraes; Giovanella, Ligia

    2011-08-01

    This article describes the shaping of institutional health spaces in the Mercosur, with analysis of themes and results and considerations on the construction of the regional agenda and on the effects of regional economic integration processes on health policies and systems. We discuss the organization, operation, focus topics, and results achieved in specific health forums (Meeting of Ministers of Health and Sub-Working Group 11), seeking to analyze the architecture and issues addressed by the regional agenda and drawing parallels with the European experience. The aim of this reflection is to identify how the work done by Mercosur structures contributes to building a regional agenda, with the expectation that the integration can contribute to reducing inequalities in access to health care in the region.

  4. Wheelchair accessibility to public buildings in Istanbul.

    PubMed

    Evcil, A Nilay

    2009-03-01

    Accessibility to public environment is the human right and basic need of each citizen and is one of the fundamental considerations for urban planning. The aim of this study is to determine the compliance of public buildings in central business districts (CBD) of Istanbul, Turkey, to wheelchair accessibility to the guidelines of the instrument and identify architectural barriers faced by wheelchair users. This is a descriptive study of 26 public buildings in CBD of Istanbul. The instrument used is the adapted Useh, Moyo and Munyonga questionnaire to collect the data from direct observation and measurement. Descriptive statistics of simple percentages and means are used to explain the compliance to the guidelines of the instrument and wheelchair accessibility. The descriptive survey results indicate that wheelchair users experience many accessibility problems in public environment of the most urbanised city (cultural capital of Europe in 2010) in a developing country. It is found that the major architectural barrier is the public transportation items with the lowest mean compliance (25%). Beside this, the most compliant to the instrument is entrance to building items with 79% as mean percentage. It is also found that there is an intention to improve accessibility when building construction period is investigated. This article describes the example of the compliance of public buildings accessibility when the country has legislation, but lacking regulations about accessibility for the wheelchair users.

  5. Students who are deaf and hard of hearing and use sign language: considerations and strategies for developing spoken language and literacy skills.

    PubMed

    Nussbaum, Debra; Waddy-Smith, Bettie; Doyle, Jane

    2012-11-01

    There is a core body of knowledge, experience, and skills integral to facilitating auditory, speech, and spoken language development when working with the general population of students who are deaf and hard of hearing. There are additional issues, strategies, and challenges inherent in speech habilitation/rehabilitation practices essential to the population of deaf and hard of hearing students who also use sign language. This article will highlight philosophical and practical considerations related to practices used to facilitate spoken language development and associated literacy skills for children and adolescents who sign. It will discuss considerations for planning and implementing practices that acknowledge and utilize a student's abilities in sign language, and address how to link these skills to developing and using spoken language. Included will be considerations for children from early childhood through high school with a broad range of auditory access, language, and communication characteristics. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  6. Patient access to medicines in two countries with similar health systems and differing medicines policies: Implications from a comprehensive literature review.

    PubMed

    Babar, Zaheer-Ud-Din; Gammie, Todd; Seyfoddin, Ali; Hasan, Syed Shahzad; Curley, Louise E

    2018-04-13

    Countries with similar health systems but different medicines policies might result in substantial medicines usage differences and resultant outcomes. The literature is sparse in this area. To review pharmaceutical policy research in New Zealand and Australia and discuss differences between the two countries and the impact these differences may have on subsequent medicine access. A review of the literature (2008-2016) was performed to identify relevant, peer-reviewed articles. Systematic searches were conducted across the six databases MEDLINE, PubMed, Science Direct, Springer Links, Scopus and Google Scholar. A further search of journals of high relevance was also conducted. Using content analysis, a narrative synthesis of pharmaceutical policy research influencing access to medicines in Australia and New Zealand was conducted. The results were critically assessed in the context of policy material available via grey literature from the respective countries. Key elements regarding pharmaceutical policy were identified from the 35 research papers identified for this review. Through a content analysis, three broad categories of pharmaceutical policy were found, which potentially could influence patient access to medicines in each country; the national health system, pricing and reimbursement. Within these three categories, 9 subcategories were identified: national health policy, pharmacy system, marketing authorization and regulation, prescription to non-prescription medicine switch, orphan drug policies, generic medicine substitution, national pharmaceutical schedule and health technology assessment, patient co-payment and managed entry agreements. This review systematically evaluated the current literature and identified key areas of difference in policy between Australia and NZ. Australia appears to cover and reimburse a greater number of medicines, while New Zealand achieves much lower prices for medicines than their Australian counterparts and has been more successful in controlling national pharmaceutical expenditure. Delays in patient access to new therapies in New Zealand have considerable implications for overall patient access to medicines; however, higher patient co-payments and relative pharmaceutical expenditure in Australia and its effect upon patient access to medicines must also be considered. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. The effect of perch availability during pullet rearing and egg laying on musculoskeletal health of caged White Leghorn hens.

    PubMed

    Hester, P Y; Enneking, S A; Haley, B K; Cheng, H W; Einstein, M E; Rubin, D A

    2013-08-01

    A major skeletal problem of conventionally caged hens is increased susceptibility to osteoporosis mainly due to lack of exercise. Osteoporosis is characterized by a progressive decrease in mineralized structural bone. Whereas considerable attention has been given to enriching laying cages, little research has been conducted on providing caged pullets with furnishments, in particular perches. The objective of the current study was to determine if metal perches during all or part of the life cycle of White Leghorns affected hen musculoskeletal health, especially at end of lay. Treatments during the pullet phase (hatch to 16.9 wk) entailed cages with and without perches. Four treatments were used during the laying phase (17 to 71 wk of age). Treatment 1 chickens never had access to perches at any point during their life cycle, typical of egg industry practices in the United States for conventional cages. Treatment 2 chickens had access to perches only during the egg-laying phase, which was from 17 to 71 wk of age. Treatment 3 chickens had access to perches only during the pullet phase (0 to 16.9 wk of age). Treatment 4 chickens had perch access throughout their entire life cycle (0 to 71 wk of age). Musculoskeletal health was assessed by measuring muscle weights, bone mineralization, bone fracture incidence, and keel bone deviations. Muscle deposition of 71-wk-old hens increased when given access to perches as pullets. Bone mineralization of 71-wk-old hens also increased if given perch access as adults. However, the disadvantage of the adult perch was the higher incidence of keel deviations and keel fractures at end of lay. The increase in bone mineralization of the keel bone as a result of perch access during the pullet and laying phases was not great enough to prevent a higher incidence of keel bone fractures at end of lay. Perch redesign and placement of perches within the cage to minimize keel fractures and deviations are possible solutions.

  8. Designing a podiatry service to meet the needs of the population: a service simulation.

    PubMed

    Campbell, Jackie A

    2007-02-01

    A model of a podiatry service has been developed which takes into consideration the effect of changing access criteria, skill mix and staffing levels (among others) given fixed local staffing budgets and the foot-health characteristics of the local community. A spreadsheet-based deterministic model was chosen to allow maximum transparency of programming. This work models a podiatry service in England, but could be adapted for other settings and, with some modification, for other community-based services. This model enables individual services to see the effect on outcome parameters such as number of patients treated, number discharged and size of waiting lists of various service configurations, given their individual local data profile. The process of designing the model has also had spin-off benefits for the participants in making explicit many of the implicit rules used in managing their services.

  9. Secure Cryptographic Key Management System (CKMS) Considerations for Smart Grid Devices

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

    Abercrombie, Robert K; Sheldon, Frederick T; Aldridge, Hal

    2011-01-01

    In this paper, we examine some unique challenges associated with key management in the Smart Grid and concomitant research initiatives: 1) effectively model security requirements and their implementations, and 2) manage keys and key distribution for very large scale deployments such as Smart Meters over a long period of performance. This will set the stage to: 3) develop innovative, low cost methods to protect keying material, and 4) provide high assurance authentication services. We will present our perspective on key management and will discuss some key issues within the life cycle of a cryptographic key designed to achieve the following:more » 1) control systems designed, installed, operated, and maintained to survive an intentional cyber assault with no loss of critical function, and 2) widespread implementation of methods for secure communication between remote access devices and control centers that are scalable and cost-effective to deploy.« less

  10. Interface test series: An in situ study of factors affecting the containment of hydraulic fractures

    NASA Astrophysics Data System (ADS)

    Warpinski, N. R.; Finley, S. J.; Vollendorf, W. C.; Obrien, M.; Eshom, E.

    1982-02-01

    In situ experiments, which are accessible for direct observation by mineback, were conducted to determine the effect that material-property interfaces and in situ stress differences have on hydraulic fracture propagation and the resultant overall geometry. These experiments show conclusively that a difference in elastic modulus at a geologic interface has little or no effect on crack growth and, therefore, is not a feature which would promote containment of fractures within a specified reservoir zone. However, differences in the in situ stress between adjacent layers is shown to have a considerable influence on fracture propagation. Experiments were conducted in a low modulus ash-fall tuff which contained two layers of high minimum principal in situ stress and which was overlain by a formation with at least a factor of 5 increase in elastic modulus. Fractures were observed to terminate in regions of high minimum principal in situ stress in nearly every case.

  11. Special Vacation Advice for Families with Special Needs Children

    ERIC Educational Resources Information Center

    Barkin, Scott L.

    2010-01-01

    The excitement of going on a family vacation can be matched only by the stress parents experience as they prepare for the excursion. Parents of children with disabilities have special considerations to keep in mind, including the mode of transportation, the accessibility of accommodations, whether the activities will be appropriate for all members…

  12. A Model of the Temporal Dynamics of Knowledge Brokerage in Sustainable Development

    ERIC Educational Resources Information Center

    Hukkinen, Janne I.

    2016-01-01

    I develop a conceptual model of the temporal dynamics of knowledge brokerage for sustainable development. Brokerage refers to efforts to make research and policymaking more accessible to each other. The model enables unbiased and systematic consideration of knowledge brokerage as part of policy evolution. The model is theoretically grounded in…

  13. Use of MCIDAS as an earth science information systems tool

    NASA Technical Reports Server (NTRS)

    Goodman, H. Michael; Karitani, Shogo; Parker, Karen G.; Stooksbury, Laura M.; Wilson, Gregory S.

    1988-01-01

    The application of the man computer interactive data access system (MCIDAS) to information processing is examined. The computer systems that interface with the MCIDAS are discussed. Consideration is given to the computer networking of MCIDAS, data base archival, and the collection and distribution of real-time special sensor microwave/imager data.

  14. An Interdisciplinary Design Project in Second Life: Creating a Virtual Marine Science Learning Environment

    ERIC Educational Resources Information Center

    Triggs, Riley; Jarmon, Leslie; Villareal, Tracy A.

    2010-01-01

    Virtual environments can resolve many practical and pedagogical challenges within higher education. Economic considerations, accessibility issues, and safety concerns can all be somewhat alleviated by creating learning activities in a virtual space. Because of the removal of real-world physical limitations like gravity, durability and scope,…

  15. Systemic Inequity

    ERIC Educational Resources Information Center

    Nathan, Linda F.

    2017-01-01

    Everyone knows money is important. For those privileged to have enough of it, money is not an obstacle for living a decent life or for college access. For the children of the "haves," the cost of college is a consideration, perhaps, but it doesn't predetermine the future. However, within the urban public school arena where the author has…

  16. Intercultural Blended Design Considerations: A Case Study of a Nordic-Baltic Course in Autism Intervention

    ERIC Educational Resources Information Center

    Kack, Annika; Roll-Pettersson, Lise; Alai-Rosales, Shahla S.; Hoium, Kari; Mannikko-Barbutiu, Sirkku; Fors, Uno G. H.

    2014-01-01

    Specialized educational programs previously unavailable to many students are now accessible to students spread throughout the world. In particular, this globalization presents new opportunities and challenges for universities educating professionals in the field of autism treatment. The aim of the present case study is to analyse the experiences…

  17. Widening Access to Higher Education--The Limits of Positive Action

    ERIC Educational Resources Information Center

    Saunders, Nick

    2004-01-01

    2003 was a tempestuous year for the formulation of higher education policy. After considerable delay, the White Paper "The Future of Higher Education" was published in January and this appeared to give a clear signal that government expected higher education institutions, particularly the pre-1992 universities, to do significantly more…

  18. 23 CFR 635.117 - Labor and employment.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... be performed by convict labor at the work site or within the limits of any Federal-aid highway... consideration are projects located on roads within or providing access to an Indian reservation or other Indian lands as defined under the term “Indian Reservation Roads” in 23 U.S.C. 101 and regulations issued...

  19. 23 CFR 635.117 - Labor and employment.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... be performed by convict labor at the work site or within the limits of any Federal-aid highway... consideration are projects located on roads within or providing access to an Indian reservation or other Indian lands as defined under the term “Indian Reservation Roads” in 23 U.S.C. 101 and regulations issued...

  20. 23 CFR 635.117 - Labor and employment.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... be performed by convict labor at the work site or within the limits of any Federal-aid highway... consideration are projects located on roads within or providing access to an Indian reservation or other Indian lands as defined under the term “Indian Reservation Roads” in 23 U.S.C. 101 and regulations issued...

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