Sandia National Laboratories: Livermore Valley Open Campus (LVOC)

Science.gov Websites

Visiting the LVOC Locations Livermore Valley Open Campus (LVOC) Open engagement Expanding opportunities for open engagement of the broader scientific community. Building on success Sandia's Combustion Research Facility pioneered open collaboration over 30 years ago. Access to DOE-funded capabilities Expanding access

Axicabtagene Ciloleucel Expanded Access Study

ClinicalTrials.gov

2018-05-29

Relapsed/Refractory Diffuse Large B Cell Lymphoma; Relapsed/Refractory Primary Mediastinal B Cell Lymphoma; Relapsed/Refractory Transformed Follicular Lymphoma; Relapsed/Refractory High-Grade B-Cell Lymphoma

Accessible Near-Earth Objects (NEOs)

NASA Technical Reports Server (NTRS)

Barbee, Brent W.

2015-01-01

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

Patterns of Student Enrolment and Attrition in Australian Open Access Online Education: A Preliminary Case Study

ERIC Educational Resources Information Center

Greenland, Steven J.; Moore, Catherine

2014-01-01

Swinburne University of Technology has experienced tremendous growth in open access online learning and as such is typical of the many Australian institutions that have ventured into online tertiary education. While research in online education continues to expand, comparatively little investigates students' enrolment and attrition. This research…

Expanding Educational Access in Eastern Turkey: A New Initiative

ERIC Educational Resources Information Center

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

2010-01-01

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

21 CFR 312.320 - Treatment IND or treatment protocol.

Code of Federal Regulations, 2010 CFR

2010-04-01

... clinical trial under an IND designed to support a marketing application for the expanded access use, or (ii) All clinical trials of the drug have been completed; and (2) Marketing status. The sponsor is actively pursuing marketing approval of the drug for the expanded access use with due diligence; and (3) Evidence...

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

ERIC Educational Resources Information Center

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

2016-01-01

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

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

ERIC Educational Resources Information Center

Vanek, Jen

2017-01-01

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

21 CFR 312.305 - Requirements for all expanded access uses.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

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

PubMed

Salkever, David

2013-02-01

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

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

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

ERIC Educational Resources Information Center

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

2014-01-01

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

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

PubMed

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

2009-01-01

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

The Future of Accessibility in International Higher Education

ERIC Educational Resources Information Center

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

2017-01-01

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

77 FR 40590 - Notice of Submission for OMB Review; Institute of Education Sciences; Pell Grant Experiments Study

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-10

...) a treatment group, which will have expanded access to Pell grants; or (2) a control group, which will not have access. Within both experiments, the treatment group will be very similar to the control... employment and earnings outcomes between treatment and control group members can then be attributed to Pell...

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

ERIC Educational Resources Information Center

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

2008-01-01

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

Expanding Access to Quality Pre-K Is Sound Public Policy

ERIC Educational Resources Information Center

Barnett, W. Steven

2013-01-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-10

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

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

PubMed

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

2017-01-01

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

Equity and Access to Higher Education in the Context of Educational Expansion and Differentiation in China

ERIC Educational Resources Information Center

Jia, Qiong

2013-01-01

Internationally, higher education has expanded greatly since the closing decades of the twentieth century. China was no exception. This study is intended to examine the status quo of issues relating to equity and access to higher education in the context of educational expansion and differentiation in China. Two research questions are addressed in…

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

ERIC Educational Resources Information Center

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

2016-01-01

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

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

ERIC Educational Resources Information Center

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

2013-01-01

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

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

ERIC Educational Resources Information Center

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

2007-01-01

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

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

ERIC Educational Resources Information Center

Frankel, Lois; Brownstein, Beth; Soiffer, Neil

2017-01-01

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

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

PubMed

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

2014-06-01

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

OPACs: The User and Subject Access.

ERIC Educational Resources Information Center

Carson, Elizabeth

1985-01-01

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

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

ERIC Educational Resources Information Center

Shaul, Marnie S.

2004-01-01

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

"If You Tell People That You Had Sex with a Fellow Man, It Is Hard to Be Helped and Treated": Barriers and Opportunities for Increasing Access to HIV Services among Men Who Have Sex with Men in Uganda.

PubMed

Wanyenze, Rhoda K; Musinguzi, Geofrey; Matovu, Joseph K B; Kiguli, Juliet; Nuwaha, Fred; Mujisha, Geoffrey; Musinguzi, Joshua; Arinaitwe, Jim; Wagner, Glenn J

2016-01-01

Despite the high HIV prevalence among men who have sex with men (MSM) in sub-Saharan Africa, little is known about their access to HIV services. This study assessed barriers and opportunities for expanding access to HIV services among MSM in Uganda. In October-December 2013, a cross-sectional qualitative study was conducted in 12 districts of Uganda. Semi-structured in-depth interviews were conducted with 85 self-identified MSM by snowball sampling and 61 key informants including HIV service providers and policy makers. Data were analysed using manifest content analysis and Atlas.ti software. Three quarters of the MSM (n = 62, 72.9%) were not comfortable disclosing their sexual orientation to providers and 69 (81.1%) felt providers did not respect MSM. Half (n = 44, 51.8%) experienced difficulties in accessing health services. Nine major barriers to access were identified, including: (i) unwelcoming provider behaviours; (ii) limited provider skills and knowledge; (iii) negative community perceptions towards MSM; (iv) fear of being exposed as MSM; (v) limited access to MSM-specific services; (vi) high mobility of MSM, (vii) lack of guidelines on MSM health services; viii) a harsh legal environment; and ix) HIV related stigma. Two-thirds (n = 56, 66%) participated in MSM social networks and 86% of these (48) received support from the networks to overcome barriers to accessing services. Negative perceptions among providers and the community present barriers to service access among MSM. Guidelines, provider skills building and use of social networks for mobilization and service delivery could expand access to HIV services among MSM in Uganda.

The effect of code expanding optimizations on instruction cache design

NASA Technical Reports Server (NTRS)

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

1991-01-01

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

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

PubMed

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

2013-01-01

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

77 FR 28400 - Notice of Proposed Information Collection for Public Comment on the Study of Public Housing...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-14

... number of homeless households served or targeting homeless households for priority housing assistance... PHAs, to develop strategies to expand access to mainstream housing opportunities for [[Page 28401...

Exploring the population-level impact of antiretroviral treatment: the influence of baseline intervention context.

PubMed

Mishra, Sharmistha; Mountain, Elisa; Pickles, Michael; Vickerman, Peter; Shastri, Suresh; Gilks, Charles; Dhingra, Nandini K; Washington, Reynold; Becker, Marissa L; Blanchard, James F; Alary, Michel; Boily, Marie-Claude

2014-01-01

To compare the potential population-level impact of expanding antiretroviral treatment (ART) in HIV epidemics concentrated among female sex workers (FSWs) and clients, with and without existing condom-based FSW interventions. Mathematical model of heterosexual HIV transmission in south India. We simulated HIV epidemics in three districts to assess the 10-year impact of existing ART programs (ART eligibility at CD4 cell count ≤350) beyond that achieved with high condom use, and the incremental benefit of expanding ART by either increasing ART eligibility, improving access to care, or prioritizing ART expansion to FSWs/clients. Impact was estimated in the total population (including FSWs and clients). In the presence of existing condom-based interventions, existing ART programs (medium-to-good coverage) were predicted to avert 11-28% of remaining HIV infections between 2014 and 2024. Increasing eligibility to all risk groups prevented an incremental 1-15% over existing ART programs, compared with 29-53% when maximizing access to all risk groups. If there was no condom-based intervention, and only poor ART coverage, then expanding ART prevented a larger absolute number but a smaller relative fraction of HIV infections for every additional person-year of ART. Across districts and baseline interventions, for every additional person-year of treatment, prioritizing access to FSWs was most efficient (and resource saving), followed by prioritizing access to FSWs and clients. The relative and absolute benefit of ART expansion depends on baseline condom use, ART coverage, and epidemic size. In south India, maximizing FSWs' access to care, followed by maximizing clients' access are the most efficient ways to expand ART for HIV prevention, across baseline intervention context.

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.

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

PubMed

Grabowsky, Adelia

2016-01-01

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

76 FR 70471 - Notice of Proposed Information Collection for Public Comment on the: Study of Public Housing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-14

... barriers to, or concerns about, increasing the number of homeless households served or targeting homeless... Urban Development (HUD), which funds PHAs, to develop strategies to expand access to mainstream housing...

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

DTIC Science & Technology

2008-03-01

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

The significance of field work in monographic studies

USDA-ARS?s Scientific Manuscript database

The focus of this paper is to document the clear and obvious advantages of field work for monographic studies. These advantages include: 1) ability to understand published distributions better and greatly expand these data, 2) access to taxonomic data obscured on herbarium sheets (as colors, odors, ...

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

PubMed

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

2016-02-01

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

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

PubMed

Bell, Kathryn P; Coplen, Amy E

2016-06-01

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

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

PubMed

Bell, Kathryn P; Coplen, Amy E

2015-02-01

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

Advantages and Disadvantages for Receiving Internet-Based HIV/AIDS Interventions at Home or at Community Based Organization

PubMed Central

Green, Shana M.; Lockhart, Elizabeth; Marhefka, Stephanie L.

2015-01-01

Within recent years public health interventions have become technologically based to reflect the digital age we currently live in and appeal to the public in innovative and novel ways. The Internet breaks down boundaries distance imposes and increases our ability to reach and connect with people. Internet-based interventions have the potential to expand access to effective behavioral interventions. The US National HIV/AIDS Strategy states that people living with HIV should have access to effective behavioral interventions like Healthy Relationships (HR) to help them develop safe sex and disclosure skills. However, access to HR is limited across the country, especially for people in remote or rural areas. Internet-based Healthy Relationships Video Groups (HR-VG) delivered at home or community based organizations (CBOs) can possibly expand access. This study assesses the preferences of women living with HIV (WLH) for participation in HR-VG among 21 WLH who participated in a randomized control trial (RCT) testing HR-VG and completed open-ended semi-structured telephone interviews. Transcripts were thematically analyzed to determine advantages, disadvantages and overall preference for home or agency delivery of HR-VG. Themes relating to convenience, technology access, privacy, distractions, HIV serostatus disclosure and social opportunities were identified as advantages or disadvantages to participating in HR-VG at each location. Overall privacy was the most salient concern of accessing HR-VG at home or at a CBO. Considering the concerns expressed by WLH, further studies are needed to assess how an Internet-based intervention delivered at home for WLH can maintain privacy while being cost effective. PMID:26357907

Advantages and disadvantages for receiving Internet-based HIV/AIDS interventions at home or at community-based organizations.

PubMed

Green, Shana M; Lockhart, Elizabeth; Marhefka, Stephanie L

2015-01-01

Within recent years, public health interventions have become technology based to reflect the digital age we currently live in and appeal to the public in innovative and novel ways. The Internet breaks down boundaries distance imposes and increases our ability to reach and connect with people. Internet-based interventions have the potential to expand access to effective behavioral interventions (EBIs). The US National HIV/AIDS Strategy states that people living with HIV should have access to EBIs such as healthy relationships (HR) to help them develop safe sex and disclosure skills. However, access to HR is limited across the country, especially for people in remote or rural areas. Internet-based healthy relationships video groups (HR-VG) delivered at home or community-based organizations (CBOs) can possibly expand access. This study assesses the preferences of women living with HIV (WLH) for participation in HR-VG among 21 WLH who participated in a randomized control trial (RCT) testing HR-VG and completed open-ended semi-structured telephone interviews. Transcripts were thematically analyzed to determine advantages and disadvantages of home or CBO delivery of HR-VG. Themes relating to convenience, technology access, privacy, distractions, HIV serostatus disclosure, and social opportunities were identified as advantages or disadvantages to participating in HR-VG at each location. Overall, privacy was the most salient concern of accessing HR-VG at home or at a CBO. Considering the concerns expressed by WLH, further studies are needed to assess how an Internet-based intervention delivered at home for WLH can maintain privacy while being cost effective.

Role of Geography and Nurse Practitioner Scope-of-Practice in Efforts to Expand Primary Care System Capacity: Health Reform and the Primary Care Workforce.

PubMed

Graves, John A; Mishra, Pranita; Dittus, Robert S; Parikh, Ravi; Perloff, Jennifer; Buerhaus, Peter I

2016-01-01

Little is known about the geographic distribution of the overall primary care workforce that includes both physician and nonphysician clinicians--particularly in areas with restrictive nurse practitioner scope-of-practice laws and where there are relatively large numbers of uninsured. We investigated whether geographic accessibility to primary care clinicians (PCCs) differed across urban and rural areas and across states with more or less restrictive scope-of-practice laws. An observational study. 2013 Area Health Resource File (AHRF) and US Census Bureau county travel data. The measures included percentage of the population in low-accessibility, medium-accessibility, and high-accessibility areas; number of geographically accessible primary care physicians (PCMDs), nurse practitioners (PCNPs), and physician assistants (PCPAs) per 100,000 population; and number of uninsured per PCC. We found divergent patterns in the geographic accessibility of PCCs. PCMDs constituted the largest share of the workforce across all settings, but were relatively more concentrated within urban areas. Accessibility to nonphysicians was highest in rural areas: there were more accessible PCNPs per 100,000 population in rural areas of restricted scope-of-practice states (21.4) than in urban areas of full practice states (13.9). Despite having more accessible nonphysician clinicians, rural areas had the largest number of uninsured per PCC in 2012. While less restrictive scope-of-practice states had up to 40% more PCNPs in some areas, we found little evidence of differences in the share of the overall population in low-accessibility areas across scope-of-practice categorizations. Removing restrictive scope-of-practice laws may expand the overall capacity of the primary care workforce, but only modestly in the short run. Additional efforts are needed that recognize the locational tendencies of physicians and nonphysicains.

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

PubMed Central

Choi, Donghee; Kim, Dohoon; Park, Seog

2015-01-01

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

Toxico-Cheminformatics: New and Expanding Public Resources to Support Chemical Toxicity Assessments

EPA Science Inventory

High-throughput screening (HTS) technologies, along with efforts to improve public access to chemical toxicity information resources and to systematize older toxicity studies, have the potential to significantly improve information gathering efforts for chemical assessments and p...

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

PubMed

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

2018-02-01

To estimate the costs of public-sector abortion provision in South Africa and to explore the potential for expanding access at reduced cost by changing the mix of technologies used. We conducted a budget impact analysis using public sector abortion statistics and published cost data. We estimated the total costs to the public health service over 10 years, starting in South Africa's financial year 2016/17, given four scenarios: (1) holding service provision constant, (2) expanding public sector provision, (3) changing the abortion technologies used (i.e. the method mix), and (4) expansion plus changing the method mix. The public sector performed an estimated 20% of the expected total number of abortions in 2016/17; 26% and 54% of all abortions were performed illegally or in the private sector respectively. Costs were lowest in scenarios where method mix shifting occurred. Holding the proportion of abortions performed in the public-sector constant, shifting to more cost-effective service provision (more first-trimester services with more medication abortion and using the combined regimen for medical induction in the second trimester) could result in savings of $28.1 million in the public health service over the 10-year period. Expanding public sector provision through elimination of unsafe abortions would require an additional $192.5 million. South Africa can provide more safe abortions for less money in the public sector through shifting the methods provided. More research is needed to understand whether the cost of expanding access could be offset by savings from averting costs of managing unsafe abortions. South Africa can provide more safe abortions for less money in the public sector through shifting to more first-trimester methods, including more medication abortion, and shifting to a combined mifepristone plus misoprostol regimen for second trimester medical induction. Expanding access in addition to method mix changes would require additional funds. Copyright © 2017 Elsevier Inc. All rights reserved.

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

PubMed

Shrivastava, Divya; Verma, Priyanka; Bhatia, Sabhyata

2014-09-01

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

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

PubMed

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

2014-08-01

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

Adams National Historical Park expanded transit service evaluation

DOT National Transportation Integrated Search

2009-12-01

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

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

ERIC Educational Resources Information Center

Buckner, Elizabeth

2013-01-01

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

Access and Achievement: Building Educational and Career Pathways for Latinos in Advanced Technology. Report on a National Study of Latino Access to Postsecondary Education and Careers in Information Technology

ERIC Educational Resources Information Center

Tornatzky, Louis G.; Macias, Elsa E.; Jenkins, Davis; Solis, Carlos

2006-01-01

One of the generally accepted premises of current economic thinking is that a large and expanding proportion of growth is tied to what has come to be known as the "knowledge economy" or equivalently, the innovation sector. Despite recent U.S. Census Bureau data indicating that Latinos now constitute the largest minority group of the U.S.…

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

PubMed

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

2015-06-01

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

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

ERIC Educational Resources Information Center

Tyckoson, David A., Ed.

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

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

ERIC Educational Resources Information Center

Cavilla, Derek

2014-01-01

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

Higher Education: In Search of Access and Scholarship.

ERIC Educational Resources Information Center

Walker, David A.

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

Paediatric and maternal schistosomiasis: shifting the paradigms.

PubMed

Bustinduy, Amaya L; Stothard, J Russell; Friedman, Jennifer F

2017-09-01

In endemic areas, schistosomiasis causes both overt and subclinical disease in young children and their mothers, as well as in returned travellers. Key recently published literature. An action plan for paediatric schistosomiasis and female genital schistosomiasis (FGS) is needed with expanded access to praziquantel (PZQ) treatment required. Schistosomiasis-related morbidity is underappreciated. Present and future demand for PZQ treatment is bottlenecked, imbalanced and inequitable. Current dosing, treatment algorithms and access plans are suboptimal with treatment stalled during pregnancy. Raised dosing of PZQ (>40 mg/kg) is being explored in young children. Surveillance of female genital schistosomiasis FGS is increasing. Use of PZQ in pregnancy is safe and preventive chemotherapy guidelines are being revised in morbidity- and transmission-control settings. Shifting focus of population-level control to individual-case management. Detection and prevention of FGS within general health services and integration of PZQ treatment for women and children in antenatal clinics. Feasibility studies assessing alternative and expanded access to PZQ treatment to at-risk children and mothers and pregnant women. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Funding antiretroviral treatment for HIV-positive temporary residents in Australia prevents transmission and is inexpensive.

PubMed

Gray, Richard T; Watson, Jo; Cogle, Aaron J; Smith, Don E; Hoy, Jennifer F; Bastian, Lisa A; Finlayson, Robert; Drummond, Fraser M; Whittaker, Bill; Law, Matthew G; Petoumenos, Kathy

2018-02-01

Background The aim of this study is to estimate the reduction in new HIV infections and resultant cost outcomes of providing antiretroviral treatment (ART) through Australia's 'universal access' health scheme to all temporary residents with HIV infection living legally in Australia, but currently deemed ineligible to access subsidised ART via this scheme. A mathematical model to estimate the number of new HIV infections averted and the associated lifetime costs over 5 years if all HIV-positive temporary residents in Australia had access to ART and subsidised medical care was developed. Input data came from a cohort of 180 HIV-positive temporary residents living in Australia who are receiving free ART donated by pharmaceutical companies for up to 4 years. Expanding ART access to an estimated total 450 HIV+ temporary residents in Australia for 5 years could avert 80 new infections. The model estimated the total median discounted (5%) cost for ART and associated care to be A$36million, while the total savings in lifetime-discounted costs for the new infections averted was A$22million. It is estimated that expanded access to ART for all HIV-positive temporary residents in Australia will substantially reduce HIV transmission to their sexual partners at little additional cost. In the context of Australia's National HIV strategy and Australia's endorsement of global goals to provide universal access to ART for all people with HIV, this is an important measure to remove inequities in the provision of HIV-related treatment and care.

A Technology-Based Peer Education Intervention: Results from a Sexual Health Textline Feasibility Study

ERIC Educational Resources Information Center

O'Malley, Teagen L.; Horowitz, Katie Rose; Garth, José; Mair, Christina; Burke, Jessica G.

2017-01-01

Sexuality health education is moving beyond the classroom, with technology expanding youth access to sexual health information. While text message services are increasingly being used to provide information, a peer education approach has yet to be incorporated. Results from this feasibility study support a sexual health textline (IOTAS),…

ToxRefDB 2.0: Improvements in Capturing Qualitative and Quantitative Data from in vivo Toxicity Studies (SOT)

EPA Science Inventory

The Toxicity Reference Database (ToxRefDB) is a publicly accessible resource that contains 40+ years of in vivo dose-response toxicological studies. ToxRefDB provides curated in vivo toxicity data for systematic evaluation of a continuously expanding catalog of chemicals, and co...

Affirmative Action in Brazil: How Students' Field of Study Choice Reproduces Social Inequalities

ERIC Educational Resources Information Center

Dias Lopes, Alice

2017-01-01

This paper aims to understand which fields of study affirmative action students graduated at the undergraduate level in public universities in Brazil in 2009 and 2010. Public universities began expanding access for underrepresented groups through racial, economic, and social affirmative action policies in 2001. The existing literature on…

A Study of ICT Infrastructure and Access to Educational Information in the Outskirts of Malang

ERIC Educational Resources Information Center

Elmunsyah, Hakkun

2012-01-01

This study aimed to determine the readiness of disadvantaged areas in support of Electronic School Books (BSE), which could be downloaded free of charge by making use of Information Communication Technology (ICT). The present study was descriptive research which was approached quantitatively, and expected to expand the model of development of…

Response Variability across Diverse Rice Accessions under Rising Temperature and Increasing Atmospheric Carbon Dioxide

USDA-ARS?s Scientific Manuscript database

Evaluating variability of rice response to concurrent increases in CO2 and temperature forecasted for future climates is a prerequisite step towards characterizing the genetic architecture underlying this response. Expanding on previous single cultivar studies, we evaluated eleven biogeographically ...

Foregrounding Effects during Reading, Revisited

ERIC Educational Resources Information Center

Cook, Anne E.; Gueraud, Sabine; Was, Christopher A.; O'Brien, Edward J.

2007-01-01

Previous researchers have argued that objects associated with a protagonist may be foregrounded, or held active, in memory. This study expanded on previous work by using an inconsistency paradigm to investigate the effects of protagonist association on object accessibility. Readers experienced more processing difficulty when a target sentence…

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

PubMed

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

2017-07-21

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

Solar in Your Community Challenge Fact Sheet

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

None

The SunShot Prize: Solar in Your Community Challenge is a $5 million prize competition funded by the U.S. Department of Energy SunShot Initiative that aims to expand solar electricity access to low-and moderate-income (LMI) households and community organizations that haven’t been able to take advantage of the booming solar market. Because of rooftop limitations, lack of a strong credit history, or inability to utilize tax incentives, over 50% of Americans don’t have access to solar electricity. Offering $5 million in cash prizes and technical assistance over 18 months, the challenge supports teams across the country as they develop and demonstratemore » replicable projects or programs that expand solar access to underserved groups.« less

Technology for People, Not Disabilities: Ensuring Access and Inclusion

ERIC Educational Resources Information Center

Foley, Alan; Ferri, Beth A.

2012-01-01

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

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

PubMed

McGowan, James G

2013-09-01

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

Smartphones in nursing education.

PubMed

Phillippi, Julia C; Wyatt, Tami H

2011-08-01

Smartphones are a new technology similar to PDAs but with expanded functions and greater Internet access. This article explores the potential uses and issues surrounding the use of smartphones in nursing education. While the functions of smartphones, such as sending text messages, viewing videos, and access to the Internet, may seem purely recreational, they can be used within the nursing curriculum to engage students and reinforce learning at any time or location. Smartphones can be used for quick access to educational materials and guidelines during clinical, class, or clinical conference. Students can review instructional videos prior to performing skills and readily reach their clinical instructor via text message. Downloadable applications, subscriptions, and reference materials expand the smartphone functions even further. Common concerns about requiring smartphones in nursing education include cost, disease transmission, and equipment interference; however, there are many ways to overcome these barriers and provide students with constant access to current clinical evidence.

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

PubMed

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

2018-02-01

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

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

PubMed

Keil, Aaron; Brown, Suzanne Robben

2015-01-01

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

Mobile health clinics in the era of reform.

PubMed

Hill, Caterina F; Powers, Brian W; Jain, Sachin H; Bennet, Jennifer; Vavasis, Anthony; Oriol, Nancy E

2014-03-01

Despite the role of mobile clinics in delivering care to the full spectrum of at-risk populations, the collective impact of mobile clinics has never been assessed. This study characterizes the scope of the mobile clinic sector and its impact on access, costs, and quality. It explores the role of mobile clinics in the era of delivery reform and expanded insurance coverage. A synthesis of observational data collected through Mobile Health Map and published literature related to mobile clinics. Analysis of data from the Mobile Health Map Project, an online platform that aggregates data on mobile health clinics in the United States, supplemented by a comprehensive literature review. Mobile clinics represent an integral component of the healthcare system that serves vulnerable populations and promotes high-quality care at low cost. There are an estimated 1500 mobile clinics receiving 5 million visits nationwide per year. Mobile clinics improve access for vulnerable populations, bolster prevention and chronic disease management, and reduce costs. Expanded coverage and delivery reform increase opportunities for mobile clinics to partner with hospitals, health systems, and insurers to improve care and lower costs. Mobile clinics have a critical role to play in providing high-quality, low-cost care to vulnerable populations. The postreform environment, with increasing accountability for population health management and expanded access among historically underserved populations, should strengthen the ability for mobile clinics to partner with hospitals, health systems, and payers to improve care and lower costs.

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

PubMed Central

Treiser, Matthew D.; Lahair, Tracy

2016-01-01

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

Focusing on Challenging Content and Practical Applications in Science, Technology, Engineering and Mathematics (STEM) Studies in Middle Grades Schools, High Schools and Technology Centers.

ERIC Educational Resources Information Center

Southern Regional Education Board (SREB), 2012

2012-01-01

Schools that give students access to STEM (science, technology, engineering and mathematics) studies are accomplishing several objectives: introducing students to higher-level academic and career studies, expanding project-based learning in the curriculum, enticing students to remain in school until graduation, and preparing students for…

The Somalia Country Case Study. Mid-Decade Review of Progress towards Education for All.

ERIC Educational Resources Information Center

Bennaars, Gerard A.; Seif, Huda A.; Mwangi, Doris

In 1995, the International Consultative Forum on Education for All commissioned case studies in developing countries as part of a mid-decade review of progress in expanding access to basic education. This paper examines the situation in Somalia, where civil war has completely destroyed the infrastructure of education. Part 1 summarizes Somalia's…

Can biosimilars help achieve the goals of US health care reform?

PubMed

Boccia, Ralph; Jacobs, Ira; Popovian, Robert; de Lima Lopes, Gilberto

2017-01-01

The US Patient Protection and Affordable Care Act (ACA) aims to expand health care coverage, contain costs, and improve health care quality. Accessibility and affordability of innovative biopharmaceuticals are important to the success of the ACA. As it is substantially more difficult to manufacture them compared with small-molecule drugs, many of which have generic alternatives, biologics may increase drug costs. However, biologics offer demonstrated improvements in patient care that can reduce expensive interventions, thus lowering net health care costs. Biosimilars, which are highly similar to their reference biologics, cost less than the originators, potentially increasing access through reduced prescription drug costs while providing equivalent therapeutic results. This review evaluates 1) the progress made toward enacting health care reform since the passage of the ACA and 2) the role of biosimilars, including the potential impact of expanded biosimilar use on access, health care costs, patient management, and outcomes. Barriers to biosimilar adoption in the USA are noted, including low awareness and financial disincentives relating to reimbursement. The evaluated evidence suggests that the ACA has partly achieved some of its aims; however, the opportunity remains to transform health care to fully achieve reform. Although the future is uncertain, increased use of biosimilars in the US health care system could help achieve expanded access, control costs, and improve the quality of care.

Will Online Learning Lower the Price of College?

ERIC Educational Resources Information Center

Casement, William

2013-01-01

Online learning is revolutionizing the way colleges do business. Study via the Internet makes more knowledge more easily obtainable for more students than ever before. Along with expanded access to higher education, many people are optimistic about an accompanying benefit--a lower price tag. Basic economic factors make the prospect appear…

Alternative Pathways into University: Are Tertiary Preparation Programs a Viable Option?

ERIC Educational Resources Information Center

Chesters, Jenny; Rutter, Kerry; Nelson, Karen; Watson, Louis

2018-01-01

During the past three decades, the student populations of Australian universities have become more heterogeneous as the higher education sector expanded and new alternative entry pathways were established. Broadening access to university study and, therefore, to professional and semi-professional occupations, provides avenues for social mobility.…

Health-Seeking Behaviors among Latinas: Practices and Reported Difficulties in Obtaining Health Services

ERIC Educational Resources Information Center

Rojas-Guyler, Liliana; King, Keith A.; Montieth, Brigid A.

2008-01-01

Background: Latinos experience disproportionate negative health status and health care access. Expanding understanding of factors impacting Latino immigrant health is imperative. Purpose: This study identified health-seeking behaviors among Latinas in a large Midwestern city with rapid immigrant population growth. Health-seeking behaviors like…

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

PubMed

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

2016-03-17

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

77 FR 25994 - Notice of Proposed Information Collection Requests; Institute of Education Sciences; Pell Grant...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-02

... will have expanded access to Pell grants; or (2) a control group, which will not have access. Within both substudies, the treatment group will be very similar to the control at the time of random... between treatment and control group members can then be attributed to Pell grant access. The first...

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

ERIC Educational Resources Information Center

Van Epps, Daniel L.

2013-01-01

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

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

ERIC Educational Resources Information Center

Corcoran, Thomas B.; Gerry, Gail B.

2010-01-01

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

"Without this program, women can lose their lives": migrant women's experiences with the Safe Abortion Referral Programme in Chiang Mai, Thailand.

PubMed

Tousaw, Ellen; La, Ra Khin; Arnott, Grady; Chinthakanan, Orawee; Foster, Angel M

2017-11-01

For displaced and migrant women in northern Thailand, access to health care is often limited, unwanted pregnancy is common, and unsafe abortion is a major contributor to maternal death and disability. Based on a pilot project and situational analysis research, in 2015 a multinational team introduced the Safe Abortion Referral Programme (SARP) in Chiang Mai, Thailand, to reduce the socio-linguistic, economic, documentation, and transportation barriers women from Burma face in accessing safe and legal abortion care in Thailand. Our qualitative study documented the experiences of women with unwanted pregnancies who accessed the SARP in order to inform programme improvement and expansion. We conducted 22 in-depth, in-person interviews and analysed them for content and themes using deductive and inductive techniques. Women were overwhelmingly positive about their experiences using the SARP. They reported lack of costs, friendly programme staff, accompaniment to and interpretation at the providing facility, and safety of services as key features. Financial and legal circumstances shaped access to the programme and women learned about the SARP through word-of-mouth and community workshops. After accessing the SARP and receiving support, women became community advocates for reproductive health. Efforts to expand the programme and raise awareness in migrant communities appear warranted. Our findings suggest that referral programmes for safe and legal abortion can be successful in settings with large displaced and migrant populations. Identifying ways to work within legal constraints to expand access to safe services has the potential to reduce harm from unsafe abortion even in humanitarian settings.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-06

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

Maintenance of Access as Demand for Substance Use Disorder Treatment Grows

PubMed Central

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

2015-01-01

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

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

PubMed

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

2015-08-01

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

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

NONE

The Library Services Alliance is a unique multi-type library consortium committed to resource sharing. As a voluntary association of university and governmental laboratory libraries supporting scientific research, the Alliance has become a leader in New Mexico in using cooperative ventures to cost-effectively expand resources supporting their scientific and technical communities. During 1994, the alliance continued to expand on their strategic planning foundation to enhance access to research information for the scientific and technical communities. Significant progress was made in facilitating easy access to the on-line catalogs of member libraries via connections through the Internet. Access to Alliance resources is nowmore » available via the World Wide Web and Gopher, as well as links to other databases and electronic information. This report highlights the accomplishments of the Alliance during calendar year 1994.« less

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

NASA Astrophysics Data System (ADS)

Fataar, Aslam

1997-07-01

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

Linkages between Youth Diversity and Organizational and Program Characteristics of Out-of-School-Time Science Programs: A Mixed-Methods Study

ERIC Educational Resources Information Center

Thiry, Heather; Archie, Timothy; Arreola-Pena, Melissa; Laursen, Sandra

2017-01-01

Science opportunities in out-of-school time (OST) programs hold potential for expanding access to science, engineering, and technology (SET) pathways for populations that have not participated in these fields at equitable rates (Coalition for Science After School, 2014). This mixed-methods study examines the relationship between the diversity of…

Expanding Access for Training of Science Teachers through ODL: A Case Study of University of Lagos, Nigeria

ERIC Educational Resources Information Center

Okunuga, A. O.; Olaoluniyi, O.; Opara, A. I.

2013-01-01

Rising up to the challenge of shortage of middle manpower in Nigeria, the University of Lagos established the Correspondence and Open Studies Unit (COSU), now Distance Learning Institute DLI). Accounting, Business Administration and Science-Education were the pilot courses at the B.Sc. level. The Special Entry Preparatory Programme (SEPP) was…

Expanded polytetrafluoroethylene graft fistula for chronic hemodialysis.

PubMed

Tellis, V A; Kohlberg, W I; Bhat, D J; Driscoll, B; Veith, F J

1979-01-01

In a retrospective study of 66 PTFE arteriovenous fistulae and 71 BCH arteriovenous fistulae for dialysis access, PTFE had a higher patency rate than BCH at 12 months (62.4 versus 32.5%). PTFE was easier to work with and easier to handle in the face of infection. The lateral upper arm approach to placement of the PTFE graft is desirable in patients who have had multiple previous access procedures because this area is usually free from scarring, is distant from neurovascular structures, and provides a greater length of graft for needle punctures.

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

PubMed

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

2016-08-15

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

What critical care nurses need to know about health care access when caring for elders in acute care settings.

PubMed

Jennings, Bonnie Mowinski; Lamb, Gerri

2007-09-01

Health care system issues, in general, and access to care, in particular, are not problems typically studied by critical care nurses. Rather, initial and continuing education focuses on clinical aspects of care. This focus is necessary to assure that critical care nurses have the expertise to care for patients who need astute surveillance for complicated physical problems and their emotional sequelae, as well as in-depth knowledge and skills related to care coordination for patient stabilization and transfer. However, evidence is growing that patients benefit when critical care nurses expand their knowledge about access to care. This article provides insights regarding access to health care and how it relates to many of the admission and readmission patterns that critical care nurses observe.

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

PubMed

Damrongplasit, Kannika; Melnick, Glenn

2015-04-01

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

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

PubMed

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

2018-05-01

Atezolizumab (anti-programmed death-ligand 1) was approved in the USA, Europe, and elsewhere for treatment-naive and platinum-treated locally advanced/metastatic urothelial carcinoma (mUC). To report efficacy and safety from an atezolizumab expanded access study. This single-arm, open-label study enrolled 218 patients at 36 US sites. Key eligibility criteria included progression during/following ≥1 platinum-based chemotherapy for mUC or in perioperative setting (progression within 12 mo) and Eastern Cooperative Oncology Group performance status (ECOG PS) 0-2. Patients received atezolizumab1200mg intravenously every 3 wk until loss of clinical benefit, unacceptable toxicity, consent withdrawal, decision to discontinue, death, atezolizumab commercial availability, or study closure. Key end points reported herein included Response Evaluation Criteria in Solid Tumors v1.1 objective response rate and duration, disease control rate (DCR; response or stable disease), and safety. All patients received prior systemic therapy (68% mUC; 27% adjuvant; and 26% neoadjuvant). At baseline, 57% of 214 treated patients had ECOG PS ≥1, 19% had hemoglobin <10g/dl, and 25% had liver metastases. Median treatment duration was 9 wk (interquartile range [IQR], 6-12 wk). Median follow-up duration was 2.3 mo (IQR, 1.6-3.4 mo) overall and 2.7 mo (IQR, 2.0-3.5 mo) in patients not known to have died. Seventeen of 114 evaluable patients (15%) had objective responses (16 ongoing at study termination). DCR was 49%. Treatment-related adverse events (mostly fatigue) occurred in 98 of 214 treated patients. The benefit/risk profile of atezolizumab was consistent with that observed in previous studies, despite pretreatment and poor prognostic factors. These results suggest a potential role for atezolizumab in a broader patient range than typically eligible for phase 1-3 studies. In this expanded access study, atezolizumab was active and tolerable in a range of patients with platinum-treated metastatic urothelial carcinoma. Copyright © 2018 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Paying to Listen: Notes from a Survey of Sexual Commerce

ERIC Educational Resources Information Center

Snow, Rachel C.; Williams, Angela; Collins, Curtis; Moorman, Jessica; Rangel, Tomas; Barick, Audrey; Clay, Crystal; Matiz Reyes, Armando

2013-01-01

As the study of sexual commerce has grown dramatically in recent decades due to interest in HIV/AIDS, an expanded literature has scrutinized how research teams manage the operational challenges of accessing spaces that typically resist scrutiny. This paper ventures a combination of both scholarly reflections on the utility of ethical listening and…

Promoting Family Literacy through the Five Pillars of Family and Community Engagement (FACE)

ERIC Educational Resources Information Center

Kuo, Nai-Cheng

2016-01-01

Family literacy involves factors beyond what is done at home between parents and children. To help preservice teachers develop their understanding of the multiple dimensions of family literacy, this study uses the five pillars of family and community engagement (FACE)--early literacy, family involvement, access to books, expanded learning, and…

Leading against the Grain: Lessons for Creating Just and Equitable Schools

ERIC Educational Resources Information Center

Brooks, Jeffrey S., Ed.; Normore, Anthony H., Ed.

2017-01-01

What new ideas and ways of thinking can educational leaders learn from great world leaders who have moved their societies to greater equity and expanded educational opportunity? In this lively, accessible volume, the editors have brought together an impressive group of senior and early-career educational scholars to study the lives and…

Off-Site Storage and Special Collections: A Study in Use and Impact in ARL Libraries in the United States

ERIC Educational Resources Information Center

Priddle, Charlotte; McCann, Laura

2015-01-01

Special collections libraries collect and preserve materials of intellectual and cultural heritage, providing access to unique research resources. As their holdings continue to expand, special collections in research libraries confront increased space pressures. Off-site storage facilities, used frequently by research libraries for general…

Services Shared by Health Care Organizations: An Annotated Bibliography.

ERIC Educational Resources Information Center

Hospital Research and Educational Trust, Chicago, IL.

This bibliography is designed to assist planners in the field of institutional health and health support services in gaining access to knowledge that will enhance their efforts to achieve new or expanded arrangements of service sharing. Entries are cross-referenced to as many categories as the material warrants. Case studies that are not annotated…

Fostering Open Space and Recreation Plan Development: A Case Study of Findlay Township, Pennsylvania.

ERIC Educational Resources Information Center

Caruso, Christopher J.

1996-01-01

A plan adopted in 1992 by Findlay Township in rural Pennsylvania protects undeveloped land from urbanization and expanded and improved the township's park and recreational system. Improvements included a fitness trail, a pavilion, a handicap-accessible jungle gym, tennis and volleyball courts, restrooms, and flower beds and trees. (LP)

Referencing Science: Teaching Undergraduates to Identify, Validate, and Utilize Peer-Reviewed Online Literature

ERIC Educational Resources Information Center

Berzonsky, William A.; Richardson, Katherine D.

2008-01-01

Accessibility of online scientific literature continues to expand due to the advent of scholarly databases and search engines. Studies have shown that undergraduates favor using online scientific literature to address research questions, but they often do not have the skills to assess the validity of research articles. Undergraduates generally are…

Bridging Natural and Digital Domains: Attitudes, Confidence, and Interest in Using Technology to Learn Outdoors

ERIC Educational Resources Information Center

Hougham, R. Justin; Nutter, Marc; Graham, Caitlin

2018-01-01

Background: The current study, Project EARPOD (Engaging At-Risk Populations Outdoors, Digitally), addressed two questions: First, does the use of technology in environmental education detract from students' experiences outdoors? Second, can these technological interventions be expanded to provide access to students and schools across the…

Access barriers to and unmet needs for home- and community-based services among older Korean Americans.

PubMed

Casado, Banghwa Lee; Lee, Sang E

2012-01-01

This cross-sectional survey study of 146 caregivers of older Korean Americans explored access barriers to and unmet needs for home- and community-based services (HCBS) programs (respite care, adult day care, personal care, home health, housekeeping, and transportation). Most often reported access barriers were lack of awareness and care recipient refusal. Predictors of unmet needs varied depending on the type of service, but included caregiver gender, relationship, education, caregiving duration, Medicaid coverage, English proficiency, caregiver self-efficacy, care recipient functional dependency, cognitive impairment, and caregiving hours. This study highlighted unmet needs for HCBS in Korean American communities, pointing to the pressing need for a collaborative effort to develop plans that modify and expand HCBS programs for older Korean Americans.

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

ERIC Educational Resources Information Center

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

2012-01-01

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

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

ERIC Educational Resources Information Center

Browne, Daniel; Syed, Sarosh; Mendels, Pamela

2013-01-01

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

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

ERIC Educational Resources Information Center

Abraham, Lee B.; Williams, Lawrence

2011-01-01

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

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

PubMed

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

2010-03-01

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

The role of tablets in accessing information throughout undergraduate medical education in Botswana.

PubMed

Witt, Rachel E; Kebaetse, Masego B; Holmes, John H; Littman-Quinn, Ryan; Ketshogileng, Dineo; Antwi, Cynthia; Kovarik, Carrie; Nkomazana, Oathokwa

2016-04-01

Mobile learning (mLearning) uses wireless networks and mobile devices to expand physician trainees' and healthcare providers' access to and exchange of medical information. Opportunities to increase implementation and expand use of mobile devices to support health care information access and delivery in Africa are vast, but the rapid growth of mLearning has caused project implementation to outpace objective measurement of impact. This study makes a contribution to the existing body of literature regarding mLearning implementation in Africa through its focus on the use of smart devices (tablets) in undergraduate medical education and medical students' perceptions of the effects on their learning environment. The population of this prospective mixed-methods study consisted of 82 undergraduate medical students (45 third year and 37 fourth year) at the University of Botswana Faculty of Medicine. They received tablets in the earliest phase of the mLearning project implementation (between November 2012 and January 2013), when they were in the third and fourth year of their medical training. Usage of the tablets was assessed both quantitatively and qualitatively, through both application usage tracking and focus groups. Based on application usage data and coding and analysis of focus group discussions, undergraduate medical students indicated that tablets were useful in their medical education, allowing them continual access to information and opportunities for communication. Participants noted that the primary barrier to use of tablets was the lack of mobile cellular Internet beyond the Wi-Fi zones at the training sites. Moreover, participants offered suggestions for improvements to the implementation process. Even in resource-limited settings where Internet access can be unreliable and intermittent, the adoption of tablets can have benefits to medical education by providing consistent access to extensive and current medical information resources. This study highlights the value of clinical resources with offline functionality, with or without consistent access to the Internet. There is also the potential for optimizing the use of tablets through improved training and technical support. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

PubMed

Meyerson, Denise

2017-09-01

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

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.…

Self-adaptive Fault-Tolerance of HLA-Based Simulations in the Grid Environment

NASA Astrophysics Data System (ADS)

Huang, Jijie; Chai, Xudong; Zhang, Lin; Li, Bo Hu

The objects of a HLA-based simulation can access model services to update their attributes. However, the grid server may be overloaded and refuse the model service to handle objects accesses. Because these objects have been accessed this model service during last simulation loop and their medium state are stored in this server, this may terminate the simulation. A fault-tolerance mechanism must be introduced into simulations. But the traditional fault-tolerance methods cannot meet the above needs because the transmission latency between a federate and the RTI in grid environment varies from several hundred milliseconds to several seconds. By adding model service URLs to the OMT and expanding the HLA services and model services with some interfaces, this paper proposes a self-adaptive fault-tolerance mechanism of simulations according to the characteristics of federates accessing model services. Benchmark experiments indicate that the expanded HLA/RTI can make simulations self-adaptively run in the grid environment.

Perspectives of people who are deaf and hard of hearing on mental health, recovery, and peer support.

PubMed

Cabral, Linda; Muhr, Kathy; Savageau, Judith

2013-12-01

This qualitative study sought to better understand the experiences of deaf and hard of hearing individuals with accessing recovery-oriented mental health services and peer support via a focus group and interviews. Cultural brokers were used to facilitate culturally-sensitive communication with study participants. Findings indicate that access to adequate mental health services, not just recovery-oriented and peer support services, is not widely available for this population, largely due to communication barriers. Feelings of isolation and stigma are high among this population. Public mental health systems need to adapt and expand services for various cultural groups to insure recovery.

Assessing early implementation of state autism insurance mandates.

PubMed

Baller, Julia Berlin; Barry, Colleen L; Shea, Kathleen; Walker, Megan M; Ouellette, Rachel; Mandell, David S

2016-10-01

In the United States, health insurance coverage for autism spectrum disorder treatments has been historically limited. In response, as of 2015, 40 states and Washington, DC, have passed state autism insurance mandates requiring many health plans in the private insurance market to cover autism diagnostic and treatment services. This study examined five states' experiences implementing autism insurance mandates. Semi-structured, key-informant interviews were conducted with 17 participants representing consumer advocacy organizations, provider organizations, and health insurance companies. Overall, participants thought that the mandates substantially affected the delivery of autism services. While access to autism treatment services has increased as a result of implementation of state mandates, states have struggled to keep up with the demand for services. Participants provided specific information about barriers and facilitators to meeting this demand. Understanding of key informants' perceptions about states' experiences implementing autism insurance mandates is useful for other states considering adopting or expanding mandates or other policies to expand access to autism treatment services. © The Author(s) 2015.

Increasing Need-Based Grant Aid Is the Most Efficient Way To Expand College Access. Illuminations: Highlighting Important Research in Postsecondary Education Access. New Agenda Series.

ERIC Educational Resources Information Center

Lumina Foundation for Education, 2004

2004-01-01

This two-page summary offers an overview of a "New Agenda Series" publication relating to need-based grant aid. The federal and state governments share the responsibility for providing access to postsecondary education. They do this through direct appropriations, student financial aid programs and other support for research and educational…

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

ERIC Educational Resources Information Center

Lewin, Keith M.

2007-01-01

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

Quality of USMC Officers: Buildup Vs. Reduction in Forces

DTIC Science & Technology

2016-03-01

the system and difficult to remove. Bacolod (2007), analyzes the decline in teacher quality due to expanded access to professional jobs for women ...the drawdown is to reduce accessions, create stricter retention policies, and entice members to leave the service through voluntary measures. This...approach during the drawdown is to reduce accessions, create stricter retention policies, and entice members to leave the service through voluntary

World Class: The Global Challenge to Canadian Education.

ERIC Educational Resources Information Center

Stewart-Patterson, David

2002-01-01

Globalization challenges governments to improve the quality of and access to postsecondary education while limiting their ability to raise revenue. By stimulating savings and expanding student loans and scholarships, Canada can improve access to postsecondary education. Educational quality can be improved through more effective assessment and…

Expanding SLA's World.

ERIC Educational Resources Information Center

Avallone, Susan

1987-01-01

Briefly summarizes topics discussed within the theme of global information access at the annual conference of the Special Libraries Association, including information policy in foreign countries, copyright laws, the impact of library automation on access to information, and findings of a task force on the value of the information professional.…

The Role of Student Financial Aid in Expanding Opportunities for Higher Education in Ohio. Report of the Financial Aid Study Committee.

ERIC Educational Resources Information Center

Ohio Board of Regents, Columbus.

The Financial Aid Study Committee of the Ohio Board of Regents was impaneled in October 1987 to determine if the state's major financial aid investments, principally the Ohio Instructional Grant Program, are an adequate resource in addressing state access objectives. Significant changes in the Ohio economic base have given rise to renewed emphasis…

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

PubMed

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

2016-08-08

Everolimus, a mammalian target of rapamycin (mTOR) inhibitor, has been shown to be effective and safe in the treatment of subependymal giant cell astrocytoma (SEGA) associated with tuberous sclerosis complex (TSC). The Everolimus For Fast Expanded aCcess in TSC SEGA (EFFECTS) study was designed to provide everolimus access to patients with SEGA associated with TSC and to mainly assess the safety and also efficacy of everolimus in a real-world setting. EFFECTS was a phase 3b, open-label, noncomparative, multicenter, expanded access study. Eligible patients were ≥ 3 years of age, with a definite diagnosis of TSC, and with at least one SEGA lesion identified by MRI or CT scan. Patients received once daily everolimus (dose adjusted to attain a trough level of 5-15 ng/mL). Safety evaluation was the primary objective and included collection of adverse events (AEs) and serious AEs, with their severity and relationship to everolimus. Efficacy evaluation, which was the secondary objective, was based on the best overall response as per medical judgment. Of the 120 patients enrolled, 100 (83.3%) completed the study. Median age of patients was 11 years (range, 1-47). Median daily dose of everolimus was 5.82 mg (range, 2.0-11.8). Median duration of exposure was 56.5 weeks (range, 0.3-130). The overall incidence of AEs was 74.2%. Aphthous stomatitis (18 [15.0%]), pyrexia (18 [15.0%]), bronchitis (11 [9.2%]), and stomatitis (10 [8.3%]) were the most common AEs reported. Overall, 25 patients had grade 3 AEs; most frequent was stomatitis (4 [3.3%]). Grade 4 AEs were reported in three (2.5%) patients. A total of 62 (51.7%) patients had suspected drug-related AEs, of which 15 (12.5%) were of grade 3 or 4. In eight (6.7%) patients, AEs led to drug discontinuation. With regard to efficacy, 81 (67.5%) patients had a partial response, 35 (29.2%) had a stable disease, and one (0.8%) had progressive disease. The response was unknown in three (2.5%) patients. This study confirms the acceptable safety profile of everolimus in patients with SEGA associated with TSC in a real-world setting. The results further support the efficacy of everolimus in the treatment of SEGA associated with TSC. (EudraCT: 2010-022583-13).

Apparatus for detecting alpha radiation in difficult access areas

DOEpatents

Steadman, Peter; MacArthur, Duncan W.

1997-09-02

An electrostatic alpha radiation detector for measuring alpha radiation emitted from inside an enclosure comprising an electrically conductive expandable electrode for insertion into the enclosure. After insertion, the electrically conductive expandable electrode is insulated from the enclosure and defines a decay cavity between the electrically conductive expandable electrode and the enclosure so that air ions generated in the decay cavity are electrostatically captured by the electrically conductive expandable electrode and the enclosure when an electric potential is applied between the electrically conductive expandable electrode and the enclosure. Indicator means are attached to the electrically conductive expandable electrode for indicating an electrical current produced by generation of the air ions generated in the decay cavity by collisions between air molecules and the alpha particles emitted from the enclosure. A voltage source is connected between the indicator means and the electrically conductive enclosure for creating an electric field between the electrically conductive expandable electrode and the enclosure.

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

ERIC Educational Resources Information Center

Noble, Sean

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

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

ERIC Educational Resources Information Center

Blyth, Dale A.; LaCroix-Dalluhn, Laura

2011-01-01

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

Increasing access to care for Brazos Valley, Texas: a rural community of solution.

PubMed

Garney, Whitney R; Drake, Kelly; Wendel, Monica L; McLeroy, Kenneth; Clark, Heather R; Ryder, Byron

2013-01-01

Compared with their urban counterparts, rural populations face substantial disparities in terms of health care and health outcomes, particularly with regard to access to health services. To address ongoing inequities, community perspectives are increasingly important in identifying health issues and developing local solutions that are effective and sustainable. This article has been developed by both academic and community representatives and presents a brief case study of the evolution of a regional community of solution (COS) servicing a 7-county region called the Brazos Valley, Texas. The regional COS gave rise to multiple, more localized COSs that implemented similar strategies designed to address access to care within rural communities. The regional COS, known as the Brazos Valley Health Partnership, was a result of a 2002 health status assessment that revealed that rural residents face poorer access to health services and their care is often fragmented. Their localized strategy, called a health resource center, was created as a "one-stop shop" where multiple health and social service providers could be housed to deliver services to rural residents. Initially piloted in Madison County, the resource center model was expanded into Burleson, Grimes, and Leon Counties because of community buy-in at each of these sites. The resource center concept allowed service providers, who previously were able to offer services only in more populous areas, to expand into the rural communities because of reduced overhead costs. The services provided at the health resource centers include transportation, information and referral, and case management along with others, depending on the location. To ensure successful ongoing operations and future planning of the resource centers, local oversight bodies known as health resource commissions were organized within each of the rural communities to represent local COSs. Through collaboration with local entities, these partnerships have been successful in continuing to expand services and initiating health improvements within their rural communities.

The effects of mandatory health insurance on equity in access to outpatient care in Indonesia.

PubMed

Hidayat, Budi; Thabrany, Hasbullah; Dong, Hengjin; Sauerborn, Rainer

2004-09-01

This paper examines the effects of mandatory health insurance on access and equity in access to public and private outpatient care in Indonesia. Data from the second round of the 1997 Indonesian Family Life Survey were used. We adopted the concentration index as a measure of equity, and this was calculated from actual data and from predicted probability of outpatient-care use saved from a multinomial logit regression. The study found that a mandatory insurance scheme for civil servants (Askes) had a strongly positive impact on access to public outpatient care, while a mandatory insurance scheme for private employees (Jamsostek) had a positive impact on access to both public and private outpatient care. The greatest effects of Jamsostek were observed amongst poor beneficiaries. A substantial increase in access will be gained by expanding insurance to the whole population. However, neither Askes nor Jamsostek had a positive impact on equity. Policy implications are discussed.

Implications for Scaling up Advanced Course Offerings and Takings: Evidence from Florida

ERIC Educational Resources Information Center

Iatarola, Patrice

2016-01-01

This chapter summarizes a set of research studies that focus on high school course offerings, takings, and effects. Improving high school experiences and having students graduate from high school ready for college are national priorities under President Obama's Race to the Top initiative. Doing so by expanding access to advanced courses dates back…

Expanding Approaches for Understanding Impact: Integrating Technology, Curriculum, and Open Educational Resources in Science Education

ERIC Educational Resources Information Center

Ye, Lei; Recker, Mimi; Walker, Andrew; Leary, Heather; Yuan, Min

2015-01-01

This article reports results from a scale-up study of the impact of a software tool designed to support teachers in the digital learning era. This tool, the Curriculum Customization Service (CCS), enables teachers to access open educational resources from multiple providers, customize them for classroom instruction, and share them with other…

Can the Virtual University Expand Access to Higher Education in Africa? The Dialectic of the Local and the Global

ERIC Educational Resources Information Center

Adala, A. Atieno

2010-01-01

A recent phenomenon in higher education is the emergence of the virtual university. Some observers have attributed its emergence to globalization and technological innovation. This dissertation study is about one particular instance of the virtual university phenomenon, the African Virtual University (AVU). The AVU initiative was launched with…

The Value of Non-Participation in Higher Education

ERIC Educational Resources Information Center

Watts, Michael; Bridges, David

2006-01-01

The drive to expand access to higher education (HE) in the UK assumes that it is a desirable option that will benefit both the individual and his or her wider community. There is also an assumption that low aspirations and low achievements present a barrier to increasing participation rates. Based upon a recent qualitative study of young people in…

Planning for Growth in Online Learning: A Case Study in How to Expand the Campus

ERIC Educational Resources Information Center

Donnelly, Eileen

2014-01-01

Many higher education institutions have implemented online learning (OL) as a response to students' needing greater access to higher education. Although many universities have determined that meeting this increasing need for OL is important to their future strategies, some universities do not know how to structure their internal operations to…

The Rise of Private Higher Education in Jamaica: Neo-Liberalism at Work?

ERIC Educational Resources Information Center

Coates, Chad O.

2012-01-01

The rise of private higher education in Jamaica plays a key role in expanding educational access to the masses. The shift towards the neo-liberal perspective has directed the focus of education policy reforms toward emphasizing economic efficiency, diversity in choice, and market mechanisms. The purpose of this qualitative study was to gain…

The Paradigm Recursion: Is It More Accessible When Introduced in Middle School?

ERIC Educational Resources Information Center

Gunion, Katherine; Milford, Todd; Stege, Ulrike

2009-01-01

Recursion is a programming paradigm as well as a problem solving strategy thought to be very challenging to grasp for university students. This article outlines a pilot study, which expands the age range of students exposed to the concept of recursion in computer science through instruction in a series of interesting and engaging activities. In…

Gendered Poverty and Education: Moving beyond Access to Expanding Freedoms through Microfinance Policy in India and Australia

ERIC Educational Resources Information Center

Voola, Archana

2016-01-01

Microfinance has been recognized globally as a poverty alleviating strategy and particularly as a gender equality enhancing approach. There have been immense, intense and nuanced debates in the field of international development, feminist studies and comparative social policy regarding the role of microfinance in addressing gendered poverty. This…

Expanding Access, Knowledge, and Participation for Learning Disabled Young Adults with Low Literacy

ERIC Educational Resources Information Center

Shaw, Donita Massengill; Disney, Laurel

2012-01-01

The purpose of this study is to provide a deeper understanding of learning disabled young adults who struggle with low literacy skills in order to learn more about their literacy profiles and, from an emic perspective, understand the affective factors that may have influenced their attendance and persistence in a post-secondary residential…

The Story of a Library: Research and Development in an African Village

ERIC Educational Resources Information Center

Parry, Kate

2009-01-01

Background: Although education in Africa is expanding, little is being done to support learners' literacy outside the school. Rural people have little access to books and so cannot develop their reading skills. Purpose of Study: The project described here has both an educational and a research purpose: to complement formal schooling by making…

Returns to Education for Those Returning to Education: Evidence from Australia

ERIC Educational Resources Information Center

Chesters, Jenny; Watson, Louise

2014-01-01

There is widespread support for expanding access to universities for under-represented groups, such as students from lower socio-economic backgrounds and older students, because of the higher rates of return to university degrees. This study examines whether this assumption holds true for mature-aged graduates who have received their degrees in an…

Being Altruistically Motivated: The Postgraduate and Career Motivational Orientations of Access Students at an Irish University

ERIC Educational Resources Information Center

Keane, Elaine

2017-01-01

The relative lack of research about postgraduate education, and especially from a widening participation (WP) perspective, is noteworthy in a context of an increasingly expanding and important postgraduate sector internationally. This paper draws on the findings of a study about the "impact" of WP initiatives at an Irish university,…

The Sophie Davis School of Biomedical Education: The First 20 Years of a Unique BS-MD Program.

ERIC Educational Resources Information Center

Roman, Stanford A., Jr.; McGanney, Mary Lou

1994-01-01

A study assessed the extent to which the City University of New York medical school's innovative integrated baccalaureate/preclinical degree program has met its objectives of expanding access to medical careers among inner-city youth, especially minorities, and encouraging pursuit of primary care specialties among graduates. Results suggest…

Leveraging Cognitive Technology Tools to Expand Opportunities for Critical Thinking in Elementary Mathematics

ERIC Educational Resources Information Center

Suh, Jennifer

2010-01-01

The following study describes design research in an elementary school near the metropolitan D.C. area with a diverse student population. The goal of the project was to design tasks that leveraged technology and enhance the access to critical thinking in specific mathematical concepts: data analysis and probability. It highlights the opportunities…

Expanding Access

ERIC Educational Resources Information Center

Roach, Ronald

2007-01-01

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

After Access: Divergent Learning Profiles in Vietnam and India

ERIC Educational Resources Information Center

Rolleston, Caine; James, Zoe

2015-01-01

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

Russian Higher Education: Who Can Afford It?

ERIC Educational Resources Information Center

Gounko, Tatiana

2012-01-01

The article explores the issue of access and equity in the Russian higher education system by examining recent government initiatives. While recently introduced measures such as the Unified State Examination and student loan project are designed to aid students and expand participation, they alone cannot ensure equitable access to higher education…

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

ERIC Educational Resources Information Center

California Postsecondary Education Commission, 2008

2008-01-01

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

Early Intervention: Expanding Access to Higher Education.

ERIC Educational Resources Information Center

Mitchell, Kevin, Ed.

2000-01-01

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

Access to Experimental Cancer Drugs

Cancer.gov

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

77 FR 76522 - Notice of Quarterly Report (July 1, 2012-September 30, 2012)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-28

.... Stakeholders reached by public outreach efforts. Personnel trained. Rural land service offices installed and...: MCA Benin Total Quarterly Disbursements \\1\\: $81,539 Access to Financial Services $15,495,910 Expand access to $15,495,910 Value of credits Project. financial granted by micro- services. finance...

77 FR 63877 - Notice of Quarterly Report (April 1, 2012-June 30, 2012)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-17

... reached by public outreach efforts. Personnel trained. Rural land service offices installed and... Quarterly Disbursements 1: $142,167 Access to Financial Services $17,688,674 Expand Access to $15,495,910 Value of credits granted Project. Financial Services. by micro-finance institutions (MFIs) (at the...

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

ERIC Educational Resources Information Center

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

2013-01-01

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

Unmarried Parents in College

ERIC Educational Resources Information Center

Goldrick-Rab, Sara; Sorensen, Kia

2010-01-01

Noting that access to higher education has expanded dramatically in the past several decades, Sara Goldrick-Rab and Kia Sorensen focus on how unmarried parents fare once they enter college. Contrary to the expectation that access to college consistently promotes family stability and economic security, the authors argue that deficiencies in current…

Time Patterns in Remote OPAC Use.

ERIC Educational Resources Information Center

Lucas, Thomas A.

1993-01-01

Describes a transaction log analysis of the New York Public Library research libraries' OPAC (online public access catalog). Much of the remote searching occurred when the libraries were closed and was more evenly distributed than internal searching, demonstrating that remote searching could expand access and reduce peak system loads. (Contains…

Is the Shine off the A.P. Apple?

ERIC Educational Resources Information Center

Hurwitz, Nina; Hurwitz, Sol

2003-01-01

Describes challenges facing College Board's efforts to expand Advanced Placement (A.P.) courses to provide equal access to previously underserved low-performing urban and rural school students while maintaining the program's high academic standards. Includes list of strategies school boards can use to achieve greater access to A.P. courses while…

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

ERIC Educational Resources Information Center

Nichols, Andrew Howard; Clinedinst, Melissa

2013-01-01

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

Verification and Trust: Background Investigations Preceding Faculty Appointment

ERIC Educational Resources Information Center

Academe, 2004

2004-01-01

Many employers in the United States have been initiating or expanding policies requiring background checks of prospective employees. The ability to perform such checks has been abetted by the growth of computerized databases and of commercial enterprises that facilitate access to personal information. Employers now have ready access to public…

Reducing the distance: equity issues in distance learning in public education

NASA Astrophysics Data System (ADS)

Campbell, Patricia B.; Storo, Jennifer

1996-12-01

Distance learning and educational equity both began with an emphasis on access, on providing underserved students with an increased access to education. Today definitions of equity have gone beyond simple access to include equal or equivalent treatment and outcomes while definitions of underserved students have expanded to include girls, children of color, children with limited English proficiency and children with disabilities. At the same time the definition of distance learning has expanded to include new technologies, new audiences and new roles. Based on these new definitions and roles, the article raises a number of equity challenges for distance learning educators centering around who is taught, what is taught and how the teaching is done. To answer these challenges, a series of recommendations are suggested that educators can implement to make distance learning a leader in increasing educational equity for all students. The time to act is now.

Supporting Clean Energy Development in Swaziland

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

2016-04-01

Swaziland, a country largely dependent on regional fossil fuel imports to meet power needs, is vulnerable to supply changes and price shocks. To address this challenge, the country's National Energy Policy and Implementation Strategy prioritizes actions to enhance energy independence through scaling up renewable energy and energy efficiency. With approximately 70 percent of the country lacking electricity, Swaziland is also strongly committed to expanding energy access to support key economic and social development goals. Within this context, energy security and energy access are two foundational objectives for clean energy development in Swaziland. The partnership between the Swaziland Energy Regulatory Authoritymore » and the Clean Energy Solutions Center led to concrete outcomes to support clean energy development in Swaziland. Improving renewable energy project licensing processes will enable Swaziland to achieve key national objectives to expand clean energy access and transition to greater energy independence.« less

U.S. Spacesuit Knowledge Capture Accomplishments in Fiscal Year 2015

NASA Technical Reports Server (NTRS)

Chullen, Cinda; Oliva, Vladenka R.

2016-01-01

The NASA U.S. Spacesuit Knowledge Capture (SKC) Program continues to capture, share, and archive significant spacesuit-related knowledge with engineers and other technical staff and invested entities. Since its 2007 inception, the SKC Program has hosted and recorded more than 75 events. By the end of Fiscal Year (FY) 2015, 40 of these were processed and uploaded to a publically accessible NASA Web site where viewers can expand their knowledge about the spacesuit's evolution, known capabilities and limitations, and lessons learned. Sharing this knowledge with entities beyond NASA can increase not only more people's understanding of the technical effort and importance involved in designing a spacesuit, it can also expand the interest and support in this valuable program that ensures significant knowledge is retained and accessible. This paper discusses the FY 2015 SKC events, the release and accessibility of the approved events, and the program's future plans.

U.S. Spacesuit Knowledge Capture Accomplishments in Fiscal Year 2015

NASA Technical Reports Server (NTRS)

Chullen, Cinda; Oliva, Vladenka R.

2016-01-01

The NASA U.S. Spacesuit Knowledge Capture (SKC) Program continues to capture, share, and archive significant spacesuit-related knowledge with engineers and other technical staff and invested entities. Since its 2007 inception, the SKC Program has hosted and recorded more than 65 events. By the end of Fiscal Year (FY) 2015, 40 of these were processed and uploaded to a publically accessible NASA Web site where viewers can expand their knowledge about the spacesuit's evolution, known capability and limitations, and lessons learned. Sharing this knowledge with entities beyond NASA can increase not only more people's understanding of the technical effort and importance involved in designing a spacesuit, it can also expand the interest and support in this valuable program that ensures significant knowledge is retained and accessible. This paper discusses the FY 2015 SKC events, the release and accessibility of the approved events, and the program's future plans.

Prevention for those who can pay: insurance reimbursement of genetic-based preventive interventions in the liminal state between health and disease

PubMed Central

Prince, Anya E.R.

2015-01-01

Clinical use of genetic testing to predict adult onset conditions allows individuals to minimize or circumvent disease when preventive medical interventions are available. Recent policy recommendations and changes expand patient access to information about asymptomatic genetic conditions and create mechanisms for expanded insurance coverage for genetic tests. The American College of Medical Genetics and Genomics (ACMG) recommends that laboratories provide incidental findings of medically actionable genetic variants after whole genome sequencing. The Patient Protection and Affordable Care Act (ACA) established mechanisms to mandate coverage for genetic tests, such as BRCA. The ACA and ACMG, however, do not address insurance coverage for preventive interventions. These policies equate access to testing as access to prevention, without exploring the accessibility and affordability of interventions. In reality, insurance coverage for preventive interventions in asymptomatic adults is variable given the US health insurance system's focus on treatment. Health disparities will be exacerbated if only privileged segments of society can access preventive interventions, such as prophylactic surgeries, screenings, or medication. To ensure equitable access to interventions, federal or state legislatures should mandate insurance coverage for both predictive genetic testing and recommended follow-up interventions included in a list established by an expert panel or regulatory body. PMID:26339500

Prevention for those who can pay: insurance reimbursement of genetic-based preventive interventions in the liminal state between health and disease.

PubMed

Prince, Anya E R

2015-07-01

Clinical use of genetic testing to predict adult onset conditions allows individuals to minimize or circumvent disease when preventive medical interventions are available. Recent policy recommendations and changes expand patient access to information about asymptomatic genetic conditions and create mechanisms for expanded insurance coverage for genetic tests. The American College of Medical Genetics and Genomics (ACMG) recommends that laboratories provide incidental findings of medically actionable genetic variants after whole genome sequencing. The Patient Protection and Affordable Care Act (ACA) established mechanisms to mandate coverage for genetic tests, such as BRCA. The ACA and ACMG, however, do not address insurance coverage for preventive interventions. These policies equate access to testing as access to prevention, without exploring the accessibility and affordability of interventions. In reality, insurance coverage for preventive interventions in asymptomatic adults is variable given the US health insurance system's focus on treatment. Health disparities will be exacerbated if only privileged segments of society can access preventive interventions, such as prophylactic surgeries, screenings, or medication. To ensure equitable access to interventions, federal or state legislatures should mandate insurance coverage for both predictive genetic testing and recommended follow-up interventions included in a list established by an expert panel or regulatory body.

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2015-10-01

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

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

PubMed

Naughton, Doreen K

2014-06-01

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

Expanded polytetrafluoroethylene graft fistula for chronic hemodialysis.

PubMed Central

Tellis, V A; Kohlberg, W I; Bhat, D J; Driscoll, B; Veith, F J

1979-01-01

In a retrospective study of 66 PTFE arteriovenous fistulae and 71 BCH arteriovenous fistulae for dialysis access, PTFE had a higher patency rate than BCH at 12 months (62.4 versus 32.5%). PTFE was easier to work with and easier to handle in the face of infection. The lateral upper arm approach to placement of the PTFE graft is desirable in patients who have had multiple previous access procedures because this area is usually free from scarring, is distant from neurovascular structures, and provides a greater length of graft for needle punctures. Images Fig. 3. PMID:758853

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

PubMed

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

2018-01-01

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

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

PubMed

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

2012-01-07

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

Education for All: An Expanded Vision. World Conference on Education for All (Jomtien, Thailand, March 5-9, 1990). Monograph II. Roundtable Themes II.

ERIC Educational Resources Information Center

Fordham, Paul

This seven-chapter monograph elaborates on five components of an expanded vision of basic education. It presents material that deals with aspects of these components: universalizing access and promoting equity, focusing on learning, broadening the means and scope of basic education, enhancing the environment for learning, and strengthening…

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

ERIC Educational Resources Information Center

Unwin, Lorna; Fuller, Alison

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

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

ERIC Educational Resources Information Center

Mazzeo, Christopher; Strawn, Julie; Roberts, Brandon

2009-01-01

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

Effectiveness of Healthy Relationships Video-Group—A Videoconferencing Group Intervention for Women Living with HIV: Preliminary Findings from a Randomized Controlled Trial

PubMed Central

Buhi, Eric R.; Baldwin, Julie; Chen, Henian; Johnson, Ayesha; Lynn, Vickie; Glueckauf, Robert

2014-01-01

Abstract Introduction: Expanded access to efficacious interventions is needed for women living with human immunodeficiency virus (WLH) in the United States. Availability of “prevention with (human immunodeficiency virus [HIV)] positives” interventions in rural/remote and low HIV prevalence areas remains limited, leaving WLH in these communities few options for receiving effective behavioral interventions such as Healthy Relationships (HR). Offering such programs via videoconferencing groups (VGs) may expand access. This analysis tests the effectiveness of HR-VG (versus wait-list control) for reducing sexual risk behavior among WLH and explores intervention satisfaction. Subjects and Methods: In this randomized controlled trial unprotected vaginal/anal sex occasions over the prior 3 months reported at the 6-month follow-up were compared across randomization groups through zero-inflated Poisson regression modeling, controlling for unprotected sex at baseline. Seventy-one WLH were randomized and completed the baseline assessment (n=36 intervention and n=35 control); 59 (83% in each group) had follow-up data. Results: Among those who engaged in unprotected sex at 6-month follow-up, intervention participants had approximately seven fewer unprotected occasions than control participants (95% confidence interval 5.43–7.43). Intervention participants reported high levels of satisfaction with HR-VG; 84% reported being “very satisfied” overall. Conclusions: This study found promising evidence for effective dissemination of HIV risk reduction interventions via VGs. Important next steps will be to determine whether VGs are effective with other subpopulations of people living with HIV (i.e., men and non-English speakers) and to assess cost-effectiveness. Possibilities for using VGs to expand access to other psychosocial and behavioral interventions and reduce stigma are discussed. PMID:24237482

Free access to hypertension and diabetes medicines among the elderly: a reality yet to be constructed.

PubMed

Paniz, Vera Maria Vieira; Fassa, Anaclaudia Gastal; Facchini, Luiz Augusto; Piccini, Roberto Xavier; Tomasi, Elaine; Thumé, Elaine; da Silveira, Denise Silva; Rodrigues, Maria Aparecida; Domingues, Marlos Rodrigues; Bertoldi, Andréa Dâmaso

2010-06-01

The study evaluated free access to hypertension and diabetes medicines and the reasons reported for lack of access. The sample included 4,003 elderly people living in Primary Care Unit coverage areas from 41 Southern and Northeastern Brazilian cities. Free access was higher in the Northeast (62.4%). The strategy of the Family Health Program (Programa Saúde da Família - PSF) was more effective in providing access than the traditional model, with higher results in the Northeast (61.2%) than in the South (39.6%). Around 20% of medicines included in the Hypertension and Diabetes Program and 26% of those included in the National Essential Medicines List (RENAME) were paid out of pocket. In the Northeast, 25% of insulin and 32% of oral antidiabetics were paid out of pocket. Unavailability in the public sector and a lack of money determined the lack of access. Although the PSF, Hypertension and Diabetes Program and RENAME expanded free access, supplies were insufficient. A greater connection between programs and a clear definition of responsibilities can improve medicine acquisition process, increasing the effectiveness of pharmaceutical assistance.

Equity and Access in Charter Schools: Identifying Issues and Solutions

ERIC Educational Resources Information Center

Marshall, David T.

2017-01-01

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

SciLinks

Science.gov Websites

SciLinks Forgot your login? Sign up for FREE access Log In I'm a ... Teacher Student User Name questions and satisfy their curiosity Learn More Sign up for Free Access Sites in the SciLinks program . SciLinks-Targeted, Grade-Specific Web Content for your Books Free web content to extend and expand student

Financial Aid: A Broken Bridge to College Access?

ERIC Educational Resources Information Center

Long, Bridget Terry; Riley, Erin

2007-01-01

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

Derrida's Right to Philosophy, Then and Now

ERIC Educational Resources Information Center

Willinsky, John

2009-01-01

In this essay, a tribute to Jacques Derrida's educational efforts at expanding access to current work in philosophy, John Willinsky examines his efforts as both a public right and an element of academic freedom that bear on the open access movement today. Willinsky covers Derrida's extension and outreach work with the Groupe de Recherches pour…

Market-Based Higher Education: Does Colorado's Voucher Model Improve Higher Education Access and Efficiency?

ERIC Educational Resources Information Center

Hillman, Nicholas W.; Tandberg, David A.; Gross, Jacob P. K.

2014-01-01

In 2004, Colorado introduced the nation's first voucher model for financing public higher education. With state appropriations now allocated to students, rather than institutions, state officials expect this model to create cost efficiencies while also expanding college access. Using difference-in-difference regression analysis, we find limited…

The "Magic" of Wireless Access in the Library

ERIC Educational Resources Information Center

Balas, Janet L.

2006-01-01

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

PROPOSED STANDARD TO GREATLY EXPAND PUBLIC ACCESS AND EXPLORATION OF TOXICITY DATA: EVALUATION OF STRUCTURE DATA FILE FORMAT

EPA Science Inventory

PROPOSED ST ANDARD TO GREA TL Y EXP AND PUBLIC ACCESS AND EXPLORATION OF TOXICITY DATA: EVALUATION OF STRUCTURE DATA FILE FORMAT

The ability to assess the potential toxicity of environmental, pharmaceutical, or industrial chemicals based on chemical structure in...

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

ERIC Educational Resources Information Center

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

2015-01-01

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

Distance Education Technology: Higher Education Barriers during the First Decade of the Twenty-First Century

ERIC Educational Resources Information Center

Owusu-Ansah, Angela; Neill, Patti; Haralson, Michele K.

2011-01-01

In the twenty-first century, despite the expanded opportunities technology affords in student-access to higher education, most institutions of higher education are hesitant to offer technology-based distance education (TBDE). The prohibiting factors include cost, accessibility, faculty concerns, state mandates, academic administrative actions, and…

Card Access Know-How.

ERIC Educational Resources Information Center

College Planning & Management, 2000

2000-01-01

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

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

ERIC Educational Resources Information Center

Jaques, Thomas F.

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

The Path Forward: School Autonomy and Its Implications for the Future of Boston's Public Schools

ERIC Educational Resources Information Center

French, Dan; Miles, Karen Hawley; Nathan, Linda

2014-01-01

This study explores the question of how Boston Public Schools (BPS) can strengthen and support autonomy and accountability across its portfolio to promote innovation and expand access to equity and high performance. Some of the specific questions guiding this work are: (1) Should all schools within BPS operate within autonomous structures? (2) Is…

Violent Red, Ogre Green, and Delicious White: Expanding Meaning Potential through Media

ERIC Educational Resources Information Center

Leigh, S. Rebecca

2010-01-01

This article reports on the meaning potential of daily access to drawing/writing media for widening and deepening meaning construction. In a yearlong study in a second grade classroom, the author worked with a second-year teacher to see what would happen when art and language were encouraged ways of knowing in which children could construct…

A Pilot Study of a Self-Voicing Computer Program for Prealgebra Math Problems

ERIC Educational Resources Information Center

Beal, Carole R.; Rosenblum, L. Penny; Smith, Derrick W.

2011-01-01

Fourteen students with visual impairments in Grades 5-12 participated in the field-testing of AnimalWatch-VI-Beta. This computer program delivered 12 prealgebra math problems and hints through a self-voicing audio feature. The students provided feedback about how the computer program can be improved and expanded to make it accessible to all users.…

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

ERIC Educational Resources Information Center

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

2010-01-01

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

School Drop-outs in Mongolia. Mid-Decade Review of Progress towards Education for All.

ERIC Educational Resources Information Center

Khishigbuyan, D.; Bandii, R.

In 1995, the International Consultative Forum on Education for All commissioned case studies in developing countries as part of a mid-decade review of progress in expanding access to basic education. This paper examines the situation in Mongolia and reports on two surveys about dropouts. In the early 1990s, Mongolia shifted from a centrally…

Students' Experiences of the Implementation of an Interactive Learning System in Their Eighth Grade Mathematics Classes: An Exploratory Study.

ERIC Educational Resources Information Center

FitzPatrick, Sarah B.

During the last decade, United States K-12 schools have approximately tripled their spending on increasingly powerful computers, and have expanded network access and novel computer applications. The number of questions being asked by educators, policymakers, and the general public about the extent to which students are using these educational…

Student Aid Time-Bomb: The Coming Crisis in Canada's Financial Aid System. Canadian Educational Report Series

ERIC Educational Resources Information Center

Junor, Sean; Usher, Alex

2006-01-01

This paper describes a looming crisis in Canadian student financial assistance. It begins by summarizing the known evidence with respect to student financial assistance. It notes that many studies have emphasized the central importance of grants targeted to low-income students as a means to expand of access to post-secondary education, but that…

An Exploratory Study of the Implementation of an Interactive Learning System in Two Eighth Grade Mathematics Classes.

ERIC Educational Resources Information Center

FitzPatrick, Sarah B.; Faux, Russell

During the last decade, U.S. K-12 schools have approximately tripled their spending on increasingly powerful computers, expanded network access, and novel computer applications. The number of questions being asked by educators, policymakers, and the general public about the extent to which these technologies are being used in classrooms, for what…

Disparities in the prevalence of comorbidities among US adults by state Medicaid expansion status.

PubMed

Akinyemiju, Tomi; Jha, Megha; Moore, Justin Xavier; Pisu, Maria

2016-07-01

About 92% of US older adults have at least one chronic disease or medical condition and 77% have at least two. Low-income and uninsured adults in particular experience a higher burden of comorbidities, and the Medicaid expansion provision of the Affordable Care Act was designed to improve access to healthcare in this population group. However, a significant number of US states have declined expansion. The purpose of this study is to determine the distribution of low-income and uninsured adults in expanded versus non-expanded states, and evaluate the prevalence of comorbidities in both groups. Data from the 2013 Behavioral Risk Factor Surveillance System (BRFSS) dataset was analyzed, and Medicaid expansion status was assessed from the Center for Medicare and Medicaid Services report on State Medicaid and CHIP Income Eligibility Standards. Next, age adjusted mean number of comorbidities between expanded and non-expanded states was compared, with adjustment for socio-demographic differences. Expanded states had a higher proportion of adults with income of at least $50,000 per year (39.6% vs. 35.5%, p<0.01) and a lower proportion of individuals with no health insurance coverage (15.2% vs. 20.3%, p<0.01) compared with non-expanded states. Among the uninsured, there was a higher proportion of obese (31.6% vs. 26.9%, p<001), and higher average number of comorbidities (1.62 vs. 1.52, p<0.01) in non-expanded states compared to expanded states. Overall, the prevalence of comorbidities was higher among BRFSS participants in states that did not expand Medicaid compared with those in expanded states. States without Medicaid expansion have a greater proportion of poor, uninsured adults with more chronic diseases and conditions. Copyright © 2016 Elsevier Inc. All rights reserved.

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

PubMed Central

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

2013-01-01

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

Molecular and Cytogenetic Characterization of Wild Musa Species

PubMed Central

Čížková, Jana; Hřibová, Eva; Christelová, Pavla; Van den Houwe, Ines; Häkkinen, Markku; Roux, Nicolas; Swennen, Rony; Doležel, Jaroslav

2015-01-01

The production of bananas is threatened by rapid spreading of various diseases and adverse environmental conditions. The preservation and characterization of banana diversity is essential for the purposes of crop improvement. The world's largest banana germplasm collection maintained at the Bioversity International Transit Centre (ITC) in Belgium is continuously expanded by new accessions of edible cultivars and wild species. Detailed morphological and molecular characterization of the accessions is necessary for efficient management of the collection and utilization of banana diversity. In this work, nuclear DNA content and genomic distribution of 45S and 5S rDNA were examined in 21 diploid accessions recently added to ITC collection, representing both sections of the genus Musa. 2C DNA content in the section Musa ranged from 1.217 to 1.315 pg. Species belonging to section Callimusa had 2C DNA contents ranging from 1.390 to 1.772 pg. While the number of 45S rDNA loci was conserved in the section Musa, it was highly variable in Callimusa species. 5S rRNA gene clusters were found on two to eight chromosomes per diploid cell. The accessions were genotyped using a set of 19 microsatellite markers to establish their relationships with the remaining accessions held at ITC. Genetic diversity done by SSR genotyping platform was extended by phylogenetic analysis of ITS region. ITS sequence data supported the clustering obtained by SSR analysis for most of the accessions. High level of nucleotide diversity and presence of more than two types of ITS sequences in eight wild diploids pointed to their origin by hybridization of different genotypes. This study significantly expands the number of wild Musa species where nuclear genome size and genomic distribution of rDNA loci is known. SSR genotyping identified Musa species that are closely related to the previously characterized accessions and provided data to aid in their classification. Sequence analysis of ITS region provided further information about evolutionary relationships between individual accessions and suggested that some of analyzed accessions were interspecific hybrids and/or backcross progeny. PMID:26252482

State-Targeted Funding and Technical Assistance to Increase Access to Medication Treatment for Opioid Use Disorder.

PubMed

Abraham, Amanda J; Andrews, Christina M; Grogan, Colleen M; Pollack, Harold A; D'Aunno, Thomas; Humphreys, Keith; Friedmann, Peter D

2018-04-01

As the United States grapples with an opioid epidemic, expanding access to effective treatment for opioid use disorder is a major public health priority. Identifying effective policy tools that can be used to expand access to care is critically important. This article examines the relationship between state-targeted funding and technical assistance and adoption of three medications for treating opioid use disorder: oral naltrexone, injectable naltrexone, and buprenorphine. This study draws from the 2013-2014 wave of the National Drug Abuse Treatment System Survey, a nationally representative, longitudinal study of substance use disorder treatment programs. The sample includes data from 695 treatment programs (85.5% response rate) and representatives from single-state agencies in 49 states and Washington, D.C. (98% response rate). Logistic regression was used to examine the relationships of single-state agency targeted funding and technical assistance to availability of opioid use disorder medications among treatment programs. State-targeted funding was associated with increased program-level adoption of oral naltrexone (adjusted odds ratio [AOR]=3.14, 95% confidence interval [CI]=1.49-6.60, p=.004) and buprenorphine (AOR=2.47, 95% CI=1.31-4.67, p=.006). Buprenorphine adoption was also correlated with state technical assistance to support medication provision (AOR=1.18, 95% CI=1.00-1.39, p=.049). State-targeted funding for medications may be a viable policy lever for increasing access to opioid use disorder medications. Given the historically low rates of opioid use disorder medication adoption in treatment programs, single-state agency targeted funding is a potentially important tool to reduce mortality and morbidity associated with opioid disorders and misuse.

Building the Future: Summary of Four Studies to Develop the Private Sector, Education, Health Care, and Data for Decisionmaking for the Kurdistan Region - Iraq (with Arabic-language version).

PubMed

Anthony, C Ross; Hansen, Michael L; Kumar, Krishna B; Shatz, Howard J; Vernez, Georges

2013-01-01

In 2010, the Kurdistan Regional Government (KRG) asked the RAND Corporation to undertake four studies aimed at improving the economic and social development of the Kurdistan Region of Iraq. RAND's work was intended to help the KRG expand access to high-quality education and health care, increase private-sector development and employment for the expanding labor force, and design a data-collection system to support high-priority policies. The studies were carried out over the year beginning February 2010. The RAND teams worked closely with the Ministries of Planning, Education, and Health to develop targeted solutions to the critical issues faced by the KRG. This article summarizes the health care study. It is intended to provide a high-level overview of the approaches, followed by the studies, key findings, and major recommendations.

Evaluation of SMS reminder messages for altering treatment adherence and health seeking perceptions among malaria care-seekers in Nigeria.

PubMed

Liu, Jenny X; Modrek, Sepideh

2016-12-01

In Nigeria, access to malaria diagnostics may be expanded if drug retailers were allowed to administer malaria rapid diagnostic tests (RDTs). A 2012 pilot intervention showed that short message service (SMS) reminder messages could boost treatment adherence to RDT results by 10-14% points. This study aimed to replicate the SMS intervention in a different population, and additionally test the effect of an expanded message about anticipated RDT access policy change on customers' acceptability for drug retailers' administration of RDTs. One day after being tested with an RDT, participants who purchased malaria treatment from drug shops were randomized to receive (1) a basic SMS reminder repeating the RDT result and appropriate treatment actions, (2) an expanded SMS reminder additionally saying that the 'government might allow pharmacists/chemists to do RDTs' or (3) no SMS reminders (i.e. control). Using regression analysis, we estimate intent-to-treat (ITT) and treatment effects on the treated for 686 study participants. Results corroborate previous findings that a basic SMS reminder increased treatment adherence [odds ratio (OR) = 1.53, 95% CI 0.96-2.44] and decreased use of unnecessary anti-malarials for RDT-negative adults [OR = 0.63, 95% CI 0.39-1.00]. The expanded SMS also increased adherence for adults [OR = 1.42, 95% CI 0.97-2.07], but the effects for sick children differed-the basic SMS did not have any measurable impact on treatment adherence [OR = 0.87, 95% CI 0.24-3.09] or use of unnecessary anti-malarials [OR = 1.27, 95% CI 0.32-1.93], and the expanded SMS actually led to poorer treatment adherence [OR = 0.26, 95% CI 0.10-0.66] and increased use of unnecessary anti-malarials [OR = 4.67, 95% CI 1.76-12.43]. Further, the targeted but neutral message in the expanded SMS lowered acceptance for drug retailers' administration of RDTs [OR = 0.55, 95% CI 0.10-2.93], counter to what we hypothesized. Future SMS interventions should show consistent positive results across populations and be attuned to message length and content before initiating a larger messaging campaign. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Evaluation of SMS reminder messages for altering treatment adherence and health seeking perceptions among malaria care-seekers in Nigeria

PubMed Central

Liu, Jenny X.; Modrek, Sepideh

2016-01-01

In Nigeria, access to malaria diagnostics may be expanded if drug retailers were allowed to administer malaria rapid diagnostic tests (RDTs). A 2012 pilot intervention showed that short message service (SMS) reminder messages could boost treatment adherence to RDT results by 10–14% points. This study aimed to replicate the SMS intervention in a different population, and additionally test the effect of an expanded message about anticipated RDT access policy change on customers’ acceptability for drug retailers’ administration of RDTs. One day after being tested with an RDT, participants who purchased malaria treatment from drug shops were randomized to receive (1) a basic SMS reminder repeating the RDT result and appropriate treatment actions, (2) an expanded SMS reminder additionally saying that the ‘government might allow pharmacists/chemists to do RDTs’ or (3) no SMS reminders (i.e. control). Using regression analysis, we estimate intent-to-treat (ITT) and treatment effects on the treated for 686 study participants. Results corroborate previous findings that a basic SMS reminder increased treatment adherence [odds ratio (OR) = 1.53, 95% CI 0.96–2.44] and decreased use of unnecessary anti-malarials for RDT-negative adults [OR = 0.63, 95% CI 0.39–1.00]. The expanded SMS also increased adherence for adults [OR = 1.42, 95% CI 0.97–2.07], but the effects for sick children differed—the basic SMS did not have any measurable impact on treatment adherence [OR = 0.87, 95% CI 0.24–3.09] or use of unnecessary anti-malarials [OR = 1.27, 95% CI 0.32–1.93], and the expanded SMS actually led to poorer treatment adherence [OR = 0.26, 95% CI 0.10–0.66] and increased use of unnecessary anti-malarials [OR = 4.67, 95% CI 1.76–12.43]. Further, the targeted but neutral message in the expanded SMS lowered acceptance for drug retailers' administration of RDTs [OR = 0.55, 95% CI 0.10–2.93], counter to what we hypothesized. Future SMS interventions should show consistent positive results across populations and be attuned to message length and content before initiating a larger messaging campaign. PMID:27315831

Apparatus for detecting alpha radiation in difficult access areas

DOEpatents

Steadman, P.; MacArthur, D.W.

1997-09-02

An electrostatic alpha radiation detector for measuring alpha radiation emitted from inside an enclosure comprising an electrically conductive expandable electrode for insertion into the enclosure is disclosed. After insertion, the electrically conductive expandable electrode is insulated from the enclosure and defines a decay cavity between the electrically conductive expandable electrode and the enclosure so that air ions generated in the decay cavity are electrostatically captured by the electrically conductive expandable electrode and the enclosure when an electric potential is applied between the electrically conductive expandable electrode and the enclosure. Indicator means are attached to the electrically conductive expandable electrode for indicating an electrical current produced by generation of the air ions generated in the decay cavity by collisions between air molecules and the alpha particles emitted from the enclosure. A voltage source is connected between the indicator means and the electrically conductive enclosure for creating an electric field between the electrically conductive expandable electrode and the enclosure. 4 figs.

Effect of the Economic Recession on Primary Care Access for the Homeless.

PubMed

White, Brandi M; Jones, Walter J; Moran, William P; Simpson, Kit N

2016-01-01

Primary care access (PCA) for the homeless can prove challenging, especially during periods of economic distress. In the United States, the most recent recession may have presented additional barriers to accessing care. Limited safety-net resources traditionally used by the homeless may have also been used by the non-homeless, resulting in delays in seeking treatment for the homeless. Using hospitalizations for ambulatory care sensitivity (ACS) conditions as a proxy measure for PCA, this study investigated the recession's impact on PCA for the homeless and non-homeless in four states. The State Inpatient Databases were used to identify ACS admissions. Findings from this study indicate the recession was a barrier to PCA for homeless people who were uninsured. Ensuring that economically-disadvantaged populations have the ability to obtain insurance coverage is crucial to facilitating PCA. With targeted outreach efforts, the Affordable Care Act provides an opportunity for expanding coverage to the homeless.

Iceland’s Financial Crisis

DTIC Science & Technology

2008-11-20

distress. In particular, access to easy credit, a boom in domestic construction that fueled rapid economic growth, and a broad deregulation of...pressure on the value of the krona and worsened the trade deficit. As Iceland deregulated its commercial banks, those banks expanded to the United Kingdom...2007 valued at $9 billion. After Iceland deregulated its commercial banks, the banks expanded their operations abroad by acquiring subsidiaries in

Multidimensional Analysis of Nuclear Detonations

DTIC Science & Technology

2015-09-17

Features on the nuclear weapons testing films because of the expanding and emissive nature of the nuclear fireball. The use of these techniques to produce...Treaty (New Start Treaty) have reduced the acceptable margins of error. Multidimensional analysis provides the modern approach to nuclear weapon ...scientific community access to the information necessary to expand upon the knowledge of nuclear weapon effects. This data set has the potential to provide

Evaluation Summary of the Expanding Opportunities Interagency Inclusion Initiative: Increasing and Enhancing Access, Participation and Supports for All Children in High Quality Inclusive Programs and Services

ERIC Educational Resources Information Center

National Early Childhood Technical Assistance Center (NECTAC), 2011

2011-01-01

This paper describes the impetus for creating the Expanding Opportunities Interagency Inclusion Initiative and achievements to date in identifying and implementing effective and efficient inclusion strategies in the participating states. In March 2004, the Child Care Bureau (CCB) (renamed the Office of Child Care) and the Administration on…

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

PubMed

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

2016-10-01

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

Data Democracy and Decision Making: Enhancing the Use and Value of Geospatial Data and Scientific Information

NASA Astrophysics Data System (ADS)

Shapiro, C. D.

2014-12-01

Data democracy is a concept that has great relevance to the use and value of geospatial data and scientific information. Data democracy describes a world in which data and information are widely and broadly accessible, understandable, and useable. The concept operationalizes the public good nature of scientific information and provides a framework for increasing benefits from its use. Data democracy encompasses efforts to increase accessibility to geospatial data and to expand participation in its collection, analysis, and application. These two pillars are analogous to demand and supply relationships. Improved accessibility, or demand, includes increased knowledge about geospatial data and low barriers to retrieval and use. Expanded participation, or supply, encompasses a broader community involved in developing geospatial data and scientific information. This pillar of data democracy is characterized by methods such as citizen science or crowd sourcing.A framework is developed for advancing the use of data democracy. This includes efforts to assess the societal benefits (economic and social) of scientific information. This knowledge is critical to continued monitoring of the effectiveness of data democracy implementation and of potential impact on the use and value of scientific information. The framework also includes an assessment of opportunities for advancing data democracy both on the supply and demand sides. These opportunities include relatively inexpensive efforts to reduce barriers to use as well as the identification of situations in which participation can be expanded in scientific efforts to enhance the breadth of involvement as well as expanding participation to non-traditional communities. This framework provides an initial perspective on ways to expand the "scientific community" of data users and providers. It also describes a way forward for enhancing the societal benefits from geospatial data and scientific information. As a result, data democracy not only provides benefits to a greater population, it enhances the value of science.

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…

78 FR 14326 - Notice of Submission of Proposed Information Collection to OMB: Community Development Block Grant...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-05

..., improved energy efficiency, and expanded educational opportunities and access to health care. All CDBG-R... and access to health care. All CDBG-R funds were required to be expended by September 30, 2012. Any... preference to activities that could be started and completed expeditiously. While the CDBG-R expenditure...

Implications of Massive Open Online Courses for Higher Education: Mitigating or Reifying Educational Inequities?

ERIC Educational Resources Information Center

Literat, Ioana

2015-01-01

The proliferation of massive open online courses (MOOCs) has stirred a fervent debate about global access to higher education. While some commentators praise MOOCs for expanding educational opportunities in a more open and accessible fashion, others criticize this trend as a threat to current models of higher education and a low-quality substitute…

Your Family and Managed Care: A Guide for Families of Children with Mental, Emotional or Behavioral Disorders.

ERIC Educational Resources Information Center

Bazelon Center for Mental Health Law, Washington, DC.

Designed for parents of children with mental, emotional, or behavior disorders, this booklet provides information on accessing mental health services through health maintenance organizations. The first part of the guide provides information on how managed care can improve children's access to behavioral health services through expanded service…

Characterization of Sugar Concentration Among Edible Podded Accessions in the USDA Phaseolus vulgaris Germplasm Collection

USDA-ARS?s Scientific Manuscript database

The objective is to gain knowledge regarding variation in sugar and flavor content among a sample of dry bean and green pod-type accessions from the USDA Phaseolus Germplasm Core Collection, Pullman, WA. The results could be used to market product quality and offer unique opportunities to expand ma...

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

ERIC Educational Resources Information Center

Colvard, Jamie; Schmit, Stephanie

2012-01-01

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

Expanding Notions of Digital Access: Parents' Negotiation of School-Based Technology Initiatives in New Immigrant Communities

ERIC Educational Resources Information Center

Noguerón-Liu, Silvia

2017-01-01

Initiatives to integrate technology in schools are continuously increasing, with efforts to bridge the "homework gap" and provide technology access in low-income households. However, it is critical to include nondominant parents in technology adoption decisions in order to avoid mirroring past patterns of inequality in home-school…

Integrated radiologist's workstation enabling the radiologist as an effective clinical consultant

NASA Astrophysics Data System (ADS)

McEnery, Kevin W.; Suitor, Charles T.; Hildebrand, Stan; Downs, Rebecca; Thompson, Stephen K.; Shepard, S. Jeff

2002-05-01

Since February 2000, radiologists at the M. D. Anderson Cancer Center have accessed clinical information through an internally developed radiologist's clinical interpretation workstation called RadStation. This project provides a fully integrated digital dictation workstation with clinical data review. RadStation enables the radiologist as an effective clinical consultant with access to pertinent sources of clinical information at the time of dictation. Data sources not only include prior radiology reports from the radiology information system (RIS) but access to pathology data, laboratory data, history and physicals, clinic notes, and operative reports. With integrated clinical information access, a radiologists's interpretation not only comments on morphologic findings but also can enable evaluation of study findings in the context of pertinent clinical presentation and history. Image access is enabled through the integration of an enterprise image archive (Stentor, San Francisco). Database integration is achieved by a combination of real time HL7 messaging and queries to SQL-based legacy databases. A three-tier system architecture accommodates expanding access to additional databases including real-time patient schedule as well as patient medications and allergies.

From the voices of women: facilitating survivor access to IPV services.

PubMed

Simmons, Catherine A; Farrar, Melissa; Frazer, Kitty; Thompson, Mary Jane

2011-10-01

This mixed-method study investigated perceptions women domestic violence survivors/victims have about why women do not seek help from formal support structures and actions domestic helping agencies can take to facilitate survivor access to services. Congruent with previous research, quantitative analysis identified 17 reasons women do not seek help from formal support structures. Expanding current knowledge, concept mapping revealed six ways family violence programs can better reach women in abusive relationships, including (1) remove barriers to services, (2) improve comfort with services, (3) "talk about it," (4) improve community awareness, (5) victim-targeted marketing, and (6) "I honestly don't know."

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

NASA Technical Reports Server (NTRS)

Dessouky, Khaled

1989-01-01

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

geneLAB: Expanding the Impact of NASA's Biological Research in Space

NASA Technical Reports Server (NTRS)

Rayl, Nicole; Smith, Jeffrey D.

2014-01-01

The geneLAB project is designed to leverage the value of large 'omics' datasets from molecular biology projects conducted on the ISS by making these datasets available, citable, discoverable, interpretable, reusable, and reproducible. geneLAB will create a collaboration space with an integrated set of tools for depositing, accessing, analyzing, and modeling these diverse datasets from spaceflight and related terrestrial studies.

Understanding Engagement in Mental Health Services for Preschool Children: An Analysis of Teacher, Clinician, and Parent Perspectives

ERIC Educational Resources Information Center

Koivunen, Julie; Van Alst, Donna; Ocasio, Kerrie; Allegra, Christine

2017-01-01

The purpose of this study was to examine the experiences of mental health clinicians in providing services in the preschool setting. Clinicians provided services for 3 years in urban, northern New Jersey preschools, in order to expand access to mental health services for vulnerable children. At the conclusion of the three-year period, focus groups…

Higher Education in Hong Kong: A Case Study of Universities Navigating through the Asian Economic Crisis

ERIC Educational Resources Information Center

Stevenson, Phoebe Hsu

2010-01-01

Since the establishment of the University of Hong Kong in 1911, higher education in Hong Kong has been transformed from an elitist system to one that supports the Hong Kong government's vision of a highly educated workforce and widely accessible lifelong learning. Between the late 1970s and 1994 the system expanded from admitting 2% of college-age…

Improving Access to Hospice Care: Informing the Debate

PubMed Central

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

2015-01-01

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

Next step in antibiotic stewardship: Pharmacist-provided penicillin allergy testing.

PubMed

Gugkaeva, Z; Crago, J S; Yasnogorodsky, M

2017-08-01

Penicillin allergy limits therapeutic options for patients but often disappears over time, leaving patients erroneously labelled allergic and leading to the utilization of broad-spectrum and more expensive antibiotics. Penicillin allergy can be effectively assessed via skin testing. To improve patient access to penicillin allergy testing by implementing a pharmacist-provided service in a hospital setting. Beta-lactams remain a mainstream therapy for many infections due to their effectiveness, low side effects and affordability. Typically, patient access to penicillin allergy testing is limited by the availability of allergy specialists, who traditionally perform such testing. A pharmacist-provided penicillin allergy testing service was implemented at our hospital in 2015 and became a powerful antibiotic stewardship tool. Removing penicillin allergy from patient profiles significantly expanded therapeutic options, expedited discharges and reduced costs of care. Pharmacists can expand patient access to penicillin allergy testing. Pharmacist-provided penicillin allergy testing permitted optimized antibiotic treatment and expedited discharges. © 2017 John Wiley & Sons Ltd.

Which way in? The Necessity of Multiple Approaches to Transcatheter Valve Therapy

PubMed Central

Bleiziffer, S.; Krane, M.; Deutsch, M.A.; Elhmidi, Y.; Piazza, N.; Voss, B.; Lange, R.

2013-01-01

TAVI (transcatheter aortic valve implantation) is a less invasive treatment of the stenotic aortic valve while avoiding midline sternotomy and cardiopulmonary bypass. A crimped biological valve on a self-expanding or balloon-expandable stent is inserted antegradely or retrogradely under fluoroscopy, and deployed on the beating heart. Among the worldwide TAVI programs, many different concepts have been established for the choice of the access site. Whether retrograde or antegrade TAVI should be considered the superior approach is matter of an ongoing debate. The published literature demonstrates safety of all techniques if performed within a dedicated multidisciplinary team. Since there is no data providing evidence if one approach is superior to another, we conclude that an individualized patient-centered decision making process is most beneficial, taking advantage of the complementarity of the different access options. The aim of this article is to give an overview of the current practice of access techniques for transcatheter based valve treatment and to outline the respective special characteristics. PMID:24313647

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2014-01-01

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

NASA commercial programs

NASA Technical Reports Server (NTRS)

1988-01-01

An expanded role for the U.S. private sector in America's space future has emerged as a key national objective, and NASA's Office of Commercial Programs is providing a focus for action. The Office supports new high technology commercial space ventures, the commercial application of existing aeronautics and space technology, and expanded commercial access to available NASA capabilities and services. The progress NASA has made in carrying out its new assignment is highlighted.

Higher Education's New Global Order: How and Why Governments Are Creating Structured Opportunity Markets. Research & Occasional Paper Series: CSHE.10.09

ERIC Educational Resources Information Center

Douglass, John Aubrey

2009-01-01

In the United States, developing "human capital" for both economic and social benefit is an idea as old as the nation itself and led to the emergence of world's first mass higher education system. Now most other nations are racing to expand access to universities and colleges and to expand their role in society. Higher education is…

Transcatheter Aortic Valve Replacement by a Novel Suprasternal Approach.

PubMed

Codner, Pablo; Pugliese, Daniel; Kouz, Rémi; Patel, Amisha; Chen, Cheng-Han; Terre, Juan; Eudailey, Kyle W; Nazif, Tamim; Vahl, Torsten P; George, Isaac; Khalique, Omar K; Hahn, Rebecca T; Leon, Martin B; Kodali, Susheel; Borger, Michael

2018-04-01

Transcatheter aortic valve replacement (TAVR) provides therapy for patients with severe aortic stenosis at extreme, high, or intermediate surgical risk. Transfemoral access has been the preferred access route; however, this approach is not suitable for many TAVR candidates. A suprasternal approach may allow for earlier ambulation and shorter hospital stay as compared with other, nontransfemoral approaches. A total of 11 patients with unsuitable transfemoral access underwent suprasternal TAVR. Propensity matching was used to compare suprasternal patients to patients undergoing transaortic, transapical, and trans-subclavian TAVR. Groups were well matched for baseline characteristics. A self-expanding valve device was used in 6 (54.5%) and a balloon-expandable valve in 5 (45.5%) of the 11 patients treated by the suprasternal route. Suprasternal and trans-subclavian patients were able to ambulate earlier than patients treated by the transaortic route, a median 1.6 days (interquartile range [IQR]: 0.9 to 1.8), 1.6 days (IQR: 0.9 to 2.7), and 3.9 days (IQR: 1.9 to 4.5) after the procedure for suprasternal, trans-subclavian, and transaortic patients, respectively (p = 0.001). Length of hospitalization was shorter for patients treated by suprasternal or trans-subclavian access in comparison with patients treated by the transaortic or transapical approach: median 4 days (IQR: 3 to 8) and 4 days (IQR: 4 to 8) versus 8 days (IQR: 6 to 14) and 6 days (IQR: 7 to 11) for suprasternal and trans-subclavian versus transaortic and transapical, respectively (p = 0.01). Suprasternal and trans-subclavian access are associated with earlier ambulation and shorter hospitalization than other nontransfemoral TAVR routes, without an increase in complications. Further study is required to determine if suprasternal is the alternative access of choice for TAVR patients with poor transfemoral vasculature. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2001-09-01

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

Medicaid Expansions from 1997 to 2009 Increased Coverage and Improved Access and Mental Health Outcomes for Low-Income Parents.

PubMed

McMorrow, Stacey; Kenney, Genevieve M; Long, Sharon K; Goin, Dana E

2016-08-01

To assess the effects of past Medicaid eligibility expansions to parents on coverage, access to care, out-of-pocket (OOP) spending, and mental health outcomes, and consider implications for the Affordable Care Act (ACA) Medicaid expansion. Person-level data from the National Health Interview Survey (1998-2010) is used to measure insurance coverage and related outcomes for low-income parents. Using state identifiers available at the National Center for Health Statistics Research Data Center, we attach state Medicaid eligibility thresholds for parents collected from a variety of sources to NHIS observations. We use changes in the Medicaid eligibility threshold for parents within states over time to identify the effects of changes in eligibility on low-income parents. We find that expanding Medicaid eligibility increases insurance coverage, reduces unmet needs due to cost and OOP spending, and improves mental health status among low-income parents. Moreover, our findings suggest that uninsured populations in states not currently participating in the ACA Medicaid expansion would experience even larger improvements in coverage and related outcomes than those in participating states if they chose to expand eligibility. The ACA Medicaid expansion has the potential to improve a wide variety of coverage, access, financial, and health outcomes for uninsured parents in states that choose to expand coverage. © Health Research and Educational Trust.

[Use of intraosseus infusion in the German air rescue service : nationwide analysis in the time period 2005 to 2009].

PubMed

Helm, M; Hossfeld, B; Schlechtriemen, T; Braun, J; Lampl, L; Bernhard, M

2011-12-01

Intraosseous infusion has become established as a fast and safe alternative to conventional vascular access in emergency situations. Originally the use of intraosseous access was limited to children up to 6 years of age and to adults for cardiopulmonary resuscitation but this limitation has now been removed. The aim of this study was to obtain data on mission reality regarding the use of intraosseous access in the prehospital setting against the background of the expanded recommendations on the use of the intraosseous infusion. An analysis of rescue missions by all rescue helicopters of the ADAC (German Automobile Club) Air Rescue as well as the German Air Rescue Service (58 helicopter emergency medical service bases) over a 4 year period from January 2005 to December 2008 was carried out. A total of 247,454 rescue missions were carried out during the study period and in 525 patients (0.2% of the total study collective) an intraosseous access was established. There was a significant increase in the intraosseous infusion rate from 0.1% to 0.4% (p<0.05). Furthermore, there was a significant increase in its use in elderly patients and in patients with lower National Advisory Committee for Aeronautics (NACA) scores (2005 vs. 2008): 92.4% vs. 42.9% of all intraosseous infusions in patients  ≤ 6 years of age (p<0.05) and 74.4% vs. 42.9% of all intraosseous infusions in patients with NACA score VI/VII (p<0.05). The proportion of trauma patients in the total study collective was 33% and there was no significant change in the frequency of trauma cases over the study period but there was a remarkable increase of intraosseous infusions in trauma patients in the last year of the study period compared to the previous years (38% in 2008 vs. 27-30% in 2005-2007). Furthermore, there was an increase in the number of different drug groups used for intraosseous infusion over the study period. The expanded indication recommendations for the use of intraosseous infusion in the prehospital setting enter more and more mission reality in air rescue services in Germany.

Rapid Operational Access and Maneuver Support (ROAMS) Platform for Improved Military Logistics Lines of Communication and Operational Vessel Routing

DTIC Science & Technology

2017-06-01

case study in a northeastern American metropolitan area. METHODOLOGY : The ROAMS platform provides expanded analysis, model automation, and enhanced...shoals. An initial route for such operations is selected much like the military logistics case . Subsequent adjustments to routes may be done on an ad...IX-45 June 2017 8 CASE STUDY: The ROAMS platform was applied to a large, northeast American metropolitan region to demonstrate the capability of

Access, Equity, and Community Colleges: The Truman Commission and Federal Higher Education Policy from 1947 To 2011

ERIC Educational Resources Information Center

Gilbert, Claire Krendl; Heller, Donald E.

2013-01-01

The 1947 President's Commission on Higher Education offers insight into higher education policy in the United States. This article reviews and assesses the adoption of its policy recommendations in two key areas: 1) improving college access and equity and 2) expanding the role of community colleges. (Contains 1 figure and 4 notes.)

Are On-Line Data Bases in Your Library's Future?

ERIC Educational Resources Information Center

Deacon, Jim

1983-01-01

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT: Today there are over 900 on-line data banks available for public access. Most microcomputers can use them through the aid of a modem and communication program. Major public information utilities that offer access to these on-line data bases are growing and expanding. The Source, a data base utility…

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

ERIC Educational Resources Information Center

Duke, Amy-Ellen; Strawn, Julie

2007-01-01

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

The Design of an Interactive Computer Based System for the Training of Signal Corps Officers in Communications Network Management

DTIC Science & Technology

1985-08-01

from the mainframe to the terminals is approximately 56k bits per second (21:3). Score: 8. Expandability. The number of terminals available to the 0...the systems controllers may access any files. For modem link up, a callback system is to be implemented to prevent unauthorized off post access (10:2

Expanding P450 catalytic reaction space through evolution and engineering

PubMed Central

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

2014-01-01

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

Tubular hydrogen permeable metal foil membrane and method of fabrication

DOEpatents

Paglieri, Stephen N.; Birdsell, Stephen A.; Barbero, Robert S.; Snow, Ronny C.; Smith, Frank M.

2006-04-04

A tubular hydrogen permeable metal membrane and fabrication process comprises obtaining a metal alloy foil having two surfaces, coating the surfaces with a metal or metal alloy catalytic layer to produce a hydrogen permeable metal membrane, sizing the membrane into a sheet with two long edges, wrapping the membrane around an elongated expandable rod with the two long edges aligned and overlapping to facilitate welding of the two together, placing the foil wrapped rod into a surrounding fixture housing with the two aligned and overlapping foil edges accessible through an elongated aperture in the surrounding fixture housing, expanding the elongated expandable rod within the surrounding fixture housing to tighten the foil about the expanded rod, welding the two long overlapping foil edges to one another generating a tubular membrane, and removing the tubular membrane from within the surrounding fixture housing and the expandable rod from with the tubular membrane.

The potential exploitation of research participants in high income countries who lack access to health care

PubMed Central

Rid, Annette; Emanuel, Ezekiel; Wendler, David

2016-01-01

There are millions of individuals living in North America and the European Union who lack access to healthcare services. When these individuals participate in research, they are at increased risk of being exposed to the risks and burdens of clinical trials without realizing the benefits that result from them. The mechanisms that have been proposed to ensure that research participants in low‐ and middle‐income countries are not exploited are unlikely to protect participants in high‐income countries. The present manuscript argues that one way to address concerns about exploitation in high‐income countries would be to require sponsors to provide targeted benefits such as medical treatment during the trial, or the study drug after the trial. The latter could be achieved through extension studies, expanded access programs, or named‐patient programs. Sponsors also might provide non‐medical benefits, such as education or social support. Ethical and regulatory guidance should be revised to ensure that research participants in high‐income countries who lack access to healthcare services receive sufficient benefits. PMID:26743927

Decreased Cancer Mortality-to-Incidence Ratios with Increased Accessibility of Federally Qualified Health Centers

PubMed Central

Adams, Swann Arp; Choi, Seul Ki; Khang, Leepao; Campbell, Dayna A.; Friedman, Daniela B.; Eberth, Jan M.; Glasgow, Russell E.; Tucker-Seeley, Reginald; Xirasagar, Sudha; Yip, Mei Po; Young, Vicki M.; Hébert, James R.

2015-01-01

Federally qualified health centers (FQHCs) offer primary and preventive healthcare, including cancer screening, for the nation’s most vulnerable population. The purpose of this study was to explore the relationship between access to FQHCs and cancer mortality-to-incidence ratios (MIRs). One-way analysis of variance was conducted to compare the mean MIRs for breast, cervical, prostate, and colorectal cancers for each U.S. county for 2006–2010 by access to FQHCs (direct access, in-county FQHC; indirect access, adjacent-county FQHC; no access, no FQHC either in the county or in adjacent counties). ArcMap 10.1 software was used to map cancer MIRs and FQHC access levels. The mean MIRs for breast, cervical, and prostate cancer differed significantly across FQHC access levels (p < 0.05). In urban and healthcare professional shortage areas, mean MIRs decreased as FQHC access increased. A trend of lower breast and prostate cancer MIRs in direct access to FQHCs was found for all racial groups, but this trend was significant for whites only. States with a large proportion of rural and medically underserved areas had high mean MIRs, with correspondingly more direct FQHC access. Expanding FQHCs to more underserved areas and concentrations of disparity populations may have an important role in reducing cancer morbidity and mortality, as well as racial-ethnic disparities, in the United States. PMID:25634545

Human Health

MedlinePlus

... an economic standpoint. 123 , 124 , 125 Innovative urban design could create increased access to active transport (such ... impact assessment of global climate change: Expanding on comparative risk assessment approaches for policy making . Annual Review ...

Maternal education and child mortality in Zimbabwe.

PubMed

Grépin, Karen A; Bharadwaj, Prashant

2015-12-01

In 1980, Zimbabwe rapidly expanded access to secondary schools, providing a natural experiment to estimate the impact of increased maternal secondary education on child mortality. Exploiting age specific exposure to these reforms, we find that children born to mothers most likely to have benefited from the policies were about 21% less likely to die than children born to slightly older mothers. We also find that increased education leads to delayed age at marriage, sexual debut, and first birth and that increased education leads to better economic opportunities for women. We find little evidence supporting other channels through which increased education might affect child mortality. Expanding access to secondary schools may greatly accelerate declines in child mortality in the developing world today. Copyright © 2015 Elsevier B.V. All rights reserved.

The German Long-Term Care Insurance Program: Evolution and Recent Developments.

PubMed

Nadash, Pamela; Doty, Pamela; von Schwanenflügel, Matthias

2018-05-08

Since 1995, Germany has operated one of the longest-running public programs providing universal support for the cost of long term services and supports (LTSS). Its self-funding, social insurance approach provides basic supports to nearly all Germans. We discuss its design and development, including recent reforms expanding the program and ensuring its ongoing sustainability. The study reviews legislative and programmatic changes, using program data, as well as legislative documents and program reports. The program is widely accepted among citizens and has achieved many of its original goals: ensuring access to LTSS and reducing reliance on the locally-funded safety-net social assistance program, which can be used to cover nursing home costs. It also strengthened the LTSS provider infrastructure and expanded access to home care. Recent reforms have addressed some of the program's key issues: the benefit's decreasing value, the eligibility and benefit structure that largely excluded cognitive impairment, and the program's longer-term financial sustainability-particularly its ability to sustain newly expanded benefits, which provide stronger protections to caregivers, index-link benefits, and more systematically incorporate cognitive impairment via a new assessment system. It has addressed financing issues by increasing premiums, introducing subsidies for the purchase of private insurance, and creating a "demographic reserve fund." The reforms constitute a significant strengthening of the program, remarkable in an era of retrenchment. Overall, the program provides evidence for the financial viability of a social insurance model, although longer-term challenges may yet arise.

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

NASA Astrophysics Data System (ADS)

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

2014-10-01

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

Over-the-counter but out of reach: a pharmacy-based survey of OTC syringe sales in Tijuana, Mexico.

PubMed

Pollini, Robin A; Gallardo, Manuel; Ruiz, Serena; Case, Patricia; Zaller, Nickolas; Lozada, Remedios

2014-05-01

Sterile syringe access is critical to HIV prevention efforts targeting injection drug users (IDUs) but some pharmacies do not sell syringes over-the-counter (OTC) even where such sales are legal. We conducted a pharmacy survey in Tijuana, Mexico (where OTC sales are legal) to characterize attitudes toward syringe sales and to explore support for expanding pharmacy-based HIV prevention efforts. Of 203 respondents, 28% supported OTC syringe sales to IDUs and 74% said their pharmacy required a prescription for at least some syringe sales. Support for OTC syringe sales was independently associated with selling OTC syringes, understanding the role of sterile syringes in HIV prevention, and recognizing pharmacies as an important health resource for IDUs. Most respondents supported an expanded role for pharmacies in HIV prevention, exclusive of OTC syringe sales. Our study provides information for developing interventions to promote OTC syringe sales and expanding pharmacy-based distribution of HIV-related information and resources.

The Promotion of Girls' Education through Recruitment and Training of Female Teachers in Nepal (Phase I). Mid-Decade Review of Progress towards Education for All.

ERIC Educational Resources Information Center

Thapa, Bijaya; Bajracharya, Hridaya; Thapa, Renu; Chitrakar, Roshan; Lamichhane, Shreeram; Tuladhar, Sumon

In 1995, the International Consultative Forum on Education for All commissioned case studies in developing countries as part of a mid-decade review of progress in expanding access to basic education. This paper examines the progress of Nepal's Basic and Primary Education Master Plan (BPEP), which aims to increase female participation in formal and…

Increasing Access to Higher Education and the Reproduction of Social Inequalities: The Case of Roma University Students in Eastern and Southeastern Europe

ERIC Educational Resources Information Center

Garaz, Stela; Torotcoi, Simona

2017-01-01

This article explores how elitist elements are preserved within an expanding higher education. It analyzes whether the choice of field of study may be one of these elements and focuses on the case of Roma students in Eastern and Southeastern Europe. The analysis reveals that Roma in the region are not only underrepresented in higher education in…

College Choice Interrupted or Facilitated: A Qualitative Case Study Examining How Social Class and Schools Structure Opportunity for Students in Urban High Schools

ERIC Educational Resources Information Center

Reavis, Tangela Blakely

2017-01-01

Although college enrollment rates have expanded over the last several decades, low-income students and students of color continue to face formidable barriers as they seek entry into higher education. While the existence of these barriers are often viewed as macro-level roadblocks that are largely systemic, much of the literature around access to…

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

PubMed

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

2016-06-01

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

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

PubMed

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

2015-02-01

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

Influence of Medical Insurance Under the Affordable Care Act on Access to Pain Management of the Trauma Patient.

PubMed

Wiznia, Daniel H; Zaki, Theodore; Maisano, Julianna; Kim, Chang-Yeon; Halaszynski, Thomas M; Leslie, Michael P

The Affordable Care Act intended to "extend affordable coverage" and "ensure access" for vulnerable patient populations. This investigation examined whether the type of insurance (Medicaid, Medicare, Blue Cross, cash pay) carried by trauma patients influences access to pain management specialty care. Investigators phoned 443 board-certified pain specialists, securing office visits with 235 pain physicians from 8 different states. Appointments for pain management were for a patient who sustained an ankle fracture requiring surgery and experiencing difficulty weaning off opioids. Offices were phoned 4 times assessing responses to the 4 different payment methodologies. Fifty-three percent of pain specialists contacted (235 of 443) were willing to see new patients to manage pain medication. Within the 53% of positive responses, 7.2% of physicians scheduled appointments for Medicaid patients, compared with 26.8% for cash-paying patients, 39.6% for those with Medicare, and 41.3% with Blue Cross (P < 0.0001). There were no differences in appointment access between states that had expanded Medicaid eligibility for low-income adults versus states that had not expanded Medicaid eligibility. Neither Medicaid nor Medicare reimbursement levels for new patient visits correlated with ability to schedule an appointment or influenced wait times. Access to pain specialists for management of pain medication in the postoperative trauma patient proved challenging. Despite the Affordable Care Act, Medicaid patients still experienced curtailed access to pain specialists and confronted the highest incidence of barriers to receiving appointments.

About Genetic Counselors

MedlinePlus

... While most genetic counseling is provided in-person, access to genetic counselors is expanding, and many now provide consultation services by telephone, videoconferencing , and the internet, or offer education and support in group settings. ...

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

PubMed

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

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

Access Based Cost Estimation for Beddown Analysis

DTIC Science & Technology

2006-03-23

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

Increasing Public Access to University Qualifications: Evolution of The University of the West Indies Open Campus

ERIC Educational Resources Information Center

Thomas, Michael L.; Soares, Judith

2009-01-01

This paper traces the evolution of The University of the West Indies' Open Campus (UWIOC), which is expected to expand service and increase access to the underserved communities of the Eastern Caribbean. At present, UWI, which caters to the needs of the 16 far flung countries of the Commonwealth Caribbean, has not been able to fully serve these…

The Power of Technology to Transform Adult Learning: Expanding Access to Adult Education & Workforce Skills through Distance Learning

ERIC Educational Resources Information Center

McCain, Mary L.

2009-01-01

There is a highly compelling case for using technology on a large scale to increase access to and improve America's adult education and workforce skills enterprise. By the reckoning of the National Commission on Adult Literacy and others, the nation must reach many more millions of adults with effective college- and job-readiness skills programs…

Project prioritization and selection process : economic vitality.

DOT National Transportation Integrated Search

2010-05-19

This measure will attempt to gauge how improvements in the regions transportation network reduce constraints on commerce and industry, improve productivity and labor market access, and expand opportunity for new business.

Essential Medicines in National Constitutions: Progress Since 2008.

PubMed

Katrina Perehudoff, S; Toebes, Brigit; Hogerzeil, Hans

2016-06-01

A constitutional guarantee of access to essential medicines has been identified as an important indicator of government commitment to the progressive realization of the right to the highest attainable standard of health. The objective of this study was to evaluate provisions on access to essential medicines in national constitutions, to identify comprehensive examples of constitutional text on medicines that can be used as a model for other countries, and to evaluate the evolution of constitutional medicines-related rights since 2008. Relevant articles were selected from an inventory of constitutional texts from WHO member states. References to states' legal obligations under international human rights law were evaluated. Twenty-two constitutions worldwide now oblige governments to protect and/or to fulfill accessibility of, availability of, and/or quality of medicines. Since 2008, state responsibilities to fulfill access to essential medicines have expanded in five constitutions, been maintained in four constitutions, and have regressed in one constitution. Government commitments to essential medicines are an important foundation of health system equity and are included increasingly in state constitutions.

Essential Medicines in National Constitutions

PubMed Central

Toebes, Brigit; Hogerzeil, Hans

2016-01-01

Abstract A constitutional guarantee of access to essential medicines has been identified as an important indicator of government commitment to the progressive realization of the right to the highest attainable standard of health. The objective of this study was to evaluate provisions on access to essential medicines in national constitutions, to identify comprehensive examples of constitutional text on medicines that can be used as a model for other countries, and to evaluate the evolution of constitutional medicines-related rights since 2008. Relevant articles were selected from an inventory of constitutional texts from WHO member states. References to states’ legal obligations under international human rights law were evaluated. Twenty-two constitutions worldwide now oblige governments to protect and/or to fulfill accessibility of, availability of, and/or quality of medicines. Since 2008, state responsibilities to fulfill access to essential medicines have expanded in five constitutions, been maintained in four constitutions, and have regressed in one constitution. Government commitments to essential medicines are an important foundation of health system equity and are included increasingly in state constitutions. PMID:27781006

Employing human rights frameworks to realize access to an HIV cure

PubMed Central

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

2015-01-01

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

The shrinking world of girls at puberty: Violence and gender-divergent access to the public sphere among adolescents in South Africa

PubMed Central

Hallman, Kelly K.; Kenworthy, Nora J.; Diers, Judith; Swan, Nick; Devnarain, Bashi

2015-01-01

Participatory mapping was undertaken with single-sex groups of grade 5 and grade 8–9 children in KwaZulu-Natal. Relative to grade 5 students, wide gender divergence in access to the public sphere was found at grade 8–9. With puberty, girls' worlds shrink, while boys' expand. At grade 5, female-defined community areas were equal or larger in size than those of males. Community area mapped by urban grade 8–9 girls, however, was only one-third that of male classmates and two-fifths that of grade 5 girls. Conversely, community area mapped by grade 8–9 boys was twice that of grade 5 boys. Similar differences emerged in the rural site. No female group rated a single community space as more than ‘somewhat safe’. Although curtailed spatial access is intended to protect girls, grade 8–9 girls reported most places in their small navigable areas as very unsafe. Expanded geographies of grade 8–9 boys contained a mix of safe and unsafe places. Reducing girls' access to the public sphere does not increase their perceived safety, but may instead limit their access to opportunities for human development. The findings emphasise the need for better violence prevention programming for very young adolescents. PMID:25303092

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

PubMed

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

2015-01-01

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

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

PubMed

Hoti, Kreshnik; Hughes, Jeffery; Sunderland, Bruce

2011-02-01

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

A DMPA Langmuir monolayer study: from gas to solid phase. An atomistic description by molecular dynamics Simulation.

PubMed

Giner-Casares, J J; Camacho, L; Martín-Romero, M T; Cascales, J J López

2008-03-04

In this work, a DMPA Langmuir monolayer at the air/water interface was studied by molecular dynamics simulations. Thus, an atomistic picture of a Langmuir monolayer was drawn from its expanded gas phase to its final solid condensed one. In this sense, some properties of monolayers that were traditionally poorly or even not reproduced in computer simulations, such as lipid domain formation or pressure-area per lipid isotherm, were properly reproduced in this work. Thus, the physical laws that control the lipid domain formation in the gas phase and the structure of lipid monolayers from the gas to solid condensed phase were studied. Thanks to the atomistic information provided by the molecular dynamics simulations, we were able to add valuable information to the experimental description of these processes and to access experimental data related to the lipid monolayers in their expanded phase, which is difficult or inaccessible to study by experimental techniques. In this sense, properties such as lipids head hydration and lipid structure were studied.

Surveillance for Health Care Access and Health Services Use, Adults Aged 18-64 Years - Behavioral Risk Factor Surveillance System, United States, 2014.

PubMed

Okoro, Catherine A; Zhao, Guixiang; Fox, Jared B; Eke, Paul I; Greenlund, Kurt J; Town, Machell

2017-02-24

As a result of the 2010 Patient Protection and Affordable Care Act, millions of U.S. adults attained health insurance coverage. However, millions of adults remain uninsured or underinsured. Compared with adults without barriers to health care, adults who lack health insurance coverage, have coverage gaps, or skip or delay care because of limited personal finances might face increased risk for poor physical and mental health and premature mortality. 2014. The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, landline- and cellular-telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. Data are collected from states, the District of Columbia, and participating U.S. territories on health risk behaviors, chronic health conditions, health care access, and use of clinical preventive services (CPS). An optional Health Care Access module was included in the 2014 BRFSS. This report summarizes 2014 BRFSS data from all 50 states and the District of Columbia on health care access and use of selected CPS recommended by the U.S. Preventive Services Task Force or the Advisory Committee on Immunization Practices among working-aged adults (aged 18-64 years), by state, state Medicaid expansion status, expanded geographic region, and federal poverty level (FPL). This report also provides analysis of primary type of health insurance coverage at the time of interview, continuity of health insurance coverage during the preceding 12 months, and other health care access measures (i.e., unmet health care need because of cost, unmet prescription need because of cost, medical debt [medical bills being paid off over time], number of health care visits during the preceding year, and satisfaction with received health care) from 43 states that included questions from the optional BRFSS Health Care Access module. In 2014, health insurance coverage and other health care access measures varied substantially by state, state Medicaid expansion status, expanded geographic region (i.e., states categorized geographically into nine regions), and FPL category. The following proportions refer to the range of estimated prevalence for health insurance and other health care access measures by examined geographical unit (unless otherwise specified), as reported by respondents. Among adults with health insurance coverage, the range was 70.8%-94.5% for states, 78.8%-94.5% for Medicaid expansion states, 70.8%-89.1% for nonexpansion states, 73.3%-91.0% for expanded geographic regions, and 64.2%-95.8% for FPL categories. Among adults who had a usual source of health care, the range was 57.2%-86.6% for states, 57.2%-86.6% for Medicaid expansion states, 61.8%-83.9% for nonexpansion states, 64.4%-83.6% for expanded geographic regions, and 61.0%-81.6% for FPL categories. Among adults who received a routine checkup, the range was 52.1%-75.5% for states, 56.0%-75.5% for Medicaid expansion states, 52.1%-71.1% for nonexpansion states, 56.8%-70.2% for expanded geographic regions, and 59.9%-69.2% for FPL categories. Among adults who had unmet health care need because of cost, the range was 8.0%-23.1% for states, 8.0%-21.9% for Medicaid expansion states, 11.9%-23.1% for nonexpansion states, 11.6%-20.3% for expanded geographic regions, and 5.3%-32.9% for FPL categories. Estimated prevalence of cancer screenings, influenza vaccination, and having ever been tested for human immunodeficiency virus also varied by state, state Medicaid expansion status, expanded geographic region, and FPL category. The prevalence of insurance coverage varied by approximately 25 percentage points among racial/ethnic groups (range: 63.9% among Hispanics to 88.4% among non-Hispanic Asians) and by approximately 32 percentage points by FPL category (range: 64.2% among adults with household income <100% of FPL to 95.8% among adults with household income >400% of FPL). The prevalence of unmet health care need because of cost varied by nearly 14 percentage points among racial/ethnic groups (range: 11.3% among non-Hispanic Asians to 25.0% among Hispanics), by approximately 17 percentage points among adults with and without disabilities (30.8% versus 13.7%), and by approximately 28 percentage points by FPL category (range: 5.3% among adults with household income >400% of FPL to 32.9% among adults with household income <100% of FPL). Among the 43 states that included questions from the optional module, a majority of adults reported private health insurance coverage (63.4%), followed by public health plan coverage (19.4%) and no primary source of insurance (17.1%). Financial barriers to health care (unmet health care need because of cost, unmet prescribed medication need because of cost, and medical bills being paid off over time [medical debt]) were typically lower among adults in Medicaid expansion states than those in nonexpansion states regardless of source of insurance. Approximately 75.6% of adults reported being continuously insured during the preceding 12 months, 12.9% reported a gap in coverage, and 11.5% reported being uninsured during the preceding 12 months. The largest proportion of adults reported ≥3 visits to a health care professional during the preceding 12 months (47.3%), followed by 1-2 visits (37.1%), and no health care visits (15.6%). Adults in expansion and nonexpansion states reported similar levels of satisfaction with received health care by primary source of health insurance coverage and by continuity of health insurance coverage during the preceding 12 months. This report presents for the first time estimates of population-based health care access and use of CPS among adults aged 18-64 years. The findings in this report indicate substantial variations in health insurance coverage; other health care access measures; and use of CPS by state, state Medicaid expansion status, expanded geographic region, and FPL category. In 2014, health insurance coverage, having a usual source of care, having a routine checkup, and not experiencing unmet health care need because of cost were higher among adults living below the poverty level (i.e., household income <100% of FPL) in states that expanded Medicaid than in states that did not. Similarly, estimates of breast and cervical cancer screening and influenza vaccination were higher among adults living below the poverty level in states that expanded Medicaid than in states that did not. These disparities might be due to larger differences to begin with, decreased disparities in Medicaid expansion states versus nonexpansion states, or increased disparities in nonexpansion states. BRFSS data from 2014 can be used as a baseline by which to assess and monitor changes that might occur after 2014 resulting from programs and policies designed to increase access to health care, reduce health disparities, and improve the health of the adult population. Post-2014 changes in health care access, such as source of health insurance coverage, attainment and continuity of coverage, financial barriers, preventive care services, and health outcomes, can be monitored using these baseline estimates.

Health Savings Accounts: Is an HSA Right for You?

MedlinePlus

... information. The hope is that as health savings accounts and other consumer-directed health care options become more widespread, access to information about cost and quality will expand. Yes, but ...

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

PubMed Central

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

2013-01-01

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

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

PubMed Central

Harris, Matthew J.; Rocha, Marcia Gomes

2017-01-01

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

Toward an open-access global database for mapping, control, and surveillance of neglected tropical diseases.

PubMed

Hürlimann, Eveline; Schur, Nadine; Boutsika, Konstantina; Stensgaard, Anna-Sofie; Laserna de Himpsl, Maiti; Ziegelbauer, Kathrin; Laizer, Nassor; Camenzind, Lukas; Di Pasquale, Aurelio; Ekpo, Uwem F; Simoonga, Christopher; Mushinge, Gabriel; Saarnak, Christopher F L; Utzinger, Jürg; Kristensen, Thomas K; Vounatsou, Penelope

2011-12-01

After many years of general neglect, interest has grown and efforts came under way for the mapping, control, surveillance, and eventual elimination of neglected tropical diseases (NTDs). Disease risk estimates are a key feature to target control interventions, and serve as a benchmark for monitoring and evaluation. What is currently missing is a georeferenced global database for NTDs providing open-access to the available survey data that is constantly updated and can be utilized by researchers and disease control managers to support other relevant stakeholders. We describe the steps taken toward the development of such a database that can be employed for spatial disease risk modeling and control of NTDs. With an emphasis on schistosomiasis in Africa, we systematically searched the literature (peer-reviewed journals and 'grey literature'), contacted Ministries of Health and research institutions in schistosomiasis-endemic countries for location-specific prevalence data and survey details (e.g., study population, year of survey and diagnostic techniques). The data were extracted, georeferenced, and stored in a MySQL database with a web interface allowing free database access and data management. At the beginning of 2011, our database contained more than 12,000 georeferenced schistosomiasis survey locations from 35 African countries available under http://www.gntd.org. Currently, the database is expanded to a global repository, including a host of other NTDs, e.g. soil-transmitted helminthiasis and leishmaniasis. An open-access, spatially explicit NTD database offers unique opportunities for disease risk modeling, targeting control interventions, disease monitoring, and surveillance. Moreover, it allows for detailed geostatistical analyses of disease distribution in space and time. With an initial focus on schistosomiasis in Africa, we demonstrate the proof-of-concept that the establishment and running of a global NTD database is feasible and should be expanded without delay.

Personal Health Records - Multiple Languages

MedlinePlus

... Seattle and King County Spanish (español) Expand Section Personal Health Records: MedlinePlus Health Topic - English ... Subscribe to RSS Follow us Disclaimers Copyright Privacy Accessibility Quality Guidelines Viewers & Players MedlinePlus Connect for ...

Expanding Primary Care Access and Workforce Act

THOMAS, 113th Congress

Sen. Sanders, Bernard [I-VT

2014-04-09

Senate - 04/09/2014 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

2009 Iowa railroad system plan.

DOT National Transportation Integrated Search

2009-01-01

The 2009 Iowa Railroad System Plan is intended to guide the Iowa Department of Transportation (DOT) in its activities of promoting access to rail transportation, helping to improve the freight railroad transportation system, expanding passenger rail ...

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

PubMed

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

2015-06-30

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

Can Free Primary Education Achieve Universal Primary Education? A Study of the Intersections of Social Exclusion, Gender and Education in Kenya

ERIC Educational Resources Information Center

Obiero, Judith A.

2012-01-01

The adoption of Free Primary Education in 2003 has expanded access to millions of children in Kenya. However, large numbers of children are still out of school. The majority of the out-of-school children belong to ethnic minority groups and the rural and urban poor, who live in abject poverty. This situation is disturbing given that free primary…

Experience Catalysts: How They Fill the Acquisition Experience Gap for the DoD

DTIC Science & Technology

2012-01-01

Russ- Eft , 1997). Other studies have shown that “the more managers are trained in how to support and coach the skills their employees learn, the more...efficacy, age, etc. (Bassi and Russ- Eft , 1997). Making a deterministic forecast is difficult. Experience Catalysts: How They Fill the Acquisition... tap freely. Provide easy access to sources of expertise. It deepens their knowledge base, expands per- spectives, and fuels their experience engine

The Fulcrum of U. S. Regional Rebalancing: Russian and U.S. Securitization Moves in Contemporary Strategic Shifts

DTIC Science & Technology

2013-06-01

countering recent advances in Chinese military technology.78 These Chines advances in military technology are tied to the anti-access and area denial...region. These patterns reflect the influence of historical and cultural dynamics on security interdependence and are best understood by expanding...Degradation?,” in Can Russia Reform? Economic , Political, and Military Perspectives, ed. Stephen J. Blank, SSI Monograph (Carlisle, PA: Strategic Studies

HIPAA's Individual Right of Access to Genomic Data: Reconciling Safety and Civil Rights.

PubMed

Evans, Barbara J

2018-01-04

In 2014, the United States granted individuals a right of access to their own laboratory test results, including genomic data. Many observers feel that this right is in tension with regulatory and bioethical standards designed to protect the safety of people who undergo genomic testing. This commentary attributes this tension to growing pains within an expanding federal regulatory program for genetic and genomic testing. The Genetic Information Nondiscrimination Act of 2008 expanded the regulatory agenda to encompass civil rights and consumer safety. The individual access right, as it applies to genomic data, is best understood as a civil-rights regulation. Competing regulatory objectives-safety and civil rights-were not successfully integrated during the initial rollout of genomic civil-rights regulations after 2008. Federal law clarifies how to prioritize safety and civil rights when the two come into conflict, although with careful policy design, the two need not collide. This commentary opens a dialog about possible solutions to advance safety and civil rights together. Copyright © 2017 American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

Centralized, capacity-building training of Lichtenstein hernioplasty in Brazil.

PubMed

Moore, Alexandra M; Datta, Néha; Wagner, Justin P; Schroeder, Alexander D; Reinpold, Wolfgang; Franciss, Maurice Y; Silva, Rodrigo A; Chen, David C; Filipi, Charles J; Roll, Sergio

2017-02-01

In Brazil, access to healthcare varies widely by community. Options for repair of surgically correctable conditions, such as inguinal hernias, are limited. A training program was instituted to expand access to Lichtenstein hernioplasty. Between September, 2014 and September, 2015, 3 orders of training series took place in São Paulo, Brazil. Participating surgeons received training and assessments from expert trainers using the Operative Performance Rating Scale (OPRS). Those who completed training successfully were invited to become trainers. OPRS scores were compared between training series. Outcomes were documented up to 6 months post-training. The 3 orders of training series resulted in 45 surgeons trained and 213 hernias repaired. Eleven trainees subsequently became trainers. Mean post-training OPRS scores were 4.4 (scale of 5) and did not vary significantly between training series. The overall complication rate was 4.7%, with no hernia recurrences or reoperations at 6 months. Competency-based training generates a regional network of surgeons proficient in Lichtenstein hernioplasty. Each training session progressively expands patient access to high quality operations in underserved communities in Brazil. Copyright © 2016 Elsevier Inc. All rights reserved.

Exploring Science Applications for Unmanned Aircraft Systems Aboard UNOLS Ships

NASA Astrophysics Data System (ADS)

Bailey, R.; Lachenmeier, T.; Hatfield, M. C.

2014-12-01

The University of Alaska Fairbanks has been expanding the use of small Unmanned Aircraft Systems (UAS) for science support from a variety of ships for several years. The ease and safety of flying from research vessels offers the science community lower cost access to overhead surveys of marine mammals without impact on sensitive populations, monitoring of AUV operations and collection of transmitted data, extensive surveys of sea ice during formation, melt, and sea temperatures through multiple seasons. As FAA expands access to the Arctic airspace over the Chukchi, Beaufort, and Bering Seas, the opportunities to employ UAS in science applications will become easier to exploit. This presentation describes the changes coming through new FAA rules, through the Alaska FAA Test Site, the Pan-Pacific UAS Test Range Complex which includes Oregon and Hawaii, and even Iceland. Airspace access advances associated with recent operations including the NASA-sponsored MIZOPEX, whale detection, and forming sea ice work in October will be presented, as well as a glider UAS connected to very high altitude balloons collecting atmospheric data. Development of safety procedures for use of UAS on UNOLS ships will be discussed.

Workplace Accommodations for Pregnant Employees: Associations With Women's Access to Health Insurance Coverage After Childbirth.

PubMed

Jou, Judy; Kozhimannil, Katy B; Blewett, Lynn A; McGovern, Patricia M; Abraham, Jean M

2016-06-01

This study evaluates the associations between workplace accommodations for pregnancy, including paid and unpaid maternity leave, and changes in women's health insurance coverage postpartum. Secondary analysis using Listening to Mothers III, a national survey of women ages 18 to 45 years who gave birth in U.S. hospitals during 2011 to 2012 (N = 700). Compared with women without access to paid maternity leave, women with access to paid leave were 0.4 times as likely to lose private health insurance coverage, 0.3 times as likely to lose public health coverage, and 0.3 times as likely to become uninsured after giving birth. Workplace accommodations for pregnant employees are associated with health insurance coverage via work continuity postpartum. Expanding protections for employees during pregnancy and after childbirth may help reduce employee turnover, loss of health insurance coverage, and discontinuity of care.

Overcoming structural constraints to patient utilization of electronic medical records: a critical review and proposal for an evaluation framework.

PubMed

Winkelman, Warren J; Leonard, Kevin J

2004-01-01

There are constraints embedded in medical record structure that limit use by patients in self-directed disease management. Through systematic review of the literature from a critical perspective, four characteristics that either enhance or mitigate the influence of medical record structure on patient utilization of an electronic patient record (EPR) system have been identified: environmental pressures, physician centeredness, collaborative organizational culture, and patient centeredness. An evaluation framework is proposed for use when considering adaptation of existing EPR systems for online patient access. Exemplars of patient-accessible EPR systems from the literature are evaluated utilizing the framework. From this study, it appears that traditional information system research and development methods may not wholly capture many pertinent social issues that arise when expanding access of EPR systems to patients. Critically rooted methods such as action research can directly inform development strategies so that these systems may positively influence health outcomes.

Future of family support: Projected living arrangements and income sources of older people in Hong Kong up to 2030.

PubMed

Ng, Kok-Hoe

2016-06-01

The study aims to project future trends in living arrangements and access to children's cash contributions and market income sources among older people in Hong Kong. A cell-based model was constructed by combining available population projections, labour force projections, an extrapolation of the historical trend in living arrangements based on national survey datasets and a regression model on income sources. Under certain assumptions, the proportion of older people living with their children may decline from 59 to 48% during 2006-2030. Although access to market income sources may improve slightly, up to 20% of older people may have no access to either children's financial support or market income sources, and will not live with their children by 2030. Family support is expected to contract in the next two decades. Public pensions should be expanded to protect financially vulnerable older people. © 2015 AJA Inc.

Who's Got the Booze? The Role of Access to Alcohol in the Relations Between Social Status and Individual Use.

PubMed

Deutsch, Arielle R; Steinley, Douglas; Sher, Kenneth J; Slutske, Wendy S

2017-09-01

The findings of previous research that examined relationships between popularity and alcohol use in adolescents have been mixed, and few hypotheses have proposed mechanisms for this relationship. The current study expands on previous literature (a) by examining a possible mechanism that can explain the relation between popularity and alcohol use (home access to alcohol) and (b) by using another sociometric measure ("betweenness"), beyond popularity, that may relate more to home alcohol access. Using network-level data from adolescents in 9th-11th grades in eight schools within two in-home waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we examined two sociometric measures of social status: popularity (number of schoolmates who nominated participants as a friend) and betweenness (level of ties participants have to multiple social subgroups within a network). Betweenness, but not popularity, related to later alcohol use. Having home access to alcohol positively related to later alcohol use, and having friends with home access to alcohol negatively related to later alcohol use. Alcohol access was also related to later sociometric status. Friends' alcohol access negatively related to later betweenness, and personal alcohol access moderated other pathways predicting betweenness. Betweenness appears to play a unique role in the association between social status and alcohol use in adolescent social networks. This is potentially tied to specific ways in which adolescents may be able to access alcohol (through home or through friends with access at home). More research is necessary to examine the ways in which multiple sociometric statuses relate to the contexts in which adolescents access and use alcohol.

Expanding the State Partnership Program within Asia Pacific

DTIC Science & Technology

2013-04-01

include Malaysia, Burma (Myanmar), and Laos .61 With established relationships in these trade associations, along with the state’s bilateral trade efforts...U.S. Department of Commerce), http://tse.export.gov/ TSE /MapDisplay.aspx (accessed November 1, 2012). 56 Ibid. 57 Author not provided, “At a...Total All Merchandise Exports from Texas (Washington, D.C.: U.S. Department of Commerce), http://tse.export.gov/ TSE /MapDisplay.aspx (accessed

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

PubMed

Dayton, Andrew I

2006-08-30

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

Perceptions of the first family physicians to adopt advanced access in the province of Quebec, Canada.

PubMed

Breton, Mylaine; Maillet, Lara; Paré, Isabelle; Abou Malham, Sabina; Touati, Nassera

2017-10-01

In Quebec, several primary care physicians have made the transition to the advanced access model to address the crisis of limited access to primary care. The objectives are to describe the implementation of the advanced access model, as perceived by the first family physicians; to analyze the factors influencing the implementation of its principles; and to document the physicians' perceptions of its effects on their practice, colleagues and patients. Qualitative methods were used to explore, through semi-structured interviews, the experiences of 21 family physicians who had made the transition to advanced access. Of the 21 physicians, 16 succeeded in adopting all five advanced access principles to varying degrees. Core implementation issues revolved around the dynamics of collaboration between physicians, nurses and other colleagues. Secretaries' functions, in particular, had to be expanded. Facilitating factors were mainly related to the physicians' leadership and the professional resources available in the organizations. Impediments related to resource availability and team functioning were also encountered. This is the first exploratory study to examine the factors influencing the adoption of the advanced access model conducted with early-adopter family physicians. The lessons drawn will inform discussions on scaling up to other settings experiencing the same problems. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Engineering Assessment of Big House at Summit Station, Greenland

DTIC Science & Technology

2011-04-01

Open cell expanded polystyrene insulation c EPS is not thought to be under the T-111 siding (communication 04 Nov 2010) d Quad-pane window ERDC...eastern side of the building where, in 2008, the roof access hatch was relocated. In 1999, the exterior was re-sheathed with 38- mm expanded ... polystyrene (EPS) insulation and 12.7-mm T-111 siding, which was attached with a number of fasteners. The wall thickness is 178 mm (Fig. 3). In 2006, a

Comparison between different thickness umbrella-shaped expandable radiofrequency electrodes (SuperSlim and CoAccess): Experimental and clinical study

PubMed Central

KODA, MASAHIKO; TOKUNAGA, SHIHO; MATONO, TOMOMITSU; SUGIHARA, TAKAAKI; NAGAHARA, TAKAKAZU; MURAWAKI, YOSHIKAZU

2011-01-01

The purpose of the present study was to compare the size and configuration of the ablation zones created by SuperSlim and CoAccess electrodes, using various ablation algorithms in ex vivo bovine liver and in clinical cases. In the experimental study, we ablated explanted bovine liver using 2 types of electrodes and 4 ablation algorithms (combinations of incremental power supply, stepwise expansion and additional low-power ablation) and evaluated the ablation area and time. In the clinical study, we compared the ablation volume and the shape of the ablation zone between both electrodes in 23 hepatocellular carcinoma (HCC) cases with the best algorithm (incremental power supply, stepwise expansion and additional low-power ablation) as derived from the experimental study. In the experimental study, the ablation area and time by the CoAccess electrode were significantly greater compared to those by the SuperSlim electrode for the single-step (algorithm 1, p=0.0209 and 0.0325, respectively) and stepwise expansion algorithms (algorithm 2, p=0.0002 and <0.0001, respectively; algorithm 3, p= 0.006 and 0.0407, respectively). However, differences were not significant for the additional low-power ablation algorithm. In the clinical study, the ablation volume and time in the CoAccess group were significantly larger and longer, respectively, compared to those in the SuperSlim group (p=0.0242 and 0.009, respectively). Round ablation zones were acquired in 91.7% of the CoAccess group, while irregular ablation zones were obtained in 45.5% of the SuperSlim group (p=0.0428). In conclusion, the CoAccess electrode achieves larger and more uniform ablation zones compared with the SuperSlim electrode, though it requires longer ablation times in experimental and clinical studies. PMID:22977647

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

PubMed

Kirby, James B; Sharma, Ravi

2017-12-01

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

2009 Iowa railroad system plan : cover.

DOT National Transportation Integrated Search

2009-01-01

The 2009 Iowa Railroad System Plan is intended to guide the Iowa Department of Transportation (DOT) in its activities of promoting access to rail transportation, helping to improve the freight railroad transportation system, expanding passenger rail ...

CDC Vital Signs: HIV and Injection Drug Use

MedlinePlus

... health departments can work with their lawmakers and law enforcement to make SSPs more available to PWID. ... to determine where services are needed. Work with law enforcement and local leaders to expand access to ...

2009 Iowa railroad system plan : part I.

DOT National Transportation Integrated Search

2009-01-01

The 2009 Iowa Railroad System Plan is intended to guide the Iowa Department of Transportation (DOT) in its activities of promoting access to rail transportation, helping to improve the freight railroad transportation system, expanding passenger rail ...

2009 Iowa railroad system plan : part III.

DOT National Transportation Integrated Search

2009-01-01

The 2009 Iowa Railroad System Plan is intended to guide the Iowa Department of Transportation (DOT) in its activities of promoting access to rail transportation, helping to improve the freight railroad transportation system, expanding passenger rail ...

2009 Iowa railroad system plan : part II.

DOT National Transportation Integrated Search

2009-01-01

The 2009 Iowa Railroad System Plan is intended to guide the Iowa Department of Transportation (DOT) in its activities of promoting access to rail transportation, helping to improve the freight railroad transportation system, expanding passenger rail ...

Capitated groups suffer under open access, consumer-driven care.

PubMed

2003-08-01

Complaints are starting to come in from capitated medical groups and medical associations about the movement to higher co-payments and deductibles in association with the rapidly expanding move toward consumer-driven health care.

2009 Iowa railroad system plan : introduction.

DOT National Transportation Integrated Search

2009-01-01

The 2009 Iowa Railroad System Plan is intended to guide the Iowa Department of Transportation (DOT) in its activities of promoting access to rail transportation, helping to improve the freight railroad transportation system, expanding passenger rail ...

Evaluation of the first pharmacist-administered vaccinations in Western Australia: a mixed-methods study

PubMed Central

Hattingh, H Laetitia; Sim, T Fei; Parsons, R; Czarniak, P; Vickery, A; Ayadurai, S

2016-01-01

Objectives This study evaluated the uptake of Western Australian (WA) pharmacist vaccination services, the profiles of consumers being vaccinated and the facilitators and challenges experienced by pharmacy staff in the preparation, implementation and delivery of services. Design Mixed-methods methodology with both quantitative and qualitative data through surveys, pharmacy computer records and immuniser pharmacist interviews. Setting Community pharmacies in WA that provided pharmacist vaccination services between March and October 2015. Participants Immuniser pharmacists from 86 pharmacies completed baseline surveys and 78 completed exit surveys; computer records from 57 pharmacies; 25 immuniser pharmacists were interviewed. Main outcome measures Pharmacy and immuniser pharmacist profiles; pharmacist vaccination services provided and consumer profiles who accessed services. Results 15 621 influenza vaccinations were administered by immuniser pharmacists at 76 WA community pharmacies between March and October 2015. There were no major adverse events, and <1% of consumers experienced minor events which were appropriately managed. Between 12% and 17% of consumers were eligible to receive free influenza vaccinations under the National Immunisation Program but chose to have it at a pharmacy. A high percentage of vaccinations was delivered in rural and regional areas indicating that provision of pharmacist vaccination services facilitated access for rural and remote consumers. Immuniser pharmacists reported feeling confident in providing vaccination services and were of the opinion that services should be expanded to other vaccinations. Pharmacists also reported significant professional satisfaction in providing the service. All participating pharmacies intended to continue providing influenza vaccinations in 2016. Conclusions This initial evaluation of WA pharmacist vaccination services showed that vaccine delivery was safe. Convenience and accessibility were important aspects in usage of services. There is scope to expand pharmacist vaccination services to other vaccines and younger children; however, government funding to pharmacists needs to be considered. PMID:27650763

Single-arm, open label study of pemetrexed plus cisplatin in chemotherapy naïve patients with malignant pleural mesothelioma: outcomes of an expanded access program.

PubMed

Obasaju, Coleman K; Ye, Zhishen; Wozniak, Antoinette J; Belani, Chandra P; Keohan, Mary-Louise; Ross, Helen J; Polikoff, Jonathan A; Mintzer, David M; Monberg, Matthew J; Jänne, Pasi A

2007-02-01

An expanded access program (EAP) provided patient access to pemetrexed prior to its commercial availability. The current report consists of US patients in the EAP who had chemotherapy naïve pleural mesothelioma. Eligible patients had a histologic or cytologic diagnosis of malignant mesothelioma that was not amenable to curative treatment with surgery. Study treatment consisted of pemetrexed 500mg/m(2) in combination with cisplatin 75mg/m(2) once every 21 days. Vitamin B12, folic acid, and dexamethasone were administered as prophylaxis. Serious adverse events (SAEs) were reported by investigators and compiled in a pharmacovigilance database for all patients enrolled in the EAP. Of 1056 patients receiving at least one dose of pemetrexed in the EAP, 728 had chemotherapy naïve pleural mesothelioma. Median age of this group was 70 years (range 23-89 years) and 84% were male. Among 615 patients, overall response rate was 20.5%, including 12 complete responses (2.0%) and 114 partial responses (18.5%). An additional 290 patients (47.2%) had stable disease. Median survival for all 728 patients was 10.8 months (95% CI=9.8, 12.3; 60.3% censorship) and 1 year survival was 45.4%. The most commonly reported SAEs in the overall EAP irrespective of causality were dehydration (7.2%), nausea (5.2%), vomiting (4.9%), dyspnea (3.8%), and pulmonary embolism (2.4%). In this large cohort, 67.7% of patients treated with first-line chemotherapy experienced a response or stable disease. Survival time and toxicity from this EAP were promising for this difficult-to-treat disease.

Primary care assessment from a male population perspective.

PubMed

Silva, Abiúde Nadabe E; Silva, Simone Albino da; Silva, Ana Roberta Vilarouca da; Araújo, Telma Maria Evangelista de; Rebouças, Cristiana Brasil Almeida; Nogueira, Lídya Tolstenko

2018-01-01

to evaluate the quality of primary health care from the perspective of the male population. a cross-sectional descriptive-evaluative study conducted at the family health units of Teresina, Piauí, Brazil, with the male population being interviewed through the Primary Care Assessment Tool (PCAT). 301 participants with mean age of 51.34 years, married, incomplete elementary school and monthly income between one and two minimum wages. The evaluation was positive for the following care domains: utilization, information system and longitudinality. The features access, comprehensiveness of care, service available and service provided, family centeredness and community orientation obtained a negative evaluation. the features of primary care are unsatisfactory, indicating the need to expand access to services offered and to qualify care for male users.

Utilities Power Change: Engaging Commercial Customers in Workplace Charging

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

Lommele, Stephen; Dafoe, Wendy

As stewards of an electric grid that is available almost anywhere people park, utilities that support workplace charging are uniquely positioned to help their commercial customers be a part of the rapidly expanding network of charging infrastructure. Utilities understand the distinctive challenges of their customers, have access to technical information about electrical infrastructure, and have deep experience modeling and managing demand for electricity. This case study highlights the experiences of two utilities with workplace charging programs.

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

DTIC Science & Technology

2007-11-01

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

Embracing Our Children: A Report Based on a Forum about Universal Access to Prekindergarten Programs (Pocantico Hills, New York, December 6-8, 2000). Pocantico Paper.

ERIC Educational Resources Information Center

2001

This report is based on a forum on the topic of universal access to prekindergarten programs, "Toward a New Education Framework: Expanding the Boundaries To Include UPK," held in December 2000 with 30 education leaders from Connecticut, New York, South Carolina, and Vermont. The goal of the forum was to provide an opportunity for school…

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

Maynar, Manuel; Llorens, Rafael; Lopez-Sanchez, Carmen

Purpose. A method to create an extraluminal femoropopliteal bypass graft using endovascular techniques was evaluated in situ on cadaver extremities in an attempt to develop a minimally invasive alternative technique for the management of infrainguinal occlusive arterial disease. Methods. The endovascular placement of an extraluminal femoropopliteal bypass graft was undertaken in 5 cadaver legs. Following percutaneous access to the popliteal artery (PA) or common femoral artery (CFA), a Rosch-Uchida needle was used to perforate the vascular wall, followed by the creation of an extraluminal tract using a looped wire and catheter. Once the desired level was reached the needle wasmore » again used to perforate the vascular wall of the proximal superficial femoral artery (SFA) or PA depending on the access used. Self-expanding expanded polytetrafluoroethylene (ePTFE) stent-grafts were then deployed to establish the extraluminal femoropopliteal bypass connecting the two arterial puncture sites. Following dilatation of the stent-graft, angiography was performed to assess the endoprostheses and to look for contrast leaks. Results. Technical success was achieved in all 5 legs. Procedure time varied from 15 to 30 min. The angiographic studies performed immediately after completion of the bypass procedure showed patency of the grafts with no evidence of kinking or leakage in any of the cases. Conclusion. This study has proved that the endovascular placement of an extraluminal femoropopliteal bypass graft in human cadaver legs using endovascular techniques under fluoroscopic control is technically feasible.« less

Application of electronic medical record data for health outcomes research: a review of recent literature.

PubMed

Lin, Junji; Jiao, Tianze; Biskupiak, Joseph E; McAdam-Marx, Carrie

2013-04-01

Electronic medical records (EMRs) have become a common source of data for outcomes research. This review discusses trends in EMR data use for outcomes research as well as strengths and limitations, and likely future developments to help optimize value and use of EMR data for outcomes research. EMR-based studies reporting treatment outcomes published between 2007 and 2012 were predominantly from the USA and Europe. There has been a substantial increase in the number of EMR-based outcomes studies published from 2007-2008 (n = 28) to 2010-2011 (n = 55). Many studies evaluated biometric and laboratory test outcomes in common chronic conditions. However, researchers are expanding the scope of evaluated diseases and outcomes using advanced techniques, such as natural language processing and linking EMRs to other patient-level data to overcome issues with missing data or data that cannot be accessed using standard queries. These advances will help to expand the scope and sophistication of outcomes research in the coming years.

Smart Columbus : Systems Engineering Management Plan (SEMP) for Smart Columbus Demonstration Program

DOT National Transportation Integrated Search

2018-01-16

The Smart City Demonstration Program is intended to improve access through expanded mobility options in major job centers, enhance visitor experience by better connecting visitors to transportation options, stimulate regional economic prosperity and ...

3 CFR 9024 - Proclamation 9024 of September 26, 2013. National Public Lands Day, 2013

Code of Federal Regulations, 2014 CFR

2014-01-01

... diverse and rugged landscapes reflect our national character, the way we care for these open spaces.... Since I established this initiative, we have expanded access to recreation, restored critical landscapes...

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

ClinicalTrials.gov

2017-11-22

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

Privacy and Security in Mobile Health: A Research Agenda

PubMed Central

Kotz, David; Gunter, Carl A.; Kumar, Santosh; Weiner, Jonathan P.

2017-01-01

Mobile health technology has great potential to increase healthcare quality, expand access to services, reduce costs, and improve personal wellness and public health. However, mHealth also raises significant privacy and security challenges. PMID:28344359

75 FR 1622 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-12

... Part A MAI is to expand access to medical, health, and social support services for disproportionately... areas with substantial need for HIV/AIDS care and support services that are most severely affected by...

NYSERDA's Green Jobs-Green New York Program: Extending Energy Efficiency Financing To Underserved Households

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

Zimring, Mark; Fuller, Merrian

2011-01-24

The New York legislature passed the Green Jobs-Green New York (GJGNY) Act in 2009. Administered by the New York State Energy Research and Development Authority (NYSERDA), GJGNY programs provide New Yorkers with access to free or low-cost energy assessments,1 energy upgrade services,2 low-cost financing, and training for various 'green-collar' careers. Launched in November 2010, GJGNY's residential initiative is notable for its use of novel underwriting criteria to expand access to energy efficiency financing for households seeking to participate in New York's Home Performance with Energy Star (HPwES) program.3 The GJGNY financing program is a valuable test of whether alternatives tomore » credit scores can be used to responsibly expand credit opportunities for households that do not qualify for traditional lending products and, in doing so, enable more households to make energy efficiency upgrades.« less

Chronic kidney disease in disadvantaged populations.

PubMed

Garcia-Garcia, Guillermo; Jha, Vivekanand

2015-01-01

The increased burden of CKD in disadavantaged populations is due to both global factors and population-specific issues. Low socioeconomic status and poor access to care contribute to health care disparities, and exacerbate the negative effects of genetic or biologic predisposition. Provision of appropriate renal care to these populations requires a two-pronged approach: expanding the reach of dialysis through development of low-cost alternatives that can be practiced in remote locations, and implementation and evaluation of cost-effective prevention strategies. Kidney transplantation should be promoted by expanding deceased donor transplant programs and use of inexpensive, generic immunosuppressive drugs. The message of WKD 2015 is that a concerted attack against the diseases that lead to ESRD, by increasing community outreach, better education, improved economic opportunity, and access to preventive medicine for those at highest risk, could end the unacceptable relationship between CKD and disadvantage in these communities.

The Transformative Experience in Engineering Education

NASA Astrophysics Data System (ADS)

Goodman, Katherine Ann

This research evaluates the usefulness of transformative experience (TE) in engineering education. With TE, students 1) apply ideas from coursework to everyday experiences without prompting (motivated use); 2) see everyday situations through the lens of course content (expanded perception); and 3) value course content in new ways because it enriches everyday affective experience (affective value). In a three-part study, we examine how engineering educators can promote student progress toward TE and reliably measure that progress. For the first study, we select a mechanical engineering technical elective, Flow Visualization, that had evidence of promoting expanded perception of fluid physics. Through student surveys and interviews, we compare this elective to the required Fluid Mechanics course. We found student interest in fluids fell into four categories: complexity, application, ubiquity, and aesthetics. Fluid Mechanics promotes interest from application, while Flow Visualization promotes interest based in ubiquity and aesthetics. Coding for expanded perception, we found it associated with students' engineering identity, rather than a specific course. In our second study, we replicate atypical teaching methods from Flow Visualization in a new design course: Aesthetics of Design. Coding of surveys and interviews reveals that open-ended assignments and supportive teams lead to increased ownership of projects, which fuels risk-taking, and produces increased confidence as an engineer. The third study seeks to establish parallels between expanded perception and measurable perceptual expertise. Our visual expertise experiment uses fluid flow images with both novices and experts (students who had passed fluid mechanics). After training, subjects sort images into laminar and turbulent categories. The results demonstrate that novices learned to sort the flow stimuli in ways similar to subjects in prior perceptual expertise studies. In contrast, the experts' significantly better results suggest they are accessing conceptual fluids knowledge to perform this new, visual task. The ability to map concepts onto visual information is likely a necessary step toward expanded perception. Our findings suggest that open-ended aesthetic experiences with engineering content unexpectedly support engineering identity development, and that visual tasks could be developed to measure conceptual understanding, promoting expanded perception. Overall, we find TE a productive theoretical framework for engineering education research.

Factors contributing to low uptake and renewal of health insurance: a qualitative study in Ghana.

PubMed

Fenny, Ama Pokuaa; Kusi, Anthony; Arhinful, Daniel K; Asante, Felix Ankoma

2016-01-01

The effort to expand access to healthcare and reduce health inequalities in many low income countries have meant that many have adopted different levels of social health protection mechanisms. Ghana introduced a National Health Insurance Scheme (NHIS) in 2005 with the aim of removing previous barriers created by the user fees financing system. Although the NHIS has made health accessible to some category of people, the majority of Ghanaians (60 %) are not enroled on the scheme. Earlier studies have looked at various factors that account for this low uptake. However, we recognise that this qualitative study will nuance the depth of these barriers to enrolment. Minimally structured, qualitative interviews were conducted with key stakeholders at the district, regional and national levels. Focus group discussions were also undertaken at the community level. Using an inductive and content analytic approach, the transcripts were analyzed to identify and define categories that explain low uptake of health insurance. The results are presented under two broad themes: sociocultural and systemic factors. Sociocultural factors identified were 1) vulnerability within certain groups such as the aged and the disabled groups which impeded access to the NHIS 2) cultural and religious norms which discouraged enrolment into the scheme. System-wide factors were 1) inadequate distribution of social infrastructure such as healthcare facilities, 2) weak administrative processes within the NHIS, and 3) poor quality of care. Mapping the interplay of these dynamic relations between the NHIS, its clients and service providers, the study identifies critical factors at the policy-making level, service provider level, and client level (reflective in household and community level institutional arrangements) that affect enrolment in the scheme. Our findings inform a number of potential reforms in the area of distribution of health resources and cost containment to expand coverage, increase choices and meeting the needs of the end user.

Three-dimensional (3D) printing and its applications for aortic diseases.

PubMed

Hangge, Patrick; Pershad, Yash; Witting, Avery A; Albadawi, Hassan; Oklu, Rahmi

2018-04-01

Three-dimensional (3D) printing is a process which generates prototypes from virtual objects in computer-aided design (CAD) software. Since 3D printing enables the creation of customized objects, it is a rapidly expanding field in an age of personalized medicine. We discuss the use of 3D printing in surgical planning, training, and creation of devices for the treatment of aortic diseases. 3D printing can provide operators with a hands-on model to interact with complex anatomy, enable prototyping of devices for implantation based upon anatomy, or even provide pre-procedural simulation. Potential exists to expand upon current uses of 3D printing to create personalized implantable devices such as grafts. Future studies should aim to demonstrate the impact of 3D printing on outcomes to make this technology more accessible to patients with complex aortic diseases.

To expand coverage, or increase frequency: Quantifying the tradeoffs between equity and efficiency facing cervical cancer screening programs in low‐resource settings

PubMed Central

Tsu, Vivien; Jeronimo, Jose; Mvundura, Mercy; Lee, Kyueun; Kim, Jane J.

2017-01-01

Cervical cancer is a leading cause of cancer death worldwide, with 85% of the disease burden residing in less developed regions. To inform evidence‐based decision‐making as cervical cancer screening programs are planned, implemented, and scaled in low‐ and middle‐income countries, we used cost and test performance data from the START‐UP demonstration project in Uganda and a microsimulation model of HPV infection and cervical carcinogenesis to quantify the health benefits, distributional equity, cost‐effectiveness, and financial impact of either (1) improving access to cervical cancer screening or (2) increasing the number of lifetime screening opportunities for women who already have access. We found that when baseline screening coverage was low (i.e., 30%), expanding coverage of screening once in a lifetime to 50% can yield comparable reductions in cancer risk to screening two or three times in a lifetime at 30% coverage, lead to greater reductions in health disparities, and cost 150 international dollars (I$) per year of life saved (YLS). At higher baseline screening coverage levels (i.e., 70%), screening three times in a lifetime yielded greater health benefits than expanding screening once in a lifetime to 90% coverage, and would have a cost‐effectiveness ratio (I$590 per YLS) below Uganda's per capita GDP. Given very low baseline coverage at present, we conclude that a policy focus on increasing access for previously unscreened women appears to be more compatible with improving both equity and efficiency than a focus on increasing frequency for a small subset of women. PMID:27925175

The determinants of long-term care utilization and equity of access to care among older adults in Dong-Ku of Incheon Metropolitan city, South Korea.

PubMed

Park, J M

2005-01-01

Under the current health care system, around three percent of the elderly remain uninsured. Based on the 2003 Dong-Ku Health Status Survey and the Aday and Andersen Access Framework, the present study examined the social and behavioral determinants of long-term care utilization and the extent to which equity in the use of long-term care services for the elderly has been achieved. The results indicate that universal health insurance system has not yielded a fully equitable distribution of services. Type of coverage and resource availability do not remain predictors of long-term care utilization. The data suggest that a universal health insurance system exists in South Korea with significant access problems for the population without insurance. Access differences also arise from obstacles in expanding the scope and level of plan benefits due to financial disparity among insurers. Health policy reforms must continue to concentrate on extending insurance coverage to the uninsured and establishing long-term insurance system for the elderly.

24 CFR 964.308 - Supportive services requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... URBAN DEVELOPMENT TENANT PARTICIPATION AND TENANT OPPORTUNITIES IN PUBLIC HOUSING Family Investment... expanded services essential to providing families in public housing with better access to educational and..., and assistance in the attainment of certificates of high school equivalency); (e) Business...

21 CFR 312.305 - Requirements for all expanded access uses.

Code of Federal Regulations, 2012 CFR

2012-04-01

... contained in an existing IND if the sponsor of the existing IND grants a right of reference to the IND. (2... therapeutic options that would ordinarily be tried before resorting to the investigational drug or an...

21 CFR 312.305 - Requirements for all expanded access uses.

Code of Federal Regulations, 2011 CFR

2011-04-01

... contained in an existing IND if the sponsor of the existing IND grants a right of reference to the IND. (2... therapeutic options that would ordinarily be tried before resorting to the investigational drug or an...

21 CFR 312.305 - Requirements for all expanded access uses.

Code of Federal Regulations, 2014 CFR

2014-04-01

... contained in an existing IND if the sponsor of the existing IND grants a right of reference to the IND. (2... therapeutic options that would ordinarily be tried before resorting to the investigational drug or an...

21 CFR 312.305 - Requirements for all expanded access uses.

Code of Federal Regulations, 2013 CFR

2013-04-01

... contained in an existing IND if the sponsor of the existing IND grants a right of reference to the IND. (2... therapeutic options that would ordinarily be tried before resorting to the investigational drug or an...

78 FR 17416 - Agency Information Collection Activities; Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-21

...). Since the purpose of the Part A MAI is to expand access to medical, health, and social support services... for HIV/AIDS care and support services that are most severely affected by the HIV/AIDS epidemic...

Health benefits, costs, and cost-effectiveness of earlier eligibility for adult antiretroviral therapy and expanded treatment coverage: a combined analysis of 12 mathematical models.

PubMed

Eaton, Jeffrey W; Menzies, Nicolas A; Stover, John; Cambiano, Valentina; Chindelevitch, Leonid; Cori, Anne; Hontelez, Jan A C; Humair, Salal; Kerr, Cliff C; Klein, Daniel J; Mishra, Sharmistha; Mitchell, Kate M; Nichols, Brooke E; Vickerman, Peter; Bakker, Roel; Bärnighausen, Till; Bershteyn, Anna; Bloom, David E; Boily, Marie-Claude; Chang, Stewart T; Cohen, Ted; Dodd, Peter J; Fraser, Christophe; Gopalappa, Chaitra; Lundgren, Jens; Martin, Natasha K; Mikkelsen, Evelinn; Mountain, Elisa; Pham, Quang D; Pickles, Michael; Phillips, Andrew; Platt, Lucy; Pretorius, Carel; Prudden, Holly J; Salomon, Joshua A; van de Vijver, David A M C; de Vlas, Sake J; Wagner, Bradley G; White, Richard G; Wilson, David P; Zhang, Lei; Blandford, John; Meyer-Rath, Gesine; Remme, Michelle; Revill, Paul; Sangrujee, Nalinee; Terris-Prestholt, Fern; Doherty, Meg; Shaffer, Nathan; Easterbrook, Philippa J; Hirnschall, Gottfried; Hallett, Timothy B

2013-12-10

New WHO guidelines recommend ART initiation for HIV-positive persons with CD4 cell counts ≤500 cells/µL, a higher threshold than was previously recommended. Country decision makers must consider whether to further expand ART eligibility accordingly. We used multiple independent mathematical models in four settings-South Africa, Zambia, India, and Vietnam-to evaluate the potential health impact, costs, and cost-effectiveness of different adult ART eligibility criteria under scenarios of current and expanded treatment coverage, with results projected over 20 years. Analyses considered extending eligibility to include individuals with CD4 ≤500 cells/µL or all HIV-positive adults, compared to the previous recommendation of initiation with CD4 ≤350 cells/µL. We assessed costs from a health system perspective, and calculated the incremental cost per DALY averted ($/DALY) to compare competing strategies. Strategies were considered 'very cost-effective' if the $/DALY was less than the country's per capita gross domestic product (GDP; South Africa: $8040, Zambia: $1425, India: $1489, Vietnam: $1407) and 'cost-effective' if $/DALY was less than three times per capita GDP. In South Africa, the cost per DALY averted of extending ART eligibility to CD4 ≤500 cells/µL ranged from $237 to $1691/DALY compared to 2010 guidelines; in Zambia, expanded eligibility ranged from improving health outcomes while reducing costs (i.e. dominating current guidelines) to $749/DALY. Results were similar in scenarios with substantially expanded treatment access and for expanding eligibility to all HIV-positive adults. Expanding treatment coverage in the general population was therefore found to be cost-effective. In India, eligibility for all HIV-positive persons ranged from $131 to $241/DALY and in Vietnam eligibility for CD4 ≤500 cells/µL cost $290/DALY. In concentrated epidemics, expanded access among key populations was also cost-effective. Earlier ART eligibility is estimated to be very cost-effective in low- and middle-income settings, although these questions should be revisited as further information becomes available. Scaling-up ART should be considered among other high-priority health interventions competing for health budgets. The Bill and Melinda Gates Foundation and World Health Organization.

Impacts of extension access and cooperative membership on technology adoption and household welfare.

PubMed

Wossen, Tesfamicheal; Abdoulaye, Tahirou; Alene, Arega; Haile, Mekbib G; Feleke, Shiferaw; Olanrewaju, Adetunji; Manyong, Victor

2017-08-01

This paper examines the impacts of access to extension services and cooperative membership on technology adoption, asset ownership and poverty using household-level data from rural Nigeria. Using different matching techniques and endogenous switching regression approach, we find that both extension access and cooperative membership have a positive and statistically significant effect on technology adoption and household welfare. Moreover, we find that both extension access and cooperative membership have heterogeneous impacts. In particular, we find evidence of a positive selection as the average treatment effects of extension access and cooperative membership are higher for farmers with the highest propensity to access extension and cooperative services. The impact of extension services on poverty reduction and of cooperatives on technology adoption is significantly stronger for smallholders with access to formal credit than for those without access. This implies that expanding rural financial markets can maximize the potential positive impacts of extension and cooperative services on farmers' productivity and welfare.

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

PubMed

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

2017-12-01

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

Universal health coverage in Turkey: enhancement of equity.

PubMed

Atun, Rifat; Aydın, Sabahattin; Chakraborty, Sarbani; Sümer, Safir; Aran, Meltem; Gürol, Ipek; Nazlıoğlu, Serpil; Ozgülcü, Senay; Aydoğan, Ulger; Ayar, Banu; Dilmen, Uğur; Akdağ, Recep

2013-07-06

Turkey has successfully introduced health system changes and provided its citizens with the right to health to achieve universal health coverage, which helped to address inequities in financing, health service access, and health outcomes. We trace the trajectory of health system reforms in Turkey, with a particular emphasis on 2003-13, which coincides with the Health Transformation Program (HTP). The HTP rapidly expanded health insurance coverage and access to health-care services for all citizens, especially the poorest population groups, to achieve universal health coverage. We analyse the contextual drivers that shaped the transformations in the health system, explore the design and implementation of the HTP, identify the factors that enabled its success, and investigate its effects. Our findings suggest that the HTP was instrumental in achieving universal health coverage to enhance equity substantially, and led to quantifiable and beneficial effects on all health system goals, with an improved level and distribution of health, greater fairness in financing with better financial protection, and notably increased user satisfaction. After the HTP, five health insurance schemes were consolidated to create a unified General Health Insurance scheme with harmonised and expanded benefits. Insurance coverage for the poorest population groups in Turkey increased from 2·4 million people in 2003, to 10·2 million in 2011. Health service access increased across the country-in particular, access and use of key maternal and child health services improved to help to greatly reduce the maternal mortality ratio, and under-5, infant, and neonatal mortality, especially in socioeconomically disadvantaged groups. Several factors helped to achieve universal health coverage and improve outcomes. These factors include economic growth, political stability, a comprehensive transformation strategy led by a transformation team, rapid policy translation, flexible implementation with continuous learning, and simultaneous improvements in the health system, on both the demand side (increased health insurance coverage, expanded benefits, and reduced cost-sharing) and the supply side (expansion of infrastructure, health human resources, and health services). Copyright © 2013 Elsevier Ltd. All rights reserved.

U.S. Physicians’ Views on Financing Options to Expand Health Insurance Coverage: A National Survey

PubMed Central

Woolhandler, Steffie; Bose-Kolanu, Anjali; Germann, Antonio; Bor, David H.; Himmelstein, David U.

2009-01-01

BACKGROUND Physician opinion can influence the prospects for health care reform, yet there are few recent data on physician views on reform proposals or access to medical care in the United States. OBJECTIVE To assess physician views on financing options for expanding health care coverage and on access to health care. DESIGN AND PARTICIPANTS Nationally representative mail survey conducted between March 2007 and October 2007 of U.S. physicians engaged in direct patient care. MEASUREMENTS Rated support for reform options including financial incentives to induce individuals to purchase health insurance and single-payer national health insurance; rated views of several dimensions of access to care. MAIN RESULTS 1,675 of 3,300 physicians responded (50.8%). Only 9% of physicians preferred the current employer-based financing system. Forty-nine percent favored either tax incentives or penalties to encourage the purchase of medical insurance, and 42% preferred a government-run, taxpayer-financed single-payer national health insurance program. The majority of respondents believed that all Americans should receive needed medical care regardless of ability to pay (89%); 33% believed that the uninsured currently have access to needed care. Nearly one fifth of respondents (19.3%) believed that even the insured lack access to needed care. Views about access were independently associated with support for single-payer national health insurance. CONCLUSIONS The vast majority of physicians surveyed supported a change in the health care financing system. While a plurality support the use of financial incentives, a substantial proportion support single payer national health insurance. These findings challenge the perception that fundamental restructuring of the U.S. health care financing system receives little acceptance by physicians. PMID:19184240

On-line atomic data access

NASA Astrophysics Data System (ADS)

Schultz, David R.; Nash, Jeffrey K.

1996-07-01

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

Evidence from the Private Option: The Arkansas Experience.

PubMed

Maylone, Bethany; Sommers, Benjamin D

2017-02-01

Issue: Arkansas was the first state to receive approval to expand Medicaid under the Affordable Care Act through a Section 1115 waiver. This approach, known as the "private option," uses Medicaid funds to purchase private health plans on the state’s marketplace. It is intended to promote market competition, continuity of coverage, and greater access to care. Goal: To describe the key features of the private option and evaluate its impact on health care for low-income adults in the state after two years. Methods: Survey data from 2013–2015 that assessed health insurance coverage, access to care, utilization, and self-reported health among low-income adults in Arkansas compared to adults in two other states. Key findings and conclusions: Arkansas’s private option improved access to primary care and prescription medications, reduced reliance on the emergency department, increased use of preventive care, and improved perceptions of quality and health among low-income adults in the state, compared to Texas, which did not expand Medicaid. Arkansas’s benefits were similar to those observed in Kentucky’s traditional Medicaid expansion. Churning in coverage remained a challenge for nearly a quarter of low-income adults each year.

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

PubMed

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

2013-01-01

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

[Trimming with argon plasma of self-expanding metal stents: report of 7 cases].

PubMed

Jury, Gastón; Amieva, Leandro; López, Fagalde Rafael; Jury, Rubén

2014-06-01

The use of self-expandable enteral stents for palliation of malignant stenosis may present the complication of concealing the ampulla of Vater behind the metallic mesh. Anchoring in the duodenal wall (distal or partial migration) may also be a complication of biliary metallic stents and therefore may cause difficulty in gaining access to the biliary tract. In these cases of difficult access, a fenestration on the prosthesis ( biliary or enteral) can be created to allow reaching the obstructed biliary tract by means of argon plasma (AP). Were retrospectively analysed 7 cases. Under endoscopic vision, AP was directed to filgurate and cut 6 biliary prosthesis and a duodenal stent. Fulguration and cut of biliary stent was performed in 5 cases of distal partial migration and cholangitis. In one case of obstruction caused by distal migration inside the duodenal stent light, cutting of the biliary stent was performed. A window was created in the enteral prosthesis in order to access the ampulla of Vater and place a biliary tract prosthesis. All cases were resolved successfully and without complications. We conclude that the use of AP to fulgurate and cut nitinol prosthesis was effective and presented no complications in this series.

Judicialization 2.0: Understanding right-to-health litigation in real time.

PubMed

Biehl, João; Socal, Mariana P; Gauri, Varun; Diniz, Debora; Medeiros, Marcelo; Rondon, Gabriela; Amon, Joseph J

2018-05-21

Over the past two decades, debate over the whys, the hows, and the effects of the ever-expanding phenomenon of right-to-health litigation ('judicialization') throughout Latin America have been marked by polarised arguments and limited information. In contrast to claims of judicialization as a positive or negative trend, less attention has been paid to ways to better understand the phenomenon in real time. In this article, we propose a new approach-Judicialization 2.0-that recognises judicialization as an integral part of democratic life. This approach seeks to expand access to information about litigation on access to medicines (and health care generally) in order to better characterise the complexity of the phenomenon and thus inform new research and more robust public discussions. Drawing from our multi-disciplinary perspectives and field experiences in highly judicialized contexts, we thus describe a new multi-source, multi-stakeholder mixed-method approach designed to capture the patterns and heterogeneity of judicialization and understand its medical and socio-political impact in real time, along with its counterfactuals. By facilitating greater data availability and open access, we can drive advancements towards transparent and participatory priority setting, as well as accountability mechanisms that promote quality universal health coverage.

Web-based access to near real-time and archived high-density time-series data: cyber infrastructure challenges & developments in the open-source Waveform Server

NASA Astrophysics Data System (ADS)

Reyes, J. C.; Vernon, F. L.; Newman, R. L.; Steidl, J. H.

2010-12-01

The Waveform Server is an interactive web-based interface to multi-station, multi-sensor and multi-channel high-density time-series data stored in Center for Seismic Studies (CSS) 3.0 schema relational databases (Newman et al., 2009). In the last twelve months, based on expanded specifications and current user feedback, both the server-side infrastructure and client-side interface have been extensively rewritten. The Python Twisted server-side code-base has been fundamentally modified to now present waveform data stored in cluster-based databases using a multi-threaded architecture, in addition to supporting the pre-existing single database model. This allows interactive web-based access to high-density (broadband @ 40Hz to strong motion @ 200Hz) waveform data that can span multiple years; the common lifetime of broadband seismic networks. The client-side interface expands on it's use of simple JSON-based AJAX queries to now incorporate a variety of User Interface (UI) improvements including standardized calendars for defining time ranges, applying on-the-fly data calibration to display SI-unit data, and increased rendering speed. This presentation will outline the various cyber infrastructure challenges we have faced while developing this application, the use-cases currently in existence, and the limitations of web-based application development.

Randomized, community-based pharmacy intervention to expand services beyond sale of sterile syringes to injection drug users in pharmacies in New York City.

PubMed

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

2013-09-01

Structural interventions may help reduce racial/ethnic disparities in HIV. In 2009 to 2011, we randomized pharmacies participating in a nonprescription syringe access program in minority communities to intervention (pharmacy enrolled and delivered HIV risk reduction information to injection drug users [IDUs]), primary control (pharmacy only enrolled IDUs), and secondary control (pharmacy did not engage IDUs). Intervention pharmacy staff reported more support for syringe sales than did control staff. An expanded pharmacy role in HIV risk reduction may be helpful.

Pediatric caregiver attitudes toward email communication: survey in an urban primary care setting.

PubMed

Dudas, Robert Arthur; Crocetti, Michael

2013-10-23

Overall usage of email communication between patients and physicians continues to increase, due in part to expanding the adoption of electronic health records and patient portals. Unequal access and acceptance of these technologies has the potential to exacerbate disparities in care. Little is known about the attitudes of pediatric caregivers with regard to their acceptance of email as a means to communicate with their health care providers. We conducted a survey to assess pediatric caregiver access to and attitudes toward the use of electronic communication modalities to communicate with health care providers in an urban pediatric primary care clinic. Participants were pediatric caregivers recruited from an urban pediatric primary care clinic in Baltimore, Maryland, who completed a 35-item questionnaire in this cross-sectional study. Of the 229 caregivers who completed the survey (91.2% response rate), 171 (74.6%) reported that they use email to communicate with others. Of the email users, 145 respondents (86.3%) stated that they would like to email doctors, although only 18 (10.7%) actually do so. Among email users, African-American caregivers were much less likely to support the expanded use of email communication with health care providers (adjusted OR 0.34, 95% CI 0.14-0.82) as were those with annual incomes less than US $30,000 (adjusted OR 0.26, 95% CI 0.09-0.74). Caregivers of children have access to email and many would be interested in communicating with health care providers. However, African-Americans and those in lower socioeconomic groups were much less likely to have positive attitudes toward email.

Comparative transcriptome analysis provides new insights into erect and prostrate growth in bermudagrass (Cynodon dactylon L.).

PubMed

Zhang, Bing; Xiao, Xiaolin; Zong, Junqin; Chen, Jingbo; Li, Jianjian; Guo, Hailin; Liu, Jianxiu

2017-12-01

Bermudagrass (Cynodon dactylon L.) is a prominent warm-season turf and forage grass species with multiple applications. In most C. dactylon cultivars and accessions, erect-growing stems (shoot) and prostrate-growing stems (stolon) often coexist. These two types of stems are both formed through tillering but grow in two directions with different tiller angles. Elucidating the mechanism of tiller angle regulation in bermudagrass could provide important clues to breed cultivars with different plant architectural features for diverse usage. In this study, we compared the stem internode transcriptome of two bermudagrass wild accessions with extremely different tiller angles and stem growth directions. A total of 2088 and 12,141 unigenes were preferentially expressed in prostrate-growing wild accession C792 and erect-growing wild accession C793, respectively. Kyoto Encyclopedia of Genes and Genomes (KEGG) Orthology-based Annotation System (KOBAS) analyses further indicated that light- and gravity-responsive genes were enriched in accession C792, whereas lignin synthesis-related genes were enriched in accession C793, which well explains the difference in lignification of vascular bundles and mechanical tissues in the two accessions. These results not only expand our understanding of the genetic control of tiller angle and stem growth direction in bermudagrass but also provide insight for future molecular breeding of C. dactylon and other turfgrass species with different plant architectures. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Fertility intentions and interest in integrated family planning services among women living with HIV in Nyanza Province, Kenya: a qualitative study.

PubMed

Harrington, Elizabeth K; Newmann, Sara J; Onono, Maricianah; Schwartz, Katie D; Bukusi, Elizabeth A; Cohen, Craig R; Grossman, Daniel

2012-01-01

Despite increasing efforts to address the reproductive health needs of people living with HIV, a high unmet need for contraception exists among HIV+ women in sub-Saharan Africa. This study explores the fertility intentions and family planning (FP) preferences of Kenyan women accessing HIV treatment. We conducted 30 semistructured interviews and qualitatively analyzed the data with a grounded theory approach. Fears of premature death, financial hardship, and perinatal HIV transmission emerged as reasons for participants' desire to delay/cease childbearing. Participants strongly identified FP needs, yet two-thirds were using male condoms alone or no modern method of contraception. Women preferred the HIV clinic as the site of FP access for reasons of convenience, provider expertise, and a sense of belonging, though some had privacy concerns. Our findings support the acceptability of integrated FP and HIV services. Efforts to empower women living with HIV to prevent unintended pregnancies must expand access to contraceptive methods, provide confidential services, and take into account women's varied reproductive intentions.

Big pharma screening collections: more of the same or unique libraries? The AstraZeneca-Bayer Pharma AG case.

PubMed

Kogej, Thierry; Blomberg, Niklas; Greasley, Peter J; Mundt, Stefan; Vainio, Mikko J; Schamberger, Jens; Schmidt, Georg; Hüser, Jörg

2013-10-01

In this study, the screening collections of two major pharmaceutical companies (AstraZeneca and Bayer Pharma AG) have been compared using a 2D molecular fingerprint by a nearest neighborhood approach. Results revealed a low overlap between both collections in terms of compound identity and similarity. This emphasizes the value of screening multiple compound collections to expand the chemical space that can be accessed by high-throughput screening (HTS). Copyright © 2012 Elsevier Ltd. All rights reserved.

Considering disparities: How do nurse practitioner regulatory policies, access to care, and health outcomes vary across four states?

PubMed

Sonenberg, Andréa; Knepper, Hillary J

Health disparities persist among morbidity and mortality rates in the United States. Contributing significantly to these disparities are the ability to pay for health care (largely, access to health insurance) and access to, and capacity of, the primary care health workforce. This article examines key determinants of health (DOH) including demographics, public and regulatory policies, health workforce capacity, and primary health outcomes of four states of the United States. The context of this study is the potential association among health care disparities and myriad DOH, among them, the restrictive nurse practitioner (NP) scope of practice (SOP) regulatory environment, which are documented to influence access to care and health outcomes. This descriptive study explores current NP SOP regulations, access to primary care, and health outcomes of key chronic disease indicators-diabetes, hypertension, and obesity in Alabama, Colorado, Mississippi, and Utah. These states represent both the greatest disparity in chronic disease health outcomes (obesity, diabetes, and hypertension) and the greatest difference in modernization of their NP SOP laws. The Affordable Care Act has greatly expanded access to health care. However, it is estimated that 23 million Americans, 7% of its total population, will remain uninsured by 2019. Restrictive and inconsistent NP SOP policies may continue to contribute to health workforce capacity and population health disparities across the country, with particular concern for primary care indicators. The study findings bring into question whether states with more restrictive NP SOP regulations impact access to primary care, which may in turn influence population health outcomes. These findings suggest the need for further research. NPs are essential for meeting the increasing demands of primary care in the United States, and quality-of-care indicator research supports their use. Copyright © 2016 Elsevier Inc. All rights reserved.

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

NASA Technical Reports Server (NTRS)

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

1999-01-01

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

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

PubMed

Widener, Michael J; Shannon, Jerry

2014-11-01

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

WICHE Workplan FY 2016

ERIC Educational Resources Information Center

Western Interstate Commission for Higher Education, 2015

2015-01-01

The Western Interstate Commission for Higher Education (WICHE) and its 16 member states and territories work collaboratively to expand educational access and excellence for their citizens. By promoting innovation, cooperation, resource sharing, and sound public policy, WICHE strengthens higher education's contributions to social, economic, and…

Recommended emergency preparedness guidelines for elderly and disabled rail transit passengers

DOT National Transportation Integrated Search

1992-02-01

Rail transit has become an important source of transportation for many elderly and disabled persons. The principal reasons forthis increased use are improved accessibility, low cost, and expanded areas of service. For the purposes of this report, "el...

NCTN/NCORP Data Archive: Expanding Access to Clinical Trial Data

Cancer.gov

NCI is launching the NCTN/NCORP Data Archive, a centralized repository of patient-level data from phase III clinical trials conducted by NCI’s NCTN and NCORP trials programs and the National Cancer Institute of Canada-Clinical Trials Group.

Calling for an end to attacks on Syrian civilians and expanded humanitarian access.

THOMAS, 113th Congress

Rep. Royce, Edward R. [R-CA-39

2014-03-14

House - 04/30/2014 Ordered to be Reported in the Nature of a Substitute (Amended) by Unanimous Consent. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Synchrotron Radiation Research--An Overview.

ERIC Educational Resources Information Center

Bienenstock, Arthur; Winick, Herman

1983-01-01

Discusses expanding user community seeking access to synchrotron radiation sources, properties/sources of synchrotron radiation, permanent-magnet technology and its impact on synchrotron radiation research, factors limiting power, the density of synchrotron radiation, and research results illustrating benefit of higher flux and brightness. Also…

75 FR 12747 - FDIC Advisory Committee on Economic Inclusion (ComE-IN); Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-17

.... SUMMARY: In accordance with the Federal Advisory Committee Act, notice is hereby given of a meeting of the... Committee will provide advice and recommendations on initiatives to expand access to banking services by...

78 FR 25442 - FDIC Advisory Committee on Economic Inclusion (ComE-IN); Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-01

.... SUMMARY: In accordance with the Federal Advisory Committee Act, notice is hereby given of a meeting of the... Committee will provide advice and recommendations on initiatives to expand access to banking services by...

77 FR 21773 - FDIC Advisory Committee on Economic Inclusion (ComE-IN); Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-11

.... SUMMARY: In accordance with the Federal Advisory Committee Act, notice is hereby given of a meeting of the... Committee will provide advice and recommendations on initiatives to expand access to banking services by...

77 FR 71001 - FDIC Advisory Committee on Economic Inclusion (ComE-IN); Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-28

.... SUMMARY: In accordance with the Federal Advisory Committee Act, notice is hereby given of a meeting of the... Committee will provide advice and recommendations on initiatives to expand access to banking services by...

76 FR 28778 - FDIC Advisory Committee on Economic Inclusion (ComE-IN); Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-18

.... SUMMARY: In accordance with the Federal Advisory Committee Act, notice is hereby given of a meeting of the... Committee will provide advice and recommendations on initiatives to expand access to banking services by...

75 FR 32778 - FDIC Advisory Committee on Economic Inclusion (ComE-IN); Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-09

.... SUMMARY: In accordance with the Federal Advisory Committee Act, notice is hereby given of a meeting of the... Committee will provide advice and recommendations on initiatives to expand access to banking services by...

77 FR 52031 - FDIC Advisory Committee on Economic Inclusion (ComE-IN); Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-28

.... SUMMARY: In accordance with the Federal Advisory Committee Act, notice is hereby given of a meeting of the... Committee will provide advice and recommendations on initiatives to expand access to banking services by...

75 FR 67091 - FDIC Advisory Committee on Economic Inclusion (ComE-IN); Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-01

.... SUMMARY: In accordance with the Federal Advisory Committee Act, notice is hereby given of a meeting of the... Committee will provide advice and recommendations on initiatives to expand access to banking services by...

76 FR 8738 - FDIC Advisory Committee on Economic Inclusion (ComE-IN); Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-15

.... SUMMARY: In accordance with the Federal Advisory Committee Act, notice is hereby given of a meeting of the... Committee will provide advice and recommendations on initiatives to expand access to banking services by...

76 FR 71033 - FDIC Advisory Committee on Economic Inclusion (ComE-IN); Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-16

.... SUMMARY: In accordance with the Federal Advisory Committee Act, notice is hereby given of a meeting of the... Committee will provide advice and recommendations on initiatives to expand access to banking services by...

78 FR 58537 - FDIC Advisory Committee on Economic Inclusion (ComE-IN); Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-24

.... SUMMARY: In accordance with the Federal Advisory Committee Act, notice is hereby given of a meeting of the... Committee will provide advice and recommendations on initiatives to expand access to banking services by...

Student Work Safety Guidelines in Roadside Applications and Work Zones : Safety Guidelines for Transportation Researchers

DOT National Transportation Integrated Search

2018-01-01

The Smart City Demonstration Program is intended to improve access through expanded mobility options in major job centers, enhance visitor experience by better connecting visitors to transportation options, stimulate regional economic prosperity and ...

3 CFR 8794 - Proclamation 8794 of April 2, 2012. National Sexual Assault Awareness and Prevention Month, 2012

Code of Federal Regulations, 2013 CFR

2013-01-01

..., and many victims, male and female, first experience abuse during childhood. The trauma of sexual... training and education in the criminal justice system; and expand access to critical health, legal, and...

Access to Workplace Accommodations to Support Breastfeeding after Passage of the Affordable Care Act.

PubMed

Kozhimannil, Katy B; Jou, Judy; Gjerdingen, Dwenda K; McGovern, Patricia M

2016-01-01

This study examines access to workplace accommodations for breastfeeding, as mandated by the Affordable Care Act, and its associations with breastfeeding initiation and duration. We hypothesize that women with access to reasonable break time and private space to express breast milk would be more likely to breastfeed exclusively at 6 months and to continue breastfeeding for a longer duration. Data are from Listening to Mothers III, a national survey of women ages 18 to 45 who gave birth in 2011 and 2012. The study population included women who were employed full or part time at the time of survey. Using two-way tabulation, logistic regression, and survival analysis, we characterized women with access to breastfeeding accommodations and assessed the associations between these accommodations and breastfeeding outcomes. Only 40% of women had access to both break time and private space. Women with both adequate break time and private space were 2.3 times (95% CI, 1.03-4.95) as likely to be breastfeeding exclusively at 6 months and 1.5 times (95% CI, 1.08-2.06) as likely to continue breastfeeding exclusively with each passing month compared with women without access to these accommodations. Employed women face unique barriers to breastfeeding and have lower rates of breastfeeding initiation and shorter durations, despite compelling evidence of associated health benefits. Expanded access to workplace accommodations for breastfeeding will likely entail collaborative efforts between public health agencies, employers, insurers, and clinicians to ensure effective workplace policies and improved breastfeeding outcomes. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

How far will they go? Assessing the travel distance of current and former drug users to access harm reduction services.

PubMed

Allen, Sean; Ruiz, Monica; O'Rourke, Allison

2015-03-01

Prior research has explored spatial access to syringe exchange programs (SEPs) among people who inject drugs (PWID), but little is known about service utilization by former PWID who continue to access services (e.g., HIV screenings and referrals for social services) at harm reduction providers. The purpose of this research is to examine differences in access to SEPs between current and former PWID seeking services at a mobile SEP in Washington, DC. A geometric point distance estimation technique was applied to data collected as part of a PWID population estimation study that took place in Washington, DC, in March and April 2014. We calculated the walking distance from the centroid point of home residence zip code to the mobile exchange site where PWID presented for services. An independent samples t-test was used to examine differences in walking distance measures between current and former PWID. Differences in mean walking distance were statistically significant with current and former PWID having mean walking distances of 2.75 and 1.80 miles, respectively. The results of this study suggest that former PWID who are engaging with SEPs primarily for non-needle exchange services (e.g., medical or social services) may have decreased access to SEPs than their counterparts who are active injectors. This research provides support for expanding SEP operations such that both active and former PWID have increased access to harm reduction providers and associated health and social services. Increasing service accessibility may help resolve unmet needs among current and former PWID.

Access to workplace accommodations to support breastfeeding after passage of the Affordable Care Act

PubMed Central

Kozhimannil, Katy B.; Jou, Judy; Gjerdingen, Dwenda K.; McGovern, Patricia M.

2015-01-01

Objectives This study examines access to workplace accommodations for breastfeeding, as mandated by the Affordable Care Act, and its associations with breastfeeding initiation and duration. We hypothesize that women with access to reasonable break time and private space to express breast milk would be more likely to breastfeed exclusively at 6 months and to continue breastfeeding for a longer duration. Methods Data are from Listening to Mothers III, a national survey of women ages 18–45 who gave birth in 2011–2012. The study population included women who were employed full- or part-time at the time of survey. Using two-way tabulation, logistic regression, and survival analysis, we characterized women with access to breastfeeding accommodations and assessed the associations between these accommodations and breastfeeding outcomes. Results Only 40% of women had access to both break time and private space. Women with both adequate break time and private space were 2.3 times (95% CI 1.03, 4.95) as likely to be breastfeeding exclusively at 6 months and 1.5 times (95% CI 1.08, 2.06) as likely to continue breastfeeding exclusively with each passing month compared to women without access to these accommodations. Conclusions Employed women face unique barriers to breastfeeding and have lower rates of breastfeeding initiation and shorter durations, despite compelling evidence of associated health benefits. Expanded access to workplace accommodations for breastfeeding will likely entail collaborative efforts between public health agencies, employers, insurers, and clinicians to ensure effective workplace policies and improved breastfeeding outcomes. PMID:26474955

Public opinion on media presence in the courthouse.

PubMed

Fusco, Nina Marie; Sabourin, Michel

2012-01-01

Very little attention has been devoted to the public's opinion of media coverage of court cases despite extensive research on pretrial publicity (PTP). Following a provincial judgment to restrict media access in Quebec courthouses, a preliminary unpublished study found that the public was largely in support of these restrictions. The present study sought to expand on this finding in a more widely generalizable sample. Subjects were recruited from continuing education classes and completed a questionnaire that assessed their support for restricting journalists in courthouses. Nearly 80% of the 243 participants supported media restrictions. Although participants in the four experimental conditions and one of the control groups were largely in favor of the restrictions, one control group was opposed to the restrictions. The results suggest that the public prefers that journalists have restricted access to courtroom participants, resonating research on PTP and the Supreme Court's decision on the case. Copyright © 2011 Elsevier Ltd. All rights reserved.

Calorimetric study of water's two glass transitions in the presence of LiCl

PubMed Central

Ruiz, Guadalupe N.; Amann-Winkel, Katrin; Bove, Livia E.; Corti, Horacio R.

2018-01-01

A DSC study of dilute glassy LiCl aqueous solutions in the water-dominated regime provides direct evidence of a glass-to-liquid transition in expanded high density amorphous (eHDA)-type solutions. Similarly, low density amorphous ice (LDA) exhibits a glass transition prior to crystallization to ice Ic. Both glass transition temperatures are independent of the salt concentration, whereas the magnitude of the heat capacity increase differs. By contrast to pure water, the glass transition endpoint for LDA can be accessed in LiCl aqueous solutions above 0.01 mole fraction. Furthermore, we also reveal the endpoint for HDA's glass transition, solving the question on the width of both glass transitions. This suggests that both equilibrated HDL and LDL can be accessed in dilute LiCl solutions, supporting the liquid–liquid transition scenario to understand water's anomalies. PMID:29442107

Accessibility of summer meals and the food insecurity of low-income households with children.

PubMed

Miller, Daniel P

2016-08-01

Almost no previous research has examined the impact of the US Department of Agriculture's (USDA) Summer Food Service Program and related Seamless Summer Option, which provide meals and snacks to low-income children over the summer. The present study investigated whether geographic accessibility of summer meals programme sites (a proxy for programme participation) was associated with food insecurity for low-income households. The study used data from the California Health Interview Survey (CHIS) and administrative data on summer meals sites in California. Geocoding was used to calculate driving time between CHIS households and nearby summer meals sites. Geographic accessibility was measured using a gravity model, which accounted for the spatially distributed supply of and demand for summer meals. Food insecurity and very low food security were measured using a standard six-item measure from the USDA. Low-income families with children (n 5394). A representative surveillance study of non-institutionalized households in California. Geographic accessibility was not associated with food insecurity. However, geographic accessibility was associated with a significantly lower probability of very low food security in the full sample and among households with younger children and those living in less urban areas. The USDA's summer meals programme may be effective at reducing the most severe form of food insecurity for low-income households with children. Expanding the number of summer meals sites, the number of meals served at sites and sites' hours of operation may be effective strategies to promote nutritional health over the summer months.

The Role of Remote Sensing in Assessing Forest Biomass in Appalachian South Carolina

NASA Technical Reports Server (NTRS)

Shain, W.; Nix, L.

1982-01-01

Information is presented on the use of color infrared aerial photographs and ground sampling methods to quantify standing forest biomass in Appalachian South Carolina. Local tree biomass equations are given and subsequent evaluation of stand density and size classes using remote sensing methods is presented. Methods of terrain analysis, environmental hazard rating, and subsequent determination of accessibility of forest biomass are discussed. Computer-based statistical analyses are used to expand individual cover-type specific ground sample data to area-wide cover type inventory figures based on aerial photographic interpretation and area measurement. Forest biomass data are presented for the study area in terms of discriminant size classes, merchantability limits, accessibility (as related to terrain and yield/harvest constraints), and potential environmental impact of harvest.

Changes in Health Insurance Coverage and Barriers to Health Care Access Among Individuals with Serious Psychological Distress Following the Affordable Care Act.

PubMed

Novak, Priscilla; Anderson, Andrew C; Chen, Jie

2018-05-12

The Affordable Care Act (ACA) aims to expand health insurance coverage and minimize financial barriers to receiving health care services for individuals. However, little is known about how the ACA has impacted individuals with mental health conditions. This study finds that the implementation of the ACA is associated with an increase in rate of health insurance coverage among nonelderly adults with serious psychological distress (SPD) and a reduction in delaying and forgoing necessary care. The ACA also reduced the odds of an individual with SPD not being able to afford mental health care. Mental health care access among racial and ethnic minority populations and people with low income has improved during 2014-2016, but gaps remain.

Pharmacies as providers of expanded health services for people who inject drugs: a review of laws, policies, and barriers in six countries.

PubMed

Hammett, Theodore M; Phan, Son; Gaggin, Julia; Case, Patricia; Zaller, Nicholas; Lutnick, Alexandra; Kral, Alex H; Fedorova, Ekaterina V; Heimer, Robert; Small, Will; Pollini, Robin; Beletsky, Leo; Latkin, Carl; Des Jarlais, Don C

2014-06-17

People who inject drugs (PWID) are underserved by health providers but pharmacies may be their most accessible care settings. Studies in the U.S., Russia, Vietnam, China, Canada and Mexico employed a three-level (macro-, meso-, and micro-) model to assess feasibility of expanded pharmacy services for PWID. Studies employed qualitative and quantitative interviews, review of legal and policy documents, and information on the knowledge, attitudes, and practices of key stakeholders. Studies produced a mixed assessment of feasibility. Provision of information and referrals by pharmacies is permissible in all study sites and sale and safe disposal of needles/syringes by pharmacies is legal in almost all sites, although needle/syringe sales face challenges related to attitudes and practices of pharmacists, police, and other actors. Pharmacy provision of HIV testing, hepatitis vaccination, opioid substitution treatment, provision of naloxone for drug overdose, and abscess treatment, face more serious legal and policy barriers. Challenges to expanded services for drug users in pharmacies exist at all three levels, especially the macro-level characterized by legal barriers and persistent stigmatization of PWID. Where deficiencies in laws, policies, and community attitudes block implementation, stakeholders should advocate for needed legal and policy changes and work to address community stigma and resistance. Laws and policies are only as good as their implementation, so attention is also needed to meso- and micro- levels. Policies, attitudes, and practices of police departments and pharmacy chains as well as knowledge, attitudes, and practices of individual PWID, individual pharmacies, and police officers should support rather than undermine positive laws and expanded services. Despite the challenges, pharmacies remain potentially important venues for delivering health services to PWID.

Pharmacies as providers of expanded health services for people who inject drugs: a review of laws, policies, and barriers in six countries

PubMed Central

2014-01-01

Background People who inject drugs (PWID) are underserved by health providers but pharmacies may be their most accessible care settings. Methods Studies in the U.S., Russia, Vietnam, China, Canada and Mexico employed a three-level (macro-, meso-, and micro-) model to assess feasibility of expanded pharmacy services for PWID. Studies employed qualitative and quantitative interviews, review of legal and policy documents, and information on the knowledge, attitudes, and practices of key stakeholders. Results Studies produced a mixed assessment of feasibility. Provision of information and referrals by pharmacies is permissible in all study sites and sale and safe disposal of needles/syringes by pharmacies is legal in almost all sites, although needle/syringe sales face challenges related to attitudes and practices of pharmacists, police, and other actors. Pharmacy provision of HIV testing, hepatitis vaccination, opioid substitution treatment, provision of naloxone for drug overdose, and abscess treatment, face more serious legal and policy barriers. Discussion Challenges to expanded services for drug users in pharmacies exist at all three levels, especially the macro-level characterized by legal barriers and persistent stigmatization of PWID. Where deficiencies in laws, policies, and community attitudes block implementation, stakeholders should advocate for needed legal and policy changes and work to address community stigma and resistance. Laws and policies are only as good as their implementation, so attention is also needed to meso- and micro- levels. Policies, attitudes, and practices of police departments and pharmacy chains as well as knowledge, attitudes, and practices of individual PWID, individual pharmacies, and police officers should support rather than undermine positive laws and expanded services. Despite the challenges, pharmacies remain potentially important venues for delivering health services to PWID. PMID:24938376

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

PubMed

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

2016-06-01

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

Overcoming Structural Constraints to Patient Utilization of Electronic Medical Records: A Critical Review and Proposal for an Evaluation Framework

PubMed Central

Winkelman, Warren J.; Leonard, Kevin J.

2004-01-01

There are constraints embedded in medical record structure that limit use by patients in self-directed disease management. Through systematic review of the literature from a critical perspective, four characteristics that either enhance or mitigate the influence of medical record structure on patient utilization of an electronic patient record (EPR) system have been identified: environmental pressures, physician centeredness, collaborative organizational culture, and patient centeredness. An evaluation framework is proposed for use when considering adaptation of existing EPR systems for online patient access. Exemplars of patient-accessible EPR systems from the literature are evaluated utilizing the framework. From this study, it appears that traditional information system research and development methods may not wholly capture many pertinent social issues that arise when expanding access of EPR systems to patients. Critically rooted methods such as action research can directly inform development strategies so that these systems may positively influence health outcomes. PMID:14633932

Removing Obstacles To Eliminating Racial And Ethnic Disparities In Behavioral Health Care.

PubMed

Alegría, Margarita; Alvarez, Kiara; Ishikawa, Rachel Zack; DiMarzio, Karissa; McPeck, Samantha

2016-06-01

Despite decades of research, racial and ethnic disparities in behavioral health care persist. The Affordable Care Act expanded access to behavioral health care, but many reform initiatives fail to consider research about racial/ethnic minorities. Mistaken assumptions that underlie the expansion of behavioral health care run the risk of replicating existing service disparities. Based on a review of relevant literature and numerous observational and field studies with minority populations, we identified the following three mistaken assumptions: Improvement in health care access alone will reduce disparities, current service planning addresses minority patients' preferences, and evidence-based interventions are readily available for diverse populations. We propose tailoring the provision of care to remove obstacles that minority patients face in accessing treatment, promoting innovative services that respond to patients' needs and preferences, and allowing flexibility in evidence-based practice and the expansion of the behavioral health workforce. These proposals should help meet the health care needs of a growing racial/ethnic minority population. Project HOPE—The People-to-People Health Foundation, Inc.

Removing Obstacles To Eliminate Racial And Ethnic Disparities In Behavioral Health Care

PubMed Central

Alegría, Margarita; Alvarez, Kiara; Ishikawa, Rachel Zack; DiMarzio, Karissa; McPeck, Samantha

2016-01-01

Despite decades of research, racial and ethnic disparities in behavioral health care persist. The Affordable Care Act expanded access to behavioral health care, but many reform initiatives fail to consider research about racial/ethnic minorities. Mistaken assumptions that underlie the expansion of behavioral health care risk replicating existing service disparities. Based on a review of relevant literature and numerous observational and field studies with minority populations, we identified the following three mistaken assumptions: improvement in health care access alone will reduce disparities, current service planning addresses minority patients’ preferences, and evidence-based interventions are readily available for diverse populations. We propose tailoring the provision of care to remove obstacles that minority patients face in accessing treatment, promoting innovative services that respond to patient needs and preferences, and allowing flexibility in evidence-based practice and the expansion of the behavioral health workforce. These proposals should help meet the health care needs of a growing racial/ethnic minority population. PMID:27269014

Pathview Web: user friendly pathway visualization and data integration

PubMed Central

Pant, Gaurav; Bhavnasi, Yeshvant K.; Blanchard, Steven G.; Brouwer, Cory

2017-01-01

Abstract Pathway analysis is widely used in omics studies. Pathway-based data integration and visualization is a critical component of the analysis. To address this need, we recently developed a novel R package called Pathview. Pathview maps, integrates and renders a large variety of biological data onto molecular pathway graphs. Here we developed the Pathview Web server, as to make pathway visualization and data integration accessible to all scientists, including those without the special computing skills or resources. Pathview Web features an intuitive graphical web interface and a user centered design. The server not only expands the core functions of Pathview, but also provides many useful features not available in the offline R package. Importantly, the server presents a comprehensive workflow for both regular and integrated pathway analysis of multiple omics data. In addition, the server also provides a RESTful API for programmatic access and conveniently integration in third-party software or workflows. Pathview Web is openly and freely accessible at https://pathview.uncc.edu/. PMID:28482075

Feasibility and Requirements Analysis of MIS for Operational Patrol Squadrons in the United States Navy.

DTIC Science & Technology

1981-12-01

with statistical data on the -est questions themselves and allows upgrading of the test ques-ion bank or changes in the method of presentation. (5...accessed to meet on-line inquires from users at the OMA, INA, and SSC levels, utilizing a number of different to access similar data. A query capability...technical directive and configured item capability * nonthly Maintanance Plan *Individual material Readiness List (I21RL) SPIE calibration Expand JCN4 Tracki

The Path to NGATS

NASA Technical Reports Server (NTRS)

Scardina, John

2006-01-01

NGATS operational Improvements and benefits include: 1) Broad area and precision navigation to access and capacity; 2) Airspace access and management to capacity; 3) 4D trajectory based ATM to capacity and efficiency; 4) Reduced separation between aircraft to capacity; 5) Flight deck situational awareness and delegation to capacity and safety; 6) ATM decision support to capacity; 7) Improved weather data and dissemination to capacity and safety; 8) Reduced cost to deliver ATM services to cost; 9) Greatly expanded airport network and improved terminals to capacity.

Data Rescue in Collaboration with Federal Open Access Efforts

NASA Astrophysics Data System (ADS)

Avila, R.

2017-12-01

The recent calls to rescue scientific data is a real opportunity to collaborate with federal agencies which have been spending years managing research data and making it secure. The 2013 memos from the White House Office of Science and Technology Policy and Office of Management and Budget have spurred innovation across federal agencies to make publicly funded data accessible. Now is the time for stakeholders to take advantage of the groundwork laid by federal government, support the work to expand data sharing, thereby encouraging open science.

ADA Compliance and Accessibility of Fitness Facilities in Western Wisconsin.

PubMed

Johnson, Marquell J; Stoelzle, Hannah Y; Finco, Kristi L; Foss, Sadie E; Carstens, Katie

2012-01-01

The study expands the research on fitness facility accessibility by determining how compliant fitness facilities in rural western Wisconsin were with Title III of the Americans with Disabilities Act (ADA). Comparisons were made with 4 other studies that were conducted in different geographical regions. The study also examined fitness professionals' disability knowledge and awareness. An ADA fitness facility compliance instrument and a fitness professional disability awareness survey were used. Direct observation and physical measurements were taken during on-site visits to 16 of 36 eligible fitness facilities in rural western Wisconsin. Ten fitness professionals from participating facilities completed an online survey. Frequencies were used to analyze the results. None of the participating facilities were in 100% compliance with ADA. Customer service desk (84%) and path of travel throughout the facility (72%) were the highest compliance areas. Telephone (6%) and locker rooms (32%) were the lowest compliance areas. No fitness professional was trained in wheelchair transfers and very few had received training in providing services to individuals with disabilities. Fitness facility accessibility remains a concern nationally. Continued efforts need to be made to raise the awareness of ADA compliance among fitness professionals across the United States, especially in rural areas where fitness facility availability is limited.

Has Embase replaced MEDLINE since coverage expansion?

PubMed

Lam, Michael Thomas; De Longhi, Christina; Turnbull, Joseph; Lam, Helen Rose; Besa, Reena

2018-04-01

The research tested the authors' hypothesis that more researchers from the academic medicine community in the United States and Canada with institutional access to Embase had started using Embase to replace MEDLINE since Embase was expanded in 2010 to cover all MEDLINE records. We contacted libraries of 140 and 17 medical schools in the United States and Canada, respectively, to confirm their subscriptions to Embase 5 years before and 5 years after 2010. We searched the names of institutions with confirmed Embase access in Ovid MEDLINE and Embase to retrieve works authored by affiliates of those institutions. We then examined 100 randomly selected records from each of the 5 years before and 5 years after the Embase coverage expansion in 2010. We hypothesized that studies that used Embase but not MEDLINE would increase due to the Embase coverage expansion. The number of studies that used Embase but not MEDLINE did not change between the pre-2010 and post-2010 periods. Our hypothesis was refuted. Studies that used Embase but not MEDLINE did not increase post-2010. Our results suggest the academic medicine community in the United States and Canada that had access did not use Embase to replace MEDLINE, despite the Embase coverage expansion.

Getting the 'blues': the existence, diffusion and influence of pornography on young peoples' sexual health in Sierra Leone.

PubMed

Day, Andrea

2014-01-01

While substantial research has examined the effects of pornography on young people in developed societies, existing studies fall short in addressing how sexually-explicit material affects young people in developing countries. The importance of such knowledge increases as the globalising effects of technology expand young peoples' access and exposure to pornography. During the summer of 2012, a study was undertaken in Sierra Leone examining factors affecting young peoples' sexual and reproductive health. The research assessed the influence of HIV knowledge, communication about sex, civil war and contraception myths on sexual behaviours, while remaining open to unanticipated factors. During data collection, respondents identified pornography, also called blues, as an influential factor, detailing its newfound accessibility driven by improved access to information and communication technologies in the country. Respondents also addressed several presumed ways in which pornography impacts young peoples' decisions about sexual health. The following study examines perceived effects of young peoples' exposure to pornography based on existing literature. It then outlines the findings of research conducted in Sierra Leone, drawing on primary data from the respondents and relevant published literature and concludes with proposals for addressing its negative effects.

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

PubMed Central

Klein, M S; Ross, F

1997-01-01

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

Brave New World: The Information Management Revolution.

ERIC Educational Resources Information Center

McIntyre, Jim

1995-01-01

Indiana University and the University of Delaware have begun to expand the notion of financial information management by the innovative use of computer and Internet applications. Widespread access to institutional information has advantages and disadvantages. At both institutions, information managers addressed administrative resistance but…

Reasons to temper enthusiasm about open access nursing journals.

PubMed

de Jong, Gideon

2017-04-01

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

Health impact assessment: assessing opportunities and barriers to intersectoral health improvement in an expanded European Union

PubMed Central

Lock, K.; McKee, M.

2005-01-01

On 1 May 2004 the European Union (EU) underwent unprecedented enlargement, from 15 to 25 countries, increasing its population by 20% to over 450 million. Although EU law has limited specific competence in the area of health, its influence on other policy sectors such as agriculture, trade, and employment has wide ranging implications for health. Yet with the exception of provisions on communicable disease control and food safety, public health considerations have played little part in negotiations on EU accession. This paper argues for an intersectoral public health approach in the expanded EU. It reviews the legal basis for assessing the health impacts of policy in the EU and, using health impact assessment as a case study, it examines how well the new member states may be prepared to tackle intersectoral public health action within the constraints imposed by EU policy. PMID:15831682

Three-dimensional (3D) printing and its applications for aortic diseases

PubMed Central

Hangge, Patrick; Pershad, Yash; Witting, Avery A.; Albadawi, Hassan

2018-01-01

Three-dimensional (3D) printing is a process which generates prototypes from virtual objects in computer-aided design (CAD) software. Since 3D printing enables the creation of customized objects, it is a rapidly expanding field in an age of personalized medicine. We discuss the use of 3D printing in surgical planning, training, and creation of devices for the treatment of aortic diseases. 3D printing can provide operators with a hands-on model to interact with complex anatomy, enable prototyping of devices for implantation based upon anatomy, or even provide pre-procedural simulation. Potential exists to expand upon current uses of 3D printing to create personalized implantable devices such as grafts. Future studies should aim to demonstrate the impact of 3D printing on outcomes to make this technology more accessible to patients with complex aortic diseases. PMID:29850416

Surveillance for Health Care Access and Health Services Use, Adults Aged 18–64 Years — Behavioral Risk Factor Surveillance System, United States, 2014

PubMed Central

Okoro, Catherine A.; Zhao, Guixiang; Fox, Jared B.; Eke, Paul I.; Greenlund, Kurt J.; Town, Machell

2017-01-01

Problem/Condition As a result of the 2010 Patient Protection and Affordable Care Act, millions of U.S. adults attained health insurance coverage. However, millions of adults remain uninsured or underinsured. Compared with adults without barriers to health care, adults who lack health insurance coverage, have coverage gaps, or skip or delay care because of limited personal finances might face increased risk for poor physical and mental health and premature mortality. Period Covered 2014. Description of System The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, landline- and cellular-telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. Data are collected from states, the District of Columbia, and participating U.S. territories on health risk behaviors, chronic health conditions, health care access, and use of clinical preventive services (CPS). An optional Health Care Access module was included in the 2014 BRFSS. This report summarizes 2014 BRFSS data from all 50 states and the District of Columbia on health care access and use of selected CPS recommended by the U.S. Preventive Services Task Force or the Advisory Committee on Immunization Practices among working-aged adults (aged 18–64 years), by state, state Medicaid expansion status, expanded geographic region, and federal poverty level (FPL). This report also provides analysis of primary type of health insurance coverage at the time of interview, continuity of health insurance coverage during the preceding 12 months, and other health care access measures (i.e., unmet health care need because of cost, unmet prescription need because of cost, medical debt [medical bills being paid off over time], number of health care visits during the preceding year, and satisfaction with received health care) from 43 states that included questions from the optional BRFSS Health Care Access module. Results In 2014, health insurance coverage and other health care access measures varied substantially by state, state Medicaid expansion status, expanded geographic region (i.e., states categorized geographically into nine regions), and FPL category. The following proportions refer to the range of estimated prevalence for health insurance and other health care access measures by examined geographical unit (unless otherwise specified), as reported by respondents. Among adults with health insurance coverage, the range was 70.8%–94.5% for states, 78.8%–94.5% for Medicaid expansion states, 70.8%–89.1% for nonexpansion states, 73.3%–91.0% for expanded geographic regions, and 64.2%–95.8% for FPL categories. Among adults who had a usual source of health care, the range was 57.2%–86.6% for states, 57.2%–86.6% for Medicaid expansion states, 61.8%–83.9% for nonexpansion states, 64.4%–83.6% for expanded geographic regions, and 61.0%–81.6% for FPL categories. Among adults who received a routine checkup, the range was 52.1%–75.5% for states, 56.0%–75.5% for Medicaid expansion states, 52.1%–71.1% for nonexpansion states, 56.8%–70.2% for expanded geographic regions, and 59.9%–69.2% for FPL categories. Among adults who had unmet health care need because of cost, the range was 8.0%–23.1% for states, 8.0%–21.9% for Medicaid expansion states, 11.9%–23.1% for nonexpansion states, 11.6%–20.3% for expanded geographic regions, and 5.3%–32.9% for FPL categories. Estimated prevalence of cancer screenings, influenza vaccination, and having ever been tested for human immunodeficiency virus also varied by state, state Medicaid expansion status, expanded geographic region, and FPL category. The prevalence of insurance coverage varied by approximately 25 percentage points among racial/ethnic groups (range: 63.9% among Hispanics to 88.4% among non-Hispanic Asians) and by approximately 32 percentage points by FPL category (range: 64.2% among adults with household income <100% of FPL to 95.8% among adults with household income >400% of FPL). The prevalence of unmet health care need because of cost varied by nearly 14 percentage points among racial/ethnic groups (range: 11.3% among non-Hispanic Asians to 25.0% among Hispanics), by approximately 17 percentage points among adults with and without disabilities (30.8% versus 13.7%), and by approximately 28 percentage points by FPL category (range: 5.3% among adults with household income >400% of FPL to 32.9% among adults with household income <100% of FPL). Among the 43 states that included questions from the optional module, a majority of adults reported private health insurance coverage (63.4%), followed by public health plan coverage (19.4%) and no primary source of insurance (17.1%). Financial barriers to health care (unmet health care need because of cost, unmet prescribed medication need because of cost, and medical bills being paid off over time [medical debt]) were typically lower among adults in Medicaid expansion states than those in nonexpansion states regardless of source of insurance. Approximately 75.6% of adults reported being continuously insured during the preceding 12 months, 12.9% reported a gap in coverage, and 11.5% reported being uninsured during the preceding 12 months. The largest proportion of adults reported ≥3 visits to a health care professional during the preceding 12 months (47.3%), followed by 1–2 visits (37.1%), and no health care visits (15.6%). Adults in expansion and nonexpansion states reported similar levels of satisfaction with received health care by primary source of health insurance coverage and by continuity of health insurance coverage during the preceding 12 months. Interpretation This report presents for the first time estimates of population-based health care access and use of CPS among adults aged 18–64 years. The findings in this report indicate substantial variations in health insurance coverage; other health care access measures; and use of CPS by state, state Medicaid expansion status, expanded geographic region, and FPL category. In 2014, health insurance coverage, having a usual source of care, having a routine checkup, and not experiencing unmet health care need because of cost were higher among adults living below the poverty level (i.e., household income <100% of FPL) in states that expanded Medicaid than in states that did not. Similarly, estimates of breast and cervical cancer screening and influenza vaccination were higher among adults living below the poverty level in states that expanded Medicaid than in states that did not. These disparities might be due to larger differences to begin with, decreased disparities in Medicaid expansion states versus nonexpansion states, or increased disparities in nonexpansion states. Public Health Action BRFSS data from 2014 can be used as a baseline by which to assess and monitor changes that might occur after 2014 resulting from programs and policies designed to increase access to health care, reduce health disparities, and improve the health of the adult population. Post-2014 changes in health care access, such as source of health insurance coverage, attainment and continuity of coverage, financial barriers, preventive care services, and health outcomes, can be monitored using these baseline estimates. PMID:28231239

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

NASA Technical Reports Server (NTRS)

Tolzman, Jean M.

1993-01-01

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

Optimization of Extrusion Process of Directly Expanded Snacks Based on Potato Starch in a Single Step for the Formation of Type IV Resistant Starch.

PubMed

Calvo-López, Amira Daniela; Martínez-Bustos, Fernando

2017-09-01

Resistant starch type IV (RSIV) can be produced by chemical modifications (etherized or esterified) such as conversion, substitution, or cross-linking, which can prevent its digestion by blocking enzyme access and forming atypical linkages. In this research, the effects of barrel temperature (145.86-174.14 °C), the screw speed (42.93-57.07 Hz) and derivatization (esterification) in the formation of RSIV content of directly expanded snacks (second generation snacks) were studied. Potato starch was chemically modified by phosphorylation and succinylation, and expanded by using the extrusion cooking process. Snacks with phosphorylated starch showed expansion index from 2.57 to 3.23, bulk density from 306.19 to 479.00 kg/m 3 and RSIV from 43.27 to 55.81%. Snacks with succinylated starch had expansion index from 3.52 to 3.82, bulk density from 99.85 to 134.51 kg/m 3 and RSIV from 23.17 to 35.01%. The results found in this work showed that it is possible to manufacture extruded directly expanded snacks (second-generation snacks) such as a ready-to-eat (RTE) with good physicochemical properties and without substantial loss of extrusion functionality, which could bring a healthy benefit due to the presence of RSIV.

Toward an Open-Access Global Database for Mapping, Control, and Surveillance of Neglected Tropical Diseases

PubMed Central

Hürlimann, Eveline; Schur, Nadine; Boutsika, Konstantina; Stensgaard, Anna-Sofie; Laserna de Himpsl, Maiti; Ziegelbauer, Kathrin; Laizer, Nassor; Camenzind, Lukas; Di Pasquale, Aurelio; Ekpo, Uwem F.; Simoonga, Christopher; Mushinge, Gabriel; Saarnak, Christopher F. L.; Utzinger, Jürg; Kristensen, Thomas K.; Vounatsou, Penelope

2011-01-01

Background After many years of general neglect, interest has grown and efforts came under way for the mapping, control, surveillance, and eventual elimination of neglected tropical diseases (NTDs). Disease risk estimates are a key feature to target control interventions, and serve as a benchmark for monitoring and evaluation. What is currently missing is a georeferenced global database for NTDs providing open-access to the available survey data that is constantly updated and can be utilized by researchers and disease control managers to support other relevant stakeholders. We describe the steps taken toward the development of such a database that can be employed for spatial disease risk modeling and control of NTDs. Methodology With an emphasis on schistosomiasis in Africa, we systematically searched the literature (peer-reviewed journals and ‘grey literature’), contacted Ministries of Health and research institutions in schistosomiasis-endemic countries for location-specific prevalence data and survey details (e.g., study population, year of survey and diagnostic techniques). The data were extracted, georeferenced, and stored in a MySQL database with a web interface allowing free database access and data management. Principal Findings At the beginning of 2011, our database contained more than 12,000 georeferenced schistosomiasis survey locations from 35 African countries available under http://www.gntd.org. Currently, the database is expanded to a global repository, including a host of other NTDs, e.g. soil-transmitted helminthiasis and leishmaniasis. Conclusions An open-access, spatially explicit NTD database offers unique opportunities for disease risk modeling, targeting control interventions, disease monitoring, and surveillance. Moreover, it allows for detailed geostatistical analyses of disease distribution in space and time. With an initial focus on schistosomiasis in Africa, we demonstrate the proof-of-concept that the establishment and running of a global NTD database is feasible and should be expanded without delay. PMID:22180793

When VSEPR Fails: Experimental and Theoretical Investigations of the Behavior of Alkaline-Earth-Metal Acetylides

PubMed Central

Guino-o, Marites A.; Alexander, Jacob S.; McKee, Michael L.; Hope, Håkon; Englich, Ulrich B.

2014-01-01

The synthesis, structural, and spectral characterization as well as a theoretical study of a family of alkaline-earth-metal acetylides provides insights into synthetic access and the structural and bonding characteristics of this group of highly reactive compounds. Based on our earlier communication that reported unusual geometry for a family of triphenylsilyl-substituted alkaline-earth-metal acetylides, we herein present our studies on an expanded family of target derivatives, providing experimental and theoretical data to offer new insights into the intensively debated theme of structural chemistry in heavy alkaline-earth-metal chemistry. PMID:19844925

The Use of Enhanced Appointment Access Strategies by Medical Practices.

PubMed

Rodriguez, Hector P; Knox, Margae; Hurley, Vanessa; Rittenhouse, Diane R; Shortell, Stephen M

2016-06-01

Strategies to enhance appointment access are being adopted by medical practices as part of patient-centered medical home (PCMH) implementation, but little is known about the use of these strategies nationally. We examine practice use of open access scheduling and after-hours care. Data were analyzed from the Third National Study of Physician Organizations (NSPO3) to examine which enhanced appointment access strategies are more likely to be used by practices with more robust PCMH capabilities and with greater external incentives. Logistic regression estimated the effect of PCMH capabilities and external incentives on practice use of open access scheduling and after-hours care. Physician organizations with >20% primary care physicians (n=1106). PCMH capabilities included team-based care, health information technology capabilities, quality improvement orientation, and patient experience orientation. External incentives included public reporting, pay-for-performance (P4P), and accountable care organization participation. A low percentage of practices (19.8%) used same-day open access scheduling, while after-hours care (56.1%) was more common. In adjusted analyses, system-owned practices and practices with greater use of team-based care, health information technology capabilities, and public reporting were more likely to use open access scheduling. Accountable care organization-affiliated practices and practices with greater use of public reporting and P4P were more likely to provide after-hours care. Open access scheduling may be most effectively implemented by practices with robust PCMH capabilities. External incentives appear to influence practice adoption of after-hours care. Expanding open access scheduling and after-hours care will require distinct policies and supports.

How the affordable care act and mental health parity and addiction equity act greatly expand coverage of behavioral health care.

PubMed

Beronio, Kirsten; Glied, Sherry; Frank, Richard

2014-10-01

The Patient Protection and Affordable Care Act (ACA) will expand coverage of mental health and substance use disorder benefits and federal parity protections to over 60 million Americans. The key to this expansion is the essential health benefit provision in the ACA that requires coverage of mental health and substance use disorder services at parity with general medical benefits. Other ACA provisions that should improve access to treatment include requirements on network adequacy, dependent coverage up to age 26, preventive services, and prohibitions on annual and lifetime limits and preexisting exclusions. The ACA offers states flexibility in expanding Medicaid (primarily to childless adults, not generally eligible previously) to cover supportive services needed by those with significant behavioral health conditions in addition to basic benefits at parity. Through these various new requirements, the ACA in conjunction with Mental Health Parity and Addiction Equity Act (MHPAEA) will expand coverage of behavioral health care by historic proportions.

Highly Cited Occupational Therapy Articles in the Science Citation Index Expanded and Social Sciences Citation Index: A Bibliometric Analysis.

PubMed

Brown, Ted; Gutman, Sharon A; Ho, Yuh-Shan; Fong, Kenneth N K

A bibliometric analysis was completed of highly cited occupational therapy literature and authors published from 1991 to 2014 and accessible in the Science Citation Index Expanded (SCI-Expanded) and Social Sciences Citation Index (SSCI) databases. Data were obtained from the SCI-Expanded and SSCI. Articles referenced >100 times were categorized as highly cited articles (HCA). Of 6,486 articles found, 31 were categorized as HCA. The American Journal of Occupational Therapy published the largest number of HCA (n = 8; 26%). The 31 HCA were distributed across seven countries: United States (20 articles), Canada (3), United Kingdom (3), Australia (2), the Netherlands (1), New Zealand (1), and Sweden (1). The three authors with the highest Y-index were S. J. Page, F. Clark, and W. Dunn. A latency period of 4 to 5 yr post-publication appears to be needed for a journal article to gain citations. Copyright © 2017 by the American Occupational Therapy Association, Inc.

State policy and teen childbearing: a review of research studies.

PubMed

Beltz, Martha A; Sacks, Vanessa H; Moore, Kristin A; Terzian, Mary

2015-02-01

Teen childbearing is affected by many individual, family, and community factors; however, another potential influence is state policy. Rigorous studies of the relationship between state policy and teen birth rates are few in number but represent a body of knowledge that can inform policy and practice. This article reviews research assessing associations between state-level policies and teen birth rates, focusing on five policy areas: access to family planning, education, sex education, public assistance, and access to abortion services. Overall, several studies have found that measures related to access to and use of family planning services and contraceptives are related to lower state-level teen birth rates. These include adolescent enrollment in clinics, minors' access to contraception, conscience laws, family planning expenditures, and Medicaid waivers. Other studies, although largely cross-sectional analyses, have concluded that policies and practices to expand or improve public education are also associated with lower teen birth rates. These include expenditures on education, teacher-to-student ratios, and graduation requirements. However, the evidence regarding the role of public assistance, abortion access, and sex education policies in reducing teen birth rates is mixed and inconclusive. These conclusions must be viewed as tentative because of the limited number of rigorous studies that examine the relationship between state policy and teen birth rates over time. Many specific policies have only been analyzed by a single study, and few findings are based on recent data. As such, more research is needed to strengthen our understanding of the role of state policies in teen birth rates. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Securely implementing remote access within health information management.

PubMed

Carroll, E T; Wright, S; Zakoworotny, C

1998-03-01

As technology changes, our definition of the workplace expands, and we no longer are limited to working at our desk in an office. The authors describe technologies that enable us to work from home or on the road and examine security regulations and precautions.

77 FR 25775 - Small Business Investment Companies-Early Stage SBICs

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-01

... of the Small Business Investment Company (``SBIC'') Management Assessment Questionnaire (``MAQ... expand entrepreneurs' access to capital and encourage innovation as part of President Obama's Start-Up... 18, 2012. Initial Review Period: Management Assessment 5 p.m. ET......... 5 p.m. ET. Questionnaires...

75 FR 67060 - Universal Service Reform Mobility Fund

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-01

... CONTACT: Wireless Telecommunications Bureau, Auctions and Spectrum Access Division: Scott Mackoul at (202... the first cellular telephone licenses, the wireless industry has continually expanded and upgraded its networks to the point where third generation (called advanced or 3G) mobile wireless services are now...

President Signs STAR Act for Kids' Cancers.

PubMed

2018-06-07

On June 5, President Donald Trump signed the Childhood Cancer Survivorship, Treatment, Access and Research Act, which aims to support pediatric cancer research by expanding the collection of patient biospecimens and records, improving surveillance, and investigating pediatric survivorship. ©2018 American Association for Cancer Research.

21 CFR 312.300 - General.

Code of Federal Regulations, 2011 CFR

2011-04-01

... INVESTIGATIONAL NEW DRUG APPLICATION Expanded Access to Investigational Drugs for Treatment Use § 312.300 General. (a) Scope. This subpart contains the requirements for the use of investigational new drugs and... on such factors as survival, day-to-day functioning, or the likelihood that the disease, if left...

21 CFR 312.300 - General.

Code of Federal Regulations, 2010 CFR

2010-04-01

... INVESTIGATIONAL NEW DRUG APPLICATION Expanded Access to Investigational Drugs for Treatment Use § 312.300 General. (a) Scope. This subpart contains the requirements for the use of investigational new drugs and... on such factors as survival, day-to-day functioning, or the likelihood that the disease, if left...

Literacy in an Information Society.

ERIC Educational Resources Information Center

Breivik, Patricia Senn

1991-01-01

Today's definition of literacy must include the ability to find and evaluate needed information. Proposes a national literacy agenda to change the way information is used in educational settings and provide greater access to expanding information resources. Considers information literacy a means of personal and national empowerment. (DMM)

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

PubMed

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

2007-04-01

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

Methodology to Estimate the Quantity, Composition, and ...

EPA Pesticide Factsheets

This report, Methodology to Estimate the Quantity, Composition and Management of Construction and Demolition Debris in the US, was developed to expand access to data on CDD in the US and to support research on CDD and sustainable materials management. Since past US EPA CDD estimates have been limited to building-related CDD, a goal in the development of this methodology was to use data originating from CDD facilities and contractors to better capture the current picture of total CDD management, including materials from roads, bridges and infrastructure. This report, Methodology to Estimate the Quantity, Composition and Management of Construction and Demolition Debris in the US, was developed to expand access to data on CDD in the US and to support research on CDD and sustainable materials management. Since past US EPA CDD estimates have been limited to building-related CDD, a goal in the development of this methodology was to use data originating from CDD facilities and contractors to better capture the current picture of total CDD management, including materials from roads, bridges and infrastructure.

Research of Ad Hoc Networks Access Algorithm

NASA Astrophysics Data System (ADS)

Xiang, Ma

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

Increasing equity of access to point-of-use water treatment products through social marketing and entrepreneurship: a case study in western Kenya.

PubMed

Freeman, Matthew C; Quick, Robert E; Abbott, Daniel P; Ogutu, Paul; Rheingans, Richard

2009-09-01

Point-of-use water chlorination reduces diarrhoea risk by 25-85%. Social marketing has expanded access to inexpensive sodium hypochlorite for water treatment, at a cost of less than US$0.01 per day, in Kenya. To increase product access, women's groups in western Kenya were trained to educate neighbours and sell health products to generate income. We evaluated this programme's impact on equity of access to water treatment products in a cross-sectional survey. We surveyed 487 randomly selected households in eight communities served by the women's groups. Overall, 20% (range 5-39%) of households in eight communities purchased and used chlorine, as confirmed by residual chlorine observed in stored water. Multivariate models using illiteracy and the poorest socioeconomic status as a referent showed that persons with at least some primary education (OR 2.5, 95% CI 1.8, 3.5) or secondary education (OR 5.4, 95% CI 1.6, 17.5) and persons in the four wealthiest quintiles (OR 2.5, 95% CI 1.0, 6.0) were more likely to chlorinate stored water. While this implementation model was associated with good product penetration and use, barriers to access to inexpensive water treatment remained among the very poor and less educated.

Developing accessible cyberinfrastructure-enabled knowledge communities in the national disability community: theory, practice, and policy.

PubMed

Myhill, William N; Cogburn, Derrick L; Samant, Deepti; Addom, Benjamin Kwasi; Blanck, Peter

2008-01-01

Since publication of the Atkins Commission report in 2003, the national scientific community has placed significant emphasis on developing cyberinfrastructure-enabled knowledge communities, which are designed to facilitate enhanced efficiency and collaboration in geographically distributed networks of researchers. This article suggests that the new cyberinfrastructure movement may not fully benefit those participants with disabilities, unless closer attention is paid to legal mandates and universal design principles. Many technology-enhanced learning communities provide geographically distributed collaboration opportunities that expand the inclusion of diverse peoples and help close the digital divide. However, to date, most collaboratory efforts have not emphasized the need for access among people with disabilities nor meeting minimum standards for technological accessibility. To address these concerns, this article reports on two pilot collaboratory studies that explore the role advanced information, communication, and collaboration technologies play in enhancing geographically distributed collaboration among specific research and applied networks within the national disability community. Universal design principles inform the design of the collaboratory and its use and our efforts to ensure access for all. Data for this article come from Web-based surveys, interviews, observations, computer logs, and detailed, mixed-methods accessibility testing. Emerging results suggest that with deliberate and systematic efforts, cyberinfrastructure can be more accessible and generate benefits among persons with disabilities. The authors provide lessons learned and recommendations for future research, policy, law, and practice.

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

PubMed Central

McMorrow, Stacey; Zuckerman, Stephen

2014-01-01

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

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

PubMed

Rowley, Lisa J; Stein, Susan M

2016-06-01

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

Randomized, Community-Based Pharmacy Intervention to Expand Services Beyond Sale of Sterile Syringes to Injection Drug Users in Pharmacies in New York City

PubMed Central

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

2013-01-01

Structural interventions may help reduce racial/ethnic disparities in HIV. In 2009 to 2011, we randomized pharmacies participating in a nonprescription syringe access program in minority communities to intervention (pharmacy enrolled and delivered HIV risk reduction information to injection drug users [IDUs]), primary control (pharmacy only enrolled IDUs), and secondary control (pharmacy did not engage IDUs). Intervention pharmacy staff reported more support for syringe sales than did control staff. An expanded pharmacy role in HIV risk reduction may be helpful. PMID:23865644

Primary care providers' lived experiences of genetics in practice.

PubMed

Harding, Brittany; Webber, Colleen; Ruhland, Lucia; Dalgarno, Nancy; Armour, Christine M; Birtwhistle, Richard; Brown, Glenn; Carroll, June C; Flavin, Michael; Phillips, Susan; MacKenzie, Jennifer J

2018-04-26

To effectively translate genetic advances into practice, engagement of primary care providers (PCPs) is essential. Using a qualitative, phenomenological methodology, we analyzed key informant interviews and focus groups designed to explore perspectives of urban and rural PCPs. PCPs endorsed a responsibility to integrate genetics into their practices and expected advances in genetic medicine to expand. However, PCPs reported limited knowledge and difficulties accessing resources, experts, and continuing education. Rural practitioners' additional concerns included cost, distance, and poor patient engagement. PCPs' perspectives are crucial to develop relevant educational and systems-based interventions to further expand genetic medicine in primary care.

Civil space technology initiative

NASA Technical Reports Server (NTRS)

1990-01-01

The Civil Space Technology Initiative (CSTI) is a major, focused, space technology program of the Office of Aeronautics, Exploration and Technology (OAET) of NASA. The program was initiated to advance technology beyond basic research in order to expand and enhance system and vehicle capabilities for near-term missions. CSTI takes critical technologies to the point at which a user can confidently incorporate the new or expanded capabilities into relatively near-term, high-priority NASA missions. In particular, the CSTI program emphasizes technologies necessary for reliable and efficient access to and operation in Earth orbit as well as for support of scientific missions from Earth orbit.

Computer numeric control generation of toric surfaces

NASA Astrophysics Data System (ADS)

Bradley, Norman D.; Ball, Gary A.; Keller, John R.

1994-05-01

Until recently, the manufacture of toric ophthalmic lenses relied largely upon expensive, manual techniques for generation and polishing. Recent gains in computer numeric control (CNC) technology and tooling enable lens designers to employ single- point diamond, fly-cutting methods in the production of torics. Fly-cutting methods continue to improve, significantly expanding lens design possibilities while lowering production costs. Advantages of CNC fly cutting include precise control of surface geometry, rapid production with high throughput, and high-quality lens surface finishes requiring minimal polishing. As accessibility and affordability increase within the ophthalmic market, torics promise to dramatically expand lens design choices available to consumers.

Developing a national stream morphology data exchange: needs, challenges, and opportunities

USGS Publications Warehouse

Collins, Mathias J.; Gray, John R.; Peppler, Marie C.; Fitzpatrick, Faith A.; Schubauer-Berigan, Joseph P.

2012-01-01

Stream morphology data, primarily consisting of channel and foodplain geometry and bed material size measurements, historically have had a wide range of applications and uses including culvert/ bridge design, rainfall- runoff modeling, food inundation mapping (e.g., U.S. Federal Emergency Management Agency food insurance studies), climate change studies, channel stability/sediment source investigations, navigation studies, habitat assessments, and landscape change research. The need for stream morphology data in the United States, and thus the quantity of data collected, has grown substantially over the past 2 decades because of the expanded interests of resource management agencies in watershed management and restoration. The quantity of stream morphology data collected has also increased because of state-of-the-art technologies capable of rapidly collecting high-resolution data over large areas with heretofore unprecedented precision. Despite increasing needs for and the expanding quantity of stream morphology data, neither common reporting standards nor a central data archive exist for storing and serving these often large and spatially complex data sets. We are proposing an open- access data exchange for archiving and disseminating stream morphology data.

Developing a national stream morphology data exchange: Needs, challenges, and opportunities

NASA Astrophysics Data System (ADS)

Collins, Mathias J.; Gray, John R.; Peppler, Marie C.; Fitzpatrick, Faith A.; Schubauer-Berigan, Joseph P.

2012-05-01

Stream morphology data, primarily consisting of channel and foodplain geometry and bed material size measurements, historically have had a wide range of applications and uses including culvert/ bridge design, rainfall- runoff modeling, food inundation mapping (e.g., U.S. Federal Emergency Management Agency food insurance studies), climate change studies, channel stability/sediment source investigations, navigation studies, habitat assessments, and landscape change research. The need for stream morphology data in the United States, and thus the quantity of data collected, has grown substantially over the past 2 decades because of the expanded interests of resource management agencies in watershed management and restoration. The quantity of stream morphology data collected has also increased because of state-of-the-art technologies capable of rapidly collecting high-resolution data over large areas with heretofore unprecedented precision. Despite increasing needs for and the expanding quantity of stream morphology data, neither common reporting standards nor a central data archive exist for storing and serving these often large and spatially complex data sets. We are proposing an open- access data exchange for archiving and disseminating stream morphology data.

Optical fiber cable and wiring techniques for fiber to the home (FTTH)

NASA Astrophysics Data System (ADS)

Takai, Hirofumi; Yamauchi, Osamu

2009-08-01

NTT group's new medium-term management strategy calls for 20 million optical subscribers by 2010, and NTT Laboratories is pushing forward to meet this goal. Before that date, an efficient optical access network must be constructed, and afterwards, when the era of mass optical communications finally arrives, the facilities and equipment supporting the network will have to be effectively operated and maintained. At NTT Access Network Service Systems Laboratories, we are developing various technologies to correspond to the massive deployment of optical broadband services. We are also developing various new technologies for efficiently operating optical access network systems that will continue to expand in the future, and to supply our customers with good services. This paper provides an overview of the new optical access network system technologies that are being developed at NTT Access Network Service Systems Laboratories to address these issues.

Amplatzer vascular plug for arteriovenous hemodialysis access occlusion: initial experience.

PubMed

Bui, J T; Gaba, R C; Knuttinen, M G; West, D L; Owens, C A

2009-01-01

The Amplatzer Vascular Plug (AVP; AGA Medical, Golden Valley, MN) is a recently developed self-expanding metallic device indicated for peripheral vascular embolizations. Herein, we describe use of this device in the treatment of vascular complications related to arteriovenous hemodialysis fistulas and grafts. This HIPAA compliant retrospective study was approved by the institutional review board with informed consent waived. Six patients with problematic arteriovenous access underwent access occlusion using the AVP. Procedure indications included vascular steal syndrome in five patients, and enlarging vascular aneurysms in one patient. Contraindications for surgical correction were determined by the referring surgeon. AVP embolizations were performed using devices oversized by 50% introduced through vascular sheaths positioned within vein segments just beyond the arteriovenous anastomoses. Noninvasive evaluation of the involved extremity was performed pre- and post-embolization in addition to clinical follow-up examinations. Measured outcomes included success of angiographic occlusion, improvement in distal arterial flow, AVP number, AVP diameter, time to access occlusion, and clinical symptomatic improvement. Technical success was 100%, with complete arteriovenous access occlusion accomplished in all cases, with an average of 1.5 AVPs used per patient. Mean time to access occlusion was 19.3 minutes. Angiographic improvement in distal arterial flow was immediately evident and resolution of clinical symptoms occurred in all patients, with mean long-term follow-up of 16 months. No procedure-related complications were encountered. The Amplatzer Vascular Plug provides a minimally invasive and efficacious method for embolization of problematic arteriovenous hemodialysis access.

Vaccinations Administered During Off-Clinic Hours at a National Community Pharmacy: Implications for Increasing Patient Access and Convenience

PubMed Central

Goad, Jeffery A.; Taitel, Michael S.; Fensterheim, Leonard E.; Cannon, Adam E.

2013-01-01

PURPOSE Approximately 50,000 adults die annually from vaccine-preventable diseases in the United States. Most traditional vaccine providers (eg, physician offices) administer vaccinations during standard clinic hours, but community pharmacies offer expanded hours that allow patients to be vaccinated at convenient times. We analyzed the types of vaccines administered and patient populations vaccinated during off-clinic hours in a national community pharmacy, and their implications for vaccination access and convenience. METHODS We retrospectively reviewed data for all vaccinations given at the Walgreens pharmacy chain between August 2011 and July 2012. The time of vaccination was categorized as occurring during traditional hours (9:00 am–6:00 pm weekdays) or off-clinic hours, consisting of weekday evenings, weekends, and federal holidays. We compared demographic characteristics and types of vaccine. We used a logistic regression model to identify predictors of being vaccinated during off-clinic hours. RESULTS During the study period, pharmacists administered 6,250,402 vaccinations, of which 30.5% were provided during off-clinic hours: 17.4% were provided on weekends, 10.2% on evenings, and 2.9% on holidays. Patients had significantly higher odds of off-clinic vaccination if they were younger than 65 years of age, were male, resided in an urban area, and did not have any chronic conditions. CONCLUSIONS A large proportion of adults being vaccinated receive their vaccines during evening, weekend, and holiday hours at the pharmacy, when traditional vaccine providers are likely unavailable. Younger, working-aged, healthy adults, in particular, a variety of immunizations during off-clinic hours. With the low rates of adult and adolescent vaccination in the United States, community pharmacies are creating new opportunities for vaccination that expand access and convenience. PMID:24019274

First Responders and Prehospital Care for Road Traffic Injuries in Malawi.

PubMed

Chokotho, Linda; Mulwafu, Wakisa; Singini, Isaac; Njalale, Yasin; Maliwichi-Senganimalunje, Limbika; Jacobsen, Kathryn H

2017-02-01

Introduction Road traffic collisions are a common cause of injuries and injury-related deaths in sub-Saharan Africa (SSA). Basic prehospital care can be the difference between life and death for injured drivers, passengers, and pedestrians. Problem This study examined the challenges associated with current first response practices in Malawi. In April 2014, focus groups were conducted in two areas of Malawi: Karonga (in the Northern Region) and Blantyre (in the Southern Region; both are along the M1 highway), and a qualitative synthesis approach was used to identify themes. All governmental and nongovernmental first response organizations identified by key informants were contacted, and a checklist was used to identify the services they offer. Access to professional prehospital care in Malawi is almost nonexistent, aside from a few city fire departments and private ambulance services. Rapid transportation to a hospital is usually the primary goal of roadside care because of limited first aid knowledge and a lack of access to basic safety equipment. The key informants recommended: expanding community-based first aid training; emphasizing umunthu (shared humanity) to inspire bystander involvement in roadside care; empowering local leaders to coordinate on-site responses; improving emergency communication systems; equipping traffic police with road safety gear; and expanding access to ambulance services. Prehospital care in Malawi would be improved by the creation of a formal network of community leaders, police, commercial drivers, and other lay volunteers who are trained in basic first aid and are equipped to respond to crash sites to provide roadside care to trauma patients and prepare them for safe transport to hospitals. Chokotho L , Mulwafu W , Singini I , Njalale Y , Maliwichi-Senganimalunje L , Jacobsen KH . First responders and prehospital care for road traffic injuries in Malawi. Prehosp Disaster Med. 2017;32(1):14-19.

Pediatric Caregiver Attitudes Toward Email Communication: Survey in an Urban Primary Care Setting

PubMed Central

2013-01-01

Background Overall usage of email communication between patients and physicians continues to increase, due in part to expanding the adoption of electronic health records and patient portals. Unequal access and acceptance of these technologies has the potential to exacerbate disparities in care. Little is known about the attitudes of pediatric caregivers with regard to their acceptance of email as a means to communicate with their health care providers. Objective We conducted a survey to assess pediatric caregiver access to and attitudes toward the use of electronic communication modalities to communicate with health care providers in an urban pediatric primary care clinic. Methods Participants were pediatric caregivers recruited from an urban pediatric primary care clinic in Baltimore, Maryland, who completed a 35-item questionnaire in this cross-sectional study. Results Of the 229 caregivers who completed the survey (91.2% response rate), 171 (74.6%) reported that they use email to communicate with others. Of the email users, 145 respondents (86.3%) stated that they would like to email doctors, although only 18 (10.7%) actually do so. Among email users, African-American caregivers were much less likely to support the expanded use of email communication with health care providers (adjusted OR 0.34, 95% CI 0.14-0.82) as were those with annual incomes less than US $30,000 (adjusted OR 0.26, 95% CI 0.09-0.74). Conclusions Caregivers of children have access to email and many would be interested in communicating with health care providers. However, African-Americans and those in lower socioeconomic groups were much less likely to have positive attitudes toward email. PMID:24152542

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

PubMed Central

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

2013-01-01

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

Patient, Program, and System Barriers and Facilitators to Detoxification Services in the U.S. Veterans Health Administration: A Qualitative Study of Provider Perspectives.

PubMed

Schultz, Nicole R; Martinez, Rociel; Cucciare, Michael A; Timko, Christine

2016-08-23

Because substance use disorder (SUD) treatment is expanding, and detoxification (detox) is often the entry point to SUD treatment, it is critical to provide ready access to detox services. The purpose of the current study was to examine patient, program, and system barriers or facilitators to detox access within an integrated health care system with variable rates of detox utilization across facilities. Inpatient and outpatient providers from 31 different U.S. Veterans Health Administration detox programs were interviewed. Qualitative analyses identified six facilitators and 11 barriers to detox access. Facilitators included program staff and program characteristics such as encouragement and immediate access, as well as systemic cooperation and patient circumstances. Barriers to detox included programmatic and systemic problems, including lack of available detox services, program rules or admission requirements, funding shortages, stigma related to a SUD diagnosis or receiving detox services, and a deficiency of education and training. Other major barriers pertained to patients' lack of motivation and competing responsibilities. To improve detox access, health care settings should consider enhancing supportive relationships by emphasizing outreach, engagement, and rapport-building with patients, improving systemic communication and teamwork, educating patients on available detox services and the detox process, and addressing patient centered barriers such as resistance to detox or competing responsibilities. In addition, programs should consider open-door and immediate-admission policies. These approaches may improve detox access, which is important for increasing the likelihood of transitioning patients to SUD treatment, thus improving outcomes and reducing utilization of high-cost services.

Using Genetic Technologies To Reduce, Rather Than Widen, Health Disparities

PubMed Central

Smith, Caren E.; Fullerton, Stephanie M.; Dookeran, Keith A.; Hampel, Heather; Tin, Adrienne; Maruthur, Nisa M.; Schisler, Jonathan C.; Henderson, Jeffrey A.; Tucker, Katherine L.; Ordovás, José M.

2016-01-01

Evidence shows that both biological and nonbiological factors contribute to health disparities. Genetics, in particular, plays a part in how common diseases manifest themselves. Today, unprecedented advances in genetically based diagnoses and treatments provide opportunities for personalized medicine. However, disadvantaged groups may lack access to these advances, and treatments based on research on non-Hispanic whites might not be generalizable to members of minority groups. Unless genetic technologies become universally accessible, existing disparities could be widened. Addressing this issue will require integrated strategies, including expanding genetic research, improving genetic literacy, and enhancing access to genetic technologies among minority populations in a way that avoids harms such as stigmatization. PMID:27503959

2015 Relaunch as Open Access Pediatric Neurology Briefs.

PubMed

Millichap, John J; Millichap, J Gordon

2015-01-01

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

Methods and apparatus for integrating, organizing, and accessing flight planning and other data on multifunction cockpit displays

NASA Technical Reports Server (NTRS)

Gibbs, Michael J. (Inventor); Adams, Michael B. (Inventor); Chase, Karl L. (Inventor); Van Omen, Debi (Inventor); Lewis, Daniel E. (Inventor); McCrobie, Daniel E. (Inventor)

2003-01-01

A method and system for displaying a flight plan such that an entire flight plan is viewable through the use of scrolling devices is disclosed. The flight plan display may also include a method and system for collapsing and expanding a flight plan display, have provisions for the conspicuous marking of changes to a flight plan, the use of tabs to switch between various displays of data, and access to a navigation database that allows a user to view information about various navigational aids. The database may also the access to the information about the navigational aids to be prioritized based on proximity to the current position of the aircraft.

Technology for hearing loss--as We Know it, and as We Dream it.

PubMed

Clark, Jackie L; Swanepoel, De Wet

2014-09-01

Worldwide demand for accessible hearing health technology continues to increase while the numbers of hearing healthcare specialists are grossly inadequate to meet this demand. Proliferation of innovative technology and the advent of greater access to global connectivity are providing an opportunity to identify and harness new resources that may change current audiological service delivery methods to maximize access, efficiency and impact. By searching through the most current literature and engaging in discussions with industry experts, it is possible to identify avenues that could increase services to those who have hearing loss with innovative healthcare technology. This article aims to review the current state as well as future trends of hearing health technology by addressing: Technology as We Know it; and Technology as We Dream it. Some of the newer technologies we have recently witnessed include: micro processors; personalized computing devices (e.g. smartphones); web-based applications; an expanding clinical repertoire with integrated test equipment; and globalization of telecommunications that opens the door to telehealth; and self-fitting of hearing aids. Yet, innovation continues scaffolding on recent successes with innovations for hearing healthcare expected to increase into the future. As technology and connectivity continue to evolve so should the practice of audiology adapt to the global needs by capitalizing on these advances to optimize service delivery access and sustainability. Capital investment in equipment will be dramatically reduced with smaller, lighter, less costly and more portable equipment. Individuals who live in remote regions with little or no hearing healthcare access can undergo valid assessments by a professional via telehealth. Web-based applications allow clinicians to expand their repertoire and reach of services.

The first men in leadership positions in the american association of nurse anesthetists.

PubMed

Arndt, Margarete

2015-01-01

This exploratory study focuses on the American Association of Nurse Anesthetists. It sheds light on the process by which men gain access to leadership positions in a female-dominated setting. It also expands the narrative of the professional association's history. As soon as men became eligible for membership in 1947, they gained access to leadership positions in disproportionate numbers and at a faster pace than women at the national level and in a number of states. The specific pattern of findings is consistent with volitional relational practices, suggesting that women facilitated the integration and empowerment of male colleagues who constituted a small minority in the association. The paper discusses the need to understand and manage the interactions between relational practices that are gendered female and views of leadership as male-gendered. © 2014 Wiley Periodicals, Inc.

Expanding patient access to quality medication-related information: the potential of medication hotlines to improve patient adherence in schizophrenia.

PubMed

Pettit, Amy R; Marcus, Steven C

2015-05-01

Medication nonadherence is a widespread problem that compromises treatment outcomes, particularly in schizophrenia. Weersink et al. (Soc Psychiatry Psychiatr Epidemiol, 2015) describe telephone calls to a national medicines information line, with a focus on queries related to antipsychotic medications. Their analysis of callers' questions and concerns offers a valuable window into patient and caregiver perspectives. Given that many callers reported that they had not shared these concerns with a health care provider, this study also highlights the capacity of medication hotlines to address unmet needs. Establishing and maintaining long-term treatment regimens is a complex task, and truly patient-centered care requires a variety of creative and accessible support resources. Medication lines have the potential to serve as a resource and to provide proactive and timely adherence support.

Quantitative and qualitative analysis of student textbook summary writing

NASA Astrophysics Data System (ADS)

Demaree, Dedra; Allie, Saalih; Low, Michael; Taylor, Julian

2008-10-01

The majority of "special access" students at the University of Cape Town are second language English speakers for whom reading the physics textbook is daunting. As a strategy to encourage meaningful engagement with the text, students wrote textbook summaries due the day material was covered in class. The summaries were returned, and they could bring them or re-write them for use during their examinations. A framework was developed to analyze the summaries based on Waywood, defining three cognitive levels seen in mathematics journaling: recounting, summarizing, and dialoging. This framework was refined, expanded, and tested. Interviews with students were conducted for their views on summary writing and survey questions were included on their final exams. The study was carried out in the 2007 spring semester of the "Foundation Physics Course," a component of the special access program.

Milliarcsecond Astronomy with the CHARA Array

NASA Astrophysics Data System (ADS)

Schaefer, Gail; ten Brummelaar, Theo; Gies, Douglas; Jones, Jeremy; Farrington, Christopher

2018-01-01

The Center for High Angular Resolution Astronomy offers 50 nights per year of open access time at the CHARA Array. The Array consists of six telescopes linked together as an interferometer, providing sub-milliarcsecond resolution in the optical and near-infrared. The Array enables a variety of scientific studies, including measuring stellar angular diameters, imaging stellar shapes and surface features, mapping the orbits of close binary companions, and resolving circumstellar environments. The open access time is part of an NSF/MSIP funded program to open the CHARA Array to the broader astronomical community. As part of the program, we will build a searchable database for the CHARA data archive and run a series of one-day community workshops at different locations across the country to expand the user base for stellar interferometry and encourage new scientific investigations with the CHARA Array.

Imagery: Thinking with the Mind's Eye.

ERIC Educational Resources Information Center

Riley, Margaret E.

Teachers teach literature to help students expand and develop their image-making powers, "to imagine, conceive, fancy, picture," to think. To get students involved in literature, especially poetry, Robert Frost's poem, "The Witch of Coos," is particularly useful because it is so immediately accessible. In order to help engage…

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…

Australian Higher Education Reforms--Unification or Diversification?

ERIC Educational Resources Information Center

Coombe, Leanne

2015-01-01

The higher education policy of the previous Australian government aimed to achieve an internationally competitive higher education sector while expanding access opportunities to all Australians. This policy agenda closely reflects global trends that focus on achieving both quality and equity objectives. In this paper, the formulation and…

WICHE: Six Decades of Collaboration in the West

ERIC Educational Resources Information Center

Western Interstate Commission for Higher Education, 2015

2015-01-01

The Western Interstate Commission for Higher Education (WICHE) and its 16 members work collaboratively to expand educational access and excellence for all citizens of the West. By promoting innovation, cooperation, resource sharing, and sound public policy among its members and their institutions, WICHE strengthens higher education's contributions…

Lessons Learned from Breaking Through. In Brief

ERIC Educational Resources Information Center

Bragg, Debra D.; Barnett, Elisabeth

2009-01-01

The Breaking Through (BT) initiative promotes an expanded and enhanced role for community colleges in providing access to college for low-skilled adults. BT is uniquely important in its systematic integration of adult education, developmental/remedial education, professional-technical education (PTE), and career planning and preparation in…

12 CFR 705.4 - Permissible uses of loan funds.

Code of Federal Regulations, 2014 CFR

2014-01-01

... members, including new or expanded share draft or credit card programs; (b) Partnership arrangements with... 705.4 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS COMMUNITY DEVELOPMENT REVOLVING LOAN FUND ACCESS FOR CREDIT UNIONS § 705.4 Permissible uses of loan funds...

12 CFR 705.4 - Permissible uses of loan funds.

Code of Federal Regulations, 2012 CFR

2012-01-01

... members, including new or expanded share draft or credit card programs; (b) Partnership arrangements with... 705.4 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS COMMUNITY DEVELOPMENT REVOLVING LOAN FUND ACCESS FOR CREDIT UNIONS § 705.4 Permissible uses of loan funds...

3 CFR 8624 - Proclamation 8624 of January 14, 2011. Martin Luther King, Jr., Federal Holiday, 2011

Code of Federal Regulations, 2012 CFR

2012-01-01

... rights leaders. As a country, we must expand access to opportunity and end structural inequalities for... contributions to our Nation and the world, but also a reminder that every day, each of us can play a part in...

As Patient Navigation Expands and Evolves, Nurses Assume Many Roles

Cancer.gov

It can be difficult to access care in our labyrinthine health care system. Oncology nurses are joining the ranks of patient navigators—a diverse group of people who help patients at all stages of cancer care, from screening and diagnosis to treatment and survivorship.

75 FR 47564 - Notice of Intent To Prepare an Environmental Impact Statement for the Proposed Modernization and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-06

... acquire lands in the vicinity of TBR on which to create new target areas to allow for a greater variety of...-acre TBR and would expand the area of controlled access around the bombing targets. The EIS will...

New Technologies, Same Ideologies: Learning from Language Revitalization Online

ERIC Educational Resources Information Center

Wagner, Irina

2017-01-01

Ease of access, production, and distribution have made online technologies popular in language revitalization. By incorporating multimodal resources, audio, video, and games, they attract indigenous communities undergoing language shift in hopes of its reversal. However, by merely expanding language revitalization to the web, many language…

21 CFR 312.310 - Individual patients, including for emergency use.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... 312.310 Section 312.310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE INVESTIGATIONAL NEW DRUG APPLICATION Expanded Access to... communications. For investigational biological drug products regulated by the Center for Biologics Evaluation and...

Supporting Immigrant Families' Access to Prekindergarten

ERIC Educational Resources Information Center

Gelatt, Julia; Adams, Gina; Huerta, Sandra

2014-01-01

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

Approaches to Reading with Multiple Lenses of Interpretation

ERIC Educational Resources Information Center

Troise, Melissa

2007-01-01

High school teacher Melissa Troise challenges students to recognize the relationships that exist between literary theories, such as Marxism, feminism, and postcolonialism, and urges students to expand their contexts for reading texts by accessing and combining theories. Troise believes theory provides students with the potential to better…

Engaging Faculty for Innovative STEM Bridge Programs

ERIC Educational Resources Information Center

Goldfien, Andrea C.; Badway, Norena Norton

2014-01-01

Bridge programs, in which underprepared students gain the academic and technical skills necessary for college level courses and entry-level employment, are a promising initiative for expanding access to, and success in, community college education. For career pathways related to science, technology, engineering, or mathematics (STEM), bridge…

Exploring the Issues: Humans and Computers.

ERIC Educational Resources Information Center

Walsh, Huber M.

This presentation addresses three basic social issues generated by the computer revolution. The first section, "Money Matters," focuses on the economic effects of computer technology. These include the replacement of workers by fully automated machines, the threat to professionals posed by expanded access to specialized information, and the…

Expanded Endonasal Endoscopic Approach for Resection of an Infrasellar Craniopharyngioma.

PubMed

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

2016-11-01

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

Changes in Self-reported Insurance Coverage, Access to Care, and Health Under the Affordable Care Act.

PubMed

Sommers, Benjamin D; Gunja, Munira Z; Finegold, Kenneth; Musco, Thomas

2015-07-28

The Affordable Care Act (ACA) completed its second open enrollment period in February 2015. Assessing the law's effects has major policy implications. To estimate national changes in self-reported coverage, access to care, and health during the ACA's first 2 open enrollment periods and to assess differences between low-income adults in states that expanded Medicaid and in states that did not expand Medicaid. Analysis of the 2012-2015 Gallup-Healthways Well-Being Index, a daily national telephone survey. Using multivariable regression to adjust for pre-ACA trends and sociodemographics, we examined changes in outcomes for the nonelderly US adult population aged 18 through 64 years (n = 507,055) since the first open enrollment period began in October 2013. Linear regressions were used to model each outcome as a function of a linear monthly time trend and quarterly indicators. Then, pre-ACA (January 2012-September 2013) and post-ACA (January 2014-March 2015) changes for adults with incomes below 138% of the poverty level in Medicaid expansion states (n = 48,905 among 28 states and Washington, DC) vs nonexpansion states (n = 37,283 among 22 states) were compared using a differences-in-differences approach. Beginning of the ACA's first open enrollment period (October 2013). Self-reported rates of being uninsured, lacking a personal physician, lacking easy access to medicine, inability to afford needed care, overall health status, and health-related activity limitations. Among the 507,055 adults in this survey, pre-ACA trends were significantly worsening for all outcomes. Compared with the pre-ACA trends, by the first quarter of 2015, the adjusted proportions who were uninsured decreased by 7.9 percentage points (95% CI, -9.1 to -6.7); who lacked a personal physician, -3.5 percentage points (95% CI, -4.8 to -2.2); who lacked easy access to medicine, -2.4 percentage points (95% CI, -3.3 to -1.5); who were unable to afford care, -5.5 percentage points (95% CI, -6.7 to -4.2); who reported fair/poor health, -3.4 percentage points (95% CI, -4.6 to -2.2); and the percentage of days with activities limited by health, -1.7 percentage points (95% CI, -2.4 to -0.9). Coverage changes were largest among minorities; for example, the decrease in the uninsured rate was larger among Latino adults (-11.9 percentage points [95% CI, -15.3 to -8.5]) than white adults (-6.1 percentage points [95% CI, -7.3 to -4.8]). Medicaid expansion was associated with significant reductions among low-income adults in the uninsured rate (differences-in-differences estimate, -5.2 percentage points [95% CI, -7.9 to -2.6]), lacking a personal physician (-1.8 percentage points [95% CI, -3.4 to -0.3]), and difficulty accessing medicine (-2.2 percentage points [95% CI, -3.8 to -0.7]). The ACA's first 2 open enrollment periods were associated with significantly improved trends in self-reported coverage, access to primary care and medications, affordability, and health. Low-income adults in states that expanded Medicaid reported significant gains in insurance coverage and access compared with adults in states that did not expand Medicaid.

Ad Hoc Access Gateway Selection Algorithm

NASA Astrophysics Data System (ADS)

Jie, Liu

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

Right-to-Try Investigational Therapies for Incurable Disorders.

PubMed

Simmons, Zachary

2017-10-01

Patients with life-threatening disorders such as amyotrophic lateral sclerosis, for which only minimally effective medical therapies currently exist, often seek treatments not proven to be effective and not approved by regulatory agencies for use outside of experimental treatment trials. The expanded access (compassionate use) provisions of the US Food and Drug Administration (FDA) for access to such therapies are often perceived as being inadequate. In response, states have passed right-to-try laws designed to improve access to experimental therapies for patients willing to assume the risks associated with such treatments. This situation has resulted in conflicts between those who perceive access to such treatments as their right as autonomous individuals and those who believe that the principles of beneficence and nonmaleficence justify actions of physicians and regulators in controlling access to such treatments. A variety of factors also contribute to the inequitable distribution of such treatments. Better systems are needed to improve access to promising new treatments while protecting these vulnerable patients from the abuses associated with human research in the preregulatory era.

The Interactions between Global Education Initiatives and National Education Policy and Planning Processes: A Comparative Case Study of the Education For All Fast Track Initiative in Rwanda and Ethiopia. CREATE Pathways to Access. Research Monograph No. 67

ERIC Educational Resources Information Center

Bermingham, Desmond

2011-01-01

The Education for All Fast Track Initiative (FTI) was launched by the World Bank in 2002 as a global initiative to help low income countries accelerate progress towards the MDG target of universal primary education by 2015. Over the past decade, the FTI has expanded to become one of the most important initiatives to emerge out of the Dakar World…

Sale of prescription drugs over the Internet.

PubMed

Armstrong, K; Bloom, B S

1999-01-01

Online drugstores represent one of the hottest categories in electronic commerce. The Internet offers great promise in expanding access to prescription drugs for the disabled, the elderly, and people living in rural areas. But with this promise comes the danger of eliminating the safeguards that protect consumers from inappropriate use of medications and adverse drug events. This Issue Brief highlights two studies that investigate the availability of prescription drugs over the Internet, and focuses on the alarming ease with which consumers can obtain drugs without seeing a physician or a pharmacist.

Getting Innovative Therapies Faster to Patients at the Right Dose: Impact of Quantitative Pharmacology Towards First Registration and Expanding Therapeutic Use

PubMed Central

Nayak, Satyaprakash; Sander, Oliver; Al‐Huniti, Nidal; de Alwis, Dinesh; Chain, Anne; Chenel, Marylore; Sunkaraneni, Soujanya; Agrawal, Shruti; Gupta, Neeraj

2018-01-01

Quantitative pharmacology (QP) applications in translational medicine, drug‐development, and therapeutic use were crowd‐sourced by the ASCPT Impact and Influence initiative. Highlighted QP case studies demonstrated faster access to innovative therapies for patients through 1) rational dose selection for pivotal trials; 2) reduced trial‐burden for vulnerable populations; or 3) simplified posology. Critical success factors were proactive stakeholder engagement, alignment on the value of model‐informed approaches, and utilizing foundational clinical pharmacology understanding of the therapy. PMID:29330855

An individually fitted physical barrier device as a tool to restrict the birds' spatial access: can their use alter behavioral responses?

PubMed

Pellegrini, S; Marin, R H; Guzman, D A

2015-10-01

Social interactions have been extensively studied in poultry in a variety of environmental situations. Many studies allow full social contacts between birds, but there are others in which the interactions are tested through barriers (wire mesh or glass). Thus a situation where, according to their needs, some birds can get access to physical contact with conspecifics while others cannot, would be useful to expand the testing options for social interaction studies. We developed an individual physical barrier device (IPB) that is fitted on the birds to delimit their ambulation areas by preventing them from passing across metal mesh boundaries that IPB free counterparts can easily overcome. The prototypes showing greater efficacy consisted of a small metal bar placed in the bird's back perpendicular to the sagittal plane that slightly exceeds body width, held with a harness fitted by 2 elastic fabric bands around the wings' base. To be useful, the IPB should allow natural movements and not affect the expression of behaviors (non-invasive). This study assessed whether the IPB may alter adult Japanese quail behavioral responses using 4 classical test situations: Open-Field, Runway, Time Budget in Home Box, and Mating Interactions. Open-field ambulatory behaviors were affected 1 h, but not 7 d, after IPB was fitted, suggesting that 7 d (or less) are required to habituate to the device. After that time period, IPB fitted birds showed no differences in any of the behaviors registered in the other 3 tests situations when compared to non IPB fitted birds. Findings suggest that after habituation, the IPB does not affect main behaviors in adult quail. Its application could be expanded if an IPB device is also found suitable for other poultry species. © 2015 Poultry Science Association Inc.

Making Geoscience Data Relevant for Students, Teachers, and the Public

NASA Astrophysics Data System (ADS)

Taber, M.; Ledley, T. S.; Prakash, A.; Domenico, B.

2009-12-01

The scientific data collected by government funded research belongs to the public. As such, the scientific and technical communities are responsible to make scientific data accessible and usable by the educational community. However, much geoscience data are difficult for educators and students to find and use. Such data are generally described by metadata that are narrowly focused and contain scientific language. Thus, data access presents a challenge to educators in determining if a particular dataset is relevant to their needs, and to effectively access and use the data. The AccessData project (EAR-0623136, EAR-0305058) has developed a model for bridging the scientific and educational communities to develop robust inquiry-based activities using scientific datasets in the form of Earth Exploration Toolbook (EET, http://serc.carleton.edu/eet) chapters. EET chapters provide step-by-step instructions for accessing specific data and analyzing it with a software analysis tool to explore issues or concepts in science, technology, and mathematics. The AccessData model involves working directly with small teams made up of data providers from scientific data archives or research teams, data analysis tool specialists, scientists, curriculum developers, and educators (AccessData, http://serc.carleton.edu/usingdata/accessdata). The process involves a number of steps including 1) building of the team; 2) pre-workshop facilitation; 3) face-to-face 2.5 day workshop; 4) post-workshop follow-up; 5) completion and review of the EET chapter. The AccessData model has been evolved over a series of six annual workshops hosting ~10 teams each. This model has been expanded to other venues to explore expanding its scope and sustainable mechanisms. These venues include 1) workshops focused on the data collected by a large research program (RIDGE, EarthScope); 2) a workshop focused on developing a citizen scientist guide to conducting research; and 3) facilitating a team on an annual basis within the structure of the Federation of Earth Science Information Partners (ESIP Federation), leveraging their semi-annual meetings. In this presentation we will describe the AccessData model of making geoscience data accessible and usable in educational contexts from the perspective of both the organizers and from a team. We will also describe how this model has been adapted to other contexts to facilitate a broader reach of geoscience data.

Evaluation of the first pharmacist-administered vaccinations in Western Australia: a mixed-methods study.

PubMed

Hattingh, H Laetitia; Sim, T Fei; Parsons, R; Czarniak, P; Vickery, A; Ayadurai, S

2016-09-20

This study evaluated the uptake of Western Australian (WA) pharmacist vaccination services, the profiles of consumers being vaccinated and the facilitators and challenges experienced by pharmacy staff in the preparation, implementation and delivery of services. Mixed-methods methodology with both quantitative and qualitative data through surveys, pharmacy computer records and immuniser pharmacist interviews. Community pharmacies in WA that provided pharmacist vaccination services between March and October 2015. Immuniser pharmacists from 86 pharmacies completed baseline surveys and 78 completed exit surveys; computer records from 57 pharmacies; 25 immuniser pharmacists were interviewed. Pharmacy and immuniser pharmacist profiles; pharmacist vaccination services provided and consumer profiles who accessed services. 15 621 influenza vaccinations were administered by immuniser pharmacists at 76 WA community pharmacies between March and October 2015. There were no major adverse events, and <1% of consumers experienced minor events which were appropriately managed. Between 12% and 17% of consumers were eligible to receive free influenza vaccinations under the National Immunisation Program but chose to have it at a pharmacy. A high percentage of vaccinations was delivered in rural and regional areas indicating that provision of pharmacist vaccination services facilitated access for rural and remote consumers. Immuniser pharmacists reported feeling confident in providing vaccination services and were of the opinion that services should be expanded to other vaccinations. Pharmacists also reported significant professional satisfaction in providing the service. All participating pharmacies intended to continue providing influenza vaccinations in 2016. This initial evaluation of WA pharmacist vaccination services showed that vaccine delivery was safe. Convenience and accessibility were important aspects in usage of services. There is scope to expand pharmacist vaccination services to other vaccines and younger children; however, government funding to pharmacists needs to be considered. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Expanding Home-Based Primary Care to American Indian Reservations and Other Rural Communities: An Observational Study.

PubMed

Kramer, B Josea; Creekmur, Beth; Mitchell, Michael N; Saliba, Debra

2018-04-01

Home-based primary care (HBPC) is a comprehensive, interdisciplinary program to meet the medical needs of community-dwelling populations needing long-term care (LTC). The U.S. Department of Veterans Affairs (VA) expanded its HBPC program to underserved rural communities, including American Indian reservations, providing a "natural laboratory" to study change in access to VA LTC benefits and utilization outcomes for rural populations that typically face challenges in accessing LTC medical support. Pretest-Posttest quasi-experimental approach with interrupted time-series design using linked VA, Medicare, and Indian Health Service (IHS) records. American Indian reservations and non-Indian communities in rural HBPC catchment areas. 376 veterans (88 IHS beneficiaries, 288 non-IHS beneficiaries) with a HBPC length of stay of 12 months or longer. Baseline demographic and health characteristics, activities of daily living (ADL), previous VA enrollment, and hospital admissions and emergency department (ED) visits as a function of time, accounting for IHS beneficiary and functional statuses. For HBPC users, VA enrollment increased by 22%. At baseline, 30% of IHS and non-IHS beneficiaries had 2 or more ADLs impairments; IHS populations were younger (P < .001) and had more diagnosed chronic diseases (P = .007). Overall, hospital admissions decreased by 0.10 (95% confidence interval (CI) = -0.14 to -0.05) and ED visits decreased by 0.13 (95% CI = -0.19 to -0.07) in the 90 days after HBPC admission (Ps < .001) and these decreases were maintained over 1 year follow-up. Before HBPC, probability of hospital admission was 12% lower for IHS than non-IHS beneficiaries (P = .02). Introducing HBPC to rural areas increased access to LTC and enrollment for healthcare benefits, with equitable outcomes in IHS and non-IHS populations. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

Development and Dissemination of the El Centro Health Disparities Measures Library.

PubMed

Mitrani, Victoria Behar; O'Day, Joanne E; Norris, Timothy B; Adebayo, Oluwamuyiwa Winifred

2017-09-01

This report describes the development and dissemination of a library of English measures, with Spanish translations, on constructs relevant to social determinants of health and behavioral health outcomes. The El Centro Measures Library is a product of the Center of Excellence for Health Disparities Research: El Centro, a program funded by the National Institute on Minority Health and Health Disparities of the U.S. National Institutes of Health. The library is aimed at enhancing capacity for minority health and health disparities research, particularly for Hispanics living in the United States and abroad. The open-access library of measures (available through www.miami.edu/sonhs/measureslibrary) contains brief descriptions of each measure, scoring information (where available), links to related peer-reviewed articles, and measure items in both languages. Links to measure websites where commercially available measures can be purchased are included, as is contact information for measures that require author permission. Links to several other measures libraries are hosted on the library website. Other researchers may contribute to the library. El Centro investigators began the library by electing to use a common set of measures across studies to assess demographic information, culture-related variables, proximal outcomes of interest, and major outcomes. The collection was expanded to include other health disparity research studies. In 2012, a formal process was developed to organize, expand, and centralize the library in preparation for a gradual process of dissemination to the national and international community of researchers. The library currently contains 61 measures encompassing 12 categories of constructs. Thus far, the library has been accessed 8,883 times (unique page views as generated by Google Analytics), and responses from constituencies of users and measure authors have been favorable. With the paucity of availability and accessibility of translated measures, behavioral nursing research focused on reducing health disparities can benefit from repositories of research instruments such as the El Centro Measures Library. © 2017 Sigma Theta Tau International.

Caring for Pregnant Women with Opioid Use Disorder in the USA: Expanding and Improving Treatment.

PubMed

Saia, Kelley A; Schiff, Davida; Wachman, Elisha M; Mehta, Pooja; Vilkins, Annmarie; Sia, Michelle; Price, Jordana; Samura, Tirah; DeAngelis, Justin; Jackson, Clark V; Emmer, Sawyer F; Shaw, Daniel; Bagley, Sarah

Opioid use disorder in the USA is rising at an alarming rate, particularly among women of childbearing age. Pregnant women with opioid use disorder face numerous barriers to care, including limited access to treatment, stigma, and fear of legal consequences. This review of opioid use disorder in pregnancy is designed to assist health care providers caring for pregnant and postpartum women with the goal of expanding evidence-based treatment practices for this vulnerable population. We review current literature on opioid use disorder among US women, existing legislation surrounding substance use in pregnancy, and available treatment options for pregnant women with opioid use disorder. Opioid agonist treatment (OAT) remains the standard of care for treating opioid use disorder in pregnancy. Medically assisted opioid withdrawal ("detoxification") is not recommended in pregnancy and is associated with high maternal relapse rates. Extended release naltrexone may confer benefit for carefully selected patients. Histories of trauma and mental health disorders are prevalent in this population; and best practice recommendations incorporate gender-specific, trauma-informed, mental health services. Breastfeeding with OAT is safe and beneficial for the mother-infant dyad. Further research investigating options of OAT and the efficacy of opioid antagonists in pregnancy is needed. The US health care system can adapt to provide quality care for these mother-infant dyads by expanding comprehensive treatment services and improving access to care.

Expansion of antiretroviral treatment to rural health centre level by a mobile service in Mumbwa district, Zambia

PubMed Central

Dube, Christopher; Hayakawa, Tadao; Kakimoto, Kazuhiro; Yamada, Norio; Simpungwe, James B

2010-01-01

Abstract Problem Despite the Government’s effort to expand services to district level, it is still hard for people living with HIV to access antiretroviral treatment (ART) in rural Zambia. Strong demands for expanding ART services at the rural health centre level face challenges of resource shortages. Approach The Mumbwa district health management team introduced mobile ART services using human resources and technical support from district hospitals, and community involvement at four rural health centres in the first quarter of 2007. This paper discusses the uptake of the mobile ART services in rural Mumbwa. Local setting Mumbwa is a rural district with an area of 23 000 km2 and a population of 167 000. Before the introduction of mobile services, ART services were provided only at Mumbwa District Hospital. Relevant changes The mobile services improved accessibility to ART, especially for clients in better functional status, i.e. still able to work. In addition, these mobile services may reduce the number of cases “lost to follow-up”. This might be due to the closer involvement of the community and the better support offered by these services to rural clients. Lessons learnt These mobile ART services helped expand services to rural health facilities where resources are limited, bringing them as close as possible to where clients live. PMID:20931065

Partnering with NASA: An Overview

NASA Technical Reports Server (NTRS)

Martin, Gary

2017-01-01

Partnerships is an important part of doing business at NASA. NASA partners with external organizations to access capabilities under collaborative agreements; enters into agreements for partner access to NASA capabilities; expand overall landscape of space activity; and spurring innovation. NASA partnerships consist of Reimbursable and Non-Reimbursable Space Act Agreements. Partnerships at Ames aligns with Ames' core competencies, and Partners often office in the NASA Research Park, which is an established regional innovation cluster that facilitates commercialization and services as a technology accelerator via onsite collaborations between NASA and its partners.

Understanding access to healthcare among Indigenous peoples: A comparative analysis of biomedical and postcolonial perspectives.

PubMed

Horrill, Tara; McMillan, Diana E; Schultz, Annette S H; Thompson, Genevieve

2018-03-25

As nursing professionals, we believe access to healthcare is fundamental to health and that it is a determinant of health. Therefore, evidence suggesting access to healthcare is problematic for many Indigenous peoples is concerning. While biomedical perspectives underlie our current understanding of access, considering alternate perspectives could expand our awareness of and ability to address this issue. In this paper, we critique how access to healthcare is understood through a biomedical lens, how a postcolonial theoretical lens can extend that understanding, and the subsequent implications this alternative view raises for the nursing profession. Drawing on peer-reviewed published and gray literature concerning healthcare access and Indigenous peoples to inform this critique, we focus on the underlying theoretical lens shaping our current understanding of access. A postcolonial analysis provides a way of understanding healthcare as a social space and social relationship, presenting a unique perspective on access to healthcare. The novelty of this finding is of particular importance for the profession of nursing, as we are well situated to influence these social aspects, improving access to healthcare services broadly, and among Indigenous peoples specifically. © 2018 The Authors Nursing Inquiry published by John Wiley & Sons Ltd.

Influencing Factors in OER Usage of Adult Learners in Korea

ERIC Educational Resources Information Center

Kim, Byoung Wook; Lee, Won Gyu; Lee, Byeong Rae; Shon, Jin Gon

2015-01-01

Open Educational Resources (OER) is terminology that refers to educational resources (content and software) distributed through the Internet, free of charge and freely accessible, expanding learning opportunities for adult learners. This terminology first appeared around 2002, although its roots can be traced to the open architecture of the…

Opportunities and Challenges for Geographically Expanding N-Sink

EPA Science Inventory

The N-Sink tool was created to provide a useful and accessible means for local land use managers to explore the relationship of land use in their towns and counties to nitrogen pollution of their waters. N-Sink focuses on three types of landscape N sinks: wetlands, lakes/ponds/re...

Chilean Universities in the Transition to a Market-Driven Policy Regime

ERIC Educational Resources Information Center

Katz, Jorge; Spence, Randy

2009-01-01

This paper briefly reviews the historical development of the university system in Chile, and describes the current structure of funding, supply and demand for tertiary education, research and university services. Both public and private universities in Chile have expanded and restructured, access to tertiary education has improved, and…

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

ERIC Educational Resources Information Center

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

2011-01-01

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

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

ERIC Educational Resources Information Center

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

2008-01-01

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

Why Not OER?

ERIC Educational Resources Information Center

Doan, Tomalee

2017-01-01

Many observers find it baffling that faculty in higher education have been slow to adopt open educational resources (OER). The William and Flora Hewlett Foundation, a private foundation that makes grants to expand access to learning materials, defines OER as: Teaching, learning, and research resources that reside in the public domain or have been…

"Disproportionately Influential?"

ERIC Educational Resources Information Center

Stuart, Reginald

2010-01-01

This article discusses why the Lumina Foundation is considered so influential in higher education despite its small size and the fact that is is a relatively new foundation. Lumina approaches its 10th anniversary this month with a focused higher education funding mission targeting efforts aimed at expanding access and success beyond high school,…

Reinventing Clinical Roles and Space at School

ERIC Educational Resources Information Center

Petersen, Sarah Bernhardt

2008-01-01

Recognizing both the need for youth-focused acute mental health services and the barriers for low-income families to access outside services, the RALLY Program expanded its services to include direct clinical services for students within the school setting. This article explores the challenges, strategies, and benefits of implementing a fluid…

Research Using Government Data Sets: An Underutilised Resource

ERIC Educational Resources Information Center

Knipe, Sally

2011-01-01

The use of existing data for education research activities can be a valuable resource. Improvement in statistical analysis and data management and retrieval techniques, as well as access to government data bases, has expanded opportunities for researchers seeking to investigate issues that are institutional in nature, such as participation…

Education = Success: Empowering Hispanic Youth and Adults.

ERIC Educational Resources Information Center

Carnevale, Anthony P.

This report discusses the education and empowerment of Hispanic Americans, stressing the importance of expanding access to educational opportunity from preschool through graduate and professional school. The report focuses on closing the educational and opportunity gap faced by Hispanics in the United States. After an introduction, "A Hard Look at…

Defense.gov Special Report: Travels with Gates - March 2011

Science.gov Websites

Troops Expand Security in Afghanistan NATO Ministers to Discuss Afghanistan, Libya Secretary Addresses , Karzai Discuss Civilian Casualties Secretary Fields Questions at Bagram Airfield Gates Arrives in FEAR Act Plain Writing Act of 2010 Accessibility/Section 508 Join the Military Careers Web Policy Stay

75 FR 34802 - Meeting To Learn of U.S. Information and Communications Technologies (ICT) Industry Efforts To...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-18

.../non-governmental organizations and corporations is encouraged. In addition, presentations on the... Coordinator for International Communications and Information Policy (CIP) will hold a public meeting on July 9...) advocates international policies for expanded access to information and communication technologies (ICT...

77 FR 55877 - Initial Test Program of Condensate and Feedwater Systems for Light-Water Reactors

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-11

...-492- 3668; email: [email protected] . NRC's Agencywide Documents Access and Management System... Systems for Light-Water Reactors AGENCY: Nuclear Regulatory Commission. ACTION: Regulatory guide; issuance... Systems for Boiling Water Reactor Power Plants.'' This regulatory guide is being revised to: (1) Expand...

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

ERIC Educational Resources Information Center

Texas Center for Educational Research, 2011

2011-01-01

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

Degrees of Freedom: Expanding College Opportunities for Currently and Formerly Incarcerated Californians

ERIC Educational Resources Information Center

Mukamal, Debbie; Silbert, Rebecca; Taylor, Rebecca M.

2015-01-01

"Degrees of Freedom" finds that California has not been adequately providing effective college opportunities for criminal justice-involved students, despite the fact that such access will help California build safer and more economically viable communities. This report is part of a larger initiative--Renewing Communities--to expand…

Dissertation Genre Change as a Result of Electronic Theses and Dissertation Programs

ERIC Educational Resources Information Center

Pantelides, Kate

2015-01-01

The increasing prevalence of mandatory Electronic Theses and Dissertations (ETDs) policies has ushered in rather dramatic dissertation genre change. The affordances of the medium offer expanded access and audience, availability of new compositional tools, and alternate formats, the implications of which are just beginning to appear in…

Expanding Access to Learning with Mobile Digital Devices

ERIC Educational Resources Information Center

Carter, Jeff

2017-01-01

From the outset of the author's career in adult education 20 years ago, teachers, program directors, and policymakers were touting the use of technology to improve student learning (and professional development for teachers as well). Unfortunately, however, despite islands of excellence here and there, the introduction of computers and digital…

What the Numbers Say about Community Colleges and Athletics

ERIC Educational Resources Information Center

Bush, V. Barbara; Castaneda, Cindy; Hardy, David E.; Katsinas, Stephen G.

2009-01-01

Evidence clearly points to the presence of intercollegiate athletics at the early junior colleges established prior to World War I. Moving into more current times, the authors find among prominent reasons for institutional involvement with athletics giving students a "true college experience," expanding access, recruiting a more diverse student…

78 FR 60177 - National Public Lands Day, 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-01

... diverse and rugged landscapes reflect our national character, the way we care for these open spaces.... Since I established this initiative, we have expanded access to recreation, restored critical landscapes, and created urban parks and water trails. We are also working with partners to let young people serve...

Distance Learning in Higher Education. CHEA Update Number 3.

ERIC Educational Resources Information Center

Council for Higher Education Accreditation, Washington, DC.

This report discusses issues related to distance learning in higher education. Section 1, "The Expanding Universe of Distance Learning," examines: data from a new national survey on higher education distance learning; Internet access in elementary and secondary schools; the 1999 national survey of information technology in higher…

The Competitive Edge: Expanded Access Drives Vendors.

ERIC Educational Resources Information Center

Pepin, Theresa; And Others

1997-01-01

This report analyzes data gathered from 29 automated library system vendors who responded to a 1996 survey. The survey also requested their perceptions of Java (an object-oriented programming language) and network computers, and issues and trends to be considered by library administrators. Contact information about the vendors is provided. (Four…

BIG SIOUX RIVER DRAINAGE BASIN INFORMATION OUTREACH PROJECT

EPA Science Inventory

The main goal of the proposed project is to raise public awareness about the importance of protecting the Big Sioux River drainage basin. To accomplish this goal, the City and its partnering agencies are seeking to expand and improve public accessibility to a wide variety of r...