The association of greater dispositional optimism with less endogenous pain facilitation is indirectly transmitted through lower levels of pain catastrophizing.

PubMed

Goodin, Burel R; Glover, Toni L; Sotolongo, Adriana; King, Christopher D; Sibille, Kimberly T; Herbert, Matthew S; Cruz-Almeida, Yenisel; Sanden, Shelley H; Staud, Roland; Redden, David T; Bradley, Laurence A; Fillingim, Roger B

2013-02-01

Dispositional optimism has been shown to beneficially influence various experimental and clinical pain experiences. One possibility that may account for decreased pain sensitivity among individuals who report greater dispositional optimism is less use of maladaptive coping strategies such as pain catastrophizing, a negative cognitive/affective response to pain. An association between dispositional optimism and conditioned pain modulation, a measure of endogenous pain inhibition, has previously been reported. However, it remains to be determined whether dispositional optimism is also associated with temporal summation (TS), a measure of endogenous pain facilitation. The current study examined whether pain catastrophizing mediated the association between dispositional optimism and TS among 140 older, community-dwelling adults with symptomatic knee osteoarthritis. Individuals completed measures of dispositional optimism and pain catastrophizing. TS was then assessed using a tailored heat pain stimulus on the forearm. Greater dispositional optimism was significantly related to lower levels of pain catastrophizing and TS. Bootstrapped confidence intervals revealed that less pain catastrophizing was a significant mediator of the relation between greater dispositional optimism and diminished TS. These findings support the primary role of personality characteristics such as dispositional optimism in the modulation of pain outcomes by abatement of endogenous pain facilitation and less use of catastrophizing. Results from this study further support the body of evidence that attests to the beneficial effects of positive personality traits on pain sensitivity and pain processing. Further, this study identified diminished pain catastrophizing as an important mechanism explaining the inverse relation between dispositional optimism and endogenous pain facilitation. Copyright © 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.

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."

The emergence of global health partnerships as facilitators of access to medication in Africa: a narrative policy analysis.

PubMed

Ngoasong, Michael Zisuh

2009-03-01

Over the last decade global health partnerships (GHPs) have been formed to provide a better policy response to Africa's health problems. This paper uses narrative policy analysis to explain the historical processes and challenges facing national and global health policy in facilitating access to medication in African countries. An overview of the historical context of events leading to the creation of GHPs is followed by a content and context analysis of two GHPs - Roll Back Malaria partnership and the Accelerating Access Initiative. The historical narratives implicitly reflect the context in which policy decisions are produced and implemented. The deployment of GHPs in Africa reflects a convergence of the competing and conflicting narratives, in relating to strategies previously promoted by various multilateral and bilateral development agencies, international civil society organizations, and the private commercial industry to facilitate access to medication.

Conscious intention to speak proactively facilitates lexical access during overt object naming

PubMed Central

Strijkers, Kristof; Holcomb, Phillip J.; Costa, Albert

2013-01-01

The present study explored when and how the top-down intention to speak influences the language production process. We did so by comparing the brain’s electrical response for a variable known to affect lexical access, namely word frequency, during overt object naming and non-verbal object categorization. We found that during naming, the event-related brain potentials elicited for objects with low frequency names started to diverge from those with high frequency names as early as 152 ms after stimulus onset, while during non-verbal categorization the same frequency comparison appeared 200 ms later eliciting a qualitatively different brain response. Thus, only when participants had the conscious intention to name an object the brain rapidly engaged in lexical access. The data offer evidence that top-down intention to speak proactively facilitates the activation of words related to perceived objects. PMID:24039339

Facilitation in Caribbean coral reefs: high densities of staghorn coral foster greater coral condition and reef fish composition.

PubMed

Huntington, Brittany E; Miller, Margaret W; Pausch, Rachel; Richter, Lee

2017-05-01

Recovery of the threatened staghorn coral (Acropora cervicornis) is posited to play a key role in Caribbean reef resilience. At four Caribbean locations (including one restored and three extant populations), we quantified characteristics of contemporary staghorn coral across increasing conspecific densities, and investigated a hypothesis of facilitation between staghorn coral and reef fishes. High staghorn densities in the Dry Tortugas exhibited significantly less partial mortality, higher branch growth, and supported greater fish abundances compared to lower densities within the same population. In contrast, partial mortality, branch growth, and fish community composition did not vary with staghorn density at the three other study locations where staghorn densities were lower overall. This suggests that density-dependent effects between the coral and fish community may only manifest at high staghorn densities. We then evaluated one facilitative mechanism for such density-dependence, whereby abundant fishes sheltering in dense staghorn aggregations deliver nutrients back to the coral, fueling faster coral growth, thereby creating more fish habitat. Indeed, dense staghorn aggregations within the Dry Tortugas exhibited significantly higher growth rates, tissue nitrogen, and zooxanthellae densities than sparse aggregations. Similarly, higher tissue nitrogen was induced in a macroalgae bioassay outplanted into the same dense and sparse aggregations, confirming greater bioavailability of nutrients at high staghorn densities. Our findings inform staghorn restoration efforts, suggesting that the most effective targets may be higher coral densities than previously thought. These coral-dense aggregations may reap the benefits of positive facilitation between the staghorn and fish community, favoring the growth and survivorship of this threatened species.

Facilitating access to pre-processed research evidence in public health

PubMed Central

2010-01-01

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

Updating in working memory predicts greater emotion reactivity to and facilitated recovery from negative emotion-eliciting stimuli

PubMed Central

Pe, Madeline L.; Koval, Peter; Houben, Marlies; Erbas, Yasemin; Champagne, Dominique; Kuppens, Peter

2015-01-01

That emotions change in response to emotion-eliciting events is a natural part of human life. However, it is equally important for emotions to return to baseline once the emotion-eliciting events have passed. This suggests that the ability to emotionally react to and recover from emotion-eliciting events is critical for healthy psychological functioning. But why do individuals differ in their emotion reactivity and recovery? The present work postulates that the ability to update emotional information in working memory (WM) may explain individual differences in emotion reactivity and recovery. Two studies are presented, which examined whether updating ability was related to emotion reactivity and recovery. In Study 1, we assessed participants' self-reported affect as they viewed negative and positive films. Our results revealed that better updating ability was related to greater emotion reactivity and facilitated (i.e., quicker) recovery from watching negative films. In Study 2, participants recalled a recent angering event, and were then instructed to either ruminate about or reappraise the event. Results revealed that updating ability was again related to greater emotion reactivity and facilitated (i.e., successful) emotion recovery in response to the angering event, and that this was unrelated to the emotion regulation strategy used. These findings identify the ability to update emotional information in WM as a possible mechanism in emotion responding. PMID:25914655

Predictors of Parent Involvement and Their Impact on Access of Postsecondary Education Facilitators among White and American Indian Parents

ERIC Educational Resources Information Center

Bardhoshi, Gerta; Duncan, Kelly; Schweinle, Amy

2016-01-01

This study examined demographic factors as predictors of parent involvement (engagement with school, support of learning, support of child) among parents of children that attended a school implementing a college access program. The authors also examined whether involvement predicted access of postsecondary education facilitators in parents, when…

The association of greater dispositional optimism with less endogenous pain facilitation is indirectly transmitted through lower levels of pain catastrophizing

PubMed Central

Goodin, Burel R.; Glover, Toni L.; Sotolongo, Adriana; King, Christopher D.; Sibille, Kimberly T.; Herbert, Matthew S.; Cruz-Almeida, Yenisel; Sanden, Shelley H.; Staud, Roland; Redden, David T.; Bradley, Laurence A.; Fillingim, Roger B.

2012-01-01

Dispositional optimism has been shown to beneficially influence various experimental and clinical pain experiences. One possibility that may account for decreased pain sensitivity among individuals who report greater dispositional optimism is less use of maladaptive coping strategies like pain catastrophizing, a negative cognitive/affective response to pain. An association between dispositional optimism and conditioned pain modulation (CPM), a measure of endogenous pain inhibition, has previously been reported. However, it remains to be determined whether dispositional optimism is also associated with temporal summation (TS), a measure of endogenous pain facilitation. The current study examined whether pain catastrophizing mediated the association between dispositional optimism and TS among 140 older, community-dwelling adults with symptomatic knee osteoarthritis. Individuals completed measures of dispositional optimism and pain catastrophizing. TS was then assessed using a tailored heat pain stimulus on the forearm. Greater dispositional optimism was significantly related to lower levels of pain catastrophizing and TS. Bootstrapped confidence intervals revealed that less pain catastrophizing was a significant mediator of the relation between greater dispositional optimism and diminished TS. These findings support the primary role of personality characteristics such as dispositional optimism in the modulation of pain outcomes by abatement of endogenous pain facilitation and less use of catastrophizing. PMID:23218934

75 FR 35989 - Facilitating the Provision of Fixed and Mobile Broadband Access, Educational and Other Advanced...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-24

...] Facilitating the Provision of Fixed and Mobile Broadband Access, Educational and Other Advanced Services in the...), clarifying the requirements necessary for Broadband Radio Service (BRS) and Educational Broadband Service (EBS) licensees to demonstrate substantial service and ensure that BRS licensees of new initial...

Barriers and facilitators to accessing skilled birth attendants in Afar region, Ethiopia.

PubMed

King, Rosemary; Jackson, Ruth; Dietsch, Elaine; Hailemariam, Asseffa

2015-05-01

to explore barriers and facilitators that enable women to access skilled birth attendance in Afar Region, Ethiopia. researchers used a Key Informant Research approach (KIR), whereby Health Extension Workers participated in an intensive training workshop and conducted interviews with Afar women in their communities. Data was also collected from health-care workers through questionnaires, interviews and focus groups. fourteen health extension workers were key informants and interviewers; 33 women and eight other health-care workers with a range of experience in caring for Afar childbearing women provided data as individuals and in focus groups. participants identified friendly service, female skilled birth attendants (SBA) and the introduction of the ambulance service as facilitators to SBA. There are many barriers to accessing SBA, including women׳s low status and restricted opportunities for decision making, lack of confidence in health-care facilities, long distances, cost, domestic workload, and traditional practices which include a preference for birthing at home with a traditional birth attendant. many Afar men and women expressed a lack of confidence in the services provided at health-care facilities which impacts on skilled birth attendance utilisation. ambulance services that are free of charge to women are effective as a means to transfer women to a hospital for emergency care if required and expansion of ambulance services would be a powerful facilitator to increasing institutional birth. Skilled birth attendants working in institutions need to ensure their practice is culturally, physically and emotionally safe if more Afar women are to accept their midwifery care. Adequate equipping and staffing of institutions providing emergency obstetric and newborn care will assist in improving community perceptions of these services. Most importantly, mutual respect and collaboration between traditional birth attendants (Afar women׳s preferred caregiver), health

Barriers and facilitators of access to maternal services for women with disabilities: scoping review protocol.

PubMed

Mheta, Doreen; Mashamba-Thompson, Tivani P

2017-05-16

The Sustainable Development Goals (SDGs) emphasises the increasing equitable coverage of quality health care and provision of integrated services as means of reducing maternal mortality. Despite so much effort being placed on improved access to maternity health care, studies show that women with disabilities are being systemically excluded from the mainstream maternal health services. The proposed scoping review aims to map literature on the barriers and facilitators of access to maternal services for women with disabilities. The search strategy for this scoping review study will involve electronic databases including Pubmed, MEDLINE via EBSCOhost, CINAHL Plus with full text via EBSCOhost, Africa-Wide Info via EBSCOhost, JSTOR and Proquest Health and Medical Complete. Articles will also be searched through the "Cited by" search as well as citations included in the reference lists of included articles. A two-stage mapping strategy would be conducted. Stage 1 would be to screen studies through examining their titles. Furthermore, we will screen abstracts of the identified studies descriptively and by focus and method as stipulated by the inclusion and exclusion criteria. In stage 2, we will extract data from the included studies. A parallel screening and data extraction will be undertaken by two reviewers. We will access the quality of the included studies using the mixed methods appraisal tool (MMAT). We will use NVIVO version 10 to extract the relevant outcomes and thematic analysis of the studies. We anticipate to find relevant studies reporting evidence on the barriers and facilitators of access to maternal health services in Sub-Saharan Africa. The evidence obtained from the included studies when summarised will help guide future research. The study findings will be disseminated electronically and in print. In addition, it will be presented at conferences related to sexual reproductive health, maternal health care and reproductive health.

"Where to find those doctors?" A qualitative study on barriers and facilitators in access to and utilization of health care services by Polish migrants in Norway.

PubMed

Czapka, Elżbieta Anna; Sagbakken, Mette

2016-09-01

Poles constitute the largest group of migrants in Norway. Research confirms a steady inflow and a minimal outflow of Polish migrants. One of the key aspects of migrants' structural integration is access to health care services. This study explored barriers to and facilitators of Polish migrants' access to Norwegian health care services. A qualitative interview-based study was carried out between November 2013 and July 2014. The study is part of a larger, ongoing mixed-method study of Polish migrants' access to health care services in Norway. Semi-structured interviews were conducted with 19 Polish migrants in Oslo. The interviews were transcribed, coded, and analyzed. Thematic analysis was performed to identify barriers and facilitators related to the use of Norwegian health care services. Migrants experienced several barriers to and facilitators of access to health care services in Norway. The barriers most often mentioned were problems resulting from insufficient command of the language, related communication problems, and lack of knowledge about navigating the Norwegian health care system. Other barriers related to the organization of the health care system, perceptions of doctors' skills and practices, and attitudes among health personnel. Factors such as having a Polish social network, meeting friendly health personnel, and perceptions of equal treatment of all patients, facilitated access to and use of health care services. The study shows that there are both system- and patient-related barriers to and facilitators of migrants' access to health services in Norway. These findings suggest that successful inclusion of migrants into the Norwegian health system requires regular evaluation of access and utilization of health care services.

Use of an angiographic catheter to facilitate fluoroscopy-guided percutaneous renal access in cases with diffuse contrast extravasation.

PubMed

Giannakopoulos, Stilianos; Bantis, Athanasios; Kalaitzis, Christos; Touloupidis, Stavros

2010-10-01

Occasionally during percutaneous surgery, significant contrast extravasation obscures the field, making fluoroscopic access no longer feasible. Herein, we describe a salvage technique. The cystoscopically placed, open-end ureteral catheter is exchanged with an angled-tip angiographic catheter. With the aid of a guidewire and under fluoroscopic guidance, the tip of the catheter is placed in a posterior calix. The "bull's eye" technique is then applied to direct the needle into the tip of the catheter. This technique was used in four cases over a 7-year period. Successful access was accomplished in all cases through a middle or upper calix. The catheter serves as a target for providing access to the renal collecting system and facilitates final tract dilatation.

Greater access to fast-food outlets is associated with poorer bone health in young children.

PubMed

Vogel, C; Parsons, C; Godfrey, K; Robinson, S; Harvey, N C; Inskip, H; Cooper, C; Baird, J

2016-03-01

A healthy diet positively influences childhood bone health, but how the food environment relates to bone development is unknown. Greater neighbourhood access to fast-food outlets was associated with lower bone mass among infants, while greater access to healthy speciality stores was associated with higher bone mass at 4 years. Identifying factors that contribute to optimal childhood bone development could help pinpoint strategies to improve long-term bone health. A healthy diet positively influences bone health from before birth and during childhood. This study addressed a gap in the literature by examining the relationship between residential neighbourhood food environment and bone mass in infants and children. One thousand one hundred and seven children participating in the Southampton Women's Survey, UK, underwent measurement of bone mineral density (BMD) and bone mineral content (BMC) at birth and 4 and/or 6 years by dual-energy X-ray absorptiometry (DXA). Cross-sectional observational data describing food outlets within the boundary of each participant's neighbourhood were used to derive three measures of the food environment: the counts of fast-food outlets, healthy speciality stores and supermarkets. Neighbourhood exposure to fast-food outlets was associated with lower BMD in infancy (β = -0.23 (z-score): 95% CI -0.38, -0.08) and lower BMC after adjustment for bone area and confounding variables (β = -0.17 (z-score): 95% CI -0.32, -0.02). Increasing neighbourhood exposure to healthy speciality stores was associated with higher BMD at 4 and 6 years (β = 0.16(z-score): 95% CI 0.00, 0.32 and β = 0.13(z-score): 95% CI -0.01, 0.26 respectively). The relationship with BMC after adjustment for bone area and confounding variables was statistically significant at 4 years, but not at 6 years. The neighbourhood food environment that pregnant mothers and young children are exposed may affect bone development during early childhood. If confirmed in

Brokered virtual hubs for facilitating access and use of geospatial Open Data

NASA Astrophysics Data System (ADS)

Mazzetti, Paolo; Latre, Miguel; Kamali, Nargess; Brumana, Raffaella; Braumann, Stefan; Nativi, Stefano

2016-04-01

Open Data is a major trend in current information technology scenario and it is often publicised as one of the pillars of the information society in the near future. In particular, geospatial Open Data have a huge potential also for Earth Sciences, through the enablement of innovative applications and services integrating heterogeneous information. However, open does not mean usable. As it was recognized at the very beginning of the Web revolution, many different degrees of openness exist: from simple sharing in a proprietary format to advanced sharing in standard formats and including semantic information. Therefore, to fully unleash the potential of geospatial Open Data, advanced infrastructures are needed to increase the data openness degree, enhancing their usability. In October 2014, the ENERGIC OD (European NEtwork for Redistributing Geospatial Information to user Communities - Open Data) project, funded by the European Union under the Competitiveness and Innovation framework Programme (CIP), has started. In response to the EU call, the general objective of the project is to "facilitate the use of open (freely available) geographic data from different sources for the creation of innovative applications and services through the creation of Virtual Hubs". The ENERGIC OD Virtual Hubs aim to facilitate the use of geospatial Open Data by lowering and possibly removing the main barriers which hampers geo-information (GI) usage by end-users and application developers. Data and services heterogeneity is recognized as one of the major barriers to Open Data (re-)use. It imposes end-users and developers to spend a lot of effort in accessing different infrastructures and harmonizing datasets. Such heterogeneity cannot be completely removed through the adoption of standard specifications for service interfaces, metadata and data models, since different infrastructures adopt different standards to answer to specific challenges and to address specific use-cases. Thus

Available Tools to Facilitate Early Patient Access to Medicines in the EU and the USA: Analysis of Conditional Approvals and the Implications for Personalized Medicine.

PubMed

Leyens, Lada; Richer, Étienne; Melien, Øyvind; Ballensiefen, Wolfgang; Brand, Angela

2015-01-01

Scientific knowledge and our understanding of the human body and diseases have limited any possible treatment tailoring to each patient. The technological advances enabling the integration of various data sets (e.g. '-omics', microbiome, epigenetics and environmental exposure) have facilitated a greater understanding of the human body, the molecular basis of disease and all the factors influencing disease onset, progression and response to treatment, thereby ushering in the era of personalized medicine. We evaluate the regulatory approaches available to facilitate early patient access to efficacious and safe compounds in the EU and the USA in order to make more informed recommendations in the future as to the gaps in regulations for early patient access. An in-depth analysis of conditional approvals (EU) and accelerated approvals (USA) is performed based on the publicly available information (European public assessment reports and a summary review of products approved under both programmes). The types of product, indications, time to approval and type of evidence submitted were analysed. Between 2007 and early 2015, 17 products were conditionally approved in the EU and 25 in the USA, most of them in the area of oncology and based on evidence from phase II clinical trial data. Early approval of promising products based on data from early phases of development is already possible in the EU and the USA. Some of the improvements could entail implementing a rolling assessment of evidence in Europe and extending the scope of early dialogues. © 2015 S. Karger AG, Basel.

What do parents perceive are the barriers and facilitators to accessing psychological treatment for mental health problems in children and adolescents? A systematic review of qualitative and quantitative studies.

PubMed

Reardon, Tessa; Harvey, Kate; Baranowska, Magdalena; O'Brien, Doireann; Smith, Lydia; Creswell, Cathy

2017-06-01

A minority of children and adolescents with mental health problems access treatment. The reasons for poor rates of treatment access are not well understood. As parents are a key gatekeeper to treatment access, it is important to establish parents' views of barriers/facilitators to accessing treatment. The aims of this study are to synthesise findings from qualitative and quantitative studies that report parents' perceptions of barriers/facilitators to accessing treatment for mental health problems in children/adolescents. A systematic review and narrative synthesis were conducted. Forty-four studies were included in the review and were assessed in detail. Parental perceived barriers/facilitators relating to (1) systemic/structural issues; (2) views and attitudes towards services and treatment; (3) knowledge and understanding of mental health problems and the help-seeking process; and (4) family circumstances were identified. Findings highlight avenues for improving access to child mental health services, including increased provision that is free to service users and flexible to their needs, with opportunities to develop trusting, supportive relationships with professionals. Furthermore, interventions are required to improve parents' identification of mental health problems, reduce stigma for parents, and increase awareness of how to access services.

Facilitators of and barriers to accessing clinical prevention services for the South Asian population in Surrey, British Columbia: a qualitative study.

PubMed

Majid, Sanaa; Douglas, Rachel; Lee, Victoria; Stacy, Elizabeth; Garg, Arun K; Ho, Kendall

2016-01-01

British Columbia falls short in uptake of recommended clinical prevention services, with even lower rates among immigrant populations. This study explored facilitators of and barriers to uptake of clinical prevention services among people from South Asia, who represent 31% of the population in Surrey, British Columbia. We used a qualitative descriptive approach and employed vignettes in a focus group setting to elicit perspectives of South Asian people on accessing clinical prevention services. Participants aged 40 years or more were recruited between October 2014 and February 2015 from health care and community settings such as older-adult housing, day programs and health education events. Letters of introduction to the study were provided in English or Punjabi or both to all potential participants. We conducted qualitative content analysis of the results. Sixty-two South Asian adults (36 women and 26 men) aged 40-87 years participated in 1 of 8 focus groups in health care or community settings. Facilitators of and barriers to accessing clinical prevention services were noted at the patient, primary care provider and health care system levels. Facilitators at the patient level included taking ownership over one's health, health literacy and respecting the provider's advice; barriers included fear of the diagnosis, death and/or procedures, perceived low risk of disease or utility of the intervention, and side effects of procedures. Provider factors centred on a trust-based patient-provider relationship, strong communication and adequate time during visits. Health care system factors included such facilitators as processes to routinely offer prevention services as part of other health care or social services, systems that encourage prevention-oriented family practice and services at low or no cost to the patient. Our findings validate previously identified facilitators of and barriers to accessing preventive care for immigrant populations. However, the results

Facilitating Oil Industry Access to Federal Lands through Interagency Data Sharing

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

Paul Jehn; Ben Grunewald

Much of the environmental and technical data useful to the oil and gas industry and regulatory agencies is now contained in disparate state and federal databases. Delays in coordinating permit approvals between federal and state agencies translate into increased operational costs and stresses for the oil and gas industry. Making federal lease stipulation and area restriction data available on state agency Web sites will streamline a potential lessors review of available leases, encourage more active bidding on unleased federal lands, and give third-party operators independent access to data who otherwise may not have access to lease restrictions and other environmentalmore » data. As a requirement of the Energy Policy Conservation Act (EPCA), the Bureau of Land Management (BLM) is in the process of inventorying oil and natural gas resources beneath onshore federal lands and the extent and nature of any stipulation, restrictions, or impediments to the development of these resources. The EPCA Phase 1 Inventory resulted in a collection of GIS coverage files organized according to numerous lease stipulation reference codes. Meanwhile, state agencies also collect millions of data elements concerning oil and gas operations. Much of the oil and gas data nationwide is catalogued in the Ground Water Protection Council's (GWPC's) successfully completed Risk Based Data Management System (RBDMS). The GWPC and the states of Colorado, New Mexico, Utah, and Montana are implementing a pilot project where BLM lease stipulation data and RBDMS data will be displayed in a GIS format on the Internet. This increased access to data will increase bid activity, help expedite permitting, and encourage exploration on federal lands. Linking environmental, lease stipulation and resource inventory assessment data and making a GIS interface for the data available to industry and other agencies via the internet represents an important step in the GWPC strategy for all oil and gas regulatory e

Mycorrhizal networks and distance from mature trees alter patterns of competition and facilitation in dry Douglas-fir forests.

PubMed

Teste, François P; Simard, Suzanne W

2008-11-01

The distribution of dry Douglas-fir forests in western North America is expected to shift northward with climate change and disappear from the grassland interface in the southern interior of British Columbia. This shift may be accentuated by clearcutting, a common harvesting practice that aims to reduce the competitive effects of residual mature trees on new regeneration, but in so doing, ignores their facilitative effects. In this study, we investigated the net effects of competition from and facilitation by mature trees retained on harvested sites on seedling establishment in the dry interface Douglas-fir forests. We demonstrate that access to a mycorrhizal network (MN) and proximity to trees have important influences on seedling performance. On six sites, we established trenched plots around 24 mature Pseudotsuga menziesii var. glauca (Douglas-fir) trees, then planted Douglas-fir seedlings into four mesh treatments that served to restrict MN access (i.e., planted into mesh bags with 0.5-, 35-, or 250-microm pores, or without mesh) or into impermeable bags (grown in isolation) at four distances (0.5, 1.0, 2.5, or 5.0 m). Seedling survival tended to be greater and water stress lower where seedlings had full access to the MN. Seedling height, shoot biomass, needle biomass, and nutrient uptake peaked at 2.5-5.0 m from mature trees. Seedlings 0.5 m from mature trees had lower CO2 assimilation rates and wood delta(13)C compared to seedlings 5.0 m away. Competition for soil resources was highest near mature trees but facilitation was relatively greater at further distances, resulting in a zone of net benefit for seedlings. These results show that intraspecific tree-seedling interactions are both competitive and facilitative in dry Douglas-fir forests, and that they are spatially dependent. After disturbance, maintaining residual mature trees may be important for their beneficial regeneration zones.

ATR-like kinase Mec1 facilitates both chromatin accessibility at DNA replication forks and replication fork progression during replication stress

PubMed Central

Rodriguez, Jairo; Tsukiyama, Toshio

2013-01-01

Faithful DNA replication is essential for normal cell division and differentiation. In eukaryotic cells, DNA replication takes place on chromatin. This poses the critical question as to how DNA replication can progress through chromatin, which is inhibitory to all DNA-dependent processes. Here, we developed a novel genome-wide method to measure chromatin accessibility to micrococcal nuclease (MNase) that is normalized for nucleosome density, the NCAM (normalized chromatin accessibility to MNase) assay. This method enabled us to discover that chromatin accessibility increases specifically at and ahead of DNA replication forks in normal S phase and during replication stress. We further found that Mec1, a key regulatory ATR-like kinase in the S-phase checkpoint, is required for both normal chromatin accessibility around replication forks and replication fork rate during replication stress, revealing novel functions for the kinase in replication stress response. These results suggest a possibility that Mec1 may facilitate DNA replication fork progression during replication stress by increasing chromatin accessibility around replication forks. PMID:23307868

[THE FAILURE MODES AND EFFECTS ANALYSIS FACILITATES A SAFE, TIME AND MONEY SAVING OPEN ACCESS COLONOSCOPY SERVICE].

PubMed

Gingold-Belfer, Rachel; Niv, Yaron; Horev, Nehama; Gross, Shuli; Sahar, Nadav; Dickman, Ram

2017-04-01

Failure modes and effects analysis (FMEA) is used for the identification of potential risks in health care processes. We used a specific FMEA - based form for direct referral for colonoscopy and assessed it for procedurerelated perforations. Ten experts in endoscopy evaluated and computed the entire referral process, modes of preparation for the endoscopic procedure, the endoscopic procedure itself and the discharge process. We used FMEA assessing for likelihood of occurrence, detection and severity and calculated the risk profile number (RPN) for each of the above points. According to the highest RPN results we designed a specific open access referral form and then compared the occurrence of colonic perforations (between 2010 and 2013) in patients who were referred through the open access arm (Group 1) to those who had a prior clinical consultation (non-open access, Group 2). Our experts in endoscopy (5 physicians and 5 nurses) identified 3 categories of failure modes that, on average, reached the highest RPNs. We identified 9,558 colonoscopies in group 1, and 12,567 in group 2. Perforations were identified in three patients from the open access group (1:3186, 0.03%) and in 10 from group 2 (1:1256, 0.07%) (p = 0.024). Direct referral for colonoscopy saved 9,558 pre-procedure consultations and the sum of $850,000. The FMEA tool-based specific referral form facilitates a safe, time and money saving open access colonoscopy service. Our form may be adopted by other gastroenterological clinics in Israel.

Empower: access to medicine - working towards early access.

PubMed

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

2015-01-01

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

Collaborative funding to facilitate airport ground access.

DOT National Transportation Integrated Search

2012-06-01

This report presents the findings and conclusions from a research study that has examined the challenges of funding airport ground access projects and the role of collaborative funding strategies between the different agencies that typically become i...

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

ERIC Educational Resources Information Center

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

2007-01-01

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

49 CFR 38.2 - Equivalent facilitation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Equivalent facilitation. 38.2 Section 38.2 Transportation Office of the Secretary of Transportation AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY SPECIFICATIONS FOR TRANSPORTATION VEHICLES General § 38.2 Equivalent facilitation. Departures from particular...

Design of a graphical and interactive interface for facilitating access to drug contraindications, cautions for use, interactions and adverse effects

PubMed Central

Lamy, Jean-Baptiste; Venot, Alain; Bar-Hen, Avner; Ouvrard, Patrick; Duclos, Catherine

2008-01-01

Background Drug iatrogeny is important but could be decreased if contraindications, cautions for use, drug interactions and adverse effects of drugs described in drug monographs were taken into account. However, the physician's time is limited during consultations, and this information is often not consulted. We describe here the design of "Mister VCM", a graphical interface based on the VCM graphical language, facilitating access to drug monographs. We also provide an assessment of the usability of this interface. Methods The "Mister VCM" interface was designed by dividing the screen into two parts: a graphical interactive one including VCM icons and synthetizing drug properties, a textual one presenting on demand drug monograph excerpts. The interface was evaluated over 11 volunteer general practitioners, trained in the use of "Mister VCM". They were asked to answer clinical questions related to fictitious randomly generated drug monographs, using a textual interface or "Mister VCM". When answering the questions, correctness of the responses and response time were recorded. Results "Mister VCM" is an interactive interface that displays VCM icons organized around an anatomical diagram of the human body with additional mental, etiological and physiological areas. Textual excerpts of the drug monograph can be displayed by clicking on the VCM icons. The interface can explicitly represent information implicit in the drug monograph, such as the absence of a given contraindication. Physicians made fewer errors with "Mister VCM" than with text (factor of 1.7; p = 0.034) and responded to questions 2.2 times faster (p < 0.001). The time gain with "Mister VCM" was greater for long monographs and questions with implicit replies. Conclusion "Mister VCM" seems to be a promising interface for accessing drug monographs. Similar interfaces could be developed for other medical domains, such as electronic patient records. PMID:18518945

Facilitators and barriers to accessing reproductive health care for migrant beer promoters in Cambodia, Laos, Thailand and Vietnam: a mixed methods study.

PubMed

Webber, Gail; Spitzer, Denise; Somrongthong, Ratana; Dat, Truong Cong; Kounnavongsa, Somphone

2012-07-02

The purpose of the research was to assess access to sexual and reproductive health services for migrant women who work as beer promoters. This mixed methods research was conducted in Phnom Penh, Cambodia, Bangkok, Thailand, Vientiane, Laos, and Hanoi, Vietnam during 2010 to 2011. Focus groups were held with beer promoters and separate focus groups or interviews with key informants to explore the factors affecting beer promoters' access to health care institutions for reproductive health care. The findings of the focus groups were used to develop a survey for beer promoters. This survey was conducted in popular health institutions for these women in each of the four Asian cities. Several common themes were evident. Work demands prevented beer promoters from accessing health care. Institutional factors affecting care included cost, location, environmental factors (e.g. waiting times, cleanliness and confidentiality) and service factors (e.g. staff attitudes, clinic hours, and availability of medications). Personal factors affecting access were shyness and fear, lack of knowledge, and support from family and friends.The survey of the beer promoters confirmed that cost, location and both environmental and service factors impact on access to health care services for beer promoters. Many beer promoters are sexually active, and a significant proportion of those surveyed rely on sex work to supplement their income. Many also drink with their clients. Despite a few differences amongst the surveyed population, the findings were remarkably similar across the four research sites. Recommendations from the research include the provision of evening and weekend clinic hours to facilitate access, free or low cost clinics, and health insurance through employer or government plans which are easy to access for migrants. Other improvements that would facilitate the access of beer promoters to these services include increased funding to hire more staff (reducing waiting times) and to

Facilitators and barriers to accessing reproductive health care for migrant beer promoters in Cambodia, Laos, Thailand and Vietnam: A mixed methods study

PubMed Central

2012-01-01

Background The purpose of the research was to assess access to sexual and reproductive health services for migrant women who work as beer promoters. This mixed methods research was conducted in Phnom Penh, Cambodia, Bangkok, Thailand, Vientiane, Laos, and Hanoi, Vietnam during 2010 to 2011. Methods Focus groups were held with beer promoters and separate focus groups or interviews with key informants to explore the factors affecting beer promoters’ access to health care institutions for reproductive health care. The findings of the focus groups were used to develop a survey for beer promoters. This survey was conducted in popular health institutions for these women in each of the four Asian cities. Results Several common themes were evident. Work demands prevented beer promoters from accessing health care. Institutional factors affecting care included cost, location, environmental factors (e.g. waiting times, cleanliness and confidentiality) and service factors (e.g. staff attitudes, clinic hours, and availability of medications). Personal factors affecting access were shyness and fear, lack of knowledge, and support from family and friends. The survey of the beer promoters confirmed that cost, location and both environmental and service factors impact on access to health care services for beer promoters. Many beer promoters are sexually active, and a significant proportion of those surveyed rely on sex work to supplement their income. Many also drink with their clients. Despite a few differences amongst the surveyed population, the findings were remarkably similar across the four research sites. Conclusions Recommendations from the research include the provision of evening and weekend clinic hours to facilitate access, free or low cost clinics, and health insurance through employer or government plans which are easy to access for migrants. Other improvements that would facilitate the access of beer promoters to these services include increased funding to hire

The maxillary molar endodontic access opening: A microscope-based approach

PubMed Central

Mamoun, John Sami

2016-01-01

This article reviews the basic clinical techniques of performing a maxillary molar endodontic access opening, starting from the initial access opening into the pulp chamber, to the point where a size #10 file has been advanced to the apices of all three or four (or more) canals. The article explains how the use of the dental surgical operating microscope or microscope-level loupes magnification of ×6–8 or greater, combined with head-mounted or coaxial illumination, improve the ability of a dentist to identify microscopic root canal orifices, which facilitates the efficient creation of conservative access openings with adequate straight-line access in maxillary molars. Magnified photos illustrate various microscopic anatomical structures or landmarks of the initial access opening. Techniques are explored for implementing an access opening for teeth with vital versus necrotic pulpal tissues. The article also explores the use of piezoelectric or ultrasonic instruments for revealing root canal orifices and for removing pulp stones or calcified pulpal tissue inside the pulp chamber. PMID:27403069

Elaboration over a Discourse Facilitates Retrieval in Sentence Processing

PubMed Central

Troyer, Melissa; Hofmeister, Philip; Kutas, Marta

2016-01-01

Language comprehension requires access to stored knowledge and the ability to combine knowledge in new, meaningful ways. Previous work has shown that processing linguistically more complex expressions (‘Texas cattle rancher’ vs. ‘rancher’) leads to slow-downs in reading during initial processing, possibly reflecting effort in combining information. Conversely, when this information must subsequently be retrieved (as in filler-gap constructions), processing is facilitated for more complex expressions, possibly because more semantic cues are available during retrieval. To follow up on this hypothesis, we tested whether information distributed across a short discourse can similarly provide effective cues for retrieval. Participants read texts introducing two referents (e.g., two senators), one of whom was described in greater detail than the other (e.g., ‘The Democrat had voted for one of the senators, and the Republican had voted for the other, a man from Ohio who was running for president’). The final sentence (e.g., ‘The senator who the {Republican/Democrat}had voted for…’) contained a relative clause picking out either the Many-Cue referent (with ‘Republican’) or the One-Cue referent (with ‘Democrat’). We predicted facilitated retrieval (faster reading times) for the Many-Cue condition at the verb region (‘had voted for’), where readers could understand that ‘The senator’ is the object of the verb. As predicted, this pattern was observed at the retrieval region and continued throughout the rest of the sentence. Participants also completed the Author/Magazine Recognition Tests (ART/MRT; Stanovich and West, 1989), providing a proxy for world knowledge. Since higher ART/MRT scores may index (a) greater experience accessing relevant knowledge and/or (b) richer/more highly structured representations in semantic memory, we predicted it would be positively associated with effects of elaboration on retrieval. We did not observe the

Elaboration over a Discourse Facilitates Retrieval in Sentence Processing.

PubMed

Troyer, Melissa; Hofmeister, Philip; Kutas, Marta

2016-01-01

Language comprehension requires access to stored knowledge and the ability to combine knowledge in new, meaningful ways. Previous work has shown that processing linguistically more complex expressions ('Texas cattle rancher' vs. 'rancher') leads to slow-downs in reading during initial processing, possibly reflecting effort in combining information. Conversely, when this information must subsequently be retrieved (as in filler-gap constructions), processing is facilitated for more complex expressions, possibly because more semantic cues are available during retrieval. To follow up on this hypothesis, we tested whether information distributed across a short discourse can similarly provide effective cues for retrieval. Participants read texts introducing two referents (e.g., two senators), one of whom was described in greater detail than the other (e.g., 'The Democrat had voted for one of the senators, and the Republican had voted for the other, a man from Ohio who was running for president'). The final sentence (e.g., 'The senator who the {Republican/Democrat}had voted for…') contained a relative clause picking out either the Many-Cue referent (with 'Republican') or the One-Cue referent (with 'Democrat'). We predicted facilitated retrieval (faster reading times) for the Many-Cue condition at the verb region ('had voted for'), where readers could understand that 'The senator' is the object of the verb. As predicted, this pattern was observed at the retrieval region and continued throughout the rest of the sentence. Participants also completed the Author/Magazine Recognition Tests (ART/MRT; Stanovich and West, 1989), providing a proxy for world knowledge. Since higher ART/MRT scores may index (a) greater experience accessing relevant knowledge and/or (b) richer/more highly structured representations in semantic memory, we predicted it would be positively associated with effects of elaboration on retrieval. We did not observe the predicted interaction between ART

[The Efficacy of Near-Infrared Devices in Facilitating Peripheral Intravenous Access in Children: A Systematic Review and Subgroup Meta-Analysis].

PubMed

Kuo, Chia-Chi; Feng, I-Jung; Lee, Wei-Jing

2017-10-01

Peripheral intravenous access is a common and invasive procedure that is performed in pediatric clinical settings. Children often have difficult intravenous-access problems that may not only increase staff stress but also affect the timeliness of immediate treatments. To determine the efficacy of near-infrared devices in facilitating peripheral intravenous access in children, using a systematic review and meta-analysis. Six databases, namely the Index to Taiwan Periodical Literature System, Airiti Library, CINAHL, Cochrane Library, PubMed/MEDLINE, and ProQuest were searched for related articles that were published between the earliest year available and February 2017. The search was limited to studies on populations of children that used either a randomized controlled trial or controlled clinical trial approach and used the key words "near-infrared devices" AND "peripheral intravenous access." The 12 articles that met these criteria were included in the analysis. The Cochrane Collaboration bias assessment tool was used to assess the methodological quality. In addition, RevMan 5.3.5 software was used to conduct the meta-analysis. The near-infrared devices did not significantly improve the first-attempt success rate, number of attempts, or the procedural time of peripheral intravenous access in children. However, the subgroup analysis of difficult intravenous-access factors revealed a significant improvement in the first-attempt success rate of children with difficult intravenous access scores (OR = 1.83, p = .03). Near-infrared devices may improve the first-attempt success rate in children with difficult intravenous access by allowing healthcare professionals to visualize the peripheral veins. Therefore, we suggest that the difficult intravenous-access score be used as a screening tool to suggest when to apply near-infrared devices to children with difficult peripheral intravenous access in order to maximize efficacy of treatment.

Stakeholders' perspectives on facilitators of and barriers to the utilisation of and access to maternal health services in Eritrea: a qualitative study.

PubMed

Chol, Chol; Hunter, Cynthia; Debru, Berhane; Haile, Berhana; Negin, Joel; Cumming, Robert G

2018-01-19

Wars affect maternal health services by destroying health systems. Eritrea experienced two wars with neighbouring Ethiopia. Despite this, the maternal mortality ratio (MMR) in Eritrea fell by 69% from 1590 per 100,000 live births in 1990 to 501 in 2015. This study aimed to examine facilitators of and barriers to the utilisation of and access to maternal health services in Eritrea. Using in-depth interviews and field observations for data collection, this qualitative study was conducted in five healthcare facilities in Asmara, the capital of Eritrea, in February and March 2016. The participants were: women (n = 40), husbands (n = 5), healthcare providers (n = 10), and decision makers (n = 5). There were two perceived facilitators of utilisation of and access to maternal health services: health education (related to the WHO health service delivery building blocks) and improvement in gender equality driven by the role played by Eritrean women as combatants during the War of Independence (1961-1991). The only perceived barrier was poor quality of care due to lack of ultrasound machines, short clinic opening hours, and shortage of healthcare workers (related to the WHO health workforce building block). This study assessed women and their husbands/partners' perceptions and the possible effects of contemporary Eritrean culture and the history of war on the utilisation of and access to maternal health services in the country. As well, we examined healthcare providers' and decision makers' perspectives. The two key facilitators of women's utilisation of and access to maternal health services were health education and women's empowerment driven by their role as combatants during the War of Independence. One main barrier was poor quality of care due to lack of ultrasound machines, short clinic opening hours, and a shortage of healthcare workers. As only a limited number of qualitative studies have been published about maternal health services in war

Towards accessible integrated palliative care: Perspectives of leaders from seven European countries on facilitators, barriers and recommendations for improvement.

PubMed

den Herder-van der Eerden, Marlieke; Ewert, Benjamin; Hodiamont, Farina; Hesse, Michaela; Hasselaar, Jeroen; Radbruch, Lukas

2017-01-01

Literature suggests that integrated palliative care (IPC) increases the quality of care for palliative patients at lower costs. However, knowledge on models encompassing all integration levels for successfully implementing IPC is scarce. The purpose of this paper is to describe the experiences of IPC leaders in seven European countries regarding core elements, facilitators and barriers of IPC implementation and provides recommendations for future policy and practice. A qualitative interview study was conducted between December 2013 and May 2014. In total, 34 IPC leaders in primary and secondary palliative care or public health in Belgium, Germany, Hungary, Ireland, the Netherlands, Spain and the UK were interviewed. Transcripts were analysed using thematic data analysis. IPC implementation efforts involved a multidisciplinary team approach and cross-sectional coordination. Informal professional relationships, basic medical education and general awareness were regarded as facilitators of IPC. Identified barriers included lack of knowledge about when to start palliative care, lack of collaboration and financial structures. Recommendations for improvement included access, patient-centeredness, coordination and cooperation, financing and ICT systems. Although IPC is becoming more common, action has been uneven at different levels. IPC implementation largely remains provisional and informal due to the lack of standardised treatment pathways, legal frameworks and financial incentives to support multilevel integration. In order to make IPC more accessible, palliative care education as well as legal and financial support within national healthcare systems needs to be enhanced.

Primary care physicians’ perspectives on facilitating older patients’ access to community support services

PubMed Central

Ploeg, Jenny; Denton, Margaret; Hutchison, Brian; McAiney, Carrie; Moore, Ainsley; Brazil, Kevin; Tindale, Joseph; Lam, Annie

2017-01-01

Abstract Objective To understand how family physicians facilitate older patients’ access to community support services (CSSs) and to identify similarities and differences across primary health care (PHC) models. Design Qualitative, multiple-case study design using semistructured interviews. Setting Four models of PHC delivery, specifically 2 family health teams (FHTs), 4 non-FHTs family health organizations, 4 fee-for-service practices, and 2 community health centres in urban Ontario. Participants Purposeful sampling of 23 family physicians in solo and small and large group practices within the 4 models of PHC. Methods A multiple-case study approach was used. Semistructured interviews were conducted and data were analyzed using within- and cross-case analysis. Case study tactics to ensure study rigour included memos and an audit trail, investigator triangulation, and the use of multiple, rather than single, case studies. Main findings Three main themes were identified: consulting and communicating with the health care team to create linkages; linking patients and families to CSSs; and relying on out-of-date resources and ineffective search strategies for information on CSSs. All participants worked with their team members; however, those in FHTs and community health centres generally had a broader range of health care providers available to assist them. Physicians relied on home-care case managers to help make linkages to CSSs. Physicians recommended the development of an easily searchable, online database containing available CSSs. Conclusion This study shows the importance of interprofessional teamwork in primary care settings to facilitate linkages of older patients to CSSs. The study also provides insight into the strategies physicians use to link older persons to CSSs and their recommendations for change. This understanding can be used to develop resources and approaches to better support physicians in making appropriate linkages to CSSs. PMID:28115458

Virtual versus physical spaces: which facilitates greater HIV risk taking among men who have sex with men in East and South-East Asia?

PubMed

Wei, Chongyi; Lim, Sin How; Guadamuz, Thomas E; Koe, Stuart

2014-08-01

Increasing use of the Internet to seek sex partners is accompanied by rising HIV infections among men who have sex with men (MSM) in East and South-East Asia. We examined whether the Internet facilitates greater HIV risk taking among MSM in the region. A cross-sectional sample of 9,367 MSM was recruited via the Internet in 2010. We compared socio-demographic and HIV-related behavioral characteristics among MSM who met sex partners on the Internet only, who met sex partners offline only, and who met sex partners through both. Multinomial logistic regression was used to identify independent correlates that were associated with differences in where participants met their male sex partners. Compared to MSM who met partners offline only, those who met partners online only were less likely to have multiple male sex partners, have paid for sex, have consumed recreational drugs, and have used alcohol before sex. MSM who met partners both online and offline appeared to be the riskiest group that they were more likely to have multiple male sex partners, have engaged in UIAI, and have consumed alcohol before sex. These findings suggest that social networking websites alone do not facilitate greater HIV risk taking among MSM. Rather, they provide additional venues for MSM who already engage in HIV-related high risk behaviors to seek sex partners. The Internet offers incredible opportunities to reach large numbers of MSM in East and South-East Asia for HIV prevention and research. Web-based outreach and prevention activities are needed to reach these men. In addition, mobile and application-based interventions should also be developed and disseminated.

Virtual vs. physical spaces: which facilitates greater HIV risk taking among men who have sex with men in East and South-East Asia?

PubMed Central

Wei, Chongyi; Lim, Sin How; Guadamuz, Thomas E.; Koe, Stuart

2013-01-01

Increasing use of the Internet to seek sex partners is accompanied by rising HIV infections among men who have sex with men (MSM) in East and South-East Asia. We examined whether the Internet facilitates greater HIV risk taking among MSM in the region. A cross-sectional sample of 9,367 MSM was recruited via the Internet in 2010. We compared socio-demographic and HIV-related behavioral characteristics among MSM who met sex partners on the Internet only, who met sex partners offline only, and who met sex partners through both. Multinomial logistic regression was used to identify independent correlates that were associated with differences in where participants met their male sex partners. Compared to MSM who met partners offline only, those who met partners online only were less likely to have multiple male sex partners, have paid for sex, have consumed recreational drugs, and have used alcohol before sex. MSM who met partners both online and offline appeared to be the riskiest group that they were more likely to have multiple male sex partners, have engaged in UIAI, and have consumed alcohol before sex. These findings suggest that social networking websites alone do not facilitate greater HIV risk taking among MSM. Rather, they provide additional venues for MSM who already engage in HIV-related high risk behaviors to seek sex partners. The Internet offers incredible opportunities to reach large numbers of MSM in East and South-East Asia for HIV prevention and research. Web-based outreach and prevention activities are needed to reach these men. In addition, mobile and application-based interventions should also be developed and disseminated. PMID:24077974

Facilitating access to prenatal care through an interprofessional student-run free clinic.

PubMed

Danhausen, Kathleen; Joshi, Deepa; Quirk, Sarah; Miller, Robert; Fowler, Michael; Schorn, Mavis N

2015-01-01

Addressing the persistent challenge of inadequate prenatal care requires innovative solutions. Student-run free health centers are poised to rise to this challenge. The Shade Tree Clinic Early Pregnancy Program, jointly operated by university medical and nursing programs, functions as an ongoing access-to-care portal for pregnant women without health insurance. The clinic is run by medical students and nurse-midwifery students and uses a service-based learning model that allows students to work and learn in supervised, interprofessional teams while providing evidence-based prenatal care. All data reported in this paper were obtained from a retrospective chart review of women served by the prenatal clinic. These data are descriptive in nature, and include the patient demographics and services provided by the clinic to 152 women between the years of 2010-2013. During this time period, the clinic served a demographically diverse clientele. Approximately half lacked documentation of legal immigration status. The majority of women seeking care were in their first trimester of pregnancy and had previously given birth. Several women had medical or obstetric complications that required timely referral to specialist care; and many women received treatment for infection and other primary care concerns. Shade Tree Clinic provides the basic components of prenatal care and assists women with other medical needs. Women also receive help when applying for and accessing public maternity insurance, and the clinic facilitates entry to any necessary specialist care while that insurance is processed. In many cases, necessary and time-sensitive care would be delayed if Shade Tree Clinic's prenatal services were not available. In addition, the clinic presents a valuable opportunity for interprofessional socialization, increased respect, and improved collaboration between students in different but complementary professions, which is an important experience while we move to meet national

Practice Facilitators' and Leaders' Perspectives on a Facilitated Quality Improvement Program.

PubMed

McHugh, Megan; Brown, Tiffany; Liss, David T; Walunas, Theresa L; Persell, Stephen D

2018-04-01

Practice facilitation is a promising approach to helping practices implement quality improvements. Our purpose was to describe practice facilitators' and practice leaders' perspectives on implementation of a practice facilitator-supported quality improvement program and describe where their perspectives aligned and diverged. We conducted interviews with practice leaders and practice facilitators who participated in a program that included 35 improvement strategies aimed at the ABCS of heart health (aspirin use in high-risk individuals, blood pressure control, cholesterol management, and smoking cessation). Rapid qualitative analysis was used to collect, organize, and analyze the data. We interviewed 17 of the 33 eligible practice leaders, and the 10 practice facilitators assigned to those practices. Practice leaders and practice facilitators both reported value in the program's ability to bring needed, high-quality resources to practices. Practice leaders appreciated being able to set the schedule for facilitation and select among the 35 interventions. According to practice facilitators, however, relying on practice leaders to set the pace of the intervention resulted in a lower level of program intensity than intended. Practice leaders preferred targeted assistance, particularly electronic health record documentation guidance and linkages to state smoking cessation programs. Practice facilitators reported that the easiest interventions were those that did not alter care practices. The dual perspectives of practice leaders and practice facilitators provide a more holistic picture of enablers and barriers to program implementation. There may be greater opportunities to assist small practices through simple, targeted practice facilitator-supported efforts rather than larger, comprehensive quality improvement projects. © 2018 Annals of Family Medicine, Inc.

A greater foraging scale, not a higher foraging precision, may facilitate invasion by exotic plants in nutrient-heterogeneous conditions.

PubMed

Chen, Bao-Ming; Su, Jin-Quan; Liao, Hui-Xuan; Peng, Shao-Lin

2018-03-05

Soil nutrient heterogeneity has been proposed to influence competitive outcomes among different plant species. Thus, it is crucial to understand the effects of environmental heterogeneity on competition between exotic invasive and native species. However, the effects of soil nutrient heterogeneity on the competition between invasive and native plants have rarely been linked to root foraging behaviour. In this study, a competition experiment was performed with two invasive-native species pairs (BP-VC, Bidens pilosa vs. Vernonia cinerea; MM-PS, Mikania micrantha vs. Paederia scandens) grown under homogeneous and heterogeneous conditions in a common greenhouse environment. Root activity was assessed by determining the amount of strontium (Sr) taken up by the shoot of each species. The invasive species exhibited a greater foraging scale, whereas the native species exhibited a higher foraging precision. A trade-off between foraging scale and precision was observed within each pair of invasive-native species. Compared with soil homogeneity, soil heterogeneity significantly increased the biomass of the two invasive species, B. pilosa and M. micrantha, under competitive conditions. Within each pair, the invasive species exhibited greater relative competitive ability with respect to shoot mass, and considerably more Sr taken up by the invasive species compared with the native species. The Sr acquisition results indicate that nutrient-poor conditions may facilitate the competitive ability of the native species V. cinerea, whereas M. micrantha may possess a stronger competitive ability regardless of soil nutrient conditions. Soil nutrient heterogeneity has the potential to promote the invasion of these two exotic species due to their larger foraging scale, stronger competitive ability and greater root activity relative to their counterpart native species. The present work highlights the importance of soil heterogeneity in plant invasion, particularly with regards to root

Greater Patient Health Information Control to Improve the Sustainability of Health Information Exchanges.

PubMed

Abdelhamid, Mohamed

2018-06-09

Health information exchanges (HIEs) are multisided platforms that facilitate the sharing of patient health information (PHI) between providers and payers across organizations within a region, community or hospital system. The benefits of HIEs to payers and providers include lower cost, faster services, and better health outcome. However, most HIEs have configured the patient healthcare consent process to give all providers who sign up with the exchange access to PHI for all consenting patients, leaving no control to patients in customized what information to share and with who. This research investigates the impact of granting greater control to patients in sharing their personal health information on consent rates and making them active participants in the HIEs system. This research utilizes a randomized experimental survey design study. The study uses responses from 388 participants and structural equation modeling (SEM) to test the conceptual model. The main findings of this research include that patients consent rate increases significantly when greater control in sharing PHI is offered to the patient. In addition, greater control reduces the negative impact of privacy concern on the intention to consent. Similarly, trust in healthcare professionals leads to higher consent when greater control is offered to the patient. Thus, greater control empowers the role of trust in engaging patients and sustaining HIEs. The paper makes a theoretical contribution to research by extending the unified theory of acceptance and use of technology (UTAUT) model. The findings impact practice by providing insights that will help sustain HIEs. Copyright © 2018. Published by Elsevier Inc.

"Refreshed…reinforced…reflective": A qualitative exploration of interprofessional education facilitators' own interprofessional learning and collaborative practice.

PubMed

Evans, Sherryn; Shaw, Nicole; Ward, Catherine; Hayley, Alexa

2016-11-01

While there is extensive research examining the outcomes of interprofessional education (IPE) for students, minimal research has investigated how facilitating student learning influences the facilitators themselves. This exploratory case study aimed to explore whether and how facilitating IPE influences facilitators' own collaborative practice attitudes, knowledge, and workplace behaviours. Sixteen facilitators of an online pre-licensure IPE unit for an Australian university participated in semi-structured telephone interviews. Inductive thematic analysis revealed three emergent themes and associated subthemes characterising participants' reflexivity as IPE facilitators: interprofessional learning; professional behaviour change; and collaborative practice expertise. Participants experienced interprofessional learning in their role as facilitators, improving their understanding of other professionals' roles, theoretical and empirical knowledge underlying collaborative practice, and the use and value of online communication. Participants also reported having changed several professional behaviours, including improved interprofessional collaboration with colleagues, a change in care plan focus, a less didactic approach to supervising students and staff, and greater enthusiasm impressing the value of collaborative practice on placement students. Participants reported having acquired their prior interprofessional collaboration expertise via professional experience rather than formal learning opportunities and believed access to formal IPE as learners would aid their continuing professional development. Overall, the outcomes of the IPE experience extended past the intended audience of the student learners and positively impacted on the facilitators as well.

Semantically Enriched Data Access Policies in eHealth.

PubMed

Drozdowicz, Michał; Ganzha, Maria; Paprzycki, Marcin

2016-11-01

Internet of Things (IoT) requires novel solutions to facilitate autonomous, though controlled, resource access. Access policies have to facilitate interactions between heterogeneous entities (devices and humans). Here, we focus our attention on access control in eHealth. We propose an approach based on enriching policies, based on well-known and widely-used eXtensible Access Control Markup Language, with semantics. In the paper we describe an implementation of a Policy Information Point integrated with the HL7 Security and Privacy Ontology.

Clinical education facilitators: a literature review.

PubMed

Lambert, Veronica; Glacken, Michèle

2005-07-01

The aim of this literature review, set within an Irish context, is to present a broad overview of former and existing clinical support personnel, explore the concept of facilitation and examine what is known about the role of the clinical education facilitator. The importance of providing a supportive clinical environment to enhance clinical teaching and learning is strongly portrayed in the literature. While the past two decades have borne witness to various clinical support personnel, the literature identifies conflicting demands that these personnel face. No suggestions are advanced as to how to overcome these difficulties, which inevitably influence the quality and quantity of their clinical teaching role. An identifiable gap exists over who has prime responsibility for clinical teaching. It is timely that alternative possibilities for organizing clinical teaching are investigated. A new post emerging in practice settings is that of the clinical education facilitator who is meant to be the key linchpin in clinical areas for reducing the theory-practice gap. Relevant literature for this review was sourced using the computerized databases CINAHL, Medline and Synergy. Manual searching of relevant nursing journals and sourcing of secondary references extended the search. Government reports and other relevant documents were obtained through pertinent websites. Papers that explicitly examined the concept of facilitation and explored the posts of clinical education facilitators were included; six research papers were accessed and reviewed. In addition seven non-empirical papers were included. It is clear that considerable lack of role clarity resides over what constitutes clinical facilitation and the role of the clinical facilitator. Thus, it is paramount to strengthen this support role with Irish empirical evidence. A major advantage in having a ward-based clinical education facilitator is the benefit of having access to someone who can concentrate solely on

Access to Money and Relation to Women's Use of Family Planning Methods Among Young Married Women in Rural India.

PubMed

Reed, Elizabeth; Donta, Balaiah; Dasgupta, Anindita; Ghule, Mohan; Battala, Madhusudana; Nair, Saritha; Silverman, Jay; Jadhav, Arun; Palaye, Prajakta; Saggurti, Niranjan; Raj, Anita

2016-06-01

Objectives The social positioning (i.e. social status and autonomy) of women in the household facilitates women's access to and decision-making power related to family planning (FP). Women's access to spending money, which may be an indicator of greater social positioning in the household, may also be greater among women who engage in income generating activities for their families, regardless of women's status in the household. However, in both scenarios, access to money may independently afford greater opportunity to obtain family planning services among women. This study seeks to assess whether access to money is associated with FP outcomes independently of women's social positioning in their households. Methods Using survey data from married couples in rural Maharashtra, India (n = 855), crude and adjusted regression was used to assess women's access to their own spending money in relation to past 3 month use of condoms and other forms of contraceptives (pills, injectables, intrauterine device). Results Access to money (59 %) was associated with condom and other contraceptive use (AORs ranged 1.5-1.8). These findings remained significant after adjusting for women's FP decision-making power in the household and mobility to seek FP services. Conclusion While preliminary, findings suggest that access to money may increase women's ability to obtain FP methods, even in contexts where social norms to support women's power in FP decision-making may not be readily adopted.

Access to Higher Education

ERIC Educational Resources Information Center

Briscoe, Felecia; De Oliver, Miguel

2006-01-01

This case study researches the degree to which the location and services offered by a multicampus university, geographically situated consistent with the commercial principles of a large mass-market enterprise, facilitate access for educationally underserved groups. First, the necessity of democratizing educational access to an underprivileged…

Access to primary and specialized somatic health care for persons with severe mental illness: a qualitative study of perceived barriers and facilitators in Swedish health care.

PubMed

Björk Brämberg, Elisabeth; Torgerson, Jarl; Norman Kjellström, Anna; Welin, Peder; Rusner, Marie

2018-01-09

Persons with severe mental illness (e.g. schizophrenia, bipolar disorder) have a high prevalence of somatic conditions compared to the general population. Mortality data in the Nordic countries reveal that these persons die 15-20 years earlier than the general population. Some factors explaining this high prevalence may be related to the individuals in question; others arise from the health care system's difficulty in offering somatic health care to these patient groups. The aim of the present study was therefore to explore the experiences and views of patients, relatives and clinicians regarding individual and organizational factors which facilitate or hinder access to somatic health care for persons with severe mental illness. Flexible qualitative design. Data was collected by means of semi-structured individual interviews with patients with severe mental illness, relatives and clinicians representing primary and specialized health care. In all, 50 participants participated. The main barrier to accessing somatic care is the gap between the organization of the health care system and the patients' individual health care needs. This is observed at both individual and organizational level. The health care system seems unable to support patients with severe mental illness and their psychiatric-somatic comorbidity. The main facilitators are the links between severe mental illness patients and medical departments. These links take the form of functions (i.e. systems which ensure that patients receive regular reminders), or persons (i.e. professional contacts who facilitate patients' access the health care). Health care services for patients with severe mental illness need reorganization. Organizational structures and systems that facilitate cooperation between different departments must be put in place, along with training for health care professionals about somatic disease among psychiatric patients. The links between individual and organizational levels could be

Facilitating the appropriate use of e-health solutions.

PubMed

Stern, Hartley S; Ceresia, Patrick; Lapner, Martin

2014-01-01

In this issue, the lead article proposes that e-health technologies should be used more broadly and that patients should have greater access to their information through such technologies. The Canadian Medical Protective Association (CMPA) agrees with this statement and suggests that to facilitate the timely and appropriate adoption of new technologies among healthcare providers to enhance patient care, barriers in the existing regulatory, legislative and legal frameworks must be addressed. While much of the discussion to date on e-health has focused primarily on high-level issues regarding regulatory compliance, "privacy by design" and the e-health "panacea," CMPA suggests that there needs to be a refocus on achieving more concrete change and gains through consideration of the specific impact on the drivers of healthcare delivery. An integrated or holistic approach is required involving healthcare providers, regulators, legislators, stakeholders, ministries of health, privacy commissioners and the courts. To better leverage potential advantages, efficiencies and enhanced, safer care for our healthcare system, all parties must work together to develop an acceptable and flexible approach to the "appropriate use" of e-health technologies that will facilitate adoption by healthcare professionals in a manner that is consistent with the expectations of the profession and applicable standards of practice.

Financing Adult Education: How Adequate Are Current Sources in Facilitating Access and Participation in Centres in Murang'a South Sub-County, Murang'a County, Kenya?

ERIC Educational Resources Information Center

Maina, Ndonga James; Orodho, John Aluko

2016-01-01

The thrust of this study was to examine the level of adequacy of current sources in facilitating access and participation in adult education centres in Murang'a South Sub-County, Murang'a County, Kenya. The study adopted the descriptive survey design. Combinations of purposive and stratified random sampling techniques were used to select 82…

Access to Money and Relation to Women’s Use of Family Planning Methods among Young Married Women in Rural India

PubMed Central

Reed, Elizabeth; Donta, Balaiah; Dasgupta, Anindita; Ghule, Mohan; Battala, Madhusudana; Nair, Saritha; Silverman, Jay; Jadhav, Arun; Palaye, Prajakta; Saggurti, Niranjan; Raj, Anita

2016-01-01

Objectives The social positioning (i.e. social status and autonomy) of women in the household facilitates women’s access to and decision-making power related to family planning (FP). Women’s access to spending money, which may be an indicator of greater social positioning in the household, may also be greater among women who engage in income generating activities for their families, regardless of women’s status in the household. However, in both scenarios, access to money may independently afford greater opportunity to obtain family planning services among women. This study seeks to assess whether access to money is associated with FP outcomes independently of women’s social positioning in their households. Methods Using survey data from married couples in rural Maharashtra, India (n=855), crude and adjusted regression was used to assess women’s access to their own spending money in relation to past 3 month use of condoms and other forms of contraceptives (pills, injectables, intrauterine device). Results Access to money (59%) was associated with condom and other contraceptive use (AORs ranged: 1.5 – 1.8). These findings remained significant after adjusting for women’s FP decision-making power in the household and mobility to seek FP services. Conclusion While preliminary, findings suggest that access to money may increase women’s ability to obtain FP methods, even in contexts where social norms to support women’s power in FP decision-making may not be readily adopted. PMID:26971270

Arteriovenous Vascular Access Selection and Evaluation

PubMed Central

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

2016-01-01

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

Morning REM Sleep Naps Facilitate Broad Access to Emotional Semantic Networks

PubMed Central

Carr, Michelle; Nielsen, Tore

2015-01-01

Study Objectives: The goals of the study were to assess semantic priming to emotion and nonemotion cue words using a novel measure of associational breadth for participants who either took rapid eye movement (REM) or nonrapid eye movement (NREM) naps or who remained awake, and to assess the relation of priming to REM sleep consolidation and REM sleep inertia effects. Design: The associational breadth task was applied in both a priming condition, where cue words were signaled to be memorized prior to sleep (primed), and a nonpriming condition, where cue words were not memorized (nonprimed). Cue words were either emotional (positive, negative) or nonemotional. Participants were randomly assigned to either an awake (WAKE) or a sleep condition, which was subsequently split into NREM or REM groups depending on stage at awakening. Setting: Hospital-based sleep laboratory. Participants: Fifty-eight healthy participants (22 male) ages 18 to 35 y (mean age = 23.3 ± 4.08 y). Measurements and Results: The REM group scored higher than the NREM or WAKE groups on primed, but not nonprimed emotional cue words; the effect was stronger for positive than for negative cue words. However, REM time and percent correlated negatively with degree of emotional priming. Priming occurred for REM awakenings but not for NREM awakenings, even when the latter sleep episodes contained some REM sleep. Conclusions: Associational breadth may be selectively consolidated during REM sleep for stimuli that have been tagged as important for future memory retrieval. That priming decreased with REM time and was higher only for REM sleep awakenings is consistent with two explanatory REM sleep processes: REM sleep consolidation serving emotional downregulation and REM sleep inertia. Citation: Carr M, Nielsen T. Morning REM sleep naps facilitate broad access to emotional semantic networks. SLEEP 2015;38(3):433–443. PMID:25409100

Limited access: gender, occupational composition, and flexible work scheduling.

PubMed

Glauber, Rebecca

2011-01-01

The current study draws on national data to explore differences in access to flexible work scheduling by the gender composition of women's and men's occupations. Results show that those who work in integrated occupations are more likely to have access to flexible scheduling. Women and men do not take jobs with lower pay in return for greater access to flexibility. Instead, jobs with higher pay offer greater flexibility. Integrated occupations tend to offer the greatest access to flexible scheduling because of their structural locations. Part-time work is negatively associated with men's access to flexible scheduling but positively associated with women's access. Women have greater flexibility when they work for large establishments, whereas men have greater flexibility when they work for small establishments.

Understanding reasons for asthma outpatient (non)‐attendance and exploring the role of telephone and e‐consulting in facilitating access to care: exploratory qualitative study

PubMed Central

van Baar, J D; Joosten, H; Car, J; Freeman, G K; Partridge, M R; van Weel, C; Sheikh, A

2006-01-01

Objective To understand factors influencing patients' decisions to attend for outpatient follow up consultations for asthma and to explore patients' attitudes to telephone and email consultations in facilitating access to asthma care. Design Exploratory qualitative study using in depth interviews. Setting Hospital outpatient clinic in West London. Participants Nineteen patients with moderate to severe asthma (12 “attenders” and 7 “non‐attenders”). Results Patients' main reasons for attending were the wish to improve control over asthma symptoms and a concern not to jeopardise the valued relationship with their doctor. Memory lapses, poor health, and disillusionment with the structure of outpatient care were important factors implicated in non‐attendance. The patients were generally sceptical about the suggestion that greater opportunity for telephone consulting might improve access to care. They expressed concerns about the difficulties in effectively communicating through non‐face to face media and were worried that clinicians would not be in a position to perform an adequate physical examination over the telephone. Email and text messaging were viewed as potentially useful for sending appointment reminders and sharing clinical information but were not considered to be acceptable alternatives to the face to face clinic encounter. Conclusions Memory lapses, impaired mobility due to poor health, and frustration with outpatient clinic organisation resulting in long waiting times and discontinuity of care are factors that deter patients from attending for hospital asthma assessments. The idea of telephone review assessments was viewed with scepticism by most study subjects. Particular attention should be given to explaining to patients the benefits of telephone consultations, and to seeking their views as to whether they would like to try them out before replacing face to face consultations with them. Email and text messaging may have a role in issuing

One small step for manuals: Computer-assisted training in twelve-step facilitation.

PubMed

Sholomskas, Diane E; Carroll, Kathleen M

2006-11-01

The burgeoning number of empirically validated therapies has not been met with systematic evaluation of practical, inexpensive means of teaching large numbers of clinicians to use these treatments effectively. An interactive, computer-assisted training program that sought to impart skills associated with the Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity) Twelve-Step Facilitation (TSF) manual was developed to address this need. Twenty-five community-based substance use-treatment clinicians were randomized to one of two training conditions: (1) access to the computer- assisted training program plus the TSF manual or (2) access to the manual only. The primary outcome measure was change from preto posttraining in the clinicians' ability to demonstrate key TSF skills. The data suggested that the clinicians' ability to implement TSF, as assessed by independent ratings of adherence and skill for the key TSF interventions, was significantly higher after training for those who had access to the computerized training condition than those who were assigned to the manual-only condition. Those assigned to the computer-assisted training condition also demonstrated greater gains in a knowledge test assessing familiarity with concepts presented in the TSF manual. Computer-based training may be a feasible and effective means of training larger numbers of clinicians in empirically supported, manual-guided therapies.

A randomized trial of motivational interviewing and facilitated contraceptive access to prevent rapid repeat pregnancy among adolescent mothers.

PubMed

Stevens, Jack; Lutz, Robyn; Osuagwu, Ngozi; Rotz, Dana; Goesling, Brian

2017-10-01

Most interventions designed to reduce teen pregnancy rates have not focused on pregnant and/or parenting adolescents. Therefore, a large randomized controlled trial was conducted regarding a motivational interviewing program entitled Teen Options to Prevent Pregnancy in a low-income sample of adolescent mothers. This program recommended monthly sessions between a participant and a registered nurse over 18 months. This program also featured facilitated birth control access through transportation assistance and a part-time contraceptive clinic. The impact of this program on rapid repeat pregnancies at 18 months after enrollment was evaluated. Five hundred ninety-eight adolescent females were enrolled from 7 obstetrics-gynecology clinics and 5 postpartum units of a large hospital system in a Midwestern city. Each participant was enrolled at least 28 weeks pregnant or less than 9 weeks postpartum. Each participant was randomized to either the Teen Options to Prevent Pregnancy intervention or a usual-care control condition. Intervention participants averaged 4.5 hours of assistance. Participants were contacted by blinded research staff at 6 and 18 months to complete self-report surveys. Differences in outcomes between the intervention and control groups were assessed using ordinary least-squares regression. There was an 18.1% absolute reduction in self-reported repeat pregnancy in the intervention group relative to the control group (20.5% vs 38.6%%; P < .001). There was a 13.7% absolute increase in self-reported long-acting reversible contraception use in the intervention group relative to the control group (40.2% vs 26.5%, P = .002). There was no evidence of harmful effects of the intervention on sexual risk behaviors, such as having sexual intercourse without a condom or greater number of partners. The Teen Options to Prevent Pregnancy program represents one of the few evidence-based interventions to reduce rapid repeat teen pregnancy. This relatively brief

Drafting standards on cognitive accessibility: a global collaboration.

PubMed

Steel, Emily J; Janeslätt, Gunnel

2017-05-01

The International Organization for Standardization (ISO) is working on accessibility of products to support people with cognitive impairment. Working Group 10, within the technical committee 173 (assistive products for persons with disability) was formed in 2014 to draft standards for assistive products that support people with cognitive impairment. This article explains the scope and purpose of the working group and the context for its formation, and describes the plans and process for drafting and publishing new international standards. The proposed suite of standards is presented, with examples from a draft standard on daily time management. It draws on international research evidence for the effectiveness of assistive products designed to support time management in people with cognitive impairment. Examples of assistive products and their key features are provided based on domains of time as defined in the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). The proposed standards will provide design recommendations for features and functions that increase the accessibility of products used by people with cognitive impairment. They are intended to be used by designers, manufactures, educators and services providers, to facilitate their commitment to inclusion and demonstrate their willingness to work with accessibility regulation. Implications for Rehabilitation New standards based on universal design (UD) principles can guide the design of more user-friendly assistive products for people with cognitive impairment. Greater usability of assistive products, whether mainstream or specially-designed, will make it easier for practitioners to find and introduce assistive solutions to individuals with cognitive impairment. Greater usability of assistive products for daily time management can decrease the need for user training and support and enable participation.

Personalisation: A Theoretical Possibility to Reinvigorate Children's Interest in Storybook Reading and Facilitate Greater Book Diversity

ERIC Educational Resources Information Center

Kucirkova, Natalia

2016-01-01

Since the early 2010s, there has been a proliferation of new platforms for children's stories (e.g. storybook apps or iBooks), but not necessarily greater diversity of story content or children's greater interest in reading. This article argues for a new approach to address the apparent paradox of a wider availability of children's literature…

A Semantically Enabled Portal for Facilitating the Public Service Provision

NASA Astrophysics Data System (ADS)

Loutas, Nikolaos; Giantsiou, Lemonia; Peristeras, Vassilios; Tarabanis, Konstantinos

During the past years, governments have made significant efforts to improve both their internal processes and the services that they provide to citizens and businesses. These led to several successful e-Government applications (e.g., see www.epractice.eu). One of the most popular tools that was used by governments in order to modernize their services and make them accessible is e-Government portals, e.g., (Drigas et al. 2005), (Fang 2002). The main goals of such portals are: To make available complete, easy to understand, and structured information about public services and public administration's modus operandi, which will assist citizens during the service provision process. To facilitate the electronic execution of public services. Nevertheless, most of such efforts did not succeed. Gartner argues that most e-Government strategies have not achieved their objectives and have failed to trigger sustainable government transformation to greater efficiency and citizen-centricity (DiMaio 2007).

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

PubMed

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

2010-01-01

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

From Web accessibility to Web adaptability.

PubMed

Kelly, Brian; Nevile, Liddy; Sloan, David; Fanou, Sotiris; Ellison, Ruth; Herrod, Lisa

2009-07-01

these approaches placed responsibility within the authoring/publishing domain without recognising the role the user might want to play, or the roles that other users in social networks, or even Web services might play. Adaptability shifts the emphasis and calls for greater freedom for the users to facilitate individual accessibility in the open Web environment.

Sequential algorithm analysis to facilitate selective biliary access for difficult biliary cannulation in ERCP: a prospective clinical study.

PubMed

Lee, Tae Hoon; Hwang, Soon Oh; Choi, Hyun Jong; Jung, Yunho; Cha, Sang Woo; Chung, Il-Kwun; Moon, Jong Ho; Cho, Young Deok; Park, Sang-Heum; Kim, Sun-Joo

2014-02-17

Numerous clinical trials to improve the success rate of biliary access in difficult biliary cannulation (DBC) during ERCP have been reported. However, standard guidelines or sequential protocol analysis according to different methods are limited in place. We planned to investigate a sequential protocol to facilitate selective biliary access for DBC during ERCP. This prospective clinical study enrolled 711 patients with naïve papillae at a tertiary referral center. If wire-guided cannulation was deemed to have failed due to the DBC criteria, then according to the cannulation algorithm early precut fistulotomy (EPF; cannulation time > 5 min, papillary contacts > 5 times, or hook-nose-shaped papilla), double-guidewire cannulation (DGC; unintentional pancreatic duct cannulation ≥ 3 times), and precut after placement of a pancreatic stent (PPS; if DGC was difficult or failed) were performed sequentially. The main outcome measurements were the technical success, procedure outcomes, and complications. Initially, a total of 140 (19.7%) patients with DBC underwent EPF (n = 71) and DGC (n = 69). Then, in DGC group 36 patients switched to PPS due to difficulty criteria. The successful biliary cannulation rate was 97.1% (136/140; 94.4% [67/71] with EPF, 47.8% [33/69] with DGC, and 100% [36/36] with PPS; P < 0.001). The mean successful cannulation time (standard deviation) was 559.4 (412.8) seconds in EPF, 314.8 (65.2) seconds in DGC, and 706.0 (469.4) seconds in PPS (P < 0.05). The DGC group had a relatively low successful cannulation rate (47.8%) but had a shorter cannulation time compared to the other groups due to early switching to the PPS method in difficult or failed DGC. Post-ERCP pancreatitis developed in 14 (10%) patients (9 mild, 1 moderate), which did not differ significantly among the groups (P = 0.870) or compared with the conventional group (P = 0.125). Based on the sequential protocol analysis, EPF, DGC, and PPS may be safe and feasible for DBC. The use of

Registered access: a 'Triple-A' approach.

PubMed

Dyke, Stephanie O M; Kirby, Emily; Shabani, Mahsa; Thorogood, Adrian; Kato, Kazuto; Knoppers, Bartha M

2016-12-01

We propose a standard model for a novel data access tier - registered access - to facilitate access to data that cannot be published in open access archives owing to ethical and legal risk. Based on an analysis of applicable research ethics and other legal and administrative frameworks, we discuss the general characteristics of this Registered Access Model, which would comprise a three-stage approval process: Authentication, Attestation and Authorization. We are piloting registered access with the Demonstration Projects of the Global Alliance for Genomics and Health for which it may provide a suitable mechanism for access to certain data types and to different types of data users.

One Small Step for Manuals: Computer-Assisted Training in Twelve-Step Facilitation*

PubMed Central

Sholomskas, Diane E.; Carroll, Kathleen M.

2008-01-01

Objective The burgeoning number of empirically validated therapies has not been met with systematic evaluation of practical, inexpensive means of teaching large numbers of clinicians to use these treatments effectively. An interactive, computer-assisted training program that sought to impart skills associated with the Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity) Twelve-Step Facilitation (TSF) manual was developed to address this need. Method Twenty-five community-based substance use-treatment clinicians were randomized to one of two training conditions: (1) access to the computer-assisted training program plus the TSF manual or (2) access to the manual only. The primary outcome measure was change from pre- to posttraining in the clinicians' ability to demonstrate key TSF skills. Results The data suggested that the clinicians' ability to implement TSF, as assessed by independent ratings of adherence and skill for the key TSF interventions, was significantly higher after training for those who had access to the computerized training condition than those who were assigned to the manual-only condition. Those assigned to the computer-assisted training condition also demonstrated greater gains in a knowledge test assessing familiarity with concepts presented in the TSF manual. Conclusions Computer-based training may be a feasible and effective means of training larger numbers of clinicians in empirically supported, manual-guided therapies. PMID:17061013

Language facilitates introspection: Verbal mind-wandering has privileged access to consciousness.

PubMed

Bastian, Mikaël; Lerique, Sébastien; Adam, Vincent; Franklin, Michael S; Schooler, Jonathan W; Sackur, Jérôme

2017-03-01

Introspection and language are the cognitive prides of humankind, but their interactions in healthy cognition remain unclear. Episodes of mind-wandering, where personal thoughts often go unnoticed for some time before being introspected, offer a unique opportunity to study the role of language in introspection. In this paper, we show that inner speech facilitates awareness of mind-wandering. In two experiments, we either interfered with verbal working memory, via articulatory suppression (Exp. 1), or entrained it, via presentation of verbal material (Exp. 2), and measured the resulting awareness of mind-wandering. Articulatory suppression decreased the likelihood to spontaneously notice mind-wandering, whereas verbal material increased retrospective awareness of mind-wandering. In addition, an ecological study using smartphones confirmed that inner speech vividness positively predicted mind-wandering awareness (Exp. 3). Together, these findings support the view that inner speech facilitates introspection of one's thoughts, and therefore provides empirical evidence for a positive relation between language and consciousness. Copyright © 2017 Elsevier Inc. All rights reserved.

Inside the ordering room: characteristics of women's in-home sex toy parties, facilitators and sexual communication.

PubMed

Herbenick, Debra; Reece, Michael; Hollub, Ariane

2009-12-01

Previous research suggests that adult bookstores are a unique way through which individuals may learn about sexuality or practice sexual communication. Recently, the woman-oriented in-home sex toy party industry has rapidly expanded in several countries. The purpose of this study was to document the characteristics of the parties, the women who run the parties ('facilitators') and facilitator-consumer communication about sexual health topics. Female facilitators for a large in-home sex toy party company in the USA were invited to participate in an anonymous, cross-sectional online survey. A total of 1197 completed surveys were received. Most respondents were white (85.2%), heterosexual (91.6%), had at least some college education (76.3%) and were married (59.4%). Most parties were held in another woman's home (88.3%), lasted 1-2 h (72.2%) and had 10 or fewer women in attendance (65.1%). At their most recent party facilitated, most respondents were asked questions about increasing desire/arousal (75.3%), orgasm (57.8%), desire discrepancy (56.4%), erection and ejaculation (73.8%), and vaginal dryness and lubrication (64.5%). Respondents who encountered sexual health questions or disclosures by consumers (those that were more 'askable') scored significantly higher on the Sexual Opinion Survey, indicating greater erotophilia. Results suggest that female in-home sex toy party facilitators have the potential to provide a diverse group of women with opportunities to access sexuality information, products and communication and that facilitators' 'askability' is related to erotophilia. Implications for sexual health professionals are discussed.

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

PubMed

Harris, R V

2013-06-01

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

Flightless I (Drosophila) homolog facilitates chromatin accessibility of the estrogen receptor α target genes in MCF-7 breast cancer cells

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

Jeong, Kwang Won, E-mail: kwjeong@gachon.ac.kr

2014-04-04

Highlights: • H3K4me3 and Pol II binding at TFF1 promoter were reduced in FLII-depleted MCF-7 cells. • FLII is required for chromatin accessibility of the enhancer of ERalpha target genes. • Depletion of FLII causes inhibition of proliferation of MCF-7 cells. - Abstract: The coordinated activities of multiple protein complexes are essential to the remodeling of chromatin structure and for the recruitment of RNA polymerase II (Pol II) to the promoter in order to facilitate the initiation of transcription in nuclear receptor-mediated gene expression. Flightless I (Drosophila) homolog (FLII), a nuclear receptor coactivator, is associated with the SWI/SNF-chromatin remodeling complexmore » during estrogen receptor (ER)α-mediated transcription. However, the function of FLII in estrogen-induced chromatin opening has not been fully explored. Here, we show that FLII plays a critical role in establishing active histone modification marks and generating the open chromatin structure of ERα target genes. We observed that the enhancer regions of ERα target genes are heavily occupied by FLII, and histone H3K4me3 and Pol II binding induced by estrogen are decreased in FLII-depleted MCF-7 cells. Furthermore, formaldehyde-assisted isolation of regulatory elements (FAIRE)-quantitative polymerase chain reaction (qPCR) experiments showed that depletion of FLII resulted in reduced chromatin accessibility of multiple ERα target genes. These data suggest FLII as a key regulator of ERα-mediated transcription through its role in regulating chromatin accessibility for the binding of RNA Polymerase II and possibly other transcriptional coactivators.« less

Facebook: Facilitating Social Access and Language Acquisition for International Students?

ERIC Educational Resources Information Center

Lee, Kent; Ranta, Leila

2014-01-01

Many international students come to Canada to improve their English language proficiency and develop friendships with Canadians and other international students. However, gaining access to host nationals (i.e., Canadians) is not an easy task for most English as a second language (ESL) learners. Factors such as language proficiency may hamper…

Surgical access via right thoracotomy facilitates tricuspid valve surgery in sheep

PubMed Central

Bothe, Wolfgang; Diab, Mahmoud; Ostermann, Romanus; Schwarzer, Michael; Woelfel, Luisa; Bischoff, Sabine; Schubert, Harald

2017-01-01

In quadrupeds, the three-dimensional orientation of the heart with respect to the thorax is fundamentally different from that in humans. In this study, we assessed the best surgical approach to the tricuspid valve in sheep. Firstly, different surgical access sites to the tricuspid valve were tested in sheep cadavers, the anatomy was analyzed, and the optimal surgical approach to the tricuspid valve was determined. Secondly - along with cardiopulmonary bypass and cardioplegic arrest -the chosen approach was tested in six adult sheep in vivo. Anatomical analyses revealed that a left thoracotomy provided optimal access to the aorta and left heart. However, visualization of the right heart was significantly impaired. In contrast, a right thoracotomy provided good access to the right heart, but the ascending aorta was difficult to approach. Therefore, in the in vivo studies, arterial cannulation was performed through a carotid (n = 4) or femoral (n = 2) artery. In conclusion, a right-sided thoracotomy allows good visualization of all components of the tricuspid valve complex in sheep, but not of the ascending aorta. Consequently, peripheral vessels are preferred for arterial cannulation. This work may stimulate the investigation of pathomechanisms and/or novel treatment options for tricuspid valve pathologies. PMID:27456775

[Reproductive health survey of young adults in greater Santiago].

PubMed

Valenzuela, M S; Herold, J M; Morris, L; López, I M

1992-01-01

In 1988 a survey was carried out in order to obtain information on knowledge about reproduction, sexual activity, attitudes, and use of contraceptive methods among residents between 15 and 24 years of age in Greater Santiago. For this purpose, a multistage, self-weighted, non-replacement probability sample was chosen from the entire Santiago urban area. After 2,898 households were visited, 865 women and 800 men were selected and interviewed. For the interview, a questionnaire with 156 questions was developed; many questions were similar to those included in similar surveys in Brazil and Guatemala. The interviewers were professionals who had received prior training. Although 75% of the interviewees had attended sex education classes, they had erroneous ideas on various basic subjects. Sixty-nine percent of the women interviewed had undergone menarche before attending these classes. In addition, 35.4% of the women and 65.0% of the men had had sexual relations prior to marriage, and less than 20% had used any contraceptive method. More than 60% of the interviewees who had children had conceived them before marrying. These findings point up the necessity of offering sex education classes for children and young people, as well as facilitating their access to family planning services, in order to decrease the number of illegitimate and unwanted children that are born in Chile.

A Comparison of Therapist-Facilitated and Self-Guided Dream Interpretation Sessions.

ERIC Educational Resources Information Center

Heaton, Kristin J.; Hill, Clara E.; Petersen, David A.; Rochlen, Aaron B.; Zack, Jason S.

1998-01-01

Volunteer clients (N=25 undergraduate students) reported achieving greater depth, mastery, insight, and other results from therapist-facilitated sessions compared to self-guided sessions. Observer and therapist ratings indicated that therapists adhered to the Hill model of dream interpretation during therapist-facilitated sessions. Implications…

Body Posture Facilitates Retrieval of Autobiographical Memories

ERIC Educational Resources Information Center

Dijkstra, Katinka; Kaschak, Michael P.; Zwaan, Rolf A.

2007-01-01

We assessed potential facilitation of congruent body posture on access to and retention of autobiographical memories in younger and older adults. Response times were shorter when body positions during prompted retrieval of autobiographical events were similar to the body positions in the original events than when body position was incongruent.…

A global view of direct access and patient self-referral to physical therapy: implications for the profession.

PubMed

Bury, Tracy J; Stokes, Emma K

2013-04-01

International policy advocates for direct access, but the extent to which it exists worldwide was unknown. The purpose of this study was to map the presence of direct access to physical therapy services in the member organizations of the World Confederation for Physical Therapy (WCPT) in the context of physical therapist practice and health systems. A 2-stage, mixed-method, descriptive study was conducted. A purposive sample of member organizations of WCPT in Europe was used to refine the survey instrument, followed by an online survey sent to all WCPT member organizations. Data were analyzed using descriptive statistics, and content analysis was used to analyze open-ended responses to identify themes. A response rate of 68% (72/106) was achieved. Direct access to physical therapy was reported by 58% of the respondents, with greater prevalence in private settings. Organizations reported that professional (entry-level) education equipped physical therapists for direct access in 69% of the countries. National physical therapy associations (89%) and the public (84%) were thought to be in support of direct access, with less support perceived from policy makers (35%) and physicians (16%). Physical therapists' ability to assess, diagnose, and refer patients on to specialists was more prevalent in the presence of direct access. The findings may not be representative of the Asia Western Pacific (AWP) region, where there was a lower response rate. Professional legislation, the medical profession, politicians, and policy makers are perceived to act as both barriers to and facilitators of direct access. Evidence for clinical effectiveness and cost-effectiveness and examples of good practice are seen as vital resources that could be shared internationally, and professional leadership has an important role to play in facilitating change and advocacy.

Effect of referral strategies on access to cardiac rehabilitation among women.

PubMed

Gravely, Shannon; Anand, Sonia S; Stewart, Donna E; Grace, Sherry L

2014-08-01

Despite its proven benefits and need, women's access to cardiac rehabilitation (CR) is suboptimal. Referral strategies, such as systematic referral, have been advocated to improve access to CR. This study examined sex differences in CR referral and enrollment by referral strategies; and the impact of referral strategies for referral and enrollment concordance among women. Prospective cohort study. This prospective study included 2635 coronary artery disease inpatients from 11 Ontario hospitals that utilized one of four referral strategies. Participants completed a sociodemographic survey, and clinical data were extracted from charts. One year later, 1809 participants (452 (25%) women) completed a mailed survey that assessed CR utilization. Referral strategies were compared among women using generalized estimating equations to control for the effect of hospital. Overall, significantly more men than women were referred (67.2% and 57.8% respectively, p < 0.001), and enrolled in CR (58.6% and 49.3% respectively, p = 0.001). Of the retained women, combined systematic and liaison-facilitated referral resulted in significantly greater CR referral (OR 10.3, 95% CI 4.11-25.58) and enrollment (OR 6.6, 95% CI 4.34-9.92) among women when compared with usual referral. Conversely, concordance between referral and enrollment was greatest following usual referral (K = 0.85), and decreased with referral intensity. While a lower proportion of referred patients enroll, systematic and liaison-facilitated inpatient referral strategies result in the greatest CR enrollment rates among women. Such strategies have the potential to improve access among women, and reduce 'cherry picking' of patients for referral. © The European Society of Cardiology 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

CUAHSI-HIS: an Internet based system to facilitate public discovery, access, and exploration of different water science data sources

NASA Astrophysics Data System (ADS)

Arrigo, J. S.; Hooper, R. P.; Choi, Y.; Ames, D. P.; Kadlec, J.; Whiteaker, T.

2011-12-01

"Water is everywhere." This sentiment underscores the importance of instilling hydrologic and earth science literacy in educators, students, and the general public, but also presents challenges for water scientists and educators. Scientific data about water is collected and distributed by several different sources, from federal agencies to scientific investigators to citizen scientists. As competition for limited water resources increase, increasing access to and understanding of the wealth of information about the nation's and the world's water will be critical. The CUAHSI-HIS system is a web based system for sharing hydrologic data that can help address this need. HydroDesktop is a free, open source application for finding, getting, analyzing and using hydrologic data from the CUAHSI-HIS system. It works with HydroCatalog which indexes the data to find out what data exists and where it is, and then it retrieves the data from HydroServers where it is stored communicating using WaterOneFlow web services. Currently, there are over 65 services registered in HydroCatalog providing central discovery of water data from several federal and state agencies, university projects, and other sources. HydroDesktop provides a simplified GIS that allows users to incorporate spatial data, and simple analysis tools to facilitate graphing and visualization. HydroDesktop is designed to be useful for a number of different groups of users with a wide variety of needs and skill levels including university faculty, graduate and undergraduate students, K-12 students, engineering and scientific consultants, and others. This presentation will highlight some of the features of HydroDesktop and the CUAHSI-HIS system that make it particularly appropriate for use in educational and public outreach settings, and will present examples of educational use. The incorporation of "real data," localization to an area of interest, and problem-based learning are all recognized as effective strategies for

Transpersonal Psychology: Facilitating Transformation in Outdoor Experiential Education.

ERIC Educational Resources Information Center

Brown, Michael H.

1989-01-01

Explores how outdoor experiential education can facilitate personal growth and transformation by balancing adventure-based activities with inner-directed processes. Discusses transpersonal psychology and research on consciousness and brain functions relevant to the process of transformation. Describes a specific technique to access deeper levels…

Greater than the Sum of Its Parts: A Qualitative Study of the Role of the Coordinating Center in Facilitating Coordinated Collaborative Science

ERIC Educational Resources Information Center

Rolland, Betsy; Lee, Charlotte P.; Potter, John D.

2017-01-01

As collaborative biomedical research has increased in size and scope, so, too, has the need to facilitate the disparate work being done by investigators across institutional, geographic and, often, disciplinary boundaries. Yet we know little about what facilitation is on a day-to-day basis or what types of facilitation work contribute to the…

WEST ELEVATION OF USAIR MAINTENANCE HANGAR AT GREATER BUFFALO INTERNATIONAL ...

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

WEST ELEVATION OF USAIR MAINTENANCE HANGAR AT GREATER BUFFALO INTERNATIONAL AIRPORT. A BOEING 737-200 HAS BEEN TOWED IN FOR AN OVERNIGHT (BALANCE) CHECK. THE TAIL DOCK STANDS ARE IN POSITION AT THE REAR OF THE AIRCRAFT TO FACILITATE INSPECTION. MAINTENANCE CREWS PERFORM NIGHTLY SERVICE ON UP TO 6 AIRCRAFT. THE NORMAL SEQUENCE OF 12 ROUTINE CHECKS COVERS SEVEN BASIC AREAS: INTERIOR, EXTERIOR, WINGS, LANDING GEAR, TAIL, AUXILIARY POWER UNIT (APU), AND ENGINES. THE WORK FORCE CONSISTS OF 5 INSPECTORS, 3 LEAD MECHANICS, AND 24 MECHANICS; NIGHTLY SCHEDULES ARE COORDINATED BY A PLANNER. - Greater Buffalo International Airport, Maintenance Hangar, Buffalo, Erie County, NY

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

PubMed

Mackey, Tim K; Schoenfeld, Virginia J

2016-02-02

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

Barriers and facilitators to family planning access in Canada.

PubMed

Hulme, Jennifer; Dunn, Sheila; Guilbert, Edith; Soon, Judith; Norman, Wendy

2015-02-01

Contraceptives are underutilized in Canada, and nearly one in three Canadian women will have an abortion in her lifetime. To help delineate a national family planning research agenda, the authors interviewed healthcare providers and organizational stakeholders to explore their perspective on barriers to contraception across regions of Canada. Semi-structured interviews were conducted based on validated frameworks for assessing family planning access and quality. The authors purposefully selected 14 key stakeholders from government agencies, professional organizations and non-governmental organizations for in-person interviews. Fifty-eight healthcare providers and representatives of stakeholder organizations in reproductive health who self-selected through an online survey were also interviewed. Transcripts were analyzed for repeated and saturated themes. Cost was the most important barrier to contraception. Sexual health education was reported as inconsistent, even within provinces. Regional differences were highlighted, including limited access to family physicians in rural Canada and throughout Quebec. Physician bias and outdated practices were cited as significant barriers to quality. New immigrants, youth, young adults and women in small rural, Northern and Aboriginal communities were all identified as particularly vulnerable. Informants identified multiple opportunities for health policy and system restructuring, including subsidized contraception, and enhancing public and healthcare provider education. Sexual health clinics were viewed as a highly successful model. Task-sharing and expanded scope of practice of nurses, nurse practitioners and pharmacists, alongside telephone and virtual healthcare consultations, were suggested to create multiple points of entry into the system. Results underscore the need for a national strategic approach to family planning health policy and health services delivery in Canada. Copyright © 2015 Longwoods Publishing.

Fixed Access Network Sharing

NASA Astrophysics Data System (ADS)

Cornaglia, Bruno; Young, Gavin; Marchetta, Antonio

2015-12-01

Fixed broadband network deployments are moving inexorably to the use of Next Generation Access (NGA) technologies and architectures. These NGA deployments involve building fiber infrastructure increasingly closer to the customer in order to increase the proportion of fiber on the customer's access connection (Fibre-To-The-Home/Building/Door/Cabinet… i.e. FTTx). This increases the speed of services that can be sold and will be increasingly required to meet the demands of new generations of video services as we evolve from HDTV to "Ultra-HD TV" with 4k and 8k lines of video resolution. However, building fiber access networks is a costly endeavor. It requires significant capital in order to cover any significant geographic coverage. Hence many companies are forming partnerships and joint-ventures in order to share the NGA network construction costs. One form of such a partnership involves two companies agreeing to each build to cover a certain geographic area and then "cross-selling" NGA products to each other in order to access customers within their partner's footprint (NGA coverage area). This is tantamount to a bi-lateral wholesale partnership. The concept of Fixed Access Network Sharing (FANS) is to address the possibility of sharing infrastructure with a high degree of flexibility for all network operators involved. By providing greater configuration control over the NGA network infrastructure, the service provider has a greater ability to define the network and hence to define their product capabilities at the active layer. This gives the service provider partners greater product development autonomy plus the ability to differentiate from each other at the active network layer.

[Creation of a complete organised care network allowing facilitated access to ophthalmological care for patients living in socially "at-risk" situations, feasibility study].

PubMed

Terrier de la Chaise, S; Criton, A; Berrod, J-P; Boivin, J-M

2017-09-01

Currently, renouncement to healthcare by socially "at-risk" patients continues to increase and access to ophthalmological care is complex. The main objective of this study is to test the feasibility of a complete organised care network allowing facilitated access to ophthalmological care for patients living in socially "at-risk" situations. A prospective interventional study was conducted within four social housing infrastructures to screen for vision problems in the "at-risk" socially population in question. Partnering with the ophthalmological department of the CHRU de Nancy, an interventional and supportive care trial for the affected population was conducted with the assistance of social workers, nursing aides, opticians, and the author. Ten screening sessions were conducted between December 2015 and April 2016 allowing a vision exam of sixty-five patients living in social housing. Twenty-five patients benefited from specialised care within a three-month time frame provided by the ophthalmological department, of which nineteen patients received corrective lenses. The remaining six patients received other types of ophthalmological care. The study allowed to demonstrate that the cooperation of willing actors makes it possible to improve access to visual healthcare for patients living in socially "at-risk" situations, in particular in the frame of ophthalmological care, often taking second place in a general medical consultation. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Barriers and Facilitators of Health Literacy among D/deaf Individuals: A Review Article

PubMed Central

NASERIBOORIABADI, Tahereh; SADOUGHI, Farahnaz; SHEIKHTAHERI, Abbas

2017-01-01

Background: The implication of health literacy is the ability of individuals to find, understand, and use their required health information from reliable sources. It is an indicator of the individuals’ participation in their own medical decision-making. Deaf individuals have limited health literacy and poor health status due to low literacy. Hence, this review was conducted to understand barriers and facilitators influencing health literacy among deaf community. Methods: We searched the ISI Web of Sciences, Scopus, and Medline from 1987 to 2016. Seventy-three papers were analyzed thematically. Results: We found three primary themes, including inadequate health literacy, barriers, and facilitators to accessing health information and health care services among deaf individuals. Facilitators were composed of four sub-theme including legal activities protecting the right of deaf patients to accessing health services, training health professionals about effective communication with deaf patients, providing sign language interpreter services, and developing deaf-tailored educational health programs and materials. Conclusion: Closing the deaf cultural gap and their limited access to health information are achievable through the removal of the communication barriers, allowing deaf individuals with more access to health learning opportunities, and informing the hearing community about the communicative skills of deaf individuals. PMID:29167764

Peer-facilitated cognitive dissonance versus healthy weight eating disorders prevention: A randomized comparison.

PubMed

Becker, Carolyn Black; Wilson, Chantale; Williams, Allison; Kelly, Mackenzie; McDaniel, Leda; Elmquist, Joanna

2010-09-01

Research supports the efficacy of both cognitive dissonance (CD) and healthy weight (HW) eating disorders prevention, and indicates that CD can be delivered by peer-facilitators, which facilitates dissemination. This study investigated if peer-facilitators can deliver HW when it is modified for their use and extended follow-up of peer-facilitated CD as compared to previous trials. Based on pilot data, we modified HW (MHW) to facilitate peer delivery, elaborate benefits of the healthy-ideal, and place greater emphasis on consuming nutrient dense foods. Female sorority members (N=106) were randomized to either two 2-h sessions of CD or MHW. Participants completed assessment pre- and post-intervention, and at 8-week, 8-month, and 14-month follow-up. Consistent with hypotheses, CD decreased negative affect, thin-ideal internalization, and bulimic pathology to a greater degree post-intervention. Both CD and MHW reduced negative affect, internalization, body dissatisfaction, dietary restraint, and bulimic pathology at 14 months. Copyright © 2010 Elsevier Ltd. All rights reserved.

46 CFR 111.01-7 - Accessibility and spacing.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Accessibility and spacing. 111.01-7 Section 111.01-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING ELECTRIC SYSTEMS... electric apparatus must afford accessibility to each part as needed to facilitate proper inspection...

46 CFR 111.01-7 - Accessibility and spacing.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Accessibility and spacing. 111.01-7 Section 111.01-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING ELECTRIC SYSTEMS... electric apparatus must afford accessibility to each part as needed to facilitate proper inspection...

46 CFR 111.01-7 - Accessibility and spacing.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Accessibility and spacing. 111.01-7 Section 111.01-7 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING ELECTRIC SYSTEMS... electric apparatus must afford accessibility to each part as needed to facilitate proper inspection...

Playground Accessibility and Neighbourhood Social Interaction among Parents

ERIC Educational Resources Information Center

Bennet, Scott A.; Yiannakoulias, Nikolaos; Williams, Allison M.; Kitchen, Peter

2012-01-01

While the positive association between social interaction and access to green space is well accepted, little research has sought to understand the role of children's playgrounds in facilitating social interaction within a community. Playgrounds are spaces designed to facilitate play and the interaction of children, but may also be important places…

From parent to 'peer facilitator': a qualitative study of a peer-led parenting programme.

PubMed

Thomson, S; Michelson, D; Day, C

2015-01-01

Peer-led interventions are increasingly common in community health settings. Although peer-led approaches have proven benefits for service users, relatively little is known about the process and outcomes of participation for peer leaders. This study investigated experiences of parents who had participated as 'peer facilitators' in Empowering Parents, Empowering Communities (EPEC), a peer-led programme designed to improve access to evidence-based parenting support in socially disadvantaged communities. A qualitative cross-sectional design was used. Semi-structured interviews were conducted with 14 peer facilitators and scrutinized using thematic analysis. Peer facilitators developed their knowledge and skills through personal experience of receiving parenting support, participation in formal training and supervised practice, access to an intervention manual, and peer modelling. Peer facilitators described positive changes in their own families, confidence and social status. Transformative personal gains reinforced peer facilitators' role commitment and contributed to a cohesive 'family' identity among EPEC staff and service users. Peer facilitators' enthusiasm, openness and mutual identification with families were seen as critical to EPEC's effectiveness and sustainability. Peer facilitators also found the training emotionally and intellectually demanding. There were particular difficulties around logistical issues (e.g. finding convenient supervision times), managing psychosocial complexity and child safeguarding. The successful delivery and sustained implementation of peer-led interventions requires careful attention to the personal qualities and support of peer leaders. Based on the findings of this study, support should include training, access to intervention manuals, regular and responsive supervision, and logistical/administrative assistance. Further research is required to elaborate and extend these findings to other peer-led programmes. © 2014 John Wiley

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…

Economic Value of Greater Access to Bariatric Procedures for Patients With Severe Obesity and Diabetes.

PubMed

Kim, David D; Arterburn, David E; Sullivan, Sean D; Basu, Anirban

2018-05-12

Designing optimal insurance is important to ensure access to care for individuals that are most likely to benefit. We examined the potential impact of lowering patient cost-sharing for bariatric procedures. After defining 10 subgroups by body mass index (BMI) and type 2 diabetes mellitus (T2DM), we analyzed the National Health and Nutrition Examination Survey datasets to estimate the prevalence of each subgroup. The MarketScan claims database provided utilization rates and costs of bariatric procedures. Using an existing cost-effectiveness model, we estimated the economic value of bariatric procedures under various cost-sharing levels (0%-25%) with 2 frameworks: (1) a traditional cost-effectiveness analysis and (2) a new approach that incorporates utilization effects across subgroups. The utilization rate was higher among individuals with T2DM than those without T2DM (90.4 vs. 59.1 cases per 100,000) for bariatric procedures, which were more cost-effective for those with T2DM and a higher BMI. After accounting for utilization effects, the economic value of bariatric surgery was $177 and $63 per individual from a lifetime and a 5-year time horizon, respectively. Under no patient cost-sharing for individuals with BMI≥40 and T2DM, utilization rates were expected to increase by 21 cases per 100,000, resulting in additional $2 realized value per patient and $7.07 million in returns at the US population level. Cost-sharing is a barrier to uptake of a clinical and cost-effective treatment for severe obesity. Reducing cost-sharing for patients with severe obesity and T2DM could potentially increase the utilization of bariatric procedures and result in greater economic value to payers.

Five Steps to an Accessible Classroom Website

ERIC Educational Resources Information Center

Amundson, Linda

2009-01-01

When teachers or technology coordinators publish a website, they are providing a product for a diverse group of people. That's why website design should follow accessibility guidelines. Websites should be accessible to those with visual, hearing, movement, cognitive, and speech disabilities. Good design means greater accessibility for all. This…

Barriers to and Facilitators of Physical Activity Program Use Among Older Adults

PubMed Central

Bethancourt, Hilary J.; Rosenberg, Dori E.; Beatty, Tara; Arterburn, David E.

2014-01-01

Objective Regular physical activity (PA) is important for maintaining long-term physical, cognitive, and emotional health. However, few older adults engage in routine PA, and even fewer take advantage of programs designed to enhance PA participation. Though most managed Medicare members have free access to the Silver Sneakers and EnhanceFitness PA programs, the vast majority of eligible seniors do not utilize these programs. The goal of this qualitative study was to better understand the barriers to and facilitators of PA and participation in PA programs among older adults. Design This was a qualitative study using focus group interviews. Setting Focus groups took place at three Group Health clinics in King County, Washington. Participants Fifty-two randomly selected Group Health Medicare members between the ages of 66 to 78 participated. Methods We conducted four focus groups with 13 participants each. Focus group discussions were audio-recorded, transcribed, and analyzed using an inductive thematic approach and a social-ecological framework. Results Men and women were nearly equally represented among the participants, and the sample was largely white (77%), well-educated (69% college graduates), and relatively physically active. Prominent barriers to PA and PA program participation were physical limitations due to health conditions or aging, lack of professional guidance, and inadequate distribution of information on available and appropriate PA options and programs. Facilitators included the motivation to maintain physical and mental health and access to affordable, convenient, and stimulating PA options. Conclusion Older adult populations may benefit from greater support and information from their providers and health care systems on how to safely and successfully improve or maintain PA levels through later adulthood. Efforts among health care systems to boost PA among older adults may need to consider patient-centered adjustments to current PA programs, as

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

PubMed

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

2017-07-13

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

Access to Health Care for Individuals with Developmental Disabilities from Minority Backgrounds

ERIC Educational Resources Information Center

Reichard, Amanda; Sacco,Therese Marie; Turnbull, H. Rutherford, III

2004-01-01

In this project we examined access to health care by individuals with developmental disabilities in Kansas from low income populations and from minority backgrounds. Four criteria for determining access were employed: availability, accessibility, affordability, and appropriateness of care. Factors that pose barriers and that facilitate access are…

Facilitators and barriers to the provision of therapeutic interventions by school psychologists

PubMed Central

Squires, Garry; Bragg, Joanna; Muscutt, Janet; Wasilewski, David

2014-01-01

There is growing concern internationally about the prevalence of mental health problems among school-aged children and their access to specialist services. School psychologists (SPs) may be one group of professionals well-positioned to support the well-being of children and young people, due to their position as applied psychologists working within educational settings and their capability to deliver therapeutic interventions. This research considers findings from a large scale, United Kingdom (UK)-wide survey of the views of SPs (N = 455) about facilitators and barriers to the provision of therapeutic interventions to children and young people. Principal Components Analyses of ranked questionnaire responses yielded three components: The role of the SP; training and practice; and support and psychology service context. Quantitative findings were then triangulated, using qualitative responses from the survey. Greater direction and clarification of the role of the SP as a provider of therapeutic interventions is recommended, particularly given the diverse roles undertaken by SPs and competing demands, particularly from assessment activities. PMID:26412911

A Conceptual Framework of Mapping Access to Health Care across EU Countries: The Patient Access Initiative.

PubMed

Souliotis, Kyriakos; Hasardzhiev, Stanimir; Agapidaki, Eirini

Research evidence suggests that access to health care is the key influential factor for improved population health outcomes and health care system sustainability. Although the importance of addressing barriers in access to health care across European countries is well documented, little has been done to improve the situation. This is due to different definitions, approaches and policies, and partly due to persisting disparities in access within and between European countries. To bridge this gap, the Patient Access Partnership (PACT) developed (a) the '5As' definition of access, which details the five critical elements (adequacy, accessibility, affordability, appropriateness, and availability) of access to health care, (b) a multi-stakeholders' approach for mapping access, and (c) a 13-item questionnaire based on the 5As definition in an effort to address these obstacles and to identify best practices. These tools are expected to contribute effectively to addressing access barriers in practice, by suggesting a common framework and facilitating the exchange of knowledge and expertise, in order to improve access to health care between and within European countries. © 2016 S. Karger AG, Basel.

Medical students' and facilitators' experiences of an Early Professional Contact course: active and motivated students, strained facilitators.

PubMed

von Below, Bernhard; Hellquist, Gunilla; Rödjer, Stig; Gunnarsson, Ronny; Björkelund, Cecilia; Wahlqvist, Mats

2008-12-02

Today, medical students are introduced to patient contact, communication skills, and clinical examination in the preclinical years of the curriculum with the purpose of gaining clinical experience. These courses are often evaluated from the student perspective. Reports with an additional emphasis on the facilitator perspective are scarce. According to constructive alignment, an influential concept from research in higher education, the learning climate between students and teachers is also of great importance. In this paper, we approach the learning climate by studying both students' and facilitators' course experiences.In 2001, a new "Early Professional Contact" longitudinal strand through term 1-4, was introduced at the Sahlgrenska Academy, University of Gothenburg, Sweden. General practitioners and hospital specialists were facilitators.The aim of this study was to assess and analyse students' and clinical facilitators' experiences of the Early Professional Contact course and to illuminate facilitators' working conditions. Inspired by a Swedish adaptation of the Course Experience Questionnaire, an Early Professional Contact Questionnaire was constructed. In 2003, on the completion of the first longitudinal strand, a student and facilitator version was distributed to 86 students and 21 facilitators. In the analysis, both Chi-square and the Mann-Whitney tests were used. Sixty students (70%) and 15 facilitators (71%) completed the questionnaire. Both students and facilitators were satisfied with the course. Students reported gaining iiration for their future work as doctors along with increased confidence in meeting patients. They also reported increased motivation for biomedical studies. Differences in attitudes between facilitators and students were found. Facilitators experienced a greater workload, less reasonable demands and less support, than students. In this project, a new Early Professional Contact course was analysed from both student and facilitator

Cancer Data Access System (CDAS) | Division of Cancer Prevention

Cancer.gov

The Cancer Data Access System (CDAS) is a web portal that facilitates access to PLCO data. Investigators can register with CDAS and request access to data collected through December 31, 2009 for the first 13 years of participation for each subject in the PLCO trial. Newly diagnosed cancers and deaths continue to be collected and will be available in the future. |

Assessment of Detectable Warning Devices for Specification Compliance or Equivalent Facilitation

DOT National Transportation Integrated Search

1992-12-01

This report evaluates the Americans with Disabilities Act Accessibility Guidelines (ADAAG) specification for detectable : warnings and the applicability of equivalent facilitation to the development of detectable warning devices. Ambiguities : in the...

Barriers and facilitators to primary care or human immunodeficiency virus clinics providing methadone or buprenorphine for the management of opioid dependence.

PubMed

Turner, Barbara J; Laine, Christine; Lin, Yi-Ting; Lynch, Kevin

Federal initiatives aim to increase office-based treatment of opioid dependence, but, to our knowledge, factors associated with willingness to deliver this care have not been defined. The objective of this study was to describe clinics' willingness to provide methadone hydrochloride or buprenorphine hydrochloride for opioid dependence. The design of the study was a survey conducted in New York State. Two hundred sixty-one directors of primary care and/or human immunodeficiency virus specialty clinics (response rate, 61.1%) that serve Medicaid enrollees were questioned. Outcomes were willingness to provide methadone and buprenorphine. Predictors included clinic characteristics, attitudes about drug users and their treatment, and reported barriers and facilitators to treatment. Clinics were more willing to provide buprenorphine than methadone treatment (59.8% vs 32.6%; P < .001). Clinics offering human immunodeficiency virus specialty care (adjusted odds ratio [AOR], 2.16; 95% confidence interval [CI], 1.18-3.95) or a safe location to store narcotics (AOR, 2.99; 95% CI, 1.57-5.70) were more willing to prescribe buprenorphine and more willing to provide methadone. Willingness was positively associated with continuing medical education credits for training, but negatively associated with greater concern about medication abuse. Immediate telephone access to an addiction expert was associated with willingness to provide buprenorphine (AOR, 2.08; 95% CI, 1.15-3.76). Greater willingness to provide methadone was associated with a belief that methadone-treated patients should be seen along with other patients (AOR, 6.20; 95% CI, 1.78-21.64), methadone program affiliation (AOR, 4.76; 95% CI, 1.64-13.82), and having more patients with chronic pain in the clinic (AOR, 2.80; 95% CI, 1.44-5.44). These clinics serving Medicaid enrollees were more receptive to buprenorphine than methadone treatment. Willingness to provide this care was greater in clinics offering human

Minority Access to Higher Education

ERIC Educational Resources Information Center

Jackson, Nathaniel

2012-01-01

Blacks, Hispanics, Native Americans, and Asian Americans are entitled to equal access to all institutions of higher education. Ensuring greater access and participation by minorities in higher education is one of the most practical ways of moving America closer to the ideal of equal opportunity, which is the actualization of the American dream.…

Tidal and seasonal effects on survival rates of the endangered California clapper rail: Does invasive Spartina facilitate greater survival in a dynamic environment?

USGS Publications Warehouse

Overton, Cory T.; Casazza, Michael L.; Takekawa, John Y.; Strong, Donald R.; Holyoak, Marcel

2014-01-01

Invasive species frequently degrade habitats, disturb ecosystem processes, and can increase the likelihood of extinction of imperiled populations. However, novel or enhanced functions provided by invading species may reduce the impact of processes that limit populations. It is important to recognize how invasive species benefit endangered species to determine overall effects on sensitive ecosystems. For example, since the 1990s, hybrid Spartina (Spartina foliosa × alterniflora) has expanded throughout South San Francisco Bay, USA, supplanting native vegetation and invading mudflats. The endangered California clapper rail (Rallus longirostris obsoletus) uses the tall, dense hybrid Spartina for cover and nesting, but the effects of hybrid Spartina on clapper rail survival was unknown. We estimated survival rates of 108 radio-marked California clapper rails in South San Francisco Bay from January 2007 to March 2010, a period of extensive hybrid Spartina eradication, with Kaplan–Meier product limit estimators. Clapper rail survival patterns were consistent with hybrid Spartina providing increased refuge cover from predators during tidal extremes which flood native vegetation, particularly during the winter when the vegetation senesces. Model averaged annual survival rates within hybrid Spartina dominated marshes before eradication (Ŝ = 0.466) were greater than the same marshes posttreatment (Ŝ = 0.275) and a marsh dominated by native vegetation (Ŝ = 0.272). However, models with and without marsh treatment as explanatory factor for survival rates had nearly equivalent support in the observed data, lending ambiguity as to whether hybrid Spartina facilitated greater survival rates than native marshland. Conservation actions to aid in recovery of this endangered species should recognize the importance of available of high tide refugia, particularly in light of invasive species eradication programs and projections of future sea-level rise.

Oligonucleotide facilitators may inhibit or activate a hammerhead ribozyme.

PubMed Central

Jankowsky, E; Schwenzer, B

1996-01-01

Facilitators are oligonucleotides capable of affecting hammerhead ribozyme activity by interacting with the substrate at the termini of the ribozyme. Facilitator effects were determined in vitro using a system consisting of a ribozyme with 7 nucleotides in every stem sequence and two substrates with inverted facilitator binding sequences. The effects of 9mer and 12mer RNA as well as DNA facilitators which bind either adjacent to the 3'- or 5'-end of the ribozyme were investigated. A kinetic model was developed which allows determination of the apparent dissociation constant of the ribozyme-substrate complex from single turnover reactions. We observed a decreased dissociation constant of the ribozyme-substrate complex due to facilitator addition corresponding to an additional stabilization energy of delta delta G=-1.7 kcal/mol with 3'-end facilitators. The cleavage rate constant was increased by 3'-end facilitators and decreased by 5'-end facilitators. Values for Km were slightly lowered by all facilitators and kcat was increased by 3'-end facilitators and decreased by 5'-end facilitators in our system. Generally the facilitator effects increased with the length of the facilitators and RNA provided greater effects than DNA of the same sequence. Results suggest facilitator influences on several steps of the hammerhead reaction, substrate association, cleavage and dissociation of products. Moreover, these effects are dependent in different manners on ribozyme and substrate concentration. This leads to the conclusion that there is a concentration dependence whether activation or inhibition is caused by facilitators. Conclusions are drawn with regard to the design of hammerhead ribozyme facilitator systems. PMID:8602353

The socioeconomic factors that facilitate or constrain restoration management: Watershed rehabilitation and wet meadow (bofedal) restoration in the Bolivian Andes.

PubMed

Hartman, Brett D; Cleveland, David A

2018-03-01

Restoration ecology holds promise for addressing land degradation in impoverished rural environments, provided the approach is adapted to rural development settings. While there is a need for increased integration of social dynamics in land restoration, few systematic studies exist. We explored the socioeconomic factors that influence restoration management, including local motives and perceived benefits, incentives, land tenancy, institutional factors, conflict resolution, accessibility, off-farm labor, and outmigration. The study area is a successful watershed rehabilitation and wet meadow restoration project in the Bolivian Andes that began in 1992. We used household survey methods (n = 237) to compare the communities that had conducted the most restoration management with those that had conducted the least. Results suggest that several factors facilitate investments in land restoration, including aligning restoration objectives with local motives and perceived benefits, ensuring incentives are in place to stimulate long-term investments, conflict resolution, private land tenancy, and accessibility. However, higher levels of organization and active leadership can facilitate land restoration on communal lands. Increased livelihood benefits from land restoration helped slow the rate of rural to urban migration, with 24.5% outmigration in the highest restoration management communities compared to 62.1% in the lowest restoration management communities. Results suggest that land restoration projects that integrate community development into project planning and implementation will achieve greater success. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cigarette access and pupil smoking rates: a circular relationship?

PubMed

Turner, Katrina M; Gordon, Jacki; Young, Robert

2004-12-01

Adolescents obtain cigarettes from both commercial and social sources. While the relationship between commercial access and adolescent smoking has been researched, no one has considered in detail whether rates of peer smoking affect cigarette availability. In two relatively deprived Scottish schools that differed in their pupil smoking rates, we assess pupil access to cigarettes. 896 13 and 15 year olds were surveyed, and 25 single-sex discussion groups held with a sub-sample of the 13 year olds. Smokers in both schools obtained cigarettes from shops, food vans and other pupils. However, pupils in the 'high' smoking school perceived greater access to both commercial and social sources, and had access to an active 'peer market'. These findings suggest that variations in cigarette access may contribute to school differences in pupil smoking rates, and that the relationship between access and adolescent smoking is circular, with greater availability increasing rates, and higher rates enhancing access.

77 FR 47440 - Office of the Assistant Secretary for Office of Disability Employment Program Accessible...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-08

... facilitate and promote the use of accessible technology in the hiring, employment, retention, and career... employment and creating accessible human resource management systems (e.g., accessible online job application...

A Novel Reference Security Model with the Situation Based Access Policy for Accessing EPHR Data.

PubMed

Gope, Prosanta; Amin, Ruhul

2016-11-01

Electronic Patient Health Record (EPHR) systems may facilitate a patient not only to share his/her health records securely with healthcare professional but also to control his/her health privacy, in a convenient and easy way even in case of emergency. In order to fulfill these requirements, it is greatly desirable to have the access control mechanism which can efficiently handle every circumstance without negotiating security. However, the existing access control mechanisms used in healthcare to regulate and restrict the disclosure of patient data are often bypassed in case of emergencies. In this article, we propose a way to securely share EPHR data under any situation including break-the-glass (BtG) without compromising its security. In this regard, we design a reference security model, which consists of a multi-level data flow hierarchy, and an efficient access control framework based on the conventional Role-Based Access Control (RBAC) and Mandatory Access Control (MAC) policies.

Vital places: Facilitators of behavioral and social health mechanisms in low-income neighborhoods

PubMed Central

Walton, E

2015-01-01

Starkly unequal built and social environments among urban neighborhoods are part of the explanation for health disparities in the United States. This study is a qualitative investigation of the ways that residents of a low-income neighborhood in Madison, WI, use and interpret nearby neighborhood places. Specifically, I ask how and why certain places may facilitate beneficial behavioral and social mechanisms that impact health. I develop the organizing concept of “vital places”: nearby destinations that are important to and frequently-used by neighborhood residents, and that have theoretical relevance to health. I argue that conceiving of certain places as vital integrates our understanding of the essential components of places that are beneficial to health, while also allowing policy-makers to be creative about the ways they intervene to improve the life chances of residents in disadvantaged neighborhoods. I synthesize the findings into the characteristics of three types of vital places. First, I find that a convenient, comprehensive, and affordable food source can facilitate a healthy diet. An attractive, accessible, and safe recreational facility can support greater physical and social activity. Finally, shared, casual, focused social spaces provide opportunities to create and sustain supportive social ties. This study adds depth and complexity to the ways we conceptualize health-relevant community assets and provides insight into revitalization strategies for distressed low-income housing. PMID:25313992

Web Accessibility and Guidelines

NASA Astrophysics Data System (ADS)

Harper, Simon; Yesilada, Yeliz

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

Barriers and facilitators to home computer and internet use among urban novice computer users of low socioeconomic position.

PubMed

Kontos, Emily Z; Bennett, Gary G; Viswanath, K

2007-10-22

Despite the increasing penetration of the Internet and amount of online health information, there are significant barriers that limit its widespread adoption as a source of health information. One is the "digital divide," with people of higher socioeconomic position (SEP) demonstrating greater access and usage compared to those from lower SEP groups. However, as the access gap narrows over time and more people use the Internet, a shift in research needs to occur to explore how one might improve Internet use as well as website design for a range of audiences. This is particularly important in the case of novice users who may not have the technical skills, experience, or social connections that could help them search for health information using the Internet. The focus of our research is to investigate the challenges in the implementation of a project to improve health information seeking among low SEP groups. The goal of the project is not to promote health information seeking as much as to understand the barriers and facilitators to computer and Internet use, beyond access, among members of lower SEP groups in an urban setting. The purpose was to qualitatively describe participants' self-identified barriers and facilitators to computer and Internet use during a 1-year pilot study as well as the challenges encountered by the research team in the delivery of the intervention. Between August and November 2005, 12 low-SEP urban individuals with no or limited computer and Internet experience were recruited through a snowball sampling. Each participant received a free computer system, broadband Internet access, monthly computer training courses, and technical support for 1 year as the intervention condition. Upon completion of the study, participants were offered the opportunity to complete an in-depth semistructured interview. Interviews were approximately 1 hour in length and were conducted by the project director. The interviews were held in the participants' homes

Barriers and Facilitators to Home Computer and Internet Use Among Urban Novice Computer Users of Low Socioeconomic Position

PubMed Central

Bennett, Gary G; Viswanath, K

2007-01-01

Background Despite the increasing penetration of the Internet and amount of online health information, there are significant barriers that limit its widespread adoption as a source of health information. One is the “digital divide,” with people of higher socioeconomic position (SEP) demonstrating greater access and usage compared to those from lower SEP groups. However, as the access gap narrows over time and more people use the Internet, a shift in research needs to occur to explore how one might improve Internet use as well as website design for a range of audiences. This is particularly important in the case of novice users who may not have the technical skills, experience, or social connections that could help them search for health information using the Internet. The focus of our research is to investigate the challenges in the implementation of a project to improve health information seeking among low SEP groups. The goal of the project is not to promote health information seeking as much as to understand the barriers and facilitators to computer and Internet use, beyond access, among members of lower SEP groups in an urban setting. Objective The purpose was to qualitatively describe participants’ self-identified barriers and facilitators to computer and Internet use during a 1-year pilot study as well as the challenges encountered by the research team in the delivery of the intervention. Methods Between August and November 2005, 12 low-SEP urban individuals with no or limited computer and Internet experience were recruited through a snowball sampling. Each participant received a free computer system, broadband Internet access, monthly computer training courses, and technical support for 1 year as the intervention condition. Upon completion of the study, participants were offered the opportunity to complete an in-depth semistructured interview. Interviews were approximately 1 hour in length and were conducted by the project director. The interviews were

Factors impacting rural Pacific Island veterans' access to care: A qualitative examination.

PubMed

Whealin, Julia M; Nelson, Dawna; Kawasaki, Michelle M; Mahoney, Michael A

2017-08-01

Pacific Island veterans suffer from greater severity of posttraumatic stress disorder (PTSD) compared with Caucasian veterans but face substantial barriers to mental health care. However, the factors that may dissuade or facilitate veterans in the Pacific Islands from seeking mental health care are not known. The main aim of this study was to identify how internal and external factors interact to impact wounded warriors' access to and use of mental health services. Veterans residing in 5 rural Pacific Island locations were mailed recruitment materials. Other veterans were made aware of the project by key stakeholders in their communities. Thirty-seven male veterans (across 5 focus groups) and 1 female veteran (via individual interview) participated. The study utilized an analytic design in which taped focus group discussions were transcribed verbatim and coded for major themes. Results indicated that most veterans identified Veterans Affairs (VA) as a positive source for health care. However, common concerns acknowledged were as follows: (a) difficulty navigating the VA system, (b) time associated with receiving care, (c) family stigma, (d) community stigma, (e) cultural differences, and (f) a lack of knowledge about VA services and benefits. Facilitators of care included the following: (a) individual knowledge and self-efficacy, (b) networking with other veterans, (c) family support, and (d) rural community support. All factor levels interacted in subtle ways to ultimately impact access to care. Next steps are described, including projects designed to better meet the needs of rural Pacific Island veterans. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The most used and most helpful facilitators for patient-centered medical home implementation.

PubMed

Gale, Randall C; Asch, Steven M; Taylor, Thomas; Nelson, Karin M; Luck, Jeff; Meredith, Lisa S; Helfrich, Christian D

2015-04-19

Like other transformative healthcare initiatives, patient-centered medical home (PCMH) implementation requires substantial investments of time and resources. Even though PCMH and PCMH-like models are being implemented by multiple provider practices and health systems, little is known about what facilitates their implementation. The purpose of this study was to assess which PCMH-implementation resources are most widely used, by whom, and which resources primary care personnel find most helpful. This study is an analysis of data from a cross-sectional survey of primary care personnel in the Veterans Health Administration in 2012, in which respondents were asked to rate whether they were aware of and accessed PCMH-implementation resources, and to rate their helpfulness. Logistic regression was used to produce odds ratios for the outcomes (1) resource use and (2) resource helpfulness. Respondents were nested within clinics, nested, in turn, within 135 parent hospitals. Teamlet huddles were the most widely accessed (80.4% accessed) and most helpful (90.4% rated helpful) resource; quality-improvement methods to conduct small tests of change were the least frequently accessed (42.4% accessed) resource though two-thirds (66.7%) of users reported as helpful. Supervisors were significantly more likely (ORs, 1.46 to 1.86) to use resources than non-supervisors but were less likely to rate the majority (8 out of 10) of resources as "somewhat/very helpful" than non-supervisors (ORs, 0.72 to 0.84). Longer-tenured employees tended to rate resources as more helpful. These findings are the first in the PCMH literature that we are aware of that systematically assesses primary care staff's access to and the helpfulness of PCMH implementation resources. Supervisors generally reported greater access to resources, relative to non-supervisors, but rated resources as less helpful, suggesting that information about them may not have been optimally disseminated. Knowing what resources

The Energy Industry Profile of ISO/DIS 19115-1: Facilitating Discovery and Evaluation of, and Access to Distributed Information Resources

NASA Astrophysics Data System (ADS)

Hills, S. J.; Richard, S. M.; Doniger, A.; Danko, D. M.; Derenthal, L.; Energistics Metadata Work Group

2011-12-01

established, capability-rich, open standard for geographic metadata, EIP v1 is expected to be widely acceptable within the community and readily sustainable over the long-term. The EIP design, also per community requirements, will enable discovery, evaluation, and access to types of information resources considered important to the community, including structured and unstructured digital resources, and physical assets such as hardcopy documents and material samples. This presentation will briefly review the development of this initiative as well as the current and planned Work Group activities. More time will be spent providing an overview of the EIP v1, including the requirements it prescribes, design efforts made to enable automated metadata capture and processing, and the structure and content of its documentation, which was written to minimize ambiguity and facilitate implementation. The Work Group considers EIP v1 a solid initial design for interoperable metadata, and first step toward the vision of the Initiative.

Funding free and universal access to Journal of Neuroinflammation.

PubMed

Mrak, Robert E; Griffin, W Sue T

2004-10-14

Journal of Neuroinflammation is an Open Access, online journal published by BioMed Central. Open Access publishing provides instant and universal availability of published work to any potential reader, worldwide, completely free of subscriptions, passwords, and charges. Further, authors retain copyright for their work, facilitating its dissemination. Open Access publishing is made possible by article-processing charges assessed "on the front end" to authors, their institutions, or their funding agencies. Beginning November 1, 2004, the Journal of Neuroinflammation will introduce article-processing charges of around US$525 for accepted articles. This charge will be waived for authors from institutions that are BioMed Central members, and in additional cases for reasons of genuine financial hardship. These article-processing charges pay for an electronic submission process that facilitates efficient and thorough peer review, for publication costs involved in providing the article freely and universally accessible in various formats online, and for the processes required for the article's inclusion in PubMed and its archiving in PubMed Central, e-Depot, Potsdam and INIST. There is no remuneration of any kind provided to the Editors-in-Chief, to any members of the Editorial Board, or to peer reviewers; all of whose work is entirely voluntary. Our article-processing charge is less than charges frequently levied by traditional journals: the Journal of Neuroinflammation does not levy any additional page or color charges on top of this fee, and there are no reprint costs as publication-quality pdf files are provided, free, for distribution in lieu of reprints. Our article-processing charge will enable full, immediate, and continued Open Access for all work published in Journal of Neuroinflammation. The benefits from such Open Access will accrue to readers, through unrestricted access; to authors, through the widest possible dissemination of their work; and to science and

45 CFR 156.330 - Changes of ownership of issuers of Qualified Health Plans in Federally-facilitated Exchanges.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Health Plans in Federally-facilitated Exchanges. 156.330 Section 156.330 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCHANGES Federally-Facilitated Exchange...

Navigating change: how outreach facilitators can help clinicians improve patient outcomes.

PubMed

Laferriere, Dianne; Liddy, Clare; Nash, Kate; Hogg, William

2012-01-01

The objective of this study was to describe outreach facilitation as an effective method of assisting and supporting primary care practices to improve processes and delivery of care. We spent 4 years working with 83 practices in Eastern Ontario, Canada, on the Improved Delivery of Cardiovascular Care through the Outreach Facilitation program. Primary care practices, even if highly motivated, face multiple challenges when providing quality patient care. Outreach facilitation can be an effective method of assisting and supporting practices to make the changes necessary to improve processes and delivery of care. Multiple jurisdictions use outreach facilitation for system redesign, improved efficiencies, and advanced access. The development and implementation of quality improvement programs using practice facilitation can be challenging. Our research team has learned valuable lessons in developing tools, finding resources, and assisting practices to reach their quality improvement goals. These lessons can lead to improved experiences for the practices and overall improved outcomes for the patients they serve.

Correlates of Access to Business Research Databases

ERIC Educational Resources Information Center

Gottfried, John C.

2010-01-01

This study examines potential correlates of business research database access through academic libraries serving top business programs in the United States. Results indicate that greater access to research databases is related to enrollment in graduate business programs, but not to overall enrollment or status as a public or private institution.…

Creating a mobile subject guide to improve access to point-of-care resources for medical students: a case study.

PubMed

Boruff, Jill T; Bilodeau, Edward

2012-01-01

Can a mobile optimized subject guide facilitate medical student access to mobile point-of-care tools? The guide was created at a library at a research-intensive university with six teaching hospital sites. The team created a guide facilitating medical student access to point-of-care tools directly on mobile devices to provide information allowing them to access and set up resources with little assistance. Two librarians designed a mobile optimized subject guide for medicine and conducted a survey to test its usefulness. Web analytics and survey results demonstrate that the guide is used and the students are satisfied. The library will continue to use the subject guide as its primary means of supporting mobile devices. It remains to be seen if the mobile guide facilitates access for those who do not need assistance and want direct access to the resources. Internet access in the hospitals remains an issue.

Food Access Patterns and Barriers among Midlife and Older Adults with Mobility Disabilities

PubMed Central

Huang, Deborah L.; Rosenberg, Dori E.; Simonovich, Shannon D.; Belza, Basia

2012-01-01

We examined where midlife and older adults with a mobility disability accessed food outside the home in King County, Washington, USA, how they travelled to these food destinations, and facilitators and barriers to food access using qualitative interviews. Thirty-five adults aged ≥50 years with a mobility disability (defined as use of an assistive device for mobility) were interviewed. Supplemental objective information was obtained from a Global Positioning System device worn by participants for 3 days. Participants primarily accessed food at grocery stores, restaurants, and coffee shops/cafés. The most common transportation modes were walking, obtaining a ride from friends, motorized chair/scooter, and public transit. Location and proximity of food destinations were factors affecting participants' ability to access these destinations. Adequate space, ease of entry, available amenities such as restrooms, and helpful people were facilitators for participants to access food outside the home. PMID:23056944

Advanced access appointments

PubMed Central

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

2010-01-01

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

Barriers and Facilitators to Scientific Writing Among Applied Epidemiologists.

PubMed

Pittman, Jessica; Stahre, Mandy; Tomedi, Laura; Wurster, Jessica

Communication in the form of written and oral reports and presentations is a core competency for epidemiologists at governmental public health agencies. Many applied epidemiologists do not publish peer-reviewed articles, limiting the scientific literature of best practices in evidence-based public health. To describe the writing and publishing experiences of applied epidemiologists and identify barriers and facilitators to publishing. Telephone focus groups and an 18-question multiple-choice and short-answer Web-based assessment were fielded in 2014. Six focus groups composed of 26 applied epidemiologists and an online assessment answered by 396 applied epidemiologists. Sample selection was stratified by years of experience. Past publishing experience, current job duties as related to publishing, barriers and facilitators to writing and publishing, and desired training in writing and publishing were assessed through focus groups and the online assessment. Focus groups identified 4 themes: job expectations, barriers to publishing, organizational culture, and the understanding of public health practice among reviewers as issues related to writing and publishing. Most respondents (80%) expressed a desire to publish; however, only 59% had published in a peer-reviewed journal. An academic appointment (among doctoral educated respondents) was identified as a facilitator to publishing as was access to peer-reviewed literature. Time (68%) was identified as the greatest barrier to writing and publishing. Other major barriers included lack of encouragement or support (33%) within the public health agency and agency clearance processes (32%). Assistance with journal selection (62%), technical writing skills (60%), and manuscript formatting (57%) were listed as the most needed trainings. Public health agencies can be facilitators for epidemiologists to contribute to the scientific literature through increasing access to the peer-reviewed literature, creating a supportive

Considering the Role of Personality in the Work-Family Experience: Relationships of the Big Five to Work-Family Conflict and Facilitation

ERIC Educational Resources Information Center

Wayne, Julie Holliday; Musisca, Nicholas; Fleeson, William

2004-01-01

Using a national, random sample (N=2130), we investigated the relationship between each of the Big Five personality traits and conflict and facilitation between work and family roles. Extraversion was related to greater facilitation between roles but was not related to conflict, whereas neuroticism was related to greater conflict but only weakly…

Facilitating access to sexual health services for men who have sex with men and male-to-female transgender persons in Guatemala City.

PubMed

Boyce, Sabrina; Barrington, Clare; Bolaños, Herbert; Arandi, Cesar Galindo; Paz-Bailey, Gabriela

2012-01-01

The purpose of this study was to identify barriers to accessing sexual health services among gay, bisexual and heterosexual-identifying men who have sex with men and male-to-female transgender persons in Guatemala City, to inform the development of high quality and population-friendly services. In-depth, semi-structured interviews were conducted with 29 purposively sampled individuals, including 8 transgender, 16 gay/bisexual and 5 heterosexual-identifying participants. Topical codes were applied to the data using software Atlas.ti™ to compare data between sub-groups. Analysis revealed that public clinics were most commonly used due to their lower cost and greater accessibility, but many participants experienced discrimination, violation of confidentiality and distrust of these services. Transgender and gay/bisexual-identifying participants preferred clinics where they felt a sense of belonging, while heterosexual-identifying participants preferred clinics unassociated with the men who have sex with men community. The most prominent barriers to sexual health services included fear of discrimination, fear of having HIV, cost and lack of social support. Findings highlight the need to strengthen existing public sexually transmitted infection clinics so that they address the multiple layers of stigma and discrimination that men who have sex with men and transgender persons experience.

Creating a mobile subject guide to improve access to point-of-care resources for medical students: a case study

PubMed Central

Boruff, Jill T; Bilodeau, Edward

2012-01-01

Question: Can a mobile optimized subject guide facilitate medical student access to mobile point-of-care tools? Setting: The guide was created at a library at a research-intensive university with six teaching hospital sites. Objectives: The team created a guide facilitating medical student access to point-of-care tools directly on mobile devices to provide information allowing them to access and set up resources with little assistance. Methods: Two librarians designed a mobile optimized subject guide for medicine and conducted a survey to test its usefulness. Results: Web analytics and survey results demonstrate that the guide is used and the students are satisfied. Conclusion: The library will continue to use the subject guide as its primary means of supporting mobile devices. It remains to be seen if the mobile guide facilitates access for those who do not need assistance and want direct access to the resources. Internet access in the hospitals remains an issue. PMID:22272160

A Facilitation of Dyslexia through a Remediation of Shakespeare's Text

ERIC Educational Resources Information Center

Whitfield, Petronilla

2016-01-01

This article shares the author's research focusing on the facilitation of acting students with dyslexia in actor-training. For some individuals with dyslexia the translation of the written text into image-based symbols using technological modalities can play a crucial role to access and make concrete the meaning of the words; in this case…

Allelic database and divergence among Psidium accessions by using microsatellite markers.

PubMed

da Costa, S R; Santos, C A F

2013-12-16

This study aimed to investigate the genetic variability among guava accessions and wild Psidium species of the Embrapa Semiárido germplasm collection by using microsatellite loci to guide genetic resources and breeding programs, emphasizing crosses between guava and other Psidium species. DNA was extracted using the 2X CTAB method, and polymerase chain reaction products were analyzed on 6% denatured polyacrylamide gels stained with silver nitrate. The unweighted pair-group method using arithmetic average dendrogram generated from the distance matrix of the Jaccard coefficient for 183 alleles of 13 microsatellite loci was used for visualization of genetic similarity. The number of base pairs was estimated using inverse mobility method based on the regression of known-size products. Analysis of molecular variance was performed using total decomposition between and within guava accessions. The accessions showed similarity from 0.75 to 1.00, with the dendrogram presenting cophenetic value of 0.85. Five groups were observed: the first included guava accessions; the second, P. guineense accessions; the third, one accession of P. friedrichsthalianum; and the last 2 groups, P. cattleianum. The genetic similarity among P. guineense and some guava accessions were above 80%, suggesting greater possibility to obtain interspecies hybrids between these 2 species. The genetic variability between the accessions was considered to be high (ΦST = 0.238), indicating that guava genetic variability is not uniformly distributed among the 9 Brazilian states from where the accession were obtained. Obtaining a greater number of accessions by Brazilian states is recommended in order to have greater diversity among the species.

Facilitators and Barriers of Electronic Health Record Patient Portal Adoption by Older Adults: A Literature Study.

PubMed

Wildenbos, Gaby Anne; Peute, Linda; Jaspers, Monique

2017-01-01

Patient portal usage by older adults, patients aged 50 years old and above, is intended to improve their access and quality of care. Acceptance of patient portals by this target group is low. This paper discusses the results of a literature review to determine the facilitators and barriers that drive or inhibit older patients to adopt patient portals. Articles were included when they described an acceptance, adoption or usability evaluation study of a patient portal. From a total of 245 potentially relevant articles, 8 articles were finally included. We used the Unified Theory of Acceptance and Use of Technology (UTAUT) as a classification model to analyze factors influencing older adults' acceptance of patient portals. Main facilitators for acceptance were 'performance expectancy' and 'voluntariness of use' related to a higher level of education and experienced health. Main barriers were limited health literacy and motivation related to involuntariness to use a patient portal. Poor facilitation conditions (limited technology access and no prior knowledge on existence of a patient portal) hampered access to a portal. More thorough insight into the latter is needed to improve the reach and effectiveness of patient portals among older patients.

Article processing charges, funding, and open access publishing at Journal of Experimental & Clinical Assisted Reproduction.

PubMed

Sills, Eric Scott; Vincent, Tina Thibault; Palermo, Gianpiero D

2005-01-13

Journal of Experimental & Clinical Assisted Reproduction is an Open Access, online, electronic journal published by BioMed Central with full contents available to the scientific and medical community free of charge to all readers. Authors maintain the copyright to their own work, a policy facilitating dissemination of data to the widest possible audience without requiring permission from the publisher. This Open Access publishing model is subsidized by authors (or their institutions/funding agencies) in the form of a single pound330 article processing charge (APC), due at the time of manuscript acceptance for publication. Payment of the APC is not a condition for formal peer review and does not apply to articles rejected after review. Additionally, this fee is waived for authors whose institutions are BioMed Central members or where genuine financial hardship exists. Considering ordinary publication fees related to page charges and reprints, the APC at Journal of Experimental & Clinical Assisted Reproduction is comparable to costs associated with publishing in some traditional print journals, and is less expensive than many. Implementation of the APC within this Open Access framework is envisioned as a modern research-friendly policy that supports networking among investigators, brings new research into reach rapidly, and empowers authors with greater control over their own scholarly publications.

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.

What does 'access to health care' mean?

PubMed

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

2002-07-01

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

Peer support for CKD patients and carers: overcoming barriers and facilitating access.

PubMed

Taylor, Francesca; Gutteridge, Robin; Willis, Carol

2016-06-01

Peer support is valued by its users. Nevertheless, there is initial low take-up of formal peer support programmes among patients with chronic kidney disease (CKD), with fewer patients participating than expressing an interest. There is little evidence on reasons for low participation levels. Few studies have examined the perspectives of carers. To explore with CKD patients and carers their needs, wants and expectations from formal peer support and examine how barriers to participation may be overcome. Qualitative interviews with a sample of 26 CKD stage five patients and carers. Principles of Grounded Theory were applied to data coding and analysis. Six NHS Hospital Trusts. Whilst informal peer support might occur naturally and is welcomed, a range of emotional and practical barriers inhibit take-up of more formalized support. Receptivity varies across time and the disease trajectory and is associated with emotional readiness; patients and carers needing to overcome complex psychological hurdles such as acknowledging support needs. Practical barriers include limited understanding of peer support. An attractive peer relationship is felt to involve reciprocity based on sharing experiences and both giving and receiving support. Establishing rapport is linked with development of reciprocity. There is potential to facilitate active uptake of formal peer support by addressing the identified barriers. Our study suggests several facilitation methods, brought together in a conceptual model, including clinician promotion of peer support as an intervention suitable for anyone with CKD and their carers, and opportunity for choice of peer supporter. © 2015 The Authors Health Expectations Published by John Wiley & Sons Ltd.

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

PubMed

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

2018-05-22

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

Facilitating Factors and Barriers to the Use of Emerging Technologies for Suicide Prevention in Europe: Multicountry Exploratory Study

PubMed Central

Delgado, Carmen; Sánchez-Prada, Andrés; Parra-Vidales, Esther; de Leo, Diego; Franco-Martín, Manuel

2018-01-01

Background This study provides an analysis on the use of emerging technologies for the prevention of suicide in 8 different European countries. Objective The objective of this study was to analyze the potentiality of using emerging technologies in the area of suicide prevention based on the opinion of different professionals involved in suicide prevention. Methods Opinions of 3 groups of stakeholders (ie, relevant professionals in suicide field) were gathered using a specifically designed questionnaire to explore dimensions underlying perceptions of facilitating factors and barriers in relation to the use of emerging technologies for suicide prevention. Results Goal 1 involved facilitating factors for the use of emerging technologies in suicide prevention. Northern European countries, except for Belgium, attach greater relevance to those that optimize implementation and benefits. On the other hand, Southern European countries attach greater importance to professionally oriented and user-centered facilitating factors. According to different stakeholders, the analysis of these facilitating factors suggest that professionals in the field of social work attach greater relevance to those that optimize implementation and benefits. However, professionals involved in the area of mental health, policy makers, and political decision makers give greater importance to professionally oriented and user-centered facilitating factors. Goal 2 was related to barriers to the usability of emerging technologies for suicide prevention. Both countries and stakeholders attach greater importance to barriers associated with resource constraints than to those centered on personal limitations. There are no differences between countries or between stakeholders. Nevertheless, there is a certain stakeholders-countries interaction that indicates that the opinions on resource constraints expressed by different stakeholders do not follow a uniform pattern in different countries, but they differ

Facilitating Factors and Barriers to the Use of Emerging Technologies for Suicide Prevention in Europe: Multicountry Exploratory Study.

PubMed

Muñoz-Sánchez, Juan-Luis; Delgado, Carmen; Parra-Vidales, Esther; Franco-Martín, Manuel

2018-01-24

This study provides an analysis on the use of emerging technologies for the prevention of suicide in 8 different European countries. The objective of this study was to analyze the potentiality of using emerging technologies in the area of suicide prevention based on the opinion of different professionals involved in suicide prevention. Opinions of 3 groups of stakeholders (ie, relevant professionals in suicide field) were gathered using a specifically designed questionnaire to explore dimensions underlying perceptions of facilitating factors and barriers in relation to the use of emerging technologies for suicide prevention. Goal 1 involved facilitating factors for the use of emerging technologies in suicide prevention. Northern European countries, except for Belgium, attach greater relevance to those that optimize implementation and benefits. On the other hand, Southern European countries attach greater importance to professionally oriented and user-centered facilitating factors. According to different stakeholders, the analysis of these facilitating factors suggest that professionals in the field of social work attach greater relevance to those that optimize implementation and benefits. However, professionals involved in the area of mental health, policy makers, and political decision makers give greater importance to professionally oriented and user-centered facilitating factors. Goal 2 was related to barriers to the usability of emerging technologies for suicide prevention. Both countries and stakeholders attach greater importance to barriers associated with resource constraints than to those centered on personal limitations. There are no differences between countries or between stakeholders. Nevertheless, there is a certain stakeholders-countries interaction that indicates that the opinions on resource constraints expressed by different stakeholders do not follow a uniform pattern in different countries, but they differ depending on the country. Although all

Facilitating Facilitators: Enhancing PBL through a Structured Facilitator Development Program

ERIC Educational Resources Information Center

Salinitri, Francine D.; Wilhelm, Sheila M.; Crabtree, Brian L.

2015-01-01

With increasing adoption of the problem-based learning (PBL) model, creative approaches to enhancing facilitator training and optimizing resources to maintain effective learning in small groups is essential. We describe a theoretical framework for the development of a PBL facilitator training program that uses the constructivist approach as the…

How Much Water Trees Access and How It Determines Forest Response to Drought

NASA Astrophysics Data System (ADS)

Berdanier, A. B.; Clark, J. S.

2015-12-01

Forests are transformed by drought as water availability drops below levels where trees of different sizes and species can maintain productivity and survive. Physiological studies have provided detailed understanding of how species differences affect drought vulnerability but they offer almost no insights about the amount of water different trees can access beyond general statements about rooting depth. While canopy architecture provides strong evidence for light availability aboveground, belowground moisture availability remains essentially unknown. For example, do larger trees always have greater access to soil moisture? In temperate mixed forests, the ability to access a large soil moisture pool could minimize damage during drought events and facilitate post-drought recovery, potentially at the expense of neighboring trees. We show that the pool of accessible soil moisture can be estimated for trees with data on whole-plant transpiration and that this data can be used to predict water availability for forest stands. We estimate soil water availability with a Bayesian state-space model based on a simple water balance, where cumulative depressions in water use below potential transpiration indicate soil resource depletion. We compare trees of different sizes and species, extend these findings to the entire stand, and connect them to our recent research showing that tree survival after drought depends on post-drought growth recovery and local moisture availability. These results can be used to predict competitive abilities for soil water, understand ecohydrological variation within stands, and identify trees that are at risk of damage from future drought events.

The utility of outpatient commitment: acute medical care access and protecting health.

PubMed

Segal, Steven P; Hayes, Stephania L; Rimes, Lachlan

2018-06-01

This study considers whether, in an easy access single-payer health care system, patients placed on outpatient commitment-community treatment orders (CTOs) in Victoria Australia-are more likely to access acute medical care addressing physical illness than voluntary patients with and without severe mental illness. For years 2000 to 2010, the study compared acute medical care access of 27,585  severely mentally ill psychiatrically hospitalized patients (11,424 with and 16,161 without CTO exposure) and 12,229 never psychiatrically hospitalized outpatients (individuals with less morbidity risk as they were not considered to have severe mental illness). Logistic regression was used to determine the influence of the CTO on the likelihood of receiving a diagnosis of physical illness requiring acute care. Validating their shared and elevated morbidity risk, 53% of each hospitalized cohort accessed acute care compared to 32% of outpatients during the decade. While not under mental health system supervision, however, the likelihood that a CTO patient would receive a physical illness diagnosis was 31% lower than for non-CTO patients, and no different from lower morbidity-risk outpatients without severe mental illness. While, under mental health system supervision, the likelihood that CTO patients would receive a physical illness diagnosis was 40% greater than non-CTO patients and 5.02 times more likely than outpatients were. Each CTO episode was associated with a 4.6% increase in the likelihood of a member of the CTO group receiving a diagnosis. Mental health system involvement and CTO supervision appeared to facilitate access to physical health care in acute care settings for patients with severe mental illness, a group that has, in the past, been subject to excess morbidity and mortality.

Different intra- and interspecific facilitation mechanisms between two Mediterranean trees under a climate change scenario.

PubMed

Gimeno, Teresa E; Escudero, Adrián; Valladares, Fernando

2015-01-01

In harsh environments facilitation alleviates biotic and abiotic constraints on tree recruitment. Under ongoing drier climate change, we expect facilitation to increase as a driver of coexistence. However, this might not hold under extreme abiotic stress and when the outcome depends on the interaction with other drivers such as altered herbivore pressure due to land use change. We performed a field water-manipulation experiment to quantify the importance of facilitation in two coexisting Mediterranean trees (dominant Juniperus thurifera and coexisting Quercus ilex subsp. ballota) under a climate change scenario. Shifts in canopy dominance favouring Q. ilex could be based on the extension of heterospecific facilitation to the detriment of conspecific alleviation. We found that saplings of both species transplanted under the canopy of nurse trees had greater survival probability, growth and photochemical efficiency. Intra- and interspecific facilitation mechanisms differed: alleviation of abiotic stress benefited both species during summer and J. thurifera during winter, whereas browsing protection was relevant only for Q. ilex. Facilitation was greater under the dry treatment only for Q. ilex, which partially agreed with the predictions of the stress gradient hypothesis. We conclude that present rainfall availability limits neither J. thurifera nor Q. ilex establishment. Nevertheless, under current global change scenarios, imposing increasing abiotic stress together with altered herbivore browsing, nurse trees could differentially facilitate the establishment of Q. ilex due to species-specific traits, i.e. palatability; drought, heat and cold tolerance, underlying species differences in the facilitation mechanisms and eventually triggering a change from pure juniper woodlands to mixed formations.

Exploring factors facilitating adults with spinal cord injury rejoining the workforce: a pilot study.

PubMed

Wilbanks, Susan R; Ivankova, Nataliya V

2015-01-01

Return-to-work (RTW) rates after spinal cord injury (SCI) in the USA are very low and are continuing to decline. Previous research has attempted to identify factors facilitating RTW; however, the phenomenon of RTW involves many personal factors and predicting RTW success remains difficult. The purpose of this pilot study was to explore the factors facilitating adults with SCI rejoining the workforce in an urban area in order to identify items that may be emphasized in the rehabilitation process. The study was completed using qualitative methods. Four adults who had acquired a traumatic SCI in adulthood and were currently employed participated. Their experiences in RTW after injury were collected via semi-structured interviews and photography of assistive devices. The most common facilitating factor was motivation, with family and rehabilitation professionals serving as extrinsic motivators. Other facilitators were resources and perceived benefits. Motivation and resources were important facilitators, including rehabilitation professional's personal influence and therapies, and resource assistance from state agencies. The results indicate that practitioners can play an important role in influencing RTW, and resources from state agencies are helpful when individuals know how to access and utilize them. Assistive technology supports successful return to work after SCI. Motivation strongly influences return to work after SCI and can be influenced by rehabilitation professionals, family and community members. Patients should be well informed about how to access assistance programs such as vocational rehabilitation.

Physics teachers' perspectives on factors that affect urban physics participation and accessibility

NASA Astrophysics Data System (ADS)

Kelly, Angela M.

2013-06-01

The accessibility of secondary physics in U.S. urban school districts is a complex issue. Many schools do not offer a physics option, and for those that do, access is often restricted by various school policies and priorities that do not promote physics participation for all. To analyze this problem in greater depth, I adopted a qualitative phenomenological methodology to explore urban physics teachers’ views on school- and district-based conditions that may marginalize traditionally underrepresented students. Teachers from three large urban districts shared concerns and suggestions regarding administrative commitment, student preparedness for physics, reform initiatives and testing mandates, promoting physics enrollments, and implementing high quality instruction. Data from interviews and focus groups provided contextual insights into ways in which physics study may be improved and encouraged for urban youth. Teachers believed expanding access could be facilitated with differentiated levels of physics, incorporating mathematical applications with multiple representations, educating students and counselors on the ramifications of choosing or not choosing elective sciences, well-designed grant-funded initiatives, and flexibility with prerequisites and science course sequencing. Teachers experienced frustration with standardized testing, lack of curricular autonomy, shifting administrative directives, and top-down reforms that did not incorporate their feedback in the decision-making processes. Data from this study revealed that physics teacher networks, often housed at local universities, have been a key resource for establishing supportive professional communities to share best practices that may influence school-based reforms that promote physics participation in urban schools.

Data access and decision tools for coastal water resources ...

EPA Pesticide Factsheets

US EPA has supported the development of numerous models and tools to support implementation of environmental regulations. However, transfer of knowledge and methods from detailed technical models to support practical problem solving by local communities and watershed or coastal management organizations remains a challenge. We have developed the Estuary Data Mapper (EDM) to facilitate data discovery, visualization and access to support environmental problem solving for coastal watersheds and estuaries. EDM is a stand-alone application based on open-source software which requires only internet access for operation. Initially, development of EDM focused on delivery of raw data streams from distributed web services, ranging from atmospheric deposition to hydrologic, tidal, and water quality time series, estuarine habitat characteristics, and remote sensing products. We have transitioned to include access to value-added products which provide end-users with results of future scenario analysis, facilitate extension of models across geographic regions, and/or promote model interoperability. Here we present three examples: 1) the delivery of input data for the development of seagrass models across estuaries, 2) scenarios illustrating the implications of riparian buffer management (loss or restoration) for stream thermal regimes and fish communities, and 3) access to hydrology model outputs to foster connections across models at different scales, ultimately feeding

Children's drawings as facilitators of communication: a meta-analysis.

PubMed

Driessnack, Martha

2005-12-01

In an attempt to explore new methods for accessing children's voices, this meta-analysis explores the facilitative effects of offering children the opportunity to draw as an interview strategy as compared with a traditional directed interview. Based on this analysis, introducing the opportunity to draw appears to be a relatively robust interview strategy with a large overall effect size (d = .95). Both research and clinical implications are discussed.

Snag density varies with intensity of timber harvest and human access

Treesearch

Michael J. Wisdom; Lisa J. Bate

2008-01-01

Many species of vertebrates depend on snags (standing dead trees) for persistence, and limited research suggests that snag density is lower in areas of intensive timber harvest and increased human access. While intensive timber harvest is one source of potential snag loss, ease of human access to forest stands may also facilitate loss via firewood cutting of snags....

Microgravity: New opportunities to facilitate biotechnology development

NASA Astrophysics Data System (ADS)

Johnson, Terry; Todd, Paul; Stodieck, Louis S.

1996-03-01

New opportunities exist to use the microgravity environment to facilitate biotechnology development. BioServe Space Technologies Center for the Commercial Development of Space offers access to microgravity environments for companies who wish to perform research or develop products in three specific life-science fields: Biomedical and Pharmaceutical Research, Biotechnology and Bioprocessing Research, and Agricultural and Environmental Research. Examples of each include physiological testing of new pharmaceutical countermeasures against symptoms that are exaggerated in space flight, crystallization and testing of novel, precompetitive biopharmaceutical substances in a convection-free environment, and closed life-support system product development.

A re-conceptualization of access for 21st century healthcare.

PubMed

Fortney, John C; Burgess, James F; Bosworth, Hayden B; Booth, Brenda M; Kaboli, Peter J

2011-11-01

Many e-health technologies are available to promote virtual patient-provider communication outside the context of face-to-face clinical encounters. Current digital communication modalities include cell phones, smartphones, interactive voice response, text messages, e-mails, clinic-based interactive video, home-based web-cams, mobile smartphone two-way cameras, personal monitoring devices, kiosks, dashboards, personal health records, web-based portals, social networking sites, secure chat rooms, and on-line forums. Improvements in digital access could drastically diminish the geographical, temporal, and cultural access problems faced by many patients. Conversely, a growing digital divide could create greater access disparities for some populations. As the paradigm of healthcare delivery evolves towards greater reliance on non-encounter-based digital communications between patients and their care teams, it is critical that our theoretical conceptualization of access undergoes a concurrent paradigm shift to make it more relevant for the digital age. The traditional conceptualizations and indicators of access are not well adapted to measure access to health services that are delivered digitally outside the context of face-to-face encounters with providers. This paper provides an overview of digital "encounterless" utilization, discusses the weaknesses of traditional conceptual frameworks of access, presents a new access framework, provides recommendations for how to measure access in the new framework, and discusses future directions for research on access.

Barriers and Facilitators to Adoption of Genomic Services for Colorectal Care within the Veterans Health Administration.

PubMed

Sperber, Nina R; Andrews, Sara M; Voils, Corrine I; Green, Gregory L; Provenzale, Dawn; Knight, Sara

2016-04-28

We examined facilitators and barriers to adoption of genomic services for colorectal care, one of the first genomic medicine applications, within the Veterans Health Administration to shed light on areas for practice change. We conducted semi-structured interviews with 58 clinicians to understand use of the following genomic services for colorectal care: family health history documentation, molecular and genetic testing, and genetic counseling. Data collection and analysis were informed by two conceptual frameworks, the Greenhalgh Diffusion of Innovation and Andersen Behavioral Model, to allow for concurrent examination of both access and innovation factors. Specialists were more likely than primary care clinicians to obtain family history to investigate hereditary colorectal cancer (CRC), but with limited detail; clinicians suggested templates to facilitate retrieval and documentation of family history according to guidelines. Clinicians identified advantage of molecular tumor analysis prior to genetic testing, but tumor testing was infrequently used due to perceived low disease burden. Support from genetic counselors was regarded as facilitative for considering hereditary basis of CRC diagnosis, but there was variability in awareness of and access to this expertise. Our data suggest the need for tools and policies to establish and disseminate well-defined processes for accessing services and adhering to guidelines.

African American Women's Perceptions on Access to Food and Water in Flint, Michigan.

PubMed

Mayfield, Kellie E; Carolan, Marsha; Weatherspoon, Lorraine; Chung, Kimberly R; Hoerr, Sharon M

2017-06-01

To explore the perceptions of food access by African American women in Flint, MI. Using womanist theory, in which African American women's experiential knowledge centered the analysis, 8 focus groups were conducted during fall/spring, 2014-2015. Seventeen mothers aged 21-50 years with children aged <18 years and 13 women aged >60 years comprised the groups. The high cost of water, poor availability of healthy foods in inner-city stores, and limited transportation were barriers to accessing healthy food. Conversely, receiving food from food giveaways, friends, and family, as well as access to transportation facilitated food access. These women also reported discriminatory experiences and diet-related health concerns. Participants were keenly aware of available free community resources and gender, racial, and income barriers to accessing them. Understanding these barriers and facilitators provides information to aid local food policy assistance decisions and inform community-based interventions, especially given the lead contamination of water and the purported importance of a healthy diet to sequester lead. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Habitat characteristics at marten subnivean access sites

USGS Publications Warehouse

Corn, Janelle G.; Raphael, Martin G.

1992-01-01

The occurrence of coarse woody debris (CWD) at sites of subnivean (under snow) access by martens (Martes americana) has not been quantified adequately, and must be better understood to provide suitable winter habitat management for the species. Consequently, we studied subnivean activity of martens in a subalpine forest in southern Wyoming to determine how subnivean space was accessed, and to examine microhabitat characteristics around entry sites. Martens used existing openings in snow, created primarily by logs at low snow depths and by small live spruce and fir trees at greater snow depths. Sites of marten subnivean entry had greater percent cover (P ≤ 0.01) and total volume of CWD (P ≤ 0.01), greater numbers of log layers (all P ≤ 0.02), greater volume of undecayed (P ≤ 0.05) and moderately decayed logs (P ≤ 0.02), less volume of very decayed logs (P ≤ 0.001), and fewer small root masses (P ≤ 0.001) than surrounding forest stands. Provision of sufficient CWD in winter habitat of martens may require specific effort, particularly in managed forests of the central Rocky Mountains.

Distributed reservation-based code division multiple access

NASA Astrophysics Data System (ADS)

Wieselthier, J. E.; Ephremides, A.

1984-11-01

The use of spread spectrum signaling, motivated primarily by its antijamming capabilities in military applications, leads naturally to the use of Code Division Multiple Access (CDMA) techniques that permit the successful simultaneous transmission by a number of users over a wideband channel. In this paper we address some of the major issues that are associated with the design of multiple access protocols for spread spectrum networks. We then propose, analyze, and evaluate a distributed reservation-based multiple access protocol that does in fact exploit CDMA properties. Especially significant is the fact that no acknowledgment or feedback information from the destination is required (thus facilitating communication with a radio-silent mode), nor is any form of coordination among the users necessary.

Migration among temporary foreign workers: Examining health and access to health care among Filipina live-in caregivers.

PubMed

Carlos, Jessica Krystle; Wilson, Kathi

2018-07-01

In 2015, approximately 14,000 migrants were accepted into Canada as live-in caregivers. While extensive research has documented the working conditions of migrant live-in caregivers, few studies examine the health experiences of this population related to their employment as caregivers. This research examines the relationship between employment under the Federal Government's (Live-in) Caregiver Program and health and access to healthcare services among 21 Filipina caregivers working in the Greater Toronto Area, Ontario. Results of in-depth interviews reveal that long work hours are perceived to negatively affect physical health while separation from family negatively impacts mental health. Among the women interviewed, work responsibilities and living-in the place of employment are perceived to negatively impact both physical and mental health. The research also demonstrates that working as a live-in caregiver both facilitates and creates barriers to accessing health services. Future research is needed to better understand the health of more socially isolated caregivers and caregivers living-out(side) their place of employment. Copyright © 2018 Elsevier Ltd. All rights reserved.

Antimicrobial Peptide Potency is Facilitated by Greater Conformational Flexibility when Binding to Gram-negative Bacterial Inner Membranes

NASA Astrophysics Data System (ADS)

Amos, Sarah-Beth T. A.; Vermeer, Louic S.; Ferguson, Philip M.; Kozlowska, Justyna; Davy, Matthew; Bui, Tam T.; Drake, Alex F.; Lorenz, Christian D.; Mason, A. James

2016-11-01

The interaction of antimicrobial peptides (AMPs) with the inner membrane of Gram-negative bacteria is a key determinant of their abilities to exert diverse bactericidal effects. Here we present a molecular level understanding of the initial target membrane interaction for two cationic α-helical AMPs that share structural similarities but have a ten-fold difference in antibacterial potency towards Gram-negative bacteria. The binding and insertion from solution of pleurocidin or magainin 2 to membranes representing the inner membrane of Gram-negative bacteria, comprising a mixture of 128 anionic and 384 zwitterionic lipids, is monitored over 100 ns in all atom molecular dynamics simulations. The effects of the membrane interaction on both the peptide and lipid constituents are considered and compared with new and published experimental data obtained in the steady state. While both magainin 2 and pleurocidin are capable of disrupting bacterial membranes, the greater potency of pleurocidin is linked to its ability to penetrate within the bacterial cell. We show that pleurocidin displays much greater conformational flexibility when compared with magainin 2, resists self-association at the membrane surface and penetrates further into the hydrophobic core of the lipid bilayer. Conformational flexibility is therefore revealed as a key feature required of apparently α-helical cationic AMPs for enhanced antibacterial potency.

Non-visual Web Browsing: Beyond Web Accessibility

PubMed Central

Ramakrishnan, I.V.; Ashok, Vikas

2017-01-01

People with vision impairments typically use screen readers to browse the Web. To facilitate non-visual browsing, web sites must be made accessible to screen readers, i.e., all the visible elements in the web site must be readable by the screen reader. But even if web sites are accessible, screen-reader users may not find them easy to use and/or easy to navigate. For example, they may not be able to locate the desired information without having to listen to a lot of irrelevant contents. These issues go beyond web accessibility and directly impact web usability. Several techniques have been reported in the accessibility literature for making the Web usable for screen reading. This paper is a review of these techniques. Interestingly, the review reveals that understanding the semantics of the web content is the overarching theme that drives these techniques for improving web usability. PMID:29202137

Non-visual Web Browsing: Beyond Web Accessibility.

PubMed

Ramakrishnan, I V; Ashok, Vikas; Billah, Syed Masum

2017-07-01

People with vision impairments typically use screen readers to browse the Web. To facilitate non-visual browsing, web sites must be made accessible to screen readers, i.e., all the visible elements in the web site must be readable by the screen reader. But even if web sites are accessible, screen-reader users may not find them easy to use and/or easy to navigate. For example, they may not be able to locate the desired information without having to listen to a lot of irrelevant contents. These issues go beyond web accessibility and directly impact web usability. Several techniques have been reported in the accessibility literature for making the Web usable for screen reading. This paper is a review of these techniques. Interestingly, the review reveals that understanding the semantics of the web content is the overarching theme that drives these techniques for improving web usability.

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…

"Freedom to go where I want": improving access to sexual and reproductive health for women with disabilities in the Philippines.

PubMed

Devine, Alexandra; Ignacio, Raquel; Prenter, Krystle; Temminghoff, Lauren; Gill-Atkinson, Liz; Zayas, Jerome; Marco, Ma Jesusa; Vaughan, Cathy

2017-05-01

Women with disabilities experience a range of violations of their sexual and reproductive rights. The Philippines ratified the United Nations Convention on the Rights of Persons with Disabilities and have laws in place to promote the rights to sexual and reproductive health and protection from violence. However, limited resourcing, and opposition to such laws undermine access to these rights for all women. Inadequate disability inclusion within policy and programming, and limited disability awareness of services, further impedes women with disabilities from attaining these rights. The W-DARE project (Women with Disability taking Action on REproductive and sexual health) was a three-year participatory action research program designed to (1) understand the sexual and reproductive health experiences and needs of women with disabilities; and (2) improve access to quality sexual and reproductive health, including violence response services, for women with disabilities in the Philippines. In response to the highlighted need for more information about sexual and reproductive health and greater access to services, the W-DARE team developed and implemented a pilot intervention focused on peer-facilitated Participatory Action Groups (PAGs) for women with disabilities. This paper focuses on the qualitative findings from the evaluation of this PAG intervention.

Perceived and desired facilitativeness of one's closest friend, need for approval and self-esteem.

PubMed

Cramer, D

1993-03-01

The hypothesis that the positive association between self-esteem and the perceived facilitativeness of one's closest friend can be explained by the presumed greater desire of low self-esteem individuals for a facilitative relationship was not confirmed in 262 16-17-year-old females, who completed the Rosenberg (1965) Self-Esteem Scale and a shortened version of the Barrett-Lennard (1964) Relationship Inventory. Although desired facilitativeness correlated significantly positively with self-esteem, the correlation between perceived facilitativeness and self-esteem remained significantly positive when desired facilitativeness was partialled out. The further prediction that the correlation between perceived facilitativeness and self-esteem would be more positive for those scoring higher on the Jones' (1969) Need for Approval Scale was also not confirmed. The opposite result was obtained in that this correlation was significantly positive for those with low need for approval but not for those with a high need.

Perceived access to fruits and vegetables associated with increased consumption.

PubMed

Caldwell, Erin M; Miller Kobayashi, M; DuBow, W M; Wytinck, S M

2009-10-01

To examine the association between fruit and vegetable access in the community and change in fruit and vegetable consumption among participants in community-based health promotion programmes. Fruit and vegetable consumption and perceived access to fresh fruit and vegetables were measured by self-administered questionnaires at programme start, end and 1-year follow-up. Community produce availability was determined by grocery store assessments measuring the display space devoted to fruit and vegetable offerings, as well as price, variety and freshness. A total of nine communities were studied; 130 participants completed the fruit and vegetable portions of the questionnaires and could be linked to grocery store assessments. Participants made modest but significant increases in fruit and vegetable consumption from programme start to end: the average increase was 2.88 (95% CI 1.52, 4.25) servings weekly; the average increase from start to follow-up was 2.52 (95% CI 1.09, 3.95) servings weekly. Greater perceived access to fruits and vegetables was significantly associated with higher increases in fruit and vegetable consumption from programme start to programme end. Greater availability of produce was associated with greater increases in fruit and vegetable servings from programme start to programme end as measured by store assessments. Environmental factors, such as access to fruits and vegetables, can modify the effects of community interventions. Interventions with the goal of increasing fruit and vegetable consumption should consider focusing on increasing access to fresh fruits and vegetables in target communities. Similarly, researchers may want to study access as an intervention, not just a contextual variable.

Institutional Change for Improving Accessibility in the Design and Delivery of Distance Learning--The Role of Faculty Accessibility Specialists at the Open University

ERIC Educational Resources Information Center

Slater, Rachel; Pearson, Victoria K.; Warren, James P.; Forbes, Tina

2015-01-01

The Open University (OU) has an established infrastructure for supporting disabled students. Historically, the thrust of this has focused on providing accessible adjustments post-production. In 2012, the OU implemented securing greater accessibility (SeGA) to raise awareness and bring about an institutional change to curriculum design so that the…

Enhancing the primary care team to provide redesigned care: the roles of practice facilitators and care managers.

PubMed

Taylor, Erin Fries; Machta, Rachel M; Meyers, David S; Genevro, Janice; Peikes, Deborah N

2013-01-01

Efforts to redesign primary care require multiple supports. Two potential members of the primary care team-practice facilitator and care manager-can play important but distinct roles in redesigning and improving care delivery. Facilitators, also known as quality improvement coaches, assist practices with coordinating their quality improvement activities and help build capacity for those activities-reflecting a systems-level approach to improving quality, safety, and implementation of evidence-based practices. Care managers provide direct patient care by coordinating care and helping patients navigate the system, improving access for patients, and communicating across the care team. These complementary roles aim to help primary care practices deliver coordinated, accessible, comprehensive, and patient-centered care.

Developing Communication Access Standards to Maximize Community Inclusion for People with Communication Support Needs

ERIC Educational Resources Information Center

Solarsh, Barbara; Johnson, Hilary

2017-01-01

People with communication support needs experience barriers that limit their social inclusion in society. A community approach such as "communication access" that targets changing attitudes, skills, and resources may assist in facilitating community participation. The authors describe the development of communication access from 2008 in…

The use of a policy dialogue to facilitate evidence-informed policy development for improved access to care: the case of the Winnipeg Central Intake Service (WCIS).

PubMed

Damani, Zaheed; MacKean, Gail; Bohm, Eric; DeMone, Brie; Wright, Brock; Noseworthy, Tom; Holroyd-Leduc, Jayna; Marshall, Deborah A

2016-10-18

Policy dialogues are critical for developing responsive, effective, sustainable, evidence-informed policy. Our multidisciplinary team, including researchers, physicians and senior decision-makers, comprehensively evaluated The Winnipeg Central Intake Service, a single-entry model in Winnipeg, Manitoba, to improve patient access to hip/knee replacement surgery. We used the evaluation findings to develop five evidence-informed policy directions to help improve access to scheduled clinical services across Manitoba. Using guiding principles of public participation processes, we hosted a policy roundtable meeting to engage stakeholders and use their input to refine the policy directions. Here, we report on the use and input of a policy roundtable meeting and its role in contributing to the development of evidence-informed policy. Our evidence-informed policy directions focused on formal measurement/monitoring of quality, central intake as a preferred model for service delivery, provincial scope, transparent processes/performance indicators, and patient choice of provider. We held a policy roundtable meeting and used outcomes of facilitated discussions to refine these directions. Individuals from our team and six stakeholder groups across Manitoba participated (n = 44), including patients, family physicians, orthopaedic surgeons, surgical office assistants, Winnipeg Central Intake team, and administrators/managers. We developed evaluation forms to assess the meeting process, and collected decision-maker partners' perspectives on the value of the policy roundtable meeting and use of policy directions to improve access to scheduled clinical services after the meeting, and again 15 months later. We analyzed roundtable and evaluation data using thematic analysis to identify key themes. Four key findings emerged. First, participants supported all policy directions, with revisions and key implementation considerations identified. Second, participants felt the policy roundtable

Bilingual lexical access in context: evidence from eye movements during reading.

PubMed

Libben, Maya R; Titone, Debra A

2009-03-01

Current models of bilingualism (e.g., BIA+) posit that lexical access during reading is not language selective. However, much of this research is based on the comprehension of words in isolation. The authors investigated whether nonselective access occurs for words embedded in biased sentence contexts (e.g., A. I. Schwartz & J. F. Kroll, 2006). Eye movements were recorded as French-English bilinguals read English sentences containing cognates (e.g., piano), interlingual homographs (e.g., coin, meaning corner in French), or matched control words. Sentences provided a low or high semantic constraint for target-language meanings. Both early-stage comprehension measures (e.g., first fixation duration, gaze duration, and skipping) and late-stage comprehension measures (e.g., go-past time and total reading time) showed significant cognate facilitation and interlingual homograph interference for low-constraint sentences. For high-constraint sentences, however, only early-stage comprehension measures were consistent with nonselective access. There was no evidence of cognate facilitation or interlingual homograph interference for late-stage comprehension measures. Thus, nonselective bilingual lexical access at early stages of comprehension is rapidly resolved in semantically biased contexts at later stages of comprehension. (c) 2009 APA, all rights reserved

Physical Access in ARL Libraries. SPEC Kit 27.

ERIC Educational Resources Information Center

Association of Research Libraries, Washington, DC. Office of Management Studies.

Resulting from the Association of Research Libraries' (ARL) 1975 survey on user services, this kit presents documentation on and discusses developments in physical access services--services which facilitate the actual delivery of information sources to the user--including circulation, interlibrary loan, book delivery, and new media services. As…

Resolving mobility constraints impeding rural seniors' access to regionalized services.

PubMed

Ryser, Laura; Halseth, Greg

2012-01-01

Rural and small town places in developed economies are aging. While attention has been paid to the local transportation needs of rural seniors, fewer researchers have explored their regional transportation needs. This is important given policies that have reduced and regionalized many services and supports. This article explores mobility constraints impeding rural seniors' access to regionalized services using the example of northern British Columbia. Drawing upon several qualitative studies, we explore geographical, maintenance, organizational, communication, human resources, infrastructure, and financial constraints that affect seniors' regional mobility. Our findings indicate that greater coordination across multiple government agencies and jurisdictions is needed and more supportive policies and resources must be in place to facilitate a comprehensive regional transportation strategy. In addition to discussing the complexities of these geographies, the article identifies innovative solutions that have been deployed in northern British Columbia to support an aging population. This research provides a foundation for developing a comprehensive understanding of the key issues that need to be addressed to inform strategic investments in infrastructure and programs that support the regional mobility and, hence, healthy aging of rural seniors.

Limiting and facilitating access to innovations in medicine and agriculture: a brief exposition of the ethical arguments.

PubMed

Timmermann, Cristian

2014-12-01

Taking people's longevity as a measure of good life, humankind can proudly say that the average person is living a much longer life than ever before. The AIDS epidemic has however for the first time in decades stalled and in some cases even reverted this trend in a number of countries. Climate change is increasingly becoming a major challenge for food security and we can anticipate that hunger caused by crop damages will become much more common.Since many of the challenges humanity faced in the past were overcome by inventive solutions coming from the life sciences, we are compelled to reconsider how we incentivize science and technology development so that those in need can benefit more broadly from scientific research. There is a huge portion of the world population that is in urgent need for medicines to combat diseases that are currently neglected by the scientific community and could immensely benefit from agricultural research that specifically targets their environmental conditions. At the same time efforts have to be made to make the fruits of current and future research more widely accessible. These changes would have to be backed by a range of moral arguments to attract people with diverging notions of global justice. This article explores the main ethical theories used to demand a greater share in the benefits from scientific progress for the poor. Since life sciences bring about a number of special concerns, a short list of conflictive issues is also offered.

elevatr: Access Elevation Data from Various APIs | Science ...

EPA Pesticide Factsheets

Several web services are available that provide access to elevation data. This package provides access to several of those services and returns elevation data either as a SpatialPointsDataFrame from point elevation services or as a raster object from raster elevation services. Currently, the package supports access to the Mapzen Elevation Service, Mapzen Terrain Service, and the USGS Elevation Point Query Service. The R language for statistical computing is increasingly used for spatial data analysis . This R package, elevatr, is in response to this and provides access to elevation data from various sources directly in R. The impact of `elevatr` is that it will 1) facilitate spatial analysis in R by providing access to foundational dataset for many types of analyses (e.g. hydrology, limnology) 2) open up a new set of users and uses for APIs widely used outside of R, and 3) provide an excellent example federal open source development as promoted by the Federal Source Code Policy (https://sourcecode.cio.gov/).

Web-based access, aggregation, and visualization of future climate projections with emphasis on agricultural assessments

NASA Astrophysics Data System (ADS)

Villoria, Nelson B.; Elliott, Joshua; Müller, Christoph; Shin, Jaewoo; Zhao, Lan; Song, Carol

2018-01-01

Access to climate and spatial datasets by non-specialists is restricted by technical barriers involving hardware, software and data formats. We discuss an open-source online tool that facilitates downloading the climate data from the global circulation models used by the Inter-Sectoral Impacts Model Intercomparison Project. The tool also offers temporal and spatial aggregation capabilities for incorporating future climate scenarios in applications where spatial aggregation is important. We hope that streamlined access to these data facilitates analysis of climate related issues while considering the uncertainties derived from future climate projections and temporal aggregation choices.

Does greater thermal plasticity facilitate range expansion of an invasive terrestrial anuran into higher latitudes?

PubMed

Winwood-Smith, Hugh S; Alton, Lesley A; Franklin, Craig E; White, Craig R

2015-01-01

Temperature has pervasive effects on physiological processes and is critical in setting species distribution limits. Since invading Australia, cane toads have spread rapidly across low latitudes, but slowly into higher latitudes. Low temperature is the likely factor limiting high-latitude advancement. Several previous attempts have been made to predict future cane toad distributions in Australia, but understanding the potential contribution of phenotypic plasticity and adaptation to future range expansion remains challenging. Previous research demonstrates the considerable thermal metabolic plasticity of the cane toad, but suggests limited thermal plasticity of locomotor performance. Additionally, the oxygen-limited thermal tolerance hypothesis predicts that reduced aerobic scope sets thermal limits for ectotherm performance. Metabolic plasticity, locomotor performance and aerobic scope are therefore predicted targets of natural selection as cane toads invade colder regions. We measured these traits at temperatures of 10, 15, 22.5 and 30°C in low- and high-latitude toads acclimated to 15 and 30°C, to test the hypothesis that cane toads have adapted to cooler temperatures. High-latitude toads show increased metabolic plasticity and higher resting metabolic rates at lower temperatures. Burst locomotor performance was worse for high-latitude toads. Other traits showed no regional differences. We conclude that increased metabolic plasticity may facilitate invasion into higher latitudes by maintaining critical physiological functions at lower temperatures.

Cross-modal prediction changes the timing of conscious access during the motion-induced blindness.

PubMed

Chang, Acer Y C; Kanai, Ryota; Seth, Anil K

2015-01-01

Despite accumulating evidence that perceptual predictions influence perceptual content, the relations between these predictions and conscious contents remain unclear, especially for cross-modal predictions. We examined whether predictions of visual events by auditory cues can facilitate conscious access to the visual stimuli. We trained participants to learn associations between auditory cues and colour changes. We then asked whether congruency between auditory cues and target colours would speed access to consciousness. We did this by rendering a visual target subjectively invisible using motion-induced blindness and then gradually changing its colour while presenting congruent or incongruent auditory cues. Results showed that the visual target gained access to consciousness faster in congruent than in incongruent trials; control experiments excluded potentially confounding effects of attention and motor response. The expectation effect was gradually established over blocks suggesting a role for extensive training. Overall, our findings show that predictions learned through cross-modal training can facilitate conscious access to visual stimuli. Copyright © 2014 Elsevier Inc. All rights reserved.

Anomaly and signature filtering improve classifier performance for detection of suspicious access to EHRs.

PubMed

Kim, Jihoon; Grillo, Janice M; Boxwala, Aziz A; Jiang, Xiaoqian; Mandelbaum, Rose B; Patel, Bhakti A; Mikels, Debra; Vinterbo, Staal A; Ohno-Machado, Lucila

2011-01-01

Our objective is to facilitate semi-automated detection of suspicious access to EHRs. Previously we have shown that a machine learning method can play a role in identifying potentially inappropriate access to EHRs. However, the problem of sampling informative instances to build a classifier still remained. We developed an integrated filtering method leveraging both anomaly detection based on symbolic clustering and signature detection, a rule-based technique. We applied the integrated filtering to 25.5 million access records in an intervention arm, and compared this with 8.6 million access records in a control arm where no filtering was applied. On the training set with cross-validation, the AUC was 0.960 in the control arm and 0.998 in the intervention arm. The difference in false negative rates on the independent test set was significant, P=1.6×10(-6). Our study suggests that utilization of integrated filtering strategies to facilitate the construction of classifiers can be helpful.

Anomaly and Signature Filtering Improve Classifier Performance For Detection Of Suspicious Access To EHRs

PubMed Central

Kim, Jihoon; Grillo, Janice M; Boxwala, Aziz A; Jiang, Xiaoqian; Mandelbaum, Rose B; Patel, Bhakti A; Mikels, Debra; Vinterbo, Staal A; Ohno-Machado, Lucila

2011-01-01

Our objective is to facilitate semi-automated detection of suspicious access to EHRs. Previously we have shown that a machine learning method can play a role in identifying potentially inappropriate access to EHRs. However, the problem of sampling informative instances to build a classifier still remained. We developed an integrated filtering method leveraging both anomaly detection based on symbolic clustering and signature detection, a rule-based technique. We applied the integrated filtering to 25.5 million access records in an intervention arm, and compared this with 8.6 million access records in a control arm where no filtering was applied. On the training set with cross-validation, the AUC was 0.960 in the control arm and 0.998 in the intervention arm. The difference in false negative rates on the independent test set was significant, P=1.6×10−6. Our study suggests that utilization of integrated filtering strategies to facilitate the construction of classifiers can be helpful. PMID:22195129

Adult Age Differences in Accessing and Retrieving Information from Long-Term Memory.

ERIC Educational Resources Information Center

Petros, Thomas V.; And Others

1983-01-01

Investigated adult age differences in accessing and retrieving information from long-term memory. Results showed that older adults (N=26) were slower than younger adults (N=35) at feature extraction, lexical access, and accessing category information. The age deficit was proportionally greater when retrieval of category information was required.…

Steam pretreatment of agricultural residues facilitates hemicellulose recovery while enhancing enzyme accessibility to cellulose.

PubMed

Chandra, Richard P; Arantes, Valdeir; Saddler, Jack

2015-06-01

The origins of lignocellulosic biomass and the pretreatment used to enhance enzyme accessibility to the cellulosic component are known to be strongly influenced by various substrate characteristics. To assess the impact that fibre properties might have on enzymatic hydrolysis, seven agricultural residues were characterised before and after steam pretreatment using a single pretreatment condition (190°C, 5min, 3% SO2) previously shown to enhance fractionation and hydrolysis of the cellulosic component of corn stover. When the fibre length, width and coarseness, viscosity, water retention value and cellulose crystallinity were monitored, no clear correlation was observed between any single substrate characteristic and the substrate's ease of enzymatic hydrolysis. However, the amount of hemicellulose that was solubilised during pretreatment correlated (r(2)=0.98) with the effectiveness of enzyme hydrolysis of each pretreated substrate. Simons's staining, to measure the cellulose accessibility, showed good correlation (r(2)=0.83) with hemicellulose removal and the extent of enzymatic hydrolysis. Copyright © 2015 Elsevier Ltd. All rights reserved.

Facilitators and Barriers to Health-Seeking Behaviours among Filipino Migrants: Inductive Analysis to Inform Health Promotion

PubMed Central

Salamonson, Y.; Descallar, J.; Davidson, P. M.

2015-01-01

Understanding factors that influence health-seeking behaviour of migrants is necessary to intervene for behaviour change. This paper explores Filipino migrants' perceptions of facilitators and barriers to maintaining health in Australia. Open-ended survey item responses reflecting factors that assisted and hindered health following migration to Australia were inductively analysed. Three hundred and thirty-seven of the 552 survey respondents (61%) provided open-ended responses. Responses were grouped into two major categories: individual factors, including personal resources and cultural influences, and environmental factors encompassing both the physical conditions in the host country and health service access. Awareness of practices that enhance health was a major personal facilitator of health-seeking behaviour; however, competing priorities of daily living were perceived as barriers. Cultural beliefs and practices influenced health-seeking behaviour. Despite high self-rated English language skills in this population, new migrants and the elderly cited communication difficulties as barriers to accessing health services. Insight into facilitators and barriers to health-seeking behaviour in this less researched migrant population revealed tools for enhancing engagement in health promotion programs addressing healthy lifestyle. PMID:26380277

Vascular Access Practice Patterns in Canada: A National Survey

PubMed Central

Dumaine, Chance; Kiaii, Mercedeh; Miller, Lisa; Moist, Louise; Oliver, Matthew J.; Lok, Charmaine E.; Hiremath, Swapnil; MacRae, Jennifer M.

2018-01-01

Background: One of the mandates of the Canadian Society of Nephrology’s (CSN) Vascular Access Working Group (VAWG) is to inform the nephrology community of the current status of vascular access (VA) practice within Canada. To better understand VA practice patterns across Canada, the CSN VAWG conducted a national survey. Objectives: (1) To inform on VA practice patterns, including fistula creation and maintenance, within Canada. (2) To determine the degree of consensus among Canadian clinicians regarding patient suitability for fistula creation and to assess barriers to and facilitators of fistula creation in Canada. Design: Development and implementation of a survey. Setting: Community and academic VA programs. Participants: Nephrologists, surgeons, and nurses who are involved in VA programs across Canada. Measurements: Practice patterns regarding access creation and maintenance, including indications and contraindications to fistula creation, as well as program-wide facilitators of and barriers to VA. Methods: A small group of CSN VAWG members determined the scope and created several VA questions which were then reviewed by 5 additional VAWG members (4 nephrologists and 1 VA nurse) to ensure that questions were clear and relevant. The survey was then tested by the remaining members of the VAWG and refinements were made. The final survey version was submitted electronically to relevant clinicians (nephrologists, surgeons, and nurses) involved or interested in VA across Canada. Questions centered around 4 major themes: (1) Practice patterns regarding access creation (preoperative assessment and maturation assessment), (2) Practice patterns regarding access maintenance (surveillance and salvage), (3) Indications and contraindications for arteriovenous (AV) access creation, and (4) Facilitators of and barriers to fistula creation and utilization. Results: Eighty-two percent (84 of 102) of invited participants completed the survey; the majority were nurses or VA

Creativity and Collaboration: Using CALL to Facilitate International Collaboration for Online Journalism at a Model United Nations Event

ERIC Educational Resources Information Center

Sheehan, Mark D.; Thorpe, Todd; Dunn, Robert

2015-01-01

Much has been gained over the years in various educational fields that have taken advantage of CALL. In many cases, CALL has facilitated learning and provided teachers and students access to materials and tools that would have remained out of reach were it not for technology. Nonetheless, there are still cases where a lack of funding or access to…

Program Retrieval/Dissemination: A Solid State Random Access System.

ERIC Educational Resources Information Center

Weeks, Walter O., Jr.

The trend toward greater flexibility in educational methods has led to a need for better and more rapid access to a variety of aural and audiovisual resource materials. This in turn has demanded the development of a flexible, reliable system of hardware designed to aid existing distribution methods in providing such access. The system must be…

Why Do Women Not Use Preconception Care? A Systematic Review On Barriers And Facilitators.

PubMed

Poels, Marjolein; Koster, Maria P H; Boeije, Hennie R; Franx, Arie; van Stel, Henk F

2016-10-01

Preconception care (PCC) has the potential to optimize pregnancy outcomes. However, awareness of PCC among the target population is generally limited, and the use of PCC remains low. The objective of this study was to review the literature on women's perceptions regarding barriers and facilitators for the use of PCC. A systematic search was conducted in MEDLINE, Embase, CINAHL, and PsycINFO for published studies until February 2015. Original qualitative and quantitative peer-reviewed studies from Western countries in English, holding women's perceptions regarding barriers and facilitators for the use of PCC. Data extraction and analysis were performed using NVivo version 10 software. A coding frame was derived from the findings and applied by 2 authors. Thematic analysis was used to identify key topics and themes. Twenty-one good-quality articles were included, of which 10 qualitative and 11 quantitative studies. Seven main themes were identified: preconditions, emotions and beliefs, perceived need, knowledge and experience, social structure, accessibility, and provider characteristics. "Not (fully) planning pregnancy", "perceived absence of risks", "lack of awareness", and "pregnancy experiences" were the most frequently identified barriers and "believing in the benefits" and "availability of PCC" the most frequently identified facilitators for PCC use. Women perceive more barriers than facilitators related to PCC uptake, which explains why the use of PCC remains low. Our results provide a starting point to refocus interventions and strategies, aiming on enlarging the awareness, perceived importance, and accessibility of PCC to improve its uptake.

Facilitating Self-Regulated Learning with Technology: Evidence for Student Motivation and Exam Improvement

ERIC Educational Resources Information Center

Barber, Larissa K.; Bagsby, Patricia G.; Grawitch, Matthew J.; Buerck, John P.

2011-01-01

The authors examined the extent to which student access to the MyGrade application in Blackboard may facilitate motivation and exam improvement via grade monitoring. In support of self-regulated learning and feedback principles, students indicated that the MyGrade application helped them better monitor their course performance and increased their…

Task Delegation Based Access Control Models for Workflow Systems

NASA Astrophysics Data System (ADS)

Gaaloul, Khaled; Charoy, François

e-Government organisations are facilitated and conducted using workflow management systems. Role-based access control (RBAC) is recognised as an efficient access control model for large organisations. The application of RBAC in workflow systems cannot, however, grant permissions to users dynamically while business processes are being executed. We currently observe a move away from predefined strict workflow modelling towards approaches supporting flexibility on the organisational level. One specific approach is that of task delegation. Task delegation is a mechanism that supports organisational flexibility, and ensures delegation of authority in access control systems. In this paper, we propose a Task-oriented Access Control (TAC) model based on RBAC to address these requirements. We aim to reason about task from organisational perspectives and resources perspectives to analyse and specify authorisation constraints. Moreover, we present a fine grained access control protocol to support delegation based on the TAC model.

Facilitating access to information in large documents with an intelligent hypertext system

NASA Technical Reports Server (NTRS)

Mathe, Nathalie

1993-01-01

Retrieving specific information from large amounts of documentation is not an easy task. It could be facilitated if information relevant in the current problem solving context could be automatically supplied to the user. As a first step towards this goal, we have developed an intelligent hypertext system called CID (Computer Integrated Documentation) and tested it on the Space Station Freedom requirement documents. The CID system enables integration of various technical documents in a hypertext framework and includes an intelligent context-sensitive indexing and retrieval mechanism. This mechanism utilizes on-line user information requirements and relevance feedback either to reinforce current indexing in case of success or to generate new knowledge in case of failure. This allows the CID system to provide helpful responses, based on previous usage of the documentation, and to improve its performance over time.

Motivating and Facilitating Advancements in Space Weather Real-Time Data Availability: Factors, Data, and Access Methods

NASA Astrophysics Data System (ADS)

Pankratz, C. K.; Baker, D. N.; Jaynes, A. N.; Elkington, S. R.; Baltzer, T.; Sanchez, F.

2017-12-01

Society's growing reliance on complex and highly interconnected technological systems makes us increasingly vulnerable to the effects of space weather events - maybe more than for any other natural hazard. An extreme solar storm today could conceivably impact hundreds of the more than 1400 operating Earth satellites. Such an extreme storm could cause collapse of the electrical grid on continental scales. The effects on navigation, communication, and remote sensing of our home planet could be devastating to our social functioning. Thus, it is imperative that the scientific community address the question of just how severe events might become. At least as importantly, it is crucial that policy makers and public safety officials be informed by the facts on what might happen during extreme conditions. This requires essentially real-time alerts, warnings, and also forecasts of severe space weather events, which in turn demands measurements, models, and associated data products to be available via the most effective data discovery and access methods possible. Similarly, advancement in the fundamental scientific understanding of space weather processes is also vital, requiring that researchers have convenient and effective access to a wide variety of data sets and models from multiple sources. The space weather research community, as with many scientific communities, must access data from dispersed and often uncoordinated data repositories to acquire the data necessary for the analysis and modeling efforts that advance our understanding of solar influences and space physics on the Earth's environment. The Laboratory for Atmospheric and Space Physics (LASP), as a leading institution in both producing data products and advancing the state of scientific understanding of space weather processes, is well positioned to address many of these issues. In this presentation, we will outline the motivating factors for effective space weather data access, summarize the various data

Barriers to and factors facilitating breast cancer screening among Iranian women: a qualitative study.

PubMed

Lamyian, M; Hydarnia, A; Ahmadi, F; Faghihzadeh, S; Aguilar-Vafaie, M E

2007-01-01

This study used qualitative methodology to understand Iranian women's views about barriers to and factors facilitating screening for early detection of breast cancer. Using grounded theory with in-depth interviews of 31 participants, themes emerged from the data in 2 main categories (internal and external) with 3 sub-categories: women's attitudes, feelings and beliefs; women's social network experiences; and accessibility. Facilitating factors for screening were self-care, fear, proactive coping, state of mind and advocacy. Barriers were negligence, cancer-related fear, low self-efficacy, fatalism, misinformation, ineffective health communication and competing priorities.

Facilitating Grant Proposal Writing in Health Behaviors for University Faculty: A Descriptive Study

PubMed Central

Stein, L. A. R.; Clair, M.; Lebeau, R.; Prochaska, J. O.; Rossi, J. S.; Swift, J.

2015-01-01

Grant proposal writing in the behavioral sciences is important for fiscal reasons and scientific reasons at many universities. This report describes a grant proposal–writing seminar series provided to University faculty (N = 20) and explores factors facilitating and impeding writing. Summary statistics are provided for quantitative data. Free responses were sorted by independent raters into meaningful categories. As a consequence of the training, 45% planned to submit within 18 months; 80% of grant proposals targeted NIH. At 1-year follow-up, 40% actually submitted grants. Factors impeding grant proposal writing included competing professional demands; factors facilitating writing included regularly scheduled feedback on written proposal sections and access to expert collaborators. Obtaining grants generates financial resources, facilitates training experiences, and vastly contributes to the growth and dissemination of the knowledge base in an area. PMID:21444921

Urban Telemedicine Enables Equity in Access to Acute Illness Care.

PubMed

Ronis, Sarah D; McConnochie, Kenneth M; Wang, Hongyue; Wood, Nancy E

2017-02-01

Children with care for acute illness available through the Health-e-Access telemedicine model at childcare and schools were previously found to have 22% less emergency department (ED) use than counterparts without this service, but they also had 24% greater acute care use overall. We assessed the hypothesis that increased utilization reflected improved access among impoverished inner-city children to a level experienced by more affluent suburban children. This observational study compared utilization among children without and with telemedicine access, beginning in 1993, ending in 2007, and based on 84,287 child-months of billing claims-based observation. Health-e-Access Telemedicine was initiated in stepwise manner over 187 study-months among 74 access sites (childcare, schools, community centers), beginning in month 105. Children dwelled in inner city, rest-of-city Rochester, NY, or in surrounding suburbs. Rate of total acute care visits (office, ED, telemedicine) was measured as visits per 100 child-years. Observed utilization rates were adjusted in multivariate analysis for age, sex, insurance type, and season of year. When both suburban and inner-city children lacked telemedicine access, overall acute illness visits were 75% greater among suburban than inner-city children (suburban:inner-city rate ratio 1.75, p < 0.0001). After telemedicine became available to inner-city children, their overall acute visits approximated those of suburban children (suburban:inner-city rate ratio 0.80, p = 0.07), whereas acute visits among suburban children remained at least (worst-case comparison) 56% greater than inner-city children without telemedicine (rate ratio 1.56, p < 0.0001). At baseline, overall acute illness utilization of suburban children exceeded that of inner-city children. Overall utilization for inner-city children increased with telemedicine to that of suburban children at baseline. Without telemedicine, however, inner-city use remained

The 'patient's physician one-step removed': the evolving roles of medical tourism facilitators.

PubMed

Snyder, Jeremy; Crooks, Valorie A; Adams, Krystyna; Kingsbury, Paul; Johnston, Rory

2011-09-01

Medical tourism involves patients travelling internationally to receive medical services. This practice raises a range of ethical issues, including potential harms to the patient's home and destination country and risks to the patient's own health. Medical tourists often engage the services of a facilitator who may book travel and accommodation and link the patient with a hospital abroad. Facilitators have the potential to exacerbate or mitigate the ethical concerns associated with medical tourism, but their roles are poorly understood. 12 facilitators were interviewed from 10 Canadian medical tourism companies. Three themes were identified: facilitators' roles towards the patient, health system and medical tourism industry. Facilitators' roles towards the patient were typically described in terms of advocacy and the provision of information, but limited by facilitators' legal liability. Facilitators felt they played a positive role in the lives of their patients and the Canadian health system and served as catalysts for reform, although they noted an adversarial relationship with some Canadian physicians. Many facilitators described personally visiting medical tourism sites and forming personal relationships with surgeons abroad, but noted the need for greater regulation of their industry. Facilitators play a substantial and evolving role in the practice of medical tourism and may be entering a period of professionalisation. Because of the key role of facilitators in determining the effects of medical tourism on patients and public health, this paper recommends a planned conversation between medical tourism stakeholders to define and shape facilitators' roles.

Sleep facilitates learning a new linguistic rule.

PubMed

Batterink, Laura J; Oudiette, Delphine; Reber, Paul J; Paller, Ken A

2014-12-01

Natural languages contain countless regularities. Extraction of these patterns is an essential component of language acquisition. Here we examined the hypothesis that memory processing during sleep contributes to this learning. We exposed participants to a hidden linguistic rule by presenting a large number of two-word phrases, each including a noun preceded by one of four novel words that functioned as an article (e.g., gi rhino). These novel words (ul, gi, ro and ne) were presented as obeying an explicit rule: two words signified that the noun referent was relatively near, and two that it was relatively far. Undisclosed to participants was the fact that the novel articles also predicted noun animacy, with two of the articles preceding animate referents and the other two preceding inanimate referents. Rule acquisition was tested implicitly using a task in which participants responded to each phrase according to whether the noun was animate or inanimate. Learning of the hidden rule was evident in slower responses to phrases that violated the rule. Responses were delayed regardless of whether rule-knowledge was consciously accessible. Brain potentials provided additional confirmation of implicit and explicit rule-knowledge. An afternoon nap was interposed between two 20-min learning sessions. Participants who obtained greater amounts of both slow-wave and rapid-eye-movement sleep showed increased sensitivity to the hidden linguistic rule in the second session. We conclude that during sleep, reactivation of linguistic information linked with the rule was instrumental for stabilizing learning. The combination of slow-wave and rapid-eye-movement sleep may synergistically facilitate the abstraction of complex patterns in linguistic input. Copyright © 2014 Elsevier Ltd. All rights reserved.

Sleep facilitates learning a new linguistic rule

PubMed Central

Batterink, Laura J.; Oudiette, Delphine; Reber, Paul J.; Paller, Ken A.

2014-01-01

Natural languages contain countless regularities. Extraction of these patterns is an essential component of language acquisition. Here we examined the hypothesis that memory processing during sleep contributes to this learning. We exposed participants to a hidden linguistic rule by presenting a large number of two-word phrases, each including a noun preceded by one of four novel words that functioned as an article (e.g., gi rhino). These novel words (ul, gi, ro and ne) were presented as obeying an explicit rule: two words signified that the noun referent was relatively near, and two that it was relatively far. Undisclosed to participants was the fact that the novel articles also predicted noun animacy, with two of the articles preceding animate referents and the other two preceding inanimate referents. Rule acquisition was tested implicitly using a task in which participants responded to each phrase according to whether the noun was animate or inanimate. Learning of the hidden rule was evident in slower responses to phrases that violated the rule. Responses were delayed regardless of whether rule-knowledge was consciously accessible. Brain potentials provided additional confirmation of implicit and explicit rule-knowledge. An afternoon nap was interposed between two 20-min learning sessions. Participants who obtained greater amounts of both slow-wave and rapid-eye-movement sleep showed increased sensitivity to the hidden linguistic rule in the second session. We conclude that during sleep, reactivation of linguistic information linked with the rule was instrumental for stabilizing learning. The combination of slow-wave and rapid-eye-movement sleep may synergistically facilitate the abstraction of complex patterns in linguistic input. PMID:25447376

Vascular access in lipoprotein apheresis: a retrospective analysis from the UK's largest lipoprotein apheresis centre.

PubMed

Doherty, Daniel J; Pottle, Alison; Malietzis, George; Hakim, Nadey; Barbir, Mahmoud; Crane, Jeremy S

2018-01-01

Lipoprotein apheresis (LA) has proven to be an effective, safe and life-saving therapy. Vascular access is needed to facilitate this treatment but has recognised complications. Despite consistency in treatment indication and duration there are no guidelines in place. The aim of this study is to characterise vascular access practice at the UK's largest LA centre and forward suggestions for future approaches. A retrospective analysis of vascular access strategies was undertaken in all patients who received LA treatment in the low-density lipoprotein (LDL) Apheresis Unit at Harefield Hospital (Middlesex, UK) from November 2000 to March 2016. Fifty-three former and current patients underwent 4260 LA treatments. Peripheral vein cannulation represented 79% of initial vascular access strategies with arteriovenous (AV) fistula use accounting for 15%. Last used method of vascular access was peripheral vein cannulation in 57% versus AV fistula in 32%. Total AV fistula failure rate was 37%. Peripheral vein cannulation remains the most common method to facilitate LA. Practice trends indicate a move towards AV fistula creation; the favoured approach receiving support from the expert body in this area. AV fistula failure rate is high and of great concern, therefore we suggest the implementation of upper limb ultrasound vascular mapping in all patients who meet treatment eligibility criteria. We encourage close ties between apheresis units and specialist surgical centres to facilitate patient counselling and monitoring. Further prospective data regarding fistula failure is needed in this expanding treatment field.

Dignity and respect: facilitating meaningful occupation for SeSotho elders.

PubMed

Du Toit, Sanetta H J; Böning, Wilmarié; Van Der Merwe, Tania Rauch

2014-03-01

Frail and vulnerable adults are divested of meaningful encounters when modernization and urbanization force them to embrace an unconventional residential care environment as a home. The aim of this article is to report on a study of SeSotho elders living in residential care to illustrate how more meaningful and culturally relevant experiences could be facilitated for them. A content analysis was done of the individual opinions of 15 collaborators as a secondary scrutiny of information obtained during a nominal group process. MAJOR FINDINGS. Findings revealed that elders were prone to experience loneliness, helplessness, and boredom due to situations dominated by occupational injustice. Co-occupations, training of staff, and environmental adaptations that allow a sense of interdependence could contribute in facilitating occupational justice for elders from a traditional South African indigenous background living in residential care. Human dignity and respect are upheld within residential care when elders have access to purposeful and meaningful activities of their choice that are culturally appropriate. Occupational therapists should advocate for doing, belonging, and becoming by facilitating meaningful occupational participation that is culturally relevant for their clients.

Health equity and migrants in the Greater Mekong Subregion

PubMed Central

McMichael, Celia; Healy, Judith

2017-01-01

ABSTRACT Background: Migrant health is receiving increasing international attention, reflecting recognition of the health inequities experienced among many migrant populations and the need for health systems to adapt to diverse migrant populations. In the Greater Mekong Subregion (GMS) there is increasing migration associated with uneven economic integration and growth, socio-economic vulnerabilities, and disparities between countries. There has been limited progress, however, in improving migrant access to health services in the Subregion. This paper examines the health needs, access barriers, and policy responses to cross-border migrants in five GMS countries. Methods: A review of published literature and research was conducted on migrant health and health service access in Cambodia, Lao People’s Democratic Republic, Myanmar, Thailand, and Viet Nam, as well as analysis of current migration trends and universal health coverage (UHC) indicators in the Subregion. The review included different migrant types: i.e. migrant workers, irregular migrants, victims of trafficking, refugees and asylum seekers, and casual cross-border migrants. Results: There is substantial diversity in the capacity of GMS health systems to address migrant populations. Thailand has sought to enhance migrant health coverage, including development of migrant health policies/programs, bilateral migrant worker agreements, and migrant health insurance schemes; Viet Nam provides health protection for emigrant workers. Overall, however, access to good quality health care remains weak for many citizens in GMS countries let alone migrants. Migrant workers – and irregular migrants in particular – face elevated health risks yet are not adequately covered and incur high out-of-pocket (OOP) payments for health services. Conclusions: UHC implies equity: UHC is only achieved when everyone has the opportunity to access and use good-quality health care. Efforts to achieve UHC in the GMS require

Health System Features That Enhance Access to Comprehensive Primary Care for Women Living with HIV in High-Income Settings: A Systematic Mixed Studies Review.

PubMed

O'Brien, Nadia; Hong, Quan Nha; Law, Susan; Massoud, Sarah; Carter, Allison; Kaida, Angela; Loutfy, Mona; Cox, Joseph; Andersson, Neil; de Pokomandy, Alexandra

2018-04-01

Women living with HIV in high-income settings continue to experience modifiable barriers to care. We sought to determine the features of care that facilitate access to comprehensive primary care, inclusive of HIV, comorbidity, and sexual and reproductive healthcare. Using a systematic mixed studies review design, we reviewed qualitative, mixed methods, and quantitative studies identified in Ovid MEDLINE, EMBASE, and CINAHL databases (January 2000 to August 2017). Eligibility criteria included women living with HIV; high-income countries; primary care; and healthcare accessibility. We performed a thematic synthesis using NVivo. After screening 3466 records, we retained 44 articles and identified 13 themes. Drawing on a social-ecological framework on engagement in HIV care, we situated the themes across three levels of the healthcare system: care providers, clinical care environments, and social and institutional factors. At the care provider level, features enhancing access to comprehensive primary care included positive patient-provider relationships and availability of peer support, case managers, and/or nurse navigators. Within clinical care environments, facilitators to care were appointment reminder systems, nonidentifying clinic signs, women and family spaces, transportation services, and coordination of care to meet women's HIV, comorbidity, and sexual and reproductive healthcare needs. Finally, social and institutional factors included healthcare insurance, patient and physician education, and dispelling HIV-related stigma. This review highlights several features of care that are particularly relevant to the care-seeking experience of women living with HIV. Improving their health through comprehensive care requires a variety of strategies at the provider, clinic, and greater social and institutional levels.

Data Reorganization for Optimal Time Series Data Access, Analysis, and Visualization

NASA Astrophysics Data System (ADS)

Rui, H.; Teng, W. L.; Strub, R.; Vollmer, B.

2012-12-01

The way data are archived is often not optimal for their access by many user communities (e.g., hydrological), particularly if the data volumes and/or number of data files are large. The number of data records of a non-static data set generally increases with time. Therefore, most data sets are commonly archived by time steps, one step per file, often containing multiple variables. However, many research and application efforts need time series data for a given geographical location or area, i.e., a data organization that is orthogonal to the way the data are archived. The retrieval of a time series of the entire temporal coverage of a data set for a single variable at a single data point, in an optimal way, is an important and longstanding challenge, especially for large science data sets (i.e., with volumes greater than 100 GB). Two examples of such large data sets are the North American Land Data Assimilation System (NLDAS) and Global Land Data Assimilation System (GLDAS), archived at the NASA Goddard Earth Sciences Data and Information Services Center (GES DISC; Hydrology Data Holdings Portal, http://disc.sci.gsfc.nasa.gov/hydrology/data-holdings). To date, the NLDAS data set, hourly 0.125x0.125° from Jan. 1, 1979 to present, has a total volume greater than 3 TB (compressed). The GLDAS data set, 3-hourly and monthly 0.25x0.25° and 1.0x1.0° Jan. 1948 to present, has a total volume greater than 1 TB (compressed). Both data sets are accessible, in the archived time step format, via several convenient methods, including Mirador search and download (http://mirador.gsfc.nasa.gov/), GrADS Data Server (GDS; http://hydro1.sci.gsfc.nasa.gov/dods/), direct FTP (ftp://hydro1.sci.gsfc.nasa.gov/data/s4pa/), and Giovanni Online Visualization and Analysis (http://disc.sci.gsfc.nasa.gov/giovanni). However, users who need long time series currently have no efficient way to retrieve them. Continuing a longstanding tradition of facilitating data access, analysis, and

Access to Space Interactive Design Web Site

NASA Technical Reports Server (NTRS)

Leon, John; Cutlip, William; Hametz, Mark

2000-01-01

The Access To Space (ATS) Group at NASA's Goddard Space Flight Center (GSFC) supports the science and technology community at GSFC by facilitating frequent and affordable opportunities for access to space. Through partnerships established with access mode suppliers, the ATS Group has developed an interactive Mission Design web site. The ATS web site provides both the information and the tools necessary to assist mission planners in selecting and planning their ride to space. This includes the evaluation of single payloads vs. ride-sharing opportunities to reduce the cost of access to space. Features of this site include the following: (1) Mission Database. Our mission database contains a listing of missions ranging from proposed missions to manifested. Missions can be entered by our user community through data input tools. Data is then accessed by users through various search engines: orbit parameters, ride-share opportunities, spacecraft parameters, other mission notes, launch vehicle, and contact information. (2) Launch Vehicle Toolboxes. The launch vehicle toolboxes provide the user a full range of information on vehicle classes and individual configurations. Topics include: general information, environments, performance, payload interface, available volume, and launch sites.

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

PubMed

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

2012-01-01

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

Young people with depression and their experience accessing an enhanced primary care service for youth with emerging mental health problems: a qualitative study.

PubMed

McCann, Terence V; Lubman, Dan I

2012-08-01

Despite the emergence of mental health problems during adolescence and early adulthood, many young people encounter difficulties accessing appropriate services. In response to this gap, the Australian Government recently established new enhanced primary care services (headspace) that target young people with emerging mental health problems. In this study, we examine the experience of young people with depression accessing one of these services, with a focus on understanding how they access the service and the difficulties they encounter in the process. Individual, in-depth, audio-recorded interviews were used to collect data. Twenty-six young people with depression were recruited from a headspace site in Melbourne, Australia. Interpretative phenomenological analysis was used to analyse the data. Four overlapping themes were identified in the data. First, school counsellors as access mediators, highlights the prominent role school counsellors have in facilitating student access to the service. Second, location as an access facilitator and inhibitor. Although the service is accessible by public transport, it is less so to those who do not live near public transport. Third, encountering barriers accessing the service initially. Two main service access barriers were experienced: unfamiliarity with the service, and delays in obtaining initial appointments for ongoing therapy. Finally, the service's funding model acts as an access facilitator and barrier. While the model provides a low or no cost services initially, it limits the number of funded sessions, and this can be problematic. Young people have contrasting experiences accessing the service. School counsellors have an influential role in facilitating access, and its close proximity to public transport enhances access. The service needs to become more prominent in young people's consciousness, while the appointment system would benefit from providing more timely appointments with therapists. The service's funding

Young people with depression and their experience accessing an enhanced primary care service for youth with emerging mental health problems: a qualitative study

PubMed Central

2012-01-01

Background Despite the emergence of mental health problems during adolescence and early adulthood, many young people encounter difficulties accessing appropriate services. In response to this gap, the Australian Government recently established new enhanced primary care services (headspace) that target young people with emerging mental health problems. In this study, we examine the experience of young people with depression accessing one of these services, with a focus on understanding how they access the service and the difficulties they encounter in the process. Method Individual, in-depth, audio-recorded interviews were used to collect data. Twenty-six young people with depression were recruited from a headspace site in Melbourne, Australia. Interpretative phenomenological analysis was used to analyse the data. Results Four overlapping themes were identified in the data. First, school counsellors as access mediators, highlights the prominent role school counsellors have in facilitating student access to the service. Second, location as an access facilitator and inhibitor. Although the service is accessible by public transport, it is less so to those who do not live near public transport. Third, encountering barriers accessing the service initially. Two main service access barriers were experienced: unfamiliarity with the service, and delays in obtaining initial appointments for ongoing therapy. Finally, the service’s funding model acts as an access facilitator and barrier. While the model provides a low or no cost services initially, it limits the number of funded sessions, and this can be problematic. Conclusions Young people have contrasting experiences accessing the service. School counsellors have an influential role in facilitating access, and its close proximity to public transport enhances access. The service needs to become more prominent in young people’s consciousness, while the appointment system would benefit from providing more timely

Partisan Activism and Access to Welfare in Lebanon

PubMed Central

2014-01-01

How do welfare regimes function when state institutions are weak and ethnic or sectarian groups control access to basic services? This paper explores how people gain access to basic services in Lebanon, where sectarian political parties from all major religious communities are key providers of social assistance and services. Based on analyses of an original national survey (n= 1,911) as well as in-depth interviews with providers and other elites (n= 175) and beneficiaries of social programs (n= 135), I make two main empirical claims in the paper. First, political activism and a demonstrated commitment to a party are associated with access to social assistance; and second, higher levels of political activism may facilitate access to higher levels or quantities of aid, including food baskets and financial assistance for medical and educational costs. These arguments highlight how politics can mediate access to social assistance in direct ways and add new dimensions to scholarly debates about clientelism by focusing on contexts with politicized religious identities and by problematizing the actual goods and services exchanged. PMID:24904187

Optical fiber cabling technologies for flexible access network

NASA Astrophysics Data System (ADS)

Tanji, Hisashi

2008-07-01

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

Addiction treatment staff perceptions of training as a facilitator or barrier to implementing evidence-based practices: a national qualitative research study.

PubMed

D'Ippolito, Melinda; Lundgren, Lena; Amodeo, Maryann; Beltrame, Clelia; Lim, Lynn; Chassler, Deborah

2015-01-01

This qualitative effort examines training-related facilitators and barriers to implementing evidence-based practices (EBPs) in 285 community-based addiction treatment organizations (CBOs) nationwide that were funded by the Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment (SAMHSA/CSAT) to implement EBPs. Using qualitative interviews, the authors explored staff (N = 514) descriptions of training as a facilitator or barrier to implementation. Training-related factors were described 663 times as facilitators (by 440 staff) and 233 times as barriers (by 170 staff). Responses were coded using content analysis. Specific characteristics of the training received, such as access to expert knowledge and quality, as well as ongoing training were described as central facilitating factors to EBP implementation. Key reasons training was perceived as a barrier included the amount of training; the training did not fit current staff and/or organizational needs; the training for some EBPs was perceived to be too demanding; and the difficulty accessing training. Since government funders of addiction treatments require that CBOs implement EBPs and they provide training resources, the quality, flexibility, and accessibility of the available training needs to be promoted throughout the addiction treatment network. Only 17% of CBOs reported that they used the SAMHSA-funded ATTC (Addiction Technology Transfer Center) training centers and 42% used SAMHSA technical assistance. Hence, federally funded resources for training were not always used.

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

PubMed Central

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

2018-01-01

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

Complying with the National Institutes of Health Public Access Policy to Facilitate Science Availability for All

ERIC Educational Resources Information Center

Eack, Shaun M.

2015-01-01

Social work researchers are making significant advances in science funded by the National Institutes of Health (NIH) to improve the health of underserved and marginalized populations throughout the world. Unfortunately, research results are often only available to other scientists at academic institutions, limiting their impact. To facilitate the…

Cognitive Facilitation Following Intentional Odor Exposure

PubMed Central

Johnson, Andrew J.

2011-01-01

This paper reviews evidence that, in addition to incidental olfactory pollutants, intentional odor delivery can impact cognitive operations both positively and negatively. Evidence for cognitive facilitation/interference is reviewed alongside four potential explanations for odor-induced effects. It is concluded that the pharmacological properties of odors can induce changes in cognition. However, these effects can be accentuated/attenuated by the shift in mood following odor exposure, expectancy of cognitive effects, and cues to behavior via the contextual association with the odor. It is proposed that greater consideration is required in the intentional utilization of odors within both industrial and private locations, since differential effects are observed for odors with positive hedonic qualities. PMID:22163909

The Internet Process Addiction Test: Screening for Addictions to Processes Facilitated by the Internet.

PubMed

Northrup, Jason C; Lapierre, Coady; Kirk, Jeffrey; Rae, Cosette

2015-07-28

The Internet Process Addiction Test (IPAT) was created to screen for potential addictive behaviors that could be facilitated by the internet. The IPAT was created with the mindset that the term "Internet addiction" is structurally problematic, as the Internet is simply the medium that one uses to access various addictive processes. The role of the internet in facilitating addictions, however, cannot be minimized. A new screening tool that effectively directed researchers and clinicians to the specific processes facilitated by the internet would therefore be useful. This study shows that the Internet Process Addiction Test (IPAT) demonstrates good validity and reliability. Four addictive processes were effectively screened for with the IPAT: Online video game playing, online social networking, online sexual activity, and web surfing. Implications for further research and limitations of the study are discussed.

VIEWCACHE: An incremental pointer-based access method for autonomous interoperable databases

NASA Technical Reports Server (NTRS)

Roussopoulos, N.; Sellis, Timos

1993-01-01

One of the biggest problems facing NASA today is to provide scientists efficient access to a large number of distributed databases. Our pointer-based incremental data base access method, VIEWCACHE, provides such an interface for accessing distributed datasets and directories. VIEWCACHE allows database browsing and search performing inter-database cross-referencing with no actual data movement between database sites. This organization and processing is especially suitable for managing Astrophysics databases which are physically distributed all over the world. Once the search is complete, the set of collected pointers pointing to the desired data are cached. VIEWCACHE includes spatial access methods for accessing image datasets, which provide much easier query formulation by referring directly to the image and very efficient search for objects contained within a two-dimensional window. We will develop and optimize a VIEWCACHE External Gateway Access to database management systems to facilitate database search.

VIEWCACHE: An incremental pointer-based access method for autonomous interoperable databases

NASA Technical Reports Server (NTRS)

Roussopoulos, N.; Sellis, Timos

1992-01-01

One of biggest problems facing NASA today is to provide scientists efficient access to a large number of distributed databases. Our pointer-based incremental database access method, VIEWCACHE, provides such an interface for accessing distributed data sets and directories. VIEWCACHE allows database browsing and search performing inter-database cross-referencing with no actual data movement between database sites. This organization and processing is especially suitable for managing Astrophysics databases which are physically distributed all over the world. Once the search is complete, the set of collected pointers pointing to the desired data are cached. VIEWCACHE includes spatial access methods for accessing image data sets, which provide much easier query formulation by referring directly to the image and very efficient search for objects contained within a two-dimensional window. We will develop and optimize a VIEWCACHE External Gateway Access to database management systems to facilitate distributed database search.

Framing access to medicines in developing countries: an analysis of media coverage of Canada's Access to Medicines Regime.

PubMed

Esmail, Laura C; Phillips, Kaye; Kuek, Victoria; Cosio, Andrea Perez; Kohler, Jillian Clare

2010-01-04

In September 2003, the Canadian government committed to developing legislation that would facilitate greater access to affordable medicines for developing countries. Over the course of eight months, the legislation, now known as Canada's Access to Medicines Regime (CAMR), went through a controversial policy development process and the newspaper media was one of the major venues in which the policy debates took place. The purpose of this study was to examine how the media framed CAMR to determine how policy goals were conceptualized, which stakeholder interests controlled the public debate and how these variables related to the public policy process. We conducted a qualitative content analysis of newspaper coverage of the CAMR policy and implementation process from 2003-2008. The primary theoretical framework for this study was framing theory. A total of 90 articles from 11 Canadian newspapers were selected for inclusion in our analysis. A team of four researchers coded the articles for themes relating to access to medicines and which stakeholders' voice figured more prominently on each issue. Stakeholders examined included: the research-based industry, the generic industry, civil society, the Canadian government, and developing country representatives. The most frequently mentioned themes across all documents were the issues of drug affordability, intellectual property, trade agreements and obligations, and development. Issues such as human rights, pharmaceutical innovation, and economic competitiveness got little media representation. Civil society dominated the media contents, followed far behind by the Canadian government, the research-based and generic pharmaceutical industries. Developing country representatives were hardly represented in the media. Media framing obscured the discussion of some of the underlying policy goals in this case and failed to highlight issues which are now significant barriers to the use of the legislation. Using the media to engage

Framing access to medicines in developing countries: an analysis of media coverage of Canada's Access to Medicines Regime

PubMed Central

2010-01-01

Background In September 2003, the Canadian government committed to developing legislation that would facilitate greater access to affordable medicines for developing countries. Over the course of eight months, the legislation, now known as Canada's Access to Medicines Regime (CAMR), went through a controversial policy development process and the newspaper media was one of the major venues in which the policy debates took place. The purpose of this study was to examine how the media framed CAMR to determine how policy goals were conceptualized, which stakeholder interests controlled the public debate and how these variables related to the public policy process. Methods We conducted a qualitative content analysis of newspaper coverage of the CAMR policy and implementation process from 2003-2008. The primary theoretical framework for this study was framing theory. A total of 90 articles from 11 Canadian newspapers were selected for inclusion in our analysis. A team of four researchers coded the articles for themes relating to access to medicines and which stakeholders' voice figured more prominently on each issue. Stakeholders examined included: the research-based industry, the generic industry, civil society, the Canadian government, and developing country representatives. Results The most frequently mentioned themes across all documents were the issues of drug affordability, intellectual property, trade agreements and obligations, and development. Issues such as human rights, pharmaceutical innovation, and economic competitiveness got little media representation. Civil society dominated the media contents, followed far behind by the Canadian government, the research-based and generic pharmaceutical industries. Developing country representatives were hardly represented in the media. Conclusions Media framing obscured the discussion of some of the underlying policy goals in this case and failed to highlight issues which are now significant barriers to the use of the

A review of the Cercyon Leach (Coleoptera, Hydrophilidae, Sphaeridiinae) of the Greater Antilles

PubMed Central

Arriaga-Varela, Emmanuel; Seidel, Matthias; Deler-Hernández, Albert; Viktor Senderov; Fikáček, Martin

2017-01-01

Abstract The representatives of the genus Cercyon Leach occurring in the Greater Antilles are reviewed. Ten species are recorded, of which five are described here as new: C. gimmeli sp. n. (Dominican Republic), C. armatipenis sp. n. (Dominican Republic), C. taino sp. n. (Dominican Republic), C. sklodowskae sp. n. (Jamaica) and C. spiniventris sp. n. (Dominican Republic). Diagnoses and detailed distributional data are also provided for C. floridanus Horn, 1890 (distributed in southeastern United States of America and Cayman Islands), C. insularis Chevrolat, 1863 (endemic to the Antilles) C. praetextatus (Say, 1825) (widely distributed in the New World incl. Greater Antilles), C. quisquilius (Linnaeus, 1761) (an adventive species of Paleartic origin) and C. nigriceps (Marshall, 1802) (an adventive species probably of Oriental origin). Cercyon armatipenis, C. gimmeli, C. taino form a group of closely related species only distinguishable by male genitalia and DNA sequences. A key to the Great Antillean Cercyon is provided and important diagnostic characters are illustrated. The larvae of C. insularis and C. taino were associated with adults using COI barcode sequences, illustrated and diagnosed. Full occurrence data, additional images and COI barcode sequences were submitted to open access on-line depositories in an effort to provide access to complete data. PMID:28769720

Access to Preventive Health Care for Cancer Survivors

PubMed Central

Yabroff, K. Robin; Short, Pamela Farley; Machlin, Steven; Dowling, Emily; Rozjabek, Heather; Li, Chunyu; McNeel, Timothy; Ekwueme, Donatus U.; Virgo, Katherine S.

2013-01-01

Background Access to healthcare, particularly effective primary and secondary preventive care, is critical for cancer survivors, in order to minimize the adverse sequelae of cancer and its treatment. Purpose The goal of the study was to evaluate the association between cancer survivorship and access to primary and preventive health care. Methods Cancer survivors (n=4960) and individuals without a cancer history (n=64,431) aged ≥18 years, from the 2008–2010 Medical Expenditure Panel Survey (MEPS), were evaluated. Multiple measures of access and preventive services use were compared. The association between cancer survivorship and access and preventive services was evaluated with multivariate logistic regression models, stratified by age group (18–64 years and ≥65 years), controlling for the effects of age, gender, race/ethnicity, education, marital status, and comorbidities. Data were analyzed in 2013. Results Cancer survivors aged ≥65 years had equivalent or greater access and preventive services use than individuals without a cancer history, in adjusted analyses. However, among those aged 18–64 years with private health insurance, cancer survivors were more likely than other individuals to have a usual source of care and to use preventive services, whereas uninsured or publicly insured cancer survivors were generally less likely to have a usual source of care and to use preventive services than were uninsured or publicly insured adults without a cancer history. Conclusions Although access and preventive care use in cancer survivors is generally equivalent or greater compared to that of other individuals, disparities for uninsured and publicly insured cancer survivors aged 18–64 years suggest that improvements in survivor care are needed. PMID:23953357

A randomised controlled non-inferiority trial of primary care-based facilitated access to an alcohol reduction website (EFAR Spain): the study protocol

PubMed Central

López-Pelayo, Hugo; Wallace, Paul; Segura, Lidia; Miquel, Laia; Díaz, Estela; Teixidó, Lidia; Baena, Begoña; Struzzo, Pierliugio; Palacio-Vieira, Jorge; Casajuana, Cristina; Colom, Joan; Gual, Antoni

2014-01-01

Introduction Early identification (EI) and brief interventions (BIs) for risky drinkers are effective tools in primary care. Lack of time in daily practice has been identified as one of the main barriers to implementation of BI. There is growing evidence that facilitated access by primary healthcare professionals (PHCPs) to a web-based BI can be a time-saving alternative to standard face-to-face BIs, but there is as yet no evidence about the effectiveness of this approach relative to conventional BI. The main aim of this study is to test non-inferiority of facilitation to a web-based BI for risky drinkers delivered by PHCP against face-to-face BI. Method and analysis A randomised controlled non-inferiority trial comparing both interventions will be performed in primary care health centres in Catalonia, Spain. Unselected adult patients attending participating centres will be given a leaflet inviting them to log on to a website to complete the Alcohol Use Disorders Identification Test (AUDIT-C) alcohol screening questionnaire. Participants with positive results will be requested online to complete a trial module including consent, baseline assessment and randomisation to either face-to-face BI by the practitioner or BI via the alcohol reduction website. Follow-up assessment of risky drinking will be undertaken online at 3 months and 1 year using the full AUDIT and D5-EQD5 scale. Proportions of risky drinkers in each group will be calculated and non-inferiority assessed against a specified margin of 10%. Assuming reduction of 30% of risky drinkers receiving standard intervention, 1000 patients will be required to give 90% power to reject the null hypothesis. Ethics and dissemination The protocol was approved by the Ethics Commmittee of IDIAP Jordi Gol i Gurina P14/028. The findings of the trial will be disseminated through peer-reviewed journals, national and international conference presentations. Trial registration number ClinicalTrials.gov NCT02082990. PMID

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.

Accessing genetic diversity for crop improvement.

PubMed

Glaszmann, J C; Kilian, B; Upadhyaya, H D; Varshney, R K

2010-04-01

Vast germplasm collections are accessible but their use for crop improvement is limited-efficiently accessing genetic diversity is still a challenge. Molecular markers have clarified the structure of genetic diversity in a broad range of crops. Recent developments have made whole-genome surveys and gene-targeted surveys possible, shedding light on population dynamics and on the impact of selection during domestication. Thanks to this new precision, germplasm description has gained analytical power for resolving the genetic basis of trait variation and adaptation in crops such as major cereals, chickpea, grapevine, cacao, or banana. The challenge now is to finely characterize all the facets of plant behavior in carefully chosen materials. We suggest broadening the use of 'core reference sets' so as to facilitate material sharing within the scientific community.

Increasing Access to Dental and Medical Care by Allowing Greater Flexibility in Scope of Practice

PubMed Central

Hoffmann, Diane; Rowthorn, Virginia

2015-01-01

In recent years, advocates for increasing access to medical and oral health care have argued for expanding the scope of practice of dentists and physicians. Although this idea may have merit, significant legal and other barriers stand in the way of allowing dentists to do more primary health care, physicians to do more oral health care, and both professions to collaborate. State practice acts, standards of care, and professional school curricula all support the historical separation between the 2 professions. Current laws do not contemplate working across professional boundaries, leaving providers who try vulnerable to legal penalties. Here we examine the legal, regulatory, and training barriers to dental and medical professionals performing services outside their traditional scope of practice. PMID:26180970

Facilitating Racial and Ethnic Diversity in the Health Workforce.

PubMed

Snyder, Cyndy R; Frogner, Bianca K; Skillman, Susan M

2018-01-01

Racial and ethnic diversity in the health workforce can facilitate access to healthcare for underserved populations and meet the health needs of an increasingly diverse population. In this study, we explored 1) changes in the racial and ethnic diversity of the health workforce in the United States over the last decade, and 2) evidence on the effectiveness of programs designed to promote racial and ethnic diversity in the U.S. health workforce. Findings suggest that although the health workforce overall is becoming more diverse, people of color are most often represented among the entry-level, lower-skilled health occupations. Promising practices to help facilitate diversity in the health professions were identified in the literature, namely comprehensive programs that integrated multiple interventions and strategies. While some efforts have been found to be promising in increasing the interest, application, and enrollment of racial and ethnic minorities into health profession schools, there is still a missing link in understanding persistence, graduation, and careers.

Open Access to Geophysical Data

NASA Astrophysics Data System (ADS)

Sergeyeva, Nataliya A.; Zabarinskaya, Ludmila P.

2017-04-01

Russian World Data Centers for Solar-Terrestrial Physics & Solid Earth Physics hosted by the Geophysical Center of the Russian Academy of Sciences are the Regular Members of the ICSU-World Data System. Guided by the principles of the WDS Constitution and WDS Data Sharing Principles, the WDCs provide full and open access to data, long-term data stewardship, compliance with agreed-upon data standards and conventions, and mechanisms to facilitate and improve access to data. Historical and current geophysical data on different media, in the form of digital data sets, analog records, collections of maps, descriptions are stored and collected in the Centers. The WDCs regularly fill up repositories and database with new data, support them up to date. Now the WDCs focus on four new projects, aimed at increase of data available in network by retrospective data collection and digital preservation of data; creation of a modern system of registration and publication of data with digital object identifier (DOI) assignment, and promotion of data citation culture; creation of databases instead of file system for more convenient access to data; participation in the WDS Metadata Catalogue and Data Portal by creating of metadata for information resources of WDCs.

Barriers and facilitators to mobile phone use for people with aphasia.

PubMed

Greig, Carole-Ann; Harper, Renée; Hirst, Tanya; Howe, Tami; Davidson, Bronwyn

2008-01-01

Mobile phone use increases social participation. People with the communication disorder of aphasia are disadvantaged in the use of information and communication technology such as mobile phones and are reported to be more socially isolated than their peers. The World Health Organization's International Classification of Functioning, Disability and Health provides a framework to address the impact of environmental factors on individual participation. The aim of this preliminary study was to identify the barriers and facilitators to mobile phone use for people with aphasia. A qualitative descriptive study involving two phases was conducted: (1) semi-structured interviews with 6 individuals with aphasia who owned or expressed a desire to own a mobile phone; (2) structured observations of key scenarios identified in the interviews of 3 participants who were sampled from the interview study. Results identified 18 barriers and 9 facilitators to mobile phone use. Key barriers and facilitators were identified in the areas of design and features, written support and training, and communicative partners. Mobile phone use can be problematic for people with aphasia. Intervention needs to address the barriers and utilise the facilitators to mobile phone use for this population. Further research is required to inform policy and intervention programs to ensure that people with aphasia have access to this technology.

Accessibility and contribution to glucan masking of natural and genetically tagged versions of yeast wall protein 1 of Candida albicans

PubMed Central

2018-01-01

Yeast wall protein 1 (Ywp1) is an abundant glycoprotein of the cell wall of the yeast form of Candida albicans, the most prevalent fungal pathogen of humans. Antibodies that bind to the polypeptide backbone of isolated Ywp1 show little binding to intact yeast cells, presumably because the Ywp1 epitopes are masked by the polysaccharides of the mannoproteins that form the outer layer of the cell wall. Rare cells do exhibit much greater anti-Ywp1 binding, however, and one of these was isolated and characterized. No differences were seen in its Ywp1, but it exhibited greater adhesiveness, sensitivity to wall perturbing agents, and exposure of its underlying β-1,3-glucan layer to external antibodies. The molecular basis for this greater epitope accessibility has not been determined, but has facilitated exploration of how these properties change as a function of cell growth and morphology. In addition, previously engineered strains with reduced quantities of Ywp1 in their cell walls were also found to have greater β-1,3-glucan exposure, indicating that Ywp1 itself contributes to the masking of wall epitopes, which may be important for understanding the anti-adhesive effect of Ywp1. Ectopic production of Ywp1 by hyphae, which reduces the adhesivity of these filamentous forms of C. albicans, was similarly found to reduce exposure of the β-1,3-glucan in their walls. To monitor Ywp1 in the cell wall irrespective of its accessibility, green fluorescent protein (Gfp) was genetically inserted into wall-anchored Ywp1 using a bifunctional cassette that also allowed production from a single transfection of a soluble, anchor-free version. The wall-anchored Ywp1-Gfp-Ywp1 accumulated in the wall of the yeast forms but not hyphae, and appeared to have properties similar to native Ywp1, including its adhesion-inhibiting effect. Some pseudohyphal walls also detectably accumulated this probe. Strains of C. albicans with tandem hemagglutinin (HA) epitopes inserted into wall

Accessibility and contribution to glucan masking of natural and genetically tagged versions of yeast wall protein 1 of Candida albicans.

PubMed

Granger, Bruce L

2018-01-01

Yeast wall protein 1 (Ywp1) is an abundant glycoprotein of the cell wall of the yeast form of Candida albicans, the most prevalent fungal pathogen of humans. Antibodies that bind to the polypeptide backbone of isolated Ywp1 show little binding to intact yeast cells, presumably because the Ywp1 epitopes are masked by the polysaccharides of the mannoproteins that form the outer layer of the cell wall. Rare cells do exhibit much greater anti-Ywp1 binding, however, and one of these was isolated and characterized. No differences were seen in its Ywp1, but it exhibited greater adhesiveness, sensitivity to wall perturbing agents, and exposure of its underlying β-1,3-glucan layer to external antibodies. The molecular basis for this greater epitope accessibility has not been determined, but has facilitated exploration of how these properties change as a function of cell growth and morphology. In addition, previously engineered strains with reduced quantities of Ywp1 in their cell walls were also found to have greater β-1,3-glucan exposure, indicating that Ywp1 itself contributes to the masking of wall epitopes, which may be important for understanding the anti-adhesive effect of Ywp1. Ectopic production of Ywp1 by hyphae, which reduces the adhesivity of these filamentous forms of C. albicans, was similarly found to reduce exposure of the β-1,3-glucan in their walls. To monitor Ywp1 in the cell wall irrespective of its accessibility, green fluorescent protein (Gfp) was genetically inserted into wall-anchored Ywp1 using a bifunctional cassette that also allowed production from a single transfection of a soluble, anchor-free version. The wall-anchored Ywp1-Gfp-Ywp1 accumulated in the wall of the yeast forms but not hyphae, and appeared to have properties similar to native Ywp1, including its adhesion-inhibiting effect. Some pseudohyphal walls also detectably accumulated this probe. Strains of C. albicans with tandem hemagglutinin (HA) epitopes inserted into wall

Barriers to and Facilitators of Research Utilization among Iranian Nurses: a Literature Review.

PubMed

Heydari, Abbas; Emami Zeydi, Amir

2014-12-01

Research utilization (RU), is an important strategy to promote the quality of patient care. The aim of this study was to present a comprehensive literature review describing barriers and facilitators of RU among Iranian nurses. Literature review was undertaken using the international databases including Pub Med/Medline, Scopus, Science Direct, and Google Scholar. Also, Persian electronic databases such as Magiran, SID and Iran Medex were searched up to May 2014. The search was limited to articles in the English and Persian languages that evaluate the barriers or facilitators of RU among Iranian nurses. A total of 11 articles were in the final dataset. The most important barriers to RU among Iranian nurses were related to the organization factors such as inadequate facilities; insufficient time on the job, lack of authority, physician cooperation, and administrative support. The most frequent facilitators of RU were education in enhancing nurses knowledge and skills in research evaluation, support from knowledgeable nursing colleagues and nursing faculty in the clinical setting, access to an expert committee for clinical appraisal, improving skills in English language and searching for articles, sufficient economic resources to carry out research, and having access to more facilities such as internet. Iranian nurses encounter with the same difficulties as to other countries regarding RU; while setting related barriers were the predominant obstacles to RU among them. Therefore, health managers are expected to plan appropriate strategies to smooth the progress of RU by nurses in their practice.

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

PubMed

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

2014-11-26

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

Access to Care Under Physician Payment Reform: A Physician-Based Analysis

PubMed Central

Meadow, Ann

1995-01-01

This article reports physician-based measures of access to care during the 3 years surrounding the 1989 physician payment reforms. Analysis was facilitated by a new system of physician identifiers in Medicare claims. Access measures include caseload per physician and related measures of the demographic composition of physicians' clientele, the proportion of physicians performing surgical and other procedures, and the assignment rate. The caseload and assignment measures were stable or improving over time, suggesting that reforms did not harm access. Procedure performance rates tended to decline between 1992 and 1993, but reductions were inversely related to the estimated fee changes, and several may be explainable by other factors. PMID:10172615

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

PubMed Central

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

2013-01-01

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

Race and the Metropolitan Origins of Postsecondary Access to Four Year Colleges: The Case of Greater Boston

ERIC Educational Resources Information Center

Berger, Joseph B.; Smith, Suzanne M.; Coelen, Stephen P.

2004-01-01

The inequities of residential segregation and their impact on educational opportunity are a national problem, but greater metropolitan Boston has a particularly problematic history in terms of the extent to which racial segregation has deeply divided the city into separate and unequal systems of opportunity. Despite decades of policy efforts to…

The facilitators and impediment factors of structural empowerment in pregnancy and delivery care: achievement of power

PubMed Central

Janighorban, M; Yousefi, H; Yamani, N

2015-01-01

Background: The organizations essentially affect empowerment of personnel through the preparation of the needed grounds for them. Also, the students may acquire the required potentials and capabilities in the educational organizations when the possibility is provided to them to access power and opportunity in educational environments. Objective: The present study aimed to explain the facilitators and impediment factors of structural empowerment in pregnancy and delivery care. Methods: According to Kanter’s theory, this qualitative study was conducted with the participation of 15 superior midwifery students, ten academic teachers of midwifery, and two midwives employed in the educational hospitals. Data were collected by semi-structured interviews individually and in the group and analyzed by using a directed content analysis method. Results: To explain the facilitators and impediment factors of empowerment in pregnancy and delivery care in the power structure, the access was provided to a support formed by three broad categories of support from the instructors, support from personnel, and support from a classmate. The access to resources was created with three broad categories of access to the appropriate clinical environment, to the laboratory of clinical skills and to information sources, and to information, forming with two broad categories of awareness of the educational objectives as well as legal and legitimate issues. Conclusion: One could prepare the ground for the midwifery students to access this empowerment in pregnancy and delivery cares more than ever by providing equipped clinical environments and the presence of all-inclusive supportive climate in such environments. Along with the efficient training of students in the laboratory PMID:28316710

Effects of neuromuscular joint facilitation on bridging exercises with respect to deep muscle changes.

PubMed

Zhou, Bin; Huang, QiuChen; Zheng, Tao; Huo, Ming; Maruyama, Hitoshi

2015-05-01

[Purpose] This study examined the effects of neuromuscular joint facilitation on bridging exercises by assessing the cross-sectional area of the multifidus muscle and thickness of the musculus transversus abdominis. [Subjects] Twelve healthy men. [Methods] Four exercises were evaluated: (a) supine resting, (b) bridging resistance exercise involving posterior pelvic tilting, (c) bridging resistance exercise involving anterior pelvic tilting, and (d) bridging resistance exercise involving neuromuscular joint facilitation. The cross-sectional area of the multifidus muscle and thickness of the musculus transversus abdominis were measured during each exercise. [Results] The cross-sectional area of the multifidus muscle and thickness of the musculus transversus abdominis were significantly greater in the neuromuscular joint facilitation group than the others. [Conclusion] Neuromuscular joint facilitation intervention improves the function of deep muscles such as the multifidus muscle and musculus transversus abdominis. Therefore, it can be recommended for application in clinical treatments such as that for back pain.

Karyotype asymmetry in Cynodon Rich. (Poaceae) accessions.

PubMed

Chiavegatto, R B; Paula, C M P; Souza Sobrinho, F; Benites, F R G; Techio, V H

2016-12-02

Cynodon is a genus of plants with forage potential that has attracted the interest of breeders. These species have high morphological variability in a large number of varieties and cytotypes, hampering identification. This study aimed to determine the karyotype asymmetry index among accessions of Cynodon to discriminate between them. Karyotype symmetry was based on three estimates, which were compared. The basic number for the genus is x = 9. The results of the chromosome count and DNA quantification, respectively, were as follows: two diploid accessions (2n = 2x = 18 and 1.08 ± 0.094 to 1.17 ± 0.036 pg DNA and ± standard deviation), one triploid accession (2n = 3x = 27 and 1.63 ± 0.017 pg DNA), four tetraploid accessions (2n = 4x = 36 and 1.88 ± 0.069 to 2.10 ± 0.07 pg DNA), and one pentaploid accession (2n = 5x = 45 and 2.55 ± 0.098 pg DNA). C. incompletus var. hirsutus had the longest total length of the haploid lot (29.05 µm), with chromosomes that ranged from 1.7 to 6.2 µm in length. On the basis of the karyotype asymmetry indices, the accessions were divided into two groups: 1) C. dactylon var. dactylon, C. transvaalensis, C. dactylon var. polevansii, three accessions of Cynodon sp, and C. nlemfuensis; and 2) C. incompletus var. hirsutus. This is the first description of tetraploidy in C. transvaalensis. The karyotypic data facilitated a determination of the degree of proximity between the accessions.

45 CFR 156.298 - Meaningful difference standard for Qualified Health Plans in the Federally-facilitated Exchanges.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Health Plans in the Federally-facilitated Exchanges. 156.298 Section 156.298 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCHANGES Qualified Health Plan Minimum...

Trends in communicative access solutions for children with cerebral palsy.

PubMed

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

2014-08-01

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

Automated Computer Access Request System

NASA Technical Reports Server (NTRS)

Snook, Bryan E.

2010-01-01

The Automated Computer Access Request (AutoCAR) system is a Web-based account provisioning application that replaces the time-consuming paper-based computer-access request process at Johnson Space Center (JSC). Auto- CAR combines rules-based and role-based functionality in one application to provide a centralized system that is easily and widely accessible. The system features a work-flow engine that facilitates request routing, a user registration directory containing contact information and user metadata, an access request submission and tracking process, and a system administrator account management component. This provides full, end-to-end disposition approval chain accountability from the moment a request is submitted. By blending both rules-based and rolebased functionality, AutoCAR has the flexibility to route requests based on a user s nationality, JSC affiliation status, and other export-control requirements, while ensuring a user s request is addressed by either a primary or backup approver. All user accounts that are tracked in AutoCAR are recorded and mapped to the native operating system schema on the target platform where user accounts reside. This allows for future extensibility for supporting creation, deletion, and account management directly on the target platforms by way of AutoCAR. The system s directory-based lookup and day-today change analysis of directory information determines personnel moves, deletions, and additions, and automatically notifies a user via e-mail to revalidate his/her account access as a result of such changes. AutoCAR is a Microsoft classic active server page (ASP) application hosted on a Microsoft Internet Information Server (IIS).

Access to means of suicide, occupation and the risk of suicide: a national study over 12 years of coronial data.

PubMed

Milner, A; Witt, K; Maheen, H; LaMontagne, A D

2017-04-04

Availability of lethal means is a significant risk factor for suicide. This study investigated whether occupations with greater access to lethal means had higher suicide rates than those without access, and further, whether this relationship differed for females versus males. A retrospective mortality study was conducted across the Australian population over the period 2001 to 2012. Data from the Australian Bureau of Statistics, which collects Census information on occupation for the Australian population, and the National Coroners Information System, which records information on suicide deaths, were combined. Employed suicide records were coded by occupation and work-related access to lethal means. Descriptive analysis and negative binomial regression were used to assess the relationship between access to means and suicide. Persons in occupations with access to firearms, medicines or drugs, and carbon monoxide more frequently used these methods to end their lives than those without access to means. Females employed in occupations with access to means had suicide rates that were 3.02 times greater (95% CI 2.60 to 3.50, p < 0.001) than those employed in occupations without access. Males in occupations with access had suicide rates that were 1.24 times greater than those without access (95% CI 1.16 to 1.33, p < 0.001). Work-related access to means is a risk factor for suicide in the employed population, but is associated with a greater risk for females than males. The findings of this study suggest the importance of controlling access to lethal methods in occupations where these are readily available.

Web accessibility and open source software.

PubMed

Obrenović, Zeljko

2009-07-01

A Web browser provides a uniform user interface to different types of information. Making this interface universally accessible and more interactive is a long-term goal still far from being achieved. Universally accessible browsers require novel interaction modalities and additional functionalities, for which existing browsers tend to provide only partial solutions. Although functionality for Web accessibility can be found as open source and free software components, their reuse and integration is complex because they were developed in diverse implementation environments, following standards and conventions incompatible with the Web. To address these problems, we have started several activities that aim at exploiting the potential of open-source software for Web accessibility. The first of these activities is the development of Adaptable Multi-Interface COmmunicator (AMICO):WEB, an infrastructure that facilitates efficient reuse and integration of open source software components into the Web environment. The main contribution of AMICO:WEB is in enabling the syntactic and semantic interoperability between Web extension mechanisms and a variety of integration mechanisms used by open source and free software components. Its design is based on our experiences in solving practical problems where we have used open source components to improve accessibility of rich media Web applications. The second of our activities involves improving education, where we have used our platform to teach students how to build advanced accessibility solutions from diverse open-source software. We are also partially involved in the recently started Eclipse projects called Accessibility Tools Framework (ACTF), the aim of which is development of extensible infrastructure, upon which developers can build a variety of utilities that help to evaluate and enhance the accessibility of applications and content for people with disabilities. In this article we briefly report on these activities.

EU accession: A policy window opportunity for nursing?

PubMed

De Raeve, Paul; Rafferty, Anne-Marie; Bariball, Louise; Young, Ruth; Boiko, Olga

2017-03-01

European enlargement has been studied in a wide range of policy areas within and beyond health. Yet the impact of EU enlargement upon one of the largest health professions, nursing, has been largely neglected. This paper aims to explore nurse leadership using a comparative case study method in two former Communist countries, Romania and Croatia. Specifically, it considers the extent to which engagement in the EU accession policy-making process provided a policy window for the leaders to formulate and implement a professional agenda while negotiating EU accession. Findings of qualitative interviews and documentary analysis indicate that the mechanisms used to facilitate the accession process were not successful in achieving compliance with the education standards in the Community Acquis, as highlighted in the criteria on the mutual recognition of professional qualifications set out in Directive 2005/36/EC. EU accession capacity building and accession funds were not deployed efficiently to upgrade Romanian and Croatian nursing education towards meeting EU standards. Conflicting views on accession held by the various nursing stakeholders (nursing regulator, nursing union, governmental chief nurse and the professional association) inhibited the setting of a common policy agenda to achieve compliance with EU standards. The study findings suggest a need to critically review EU accession mechanisms and better align leadership at all governance levels. Copyright © 2017 Elsevier B.V. All rights reserved.

The Influence of Facilitator and Facilitation Characteristics on Participants' Ratings of Stepfamily Education

ERIC Educational Resources Information Center

Higginbotham, Brian J.; Myler, Cory

2010-01-01

We examine the relative importance of facilitator and facilitation characteristics on participant ratings of a stepfamily education program. Data from 48 facilitators and 598 participants suggest that quality facilitation is more meaningful to participants than whether facilitators have comparable demographic characteristics or life experiences.…

The Internet Process Addiction Test: Screening for Addictions to Processes Facilitated by the Internet

PubMed Central

Northrup, Jason C.; Lapierre, Coady; Kirk, Jeffrey; Rae, Cosette

2015-01-01

The Internet Process Addiction Test (IPAT) was created to screen for potential addictive behaviors that could be facilitated by the internet. The IPAT was created with the mindset that the term “Internet addiction” is structurally problematic, as the Internet is simply the medium that one uses to access various addictive processes. The role of the internet in facilitating addictions, however, cannot be minimized. A new screening tool that effectively directed researchers and clinicians to the specific processes facilitated by the internet would therefore be useful. This study shows that the Internet Process Addiction Test (IPAT) demonstrates good validity and reliability. Four addictive processes were effectively screened for with the IPAT: Online video game playing, online social networking, online sexual activity, and web surfing. Implications for further research and limitations of the study are discussed. PMID:26226007

Perceived barriers and facilitators to physical activity for children with disability: a systematic review.

PubMed

Shields, Nora; Synnot, Anneliese Jane; Barr, Megan

2012-11-01

The aim of this systematic review was to investigate the perceived barriers and facilitators to physical activity among children with disability. 10 electronic databases were searched from the earliest time available to September 2010 to identify relevant articles. Articles were included if they examined the barriers or facilitators to physical activity for children with disability and were written in English. Articles were excluded if they included children with an acute, transient or chronic medical condition, examined sedentary leisure activities, or societal participation in general. Two reviewers independently assessed the search yields, extracted the data and assessed trial quality. Data were analysed descriptively. 14 articles met the inclusion criteria. Barriers included lack of knowledge and skills, the child's preferences, fear, parental behaviour, negative attitudes to disability, inadequate facilities, lack of transport, programmes and staff capacity, and cost. Facilitators included the child's desire to be active, practising skills, involvement of peers, family support, accessible facilities, proximity of location, better opportunities, skilled staff and information. Personal, social, environmental, and policy and programme-related barriers and facilitators influence the amount of activity children with disability undertake. The barriers to physical activity have been studied more comprehensively than the facilitators.

Remote Access to Earth Science Data by Content, Space and Time

NASA Technical Reports Server (NTRS)

Dobinson, E.; Raskin, G.

1998-01-01

This demo presents the combination on an http-based client/server application that facilitates internet access to Earth science data coupled with a Java applet GUI that allows the user to graphically select data based on spatial and temporal coverage plots and scientific parameters.

Identification and Accessioning of Individuals for Officer Candidate School: Developing Realistic Job Previews

DTIC Science & Technology

2014-07-01

useful to them before they applied to OCS, and 86% of candidates saying they would refer someone else to the RJP. 15. SUBJECT TERMS Officers...Candidate School,” or AccessOCS, used qualitative methods (Oliver, Ardison, Russell, & Babin, 2010) to (a) identify and describe OCS applicants in terms...job previews (RJPs) that would provide OCS applicants with useful information in a single, but comprehensive document to facilitate the accessioning

Factors that impact access to ongoing health care for First Nation children with a chronic condition.

PubMed

Coombes, Julieann; Hunter, Kate; Mackean, Tamara; Holland, Andrew J A; Sullivan, Elizabeth; Ivers, Rebecca

2018-06-14

Access to multidisciplinary health care services for First Nation children with a chronic condition is critical for the child's health and well-being, but disparities and inequality in health care systems have been almost impossible to eradicate for First Nation people globally. The objective of this review is to identify the factors that impact access and ongoing care for First Nation children globally with a chronic condition. An extensive systematic search was conducted of nine electronic databases to identify primary studies that explored factors affecting access to ongoing services for First Nation children with a chronic disease or injury. Due to the heterogeneity of included studies the Mixed Method Appraisal Tool (MMAT) was used to assess study quality. A total of six studies from Australia, New Zealand and Canada were identified and included in this review. Four studies applied qualitative approaches using in-depth semi structured interviews, focus groups and community fora. Two of the six studies used quantitative approaches. Facilitators included the utilisation of First Nation liaison workers or First Nation Health workers. Key barriers that emerged included lack of culturally appropriate health care, distance, language and cultural barriers, racism, the lack of incorporation of First Nation workers in services, financial difficulties and transport issues. There are few studies that have identified positive factors that facilitate access to health care for First Nation children. There is an urgent need to develop programs and processes to facilitate access to appropriate health care that are inclusive of the cultural needs of First Nation children.

Facilitating organizational mergers: amalgamation of community care access centres.

PubMed

Mercer, Kevin

2008-01-01

The development of 14 Local Health Integration Networks (LHINs) in Ontario necessitated the re-organization of Community Care Access Centres (CCACs). The achievement of LHIN objectives was contingent upon the organizations responsible for home and long-term care placement being aligned within the LHIN geographic boundaries. This re-alignment required 42 provincial organizations to re-structure, integrate and reduce to 14. This project was focused on the amalgamation of two CCACs in the Waterloo Wellington LHIN. Both were distinctly different due to their organizational evolution, the composition of the region and leadership approach. The different organizational cultures, if not managed properly, could result in a derailing of several current projects that were underway and were also key to the overall health system transformation agenda. A literature search provided a plethora of critiques of organizational change approaches and practical suggestions. Of particular relevance was a report to the Royal Commission on Health Care in 2002 that authenticates the dismal success in health care to meet change objectives. The project included a joint planning day for the leadership teams of the two organizations followed by an Organizational Readiness Assessment conducted by the Canadian Council on Health Services Accreditation (CCHSA). Both activities brought the leadership and staff of Waterloo and Wellington together, started the integration process and solicited staff participation. A follow-up survey of the leadership teams revealed the effectiveness of the project in advancing integration between the two organizations and recognizing organizational cultural differences. The CCHSA Organizational Readiness Assessment process was viewed as an effective means for advancing the integration of the two organizations, particularly as it relates to allowing the staff groups to define for themselves the benefits of the merger. The lack of hard evidence on the benefits of a

Fast Magnetoresistive Random-Access Memory

NASA Technical Reports Server (NTRS)

Wu, Jiin-Chuan; Stadler, Henry L.; Katti, Romney R.

1991-01-01

Magnetoresistive binary digital memories of proposed new type expected to feature high speed, nonvolatility, ability to withstand ionizing radiation, high density, and low power. In memory cell, magnetoresistive effect exploited more efficiently by use of ferromagnetic material to store datum and adjacent magnetoresistive material to sense datum for readout. Because relative change in sensed resistance between "zero" and "one" states greater, shorter sampling and readout access times achievable.

Implementing Patient Access to Electronic Health Records Under HIPAA: Lessons Learned

PubMed Central

Wang, Tiffany; Pizziferri, Lisa; Volk, Lynn A; Mikels, Debra A; Grant, Karen G; Wald, Jonathan S; Bates, David W

2004-01-01

In 2001, the Institute of Medicine (IOM) and the Health Insurance Portability and Accountability Act (HIPAA) emphasized the need for patients to have greater control over their health information. We describe a Boston healthcare system's approach to providing patients access to their electronic health records (EHRs) via Patient Gateway, a secure, Web-based portal. Implemented in 19 clinic sites to date, Patient Gateway allows patients to access information from their medical charts via the Internet in a secure manner. Since 2002, over 19,000 patients have enrolled in Patient Gateway, more than 125,000 patients have logged into the system, and over 37,000 messages have been sent by patients to their practices. There have been no major security concerns. By providing access to EHR data, secure systems like Patient Gateway allow patients a greater role in their healthcare process, as envisioned by the IOM and HIPAA. PMID:18066391

Local anesthesia and hydro-distension to facilitate cystic calculus removal in horses.

PubMed

Russell, Tom; Pollock, Patrick J

2012-07-01

To report a technique for improving surgical access to the bladder for removal of cystic calculi in male horses. Retrospective case series. Geldings (8) with cystic calculi. After catheterization of the bladder through the penis, 100 mL 2% lidocaine hydrochloride solution was instilled. After 10 minutes, the bladder was distended with sterile, warmed Hartmann's solution to a pressure of ≈ 40 cm H(2) O, using gravity feed. This was left in place until abdominal access was gained at surgery, then the fluid siphoned off via the catheter. Calculi were 3-11 cm in diameter (median, 6 cm). Bladder capacity ranged from 1.4 to 2.5 L (median, 1.8 L). Exteriorization time from placing a hand in the abdomen to having the bladder in a surgically accessible position was <5 minutes. The described technique facilitates exteriorization of the bladder for removal of cystic calculi. Copyright 2012 by The American College of Veterinary Surgeons.

To Understand and Be Understood: Facilitating Interdisciplinary Learning through the Promotion of Communicative Competence

ERIC Educational Resources Information Center

Taylor, Stephen

2018-01-01

Whilst interdisciplinarity has become a central concern of research and learning in geography, few from the discipline have considered the practical facilitation of interdisciplinarity in the classroom. Module convenors, I argue, must pay greater attention to how learners engage and negotiate with peers and perspectives from other disciplines. In…

Information Control in the Virtual Office: Preparing Intermediaries To Facilitate Information Exchange in the Home Work Environment.

ERIC Educational Resources Information Center

Fulton, Crystal

2002-01-01

Discusses work done by information professionals and the increase in teleworking, using telecommunications technology; considers teleworkers' information needs; examines ways in which library and information science professionals can facilitate teleworkers' information access; and investigates information environments of 20 teleworkers and 20…

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.

Using learning theory, interprofessional facilitation competencies, and behavioral indicators to evaluate facilitator training.

PubMed

LeGros, Theresa A; Amerongen, Helen M; Cooley, Janet H; Schloss, Ernest P

2015-01-01

Despite the increasing need for faculty and preceptors skilled in interprofessional facilitation (IPF), the relative novelty of the field poses a challenge to the development and evaluation of IPF programs. We use learning theory and IPF competencies with associated behavioral indicators to develop and evaluate six key messages in IPF training and experience. Our mixed methods approach included two phases: quantitative data collection with embedded qualitative data, followed by qualitative data collection in explanatory sequential fashion. This enabled triangulated analyses of both data types and of facilitation behaviors from facilitator and student perspectives. Results indicate the competency-based training was effective. Facilitators felt comfortable performing behaviors associated with IPF competencies; student observations of those behaviors supported facilitator self-reported performance. Overall, students perceived more facilitation opportunities than facilitators. Findings corroborate the importance of recruiting seasoned facilitators and establishing IPF guidelines that acknowledge variable team dynamics and help facilitators recognize teachable moments.

Facilitated peer support in breast cancer: a pre- and post-program evaluation of women's expectations and experiences of a facilitated peer support program.

PubMed

Power, Sinead; Hegarty, Josephine

2010-01-01

Peer support programs are associated with the provision of emotional, informational, and appraisal support. The benefits of peer support for women with breast cancer include reduced social isolation, enhanced coping, and access to information. The aim of this study was to conduct a pre- and post-program evaluation of a 7-week facilitated breast cancer peer support program in a cancer support house. Women with primary breast cancer (n = 8) participated in pre- and post-program focus groups. The interviews were recorded and were transcribed verbatim by the researcher. The data were analyzed using content analysis. Eight themes were identified. The key themes emerging from the pre and post programme focus groups included: The need for mutual identification; Post-treatment isolation; Help with moving on; The impact of hair loss; Consolidation of information; Enablement/empowerment; The importance of the cancer survivor; Mutual sharing. It is essential that facilitated peer support programs are tailored to meet the support needs of women with breast cancer. There is a particular need to facilitate mutual sharing and support for hair loss within these programs. Implications for practice emerging from this study include the importance of pre- and post-program evaluations in identifying whether peer support programs meet the expectations of women with breast cancer, the need for peer/professional programs to support women with treatment-induced hair loss, the importance of including cancer survivors in support programs, and the need to allow more informal sharing to occur in facilitated peer support programs.

Access and utilisation of maternity care for disabled women who experience domestic abuse: a systematic review

PubMed Central

2014-01-01

Background Although disabled women are significantly more likely to experience domestic abuse during pregnancy than non-disabled women, very little is known about how maternity care access and utilisation is affected by the co-existence of disability and domestic abuse. This systematic review of the literature explored how domestic abuse impacts upon disabled women’s access to maternity services. Methods Eleven articles were identified through a search of six electronic databases and data were analysed to identify: the factors that facilitate or compromise access to care; the consequences of inadequate care for pregnant women’s health and wellbeing; and the effectiveness of existing strategies for improvement. Results Findings indicate that a mental health diagnosis, poor relationships with health professionals and environmental barriers can compromise women’s utilisation of maternity services. Domestic abuse can both compromise, and catalyse, access to services and social support is a positive factor when accessing care. Delayed and inadequate care has adverse effects on women’s physical and psychological health, however further research is required to fully explore the nature and extent of these consequences. Only one study identified strategies currently being used to improve access to services for disabled women experiencing abuse. Conclusions Based upon the barriers and facilitators identified within the review, we suggest that future strategies for improvement should focus on: understanding women’s reasons for accessing care; fostering positive relationships; being women-centred; promoting environmental accessibility; and improving the strength of the evidence base. PMID:25029907

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

PubMed

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

2016-04-18

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

Barriers to and Facilitators of Antiretroviral Therapy Adherence in Nepal: A Qualitative Study

PubMed Central

Simkhada, Padam; Randall, Julian; Freeman, Jennifer V; van Teijlingen, Edwin

2012-01-01

Patient's adherence is crucial to get the best out of antiretroviral therapy (ART). This study explores in-depth the barriers to and facilitators of ART adherence among Nepalese patients and service providers prescribing ART. Face-to-face semi-structured interviews were conducted with 34 participants. Interviews were audio-taped, transcribed, and translated into English before being analyzed thematically. ART-prescribed patients described a range of barriers for failing to adhere to ART. Financial difficulties, access to healthcare services, frequent transport blockades, religious/ritual obstacles, stigma and discrimination, and side-effects were the most-frequently discussed barriers whereas trustworthy health workers, perceived health benefits, and family support were the most-reported facilitators. Understanding barriers and facilitators can help in the design of an appropriate and targeted intervention. Healthcare providers should address some of the practical and cultural issues around ART whilst policy-makers should develop appropriate social policy to promote adherence among ART-prescribed patients. PMID:23304907

Evaluation of spatial accessibility to primary healthcare using GIS

NASA Astrophysics Data System (ADS)

Jamtsho, S.; Corner, R. J.

2014-11-01

Primary health care is considered to be one of the most important aspects of the health care system in any country, which directly helps in improving the health of the population. Potential spatial accessibility is a very important component of the primary health care system. One technique for studying spatial accessibility is by computing a gravity-based measure within a geographic information system (GIS) framework. In this study, straight-line distances between the associated population clusters and the health facilities and the provider-to-population ratio were used to compute the spatial accessibility of the population clusters for the whole country. Bhutan has been chosen as the case study area because it is quite easy to acquire and process data for the whole country due to its small size and population. The spatial accessibility measure of the 203 sub-districts shows noticeable disparities in health care accessibility in this country with about only 19 sub-districts achieving good health accessibility ranking. This study also examines a number of different health accessibility policy scenarios which can assist in identifying the most effective health policy from amongst many probable planning scenarios. Such a health accessibility measuring system can be incorporated into an existing spatial health system in developing countries to facilitate the proper planning and equitable distribution of health resources.

Access and Mobilization: How Social Capital Relates to Low-Income Youth's Postsecondary Educational (PSE) Attainment

ERIC Educational Resources Information Center

Ashtiani, Mariam; Feliciano, Cynthia

2018-01-01

Youth from advantaged backgrounds have more social relationships that provide access to resources facilitating their educational success than those from low-income families. Does access to and mobilization of social capital also relate to success among the few low-income youth who "overcome the odds" and persist in higher education?…

Sexual stigma, criminalization, investment, and access to HIV services among men who have sex with men worldwide.

PubMed

Arreola, Sonya; Santos, Glenn-Milo; Beck, Jack; Sundararaj, Mohan; Wilson, Patrick A; Hebert, Pato; Makofane, Keletso; Do, Tri D; Ayala, George

2015-02-01

Globally, HIV disproportionately affects men who have sex with men (MSM). This study explored associations between access to HIV services and (1) individual-level perceived sexual stigma; (2) country-level criminalization of homosexuality; and (3) country-level investment in HIV services for MSM. 3,340 MSM completed an online survey assessing access to HIV services. MSM from over 115 countries were categorized according to criminalization of homosexuality policy and investment in HIV services targeting MSM. Lower access to condoms, lubricants, and HIV testing were each associated with greater perceived sexual stigma, existence of homosexuality criminalization policies, and less investment in HIV services. Lower access to HIV treatment was associated with greater perceived sexual stigma and criminalization. Criminalization of homosexuality and low investment in HIV services were both associated with greater perceived sexual stigma. Efforts to prevent and treat HIV among MSM should be coupled with structural interventions to reduce stigma, overturn homosexuality criminalization policies, and increase investment in MSM-specific HIV services.

The Sequences of 1504 Mutants in the Model Rice Variety Kitaake Facilitate Rapid Functional Genomic Studies

PubMed Central

Pham, Nikki T.; Wei, Tong; Schackwitz, Wendy S.; Lipzen, Anna M.; Duong, Phat Q.; Jones, Kyle C.; Ruan, Deling; Bauer, Diane; Peng, Yi; Schmutz, Jeremy

2017-01-01

The availability of a whole-genome sequenced mutant population and the cataloging of mutations of each line at a single-nucleotide resolution facilitate functional genomic analysis. To this end, we generated and sequenced a fast-neutron-induced mutant population in the model rice cultivar Kitaake (Oryza sativa ssp japonica), which completes its life cycle in 9 weeks. We sequenced 1504 mutant lines at 45-fold coverage and identified 91,513 mutations affecting 32,307 genes, i.e., 58% of all rice genes. We detected an average of 61 mutations per line. Mutation types include single-base substitutions, deletions, insertions, inversions, translocations, and tandem duplications. We observed a high proportion of loss-of-function mutations. We identified an inversion affecting a single gene as the causative mutation for the short-grain phenotype in one mutant line. This result reveals the usefulness of the resource for efficient, cost-effective identification of genes conferring specific phenotypes. To facilitate public access to this genetic resource, we established an open access database called KitBase that provides access to sequence data and seed stocks. This population complements other available mutant collections and gene-editing technologies. This work demonstrates how inexpensive next-generation sequencing can be applied to generate a high-density catalog of mutations. PMID:28576844

Potential facilitators and barriers to adopting standard treatment guidelines in clinical practice.

PubMed

Sharma, Sangeeta; Pandit, Ajay; Tabassum, Fauzia

2017-04-18

Purpose The purpose of this paper is to assess medicines information sources accessed by clinicians, if sources differed in theory and practice and to find out the barriers and facilitators to effective guideline adoption. Design/methodology/approach In all, 183 doctors were surveyed. Barriers and facilitators were classified as: communication; potential adopters; innovation; organization characteristics and environmental/social/economic context. Findings Most of the clinicians accessed multiple information sources including standard treatment guidelines, but also consulted seniors/colleagues in practice. The top three factors influencing clinical practice guideline adoption were innovation characteristics, environmental context and individual characteristics. The respondents differed in the following areas: concerns about flexibility offered by the guideline; denying patients' individuality; professional autonomy; insights into gaps in current practice and evidence-based practice; changing practices with little or no benefit. Barriers included negative staff attitudes/beliefs, guideline integration into organizational structures/processes, time/resource constraints. Fearing third parties (government and insurance companies) restricting medicines reimbursement and poor liability protection offered by the guidelines emerged as the barriers. Facilitators include aligning organizational structures/processes with the innovation; providing leadership support to guide diffusion; increasing awareness and enabling early innovation during pre/in-service training, with regular feedback on outcomes and use. Practical implications Guideline adoption in clinical practice is partly within doctors' control. There are other key prevailing factors in the local context such as environmental, social context, professional and organizational culture affecting its adoption. Organizational policy and accreditation standards necessitating adherence can serve as a driver. Originality

Limited accessibility to HIV services for persons with disabilities living with HIV in Ghana, Uganda and Zambia.

PubMed

Tun, Waimar; Okal, Jerry; Schenk, Katie; Esantsi, Selina; Mutale, Felix; Kyeremaa, Rita Kusi; Ngirabakunzi, Edson; Asiah, Hilary; McClain-Nhlapo, Charlotte; Moono, Grimond

2016-01-01

Knowledge about experiences in accessing HIV services among persons with disabilities who are living with HIV in sub-Saharan Africa is limited. Although HIV transmission among persons with disabilities in Africa is increasingly acknowledged, there is a need to bring to life the experiences and voices from persons with disabilities living with HIV to raise awareness of programme implementers and policy makers about their barriers in accessing HIV services. This paper explores how the barriers faced by persons with disabilities living with HIV impede their ability to access HIV-related services and manage their disease. We conducted focus group discussions with 76 persons (41 females; 35 males) with physical, visual and/or hearing impairments who were living with HIV in Ghana, Uganda and Zambia (2012-2013). We explored challenges and facilitators at different levels (individual, psychosocial and structural) of access to HIV services. Transcripts were analyzed using a framework analysis approach. Persons with disabilities living with HIV encountered a wide variety of challenges in accessing HIV services. Delays in testing for HIV were common, with most waiting until they were sick to be tested. Reasons for delayed testing included challenges in getting to the health facilities, lack of information about HIV and testing, and HIV- and disability-related stigma. Barriers to HIV-related services, including care and treatment, at health facilities included lack of disability-friendly educational materials and sign interpreters, stigmatizing treatment by providers and other patients, lack of skills to provide tailored services to persons with disabilities living with HIV and physically inaccessible infrastructure, all of which make it extremely difficult for persons with disabilities to initiate and adhere to HIV treatment. Accessibility challenges were greater for women than men due to gender-related roles. Challenges were similar across the three countries. Favourable

Limited accessibility to HIV services for persons with disabilities living with HIV in Ghana, Uganda and Zambia

PubMed Central

Tun, Waimar; Okal, Jerry; Schenk, Katie; Esantsi, Selina; Mutale, Felix; Kyeremaa, Rita Kusi; Ngirabakunzi, Edson; Asiah, Hilary; McClain-Nhlapo, Charlotte; Moono, Grimond

2016-01-01

Introduction Knowledge about experiences in accessing HIV services among persons with disabilities who are living with HIV in sub-Saharan Africa is limited. Although HIV transmission among persons with disabilities in Africa is increasingly acknowledged, there is a need to bring to life the experiences and voices from persons with disabilities living with HIV to raise awareness of programme implementers and policy makers about their barriers in accessing HIV services. This paper explores how the barriers faced by persons with disabilities living with HIV impede their ability to access HIV-related services and manage their disease. Methods We conducted focus group discussions with 76 persons (41 females; 35 males) with physical, visual and/or hearing impairments who were living with HIV in Ghana, Uganda and Zambia (2012–2013). We explored challenges and facilitators at different levels (individual, psychosocial and structural) of access to HIV services. Transcripts were analyzed using a framework analysis approach. Results Persons with disabilities living with HIV encountered a wide variety of challenges in accessing HIV services. Delays in testing for HIV were common, with most waiting until they were sick to be tested. Reasons for delayed testing included challenges in getting to the health facilities, lack of information about HIV and testing, and HIV- and disability-related stigma. Barriers to HIV-related services, including care and treatment, at health facilities included lack of disability-friendly educational materials and sign interpreters, stigmatizing treatment by providers and other patients, lack of skills to provide tailored services to persons with disabilities living with HIV and physically inaccessible infrastructure, all of which make it extremely difficult for persons with disabilities to initiate and adhere to HIV treatment. Accessibility challenges were greater for women than men due to gender-related roles. Challenges were similar across the

Barriers and facilitators to effective coverage of Intimate Partner Violence services for immigrant women in Spain.

PubMed

Briones-Vozmediano, Erica; La Parra, Daniel; Vives-Cases, Carmen

2015-12-01

To explore service providers' perceptions in order to identify barriers and facilitators to effective coverage of Intimate Partner Violence (IPV) services for immigrant women in Spain, according to the different categories proposed in Tanahashi's model of effective coverage. A qualitative study based on 29 in-depth personal interviews and four group interviews with a total of 43 professionals working in public services (social and health-care services, women's refuges, the police force, the judiciary) and NGOs in Barcelona, Madrid, Valencia and Alicante (Spain) in 2011. Current IPV services in Spain partially fail in their coverage of abused immigrant women due to barriers of (i) availability, such as the inexistence of culturally appropriate services; (ii) accessibility, as having a residence permit is a prerequisite for women's access to different services and rights; (iii) acceptability, such as women's lack of confidence in the effectiveness of services; and (iv) effectiveness, for example, lack of specific training among professionals on the issues of IPV and immigration. However, interviewees also identified facilitators, such as the enabling environment promoted by the Spanish Law on Gender-Based Violence (1/2004), and the impetus it has provided for the development of other specific legislative tools to address IPV in immigrant populations in Spain (availability, accessibility and effectiveness). Whilst not dismissing cultural barriers, aspects related to service structure are identified by providers as the main barriers and facilitators to immigrant women use of IPV services. Despite noteworthy achievements, improvements are still required in terms of mainstreaming assistance tailored to immigrant women's needs in IPV policies and services. © 2014 John Wiley & Sons Ltd.

Barriers to and Facilitators of Research Utilization among Iranian Nurses: a Literature Review

PubMed Central

Heydari, Abbas; Emami Zeydi, Amir

2014-01-01

Introduction: Research utilization (RU), is an important strategy to promote the quality of patient care. The aim of this study was to present a comprehensive literature review describing barriers and facilitators of RU among Iranian nurses. Methods: Literature review was undertaken using the international databases including Pub Med/Medline, Scopus, Science Direct, and Google Scholar. Also, Persian electronic databases such as Magiran, SID and Iran Medex were searched up to May 2014. The search was limited to articles in the English and Persian languages that evaluate the barriers or facilitators of RU among Iranian nurses. Results: A total of 11 articles were in the final dataset. The most important barriers to RU among Iranian nurses were related to the organization factors such as inadequate facilities; insufficient time on the job, lack of authority, physician cooperation, and administrative support. The most frequent facilitators of RU were education in enhancing nurses knowledge and skills in research evaluation, support from knowledgeable nursing colleagues and nursing faculty in the clinical setting, access to an expert committee for clinical appraisal, improving skills in English language and searching for articles, sufficient economic resources to carry out research, and having access to more facilities such as internet. Conclusion: Iranian nurses encounter with the same difficulties as to other countries regarding RU; while setting related barriers were the predominant obstacles to RU among them. Therefore, health managers are expected to plan appropriate strategies to smooth the progress of RU by nurses in their practice. PMID:25717456

Nonprofits Partnering with Postsecondary Institutions to Increase Low-Income Student Access

ERIC Educational Resources Information Center

Kezar, Adrianna; Lester, Jaime; Yang, Hannah

2010-01-01

This article reports on a three year case study and interview project of a federal initiative to help low income students access college called individual development accounts (IDA). The study focused on partnership development between community agencies that offer IDAs and postsecondary institutions, examining challenges and facilitators. A set…

Facilitating Scientific Collaboration and Education with Easy Access Web Maps Using the AGAP Antarctic Geophysical Data

NASA Astrophysics Data System (ADS)

Abdi, A.

2012-12-01

Science and science education benefit from easy access to data yet often geophysical data sets are large, complex and difficult to share. The difficulty in sharing data and imagery easily inhibits both collaboration and the use of real data in educational applications. The dissemination of data products through web maps serves a very efficient and user-friendly method for students, the public and the science community to gain insights and understanding from data. Few research groups provide direct access to their data, let alone map-based visualizations. By building upon current GIS infrastructure with web mapping technologies, like ArcGIS Server, scientific groups, institutions and agencies can enhance the value of their GIS investments. The advantages of web maps to serve data products are many; existing web-mapping technology allows complex GIS analysis to be shared across the Internet, and can be easily scaled from a few users to millions. This poster highlights the features of an interactive web map developed at the Polar Geophysics Group at the Lamont-Doherty Earth Observatory of Columbia University that provides a visual representation of, and access to, data products that resulted from the group's recently concluded AGAP project (http://pgg.ldeo.columbia.edu). The AGAP project collected more than 120,000 line km of new aerogeophysical data using two Twin Otter aircrafts. Data included ice penetrating radar, magnetometer, gravimeter and laser altimeter measurements. The web map is based upon ArcGIS Viewer for Flex, which is a configurable client application built on the ArcGIS API for Flex that works seamlessly with ArcGIS Server 10. The application can serve a variety of raster and vector file formats through the Data Interoperability for Server, which eliminates data sharing barriers across numerous file formats. The ability of the application to serve large datasets is only hindered by the availability of appropriate hardware. ArcGIS is a proprietary

Unrestricted access to methamphetamine or cocaine in the past is associated with increased current use

PubMed Central

Culbertson, C.; De La Garza, R.; Costello, M.; Newton, T. F.

2009-01-01

Laboratory animals allowed to self-administer stimulants for extended periods of time escalate drug intake compared to animals that self-administer under temporally limited conditions. To our knowledge, this phenomenon has not been systematically investigated in humans. We interviewed 106 (77 male, 29 female) methamphetamine (Meth) and 96 (81 male, 15 female) cocaine (Coc) users to determine if they had experienced discrete period(s) of unrestricted access to unlimited quantities of Meth or Coc in the past. Fifty-eight Meth users and 53 Coc users reported having a discrete period of unrestricted access in the past, but not in the present. Meth-using participants with a prior history of unrestricted access reported significantly more current Meth use, compared to Meth users with no prior history of unrestricted access. Specifically, these participants reported more days used in the past 30 d, more days of use per week, greater use per day and greater total use per week (p<0.05 for each). Coc-using participants with a prior history of unrestricted access also reported significantly more current Coc use, compared to Coc users with no prior history of unrestricted access. This was true across all measures of current use for these participants, including more days used in the past 30 d, more days of use per week, greater use per day, and higher total use per week (p<0.02 for each). Taken together, these results suggest that a history of unrestricted access to stimulants is associated with long-lasting increases in stimulant use. PMID:19220922

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

PubMed

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

2016-02-01

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

Typology of person-environment fit constellations: a platform addressing accessibility problems in the built environment for people with functional limitations.

PubMed

Slaug, Björn; Schilling, Oliver; Iwarsson, Susanne; Carlsson, Gunilla

2015-09-02

Making the built environment accessible for all regardless of functional capacity is an important goal for public health efforts. Considerable impediments to achieving this goal suggest the need for valid measurements of acccessibility and for greater attention to the complexity of person-environment fit issues. To address these needs, this study aimed to provide a methodological platform, useful for further research and instrument development within accessibility research. This was accomplished by the construction of a typology of problematic person-environment fit constellations, utilizing an existing methodology developed to assess and analyze accessibility problems in the built environment. By means of qualitative review and statistical methods we classified the person-environment fit components covered by an existing application which targets housing accessibility: the Housing Enabler (HE) instrument. The International Classification of Functioning, Disability and Health (ICF) was used as a conceptual framework. Qualitative classification principles were based on conceptual similarities and for quantitative analysis of similarities, Principal Component Analysis was carried out. We present a typology of problematic person-environment fit constellations classified along three dimensions: 1) accessibility problem range and severity 2) aspects of functioning 3) environmental context. As a result of the classification of the HE components, 48 typical person-environment fit constellations were recognised. The main contribution of this study is the proposed typology of person-environment fit constellations. The typology provides a methodological platform for the identification and quantification of problematic person-environment fit constellations. Its link to the globally accepted ICF classification system facilitates communication within the scientific and health care practice communities. The typology also highlights how relations between aspects of functioning

Clean subglacial access: prospects for future deep hot-water drilling

PubMed Central

Pearce, David; Hodgson, Dominic A.; Smith, Andrew M.; Rose, Mike; Ross, Neil; Mowlem, Matt; Parnell, John

2016-01-01

Accessing and sampling subglacial environments deep beneath the Antarctic Ice Sheet presents several challenges to existing drilling technologies. With over half of the ice sheet believed to be resting on a wet bed, drilling down to this environment must conform to international agreements on environmental stewardship and protection, making clean hot-water drilling the most viable option. Such a drill, and its water recovery system, must be capable of accessing significantly greater ice depths than previous hot-water drills, and remain fully operational after connecting with the basal hydrological system. The Subglacial Lake Ellsworth (SLE) project developed a comprehensive plan for deep (greater than 3000 m) subglacial lake research, involving the design and development of a clean deep-ice hot-water drill. However, during fieldwork in December 2012 drilling was halted after a succession of equipment issues culminated in a failure to link with a subsurface cavity and abandonment of the access holes. The lessons learned from this experience are presented here. Combining knowledge gained from these lessons with experience from other hot-water drilling programmes, and recent field testing, we describe the most viable technical options and operational procedures for future clean entry into SLE and other deep subglacial access targets. PMID:26667913

The Role of Health Systems Factors in Facilitating Access to Psychotropic Medicines: A Cross-Sectional Analysis of the WHO-AIMS in 63 Low- and Middle-Income Countries

PubMed Central

McBain, Ryan; Norton, Daniel J.; Morris, Jodi; Yasamy, M. Taghi; Betancourt, Theresa S.

2012-01-01

Background Neuropsychiatric conditions comprise 14% of the global burden of disease and 30% of all noncommunicable disease. Despite the existence of cost-effective interventions, including administration of psychotropic medicines, the number of persons who remain untreated is as high as 85% in low- and middle-income countries (LAMICs). While access to psychotropic medicines varies substantially across countries, no studies to date have empirically investigated potential health systems factors underlying this issue. Methods and Findings This study uses a cross-sectional sample of 63 LAMICs and country regions to identify key health systems components associated with access to psychotropic medicines. Data from countries that completed the World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS) were included in multiple regression analyses to investigate the role of five major mental health systems domains in shaping medicine availability and affordability. These domains are: mental health legislation, human rights implementations, mental health care financing, human resources, and the role of advocacy groups. Availability of psychotropic medicines was associated with features of all five mental health systems domains. Most notably, within the domain of mental health legislation, a comprehensive national mental health plan was associated with 15% greater availability; and in terms of advocacy groups, the participation of family-based organizations in the development of mental health legislation was associated with 17% greater availability. Only three measures were related with affordability of medicines to consumers: level of human resources, percentage of countries' health budget dedicated to mental health, and availability of mental health care in prisons. Controlling for country development, as measured by the Human Development Index, health systems features were associated with medicine availability but not affordability. Conclusions

Perceived Access and Parental Monitoring as Moderators of Impulsivity and Marijuana Use Among Adolescents.

PubMed

Haas, Amie L; Zamboanga, Byron L; Bersamin, Melina; Hyke, Travis

2018-04-01

The social and political climate regarding marijuana use has been changing in the US over the past decade. Research suggests that many adolescents report relatively easy access to marijuana and perceptions that recreational use involves minimal harm despite a growing body of research implicating the deleterious effects of use on cognitive and psychological development. Not surprisingly, prevalence rates have been rising in recent years, making it important to identify risk and protective factors associated with adolescent marijuana use. We tested a 3-way interaction model designed to (a) examine the relationship between behavioral impulsivity and marijuana use in adolescents, and (b) evaluate the roles of perceived access and parental monitoring as moderators of this relationship. High school students (N = 498, M age  = 15.7, 53% female, 77% White) completed an anonymous self-report assessment examining substance use, perceived access, and psychosocial factors related to substance use (i.e., behavioral impulsivity and parental monitoring). Results indicated that higher levels of impulsivity, greater access, and reduced parental monitoring were related to marijuana use. Significant moderating effects were found for perceived access and parental monitoring, such that use was greater for adolescents who perceived that marijuana was easier to acquire and for those with lower levels of parental monitoring. Among individuals with greater levels of impulsivity, parental monitoring reduced the impact of perceived access. Overall, results highlight risk and protective factors related to adolescent marijuana use and indicate that parental monitoring can be an effective means for reducing consumption.

Improving access to specialists in remote communities: a cross-sectional study and cost analysis of the use of eConsult in Nunavut.

PubMed

Liddy, Clare; McKellips, Fanny; Armstrong, Catherine Deri; Afkham, Amir; Fraser-Roberts, Leigh; Keely, Erin

2017-01-01

Residents of remote communities face inequities in access to specialists, excessive wait times, and poorly coordinated care. The Champlain BASE TM (Building Access to Specialists through eConsultation) service facilitates asynchronous communication between primary care providers (PCP) and specialists. The service was extended to several PCPs in Nunavut in 2014. To (1) describe the use of eConsult services in Nunavut, and (2) conduct a costing evaluation. A cross-sectional study and cost analysis of all eConsult cases submitted between August 2014 and April 2016. PCPs from Nunavut submitted 165 eConsult cases. The most popular specialties were dermatology (16%), cardiology (8%), endocrinology (7%), otolaryngology (7%), and obstetrics/gynaecology (7%). Specialists provided a response in a median of 0.9 days (IQR=0.3-3.0, range=0.01-15.02). In 35% of cases, PCPs were able to avoid the face-to-face specialist visits they had originally planned for their patients. Total savings associated with eConsult in Nunavut are estimated at $180,552.73 or $1,100.93 per eConsult. The eConsult service provided patients in Nunavut's remote communities with prompt access to specialist advice. The service's chief advantage in Canada's northern communities is its ability to offer electronic access to a breadth of specialties far greater than could be supported locally. Our findings suggest that a territory-wide adoption of eConsult would generate enormous savings.

Barriers and facilitators to HIV and sexually transmitted infections testing for gay, bisexual, and other transgender men who have sex with men.

PubMed

Scheim, Ayden I; Travers, Robb

2017-08-01

Transgender men who have sex with men (trans MSM) may be at elevated risk for HIV and other sexually transmitted infections (STI), and therefore require access to HIV and STI testing services. However, trans people often face stigma, discrimination, and gaps in provider competence when attempting to access health care and may therefore postpone, avoid, or be refused care. In this context, quantitative data have indicated low access to, and uptake of, HIV testing among trans MSM. The present manuscript aimed to identify trans MSM's perspectives on barriers and facilitators to HIV and STI testing. As part of a community-based research project investigating HIV risk and resilience among trans MSM, 40 trans MSM aged 18 and above and living in Ontario, Canada participated in one-on-one qualitative interviews in 2013. Participants described a number of barriers to HIV and other STI testing. These included both trans-specific and general difficulties in accessing sexual health services, lack of trans health knowledge among testing providers, limited clinical capacity to meet STI testing needs, and a perceived gap between trans-inclusive policies and their implementation in practice. Two major facilitators were identified: access to trusted and flexible testing providers, and integration of testing with ongoing monitoring for hormone therapy. Based on these findings, we provide recommendations for enhancing access to HIV and STI testing for this key population.

Long-term venous access using a subcutaneous implantable drug delivery system.

PubMed Central

Soo, K. C.; Davidson, T. I.; Selby, P.; Westbury, G.

1985-01-01

To facilitate long-term venous access in patients receiving chemotherapy, a subcutaneous totally implantable system (Port-a-Cath, Phamacia) has been used in 14 patients. The method of implantation and the advantages over conventional central venous catheters are discussed. The expense of the system necessitates careful patient selection. PMID:4037644

Perspectives of Latina and Non-Latina White Women on Barriers and Facilitators to Exercise in Pregnancy

PubMed Central

Marquez, David X.; Bustamante, Eduardo E.; Bock, Beth C.; Markenson, Glenn; Tovar, Alison; Chasan-Taber, Lisa

2009-01-01

Exercise during pregnancy has been associated with reduced risk of gestational diabetes mellitus (GDM);, however, twice as many women are sedentary during pregnancy as compared to when they are not pregnant. We conducted 3 focus groups among 20 pregnant Latina and non-Latina white women to identify barriers and facilitators to exercise in pregnancy to inform a GDM intervention study. Quantitative analyses of demographic data, and qualitative analyses of focus groups were conducted. Women identified physical limitations and restrictions, lack of resources, energy, and time as powerful exercise barriers. Social support, access to resources, information, proper diet, scheduling and the weather were identified as powerful facilitators. Intervention programs designed for pregnant women should facilitate social support, provide information and resources, as well as promote short-term and long-term benefits. PMID:20013518

Access to environmental resources and physical activity levels of adults in Hawaii.

PubMed

Geller, Karly S; Nigg, Claudio R; Ollberding, Nicholas J; Motl, Robert W; Horwath, Caroline; Dishman, Rodney K

2015-03-01

Examine associations between physical activity (PA) and spatial accessibility to environmental PA resources in Hawaii. Metabolic equivalents (METs) of mild, moderate, and strenuous PA were compared for accessibility with environmental PA resources within a population-based sample of Hawaiian adults (n = 381). Multiple linear regression estimated differences in PA levels for residing further from a PA resource or residing in an area with a greater number of resources. No associations were found in the total sample. Analyses within subsamples stratified by ethnicity revealed that greater spatial accessibility to a PA resource was positively associated with strenuous PA among Caucasians (P = .04) but negatively associated with moderate PA among Native Hawaiians (P = .00). The lack of association in the total sample may be a consequence of Hawaii's unique environment. Results of stratified sample analyses are unique, providing groundwork for future examinations within parallel environments and among similar ethnic groups. © 2012 APJPH.

Students Pave the Way for Greater Accessibility

ERIC Educational Resources Information Center

Hollingsworth, Jan Carter

2007-01-01

This article reports how the engineering students at the University of South Florida (USP) presented their latest inventions last April 17 and 19. As part of a senior level class in the rehabilitation engineering and technology program, these students were challenged to design assistive devices that will aid those with disabilities to better…

Enhancing access to health information in Africa: a librarian's perspective.

PubMed

Gathoni, Nasra

2012-01-01

In recent years, tremendous progress has been made toward providing health information in Africa, in part because of technological advancements. Nevertheless, ensuring that information is accessible, comprehensible, and usable remains problematic, and there remain needs in many settings to address issues such as computer skills, literacy, and the infrastructure to access information. To determine how librarians might play a more strategic role in meeting information needs of health professionals in Africa, the author reviewed key components of information systems pertinent to knowledge management for the health sector, including access to global online resources, capacity to use computer technology for information retrieval, information literacy, and the potential for professional networks to play a role in improving access to and use of information. The author concluded that, in regions that lack adequate information systems, librarians could apply their knowledge and skills to facilitate access and use by information seekers. Ensuring access to and use of health information can also be achieved by engaging organizations and associations working to enhance access to health information, such as the Association for Health Information and Libraries in Africa. These groups can provide assistance through training, dissemination, information repackaging, and other approaches known to improve information literacy.

Facilitating access to surgical care through a decentralised case-finding strategy: experience in Madagascar

PubMed Central

Hamer, Mirjam; Biddell, Jasmin; Claus, Nathan; Randall, Kirsten; Alcorn, Dennis; Parker, Gary; Shrime, Mark G

2017-01-01

Over two-thirds of the world’s population lack access to surgical care. Non-governmental organisation’s providing free surgeries may overcome financial barriers, but other barriers to care still exist. This analysis paper discusses two different case-finding strategies in Madagascar that aimed to increase the proportion of poor patients, women and those for whom multiple barriers to care exist. From October 2014 to June 2015, we used a centralised selection strategy, aiming to find 70% of patients from the port city, Toamasina, and 30% from the national capital and two remote cities. From August 2015 to June 2016, a decentralised strategy was used, aiming to find 30% of patients from Toamasina and 70% from 11 remote locations, including the capital. Demographic information and self-reported barriers to care were collected. Wealth quintile was calculated for each patient using a combination of participant responses to asset-related and demographic questions, and publicly available data. A total of 2971 patients were assessed. The change from centralised to decentralised selection resulted in significantly poorer patients undergoing surgery. All reported barriers to prior care, except for lack of transportation, were significantly more likely to be identified in the decentralised group. Patients who identified multiple barriers to prior surgical care were less likely to be from the richest quintile (p=0.037) and more likely to be in the decentralised group (p=0.046). Our country-specific analysis shows that decentralised patient selection strategies may be used to overcome barriers to care and allow patients in greatest need to access surgical care. PMID:29071129

High mobility, low access thwarts interventions among seasonal workers in the Greater Mekong Sub-region: lessons from the malaria containment project.

PubMed

Canavati, Sara E; Quintero, Cesia E; Lawford, Harriet L S; Yok, Sovann; Lek, Dysoley; Richards, Jack S; Whittaker, Maxine Anne

2016-08-26

During the process of malaria elimination in the Greater Mekong Sub-region, mobile and migrant populations (MMPs) have been identified as the most at-risk demographic. An important sub-group of MMPs are seasonal workers, and this paper presents an evaluation of the reach and effectiveness of interventions tailored towards this group and was carried out as part of the Containment Project from 2009-11. A mixed-methods study was conducted in Pailin Province in Western Cambodia. Three-hundred-and-four seasonal workers were surveyed using a structured questionnaire. Qualitative data were gathered through a total of eight focus group discussions and 14 in-depth interviews. Data triangulation of the qualitative and quantitative data was used during analysis. High mobility and low access of the target population to the interventions, as well as lack of social and anthropological research that led to implementation oversights, resulted in under-exposure of seasonal workers to interventions. Consequently, their reach and impact were severely limited. Some services, particularly Mobile Malaria Workers, had the ability to significantly impact key factors, such as risky behaviours among those they did reach. Others, like Listening and Viewing Clubs and mass media campaigns, showed little impact. There is potential in two of the interventions assessed, but high mobility and inadequate exposure of seasonal workers to these interventions must be considered in the development and planning of future interventions to avoid investing in low-impact activities and ensure that all interventions perform according to their maximum potential. This will be critical in order for Cambodia to achieve its aim of malaria elimination. The lessons learned from this study can be extrapolated to other areas of health care in Cambodia and other countries in order to reduce the gap between healthcare provided to MMPs, especially seasonal workers, and to the general population.

Stabilization of memory States by stochastic facilitating synapses.

PubMed

Miller, Paul

2013-12-06

Bistability within a small neural circuit can arise through an appropriate strength of excitatory recurrent feedback. The stability of a state of neural activity, measured by the mean dwelling time before a noise-induced transition to another state, depends on the neural firing-rate curves, the net strength of excitatory feedback, the statistics of spike times, and increases exponentially with the number of equivalent neurons in the circuit. Here, we show that such stability is greatly enhanced by synaptic facilitation and reduced by synaptic depression. We take into account the alteration in times of synaptic vesicle release, by calculating distributions of inter-release intervals of a synapse, which differ from the distribution of its incoming interspike intervals when the synapse is dynamic. In particular, release intervals produced by a Poisson spike train have a coefficient of variation greater than one when synapses are probabilistic and facilitating, whereas the coefficient of variation is less than one when synapses are depressing. However, in spite of the increased variability in postsynaptic input produced by facilitating synapses, their dominant effect is reduced synaptic efficacy at low input rates compared to high rates, which increases the curvature of neural input-output functions, leading to wider regions of bistability in parameter space and enhanced lifetimes of memory states. Our results are based on analytic methods with approximate formulae and bolstered by simulations of both Poisson processes and of circuits of noisy spiking model neurons.

A Bibliometric Study of Scholarly Articles Published by Library and Information Science Authors about Open Access

ERIC Educational Resources Information Center

Grandbois, Jennifer; Beheshti, Jamshid

2014-01-01

Introduction: This study aims to gain a greater understanding of the development of open access practices amongst library and information science authors, since their role is integral to the success of the broader open access movement. Method: Data were collected from scholarly articles about open access by library and information science authors…

Describing Online Learning Content to Facilitate Resource Discovery and Sharing: The Development of the RU LOM Core

ERIC Educational Resources Information Center

Krull, G. E.; Mallinson, B. J.; Sewry, D. A.

2006-01-01

The development of Internet technologies has the ability to provide a new era of easily accessible and personalised learning, facilitated through the flexible deployment of small, reusable pieces of digital learning content over networks. Higher education institutions can share and reuse digital learning resources in order to improve their…

Freedom of Information in a Parliamentary Government: Canada's New Access to Information Legislation.

ERIC Educational Resources Information Center

Einsiedel, Edna F.

Despite a tradition of government secrecy, Canada recently adopted freedom of information legislation. Reflecting greater public and media interest in the issue of public access to information and government secrecy, Bill C-34, the Access to Information Act, received royal assent in 1982, as did a privacy act, enacted to protect the complementary…

Direct access and patient/client self-referral to physiotherapy: a review of contemporary practice within the European Union.

PubMed

Bury, T J; Stokes, E K

2013-12-01

Direct access refers to service users being able to refer themselves to physiotherapy without a third-party referral. It represents a model of practice supported globally by the profession, growing research evidence and health policy in some health systems. To the authors' knowledge, no research has been reported to ascertain the extent to which direct access is available within the physiotherapy profession within the European Union (EU). To survey member organisations of the World Confederation for Physical Therapy (WCPT); establish the number of member states within the EU where it is possible for individuals seeking physiotherapy services to self-refer; describe the legislative/regulatory and reimbursement contexts in which physiotherapy services are delivered; examine if physiotherapy practice is different in member states where direct access is permitted compared with member states where direct access is not permitted; and to describe the barriers and facilitators to direct access perceived by member organisations of the WCPT. Cross-sectional, online survey using a purposive sample. Member organisations of the WCPT in the EU. Direct access is not available in all member states of the EU, despite the majority having legislation to regulate the profession, and entry-level education programmes that produce graduates with the requisite competencies. Key barriers perceived are those that can influence policy development, including the views of the medical profession and politicians. Support of service users and politicians, as well as professional autonomy, are seen as key facilitators. These results represent the first report of a comprehensive mapping of direct access to physiotherapy and contexts within the EU. In over half of member states, service users can self-refer to physiotherapists. These results provide insights to further individuals' understanding about the similarities and differences in working practices and service delivery factors, such as

A Decentralized IT Architecture for Locating and Negotiating Access to Biobank Samples.

PubMed

Proynova, Rumyana; Alexandre, Diogo; Lablans, Martin; Van Enckevort, David; Mate, Sebastian; Eklund, Niina; Silander, Kaisa; Hummel, Michael; Holub, Petr; Ückert, Frank

2017-01-01

There is a need among researchers for the easy discoverability of biobank samples. Currently, there is no uniform way for finding samples and negotiate access. Instead, researchers have to communicate with each biobank separately. We present the architecture for the BBMRI-CS IT platform, whose goal is to facilitate sample location and access. We chose a decentral approach, which allows for strong data protection and provides the high flexibility needed in the highly heterogeneous landscape of European biobanks. This is the first implementation of a decentral search in the biobank field. With the addition of a Negotiator component, it also allows for easy communication and a follow-through of the lengthy approval process for accessing samples.

NSF Anticipates Pushing Boundaries on Open-Access Plan

ERIC Educational Resources Information Center

Basken, Paul

2013-01-01

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

Barriers and facilitators to being physically active on a rural U.S. Northern Plains American Indian reservation.

PubMed

Jahns, Lisa; McDonald, Leander R; Wadsworth, Ann; Morin, Charles; Liu, Yan

2014-11-21

The objective of the present study was to identify barriers to and facilitators of physical activity among American Indian adults living on a rural, U.S. Northern Plains reservation using the nominal group technique (NGT). NGT is a method of data generation and interpretation that combines aspects of qualitative (free generation of responses) and quantitative (systematic ranking of responses) methodologies. Adults participated in one of two NGT sessions asking about either barriers to (n = 6), or facilitators of (n = 5), being physically active. Participants nominated and ranked 21 barriers and 18 facilitators. Barriers indicated lack of knowledge of how to fit physical activity into a daily schedule, work, caring for family members, and prioritizing sedentary pursuits. Other responses included environmental barriers such as lack of access and transportation to a gym, unsafe walking conditions, and inclement weather. Facilitators to following recommendations included knowledge of health benefits of physical activity and the perception of physical activity as enjoyable, including feeling good when working out. Environmental facilitators included being outdoors walking and biking as well as parks and exercise facilities. Responses provided direction for locally designed community-based programs to promote facilitators and decrease barriers to individual's engagement in physical activity.

A model for optimizing file access patterns using spatio-temporal parallelism

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

Boonthanome, Nouanesengsy; Patchett, John; Geveci, Berk

2013-01-01

For many years now, I/O read time has been recognized as the primary bottleneck for parallel visualization and analysis of large-scale data. In this paper, we introduce a model that can estimate the read time for a file stored in a parallel filesystem when given the file access pattern. Read times ultimately depend on how the file is stored and the access pattern used to read the file. The file access pattern will be dictated by the type of parallel decomposition used. We employ spatio-temporal parallelism, which combines both spatial and temporal parallelism, to provide greater flexibility to possible filemore » access patterns. Using our model, we were able to configure the spatio-temporal parallelism to design optimized read access patterns that resulted in a speedup factor of approximately 400 over traditional file access patterns.« less

Virtual and live social facilitation while exergaming: competitiveness moderates exercise intensity.

PubMed

Snyder, Amanda L; Anderson-Hanley, Cay; Arciero, Paul J

2012-04-01

Grounded in social facilitation theory, this study compared the impact on exercise intensity of a virtual versus a live competitor, when riding a virtual reality-enhanced stationary bike ("cybercycle"). It was hypothesized that competitiveness would moderate effects. Twenty-three female college students were exposed to three conditions on a cybercycle: solo training, virtual competitor, and live competitor. After training without a competitor (solo condition for familiarization with equipment), participants competed against a virtual avatar or live rider (random order of presentation). A repeated-measures analysis revealed a significant condition (virtual/live) by competitiveness (high/low) interaction for exercise intensity (watts). More competitive participants exhibited significantly greater exercise intensity when competing against a live versus virtual competitor. The implication is that live competitors can have an added social facilitation effect and influence exercise intensity, although competitiveness moderates this effect.

A survey of exercise professionals' barriers and facilitators to working with stroke survivors.

PubMed

Condon, Marie; Guidon, Marie

2018-03-01

Stroke survivors (SSs) are largely inactive despite the benefits of exercise. Exercise professionals (EPs), skilled in exercise prescription and motivation, may have a role in promoting exercise among SSs. However, the number of EPs working with SSs is estimated to be low. This study aimed to investigate EPs' opinions on working with SSs by rating their agreement of barriers and facilitators to working with SSs. The study also investigated EPs skills, interest and experience working with SSs and the relationship between EPs' barriers and facilitators with their training on stroke. A descriptive cross-sectional study was conducted using a researcher-designed online survey between October and December 2015. Purposive sampling was used to survey EPs on the Register of Exercise Professionals in Ireland (n = 277). The response rate was 31% (87/277). Only 22% (19/86) of EPs had experience working with SSs. The primary barriers rated by EPs included insufficient training on psychological problems post-stroke (84%; 61/73), unsuitable equipment for SSs (69%; 50/73) and the level of supervision SSs require (56%; 41/73). The primary facilitators rated included access to suitable equipment (97%; 69/71), practical (100%; 71/71) and theoretical training (93%; 66/71) on stroke. Respondents with no training on stroke were significantly more likely to agree that insufficient training on psychological problems post-stroke and lack of experience were barriers. Seventy-six per cent of EPs (58/76) were interested in one-to-one exercise sessions with SSs but only 53% (40/76) were interested in group sessions. Eighty-two per cent of EPs (62/76) rated their motivational skills as good or very good but 42% (32/76) indicated having only acceptable skills dealing with psychological problems. Results indicate that EPs are interested in working with SSs despite limited experience and practical barriers. Training opportunities on stroke need to be developed; taking into account EPs' barriers

Barriers and facilitators to provide quality TIA care in the Veterans Healthcare Administration

PubMed Central

Miech, Edward J.; Sico, Jason J.; Phipps, Michael S.; Arling, Greg; Ferguson, Jared; Austin, Charles; Myers, Laura; Baye, Fitsum; Luckhurst, Cherie; Keating, Ava B.; Moran, Eileen; Bravata, Dawn M.

2017-01-01

Objective: To identify key barriers and facilitators to the delivery of guideline-based care of patients with TIA in the national Veterans Health Administration (VHA). Methods: We conducted a cross-sectional, observational study of 70 audiotaped interviews of multidisciplinary clinical staff involved in TIA care at 14 VHA hospitals. We de-identified and analyzed all transcribed interviews. We identified emergent themes and patterns of barriers to providing TIA care and of facilitators applied to overcome these barriers. Results: Identified barriers to providing timely acute and follow-up TIA care included difficulties accessing brain imaging, a constantly rotating pool of housestaff, lack of care coordination, resource constraints, and inadequate staff education. Key informants revealed that both stroke nurse coordinators and system-level factors facilitated the provision of TIA care. Few facilities had specific TIA protocols. However, stroke nurse coordinators often expanded upon their role to include TIA. They facilitated TIA care by (1) coordinating patient care across services, communicating across service lines, and educating clinical staff about facility policies and evidence-based practices; (2) tracking individual patients from emergency departments to inpatient settings and to discharge for timely follow-up care; (3) providing and referring TIA patients to risk factor management programs; and (4) performing regular audit and feedback of quality performance data. System-level facilitators included clinical service leadership engagement and use of electronic tools for continuous care across services. Conclusions: The local organization within a health care facility may be targeted to cultivate internal facilitators and a systemic infrastructure to provide evidence-based TIA care. PMID:29117959

Chromatin Dynamics in Genome Stability: Roles in Suppressing Endogenous DNA Damage and Facilitating DNA Repair

PubMed Central

Nair, Nidhi; Shoaib, Muhammad

2017-01-01

Genomic DNA is compacted into chromatin through packaging with histone and non-histone proteins. Importantly, DNA accessibility is dynamically regulated to ensure genome stability. This is exemplified in the response to DNA damage where chromatin relaxation near genomic lesions serves to promote access of relevant enzymes to specific DNA regions for signaling and repair. Furthermore, recent data highlight genome maintenance roles of chromatin through the regulation of endogenous DNA-templated processes including transcription and replication. Here, we review research that shows the importance of chromatin structure regulation in maintaining genome integrity by multiple mechanisms including facilitating DNA repair and directly suppressing endogenous DNA damage. PMID:28698521

libChEBI: an API for accessing the ChEBI database.

PubMed

Swainston, Neil; Hastings, Janna; Dekker, Adriano; Muthukrishnan, Venkatesh; May, John; Steinbeck, Christoph; Mendes, Pedro

2016-01-01

ChEBI is a database and ontology of chemical entities of biological interest. It is widely used as a source of identifiers to facilitate unambiguous reference to chemical entities within biological models, databases, ontologies and literature. ChEBI contains a wealth of chemical data, covering over 46,500 distinct chemical entities, and related data such as chemical formula, charge, molecular mass, structure, synonyms and links to external databases. Furthermore, ChEBI is an ontology, and thus provides meaningful links between chemical entities. Unlike many other resources, ChEBI is fully human-curated, providing a reliable, non-redundant collection of chemical entities and related data. While ChEBI is supported by a web service for programmatic access and a number of download files, it does not have an API library to facilitate the use of ChEBI and its data in cheminformatics software. To provide this missing functionality, libChEBI, a comprehensive API library for accessing ChEBI data, is introduced. libChEBI is available in Java, Python and MATLAB versions from http://github.com/libChEBI, and provides full programmatic access to all data held within the ChEBI database through a simple and documented API. libChEBI is reliant upon the (automated) download and regular update of flat files that are held locally. As such, libChEBI can be embedded in both on- and off-line software applications. libChEBI allows better support of ChEBI and its data in the development of new cheminformatics software. Covering three key programming languages, it allows for the entirety of the ChEBI database to be accessed easily and quickly through a simple API. All code is open access and freely available.

Environmental factors associated with primary care access among urban older adults.

PubMed

Ryvicker, Miriam; Gallo, William T; Fahs, Marianne C

2012-09-01

Disparities in primary care access and quality impede optimal chronic illness prevention and management for older adults. Although research has shown associations between neighborhood attributes and health, little is known about how these factors - in particular, the primary care infrastructure - inform older adults' primary care use. Using geographic data on primary care physician supply and surveys from 1260 senior center attendees in New York City, we examined factors that facilitate and hinder primary care use for individuals living in service areas with different supply levels. Supply quartiles varied in primary care use (visit within the past 12 months), racial and socio-economic composition, and perceived neighborhood safety and social cohesion. Primary care use did not differ significantly after controlling for compositional factors. Individuals who used a community clinic or hospital outpatient department for most of their care were less likely to have had a primary care visit than those who used a private doctor's office. Stratified multivariate models showed that within the lowest-supply quartile, public transit users had a higher odds of primary care use than non-transit users. Moreover, a higher score on the perceived neighborhood social cohesion scale was associated with a higher odds of primary care use. Within the second-lowest quartile, nonwhites had a lower odds of primary care use compared to whites. Different patterns of disadvantage in primary care access exist that may be associated with - but not fully explained by - local primary care supply. In lower-supply areas, racial disparities and inadequate primary care infrastructure hinder access to care. However, accessibility and elder-friendliness of public transit, as well as efforts to improve social cohesion and support, may facilitate primary care access for individuals living in low-supply areas. Copyright © 2012 Elsevier Ltd. All rights reserved.

Access 5 - Step 1: Human Systems Integration Program Plan (HSIPP)

NASA Technical Reports Server (NTRS)

2005-01-01

This report describes the Human System Interface (HSI) analysis, design and test activities that will be performed to support the development of requirements and design guidelines to facilitate the incorporation of High Altitude Long Endurance (HALE) Remotely Operated Aircraft (ROA) at or above FL400 in the National Airspace System (NAS). These activities are required to support the design and development of safe, effective and reliable ROA operator and ATC interfaces. This plan focuses on the activities to be completed for Step 1 of the ACCESS 5 program. Updates to this document will be made for each of the four ACCESS 5 program steps.

Changes in nutrient dynamics of midcontinent greater white-fronted geese during spring migration

USGS Publications Warehouse

Pearse, Aaron T.; Alisauskas, Ray T.; Krapu, Gary L.; Cox, Robert R.

2011-01-01

Waterfowl and other migratory birds commonly store nutrients at traditional staging areas during spring for later use during migration and reproduction. We investigated nutrient-storage dynamics in the midcontinent population of greater white-fronted geese (Anser albifrons; hereafter white-fronted geese) at spring staging sites in the Rainwater Basin of Nebraska during February-April and in southern Saskatchewan during April-May, 1998 and 1999. In Nebraska, lipid content of white-fronted geese did not increase, and protein content changed little over time for most age and sex categories. In Saskatchewan, lipids increased 11.4 g/day (SE = 1.7) and protein content increased 1.6 g/day (SE = 0.6) in the sample of adult geese collected over a 3-week period. A study conducted during 1979-1980 in the Rainwater Basin reported that white-fronted geese gained 8.8-17.7 g of lipids per day during spring, differing greatly from our results 2 decades later. In addition, lipid levels were less in the 1990s compared to spring 1980 for adult geese nearing departure from staging sites in Saskatchewan. This shift in where geese acquired nutrient stores from Nebraska to more northern staging sites coincided with a decrease in availability of waste corn in Nebraska, their primary food source while staging at that stopover site, and an increase in cultivation of high-energy pulse crops in Saskatchewan. White-fronted geese exhibited flexibility in nutrient dynamics during spring migration, likely in response to landscape-level variation in food availability caused by changes in agricultural trends and practices. Maintaining a wide distribution of wetlands in the Great Plains may allow springstaging waterfowl to disperse across the region and facilitate access to high-energy foods over a larger cropland base.

Barriers to and facilitators of sports participation for people with physical disabilities: a systematic review.

PubMed

Jaarsma, E A; Dijkstra, P U; Geertzen, J H B; Dekker, R

2014-12-01

Most people with physical disabilities do not participate in sports regularly, which could increase the chances of developing secondary health conditions. Therefore, knowledge about barriers to and facilitators of sports participation is needed. Barriers and facilitators for people with physical disabilities other than amputation or spinal cord injuries (SCI) are unknown. The aim of this study was to provide an overview of the literature focusing on barriers to and facilitators of sports participation for all people with various physical disabilities. Four databases were searched using MeSH terms and free texts up to April 2012. The inclusion criteria were articles focusing on people with physical disabilities, sports and barriers and/or facilitators. The exclusion criteria were articles solely focusing on people with cognitive disabilities, sensory impairments or disabilities related to a recent organ transplant or similar condition. Fifty-two articles were included in this review, with 27 focusing on people with SCI. Personal barriers were disability and health; environmental barriers were lack of facilities, transport and difficulties with accessibility. Personal facilitators were fun and health, and the environmental facilitator was social contacts. Experiencing barriers to and facilitators of sports participation depends on age and type of disability and should be considered when advising people about sports. The extent of sports participation for people with physical disabilities also increases with the selection of the most appropriate sport. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Operationalization of Sign Language Phonological Similarity and Its Effects on Lexical Access

ERIC Educational Resources Information Center

Williams, Joshua T.; Stone, Adam; Newman, Sharlene D.

2017-01-01

Cognitive mechanisms for sign language lexical access are fairly unknown. This study investigated whether phonological similarity facilitates lexical retrieval in sign languages using measures from a new lexical database for American Sign Language. Additionally, it aimed to determine which similarity metric best fits the present data in order to…

The Sequences of 1504 Mutants in the Model Rice Variety Kitaake Facilitate Rapid Functional Genomic Studies.

PubMed

Li, Guotian; Jain, Rashmi; Chern, Mawsheng; Pham, Nikki T; Martin, Joel A; Wei, Tong; Schackwitz, Wendy S; Lipzen, Anna M; Duong, Phat Q; Jones, Kyle C; Jiang, Liangrong; Ruan, Deling; Bauer, Diane; Peng, Yi; Barry, Kerrie W; Schmutz, Jeremy; Ronald, Pamela C

2017-06-01

The availability of a whole-genome sequenced mutant population and the cataloging of mutations of each line at a single-nucleotide resolution facilitate functional genomic analysis. To this end, we generated and sequenced a fast-neutron-induced mutant population in the model rice cultivar Kitaake ( Oryza sativa ssp japonica ), which completes its life cycle in 9 weeks. We sequenced 1504 mutant lines at 45-fold coverage and identified 91,513 mutations affecting 32,307 genes, i.e., 58% of all rice genes. We detected an average of 61 mutations per line. Mutation types include single-base substitutions, deletions, insertions, inversions, translocations, and tandem duplications. We observed a high proportion of loss-of-function mutations. We identified an inversion affecting a single gene as the causative mutation for the short-grain phenotype in one mutant line. This result reveals the usefulness of the resource for efficient, cost-effective identification of genes conferring specific phenotypes. To facilitate public access to this genetic resource, we established an open access database called KitBase that provides access to sequence data and seed stocks. This population complements other available mutant collections and gene-editing technologies. This work demonstrates how inexpensive next-generation sequencing can be applied to generate a high-density catalog of mutations. © 2017 American Society of Plant Biologists. All rights reserved.

Electronic health records to facilitate clinical research.

PubMed

Cowie, Martin R; Blomster, Juuso I; Curtis, Lesley H; Duclaux, Sylvie; Ford, Ian; Fritz, Fleur; Goldman, Samantha; Janmohamed, Salim; Kreuzer, Jörg; Leenay, Mark; Michel, Alexander; Ong, Seleen; Pell, Jill P; Southworth, Mary Ross; Stough, Wendy Gattis; Thoenes, Martin; Zannad, Faiez; Zalewski, Andrew

2017-01-01

Electronic health records (EHRs) provide opportunities to enhance patient care, embed performance measures in clinical practice, and facilitate clinical research. Concerns have been raised about the increasing recruitment challenges in trials, burdensome and obtrusive data collection, and uncertain generalizability of the results. Leveraging electronic health records to counterbalance these trends is an area of intense interest. The initial applications of electronic health records, as the primary data source is envisioned for observational studies, embedded pragmatic or post-marketing registry-based randomized studies, or comparative effectiveness studies. Advancing this approach to randomized clinical trials, electronic health records may potentially be used to assess study feasibility, to facilitate patient recruitment, and streamline data collection at baseline and follow-up. Ensuring data security and privacy, overcoming the challenges associated with linking diverse systems and maintaining infrastructure for repeat use of high quality data, are some of the challenges associated with using electronic health records in clinical research. Collaboration between academia, industry, regulatory bodies, policy makers, patients, and electronic health record vendors is critical for the greater use of electronic health records in clinical research. This manuscript identifies the key steps required to advance the role of electronic health records in cardiovascular clinical research.

Understanding Facilitation: Theory and Principles.

ERIC Educational Resources Information Center

Hogan, Christine

This book introduces newcomers to the concept of facilitation, and it presents a critical analysis of established and current theory on facilitation for existing practitioners. The following are among the topics discussed: (1) emergence of the field of facilitation; (2) development of facilitation in management; (3) development of facilitation in…

Understanding asexual identity as a means to facilitate culturally competent care: A systematic literature review.

PubMed

Jones, Catriona; Hayter, Mark; Jomeen, Julie

2017-12-01

To provide a contemporary overview of asexuality and the implications this has for healthcare practice. Individuals belonging to sexual minority groups face many barriers in accessing appropriate health care. The term "sexual minority group" is usually used to refer to lesbian women, gay, bisexual and transgender individuals. Anecdotal and research evidence suggests that those who identify as asexual have similar poor experiences. Systematic review and qualitative analysis. This work uses a systematic review and qualitative analysis of the existing interview data from self-identified asexuals, to construct features of the asexual identity. The findings will help practitioners and health professionals develop an understanding of this poorly understood construct. Ultimately this work is aimed at facilitating culturally competent care in the context of asexuality. Qualitative analysis produced three themes, which can be used, not only to frame asexuality in a positive and normalising way, but also to provide greater understanding of asexuality, "romantic differences coupled with sexual indifference," "validation through engagement with asexual communities" and "a diversity of subasexual identities." Having some understanding of what it means to identify as asexual, and respecting the choices made by asexuals can markedly improve the experiences of those who embrace an asexual identity when engaging with health care. Anecdotal evidence, taken from one of the largest asexual online forums, suggests that a number of self-identified asexuals choose not to disclose their identity to healthcare professionals through fear of their asexual status being pathologised, problematised or judged. Given that asexuality is a poorly understood concept, this may be due to lack of understanding on behalf of healthcare providers. The review provides health professionals and practitioners working in clinical settings with some insights of the features of an asexual identity to facilitate

A Patient Advocate to facilitate access and improve communication, care, and outcomes in adults with moderate or severe asthma: Rationale, design, and methods of a randomized controlled trial

PubMed Central

Apter, Andrea J.; Morales, Knashawn H.; Han, Xiaoyan; Perez, Luzmercy; Huang, Jingru; Ndicu, Grace; Localio, Anna; Nardi, Alyssa; Klusaritz, Heather; Rogers, Marisa; Phillips, Alexis; Cidav, Zuleyha; Schwartz, J. Sanford

2017-01-01

Few interventions to improve asthma outcomes have targeted low-income minority adults. Even fewer have focused on the real-world practice where care is delivered. We adapted a patient navigator, here called a Patient Advocate (PA), a term preferred by patients, to facilitate and maintain access to chronic care for adults with moderate or severe asthma and prevalent co-morbidities recruited from clinics serving low-income urban neighborhoods. We describe the planning, design, methodology (informed by patient and provider focus groups), baseline results, and challenges of an ongoing randomized controlled trial of 312 adults of a PA intervention implemented in a variety of practices. The PA coaches, models, and assists participants with preparations for a visit with the asthma clinician; attends the visit with permission of participant and provider; and confirms participants’ understanding of what transpired at the visit. The PA facilitates scheduling, obtaining insurance coverage, overcoming patients’ unique social and administrative barriers to carrying out medical advice and transfer of information between providers and patients. PA activities are individualized, take account of comorbidities, and are generalizable to other chronic diseases. PAs are recent college graduates interested in health-related careers, research experience, working with patients, and generally have the same race/ethnicity distribution as potential participants. We test whether the PA intervention, compared to usual care, is associated with improved and sustained asthma control and other asthma outcomes (prednisone bursts, ED visits, hospitalizations, quality of life, FEV1) relative to baseline. Mediators and moderators of the PA-asthma outcome relationship are examined along with the intervention’s cost-effectiveness. PMID:28315481

Continuing Education Preferences, Facilitators, and Barriers for Nursing Home Nurses.

PubMed

Dyck, Mary J; Kim, Myoung Jin

2018-01-01

The purpose of the study was to determine the continuing education needs for nursing home nurses in rural central Illinois and to determine any potential facilitators or barriers to obtaining continuing education. Data were collected using the Educational Needs Assessment questionnaire. Descriptive statistics were computed to examine continuing education preferences, facilitators, and barriers among nursing home nurses. Independent samples t tests were used to compare preferences between administrative and staff nurses. The sample included 317 nurses from 34 facilities. The five top needs were related to clinical problems. Administrative nurses had greater needs for professional issues, managerial skills, and quality improvement than staff nurses. Barriers included rural settings, need for vacation time for programs, and inadequate staffing. Continuing education needs of nursing home nurses in Illinois are similar to previous studies conducted in Arizona and North Carolina. Continuing education barriers were mostly organizational, rather than personal. J Contin Nurs Educ. 2018;49(1):26-33. Copyright 2018, SLACK Incorporated.

[Access to medicines prescribed for acute health conditions in adults in South and Northeast Brazil].

PubMed

Paniz, Vera Maria Vieira; Cechin, Isabel Carolina Coelho Flores; Fassa, Anaclaudia Gastal; Piccini, Roberto Xavier; Tomasi, Elaine; Thumé, Elaine; Silveira, Denise Silva da; Facchini, Luiz Augusto

2016-01-01

This was a cross-sectional study within Brazil's Project for the Expansion and Consolidation of Family Health, 2005, with the objective of universal and free access to the medication prescribed in the last medical appointment for acute health problems and to estimate the degree to which access may have improved with inclusion of the medicines in prevailing policies and programs. The sample included 4,060 adults living in the area of primary health care units in 41 municipalities in South and Northeast Brazil. Access was greater in the South (83.2%) than in the Northeast (71%), and free access was similar (37%), with a greater share by the Family Health Program (FHP) when compared to the traditional model, especially in the Northeast. Some 60% of prescribed medicines and 50% of those on the National List of Essential Medicines (RENAME) were paid for. No variation was observed in the proportion of medicines present on the prevailing RENAME list and access. However, 40% of the medicines that were paid for can currently be obtained through the Popular Pharmacy Program. The latter program appears to emerge as a new way to guarantee access to medicines prescribed in the health system.

Is Industry Funding Associated with Greater Scholarly Impact Among Academic Neurosurgeons?

PubMed

Eloy, Jean Anderson; Kilic, Suat; Yoo, Nicholas G; Mcleod, Thomas; Svider, Peter F; Baredes, Soly; Folbe, Adam J; Couldwell, William T; Liu, James K

2017-07-01

To determine the relationship between industry payments and scholarly impact among academic neurosurgeons. Faculty names and academic rank data were obtained from department websites, bibliometric data were obtained from the Scopus database, and industry payment data were obtained from the Center for Medicare and Medicaid Services open payments database (openpayments.cms.gov). The h-index was used to estimate scholarly impact. Payments were classified as "general," "associated research," and "research payments." Subgroup analyses were done for academic rank, fellowship training, and sex. Among 1008 academic neurosurgeons, scholarly impact was greater among individuals receiving associated research industry support compared with those not receiving it. Scholarly impact also was greater among individuals who received more than $10,000 of any type of industry support compared with individuals who received less than that or no payment. This association also was seen in fellowship-trained surgeons. Female neurosurgeons were less likely than male neurosurgeons to get industry funding and were likely to get less funding. There is a strong association between associated research funding from industry and scholarly impact among academic neurosurgeons. It's unclear whether this association is a result of funding facilitating more research projects that eventually lead to more high-impact publications, if industry is providing more funding to academic neurosurgeons with greater scholarly impact, or whether it represents intrinsic academic activity among a group of neurosurgeons who are more likely to be academically productive and procure funding from all potential sources to increase this activity. Copyright © 2017 Elsevier Inc. All rights reserved.

Service system integration, access to services, and housing outcomes in a program for homeless persons with severe mental illness.

PubMed

Rosenheck, R; Morrissey, J; Lam, J; Calloway, M; Johnsen, M; Goldman, H; Randolph, F; Blasinsky, M; Fontana, A; Calsyn, R; Teague, G

1998-11-01

This study evaluated the hypothesis that greater integration and coordination between agencies within service systems is associated with greater accessibility of services and improved client housing outcomes. As part of the Access to Community Care and Effective Services and Supports program, data were obtained on baseline client characteristics, service use, and 3-month and 12-month outcomes from 1832 clients seen at 18 sites during the first year of program operation. Data on interorganizational relationships were obtained from structured interviews with key informants from relevant organizations in each community (n = 32-82 at each site). Complete follow-up data were obtained from 1340 clients (73%). After control for baseline characteristics, service system integration was associated with superior housing outcomes at 12 months, and this relationship was mediated through greater access to housing agencies. Service system integration is related to improved access to housing services and better housing outcomes among homeless people with mental illness.

Adequacy and clarity of information on out-of-hours emergency dental services at Greater Manchester NHS dental practices: a cross-sectional study.

PubMed

Aldallal, S N; Aldallal, F N; Khajah, A S

2017-03-24

Objective To perform an evaluation of the information given to patients seeking emergency dental services during out-of-hours periods in Greater Manchester.Method This is a cross-sectional study. A list of all NHS dental practices in Greater Manchester was obtained from the NHS website. The investigators then accessed websites and voicemails of all practices to assess the information given to patients.Results The study shows that most practices have voicemail, which includes varying information on how to access emergency dental services during out-of-hours periods. Few of those included advice on the management of common dental emergencies. On the other hand, the majority of practices did not have websites. From those who included advice on how to access emergency dental services during out-of-hours periods on how to manage common dental emergencies on their websites, the information was easy to find.Conclusion The current information could be improved by ensuring the inclusion of essential details. Websites would help by including more details. In turn, this could help to reduce the number of inappropriate presentations to A&E departments.

Simple Tools to Facilitate Project Management of a Nursing Research Project.

PubMed

Aycock, Dawn M; Clark, Patricia C; Thomas-Seaton, LaTeshia; Lee, Shih-Yu; Moloney, Margaret

2016-07-01

Highly organized project management facilitates rigorous study implementation. Research involves gathering large amounts of information that can be overwhelming when organizational strategies are not used. We describe a variety of project management and organizational tools used in different studies that may be particularly useful for novice researchers. The studies were a multisite study of caregivers of stroke survivors, an Internet-based diary study of women with migraines, and a pilot study testing a sleep intervention in mothers of low-birth-weight infants. Project management tools were used to facilitate enrollment, data collection, and access to results. The tools included protocol and eligibility checklists, event calendars, screening and enrollment logs, instrument scoring tables, and data summary sheets. These tools created efficiency, promoted a positive image, minimized errors, and provided researchers with a sense of control. For the studies described, there were no protocol violations, there were minimal missing data, and the integrity of data collection was maintained. © The Author(s) 2016.

Improving Data Access for Climate Preparedness Through Public-Private Partnerships

NASA Astrophysics Data System (ADS)

Satkowski, L.; Tewksbury, J.

2017-12-01

With increasing exposure to extreme hurricane and flooding events, a growing number of communities, companies, and civil society organizations around the world are looking to assess climate impacts and vulnerability, and to develop resilience plans. Currently, efforts to turn data into actionable plans are constrained by limited access to robust, actionable data and information. The Partnership for Resilience and Preparedness (PREP), public-private collaboration that seeks to empower a data-driven approach to building climate resilience, aims to facilitate the process for planners, investors, resource managers, and others to routinely incorporate climate risks into their decisions, by enhancing access to relevant data and facilitating collective learning. Together, this peer-to-peer initiative of approximately 30 government, NGO, and business partners built PREPdata, an intuitive, open map-based platform that enables users to visualize, download and layer data to inform adaptation decision-making. The platform also connects practitioners to data providers, closing the feedback loop between them and enhancing the climate data ecosystem. In this session participants will learn how public-private partnerships can reduce barriers to discovering, accessing climate data and will be given an interactive tutorial on PREPdata, specific to the Gulf of Mexico and hurricane and flooding events. Participants will discover ways to incorporate local data with national and global data, learn about PREPdata application case studies, and how PREPdata can be used to analyze risk in hurricane vulnerable geographies.

Barriers to and Facilitators of Help-Seeking Behavior Among Men Who Experience Sexual Violence

PubMed Central

Donne, Martina Delle; DeLuca, Joseph; Pleskach, Pavel; Bromson, Christopher; Mosley, Marcus P.; Perez, Edward T.; Mathews, Shibin G.; Stephenson, Rob; Frye, Victoria

2017-01-01

Research on sexual violence and related support services access has mainly focused on female victims; there is still a remarkable lack of research on men who experience sexual violence. Research demonstrates that people who both self-identify as men and are members of sexual-orientation minority populations are at higher risk of sexual violence. They are also less likely to either report or seek support services related to such experiences. The present study is an exploratory one aimed at filling the gap in the literature and better understanding how men, both straight and gay as well as cisgender and transgender, conceptualize, understand, and seek help related to sexual violence. A sample of 32 men was recruited on-line and participated in either a one-on-one in-depth interview (N = 19) or one of two focus group discussions (N = 13). All interviews and groups were audiotaped, professionally transcribed and coded using NVivo 9 qualitative software. The present analysis focused on barriers to and facilitators of support service access. Emergent and cross-cutting themes were identified and presented, with an emphasis on understanding what factors may prevent disclosure of a sexual violence experience and facilitate seeking support services and/or professional help. Through this analysis, the research team aims to add knowledge to inform the development of tools to increase service access and receipt, for use by both researchers and service professionals. Although this study contributes to the understanding of the issue of men’s experiences of sexual violence, more research with diverse populations is needed. PMID:29161934

Barriers to and Facilitators of Help-Seeking Behavior Among Men Who Experience Sexual Violence.

PubMed

Donne, Martina Delle; DeLuca, Joseph; Pleskach, Pavel; Bromson, Christopher; Mosley, Marcus P; Perez, Edward T; Mathews, Shibin G; Stephenson, Rob; Frye, Victoria

2018-03-01

Research on sexual violence and related support services access has mainly focused on female victims; there is still a remarkable lack of research on men who experience sexual violence. Research demonstrates that people who both self-identify as men and are members of sexual-orientation minority populations are at higher risk of sexual violence. They are also less likely to either report or seek support services related to such experiences. The present study is an exploratory one aimed at filling the gap in the literature and better understanding how men, both straight and gay as well as cisgender and transgender, conceptualize, understand, and seek help related to sexual violence. A sample of 32 men was recruited on-line and participated in either a one-on-one in-depth interview ( N = 19) or one of two focus group discussions ( N = 13). All interviews and groups were audiotaped, professionally transcribed and coded using NVivo 9 qualitative software. The present analysis focused on barriers to and facilitators of support service access. Emergent and cross-cutting themes were identified and presented, with an emphasis on understanding what factors may prevent disclosure of a sexual violence experience and facilitate seeking support services and/or professional help. Through this analysis, the research team aims to add knowledge to inform the development of tools to increase service access and receipt, for use by both researchers and service professionals. Although this study contributes to the understanding of the issue of men's experiences of sexual violence, more research with diverse populations is needed.

Exploring obesogenic food environments in Edmonton, Canada: the association between socioeconomic factors and fast-food outlet access.

PubMed

Hemphill, Eric; Raine, Kim; Spence, John C; Smoyer-Tomic, Karen E

2008-01-01

To explore the relationship between the placement of fast-food outlets and neighborhood-level socioeconomic variables by determining if indicators of lower socioeconomic status were predictive of exposure to fast food. A descriptive analysis of the fast-food environment in a Canadian urban center, using secondary analysis of census data and Geographic Information Systems technology. Edmonton, Alberta, Canada. Neighborhoods were classified as High, Medium, or Low Access based on the number of fast-food opportunities available to them. Neighborhood-level socioeconomic data (income, education, employment, immigration status, and housing tenure) from the 2001 Statistics Canada federal census were obtained. A discriminant function analysis was used to determine if any association existed between neighborhood demographic characteristics and accessibility of fast-food outlets. Significant differences were found between the three levels of fast-food accessibility across the socioeconomic variables, with successively greater percentages of unemployment, low income, and renters in neighborhoods with increasingly greater access to fast-food restaurants. A high score on several of these variables was predictive of greater access to fast-food restaurants. Although a causal inference is not possible, these results suggest that the distribution of fast-food outlets relative to neighborhood-level socioeconomic status requires further attention in the process of explaining the increased rates of obesity observed in relatively deprived populations.

Improving access to medicines via the Health Impact Fund in India: a stakeholder analysis.

PubMed

McMullan, Patrick; Ajay, Vamadevan S; Srinivas, Ravi; Bhalla, Sandeep; Prabhakaran, Dorairaj; Banerjee, Amitava

2018-01-01

In India, 50-65% of the population face difficulties in accessing medicines. The Health Impact Fund (HIF) is a novel proposal whereby pharmaceutical companies would be paid based on the measured global health impact of their drugs. We conducted a key stakeholder analysis to explore access to medicines in India, acceptability of the HIF and potential barriers and facilitators at policy level. To conduct a stakeholder analysis of the HIF in India: to determine key stakeholder views regarding access to medicines in India; to evaluate acceptability of the HIF; and to assess potential barriers and facilitators to the HIF as a policy. In New Delhi, we conducted semi-structured interviews. There was purposive recruitment of participants with snowball sampling. Transcribed data were analysed using stakeholder analysis frameworks and directed content analysis. Participation rate was 29% (14/49). 14 semi-structured interviews were conducted among stakeholders in New Delhi. All participants highlighted access to medicines as a problem in India. There were mixed views about the HIF in terms of relevance and scaleability. Stakeholders felt it should focus on diseases with limited or no market and potentially incorporate direct investment in research. First, access to medicines is perceived to be a major problem in India by all stakeholders, but affordability is just one factor. Second, stakeholders despite considerable support for the idea of the HIF, there are major concerns about scaleability, generalisability and impact on access to medicines. Third, the HIF and other novel drug-related health policies can afford to be more radical, e.g. working outside the existing intellectual property rights regime, targeting generic as well as branded drugs, or extending to research and development. Further innovations in access to medicines must involve country-specific key stakeholders in order to increase the likelihood of their success.

Improving access to medicines via the Health Impact Fund in India: a stakeholder analysis

PubMed Central

McMullan, Patrick; Ajay, Vamadevan S.; Srinivas, Ravi; Bhalla, Sandeep; Prabhakaran, Dorairaj; Banerjee, Amitava

2018-01-01

ABSTRACT Background: In India, 50–65% of the population face difficulties in accessing medicines. The Health Impact Fund (HIF) is a novel proposal whereby pharmaceutical companies would be paid based on the measured global health impact of their drugs. We conducted a key stakeholder analysis to explore access to medicines in India, acceptability of the HIF and potential barriers and facilitators at policy level. Objectives: To conduct a stakeholder analysis of the HIF in India: to determine key stakeholder views regarding access to medicines in India; to evaluate acceptability of the HIF; and to assess potential barriers and facilitators to the HIF as a policy. Methods: In New Delhi, we conducted semi-structured interviews. There was purposive recruitment of participants with snowball sampling. Transcribed data were analysed using stakeholder analysis frameworks and directed content analysis. Results: Participation rate was 29% (14/49). 14 semi-structured interviews were conducted among stakeholders in New Delhi. All participants highlighted access to medicines as a problem in India. There were mixed views about the HIF in terms of relevance and scaleability. Stakeholders felt it should focus on diseases with limited or no market and potentially incorporate direct investment in research. Conclusions: First, access to medicines is perceived to be a major problem in India by all stakeholders, but affordability is just one factor. Second, stakeholders despite considerable support for the idea of the HIF, there are major concerns about scaleability, generalisability and impact on access to medicines. Third, the HIF and other novel drug-related health policies can afford to be more radical, e.g. working outside the existing intellectual property rights regime, targeting generic as well as branded drugs, or extending to research and development. Further innovations in access to medicines must involve country-specific key stakeholders in order to increase the likelihood

Access and Use of FIA Data Through FIA Spatial Data Services

Treesearch

Elizabeth LaPoint

2005-01-01

Forest Inventory and Analysis (FIA) Spatial Data Services (SDS) was established in May 2002 to facilitate outside access to FIA data and allow use of georeferenced plot data while protecting the confidentiality of plot locations. Modification of the Food Security Act of 1985 legislated the protection of information on plot location and ownership. Penalties were put in...

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

PubMed

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

2012-01-01

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

Family support and ease of access link socio-economic status and sports club membership in adolescent girls: a mediation study

PubMed Central

2013-01-01

facilitate and promote greater participation in club sport among adolescent girls from low SES neighbourhoods and households, strategies should target modifiable determinants such as facility access and parental support. This will involve improving access to sports facilities and promoting, encouraging and assisting parents to provide support for their daughters’ participation in sport clubs. PMID:23618407

Family support and ease of access link socio-economic status and sports club membership in adolescent girls: a mediation study.

PubMed

Eime, Rochelle M; Harvey, Jack T; Craike, Melinda J; Symons, Caroline M; Payne, Warren R

2013-04-25

Much research has been conducted into the determinants of physical activity (PA) participation among adolescent girls. However, the more specific question of what are the determinants of particular forms of PA participation, such as the link between participation through a sports club, has not been investigated. Accordingly, the aim of this study was to investigate the relationships between participation in a sports club and socio-economic status (SES), access to facilities, and family and peer support, for female adolescents. A survey of 732 female adolescent school students (521 metropolitan, 211 non-metropolitan; 489 Year 7, 243 Year 11) was conducted. The survey included demographic information (living arrangements, ethnicity indicators, and indicators of SES such as parental education and employment status and locality); access to facilities; and family and peer support (travel, encouragement, watching, praise, joint participation). For each characteristic, sports club participants and non-participants were compared using chi-square tests. Multiple mediation analyses were used to investigate the role of access, family and peer support in the link between SES and sport participation. There were significant associations (p<0.05) between sports club participation and: all demographic characteristics; all measures of family and peer support; and access to sport-related facilities. Highest levels of participation were associated with monolingual Australian-born families, with two parents, at least one of whom was well-educated, with both parents employed, and high levels of parental assistance, engagement and support. Participation in club sport among both younger and older adolescent girls was significantly positively associated with the SES of both their neighbourhoods and their households, particularly in metropolitan areas. These associations were most strongly mediated by family support and by access to facilities. To facilitate and promote greater

Greater involvement of action simulation mechanisms in emotional vs cognitive empathy

PubMed Central

Oliver, Lindsay D; Vieira, Joana B; Neufeld, Richard W J; Dziobek, Isabel; Mitchell, Derek G V

2018-01-01

Abstract Empathy is crucial for successful interpersonal interactions, and it is impaired in many psychiatric and neurological disorders. Action-perception matching, or action simulation mechanisms, has been suggested to facilitate empathy by supporting the simulation of perceived experience in others. However, this remains unclear, and the involvement of the action simulation circuit in cognitive empathy (the ability to adopt another’s perspective) vs emotional empathy (the capacity to share and react affectively to another’s emotional experience) has not been quantitatively compared. Presently, healthy adults completed a classic cognitive empathy task (false belief), an emotional empathy task and an action simulation button-pressing task during functional magnetic resonance imaging. Conjunction analyses revealed common recruitment of the inferior frontal gyrus (IFG), thought to be critical for action-perception matching, during both action simulation and emotional, but not cognitive, empathy. Furthermore, activation was significantly greater in action simulation regions in the left IFG during emotional vs cognitive empathy, and activity in this region was positively correlated with mean feeling ratings during the emotional empathy task. These findings provide evidence for greater involvement of action simulation mechanisms in emotional than cognitive empathy. Thus, the action simulation circuit may be an important target for delineating the pathophysiology of disorders featuring emotional empathy impairments. PMID:29462481

Barriers and Facilitators to HIV Testing Among Women

PubMed Central

McDougall, Graham J.; Dalmida, Safiya George; Foster, Pamela Payne; Burrage, Joe

2017-01-01

Aim The purpose of this secondary analysis was to analyze for barriers and facilitators to HIV testing in women attending community health clinics. Introduction The Centers for Disease Control and Prevention (CDC), reported that all women account for 20% or 1 in 5 of new HIV cases (CDC, 2012). Of those new cases in heterosexual women, 5,300 were Black, 1,300 were White, and 1,200 were Hispanic/Latina. The CDC estimated that in 2012 there were 9,268 individuals living with a diagnosis of HIV or AIDS, of which 19% were women. Results The existing de-identified data consisted of thirty individual interviews conducted using a semi-structured interview guide was collected as the initial phase of the parent study, “HIV Testing and Women’s Attitudes on HIV Vaccine Trials”. This secondary analysis addressed the identification of key obstacles to HIV testing and only those related portions of the transcripts were analyzed. The major themes identified were familiarity with testing, stigma, fear, perceived risks, and access to care. Conclusion The themes implicated the need to further assess women for barriers and facilitators to testing, tailor community based interventions that have the ability to decrease fear and stigma, increase trust in testing methods and offer counseling to positive results. PMID:29607406

The UK DNA banking network: a "fair access" biobank.

PubMed

Yuille, Martin; Dixon, Katherine; Platt, Andrew; Pullum, Simon; Lewis, David; Hall, Alistair; Ollier, William

2010-08-01

The UK DNA Banking Network (UDBN) is a secondary biobank: it aggregates and manages resources (samples and data) originated by others. The network comprises, on the one hand, investigator groups led by clinicians each with a distinct disease specialism and, on the other hand, a research infrastructure to manage samples and data. The infrastructure addresses the problem of providing secure quality-assured accrual, storage, replenishment and distribution capacities for samples and of facilitating access to DNA aliquots and data for new peer-reviewed studies in genetic epidemiology. 'Fair access' principles and practices have been pragmatically developed that, unlike open access policies in this area, are not cumbersome but, rather, are fit for the purpose of expediting new study designs and their implementation. UDBN has so far distributed >60,000 samples for major genotyping studies yielding >10 billion genotypes. It provides a working model that can inform progress in biobanking nationally, across Europe and internationally.

The climate4impact platform: Providing, tailoring and facilitating climate model data access

NASA Astrophysics Data System (ADS)

Pagé, Christian; Pagani, Andrea; Plieger, Maarten; Som de Cerff, Wim; Mihajlovski, Andrej; de Vreede, Ernst; Spinuso, Alessandro; Hutjes, Ronald; de Jong, Fokke; Bärring, Lars; Vega, Manuel; Cofiño, Antonio; d'Anca, Alessandro; Fiore, Sandro; Kolax, Michael

2017-04-01

One of the main objectives of climate4impact is to provide standardized web services and tools that are reusable in other portals. These services include web processing services, web coverage services and web mapping services (WPS, WCS and WMS). Tailored portals can be targeted to specific communities and/or countries/regions while making use of those services. Easier access to climate data is very important for the climate change impact communities. To fulfill this objective, the climate4impact (http://climate4impact.eu/) web portal and services has been developed, targeting climate change impact modellers, impact and adaptation consultants, as well as other experts using climate change data. It provides to users harmonized access to climate model data through tailored services. It features static and dynamic documentation, Use Cases and best practice examples, an advanced search interface, an integrated authentication and authorization system with the Earth System Grid Federation (ESGF), a visualization interface with ADAGUC web mapping tools. In the latest version, statistical downscaling services, provided by the Santander Meteorology Group Downscaling Portal, were integrated. An innovative interface to integrate statistical downscaling services will be released in the upcoming version. The latter will be a big step in bridging the gap between climate scientists and the climate change impact communities. The climate4impact portal builds on the infrastructure of an international distributed database that has been set to disseminate the results from the global climate model results of the Coupled Model Intercomparison project Phase 5 (CMIP5). This database, the ESGF, is an international collaboration that develops, deploys and maintains software infrastructure for the management, dissemination, and analysis of climate model data. The European FP7 project IS-ENES, Infrastructure for the European Network for Earth System modelling, supports the European

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

PubMed

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

2008-08-01

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

The Effects of Promoting Patient Access to Medical Records: A Review

PubMed Central

Ross, Stephen E.; Lin, Chen-Tan

2003-01-01

The Health Insurance Privacy and Portability Act (HIPPA) stipulates that patients must be permitted to review and amend their medical records. As information technology makes medical records more accessible to patients, it may become more commonplace for patients to review their records routinely. This article analyzes the potential benefits and drawbacks of facilitating patient access to the medical record by reviewing previously published research. Previous research includes analysis of clinical notes, surveys of patients and practitioners, and studies of patient-accessible medical records. Overall, studies suggest the potential for modest benefits (for instance, in enhancing doctor-patient communication). Risks (for instance, increasing patient worry or confusion) appear to be minimal in medical patients. The studies, however, were of limited quality and low statistical power to detect the variety of outcomes that may result from implementation of a patient-accessible medical record. The data from these studies lay the foundation for future research. PMID:12595402

[The PAHO Strategic Fund: a mechanism to facilitate access to medicines].

PubMed

de L Horst, Myrza M L; Soler, Orenzio

2010-01-01

To describe the medicine procurement activities of the PAHO Strategic Fund. This is a retrospective study covering the period from 2004 to 2007, based on a bibliographic and document survey of Pan American Health Organization (PAHO) archives in the United States, El Salvador, Guatemala, Honduras, and Brazil. The volume of resources and the types of drugs procured by the fund were determined for the years 2004, 2005, and 2006 and for the period of January to September 2007. The survey revealed a well-structured fund handling increasing resources, from US$ 3,475,043.00 in 2004 to US$ 19,646,634.00 in 2007 (January to September). The participation of antiretroviral drugs in this expenditure has grown from less than 8% of the total in 2004 to 57.89% in 2007. Still, in 2007, 66.63% of the financial resources managed by the Strategic Fund were allocated to the purchase of antiretroviral drugs for nine countries (Brazil, Guatemala, El Salvador, Ecuador, Honduras, Haiti, Belize, Nicaragua, and Bolivia) out of a total of 17 participating countries. Brazil was the country using the most resources through the Strategic Fund, accounting for 63% of the expenditure for the purchase of strategic supplies between January and September 2007. The proposal to unify the purchase of medications for all participating countries to improve pricing and purchasing management will result in large-scale savings. The Strategic Fund can contribute to increasing access to medicines and improving the management of the public health care system in Latin America.

Emotional words facilitate lexical but not early visual processing.

PubMed

Trauer, Sophie M; Kotz, Sonja A; Müller, Matthias M

2015-12-12

Emotional scenes and faces have shown to capture and bind visual resources at early sensory processing stages, i.e. in early visual cortex. However, emotional words have led to mixed results. In the current study ERPs were assessed simultaneously with steady-state visual evoked potentials (SSVEPs) to measure attention effects on early visual activity in emotional word processing. Neutral and negative words were flickered at 12.14 Hz whilst participants performed a Lexical Decision Task. Emotional word content did not modulate the 12.14 Hz SSVEP amplitude, neither did word lexicality. However, emotional words affected the ERP. Negative compared to neutral words as well as words compared to pseudowords lead to enhanced deflections in the P2 time range indicative of lexico-semantic access. The N400 was reduced for negative compared to neutral words and enhanced for pseudowords compared to words indicating facilitated semantic processing of emotional words. LPC amplitudes reflected word lexicality and thus the task-relevant response. In line with previous ERP and imaging evidence, the present results indicate that written emotional words are facilitated in processing only subsequent to visual analysis.

A clearing house for diagnostic testing: the solution to ensure access to and use of patented genetic inventions?

PubMed Central

van Zimmeren, Esther; Verbeure, Birgit; Matthijs, Gert; Van Overwalle, Geertrui

2006-01-01

In genetic diagnostics, the emergence of a so-called "patent thicket" is imminent. Such an overlapping set of patent rights may have restrictive effects on further research and development of diagnostic tests, and the provision of clinical diagnostic services. Currently, two models that may facilitate access to and use of patented genetic inventions are attracting much debate in various national and international fora: patent pools and clearing houses. In this article, we explore the concept of clearing houses. Several types of clearing houses are identified. First, we describe and discuss two types that would provide access to information on the patented inventions: the information clearing house and the technology exchange clearing house. Second, three types of clearing houses are analysed that not only offer access to information but also provide an instrument to facilitate the use of the patented inventions: the open access clearing house, the standardized licences clearing house and the royalty collection clearing house. A royalty collection clearing house for genetic diagnostic testing would be the most comprehensive as it would serve several functions: identifying patents and patent claims essential to diagnostic testing, matching licensees with licensors, developing and supplying standardized licences, collecting royalties, monitoring whether users respect licensing conditions, and providing dispute resolution services such as mediation and arbitration. In this way, it might function as an effective model for users to facilitate access to and use of the patented inventions. However, it remains to be seen whether patent holders with a strong patent portfolio will be convinced by the advantages of the royalty collection clearing house and be willing to participate. PMID:16710543

Extinction of fear is facilitated by social presence: Synergism with prefrontal oxytocin.

PubMed

Brill-Maoz, Naama; Maroun, Mouna

2016-04-01

This study addressed the question of whether extinction in pairs would have a beneficial effect on extinction of fear conditioning. To that end, we established an experimental setting for extinction in which we trained animals to extinguish contextual fear memory in pairs. Taking advantage of the role of oxytocin (OT) in the medial prefrontal cortex (mPFC) in the mediation of memory extinction and social interaction, we also sought to study its role in social interaction-induced effects on extinction. Our results clearly show that the social presence of another animal in the extinction context facilitates extinction, and that this facilitation is mediated through mPFC-OT. Our results suggest that social interaction may be a positive regulator of fear inhibition, implying that social interaction may be an easy, accessible therapeutic tool for the treatment of fear-associated disorders. Copyright © 2016. Published by Elsevier Ltd.

Probabilistic Motor Sequence Yields Greater Offline and Less Online Learning than Fixed Sequence

PubMed Central

Du, Yue; Prashad, Shikha; Schoenbrun, Ilana; Clark, Jane E.

2016-01-01

It is well acknowledged that motor sequences can be learned quickly through online learning. Subsequently, the initial acquisition of a motor sequence is boosted or consolidated by offline learning. However, little is known whether offline learning can drive the fast learning of motor sequences (i.e., initial sequence learning in the first training session). To examine offline learning in the fast learning stage, we asked four groups of young adults to perform the serial reaction time (SRT) task with either a fixed or probabilistic sequence and with or without preliminary knowledge (PK) of the presence of a sequence. The sequence and PK were manipulated to emphasize either procedural (probabilistic sequence; no preliminary knowledge (NPK)) or declarative (fixed sequence; with PK) memory that were found to either facilitate or inhibit offline learning. In the SRT task, there were six learning blocks with a 2 min break between each consecutive block. Throughout the session, stimuli followed the same fixed or probabilistic pattern except in Block 5, in which stimuli appeared in a random order. We found that PK facilitated the learning of a fixed sequence, but not a probabilistic sequence. In addition to overall learning measured by the mean reaction time (RT), we examined the progressive changes in RT within and between blocks (i.e., online and offline learning, respectively). It was found that the two groups who performed the fixed sequence, regardless of PK, showed greater online learning than the other two groups who performed the probabilistic sequence. The groups who performed the probabilistic sequence, regardless of PK, did not display online learning, as indicated by a decline in performance within the learning blocks. However, they did demonstrate remarkably greater offline improvement in RT, which suggests that they are learning the probabilistic sequence offline. These results suggest that in the SRT task, the fast acquisition of a motor sequence is driven

Probabilistic Motor Sequence Yields Greater Offline and Less Online Learning than Fixed Sequence.

PubMed

Du, Yue; Prashad, Shikha; Schoenbrun, Ilana; Clark, Jane E

2016-01-01

It is well acknowledged that motor sequences can be learned quickly through online learning. Subsequently, the initial acquisition of a motor sequence is boosted or consolidated by offline learning. However, little is known whether offline learning can drive the fast learning of motor sequences (i.e., initial sequence learning in the first training session). To examine offline learning in the fast learning stage, we asked four groups of young adults to perform the serial reaction time (SRT) task with either a fixed or probabilistic sequence and with or without preliminary knowledge (PK) of the presence of a sequence. The sequence and PK were manipulated to emphasize either procedural (probabilistic sequence; no preliminary knowledge (NPK)) or declarative (fixed sequence; with PK) memory that were found to either facilitate or inhibit offline learning. In the SRT task, there were six learning blocks with a 2 min break between each consecutive block. Throughout the session, stimuli followed the same fixed or probabilistic pattern except in Block 5, in which stimuli appeared in a random order. We found that PK facilitated the learning of a fixed sequence, but not a probabilistic sequence. In addition to overall learning measured by the mean reaction time (RT), we examined the progressive changes in RT within and between blocks (i.e., online and offline learning, respectively). It was found that the two groups who performed the fixed sequence, regardless of PK, showed greater online learning than the other two groups who performed the probabilistic sequence. The groups who performed the probabilistic sequence, regardless of PK, did not display online learning, as indicated by a decline in performance within the learning blocks. However, they did demonstrate remarkably greater offline improvement in RT, which suggests that they are learning the probabilistic sequence offline. These results suggest that in the SRT task, the fast acquisition of a motor sequence is driven

Data Quality Parameters and Web Services Facilitate User Access to Research-Ready Seismic Data

NASA Astrophysics Data System (ADS)

Trabant, C. M.; Templeton, M. E.; Van Fossen, M.; Weertman, B.; Ahern, T. K.; Casey, R. E.; Keyson, L.; Sharer, G.

2016-12-01

IRIS Data Services has the mission of providing efficient access to a wide variety of seismic and related geoscience data to the user community. With our vast archive of freely available data, we recognize that there is a constant challenge to provide data to scientists and students that are of a consistently useful level of quality. To address this issue, we began by undertaking a comprehensive survey of the data and generating metrics measurements that provide estimates of data quality. These measurements can inform the scientist of the level of suitability of a given set of data for their scientific investigation. They also serve as a quality assurance check for network operators, who can act on this information to improve their current recording or mitigate issues with already recorded data and metadata. Following this effort, IRIS Data Services is moving forward to focus on providing tools for the scientist that make it easier to access data of a quality and characteristic that suits their investigation. Data that fulfill this criterion are termed "research-ready". In addition to filtering data by type, geographic location, proximity to events, and specific time ranges, we will offer the ability to filter data based on specific quality assessments. These include signal-to-noise ratio measurements, data continuity, timing quality, absence of channel cross-talk, and potentially many other factors. Our goal is to ensure that the user receives only the data that meets their specifications and will not require extensive review and culling after delivery. We will present the latest developments of the MUSTANG automated data quality system and introduce the Research-Ready Data Sets (RRDS) service. Together these two technologies serve as a data quality assurance ecosystem that will provide benefit to the scientific community by aiding efforts to readily find appropriate and suitable data for use in any number of objectives.

Health and mental health policies' role in better understanding and closing African American-White American disparities in treatment access and quality of care.

PubMed

Snowden, Lonnie R

2012-10-01

Since publication of the U.S. Surgeon General's report Mental Health: Culture, Race and Ethnicity--A Supplement to Mental Health: A Report of the Surgeon General (U.S. Department of Health and Human Services, 2001), several federal initiatives signal a sustained focus on addressing African American-White American disparities in mental health treatment access and quality and open the way to unprecedented disparity reduction. These initiatives include institutional commitments to (a) research by the National Center for Minority Health and Health Disparities; (b) disparities monitoring by the Agency for Healthcare Research and Quality; (c) new epidemiologic and service delivery information on African American populations from the National Survey of American Life sponsored by the National Institute of Mental Health; as well as (d) opportunities inherent in the World Health Organization's interest in disease burden for making it possible to view African Americans' likely greater disease burden from mental illness as a legitimate source of concern. The Patient Protection and Affordable Care Act affords unprecedented opportunities for increasing African Americans' treatment access and quality of care nationwide. By familiarizing themselves with these initiatives, and taking advantage of possibilities they offer, those committed to reducing African American-White American disparities in mental illness, and treatment access and quality, can make inroads toward improving African Americans' mental health and facilitating their successful functioning in all spheres of community living.

Golf in the United States: an evolution of accessibility.

PubMed

Parziale, John R

2014-09-01

Golf affords physical and psychological benefits to persons who are physically challenged. Advances in adaptive technology, changes in golf course design, and rules modifications have enabled persons with neurological, musculoskeletal, and other impairments to play golf at a recreational, elite amateur, or professional level. The Americans with Disabilities Act has been cited in both federal and US Supreme Court rulings that have improved access for physically challenged golfers. Medical specialties, including physiatry, have played an important role in this process. This article reviews the history of golf's improvements in accessibility, and provides clinicians and physically challenged golfers with information that will facilitate participation in the sport. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Facilitators and Barriers to Performing Activities and Participation in Children With Cerebral Palsy: Caregivers' Perspective.

PubMed

Earde, Pinailug Tantilipikorn; Praipruk, Aina; Rodpradit, Phanlerd; Seanjumla, Parichad

2018-01-01

To investigate contextual factors that were facilitators and barriers to performing activity and participation for children with cerebral palsy from the caregivers' perspective. Qualitative in-depth interview with primary caregivers of children with cerebral palsy aged 4 to 12 years was conducted in the metropolitan area of Thailand. Semistructured questions related to environmental and personal factors were recorded. Interviews were transcribed verbatim and analyzed for main themes on the basis of the International Classification of Functioning, Disability, and Health-Children and Youth Version (ICF-CY) classification. Twenty-seven caregivers participated. Facilitators were appropriateness of assistive devices, support and acceptance from family, friends, and society, health services, willingness, and self-acceptance. Barriers were inappropriate design and facilities, overprotection of family, nonacceptance from family, friends, and society, inconvenient transportation, financial problems, limited health services, limited access to education, frustration, and being an introvert. Contextual factors that can be facilitators and barriers to perform activities and participation should be considered for improving lives of children with cerebral palsy.

Adult College Career Employment Support Services: ACCESS. Emeritus Career and Vocational Exploration.

ERIC Educational Resources Information Center

McGrew, Lee

A part of the Adult College Career Employment Support Services (ACCESS), the minicourse entitled Emeritus Career and Vocational Exploration has been designed to facilitate the entry or reentry of older persons into the work force as paid or volunteer workers. Organized into two four-week modules, the course offers participants assistance in…

Facilitated versus Non-Facilitated Online Case Discussions: Comparing Differences in Problem Space Coverage

ERIC Educational Resources Information Center

Ertmer, Peggy A.; Koehler, Adrie A.

2015-01-01

The facilitator plays a key role in guiding students' efforts during case discussions. However, few studies have compared differences in learning outcomes for students participating in facilitated versus non-facilitated discussions. In this research, we used "problem space coverage" as a learning measure to compare outcomes between…

[How do immigrant women access health services in the Basque Country? Perceptions of health professionals].

PubMed

Pérez-Urdiales, Iratxe; Goicolea, Isabel

2017-09-12

To determine the perception of health professionals working in alternative health centres on the barriers and facilitators in the access by immigrant women to general public health services and sexual and reproductive health in the Basque Country. Basque Country. Analysis of qualitative content based on 11 individual interviews. Health professionals working in alternative health centres of Primary Care and sexual and reproductive health. Data collection was performed between September and December 2015 in four alternative health centres. After transcription, the units of meaning, codes and categories were identified. Four categories emerged from the analysis, which represented how the characteristics of immigrant women (Tell me how you are and I will tell you how to access), the attitude of the administrative and health staff ("When they are already taken care of"), the functioning of the health system (Inflexible, passive and needs-responsive health system), and health policies ("If you do not meet the requirements, you do not go in. The law is the law") influence access to health services of immigrant women. This study shows that there are a considerable number of barriers and few facilitators to the access by immigrant women to public health and sexual and reproductive health services in the Basque Country. The alternative health centres were presented as favouring the improvement of the health of the immigrant population and in their access. Copyright © 2017. Publicado por Elsevier España, S.L.U.

Barriers and facilitators to provide quality TIA care in the Veterans Healthcare Administration.

PubMed

Damush, Teresa M; Miech, Edward J; Sico, Jason J; Phipps, Michael S; Arling, Greg; Ferguson, Jared; Austin, Charles; Myers, Laura; Baye, Fitsum; Luckhurst, Cherie; Keating, Ava B; Moran, Eileen; Bravata, Dawn M

2017-12-12

To identify key barriers and facilitators to the delivery of guideline-based care of patients with TIA in the national Veterans Health Administration (VHA). We conducted a cross-sectional, observational study of 70 audiotaped interviews of multidisciplinary clinical staff involved in TIA care at 14 VHA hospitals. We de-identified and analyzed all transcribed interviews. We identified emergent themes and patterns of barriers to providing TIA care and of facilitators applied to overcome these barriers. Identified barriers to providing timely acute and follow-up TIA care included difficulties accessing brain imaging, a constantly rotating pool of housestaff, lack of care coordination, resource constraints, and inadequate staff education. Key informants revealed that both stroke nurse coordinators and system-level factors facilitated the provision of TIA care. Few facilities had specific TIA protocols. However, stroke nurse coordinators often expanded upon their role to include TIA. They facilitated TIA care by (1) coordinating patient care across services, communicating across service lines, and educating clinical staff about facility policies and evidence-based practices; (2) tracking individual patients from emergency departments to inpatient settings and to discharge for timely follow-up care; (3) providing and referring TIA patients to risk factor management programs; and (4) performing regular audit and feedback of quality performance data. System-level facilitators included clinical service leadership engagement and use of electronic tools for continuous care across services. The local organization within a health care facility may be targeted to cultivate internal facilitators and a systemic infrastructure to provide evidence-based TIA care. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

Policy reconciliation for access control in dynamic cross-enterprise collaborations

NASA Astrophysics Data System (ADS)

Preuveneers, D.; Joosen, W.; Ilie-Zudor, E.

2018-03-01

In dynamic cross-enterprise collaborations, different enterprises form a - possibly temporary - business relationship. To integrate their business processes, enterprises may need to grant each other limited access to their information systems. Authentication and authorization are key to secure information handling. However, access control policies often rely on non-standardized attributes to describe the roles and permissions of their employees which convolutes cross-organizational authorization when business relationships evolve quickly. Our framework addresses the managerial overhead of continuous updates to access control policies for enterprise information systems to accommodate disparate attribute usage. By inferring attribute relationships, our framework facilitates attribute and policy reconciliation, and automatically aligns dynamic entitlements during the evaluation of authorization decisions. We validate our framework with a Industry 4.0 motivating scenario on networked production where such dynamic cross-enterprise collaborations are quintessential. The evaluation reveals the capabilities and performance of our framework, and illustrates the feasibility of liberating the security administrator from manually provisioning and aligning attributes, and verifying the consistency of access control policies for cross-enterprise collaborations.

Barriers and Facilitators to Being Physically Active on a Rural U.S. Northern Plains American Indian Reservation

PubMed Central

Jahns, Lisa; McDonald, Leander R.; Wadsworth, Ann; Morin, Charles; Liu, Yan

2014-01-01

The objective of the present study was to identify barriers to and facilitators of physical activity among American Indian adults living on a rural, U.S. Northern Plains reservation using the nominal group technique (NGT). NGT is a method of data generation and interpretation that combines aspects of qualitative (free generation of responses) and quantitative (systematic ranking of responses) methodologies. Adults participated in one of two NGT sessions asking about either barriers to (n = 6), or facilitators of (n = 5), being physically active. Participants nominated and ranked 21 barriers and 18 facilitators. Barriers indicated lack of knowledge of how to fit physical activity into a daily schedule, work, caring for family members, and prioritizing sedentary pursuits. Other responses included environmental barriers such as lack of access and transportation to a gym, unsafe walking conditions, and inclement weather. Facilitators to following recommendations included knowledge of health benefits of physical activity and the perception of physical activity as enjoyable, including feeling good when working out. Environmental facilitators included being outdoors walking and biking as well as parks and exercise facilities. Responses provided direction for locally designed community-based programs to promote facilitators and decrease barriers to individual’s engagement in physical activity. PMID:25421064

Operationalization of Sign Language Phonological Similarity and its Effects on Lexical Access.

PubMed

Williams, Joshua T; Stone, Adam; Newman, Sharlene D

2017-07-01

Cognitive mechanisms for sign language lexical access are fairly unknown. This study investigated whether phonological similarity facilitates lexical retrieval in sign languages using measures from a new lexical database for American Sign Language. Additionally, it aimed to determine which similarity metric best fits the present data in order to inform theories of how phonological similarity is constructed within the lexicon and to aid in the operationalization of phonological similarity in sign language. Sign repetition latencies and accuracy were obtained when native signers were asked to reproduce a sign displayed on a computer screen. Results indicated that, as predicted, phonological similarity facilitated repetition latencies and accuracy as long as there were no strict constraints on the type of sublexical features that overlapped. The data converged to suggest that one similarity measure, MaxD, defined as the overlap of any 4 sublexical features, likely best represents mechanisms of phonological similarity in the mental lexicon. Together, these data suggest that lexical access in sign language is facilitated by phonologically similar lexical representations in memory and the optimal operationalization is defined as liberal constraints on overlap of 4 out of 5 sublexical features-similar to the majority of extant definitions in the literature. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The Sequences of 1,504 Mutants in the Model Rice Variety Kitaake Facilitate Rapid Functional Genomic Studies

DOE PAGES

Li, Guotian; Jain, Rashmi; Chern, Mawsheng; ...

2017-06-02

The availability of a whole-genome sequenced mutant population and the cataloging of mutations of each line at a single-nucleotide resolution facilitate functional genomic analysis. To this end, we generated and sequenced a fast-neutron-induced mutant population in the model rice cultivar Kitaake (Oryza sativa ssp japonica), which completes its life cycle in 9 weeks. We sequenced 1504 mutant lines at 45-fold coverage and identified 91,513 mutations affecting 32,307 genes, i.e., 58% of all rice genes. We detected an average of 61 mutations per line. Mutation types include single-base substitutions, deletions, insertions, inversions, translocations, and tandem duplications. We observed a high proportionmore » of loss-of-function mutations. We identified an inversion affecting a single gene as the causative mutation for the short-grain phenotype in one mutant line. This result reveals the usefulness of the resource for efficient, cost-effective identification of genes conferring specific phenotypes. To facilitate public access to this genetic resource, we established an open access database called KitBase that provides access to sequence data and seed stocks. This population complements other available mutant collections and gene-editing technologies. In conclusion, this work demonstrates how inexpensive next-generation sequencing can be applied to generate a high-density catalog of mutations.« less

An Everting Ureteral Access Sheath: Concepts and In Vitro Testing

NASA Astrophysics Data System (ADS)

Lee, Keith L.; Stoller, Marshall L.

2007-04-01

Ureteral access sheaths have been a recent innovation in facilitating ureteral stone surgery. Once properly placed, access sheaths allow the movement of ureteroscopes and other instruments through the ureter with minimal injury to the urothelium. However, there are shortcomings of the current device designs. Initial sheath placement requires significant force, and shear stress can injure the ureter. In addition, inadvertent advancement of the outer sheath without the inner introducer stylet can tear and avulse the ureter. A novel eversion design incorporating a lubricous film provides marked improvement over current access sheaths. In bench top and animal models, the eversion shealths require less force during advancement, cause less injury to the urothelial tissue, and have a lower potential of introducing extraneous materials (e.g., microbes) into a simulated urinary tract. While, the everting design provides important advantages over traditional non-everting designs, further preclinical and clinical trials are required.

Changing Students' Perceptions of Inequality?: Combining Traditional Methods and a Budget Exercise to Facilitate a Sociological Perspective

ERIC Educational Resources Information Center

Garoutte, Lisa; Bobbitt-Zeher, Donna

2011-01-01

Budget exercises are frequently used in introductory and social problems courses to facilitate student understanding of income inequality. But do these exercises actually lead to greater sociological understanding? To explore this issue, the authors studied undergraduate students enrolled in introductory sociology courses during the 2008-2009…

Physician perspectives on a tailored multifaceted primary care practice facilitation intervention for improvement of cardiovascular care.

PubMed

Liddy, Clare; Singh, Jatinderpreet; Guo, Merry; Hogg, William

2016-02-01

Practice facilitation is an effective way to help physicians implement change in their clinics, but little is known about physicians' perspectives on this service. To examine physicians' responses to a practice facilitation program, focussing on their overall satisfaction, perceived most significant clinical changes, and interactions with the facilitator. The Improved Delivery of Cardiovascular Care program investigated the impact of practice facilitation on improving the quality of cardiovascular primary care in Eastern Ontario, Canada, from 2007 to 2011. We conducted a qualitative content analysis of post-intervention surveys completed by participating physicians, using a constant comparison approach framed around the Chronic Care Model. Ninety-five physicians completed the survey. Physicians overwhelmingly viewed the program positively, though descriptions of its benefits and impact varied widely. Facilitators filled three key roles for physicians, acting as a resource centre, motivator and outside perspective. Physicians adopted a number of changes in their practices. These changes include adoption of clinical information systems (diabetes registries), decision support tools (chart audits, guideline documents, flow sheets) and delivery system design (community resources). Most physicians appreciated having access to a practice facilitator and viewed the intervention positively. Insight into physicians' perspectives on practice facilitation provides a valuable counterpoint to outcomes-based evaluations of such services. Further research should investigate potential obstacles in the group of physicians who make fewer practice changes, as well as the sustainability of this type of facilitation intervention. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Enhancing Access to Patient Education Information: A Pilot Usability Study

PubMed Central

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

2005-01-01

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

Preparing Facilitators From Community-Based Organizations for Evidence-Based Intervention Training in Second Life

PubMed Central

Valladares, Angel Felix; Tschannen, Dana; Villarruel, Antonia Maria

2014-01-01

Background A major barrier to the use and scale-up of evidence-based interventions are challenges related to training and capacity building. A cost-effective and highly interactive multi-user virtual environment, Second Life (SL) is a promising alternative for comprehensive face-to-face facilitator training. Objective The purpose of this study was to examine the feasibility of using SL to train facilitators from community-based organizations to use ¡Cuídate! (Take Care of Yourself), one of the few evidence-based interventions developed and tested with Latino youth to reduce sexual risk behaviors. Methods We recruited 35 participants from community-based organizations throughout the United States to participate in the SL ¡Cuídate! Training of Facilitators. Preparation to use SL consisted of four phases: (1) recruitment and computer capacity screening, (2) enrollment, (3) orientation to the SL program, and (4) technical support throughout the synchronous training sessions. Technical difficulties, the associated cause, and the mitigation strategy implemented were recorded during each session. Participants completed evaluations including perceptions of self-efficacy and confidence to complete the necessary skills to participate in SL training. Results Overall, participants reported high levels of self-efficacy for all skills necessary to participate in SL training. Based on an 11-point scale (0-10), self-efficacy to download and access the software was rated the highest: mean 8.29 (SD 2.19). Interacting with items in SL had the lowest mean score: mean 7.49 (SD 2.89). The majority of technical difficulties experienced by participants were related to inadequate Internet connections or computer malfunctions. Conclusions Our findings support the feasibility of using SL for the ¡Cuídate! Training of Facilitators. The process used in this study to prepare participants to use SL can be used as a basis for other evidence-based intervention training in SL. This study is

Preparing facilitators from community-based organizations for evidence-based intervention training in Second Life.

PubMed

Valladares, Angel Felix; Aebersold, Michelle; Tschannen, Dana; Villarruel, Antonia Maria

2014-09-30

A major barrier to the use and scale-up of evidence-based interventions are challenges related to training and capacity building. A cost-effective and highly interactive multi-user virtual environment, Second Life (SL) is a promising alternative for comprehensive face-to-face facilitator training. The purpose of this study was to examine the feasibility of using SL to train facilitators from community-based organizations to use ¡Cuídate! (Take Care of Yourself), one of the few evidence-based interventions developed and tested with Latino youth to reduce sexual risk behaviors. We recruited 35 participants from community-based organizations throughout the United States to participate in the SL ¡Cuídate! Training of Facilitators. Preparation to use SL consisted of four phases: (1) recruitment and computer capacity screening, (2) enrollment, (3) orientation to the SL program, and (4) technical support throughout the synchronous training sessions. Technical difficulties, the associated cause, and the mitigation strategy implemented were recorded during each session. Participants completed evaluations including perceptions of self-efficacy and confidence to complete the necessary skills to participate in SL training. Overall, participants reported high levels of self-efficacy for all skills necessary to participate in SL training. Based on an 11-point scale (0-10), self-efficacy to download and access the software was rated the highest: mean 8.29 (SD 2.19). Interacting with items in SL had the lowest mean score: mean 7.49 (SD 2.89). The majority of technical difficulties experienced by participants were related to inadequate Internet connections or computer malfunctions. Our findings support the feasibility of using SL for the ¡Cuídate! Training of Facilitators. The process used in this study to prepare participants to use SL can be used as a basis for other evidence-based intervention training in SL. This study is an important contribution to developing cost

Internet Information-Seeking and Its Relation to Support for Access to Government Records

ERIC Educational Resources Information Center

Cuillier, David; Piotrowski, Suzanne J.

2009-01-01

Public access to government records is essential for democratic self-governance, and attitudes toward that right can facilitate or hinder public policy regarding transparency. As more people use the internet for gathering information about their governments and communities, it is unknown whether such online information-seeking is related to…

Smallholder Marketing Cooperatives and Smallholders' Market Access: Lessons Learned from the Actors Involved

ERIC Educational Resources Information Center

Gouet, Christian; Van Paassen, Annemarie

2012-01-01

Purpose: This article explores the views of Smallholder Marketing Cooperatives' (SMCs) leaders and staff, to gain insight about the particular roles SMCs play in facilitating smallholders' market access. Design/methodology/approach: The authors conceptualized and executed two international workshops in which participants from 42 SMCs from 24…

Facilitating biomedical researchers' interrogation of electronic health record data: Ideas from outside of biomedical informatics.

PubMed

Hruby, Gregory W; Matsoukas, Konstantina; Cimino, James J; Weng, Chunhua

2016-04-01

Electronic health records (EHR) are a vital data resource for research uses, including cohort identification, phenotyping, pharmacovigilance, and public health surveillance. To realize the promise of EHR data for accelerating clinical research, it is imperative to enable efficient and autonomous EHR data interrogation by end users such as biomedical researchers. This paper surveys state-of-art approaches and key methodological considerations to this purpose. We adapted a previously published conceptual framework for interactive information retrieval, which defines three entities: user, channel, and source, by elaborating on channels for query formulation in the context of facilitating end users to interrogate EHR data. We show the current progress in biomedical informatics mainly lies in support for query execution and information modeling, primarily due to emphases on infrastructure development for data integration and data access via self-service query tools, but has neglected user support needed during iteratively query formulation processes, which can be costly and error-prone. In contrast, the information science literature has offered elaborate theories and methods for user modeling and query formulation support. The two bodies of literature are complementary, implying opportunities for cross-disciplinary idea exchange. On this basis, we outline the directions for future informatics research to improve our understanding of user needs and requirements for facilitating autonomous interrogation of EHR data by biomedical researchers. We suggest that cross-disciplinary translational research between biomedical informatics and information science can benefit our research in facilitating efficient data access in life sciences. Copyright © 2016 Elsevier Inc. All rights reserved.

Beliefs, Barriers and Facilitators to Physical Activity in Bariatric Surgery Candidates.

PubMed

Zabatiero, Juliana; Hill, Kylie; Gucciardi, Daniel F; Hamdorf, Jeffrey M; Taylor, Susan F; Hagger, Martin S; Smith, Anne

2016-05-01

Bariatric surgery candidates engage in less physical activity (PA) and spend longer periods in sedentary behaviour (SB) when compared to the general adult population. The aim of this study was to explore the beliefs about PA and perceived barriers and facilitators to PA in obese adults scheduled for bariatric surgery. Nineteen obese adults (15 females), with a mean (SD) age of 41.6 (12.1) years, weight of 119.2 (20.5) kg and body mass index of 41.6 (6.7) kg/m(2) participated in a one-on-one in-depth qualitative interview before undergoing bariatric surgery. Data were analysed using inductive thematic analysis. Most participants believed that engaging in regular PA confers important health benefits, however reported insufficient PA levels to obtain those benefits. The perceived barriers to PA reported by participants were both obesity related (e.g. bodily pain, physical limitation and self-presentational concerns) and non-obesity related (e.g. lack of motivation, environment and restricted resources). All participants stated weight loss to be the main perceived facilitator to PA, together with social factors, better time management and access to financial resources. In bariatric surgery candidates, many of the perceived barriers and facilitators to PA are not obesity related and are therefore unlikely to change as a result of bariatric surgery. This may explain why earlier research shows little change in PA or SB following surgery. It is likely that an approach that aims to address the barriers and facilitators identified in this study is needed to change the inactive lifestyle adopted in this population.

Automatic Semantic Facilitation in Anterior Temporal Cortex Revealed through Multimodal Neuroimaging

PubMed Central

Gramfort, Alexandre; Hämäläinen, Matti S.; Kuperberg, Gina R.

2013-01-01

A core property of human semantic processing is the rapid, facilitatory influence of prior input on extracting the meaning of what comes next, even under conditions of minimal awareness. Previous work has shown a number of neurophysiological indices of this facilitation, but the mapping between time course and localization—critical for separating automatic semantic facilitation from other mechanisms—has thus far been unclear. In the current study, we used a multimodal imaging approach to isolate early, bottom-up effects of context on semantic memory, acquiring a combination of electroencephalography (EEG), magnetoencephalography (MEG), and functional magnetic resonance imaging (fMRI) measurements in the same individuals with a masked semantic priming paradigm. Across techniques, the results provide a strikingly convergent picture of early automatic semantic facilitation. Event-related potentials demonstrated early sensitivity to semantic association between 300 and 500 ms; MEG localized the differential neural response within this time window to the left anterior temporal cortex, and fMRI localized the effect more precisely to the left anterior superior temporal gyrus, a region previously implicated in semantic associative processing. However, fMRI diverged from early EEG/MEG measures in revealing semantic enhancement effects within frontal and parietal regions, perhaps reflecting downstream attempts to consciously access the semantic features of the masked prime. Together, these results provide strong evidence that automatic associative semantic facilitation is realized as reduced activity within the left anterior superior temporal cortex between 300 and 500 ms after a word is presented, and emphasize the importance of multimodal neuroimaging approaches in distinguishing the contributions of multiple regions to semantic processing. PMID:24155321

A qualitative study examining the perceived barriers and facilitators to medical healthcare services among women with a serious mental illness.

PubMed

Borba, Christina P C; DePadilla, Lara; McCarty, Frances A; von Esenwein, Silke A; Druss, Benjamin G; Sterk, Claire E

2012-03-01

This qualitative study investigates the barriers and facilitators to accessing and utilizing healthcare services among women with a serious mental illness (SMI). A purposive sample of 30 poor, urban, predominantly African-American women with a diagnosis of an SMI was recruited. Interviews were audio-taped and transcribed verbatim. Data analysis was guided by a modified constant comparison approach. The findings highlight a variety of nonmedical factors that serve as both barriers and facilitators to accessing and utilizing medical healthcare services, such as a trusting relationship with a mental health provider and a women's social network. Nonmedical factors and personal circumstances seem to be important factors influencing pathways to healthcare services among women with an SMI. Efforts to better engage and retain women with an SMI into healthcare will need to better acknowledge and incorporate the larger social context of the women's lives. Copyright © 2012 Jacobs Institute of Women

Accessibility of condoms to young people in Manchester, UK.

PubMed

Sixsmith, Judith; Griffiths, John; Hughes, John; Wren, Joanne; Penfold, Steve; Natusch, Hilary

2006-10-01

Issues relevant to the accessibility of male condoms for young people in the Greater Manchester area (UK) were investigated, using semi-structured, in-depth interviews and a questionnaire survey. Family planning clinics and condom vending machines (CVMs) were the most cited sources for condom acquisition. Young people's knowledge of where and when they could access condoms varied by age and gender. Suitable positioning of CVMs would need to take such variations into account when targeting potential customers. Levels of embarrassment about acquiring condoms also varied according to gender. The lifestyles of young people indicated the sorts of places in which CVMs might offer increased accessibility. For younger men and women this tended to involve low-cost, semi-private places such as local parks, school toilets and shopping malls/streets. Older men with higher spending power and increased confidence could access condoms through pub and club toilets and chemist shops. Accessible positioning of CVMs was related to the age, gender and lifestyle of the participants, and programmes to enhance accessibility should reflect this. Increased accessibility for younger groups, and especially women, needs to take into account issues of cost, confidence and embarrassment. For older groups, lifestyle choices indicated pubs and clubs as key locations for both men and women.

Transforming Marginalised Adult Learners' Views of Themselves: Access to Higher Education Courses in England

ERIC Educational Resources Information Center

Busher, Hugh; James, Nalita; Piela, Anna; Palmer, Anna-Marie

2014-01-01

Adult learners on Access to Higher Education courses struggled with institutional and social structures to attend their courses, but transformed their identities as learners through them. Although asymmetrical power relationships dominated the intentional learning communities of their courses, their work was facilitated by collaborative cultures…

Socioieconomic outcomes of restricted access to abortion.

PubMed

Muller, C

1971-06-01

Such questions as the extent to which greater accessibility to abortion services affects poverty and its problems are analyzed, and proposals for identifying the socioeconomic impact of liberalized abortion laws and accessible services are developed. The number of unwanted children born is directly affected by the barriers to legal abortion. In countries that have improved access to legal abortion, the demand for the service has risen among all socioeconomic groups. Long-time family earning potential is severely effected by the defects in the timing and spacing of the birth of children, which often leads to young men and pregnant teen-agers leaving school because of the burdens of pregnancy and child support. Large family size was found in 35% of families in 1965 where the head of the household was a fully employed worker. Children born and living as psychologically rejected or unwanted children risk impaired learning and development which in turn limits future economic achievments. Research into the access of and financing of abortion services should deal with the financial needs of patient groups. The effects of nonhospital service programs, manpower needs, and the surveillance of gaps and coverage of the service needs should be prime research targets.

New Collaboration Among Geodesy Data Centers in Europe and the US Facilitates Data Discovery and Access

NASA Astrophysics Data System (ADS)

Boler, Fran; Wier, Stuart; D'Agostino, Nicola; Fernandes, Rui R. M.; Ganas, Athanassios; Bruyninx, Carine; Ofeigsson, Benedikt

2014-05-01

COOPEUS, the European Union project to strengthen the cooperation between the US and the EU in the field of environmental research infrastructures, is linking the US NSF-supported geodesy Facility at UNAVCO with the European Plate Observing System (EPOS) in joint research infrastructure enhancement activities that will ultimately advance international geodesy data discovery and access. (COOPEUS also links a broad set of additional EU and US based Earth, oceans, and environmental science research entities in joint research infrastructure enhancement activities.) The UNAVCO Data Center in Boulder, Colorado, archives for preservation and distributes geodesy data and products, including hosting GNSS data from 2,500 continuously operating stations around the globe. UNAVCO is only one of several hundred data centers worldwide hosting GNSS data, which are valuable for scientific research, education, hazards assessment and monitoring, and emergency management. However, the disparate data holdings structures, metadata encodings, and infrastructures at these data centers represent a significant obstacle to use by scientists, government entities, educators and the public. Recently a NASA-funded project at UNAVCO and two partner geodesy data centers in the US (CDDIS and SOPAC) has successfully designed and implemented software for simplified data search and access called the Geodesy Seamless Archive Centers (GSAC). GSAC is a web services based technology that is intended to be simple to install and run for most geodesy data centers. The GSAC services utilize a repository layer and a service layer to identify and present both the required metadata elements along with any data center-specific services and capabilities. In addition to enabling web services and related capabilities at the data center level, GSAC repository code can be implemented to federate two or more GSAC-enabled data centers wishing to present a unified search and access capability to their user community. In

New Collaboration Among Geodesy Data Centers in Europe and the US Facilitates Data Discovery and Access

NASA Astrophysics Data System (ADS)

Boler, F. M.; Wier, S.; D'Agostino, N.; Fernandes, R. M.; Ganas, A.; Bruyninx, C.

2013-12-01

COOPEUS, the European Union project to strengthen the cooperation between the US and the EU in the field of environmental research infrastructures, is linking the US NSF-supported geodesy Facility at UNAVCO with the European Plate Observing System (EPOS) in joint research infrastructure enhancement activities that will ultimately advance international geodesy data discovery and access. (COOPEUS also links a broad set of additional EU and US based Earth, oceans, and environmental science research entities in joint research infrastructure enhancement activities.) The UNAVCO Data Center in Boulder, Colorado, archives for preservation and distributes geodesy data and products, including hosting GNSS data from 2,500 continuously operating stations around the globe. UNAVCO is only one of several hundred data centers worldwide hosting GNSS data, which are valuable for scientific research, education, hazards assessment and monitoring, and emergency management. However, the disparate data holdings structures, metadata encodings, and infrastructures at these data centers represent a significant obstacle to use by scientists, government entities, educators and the public. Recently a NASA-funded project at UNAVCO and two partner geodesy data centers in the US (CDDIS and SOPAC) has successfully designed and implemented software for simplified data search and access called the Geodesy Seamless Archive Centers (GSAC). GSAC is a web services based technology that is intended to be simple to install and run for most geodesy data centers. The GSAC services utilize a repository layer and a service layer to identify and present both the required metadata elements along with any data center-specific services and capabilities. In addition to enabling web services and related capabilities at the data center level, GSAC repository code can be implemented to federate two or more GSAC-enabled data centers wishing to present a unified search and access capability to their user community

Trends in Disparities in Low-Income Children's Health Insurance Coverage and Access to Care by Family Immigration Status.

PubMed

Jarlenski, Marian; Baller, Julia; Borrero, Sonya; Bennett, Wendy L

2016-03-01

To examine time trends in disparities in low-income children's health insurance coverage and access to care by family immigration status. We used data from the National Survey of Children's Health in 2003 to 2011-2012, including 83,612 children aged 0 to 17 years with family incomes <200% of the federal poverty level. We examined 3 immigration status categories: citizen children with nonimmigrant parents; citizen children with immigrant parents; and immigrant children. We used multivariable regression analyses to obtain adjusted trends in health insurance coverage and access to care. All low-income children experienced gains in health insurance coverage and access to care from 2003 to 2011-2012, regardless of family immigration status. Relative to citizen children with nonimmigrant parents, citizen children with immigrant parents had a 5 percentage point greater increase in health insurance coverage (P = .06), a 9 percentage point greater increase in having a personal doctor or nurse (P < .01), and an 11 percentage point greater increase in having no unmet medical need (P < .01). Immigrant children had significantly lower health insurance coverage than other groups. However, the group had a 14 percentage point greater increase in having a personal doctor or nurse (P < .01) and a 26 percentage point greater increase in having no unmet medical need (P < .01) relative to citizen children with nonimmigrant parents. Some disparities in access to care related to family immigration status have lessened over time among children in low-income families, although large disparities still exist. Policy efforts are needed to ensure that children of immigrant parents and immigrant children are able to access health insurance and health care. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Improving Access to Online Multilingual Resources by Adopting the My Language Portal in the City of Greater Dandenong Libraries

ERIC Educational Resources Information Center

Bogdanovic, Marijana; Johanson, Graeme

2007-01-01

This paper reports on the implementation of "My Language Portal" in the City of Greater Dandenong Libraries (CGDL), Melbourne, Victoria, through the development of a "My Language Portal Project Plan" in 2006. It discusses how the aims of the designers of My Language Portal (MLP) are fulfilled in the exceptional, changing…

Substrate-Induced Facilitated Dissociation of the Competitive Inhibitor from the Active Site of O-Acetyl Serine Sulfhydrylase Reveals a Competitive-Allostery Mechanism.

PubMed

Singh, Appu Kumar; Ekka, Mary Krishna; Kaushik, Abhishek; Pandya, Vaibhav; Singh, Ravi P; Banerjee, Shrijita; Mittal, Monica; Singh, Vijay; Kumaran, S

2017-09-19

By classical competitive antagonism, a substrate and competitive inhibitor must bind mutually exclusively to the active site. The competitive inhibition of O-acetyl serine sulfhydrylase (OASS) by the C-terminus of serine acetyltransferase (SAT) presents a paradox, because the C-terminus of SAT binds to the active site of OASS with an affinity that is 4-6 log-fold (10 4 -10 6 ) greater than that of the substrate. Therefore, we employed multiple approaches to understand how the substrate gains access to the OASS active site under physiological conditions. Single-molecule and ensemble approaches showed that the active site-bound high-affinity competitive inhibitor is actively dissociated by the substrate, which is not consistent with classical views of competitive antagonism. We employed fast-flow kinetic approaches to demonstrate that substrate-mediated dissociation of full length SAT-OASS (cysteine regulatory complex) follows a noncanonical "facilitated dissociation" mechanism. To understand the mechanism by which the substrate induces inhibitor dissociation, we resolved the crystal structures of enzyme·inhibitor·substrate ternary complexes. Crystal structures reveal a competitive allosteric binding mechanism in which the substrate intrudes into the inhibitor-bound active site and disengages the inhibitor before occupying the site vacated by the inhibitor. In summary, here we reveal a new type of competitive allosteric binding mechanism by which one of the competitive antagonists facilitates the dissociation of the other. Together, our results indicate that "competitive allostery" is the general feature of noncanonical "facilitated/accelerated dissociation" mechanisms. Further understanding of the mechanistic framework of "competitive allosteric" mechanism may allow us to design a new family of "competitive allosteric drugs/small molecules" that will have improved selectivity and specificity as compared to their competitive and allosteric counterparts.

Barriers and Facilitators to Adoption of a Lay-Delivered Community-Based Strength Training Program for Women in Rural Areas

ERIC Educational Resources Information Center

Washburn, Lisa T.; Cornell, Carol E.; Traywick, LaVona; Felix, Holly C.; Phillips, Martha E.

2017-01-01

Background: Limited access to fitness programs for rural older adults make lay or volunteer delivery approaches potentially desirable to extend reach. However, factors affecting adoption of such approaches are not well explored. Purpose: This study sought to identify barriers and facilitators affecting adoption of a volunteer lay delivery approach…

ICT Accessibility and Usability to Support Learning of Visually-Impaired Students in Tanzania

ERIC Educational Resources Information Center

Eligi, Innosencia; Mwantimwa, Kelefa

2017-01-01

The main objective of this study was to assess the accessibility and usability of Information and Communication Technology facilities to facilitate learning among visually-impaired students at the University of Dar es Salaam (UDSM). The study employed a mixed methods design in gathering, processing and analysing quantitative and qualitative data.…

Integrating across Episodes: Investigating the Long-term Accessibility of Self-derived Knowledge in 4-Year-Old Children

PubMed Central

Varga, Nicole L.; Stewart, Rebekah A.; Bauer, Patricia J.

2016-01-01

Semantic memory, defined as our store of knowledge about the world, provides representational support for all of our higher order cognitive functions. As such, it is crucial that the contents of semantic memory remain accessible over time. Although memory for knowledge learned through direct observation has been previously investigated, we know very little about the retention of knowledge derived through integration of information acquired across separate learning episodes. The present research investigated cross-episode integration in 4-year-old children. Participants were presented with novel facts via distinct story episodes and tested for knowledge extension through cross-episode integration, as well as for retention of the information over a 1-week delay. In Experiment 1, children retained the self-derived knowledge over the delay, though performance was primarily evidenced in a forced-choice format. In Experiment 2, we sought to facilitate the accessibility and robustness of self-derived knowledge by providing a verbal reminder after the delay. The accessibility of self-derived knowledge increased, irrespective of whether participants successfully demonstrated knowledge of the integration facts during the first visit. The results suggest knowledge extended through integration remains accessible after delays, even in a population in which this learning process is less robust. The findings also demonstrate the facilitative effect of reminders on the accessibility and further extension of knowledge over extended time periods. PMID:26774259

Predator facilitation or interference: a game of vipers and owls.

PubMed

Embar, Keren; Raveh, Ashael; Hoffmann, Ishai; Kotler, Burt P

2014-04-01

In predator-prey foraging games, the prey's reaction to one type of predator may either facilitate or hinder the success of another predator. We ask, do different predator species affect each other's patch selection? If the predators facilitate each other, they should prefer to hunt in the same patch; if they interfere, they should prefer to hunt alone. We performed an experiment in a large outdoor vivarium where we presented barn owls (Tyto alba) with a choice of hunting greater Egyptian gerbils (Gerbillus pyramidum) in patches with or without Saharan horned vipers (Cerastes cerastes). Gerbils foraged on feeding trays set under bushes or in the open. We monitored owl location, activity, and hunting attempts, viper activity and ambush site location, and the foraging behavior of the gerbils in bush and open microhabitats. Owls directed more attacks towards patches with vipers, and vipers were more active in the presence of owls. Owls and vipers facilitated each other's hunting through their combined effect on gerbil behavior, especially on full moon nights when vipers are more active. Owls forced gerbils into the bushes where vipers preferred to ambush, while viper presence chased gerbils into the open where they were exposed to owls. Owls and vipers took advantage of their indirect positive effect on each other. In the foraging game context, they improve each other's patch quality and hunting success.

Development and pilot evaluation of an Internet-facilitated cognitive-behavioral intervention for maternal depression.

PubMed

Sheeber, Lisa B; Seeley, John R; Feil, Edward G; Davis, Betsy; Sorensen, Erik; Kosty, Derek B; Lewinsohn, Peter M

2012-10-01

Develop and pilot an Internet-facilitated cognitive-behavioral treatment intervention for depression, tailored to economically disadvantaged mothers of young children. Mothers (N = 70) of children enrolled in Head Start, who reported elevated levels of depressive symptoms, were randomized to either the 8-session, Internet-facilitated intervention (Mom-Net) or delayed intervention/facilitated treatment-as-usual (DI/TAU). Outcomes were measured using the Beck Depression Inventory (BDI-II; Beck, Steer, & Brown, 1996); the Patient Health Questionnaire 9 (PHQ-9; Spitzer et al., 1999), Behavioral Observations of Parent-Child Interactions using the Living in Family Environments coding system (LIFE; Hops, Davis, & Longoria, 1995); the Dyadic Parent-Child Interaction Coding Systems (DPICS; Eyberg, Nelson, Duke, & Boggs, 2005); the Parent Behavior Inventory (PBI; Lovejoy, Weis, O'Hare, & Rubin, 1999); and the Parenting Sense of Competence scale (PSOC; Gibaud-Wallston & Wandersman, 1978). Mom-Net demonstrated high levels of feasibility as indicated by low attrition and high program usage and satisfaction ratings. Participants in the Mom-Net condition demonstrated significantly greater reduction in depression, the primary outcome, at the level of both symptoms and estimates of criteria-based diagnoses over the course of the intervention. They also demonstrated significantly greater improvement on a questionnaire measure of parent satisfaction and efficacy as well as on both questionnaire and observational indices of harsh parenting behavior. Initial results suggest that the Mom-Net intervention is feasible and efficacious as a remotely delivered intervention for economically disadvantaged mothers. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Exploring Facilitators of Post-traumatic Growth in Patients with Spinal Cord Injury: A Qualitative Study

PubMed Central

Khanjani, Mohammad Saeed; Younesi, Seyed Jalal; Khankeh, Hamid Reza; Azkhosh, Manouchehr

2017-01-01

Introduction There is increasing evidence regarding people’s reactions to life stressors in which people also may show positive experiences following a traumatic event. The aim of the present study was to explain the facilitators of post-traumatic growth based on the experiences of patients with a spinal cord injury. Methods This was a qualitative study conducted on 16 Iranian patients with a spinal cord injury using semistructured, in-depth interviews, and content analysis in 2015. These participants, despite their spinal cord injury, were successful in their lives and were considered successful members of society. A purposive sampling method was used until reaching data saturation, and then the collected data were analyzed using a content analysis method. Results The study revealed several factors as facilitators of post-traumatic growth in the patients. The extracted facilitators were put into seven categories of main concepts, including existence of support resources, contact with spinal cord injury associations, spiritual beliefs, positive attitude toward injury, access to proper facilities, enhancement of knowledge and awareness, and active presence in society. Conclusion Different factors may facilitate post-traumatic growth in patients with a spinal cord injury. Understanding these facilitators may help us in designing educational, support, and consulting programs for patients and their families as well as to the correct the support programs. PMID:28243405

Facilitators and Barriers to Dental Care Among Mexican Migrant Women and Their Families in North San Diego County.

PubMed

Velez, Diane; Palomo-Zerfas, Ana; Nunez-Alvarez, Arcela; Ayala, Guadalupe X; Finlayson, Tracy L

2017-10-01

To qualitatively examine facilitators and barriers to dental care access and quality services among Mexican migrant women and their families living in North San Diego County, California. Six focus groups were conducted, with 52 participants. Three focus groups were with community residents (average group size of 10), and three were with community health workers/leaders (called Lideres; average group size of 7). The behavioral model for vulnerable populations theoretical framework guided qualitative data analyses. Predisposing factors to dental care access varied and included immigration status, language, and dental care experiences. Barriers to accessing quality dental services included high cost, lack of insurance coverage, dissatisfaction with providers, long wait times and discrimination. Participants expressed a desire for health policy changes, including affordable coverage for immigrants and their families. This study provided insights into how dental care providers, community health centers, and policymakers can improve dental care access and services to migrant populations.

The NIF DISCO Framework: facilitating automated integration of neuroscience content on the web.

PubMed

Marenco, Luis; Wang, Rixin; Shepherd, Gordon M; Miller, Perry L

2010-06-01

This paper describes the capabilities of DISCO, an extensible approach that supports integrative Web-based information dissemination. DISCO is a component of the Neuroscience Information Framework (NIF), an NIH Neuroscience Blueprint initiative that facilitates integrated access to diverse neuroscience resources via the Internet. DISCO facilitates the automated maintenance of several distinct capabilities using a collection of files 1) that are maintained locally by the developers of participating neuroscience resources and 2) that are "harvested" on a regular basis by a central DISCO server. This approach allows central NIF capabilities to be updated as each resource's content changes over time. DISCO currently supports the following capabilities: 1) resource descriptions, 2) "LinkOut" to a resource's data items from NCBI Entrez resources such as PubMed, 3) Web-based interoperation with a resource, 4) sharing a resource's lexicon and ontology, 5) sharing a resource's database schema, and 6) participation by the resource in neuroscience-related RSS news dissemination. The developers of a resource are free to choose which DISCO capabilities their resource will participate in. Although DISCO is used by NIF to facilitate neuroscience data integration, its capabilities have general applicability to other areas of research.

Benefits of testing for nontested information: retrieval-induced facilitation of episodically bound material.

PubMed

Rowland, Christopher A; DeLosh, Edward L

2014-12-01

Testing is a powerful means to boost the retention of information. The extent to which the benefits of testing generalize to nontested information, however, is not clear. In three experiments, we found that completing cued-recall tests for a subset of studied materials enhanced retention for the specific information tested, as well as for associated, nontested information during later free-recall testing. In Experiment 1, this generalized benefit was revealed for lists of category-exemplar pairs. Experiment 2 extended the effect to unrelated words, suggesting that retrieval can enhance later free recall of nontested information that is bound solely through episodic context. In Experiment 3, we manipulated the format of the final test and found facilitation in free-recall, but not in cued-recall, testing. The results suggest that testing may facilitate later free recall in part by enhancing access to information that is present during a prior temporal or list context. More generally, these findings suggest that retrieval-induced facilitation extends to a broader range of conditions than has previously been suggested, and they further motivate the adoption of testing as a practical and effective learning tool.

Discrepant visual speech facilitates covert selective listening in "cocktail party" conditions.

PubMed

Williams, Jason A

2012-06-01

The presence of congruent visual speech information facilitates the identification of auditory speech, while the addition of incongruent visual speech information often impairs accuracy. This latter arrangement occurs naturally when one is being directly addressed in conversation but listens to a different speaker. Under these conditions, performance may diminish since: (a) one is bereft of the facilitative effects of the corresponding lip motion and (b) one becomes subject to visual distortion by incongruent visual speech; by contrast, speech intelligibility may be improved due to (c) bimodal localization of the central unattended stimulus. Participants were exposed to centrally presented visual and auditory speech while attending to a peripheral speech stream. In some trials, the lip movements of the central visual stimulus matched the unattended speech stream; in others, the lip movements matched the attended peripheral speech. Accuracy for the peripheral stimulus was nearly one standard deviation greater with incongruent visual information, compared to the congruent condition which provided bimodal pattern recognition cues. Likely, the bimodal localization of the central stimulus further differentiated the stimuli and thus facilitated intelligibility. Results are discussed with regard to similar findings in an investigation of the ventriloquist effect, and the relative strength of localization and speech cues in covert listening.

Global access to surgical care: a modelling study.

PubMed

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

2015-06-01

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

Implementing new care models: learning from the Greater Manchester demonstrator pilot experience.

PubMed

Elvey, Rebecca; Bailey, Simon; Checkland, Kath; McBride, Anne; Parkin, Stephen; Rothwell, Katy; Hodgson, Damian

2018-06-19

Current health policy focuses on improving accessibility, increasing integration and shifting resources from hospitals to community and primary care. Initiatives aimed at achieving these policy aims have supported the implementation of various 'new models of care', including general practice offering 'additional availability' appointments during evenings and at weekends. In Greater Manchester, six 'demonstrator sites' were funded: four sites delivered additional availability appointments, other services included case management and rapid response. The aim of this paper is to explore the factors influencing the implementation of services within a programme designed to improve access to primary care. The paper consists of a qualitative process evaluation undertaken within provider organisations, including general practices, hospitals and care homes. Semi-structured interviews, with the data subjected to thematic analysis. Ninety-one people participated in interviews. Six key factors were identified as important for the establishment and running of the demonstrators: information technology; information governance; workforce and organisational development; communications and engagement; supporting infrastructure; federations and alliances. These factors brought to light challenges in the attempt to provide new or modify existing services. Underpinning all factors was the issue of trust; there was consensus amongst our participants that trusting relationships, particularly between general practices, were vital for collaboration. It was also crucial that general practices trusted in the integrity of anyone external who was to work with the practice, particularly if they were to access data on the practice computer system. A dialogical approach was required, which enabled staff to see themselves as active rather than passive participants. The research highlights various challenges presented by the context within which extended access is implemented. Trust was the

Facilitators and barriers experienced by federal cross-sector partners during the implementation of a healthy eating campaign.

PubMed

Fernandez, Melissa Anne; Desroches, Sophie; Marquis, Marie; Turcotte, Mylène; Provencher, Véronique

2017-09-01

To identify facilitators and barriers that Health Canada's (HC) cross-sector partners experienced while implementing the Eat Well Campaign: Food Skills (EWC; 2013-2014) and describe how these experiences might differ according to distinct partner types. A qualitative study using hour-long semi-structured telephone interviews conducted with HC partners that were transcribed verbatim. Facilitators and barriers were identified inductively and analysed according partner types. Implementation of a national mass-media health education campaign. Twenty-one of HC's cross-sector partners (food retailers, media and health organizations) engaged in the EWC. Facilitators and barriers were grouped into seven major themes: operational elements, intervention factors, resources, collaborator traits, developer traits, partnership factors and target population factors. Four of these themes had dual roles as both facilitators and barriers (intervention factors, resources, collaborator traits and developer traits). Sub-themes identified as both facilitators and barriers illustrate the extent to which a facilitator can easily become a barrier. Partnership factors were unique facilitators, while operational and target population factors were unique barriers. Time was a barrier that was common to almost all partners regardless of partnership type. There appeared to be a greater degree of uniformity among facilitators, whereas barriers were more diverse and unique to the realities of specific types of partner. Collaborative planning will help public health organizations anticipate barriers unique to the realities of specific types of organizations. It will also prevent facilitators from becoming barriers. Advanced planning will help organizations manage time constraints and integrate activities, facilitating implementation.

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.

Patellar tendon vibration reduces the increased facilitation from quadriceps to soleus in post-stroke hemiparetic individuals.

PubMed

Maupas, Eric; Dyer, Joseph-Omer; Melo, Sibele de Andrade; Forget, Robert

2017-09-01

Stimulation of the femoral nerve in healthy people can facilitate soleus H-reflex and electromyography (EMG) activity. In stroke patients, such facilitation of transmission in spinal pathways linking the quadriceps and soleus muscles is enhanced and related to co-activation of knee and ankle extensors while sitting and walking. Soleus H-reflex facilitation can be depressed by vibration of the quadriceps in healthy people, but the effects of such vibration have never been studied on the abnormal soleus facilitation observed in people after stroke. To determine whether vibration of the quadriceps can modify the enhanced heteronymous facilitation of the soleus muscle observed in people with spastic stroke after femoral nerve stimulation and compare post-vibration effects on soleus facilitation in control and stroke individuals. Modulation of voluntary soleus EMG activity induced by femoral nerve stimulation (2×motor threshold) was assessed before, during and after vibration of the patellar tendon in 10 healthy controls and 17 stroke participants. Voluntary soleus EMG activity was facilitated by femoral nerve stimulation in 4/10 (40%) controls and 11/17 (65%) stroke participants. The level of facilitation was greater in the stroke than control group. Vibration significantly reduced early heteronymous facilitation in both groups (50% of pre-vibration values). However, the delay in recovery of soleus facilitation after vibration was shorter for the stroke than control group. The control condition with the vibrator turned off had no effect on the modulation. Patellar tendon vibration can reduce the facilitation between knee and ankle extensors, which suggests effective presynaptic inhibition but decreased post-activation depression in the lower limb of people after chronic hemiparetic stroke. Further studies are warranted to determine whether such vibration could be used to reduce the abnormal extension synergy of knee and ankle extensors in people after hemiparetic

The risk typology of healthcare access and its association with unmet healthcare needs in Asian Americans.

PubMed

Jang, Yuri; Park, Nan Sook; Yoon, Hyunwoo; Huang, Ya-Ching; Rhee, Min-Kyoung; Chiriboga, David A; Kim, Miyong T

2018-01-01

Using data from the 2015 Asian American Quality of Life Survey (N = 2,609), latent profile analysis was conducted on general (health insurance, usual place for care and income) and immigrant-specific (nativity, length of stay in the U.S., English proficiency and acculturation) risk factors of healthcare access. Latent profile analysis identified a three-cluster model (low-risk, moderate-risk and high-risk groups). Compared with the low-risk group, the odds of having an unmet healthcare need was 1.52 times greater in the moderate-risk group and 2.24 times greater in the high-risk group. Challenging the myth of model minority, the present sample of Asian Americans demonstrates its vulnerability in access to healthcare. Findings also show the heterogeneity in healthcare access risk profiles. © 2017 John Wiley & Sons Ltd.

Reactome graph database: Efficient access to complex pathway data

PubMed Central

Korninger, Florian; Viteri, Guilherme; Marin-Garcia, Pablo; Ping, Peipei; Wu, Guanming; Stein, Lincoln; D’Eustachio, Peter

2018-01-01

Reactome is a free, open-source, open-data, curated and peer-reviewed knowledgebase of biomolecular pathways. One of its main priorities is to provide easy and efficient access to its high quality curated data. At present, biological pathway databases typically store their contents in relational databases. This limits access efficiency because there are performance issues associated with queries traversing highly interconnected data. The same data in a graph database can be queried more efficiently. Here we present the rationale behind the adoption of a graph database (Neo4j) as well as the new ContentService (REST API) that provides access to these data. The Neo4j graph database and its query language, Cypher, provide efficient access to the complex Reactome data model, facilitating easy traversal and knowledge discovery. The adoption of this technology greatly improved query efficiency, reducing the average query time by 93%. The web service built on top of the graph database provides programmatic access to Reactome data by object oriented queries, but also supports more complex queries that take advantage of the new underlying graph-based data storage. By adopting graph database technology we are providing a high performance pathway data resource to the community. The Reactome graph database use case shows the power of NoSQL database engines for complex biological data types. PMID:29377902

Reactome graph database: Efficient access to complex pathway data.

PubMed

Fabregat, Antonio; Korninger, Florian; Viteri, Guilherme; Sidiropoulos, Konstantinos; Marin-Garcia, Pablo; Ping, Peipei; Wu, Guanming; Stein, Lincoln; D'Eustachio, Peter; Hermjakob, Henning

2018-01-01

Reactome is a free, open-source, open-data, curated and peer-reviewed knowledgebase of biomolecular pathways. One of its main priorities is to provide easy and efficient access to its high quality curated data. At present, biological pathway databases typically store their contents in relational databases. This limits access efficiency because there are performance issues associated with queries traversing highly interconnected data. The same data in a graph database can be queried more efficiently. Here we present the rationale behind the adoption of a graph database (Neo4j) as well as the new ContentService (REST API) that provides access to these data. The Neo4j graph database and its query language, Cypher, provide efficient access to the complex Reactome data model, facilitating easy traversal and knowledge discovery. The adoption of this technology greatly improved query efficiency, reducing the average query time by 93%. The web service built on top of the graph database provides programmatic access to Reactome data by object oriented queries, but also supports more complex queries that take advantage of the new underlying graph-based data storage. By adopting graph database technology we are providing a high performance pathway data resource to the community. The Reactome graph database use case shows the power of NoSQL database engines for complex biological data types.

Barriers and facilitators to antiretroviral therapy adherence among Peruvian adolescents living with HIV: A qualitative study

PubMed Central

Wong, Milagros; Muñoz, Maribel; Valle, Emiliano; Leon, Segundo R.; Díaz Perez, Dayana; Kolevic, Lenka; Franke, Molly

2018-01-01

AIDS deaths among adolescents are increasing globally. This qualitative study investigated the barriers and facilitators to cART adherence among Peruvian adolescents living with HIV. Guided by a social ecological model, we analyzed transcripts from 24 psychosocial support groups for HIV-positive adolescents aged 13–17 years and 15 individual, in-depth interviews with cART providers and caregivers to identify the barriers and facilitators to cART adherence at the individual, family/caregiver and hospital levels. Most barriers and facilitators to cART adherence clustered at the individual and family/caregiver levels, centering on support provided to adolescents; history of declining health due to suboptimal cART adherence; side effects from antiretroviral drugs; and cART misinformation. Interventions to support adolescent HIV cART adherence should begin at the individual and family/caregiver levels and include an educational component. No adolescent living with HIV should die from AIDS in an era of accessible cART. PMID:29447226

Barriers and Facilitators of HIV Care Engagement: Results of a Qualitative Study in St. Petersburg, Russia

PubMed Central

Kuznetsova, Anna V.; Meylakhs, Anastasia Y.; Amirkhanian, Yuri A.; Kelly, Jeffrey A.; Yakovlev, Alexey A.; Musatov, Vladimir B.; Amirkhanian, Anastasia G.

2016-01-01

Russia has a large HIV epidemic, but medical care engagement is low. Eighty HIV-positive persons in St. Petersburg completed in-depth interviews to identify barriers and facilitators of medical HIV care engagement. The most commonly-reported barriers involved difficulties accessing care providers, dissatisfaction with the quality of services, and negative attitudes of provider staff. Other barriers included not having illness symptoms, life stresses, low value placed on health, internalized stigma and wanting to hide one’s HIV status, fears of learning about one’s true health status, and substance abuse. Care facilitators were feeling responsible for one’s health and one’s family, care-related support from other HIV-positive persons, and the onset of health decline and fear of death. Substance use remission facilitated care engagement, as did good communication from providers and trust in one’s doctor. Interventions are needed in Russia to address HIV care infrastructural barriers and integrate HIV, substance abuse, care, and psychosocial services. PMID:26767534

Barriers and Facilitators of HIV Care Engagement: Results of a Qualitative Study in St. Petersburg, Russia.

PubMed

Kuznetsova, Anna V; Meylakhs, Anastasia Y; Amirkhanian, Yuri A; Kelly, Jeffrey A; Yakovlev, Alexey A; Musatov, Vladimir B; Amirkhanian, Anastasia G

2016-10-01

Russia has a large HIV epidemic, but medical care engagement is low. Eighty HIV-positive persons in St. Petersburg completed in-depth interviews to identify barriers and facilitators of medical HIV care engagement. The most commonly-reported barriers involved difficulties accessing care providers, dissatisfaction with the quality of services, and negative attitudes of provider staff. Other barriers included not having illness symptoms, life stresses, low value placed on health, internalized stigma and wanting to hide one's HIV status, fears of learning about one's true health status, and substance abuse. Care facilitators were feeling responsible for one's health and one's family, care-related support from other HIV-positive persons, and the onset of health decline and fear of death. Substance use remission facilitated care engagement, as did good communication from providers and trust in one's doctor. Interventions are needed in Russia to address HIV care infrastructural barriers and integrate HIV, substance abuse, care, and psychosocial services.

Access to hepatitis C medicines

PubMed Central

Coppens, Delphi GM; Prasad, Tara L; Rook, Laurien A; Iyer, Jayasree K

2015-01-01

Abstract Hepatitis C is a global epidemic. Worldwide, 185 million people are estimated to be infected, most of whom live in low- and middle-income countries. Recent advances in the development of antiviral drugs have produced therapies that are more effective, safer and better tolerated than existing treatments for the disease. These therapies present an opportunity to curb the epidemic, provided that they are affordable, that generic production of these medicines is scaled up and that awareness and screening programmes are strengthened. Pharmaceutical companies have a central role to play. We examined the marketed products, pipelines and access to medicine strategies of 20 of the world’s largest pharmaceutical companies. Six of these companies are developing medicines for hepatitis C: AbbVie, Bristol-Myers Squibb, Gilead, Johnson & Johnson, Merck & Co. and Roche. These companies employ a range of approaches to supporting hepatitis C treatment, including pricing strategies, voluntary licensing, capacity building and drug donations. We give an overview of the engagement of these companies in addressing access to hepatitis C products. We suggest actions companies can take to play a greater role in curbing this epidemic: (i) prioritizing affordability assessments; (ii) developing access strategies early in the product lifecycle; and (iii) licensing to manufacturers of generic medicines. PMID:26549908

Access to hepatitis C medicines.

PubMed

Edwards, Danny J; Coppens, Delphi Gm; Prasad, Tara L; Rook, Laurien A; Iyer, Jayasree K

2015-11-01

Hepatitis C is a global epidemic. Worldwide, 185 million people are estimated to be infected, most of whom live in low- and middle-income countries. Recent advances in the development of antiviral drugs have produced therapies that are more effective, safer and better tolerated than existing treatments for the disease. These therapies present an opportunity to curb the epidemic, provided that they are affordable, that generic production of these medicines is scaled up and that awareness and screening programmes are strengthened. Pharmaceutical companies have a central role to play. We examined the marketed products, pipelines and access to medicine strategies of 20 of the world's largest pharmaceutical companies. Six of these companies are developing medicines for hepatitis C: AbbVie, Bristol-Myers Squibb, Gilead, Johnson & Johnson, Merck & Co. and Roche. These companies employ a range of approaches to supporting hepatitis C treatment, including pricing strategies, voluntary licensing, capacity building and drug donations. We give an overview of the engagement of these companies in addressing access to hepatitis C products. We suggest actions companies can take to play a greater role in curbing this epidemic: (i) prioritizing affordability assessments; (ii) developing access strategies early in the product lifecycle; and (iii) licensing to manufacturers of generic medicines.

(Lack of) Corticospinal facilitation in association with hand laterality judgments.

PubMed

Ferron, Lucas; Tremblay, François

2017-07-01

In recent years, mental practice strategies have drawn much interest in the field of rehabilitation. One form of mental practice particularly advocated involves judging the laterality of images depicting body parts. Such laterality judgments are thought to rely on implicit motor imagery via mental rotation of one own's limb. In this study, we sought to further characterize the involvement of the primary motor cortex (M1) in hand laterality judgments (HLJ) as performed in the context of an application designed for rehabilitation. To this end, we measured variations in corticospinal excitability in both hemispheres with motor evoked potentials (MEPs) while participants (n = 18, young adults) performed either HLJ or a mental counting task. A third condition (foot observation) provided additional control. We hypothesized that HLJ would lead to a selective MEP facilitation when compared to the other tasks and that this facilitation would be greater on the right than the left hemisphere. Contrary to our predictions, we found no evidence of task effects and hemispheric effects for the HLJ task. Significant task-related MEP facilitation was detected only for the mental counting task. A secondary experiment performed in a subset of participants (n = 6) to further test modulation during HLJ yielded the same results. We interpret the lack of facilitation with HLJ in the light of evidence that participants may rely on alternative strategies when asked to judge laterality when viewing depictions of body parts. The use of visual strategies notably would reduce the need to engage in mental rotation, thus reducing M1 involvement. These results have implications for applications of laterality tasks in the context of the rehabilitation program.

Addressing data access challenges in seismology

NASA Astrophysics Data System (ADS)

Trabant, C. M.; Ahern, T.; Weertman, B.; Benson, R. B.; Van Fossen, M.; Weekly, R. T.; Casey, R. E.; Suleiman, Y. Y.; Stults, M.

2016-12-01

The development of web services at the IRIS Data Management Center (DMC) over the last 6 years represents the most significant enhancement of data access ever introduced at the DMC. These web services have allowed the us to focus our internal operations around a single, consistent data access layer while facilitating development of a new generation of tools and methods for researchers to conduct their work. This effort led the DMC to propose standardized web service interfaces within the International Federation of Digital Seismograph Networks (FDSN), enabling other seismological data centers to offer data using compatible interfaces. With this new foundation, we now turn our attention to more advanced data access challenges. In particular, we will present the status of two developments intending to address 1) access to data of consistent quality for science and 2) discovery and access of data from multiple data centers. To address the challenge of requesting high or consistent quality data we will introduce our Research-Ready Data Sets (RRDS) initiative. The purpose of the RRDS project is to reduce the time a researcher spends culling and otherwise identifying data appropriate for given study. RRDS will provide users with additional criteria related to data quality that can be specified when requesting data. Leveraging the data quality measurements provided by our MUSTANG system, these criteria will include ambient noise, completeness, dead channel identification and more. To address the challenge of seismological data discovery and access, we have built and continue to improve the IRIS Federator. The Federator takes advantage of the FDSN-standard web services at various data centers to help a user locate specific channels, wherever they may be offered globally. The search interface provides results that are pre-formatted requests, ready for submission to each data center that serves that data. These two developments are aimed squarely at reducing the time

Facilitation as Attenuating of Environmental Stress among Structured Microbial Populations.

PubMed

Martins, Suzana Cláudia Silveira; Santaella, Sandra Tédde; Martins, Claudia Miranda; Martins, Rogério Parentoni

2016-01-01

There is currently an intense debate in microbial societies on whether evolution in complex communities is driven by competition or cooperation. Since Darwin, competition for scarce food resources has been considered the main ecological interaction shaping population dynamics and community structure both in vivo and in vitro. However, facilitation may be widespread across several animal and plant species. This could also be true in microbial strains growing under environmental stress. Pure and mixed strains of Serratia marcescens and Candida rugosa were grown in mineral culture media containing phenol. Growth rates were estimated as the angular coefficients computed from linearized growth curves. Fitness index was estimated as the quotient between growth rates computed for lineages grown in isolation and in mixed cultures. The growth rates were significantly higher in associated cultures than in pure cultures and fitness index was greater than 1 for both microbial species showing that the interaction between Serratia marcescens and Candida rugosa yielded more efficient phenol utilization by both lineages. This result corroborates the hypothesis that facilitation between microbial strains can increase their fitness and performance in environmental bioremediation.

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

ERIC Educational Resources Information Center

Doi, Carolyn

2015-01-01

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

Venous access and care: harnessing pragmatics in harm reduction for people who inject drugs.

PubMed

Harris, Magdalena; Rhodes, Tim

2012-06-01

To explore the facilitators of long-term hepatitis C avoidance among people who inject drugs. We employed a qualitative life history design. Recruitment took place through low-threshold drug services and drug user networks in South East and North London. Participants were interviewed at the recruitment services or in their homes. The sample comprised 35 people who inject drugs, 20 of whom were hepatitis C antibody-negative. Participants' average injecting trajectory was 19 years (6-33), with 66% primarily injecting heroin, and 34% a crack and heroin mix. Nine (26%) of the sample were female and the average age was 39 years (23-53). Two interviews were conducted with each participant, with the second interview incorporating reference to a computer-constructed life history time-line. Interview accounts were audiorecorded, transcribed verbatim and analysed thematically. Hepatitis C risk awareness was recent and deprioritized by the majority of participants. The facilitation of venous access and care was an initial and enduring rationale for safe injecting practices. Difficult venous access resulted in increased contamination of injecting environments and transitions to femoral injecting. Participants expressed an unmet desire for non-judgemental venous access information and advice. Harm reduction interventions which attend to the immediate priorities of people who inject drugs, such as venous access and care, have the potential to re-engage individuals who are jaded or confused by hepatitis C prevention messages. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Evaluation of a polymer implanted port access device.

PubMed

Brown, J M

1996-01-01

The implanted port vascular access system has provided many patients with safe and reliable vascular access. Its implanted design provides improved body image, reduced maintenance and a better quality of life. The Huber needle has been the standard means of accessing the implanted port system. Because of the problems associated with the Huber needle system, current standards recommend that the Huber needle be changed every 7 days. This evaluation examines the use of a polymer cannula to access the implanted port system. This polymer cannula eliminates many of the problems associated with the Huber needle and provides longer dwell times without increased complications. Seventy nine patients were accessed for a total of 1533 days with the mean dwell time being 19.4 days with no increase in complications associated with port access. To establish implanted port access times of greater than 7 days without increased complications. A multicenter voluntary enrollment evaluation of a medical device. Patients were offered the opportunity to participate in the evaluation if they had an implanted port and were going to be accessed for therapy for periods of 7 days or more. Patients were observed for adverse cutaneous reactions at the insertion site and any port access complications such as sepsis, leakage, changes in portal chamber integrity, and implant pocket integrity. From October 1994 through November 1995, 79 L-Cath for Ports (Luther Medical Products) polymer catheter port access devices (Illustration 1) were inserted in 54 patients. This polymer port access device was used instead of a rigid metal Huber needle for port access. The total number of access days was 1533 days with the mean duration of access being 19.4 days. Two patients experienced blood stream infections while they were accessed with the polymer port access device. These infections ensued with fever of unknown origin as the presenting symptom during neutropenic episodes after chemotherapy treatment. The

Rural New Zealand health professionals' perceived barriers to greater use of the internet for learning.

PubMed

Janes, Ron; Arroll, Bruce; Buetow, Stephen; Coster, Gregor; McCormick, Ross; Hague, Iain

2005-01-01

The purpose of this research was to investigate rural North Island (New Zealand) health professionals' attitudes and perceived barriers to using the internet for ongoing professional learning. A cross-sectional postal survey of all rural North Island GPs, practice nurses and pharmacists was conducted in mid-2003. The questionnaire contained both quantitative and qualitative questions. The transcripts from two open questions requiring written answers were analysed for emergent themes, which are reported here. The first open question asked: 'Do you have any comments on the questionnaire, learning, computers or the Internet?' The second open question asked those who had taken a distance-learning course using the internet to list positive and negative aspects of their course, and suggest improvements. Out of 735 rural North Island health professionals surveyed, 430 returned useable questionnaires (a response rate of 59%). Of these, 137 answered the question asking for comments on learning, computers and the internet. Twenty-eight individuals who had completed a distance-learning course using the internet, provided written responses to the second question. Multiple barriers to greater use of the internet were identified. They included lack of access to computers, poor availability of broadband (fast) internet access, lack of IT skills/knowledge, lack of time, concerns about IT costs and database security, difficulty finding quality information, lack of time, energy or motivation to learn new skills, competing priorities (eg family), and a preference for learning modalities which include more social interaction. Individuals also stated that rural health professionals needed to engage the technology, because it provided rapid, flexible access from home or work to a significant health information resource, and would save money and travelling time to urban-based education. In mid-2003, there were multiple barriers to rural North Island health professionals making greater

Enhancing Ocean Research Data Access

NASA Astrophysics Data System (ADS)

Chandler, Cynthia; Groman, Robert; Shepherd, Adam; Allison, Molly; Arko, Robert; Chen, Yu; Fox, Peter; Glover, David; Hitzler, Pascal; Leadbetter, Adam; Narock, Thomas; West, Patrick; Wiebe, Peter

2014-05-01

The Biological and Chemical Oceanography Data Management Office (BCO-DMO) works in partnership with ocean science investigators to publish data from research projects funded by the Biological and Chemical Oceanography Sections and the Office of Polar Programs Antarctic Organisms & Ecosystems Program at the U.S. National Science Foundation. Since 2006, researchers have been contributing data to the BCO-DMO data system, and it has developed into a rich repository of data from ocean, coastal and Great Lakes research programs. While the ultimate goal of the BCO-DMO is to ensure preservation of NSF funded project data and to provide open access to those data, achievement of those goals is attained through a series of related phases that benefits from active collaboration and cooperation with a large community of research scientists as well as curators of data and information at complementary data repositories. The BCO-DMO is just one of many intermediate data management centers created to facilitate long-term preservation of data and improve access to ocean research data. Through partnerships with other data management professionals and active involvement in local and global initiatives, BCO-DMO staff members are working to enhance access to ocean research data available from the online BCO-DMO data system. Continuing efforts in use of controlled vocabulary terms, development of ontology design patterns and publication of content as Linked Open Data are contributing to improved discovery and availability of BCO-DMO curated data and increased interoperability of related content available from distributed repositories. We will demonstrate how Semantic Web technologies (e.g. RDF/XML, SKOS, OWL and SPARQL) have been integrated into BCO-DMO data access and delivery systems to better serve the ocean research community and to contribute to an expanding global knowledge network.

The N400 as an index of racial stereotype accessibility.

PubMed

Hehman, Eric; Volpert, Hannah I; Simons, Robert F

2014-04-01

The current research examined the viability of the N400, an event-related potential (ERP) related to the detection of semantic incongruity, as an index of both stereotype accessibility and interracial prejudice. Participants' EEG was recorded while they completed a sequential priming task, in which negative or positive, stereotypically black (African American) or white (Caucasian American) traits followed the presentation of either a black or white face acting as a prime. ERP examination focused on the N400, but additionally examined N100 and P200 reactivity. Replicating and extending previous N400 stereotype research, results indicated that the N400 can indeed function as an index of stereotype accessibility in an interracial domain, as greater N400 reactivity was elicited by trials in which the face prime was incongruent with the target trait than when primes and traits matched. Furthermore, N400 activity was moderated by participants' self-reported explicit bias. More explicitly biased participants demonstrated greater N400 reactivity to stereotypically white traits following black faces than black traits following black faces. P200 activity was additionally associated with participants' implicit biases, as more implicitly biased participants similarly demonstrated greater P200 reactivity to stereotypically white traits following black faces than black traits following black faces.

Access to Pharmacotherapy Amongst Women with Bipolar Disorder during Pregnancy: a Preliminary Study.

PubMed

Byatt, Nancy; Cox, Lucille; Moore Simas, Tiffany A; Biebel, Kathleen; Sankaran, Padma; Swartz, Holly A; Weinreb, Linda

2018-03-01

Bipolar disorder among pregnant women has deleterious effects on birth and child outcomes and is currently under-detected, not addressed effectively, or exacerbated through inappropriate treatment. The goal of this study was to identify perspectives of pregnant and postpartum women with bipolar disorder on barriers and facilitators to psychiatric treatment during pregnancy. In-depth interviews were conducted with pregnant and postpartum women who scored ≥ 10 on the Edinburgh Postnatal Depression Scale and met DSM-IV criteria for bipolar disorder I, II or not otherwise specified using the Mini International Neuropsychiatric Interview version 5.0. Interviews were transcribed, and resulting data were analyzed using a grounded theory approach to identify barriers and facilitators to bipolar disorder treatment access in pregnancy. Participant identified barriers included perception that psychiatric providers lack training and experience in the treatment of psychiatric illness during pregnancy, are reluctant to treat bipolar disorder among pregnant women, and believe that pharmacotherapy is not needed for psychiatric illness during pregnancy. Facilitators included participants' perception that providers' acknowledge risks associated with untreated or undertreated psychiatric illness during pregnancy and provide psycho-education about the risks, benefits and alternatives to pharmacotherapy. Psychiatric providers are critically important to the treatment of bipolar disorder and need knowledge and skills necessary to provide care during the perinatal period. Advancing psychiatric providers' knowledge/skills may improve access to pharmacotherapy for pregnant women with bipolar disorder.

Barriers and facilitators to using NHS Direct: a qualitative study of 'users' and 'non-users'.

PubMed

Cook, Erica J; Randhawa, Gurch; Large, Shirley; Guppy, Andy; Chater, Angel M; Ali, Nasreen

2014-10-25

NHS Direct, introduced in 1998, has provided 24/7 telephone-based healthcare advice and information to the public in England and Wales. National studies have suggested variation in the uptake of this service amongst the UK's diverse population. This study provides the first exploration of the barriers and facilitators that impact upon the uptake of this service from the perspectives of both 'users' and 'non- users'. Focus groups were held with NHS Direct 'users' (N = 2) from Bedfordshire alongside 'non-users' from Manchester (N = 3) and Mendip, Somerset (N = 4). Each focus group had between five to eight participants. A total of eighty one people aged between 21 and 94 years old (M: 58.90, SD: 22.70) took part in this research. Each focus group discussion lasted approximately 90 minutes and was audiotape-recorded with participants' permission. The recordings were transcribed verbatim. A framework approach was used to analyse the transcripts. The findings from this research uncovered a range of barriers and facilitators that impact upon the uptake of NHS Direct. 'Non-users' were unaware of the range of services that NHS Direct provided. Furthermore, 'non-users' highlighted a preference for face-to face communication, identifying a lack of confidence in discussing healthcare over the telephone. This was particularly evident among older people with cognitive difficulties. The cost to telephone a '0845' number from a mobile was also viewed to be a barrier to access NHS Direct, expressed more often by 'non-users' from deprived communities. NHS Direct 'users' identified that awareness, ease of use and convenience were facilitators which influenced their decision to use the service. An understanding of the barriers and facilitators which impact on the access and uptake of telephone-based healthcare is essential to move patients towards the self-care model. This research has highlighted the need for telephone-based healthcare services to increase public awareness; through

Differential facilitation of N- and P/Q-type calcium channels during trains of action potential-like waveforms

PubMed Central

Currie, Kevin P M; Fox, Aaron P

2002-01-01

Inhibition of presynaptic voltage-gated calcium channels by direct G-protein βγ subunit binding is a widespread mechanism that regulates neurotransmitter release. Voltage-dependent relief of this inhibition (facilitation), most likely to be due to dissociation of the G-protein from the channel, may occur during bursts of action potentials. In this paper we compare the facilitation of N- and P/Q-type Ca2+ channels during short trains of action potential-like waveforms (APWs) using both native channels in adrenal chromaffin cells and heterologously expressed channels in tsA201 cells. While both N- and P/Q-type Ca2+ channels exhibit facilitation that is dependent on the frequency of the APW train, there are important quantitative differences. Approximately 20 % of the voltage-dependent inhibition of N-type ICa was reversed during a train while greater than 40 % of the inhibition of P/Q-type ICa was relieved. Changing the duration or amplitude of the APW dramatically affected the facilitation of N-type channels but had little effect on the facilitation of P/Q-type channels. Since the ratio of N-type to P/Q-type Ca2+ channels varies widely between synapses, differential facilitation may contribute to the fine tuning of synaptic transmission, thereby increasing the computational repertoire of neurons. PMID:11882675

Age-Associated Perceptions of Physical Activity Facilitators and Barriers Among Women in Rural Southernmost Illinois

PubMed Central

Carnahan, Leslie R.; Peacock, Nadine R.

2016-01-01

Introduction Women living in rural areas in the United States experience disproportionately high rates of diseases such as obesity and heart disease and are less likely than women living in urban areas to meet daily physical activity (PA) recommendations. The purpose of our research was to understand age-specific perceptions of barriers and facilitators to rural women engaging in PA and to identify strategies to promote PA among these women. Methods As part of a community health assessment to learn about women’s health issues, 110 adult women participated in 14 focus groups. The women were divided into 4 age groups, and focus groups were held in various community settings. We used qualitative analysis methods to explore themes in the women’s narratives, including themes related to PA knowledge, PA behavior, and access to PA facilities. Results Participants described multiple and often conflicting individual, social, and environmental barriers and facilitators to PA. Several barriers and facilitators were shared across age groups (eg, competing priorities and inadequate knowledge about PA’s role in disease prevention and disease management). Other barriers (eg, illness and injury) and facilitators (eg, PA as a social opportunity) differed by age group. Conclusion Rural women in southernmost Illinois have often contradictory barriers and facilitators to PA, and those barriers and facilitators are different at different points in a woman’s life. Our findings suggest the need for multilevel, multisector approaches to promote PA. Additionally, this research supports the need for tailored PA promotion programs for rural women to address the barriers these women face across their lifespan. PMID:27685431

Negotiating boundaries: Accessing donor gametes in India.

PubMed

Widge, A; Cleland, J

2011-01-01

This paper documents how couples and providers access donor materials for conception in the Indian context and perceptions about using them. The objective is to facilitate understanding of critical issues and relevant concerns. A postal survey was conducted with a sample of 6000 gynaecologists and in-depth interviews were -conducted with 39 gynaecologists in four cities. Donor gametes are relatively more acceptable than a few years ago, especially if confidentiality can be -maintained, though lack of availability of donor materials is sometimes an impediment to infertility treatment. Donor sperms are usually accessed from in-house or commercial sperm banks, pathology laboratories, IVF centres, -professional donors, relatives or friends. There is scepticism about screening procedures of sperm banks. Donor eggs are usually accessed from voluntary donors, friends, relatives, egg sharing programmes, donation from other patients, advertising and commercial donors. There are several concerns regarding informed consent for using donated gametes, using -relatives and friends gametes, the unregulated use of gametes and embryos, record keeping and documentation, -unethical and corrupt practices and commercialisation. These issues need to be addressed by patients, providers and regulatory authorities by providing -information, counselling, ensuring informed consent, addressing exploitation and commercialisation, ensuring -monitoring, proper documentation and transparency.

Negotiating boundaries: Accessing donor gametes in India

PubMed Central

Widge, A.; Cleland, J.

2011-01-01

Background: This paper documents how couples and providers access donor materials for conception in the Indian context and perceptions about using them. The objective is to facilitate understanding of critical issues and relevant concerns. Methods: A postal survey was conducted with a sample of 6000 gynaecologists and in-depth interviews were conducted with 39 gynaecologists in four cities. Results: Donor gametes are relatively more acceptable than a few years ago, especially if confidentiality can be maintained, though lack of availability of donor materials is sometimes an impediment to infertility treatment. Donor sperms are usually accessed from in-house or commercial sperm banks, pathology laboratories, IVF centres, professional donors, relatives or friends. There is scepticism about screening procedures of sperm banks. Donor eggs are usually accessed from voluntary donors, friends, relatives, egg sharing programmes, donation from other patients, advertising and commercial donors. There are several concerns regarding informed consent for using donated gametes, using relatives and friends gametes, the unregulated use of gametes and embryos, record keeping and documentation, unethical and corrupt practices and commercialisation. Conclusion: These issues need to be addressed by patients, providers and regulatory authorities by providing information, counselling, ensuring informed consent, addressing exploitation and commercialisation, ensuring monitoring, proper documentation and transparency. PMID:24753849

Resting Functional Connectivity of the Periaqueductal Gray Is Associated With Normal Inhibition and Pathological Facilitation in Conditioned Pain Modulation.

PubMed

Harper, Daniel E; Ichesco, Eric; Schrepf, Andrew; Hampson, Johnson P; Clauw, Daniel J; Schmidt-Wilcke, Tobias; Harris, Richard E; Harte, Steven E

2018-06-01

Conditioned pain modulation (CPM), a psychophysical paradigm that is commonly used to infer the integrity of endogenous pain-altering systems by observation of the effect of one noxious stimulus on another, has previously identified deficient endogenous analgesia in fibromyalgia (FM) and other chronic pain conditions. The mechanisms underlying this deficiency, be they insufficient inhibition and/or active facilitation, are largely unknown. The present cross-sectional study used a combination of behavioral CPM testing, voxel-based morphometry, and resting state functional connectivity to identify neural correlates of CPM in healthy controls (HC; n = 14) and FM patients (n = 15), and to probe for differences that could explain the pain-facilitative CPM that was observed in our patient sample. Voxel-based morphometry identified a cluster encompassing the periaqueductal gray (PAG) that contained significantly less gray matter volume in FM patients. Higher resting connectivity between this cluster and cortical pain processing regions was associated with more efficient inhibitory CPM in both groups, whereas PAG connectivity with the dorsal pons was associated with greater CPM inhibition only in HC. Greater PAG connectivity to the caudal pons/rostral medulla, which was pain-inhibitory in HC, was associated with pain facilitation in FM patients. These findings indicate that variation in the strength of the PAG resting functional connectivity can explain some of the normal variability in CPM. In addition, pain-facilitative CPM observed in FM patients likely involves attenuation of pain inhibitory as well as amplification of pain facilitative processes in the central nervous system. Copyright © 2018 The American Pain Society. Published by Elsevier Inc. All rights reserved.

Web accessibility support for visually impaired users using link content analysis.

PubMed

Iwata, Hajime; Kobayashi, Naofumi; Tachibana, Kenji; Shirogane, Junko; Fukazawa, Yoshiaki

2013-12-01

Web pages are used for a variety of purposes. End users must understand dynamically changing content and sequentially follow page links to find desired material, requiring significant time and effort. However, for visually impaired users using screen readers, it can be difficult to find links to web pages when link text and alternative text descriptions are inappropriate. Our method supports the discovery of content by analyzing 8 categories of link types, and allows visually impaired users to be aware of the content represented by links in advance. This facilitates end users access to necessary information on web pages. Our method of classifying web page links is therefore effective as a means of evaluating accessibility.

Spanish Clinical Guidelines on Vascular Access for Haemodialysis.

PubMed

Ibeas, José; Roca-Tey, Ramon; Vallespín, Joaquín; Moreno, Teresa; Moñux, Guillermo; Martí-Monrós, Anna; Del Pozo, José Luis; Gruss, Enrique; Ramírez de Arellano, Manel; Fontseré, Néstor; Arenas, María Dolores; Merino, José Luis; García-Revillo, José; Caro, Pilar; López-Espada, Cristina; Giménez-Gaibar, Antonio; Fernández-Lucas, Milagros; Valdés, Pablo; Fernández-Quesada, Fidel; de la Fuente, Natalia; Hernán, David; Arribas, Patricia; Sánchez de la Nieta, María Dolores; Martínez, María Teresa; Barba, Ángel

2017-11-01

Vascular access for haemodialysis is key in renal patients both due to its associated morbidity and mortality and due to its impact on quality of life. The process, from the creation and maintenance of vascular access to the treatment of its complications, represents a challenge when it comes to decision-making, due to the complexity of the existing disease and the diversity of the specialities involved. With a view to finding a common approach, the Spanish Multidisciplinary Group on Vascular Access (GEMAV), which includes experts from the five scientific societies involved (nephrology [S.E.N.], vascular surgery [SEACV], vascular and interventional radiology [SERAM-SERVEI], infectious diseases [SEIMC] and nephrology nursing [SEDEN]), along with the methodological support of the Cochrane Center, has updated the Guidelines on Vascular Access for Haemodialysis, published in 2005. These guidelines maintain a similar structure, in that they review the evidence without compromising the educational aspects. However, on one hand, they provide an update to methodology development following the guidelines of the GRADE system in order to translate this systematic review of evidence into recommendations that facilitate decision-making in routine clinical practice, and, on the other hand, the guidelines establish quality indicators which make it possible to monitor the quality of healthcare. Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

PAT: an intelligent authoring tool for facilitating clinical trial design.

PubMed

Tagaris, Anastasios; Andronikou, Vassiliki; Karanastasis, Efstathios; Chondrogiannis, Efthymios; Tsirmpas, Charalambos; Varvarigou, Theodora; Koutsouris, Dimitris

2014-01-01

Great investments are made by both private and public funds and a wealth of research findings is published, the research and development pipeline phases quite low productivity and tremendous delays. In this paper, we present a novel authoring tool which has been designed and developed for facilitating study design. Its underlying models are based on a thorough analysis of existing clinical trial protocols (CTPs) and eligibility criteria (EC) published in clinicaltrials.gov by domain experts. Moreover, its integration with intelligent decision support services and mechanisms linking the study design process with healthcare patient data as well as its direct access to literature designate it as a powerful tool offering great support to researchers during clinical trial design.

Student access to competitive foods in elementary schools: trends over time and regional differences.

PubMed

Turner, Lindsey R; Chaloupka, Frank J

2012-02-01

To examine the availability of competitive foods in elementary schools. Nationally representative mail-back survey. United States public and private elementary schools during the 2006-2007, 2007-2008, 2008-2009, and 2009-2010 school years. Survey respondents at 2647 public and 1205 private elementary schools. The availability of foods offered in competitive venues. Elementary school students' access to foods in competitive venues on campus (vending machines, school stores, snack bars, or à la carte lines) remained constant over time. As of the 2009-2010 school year, approximately half of all public and private elementary school students could purchase foods in 1 or more competitive venues on campus. Sugary foods were available to almost all students with access to competitive foods on campus. Public elementary school students in the South had more access to competitive food venues and greater availability of salty and sweet products in those venues compared with students in other parts of the country; however, they also had greater availability of healthier foods, such as fruits and vegetables. Many elementary school students can purchase competitive foods on campus. Most students with access to competitive venues could purchase sweet products, but healthier foods were less widely available.

Availability and accessibility of evidence-based information resources provided by medical libraries in Australia.

PubMed

Ritchie, A; Sowter, B

2000-01-01

This article reports on the results of an exploratory survey of the availability and accessibility of evidence-based information resources provided by medical libraries in Australia. Although barriers impede access to evidence-based information for hospital clinicians, the survey revealed that Medline and Cinahl are available in over 90% of facilities. In most cases they are widely accessible via internal networks and the Internet. The Cochrane Library is available in 69% of cases. The Internet is widely accessible and most libraries provide access to some full-text, electronic journals. Strategies for overcoming restrictions and integrating information resources with clinical workflow are being pursued. State, regional and national public and private consortia are developing agreements utilising on-line technology. These could produce cost savings and more equitable access to a greater range of evidence-based resources.

Sci-Hub provides access to nearly all scholarly literature

PubMed Central

Romero, Ariel Rodriguez; Levernier, Jacob G; Munro, Thomas Anthony; McLaughlin, Stephen Reid; Greshake Tzovaras, Bastian

2018-01-01

The website Sci-Hub enables users to download PDF versions of scholarly articles, including many articles that are paywalled at their journal’s site. Sci-Hub has grown rapidly since its creation in 2011, but the extent of its coverage has been unclear. Here we report that, as of March 2017, Sci-Hub’s database contains 68.9% of the 81.6 million scholarly articles registered with Crossref and 85.1% of articles published in toll access journals. We find that coverage varies by discipline and publisher, and that Sci-Hub preferentially covers popular, paywalled content. For toll access articles, we find that Sci-Hub provides greater coverage than the University of Pennsylvania, a major research university in the United States. Green open access to toll access articles via licit services, on the other hand, remains quite limited. Our interactive browser at https://greenelab.github.io/scihub allows users to explore these findings in more detail. For the first time, nearly all scholarly literature is available gratis to anyone with an Internet connection, suggesting the toll access business model may become unsustainable. PMID:29424689

Delayed access to treatments for rare diseases: who's to blame?

PubMed

Feltmate, Karen; Janiszewski, Peter M; Gingerich, Sheena; Cloutier, Michael

2015-04-01

The development and commercialization of drugs for rare diseases, termed 'orphan drugs', has historically been economically unattractive. However, because of the introduction of legislation that provides financial and regulatory incentives for the development of orphan drugs, new developments are making their way through the regulatory approval processes. Unfortunately, delays in availability of new drugs for treating rare disease continue to persist. This paper reviews the approach of several regulatory jurisdictions to orphan drugs in an effort to determine their relative effectiveness in providing patient access. Generally speaking, regulatory authorities across jurisdictions have recognized the need to enhance timely access to safe, effective treatment for patients with rare diseases and have been able to shift the approval timelines for access to new care. The greater impediment to orphan drug access appears to be funding, particularly in publicly sponsored health-care systems. Redundancies in federal and provincial reviews of orphan drugs can result in significant delays in access to new drugs. Clearly, more must be done to accelerate access to the treatments so desperately needed by patients. Public payers must be held accountable for their process and decisions--especially for rare disease therapies. © 2015 Asian Pacific Society of Respirology.

Barriers and facilitators to implementing the Baby-Friendly hospital initiative in neonatal intensive care units.

PubMed

Benoit, Britney; Semenic, Sonia

2014-01-01

To explore manager, educator, and clinical leader perceptions of barriers and facilitators to implementing Baby-Friendly practice in the neonatal intensive care unit (NICU). Qualitative, descriptive design. Two university-affiliated level-III NICUs in Canada. A purposive sample of 10 medical and nursing managers, nurse educators, lactation consultants, and neonatal nurse practitioners. In-depth, semistructured interviews transcribed and analyzed using qualitative content analysis. Participants valued breastfeeding and family-centered care yet identified numerous contextual barriers to Baby-Friendly care including infant health status, parent/infant separation, staff workloads and work patterns, gaps in staff knowledge and skills, and lack of continuity of breastfeeding support. Facilitators included breastfeeding education, breastfeeding champions, and interprofessional collaboration. Despite identifying numerous barriers, participants recognized the potential value of expanding the Baby-Friendly Hospital Initiative (BFHI) to the NICU setting. Recommendations include promoting BFHI as a facilitator of family-centered care, interdisciplinary staff education, increasing access to lactation consultants, and establishing a group of NICU champions dedicated to BFHI implementation. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Facilitating Facilitators to Facilitate, in Problem or Enquiry Based Learning Sessions

ERIC Educational Resources Information Center

Coelho, Catherine

2014-01-01

Problem based learning (PBL) has been used in dental education over the past 20 years and uses a patient case scenario to stimulate learning in a small group setting, where a trained facilitator does not teach but guides the group to bring about deep contextualized learning, to be empathetic to each other and to encourage fair and equitable…

Sexual Assertiveness Mediates the Associations Between Partner Facilitative Responses and Sexual Outcomes in Women With Provoked Vestibulodynia.

PubMed

McNicoll, Gabrielle; Corsini-Munt, Serena; O Rosen, Natalie; McDuff, Pierre; Bergeron, Sophie

2017-10-03

Provoked vestibulodynia (PVD) is a recurrent idiopathic vulvo-vaginal pain associated with negative sexual and psychological consequences. Facilitative partner responses to pain are currently receiving empirical attention because they are positively associated with women's sexual outcomes. However, the mechanisms through which facilitative responses to pain are associated with these outcomes have not been examined. One potential mechanism is sexual assertiveness, which has been found to be associated with better sexual function and satisfaction in women with PVD. The present study examined whether women's sexual assertiveness mediated the association between women's perception of facilitative partner responses and women's sexual function and satisfaction. Women (N = 140) with PVD symptomatology completed self-reported questionnaires evaluating their perception of their partners' facilitative responses, and their own sexual assertiveness, sexual function, and sexual satisfaction. Dependent measures were sexual function measured by the Female Sexual Function Index and sexual satisfaction assessed by the Global Measure of Sexual Satisfaction Scale. Results indicated that women's higher sexual assertiveness mediated the association between their greater perceived facilitative partner responses and their improved sexual function and satisfaction. Findings suggest a potential mechanism through which partner responses may be associated with women's sexual outcomes.

Health Websites: Accessibility and Usability for American Sign Language Users

PubMed Central

Kushalnagar, Poorna; Naturale, Joan; Paludneviciene, Raylene; Smith, Scott R.; Werfel, Emily; Doolittle, Richard; Jacobs, Stephen; DeCaro, James

2015-01-01

To date, there have been efforts towards creating better health information access for Deaf American Sign Language (ASL) users. However, the usability of websites with access to health information in ASL has not been evaluated. Our paper focuses on the usability of four health websites that include ASL videos. We seek to obtain ASL users’ perspectives on the navigation of these ASL-accessible websites, finding the health information that they needed, and perceived ease of understanding ASL video content. ASL users (N=32) were instructed to find specific information on four ASL-accessible websites, and answered questions related to: 1) navigation to find the task, 2) website usability, and 3) ease of understanding ASL video content for each of the four websites. Participants also gave feedback on what they would like to see in an ASL health library website, including the benefit of added captioning and/or signer model to medical illustration of health videos. Participants who had lower health literacy had greater difficulty in finding information on ASL-accessible health websites. This paper also describes the participants’ preferences for an ideal ASL-accessible health website, and concludes with a discussion on the role of accessible websites in promoting health literacy in ASL users. PMID:24901350

Health websites: accessibility and usability for American sign language users.

PubMed

Kushalnagar, Poorna; Naturale, Joan; Paludneviciene, Raylene; Smith, Scott R; Werfel, Emily; Doolittle, Richard; Jacobs, Stephen; DeCaro, James

2015-01-01

To date, there have been efforts toward creating better health information access for Deaf American Sign Language (ASL) users. However, the usability of websites with access to health information in ASL has not been evaluated. Our article focuses on the usability of four health websites that include ASL videos. We seek to obtain ASL users' perspectives on the navigation of these ASL-accessible websites, finding the health information that they needed, and perceived ease of understanding ASL video content. ASL users (n = 32) were instructed to find specific information on four ASL-accessible websites, and answered questions related to (a) navigation to find the task, (b) website usability, and (c) ease of understanding ASL video content for each of the four websites. Participants also gave feedback on what they would like to see in an ASL health library website, including the benefit of added captioning and/or signer model to medical illustration of health videos. Participants who had lower health literacy had greater difficulty in finding information on ASL-accessible health websites. This article also describes the participants' preferences for an ideal ASL-accessible health website, and concludes with a discussion on the role of accessible websites in promoting health literacy in ASL users.

interPopula: a Python API to access the HapMap Project dataset

PubMed Central

2010-01-01

Background The HapMap project is a publicly available catalogue of common genetic variants that occur in humans, currently including several million SNPs across 1115 individuals spanning 11 different populations. This important database does not provide any programmatic access to the dataset, furthermore no standard relational database interface is provided. Results interPopula is a Python API to access the HapMap dataset. interPopula provides integration facilities with both the Python ecology of software (e.g. Biopython and matplotlib) and other relevant human population datasets (e.g. Ensembl gene annotation and UCSC Known Genes). A set of guidelines and code examples to address possible inconsistencies across heterogeneous data sources is also provided. Conclusions interPopula is a straightforward and flexible Python API that facilitates the construction of scripts and applications that require access to the HapMap dataset. PMID:21210977

Barriers, motivators, and facilitators of physical activity in dementia patients: A systematic review.

PubMed

van Alphen, Helena J M; Hortobágyi, Tibor; van Heuvelen, Marieke J G

2016-01-01

Physical activity (PA) has the potential to slow the progression of dementia patients' cognitive and physical decline. A better understanding of the factors that facilitate or hamper dementia patients' PA participation will increase the success rate of implementing PA in dementia patients' daily care. We systematically screened the barriers, motivators, and facilitators of PA participation in dementia patients, complementing previous analyses of quantitative correlates of PA in community-dwelling dementia patients. Systematic searches yielded 78 potential studies of which seven met the eligibility criteria including 39 dementia patients and 36 caregivers (33 spouses and three daughters). We identified 35 barriers, 26 motivators, and 21 facilitators related to PA. We reduced these factors to six themes within the social-ecological model. Prominent barriers to PA were physical and mental limitations and difficulties with guidance and organization of PA by caregivers. Motivators included the motivation to maintain physical and mental health and participate in preferred PA options. Facilitators included strategies to avoid health problems, providing support and guidance for PA, and access to convenient and personalized PA options. The emerging picture suggests that dementia patients' PA participation will increase if service providers become familiar with the health benefits of PA, the characteristics of PA programs, methods of delivery, and the concepts of how such programs can be personalized to and synchronized with patients' individual needs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Social network characteristics and resource access among formerly displaced households in Lira, Uganda.

PubMed

Obaa, Bernard B; Mazur, Robert E

2017-07-01

In rural African communities, the support of extended family, friends, and neighbours is essential in borrowing or leveraging land, labour, food, and money, especially at times of social and financial turmoil. Little is known, though, about the nature of the networks and the conditions under which they may generate greater support in post-conflict communities. This study, conducted in the Lira district of northern Uganda, examined the composition, proximity, and size of the networks that households utilise to gain access to resources during and after resettlement. Network structures with more kin and co-resident ties were found to offer greater resource access to households in post-conflict settings. Furthermore, there was a lack of meaningful linkages outside of a person's own village, especially with regard to households whose head has no or a low level of education. These findings enhance understanding of the specific role of relationships in social support for resource access among households in post-conflict communities. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

FACILITATING ADVANCED URBAN METEOROLOGY AND AIR QUALITY MODELING CAPABILITIES WITH HIGH RESOLUTION URBAN DATABASE AND ACCESS PORTAL TOOLS

EPA Science Inventory

Information of urban morphological features at high resolution is needed to properly model and characterize the meteorological and air quality fields in urban areas. We describe a new project called National Urban Database with Access Portal Tool, (NUDAPT) that addresses this nee...

Open access, library and publisher competition, and the evolution of general commerce.

PubMed

Odlyzko, Andrew M

2015-02-01

Discussions of the economics of scholarly communication are usually devoted to Open Access, rising journal prices, publisher profits, and boycotts. That ignores what seems a much more important development in this market. Publishers, through the oft-reviled Big Deal packages, are providing much greater and more egalitarian access to the journal literature, an approximation to true Open Access. In the process, they are also marginalizing libraries and obtaining a greater share of the resources going into scholarly communication. This is enabling a continuation of publisher profits as well as of what for decades has been called "unsustainable journal price escalation." It is also inhibiting the spread of Open Access and potentially leading to an oligopoly of publishers controlling distribution through large-scale licensing. The Big Deal practices are worth studying for several general reasons. The degree to which publishers succeed in diminishing the role of libraries may be an indicator of the degree and speed at which universities transform themselves. More importantly, these Big Deals appear to point the way to the future of the whole economy, where progress is characterized by declining privacy, increasing price discrimination, increasing opaqueness in pricing, increasing reliance on low-paid or unpaid work of others for profits, and business models that depend on customer inertia. © The Author(s) 2014.

Using Open and Interoperable Ways to Publish and Access LANCE AIRS Near-Real Time Data

NASA Technical Reports Server (NTRS)

Zhao, Peisheng; Lynnes, Christopher; Vollmer, Bruce; Savtchenko, Andrey; Theobald, Michael; Yang, Wenli

2011-01-01

The Atmospheric Infrared Sounder (AIRS) Near-Real Time (NRT) data from the Land Atmosphere Near real-time Capability for EOS (LANCE) element at the Goddard Earth Sciences Data and Information Services Center (GES DISC) provides information on the global and regional atmospheric state, with very low temporal latency, to support climate research and improve weather forecasting. An open and interoperable platform is useful to facilitate access to, and integration of, LANCE AIRS NRT data. As Web services technology has matured in recent years, a new scalable Service-Oriented Architecture (SOA) is emerging as the basic platform for distributed computing and large networks of interoperable applications. Following the provide-register-discover-consume SOA paradigm, this presentation discusses how to use open-source geospatial software components to build Web services for publishing and accessing AIRS NRT data, explore the metadata relevant to registering and discovering data and services in the catalogue systems, and implement a Web portal to facilitate users' consumption of the data and services.

The facilitated component of intestinal glucose absorption

PubMed Central

Kellett, George L

2001-01-01

Over the last decade, a debate has developed about the mechanism of the passive or ‘diffusive’ component of intestinal glucose absorption and, indeed, whether it even exists. Pappenheimer and colleagues have proposed that paracellular solvent drag contributes a passive component, which, at high concentrations of sugars similar to those in the jejunal lumen immediately after a meal, is severalfold greater than the active component mediated by the Na+-glucose cotransporter SGLT1. On the other hand, Ferraris & Diamond maintain that the kinetics of glucose absorption can be explained solely in terms of SGLT1 and that a passive or paracellular component plays little, if any, part. Recently, we have provided new evidence that the passive component of glucose absorption exists, but is in fact facilitated since it is mediated by the rapid, glucose-dependent activation and recruitment of the facilitative glucose transporter GLUT2 to the brush-border membrane; regulation involves a protein kinase C (PKC)-dependent pathway activated by glucose transport through SGLT1 and also involves mitogen-activated protein kinase (MAP kinase) signalling pathways. This topical review seeks to highlight the significant points of the debate, to show how our proposals on GLUT2 impact on different aspects of the debate and to look at the regulatory events that are likely to be involved in the short-term regulation of sugar absorption during the assimilation of a meal. PMID:11251042

A greater voice for academic health sciences libraries: the Association of Academic Health Sciences Libraries' vision

PubMed Central

Bunting, Alison

2003-01-01

The founders of the Association of Academic Health Sciences Libraries (AAHSL) envisioned the development of a professional organization that would provide a greater voice for academic health sciences libraries, facilitate cooperation and communication with the Association of American Medical Colleges, and create a forum for identifying problems and solutions that are common to academic health sciences libraries. This article focuses on the fulfillment of the “greater voice” vision by describing action and leadership by AAHSL and its members on issues that directly influenced the role of academic health sciences libraries. These include AAHSL's participation in the work that led to the publication of the landmark report, Academic Information in the Academic Health Sciences Center: Roles for the Library in Information Management; its contributions to the recommendations of the Physicians for the Twenty-first Century: The GPEP Report; and the joint publication with the Medical Library Association of Challenge to Action: Planning and Evaluation Guidelines for Academic Health Sciences Libraries. PMID:12883583

Spatial Access to Primary Care Providers in Appalachia

PubMed Central

Donohoe, Joseph; Marshall, Vince; Tan, Xi; Camacho, Fabian T.; Anderson, Roger T.; Balkrishnan, Rajesh

2016-01-01

Purpose: The goal of this research was to examine spatial access to primary care physicians in Appalachia using both traditional access measures and the 2-step floating catchment area (2SFCA) method. Spatial access to care was compared between urban and rural regions of Appalachia. Methods: The study region included Appalachia counties of Pennsylvania, Ohio, Kentucky, and North Carolina. Primary care physicians during 2008 and total census block group populations were geocoded into GIS software. Ratios of county physicians to population, driving time to nearest primary care physician, and various 2SFCA approaches were compared. Results: Urban areas of the study region had shorter travel times to their closest primary care physician. Provider to population ratios produced results that varied widely from one county to another because of strict geographic boundaries. The 2SFCA method produced varied results depending on the distance decay weight and variable catchment size techniques chose. 2SFCA scores showed greater access to care in urban areas of Pennsylvania, Ohio, and North Carolina. Conclusion: The different parameters of the 2SFCA method—distance decay weights and variable catchment sizes—have a large impact on the resulting spatial access to primary care scores. The findings of this study suggest that using a relative 2SFCA approach, the spatial access ratio method, when detailed patient travel data are unavailable. The 2SFCA method shows promise for measuring access to care in Appalachia, but more research on patient travel preferences is needed to inform implementation. PMID:26906524

Greater India

NASA Astrophysics Data System (ADS)

Ali, Jason R.; Aitchison, Jonathan C.

2005-10-01

"Greater India" is an 80-yr-old concept that has been used by geoscientists in plate tectonic models of the India-Asia collision system. Numerous authors working on the orogen and/or plate models of the broader region have added various sized chunks of continental lithosphere to the now northern edge of their reconstructed Indian plate. Prior to plate tectonic theory, Emile Argand (1924) [Argand, E., 1924. La tectonique de l' Asie. Proc. 13th Int. Geol. Cong. 7 (1924), 171-372.] and Arthur Holmes (1965) [Holmes, A., 1965. Principles of Physical Geology, Second Edition. The Ronald Press Company, New York, 1128.] thought that the Himalayan Mountains and Tibetan Plateau had been raised due to the northern edge of the Indian craton under-thrusting the entire region. Since the advent of plate tectonic theory, Greater India proposals have been based principally on three lines of logic. One group of workers has added various amounts of continental lithosphere to India as part of their Mesozoic Gondwana models. A second form of reconstruction is based on Himalayan crustal-shortening estimates. A third body of researchers has used India continent extensions as means of allowing initial contact between the block and the Eurasian backstop plate in southern Tibet to take place at various times between the Late Cretaceous and late Eocene in what we call "fill-the-gap" solutions. The Indian craton and the southern edge of Eurasia were almost invariably some distance from one another when the collision was supposed to have started; extensions to the sub-continent were used to circumvent the problem. Occasionally, Greater India extensions have been based on a combination of fill-the-gap and shortening estimate arguments. In this paper, we exhume and re-examine the key Greater India proposals. From our analysis, it is clear that many proponents have ignored key information regarding the sub-continent's pre break-up position within Gondwana and the bathymetry of the Indian Ocean

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

PubMed

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

2016-01-01

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

Stellar Atmospheric Modelling for the ACCESS Program

NASA Astrophysics Data System (ADS)

Morris, Matthew; Kaiser, Mary Elizabeth; Bohlin, Ralph; Kurucz, Robert; ACCESS Team

2018-01-01

A goal of the ACCESS program (Absolute Color Calibration Experiment for Standard Stars) is to enable greater discrimination between theoretical astrophysical models and observations, where the comparison is limited by systematic errors associated with the relative flux calibration of the targets. To achieve these goals, ACCESS has been designed as a sub-orbital rocket borne payload and ground calibration program, to establish absolute flux calibration of stellar targets at <1 % precision, with a resolving power of 500 across the 0.35 to 1.7 micron bandpass.In order to obtain higher resolution spectroscopy in the optical and near-infrared range than either the ACCESS payload or CALSPEC observations provide, the ACCESS team has conducted a multi-instrument observing program at Apache Point Observatory. Using these calibrated high resolution spectra in addition to the HST/CALSPEC data, we have generated stellar atmosphere models for ACCESS flight candidates, as well as a selection of A and G stars from the CALSPEC database. Stellar atmosphere models were generated using Atlas 9 and Atlas 12 Kurucz stellar atmosphere software. The effective temperature, log(g), metallicity, and redenning were varied and the chi-squared statistic was minimized to obtain a best-fit model. A comparison of these models and the results from interpolation between grids of existing models will be presented. The impact of the flexibility of the Atlas 12 input parameters (e.g. solar metallicity fraction, abundances, microturbulent velocity) is being explored.

Dignity and deferral narratives as strategies in facilitated technology-based support groups for people with advanced cancer.

PubMed

Street, Annette F; Wakelin, Kate; Hordern, Amanda; Bruce, Nicola; Horey, Dell

2012-01-01

This paper examines the value of facilitated telephone and online support groups for palliative care. Telephone interviews were conducted with twenty people living with advanced cancer who had participated in either a telephone or online support group facilitated by the Cancer Council Victoria, Melbourne, Australia. Two dominant participant narratives emerged: a focus on dying with dignity or an interest in deferring discussion of death and dying to focus on the present. Despite the different approaches, participants found the technology-based support groups to be accessible and safe environments in which to discuss difficult topics in privacy. Technology-based strategies provide opportunities for health professionals to provide social and emotional care to more people by moving beyond individualised care and facilitate peer-to-peer support at the end of life, especially to those with specific needs. Such options are feasible for palliative care services to set up and acceptable to a group of clients, especially for younger clients or those socially or geographically isolated.

Dignity and Deferral Narratives as Strategies in Facilitated Technology-Based Support Groups for People with Advanced Cancer

PubMed Central

Street, Annette F.; Wakelin, Kate; Hordern, Amanda; Bruce, Nicola; Horey, Dell

2012-01-01

This paper examines the value of facilitated telephone and online support groups for palliative care. Telephone interviews were conducted with twenty people living with advanced cancer who had participated in either a telephone or online support group facilitated by the Cancer Council Victoria, Melbourne, Australia. Two dominant participant narratives emerged: a focus on dying with dignity or an interest in deferring discussion of death and dying to focus on the present. Despite the different approaches, participants found the technology-based support groups to be accessible and safe environments in which to discuss difficult topics in privacy. Technology-based strategies provide opportunities for health professionals to provide social and emotional care to more people by moving beyond individualised care and facilitate peer-to-peer support at the end of life, especially to those with specific needs. Such options are feasible for palliative care services to set up and acceptable to a group of clients, especially for younger clients or those socially or geographically isolated. PMID:22530115

Enhancing Ear and Hearing Health Access for Children With Technology and Connectivity.

PubMed

Swanepoel, De Wet

2017-10-12

Technology and connectivity advances are demonstrating increasing potential to improve access of service delivery to persons with hearing loss. This article demonstrates use cases from community-based hearing screening and automated diagnosis of ear disease. This brief report reviews recent evidence for school- and home-based hearing testing in underserved communities using smartphone technologies paired with calibrated headphones. Another area of potential impact facilitated by technology and connectivity is the use of feature extraction algorithms to facilitate automated diagnosis of most common ear conditions from video-otoscopic images. Smartphone hearing screening using calibrated headphones demonstrated equivalent sensitivity and specificity for school-based hearing screening. Automating test sequences with a forced-choice response paradigm allowed persons with minimal training to offer screening in underserved communities. The automated image analysis and diagnosis system for ear disease demonstrated an overall accuracy of 80.6%, which is up to par and exceeds accuracy rates previously reported for general practitioners and pediatricians. The emergence of these tools that capitalize on technology and connectivity advances enables affordable and accessible models of service delivery for community-based ear and hearing care.

Changing the Frame: Queering Access to Higher Education for Trans* Students

ERIC Educational Resources Information Center

Marine, Susan B.

2017-01-01

College access and graduation results in significant life advantages, including higher lifetime incomes, better physical and mental health outcomes, and greater rates of civic engagement. Unfortunately, trans* youth have been systematically prevented from full participation in post-secondary education due to genderist practices and policies.…

Labeling and Rating Systems: Greater Access or Censorship?

ERIC Educational Resources Information Center

Martin, Ann M.

2015-01-01

This article asks the question: How well versed are school librarians on issues related to labeling and rating systems? As school librarians continue to design and implement resource location schemes to assist patrons, they must recognize the difference between using labels to create interest in books or implementing labeling and rating systems…

Event-related theta oscillatory substrates for facilitation and interference effects of negative emotion on children's cognition.

PubMed

Jiang, Zhongqing; Waters, Allison C; Liu, Ying; Li, Wenhui; Yang, Lizhu

2017-06-01

We investigated the brain oscillatory contribution to emotion-cognition interaction in young children. Five-year-old participants (n=27) underwent EEG recording while engaged in a color identification task. Each trial began with an emotional prime. Response times indicated whether emotional primes facilitated or interfered with performance. Related effects were detected in theta-band power over parietal-occipital cortex, early in the response epoch (<500ms). Children in the emotion facilitation group showed greater theta synchronization for negative stimuli. The opposite trend was observed in the interference group. Results suggest a role for theta oscillations in children's adaptive response to emotional content in cognitive performance. Copyright © 2017 Elsevier B.V. All rights reserved.

A comparison of health access between permanent residents, undocumented immigrants and refugee claimants in Toronto, Canada.

PubMed

Campbell, Ruth M; Klei, A G; Hodges, Brian D; Fisman, David; Kitto, Simon

2014-02-01

Understanding the immigrant experience accessing healthcare is essential to improving their health. This qualitative study reports on experiences seeking healthcare for three groups of immigrants in Toronto, Canada: permanent residents, refugee claimants and undocumented immigrants. Undocumented immigrants who are on the Canadian Border Services Agency deportation list are understudied in Canada due to their precarious status. This study will examine the vulnerabilities of this particular subcategory of immigrant and contrast their experiences seeking healthcare with refugee claimants and permanent residents. Twenty-one semi-structured, one-on-one qualitative interviews were conducted with immigrants to identify barriers and facilitators to accessing healthcare. The open structure of the interviews enabled the participants to share their experiences seeking healthcare and other factors that were an integral part of their health. This study utilized a community-based participatory research framework. The study identifies seven sections of results. Among them, immigration status was the single most important factor affecting both an individual's ability to seek out healthcare and her experiences when trying to access healthcare. The healthcare seeking behaviour of undocumented immigrants was radically distinct from refugee claimants or immigrants with permanent resident status, with undocumented immigrants being at a greater disadvantage than permanent residents and refugee claimants. Language barriers are also noted as an impediment to healthcare access. An individual's immigration status further complicates their ability to establish relationships with family doctors, access prescriptions and medications and seek out emergency room care. Fear of authorities and the complications caused by the above factors can lead to the most disadvantaged to seek out informal or black market sources of healthcare. This study reaffirmed previous findings that fear of deportation