Analyzing Public Sector Education Facilities: A Step Further towards Accessible Basic Education Institutions in Destitute Subregions

ERIC Educational Resources Information Center

Talpur, Mir Aftab Hussain; Napiah, Madzlan; Chandio, Imtiaz Ahmed; Memon, Irfan Ahmed

2014-01-01

Rural subregions of the developing countries are suffering from many physical and socioeconomic problems, including scarcity of basic education institutions. The shortage of education institutions extended distance between rural localities and education institutions. Hence, to curb this problem, this research is aimed to deal with the basic…

Impact of geographic accessibility on utilization of the annual health check-ups by income level in Japan: A multilevel analysis.

PubMed

Fujita, Misuzu; Sato, Yasunori; Nagashima, Kengo; Takahashi, Sho; Hata, Akira

2017-01-01

Although both geographic accessibility and socioeconomic status have been indicated as being important factors for the utilization of health care services, their combined effect has not been evaluated. The aim of this study was to reveal whether an income-dependent difference in the impact of geographic accessibility on the utilization of government-led annual health check-ups exists. Existing data collected and provided by Chiba City Hall were employed and analyzed as a retrospective cohort study. The subjects were 166,966 beneficiaries of National Health Insurance in Chiba City, Japan, aged 40 to 74 years. Of all subjects, 54,748 (32.8%) had an annual health check-up in fiscal year 2012. As an optimal index of geographic accessibility has not been established, five measures were calculated: travel time to the nearest health care facility, density of health care facilities (number facilities within a 30-min walking distance from the district of residence), and three indices based on the two-step floating catchment area method. Three-level logistic regression modeling with random intercepts for household and district of residence was performed. Of the five measures, density of health care facilities was the most compatible according to Akaike's information criterion. Both low density and low income were associated with decreased utilization of the health check-ups. Furthermore, a linear relationship was observed between the density of facilities and utilization of the health check-ups in all income groups and its slope was significantly steeper among subjects with an equivalent income of 0.00 yen than among those with equivalent income of 1.01-2.00 million yen (p = 0.028) or 2.01 million yen or more (p = 0.040). This result indicated that subjects with lower incomes were more susceptible to the effects of geographic accessibility than were those with higher incomes. Thus, better geographic accessibility could increase the health check-up utilization and also decrease the income-related disparity of utilization.

Machine Learning for Zwicky Transient Facility

NASA Astrophysics Data System (ADS)

Mahabal, Ashish; Zwicky Transient Facility, Catalina Real-Time Transient Survey

2018-01-01

The Zwicky Transient Facility (ZTF) will operate from 2018 to 2020 covering the accessible sky with its large 47 square degree camera. The transient detection rate is expected to be about a million per night. ZTF is thus a perfect LSST prototype. The big difference is that all of the ZTF transients can be followed up by 4- to 8-m class telescopes. Given the large numbers, using human scanners for separating the genuine transients from artifacts is out of question. For that first step as well as for classifying the transients with minimal follow-up requires machine learning. We describe the tools and plans to take on this task using follow-up facilities, and knowledge gained from archival datasets.

The ASCENT (Allocation System Changes for Equity in Kidney Transplantation) Study: a Randomized Effectiveness-Implementation Study to Improve Kidney Transplant Waitlisting and Reduce Racial Disparity.

PubMed

Patzer, Rachel E; Smith, Kayla; Basu, Mohua; Gander, Jennifer; Mohan, Sumit; Escoffery, Cam; Plantinga, Laura; Melanson, Taylor; Kalloo, Sean; Green, Gary; Berlin, Alex; Renville, Gary; Browne, Teri; Turgeon, Nicole; Caponi, Susan; Zhang, Rebecca; Pastan, Stephen

2017-05-01

The United Network for Organ Sharing (UNOS) implemented a new Kidney Allocation System (KAS) in December 2014 that is expected to substantially reduce racial disparities in kidney transplantation among waitlisted patients. However, not all dialysis facility clinical providers and end stage renal disease (ESRD) patients are aware of how the policy change could improve access to transplant. We describe the ASCENT (Allocation System Changes for Equity in KidNey Transplantation) study, a randomized controlled effectiveness-implementation study designed to test the effectiveness of a multicomponent intervention to improve access to the early steps of kidney transplantation among dialysis facilities across the United States. The multicomponent intervention consists of an educational webinar for dialysis medical directors, an educational video for patients and an educational video for dialysis staff, and a dialysis-facility specific transplant performance feedback report. Materials will be developed by a multidisciplinary dissemination advisory board and will undergo formative testing in dialysis facilities across the United States. This study is estimated to enroll ~600 U.S. dialysis facilities with low waitlisting in all 18 ESRD Networks. The co-primary outcomes include change in waitlisting, and waitlist disparity at 1 year; secondary outcomes include changes in facility medical director knowledge about KAS, staff training regarding KAS, patient education regarding transplant, and a medical director's intent to refer patients for transplant evaluation. The results from the ASCENT study will demonstrate the feasibility and effectiveness of a multicomponent intervention designed to increase access to the deceased-donor kidney waitlist and reduce racial disparities in waitlisting.

A Public Private Partnership to Reopen Public Schools in New Orleans: The Edward Hynes Elementary School as a Model

ERIC Educational Resources Information Center

21st Century School Fund, 2006

2006-01-01

The State of Louisiana and the City of New Orleans have a daunting task before them. They must restore community access to public education. It will not be enough to repair and rebuild buildings. The educational programs and staff must also be redeveloped. However, the improvements to public school facilities is a critical first step in…

Identifying built environmental patterns using cluster analysis and GIS: relationships with walking, cycling and body mass index in French adults.

PubMed

Charreire, Hélène; Weber, Christiane; Chaix, Basile; Salze, Paul; Casey, Romain; Banos, Arnaud; Badariotti, Dominique; Kesse-Guyot, Emmanuelle; Hercberg, Serge; Simon, Chantal; Oppert, Jean-Michel

2012-05-23

Socio-ecological models suggest that both individual and neighborhood characteristics contribute to facilitating health-enhancing behaviors such as physical activity. Few European studies have explored relationships between local built environmental characteristics, recreational walking and cycling and weight status in adults. The aim of this study was to identify built environmental patterns in a French urban context and to assess associations with recreational walking and cycling behaviors as performed by middle-aged adult residents. We used a two-step procedure based on cluster analysis to identify built environmental patterns in the region surrounding Paris, France, using measures derived from Geographic Information Systems databases on green spaces, proximity facilities (destinations) and cycle paths. Individual data were obtained from participants in the SU.VI.MAX cohort; 1,309 participants residing in the Ile-de-France in 2007 were included in this analysis. Associations between built environment patterns, leisure walking/cycling data (h/week) and measured weight status were assessed using multinomial logistic regression with adjustment for individual and neighborhood characteristics. Based on accessibility to green spaces, proximity facilities and availability of cycle paths, seven built environmental patterns were identified. The geographic distribution of built environmental patterns in the Ile-de-France showed that a pattern characterized by poor spatial accessibility to green spaces and proximity facilities and an absence of cycle paths was found only in neighborhoods in the outer suburbs, whereas patterns characterized by better spatial accessibility to green spaces, proximity facilities and cycle paths were more evenly distributed across the region. Compared to the reference pattern (poor accessibility to green areas and facilities, absence of cycle paths), subjects residing in neighborhoods characterized by high accessibility to green areas and local facilities and by a high density of cycle paths were more likely to walk/cycle, after adjustment for individual and neighborhood sociodemographic characteristics (OR = 2.5 95%CI 1.4-4.6). Body mass index did not differ across patterns. Built environmental patterns were associated with walking and cycling among French adults. These analyses may be useful in determining urban and public health policies aimed at promoting a healthy lifestyle.

Impact of geographic accessibility on utilization of the annual health check-ups by income level in Japan: A multilevel analysis

PubMed Central

Fujita, Misuzu; Hata, Akira

2017-01-01

Although both geographic accessibility and socioeconomic status have been indicated as being important factors for the utilization of health care services, their combined effect has not been evaluated. The aim of this study was to reveal whether an income-dependent difference in the impact of geographic accessibility on the utilization of government-led annual health check-ups exists. Existing data collected and provided by Chiba City Hall were employed and analyzed as a retrospective cohort study. The subjects were 166,966 beneficiaries of National Health Insurance in Chiba City, Japan, aged 40 to 74 years. Of all subjects, 54,748 (32.8%) had an annual health check-up in fiscal year 2012. As an optimal index of geographic accessibility has not been established, five measures were calculated: travel time to the nearest health care facility, density of health care facilities (number facilities within a 30-min walking distance from the district of residence), and three indices based on the two-step floating catchment area method. Three-level logistic regression modeling with random intercepts for household and district of residence was performed. Of the five measures, density of health care facilities was the most compatible according to Akaike’s information criterion. Both low density and low income were associated with decreased utilization of the health check-ups. Furthermore, a linear relationship was observed between the density of facilities and utilization of the health check-ups in all income groups and its slope was significantly steeper among subjects with an equivalent income of 0.00 yen than among those with equivalent income of 1.01–2.00 million yen (p = 0.028) or 2.01 million yen or more (p = 0.040). This result indicated that subjects with lower incomes were more susceptible to the effects of geographic accessibility than were those with higher incomes. Thus, better geographic accessibility could increase the health check-up utilization and also decrease the income-related disparity of utilization. PMID:28486522

The Effect of the Removal of User Fees for Delivery at Public Health Facilities on Institutional Delivery in Urban Kenya.

PubMed

Calhoun, Lisa M; Speizer, Ilene S; Guilkey, David; Bukusi, Elizabeth

2018-03-01

Objectives In 2013, Kenya removed delivery fees at public health facilities in an effort to promote equity in access to health services and address high maternal mortality. This study determines the effect of the policy to remove user fees on institutional delivery in a population-based sample of women from urban Kenya. Methods Longitudinal data were collected from a representative sample of 8500 women from five cities in Kenya in 2010 with a follow-up interview in 2014 (response rate 58.9%). Respondents were asked about their most recent birth since 2008 at baseline and 2012 at endline, including the delivery location. Multinomial logistic regression is used, controlling for the temporal time trend and background characteristics, to determine if births which occurred after the national policy change were more likely to occur at a public facility than at home or a private facility. Results Multivariate findings show that women were significantly more likely to deliver at a public facility as compared to a private facility after the policy. Among the poor, the results show that poor women were significantly more likely to deliver in a public facility compared to home or a private facility after policy change. Conclusions for Practice These findings show Kenya's progress towards achieving universal access to delivery services and meeting its national development targets. The removal of delivery fees in the public sector is leading to increased use of facilities for delivery among the urban poor; this is an important first step in reducing maternal death.

Wheelchair accessibility to public buildings in the Kumasi metropolis, Ghana.

PubMed

Yarfi, Cosmos; Ashigbi, Evans Y K; Nakua, Emmanuel K

2017-01-01

Accessibility implies making public places accessible to every individual, irrespective of his or her disability or special need, ensuring the integration of the wheelchair user into the society and thereby granting them the capability of participating in activities of daily living and ensuring equality in daily life. This study was carried out to assess the accessibility of the physical infrastructures (public buildings) in the Kumasi metropolis to wheelchairs after the passage of the Ghanaian Disability Law (Act 716, 2006). Eighty-four public buildings housing education facilities, health facilities, ministries, departments and agencies, sports and recreation, religious groups and banks were assessed. The routes, entrances, height of steps, grade of ramps, sinks, entrance to washrooms, toilets, urinals, automated teller machines and tellers' counters were measured and computed. Out of a total of 84 buildings assessed, only 34 (40.5%) of the buildings, 52.3% of the entrances and 87.4% of the routes of the buildings were accessible to wheelchair users. A total of 25% (13 out of 52) of the public buildings with more than one floor were fitted with elevators to connect the different levels of floors. The results of this study show that public buildings in the Kumasi metropolis are not wheelchair accessible. An important observation made during this study was that there is an intention to improve accessibility when buildings are being constructed or renovated, but there are no laid down guidelines as how to make the buildings accessible for wheelchair users.

Wheelchair accessibility to public buildings in the Kumasi metropolis, Ghana

PubMed Central

Ashigbi, Evans Y.K.

2017-01-01

Background Accessibility implies making public places accessible to every individual, irrespective of his or her disability or special need, ensuring the integration of the wheelchair user into the society and thereby granting them the capability of participating in activities of daily living and ensuring equality in daily life. Objective This study was carried out to assess the accessibility of the physical infrastructures (public buildings) in the Kumasi metropolis to wheelchairs after the passage of the Ghanaian Disability Law (Act 716, 2006). Methods Eighty-four public buildings housing education facilities, health facilities, ministries, departments and agencies, sports and recreation, religious groups and banks were assessed. The routes, entrances, height of steps, grade of ramps, sinks, entrance to washrooms, toilets, urinals, automated teller machines and tellers’ counters were measured and computed. Results Out of a total of 84 buildings assessed, only 34 (40.5%) of the buildings, 52.3% of the entrances and 87.4% of the routes of the buildings were accessible to wheelchair users. A total of 25% (13 out of 52) of the public buildings with more than one floor were fitted with elevators to connect the different levels of floors. Conclusion The results of this study show that public buildings in the Kumasi metropolis are not wheelchair accessible. An important observation made during this study was that there is an intention to improve accessibility when buildings are being constructed or renovated, but there are no laid down guidelines as how to make the buildings accessible for wheelchair users. PMID:29062761

High-Spatial-Resolution OH PLIF Visualization in a Cavity-Stabilized Ethylene-Air Turbulent Flame

NASA Technical Reports Server (NTRS)

Geipel, Clayton M.; Rockwell, Robert D.; Chelliah, Harsha K.; Cutler, Andrew D.; Spelker, Christopher A.; Hashem, Zeid; Danehy, Paul M.

2017-01-01

High-spatial-resolution OH planar laser-induced fluorescence was measured for a premixed ethylene-air turbulent flame in an electrically-heated Mach 2 continuous-flow facility (University of Virginia Supersonic Combustion Facility, Configuration E.) The facility comprised a Mach 2 nozzle, an isolator with flush-wall fuel injectors, a combustor with optical access, and an extender. The flame was anchored at a cavity flameholder with a backward-facing step of height 9 mm. The temperature-insensitive Q1(8) transition of OH was excited using laser light of wavelength 283.55 nm. A spatial filter was used to create a laser sheet approximately 25 microns thick based on full-width at half maximum (FWHM). Extension tubes increased the magnification of an intensified camera system, achieving in-plane resolution of 40 microns based on a 50% modulation transfer function (MTF). The facility was tested with total temperature 1200 K, total pressure 300 kPa, local fuel/air equivalence ratios of approximately 0.4, and local Mach number of approximately 0.73 in the combustor. A test case with reduced total temperature and another with reduced equivalence ratio were also tested. PLIF images were acquired along a streamwise plane bisecting the cavity flameholder, from the backward facing step to 120 mm downstream of the step. The smallest observed features in the flow had width of approximately 110 microns. Flame surface density was calculated for OH PLIF images.

Health worker perspectives on the possible use of intramuscular artesunate for the treatment of severe malaria at lower-level health facilities in settings with poor access to referral facilities in Nigeria: a qualitative study.

PubMed

Adesoro, Olatunde; Shumba, Constance; Kpamor, John; Achan, Jane; Kivumbi, Harriet; Dada, John; Maxwell, Kolawole; Tibenderana, James; Marasciulo, Madeline; Hamade, Prudence; Oresanya, Olusola; Nankabirwa, Joanita; Baba, Ebenezer

2016-10-12

Innovative strategies are needed to reduce malaria mortality in high burden countries like Nigeria. Given that one of the important reasons for this high malaria mortality is delay in receiving effective treatment, improved access to such treatment is critical. Intramuscular artesunate could be used at lower-level facilities given its proven efficacy, ease of use and excellent safety profile. The objective of this study was therefore to explore health workers' perspectives on the possible use of intramuscular artesunate as definitive treatment for severe malaria at lower-level facilities, especially when access to referral facilities is challenging. The study was to provide insight as a formative step into the conduct of future experimental studies to ascertain the feasibility of the use of intramuscular artesunate for definitive treatment of severe malaria in lower level facilities where access to referral care is limited. This qualitative study was done across three southern States in Nigeria (Oyo, Cross River and Enugu). Key informant interviews were conducted over a period of three months between October and December 2014 among 90 purposively selected health workers with different roles in malaria case management from primary care to policy level. A thematic content analysis was used to analyse data. Overall, most of health workers and other key informant groups thought that the use of intramuscular artesunate for definitive treatment of severe malaria at lower-level facilities was possible. They however reported human resource and infrastructure constraints as factors affecting the feasibility of intramuscular artesunate use as definitive treatment for severe malaria in lower-level facilities.. Specifically identified barriers included limited numbers of skilled health workers available to manage potential complications of severe malaria and poorly equipped facilities for supportive treatment. Intramuscular artesunate was considered easy to administer and the proximity of lower-level facilities to communities was deemed important in considering the possibility of its use at lower-level facilities. Health workers also emphasised the important role of operational research to provide additional evidence to guide the implementation of existing policy recommendations and inform future policy revisions. From the perspective of health workers, use of intramuscular artesunate for definitive treatment of severe malaria at lower-level health facilities in Nigeria is possible but dependent on availability of skilled workers, well-equipped lower-level facilities to provide supportive treatment There is need for further operational research to establish feasibility and guide the implementation of such an intervention.

42 CFR 51.42 - Access to facilities and residents.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Access to facilities and residents. 51.42 Section... Records, Facilities and Individuals § 51.42 Access to facilities and residents. (a) Access to facilities... reasonable unaccompanied access to public and private facilities and programs in the State which render care...

[The status of travel by severely handicapped patients by railroads].

PubMed

Mittler, H

1989-02-01

An essential prerequisite for integrating disabled persons is their mobility. The special transport approach, both in terms of handling capacity and cost involved, is increasingly turning out to be unable to achieve future-oriented solutions in this context. Disabled people wish to use the transport services available to the general public. They therefore demand public transportation policies to provide for their access to the mainstream system, ideally independent of outside assistance. Deutsche Bundesbahn, the German federal railways, in the field of tension between the need to orient its business policies on economic and financial considerations and disabled persons' demands that vehicles and premises be designed in a barrier-free manner, seeks to achieve solutions that are responsive to users' needs and at the same time economically justifiable. On account of the 19th century infrastructure legacy and a wide range of rolling stock in long- and short-distance rail travel, this can however be realized only step by step. The facilities offered to disabled people so far range from free use of short-distance trains to the accessibility-oriented design of coaches for the Intercity Express, the future of the railways in the European rapid transit network. The various services and facilities provided are hoped to foster disabled persons' decision in favour of the environmentally compatible rail mode of travelling.

Universal accessibility of "accessible" fitness and recreational facilities for persons with mobility disabilities.

PubMed

Arbour-Nicitopoulos, Kelly P; Ginis, Kathleen A Martin

2011-01-01

This study descriptively measured the universal accessibility of "accessible" fitness and recreational facilities for Ontarians living with mobility disabilities. The physical and social environments of 44 fitness and recreational facilities that identified as "accessible" were assessed using a modified version of the AIMFREE. None of the 44 facilities were completely accessible. Mean accessibility ratings ranged between 31 and 63 out of a possible 100. Overall, recreational facilities had higher accessibility scores than fitness centers, with significant differences found on professional support and training, entrance areas, and parking lot. A modest correlation was found between the availability of fitness programming and the overall accessibility of fitness-center specific facility areas. Overall, the physical and social environments of the 44 fitness and recreational facilities assessed were limited in their accessibility for persons with mobility disabilities. Future efforts should be directed at establishing and meeting universal accessibility guidelines for Canadian physical activity facilities.

Roadmap to a Sustainable Structured Trusted Employee Program

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

Coates, Cameron W; Eisele, Gerhard R

2013-08-01

Organizations (facility, regulatory agency, or country) have a compelling interest in ensuring that individuals who occupy sensitive positions affording access to chemical biological, radiological and nuclear (CBRN) materials facilities and programs are functioning at their highest level of reliability. Human reliability and human performance relate not only to security but also focus on safety. Reliability has a logical and direct relationship to trustworthiness for the organization is placing trust in their employees to conduct themselves in a secure, safe, and dependable manner. This document focuses on providing an organization with a roadmap to implementing a successful and sustainable Structured Trustedmore » Employee Program (STEP).« less

Meeting the contraceptive needs of teens and young adults: youth-friendly and long-acting reversible contraceptive services in U.S. family planning facilities.

PubMed

Kavanaugh, Megan L; Jerman, Jenna; Ethier, Kathleen; Moskosky, Susan

2013-03-01

Increased use of contraceptive services, including long-acting reversible contraceptives (LARCs), among sexually active teens and young adults could significantly reduce unintended pregnancy. Objectives were to describe youth-friendly contraceptive services (including LARC) available to teens and young adults at U.S. publicly funded family planning facilities. Between April and September 2011, center directors at a nationally representative sample of 1,196 U.S. publicly funded family planning facilities were surveyed to assess accessibility and provision of contraceptive services for teens and young adults; 584 (52%) responded. Facilities were accessible to young clients in several ways, including not requiring scheduled appointments for method refills (67%) and having flexible hours (64%). Most facilities provided outreach and/or education to young people (70%), and 27% used social network media to do this. Most facilities took steps to ensure confidentiality for young clients. These youth-friendly practices were more common at Planned Parenthood, Title X, and reproductive health focused facilities than at other facilities. Long-acting reversible contraceptive methods were regularly discussed with younger clients at less than half the facilities. Youth-friendly sites had increased rates of LARC provision among younger clients. The most common challenges to providing contraceptive and LARC services to younger clients were the costs of LARC methods (60%), inconvenient clinic hours (51%), staff concerns about intrauterine device (IUD) use among teens (47%), and limited training on implant insertion (47%). Improving the ability of family planning facilities to provide youth-friendly contraceptive and LARC-specific methods to younger clients may increase the use of highly effective contraception in this population. Copyright © 2013 Society for Adolescent Health and Medicine. All rights reserved.

Bringing healthcare closer to home: one province's approach to home care.

PubMed

Witmer, E

2000-01-01

Ontario is implementing a number of steps to address the growing need for home care and continuing care. One of these steps is the establishment of Ontario's network of 43 Community Care Access Centres (CCACs). Responsible for aiding Ontario residents who seek community-based long-term healthcare, CCACs coordinate access to home services such as nursing and homemaking, manage placement to long-term care facilities and provide information and referral services. In 2000/01 the Ontario government announced 92.5 million Canadian dollars in new funding for long-term community services. This new funding includes 70.1 million Canadian dollars for CCACs. During this time, the provincial government will spend more than 1.6 billion Canadian dollars for long-term-care community-based services. Of this amount, 1.1 Canadian dollars billion will go to CCACs. Community Care Access Centres served more than 400,000 people in 1998/99 and are estimated to serve more than 420,000 in 2000/01. The administrative funds saved by this province-wide system are reinvested in front-line health services.

Ageing management program for the Spanish low and intermediate level waste disposal and spent fuel and high-level waste centralised storage facilities

NASA Astrophysics Data System (ADS)

Zuloaga, P.; Ordoñez, M.; Andrade, C.; Castellote, M.

2011-04-01

The generic design of the centralised spent fuel storage facility was approved by the Spanish Safety Authority in 2006. The planned operational life is 60 years, while the design service life is 100 years. Durability studies and surveillance of the behaviour have been considered from the initial design steps, taking into account the accessibility limitations and temperatures involved. The paper presents an overview of the ageing management program set in support of the Performance Assessment and Safety Review of El Cabril low and intermediate level waste (LILW) disposal facility. Based on the experience gained for LILW, ENRESA has developed a preliminary definition of the Ageing Management Plan for the Centralised Interim Storage Facility of spent Fuel and High Level Waste (HLW), which addresses the behaviour of spent fuel, its retrievability, the confinement system and the reinforced concrete structure. It includes tests plans and surveillance design considerations, based on the El Cabril LILW disposal facility.

Sequential allylic substitution/Pauson-Khand reaction: a strategy to bicyclic fused cyclopentenones from MBH-acetates of acetylenic aldehydes.

PubMed

Raji Reddy, Chada; Kumaraswamy, Paridala; Singarapu, Kiran K

2014-09-05

An efficient approach for the construction of novel bicyclic fused cyclopentenones starting from Morita-Baylis-Hillman (MBH) acetates of acetylenic aldehydes with flexible scaffold diversity has been achieved using a two-step reaction sequence involving allylic substitution and the Pauson-Khand reaction. This strategy provided a facile access to various bicyclic cyclopentenones fused with either a carbocyclic or a heterocyclic ring system in good yield.

43 CFR 17.550 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

Identifying built environmental patterns using cluster analysis and GIS: Relationships with walking, cycling and body mass index in French adults

PubMed Central

2012-01-01

Background Socio-ecological models suggest that both individual and neighborhood characteristics contribute to facilitating health-enhancing behaviors such as physical activity. Few European studies have explored relationships between local built environmental characteristics, recreational walking and cycling and weight status in adults. The aim of this study was to identify built environmental patterns in a French urban context and to assess associations with recreational walking and cycling behaviors as performed by middle-aged adult residents. Methods We used a two-step procedure based on cluster analysis to identify built environmental patterns in the region surrounding Paris, France, using measures derived from Geographic Information Systems databases on green spaces, proximity facilities (destinations) and cycle paths. Individual data were obtained from participants in the SU.VI.MAX cohort; 1,309 participants residing in the Ile-de-France in 2007 were included in this analysis. Associations between built environment patterns, leisure walking/cycling data (h/week) and measured weight status were assessed using multinomial logistic regression with adjustment for individual and neighborhood characteristics. Results Based on accessibility to green spaces, proximity facilities and availability of cycle paths, seven built environmental patterns were identified. The geographic distribution of built environmental patterns in the Ile-de-France showed that a pattern characterized by poor spatial accessibility to green spaces and proximity facilities and an absence of cycle paths was found only in neighborhoods in the outer suburbs, whereas patterns characterized by better spatial accessibility to green spaces, proximity facilities and cycle paths were more evenly distributed across the region. Compared to the reference pattern (poor accessibility to green areas and facilities, absence of cycle paths), subjects residing in neighborhoods characterized by high accessibility to green areas and local facilities and by a high density of cycle paths were more likely to walk/cycle, after adjustment for individual and neighborhood sociodemographic characteristics (OR = 2.5 95%CI 1.4-4.6). Body mass index did not differ across patterns. Conclusions Built environmental patterns were associated with walking and cycling among French adults. These analyses may be useful in determining urban and public health policies aimed at promoting a healthy lifestyle. PMID:22620266

Extension of drop experiments with the MIKROBA balloon drop facility

NASA Astrophysics Data System (ADS)

Sommer, K.; Kretzschmar, K.; Dorn, C.

1992-12-01

The German balloon drop facility MIKROBA extends the worldwide available drop experiment opportunities to the presently highest usable experimentation time span of 55 s at microgravity conditions better than 0.001 g. The microgravity period is started with the typical quasi-deal step function from 1 to 0 g. MIKROBA allows flexible experiment design, short access time, and easy hands-on payload integration. The transport to the operational height is realized by soft energies and technologies compatible with the earth's environment. Balloon campaigns are not restricted to a certain test range, i.e., several suitable sites are available all over the world. MIKROBA combines negligible mechanical loads at the mission start, typical of all drop facilities, with extremely low drop deceleration loads (less than g), due to the implemented three-stage parachute and airbag recovery subsystem.

Water Infrastructure Needs and Investment: Review and Analysis of Key Issues

DTIC Science & Technology

2008-11-24

the Rural Development Act of 1972, as amended (7 U.S.C. § 1926). The purpose of these USDA programs is to provide basic amenities, alleviate health...nonregulatory costs (e.g., routine replacement of basic infrastructure).12 Wastewater Needs. The most recent wastewater survey, conducted in 2004 and issued...1.6 billion just to implement the most basic steps needed to improve security (such as better controlling access to facilities with fences, locks

Accessing Stereochemically Rich Sultams via Microwave-Assisted, Continuous Flow Organic Synthesis (MACOS) Scale-out

PubMed Central

Organ, Michael G.; Hanson, Paul R.; Rolfe, Alan; Samarakoon, Thiwanka B.; Ullah, Farman

2011-01-01

The generation of stereochemically-rich benzothiaoxazepine-1,1′-dioxides for enrichment of high-throughput screening collections is reported. Utilizing a microwave-assisted, continuous flow organic synthesis platform (MACOS), scale-out of core benzothiaoxazepine-1,1′-dioxide scaffolds has been achieved on multi-gram scale using an epoxide opening/SNAr cyclization protocol. Diversification of these sultam scaffolds was attained via a microwave-assisted intermolecular SNAr reaction with a variety of amines. Overall, a facile, 2-step protocol generated a collection of benzothiaoxazepine-1,1′-dioxides possessing stereochemical complexity in rapid fashion, where all 8 stereoisomers were accessed from commercially available starting materials. PMID:22116791

Rapid access to diverse, trifluoromethyl-substituted alkenes using complementary strategies† †Electronic supplementary information (ESI) available. CCDC 1811877, 1817386–1817390. For ESI and crystallographic data in CIF or other electronic format see DOI: 10.1039/c7sc05420c

PubMed Central

Phelan, James P.; Wiles, Rebecca J.; Lang, Simon B.; Kelly, Christopher B.

2018-01-01

Two synergistic approaches to the facile assembly of complex α-trifluoromethyl alkenes are described. Using α-trifluoromethyl-β-silyl alcohols as masked trifluoromethyl alkenes, cross-coupling or related functionalization processes at distal electrophilic sites can be executed without inducing Peterson elimination. Subsequent Lewis acidic activation affords functionalized α-trifluoromethyl alkenes. Likewise, the development of a novel α-trifluoromethylvinyl trifluoroborate reagent complements this approach and allows a one-step cross-coupling of (hetero)aryl halides to access a broad array of complex α-trifluoromethyl alkenes. PMID:29732105

49 CFR 807.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

14 CFR 1251.301 - Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... HANDICAP Accessibility § 1251.301 Existing facilities. (a) Accessibility. A recipient shall operate each... readily accessible to handicapped persons. This paragraph does not require a recipient to make each of its existing facilities or every part of a facility accessible to and usable by handicapped persons. (b...

14 CFR 1251.301 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... HANDICAP Accessibility § 1251.301 Existing facilities. (a) Accessibility. A recipient shall operate each... readily accessible to handicapped persons. This paragraph does not require a recipient to make each of its existing facilities or every part of a facility accessible to and usable by handicapped persons. (b...

14 CFR 1251.301 - Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... HANDICAP Accessibility § 1251.301 Existing facilities. (a) Accessibility. A recipient shall operate each... readily accessible to handicapped persons. This paragraph does not require a recipient to make each of its existing facilities or every part of a facility accessible to and usable by handicapped persons. (b...

14 CFR 1251.301 - Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... HANDICAP Accessibility § 1251.301 Existing facilities. (a) Accessibility. A recipient shall operate each... readily accessible to handicapped persons. This paragraph does not require a recipient to make each of its existing facilities or every part of a facility accessible to and usable by handicapped persons. (b...

49 CFR 28.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

77 FR 6915 - Medical Diagnostic Equipment Accessibility Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-09

... Israel Deaconess Medical Center (October 22, 2009) accessible facilities and accessible medical equipment... of types of accessible medical equipment required in different types of health care facilities. If... facilities, accessible medical equipment, and auxiliary aids and services; University of Southern California...

ACCESS, SOURCES AND VALUE OF NEW MEDICAL INFORMATION - VIEWS OF FINAL YEAR MEDICAL STUDENTS AT THE UNIVERSITY OF NAIROBI

PubMed Central

Gituma, Adrian; Masika, Moses; Muchangi, Eric; Nyagah, Lily; Otieno, Vincent; Irimu, Grace; Wasunna, Aggrey; Ndiritu, Moses; English, Mike

2009-01-01

Background Globally many doctors, particularly in low-income countries, have no formal training in using new information to improve their practice. As a first step clinicians must have access to information and so we explored reported access in graduating medical students in Nairobi. Objectives To evaluate final year medical students’ access to new medical information. Methods A cross-sectional survey of fifth (final) year medical students at the University of Nairobi using anonymous, self-administered questionnaires. Findings Questionnaires were distributed to 291 (85%) of a possible 343 students and returned by 152 (44%). Within the previous 12 months half reported accessing some form of new medical information most commonly from books and the internet. However, only a small number reported regular access and specific, new journal articles were rarely accessed. Absence of internet facilities, slow internet speeds and cost were common barriers to access while current training seems rarely to encourage students to seek new information. Conclusion Almost half the students had not accessed any new medical information in their final year in medical school suggesting they are ill prepared for a career that may increasingly demand life-long, self-learning. PMID:19152558

49 CFR 655.73 - Access to facilities and records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Access to facilities and records. 655.73 Section... OPERATIONS Administrative Requirements § 655.73 Access to facilities and records. (a) Except as required by... payment for the production of those records. (c) An employer shall permit access to all facilities...

The influence of oxidation reduction potential and water treatment processes on quartz lamp sleeve fouling in ultraviolet disinfection reactors.

PubMed

Wait, Isaac W; Johnston, Cliff T; Blatchley, Ernest R

2007-06-01

Ultraviolet (UV) disinfection systems are incorporated into drinking water production facilities because of their broad-spectrum antimicrobial capabilities, and the minimal disinfection by-product formation that generally accompanies their use. Selection of an optimal location for a UV system within a drinking water treatment facility depends on many factors; a potentially important consideration is the effect of system location on operation and maintenance issues, including the potential for fouling of quartz surfaces. To examine the effect of system location on fouling, experiments were conducted at a groundwater treatment facility, wherein aeration, chlorination, and sand filtration were applied sequentially for treatment. In this facility, access to the water stream was available prior to and following each of the treatment steps. Therefore, it was possible to examine the effects of each of these unit operations on fouling dynamics within a UV system. Results indicated zero-order formation kinetics for the fouling reactions at all locations. Increases in oxidation reduction potential, caused by water treatment steps such as aeration and chlorination, increased the rate of sleeve fouling and the rate of irradiance loss within the reactor. Analysis of metals in the sleeve foulant showed that calcium and iron predominate, and relative comparisons of foulant composition to water chemistry highlighted a high affinity for incorporation into the foulant matrix for both iron and manganese, particularly after oxidizing treatment steps. Fouling behavior was observed to be in qualitative agreement with representations of the degree of saturation, relative to the metal:ligand combinations that are believed to comprise a large fraction of the foulants that accumulate on the surfaces of quartz jackets in UV systems used to treat water.

49 CFR 199.231 - Access to facilities and records.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Access to facilities and records. 199.231 Section... TESTING Alcohol Misuse Prevention Program § 199.231 Access to facilities and records. (a) Except as... access to all facilities utilized in complying with the requirements of this subpart to the Secretary of...

76 FR 44663 - Accessibility Guidelines for Pedestrian Facilities in the Public Right-of-Way

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-26

... buildings, facilities, rail passenger cars, and vehicles are accessible in terms of architecture and design... Compliance Board 36 CFR Part 1190 Accessibility Guidelines for Pedestrian Facilities in the Public Right- of... [Docket No. ATBCB 2011-04] RIN 3014-AA26 Accessibility Guidelines for Pedestrian Facilities in the Public...

Molecularly Defined Nanostructures Based on a Novel AAA-DDD Triple Hydrogen-Bonding Motif.

PubMed

Papmeyer, Marcus; Vuilleumier, Clément A; Pavan, Giovanni M; Zhurov, Konstantin O; Severin, Kay

2016-01-26

A facile and flexible method for the synthesis of a new AAA-DDD triple hydrogen-bonding motif is described. Polytopic supramolecular building blocks with precisely oriented AAA and DDD groups are thus accessible in few steps. These building blocks were used for the assembly of large macrocycles featuring four AAA-DDD interactions and a macrobicyclic complex with a total of six AAA-DDD interactions. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

40 CFR 35.925-1 - Facilities planning.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Facilities planning. 35.925-1 Section... Facilities planning. That, if the award is for step 2, step 3, or step 2=3 grant assistance, the facilities planning requirements in § 35.917 et seq. have been met. ...

Financial performance monitoring of the technical efficiency of critical access hospitals: a data envelopment analysis and logistic regression modeling approach.

PubMed

Wilson, Asa B; Kerr, Bernard J; Bastian, Nathaniel D; Fulton, Lawrence V

2012-01-01

From 1980 to 1999, rural designated hospitals closed at a disproportionally high rate. In response to this emergent threat to healthcare access in rural settings, the Balanced Budget Act of 1997 made provisions for the creation of a new rural hospital--the critical access hospital (CAH). The conversion to CAH and the associated cost-based reimbursement scheme significantly slowed the closure rate of rural hospitals. This work investigates which methods can ensure the long-term viability of small hospitals. This article uses a two-step design to focus on a hypothesized relationship between technical efficiency of CAHs and a recently developed set of financial monitors for these entities. The goal is to identify the financial performance measures associated with efficiency. The first step uses data envelopment analysis (DEA) to differentiate efficient from inefficient facilities within a data set of 183 CAHs. Determining DEA efficiency is an a priori categorization of hospitals in the data set as efficient or inefficient. In the second step, DEA efficiency is the categorical dependent variable (efficient = 0, inefficient = 1) in the subsequent binary logistic regression (LR) model. A set of six financial monitors selected from the array of 20 measures were the LR independent variables. We use a binary LR to test the null hypothesis that recently developed CAH financial indicators had no predictive value for categorizing a CAH as efficient or inefficient, (i.e., there is no relationship between DEA efficiency and fiscal performance).

Reagent-based DOS: developing a diastereoselective methodology to access spirocyclic- and fused heterocyclic ring systems.

PubMed

Damerla, V Surendra Babu; Tulluri, Chiranjeevi; Gundla, Rambabu; Naviri, Lava; Adepally, Uma; Iyer, Pravin S; Murthy, Y L N; Prabhakar, Nampally; Sen, Subhabrata

2012-10-01

Herein, we report a diversity-oriented-synthesis (DOS) approach for the synthesis of biologically relevant molecular scaffolds. Our methodology enables the facile synthesis of fused N-heterocycles, spirooxoindolones, tetrahydroquinolines, and fused N-heterocycles. The two-step sequence starts with a chiral-bicyclic-lactam-directed enolate-addition/substitution step. This step is followed by a ring-closure onto the built-in scaffold electrophile, thereby leading to stereoselective carbocycle- and spirocycle-formation. We used in silico tools to calibrate our compounds with respect to chemical diversity and selected drug-like properties. We evaluated the biological significance of our scaffolds by screening them in two cancer cell-lines. In summary, our DOS methodology affords new, diverse scaffolds, thereby resulting in compounds that may have significance in medicinal chemistry. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Revealed access to haemodialysis facilities in northeastern Iran: Factors that matter in rural and urban areas.

PubMed

Kiani, Behzad; Bagheri, Nasser; Tara, Ahmad; Hoseini, Benyamin; Tabesh, Hamed; Tara, Mahmood

2017-11-07

Poor access to haemodialysis facilities is associated with high mortality and morbidity rates. This study investigated factors affecting revealed access to the haemodialysis facilities considering patients living in rural and urban areas without any haemodialysis facility (Group A) and those living urban areas with haemodialysis facilities (Group B). This study is based on selfreported Actual Access Time (AAT) to referred haemodialysis facilities and other information regarding travel to haemodialysis facilities from patients. All significant variables on univariate analysis were entered into a univariate general linear model in order to identify factors associated with AAT. Both spatial (driving time and distance) and non-spatial factors (sex, income level, caregivers, transportation mode, education level, ethnicity and personal vehicle ownership) influenced the revealed access identified in Group A. The non-spatial factors for Group B patients were the same as for Group A, but no spatial factor was identified in Group B. It was found that accessibility is strongly underestimated when driving time is chosen as accessibility measure to haemodialysis facilities. Analysis of revealed access determinants provides policymakers with an appropriate decision base for making appropriate decisions and finding solutions to decrease the access time for patients under haemodialysis therapy. Driving time alone is not a good proxy for measuring access to haemodialysis facilities as there are many other potential obstacles, such as women's special travel problems, poor other transportation possibilities, ethnicity disparities, low education levels, low caregiver status and low-income.

A public health initiative for reducing access to pesticides as a means to committing suicide: findings from a qualitative study.

PubMed

Mohanraj, Rani; Kumar, Shuba; Manikandan, Sarojini; Kannaiyan, Veerapandian; Vijayakumar, Lakshmi

2014-08-01

Widespread use of pesticides among farmers in rural India, provides an easy means for suicide. A public health initiative involving storage of pesticides in a central storage facility could be a possible strategy for reducing mortality and morbidity related to pesticide poisoning. This qualitative study explored community perceptions towards a central pesticide storage facility in villages in rural South India. Sixteen focus group discussions held with consenting adults from intervention and control villages were followed by eight more a year after initiation of the storage facility. Analysis revealed four themes, namely, reasons for committing suicide and methods used, exposure to pesticides and first-aid practices, storage and disposal of pesticides, and perceptions towards the storage facility. The facility was appreciated as a means of preventing suicides and for providing a safe haven for pesticide storage. The participatory process that guided its design, construction and location ensured its acceptability. Use of qualitative methods helped provide deep insights into the phenomenon of pesticide suicide and aided the understanding of community perceptions towards the storage facility. The study suggests that communal storage of pesticides could be an important step towards reducing pesticide suicides in rural areas.

Accessibility of health clubs for people with mobility disabilities and visual impairments.

PubMed

Rimmer, James H; Riley, Barth; Wang, Edward; Rauworth, Amy

2005-11-01

We sought to examine the accessibility of health clubs to persons with mobility disabilities and visual impairments. We assessed 35 health clubs and fitness facilities as part of a national field trial of a new instrument, Accessibility Instruments Measuring Fitness and Recreation Environments (AIMFREE), designed to assess accessibility of fitness facilities in the following domains: (1) built environment, (2) equipment, (3) swimming pools, (4) information, (5) facility policies, and (6) professional behavior. All facilities had a low to moderate level of accessibility. Some of the deficiencies concerned specific Americans with Disabilities Act guidelines pertaining to the built environment, whereas other deficiency areas were related to aspects of the facilities' equipment, information, policies, and professional staff. Persons with mobility disabilities and visual impairments have difficulty accessing various areas of fitness facilities and health clubs. AIMFREE is an important tool for increasing awareness of these accessibility barriers for people with disabilities.

Limited electricity access in health facilities of sub-Saharan Africa: a systematic review of data on electricity access, sources, and reliability

PubMed Central

Adair-Rohani, Heather; Zukor, Karen; Bonjour, Sophie; Wilburn, Susan; Kuesel, Annette C; Hebert, Ryan; Fletcher, Elaine R

2013-01-01

ABSTRACT Background: Access to electricity is critical to health care delivery and to the overarching goal of universal health coverage. Data on electricity access in health care facilities are rarely collected and have never been reported systematically in a multi-country study. We conducted a systematic review of available national data on electricity access in health care facilities in sub-Saharan Africa. Methods: We identified publicly-available data from nationally representative facility surveys through a systematic review of articles in PubMed, as well as through websites of development agencies, ministries of health, and national statistics bureaus. To be included in our analysis, data sets had to be collected in or after 2000, be nationally representative of a sub-Saharan African country, cover both public and private health facilities, and include a clear definition of electricity access. Results: We identified 13 health facility surveys from 11 sub-Saharan African countries that met our inclusion criteria. On average, 26% of health facilities in the surveyed countries reported no access to electricity. Only 28% of health care facilities, on average, had reliable electricity among the 8 countries reporting data. Among 9 countries, an average of 7% of facilities relied solely on a generator. Electricity access in health care facilities increased by 1.5% annually in Kenya between 2004 and 2010, and by 4% annually in Rwanda between 2001 and 2007. Conclusions: Energy access for health care facilities in sub-Saharan African countries varies considerably. An urgent need exists to improve the geographic coverage, quality, and frequency of data collection on energy access in health care facilities. Standardized tools should be used to collect data on all sources of power and supply reliability. The United Nations Secretary-General's “Sustainable Energy for All” initiative provides an opportunity to comprehensively monitor energy access in health care facilities. Such evidence about electricity needs and gaps would optimize use of limited resources, which can help to strengthen health systems. PMID:25276537

44 CFR 16.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

...: Existing facilities. 16.150 Section 16.150 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the... facilities accessible to and usable by individuals with handicaps; (2) In the case of historic preservation...

49 CFR Appendix A to Part 37 - Modifications to Standards for Accessible Transportation Facilities

Code of Federal Regulations, 2011 CFR

2011-10-01

... Transportation Facilities A Appendix A to Part 37 Transportation Office of the Secretary of Transportation...—Modifications to Standards for Accessible Transportation Facilities The Department of Transportation, in § 37.9 of this part, adopts as its regulatory standards for accessible transportation facilities the revised...

Use of parks or playgrounds: reported access to drinking water fountains among US adults, 2009.

PubMed

Park, Sohyun; Sherry, Bettylou; Wethington, Holly; Pan, Liping

2012-03-01

As a first step to determining the public availability of drinking water, self-reported access to water fountains in parks and playgrounds was examined. A cross-sectional analysis was conducted on a convenience sample of 4163 US adults (aged ≥ 18 years) using the 2009 HealthStyles Survey. The outcome measure was reported access to water fountains in parks/playgrounds. Among those who reported using parks/playgrounds, multivariable logistic regression was used to examine the associations between sociodemographic variables and reported access to water fountains. About half (54.7%) of participants used parks/playgrounds. Among those, 55.0% reported access to water fountains. Factors significantly associated with reported access to water fountains were being male [odds ratio (OR) = 1.42; 95% confidence interval (CI) = 1.09, 1.85] and living in the Pacific region (versus East North Central region, OR = 2.56; 95% CI = 1.61, 4.06). Age, race/ethnicity, household income, marital status, education, smoking and physical activity were not significantly associated with reported access to water fountains. Among 54.7% of adults using parks/playgrounds, reported access to water fountains was significantly differed by sex and region. This study provides information that can be considered when developing interventions to increase access to drinking water in public facilities.

Telepsychiatry in correctional facilities: using technology to improve access and decrease costs of mental health care in underserved populations.

PubMed

Deslich, Stacie Anne; Thistlethwaite, Timothy; Coustasse, Alberto

2013-01-01

It is unclear if telepsychiatry, a subset of telemedicine, increases access to mental health care for inmates in correctional facilities or decreases costs for clinicians or facility administrators. The purpose of this investigation was to determine how utilization of telepsychiatry affected access to care and costs of providing mental health care in correctional facilities. A literature review complemented by a semistructured interview with a telepsychiatry practitioner. Five electronic databases, the National Bureau of Justice, and the American Psychiatric Association Web sites were searched for this research, and 49 sources were referenced. The literature review examined implementation of telepsychiatry in correctional facilities in Arizona, California, Georgia, Kansas, Ohio, Texas, and West Virginia to determine the effect of telepsychiatry on inmate access to mental health services and the costs of providing mental health care in correctional facilities. Telepsychiatry provided improved access to mental health services for inmates, and this increase in access is through the continuum of mental health care, which has been instrumental in increasing quality of care for inmates. Use of telepsychiatry saved correctional facilities from $12,000 to more than $1 million. The semistructured interview with the telepsychiatry practitioner supported utilization of telepsychiatry to increase access and lower costs of providing mental health care in correctional facilities. Increasing access to mental health care for this underserved group through telepsychiatry may improve living conditions and safety inside correctional facilities. Providers, facilities, and state and federal governments can expect increased savings with utilization of telepsychiatry.

An Overview of Facilities and Capabilities to Support the Development of Nuclear Thermal Propulsion

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

James Werner; Sam Bhattacharyya; Mike Houts

Abstract. The future of American space exploration depends on the ability to rapidly and economically access locations of interest throughout the solar system. There is a large body of work (both in the US and the Former Soviet Union) that show that Nuclear Thermal Propulsion (NTP) is the most technically mature, advanced propulsion system that can enable this rapid and economical access by its ability to provide a step increase above what is a feasible using a traditional chemical rocket system. For an NTP system to be deployed, the earlier measurements and recent predictions of the performance of the fuelmore » and the reactor system need to be confirmed experimentally prior to launch. Major fuel and reactor system issues to be addressed include fuel performance at temperature, hydrogen compatibility, fission product retention, and restart capability. The prime issue to be addressed for reactor system performance testing involves finding an affordable and environmentally acceptable method to test a range of engine sizes using a combination of nuclear and non-nuclear test facilities. This paper provides an assessment of some of the capabilities and facilities that are available or will be needed to develop and test the nuclear fuel, and reactor components. It will also address briefly options to take advantage of the greatly improvement in computation/simulation and materials processing capabilities that would contribute to making the development of an NTP system more affordable. Keywords: Nuclear Thermal Propulsion (NTP), Fuel fabrication, nuclear testing, test facilities.« less

Neighbourhood environment correlates of physical activity: a study of eight Czech regional towns.

PubMed

Sigmundová, Dagmar; El Ansari, Walid; Sigmund, Erik

2011-02-01

An adequate amount of physical activity (PA) is a key factor that is associated with good health. This study assessed socio-environmental factors associated with meeting the health recommendations for PA (achieving 10,000 steps per day). In total, 1,653 respondents randomly selected from across eight regional towns (each >90,000 inhabitants) in the Czech Republic participated in the study. The ANEWS questionnaire assessed the environment in neighbourhoods, and participants' weekly PA was objectively monitored (Yamax Digiwalker SW-700 pedometer). About 24% of participants were sufficiently active, 27% were highly active; 28% participants were overweight and 5% were obese. Although BMI was significantly inversely associated with the daily step counts achieved only in females, for both genders, BMI was generally not significantly associated with the criterion of achieving 10,000 steps per day during the week. Increased BMI in both genders was accompanied with a decline in participation in organized PA and with increasing age. As regards to the demographic/lifestyle factors, for females, more participation in organized PA was significantly positively correlated with the achieved daily step counts. In contrast, older age and higher BMI (for females) and smoking (for males) were significantly negatively correlated with the achieved daily step counts. In terms of the environmental aspects, pleasant environments were significantly positively correlated to daily step counts for both genders. Additionally, for males, better residencies (more family homes rather than apartment blocks) in the neighbourhood were significantly positively correlated with their daily step counts. For females, less accessibility of shops and non-sport facilities (depending on walking distance in minutes) were significantly negatively correlated to the achieved daily step counts. Individuals who lived in pleasant neighbourhoods, with better access to shops and who participated in organized PA (≥ 2 times a week) tended to meet the recommendations for health-enhancing PA levels. The creation of physical activity-friendly environments could be associated with enhancing people's achieved daily step counts and meeting the health criteria for PA.

10 CFR 62.13 - Contents of a request for emergency access: Alternatives.

Code of Federal Regulations, 2010 CFR

2010-01-01

... radioactive waste in a licensed storage facility; (3) Obtaining access to a disposal facility by voluntary... disposal at a Federal low-level radioactive waste disposal facility in the case of a Federal or defense... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission...

Sociospatial distribution of access to facilities for moderate and vigorous intensity physical activity in Scotland by different modes of transport

PubMed Central

2012-01-01

Background People living in neighbourhoods of lower socioeconomic status have been shown to have higher rates of obesity and a lower likelihood of meeting physical activity recommendations than their more affluent counterparts. This study examines the sociospatial distribution of access to facilities for moderate or vigorous intensity physical activity in Scotland and whether such access differs by the mode of transport available and by Urban Rural Classification. Methods A database of all fixed physical activity facilities was obtained from the national agency for sport in Scotland. Facilities were categorised into light, moderate and vigorous intensity activity groupings before being mapped. Transport networks were created to assess the number of each type of facility accessible from the population weighted centroid of each small area in Scotland on foot, by bicycle, by car and by bus. Multilevel modelling was used to investigate the distribution of the number of accessible facilities by small area deprivation within urban, small town and rural areas separately, adjusting for population size and local authority. Results Prior to adjustment for Urban Rural Classification and local authority, the median number of accessible facilities for moderate or vigorous intensity activity increased with increasing deprivation from the most affluent or second most affluent quintile to the most deprived for all modes of transport. However, after adjustment, the modelling results suggest that those in more affluent areas have significantly higher access to moderate and vigorous intensity facilities by car than those living in more deprived areas. Conclusions The sociospatial distributions of access to facilities for both moderate intensity and vigorous intensity physical activity were similar. However, the results suggest that those living in the most affluent neighbourhoods have poorer access to facilities of either type that can be reached on foot, by bicycle or by bus than those living in less affluent areas. This poorer access from the most affluent areas appears to be reversed for those with access to a car. PMID:22568969

Household trends in access to improved water sources and sanitation facilities in Vietnam and associated factors: findings from the Multiple Indicator Cluster Surveys, 2000-2011.

PubMed

Tuyet-Hanh, Tran Thi; Lee, Jong-Koo; Oh, Juhwan; Van Minh, Hoang; Ou Lee, Chul; Hoan, Le Thi; Nam, You-Seon; Long, Tran Khanh

2016-01-01

Despite progress made by the Millennium Development Goal (MDG) number 7.C, Vietnam still faces challenges with regard to the provision of access to safe drinking water and basic sanitation. This paper describes household trends in access to improved water sources and sanitation facilities separately, and analyses factors associated with access to improved water sources and sanitation facilities in combination. Secondary data from the Vietnam Multiple Indicator Cluster Survey in 2000, 2006, and 2011 were analyzed. Descriptive statistics and tests of significance describe trends over time in access to water and sanitation by location, demographic and socio-economic factors. Binary logistic regressions (2000, 2006, and 2011) describe associations between access to water and sanitation, and geographic, demographic, and socio-economic factors. There have been some outstanding developments in access to improved water sources and sanitation facilities from 2000 to 2011. In 2011, the proportion of households with access to improved water sources and sanitation facilities reached 90% and 77%, respectively, meeting the 2015 MDG targets for safe drinking water and basic sanitation set at 88% and 75%, respectively. However, despite these achievements, in 2011, only 74% of households overall had access to combined improved drinking water and sanitation facilities. There were also stark differences between regions. In 2011, only 47% of households had access to both improved water and sanitation facilities in the Mekong River Delta compared with 94% in the Red River Delta. In 2011, households in urban compared to rural areas were more than twice as likely (odds ratio [OR]: 2.2; 95% confidence interval [CI]: 1.9-2.5) to have access to improved water and sanitation facilities in combination, and households in the highest compared with the lowest wealth quintile were over 40 times more likely (OR: 42.3; 95% CI: 29.8-60.0). More efforts are required to increase household access to both improved water and sanitation facilities in the Mekong River Delta, South East and Central Highlands regions of Vietnam. There is also a need to address socio-economic factors associated with inadequate access to improved sanitation facilities.

Telehealth forging ahead: overcoming barriers in licensure to improve access to care for service members.

PubMed

Stout, Katie Ambrose; Martinez, Kristina

2011-01-01

The telehealth initiatives of the Department of Defense (DoD) and Veterans' Health Administration (VHA) continue to test the limits of technology to provide the best care to our service members, veterans and their families. The DoD and VHA have credentialing systems in place to allow clinical practice between facilities. New legislation in the form of the Servicemembers' Telemedicine and E-Health Portability (STEP) Act will potentially expand telehealth clinical services across state lines into the homes of our service members and veterans.

Spatial access to inpatient health care in northern rural India.

PubMed

Ranga, Vikram; Panda, Pradeep

2014-05-01

Access to health care in rural areas is a major concern for local populations as well as for policy makers in developing countries. This paper examines spatial access to in-patient health care in northern rural India. In order to measure spatial access, impedance-based competition using the Three-Step floating Catchment Area (3SFCA) method, a modification of the simple gravity model, was used. 3SFCA was chosen for the study of the districts of Pratapgarh and Kanpur Dehat in the Uttar Pradesh state and Vaishali in the Bihar state, two of India's poorest states. This approach is based on discrete distance decay and also considers more parameters than other available methods, hence is believed to be a robust methodology. It was found that Vaishali district has the highest spatial access to in-patient health care followed by Pratapgarh and Kanpur Dehat. There is serious lack of health care, in Pratapgarh and Kanpur Dehat with 40% and 90% of the villages having shortage of in-patient care facilities in these respective districts. The most important factor affecting spatial access was found to be the distance to the nearest major urban agglomeration.

Disparities in Geographic Accessibility of National Cancer Institute Cancer Centers in the United States.

PubMed

Xu, Yanqing; Fu, Cong; Onega, Tracy; Shi, Xun; Wang, Fahui

2017-11-11

The National Cancer Institute (NCI) Cancer Centers form the backbone of the cancer care system in the United States since their inception in the early 1970s. Most studies on their geographic accessibility used primitive measures, and did not examine the disparities across urbanicity or demographic groups. This research uses an advanced accessibility method, termed "2-step floating catchment area (2SFCA)" and implemented in Geographic Information Systems (GIS), to capture the degree of geographic access to NCI Cancer Centers by accounting for competition intensity for the services and travel time between residents and the facilities. The results indicate that urban advantage is pronounced as the average accessibility is highest in large central metro areas, declines to large fringe metro, medium metro, small metro, micropolitan and noncore rural areas. Population under the poverty line are disproportionally concentrated in lower accessibility areas. However, on average Non-Hispanic White have the lowest geographic accessibility, followed by Hispanic, Non-Hispanic Black and Asian, and the differences are statistically significant. The "reversed racial disadvantage" in NCI Cancer Center accessibility seems counterintuitive but is consistent with an influential prior study; and it is in contrast to the common observation of co-location of concentration of minority groups and people under the poverty line.

Accessibility of Health Clubs for People with Mobility Disabilities and Visual Impairments

PubMed Central

Rimmer, James H.; Riley, Barth; Wang, Edward; Rauworth, Amy

2005-01-01

Objective. We sought to examine the accessibility of health clubs to persons with mobility disabilities and visual impairments. Methods. We assessed 35 health clubs and fitness facilities as part of a national field trial of a new instrument, Accessibility Instruments Measuring Fitness and Recreation Environments (AIMFREE), designed to assess accessibility of fitness facilities in the following domains: (1) built environment, (2) equipment, (3) swimming pools, (4) information, (5) facility policies, and (6) professional behavior. Results. All facilities had a low to moderate level of accessibility. Some of the deficiencies concerned specific Americans with Disabilities Act guidelines pertaining to the built environment, whereas other deficiency areas were related to aspects of the facilities’ equipment, information, policies, and professional staff. Conclusions. Persons with mobility disabilities and visual impairments have difficulty accessing various areas of fitness facilities and health clubs. AIMFREE is an important tool for increasing awareness of these accessibility barriers for people with disabilities. PMID:16254234

49 CFR 39.61 - What requirements must PVOs meet concerning the accessibility of terminals and other landside...

Code of Federal Regulations, 2011 CFR

2011-10-01

... accessibility of terminals and other landside facilities? 39.61 Section 39.61 Transportation Office of the... Accessibility of Landside Facilities § 39.61 What requirements must PVOs meet concerning the accessibility of terminals and other landside facilities? As a PVO, you must comply with the following requirements with...

Spatial accessibility to physical activity facilities and to food outlets and overweight in French youth.

PubMed

Casey, R; Chaix, B; Weber, C; Schweitzer, B; Charreire, H; Salze, P; Badariotti, D; Banos, A; Oppert, J-M; Simon, C

2012-07-01

Some characteristics of the built environment have been associated with obesity in youth. Our aim was to determine whether individual and environmental socio-economic characteristics modulate the relation between youth overweight and spatial accessibility to physical activity (PA) facilities and to food outlets. Cross-sectional study. 3293 students, aged 12 ± 0.6 years, randomly selected from eastern France middle schools. Using geographical information systems (GIS), spatial accessibility to PA facilities (urban and nature) was assessed using the distance to PA facilities at the municipality level; spatial accessibility to food outlets (general food outlets, bakeries and fast-food outlets) was calculated at individual level using the student home address and the food outlets addresses. Relations of weight status with spatial accessibility to PA facilities and to food outlets were analysed using mixed logistic models, testing potential direct and interaction effects of individual and environmental socio-economic characteristics. Individual socio-economic status modulated the relation between spatial accessibility to PA facilities and to general food outlets and overweight. The likelihood of being overweight was higher when spatial accessibility to urban PA facilities and to general food outlets was low, but in children of blue-collar-workers only. The odds ratio (OR) (95% confidence interval) for being overweight of blue-collar-workers children compared with non-blue-collar-workers children was 1.76 (1.25-2.49) when spatial accessibility to urban PA facilities was low. This OR was 1.86 (1.20-2.86) when spatial accessibility to general food outlets was low. There was no significant relationship of overweight with either nature PA facilities or other food outlets (bakeries and fast-food outlets). These results indicate that disparities in spatial accessibility to PA facilities and to general food outlets may amplify the risk of overweight in socio-economically disadvantaged youth. These data should be relevant for influencing health policies and urban planning at both a national and local level.

Radiation therapy facilities in the United States

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

Ballas, Leslie K.; Elkin, Elena B.; Schrag, Deborah

2006-11-15

Purpose: About half of all cancer patients in the United States receive radiation therapy as a part of their cancer treatment. Little is known, however, about the facilities that currently deliver external beam radiation. Our goal was to construct a comprehensive database of all radiation therapy facilities in the United States that can be used for future health services research in radiation oncology. Methods and Materials: From each state's health department we obtained a list of all facilities that have a linear accelerator or provide radiation therapy. We merged these state lists with information from the American Hospital Association (AHA),more » as well as 2 organizations that audit the accuracy of radiation machines: the Radiologic Physics Center (RPC) and Radiation Dosimetry Services (RDS). The comprehensive database included all unique facilities listed in 1 or more of the 4 sources. Results: We identified 2,246 radiation therapy facilities operating in the United States as of 2004-2005. Of these, 448 (20%) facilities were identified through state health department records alone and were not listed in any other data source. Conclusions: Determining the location of the 2,246 radiation facilities in the United States is a first step in providing important information to radiation oncologists and policymakers concerned with access to radiation therapy services, the distribution of health care resources, and the quality of cancer care.« less

Spatial accessibility to specific sport facilities and corresponding sport practice: the RECORD Study.

PubMed

Karusisi, Noëlla; Thomas, Frédérique; Méline, Julie; Chaix, Basile

2013-04-20

Physical activity is considered as a major component of a healthy lifestyle. However, few studies have examined the relationships between the spatial accessibility to sport facilities and sport practice with a sufficient degree of specificity. The aim of this study was to investigate the associations between the spatial accessibility to specific types of sports facilities and the practice of the corresponding sports after carefully controlling for various individual socio-demographic characteristics and neighborhood socioeconomic variables. Data from the RECORD Study involving 7290 participants recruited in 2007-2008, aged 30-79 years, and residing in the Paris metropolitan area were analyzed. Four categories of sports were studied: team sports, racket sports, swimming and related activities, and fitness. Spatial accessibility to sport facilities was measured with two complementary approaches that both take into account the street network (distance to the nearest facility and count of facilities around the dwelling). Associations between the spatial accessibility to sport facilities and the practice of the corresponding sports were assessed using multilevel logistic regression after adjusting for individual and contextual characteristics. High individual education and high household income were associated with the practice of racket sports, swimming or related activities, and fitness over the previous 7 days. The spatial accessibility to swimming pools was associated with swimming and related sports, even after adjustment for individual/contextual factors. The spatial accessibility to facilities was not related to the practice of other sports. High neighborhood income was associated with the practice of a racket sport and fitness. Accessibility is a multi-dimensional concept that integrates educational, financial, and geographical aspects. Our work supports the evidence that strategies to increase participation in sport activities should improve the spatial and financial access to specific facilities, but also address educational disparities in sport practice.

Coeur d'Alene Tribal Production Facility, Volume I of III, 2002-2003 Progress Report.

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

Anders, Paul

2003-01-01

In fulfillment of the NWPPC's 3-Step Process for the implementation of new hatcheries in the Columbia Basin, this Step 1 submission package to the Council includes four items: (1) Cover letter from the Coeur d'Alene Tribe, Interdisciplinary Team Chair, and the USFWS; (2) References to key information (Attachments 1-4); (3) The updated Master Plan for the Tribe's native cutthroat restoration project; and (4) Appendices. In support of the Master Plan submitted by the Coeur d'Alene Tribe the reference chart (Item 2) was developed to allow reviewers to quickly access information necessary for accurate peer review. The Northwest Power Planning Councilmore » identified pertinent issues to be addressed in the master planning process for new artificial production facilities. References to this key information are provided in three attachments: (1) NWPPC Program language regarding the Master Planning Process, (2) Questions Identified in the September 1997 Council Policy, and (3) Program language identified by the Council's Independent Scientific Review Panel (ISRP). To meet the need for off-site mitigation for fish losses on the mainstem Columbia River, in a manner consistent with the objectives of the Council's Program, the Coeur d'Alene Tribe is proposing that the BPA fund the design, construction, operation, and maintenance of a trout production facility located adjacent to Coeur d'Alene Lake on the Coeur d'Alene Indian Reservation. The updated Master Plan (Item 3) represents the needs associated with the re-evaluation of the Coeur d'Alene Tribe's Trout Production Facility (No.199004402). This plan addresses issues and concerns expressed by the NWPPC as part of the issue summary for the Mountain Columbia provincial review, and the 3-step hatchery review process. Finally, item 4 (Appendices) documents the 3-Step process correspondence to date between the Coeur d'Alene Tribe and additional relevant entities. Item 4 provides a chronological account of previous ISRP reviews, official Coeur d'Alene fisheries program responses to a series of ISRP reviews, master planning documentation, and annual reports dating back to 1990. Collectively, the materials provided by the Coeur d'Alene Tribe in this Step-1 submission package comprehensively assesses key research, habitat improvement activities, and hatchery production issues to best protect and enhance native cutthroat trout populations and the historically and culturally important tribal fisheries they support.« less

19 CFR 201.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 3 2010-04-01 2010-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

19 CFR 201.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 3 2012-04-01 2012-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

19 CFR 201.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 3 2014-04-01 2014-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

19 CFR 201.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 3 2013-04-01 2013-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

19 CFR 201.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 3 2011-04-01 2011-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

45 CFR 2301.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 2301.150 Section 2301.150 Public Welfare Regulations Relating to Public Welfare (Continued) ARCTIC RESEARCH... THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.150 Program accessibility: Existing facilities. (a...

45 CFR 2301.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Program accessibility: Existing facilities. 2301.150 Section 2301.150 Public Welfare Regulations Relating to Public Welfare (Continued) ARCTIC RESEARCH... THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.150 Program accessibility: Existing facilities. (a...

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

Willoner, T.; Turlington, R.; Koenig, R.

The U.S. Department of Energy (DOE) (Environmental Management [EM], Office of Packaging and Transportation [EM-45]) Packaging and Certification Program (DOE PCP) has developed a Radio Frequency Identification (RFID) tracking and monitoring system, called ARG-US, for the management of nuclear materials packages during transportation and storage. The performance of the ARG-US RFID equipment and system has been fully tested in two demonstration projects in April 2008 and August 2009. With the strong support of DOE-SR and DOE PCP, a field testing program was completed in Savannah River Site's K-Area Material Storage (KAMS) Facility, an active Category I Plutonium Storage Facility, inmore » 2010. As the next step (Phase II) of continued vault testing for the ARG-US system, the Savannah River Site K Area Material Storage facility has placed the ARG-US RFIDs into the 910B storage vault for operational testing. This latest version (Mark III) of the Argonne RFID system now has the capability to measure radiation dose and dose rate. This paper will report field testing progress of the ARG-US RFID equipment in KAMS, the operability and reliability trend results associated with the applications of the system, and discuss the potential benefits in enhancing safety, security and materials accountability. The purpose of this Phase II K Area test is to verify the accuracy of the radiation monitoring and proper functionality of the ARG-US RFID equipment and system under a realistic environment in the KAMS facility. Deploying the ARG-US RFID system leads to a reduced need for manned surveillance and increased inventory periods by providing real-time access to status and event history traceability, including environmental condition monitoring and radiation monitoring. The successful completion of the testing program will provide field data to support a future development and testing. This will increase Operation efficiency and cost effectiveness for vault operation. As the next step (Phase II) of continued vault testing for the ARG-US system, the Savannah River Site K Area Material Storage facility has placed the ARG-US RFIDs into the 910B storage vault. Deploying the ARG-US RFID system lends to a reduced need for manned surveillance and increased inventory periods by providing real-time access to status and event history traceability, including radiation and environmental monitoring. The successful completion of the testing program will provide field data to support future development and testing.« less

Understanding the relationship between access to care and facility-based delivery through analysis of the 2008 Ghana Demographic Health Survey.

PubMed

Moyer, Cheryl A; McLaren, Zoë M; Adanu, Richard M; Lantz, Paula M

2013-09-01

To determine the types of access to care most strongly associated with facility-based delivery among women in Ghana. Data relating to the "5 As of Access" framework were extracted from the 2008 Ghana Demographic Health Survey and analyzed using multivariate logistic regression. In all, 55.5% of a weighted sample of 1102 women delivered in a healthcare facility, whereas 45.5% delivered at home. Affordability was the strongest access factor associated with delivery location, with health insurance coverage tripling the odds of facility delivery. Availability, accessibility (except urban residence), acceptability, and social access variables were not significant factors in the final models. Social access variables, including needing permission to seek healthcare and not being involved in decisions regarding healthcare, were associated with a reduced likelihood of facility-based delivery when examined individually. Multivariate analysis suggested that these variables reflected maternal literacy, health insurance coverage, and household wealth, all of which attenuated the effects of social access. Affordability was an important determinant of facility delivery in Ghana-even among women with health insurance-but social access variables had a mediating role. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Household trends in access to improved water sources and sanitation facilities in Vietnam and associated factors: findings from the Multiple Indicator Cluster Surveys, 2000–2011

PubMed Central

Tuyet-Hanh, Tran Thi; Lee, Jong-Koo; Oh, Juhwan; Van Minh, Hoang; Ou Lee, Chul; Hoan, Le Thi; Nam, You-Seon; Long, Tran Khanh

2016-01-01

Background Despite progress made by the Millennium Development Goal (MDG) number 7.C, Vietnam still faces challenges with regard to the provision of access to safe drinking water and basic sanitation. Objective This paper describes household trends in access to improved water sources and sanitation facilities separately, and analyses factors associated with access to improved water sources and sanitation facilities in combination. Design Secondary data from the Vietnam Multiple Indicator Cluster Survey in 2000, 2006, and 2011 were analyzed. Descriptive statistics and tests of significance describe trends over time in access to water and sanitation by location, demographic and socio-economic factors. Binary logistic regressions (2000, 2006, and 2011) describe associations between access to water and sanitation, and geographic, demographic, and socio-economic factors. Results There have been some outstanding developments in access to improved water sources and sanitation facilities from 2000 to 2011. In 2011, the proportion of households with access to improved water sources and sanitation facilities reached 90% and 77%, respectively, meeting the 2015 MDG targets for safe drinking water and basic sanitation set at 88% and 75%, respectively. However, despite these achievements, in 2011, only 74% of households overall had access to combined improved drinking water and sanitation facilities. There were also stark differences between regions. In 2011, only 47% of households had access to both improved water and sanitation facilities in the Mekong River Delta compared with 94% in the Red River Delta. In 2011, households in urban compared to rural areas were more than twice as likely (odds ratio [OR]: 2.2; 95% confidence interval [CI]: 1.9–2.5) to have access to improved water and sanitation facilities in combination, and households in the highest compared with the lowest wealth quintile were over 40 times more likely (OR: 42.3; 95% CI: 29.8–60.0). Conclusions More efforts are required to increase household access to both improved water and sanitation facilities in the Mekong River Delta, South East and Central Highlands regions of Vietnam. There is also a need to address socio-economic factors associated with inadequate access to improved sanitation facilities. PMID:26950563

High-Performance Computing User Facility | Computational Science | NREL

Science.gov Websites

User Facility High-Performance Computing User Facility The High-Performance Computing User Facility technologies. Photo of the Peregrine supercomputer The High Performance Computing (HPC) User Facility provides Gyrfalcon Mass Storage System. Access Our HPC User Facility Learn more about these systems and how to access

Accessing FMS Functionality: The Impact of Design on Learning

NASA Technical Reports Server (NTRS)

Fennell, Karl; Sherry, Lance; Roberts, Ralph, Jr.

2004-01-01

In modern commercial and military aircraft, the Flight Management System (FMS) lies at the heart of the functionality of the airplane. The nature of the FMS has also caused great difficulties learning and accessing this functionality. This study examines actual Air Force pilots who were qualified on the newly introduced advanced FMS and shows that the design of the system itself is a primary source of difficulty learning the system. Twenty representative tasks were selected which the pilots could be expected to accomplish on an ' actual flight. These tasks were analyzed using the RAFIV stage model (Sherry, Polson, et al. 2002). This analysis demonstrates that a great burden is placed on remembering complex reformulation of the task to function mapping. 65% of the tasks required retaining one access steps in memory to accomplish the task, 20% required two memorized access steps, and 15% required zero memorized access steps. The probability that a participant would make an access error on the tasks was: two memorized access steps - 74%, one memorized access step - 13%, and zero memorized access steps - 6%. Other factors were analyzed as well, including experience with the system and frequency of use. This completed the picture of a system with many memorized steps causing difficulty with the new system, especially when trying to fine where to access the correct function.

33 CFR 105.255 - Security measures for access control.

Code of Federal Regulations, 2010 CFR

2010-07-01

... and facilities; (4) Granting access to only those responding to the security incident or threat... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Security measures for access... SECURITY MARITIME SECURITY MARITIME SECURITY: FACILITIES Facility Security Requirements § 105.255 Security...

Use of a geographic information system to assess accessibility to health facilities providing emergency obstetric and newborn care in Bangladesh.

PubMed

Chowdhury, Mahbub E; Biswas, Taposh K; Rahman, Monjur; Pasha, Kamal; Hossain, Mollah A

2017-08-01

To use a geographic information system (GIS) to determine accessibility to health facilities for emergency obstetric and newborn care (EmONC) and compare coverage with that stipulated by UN guidelines (5 EmONC facilities per 500 000 individuals, ≥1 comprehensive). A cross-sectional study was undertaken of all public facilities providing EmONC in 24 districts of Bangladesh from March to October 2012. Accessibility to each facility was assessed by applying GIS to estimate the proportion of catchment population (comprehensive 500 000; basic 100 000) able to reach the nearest facility within 2 hours and 1 hour of travel time, respectively, by existing road networks. The minimum number of public facilities providing comprehensive and basic EmONC services (1 and 5 per 500 000 individuals, respectively) was reached in 16 and 3 districts, respectively. However, after applying GIS, in no district did 100% of the catchment population have access to these services. A minimum of 75% and 50% of the population had accessibility to comprehensive services in 11 and 5 districts, respectively. For basic services, accessibility was much lower. Assessing only the number of EmONC facilities does not ensure universal coverage; accessibility should be assessed when planning health systems. © 2017 International Federation of Gynecology and Obstetrics.

Facile one-step coating approach to magnetic submicron particles with poly(ethylene glycol) coats and abundant accessible carboxyl groups

PubMed Central

Long, Gaobo; Yang, Xiao-lan; Zhang, Yi; Pu, Jun; Liu, Lin; Liu, Hong-bo; Li, Yuan-li; Liao, Fei

2013-01-01

Purpose Magnetic submicron particles (MSPs) are pivotal biomaterials for magnetic separations in bioanalyses, but their preparation remains a technical challenge. In this report, a facile one-step coating approach to MSPs suitable for magnetic separations was investigated. Methods Polyethylene glycol) (PEG) was derived into PEG-bis-(maleic monoester) and maleic monoester-PEG-succinic monoester as the monomers. Magnetofluids were prepared via chemical co-precipitation and dispersion with the monomers. MSPs were prepared via one-step coating of magnetofluids in a water-in-oil microemulsion system of aerosol-OT and heptane by radical co-polymerization of such monomers. Results The resulting MSPs contained abundant carboxyl groups, exhibited negligible nonspecific adsorption of common substances and excellent suspension stability, appeared as irregular particles by electronic microscopy, and had submicron sizes of broad distribution by laser scattering. Saturation magnetizations and average particle sizes were affected mainly by the quantities of monomers used for coating magnetofluids, and steric hindrance around carboxyl groups was alleviated by the use of longer monomers of one polymerizable bond for coating. After optimizations, MSPs bearing saturation magnetizations over 46 emu/g, average sizes of 0.32 μm, and titrated carboxyl groups of about 0.21 mmol/g were obtained. After the activation of carboxyl groups on MSPs into N-hydroxysuccinimide ester, biotin was immobilized on MSPs and the resulting biotin-functionalized MSPs isolated the conjugate of streptavidin and alkaline phosphatase at about 2.1 mg/g MSPs; streptavidin was immobilized at about 10 mg/g MSPs and retained 81% ± 18% (n = 5) of the specific activity of the free form. Conclusion The facile approach effectively prepares MSPs for magnetic separations. PMID:23589687

Indoor Athletic Facilities.

ERIC Educational Resources Information Center

Fleming, E. Scott

2000-01-01

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

10 CFR 4.127 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Existing facilities. 4.127 Section 4.127 Energy NUCLEAR... 1973, as Amended Discriminatory Practices § 4.127 Existing facilities. (a) Accessibility. A recipient... make each of its existing facilities or every part of an existing facility accessible to and usable by...

10 CFR 1040.72 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Existing facilities. 1040.72 Section 1040.72 Energy... § 1040.72 Existing facilities. (a) Accessibility. A recipient shall operate any program or activity to... facilities or every part of a facility accessible to and useable by handicapped persons. (b) Methods. A...

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

Nelson, Cynthia Lee

There is a need in security systems to rapidly and accurately grant access of authorized personnel to a secure facility while denying access to unauthorized personnel. In many cases this role is filled by security personnel, which can be very costly. Systems that can perform this role autonomously without sacrificing accuracy or speed of throughput are very appealing. To address the issue of autonomous facility access through the use of technology, the idea of a ''secure portal'' is introduced. A secure portal is a defined zone where state-of-the-art technology can be implemented to grant secure area access or to allowmore » special privileges for an individual. Biometric technologies are of interest because they are generally more difficult to defeat than technologies such as badge swipe and keypad entry. The biometric technologies selected for this concept were facial and gait recognition. They were chosen since they require less user cooperation than other biometrics such as fingerprint, iris, and hand geometry and because they have the most potential for flexibility in deployment. The secure portal concept could be implemented within the boundaries of an entry area to a facility. As a person is approaching a badge and/or PIN portal, face and gait information can be gathered and processed. The biometric information could be fused for verification against the information that is gathered from the badge. This paper discusses a facial recognition technology that was developed for the purposes of providing high verification probabilities with low false alarm rates, which would be required of an autonomous entry control system. In particular, a 3-D facial recognition approach using Fisher Linear Discriminant Analysis is described. Gait recognition technology, based on Hidden Markov Models has been explored, but those results are not included in this paper. Fusion approaches for combining the results of the biometrics would be the next step in realizing the secure portal concept.« less

Spatial accessibility to physical activity facilities and to food outlets and overweight in French youth

PubMed Central

Casey, R; Chaix, B; Weber, C; Schweitzer, B; Charreire, H; Salze, P; Badariotti, D; Banos, A; Oppert, J-M; Simon, C

2012-01-01

Objective: Some characteristics of the built environment have been associated with obesity in youth. Our aim was to determine whether individual and environmental socio-economic characteristics modulate the relation between youth overweight and spatial accessibility to physical activity (PA) facilities and to food outlets. Design: Cross-sectional study. Subjects: 3293 students, aged 12±0.6 years, randomly selected from eastern France middle schools. Measurements and methods: Using geographical information systems (GIS), spatial accessibility to PA facilities (urban and nature) was assessed using the distance to PA facilities at the municipality level; spatial accessibility to food outlets (general food outlets, bakeries and fast-food outlets) was calculated at individual level using the student home address and the food outlets addresses. Relations of weight status with spatial accessibility to PA facilities and to food outlets were analysed using mixed logistic models, testing potential direct and interaction effects of individual and environmental socio-economic characteristics. Results: Individual socio-economic status modulated the relation between spatial accessibility to PA facilities and to general food outlets and overweight. The likelihood of being overweight was higher when spatial accessibility to urban PA facilities and to general food outlets was low, but in children of blue-collar-workers only. The odds ratio (OR) (95% confidence interval) for being overweight of blue-collar-workers children compared with non-blue-collar-workers children was 1.76 (1.25–2.49) when spatial accessibility to urban PA facilities was low. This OR was 1.86 (1.20–2.86) when spatial accessibility to general food outlets was low. There was no significant relationship of overweight with either nature PA facilities or other food outlets (bakeries and fast-food outlets). Conclusion: These results indicate that disparities in spatial accessibility to PA facilities and to general food outlets may amplify the risk of overweight in socio-economically disadvantaged youth. These data should be relevant for influencing health policies and urban planning at both a national and local level. PMID:22310474

SafeCare: An Innovative Approach for Improving Quality Through Standards, Benchmarking, and Improvement in Low- and Middle- Income Countries.

PubMed

Johnson, Michael C; Schellekens, Onno; Stewart, Jacqui; van Ostenberg, Paul; de Wit, Tobias Rinke; Spieker, Nicole

2016-08-01

In low- and middle-income countries (LMICs), patients often have limited access to high-quality care because of a shortage of facilities and human resources, inefficiency of resource allocation, and limited health insurance. SafeCare was developed to provide innovative health care standards; surveyor training; a grading system for quality of care; a quality improvement process that is broken down into achievable, measurable steps to facilitate incremental improvement; and a private sector-supported health financing model. Three organizations-PharmAccess Foundation, Joint Commission International, and the Council for Health Service Accreditation of Southern Africa-launched SafeCare in 2011 as a formal partnership. Five SafeCare levels of improvement are allocated on the basis of an algorithm that incorporates both the overall score and weighted criteria, so that certain high-risk criteria need to be in place before a facility can move to the next SafeCare certification level. A customized quality improvement plan based on the SafeCare assessment results lists the specific, measurable activities that should be undertaken to address gaps in quality found during the initial assessment and to meet the nextlevel SafeCare certificate. The standards have been implemented in more than 800 primary and secondary facilities by qualified local surveyors, in partnership with various local public and private partner organizations, in six sub-Saharan African countries (Ghana, Kenya, Nigeria, Namibia, Tanzania, and Zambia). Expanding access to care and improving health care quality in LMICs will require a coordinated effort between institutions and other stakeholders. SafeCare's standards and assessment methodology can help build trust between stakeholders and lay the foundation for country-led quality monitoring systems.

Three Short Stories about Hexaarylbenzene-Porphyrin Scaffolds.

PubMed

Lungerich, Dominik; Hitzenberger, Jakob F; Donaubauer, Wolfgang; Drewello, Thomas; Jux, Norbert

2016-11-14

A feasible two-step synthesis and characterization of a full series of hexaarylbenzene (HAB) substituted porphyrins and tetrabenzoporphyrins is presented. Key steps represent the microwave-assisted porphyrin condensation and the statistical Diels-Alder reaction to the desired HAB-porphyrins. Regarding their applications, they proved to be easily accessible and effective high molecular mass calibrants for (MA)LDI mass spectrometry. The free-base and zinc(II) porphyrin systems, as well as the respective tetrabenzoporphyrins, demonstrate in solid state experiments strong red- and near-infrared-light emission and are potentially interesting for the application in "truly organic" light-emitting devices. Lastly, they represent facile precursors to large polycyclic aromatic hydrocarbon (PAH) substituted porphyrins. We prepared the first tetra-hexa-peri-hexabenzocoronene substituted porphyrin, which represents the largest prepared PAH-porphyrin conjugate to date. © 2016 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

10 CFR 1016.8 - Approval for processing access permittees for security facility approval.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Approval for processing access permittees for security facility approval. 1016.8 Section 1016.8 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) SAFEGUARDING OF RESTRICTED DATA Physical Security § 1016.8 Approval for processing access permittees for security facility...

10 CFR 1016.8 - Approval for processing access permittees for security facility approval.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Approval for processing access permittees for security facility approval. 1016.8 Section 1016.8 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) SAFEGUARDING OF RESTRICTED DATA Physical Security § 1016.8 Approval for processing access permittees for security facility...

43 CFR 17.217 - Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Existing facilities. 17.217 Section 17.217... facilities. (a) Accessibility. A recipient shall operate each program or activity so that when each part is... not require a recipient to make each of its existing facilities or every part of a facility accessible...

Spatial accessibility to specific sport facilities and corresponding sport practice: the RECORD Study

PubMed Central

2013-01-01

Background Physical activity is considered as a major component of a healthy lifestyle. However, few studies have examined the relationships between the spatial accessibility to sport facilities and sport practice with a sufficient degree of specificity. The aim of this study was to investigate the associations between the spatial accessibility to specific types of sports facilities and the practice of the corresponding sports after carefully controlling for various individual socio-demographic characteristics and neighborhood socioeconomic variables. Methods Data from the RECORD Study involving 7290 participants recruited in 2007–2008, aged 30–79 years, and residing in the Paris metropolitan area were analyzed. Four categories of sports were studied: team sports, racket sports, swimming and related activities, and fitness. Spatial accessibility to sport facilities was measured with two complementary approaches that both take into account the street network (distance to the nearest facility and count of facilities around the dwelling). Associations between the spatial accessibility to sport facilities and the practice of the corresponding sports were assessed using multilevel logistic regression after adjusting for individual and contextual characteristics. Results High individual education and high household income were associated with the practice of racket sports, swimming or related activities, and fitness over the previous 7 days. The spatial accessibility to swimming pools was associated with swimming and related sports, even after adjustment for individual/contextual factors. The spatial accessibility to facilities was not related to the practice of other sports. High neighborhood income was associated with the practice of a racket sport and fitness. Conclusions Accessibility is a multi-dimensional concept that integrates educational, financial, and geographical aspects. Our work supports the evidence that strategies to increase participation in sport activities should improve the spatial and financial access to specific facilities, but also address educational disparities in sport practice. PMID:23601332

Computerized procedures system

DOEpatents

Lipner, Melvin H.; Mundy, Roger A.; Franusich, Michael D.

2010-10-12

An online data driven computerized procedures system that guides an operator through a complex process facility's operating procedures. The system monitors plant data, processes the data and then, based upon this processing, presents the status of the current procedure step and/or substep to the operator. The system supports multiple users and a single procedure definition supports several interface formats that can be tailored to the individual user. Layered security controls access privileges and revisions are version controlled. The procedures run on a server that is platform independent of the user workstations that the server interfaces with and the user interface supports diverse procedural views.

Benzylation of Nitroalkanes Using Copper-Catalyzed Thermal Redox Catalysis: Toward the Facile C-Alkylation of Nitroalkanes

PubMed Central

Gildner, Peter G.; Gietter, Amber A. S.; Cui, Di; Watson, Donald A.

2012-01-01

The C-alkylation of nitroalkanes under mild conditions has been a significant challenge in organic synthesis for more than a century. Herein, we report a simple Cu(I) catalyst, generated in situ, that is highly effective for C-benzylation of nitroalkanes using abundant benzyl bromides and related heteroaromatic compounds. This process, which we believe proceeds via a thermal redox mechanism, allows access to a variety of complex nitroalkanes under mild reaction conditions and represents the first step towards developing a general catalytic system for the alkylation of nitroalkanes. PMID:22691127

Safeguards Approaches for Black Box Processes or Facilities

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

Diaz-Marcano, Helly; Gitau, Ernest TN; Hockert, John

2013-09-25

The objective of this study is to determine whether a safeguards approach can be developed for “black box” processes or facilities. These are facilities where a State or operator may limit IAEA access to specific processes or portions of a facility; in other cases, the IAEA may be prohibited access to the entire facility. The determination of whether a black box process or facility is safeguardable is dependent upon the details of the process type, design, and layout; the specific limitations on inspector access; and the restrictions placed upon the design information that can be provided to the IAEA. Thismore » analysis identified the necessary conditions for safeguardability of black box processes and facilities.« less

10 CFR 62.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... Emergency access means access to an operating non-Federal or regional low-level radioactive waste disposal... regional low-level radioactive waste disposal facility or facilities for a period not to exceed 180 days... waste. Non-Federal disposal facility means a low-level radioactive waste disposal facility that is...

National Cryo-Electron Microscopy Facility

Cancer.gov

Information about the National Cryo-EM Facility at NCI, created to provide researchers access to the latest cryo-EM technology for high resolution imaging. Includes timeline for installation and how to access the facility.

14 CFR 382.51 - What requirements must carriers meet concerning the accessibility of airport facilities?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false What requirements must carriers meet concerning the accessibility of airport facilities? 382.51 Section 382.51 Aeronautics and Space OFFICE OF THE... BASIS OF DISABILITY IN AIR TRAVEL Accessibility of Airport Facilities § 382.51 What requirements must...

14 CFR 382.51 - What requirements must carriers meet concerning the accessibility of airport facilities?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false What requirements must carriers meet concerning the accessibility of airport facilities? 382.51 Section 382.51 Aeronautics and Space OFFICE OF THE... BASIS OF DISABILITY IN AIR TRAVEL Accessibility of Airport Facilities § 382.51 What requirements must...

Neighbourhood Environment Correlates of Physical Activity: A Study of Eight Czech Regional Towns

PubMed Central

Sigmundová, Dagmar; El Ansari, Walid; Sigmund, Erik

2011-01-01

An adequate amount of physical activity (PA) is a key factor that is associated with good health. This study assessed socio-environmental factors associated with meeting the health recommendations for PA (achieving 10,000 steps per day). In total, 1,653 respondents randomly selected from across eight regional towns (each >90,000 inhabitants) in the Czech Republic participated in the study. The ANEWS questionnaire assessed the environment in neighbourhoods, and participants’ weekly PA was objectively monitored (Yamax Digiwalker SW-700 pedometer). About 24% of participants were sufficiently active, 27% were highly active; 28% participants were overweight and 5% were obese. Although BMI was significantly inversely associated with the daily step counts achieved only in females, for both genders, BMI was generally not significantly associated with the criterion of achieving 10,000 steps per day during the week. Increased BMI in both genders was accompanied with a decline in participation in organized PA and with increasing age. As regards to the demographic/lifestyle factors, for females, more participation in organized PA was significantly positively correlated with the achieved daily step counts. In contrast, older age and higher BMI (for females) and smoking (for males) were significantly negatively correlated with the achieved daily step counts. In terms of the environmental aspects, pleasant environments were significantly positively correlated to daily step counts for both genders. Additionally, for males, better residencies (more family homes rather than apartment blocks) in the neighbourhood were significantly positively correlated with their daily step counts. For females, less accessibility of shops and non-sport facilities (depending on walking distance in minutes) were significantly negatively correlated to the achieved daily step counts. Individuals who lived in pleasant neighbourhoods, with better access to shops and who participated in organized PA (≥2 times a week) tended to meet the recommendations for health-enhancing PA levels. The creation of physical activity-friendly environments could be associated with enhancing people’s achieved daily step counts and meeting the health criteria for PA. PMID:21556190

78 FR 10110 - Accessibility Guidelines for Pedestrian Facilities in the Public Right-of-Way; Shared Use Paths

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

... guidelines would apply to the design, construction, and alteration of pedestrian facilities in the public... guidelines for the design, construction, and alteration of facilities covered by the Americans with... required to adopt accessibility standards for the design, construction, and alteration of facilities...

Americans with Disabilities Act: Accessibility Guidelines for Buildings and Facilities, Transportation Facilities, Transportation Vehicles.

ERIC Educational Resources Information Center

Architectural and Transportation Barriers Compliance Board, Washington, DC.

Guidelines are presented regarding accessibility to buildings and facilities, transportation facilities, and transportation vehicles by individuals with disabilities, under the Americans with Disabilities Act of 1990. These guidelines are to be applied during building design, construction, and alteration. Part 1 offers detailed facility…

49 CFR 37.9 - Standards for accessible transportation facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... construction or alterations of buildings or facilities on which construction has begun, or all approvals for... requirements set forth in Appendices B and D to 36 CFR part 1191, which apply to buildings and facilities... Making Buildings and Facilities Accessible to and Usable by the Physically Handicapped). This paragraph...

49 CFR 37.9 - Standards for accessible transportation facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... construction or alterations of buildings or facilities on which construction has begun, or all approvals for... requirements set forth in Appendices B and D to 36 CFR part 1191, which apply to buildings and facilities... Making Buildings and Facilities Accessible to and Usable by the Physically Handicapped). This paragraph...

49 CFR 37.9 - Standards for accessible transportation facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... construction or alterations of buildings or facilities on which construction has begun, or all approvals for... requirements set forth in appendices B and D to 36 CFR part 1191, which apply to buildings and facilities... Making Buildings and Facilities Accessible to and Usable by the Physically Handicapped). This paragraph...

49 CFR 37.9 - Standards for accessible transportation facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... construction or alterations of buildings or facilities on which construction has begun, or all approvals for... requirements set forth in Appendices B and D to 36 CFR part 1191, which apply to buildings and facilities... Making Buildings and Facilities Accessible to and Usable by the Physically Handicapped). This paragraph...

49 CFR 37.9 - Standards for accessible transportation facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... construction or alterations of buildings or facilities on which construction has begun, or all approvals for... requirements set forth in Appendices B and D to 36 CFR part 1191, which apply to buildings and facilities... Making Buildings and Facilities Accessible to and Usable by the Physically Handicapped). This paragraph...

The association between recreational parks, facilities and childhood obesity: a cross-sectional study of the 2007 National Survey of Children's Health.

PubMed

Alexander, Dayna S; Huber, Larissa R Brunner; Piper, Crystal R; Tanner, Amanda E

2013-05-01

Despite the rising childhood obesity rates, few studies have examined the association between access to recreational parks and facilities and obesity. A cross-sectional study was performed among 42 278 US children who participated in the 2007 National Survey of Children's Health. Access to parks and recreational facilities was self-reported by parents, and body mass index was calculated from parents' self-report of the child's height and weight. Logistic regression was used to obtain ORs and 95% CIs. Since obesity was not a rare occurrence, an OR correction method was used to provide a more reliable estimate of the prevalence ratio (PR). Children with access to parks and facilities had decreased prevalence of obesity as compared to children without access (PR=0.79, 95% CI 0.69 to 0.91). After adjustment for covariates, the magnitude of the association remained unchanged; however, results were no longer statistically significant (PR=0.77, 95% CI 0.55 to 1.07). Race/ethnicity was an effect modifier of the access-obesity relationship (p<0.0001). Among Non-Hispanic White children, there was no strong association (PR=0.89, 95% CI 0.64 to 1.23). However, among Non-Hispanic Black children, those who had access to recreational parks and facilities had 0.40 times the prevalence of obesity as compared to those without access, and this result was statistically significant (95% CI 0.17 to 0.90). This research highlights potential health disparities in childhood obesity due to limited access to recreational parks and facilities. Additional studies are needed to further investigate this association. If confirmed, providing safe, accessible parks and facilities may be one way to combat childhood obesity, particularly among minority children.

Dialysis Facility Transplant Philosophy and Access to Kidney Transplantation in the Southeast.

PubMed

Gander, Jennifer; Browne, Teri; Plantinga, Laura; Pastan, Stephen O; Sauls, Leighann; Krisher, Jenna; Patzer, Rachel E

2015-01-01

Little is known about the impact of dialysis facility treatment philosophy on access to transplant. The aim of our study was to determine the relationship between the dialysis facility transplant philosophy and facility-level access to kidney transplant waitlisting. A 25-item questionnaire administered to Southeastern dialysis facilities (n = 509) in 2012 captured the facility transplant philosophy (categorized as 'transplant is our first choice', 'transplant is a great option for some', and 'transplant is a good option, if the patient is interested'). Facility-level waitlisting and facility characteristics were obtained from the 2008-2011 Dialysis Facility Report. Multivariable logistic regression was used to examine the association between the dialysis facility transplant philosophy and facility waitlisting performance (dichotomized using the national median), where low performance was defined as fewer than 21.7% of dialysis patients waitlisted within a facility. Fewer than 25% (n = 124) of dialysis facilities reported 'transplant is our first option'. A total of 131 (31.4%) dialysis facilities in the Southeast were high-performing facilities with respect to waitlisting. Adjusted analysis showed that facilities who reported 'transplant is our first option' were twice (OR 2.0; 95% CI 1.0-3.9) as likely to have high waitlisting performance compared to facilities who reported that 'transplant is a good option, if the patient is interested'. Facilities with staff who had a more positive transplant philosophy were more likely to have better facility waitlisting performance. Future prospective studies are needed to further investigate if improving the kidney transplant philosophy in dialysis facilities improves access to transplantation.

41 CFR 102-74.210 - What steps must Executive agencies take to promote ridesharing at Federal facilities?

Code of Federal Regulations, 2010 CFR

2010-07-01

... MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Ridesharing § 102-74.210 What... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What steps must Executive agencies take to promote ridesharing at Federal facilities? 102-74.210 Section 102-74.210 Public...

Population-based geographic access to parent and satellite National Cancer Institute Cancer Center Facilities.

PubMed

Onega, Tracy; Alford-Teaster, Jennifer; Wang, Fahui

2017-09-01

Satellite facilities of National Cancer Institute (NCI) cancer centers have expanded their regional footprints. This study characterized geographic access to parent and satellite NCI cancer center facilities nationally overall and by sociodemographics. Parent and satellite NCI cancer center facilities, which were geocoded in ArcGIS, were ascertained. Travel times from every census tract in the continental United States and Hawaii to the nearest parent and satellite facilities were calculated. Census-based population attributes were used to characterize measures of geographic access for sociodemographic groups. From the 62 NCI cancer centers providing clinical care in 2014, 76 unique parent locations and 211 satellite locations were mapped. The overall proportion of the population within 60 minutes of a facility was 22% for parent facilities and 32.7% for satellite facilities. When satellites were included for potential access, the proportion of some racial groups for which a satellite was the closest NCI cancer center facility increased notably (Native Americans, 22.6% with parent facilities and 39.7% with satellite facilities; whites, 34.8% with parent facilities and 50.3% with satellite facilities; and Asians, 40.0% with parent facilities and 54.0% with satellite facilities), with less marked increases for Hispanic and black populations. Rural populations of all categories had dramatically low proportions living within 60 minutes of an NCI cancer center facility of any type (1.0%-6.6%). Approximately 14% of the population (n = 43,033,310) lived more than 180 minutes from a parent or satellite facility, and most of these individuals were Native Americans and/or rural residents (37% of Native Americans and 41.7% of isolated rural residents). Racial/ethnic and rural populations showed markedly improved geographic access to NCI cancer center care when satellite facilities were included. Cancer 2017;123:3305-11. © 2017 American Cancer Society. © 2017 American Cancer Society.

STORAGE/SEDIMENTATION FACILITIES FOR CONTROL OF STORM AND COMBINED SEWER OVERFLOW: DESIGN MANUAL

EPA Science Inventory

This manual describes applications of storage facilities in wet-weather flow management and presents step-by-step procedures for analysis and design of storage-treatment facilities. Retention, detention, and sedimentation storage information is classified and described. Internati...

The influence of distance and level of care on delivery place in rural Zambia: a study of linked national data in a geographic information system.

PubMed

Gabrysch, Sabine; Cousens, Simon; Cox, Jonathan; Campbell, Oona M R

2011-01-25

Maternal and perinatal mortality could be reduced if all women delivered in settings where skilled attendants could provide emergency obstetric care (EmOC) if complications arise. Research on determinants of skilled attendance at delivery has focussed on household and individual factors, neglecting the influence of the health service environment, in part due to a lack of suitable data. The aim of this study was to quantify the effects of distance to care and level of care on women's use of health facilities for delivery in rural Zambia, and to compare their population impact to that of other important determinants. Using a geographic information system (GIS), we linked national household data from the Zambian Demographic and Health Survey 2007 with national facility data from the Zambian Health Facility Census 2005 and calculated straight-line distances. Health facilities were classified by whether they provided comprehensive EmOC (CEmOC), basic EmOC (BEmOC), or limited or substandard services. Multivariable multilevel logistic regression analyses were performed to investigate the influence of distance to care and level of care on place of delivery (facility or home) for 3,682 rural births, controlling for a wide range of confounders. Only a third of rural Zambian births occurred at a health facility, and half of all births were to mothers living more than 25 km from a facility of BEmOC standard or better. As distance to the closest health facility doubled, the odds of facility delivery decreased by 29% (95% CI, 14%-40%). Independently, each step increase in level of care led to 26% higher odds of facility delivery (95% CI, 7%-48%). The population impact of poor geographic access to EmOC was at least of similar magnitude as that of low maternal education, household poverty, or lack of female autonomy. Lack of geographic access to emergency obstetric care is a key factor explaining why most rural deliveries in Zambia still occur at home without skilled care. Addressing geographic and quality barriers is crucial to increase service use and to lower maternal and perinatal mortality. Linking datasets using GIS has great potential for future research and can help overcome the neglect of health system factors in research and policy. Please see later in the article for the Editors' Summary.

Open Access: "à consommer avec modération"

NASA Astrophysics Data System (ADS)

Mahoney, Terence J.

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

Truck facility access design guidelines statewide.

DOT National Transportation Integrated Search

2011-06-01

The overall purpose of this project is to develop design guidelines for truck access to truck stop facilities adjoining interstate highways and accessed by interchanges in Louisiana. The specific objectives of the research are to: 1. Identify existin...

Access to recreational physical activities by car and bus: an assessment of socio-spatial inequalities in mainland Scotland.

PubMed

Ferguson, Neil S; Lamb, Karen E; Wang, Yang; Ogilvie, David; Ellaway, Anne

2013-01-01

Obesity and other chronic conditions linked with low levels of physical activity (PA) are associated with deprivation. One reason for this could be that it is more difficult for low-income groups to access recreational PA facilities such as swimming pools and sports centres than high-income groups. In this paper, we explore the distribution of access to PA facilities by car and bus across mainland Scotland by income deprivation at datazone level. GIS car and bus networks were created to determine the number of PA facilities accessible within travel times of 10, 20 and 30 minutes. Multilevel negative binomial regression models were then used to investigate the distribution of the number of accessible facilities, adjusting for datazone population size and local authority. Access to PA facilities by car was significantly (p<0.01) higher for the most affluent quintile of area-based income deprivation than for most other quintiles in small towns and all other quintiles in rural areas. Accessibility by bus was significantly lower for the most affluent quintile than for other quintiles in urban areas and small towns, but not in rural areas. Overall, we found that the most disadvantaged groups were those without access to a car and living in the most affluent areas or in rural areas.

Unsafe abortion: the silent scourge.

PubMed

Grimes, David A

2003-01-01

An estimated 19 million unsafe abortions occur worldwide each year, resulting in the deaths of about 70,000 women. Legalization of abortion is a necessary but insufficient step toward improving women's health. Without skilled providers, adequate facilities and easy access, the promise of safe, legal abortion will remain unfulfilled, as in India and Zambia. Both suction curettage and pharmacological abortion are safe methods in early pregnancy; sharp curettage is inferior and should be abandoned. For later abortions, either dilation and evacuation or labour induction are appropriate. Hysterotomy should not be used. Timely and appropriate management of complications can reduce morbidity and prevent mortality. Treatment delays are dangerous, regardless of their origin. Misoprostol may reduce the risks of unsafe abortion by providing a safer alternative to traditional clandestine abortion methods. While the debate over abortion will continue, the public health record is settled: safe, legal, accessible abortion improves health.

36 CFR Appendix A to Part 1191 - Table Of Contents

Code of Federal Regulations, 2014 CFR

2014-07-01

... Protruding Objects 205 Operable Parts 206 Accessible Routes 207 Accessible Means of Egress 208 Parking Spaces..., Kitchenettes, and Sinks 213 Toilet Facilities and Bathing Facilities 214 Washing Machines and Clothes Dryers... F205 Operable Parts F206 Accessible Routes F207 Accessible Means of Egress F208 Parking Spaces F209...

20 CFR 655.350 - Public access.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Nurses § 655.350 Public access. (a) Public examination at ETA. ETA shall make available for public... petitions (if any) for H-1A nurses, and for each such facility, a copy of the facility's attestation and any... thereafter for so long as the facility uses any H-1 or H-1A nurse under the attestation, the facility shall...

20 CFR 655.350 - Public access.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Nurses § 655.350 Public access. (a) Public examination at ETA. ETA shall make available for public... petitions (if any) for H-1A nurses, and for each such facility, a copy of the facility's attestation and any... thereafter for so long as the facility uses any H-1 or H-1A nurse under the attestation, the facility shall...

45 CFR 605.23 - New construction.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE... that the facility or part of the facility is readily accessible to and usable by qualified handicapped... portion of the facility is readily accessible to and usable by qualified handicapped persons. (c...

Design, development, mechanistic elucidation, and rational optimization of a tandem Ireland Claisen/Cope rearrangement reaction for rapid access to the (iso)cyclocitrinol core.

PubMed

Plummer, Christopher W; Wei, Carolyn S; Yozwiak, Carrie E; Soheili, Arash; Smithback, Sara O; Leighton, James L

2014-07-16

An approach to the synthesis of the (iso)cyclocitrinol core structure is described. The key step is a tandem Ireland Claisen/Cope rearrangement sequence, wherein the Ireland Claisen rearrangement effects ring contraction to a strained 10-membered ring, and that strain in turn drives the Cope rearrangement under unusually mild thermal conditions. A major side product was identified as resulting from an unexpected and remarkably facile [1,3]-sigmatropic rearrangement, and a tactic to disfavor the [1,3] pathway and increase the efficiency of the tandem reaction was rationally devised.

Accessibility to health care facilities in Montreal Island: an application of relative accessibility indicators from the perspective of senior and non-senior residents.

PubMed

Paez, Antonio; Mercado, Ruben G; Farber, Steven; Morency, Catherine; Roorda, Matthew

2010-10-25

Geographical access to health care facilities is known to influence health services usage. As societies age, accessibility to health care becomes an increasingly acute public health concern. It is known that seniors tend to have lower mobility levels, and it is possible that this may negatively affect their ability to reach facilities and services. Therefore, it becomes important to examine the mobility situation of seniors vis-a-vis the spatial distribution of health care facilities, to identify areas where accessibility is low and interventions may be required. Accessibility is implemented using a cumulative opportunities measure. Instead of assuming a fixed bandwidth (i.e. a distance threshold) for measuring accessibility, in this paper the bandwidth is defined using model-based estimates of average trip length. Average trip length is an all-purpose indicator of individual mobility and geographical reach. Adoption of a spatial modelling approach allows us to tailor these estimates of travel behaviour to specific locations and person profiles. Replacing a fixed bandwidth with these estimates permits us to calculate customized location- and person-based accessibility measures that allow inter-personal as well as geographical comparisons. The case study is Montreal Island. Geo-coded travel behaviour data, specifically average trip length, and relevant traveller's attributes are obtained from the Montreal Household Travel Survey. These data are complemented with information from the Census. Health care facilities, also geo-coded, are extracted from a comprehensive business point database. Health care facilities are selected based on Standard Industrial Classification codes 8011-21 (Medical Doctors and Dentists). Model-based estimates of average trip length show that travel behaviour varies widely across space. With the exception of seniors in the downtown area, older residents of Montreal Island tend to be significantly less mobile than people of other age cohorts. The combination of average trip length estimates with the spatial distribution of health care facilities indicates that despite being more mobile, suburban residents tend to have lower levels of accessibility compared to central city residents. The effect is more marked for seniors. Furthermore, the results indicate that accessibility calculated using a fixed bandwidth would produce patterns of exposure to health care facilities that would be difficult to achieve for suburban seniors given actual mobility patterns. The analysis shows large disparities in accessibility between seniors and non-seniors, between urban and suburban seniors, and between vehicle owning and non-owning seniors. This research was concerned with potential accessibility levels. Follow up research could consider the results reported here to select case studies of actual access and usage of health care facilities, and related health outcomes.

People living with HIV travel farther to access healthcare: a population-based geographic analysis from rural Uganda.

PubMed

Akullian, Adam N; Mukose, Aggrey; Levine, Gillian A; Babigumira, Joseph B

2016-01-01

The availability of specialized HIV services is limited in rural areas of sub-Saharan Africa where the need is the greatest. Where HIV services are available, people living with HIV (PLHIV) must overcome large geographic, economic and social barriers to access healthcare. The objective of this study was to understand the unique barriers PLHIV face when accessing healthcare compared with those not living with HIV in a rural area of sub-Saharan Africa with limited availability of healthcare infrastructure. We conducted a population-based cross-sectional study of 447 heads of household on Bugala Island, Uganda. Multiple linear regression models were used to compare travel time, cost and distance to access healthcare, and log binomial models were used to test for associations between HIV status and access to nearby health services. PLHIV travelled an additional 1.9 km (95% CI (0.6, 3.2 km), p=0.004) to access healthcare compared with those not living with HIV, and they were 56% less likely to access healthcare at the nearest health facility to their residence, so long as that facility lacked antiretroviral therapy (ART) services (aRR=0.44, 95% CI (0.24 to 0.83), p=0.011). We found no evidence that PLHIV travelled further for care if the nearest facility supplies ART services (aRR=0.95, 95% CI (0.86 to 1.05), p=0.328). Among those who reported uptake of care at one of two facilities on the island that provides ART (81% of PLHIV and 68% of HIV-negative individuals), PLHIV tended to seek care at a higher tiered facility that provides ART, even when this facility was not their closest facility (30% of PLHIV travelled further than the closest ART facility compared with 16% of HIV-negative individuals), and travelled an additional 2.2 km (p=0.001) to access that facility, relative to HIV-negative individuals (aRR=1.91, 95% CI (1.00 to 3.65), p=0.05). Among PLHIV, residential distance was associated with access to facilities providing ART (RR=0.78, 95% CI (0.61 to 0.99), p=0.044, comparing residential distances of 3-5 km to 0-2 km; RR=0.71, 95% CI (0.58 to 0.87), p=0.001, comparing residential distances of 6-10 km to 0-2 km). PLHIV travel longer distances for care, a phenomenon that may be driven by both the limited availability of specialized HIV services and preference for higher tiered facilities.

Argonne Collaborative Center for Energy Storage Science (ACCESS)

Science.gov Websites

Analysis and Diagnostics Laboratory (EADL) Post- Test Facility Access Proven Capabilities Argonne has Analysis, Modeling and Prototyping (CAMP) Electrochemical Analysis and Diagnostics Laboratory (EADL) Post -Test Facility Argonne User Facilities Industries Transportation Consumer Electronics Defense Electric

31. FLOOR PLANS OF WASTE CALCINATION FACILITY. SHOWS ACCESS CORRIDOR ...

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

31. FLOOR PLANS OF WASTE CALCINATION FACILITY. SHOWS ACCESS CORRIDOR AT MEZZANINE AND LOWER LEVELS. INEEL DRAWING NUMBER 200-0633-00-287-106352. FLUOR NUMBER 5775-CPP-633-A-2. - Idaho National Engineering Laboratory, Old Waste Calcining Facility, Scoville, Butte County, ID

14 CFR 1251.302 - New construction.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION NONDISCRIMINATION ON BASIS OF HANDICAP... that the facility or part of the facility is readily accessible to and usable by handicapped persons... that the altered portion of the facility is readily accessible to and usable by handicapped persons. (c...

45 CFR 605.22 - Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE... accessible to qualified handicapped persons. This paragraph does not require a recipient to make each of its existing facilities or every part of a facility accessible to and usable by qualified handicapped persons...

14 CFR 1251.302 - New construction.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION NONDISCRIMINATION ON BASIS OF HANDICAP... that the facility or part of the facility is readily accessible to and usable by handicapped persons... that the altered portion of the facility is readily accessible to and usable by handicapped persons. (c...

Uniform Federal Accessibility Standards.

ERIC Educational Resources Information Center

Department of Housing and Urban Development, Washington, DC.

The document presents uniform standards for facility accessibility by physically handicapped persons for Federal and federally funded facilities. The standards are to be applied during the design, construction, and alteration of buildings and facilities to the extent required by the Architectural Barriers Act of 1968, as amended. Technical…

10 CFR 4.550 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Program accessibility: Existing facilities. 4.550 Section 4.550 Energy NUCLEAR REGULATORY COMMISSION NONDISCRIMINATION IN FEDERALLY ASSISTED PROGRAMS OR...) Transition plan. In the event that structural changes to facilities will be undertaken to achieve program...

10 CFR 4.550 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Program accessibility: Existing facilities. 4.550 Section 4.550 Energy NUCLEAR REGULATORY COMMISSION NONDISCRIMINATION IN FEDERALLY ASSISTED PROGRAMS OR...) Transition plan. In the event that structural changes to facilities will be undertaken to achieve program...

5 CFR 1636.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... facilities. 1636.150 Section 1636.150 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD... RETIREMENT THRIFT INVESTMENT BOARD § 1636.150 Program accessibility: Existing facilities. (a) General. The... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens...

Family planning services for incarcerated women: models for filling an unmet need.

PubMed

Sufrin, Carolyn; Baird, Sara; Clarke, Jennifer; Feldman, Elizabeth

2017-03-13

Purpose Incarcerated women around the globe are predominantly of reproductive age. Most of these women have been pregnant before, and many want to be sexually active and avoid pregnancy upon release. Yet few of these women are on a regular method of contraception. Providing contraceptive services for women in custody benefits individual and public health goals of reducing unintended pregnancy. This policy briefing reviews evidence for an unmet need for family planning in the correctional setting, and policy implications for expanding services. The paper aims to discuss these issues. Design/methodology/approach The authors describe four model programs in the USA with established contraceptive services on site, highlighting practical steps other facilities can implement. Findings Correctional facilities health administrators, providers, advocates, and legislators should advance policies which should counsel women on family planning and should make a range of contraceptive methods available before release, while remaining sensitive to the potential pressure these women may feel to use birth control in this unique environment. Practical implications Family planning services for incarcerated women benefits individuals, facilities, and the community. Social implications Policies which enable correctional facilities to provide comprehensive family planning to incarcerated women - including reproductive life goals counseling and contraceptive method provision - promote equity in access to critical reproductive health services and also provide broad scale population level benefits in preventing unintended pregnancy or enabling counseling for healthy pregnancies for a group of women who often have limited access to such services. Originality/value This policy briefing highlights an area of health care in prisons and jails which gets little attention in research and in policy circles: family planning services for incarcerated women. In addition to reviewing the importance of such services for this population, the authors also highlight model family planning programs in correctional facilities. These provide actionable insights for other administrators and providers.

Step 1: Offers All Birthing Mothers Unrestricted Access to Birth Companions, Labor Support, Professional Midwifery Care

PubMed Central

Leslie, Mayri Sagady; Storton, Sharon

2007-01-01

The first step of the Ten Steps of Mother-Friendly Care insures that women have access to a wide variety of support in labor and during the pregnancy and postpartum periods: unrestricted access to birth companions of their choice, including family and friends; unrestricted access to continuous emotional and physical support from a skilled woman such as a doula; and access to midwifery care. The rationales for the importance of each factor and the evidence to support those rationales are presented. PMID:18523678

Assessing access to surgical care in Nepal via a cross-sectional, countrywide survey.

PubMed

Boeck, Marissa A; Nagarajan, Neeraja; Gupta, Shailvi; Varadaraj, Varshini; Groen, Reinou S; Shrestha, Sunil; Gurung, Susant; Kushner, Adam L; Nwomeh, Benedict; Swaroop, Mamta

2016-08-01

Adequate surgical care is lacking in many low- and middle-income countries because of diverse barriers preventing patients from reaching providers. We sought to assess perceived difficulties to accessing surgical care in Nepal using the Surgeons OverSeas Assessment of Surgical Need tool. Fifteen of 75 Nepali districts were selected proportionate to the population, with 1,350 households surveyed. Household heads answered questions regarding access to health facilities, and 2 household members were interviewed for medical history. Continuous and categorical variables were analyzed via Wilcoxon rank sum test and Pearson χ(2) test. Multivariable logistic regressions for independent predictors of care access were performed controlling for age, sex, location, and literacy. Of respondents with a surgical condition (n = 1,342), 650 (48.4%) accessed care and 237 (17.7%) did not. Unadjusted analyses showed greater median travel times to all facilities (P < .001) and median transport costs to secondary and tertiary centers (P < .001) for those who did not access care versus those who did. Literate respondents were more likely to access care across all facilities and access variables in adjusted models (odds ratio 1.66-1.80, P < .01). Those without transport money were less likely to access care at any facility in all analyses (P < .01). The data project that at least 2.4 million individuals lack access to needed surgical care in Nepal during their lifetimes, with those not accessing health facilities having lower literacy rates and fewer transport resources. Promoting education, outreach programs, and transportation access could lessen barriers but will require further exploration. Copyright © 2016 Elsevier Inc. All rights reserved.

Access to Recreational Physical Activities by Car and Bus: An Assessment of Socio-Spatial Inequalities in Mainland Scotland

PubMed Central

Ferguson, Neil S.; Lamb, Karen E.; Wang, Yang; Ogilvie, David; Ellaway, Anne

2013-01-01

Obesity and other chronic conditions linked with low levels of physical activity (PA) are associated with deprivation. One reason for this could be that it is more difficult for low-income groups to access recreational PA facilities such as swimming pools and sports centres than high-income groups. In this paper, we explore the distribution of access to PA facilities by car and bus across mainland Scotland by income deprivation at datazone level. GIS car and bus networks were created to determine the number of PA facilities accessible within travel times of 10, 20 and 30 minutes. Multilevel negative binomial regression models were then used to investigate the distribution of the number of accessible facilities, adjusting for datazone population size and local authority. Access to PA facilities by car was significantly (p<0.01) higher for the most affluent quintile of area-based income deprivation than for most other quintiles in small towns and all other quintiles in rural areas. Accessibility by bus was significantly lower for the most affluent quintile than for other quintiles in urban areas and small towns, but not in rural areas. Overall, we found that the most disadvantaged groups were those without access to a car and living in the most affluent areas or in rural areas. PMID:23409012

Associations between access to recreational physical activity facilities and body mass index in Scottish adults.

PubMed

Ellaway, Anne; Lamb, Karen E; Ferguson, Neil S; Ogilvie, David

2016-08-09

The aim of this country-wide study was to link individual health and behavioural data with area-level spatial data to examine whether the body mass index (BMI) of adults was associated with access to recreational physical activity (PA) facilities by different modes of transport (bus, car, walking, cycling) and the extent to which any associations were mediated by PA participation. Data on individual objectively-measured BMI, PA (number of days of (a) ≥20 min of moderate-to-vigorous PA, and (b) ≥15 min of sport or exercise, in previous 4 weeks), and socio-demographic characteristics were obtained from a nationally representative sample of 6365 adults. The number of accessible PA facilities per 1,000 individuals in each small area (data zones) was obtained by mapping a representative list of all fixed PA facilities throughout mainland Scotland. A novel transport network was developed for the whole country, and routes on foot, by bike, by car and by bus from the weighted population centroid of each data zone to each facility were calculated. Separate multilevel models were fitted to examine associations between BMI and each of the 24 measures of accessibility of PA facilities and BMI, adjusting for age, gender, longstanding illness, car availability, social class, dietary quality and urban/rural classification. We found associations (p < 0.05) between BMI and 7 of the 24 accessibility measures, with mean BMI decreasing with increasing accessibility of facilities-for example, an estimated decrease of 0.015 BMI units per additional facility within a 20-min walk (p = 0.02). None of these accessibility measures were found to be associated with PA participation. Our national study has shown that some measures of the accessibility of PA facilities by different modes of transport (particularly by walking and cycling) were associated with BMI; but PA participation, as measured here, did not appear to play a part in this relationship. Understanding the multi-factorial environmental influences upon obesity is key to developing effective interventions to reduce it.

Evaluating the impact of the community-based health planning and services initiative on uptake of skilled birth care in Ghana.

PubMed

Johnson, Fiifi Amoako; Frempong-Ainguah, Faustina; Matthews, Zoe; Harfoot, Andrew J P; Nyarko, Philomena; Baschieri, Angela; Gething, Peter W; Falkingham, Jane; Atkinson, Peter M

2015-01-01

The Community-based Health Planning and Services (CHPS) initiative is a major government policy to improve maternal and child health and accelerate progress in the reduction of maternal mortality in Ghana. However, strategic intelligence on the impact of the initiative is lacking, given the persistant problems of patchy geographical access to care for rural women. This study investigates the impact of proximity to CHPS on facilitating uptake of skilled birth care in rural areas. Data from the 2003 and 2008 Demographic and Health Survey, on 4,349 births from 463 rural communities were linked to georeferenced data on health facilities, CHPS and topographic data on national road-networks. Distance to nearest health facility and CHPS was computed using the closest facility functionality in ArcGIS 10.1. Multilevel logistic regression was used to examine the effect of proximity to health facilities and CHPS on use of skilled care at birth, adjusting for relevant predictors and clustering within communities. The results show that a substantial proportion of births continue to occur in communities more than 8 km from both health facilities and CHPS. Increases in uptake of skilled birth care are more pronounced where both health facilities and CHPS compounds are within 8 km, but not in communities within 8 km of CHPS but lack access to health facilities. Where both health facilities and CHPS are within 8 km, the odds of skilled birth care is 16% higher than where there is only a health facility within 8km. Where CHPS compounds are set up near health facilities, there is improved access to care, demonstrating the facilitatory role of CHPS in stimulating access to better care at birth, in areas where health facilities are accessible.

Evaluating the Impact of the Community-Based Health Planning and Services Initiative on Uptake of Skilled Birth Care in Ghana

PubMed Central

Johnson, Fiifi Amoako; Frempong-Ainguah, Faustina; Matthews, Zoe; Harfoot, Andrew J. P.; Nyarko, Philomena; Baschieri, Angela; Gething, Peter W.; Falkingham, Jane; Atkinson, Peter M.

2015-01-01

Background The Community-based Health Planning and Services (CHPS) initiative is a major government policy to improve maternal and child health and accelerate progress in the reduction of maternal mortality in Ghana. However, strategic intelligence on the impact of the initiative is lacking, given the persistant problems of patchy geographical access to care for rural women. This study investigates the impact of proximity to CHPS on facilitating uptake of skilled birth care in rural areas. Methods and Findings Data from the 2003 and 2008 Demographic and Health Survey, on 4,349 births from 463 rural communities were linked to georeferenced data on health facilities, CHPS and topographic data on national road-networks. Distance to nearest health facility and CHPS was computed using the closest facility functionality in ArcGIS 10.1. Multilevel logistic regression was used to examine the effect of proximity to health facilities and CHPS on use of skilled care at birth, adjusting for relevant predictors and clustering within communities. The results show that a substantial proportion of births continue to occur in communities more than 8 km from both health facilities and CHPS. Increases in uptake of skilled birth care are more pronounced where both health facilities and CHPS compounds are within 8 km, but not in communities within 8 km of CHPS but lack access to health facilities. Where both health facilities and CHPS are within 8 km, the odds of skilled birth care is 16% higher than where there is only a health facility within 8km. Conclusion Where CHPS compounds are set up near health facilities, there is improved access to care, demonstrating the facilitatory role of CHPS in stimulating access to better care at birth, in areas where health facilities are accessible. PMID:25789874

45 CFR 2490.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Program accessibility: Existing facilities. 2490.150 Section 2490.150 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility...

45 CFR 2490.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Program accessibility: Existing facilities. 2490.150 Section 2490.150 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility...

45 CFR 2490.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Program accessibility: Existing facilities. 2490.150 Section 2490.150 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility...

45 CFR 2490.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Program accessibility: Existing facilities. 2490.150 Section 2490.150 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility...

45 CFR 2104.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

45 CFR 2104.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

45 CFR 2104.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

45 CFR 2104.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

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

45 CFR 2104.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

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

5 CFR 1207.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... facilities. 1207.150 Section 1207.150 Administrative Personnel MERIT SYSTEMS PROTECTION BOARD ORGANIZATION... CONDUCTED BY THE MERIT SYSTEMS PROTECTION BOARD § 1207.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in...

An Application of Business Process Management to Health Care Facilities.

PubMed

Hassan, Mohsen M D

The purpose of this article is to help health care facility managers and personnel identify significant elements of their facilities to address, and steps and actions to follow, when applying business process management to them. The ABPMP (Association of Business Process Management Professionals) life-cycle model of business process management is adopted, and steps from Lean, business process reengineering, and Six Sigma, and actions from operations management are presented to implement it. Managers of health care facilities can find in business process management a more comprehensive approach to improving their facilities than Lean, Six Sigma, business process reengineering, and ad hoc approaches that does not conflict with them because many of their elements can be included under its umbrella. Furthermore, the suggested application of business process management can guide and relieve them from selecting among these approaches, as well as provide them with specific steps and actions that they can follow. This article fills a gap in the literature by presenting a much needed comprehensive application of business process management to health care facilities that has specific steps and actions for implementation.

Racial/ethnic differences in access to substance abuse treatment.

PubMed

Lo, Celia C; Cheng, Tyrone C

2011-05-01

A secondary dataset, Collaborative Psychiatric Epidemiology Surveys (CPES), 2001-2003, was employed to examine racial/ethnic differences in access to specialty and non-specialty substance abuse treatment (compared with no access to treatment). The study found that non-Hispanic White Americans were (1) likelier than members of all racial/ethnic minority groups (other than Hispanics) to address substance abuse by accessing care through specialty addiction-treatment facilities, and were (2) also less likely to access substance abuse care through non-specialty facilities. Because non-specialty facilities may have staffs whose professional training does not target treating chronic, bio-psycho-social illness such as substance abuse, our results imply that treatment facilities deemed non-specialty may need to enhance staff training, in order to ensure individuals are properly screened for substance use conditions and are referred for or provided with effective counseling and medications as appropriate.

40 CFR 35.2025 - Allowance and advance of allowance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... advance of allowance. (a) Allowance. Step 2+3 and Step 3 grant agreements will include an allowance for facilities planning and design of the project and Step 7 agreements will include an allowance for facility... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Allowance and advance of allowance. 35...

7 CFR 15b.18 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Accessibility § 15b.18 Existing facilities. (a) Accessibility. A recipient shall operate each assisted program or activity so that when each part is viewed in... results in making its program or activity accessible to qualified handicapped persons. A recipient is not...

14 CFR § 1251.301 - Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... OF HANDICAP Accessibility § 1251.301 Existing facilities. (a) Accessibility. A recipient shall... entirety it is readily accessible to handicapped persons. This paragraph does not require a recipient to... handicapped persons. (b) Methods. A recipient may comply with the requirement of paragraph (a) of this section...

29 CFR 4907.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

36 CFR 1208.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

45 CFR 2490.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

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

Code of Federal Regulations, 2012 CFR

2012-04-01

... of Property Disposition Program multifamily housing facilities. 9.152 Section 9.152 Housing and Urban... URBAN DEVELOPMENT § 9.152 Program accessibility: alterations of Property Disposition Program multifamily housing facilities. (a) Substantial alteration. If the agency undertakes alterations to a PDP multifamily...

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

Code of Federal Regulations, 2014 CFR

2014-04-01

... of Property Disposition Program multifamily housing facilities. 9.152 Section 9.152 Housing and Urban... URBAN DEVELOPMENT § 9.152 Program accessibility: alterations of Property Disposition Program multifamily housing facilities. (a) Substantial alteration. If the agency undertakes alterations to a PDP multifamily...

9 CFR 88.5 - Requirements at a slaughtering facility.

Code of Federal Regulations, 2010 CFR

2010-01-01

... COMMERCIAL TRANSPORTATION OF EQUINES FOR SLAUGHTER § 88.5 Requirements at a slaughtering facility. (a) Upon arrival at a slaughtering facility, the owner/shipper must: (1) Ensure that each equine has access to... representative; (3) Allow a USDA representative access to the equines for the purpose of examination; and (4...

Manual for Accessibility: [Conference, Meeting, and Lodging Facilities]. Revised.

ERIC Educational Resources Information Center

National Rehabilitation Association, Alexandria, VA.

This illustrated manual and survey forms are designed to be used by organizations, hotel and restaurant associations, interested individuals and others as a guide for selecting accessible conference, meeting, and lodging facilities. The guidelines can also be used with existing facilities to identify specific modifications and accommodations. The…

22 CFR 217.22 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Existing facilities. 217.22 Section 217.22... PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Accessibility § 217.22 Existing facilities... necessary to achieve full accessibility under § 217.22(a) and, if the time period of the transition plan is...

22 CFR 217.22 - Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Existing facilities. 217.22 Section 217.22... PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Accessibility § 217.22 Existing facilities... necessary to achieve full accessibility under § 217.22(a) and, if the time period of the transition plan is...

22 CFR 217.22 - Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Existing facilities. 217.22 Section 217.22... PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Accessibility § 217.22 Existing facilities... necessary to achieve full accessibility under § 217.22(a) and, if the time period of the transition plan is...

22 CFR 217.22 - Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Existing facilities. 217.22 Section 217.22... PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Accessibility § 217.22 Existing facilities... necessary to achieve full accessibility under § 217.22(a) and, if the time period of the transition plan is...

22 CFR 217.22 - Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Existing facilities. 217.22 Section 217.22... PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Accessibility § 217.22 Existing facilities... necessary to achieve full accessibility under § 217.22(a) and, if the time period of the transition plan is...

42 CFR 51.42 - Access to facilities and residents.

Code of Federal Regulations, 2013 CFR

2013-10-01

... REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Access to... or treatment for individuals with mental illness, and to all areas of the facility which are used by... of an individual with mental illness. (c) In addition to access as prescribed in paragraph (b) of...

42 CFR 51.42 - Access to facilities and residents.

Code of Federal Regulations, 2014 CFR

2014-10-01

... REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Access to... or treatment for individuals with mental illness, and to all areas of the facility which are used by... of an individual with mental illness. (c) In addition to access as prescribed in paragraph (b) of...

42 CFR 51.42 - Access to facilities and residents.

Code of Federal Regulations, 2012 CFR

2012-10-01

... REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Access to... or treatment for individuals with mental illness, and to all areas of the facility which are used by... of an individual with mental illness. (c) In addition to access as prescribed in paragraph (b) of...

42 CFR 51.42 - Access to facilities and residents.

Code of Federal Regulations, 2011 CFR

2011-10-01

... REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Access to... or treatment for individuals with mental illness, and to all areas of the facility which are used by... of an individual with mental illness. (c) In addition to access as prescribed in paragraph (b) of...

22 CFR 1005.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

12 CFR 794.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

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

50 CFR 550.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

28 CFR 39.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

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

Code of Federal Regulations, 2010 CFR

2010-04-01

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

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

Code of Federal Regulations, 2011 CFR

2011-04-01

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

10 CFR 1705.06 - Appeals from access denials.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Appeals from access denials. 1705.06 Section 1705.06 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.06 Appeals from access denials. When.... This appeal should be directed to The Chairman, Defense Nuclear Facilities Safety Board, 625 Indiana...

10 CFR 1705.06 - Appeals from access denials.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Appeals from access denials. 1705.06 Section 1705.06 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.06 Appeals from access denials. When.... This appeal should be directed to The Chairman, Defense Nuclear Facilities Safety Board, 625 Indiana...

10 CFR 1705.06 - Appeals from access denials.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Appeals from access denials. 1705.06 Section 1705.06 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.06 Appeals from access denials. When.... This appeal should be directed to The Chairman, Defense Nuclear Facilities Safety Board, 625 Indiana...

10 CFR 1705.06 - Appeals from access denials.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Appeals from access denials. 1705.06 Section 1705.06 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.06 Appeals from access denials. When.... This appeal should be directed to The Chairman, Defense Nuclear Facilities Safety Board, 625 Indiana...

10 CFR 1705.06 - Appeals from access denials.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Appeals from access denials. 1705.06 Section 1705.06 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.06 Appeals from access denials. When.... This appeal should be directed to The Chairman, Defense Nuclear Facilities Safety Board, 625 Indiana...

32 CFR 1906.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

32 CFR 1906.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

32 CFR 1906.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

32 CFR 1906.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

32 CFR 1906.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

Linking data sources for measurement of effective coverage in maternal and newborn health: what do we learn from individual- vs ecological-linking methods?

PubMed

Willey, Barbara; Waiswa, Peter; Kajjo, Darious; Munos, Melinda; Akuze, Joseph; Allen, Elizabeth; Marchant, Tanya

2018-06-01

Improving maternal and newborn health requires improvements in the quality of facility-based care. This is challenging to measure: routine data may be unreliable; respondents in population surveys may be unable to accurately report on quality indicators; and facility assessments lack population level denominators. We explored methods for linking access to skilled birth attendance (SBA) from household surveys to data on provision of care from facility surveys with the aim of estimating population level effective coverage reflecting access to quality care. We used data from Mayuge District, Uganda. Data from household surveys on access to SBA were linked to health facility assessment census data on readiness to provide basic emergency obstetric and newborn care (BEmONC) in the same district. One individual- and two ecological-linking methods were applied. All methods used household survey reports on where care at birth was accessed. The individual-linking method linked this to data about facility readiness from the specific facility where each woman delivered. The first ecological-linking approach used a district-wide mean estimate of facility readiness. The second used an estimate of facility readiness adjusted by level of health facility accessed. Absolute differences between estimates derived from the different linking methods were calculated, and agreement examined using Lin's concordance correlation coefficient. A total of 1177 women resident in Mayuge reported a birth during 2012-13. Of these, 664 took place in facilities within Mayuge, and were eligible for linking to the census of the district's 38 facilities. 55% were assisted by a SBA in a facility. Using the individual-linking method, effective coverage of births that took place with an SBA in a facility ready to provide BEmONC was just 10% (95% confidence interval CI 3-17). The absolute difference between the individual- and ecological-level linking method adjusting for facility level was one percentage point (11%), and tests suggested good agreement. The ecological method using the district-wide estimate demonstrated poor agreement. The proportion of women accessing appropriately equipped facilities for care at birth is far lower than the coverage of facility delivery. To realise the life-saving potential of health services, countries need evidence to inform actions that address gaps in the provision of quality care. Linking household and facility-based information provides a simple but innovative method for estimating quality of care at the population level. These encouraging findings suggest that linking data sets can result in meaningful evidence even when the exact location of care seeking is not known.

Compliance with youth access regulations for indoor UV tanning.

PubMed

Hester, Eric J; Heilig, Lauren F; D'Ambrosia, Renee; Drake, Amanda L; Schilling, Lisa M; Dellavalle, Robert P

2005-08-01

To describe youth access to indoor UV tanning and youth discount pricing incentives in 4 states with different age restrictions: Colorado (no age restrictions), Texas (age 13 years), Illinois (age 14 years), and Wisconsin (age 16 years). Cross-sectional telephone survey conducted in October 2003 using a standardized script to assess the practices of randomly selected UV tanning operators. Randomly selected licensed indoor UV tanning facility operators in Colorado, Texas, Illinois, and Wisconsin. Number of facilities (1) complying with indoor UV tanning minimum age regulations for a 12-year-old potential patron and a 15-year-old potential patron and (2) offering youth discounts. For a 12-year-old potential patron, 62% of facilities in states with minimum age restrictions prohibiting 12-year-olds had an operator report that they would not permit indoor tanning (Texas, 23%; Illinois, 74%; and Wisconsin, 89%) compared with 18% in Colorado, a state without youth access regulations. For a 15-year-old patron, most facilities in Wisconsin, the only state with a minimum age restriction for 15-year-olds, prohibited access (77%). Overall, 15% of operators offered youth discounts: Texas, 23%; Illinois, 14%; Wisconsin, 11%; and Colorado, 11%. Tanning facilities in 4 states offered price incentives directed at youths. State youth access regulations were associated with decreased youth access to indoor tanning. High compliance levels in states with long-standing youth access regulations (Illinois and Wisconsin) demonstrate the potential for successful tanning industry youth access regulation.

Fluoroscopy guided percutaneous renal access in prone position

PubMed Central

Sharma, Gyanendra R; Maheshwari, Pankaj N; Sharma, Anshu G; Maheshwari, Reeta P; Heda, Ritwik S; Maheshwari, Sakshi P

2015-01-01

Percutaneous nephrolithotomy is a very commonly done procedure for management of renal calculus disease. Establishing a good access is the first and probably the most crucial step of this procedure. A proper access is the gateway to success. However, this crucial step has the steepest learning curve for, in a fluoroscopy guided access, it involves visualizing a three dimensional anatomy on a two dimensional fluoroscopy screen. This review describes the anatomical basis of the renal access. It provides a literature review of all aspects of percutaneous renal access along with the advances that have taken place in this field over the years. The article describes a technique to determine the site of skin puncture, the angle and depth of puncture using a simple mathematical principle. It also reviews the common problems faced during the process of puncture and dilatation and describes the ways to overcome them. The aim of this article is to provide the reader a step by step guide for percutaneous renal access. PMID:25789297

7 CFR Appendix A to Subpart E of... - Hazard Potential Classification for Civil Works Projects

Code of Federal Regulations, 2010 CFR

2010-01-01

... essential facilities and access Disruption of critical facilities and access. Property Losses 4 Private..., communications, power supply, etc. 4 Direct economic impact of value of property damages to project facilities and down stream property and indirect economic impact due to loss of project services, i.e., impact on...

Charter Schools: Limited Access to Facility Financing. Report to Congressional Requesters.

ERIC Educational Resources Information Center

Shaul, Marnie S.

This report determines the degree to which charter schools have access to traditional public school facility financing, and whether alternative sources of facility financing are available to charter schools. Further discussed are potential options generally available to the federal government if it were to assume a larger role in charter school…

10 CFR 62.12 - Contents of a request for emergency access: General information.

Code of Federal Regulations, 2014 CFR

2014-01-01

... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission... the disposal facility or facilities which had been receiving the waste stream of concern before the... the person(s) or company(ies) generating the low-level radioactive waste for which the determination...

10 CFR 62.12 - Contents of a request for emergency access: General information.

Code of Federal Regulations, 2011 CFR

2011-01-01

... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission... the disposal facility or facilities which had been receiving the waste stream of concern before the... the person(s) or company(ies) generating the low-level radioactive waste for which the determination...

10 CFR 62.12 - Contents of a request for emergency access: General information.

Code of Federal Regulations, 2012 CFR

2012-01-01

... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission... the disposal facility or facilities which had been receiving the waste stream of concern before the... the person(s) or company(ies) generating the low-level radioactive waste for which the determination...

10 CFR 62.12 - Contents of a request for emergency access: General information.

Code of Federal Regulations, 2013 CFR

2013-01-01

... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission... the disposal facility or facilities which had been receiving the waste stream of concern before the... the person(s) or company(ies) generating the low-level radioactive waste for which the determination...

Public Computer Assisted Learning Facilities for Children with Visual Impairment: Universal Design for Inclusive Learning

ERIC Educational Resources Information Center

Siu, Kin Wai Michael; Lam, Mei Seung

2012-01-01

Although computer assisted learning (CAL) is becoming increasingly popular, people with visual impairment face greater difficulty in accessing computer-assisted learning facilities. This is primarily because most of the current CAL facilities are not visually impaired friendly. People with visual impairment also do not normally have access to…

Facility Accessibility: Opening the Doors to All

ERIC Educational Resources Information Center

Petersen, Jeffrey C.; Piletic, Cindy K.

2006-01-01

A facility developed for fitness, physical activity, recreation, or sport is a vital community resource that contributes to the overall health and wellness of that community's citizens. In order to maximize the benefits derived from these facilities, it is imperative that they be accessible to as wide a range of people as possible. The Americans…

33 CFR 106.260 - Security measures for access control.

Code of Federal Regulations, 2013 CFR

2013-07-01

... SECURITY MARITIME SECURITY MARINE SECURITY: OUTER CONTINENTAL SHELF (OCS) FACILITIES Outer Continental... unattended spaces that adjoin areas to which OCS facility personnel and visitors have access; (9) Ensure OCS...

33 CFR 106.260 - Security measures for access control.

Code of Federal Regulations, 2012 CFR

2012-07-01

... SECURITY MARITIME SECURITY MARINE SECURITY: OUTER CONTINENTAL SHELF (OCS) FACILITIES Outer Continental... unattended spaces that adjoin areas to which OCS facility personnel and visitors have access; (9) Ensure OCS...

33 CFR 106.260 - Security measures for access control.

Code of Federal Regulations, 2011 CFR

2011-07-01

... SECURITY MARITIME SECURITY MARINE SECURITY: OUTER CONTINENTAL SHELF (OCS) FACILITIES Outer Continental... unattended spaces that adjoin areas to which OCS facility personnel and visitors have access; (9) Ensure OCS...

33 CFR 106.260 - Security measures for access control.

Code of Federal Regulations, 2014 CFR

2014-07-01

... SECURITY MARITIME SECURITY MARINE SECURITY: OUTER CONTINENTAL SHELF (OCS) FACILITIES Outer Continental... unattended spaces that adjoin areas to which OCS facility personnel and visitors have access; (9) Ensure OCS...

33 CFR 106.260 - Security measures for access control.

Code of Federal Regulations, 2010 CFR

2010-07-01

... SECURITY MARITIME SECURITY MARINE SECURITY: OUTER CONTINENTAL SHELF (OCS) FACILITIES Outer Continental... unattended spaces that adjoin areas to which OCS facility personnel and visitors have access; (9) Ensure OCS...

Timeliness and access to healthcare services via telemedicine for adolescents in state correctional facilities.

PubMed

Fox, Karen C; Somes, Grant W; Waters, Teresa M

2007-08-01

The aim of this study was to examine the effectiveness of a telemedicine program in improving timeliness of and access to healthcare services in adolescent correctional facilities. This study is a pre/post quasi-experimental design comparing time to treatment and healthcare use in the year preceding and the 2 years after the implementation of a telemedicine program in four facilities housing adolescents from 12 to 19. Timeliness of care is measured by time from referral to date of service (for behavioral healthcare only). Access to care is measured by use of outpatient care, emergency department (ED) visits, and inpatient visits. Two of the four state correctional facilities had a significant decrease (24%) in time from referral to treatment after the implementation of the telemedicine intervention. The facilities not showing significant improvements in timeliness experienced difficulty implementing the telemedicine program. The telemedicine program was also associated with significant improvements in access to care. Outpatient visits increased by 40% in the 2 years after implementation of telemedicine. For each 1% increase in telemedicine usage, outpatient visits increased by 1%, whereas emergency room visits decreased by 7%. Telemedicine can have a positive impact on timeliness of and access to care for youth in correctional facilities.

The Influence of Distance and Level of Care on Delivery Place in Rural Zambia: A Study of Linked National Data in a Geographic Information System

PubMed Central

Gabrysch, Sabine; Cousens, Simon; Cox, Jonathan; Campbell, Oona M. R.

2011-01-01

Background Maternal and perinatal mortality could be reduced if all women delivered in settings where skilled attendants could provide emergency obstetric care (EmOC) if complications arise. Research on determinants of skilled attendance at delivery has focussed on household and individual factors, neglecting the influence of the health service environment, in part due to a lack of suitable data. The aim of this study was to quantify the effects of distance to care and level of care on women's use of health facilities for delivery in rural Zambia, and to compare their population impact to that of other important determinants. Methods and Findings Using a geographic information system (GIS), we linked national household data from the Zambian Demographic and Health Survey 2007 with national facility data from the Zambian Health Facility Census 2005 and calculated straight-line distances. Health facilities were classified by whether they provided comprehensive EmOC (CEmOC), basic EmOC (BEmOC), or limited or substandard services. Multivariable multilevel logistic regression analyses were performed to investigate the influence of distance to care and level of care on place of delivery (facility or home) for 3,682 rural births, controlling for a wide range of confounders. Only a third of rural Zambian births occurred at a health facility, and half of all births were to mothers living more than 25 km from a facility of BEmOC standard or better. As distance to the closest health facility doubled, the odds of facility delivery decreased by 29% (95% CI, 14%–40%). Independently, each step increase in level of care led to 26% higher odds of facility delivery (95% CI, 7%–48%). The population impact of poor geographic access to EmOC was at least of similar magnitude as that of low maternal education, household poverty, or lack of female autonomy. Conclusions Lack of geographic access to emergency obstetric care is a key factor explaining why most rural deliveries in Zambia still occur at home without skilled care. Addressing geographic and quality barriers is crucial to increase service use and to lower maternal and perinatal mortality. Linking datasets using GIS has great potential for future research and can help overcome the neglect of health system factors in research and policy. Please see later in the article for the Editors' Summary PMID:21283606

28 CFR 36.601 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... requirements of title III of the Act for accessibility and usability of facilities covered by that title. Code... accessibility and usability of facilities covered by that title. Submitting official means the State or local...

28 CFR 36.601 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... requirements of title III of the Act for accessibility and usability of facilities covered by that title. Code... accessibility and usability of facilities covered by that title. Submitting official means the State or local...

32 CFR 637.9 - Access to U.S. Army facilities and records.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Access to U.S. Army facilities and records. 637.9 Section 637.9 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS MILITARY POLICE INVESTIGATION Investigations § 637.9 Access to U.S...

75 FR 55297 - Further Inquiry Into Two Under-Developed Issues in the Open Internet Proceeding

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-10

... facilities as broadband Internet access service (commonly called ``managed'' or ``specialized'' services). The second is the application of open Internet rules to mobile wireless Internet access services... Framework for Broadband Access to the Internet Over Wireline Facilities et al., CC Docket Nos. 02-33, 01-337...

Estimating spatial accessibility to facilities on the regional scale: an extended commuting-based interaction potential model

PubMed Central

2011-01-01

Background There is growing interest in the study of the relationships between individual health-related behaviours (e.g. food intake and physical activity) and measurements of spatial accessibility to the associated facilities (e.g. food outlets and sport facilities). The aim of this study is to propose measurements of spatial accessibility to facilities on the regional scale, using aggregated data. We first used a potential accessibility model that partly makes it possible to overcome the limitations of the most frequently used indices such as the count of opportunities within a given neighbourhood. We then propose an extended model in order to take into account both home and work-based accessibility for a commuting population. Results Potential accessibility estimation provides a very different picture of the accessibility levels experienced by the population than the more classical "number of opportunities per census tract" index. The extended model for commuters increases the overall accessibility levels but this increase differs according to the urbanisation level. Strongest increases are observed in some rural municipalities with initial low accessibility levels. Distance to major urban poles seems to play an essential role. Conclusions Accessibility is a multi-dimensional concept that should integrate some aspects of travel behaviour. Our work supports the evidence that the choice of appropriate accessibility indices including both residential and non-residential environmental features is necessary. Such models have potential implications for providing relevant information to policy-makers in the field of public health. PMID:21219597

Using Wearable Computers in Shuttle Processing: A Feasibility Study

NASA Technical Reports Server (NTRS)

Centeno, Martha A.; Correa, Daisy; Groh-Hammond, Marcia

2001-01-01

Shuttle processing operations are performed following prescribed instructions compiled in a Work Authorization Document (WAD). Until very recently, WADs were printed so that they could be properly executed, including the buy off of each and every step by the appropriate authorizing agent. However, with the development of EPICs, Maximo, and PeopleSoft applications, some of these documents are now available in electronic format; hence, it is possible for technicians and engineers to access them on line and buy off the steps electronically. To take full advantage of these developments, technicians need access to such documents at the point of job execution. Body wearable computers present an opportunity to develop a WAD delivery system that enables access while preserving technician's mobility, safety levels, and quality of work done. The primary objectives of this project were to determine if body wearable computers are a feasible delivery system for WADs. More specifically, identify and recommend specific brands of body wearable computers readily available on the market. Thus, this effort has field-tested this technology in two areas of shuttle processing, and it has examined the usability of the technology. Results of two field tests and a Human Factors Usability Test are presented. Section 2 provides a description of the body wearable computer technology. Section 3 presents the test at the Space Shuttle Main Engine (SSME) Shop. Section 4 presents the results of the integration test at the Solid Rocket Boosters Assembly and Refurbishing Facility (SRBARF). Section 5 presents the results of the usability test done at the Operations Support Building (OSB).

AccessMod 3.0: computing geographic coverage and accessibility to health care services using anisotropic movement of patients

PubMed Central

Ray, Nicolas; Ebener, Steeve

2008-01-01

Background Access to health care can be described along four dimensions: geographic accessibility, availability, financial accessibility and acceptability. Geographic accessibility measures how physically accessible resources are for the population, while availability reflects what resources are available and in what amount. Combining these two types of measure into a single index provides a measure of geographic (or spatial) coverage, which is an important measure for assessing the degree of accessibility of a health care network. Results This paper describes the latest version of AccessMod, an extension to the Geographical Information System ArcView 3.×, and provides an example of application of this tool. AccessMod 3 allows one to compute geographic coverage to health care using terrain information and population distribution. Four major types of analysis are available in AccessMod: (1) modeling the coverage of catchment areas linked to an existing health facility network based on travel time, to provide a measure of physical accessibility to health care; (2) modeling geographic coverage according to the availability of services; (3) projecting the coverage of a scaling-up of an existing network; (4) providing information for cost effectiveness analysis when little information about the existing network is available. In addition to integrating travelling time, population distribution and the population coverage capacity specific to each health facility in the network, AccessMod can incorporate the influence of landscape components (e.g. topography, river and road networks, vegetation) that impact travelling time to and from facilities. Topographical constraints can be taken into account through an anisotropic analysis that considers the direction of movement. We provide an example of the application of AccessMod in the southern part of Malawi that shows the influences of the landscape constraints and of the modes of transportation on geographic coverage. Conclusion By incorporating the demand (population) and the supply (capacities of heath care centers), AccessMod provides a unifying tool to efficiently assess the geographic coverage of a network of health care facilities. This tool should be of particular interest to developing countries that have a relatively good geographic information on population distribution, terrain, and health facility locations. PMID:19087277

33 CFR 125.15 - Access to waterfront facilities, and port and harbor areas, including vessels and harbor craft...

Code of Federal Regulations, 2010 CFR

2010-07-01

..., and port and harbor areas, including vessels and harbor craft therein. 125.15 Section 125.15....15 Access to waterfront facilities, and port and harbor areas, including vessels and harbor craft....09 to those waterfront facilities, and port and harbor areas, including vessels and harbor craft...

Security breaches: tips for assessing and limiting your risks.

PubMed

Coons, Leeanne R

2011-01-01

As part of their compliance planning, medical practices should undergo a risk assessment to determine any vulnerability within the practice relative to security breaches. Practices should also implement safeguards to limit their risks. Such safeguards include facility access controls, information and electronic media management, use of business associate agreements, and education and enforcement. Implementation of specific policies and procedures to address security incidents is another critical step that medical practices should take as part of their security incident prevention plan. Medical practices should not only develop policies and procedures to prevent, detect, contain, and correct security violations, but should make sure that such policies and procedures are actually implemented in their everyday operations.

Dirt, disease and death: control, resistance and change in the post-emancipation Caribbean.

PubMed

Pemberton, Rita

2012-12-01

This study examines how health facilities and services were used as an agency of worker control in the British Caribbean between 1838 and 1860. It argues that planter health strategies were based on flawed assumptions. The resultant policy of deprivation of access to medical services by the labouring population backfired within 16 years of freedom when a cholera epidemic rocked the region. It exposed the poor living conditions of the free villages and generated fear and panic among the local elite who were forced to make policy changes regarding health and sanitation. As a result the first steps towards the establishment of public health services in the British Caribbean were stimulated.

Using Spacelab as a precursor of science operations for the Space Station

NASA Technical Reports Server (NTRS)

Marmann, R. A.

1997-01-01

For more than 15 years, Spacelab, has provided a laboratory in space for an international array of experiments, facilities, and experimenters. In addition to continuing this important work, Spacelab is now serving as a crucial stepping-stone to the improved science, improved operations, and rapid access to space that will characterize International Space Station. In the Space Station era, science operations will depend primarily on distributed/remote operations that will allow investigators to direct science activities from their universities, facilities, or home bases. Spacelab missions are a crucial part of preparing for these activities, having been used to test, prove, and refine remote operations over several missions. The knowledge gained from preparing these Missions is also playing a crucial role in reducing the time required to put an experiment into orbit, from revolutionizing the processes involved to testing the hardware needed for these more advanced operations. This paper discusses the role of the Spacelab program and the NASA Marshall Space Flight Center- (MSFC-) managed missions in developing and refining remote operations, new hardware and facilities for use on Space Station, and procedures that dramatically reduce preparation time for flight.

ADA Compliance and Accessibility of Fitness Facilities in Western Wisconsin.

PubMed

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

2012-01-01

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

48 CFR 3004.470 - Security requirements for access to unclassified facilities, Information Technology resources...

Code of Federal Regulations, 2013 CFR

2013-10-01

... access to unclassified facilities, Information Technology resources, and sensitive information. 3004.470... Technology resources, and sensitive information. ... ACQUISITION REGULATION (HSAR) GENERAL ADMINISTRATIVE MATTERS Safeguarding Classified and Sensitive Information...

48 CFR 3004.470 - Security requirements for access to unclassified facilities, Information Technology resources...

Code of Federal Regulations, 2010 CFR

2010-10-01

... access to unclassified facilities, Information Technology resources, and sensitive information. 3004.470... Technology resources, and sensitive information. ... ACQUISITION REGULATION (HSAR) GENERAL ADMINISTRATIVE MATTERS Safeguarding Classified and Sensitive Information...

48 CFR 3004.470 - Security requirements for access to unclassified facilities, Information Technology resources...

Code of Federal Regulations, 2014 CFR

2014-10-01

... access to unclassified facilities, Information Technology resources, and sensitive information. 3004.470... Technology resources, and sensitive information. ... ACQUISITION REGULATION (HSAR) GENERAL ADMINISTRATIVE MATTERS Safeguarding Classified and Sensitive Information...

48 CFR 3004.470 - Security requirements for access to unclassified facilities, Information Technology resources...

Code of Federal Regulations, 2011 CFR

2011-10-01

... access to unclassified facilities, Information Technology resources, and sensitive information. 3004.470... Technology resources, and sensitive information. ... ACQUISITION REGULATION (HSAR) GENERAL ADMINISTRATIVE MATTERS Safeguarding Classified and Sensitive Information...

48 CFR 3004.470 - Security requirements for access to unclassified facilities, Information Technology resources...

Code of Federal Regulations, 2012 CFR

2012-10-01

... access to unclassified facilities, Information Technology resources, and sensitive information. 3004.470... Technology resources, and sensitive information. ... ACQUISITION REGULATION (HSAR) GENERAL ADMINISTRATIVE MATTERS Safeguarding Classified and Sensitive Information...

Travel by public transit to mammography facilities in 6 US urban areas.

PubMed

Graham, S; Lewis, B; Flanagan, B; Watson, M; Peipins, L

2015-12-01

We examined lack of private vehicle access and 30 minutes or longer public transportation travel time to mammography facilities for women 40 years of age or older in the urban areas of Boston, Philadelphia, San Antonio, San Diego, Denver, and Seattle to identify transit marginalized populations - women for whom these travel characteristics may jointly present a barrier to clinic access. This ecological study used sex and race/ethnicity data from the 2010 US Census and household vehicle availability data from the American Community Survey 2008-2012, all at Census tract level. Using the public transportation option on Google Trip Planner we obtained the travel time from the centroid of each census tract to all local mammography facilities to determine the nearest mammography facility in each urban area. Median travel times by public transportation to the nearest facility for women with no household access to a private vehicle were obtained by ranking travel time by population group across all U.S. census tracts in each urban area and across the entire study area. The overall median travel times for each urban area for women without household access to a private vehicle ranged from a low of 15 minutes in Boston and Philadelphia to 27 minutes in San Diego. The numbers and percentages of transit marginalized women were then calculated for all urban areas by population group. While black women were less likely to have private vehicle access, and both Hispanic and black women were more likely to be transit marginalized, this outcome varied by urban area. White women constituted the largest number of transit marginalized. Our results indicate that mammography facilities are favorably located for the large majority of women, although there are still substantial numbers for whom travel may likely present a barrier to mammography facility access.

25 CFR 170.813 - When can access to IRR transportation facilities be restricted?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false When can access to IRR transportation facilities be restricted? 170.813 Section 170.813 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM BIA Road Maintenance § 170.813 When can access to IRR...

Availability and acceptability of HIV counselling and testing services. A qualitative study comparing clients' experiences of accessing HIV testing at public sector primary health care facilities or non-governmental mobile services in Cape Town, South Africa.

PubMed

Meehan, Sue-Ann; Leon, Natalie; Naidoo, Pren; Jennings, Karen; Burger, Ronelle; Beyers, Nulda

2015-09-02

The South African government is striving for universal access to HIV counselling and testing (HCT), a fundamental component of HIV care and prevention. In the Cape Town district, Western Cape Province of South Africa, HCT is provided free of charge at publically funded primary health care (PHC) facilities and through non-governmental organizations (NGOs). This study investigated the availability and accessibility of HCT services; comparing health seeking behaviour and client experiences of HCT across public PHC facilities (fixed sites) and NGO mobile services. This qualitative study used semi-structured interviews. Systematic sampling was used to select 16 participants who accessed HCT in either a PHC facility (8) or a NGO mobile service (8). Interviews, conducted between March and June 2011, were digitally recorded, transcribed and where required, translated into English. Constant comparative and thematic analysis was used to identify common and divergent responses and themes in relation to the key questions (reasons for testing, choice of service provider and experience of HCT). The sample consisted of 12 females and 4 males with an age range of 19-60 years (median age 28 years). Motivations for accessing health facilities and NGO services were similar; opportunity to test, being affected by HIV and a perceived personal risk for contracting HIV. Participants chose a particular service provider based on accessibility, familiarity with and acceptability of that service. Experiences of both services were largely positive, though instances of poor staff attitude and long waiting times were reported at PHC facilities. Those attending NGO services reported shorter waiting times and overall positive testing experiences. Concerns about lack of adequate privacy and associated stigma were expressed about both services. Realised access to HCT is dependent on availability and acceptability of HCT services. Those who utilised either a NGO mobile service or a public PHC facility perceived both service types as available and acceptable. Mobile NGO services provided an accessible opportunity for those who would otherwise not have tested at that time. Policy makers should consider the perceptions and experiences of those accessing HCT services when increasing access to HCT.

Challenges in accessing sexual and reproductive health services by people with physical disabilities in Kampala, Uganda

PubMed Central

2014-01-01

Introduction Despite the universal right to access the same range, quality and standard of free or affordable health care and programs as provided to other persons, people with physical disabilities (PWPDs) continue to experience challenges in accessing these services. This article presents the challenges faced by PWPDs in accessing sexual and reproductive health (SRH) services in Kampala, Uganda. Methods This was a qualitative study that was conducted with male and female PWPDs in Kampala in 2007. Data on the challenges experienced by PWPDs in accessing SRH services were collected using in-depth interviews with 40 PWPDs and key informant interviews with 10 PWPDs’ representatives, staff of agencies supporting PWPDs and health workers. All data were captured verbatim using an audio-tape recorder, entered into a Microsoft Word computer program and analyzed manually following a content thematic approach. Results The study findings show that PWPDs face a multitude of challenges in accessing SRH services including negative attitudes of service providers, long queues at health facilities, distant health facilities, high costs of services involved, unfriendly physical structures and the perception from able-bodied people that PWPDs should be asexual. Conclusion People with physical disabilities (PWPDs) face health facility-related (service provider and facility-related challenges), economic and societal challenges in accessing SRH services. These findings call for a need to sensitize service providers on SRH needs of PWPDs for better support and for the government to enforce the provision of PWPD-friendly services in all health facilities. PMID:25086444

Challenges in accessing sexual and reproductive health services by people with physical disabilities in Kampala, Uganda.

PubMed

Ahumuza, Sharon Eva; Matovu, Joseph K B; Ddamulira, John Bosco; Muhanguzi, Florence Kyoheirwe

2014-08-02

Despite the universal right to access the same range, quality and standard of free or affordable health care and programs as provided to other persons, people with physical disabilities (PWPDs) continue to experience challenges in accessing these services. This article presents the challenges faced by PWPDs in accessing sexual and reproductive health (SRH) services in Kampala, Uganda. This was a qualitative study that was conducted with male and female PWPDs in Kampala in 2007. Data on the challenges experienced by PWPDs in accessing SRH services were collected using in-depth interviews with 40 PWPDs and key informant interviews with 10 PWPDs' representatives, staff of agencies supporting PWPDs and health workers. All data were captured verbatim using an audio-tape recorder, entered into a Microsoft Word computer program and analyzed manually following a content thematic approach. The study findings show that PWPDs face a multitude of challenges in accessing SRH services including negative attitudes of service providers, long queues at health facilities, distant health facilities, high costs of services involved, unfriendly physical structures and the perception from able-bodied people that PWPDs should be asexual. People with physical disabilities (PWPDs) face health facility-related (service provider and facility-related challenges), economic and societal challenges in accessing SRH services. These findings call for a need to sensitize service providers on SRH needs of PWPDs for better support and for the government to enforce the provision of PWPD-friendly services in all health facilities.

A Case-Series Test of the Interactive Two-Step Model of Lexical Access: Predicting Word Repetition from Picture Naming

ERIC Educational Resources Information Center

Dell, Gary S.; Martin, Nadine; Schwartz, Myrna F.

2007-01-01

Lexical access in language production, and particularly pathologies of lexical access, are often investigated by examining errors in picture naming and word repetition. In this article, we test a computational approach to lexical access, the two-step interactive model, by examining whether the model can quantitatively predict the repetition-error…

First Amendment Issues in the Control and Use of Public School Facilities

ERIC Educational Resources Information Center

Davis, Thomas E., Jr.

2011-01-01

The passage of the Equal Access Act (1984) brought to light the legal conflict that had been building over the previous four decades over who should or should not have access to public school facilities. Following the passage of the Act, many student and community groups began to request use of school facilities. School leaders were called on to…

Current sickle cell disease management practices in Nigeria.

PubMed

Galadanci, N; Wudil, B J; Balogun, T M; Ogunrinde, G O; Akinsulie, A; Hasan-Hanga, F; Mohammed, A S; Kehinde, M O; Olaniyi, J A; Diaku-Akinwumi, I N; Brown, B J; Adeleke, S; Nnodu, O E; Emodi, I; Ahmed, S; Osegbue, A O; Akinola, N; Opara, H I O; Adegoke, S A; Aneke, J; Adekile, A D

2014-03-01

Although Nigeria has the highest burden of sickle cell disease (SCD) worldwide, there is still variable and poor utilisation of standard-of-care practices for SCD patients in the country. This was a questionnaire survey of doctors in some dedicated SCD clinics in Nigeria in order to document the facilities available and common management practices. There were responses from 18 clinics based in 11 institutions. The number of patients being followed in each centre ranged from 15 to approximately 11 000. All clinics provided malaria prophylaxis and folic acid routinely to their patients. Only eight clinics prescribe penicillin prophylaxis. Eight prescribe hydroxyurea to patients who can afford it when indicated. All of the centres except three have electronic cell counters, but all had access to haemoglobin electrophoresis. Three had high-performance liquid chromatography machines installed but none was being routinely used. One institution had a functioning molecular biology laboratory. There is no official newborn screening programme in the country. All had access to microbiology and chemistry laboratories. Nine institutions had CT, six had MRI and three had transcranial Doppler facilities. The care available for SCD in Nigeria is still suboptimal and there is an urgent need for concerted effort to tackle the problem, but to make a significant impact on the burden of the disease would require more focus at the primary care level. Some steps to achieving this are outlined.

Human factors in space station architecture 2. EVA access facility: A comparative analysis of 4 concepts for on-orbit space suit servicing

NASA Technical Reports Server (NTRS)

Cohen, Marc M.; Bussolari, Steven

1987-01-01

Four concepts for on-orbit spacesuit donning, doffing, servicing, check-out, egress and ingress are presented. These are: the Space Transportation System (STS) Type (shuttle system enlarged), the Transit Airlock (Shuttle Airlock with suit servicing removed from the pump-down chamber), the Suitport (a rear-entry suit mates to a port in the airlock wall), and the Crewlock (a small, individual, conformal airlock). Each of these four concepts is compared through a series of seven steps representing a typical Extra Vehicular Activity (EVA) mission: (1) Predonning suit preparation; (2) Portable Life Support System (PLSS) preparation; (3) Suit Donning and Final Check; (4) Egress/Ingress; (5) Mid-EVA rest period; (6) Post-EVA Securing; (7) Non-Routine Maintenance. The different characteristics of each concept are articulated through this step-by-step approach. Recommendations concerning an approach for further evaluations of airlock geometry, anthropometrics, ergonomics, and functional efficiency are made. The key recommendation is that before any particular airlock can be designed, the full range of spacesuit servicing functions must be considered, including timelines that are most supportive of EVA human productivity.

Investigating disparities in spatial accessibility to and characteristics of sport facilities: direction, strength, and spatial scale of associations with area income.

PubMed

Billaudeau, Nathalie; Oppert, Jean-Michel; Simon, Chantal; Charreire, Hélène; Casey, Romain; Salze, Paul; Badariotti, Dominique; Banos, Arnaud; Weber, Christiane; Chaix, Basile

2011-01-01

We conducted an environmental justice study of the spatial distribution of sport facilities, a major resource for physical activity, in the Paris Region in France. Comprehensive data of the French Census of Sport Facilities allowed us to investigate disparities not only in the spatial accessibility to facilities, but also in the characteristics of these facilities. We found that the associations between area income and the presence of facilities or favorable characteristics of these facilities varied from positive to negative depending on the facilities and on the characteristics examined. Sensitivity analyses defining area income in circular areas of different radii permitted a refined identification of areas underserved in sport facilities. Copyright © 2010 Elsevier Ltd. All rights reserved.

Bloodstream infection rates in outpatient hemodialysis facilities participating in a collaborative prevention effort: a quality improvement report.

PubMed

Patel, Priti R; Yi, Sarah H; Booth, Stephanie; Bren, Virginia; Downham, Gemma; Hess, Sally; Kelley, Karen; Lincoln, Mary; Morrissette, Kathy; Lindberg, Curt; Jernigan, John A; Kallen, Alexander J

2013-08-01

Bloodstream infections (BSIs) cause substantial morbidity in hemodialysis patients. In 2009, the US Centers for Disease Control and Prevention (CDC) sponsored a collaborative project to prevent BSIs in outpatient hemodialysis facilities. We sought to assess the impact of a set of interventions on BSI and access-related BSI rates in participating facilities using data reported to the CDC's National Healthcare Safety Network (NHSN). Quality improvement project. Patients in 17 outpatient hemodialysis facilities that volunteered to participate. Facilities reported monthly event and denominator data to NHSN, received guidance from the CDC, and implemented an evidence-based intervention package that included chlorhexidine use for catheter exit-site care, staff training and competency assessments focused on catheter care and aseptic technique, hand hygiene and vascular access care audits, and feedback of infection and adherence rates to staff. Crude and modeled BSI and access-related BSI rates. Up to 12 months of preintervention (January 2009 through December 2009) and 15 months of intervention period (January 2010 through March 2011) data from participating centers were analyzed. Segmented regression analysis was used to assess changes in BSI and access-related BSI rates during the preintervention and intervention periods. Most (65%) participating facilities were hospital based. Pooled mean BSI and access-related BSI rates were 1.09 and 0.73 events per 100 patient-months during the preintervention period and 0.89 and 0.42 events per 100 patient-months during the intervention period, respectively. Modeled rates decreased 32% (P = 0.01) for BSIs and 54% (P < 0.001) for access-related BSIs at the start of the intervention period. Participating facilities were not representative of all outpatient hemodialysis centers nationally. There was no control arm to this quality improvement project. Facilities participating in a collaborative successfully decreased their BSI and access-related BSI rates. The decreased rates appeared to be maintained in the intervention period. These findings suggest that improved implementation of recommended practices can reduce BSIs in hemodialysis centers. Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc.

Dialysis Facility Transplant Philosophy and Access to Kidney Transplantation in the Southeast

PubMed Central

Gander, Jennifer; Browne, Teri; Plantinga, Laura; Pastan, Stephen O; Sauls, Leighann; Krisher, Jenna; Patzer, Rachel E

2015-01-01

Background Little is known about the impact of dialysis facility treatment philosophy on access to transplant. The aim of our study was to determine the relationship between dialysis facility transplant philosophy and facility-level access to kidney transplant waitlisting. Methods A 25-item questionnaire administered to Southeastern dialysis facilities (n=509) in 2012 captured facility transplant philosophy (categorized as “transplant is our first choice,” “transplant is a great option for some,” and “transplant is a good option, if the patient is interested”) .. Facility-level waitlisting and facility characteristics were obtained from the 2008-2011 Dialysis Facility Report. Multivariable logistic regression was used to examinethe association between dialysis facility transplant philosophy and facility waitlisting performance (dichotomized using the national median), where low performance was defined as less than 21.7% of dialysis patients waitlisted within a facility. Results Fewer than 25% (n=124) of dialysis facilities reported “transplant is our first option.” A total of 131 (31.4%) dialysis facilities in the Southeast were high-performing with respect to waitlisting. Adjusted analysis showed that facilities who reported “transplant is our first option” were twice (OR=2.0, 95% CI 1.0, 3.9) as likely to have high waitlisting performance compared to facilities who reported “transplant is a good option, if the patient is interested.” Conclusions Facilities with staff who had a more positive transplant philosophy were more likely to have better facility waitlisting performance. Future prospective studies are needed to further transplantation. PMID:26278585

50 CFR 80.24 - Recreational boating access facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... INTERIOR (CONTINUED) FINANCIAL ASSISTANCE-WILDLIFE SPORT FISH RESTORATION PROGRAM ADMINISTRATIVE REQUIREMENTS, PITTMAN-ROBERTSON WILDLIFE RESTORATION AND DINGELL-JOHNSON SPORT FISH RESTORATION ACTS § 80.24... the Dingell-Johnson Sport Fish Restoration Act for recreational boating access facilities. However, a...

How to Perform Transcaval Access and Closure for Transcatheter Aortic Valve Implantation

PubMed Central

Lederman, Robert J.; Babaliaros, Vasilis C.; Greenbaum, Adam B.

2016-01-01

Transcaval, or caval-aortic, access is a promising approach for fully percutaneous trans-catheter aortic valve implantation in patients without good conventional access options. This tutorial review provides step-by-step guidance to planning and executing the procedure, along with approaches to remedy complications. PMID:26356244

Is the closest facility the one actually used? An assessment of travel time estimation based on mammography facilities.

PubMed

Alford-Teaster, Jennifer; Lange, Jane M; Hubbard, Rebecca A; Lee, Christoph I; Haas, Jennifer S; Shi, Xun; Carlos, Heather A; Henderson, Louise; Hill, Deirdre; Tosteson, Anna N A; Onega, Tracy

2016-02-18

Characterizing geographic access depends on a broad range of methods available to researchers and the healthcare context to which the method is applied. Globally, travel time is one frequently used measure of geographic access with known limitations associated with data availability. Specifically, due to lack of available utilization data, many travel time studies assume that patients use the closest facility. To examine this assumption, an example using mammography screening data, which is considered a geographically abundant health care service in the United States, is explored. This work makes an important methodological contribution to measuring access--which is a critical component of health care planning and equity almost everywhere. We analyzed one mammogram from each of 646,553 women participating in the US based Breast Cancer Surveillance Consortium for years 2005-2012. We geocoded each record to street level address data in order to calculate travel time to the closest and to the actually used mammography facility. Travel time between the closest and the actual facility used was explored by woman-level and facility characteristics. Only 35% of women in the study population used their closest facility, but nearly three-quarters of women not using their closest facility used a facility within 5 min of the closest facility. Individuals that by-passed the closest facility tended to live in an urban core, within higher income neighborhoods, or in areas where the average travel times to work was longer. Those living in small towns or isolated rural areas had longer closer and actual median drive times. Since the majority of US women accessed a facility within a few minutes of their closest facility this suggests that distance to the closest facility may serve as an adequate proxy for utilization studies of geographically abundant services like mammography in areas where the transportation networks are well established.

Operational Experience of an Open-Access, Subscription-Based Mass Spectrometry and Proteomics Facility.

PubMed

Williamson, Nicholas A

2018-03-01

This paper discusses the successful adoption of a subscription-based, open-access model of service delivery for a mass spectrometry and proteomics facility. In 2009, the Mass Spectrometry and Proteomics Facility at the University of Melbourne (Australia) moved away from the standard fee for service model of service provision. Instead, the facility adopted a subscription- or membership-based, open-access model of service delivery. For a low fixed yearly cost, users could directly operate the instrumentation but, more importantly, there were no limits on usage other than the necessity to share available instrument time with all other users. All necessary training from platform staff and many of the base reagents were also provided as part of the membership cost. These changes proved to be very successful in terms of financial outcomes for the facility, instrument access and usage, and overall research output. This article describes the systems put in place as well as the overall successes and challenges associated with the operation of a mass spectrometry/proteomics core in this manner. Graphical abstract ᅟ.

Operational Experience of an Open-Access, Subscription-Based Mass Spectrometry and Proteomics Facility

NASA Astrophysics Data System (ADS)

Williamson, Nicholas A.

2018-03-01

This paper discusses the successful adoption of a subscription-based, open-access model of service delivery for a mass spectrometry and proteomics facility. In 2009, the Mass Spectrometry and Proteomics Facility at the University of Melbourne (Australia) moved away from the standard fee for service model of service provision. Instead, the facility adopted a subscription- or membership-based, open-access model of service delivery. For a low fixed yearly cost, users could directly operate the instrumentation but, more importantly, there were no limits on usage other than the necessity to share available instrument time with all other users. All necessary training from platform staff and many of the base reagents were also provided as part of the membership cost. These changes proved to be very successful in terms of financial outcomes for the facility, instrument access and usage, and overall research output. This article describes the systems put in place as well as the overall successes and challenges associated with the operation of a mass spectrometry/proteomics core in this manner. [Figure not available: see fulltext.

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

ERIC Educational Resources Information Center

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

2015-01-01

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

Which future for electromagnetic Astronomy: Ground Based vs Space Borne Large Astrophysical Facilities

NASA Astrophysics Data System (ADS)

Ubertini, Pietro

2015-08-01

The combined use of large ground based facilities and large space observatories is playing a key role in the advance of astrophysics by providing access to the entire electromagnetic spectrum, allowing high sensitivity observations from the lower radio wavelength to the higher energy gamma rays.It is nowadays clear that a forward steps in the understanding of the Universe evolution and large scale structure formation is essential and only possible with the combined use of multiwavelength imaging and spectral high resolution instruments.The increasing size, complexity and cost of large ground and space observatories places a growing emphasis on international collaboration. If the present set of astronomical facilities is impressive and complete, with nicely complementary space and ground based telescopes, the scenario becomes worrisome and critical in the next two decades. In fact, only a few ‘Large’ main space missions are planned and there is a need to ensure proper ground facility coverage: the synergy Ground-Space is not escapable in the timeframe 2020-2030.The scope of this talk is to review the current astronomical instrumentation panorama also in view of the recent major national agencies and international bodies programmatic decisions.This Division B meeting give us a unique opportunity to review the current situation and discuss the future perspectives taking advantage of the large audience ensured by the IAU GA.

Shifting the burden or expanding access to care? Assessing malaria trends following scale-up of community health worker malaria case management and reactive case detection.

PubMed

Larsen, David A; Winters, Anna; Cheelo, Sanford; Hamainza, Busiku; Kamuliwo, Mulakwa; Miller, John M; Bridges, Daniel J

2017-11-02

Malaria is a significant burden to health systems and is responsible for a large proportion of outpatient cases at health facilities in endemic regions. The scale-up of community management of malaria and reactive case detection likely affect both malaria cases and outpatient attendance at health facilities. Using health management information data from 2012 to 2013 this article examines health trends before and after the training of volunteer community health workers to test and treat malaria cases in Southern Province, Zambia. An estimated 50% increase in monthly reported malaria infections was found when community health workers were involved with malaria testing and treating in the community (incidence rate ratio 1.52, p < 0.001). Furthermore, an estimated 6% decrease in outpatient attendance at the health facility was found when community health workers were involved with malaria testing and treating in the community. These results suggest a large public health benefit to both community case management of malaria and reactive case detection. First, the capacity of the malaria surveillance system to identify malaria infections was increased by nearly one-third. Second, the outpatient attendance at health facilities was modestly decreased. Expanding the capacity of the malaria surveillance programme through systems such as community case management and reactive case detection is an important step toward malaria elimination.

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

NASA Astrophysics Data System (ADS)

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

2017-09-01

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

A facile one-step route to synthesize cage-like silica hollow spheres loaded with superparamagnetic iron oxide nanoparticles in their shells.

PubMed

Li, Ling; Choo, Eugene Shi Guang; Tang, Xiaosheng; Ding, Jun; Xue, Junmin

2009-02-28

Cage-like silica hollow spheres loaded with superparamagnetic iron oxide nanoparticles incorporated in their macroporous shells are synthesized in a facile manner through a one-step oil-in-diethylene glycol (DEG) microemulsion route.

Accessibility of low-income family flats in North Jakarta city

NASA Astrophysics Data System (ADS)

Feminin, T. A.; Wiranegara, H. W.; Supriatna, Y.

2018-01-01

The majority of relocated, low-income families in North Jakarta city who residing the flats, complained at decreasing their accessibility to the workplaces and to the social facilities. The aim of this research was to identify the changing of their accessibility before and after relocated, viewed from three dimensions: distance, travel time, and travel cost to the workplaces, educational facilities, and shopping areas. The research design was questionnaire survey containing the degree of accessibility before and after resided the flats. Five flats were chosen as cases. Their inhabitants were chosen as respondents which used simple random sampling. The result showed that their flats accessibility to the workplaces in all three dimensions was lower than when they resided in the slum area. Also, in distance and travel time accessibility to shopping areas was lower. Only accessibility to educational facilities measured in those three dimensions was higher after they moved. Supply for affordable public transport from their flats to reach their workplaces is needed to raise their accessibility. Also, they need subsidizeto rent of their flats so the burden to their income lesser.Using the ground space of their flats for retail activities was to make more accessible for their shopping activities.

U.S. EPAs Geospatial Data Access Project

EPA Pesticide Factsheets

To improve public health and the environment, the United States Environmental Protection Agency (EPA) collects information about facilities, sites, or places subject to environmental regulation or of environmental interest. Through the Geospatial Data Download Service, the public is now able to download the EPA Geodata Shapefile, Feature Class or extensible markup language (XML) file containing facility and site information from EPA's national program systems. The files are Internet accessible from the Envirofacts Web site (https://www3.epa.gov/enviro/). The data may be used with geospatial mapping applications. (Note: The files omit facilities without latitude/longitude coordinates.) The EPA Geospatial Data contains the name, location (latitude/longitude), and EPA program information about specific facilities and sites. In addition, the files contain a Uniform Resource Locator (URL), which allows mapping applications to present an option to users to access additional EPA data resources on a specific facility or site.

Geographic Access Modeling of Emergency Obstetric and Neonatal Care in Kigoma Region, Tanzania: Transportation Schemes and Programmatic Implications.

PubMed

Chen, Yi No; Schmitz, Michelle M; Serbanescu, Florina; Dynes, Michelle M; Maro, Godson; Kramer, Michael R

2017-09-27

Access to transportation is vital to reducing the travel time to emergency obstetric and neonatal care (EmONC) for managing complications and preventing adverse maternal and neonatal outcomes. This study examines the distribution of travel times to EmONC in Kigoma Region, Tanzania, using various transportation schemes, to estimate the proportion of live births (a proxy indicator of women needing delivery care) with poor geographic access to EmONC services. The 2014 Reproductive Health Survey of Kigoma Region identified 4 primary means of transportation used to travel to health facilities: walking, cycling, motorcycle, and 4-wheeled motor vehicle. A raster-based travel time model was used to map the 2-hour travel time catchment for each mode of transportation. Live birth density distributions were aggregated by travel time catchments, and by administrative council, to estimate the proportion of births with poor access. Of all live births in Kigoma Region, 13% occurred in areas where women can reach EmONC facilities within 2 hours on foot, 33% in areas that can be reached within 2 hours only by motorized vehicles, and 32% where it is impossible to reach EmONC facilities within 2 hours. Over 50% of births in 3 of the 8 administrative councils had poor estimated access. In half the councils, births with poor access could be reduced to no higher than 12% if all female residents had access to motorized vehicles. Significant differences in geographic access to EmONC in Kigoma Region, Tanzania, were observed both by location and by primary transportation type. As most of the population may only have good EmONC access when using mechanized or motorized vehicles, bicycles and motorcycles should be incorporated into the health transportation strategy. Collaboration between private transportation sectors and obstetric service providers could improve access to EmONC services among most populations. In areas where residents may not access EmONC facilities within 2 hours regardless of the type of transportation used, upgrading EmONC capacity among nearby non-EmONC facilities may be required to improve accessibility. © Chen Y, Schmitz, et al.

Geographic Access Modeling of Emergency Obstetric and Neonatal Care in Kigoma Region, Tanzania: Transportation Schemes and Programmatic Implications

PubMed Central

Chen, Yi No; Schmitz, Michelle M; Serbanescu, Florina; Dynes, Michelle M; Maro, Godson; Kramer, Michael R

2017-01-01

ABSTRACT Background: Access to transportation is vital to reducing the travel time to emergency obstetric and neonatal care (EmONC) for managing complications and preventing adverse maternal and neonatal outcomes. This study examines the distribution of travel times to EmONC in Kigoma Region, Tanzania, using various transportation schemes, to estimate the proportion of live births (a proxy indicator of women needing delivery care) with poor geographic access to EmONC services. Methods: The 2014 Reproductive Health Survey of Kigoma Region identified 4 primary means of transportation used to travel to health facilities: walking, cycling, motorcycle, and 4-wheeled motor vehicle. A raster-based travel time model was used to map the 2-hour travel time catchment for each mode of transportation. Live birth density distributions were aggregated by travel time catchments, and by administrative council, to estimate the proportion of births with poor access. Results: Of all live births in Kigoma Region, 13% occurred in areas where women can reach EmONC facilities within 2 hours on foot, 33% in areas that can be reached within 2 hours only by motorized vehicles, and 32% where it is impossible to reach EmONC facilities within 2 hours. Over 50% of births in 3 of the 8 administrative councils had poor estimated access. In half the councils, births with poor access could be reduced to no higher than 12% if all female residents had access to motorized vehicles. Conclusion: Significant differences in geographic access to EmONC in Kigoma Region, Tanzania, were observed both by location and by primary transportation type. As most of the population may only have good EmONC access when using mechanized or motorized vehicles, bicycles and motorcycles should be incorporated into the health transportation strategy. Collaboration between private transportation sectors and obstetric service providers could improve access to EmONC services among most populations. In areas where residents may not access EmONC facilities within 2 hours regardless of the type of transportation used, upgrading EmONC capacity among nearby non-EmONC facilities may be required to improve accessibility. PMID:28839113

Hospital-Based Outpatient Direct Access to Physical Therapist Services: Current Status in Wisconsin.

PubMed

Boissonnault, William G; Lovely, Karen

2016-11-01

Direct access to physical therapist services is available in all 50 states, with reported benefits including reduced health care costs, enhanced patient satisfaction, and no apparent compromised patient safety. Despite the benefits and legality of direct access, few data exist regarding the degree of model adoption, implementation, and utilization. The purposes of the study were: (1) to investigate the extent of implementation and utilization of direct access to outpatient physical therapist services in Wisconsin hospitals and medical centers, (2) to identify barriers to and facilitators for the provisioning of such services, and (3) to identify potential differences between facilities that do and do not provide direct access services. A descriptive survey was conducted. Eighty-nine survey questionnaires were distributed via email to the directors of rehabilitation services at Wisconsin hospitals and medical centers. The survey investigated facility adoption of the direct access model, challenges to and resources utilized during model implementation, and current barriers affecting model utilization. Forty-seven (52.8%) of the 89 survey questionnaires were completed and returned. Forty-two percent of the survey respondents (20 of 47) reported that their facility offered direct access to physical therapist services, but fewer than 10% of patients were seen via direct access at 95% of the facilities offering such services. The most frequently reported obstacles to model implementation and utilization were lack of health care provider, administrator, and patient knowledge of direct access; its legality in Wisconsin; and physical therapists' differential diagnosis and medical screening abilities. Potential respondent bias and limited generalizability of the results are limitations of the study. These findings apply to hospitals and medical centers located in Wisconsin, not to facilities located in other geographic regions. Respondents representing direct access organizations reported more timely access to physical therapist services, enhanced patient satisfaction, decreased organizational health care costs, and improved efficiency of resource utilization as benefits of model implementation. For organizations without direct access, not being an organizational priority, concerns from referral sources, and concerns that the physician-patient relationship would be negatively affected were noted as obstacles to model adoption. © 2016 American Physical Therapy Association.

Strategies for coping with the costs of inpatient care: a mixed methods study of urban and rural poor in Vadodara District, Gujarat, India.

PubMed

Ranson, Michael Kent; Jayaswal, Rupal; Mills, Anne J

2012-07-01

In India, coping mechanisms for inpatient care costs have been explored in rural areas, but seldom among urbanites. This study aims to explore and compare mechanisms employed by the urban and rural poor for coping with inpatient expenditures, in order to help identify formal mechanisms and policies to provide improved social protection for health care. A three-step methodology was used: (1) six focus-group discussions; (2) 800 exit survey interviews with users of public and private facilities in both urban and rural areas; and (3) 18 in-depth interviews with poor (below 30th percentile of socio-economic status) hospital users, to explore coping mechanisms in greater depth. Users of public hospitals, in both urban and rural areas, were poor relative to users of private hospitals. Median expenditures per day were much higher at private than at public facilities. Most respondents using public facilities (in both urban and rural areas) were able to pay out of their savings or income; or by borrowing from friends, family or employer. Those using private facilities were more likely to report selling land or other assets as the primary source of coping (particularly in rural areas) and they were more likely to have to borrow money at interest (particularly in urban areas). Poor individuals who used private facilities cited as reasons their closer proximity and higher perceived quality of care. In India, national and state governments should invest in improving the quality and access of public first-referral hospitals. This should be done selectively-with a focus, for example, on rural areas and urban slum areas-in order to promote a more equitable distribution of resources. Policy makers should continue to explore and support efforts to provide financial protection through insurance mechanisms. Past experience suggests that these efforts must be carefully monitored to ensure that the poorer among the insured are able to access scheme benefits, and the quality and quantity of health care provided must be monitored and regulated.

Strategies for coping with the costs of inpatient care: a mixed methods study of urban and rural poor in Vadodara District, Gujarat, India

PubMed Central

Ranson, Michael Kent; Jayaswal, Rupal; Mills, Anne J

2012-01-01

Background In India, coping mechanisms for inpatient care costs have been explored in rural areas, but seldom among urbanites. This study aims to explore and compare mechanisms employed by the urban and rural poor for coping with inpatient expenditures, in order to help identify formal mechanisms and policies to provide improved social protection for health care. Methods A three-step methodology was used: (1) six focus-group discussions; (2) 800 exit survey interviews with users of public and private facilities in both urban and rural areas; and (3) 18 in-depth interviews with poor (below 30th percentile of socio-economic status) hospital users, to explore coping mechanisms in greater depth. Results Users of public hospitals, in both urban and rural areas, were poor relative to users of private hospitals. Median expenditures per day were much higher at private than at public facilities. Most respondents using public facilities (in both urban and rural areas) were able to pay out of their savings or income; or by borrowing from friends, family or employer. Those using private facilities were more likely to report selling land or other assets as the primary source of coping (particularly in rural areas) and they were more likely to have to borrow money at interest (particularly in urban areas). Poor individuals who used private facilities cited as reasons their closer proximity and higher perceived quality of care. Conclusions In India, national and state governments should invest in improving the quality and access of public first-referral hospitals. This should be done selectively—with a focus, for example, on rural areas and urban slum areas—in order to promote a more equitable distribution of resources. Policy makers should continue to explore and support efforts to provide financial protection through insurance mechanisms. Past experience suggests that these efforts must be carefully monitored to ensure that the poorer among the insured are able to access scheme benefits, and the quality and quantity of health care provided must be monitored and regulated. PMID:21653545

22 CFR 711.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

....150 Section 711.150 Foreign Relations OVERSEAS PRIVATE INVESTMENT CORPORATION ADMINISTRATIVE... THE OVERSEAS PRIVATE INVESTMENT CORPORATION § 711.150 Program accessibility: Existing facilities. (a... result in a fundamental alteration in the nature of a program or activity or in undue financial and...

The relationship between physical activity facility proximity and leisure-time physical activity in persons with spinal cord injury.

PubMed

Arbour, Kelly P; Martin Ginis, Kathleen A

2009-07-01

Within the general able-bodied population, proximity of one's home to physical activity facilities is modestly associated with physical activity behavior. Currently, no research has examined whether facility proximity is related to physical activity among persons living with disabilities. To examine (1) the level of agreement between perceived and actual proximity to accessible physical activity facilities and (2) the relationship between facility proximity (perceived and actual) and leisure-time physical activity (LTPA) among persons with spinal cord injury (SCI). It was hypothesized that (1) perceived and actual proximity measures would exhibit low agreement and (2) a small, positive relationship would emerge between proximity (perceived and actual) and LTPA. Data from 50 Ontario residents living with SCI (70% male; 52% tetraplegia) were collected for proximity and LTPA. Perceived facility proximity was determined by a self-report "YES" versus "NO" presence measure, while actual facility proximity was assessed using Geographical Information Systems. An SCI-specific instrument, the PARA-SCI, was used to measure LTPA. Low agreement levels were found between perceived and actual proximity. LTPA status (active versus inactive) was shown to moderate the relationship, with higher agreement levels found for participants who reported engaging in mild or heavy LTPA versus their inactive counterparts, but only for the 30-minute wheeling boundary. Contrary to hypothesis, people living within a 30-minute wheel from an accessible facility were less likely to engage in heavy LTPA than were people who did not have an accessible facility located within a 30-minute wheel. No significant associations were found between LTPA and perceived proximity. Living in close proximity to a facility that provides accessible programming and equipment does not necessarily translate into greater physical activity behavior.

Acceptability and Use of Portable Drinking Water and Hand Washing Stations in Health Care Facilities and Their Impact on Patient Hygiene Practices, Western Kenya

PubMed Central

Otieno, Ronald; Odhiambo, Aloyce; Faith, Sitnah H.

2015-01-01

Many health care facilities (HCF) in developing countries lack access to reliable hand washing stations and safe drinking water. To address this problem, we installed portable, low-cost hand washing stations (HWS) and drinking water stations (DWS), and trained healthcare workers (HCW) on hand hygiene, safe drinking water, and patient education techniques at 200 rural HCFs lacking a reliable water supply in western Kenya. We performed a survey at baseline and a follow-up evaluation at 15 months to assess the impact of the intervention at a random sample of 40 HCFs and 391 households nearest to these HCFs. From baseline to follow-up, there was a statistically significant increase in the percentage of dispensaries with access to HWSs with soap (42% vs. 77%, p<0.01) and access to safe drinking water (6% vs. 55%, p<0.01). Female heads of household in the HCF catchment area exhibited statistically significant increases from baseline to follow-up in the ability to state target times for hand washing (10% vs. 35%, p<0.01), perform all four hand washing steps correctly (32% vs. 43%, p = 0.01), and report treatment of stored drinking water using any method (73% vs. 92%, p<0.01); the percentage of households with detectable free residual chlorine in stored drinking water did not change (6%, vs. 8%, p = 0.14). The installation of low-cost, low-maintenance, locally-available, portable hand washing and drinking water stations in rural HCFs without access to 24-hour piped water helped assure that health workers had a place to wash their hands and provide safe drinking water. This HCF intervention may have also contributed to the improvement of hand hygiene and reported safe drinking water behaviors among households nearest to HCFs. PMID:25961293

Acceptability and use of portable drinking water and hand washing stations in health care facilities and their impact on patient hygiene practices, Western kenya.

PubMed

Bennett, Sarah D; Otieno, Ronald; Ayers, Tracy L; Odhiambo, Aloyce; Faith, Sitnah H; Quick, Robert

2015-01-01

Many health care facilities (HCF) in developing countries lack access to reliable hand washing stations and safe drinking water. To address this problem, we installed portable, low-cost hand washing stations (HWS) and drinking water stations (DWS), and trained healthcare workers (HCW) on hand hygiene, safe drinking water, and patient education techniques at 200 rural HCFs lacking a reliable water supply in western Kenya. We performed a survey at baseline and a follow-up evaluation at 15 months to assess the impact of the intervention at a random sample of 40 HCFs and 391 households nearest to these HCFs. From baseline to follow-up, there was a statistically significant increase in the percentage of dispensaries with access to HWSs with soap (42% vs. 77%, p<0.01) and access to safe drinking water (6% vs. 55%, p<0.01). Female heads of household in the HCF catchment area exhibited statistically significant increases from baseline to follow-up in the ability to state target times for hand washing (10% vs. 35%, p<0.01), perform all four hand washing steps correctly (32% vs. 43%, p = 0.01), and report treatment of stored drinking water using any method (73% vs. 92%, p<0.01); the percentage of households with detectable free residual chlorine in stored drinking water did not change (6%, vs. 8%, p = 0.14). The installation of low-cost, low-maintenance, locally-available, portable hand washing and drinking water stations in rural HCFs without access to 24-hour piped water helped assure that health workers had a place to wash their hands and provide safe drinking water. This HCF intervention may have also contributed to the improvement of hand hygiene and reported safe drinking water behaviors among households nearest to HCFs.

Physical access to health facilities and contraceptive use in Kenya: evidence from the 2008-2009 Kenya Demographic and Health Survey.

PubMed

Ettarh, Remare R; Kyobutungi, Catherine

2012-09-01

The objective of the study was to determine the spatial variation in modern contraceptive use and unmet need for family planning across the counties of Kenya and to examine whether the spatial patterns were associated with inequalities in physical access to health facilities. Data were obtained from the 2008-2009 Kenya Demographic and Health Survey and linked to the location of health facilities in the country. Multivariate logistic regression was used to examine the influence of distance to the nearest health facility and health facility density, in addition to other covariates, on modern contraceptive use and unmet need. Overall, the prevalence of modern contraceptive use and unmet need among women aged 15-49 in Kenya was 42.1% and 19.7% respectively. Among the respondents who lived more than 5 km from the nearest health facility modern contraceptive use was significantly less likely compared to women resident 5 km or less from the nearest health facility. Women from counties with higher health facility density were 53% more likely to use modern contraceptives compared to women in counties with low health facility density. Distance and health facility density in the county were not significantly associated with unmet need. Physical access to health facilities is an important determinant of modern contraceptive use and unmet need in Kenya. Strategies should be developed in underserved counties to mitigate the challenge of distance to health facilities, such as delivering services by outreach and mobile facilities.

Scheduled Peripheral Component Interconnect Arbiter

NASA Technical Reports Server (NTRS)

Nixon, Scott Alan (Inventor)

2015-01-01

Systems and methods are described for arbitrating access of a communication bus. In one embodiment, a method includes performing steps on one or more processors. The steps include: receiving an access request from a device of the communication bus; evaluating a bus schedule to determine an importance of the device based on the access request; and selectively granting access of the communication bus to the device based on the importance of the device.

Webinar Presentation: Environmental Exposures and Health Risks in California Child Care Facilities: First Steps to Improve Environmental Health where Children Spend Time

EPA Pesticide Factsheets

This presentation, Environmental Exposures and Health Risks in California Child Care Facilities: First Steps to Improve Environmental Health where Children Spend Time, was given at the NIEHS/EPA Children's Centers 2016 Webinar Series: Exposome.

National Study of Changes in Community Access to School Physical Activity Facilities: The School Health Policies and Programs Study

PubMed Central

Evenson, Kelly R.; Wen, Fang; Lee, Sarah M.; Heinrich, Katie M.; Eyler, Amy

2016-01-01

Background A Healthy People 2010 developmental objective (22-12) was set to increase the proportion of the nation’s public and private schools that provide access to their physical activity spaces and facilities for all persons outside of normal school hours. The purpose of this study was to describe the prevalence of indoor and outdoor facilities at schools and the availability of those facilities to the public in 2000 and 2006. Methods In 2000 and 2006, the School Health Policies and Programs Study (SHPPS) was conducted in each state and in randomly selected districts, schools, and classrooms. This analysis focused on the school level questionnaire from a nationally representative sample of public and nonpublic elementary, middle, and high schools (n = 921 in 2000 and n = 984 in 2006). Results No meaningful changes in the prevalence of access to school physical activity facilities were found from 2000 to 2006, for youth or adult community sports teams, classes, or open gym. Conclusions These national data indicate a lack of progress from 2000 and 2006 toward increasing the proportion of the nation’s public and private schools that provide access to their physical activity facilities for all persons outside of normal school hours. PMID:20440007

An investigation of ADA compliance of aquatic facilities in the North Texas area.

PubMed

Pike, Hilary; Walker, Joseph; Collins, John; Hodges, Jan

2008-01-01

The study expands research on accessibility, comparing compliance scores of aquatic facilities in North Texas built before the 1991 Title III Americans with Disabilities Act Accessibility Guidelines (ADAAG) with facilities built after the 1991 ADAAG and the proposed 2002 supplement. A quasi-experimental design directed the selection of 52 facilities where measurements were taken to determine compliance with ADAAG and the supplement. A focus group provided insight into interpreting which features functioned as barriers or constraints to participation. Metropolitan statistical area in North Texas. A total of 52 aquatic facilities and 12 focus group participants (University of North Texas institutional review board 07-283). ADA aquatic facility compliance instrument. Frequency, ratios. No facilities were 100% ADA compliant overall, although some facilities were 100% compliant with specific structural domains. Women's restrooms rated lowest (average = 55%), and men's restrooms received the second lowest rating (average = 64%). Focus group results indicated that improperly designed restrooms and pool entries are primary barriers to participation. The findings support a need for stronger enforcement of policies that improve accessibility of facilities. Architectural reviews and construction practices need to be improved. The structural barriers and constraints identified can be limiting factors in efforts aimed at increasing physical activity among individuals with disabilities and individuals with physical limitations.

33 CFR 125.07 - Waterfront facility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Waterfront facility. 125.07...) WATERFRONT FACILITIES IDENTIFICATION CREDENTIALS FOR PERSONS REQUIRING ACCESS TO WATERFRONT FACILITIES OR VESSELS § 125.07 Waterfront facility. The term waterfront facility as used in this subchapter, means all...

Developing Poultry Facility Type Information from USDA Agricultural Census Data for Use in Epidemiological and Economic Models

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

Melius, C

2007-12-05

The epidemiological and economic modeling of poultry diseases requires knowing the size, location, and operational type of each poultry type operation within the US. At the present time, the only national database of poultry operations that is available to the general public is the USDA's 2002 Agricultural Census data, published by the National Agricultural Statistics Service, herein referred to as the 'NASS data'. The NASS data provides census data at the county level on poultry operations for various operation types (i.e., layers, broilers, turkeys, ducks, geese). However, the number of farms and sizes of farms for the various types aremore » not independent since some facilities have more than one type of operation. Furthermore, some data on the number of birds represents the number sold, which does not represent the number of birds present at any given time. In addition, any data tabulated by NASS that could identify numbers of birds or other data reported by an individual respondent is suppressed by NASS and coded with a 'D'. To be useful for epidemiological and economic modeling, the NASS data must be converted into a unique set of facility types (farms having similar operational characteristics). The unique set must not double count facilities or birds. At the same time, it must account for all the birds, including those for which the data has been suppressed. Therefore, several data processing steps are required to work back from the published NASS data to obtain a consistent database for individual poultry operations. This technical report documents data processing steps that were used to convert the NASS data into a national poultry facility database with twenty-six facility types (7 egg-laying, 6 broiler, 1 backyard, 3 turkey, and 9 others, representing ducks, geese, ostriches, emus, pigeons, pheasants, quail, game fowl breeders and 'other'). The process involves two major steps. The first step defines the rules used to estimate the data that is suppressed within the NASS database. The first step is similar to the first step used to estimate suppressed data for livestock [Melius et al (2006)]. The second step converts the NASS poultry types into the operational facility types used by the epidemiological and economic model. We also define two additional facility types for high and low risk poultry backyards, and an additional two facility types for live bird markets and swap meets. The distribution of these additional facility types among counties is based on US population census data. The algorithm defining the number of premises and the corresponding distribution among counties and the resulting premises density plots for the continental US are provided.« less

The European perspective for LSST

NASA Astrophysics Data System (ADS)

Gangler, Emmanuel

2017-06-01

LSST is a next generation telescope that will produce an unprecedented data flow. The project goal is to deliver data products such as images and catalogs thus enabling scientific analysis for a wide community of users. As a large scale survey, LSST data will be complementary with other facilities in a wide range of scientific domains, including data from ESA or ESO. European countries have invested in LSST since 2007, in the construction of the camera as well as in the computing effort. This latter will be instrumental in designing the next step: how to distribute LSST data to Europe. Astroinformatics challenges for LSST indeed includes not only the analysis of LSST big data, but also the practical efficiency of the data access.

44 CFR 16.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 16.150 Section 16.150 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE FEDERAL EMERGENCY MANAGEMENT AGENCY § 16.150 Program...

10 CFR 4.550 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE FROM THE COMMISSION Enforcement of Nondiscrimination on the Basis of Handicap in Programs or Activities Conducted by the U.S. Nuclear Regulatory Commission § 4.550 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity...

36 CFR 1154.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... TRANSPORTATION BARRIERS COMPLIANCE BOARD ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE BOARD § 1154.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the...

Comparing countermeasures for mitigating wrong-way entries onto limited access facilities.

DOT National Transportation Integrated Search

2017-03-01

Wrong-way crashes are a major cause for safety concerns along freeways and limited-access facilities. Although wrong-way crashes account for a relatively small portion of total crashes, the impact between two cars crashing into each other at high spe...

Travel by public transit to mammography facilities in 6 US urban areas

PubMed Central

Graham, S; Lewis, B; Flanagan, B; Watson, M; Peipins, L

2017-01-01

We examined lack of private vehicle access and 30 minutes or longer public transportation travel time to mammography facilities for women 40 years of age or older in the urban areas of Boston, Philadelphia, San Antonio, San Diego, Denver, and Seattle to identify transit marginalized populations - women for whom these travel characteristics may jointly present a barrier to clinic access. This ecological study used sex and race/ethnicity data from the 2010 US Census and household vehicle availability data from the American Community Survey 2008–2012, all at Census tract level. Using the public transportation option on Google Trip Planner we obtained the travel time from the centroid of each census tract to all local mammography facilities to determine the nearest mammography facility in each urban area. Median travel times by public transportation to the nearest facility for women with no household access to a private vehicle were obtained by ranking travel time by population group across all U.S. census tracts in each urban area and across the entire study area. The overall median travel times for each urban area for women without household access to a private vehicle ranged from a low of 15 minutes in Boston and Philadelphia to 27 minutes in San Diego. The numbers and percentages of transit marginalized women were then calculated for all urban areas by population group. While black women were less likely to have private vehicle access, and both Hispanic and black women were more likely to be transit marginalized, this outcome varied by urban area. White women constituted the largest number of transit marginalized. Our results indicate that mammography facilities are favorably located for the large majority of women, although there are still substantial numbers for whom travel may likely present a barrier to mammography facility access. PMID:29285434

Operational Philosophy for the Advanced Test Reactor National Scientific User Facility

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

J. Benson; J. Cole; J. Jackson

2013-02-01

In 2007, the Department of Energy (DOE) designated the Advanced Test Reactor (ATR) as a National Scientific User Facility (NSUF). At its core, the ATR NSUF Program combines access to a portion of the available ATR radiation capability, the associated required examination and analysis facilities at the Idaho National Laboratory (INL), and INL staff expertise with novel ideas provided by external contributors (universities, laboratories, and industry). These collaborations define the cutting edge of nuclear technology research in high-temperature and radiation environments, contribute to improved industry performance of current and future light-water reactors (LWRs), and stimulate cooperative research between user groupsmore » conducting basic and applied research. To make possible the broadest access to key national capability, the ATR NSUF formed a partnership program that also makes available access to critical facilities outside of the INL. Finally, the ATR NSUF has established a sample library that allows access to pre-irradiated samples as needed by national research teams.« less

Defining equity in physical access to clinical services using geographical information systems as part of malaria planning and monitoring in Kenya

PubMed Central

Noor, A. M.; Zurovac, D.; Hay, S. I.; Ochola, S. A.; Snow, R. W.

2010-01-01

Summary Distance is a crucial feature of health service use and yet its application and utility to health care planning have not been well explored, particularly in the light of large-scale international and national efforts such as Roll Back Malaria. We have developed a high-resolution map of population-to-service access in four districts of Kenya. Theoretical physical access, based upon national targets, developed as part of the Kenyan health sector reform agenda, was compared with actual health service usage data among 1668 paediatric patients attending 81 sampled government health facilities. Actual and theoretical use were highly correlated. Patients in the larger districts of Kwale and Makueni, where access to government health facilities was relatively poor, travelled greater mean distances than those in Greater Kisii and Bondo. More than 60% of the patients in the four districts attended health facilities within a 5-km range. Interpolated physical access surfaces across districts highlighted areas of poor access and large differences between urban and rural settings. Users from rural communities travelled greater distances to health facilities than those in urban communities. The implications of planning and monitoring equitable delivery of clinical services at national and international levels are discussed. PMID:14516303

Remote sensing from the desktop up, a students's personal stairway to space (Invited)

NASA Astrophysics Data System (ADS)

Church, W.

2013-12-01

Doing science with real-time quantitative experiments is becoming more and more affordable and accessible. Because lab equipment is more affordable and accessible, many universities are using lab class models wherein students conduct their experiments in informal settings such as the dorm, outside, or other places throughout the campus. Students are doing real-time measurements homework outside of class. By liberating experiments from facilities, the hope is to give students more experimental science opportunities. The challenge is support. In lab settings, instructors and peers can help students if they have trouble with the steps of assembling their experimental set-up, configuring the data acquisition software, conducting the real-time measurement and doing the analysis. Students working on their own in a dorm do not benefit from this support. Furthermore, when students are given the open ended experimental task of designing their own measurement system, they may need more guidance. In this poster presentation, I will articulate a triangle model to support students through the task of finding the necessary resources to design and build a mission to space. In the triangle model, students have access to base layer concept and skill resources to help them build their experiment. They then have access to middle layer mini-experiments to help them configure and test their experimental set-up. Finally, they have a motivating real-time experiment. As an example of this type of resource used in practice, I will have a balloon science remote sensing project as a stand-in for a balloon mission to 100,000 feet. I will use an Arduino based DAQ system and XBee modules for wireless data transmission to a LabVIEW front-panel. I will attach the DAQ to a tethered balloon to conduct a real-time microclimate experiment in the Moscone Center. Expanded microclimate studies can be the capstone project or can be a stepping-stone to space wherein students prepare a sensor package for a weather balloon launch to 100,000 feet.

Barriers and outcomes: TB patients co-infected with HIV accessing antiretroviral therapy in rural Zambia.

PubMed

Chileshe, Muatale; Bond, Virginia Anne

2010-01-01

The vulnerabilities that underlie barriers faced by the rural poor whilst trying to access and adhere to "free" antiretroviral treatment (ART) demand more attention. This paper highlights barriers that poor rural Zambians co-infected with tuberculosis (TB) and HIV and their households faced in accessing ART between September 2006 and July 2007, and accounts for patient outcomes by the end of TB treatment and (more sporadically) beyond October 2009. The analysis draws on findings from wider anthropological fieldwork on the converging impact of TB, HIV and food insecurity, focusing for the purpose of this paper on ethnographic case-studies of seven newly diagnosed TB patients co-infected with HIV and their six households (one household had two TB patients). Economic barriers included being pushed into deeper poverty by managing TB, rural location, absence of any external assistance, and mustering time and extended funds for transport and "special food" during and beyond the end of TB. In the case of death, funeral costs were astronomical. Social barriers included translocation, broken marriages, a sub-ordinate household position, gender relations, denial, TB/HIV stigma and the difficulty of disclosure. Health facility barriers involved understaffing, many steps, lengthy procedures and inefficiencies (lost blood samples, electricity cuts). By the end of TB treatment, outcomes were mixed; two co-infected patients had died, three had started ART and two had yet to start ART. The three on ART underwent a striking transformation in the short term. By October 2009, two more had died and three were doing well. The study advocates nutritional support and other material support (especially transport funds) for co-infected TB patients until ART is accessed and livelihood regained. More prompt diagnosis of TB and reducing steps and increasing the reach of the ART programme in rural areas are also recommended.

Variation in fistula use across dialysis facilities: is it explained by case-mix?

PubMed

Tangri, Navdeep; Moorthi, Ranjani; Tighiouhart, Hocine; Meyer, Klemens B; Miskulin, Dana C

2010-02-01

Arteriovenous fistulas (AVFs) remain the preferred vascular access for hemodialysis patients. Dialysis facilities that fail to meet Centers for Medicare & Medicaid Services goals cite patient case-mix as a reason for low AVF prevalence. This study aimed to determine the magnitude of the variability in AVF usage across dialysis facilities and the extent to which patient case-mix explains it. The vascular access used in 10,112 patients dialyzed at 173 Dialysis Clinic Inc. facilities from October 1 to December 31, 2004, was evaluated. The access in use was considered to be an AVF if it was used for >70% of hemodialysis treatments. Mixed-effects models with a random intercept for dialysis facilities evaluated the effect of facilities on AVF usage. Sequentially adjusted multivariate models measured the extent to which patient factors (case-mix) explain variation across facilities in AVF rates. 3787 patients (38%) were dialyzed using AVFs. There was a significant facility effect: 7.6% of variation in AVF use was attributable to facility. This was reduced to 7.1% after case-mix adjustment. There were no identified specific facility-level factors that explained the interfacility variation. AVF usage varies across dialysis facilities, and patient case-mix did not reduce this variation. In this study, 92% of the total variation in AVF usage was due to patient factors, but most were not measurable. A combination of patient factors and process indicators should be considered in adjudicating facility performance for this quality indicator.

WaveNet: A Web-Based Metocean Data Access, Processing and Analysis Tool. Part 4 - GLOS/GLCFS Database

DTIC Science & Technology

2014-06-01

and Coastal Data Information Program ( CDIP ). This User’s Guide includes step-by-step instructions for accessing the GLOS/GLCFS database via WaveNet...access, processing and analysis tool; part 3 – CDIP database. ERDC/CHL CHETN-xx-14. Vicksburg, MS: U.S. Army Engineer Research and Development Center

Cost and unit cost calculations using step-down accounting.

PubMed

Conteh, Lesong; Walker, Damian

2004-03-01

There is paucity of unit cost data from low- and middle-income countries, although recent initiatives have emerged to help rectify this. The limited budgets assigned to health care facilities mean that health planners and managers must be able to account for the resources used in health facilities as well as use them efficiently. Step-down cost accounting (SDCA) offers a relatively simple method for generating cost and unit cost data at the facility level. However, to the best of our knowledge, there is a lack of clear and concise guidance on how to undertake SDCA. Therefore, this paper, using a worked example, illustrates the different steps involved to generate cost and unit costs for a small hospital.

Preparing The U.S. Air Force for Military Operations Other Than War,

DTIC Science & Technology

1997-01-01

Step 1: Detect and Identify WMD Facilities 70 5.5. Step 2: Neutralize WMD Facilities 71 5.6. Step 3: Conduct BDA Following Attack on...FUTURE It would generally appear that there is no way to predict whether global instability will mushroom . In any case, there is not necessarily a...serious enough problem, then the United States should do some- thing about it. Thus, policymakers often feel compelled by pubic and media pressures to

5 CFR 723.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... facilities. 723.150 Section 723.150 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL... ACTIVITIES CONDUCTED BY THE OFFICE OF PERSONNEL MANAGEMENT § 723.150 Program accessibility: Existing... would result in a fundamental alteration in the nature of a program or activity or in undue financial...

22 CFR 1600.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Program accessibility: Existing facilities. 1600.150 Section 1600.150 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED STATES FRIENDSHIP...

22 CFR 1600.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 2 2012-04-01 2009-04-01 true Program accessibility: Existing facilities. 1600.150 Section 1600.150 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED STATES FRIENDSHIP...

22 CFR 1600.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Program accessibility: Existing facilities. 1600.150 Section 1600.150 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED STATES FRIENDSHIP...

22 CFR 1600.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Program accessibility: Existing facilities. 1600.150 Section 1600.150 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED STATES FRIENDSHIP...

22 CFR 142.16 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Foreign Relations DEPARTMENT OF STATE CIVIL RIGHTS NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS... part is viewed in its entirety it is readily accessible to and usable by handicapped persons. This... facility accessible to and usable by handicapped persons. (b) Methods. A recipient may comply with the...

22 CFR 142.16 - Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Foreign Relations DEPARTMENT OF STATE CIVIL RIGHTS NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS... part is viewed in its entirety it is readily accessible to and usable by handicapped persons. This... facility accessible to and usable by handicapped persons. (b) Methods. A recipient may comply with the...

22 CFR 142.16 - Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Foreign Relations DEPARTMENT OF STATE CIVIL RIGHTS NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS... part is viewed in its entirety it is readily accessible to and usable by handicapped persons. This... facility accessible to and usable by handicapped persons. (b) Methods. A recipient may comply with the...

22 CFR 142.16 - Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Foreign Relations DEPARTMENT OF STATE CIVIL RIGHTS NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS... part is viewed in its entirety it is readily accessible to and usable by handicapped persons. This... facility accessible to and usable by handicapped persons. (b) Methods. A recipient may comply with the...

22 CFR 142.16 - Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Foreign Relations DEPARTMENT OF STATE CIVIL RIGHTS NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS... part is viewed in its entirety it is readily accessible to and usable by handicapped persons. This... facility accessible to and usable by handicapped persons. (b) Methods. A recipient may comply with the...

14 CFR § 1251.302 - New construction.

Code of Federal Regulations, 2014 CFR

2014-01-01

... OF HANDICAP Accessibility § 1251.302 New construction. (a) Design and construction. Each facility or... handicapped persons, if the construction (ground breaking) was commenced after the effective date of this part... manner that the altered portion of the facility is readily accessible to and usable by handicapped...

10 CFR 4.550 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Program accessibility: Existing facilities. 4.550 Section 4.550 Energy NUCLEAR REGULATORY COMMISSION NONDISCRIMINATION IN FEDERALLY ASSISTED PROGRAMS OR... changes shall be made by August 22, 1989, but in any event as expeditiously as possible. (d) Transition...

10 CFR 1041.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Program accessibility: Existing facilities. 1041.150 Section 1041.150 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF ENERGY § 1041.150 Program...

10 CFR 1041.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Program accessibility: Existing facilities. 1041.150 Section 1041.150 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF ENERGY § 1041.150 Program...

10 CFR 1041.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Program accessibility: Existing facilities. 1041.150 Section 1041.150 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF ENERGY § 1041.150 Program...

10 CFR 1041.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Program accessibility: Existing facilities. 1041.150 Section 1041.150 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF ENERGY § 1041.150 Program...

10 CFR 4.550 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Program accessibility: Existing facilities. 4.550 Section 4.550 Energy NUCLEAR REGULATORY COMMISSION NONDISCRIMINATION IN FEDERALLY ASSISTED PROGRAMS OR... changes shall be made by August 22, 1989, but in any event as expeditiously as possible. (d) Transition...

10 CFR 1041.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Program accessibility: Existing facilities. 1041.150 Section 1041.150 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF ENERGY § 1041.150 Program...

22 CFR 1600.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Program accessibility: Existing facilities. 1600.150 Section 1600.150 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED STATES FRIENDSHIP...

Airport offsite passenger service facilities : an option for improving landside access. Volume II, Access characteristics and travel demand.

DOT National Transportation Integrated Search

2009-01-01

Offsite airport facilities provide ground transportation, baggage and passenger check in, and other transportation services to departing air passengers from a remote location. The purpose of this study was to develop models to determine the airports ...

Orbiter processing facility: Access platforms Kennedy Space Center, Florida, from challenge to achievement

NASA Technical Reports Server (NTRS)

Haratunian, M.

1985-01-01

A system of access platforms and equipment within the space shuttle orbiter processing facility at Kennedy Space Center is described. The design challenges of the platforms, including clearance envelopes, load criteria, and movement, are discussed. Various applications of moveable platforms are considered.

32 CFR 1699.150 - Program accessibility: existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... SYSTEM ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY SELECTIVE SERVICE SYSTEM § 1699.150 Program accessibility: existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is...

An exploration of the socio-economic profile of women and costs of receiving abortion services at public health facilities of Madhya Pradesh, India.

PubMed

Banerjee, Sushanta K; Kumar, Rakesh; Warvadekar, Janardan; Manning, Vinoj; Andersen, Kathryn Louise

2017-03-21

Maternal mortality, which primarily burdens developing countries, reflects the greatest health divide between rich and poor. This is especially pronounced for access to safe abortion services which alone avert 1 of every 10 maternal deaths in India. Primarily due to confidentiality concerns, poor women in India prefer private services which are often offered by untrained providers and may be expensive. In 2006 the state government of Madhya Pradesh (population 73 million) began a concerted effort to ensure access to safe abortion services at public health facilities to both rural and urban poor women. This study aims to understand the socio-economic profile of women seeking abortion services in public health facilities across this state and out of pocket cost accessing abortion services. In particular, we examine the level of access that poor women have to safe abortion services in Madhya Pradesh. This study consisted of a cross-sectional client follow-up design. A total of 19 facilities were selected using two-stage random sampling and 1036 women presenting to chosen facilities with abortion and post-abortion complications were interviewed between May and December 2014. A structured data collection tool was developed. A composite wealth index computed using principal component analysis derived weights from consumer durables and asset holding and classified women into three categories, poor, moderate, and rich. Findings highlight that overall 57% of women who received abortion care at public health facilities were poor, followed by 21% moderate and 22% rich. More poor women sought care at primary level facilities (58%) than secondary level facilities and among women presenting for postabortion complications (67%) than induced abortion. Women reported spending no money to access abortion services as abortion services are free of cost at public facilities. However, poor women spend INR 64 (1 USD) while visiting primary level facilities and INR 256 (USD 4) while visiting urban hospitals, primarily for transportation and food. Improved availability of safe abortion services at the primary level in Madhya Pradesh has helped meeting the need of safe abortion services among poor, which eventually will help reducing the maternal mortality and morbidity due to unsafe abortion.

Developing Livestock Facility Type Information from USDA Agricultural Census Data for Use in Epidemiological and Economic Models

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

Melius, C; Robertson, A; Hullinger, P

2006-10-24

The epidemiological and economic modeling of livestock diseases requires knowing the size, location, and operational type of each livestock facility within the US. At the present time, the only national database of livestock facilities that is available to the general public is the USDA's 2002 Agricultural Census data, published by the National Agricultural Statistics Service, herein referred to as the 'NASS data.' The NASS data provides facility data at the county level for various livestock types (i.e., beef cows, milk cows, cattle on feed, other cattle, total hogs and pigs, sheep and lambs, milk goats, and angora goats). However, themore » number and sizes of facilities for the various livestock types are not independent since some facilities have more than one type of livestock, and some livestock are of more than one type (e.g., 'other cattle' that are being fed for slaughter are also 'cattle on feed'). In addition, any data tabulated by NASS that could identify numbers of animals or other data reported by an individual respondent is suppressed by NASS and coded with a 'D.'. To be useful for epidemiological and economic modeling, the NASS data must be converted into a unique set of facility types (farms having similar operational characteristics). The unique set must not double count facilities or animals. At the same time, it must account for all the animals, including those for which the data has been suppressed. Therefore, several data processing steps are required to work back from the published NASS data to obtain a consistent database for individual livestock operations. This technical report documents data processing steps that were used to convert the NASS data into a national livestock facility database with twenty-eight facility types. The process involves two major steps. The first step defines the rules used to estimate the data that is suppressed within the NASS database. The second step converts the NASS livestock types into the operational facility types used by the epidemiological and economic model. Comparison of the resulting database with an independent survey of farms in central California shows excellent agreement between the numbers of farms for the various facility types. This suggests that the NASS data are well suited for providing a consistent set of county-level information on facility numbers and sizes that can be used in epidemiological and economic models.« less

What capacity exists to provide essential inpatient care to small and sick newborns in a high mortality urban setting? - A cross-sectional study in Nairobi City County, Kenya

PubMed Central

Gathara, David; Abuya, Nancy; Mwachiro, Jacintah; Ochola, Sam; Ayisi, Robert; English, Mike

2018-01-01

Introduction Appropriate demand for, and supply of, high quality essential neonatal care is key to improving newborn survival but evaluating such provision has received limited attention in low- and middle-income countries. Moreover, specific local data are needed to support healthcare planning for this vulnerable population. Methods We conducted health facility assessments between July 2015-April 2016, with retrospective review of admission events between 1st July 2014 and 30th June 2015, and used estimates of population-based incidence of neonatal conditions in Nairobi to explore access and evaluate readiness of public, private not-for-profit (mission), and private-for-profit (private) sector facilities providing 24/7 inpatient neonatal care in Nairobi City County. Results In total, 33 (4 public, 6 mission, and 23 private) facilities providing 24/7 inpatient neonatal care in Nairobi City County were identified, 31 were studied in detail. Four public sector facilities, including the only three facilities in which services were free, accounted for 71% (8,630/12,202) of all neonatal admissions. Large facilities (>900 annual admissions) with adequate infrastructure tended to have high bed occupancy (over 100% in two facilities), high mortality (15%), and high patient to nurse ratios (7–15 patients per nurse). Twenty-one smaller, predominantly private, facilities were judged insufficiently resourced to provide adequate care. In many of these, nurses provided newborn and maternity care simultaneously using resources shared across settings, newborn care experience was likely to be limited (<50 cases per year), there was often no resident clinician, and sick babies were often referred onwards. Results suggest 44% (9,764/21,966) of Nairobi’s small and sick newborns may not access any of the identified facilities and a further 9% (2,026/21,966) access facilities judged to be inadequately equipped. Conclusion Over 50% of Nairobi’s sick newborns may not access a facility with adequate resources to provide essential care. A very high proportion of care accessed is provided by four public and one low cost mission facility; these face major challenges of high patient acuity (high mortality), high patient to nurse ratios, and often overcrowding. Reducing high neonatal mortality in this urban, predominantly poor, population will require effective long-term, multi-sectoral planning and investment. PMID:29702700

Investigating the accessibility factors that influence antenatal care services utilisation in Mangwe district, Zimbabwe

PubMed Central

Tugli, Augustine K.; Mpofu, Molyn

2017-01-01

Background Maternal and infant mortality remains a huge public health problem in developing countries. One of the strategies to minimise the risks of both maternal and infant mortality is access to and utilisation of antenatal care (ANC) services. Aim This study aimed to investigate the accessibility factors that influence the use of ANC services in Mangwe district. Methods A qualitative approach using explorative design was adopted to target women who have babies under 1 year of age. The study was conducted in Mangwe district, Matabeleland South province, Zimbabwe. Data were collected through semi-structured interviews and observations. Data saturation was reached after 15 women who were conveniently sampled were interviewed. Field notes were analysed thematically using Tech’s steps. Lincoln and Guba’s criteria ensured trustworthiness of the study findings. Results Accessibility factors such as lack of transport, high transport costs and long distances to health care facilities, health care workers’ attitudes, type and quality of services as well as delays in receiving care influence women’s utilisation of ANC services in Mangwe district, Zimbabwe. Conclusion The study concluded that women were still facing problems of unavailability of nearby clinics; therefore, it was recommended that the government should avail resources for women to use. Recommendations Mangwe District Health Department should provide mobile clinics rendering ANC services in distant rural areas. PMID:28697619

40 CFR 35.917 - Facilities planning (step 1).

Code of Federal Regulations, 2012 CFR

2012-07-01

... plans. (b) Facilities planning consists of those necessary plans and studies which directly relate to... environmental and social considerations. (See appendix A to this subpart.) (c) EPA requires full compliance with... be initiated before award of a step 1 grant or written approval of a plan of study (see § 35.920-3(a...

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

PubMed

Miller, N A

1992-05-01

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

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

Background 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. Methods 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. Results 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. Conclusions To 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

Access to primary health care for acute vascular events in rural low income settings: a mixed methods study.

PubMed

Ahmed, Shyfuddin; Chowdhury, Muhammad Ashique Haider; Khan, Md Alfazal; Huq, Nafisa Lira; Naheed, Aliya

2017-01-18

Cardiovascular diseases (CVDs) are the leading cause of global mortality. Among the CVDs, acute vascular events (AVE) mainly ischemic heart diseases and stroke are the largest contributors. To achieve 25% reduction in preventable deaths from CVDs by 2025, health systems need to be equipped with extended service coverage in order to provide person-centered care. The overall goal of this proposed study is to assess access to health care in-terms of service availability, care seeking patterns and barriers to access care after AVE in rural Bangladesh. We will consider myocardial infarction (MI) and stroke as acute vascular events. We will conduct a mixed methods study in rural Matlab, Bangladesh. This study will comprise of a) health facility survey, b) structured questionnaire interview and c) qualitative study. We will assess service availabilities by creating an inventory of public and private health facilities. Readiness of the facilities to deliver services for AVE will be assessed through a health facility survey using 'service availability and readiness assessment' (SARA) tools of the World Health Organization (WHO). We will interview survivors of AVE and caregivers (present and accompanied the person during the event) of person who died from AVE for exploring patterns of care seeking during an AVE. For exploring barriers to access care for AVE, we will conduct in-depth interview with survivors of AVE and caregivers of the person who died from AVE. We will also conduct key informant interviews with the service providers at primary health care (PHC) facilities and government high level officials at central health administration of Bangladesh. This study will provide a comprehensive picture of access to primary health care services during acute cardiovascular events as stroke & MI in rural context of Bangladesh. It will explore available service facilities in rural area for management, utilization of services and barriers to access care during an acute emergency. This study will help to generate hypothesis, develop programs and policies for better access to care for AVE in similar rural settings considering barriers of access and improving utilization.

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 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.

International Human Rights and the Mistreatment of Women During Childbirth

PubMed Central

Zampas, Christina; Vogel, Joshua P.; Bohren, Meghan A.; Roseman, Mindy; Erdman, Joanna N.

2016-01-01

Abstract International human rights bodies have played a critical role in codifying, setting standards, and monitoring human rights violations in the context of sexual and reproductive health and rights. In recent years, these institutions have developed and applied human rights standards in the more particular context of maternal mortality and morbidity, and have increasingly recognized a critical human rights issue in the provision and experience of care during and after pregnancy, including during childbirth. However, the international human rights standards on mistreatment during facility-based childbirth remain, in an early stage of development, focused largely on a discrete subset of experiences, such as forced sterilization and lack of access to emergency obstetric care. As a consequence, the range of mistreatment that women may experience has not been adequately addressed or analyzed under international human rights law. Identifying human rights norms and standards related to the full range of documented mistreatment is thus a first step towards addressing violations of human rights during facility-based childbirth, ensuring respectful and humane treatment, and developing a program of work to improve the overall quality of maternal care. This article reviews international human rights standards related to the mistreatment of women during childbirth in facility settings under regional and international human rights law and lays out an agenda for further research and action. PMID:28559681

International Human Rights and the Mistreatment of Women During Childbirth.

PubMed

Khosla, Rajat; Zampas, Christina; Vogel, Joshua P; Bohren, Meghan A; Roseman, Mindy; Erdman, Joanna N

2016-12-01

International human rights bodies have played a critical role in codifying, setting standards, and monitoring human rights violations in the context of sexual and reproductive health and rights. In recent years, these institutions have developed and applied human rights standards in the more particular context of maternal mortality and morbidity, and have increasingly recognized a critical human rights issue in the provision and experience of care during and after pregnancy, including during childbirth. However, the international human rights standards on mistreatment during facility-based childbirth remain, in an early stage of development, focused largely on a discrete subset of experiences, such as forced sterilization and lack of access to emergency obstetric care. As a consequence, the range of mistreatment that women may experience has not been adequately addressed or analyzed under international human rights law. Identifying human rights norms and standards related to the full range of documented mistreatment is thus a first step towards addressing violations of human rights during facility-based childbirth, ensuring respectful and humane treatment, and developing a program of work to improve the overall quality of maternal care. This article reviews international human rights standards related to the mistreatment of women during childbirth in facility settings under regional and international human rights law and lays out an agenda for further research and action.

Extremely large telescopes as a motor of socio-economic development and implications of their construction and installation

NASA Astrophysics Data System (ADS)

Burgos-Martin, J.; Sanchez-Padron, M.; Sanchez, F.; Martinez-Roger, Carlos

2004-07-01

Large-Scale observing facilities are scarce and costly. Even so, the perspective to enlarge or to increase the number of these facilities are quite real and several projects are undertaking their first steps in this direction. These costly facilities require the cooperation of highly qualified institutions, able to undertake the project from the scientific and technological point of view, as well as the vital collaboration and effective support of several countries, at the highest level, able to provide the necessary investment for their construction. Because of these technological implications and the financial magnitude of these projects, their impact goes well beyond the international astrophysical community. We propose to carry out a study on the socio-economic impact from the construction and operation of an Extremely Large Telescope of class 30 - 100 m. We plan to approach several aspects such as its impact in the promotion of the employment; social, educational and cultural integration of the population; the impulse of industries; its impact on the national and international policies on research; environmental issues; etc. We will also analyze the financial instruments available, and those special aids only accessible for some countries and regions to encourage their participation in projects of this magnitude.

Impact of early initiation versus national standard of care of antiretroviral therapy in Swaziland's public sector health system: study protocol for a stepped-wedge randomized trial.

PubMed

Walsh, Fiona J; Bärnighausen, Till; Delva, Wim; Fleming, Yvette; Khumalo, Gavin; Lejeune, Charlotte L; Mazibuko, Sikhathele; Mlambo, Charmaine Khudzie; Reis, Ria; Spiegelman, Donna; Zwane, Mandisa; Okello, Velephi

2017-08-18

There is robust clinical evidence to support offering early access to antiretroviral treatment (ART) to all HIV-positive individuals, irrespective of disease stage, to both improve patient health outcomes and reduce HIV incidence. However, as the global treatment guidelines shift to meet this evidence, it is still largely unknown if early access to ART for all (also referred to as "treatment as prevention" or "universal test and treat") is a feasible intervention in the resource-limited countries where this approach could have the biggest impact on the course of the HIV epidemics. The MaxART Early Access to ART for All (EAAA) implementation study was designed to determine the feasibility, acceptability, clinical outcomes, affordability, and scalability of offering early antiretroviral treatment to all HIV-positive individuals in Swaziland's public sector health system. This is a three-year stepped-wedge randomized design with open enrollment for all adults aged 18 years and older across 14 government-managed health facilities in Swaziland's Hhohho Region. Primary endpoints are retention and viral suppression. Secondary endpoints include ART initiation, adherence, drug resistance, tuberculosis, HIV disease progression, patient satisfaction, and cost per patient per year. Sites are grouped to transition two at a time from the control (standard of care) to intervention (EAAA) stage at each four-month step. This design will result in approximately one half of the total observation time to accrue in the intervention arm and the other half in the control arm. Our estimated enrolment number, which is supported by conservative power calculations, is 4501 patients over the course of the 36-month study period. A multidisciplinary, mixed-methods approach will be adopted to supplement the randomized controlled trial and meet the study aims. Additional study components include implementation science, social science, economic evaluation, and predictive HIV incidence modeling. A stepped-wedge randomized design is a causally strong and robust approach to determine if providing antiretroviral treatment for all HIV-positive individuals is a feasible intervention in a resource-limited, public sector health system. We expect our study results to contribute to health policy decisions related to the HIV response in Swaziland and other countries in sub-Saharan Africa. ClinicalTrials.gov, NCT02909218 . Registered on 10 July 2016.

A Cross Sectional Study of the Association between Sanitation Type and Fecal Contamination of the Household Environment in Rural Bangladesh.

PubMed

Huda, Tarique Md Nurul; Schmidt, Wolf-Peter; Pickering, Amy J; Mahmud, Zahid Hayat; Islam, Mohammad Sirajul; Rahman, Md Sajjadur; Luby, Stephen P; Biran, Adam

2018-04-01

We conducted a cross sectional study to assess 1) the association between access to basic sanitation and fecal contamination of sentinel toy balls and 2) if other sanitation factors such as shared use and cleanliness are associated with fecal contamination of sentinel toy balls. We assessed sanitation facilities in 454 households with a child aged 6-24 months in rural Bangladesh. We defined "basic" sanitation as access to improved sanitation facilities (pit latrine with a slab or better) not shared with other households. In each household, an identical toy ball was given to the target child. After 24 hours, the balls were rinsed to enumerate fecal coliforms as an indicator of household fecal contamination. Households with basic sanitation had lower fecal coliform contamination than households with no access to basic sanitation (adjusted difference in means: -0.31 log 10 colony forming units [CFU]/toy ball; 95% confidence interval [CI]: -0.61, -0.01). Shared sanitation facilities of otherwise improved type were more likely to have visible feces on the latrine slab compared with private facilities. Among households with access to improved sanitation, households with no visible feces on the latrine slab had less toy ball contamination than households with visible feces on the latrine slab (adjusted difference in means: -0.38 log 10 CFU/toy ball; 95% CI: -0.77, 0.02). Access to basic sanitation may prevent fecal contamination of the household environment. An Improved sanitation facility used by an individual household may be better in preventing household fecal contamination compared with improved facilities shared with other households.

41 CFR 51-10.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Program accessibility: Existing facilities. 51-10.150 Section 51-10.150 Public Contracts and Property Management Other Provisions... result in a fundamental alteration in the nature of a program or activity or in undue financial and...

75 FR 56163 - Nondiscrimination on the Basis of Disability in State and Local Government Services

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-15

... and maintain accessibility guidelines for facilities designed, constructed, altered, or leased with... Design for purposes of subchapters II and III of this chapter * * * to ensure that buildings, facilities, rail passenger cars, and vehicles are accessible, in terms of architecture and design, transportation...

12 CFR 268.707 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Programs and Activities Because of Physical or Mental Disability § 268.707 Program accessibility: Existing facilities. (a) General. The Board shall operate each program or activity so that the program or activity... can demonstrate would result in a fundamental alteration in the nature of a program or activity or in...

12 CFR 268.707 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Programs and Activities Because of Physical or Mental Disability § 268.707 Program accessibility: Existing facilities. (a) General. The Board shall operate each program or activity so that the program or activity... can demonstrate would result in a fundamental alteration in the nature of a program or activity or in...

46 CFR 507.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE FEDERAL MARITIME COMMISSION... and usable by handicapped persons. This paragraph does not— (1) Necessarily require the agency to make each of its existing facilities accessible to and usable by handicapped persons; (2) In the case of...

34 CFR 105.32 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Program accessibility: Existing facilities. 105.32 Section 105.32 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES...

34 CFR 1200.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false Program accessibility: Existing facilities. 1200.150 Section 1200.150 Education Regulations of the Offices of the Department of Education (Continued) NATIONAL... Architectural Barriers Act of 1968, as amended (42 U.S.C. 4151-4157), and any regulations implementing it. In...

31 CFR 17.150 - Program accessibility; Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

...'s facilities that limit the physical accessibility of its programs or activities to individuals with... ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE... operate each program or activity so that the program or activity, when viewed in its entirety, is readily...

45 CFR 1214.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ACTIVITIES CONDUCTED BY ACTION § 1214.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens...

77 FR 1498 - Draft Environmental Assessment and Proposed Single-Species Habitat Conservation Plan for the...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-10

... wind turbines and associated facilities and access roads, maintenance of the wind turbines and... include constructing and installing the wind turbines and associated electrical facilities and access... new 230- kilovolt substation (to be built on an existing pad), maintaining the new wind turbines and...

12 CFR 410.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Program accessibility: Existing facilities. 410.150 Section 410.150 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY EXPORT-IMPORT BANK OF THE UNITED...

22 CFR 1005.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Program accessibility: Existing facilities. 1005.150 Section 1005.150 Foreign Relations INTER-AMERICAN FOUNDATION ENFORCEMENT OF NONDISCRIMINATION ON... undertaken, such changes shall be made by August 22, 1989, but in any event as expeditiously as possible. (d...

Can contracted out health facilities improve access, equity, and quality of maternal and newborn health services? Evidence from Pakistan.

PubMed

Zaidi, Shehla; Riaz, Atif; Rabbani, Fauziah; Azam, Syed Iqbal; Imran, Syeda Nida; Pradhan, Nouhseen Akber; Khan, Gul Nawaz

2015-11-25

The case of contracting out government health services to non-governmental organizations (NGOs) has been weak for maternal, newborn, and child health (MNCH) services, with documented gains being mainly in curative services. We present an in-depth assessment of the comparative advantages of contracting out on MNCH access, quality, and equity, using a case study from Pakistan. An end-line, cross-sectional assessment was conducted of government facilities contracted out to a large national NGO and government-managed centres serving as controls, in two remote rural districts of Pakistan. Contracting out was specific for augmenting MNCH services but without contractual performance incentives. A household survey, a health facility survey, and focus group discussions with client and spouses were used for assessment. Contracted out facilities had a significantly higher utilization as compared to control facilities for antenatal care, delivery, postnatal care, emergency obstetric care, and neonatal illness. Contracted facilities had comparatively better quality of MNCH services but not in all aspects. Better household practices were also seen in the district where contracting involved administrative control over outreach programs. Contracting was also faced with certain drawbacks. Facility utilization was inequitably higher amongst more educated and affluent clients. Contracted out catchments had higher out-of-pocket expenses on MNCH services, driven by steeper transport costs and user charges for additional diagnostics. Contracting out did not influence higher MNCH service coverage rates across the catchment. Physical distances, inadequate transport, and low demand for facility-based care in non-emergency settings were key client-reported barriers. Contracting out MNCH services at government health facilities can improve facility utilization and bring some improvement in  quality of services. However, contracting out of health facilities is insufficient to increase service access across the catchment in remote rural contexts and requires accompanying measures for demand enhancement, transportation access, and targeting of the more disadvantaged clientele.

Tracking implementation and (un)intended consequences: a process evaluation of an innovative peripheral health facility financing mechanism in Kenya.

PubMed

Waweru, Evelyn; Goodman, Catherine; Kedenge, Sarah; Tsofa, Benjamin; Molyneux, Sassy

2016-03-01

In many African countries, user fees have failed to achieve intended access and quality of care improvements. Subsequent user fee reduction or elimination policies have often been poorly planned, without alternative sources of income for facilities. We describe early implementation of an innovative national health financing intervention in Kenya; the health sector services fund (HSSF). In HSSF, central funds are credited directly into a facility's bank account quarterly, and facility funds are managed by health facility management committees (HFMCs) including community representatives. HSSF is therefore a finance mechanism with potential to increase access to funds for peripheral facilities, support user fee reduction and improve equity in access. We conducted a process evaluation of HSSF implementation based on a theory of change underpinning the intervention. Methods included interviews at national, district and facility levels, facility record reviews, a structured exit survey and a document review. We found impressive achievements: HSSF funds were reaching facilities; funds were being overseen and used in a way that strengthened transparency and community involvement; and health workers' motivation and patient satisfaction improved. Challenges or unintended outcomes included: complex and centralized accounting requirements undermining efficiency; interactions between HSSF and user fees leading to difficulties in accessing crucial user fee funds; and some relationship problems between key players. Although user fees charged had not increased, national reduction policies were still not being adhered to. Finance mechanisms can have a strong positive impact on peripheral facilities, and HFMCs can play a valuable role in managing facilities. Although fiduciary oversight is essential, mechanisms should allow for local decision-making and ensure that unmanageable paperwork is avoided. There are also limits to what can be achieved with relatively small funds in contexts of enormous need. Process evaluations tracking (un)intended consequences of interventions can contribute to regional financing and decentralization debates. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

A prototype of Virtual Observatory access for planetary data in the framework of Europlanet-RI/IDIS

NASA Astrophysics Data System (ADS)

Gangloff, M.; Cecconi, B.; Bourrel, N.; Jacquey, C.; Le Sidaner, P.; Berthier, J.; André, N.; Pallier, E.; Erard, S.; Aboudarham, J.; Chanteur, G. M.; Capria, M. T.; Khodachenko, M.; Manaud, N.; Schmidt, W.; Schmitt, B.; Topf, F.; Trautan, F.; Sarkissian, A.

2011-12-01

Europlanet RI is a four-year project supported by the European Union under the Seventh Framework Programme. Launched in January 2009, it is an Integrated Infrastructure Initiative, ie. A combination of Networking Activities, Transnational Access Activities and Joint Research Activities. The Networking Activities aim at further fostering a culture of cooperation in the field of Planetary Sciences. The objective of the Transnational Access Activities is to provide transnational access to a range of laboratory and field site facilities tailored to the needs of planetary research and on-line access to the available planetary science data, information and software tools, through the IDIS e-service. The overall aim of the Joint Research Activities (JRA) is to improve the services provided by the ensemble of Transnational Access Activities. In EuroPlaNet-RI, JRA4 must prepare essential tools for IDIS (Integrated and Distributed Information Service) allowing the planetary science community to interrogate some selected data centres, access and process data and visualize the results. This is the first step towards a Planetary Virtual Observatory. The first requirement for different data centres to be able to operate together collectively is adequate standardization. In particular a common description of data and services is essential. This is why the major part of JRA4/Task2 activity is focussing on data models, associated dictionnaries, and protocols to exchange queries. A specific data model is being developed for IDIS, associated with the PDAP protocol, a standard defined by the IPDA (International Planetary Data Alliance) The scope of this prototype is to demonstrate the capabilities of the IDIS Data Model, and the PDAP protocol to search and retrieve data in the wide topical planetology context.

Energy poverty in healthcare facilities: a "silent barrier" to improved healthcare in sub-Saharan Africa.

PubMed

Ouedraogo, Nadia S; Schimanski, Caroline

2018-06-27

This paper addresses an important topic, energy poverty in healthcare facilities. We try to provide an interesting perspective on bringing together two SDGs. The SDG 7, which seeks to ensure access to affordable, sustainable, and modern energy for all, is interlinked with Goal 3 on Health. The literature studies as well as data on the subject are sparse. Nevertheless, a systematic documentation of the levels and variation in access to energy at the health-facility level is important for designing effective policies to improve the quality of healthcare and the ultimate health of the population. Using the 2012-2013 Senegal Service Provision Assessment (SCSPA), we assessed energy access in health facilities and health systems' performance. Data were also geocoded using ArcGIS 10.3 to give a snapshot of the situation.

Optimizing the process of recovery after road network break-up

NASA Astrophysics Data System (ADS)

Bíl, Michal; Vodák, Rostislav; Křivánková, Zuzana

2016-04-01

A functioning road network provides accessibility to municipalities, important services and facilities. This basic role of the network can be disrupted by natural disasters which usually affect large areas and cause temporal blockages or even destruction of many roads at the same time. This often leads to road network break-up, when a number of disconnected parts emerge. These parts are often of varying importance to society. Some of them may contain large cities or important facilities such as hospitals. This should be reflected during reconnection works when the most important parts of the network should be reconnected among the first in order to reduce the impact of the event. Decision makers and crisis managers, however, do still not have any dynamic tool which might help them with prioritizing the necessary steps. In our presentation we introduce an algorithm and examples of suitable loss functions which enable us to rapidly identify isolated parts of the network, evaluate them and consequently establish an optimal ranked sequence of interrupted links which have to be repaired to reduce the consequences of the disasters.

Kennedy Space Center

NASA Technical Reports Server (NTRS)

Griffin, Amanda

2012-01-01

Among 2011's many accomplishments, we safely retired the Space Shuttle Program after 30 incredible years; completed the International Space Station and are taking steps to enable it to reach its full potential as a multi-purpose laboratory; and helped to expand scientific knowledge with missions like Aquarius, GRAIL, and the Mars Science Laboratory. Responding to national budget challenges, we are prioritizing critical capabilities and divesting ourselves of assets no longer needed for NASA's future exploration programs. Since these facilities do not have to be maintained or demolished, the government saves money. At the same time, our commercial partners save money because they do not have to build new facilities. It is a win-win for everyone. Moving forward, 2012 will be even more historically significant as we celebrate the 50th Anniversary of Kennedy Space Center. In the coming year, KSC will facilitate commercial transportation to low-Earth orbit and support the evolution of the Space Launch System and Orion crew vehicle as they ready for exploration missions, which will shape how human beings view the universe. While NASA's Vision is to lead scientific and technological advances in aeronautics and space for a Nation on the frontier of discovery KSC's vision is to be the world's preeminent launch complex for government and commercial space access, enabling the world to explore and work in space. KSC's Mission is to safely manage, develop, integrate, and sustain space systems through partnerships that enable innovative, diverse access to space and inspires the Nation's future explorers.

Using GIS and perceived distance to understand the unequal geographies of healthcare in lower-income urban neighbourhoods.

PubMed

Hawthorne, Timothy L; Kwan, Mei-Po

2012-01-01

Geographers play important roles in public health research, particularly in understanding healthcare accessibility, utilisation, and individual healthcare experiences. Most accessibility studies have benefited from the increased sophistication of geographic information systems (GIS). Some studies have been enhanced with semi-structured in-depth interviews to understand individual experiences of people as they access healthcare. However, few accessibility studies have explicitly utilised individual in-depth interview data in the construction of new GIS accessibility measures. Using mixed methods including GIS analysis and individual data from semi-structured in-depth interviews, we offer satisfaction-adjusted distance as a new way of conceptualising accessibility in GIS. Based on fieldwork in a predominantly lower-income community in Columbus, Ohio (USA), we find many residents felt neighbourhood healthcare facilities offered low-quality care, which suggested an added perceived distance as they attempt to access high-quality healthcare facilities. The satisfaction-adjusted distance measure accounts for the perceived distance some residents feel as they search for high-quality healthcare in lower-income urban neighbourhoods. In moving beyond conventional GIS and re-conceptualising accessibility in this way, we offer a more realistic portrayal of the issues lower-income urban residents face as they attempt to access high-quality healthcare facilities. The work has theoretical implications for conceptualising healthcare accessibility, advances the mixed-methodologies literature, and argues for a more equitable distribution of high-quality healthcare in urban neighbourhoods.

Do free caesarean section policies increase inequalities in Benin and Mali?

PubMed

Ravit, Marion; Audibert, Martine; Ridde, Valéry; De Loenzien, Myriam; Schantz, Clémence; Dumont, Alexandre

2018-06-05

Benin and Mali introduced user fee exemption policies focused on caesarean sections (C-sections) in 2005 and 2009, respectively. These policies had a positive impact on access to C-sections and facility based deliveries among all women, but the impact on socioeconomic inequality is still highly uncertain. The objective of this study was to observe whether there was an increase or a decrease in urban/rural and socioeconomic inequalities in access to C-sections and facility based deliveries after the free C-section policy was introduced. We used data from three consecutive Demographic and Health Surveys (DHS): 2001, 2006 and 2011-2012 in Benin and 2001, 2006 and 2012-13 in Mali. We evaluated trends in inequality in terms of two outcomes: C-sections and facility based deliveries. Adjusted odds ratios were used to estimate whether the distributions of C-sections and facility based deliveries favoured the least advantaged categories (rural, non-educated and poorest women) or the most advantaged categories (urban, educated and richest women). Concentration curves were used to observe the degree of wealth-related inequality in access to C-sections and facility based deliveries. We analysed 47,302 childbirths (23,266 in Benin and 24,036 in Mali). In Benin, we found no significant difference in access to C-sections between urban and rural women or between educated and non-educated women. However, the richest women had greater access to C-sections than the poorest women. There was no significant change in these inequalities in terms of access to C-sections and facility based deliveries after introduction of the free C-section policy. In Mali, we found a reduction in education-related inequalities in access to C-sections after implementation of the policy (p-value = 0.043). Inequalities between urban and rural areas had already decreased prior to implementation of the policy, but wealth-related inequalities were still present. Urban/rural and socioeconomic inequalities in C-section access did not change substantially after the countries implemented free C-section policies. User fee exemption is not enough. We recommend switching to mechanisms that combine both a universal approach and targeted action for vulnerable populations to address this issue and ensure equal health care access for all individuals.

Using Workflow Diagrams to Address Hand Hygiene in Pediatric Long-Term Care Facilities1

PubMed Central

Carter, Eileen J.; Cohen, Bevin; Murray, Meghan T.; Saiman, Lisa; Larson, Elaine L.

2015-01-01

Hand hygiene (HH) in pediatric long-term care settings has been found to be sub-optimal. Multidisciplinary teams at three pediatric long-term care facilities developed step-by-step workflow diagrams of commonly performed tasks highlighting HH opportunities. Diagrams were validated through observation of tasks and concurrent diagram assessment. Facility teams developed six workflow diagrams that underwent 22 validation observations. Four main themes emerged: 1) diagram specificity, 2) wording and layout, 3) timing of HH indications, and 4) environmental hygiene. The development of workflow diagrams is an opportunity to identify and address the complexity of HH in pediatric long-term care facilities. PMID:25773517

Assessment of the proportion of neonates and children in low and middle income countries with access to a healthcare facility: A systematic review

PubMed Central

2011-01-01

Background Comprehensive antenatal, perinatal and early postnatal care has the potential to significantly reduce the 3.58 million neonatal deaths that occur annually worldwide. This paper systematically reviews data on the proportion of neonates and children < 5 years of age that have access to health facilities in low and middle income countries. Gaps in available data by WHO region are identified, and an agenda for future research and advocacy is proposed. Methods For this paper, "utilization" was used as a proxy for "access" to a healthcare facility, and the term "facility" was used for any clinic or hospital outside of a person's home staffed by a "medical professional". A systematic literature search was conducted for published studies of children up to 5 years of age that included the neonatal age group with an illness or illness symptoms in which health facility utilization was quantified. In addition, information from available Demographic and Health Surveys (DHS) was extracted. Results The initial broad search yielded 2,239 articles, of which 14 presented relevant data. From the community-based neonatal studies conducted in the Southeast Asia region with the goal of enhancing care-seeking for neonates with sepsis, the 10-48% of sick neonates in the studies' control arms utilized a healthcare facility. Data from cross-sectional surveys involving young children indicate that 12 to 86% utilizing healthcare facilities when sick. From the DHS surveys, a global median of 58.1% of infants < 6 months were taken to a facility for symptoms of ARI. Conclusions There is a scarcity of data regarding the access to facility-based care for sick neonates/young children in many areas of the world; it was not possible to generalize an overall number of neonates or young children that utilize a healthcare facility when showing signs and symptoms of illness. The estimate ranges were broad, and there was a paucity of data from some regions. It is imperative that researchers, advocates, and policy makers join together to better understand the factors affecting health care utilization/access for newborns in different settings and what the barriers are that prevent children from being taken to a facility in a timely manner. PMID:22166258

Non-physician communities in Japan: are they still disadvantaged?

PubMed

Kashima, S; Inoue, K; Matsumoto, M; Takeuchi, K

2014-01-01

Non-physician community' (NPC) is a policy term that indicates a medically underserved area in Japan. Designated NPCs are politically targeted as the foci of medical resource allocation. NPC is defined as a specified district where 50 or more persons dwell within a geographic diameter of 4 km and medical care is not easily accessible. The definition of NPC was first introduced in 1960 and has been unchanged for more than half a century despite radical social changes in rural Japan. This study examines whether designated NPCs are still more disadvantaged in terms of geographical access to healthcare in comparison to other communities. Hiroshima prefecture, which has the largest number of NPCs in terms of tertiary healthcare areas of Japan, was used as the study area. Targeted communities were all the NPCs in the prefecture, and, as controls, two community groups were selected: non-NPC adjacent to NPC, and municipal center. We measured driving time from NPCs and control communities to the nearest healthcare facilities, which were classified into the following two types: primary or secondary care facilities (n=2636) and tertiary care facilities (equal to tertiary emergency care centers; n=6). We further calculated the driving time to the nearest facilities for secondary emergency care (n=246) extracted from the 2636 primary or secondary care facilities. The median driving times to the nearest primary or secondary healthcare facility for NPC, non-NPC, and municipal center were 11 minutes, 11 minutes, and 1 minute, respectively; the times to a tertiary healthcare facility (equal to an accident and emergency care center) were 80 minutes, 84 minutes, and 68 minutes, respectively; and the times to a secondary emergency care facility were 24 minutes, 18 minutes, and 15 minutes, respectively. Although a municipal center was significantly more advantageous in driving time compared to a primary or secondary care facility, the disadvantage of a NPC in access was no more obvious than an adjacent non-NPC for any type of healthcare facility. NPCs had a disadvantage in access time to primary, secondary and tertiary medical care compared with a municipal center. NPCs, however, did not have a greater access disadvantage in comparison to adjacent rural communities for any type of medical facility. As such, future resource allocation policies in Japan need to redefine medically underserved communities.

36 CFR 1191.1 - Accessibility guidelines.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Accessibility guidelines... COMPLIANCE BOARD AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY GUIDELINES FOR BUILDINGS AND FACILITIES; ARCHITECTURAL BARRIERS ACT (ABA) ACCESSIBILITY GUIDELINES § 1191.1 Accessibility guidelines. (a) The...

Informed push distribution of contraceptives in Senegal reduces stockouts and improves quality of family planning services.

PubMed

Daff, Bocar Mamadou; Seck, Cheikh; Belkhayat, Hassan; Sutton, Perri

2014-05-01

Contraceptive use in Senegal is among the lowest in the world and has barely increased over the past 5 years, from 10% of married women in 2005 to 12% in 2011. Contraceptive stockouts in public facilities, where 85% of women access family planning services, are common. In 2011, we conducted a supply chain study of 33 public-sector facilities in Pikine and Guediawaye districts of the Dakar region to understand the magnitude and root causes of stockouts. The study included stock audits, surveys with 156 consumers, and interviews with facility staff, managers, and other stakeholders. At the facility level, stockouts of injectables and implants occurred, on average, 43% and 83% of the year, respectively. At least 60% of stockouts occurred despite stock availability at the national level. Data from interviews revealed that the current "pull-based" distribution system was complex and inefficient. In order to reduce stockout rates to the commercial-sector standard of 2% or less, the Government of Senegal and the Senegal Urban Reproductive Health Initiative developed the informed push distribution model (IPM) and pilot-tested it in Pikine district between February 2012 and July 2012. IPM brings the source of supply (a delivery truck loaded with supplies) closer to the source of demand (clients in health facilities) and streamlines the steps in between. With a professional logistician managing stock and deliveries, the health facilities no longer need to place and pick up orders. Stockouts of contraceptive pills, injectables, implants, and intrauterine devices (IUDs) were completely eliminated at the 14 public health facilities in Pikine over the 6-month pilot phase. The government expanded IPM to all 140 public facilities in the Dakar region, and 6 months later stockout rates throughout the region dropped to less than 2%. National coverage of the IPM is expected by July 2015.

Informed push distribution of contraceptives in Senegal reduces stockouts and improves quality of family planning services

PubMed Central

Daff, Bocar Mamadou; Seck, Cheikh; Belkhayat, Hassan; Sutton, Perri

2014-01-01

Contraceptive use in Senegal is among the lowest in the world and has barely increased over the past 5 years, from 10% of married women in 2005 to 12% in 2011. Contraceptive stockouts in public facilities, where 85% of women access family planning services, are common. In 2011, we conducted a supply chain study of 33 public-sector facilities in Pikine and Guediawaye districts of the Dakar region to understand the magnitude and root causes of stockouts. The study included stock audits, surveys with 156 consumers, and interviews with facility staff, managers, and other stakeholders. At the facility level, stockouts of injectables and implants occurred, on average, 43% and 83% of the year, respectively. At least 60% of stockouts occurred despite stock availability at the national level. Data from interviews revealed that the current “pull-based” distribution system was complex and inefficient. In order to reduce stockout rates to the commercial-sector standard of 2% or less, the Government of Senegal and the Senegal Urban Reproductive Health Initiative developed the informed push distribution model (IPM) and pilot-tested it in Pikine district between February 2012 and July 2012. IPM brings the source of supply (a delivery truck loaded with supplies) closer to the source of demand (clients in health facilities) and streamlines the steps in between. With a professional logistician managing stock and deliveries, the health facilities no longer need to place and pick up orders. Stockouts of contraceptive pills, injectables, implants, and intrauterine devices (IUDs) were completely eliminated at the 14 public health facilities in Pikine over the 6-month pilot phase. The government expanded IPM to all 140 public facilities in the Dakar region, and 6 months later stockout rates throughout the region dropped to less than 2%. National coverage of the IPM is expected by July 2015. PMID:25276582

Access to Core Facilities and Other Research Resources Provided by the Clinical and Translational Science Awards

PubMed Central

2012-01-01

Abstract  Principal investigators who received Clinical and Translational Science Awards created academic homes for biomedical research. They developed program‐supported websites to offer coordinated access to a range of core facilities and other research resources. Visitors to the 60 websites will find at least 170 generic services, which this review has categorized in the following seven areas: (1) core facilities, (2) biomedical informatics, (3) funding, (4) regulatory knowledge and support, (5) biostatistics, epidemiology, research design, and ethics, (6) participant and clinical interaction resources, and (7) community engagement. In addition, many websites facilitate access to resources with search engines, navigators, studios, project development teams, collaboration tools, communication systems, and teaching tools. Each of these websites may be accessed from a single site, http://www.CTSAcentral.org. The ability to access the research resources from 60 of the nation's academic health centers presents a novel opportunity for investigators engaged in clinical and translational research. Clin Trans Sci 2012; Volume #: 1–5 PMID:22376262

Access to core facilities and other research resources provided by the Clinical and Translational Science Awards.

PubMed

Rosenblum, Daniel

2012-02-01

Principal investigators who received Clinical and Translational Science Awards created academic homes for biomedical research. They developed program-supported websites to offer coordinated access to a range of core facilities and other research resources. Visitors to the 60 websites will find at least 170 generic services, which this review has categorized in the following seven areas: (1) core facilities, (2) biomedical informatics, (3) funding, (4) regulatory knowledge and support, (5) biostatistics, epidemiology, research design, and ethics, (6) participant and clinical interaction resources, and (7) community engagement. In addition, many websites facilitate access to resources with search engines, navigators, studios, project development teams, collaboration tools, communication systems, and teaching tools. Each of these websites may be accessed from a single site, http://www.CTSAcentral.org. The ability to access the research resources from 60 of the nation's academic health centers presents a novel opportunity for investigators engaged in clinical and translational research. © 2012 Wiley Periodicals, Inc.

Decline in Radiation Hardened Microcircuit Infrastructure

NASA Technical Reports Server (NTRS)

LaBel, Kenneth A.

2015-01-01

Two areas of radiation hardened microcircuit infrastructure will be discussed: 1) The availability and performance of radiation hardened microcircuits, and, and 2) The access to radiation test facilities primarily for proton single event effects (SEE) testing. Other areas not discussed, but are a concern include: The challenge for maintaining radiation effects tool access for assurance purposes, and, the access to radiation test facilities primarily for heavy ion single event effects (SEE) testing. Status and implications will be discussed for each area.

77 FR 24646 - Open Access and Priority Rights on Interconnection Facilities

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-25

... multiple generation facilities to transmit power from the generation facility to the integrated... power flows toward the network grid, with no electrical loads between the generation facilities and the... generator expansion plans with milestones for construction of generation facilities and can demonstrate that...

30 CFR 57.20008 - Toilet facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Toilet facilities. 57.20008 Section 57.20008....20008 Toilet facilities. (a) Toilet facilities shall be provided at locations that are compatible with the mine operations and that are readily accessible to mine personnel. (b) The facilities shall be...

VICS-120 - A tube-vehicle system test facility.

NASA Technical Reports Server (NTRS)

Marte, J. E.

1973-01-01

Description of a large test facility for carrying out research in support of the aerodynamic and ventilation section of a handbook on subway design. The facility described is vertically oriented and has a test section with a nominal inside diameter of 2 in. and a length of 109 ft. It is capable of operating at Reynolds numbers up to full-scale (60,000,000) under open-end tube conditions. The facility is distinguished by a high degree of flexibility in configuration and operational limits. Details are given concerning the plenum assembly, the test section tubes, the scaffold, the instrumentation, the model launcher, the model arrestor, and the models themselves. A step-by-step account is given of the operation of the facility, and a brief sample of the type of data obtained from the facility is presented.

Longitudinal Household Trends in Access to Improved Water Sources and Sanitation in Chi Linh Town, Hai Duong Province, Viet Nam and Associated Factors.

PubMed

Tuyet-Hanh, Tran Thi; Long, Tran Khanh; Van Minh, Hoang; Huong, Le Thi Thanh

2016-01-01

This study aims to characterize household trends in access to improved water sources and sanitaton in Chi Linh Town, Hai Duong Province, Vietnam, and to identify factors affecting those trends. Data were extracted from the Chi Linh Health and Demographic Surveillance System (CHILILAB HDSS) database from 2004-2014, which included household access to improved water sources, household access to improved sanitation, and household demographic data. Descriptive statistical analysis and multinominal logistic regression were used. The results showed that over a 10-year period (2004-2014), the proportion of households with access to improved water and improved sanitation increased by 3.7% and 28.3%, respectively. As such, the 2015 Millennium Development Goal targets for safe drinking water and basic sanitation were met. However, 13.5% of households still had unimproved water and sanitation. People who are retired, work in trade or services, or other occupations were 1.49, 1.97, and 1.34 times more likely to have access to improved water and sanitation facilities than farming households, respectively ( p < 0.001). Households living in urban areas were 1.84 times more likely than those living in rural areas to have access to improved water sources and improved sanitation facilities (OR =1.84; 95% CI = 1.73-1.96). Non-poor households were 2.12 times more likely to have access to improved water sources and improved sanitation facilities compared to the poor group (OR = 2.12; 95% CI = 2.00-2.25). More efforts are required to increase household access to both improved water and sanitation in Chi Linh Town, focusing on the 13.5% of households currently without access. Similar to situations observed elsewhere in Vietnam and other low- and middle- income countries, there is a need to address socio-economic factors that are associated with inadequate access to improved water sources and sanitation facilities.

76 FR 75844 - Accessibility Guidelines for Pedestrian Facilities in the Public Right-of-Way; Reopening of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-05

... additional time to review and more fully assess the proposed rule. In addition, just prior to the closing of...: Notice of proposed rulemaking; reopening of comment period. SUMMARY: The Architectural and Transportation... notice entitled ``Accessibility Guidelines for Pedestrian Facilities in the Public Right-of-Way,'' that...

Telescope Bibliography Cookbook: Creating a Database of Scientific Papers that Use Observational Data

NASA Astrophysics Data System (ADS)

Kitt, S.; Grothkopf, U.

2010-10-01

This paper explains the procedures involved in creating a database of scientific papers that use observational data and linking the records to the observations residing in a data archive. Based on our experiences with the ESO Telescope Bibliography, we describe the workflow we apply in order to retrieve relevant articles, assign tags to describe the observing facilities that generated the data, and identify the correct program identification numbers (IDs). These program identifiers are particularly important as they link the published papers and the underlying data and enable scientists to access the data for new studies. With the understanding that the difficulty of compiling correct and complete data varies, depending on the information readily provided in the published literature, this paper proposes an evolution of search options for finding appropriate ID numbers. To explore the process and its various stages, we use the analogy of the "cookbook." These search methodologies might be labeled fast, medium, and slow heat recipes within our culinary theme. We provide a step-by-step guide in order to assist other bibliography compilers, in particular those who are new to the field.

Tracking implementation and (un)intended consequences: a process evaluation of an innovative peripheral health facility financing mechanism in Kenya

PubMed Central

Waweru, Evelyn; Goodman, Catherine; Kedenge, Sarah; Tsofa, Benjamin; Molyneux, Sassy

2016-01-01

In many African countries, user fees have failed to achieve intended access and quality of care improvements. Subsequent user fee reduction or elimination policies have often been poorly planned, without alternative sources of income for facilities. We describe early implementation of an innovative national health financing intervention in Kenya; the health sector services fund (HSSF). In HSSF, central funds are credited directly into a facility’s bank account quarterly, and facility funds are managed by health facility management committees (HFMCs) including community representatives. HSSF is therefore a finance mechanism with potential to increase access to funds for peripheral facilities, support user fee reduction and improve equity in access. We conducted a process evaluation of HSSF implementation based on a theory of change underpinning the intervention. Methods included interviews at national, district and facility levels, facility record reviews, a structured exit survey and a document review. We found impressive achievements: HSSF funds were reaching facilities; funds were being overseen and used in a way that strengthened transparency and community involvement; and health workers’ motivation and patient satisfaction improved. Challenges or unintended outcomes included: complex and centralized accounting requirements undermining efficiency; interactions between HSSF and user fees leading to difficulties in accessing crucial user fee funds; and some relationship problems between key players. Although user fees charged had not increased, national reduction policies were still not being adhered to. Finance mechanisms can have a strong positive impact on peripheral facilities, and HFMCs can play a valuable role in managing facilities. Although fiduciary oversight is essential, mechanisms should allow for local decision-making and ensure that unmanageable paperwork is avoided. There are also limits to what can be achieved with relatively small funds in contexts of enormous need. Process evaluations tracking (un)intended consequences of interventions can contribute to regional financing and decentralization debates. PMID:25920355

State Requirements for Educational Facilities, 1997.

ERIC Educational Resources Information Center

Florida State Dept. of Education, Tallahassee. Office of Educational Facilities.

This document updates Florida's deregulation of construction of educational facilities guidelines, while keeping as the primary focus the safety of the students in pre-K through community college facilities. Organized by the sequence of steps required in the facilities procurement process, it covers general definitions, property…

Availability of essential health services in post-conflict Liberia.

PubMed

Kruk, Margaret E; Rockers, Peter C; Williams, Elizabeth H; Varpilah, S Tornorlah; Macauley, Rose; Saydee, Geetor; Galea, Sandro

2010-07-01

To assess the availability of essential health services in northern Liberia in 2008, five years after the end of the civil war. We carried out a population-based household survey in rural Nimba county and a health facility survey in clinics and hospitals nearest to study villages. We evaluated access to facilities that provide index essential services: artemisinin combination therapy for malaria, integrated management of childhood illness, human immunodeficiency virus (HIV) counselling and testing, basic emergency obstetric care and treatment of mental illness. Data were obtained from 1405 individuals (98% response rate) selected with a three-stage population-representative sampling method, and from 43 of Nimba county's 49 health facilities selected because of proximity to the study villages. Respondents travelled an average of 136 minutes to reach a health facility. All respondents could access malaria treatment at the nearest facility and 55.9% could access HIV testing. Only 26.8%, 14.5%, and 12.1% could access emergency obstetric care, integrated management of child illness and mental health services, respectively. Although there has been progress in providing basic services, rural Liberians still have limited access to life-saving health care. The reasons for the disparities in the services available to the population are technical and political. More frequently available services (HIV testing, malaria treatment) were less complex to implement and represented diseases favoured by bilateral and multilateral health sector donors. Systematic investments in the health system are required to ensure that health services respond to current and future health priorities.

30 CFR 56.20008 - Toilet facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Toilet facilities. 56.20008 Section 56.20008... Toilet facilities. (a) Toilet facilities shall be provided at locations that are compatible with the mine operations and that are readily accessible to mine personnel. (b) The facilities shall be kept clean and...

Synthetic nat- or ent-steroids in as few as five chemical steps from epichlorohydrin

NASA Astrophysics Data System (ADS)

Kim, Wan Shin; Du, Kang; Eastman, Alan; Hughes, Russell P.; Micalizio, Glenn C.

2018-01-01

Today, more than 100 Food and Drug Administration-approved steroidal agents are prescribed daily for indications including heart failure, inflammation, pain and cancer. While triumphs in organic chemistry have enabled the establishment and sustained growth of the steroid pharmaceutical industry, the production of highly functionalized synthetic steroids of varying substitution and stereochemistry remains challenging, despite the numerous reports of elegant strategies for their de novo synthesis. Here, we describe an advance in chemical synthesis that has established an enantiospecific means to access novel steroids with unprecedented facility and flexibility through the sequential use of two powerful ring-forming reactions: a modern metallacycle-mediated annulative cross-coupling and a new acid-catalysed vinylcyclopropane rearrangement cascade. In addition to accessing synthetic steroids of either enantiomeric series, these steroidal products have been selectively functionalized within each of the four carbocyclic rings, a synthetic ent-steroid has been prepared on a multigram scale, the enantiomer of a selective oestrogen has been synthesized, and a novel ent-steroid with growth inhibitory properties in three cancer cell lines has been discovered.

The association between high recreational physical activity and physical activity as a part of daily living in adolescents and availability of local indoor sports facilities and sports clubs.

PubMed

Niclasen, Birgit; Petzold, Max; Schnohr, Christina W

2012-11-01

The aim of this study was to examine how vigorous physical activity (recreational physical activity) (VPA) and moderate to vigorous physical activity as a part of daily life (MVPA) is associated with structural characteristics (availability of sports facilities and sports clubs with child members) in Greenlandic adolescents. Data from the 2006 Health Behaviour in School-aged Children survey including 2,430 children aged 11-17 years was used. Logistic regression models were developed with dichotomous measures on VPA and MVPA as outcomes, number of indoor sports facilities and of sports clubs with child members as independent variables, and adjusted for age, gender, family affluence (FAS), and type of habitation (capital, town or village). High VPA increased with access to indoor facilities, while high MVPA was less likely (odds ratio (OR) 0.54 (0.42-0.70)) if indoor sports facilities were present, both unadjusted and adjusted. Access to a local sports club increased OR for high VPA both unadjusted and adjusted to about 2.3 for five or more clubs, while access to sports clubs was not associated with unadjusted MVPA, negatively associated if adjusted for age, gender and FAS but positively associated if also adjusted for indoor sports facilities. Access to indoor sports facilities itself had a positive association with high VPA, but was persistently negatively associated with high MVPA. Presence of sports clubs with child members was positively associated with high VPA while the association with high MVPA was more complex. The findings have implications for public health planning.

BWI terminal accessibility study.

DOT National Transportation Integrated Search

2001-12-01

This study details the landside accessibility of the BWI airport. The accessibility of the airport is examined from : each of the access facilities. Included in the study are the terminal garage, ESP parking lot, all satellite lots and : terminal cur...

Availability and accessibility of subsidized mammogram screening program in peninsular Malaysia: A preliminary study using travel impedance approach.

PubMed

Mahmud, Aidalina; Aljunid, Syed Mohamed

2018-01-01

Access to healthcare is essential in the pursuit of universal health coverage. Components of access are availability, accessibility (spatial and non-spatial), affordability and acceptability. Measuring spatial accessibility is common approach to evaluating access to health care. This study aimed to determine the availability and spatial accessibility of subsidised mammogram screening in Peninsular Malaysia. Availability was determined from the number and distribution of facilities. Spatial accessibility was determined using the travel impedance approach to represent the revealed access as opposed to potential access measured by other spatial measurement methods. The driving distance of return trips from the respondent's residence to the facilities was determined using a mapping application. The travel expenditure was estimated by multiplying the total travel distance by a standardised travel allowance rate, plus parking fees. Respondents in this study were 344 breast cancer patients who received treatment at 4 referral hospitals between 2015 and 2016. In terms of availability, there were at least 6 major entities which provided subsidised mammogram programs. Facilities with mammogram involved with these programs were located more densely in the central and west coast region of the Peninsula. The ratio of mammogram facility to the target population of women aged 40-74 years ranged between 1: 10,000 and 1:80,000. In terms of accessibility, of the 3.6% of the respondents had undergone mammogram screening, their mean travel distance was 53.4 km (SD = 34.5, range 8-112 km) and the mean travel expenditure was RM 38.97 (SD = 24.00, range RM7.60-78.40). Among those who did not go for mammogram screening, the estimated travel distance and expenditure had a skewed distribution with median travel distance of 22.0 km (IQR 12.0, 42.0, range 2.0-340.0) and the median travel cost of RM 17.40 (IQR 10.40, 30.00, range 3.40-240.00). Higher travel impedance was noted among those who lived in sub-urban and rural areas. In summary, availability of mammogram facilities was good in the central and west coast of the peninsula. The overall provider-to-population ratio was lower than recommended. Based on the travel impedance approach used, accessibility to subsidised mammogram screening among the respondents was good in urban areas but deprived in other areas. This study was a preliminary study with limitations. Nonetheless, the evidence suggests that actions have to be taken to improve the accessibility to opportunistic mammogram screening in Malaysia in pursuit of universal health coverage.

Planners guide for estimating cost per user-day of proposed recreational facilities.

Treesearch

Roger D. Fight

1980-01-01

In the absence of prices for nonmarketed outdoor recreational services provided by public agencies, it is not possible to do a complete benefit cost analysis for proposed facilities for recreation. Good information on the cost of providing recreational services to the public is nonetheless important. This paper provides a step-by-step procedure that recreation planners...

A Guide for Developing Standard Operating Job Procedures for the Screening & Grinding Process Wastewater Treatment Facility. SOJP No. 1.

ERIC Educational Resources Information Center

Deal, Gerald A.; Montgomery, James A.

This guide describes standard operating job procedures for the screening and grinding process of wastewater treatment facilities. The objective of this process is the removal of coarse materials from the raw waste stream for the protection of subsequent equipment and processes. The guide gives step-by-step instructions for safety inspection,…

A Guide for Developing Standard Operating Job Procedures for the Sludge Thickening Process Wastewater Treatment Facility. SOJP No. 9.

ERIC Educational Resources Information Center

Schwing, Carl M.

This guide describes standard operating job procedures for the screening and grinding process of wastewater treatment facilities. The objective of this process is the removal of coarse materials from the raw waste stream for the protection of subsequent equipment and processes. The guide gives step-by-step instructions for safety inspection,…

A Guide for Developing Standard Operating Job Procedures for the Digestion Process Wastewater Treatment Facility. SOJP No. 10.

ERIC Educational Resources Information Center

Schwing, Carl M.

This guide describes standard operating job procedures for the digestion process of wastewater treatment facilities. This process is for reducing the volume of sludge to be treated in subsequent units and to reduce the volatile content of sludge. The guide gives step-by-step instructions for pre-startup, startup, continuous operating, shutdown,…

Scissors Mode of 162 Dy Studied from Resonance Neutron Capture

DOE PAGES

Baramsai, B.; Bečvář, F.; Bredeweg, T. A.; ...

2015-05-28

Multi-step cascade γ-ray spectra from the neutron capture at isolated resonances of 161Dy nucleus were measured at the LANSCE/DANCE time-of-flight facility in Los Alamos National Laboratory. The objectives of this experiment were to confirm and possibly extend the spin assignment of s-wave neutron resonances and get new information on photon strength functions with emphasis on the role of the M1 scissors mode vibration. The preliminary results show that the scissors mode plays a significant role in all transitions between accessible states of the studied nucleus. The photon strength functions describing well our data are compared to results from 3He-induced reactions,more » (n,γ) experiments on Gd isotopes, and (γ,γ’) reactions.« less

Next step in Studying the Ultraviolet Universe: WSO-UV

NASA Astrophysics Data System (ADS)

Shustov, Boris M.; Sachkov, Mikhail; Gomez De Castro, Ana

The World Space Observatory-Ultraviolet (WSO-UV) is an international space mission born as a response to the growing up demand for UV facilities by the astronomical community. In the horizon of the next 10 years, the WSO-UV will be the only 2-meters class mission in the after-HST epoch that will guarantee access to UV wavelength domain. The project is managed by an international consortium led by the Federal Space Agency (ROSCOSMOS, Russia). Here we describe the WSO-UV project with its general objectives and main features, the details and status of instrumentation that includes WUVS (spectrographs) and the ISSIS instrument (Field Camera Unit), WSO-UV ground segment, science management plan, the WSO-UV key science issues and prospects of high resolution spectroscopic studies with WSO-UV.

A minimalist approach to stereoselective glycosylation with unprotected donors.

PubMed

Le Mai Hoang, Kim; He, Jing-Xi; Báti, Gábor; Chan-Park, Mary B; Liu, Xue-Wei

2017-10-27

Mechanistic study of carbohydrate interactions in biological systems calls for the chemical synthesis of these complex structures. Owing to the specific stereo-configuration at each anomeric linkage and diversity in branching, significant breakthroughs in recent years have focused on either stereoselective glycosylation methods or facile assembly of glycan chains. Here, we introduce the unification approach that offers both stereoselective glycosidic bond formation and removal of protection/deprotection steps required for further elongation. Using dialkylboryl triflate as an in situ masking reagent, a wide array of glycosyl donors carrying one to three unprotected hydroxyl groups reacts with various glycosyl acceptors to furnish the desired products with good control over regioselectivity and stereoselectivity. This approach demonstrates the feasibility of straightforward access to important structural scaffolds for complex glycoconjugate synthesis.

30 CFR 56.20008 - Toilet facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... operations and that are readily accessible to mine personnel. (b) The facilities shall be kept clean and sanitary. Separate toilet facilities shall be provided for each sex except where toilet rooms will be...

30 CFR 56.20008 - Toilet facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... operations and that are readily accessible to mine personnel. (b) The facilities shall be kept clean and sanitary. Separate toilet facilities shall be provided for each sex except where toilet rooms will be...

30 CFR 56.20008 - Toilet facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... operations and that are readily accessible to mine personnel. (b) The facilities shall be kept clean and sanitary. Separate toilet facilities shall be provided for each sex except where toilet rooms will be...

30 CFR 56.20008 - Toilet facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... operations and that are readily accessible to mine personnel. (b) The facilities shall be kept clean and sanitary. Separate toilet facilities shall be provided for each sex except where toilet rooms will be...

Airspace Operations Demo Functional Requirements Matrix

NASA Technical Reports Server (NTRS)

2005-01-01

The Flight IPT assessed the reasonableness of demonstrating each of the Access 5 Step 1 functional requirements. The functional requirements listed in this matrix are from the September 2005 release of the Access 5 Functional Requirements Document. The demonstration mission considered was a notional Western US mission (WUS). The conclusion of the assessment is that 90% of the Access 5 Step 1 functional requirements can be demonstrated using the notional Western US mission.

Developing stepped care treatment for depression (STEPS): study protocol for a pilot randomised controlled trial.

PubMed

Hill, Jacqueline J; Kuyken, Willem; Richards, David A

2014-11-20

Stepped care is recommended and implemented as a means to organise depression treatment. Compared with alternative systems, it is assumed to achieve equivalent clinical effects and greater efficiency. However, no trials have examined these assumptions. A fully powered trial of stepped care compared with intensive psychological therapy is required but a number of methodological and procedural uncertainties associated with the conduct of a large trial need to be addressed first. STEPS (Developing stepped care treatment for depression) is a mixed methods study to address uncertainties associated with a large-scale evaluation of stepped care compared with high-intensity psychological therapy alone for the treatment of depression. We will conduct a pilot randomised controlled trial with an embedded process study. Quantitative trial data on recruitment, retention and the pathway of patients through treatment will be used to assess feasibility. Outcome data on the effects of stepped care compared with high-intensity therapy alone will inform a sample size calculation for a definitive trial. Qualitative interviews will be undertaken to explore what people think of our trial methods and procedures and the stepped care intervention. A minimum of 60 patients with Major Depressive Disorder will be recruited from an Improving Access to Psychological Therapies service and randomly allocated to receive stepped care or intensive psychological therapy alone. All treatments will be delivered at clinic facilities within the University of Exeter. Quantitative patient-related data on depressive symptoms, worry and anxiety and quality of life will be collected at baseline and 6 months. The pilot trial and interviews will be undertaken concurrently. Quantitative and qualitative data will be analysed separately and then integrated. The outcomes of this study will inform the design of a fully powered randomised controlled trial to evaluate the effectiveness and efficiency of stepped care. Qualitative data on stepped care will be of immediate interest to patients, clinicians, service managers, policy makers and guideline developers. A more informed understanding of the feasibility of a large trial will be obtained than would be possible from a purely quantitative (or qualitative) design. Current Controlled Trials ISRCTN66346646 registered on 2 July 2014.

10 CFR 1705.04 - Requests by persons for access to their own records.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Requests by persons for access to their own records. 1705.04 Section 1705.04 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.04 Requests by... her own records in writing by addressing a letter to: Privacy Act Officer, Defense Nuclear Facilities...

10 CFR 62.13 - Contents of a request for emergency access: Alternatives.

Code of Federal Regulations, 2011 CFR

2011-01-01

... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission... following: (1) Storage of low-level radioactive waste at the site of generation; (2) Storage of low-level... disposal at a Federal low-level radioactive waste disposal facility in the case of a Federal or defense...

14 CFR 382.51 - What requirements must carriers meet concerning the accessibility of airport facilities?

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false What requirements must carriers meet concerning the accessibility of airport facilities? 382.51 Section 382.51 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) SPECIAL REGULATIONS NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL...

14 CFR 382.51 - What requirements must carriers meet concerning the accessibility of airport facilities?

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false What requirements must carriers meet concerning the accessibility of airport facilities? 382.51 Section 382.51 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) SPECIAL REGULATIONS NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL...

10 CFR 1705.04 - Requests by persons for access to their own records.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Requests by persons for access to their own records. 1705.04 Section 1705.04 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.04 Requests by... her own records in writing by addressing a letter to: Privacy Act Officer, Defense Nuclear Facilities...

10 CFR 1705.04 - Requests by persons for access to their own records.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Requests by persons for access to their own records. 1705.04 Section 1705.04 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.04 Requests by... her own records in writing by addressing a letter to: Privacy Act Officer, Defense Nuclear Facilities...

14 CFR 382.51 - What requirements must carriers meet concerning the accessibility of airport facilities?

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false What requirements must carriers meet concerning the accessibility of airport facilities? 382.51 Section 382.51 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) SPECIAL REGULATIONS NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL...

10 CFR 1705.04 - Requests by persons for access to their own records.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Requests by persons for access to their own records. 1705.04 Section 1705.04 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.04 Requests by... her own records in writing by addressing a letter to: Privacy Act Officer, Defense Nuclear Facilities...

10 CFR 1705.04 - Requests by persons for access to their own records.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Requests by persons for access to their own records. 1705.04 Section 1705.04 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.04 Requests by... her own records in writing by addressing a letter to: Privacy Act Officer, Defense Nuclear Facilities...

US EPA Region 4 RMP Facilities

EPA Pesticide Factsheets

To improve public health and the environment, the United States Environmental Protection Agency (USEPA) collects information about facilities, sites, or places subject to environmental regulation or of environmental interest. Through the Geospatial Data Download Service, the public is now able to download the EPA Geodata shapefile containing facility and site information from EPA's national program systems. The file is Internet accessible from the Envirofacts Web site (http://www.epa.gov/enviro). The data may be used with geospatial mapping applications. (Note: The shapefile omits facilities without latitude/longitude coordinates.) The EPA Geospatial Data contains the name, location (latitude/longitude), and EPA program information about specific facilities and sites. In addition, the file contains a Uniform Resource Locator (URL), which allows mapping applications to present an option to users to access additional EPA data resources on a specific facility or site.

Expanding Your Laboratory by Accessing Collaboratory Resources

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

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

2004-03-01

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

Making our offices universally accessible: guidelines for physicians

PubMed Central

Jones, K E; Tamari, I E

1997-01-01

OBJECTIVE: To develop recommendations for office-based physicians who wish to make their offices accessible to all patients. OPTIONS: Include taking steps to make offices more accessible, or not; offices may be accessible to varying degrees. OUTCOMES: Outcomes of accessibility involve patient-care, economic, ethical and legal issues. Stakeholders in these outcomes include patients, physicians, government and society. EVIDENCE: Data were obtained from a series of searches of MEDLINE, CINAHL and Healthstar (previously Health) databases for articles on disability and family medicine, primary (health) care and family practice, and on access and offices, and health services accessibility, and from a telephone survey of 50 stakeholders. VALUES: A high value was placed on services to persons with disabilities and on stakeholder input. Universal accessibility was valued as an overall goal; improved accessibility was also highly valued. BENEFITS, HARMS AND COSTS: Benefits to patients include improved access to care as guaranteed by the Canada Health Act and in keeping with provincial Human Rights Codes. Benefits to physicians include contact with a broader patient population and freedom from fear of litigation. Costs of improved accessibility vary depending on individual circumstances and on whether an office is being built or renovated; some improvement costs are minimal. RECOMMENDATIONS: All physicians should take measures to improve practice accessibility. Improved access should be considered in each of the following areas: transportation and entrance to the facility, entrance to the office, waiting rooms, rest rooms, examination rooms, general building features and other features. VALIDATION: No similar guidelines exist. To assess the content validity of these guidelines, the authors had a draft document reviewed by 18 stakeholders. All specific recommendations met the minimum criterion of adherence to current legislation, including national and provincial building codes. The specific recommendations are endorsed by the Canadian Paraplegic Association (national and Ontario offices), the DisAbled Women's Network (Ontario) and the Centre for Independent Living (Toronto). SPONSORS: Development of these guidelines was supported in part by the Department of Family and Community Medicine, Toronto Hospital, Toronto, Ont. PMID:9068570

Perceived Barriers Affecting Access to Preventive Dental Services: Application of DEMATEL Method.

PubMed

Bahadori, Mohammadkarim; Ravangard, Ramin; Asghari, Baratali

2013-08-01

Identifying perceived access barriers to preventive dental services is one of the basic steps to improve the public health. This study aimed to determine the perceived barriers affecting access to preventive dental services in one of Tehran dental clinics in 2012. This research was a cross-sectional descriptive-analytical study conducted in one of Tehran dental clinics in 2012 using decision-making trial and evaluation laboratory (DEMATEL) method. The study sample included all patients (100 patients) who had referred to the endodontic treatment department from 26 - 31 May, 2012. The required data were collected using a questionnaire. Collected data were analyzed using SPSS 18.0 and MATLAB 7.9.0 SPSSS 18.0, as well as, some descriptive and analytical tests including Mean, Standard Deviation (SD), and Independent T- Test. The five determinants of cost, inconvenience, fear, organization, and patient-dentist relationship were determined as barriers to access to dental services among which the cost and patient-dentist relationship were identified as the first and last priorities with the coordinates (1.4 and 1.4) and (1.25 and -0.65), respectively. High cost of dental care has led to not referring patients to the clinic. Oral health costs are too high; however insurance organizations have no commitment to support such services. Policymakers, administrators, and insurance organizations have a major role in improving access to dental services. These decision-makers in making their policies can provide the required financial resources, shift the available resources towards preventive care and periodic checkups, and consider providing proper and sufficient places for dental care facilities.

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.

The impact of rural hospital closures on equity of commuting time for haemodialysis patients: simulation analysis using the capacity-distance model.

PubMed

Matsumoto, Masatoshi; Ogawa, Takahiko; Kashima, Saori; Takeuchi, Keisuke

2012-07-23

Frequent and long-term commuting is a requirement for dialysis patients. Accessibility thus affects their quality of lives. In this paper, a new model for accessibility measurement is proposed in which both geographic distance and facility capacity are taken into account. Simulation of closure of rural facilities and that of capacity transfer between urban and rural facilities are conducted to evaluate the impacts of these phenomena on equity of accessibility among dialysis patients. Post code information as of August 2011 of all the 7,374 patients certified by municipalities of Hiroshima prefecture as having first or third grade renal disability were collected. Information on post code and the maximum number of outpatients (capacity) of all the 98 dialysis facilities were also collected. Using geographic information systems, patient commuting times were calculated in two models: one that takes into account road distance (distance model), and the other that takes into account both the road distance and facility capacity (capacity-distance model). Simulations of closures of rural and urban facilities were then conducted. The median commuting time among rural patients was more than twice as long as that among urban patients (15 versus 7 minutes, p<0.001). In the capacity-distance model 36.1% of patients commuted to the facilities which were different from the facilities in the distance model, creating a substantial gap of commuting time between the two models. In the simulation, when five rural public facilitiess were closed, Gini coefficient of commuting times among the patients increased by 16%, indicating a substantial worsening of equity, and the number of patients with commuting times longer than 90 minutes increased by 72 times. In contrast, closure of four urban public facilities with similar capacities did not affect these values. Closures of dialysis facilities in rural areas have a substantially larger impact on equity of commuting times among dialysis patients than closures of urban facilities. The accessibility simulations using the capacity-distance model will provide an analytic framework upon which rational resource distribution policies might be planned.

The impact of rural hospital closures on equity of commuting time for haemodialysis patients: simulation analysis using the capacity-distance model

PubMed Central

2012-01-01

Background Frequent and long-term commuting is a requirement for dialysis patients. Accessibility thus affects their quality of lives. In this paper, a new model for accessibility measurement is proposed in which both geographic distance and facility capacity are taken into account. Simulation of closure of rural facilities and that of capacity transfer between urban and rural facilities are conducted to evaluate the impacts of these phenomena on equity of accessibility among dialysis patients. Methods Post code information as of August 2011 of all the 7,374 patients certified by municipalities of Hiroshima prefecture as having first or third grade renal disability were collected. Information on post code and the maximum number of outpatients (capacity) of all the 98 dialysis facilities were also collected. Using geographic information systems, patient commuting times were calculated in two models: one that takes into account road distance (distance model), and the other that takes into account both the road distance and facility capacity (capacity-distance model). Simulations of closures of rural and urban facilities were then conducted. Results The median commuting time among rural patients was more than twice as long as that among urban patients (15 versus 7 minutes, p < 0.001). In the capacity-distance model 36.1% of patients commuted to the facilities which were different from the facilities in the distance model, creating a substantial gap of commuting time between the two models. In the simulation, when five rural public facilitiess were closed, Gini coefficient of commuting times among the patients increased by 16%, indicating a substantial worsening of equity, and the number of patients with commuting times longer than 90 minutes increased by 72 times. In contrast, closure of four urban public facilities with similar capacities did not affect these values. Conclusions Closures of dialysis facilities in rural areas have a substantially larger impact on equity of commuting times among dialysis patients than closures of urban facilities. The accessibility simulations using thecapacity-distance model will provide an analytic framework upon which rational resource distribution policies might be planned. PMID:22824294

Evolution of area access safety training required for gaining access to Space Shuttle launch and landing facilities

NASA Technical Reports Server (NTRS)

Willams, M. C.

1985-01-01

Assuring personnel and equipment are fully protected during the Space Shuttle launch and landing operations has been a primary concern of NASA and its associated contractors since the inception of the program. A key factor in support of this policy has been the area access safety training requirements for badging of employees assigned to work on Space Shuttle Launch and Facilities. This requirement was targeted for possible cost savings and the transition of physical on-site walkdowns to the use of television tapes has realized program cost savings while continuing to fully satisfy the area access safety training requirements.

47 CFR 69.114 - Special access.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) ACCESS CHARGES... of equipment or facilities that are assigned to the Special Access element for purposes of... requirement for the Special Access element. (c) Charges for an individual element shall be assessed upon all...

75 FR 18192 - Vermont Marble Power Division of Omya Inc.; Notice of Application Tendered for Filing with the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-09

... capacity of 325 cfs; (7) generator leads; (8) a 0.48/4.16 kV single phase transformer; (9) a 0.48/46 kV step-up transformer; (10) three winding transformer banks; and (11) appurtenant facilities. The Beldens...; (9) a 2.4/46 kV step-up transformer bank; and (10) appurtenant facilities. The Huntington Falls...

Database Access Manager for the Software Engineering Laboratory (DAMSEL) user's guide

NASA Technical Reports Server (NTRS)

1990-01-01

Operating instructions for the Database Access Manager for the Software Engineering Laboratory (DAMSEL) system are presented. Step-by-step instructions for performing various data entry and report generation activities are included. Sample sessions showing the user interface display screens are also included. Instructions for generating reports are accompanied by sample outputs for each of the reports. The document groups the available software functions by the classes of users that may access them.

Efficient Machine Learning Approach for Optimizing Scientific Computing Applications on Emerging HPC Architectures

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

Arumugam, Kamesh

Efficient parallel implementations of scientific applications on multi-core CPUs with accelerators such as GPUs and Xeon Phis is challenging. This requires - exploiting the data parallel architecture of the accelerator along with the vector pipelines of modern x86 CPU architectures, load balancing, and efficient memory transfer between different devices. It is relatively easy to meet these requirements for highly structured scientific applications. In contrast, a number of scientific and engineering applications are unstructured. Getting performance on accelerators for these applications is extremely challenging because many of these applications employ irregular algorithms which exhibit data-dependent control-ow and irregular memory accesses. Furthermore,more » these applications are often iterative with dependency between steps, and thus making it hard to parallelize across steps. As a result, parallelism in these applications is often limited to a single step. Numerical simulation of charged particles beam dynamics is one such application where the distribution of work and memory access pattern at each time step is irregular. Applications with these properties tend to present significant branch and memory divergence, load imbalance between different processor cores, and poor compute and memory utilization. Prior research on parallelizing such irregular applications have been focused around optimizing the irregular, data-dependent memory accesses and control-ow during a single step of the application independent of the other steps, with the assumption that these patterns are completely unpredictable. We observed that the structure of computation leading to control-ow divergence and irregular memory accesses in one step is similar to that in the next step. It is possible to predict this structure in the current step by observing the computation structure of previous steps. In this dissertation, we present novel machine learning based optimization techniques to address the parallel implementation challenges of such irregular applications on different HPC architectures. In particular, we use supervised learning to predict the computation structure and use it to address the control-ow and memory access irregularities in the parallel implementation of such applications on GPUs, Xeon Phis, and heterogeneous architectures composed of multi-core CPUs with GPUs or Xeon Phis. We use numerical simulation of charged particles beam dynamics simulation as a motivating example throughout the dissertation to present our new approach, though they should be equally applicable to a wide range of irregular applications. The machine learning approach presented here use predictive analytics and forecasting techniques to adaptively model and track the irregular memory access pattern at each time step of the simulation to anticipate the future memory access pattern. Access pattern forecasts can then be used to formulate optimization decisions during application execution which improves the performance of the application at a future time step based on the observations from earlier time steps. In heterogeneous architectures, forecasts can also be used to improve the memory performance and resource utilization of all the processing units to deliver a good aggregate performance. We used these optimization techniques and anticipation strategy to design a cache-aware, memory efficient parallel algorithm to address the irregularities in the parallel implementation of charged particles beam dynamics simulation on different HPC architectures. Experimental result using a diverse mix of HPC architectures shows that our approach in using anticipation strategy is effective in maximizing data reuse, ensuring workload balance, minimizing branch and memory divergence, and in improving resource utilization.« less

42 CFR 51.43 - Denial or delay of access.

Code of Federal Regulations, 2010 CFR

2010-10-01

... APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Access to Records..., or other legal representative of an individual with mental illness. Access to facilities, records or...

27 CFR 22.92 - Storage facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Storage facilities. 22.92... Storage facilities. (a) Storerooms or compartments shall be so constructed and secured as to prevent unauthorized access and will be equipped for locking. These storage facilities shall be of sufficient capacity...

27 CFR 22.92 - Storage facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Storage facilities. 22.92... Storage facilities. (a) Storerooms or compartments shall be so constructed and secured as to prevent unauthorized access and will be equipped for locking. These storage facilities shall be of sufficient capacity...

27 CFR 22.92 - Storage facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Storage facilities. 22.92... Storage facilities. (a) Storerooms or compartments shall be so constructed and secured as to prevent unauthorized access and will be equipped for locking. These storage facilities shall be of sufficient capacity...

27 CFR 22.92 - Storage facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Storage facilities. 22.92... Storage facilities. (a) Storerooms or compartments shall be so constructed and secured as to prevent unauthorized access and will be equipped for locking. These storage facilities shall be of sufficient capacity...

27 CFR 22.92 - Storage facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Storage facilities. 22.92... Storage facilities. (a) Storerooms or compartments shall be so constructed and secured as to prevent unauthorized access and will be equipped for locking. These storage facilities shall be of sufficient capacity...

Availability of essential health services in post-conflict Liberia

PubMed Central

Rockers, Peter C; Williams, Elizabeth H; Varpilah, S Tornorlah; Macauley, Rose; Saydee, Geetor; Galea, Sandro

2010-01-01

Abstract Objective To assess the availability of essential health services in northern Liberia in 2008, five years after the end of the civil war. Methods We carried out a population-based household survey in rural Nimba county and a health facility survey in clinics and hospitals nearest to study villages. We evaluated access to facilities that provide index essential services: artemisinin combination therapy for malaria, integrated management of childhood illness, human immunodeficiency virus (HIV) counselling and testing, basic emergency obstetric care and treatment of mental illness. Findings Data were obtained from 1405 individuals (98% response rate) selected with a three-stage population-representative sampling method, and from 43 of Nimba county’s 49 health facilities selected because of proximity to the study villages. Respondents travelled an average of 136 minutes to reach a health facility. All respondents could access malaria treatment at the nearest facility and 55.9% could access HIV testing. Only 26.8%, 14.5%, and 12.1% could access emergency obstetric care, integrated management of child illness and mental health services, respectively. Conclusion Although there has been progress in providing basic services, rural Liberians still have limited access to life-saving health care. The reasons for the disparities in the services available to the population are technical and political. More frequently available services (HIV testing, malaria treatment) were less complex to implement and represented diseases favoured by bilateral and multilateral health sector donors. Systematic investments in the health system are required to ensure that health services respond to current and future health priorities. PMID:20616972

A software for managing after-hours activities in research user facilities

DOE PAGES

Camino, F. E.

2017-05-01

Here, we present an afterhours activity management program for shared facilities, which handles the processes required for afterhours access (request, approval, extension, etc.). It implements the concept of permitted afterhours activities, which consists of a list of well-defined activities that each user can perform afterhours. The program provides an easy and unambiguous way for users to know which activities they are allowed to perform afterhours. In addition, the program can enhance its safety efficacy by interacting with lab and instrument access control systems commonly present in user facilities.

Reproductive Rights Denied: The Hyde Amendment and Access to Abortion for Native American Women Using Indian Health Service Facilities

PubMed Central

2014-01-01

Restrictions on the use of federal funds to provide abortions have limited the access to abortion services for Native American women receiving care at Indian Health Service facilities. Current data suggest that the vast majority of Indian Health Service facilities are unequipped to provide abortions under any circumstances. Native American women experience disproportionately high rates of sexual assault and unintended pregnancy. Hyde Amendment restrictions systematically infringe on the reproductive rights of Native American women and present a pressing public health policy concern. PMID:25122025

A software for managing after-hours activities in research user facilities

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

Camino, F. E.

Here, we present an afterhours activity management program for shared facilities, which handles the processes required for afterhours access (request, approval, extension, etc.). It implements the concept of permitted afterhours activities, which consists of a list of well-defined activities that each user can perform afterhours. The program provides an easy and unambiguous way for users to know which activities they are allowed to perform afterhours. In addition, the program can enhance its safety efficacy by interacting with lab and instrument access control systems commonly present in user facilities.

Reproductive rights denied: the Hyde Amendment and access to abortion for Native American women using Indian health service facilities.

PubMed

Arnold, Shaye Beverly

2014-10-01

Restrictions on the use of federal funds to provide abortions have limited the access to abortion services for Native American women receiving care at Indian Health Service facilities. Current data suggest that the vast majority of Indian Health Service facilities are unequipped to provide abortions under any circumstances. Native American women experience disproportionately high rates of sexual assault and unintended pregnancy. Hyde Amendment restrictions systematically infringe on the reproductive rights of Native American women and present a pressing public health policy concern.

Subtitle Synchronization across Multiple Screens and Devices

PubMed Central

Rodriguez-Alsina, Aitor; Talavera, Guillermo; Orero, Pilar; Carrabina, Jordi

2012-01-01

Ambient Intelligence is a new paradigm in which environments are sensitive and responsive to the presence of people. This is having an increasing importance in multimedia applications, which frequently rely on sensors to provide useful information to the user. In this context, multimedia applications must adapt and personalize both content and interfaces in order to reach acceptable levels of context-specific quality of service for the user, and enable the content to be available anywhere and at any time. The next step is to make content available to everybody in order to overcome the existing access barriers to content for users with specific needs, or else to adapt to different platforms, hence making content fully usable and accessible. Appropriate access to video content, for instance, is not always possible due to the technical limitations of traditional video packaging, transmission and presentation. This restricts the flexibility of subtitles and audio-descriptions to be adapted to different devices, contexts and users. New Web standards built around HTML5 enable more featured applications with better adaptation and personalization facilities, and thus would seem more suitable for accessible AmI environments. This work presents a video subtitling system that enables the customization, adaptation and synchronization of subtitles across different devices and multiple screens. The benefits of HTML5 applications for building the solution are analyzed along with their current platform support. Moreover, examples of the use of the application in three different cases are presented. Finally, the user experience of the solution is evaluated. PMID:23012513

Subtitle synchronization across multiple screens and devices.

PubMed

Rodriguez-Alsina, Aitor; Talavera, Guillermo; Orero, Pilar; Carrabina, Jordi

2012-01-01

Ambient Intelligence is a new paradigm in which environments are sensitive and responsive to the presence of people. This is having an increasing importance in multimedia applications, which frequently rely on sensors to provide useful information to the user. In this context, multimedia applications must adapt and personalize both content and interfaces in order to reach acceptable levels of context-specific quality of service for the user, and enable the content to be available anywhere and at any time. The next step is to make content available to everybody in order to overcome the existing access barriers to content for users with specific needs, or else to adapt to different platforms, hence making content fully usable and accessible. Appropriate access to video content, for instance, is not always possible due to the technical limitations of traditional video packaging, transmission and presentation. This restricts the flexibility of subtitles and audio-descriptions to be adapted to different devices, contexts and users. New Web standards built around HTML5 enable more featured applications with better adaptation and personalization facilities, and thus would seem more suitable for accessible AmI environments. This work presents a video subtitling system that enables the customization, adaptation and synchronization of subtitles across different devices and multiple screens. The benefits of HTML5 applications for building the solution are analyzed along with their current platform support. Moreover, examples of the use of the application in three different cases are presented. Finally, the user experience of the solution is evaluated.

Delivering information: A descriptive study of Australian women’s information needs for decision-making about birth facility

PubMed Central

2012-01-01

Background Little information is known about what information women want when choosing a birth facility. The objective of this study was to inform the development of a consumer decision support tool about birth facility by identifying the information needs of maternity care consumers in Queensland, Australia. Methods Participants were 146 women residing in both urban and rural areas of Queensland, Australia who were pregnant and/or had recently given birth. A cross-sectional survey was administered in which participants were asked to rate the importance of 42 information items to their decision-making about birth facility. Participants could also provide up to ten additional information items of interest in an open-ended question. Results On average, participants rated 30 of the 42 information items as important to decision-making about birth facility. While the majority of information items were valued by most participants, those related to policies about support people, other women’s recommendations about the facility, freedom to choose one’s preferred position during labour and birth, the aesthetic quality of the facility, and access to on-site neonatal intensive care were particularly widely valued. Additional items of interest frequently focused on postnatal care and support, policies related to medical intervention, and access to water immersion. Conclusions The women surveyed had significant and diverse information needs for decision-making about birth facility. These findings have immediate applications for the development of decision support tools about birth facility, and highlight the need for tools which provide a large volume of information in an accessible and user-friendly format. These findings may also be used to guide communication and information-sharing by care providers involved in counselling pregnant women and families about their options for birth facility or providing referrals to birth facilities. PMID:22708648

Delivering information: a descriptive study of Australian women's information needs for decision-making about birth facility.

PubMed

Thompson, Rachel; Wojcieszek, Aleena M

2012-06-18

Little information is known about what information women want when choosing a birth facility. The objective of this study was to inform the development of a consumer decision support tool about birth facility by identifying the information needs of maternity care consumers in Queensland, Australia. Participants were 146 women residing in both urban and rural areas of Queensland, Australia who were pregnant and/or had recently given birth. A cross-sectional survey was administered in which participants were asked to rate the importance of 42 information items to their decision-making about birth facility. Participants could also provide up to ten additional information items of interest in an open-ended question. On average, participants rated 30 of the 42 information items as important to decision-making about birth facility. While the majority of information items were valued by most participants, those related to policies about support people, other women's recommendations about the facility, freedom to choose one's preferred position during labour and birth, the aesthetic quality of the facility, and access to on-site neonatal intensive care were particularly widely valued. Additional items of interest frequently focused on postnatal care and support, policies related to medical intervention, and access to water immersion. The women surveyed had significant and diverse information needs for decision-making about birth facility. These findings have immediate applications for the development of decision support tools about birth facility, and highlight the need for tools which provide a large volume of information in an accessible and user-friendly format. These findings may also be used to guide communication and information-sharing by care providers involved in counselling pregnant women and families about their options for birth facility or providing referrals to birth facilities.

Design and implementation of community engagement interventions towards healthcare quality improvement in Ghana: a methodological approach.

PubMed

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Arhinful, Daniel Kojo

2016-12-01

Nearly four decades after the Alma-Ata declaration of 1978 on the need for active client/community participation in healthcare, not much has been achieved in this regard particularly in resource constrained countries like Ghana, where over 70 % of communities in rural areas access basic healthcare from primary health facilities. Systematic Community Engagement (SCE) in healthcare quality assessment remains a grey area in many health systems in Africa, albeit the increasing importance in promoting universal access to quality basic healthcare services. Design and implement SCE interventions that involve existing community groups engaged in healthcare quality assessment in 32 intervention primary health facilities. The SCE interventions form part of a four year randomized controlled trial (RCT) in the Greater Accra and Western regions of Ghana. Community groups (n = 52) were purposively recruited and engaged to assess non-technical components of healthcare quality, recommend quality improvement plans and reward best performing facilities. The interventions comprised of five cyclical implementation steps executed for nearly a year. Wilcoxon sign rank test was used to ascertain differences in group perceptions of service quality during the first and second assessments, and ordered logistic regression analysis performed to determine factors associated with groups' perception of healthcare quality. Healthcare quality was perceived to be lowest in non-technical areas such as: information provision to clients, directional signs in clinics, drug availability, fairness in queuing, waiting times, and information provision on use of suggestion boxes and feedback on clients' complaints. Overall, services in private health facilities were perceived to be better than public facilities (p < 0.05). Community groups dominated by artisans and elderly members (60 + years) had better perspectives on healthcare quality than youthful groups (Coef. =1.78; 95 % CI = [-0.16 3.72]) and other categories of community groups (Coef. = 0.98; 95 % CI = [-0.10 2.06]). Non-technical components of healthcare quality remain critical to clients and communities served by primary healthcare providers. The SCE concept is a potential innovative and complementary quality improvement strategy that could help enhance client experiences, trust and confidence in healthcare providers. SCE interventions are more cost effective, community-focused and could easily be scaled-up and sustained by local health authorities.

Racial disparities in travel time to radiotherapy facilities in the Atlanta metropolitan area

PubMed Central

Peipins, Lucy A.; Graham, Shannon; Young, Randall; Lewis, Brian; Flanagan, Barry

2018-01-01

Low-income women with breast cancer who rely on public transportation may have difficulty in completing recommended radiation therapy due to inadequate access to radiation facilities. Using a geographic information system (GIS) and network analysis we quantified spatial accessibility to radiation treatment facilities in the Atlanta, Georgia metropolitan area. We built a transportation network model that included all bus and rail routes and stops, system transfers and walk and wait times experienced by public transportation system travelers. We also built a private transportation network to model travel times by automobile. We calculated travel times to radiation therapy facilities via public and private transportation from a population-weighted center of each census tract located within the study area. We broadly grouped the tracts by low, medium and high household access to a private vehicle and by race. Facility service areas were created using the network model to map the extent of areal coverage at specified travel times (30, 45 and 60 min) for both public and private modes of transportation. The median public transportation travel time to the nearest radiotherapy facility was 56 min vs. approximately 8 min by private vehicle. We found that majority black census tracts had longer public transportation travel times than white tracts across all categories of vehicle access and that 39% of women in the study area had longer than 1 h of public transportation travel time to the nearest facility. In addition, service area analyses identified locations where the travel time barriers are the greatest. Spatial inaccessibility, especially for women who must use public transportation, is one of the barriers they face in receiving optimal treatment. PMID:23726213

Racial disparities in travel time to radiotherapy facilities in the Atlanta metropolitan area.

PubMed

Peipins, Lucy A; Graham, Shannon; Young, Randall; Lewis, Brian; Flanagan, Barry

2013-07-01

Low-income women with breast cancer who rely on public transportation may have difficulty in completing recommended radiation therapy due to inadequate access to radiation facilities. Using a geographic information system (GIS) and network analysis we quantified spatial accessibility to radiation treatment facilities in the Atlanta, Georgia metropolitan area. We built a transportation network model that included all bus and rail routes and stops, system transfers and walk and wait times experienced by public transportation system travelers. We also built a private transportation network to model travel times by automobile. We calculated travel times to radiation therapy facilities via public and private transportation from a population-weighted center of each census tract located within the study area. We broadly grouped the tracts by low, medium and high household access to a private vehicle and by race. Facility service areas were created using the network model to map the extent of areal coverage at specified travel times (30, 45 and 60 min) for both public and private modes of transportation. The median public transportation travel time to the nearest radiotherapy facility was 56 min vs. approximately 8 min by private vehicle. We found that majority black census tracts had longer public transportation travel times than white tracts across all categories of vehicle access and that 39% of women in the study area had longer than 1 h of public transportation travel time to the nearest facility. In addition, service area analyses identified locations where the travel time barriers are the greatest. Spatial inaccessibility, especially for women who must use public transportation, is one of the barriers they face in receiving optimal treatment. Published by Elsevier Ltd.

Collaborative Russian-US work in nuclear material protection, control and accounting at the Institute of Physics and Power Engineering. 2: Extension to additional facilities

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

Kuzin, V.V.; Pshakin, G.M.; Belov, A.P.

1996-12-31

During 1995, collaborative Russian-US nuclear material protection, control, and accounting (MPC and A) tasks at the Institute of Physics and Power Engineering (IPPE) in Obninsk, Russia focused on improving the protection of nuclear materials at the BFS Fast Critical Facility. BFS has tens of thousands of fuel disks containing highly enriched uranium and weapons-grade plutonium that are used to simulate the core configurations of experimental reactors in two critical assemblies. Completed tasks culminated in demonstrations of newly implemented equipment (Russian and US) and methods that enhanced the MPC and A at BFS through computerized accounting, nondestructive inventory verification measurements, personnelmore » identification and access control, physical inventory taking, physical protection, and video surveillance. The collaborative work with US Department of Energy national laboratories is now being extended. In 1996 additional tasks to improve MPC and A have been implemented at BFS, the Technological Laboratory for Fuel Fabrication (TLFF) the Central Storage Facility (CSF), and for the entire site. The TLFF reclads BFS uranium metal fuel disks (process operations and transfers of fissile material). The CSF contains many different types of nuclear material. MPC and A at these additional facilities will be integrated with that at BFS as a prototype site-wide approach. Additional site-wide tasks encompass communications and tamper-indicating devices. Finally, new storage alternatives are being implemented that will consolidate the more attractive nuclear materials in a better-protected nuclear island. The work this year represents not just the addition of new facilities and the site-wide approach, but the systematization of the MPC and A elements that are being implemented as a first step and the more comprehensive ones planned.« less

75 FR 56236 - Nondiscrimination on the Basis of Disability by Public Accommodations and in Commercial Facilities

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-15

... subject to the ABA (i.e., facilities designed, built, altered, or leased with Federal funds). Chapters 3... to title III of the ADA may also be subject to title I of the ADA, which prohibits discrimination on... addressing accessibility in these areas and others, including next generation 9-1-1 and accessibility of Web...

Parents’ Perceived Barriers to Accessing Sports and Recreation Facilities in Ontario, Canada: Exploring the Relationships between Income, Neighbourhood Deprivation, and Community

PubMed Central

Jarvis, Jocelyn W.

2017-01-01

Sports and recreation facilities provide places where children can be physically active. Previous research has shown that availability is often worse in lower-socioeconomic status (SES) areas, yet others have found inverse relationships, no relationships, or mixed findings. Since children’s health behaviours are influenced by their parents, it is important to understand parents’ perceived barriers to accessing sports and recreation facilities. Data from computer assisted telephone interviews with parents living in Ontario, Canada were merged via postal codes with neighbourhood deprivation data. Multivariable logistic regression modeling was used to estimate the likelihood that parents reported barriers to accessing local sports and recreation facilities. Parents with lower household incomes were more likely to report barriers to access. For each unit increase in deprivation score (i.e., more deprived), the likelihood of reporting a barrier increased 16% (95% CI: 1.04, 1.28). For parents, the relationships between household income, neighbourhood-level deprivation, and barriers are complex. Understanding these relationships is important for research, policy and planning, as parental barriers to opportunities for physical activity have implications for child health behaviours, and ultimately childhood overweight and obesity. PMID:29065524

Parents' Perceived Barriers to Accessing Sports and Recreation Facilities in Ontario, Canada: Exploring the Relationships between Income, Neighbourhood Deprivation, and Community.

PubMed

Harrington, Daniel W; Jarvis, Jocelyn W; Manson, Heather

2017-10-23

Sports and recreation facilities provide places where children can be physically active. Previous research has shown that availability is often worse in lower-socioeconomic status (SES) areas, yet others have found inverse relationships, no relationships, or mixed findings. Since children's health behaviours are influenced by their parents, it is important to understand parents' perceived barriers to accessing sports and recreation facilities. Data from computer assisted telephone interviews with parents living in Ontario, Canada were merged via postal codes with neighbourhood deprivation data. Multivariable logistic regression modeling was used to estimate the likelihood that parents reported barriers to accessing local sports and recreation facilities. Parents with lower household incomes were more likely to report barriers to access. For each unit increase in deprivation score (i.e., more deprived), the likelihood of reporting a barrier increased 16% (95% CI: 1.04, 1.28). For parents, the relationships between household income, neighbourhood-level deprivation, and barriers are complex. Understanding these relationships is important for research, policy and planning, as parental barriers to opportunities for physical activity have implications for child health behaviours, and ultimately childhood overweight and obesity.

The impact of primary health care on malaria morbidity - defining access by disease burden

PubMed Central

O’Meara, W.P.; Noor, A.; Gatakaa, H.; Tsofa, B.; McKenzie, F. E.; Marsh, K.

2009-01-01

Objectives The convergence of malaria endemicity and poor health care infrastructure has resulted in persistently high rates of malaria morbidity and mortality in many parts of sub-Saharan Africa. Primary care facilities are increasingly becoming the focal point for distribution of intervention strategies, but physical access to these facilities may limit the extent to which communities can be reached. Here we investigate the impact of travel time to primary care on the incidence of hospitalized malaria episodes in a rural district in Kenya. Methods The incidence of hospitalized malaria in a population under continuous demographic surveillance was recorded over three years. The time to travel to the nearest primary health care facility was calculated for every child between birth and five years of age and trends in incidence of hospitalized malaria as a function of travel time were evaluated. Results and conclusions We show that the incidence of hospitalized malaria more than doubled as travel time to the nearest primary care facility increased from ten minutes up to two hours. Good access to primary health facilities may reduce the burden of disease by as much as 66%. Our results highlight both the potential of the primary health care system in reaching those most at risk and reducing the disease burden, and that insufficient access is an important risk factor, one that may be inequitably distributed to the poorest households. PMID:19121148

User Access | Energy Systems Integration Facility | NREL

Science.gov Websites

User Access User Access The ESIF houses an unparalleled collection of state-of-the-art capabilities user access program, the ESIF allows researchers access to its premier laboratories in support of research and development that aims to optimize our entire energy system at full power. Requests for access

US EPA Region 4 Brownfields

EPA Pesticide Factsheets

To improve public health and the environment, the United States Environmental Protection Agency (USEPA) collects information about facilities, sites, or places subject to environmental regulation or of environmental interest. Through the Geospatial Data Download Service, the public is now able to download the EPA Geodata shapefile containing facility and site information from EPA's national program systems. The file is Internet accessible from the Envirofacts Web site (https://www3.epa.gov/enviro/). The data may be used with geospatial mapping applications. (Note: The shapefile omits facilities without latitude/longitude coordinates.) The EPA Geospatial Data contains the name, location (latitude/longitude), and EPA program information about specific facilities and sites. In addition, the file contains a Uniform Resource Locator (URL), which allows mapping applications to present an option to users to access additional EPA data resources on a specific facility or site. This dataset shows Brownfields listed in the 2012 Facility Registry System.

A Guide to Preparing Educational Specifications for Secondary Industrial Arts Facilities. Monograph No. 1.

ERIC Educational Resources Information Center

Steeb, Ralph V.

The guide describes procedures for designing secondary industrial arts facilities based on careful scrutiny of the educational program which the facilities are intended to serve. It offers a four step general outline for planning such facilities and discusses in detail the following considerations with respect to writing subject area…

A user-friendly approach to cost accounting in laboratory animal facilities.

PubMed

Baker, David G

2011-08-19

Cost accounting is an essential management activity for laboratory animal facility management. In this report, the author describes basic principles of cost accounting and outlines steps for carrying out cost accounting in laboratory animal facilities. Methods of post hoc cost accounting analysis for maximizing the efficiency of facility operations are also described.

[Handover between home and respite care facilities : Delphi survey within the context of continuity of care for people with dementia].

PubMed

Kuske, S; Roes, M; Bartholomeyczik, S

2016-07-01

Criteria for the handover between healthcare settings were identified based on a review and on results of empirical data. This study was carried out to select the most relevant criteria for defining the quality of continuity of care of people with dementia (PwD) in the context of the handover between care at home and respite care facilities. A modified classical two-step Delphi design was used in combination with a group Delphi design. A total of 28 core criteria with a consensus strength of > 60 % are presented. Safety-relevant information, especially the personal habits of PwD and the role of informal caregivers in the handover between care settings are important. Furthermore, the following general principles to ensure the quality of continuity of the care of PwD were deduced: completeness, verification, multipath communication, timeliness and topicality, accessibility and defined responsibilities, roles and standardization. A successful transition of PwD to respite care facilities relies on the provision of relevant information, considering personal habits, before the day of transition. Furthermore, a timely preparation for discharge is important. The individual needs of the informal caregivers with regard to their support should be considered. Professionals who are responsible in handover processes should have solid communication competence in order to collect relevant information from informal caregivers, who have a strong individual care experience with the PwD.

49 CFR 37.41 - Construction of transportation facilities by public entities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... public entities. 37.41 Section 37.41 Transportation Office of the Secretary of Transportation... transportation facilities by public entities. (a) A public entity shall construct any new facility to be used in providing designated public transportation services so that the facility is readily accessible to and usable...

40 CFR 160.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Specimen and data storage facilities... PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Facilities § 160.51 Specimen and data storage facilities. Space shall be provided for archives, limited to access by authorized personnel only, for the storage and...

40 CFR 160.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Specimen and data storage facilities... PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Facilities § 160.51 Specimen and data storage facilities. Space shall be provided for archives, limited to access by authorized personnel only, for the storage and...

40 CFR 160.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Specimen and data storage facilities... PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Facilities § 160.51 Specimen and data storage facilities. Space shall be provided for archives, limited to access by authorized personnel only, for the storage and...

40 CFR 160.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 24 2014-07-01 2014-07-01 false Specimen and data storage facilities... PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Facilities § 160.51 Specimen and data storage facilities. Space shall be provided for archives, limited to access by authorized personnel only, for the storage and...

Southern Nevada assisted living residents' perception of their oral health status and access to dental care.

PubMed

Dounis, Georgia; Ditmyer, Marcia M; McCants, Robert; Lee, Yoonah; Mobley, Connie

2012-06-01

Oral health is an integral component of general health, and quality of life. The purpose of this study was to determine the perceptions of oral health status and acces\\s to dental care by Southern Nevada Assisted Living Facilities Residents. A cross-sectional questionnaire study design was used to survey residents between 34 and 99 years old residing in Assisted Living Facilities. Seventy respondents (42 males and 28 females) completed a survey that included personal oral hygiene, access to care, and demographic information. Data analyses included descriptive statistics and chi-square. Mean age was 75.78 years, and the majority had a college education (n = 41). Four currently smoked cigarettes. Twenty-nine (males = 14; females = 15) reported having dental insurance. Eleven respondents had seen a dentist twice a year, while 33 reported a visit less than 6 months. Forty-one reported the facility did not provide oral health care with majority (n = 64) indicating that accessing oral health care was difficult. Self-rated response to oral hygiene, a majority (n = 64) reported their oral hygiene as fair and five reported their oral hygiene as poor. Assisted living residents in Southern Nevada reported difficulty accessing dental services within and outside of the facility. Oral care models to address this unique population should be explored. © 2010 The Gerodontology Society and John Wiley & Sons A/S.

The geographical accessibility of hospitals to the aged: a geographic information systems analysis within Illinois.

PubMed Central

Love, D; Lindquist, P

1995-01-01

OBJECTIVE. This article uses geographic information systems and their related tools to empirically measure and display the geographic accessibility of the aged population to hospital facilities within Illinois. DATA SOURCES AND STUDY SETTING. Geographic accessibility of Illinois' aged population is measured from each of the state's 10,796 census block groups to the state's 214 hospital facilities. Block group demographic compositions and centroids are obtained from 1990 census files. Hospital coordinates are obtained by the authors. STUDY DESIGN. Of five alternative measures of accessibility considered, empirical estimates are obtained for two: choice set and minimum distance. Access to both general hospitals and the subset having specialized geriatric facilities is measured with special attention to differences in accessibility between the aged within metropolitan statistical areas (MSAs) and those outside MSAs. Cumulative accessibility distributions and their summary statistics provide a basis of comparison among subgroups. DATA COLLECTION AND EXTRACTION. Geographic information systems (GIS) and their related tools are used as a means of efficiently capturing, organizing, storing, and retrieving the required data. Hospitals and census block groups are geocoded to specific locations in the database, and aspatial attributes are assigned to the hospitals and block groups. The GIS database is queried to produce shaded isarithm and point distribution maps that show the location of hospitals relative to surrounding aged populations. CONCLUSION. The vast majority of Illinois' aged population is within close proximity to hospital facilities. Eighty percent (1,147,504 persons) of the aged in Illinois are within 4.8 miles (7.7 km) of a hospital and 11.6 miles (18.7 km) of two hospitals. However, geographic accessibility differences between the aged living in MSAs and those living outside MSAs to hospitals offering geriatric services are substantial; but there is no evidence that the aged's geographical accessibility to hospitals is less favorable than that of the general population. Detailed accessibility measures permitted by geographic information system technology call into question the continued use of crude empirical accessibility measures. Images Figure 2 PMID:7860317

Access to Drugs and Out of Pocket Expenditure in Primary Health Facilities.

PubMed

Thapa, A K; Ghimire, N; Adhikari, S R

2016-09-01

The Government of Nepal promulgated health as a human right via Interim constitution and implemented Free Health Service Program in 2008 as a commitment to universalize basic health care services. So, the aim of this study was to understand reported access to medicine and health care services received by outpatients in public primary facilities. The study followed cross sectional study design. Two hundred and thirty-four For data 234 out patients were interviewed on the day of the field visit in March and October 2014 across 28 primary health facilities of seven purposively selected districts representing three ecological belts and five development regions of the country. Our study revealed that the average number of medicines prescribed per patient was 2.65 per case in primary public health facilities, of which 91.2% were dispensed. Around 86.6% dispensed medicines were appropriately labeled and 84% of outpatients had proper knowledge of dosage and timing of medicine use. Around 55.6% of outpatients purchased some or all prescribed medicines from nearby private facilities which were not available in public facilities. Around 40% of them travelled more than half an hour to reach the facility. The gap in medicines prescribed and dispensed, Out of Pocket expenditure coupled with opportunity cost of travelling, appear as hurdles in access to basic health care services. So increasing free medicines list in public primary facilities with all round the year availability might answer major part of the problem.

Facile one-step construction of covalently networked, self-healable, and transparent superhydrophobic composite films

NASA Astrophysics Data System (ADS)

Lee, Yujin; You, Eun-Ah; Ha, Young-Geun

2018-07-01

Despite the considerable demand for bioinspired superhydrophobic surfaces with highly transparent, self-cleaning, and self-healable properties, a facile and scalable fabrication method for multifunctional superhydrophobic films with strong chemical networks has rarely been established. Here, we report a rationally designed facile one-step construction of covalently networked, transparent, self-cleaning, and self-healable superhydrophobic films via a one-step preparation and single-reaction process of multi-components. As coating materials for achieving the one-step fabrication of multifunctional superhydrophobic films, we included two different sizes of Al2O3 nanoparticles for hierarchical micro/nano dual-scale structures and transparent films, fluoroalkylsilane for both low surface energy and covalent binding functions, and aluminum nitrate for aluminum oxide networked films. On the basis of stability tests for the robust film composition, the optimized, covalently linked superhydrophobic composite films with a high water contact angle (>160°) and low sliding angle (<1°) showed excellent thermal stability (up to 400 °C), transparency (≈80%), self-healing, self-cleaning, and waterproof abilities. Therefore, the rationally designed, covalently networked superhydrophobic composite films, fabricated via a one-step solution-based process, can be further utilized for various optical and optoelectronic applications.

Availability and accessibility of subsidized mammogram screening program in peninsular Malaysia: A preliminary study using travel impedance approach

PubMed Central

Aljunid, Syed Mohamed

2018-01-01

Access to healthcare is essential in the pursuit of universal health coverage. Components of access are availability, accessibility (spatial and non-spatial), affordability and acceptability. Measuring spatial accessibility is common approach to evaluating access to health care. This study aimed to determine the availability and spatial accessibility of subsidised mammogram screening in Peninsular Malaysia. Availability was determined from the number and distribution of facilities. Spatial accessibility was determined using the travel impedance approach to represent the revealed access as opposed to potential access measured by other spatial measurement methods. The driving distance of return trips from the respondent’s residence to the facilities was determined using a mapping application. The travel expenditure was estimated by multiplying the total travel distance by a standardised travel allowance rate, plus parking fees. Respondents in this study were 344 breast cancer patients who received treatment at 4 referral hospitals between 2015 and 2016. In terms of availability, there were at least 6 major entities which provided subsidised mammogram programs. Facilities with mammogram involved with these programs were located more densely in the central and west coast region of the Peninsula. The ratio of mammogram facility to the target population of women aged 40–74 years ranged between 1: 10,000 and 1:80,000. In terms of accessibility, of the 3.6% of the respondents had undergone mammogram screening, their mean travel distance was 53.4 km (SD = 34.5, range 8–112 km) and the mean travel expenditure was RM 38.97 (SD = 24.00, range RM7.60–78.40). Among those who did not go for mammogram screening, the estimated travel distance and expenditure had a skewed distribution with median travel distance of 22.0 km (IQR 12.0, 42.0, range 2.0–340.0) and the median travel cost of RM 17.40 (IQR 10.40, 30.00, range 3.40–240.00). Higher travel impedance was noted among those who lived in sub-urban and rural areas. In summary, availability of mammogram facilities was good in the central and west coast of the peninsula. The overall provider-to-population ratio was lower than recommended. Based on the travel impedance approach used, accessibility to subsidised mammogram screening among the respondents was good in urban areas but deprived in other areas. This study was a preliminary study with limitations. Nonetheless, the evidence suggests that actions have to be taken to improve the accessibility to opportunistic mammogram screening in Malaysia in pursuit of universal health coverage. PMID:29389972

Oral healthcare access and adequacy in alternative long-term care facilities.

PubMed

Smith, Barbara J; Ghezzi, Elisa M; Manz, Michael C; Markova, Christiana P

2010-01-01

This study was undertaken to determine practices and perceived barriers to access related to oral health by surveying administrators in Michigan alternative long-term care facilities (ALTCF). A 24-item questionnaire was mailed to all 2,275 Michigan ALTCF serving residents aged 60+. Facility response rate was 22% (n = 508). Eleven percent of facilities had a written dental care plan; 18% stated a dentist examined new residents; and 19% of facilities had an agreement with a dentist to come to the facility, with 52% of those being for emergency care only. The greatest perceived barriers were willingness of general and specialty dentists to treat residents at the nursing facility and/or private offices as well as financial concerns. Substantial barriers to care were uniformly perceived. Oral health policies and practices within Michigan ALTCF vary, as measured by resources, attitudes, and the availability of professional care. There is limited involvement by dental professionals in creating policy and providing consultation and service.

34 CFR Appendix A to Part 104 - Analysis of Final Regulation

Code of Federal Regulations, 2012 CFR

2012-07-01

... facilities, be designed and constructed in a manner so as to make the facility accessible to and usable by... will not be required to alter the design of a facility that has progressed beyond groundbreaking prior...

34 CFR Appendix A to Part 104 - Analysis of Final Regulation

Code of Federal Regulations, 2013 CFR

2013-07-01

... facilities, be designed and constructed in a manner so as to make the facility accessible to and usable by... will not be required to alter the design of a facility that has progressed beyond groundbreaking prior...

34 CFR Appendix A to Part 104 - Analysis of Final Regulation

Code of Federal Regulations, 2014 CFR

2014-07-01

... facilities, be designed and constructed in a manner so as to make the facility accessible to and usable by... will not be required to alter the design of a facility that has progressed beyond groundbreaking prior...

34 CFR Appendix A to Part 104 - Analysis of Final Regulation

Code of Federal Regulations, 2011 CFR

2011-07-01

... facilities, be designed and constructed in a manner so as to make the facility accessible to and usable by... will not be required to alter the design of a facility that has progressed beyond groundbreaking prior...

Physical Education Facilities for the Handicapped.

ERIC Educational Resources Information Center

Isaacs, Larry; Frederick, Stephen D.

1980-01-01

Physical education facilities at Wright State University in Dayton, Ohio have been adapted for the recreational needs of handicapped students. Changes include a special exercise room, accessible locker and shower facilities, a pool area, and a wheelchair repair shop. (CJ)

Student Residence.

ERIC Educational Resources Information Center

Department of Education and Science, London (England).

Principal facility requirements and costs of residential accommodations for students are discussed. After specifying the various space and facility requirements and providing cost information for the various classes of facilities, the report details requirements pertaining to external works (road access; car parking; grassing, planting, and…

A Case-Series Test of the Interactive Two-step Model of Lexical Access: Predicting Word Repetition from Picture Naming

PubMed Central

Dell, Gary S.; Martin, Nadine; Schwartz, Myrna F.

2010-01-01

Lexical access in language production, and particularly pathologies of lexical access, are often investigated by examining errors in picture naming and word repetition. In this article, we test a computational approach to lexical access, the two-step interactive model, by examining whether the model can quantitatively predict the repetition-error patterns of 65 aphasic subjects from their naming errors. The model’s characterizations of the subjects’ naming errors were taken from the companion paper to this one (Schwartz, Dell, N. Martin, Gahl & Sobel, 2006), and their repetition was predicted from the model on the assumption that naming involves two error prone steps, word and phonological retrieval, whereas repetition only creates errors in the second of these steps. A version of the model in which lexical-semantic and lexical-phonological connections could be independently lesioned was generally successful in predicting repetition for the aphasics. An analysis of the few cases in which model predictions were inaccurate revealed the role of input phonology in the repetition task. PMID:21085621

Water, sanitation and hygiene infrastructure and quality in rural healthcare facilities in Rwanda.

PubMed

Huttinger, Alexandra; Dreibelbis, Robert; Kayigamba, Felix; Ngabo, Fidel; Mfura, Leodomir; Merryweather, Brittney; Cardon, Amelie; Moe, Christine

2017-08-03

WHO and UNICEF have proposed an action plan to achieve universal water, sanitation and hygiene (WASH) coverage in healthcare facilities (HCFs) by 2030. The WASH targets and indicators for HCFs include: an improved water source on the premises accessible to all users, basic sanitation facilities, a hand washing facility with soap and water at all sanitation facilities and patient care areas. To establish viable targets for WASH in HCFs, investigation beyond 'access' is needed to address the state of WASH infrastructure and service provision. Patient and caregiver use of WASH services is largely unaddressed in previous studies despite being critical for infection control. The state of WASH services used by staff, patients and caregivers was assessed in 17 rural HCFs in Rwanda. Site selection was non-random and predicated upon piped water and power supply. Direct observation and semi-structured interviews assessed drinking water treatment, presence and condition of sanitation facilities, provision of soap and water, and WASH-related maintenance and record keeping. Samples were collected from water sources and treated drinking water containers and analyzed for total coliforms, E. coli, and chlorine residual. Drinking water treatment was reported at 15 of 17 sites. Three of 18 drinking water samples collected met the WHO guideline for free chlorine residual of >0.2 mg/l, 6 of 16 drinking water samples analyzed for total coliforms met the WHO guideline of <1 coliform/100 mL and 15 of 16 drinking water samples analyzed for E. coli met the WHO guideline of <1 E. coli/100 mL. HCF staff reported treating up to 20 L of drinking water per day. At all sites, 60% of water access points (160 of 267) were observed to be functional, 32% of hand washing locations (46 of 142) had water and soap and 44% of sanitary facilities (48 of 109) were in hygienic condition and accessible to patients. Regular maintenance of WASH infrastructure consisted of cleaning; no HCF had on-site capacity for performing repairs. Quarterly evaluations of HCFs for Rwanda's Performance Based Financing system included WASH indicators. All HCFs met national policies for water access, but WHO guidelines for environmental standards including water quality were not fully satisfied. Access to WASH services at the HCFs differed between staff and patients and caregivers.

Use of geographic information systems technology to track critical health code violations in retail facilities available to populations of different socioeconomic status and demographics.

PubMed

Darcey, Valerie L; Quinlan, Jennifer J

2011-09-01

Research shows that community socioeconomic status (SES) predicts, based on food service types available, whether a population has access to healthy food. It is not known, however, if a relationship exists between SES and risk for foodborne illness (FBI) at the community level. Geographic information systems (GIS) give researchers the ability to pinpoint health indicators to specific geographic locations and detect resulting environmental gradients. It has been used extensively to characterize the food environment, with respect to access to healthy foods. This research investigated the utility of GIS in determining whether community SES and/or demographics relate to access to safe food, as measured by food service critical health code violations (CHV) as a proxy for risk for FBI. Health inspection records documenting CHV for 10,859 food service facilities collected between 2005 and 2008 in Philadelphia, PA, were accessed. Using an overlay analysis through GIS, CHV were plotted over census tracts of the corresponding area. Census tracts (n = 368) were categorized into quintiles, based on poverty level. Overall, food service facilities in higher poverty areas had a greater number of facilities (with at least one CHV) and had more frequent inspections than facilities in lower poverty areas. The facilities in lower poverty areas, however, had a higher average number of CHV per inspection. Analysis of CHV rates in census tracts with high concentrations of minority populations found Hispanic facilities had more CHV than other demographics, and Hispanic and African American facilities had fewer days between inspections. This research demonstrates the potential for utilization of GIS mapping for tracking risks for FBI. Conversely, it sheds light on the subjective nature of health inspections, and indicates that underlying factors might be affecting inspection frequency and identification of CHV, such that CHV might not be a true proxy for risk for FBI.

State parity laws and access to treatment for substance use disorder in the United States: implications for federal parity legislation.

PubMed

Wen, Hefei; Cummings, Janet R; Hockenberry, Jason M; Gaydos, Laura M; Druss, Benjamin G

2013-12-01

The passage of the 2008 Mental Health Parity and Addiction Equity Act and the 2010 Affordable Care Act incorporated parity for substance use disorder (SUD) treatment into federal legislation. However, prior research provides us with scant evidence as to whether federal parity legislation will hold the potential for improving access to SUD treatment. To examine the effect of state-level SUD parity laws on state-aggregate SUD treatment rates and to shed light on the impact of the recent federal SUD parity legislation. We conducted a quasi-experimental study using a 2-way (state and year) fixed-effect method. We included all known specialty SUD treatment facilities in the United States and examined treatment rates from October 1, 2000, through March 31, 2008. Our main source of data was the National Survey of Substance Abuse Treatment Services, which provides facility-level information on specialty SUD treatment. State-level SUD parity laws during the study period. State-aggregate SUD treatment rates in (1) all specialty SUD treatment facilities and (2) specialty SUD treatment facilities accepting private insurance. The implementation of any SUD parity law increased the treatment rate by 9% (P < .001) in all specialty SUD treatment facilities and by 15% (P = .02) in facilities accepting private insurance. Full parity and parity only if SUD coverage is offered increased the SUD treatment rate by 13% (P = .02) and 8% (P = .04), respectively, in all facilities and by 21% (P = .03) and 10% (P = .04), respectively, in facilities accepting private insurance. We found a positive effect of the implementation of state SUD parity legislation on access to specialty SUD treatment. Furthermore, the positive association is more pronounced in states with more comprehensive parity laws. Our findings suggest that federal parity legislation holds the potential to improve access to SUD treatment.

Access to Educational Opportunity in Rural Communities: Alternative Patterns of Delivering Vocational Education in Sparsely Populated Areas. Volume 3: The Northwest Multi-District: A Mobile Facilities Center.

ERIC Educational Resources Information Center

Peterson, Roland L.; And Others

Representing the mobile facilities pattern of inter-district cooperation, the Northwest Multi-District case is one of four studies addressing access of rural students to vocational education through inter-school district cooperation. The report identifies essential features of this form of cooperation, details factors facilitating/impeding the…

78 FR 67303 - Americans With Disabilities Act (ADA) Accessibility Guidelines for Buildings and Facilities...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-12

... continuing on page 59501, in the first column, Table 208.2--PARKING SPACES is corrected to read as follows: Table 208.2--Parking Spaces Total number of parking spaces provided in Minimum number of required parking facility accessible parking spaces 1 to 25 1. 26 to 50 2. 51 to 75 3. 76 to 100 4. 101 to 150 5...

A spatial analysis of variations in health access: linking geography, socio-economic status and access perceptions

PubMed Central

2011-01-01

Background This paper analyses the relationship between public perceptions of access to general practitioners (GPs) surgeries and hospitals against health status, car ownership and geographic distance. In so doing it explores the different dimensions associated with facility access and accessibility. Methods Data on difficulties experienced in accessing health services, respondent health status and car ownership were collected through an attitudes survey. Road distances to the nearest service were calculated for each respondent using a GIS. Difficulty was related to geographic distance, health status and car ownership using logistic generalized linear models. A Geographically Weighted Regression (GWR) was used to explore the spatial non-stationarity in the results. Results Respondent long term illness, reported bad health and non-car ownership were found to be significant predictors of difficulty in accessing GPs and hospitals. Geographic distance was not a significant predictor of difficulty in accessing hospitals but was for GPs. GWR identified the spatial (local) variation in these global relationships indicating locations where the predictive strength of the independent variables was higher or lower than the global trend. The impacts of bad health and non-car ownership on the difficulties experienced in accessing health services varied spatially across the study area, whilst the impacts of geographic distance did not. Conclusions Difficulty in accessing different health facilities was found to be significantly related to health status and car ownership, whilst the impact of geographic distance depends on the service in question. GWR showed how these relationships were varied across the study area. This study demonstrates that the notion of access is a multi-dimensional concept, whose composition varies with location, according to the facility being considered and the health and socio-economic status of the individual concerned. PMID:21787394

7 CFR 1739.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... terrestrial technology having the capacity to provide transmission facilities that enable subscribers of the...) Computer Access Points and wireless access, that is used for the purposes of providing free access to and..., and after normal working hours and on Saturdays or Sunday. Computer Access Point means a new computer...

40 CFR 35.925-8 - Environmental review.

Code of Federal Regulations, 2014 CFR

2014-07-01

... impacts, consistent with the requirements of part 6 of this chapter, as part of facilities planning, in accordance with § 35.917-1(d)(7). The Regional Administrator must insure that an environmental impact... award of step 2 or step 3 grant assistance. (b) The Regional Administrator may not award step 2 or step...

40 CFR 35.925-8 - Environmental review.

Code of Federal Regulations, 2012 CFR

2012-07-01

... impacts, consistent with the requirements of part 6 of this chapter, as part of facilities planning, in accordance with § 35.917-1(d)(7). The Regional Administrator must insure that an environmental impact... award of step 2 or step 3 grant assistance. (b) The Regional Administrator may not award step 2 or step...

Facilities Audit Workbook: A Self-Evaluation for Higher Education.

ERIC Educational Resources Information Center

Kaiser, Harvey H.

The purpose and scope of a facilities audit and steps in conducting an audit are outlined, and facility ratings forms that can be used in the process are included. The audit is presented as a part of the comprehensive facilities management approach, and the users and different audit uses are also addressed. The audit design phase includes deciding…

R4FRS_RCRAINFO

EPA Pesticide Factsheets

To improve public health and the environment, the United States Environmental Protection Agency (USEPA) collects information about facilities, sites, or places subject to environmental regulation or of environmental interest. Through the Geospatial Data Download Service, the public is now able to download the EPA Geodata shapefile containing facility and site information from EPA's national program systems. The file is Internet accessible from the Envirofacts Web site (http://www.epa.gov/enviro). The data may be used with geospatial mapping applications. (Note: The shapefile omits facilities without latitude/longitude coordinates.) The EPA Geospatial Data contains the name, location (latitude/longitude), and EPA program information about specific facilities and sites. In addition, the file contains a Uniform Resource Locator (URL), which allows mapping applications to present an option to users to access additional EPA data resources on a specific facility or site.

Study of the impact of automation on productivity in bus-maintenance facilities. Final report

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

Sumanth, D.J.; Weiss, H.J.; Adya, B.

1988-12-01

Whether or not the various types of automation and new technologies introduced in a bus-transit system really have an impact on productivity is the question addressed in the study. The report describes a new procedure of productivity measurement and evaluation for a county-transit system and provides an objective perspective on the impact of automation on productivity in bus maintenance facilities. The research objectives were: to study the impact of automation on total productivity in transit maintenance facilities; to develop and apply a methodology for measuring the total productivity of a Floridian transit maintenance facility (Bradenton-Manatee County bus maintenance facility whichmore » has been introducing automation since 1983); and to develop a practical step-by-step implementation scheme for the total productivity-based productivity measurement system that any bus manager can use. All 3 objectives were successfully accomplished.« less

Waiting for attention and care: birthing accounts of women in rural Tanzania who developed obstetric fistula as an outcome of labour.

PubMed

Mselle, Lilian T; Kohi, Thecla W; Mvungi, Abu; Evjen-Olsen, Bjørg; Moland, Karen Marie

2011-10-21

Obstetric fistula is a physically and socially disabling obstetric complication that affects about 3,000 women in Tanzania every year. The fistula, an opening that forms between the vagina and the bladder and/or the rectum, is most frequently caused by unattended prolonged labour, often associated with delays in seeking and receiving appropriate and adequate birth care. Using the availability, accessibility, acceptability and quality of care (AAAQ) concept and the three delays model, this article provides empirical knowledge on birth care experiences of women who developed fistula after prolonged labour. We used a mixed methods approach to explore the birthing experiences of women affected by fistula and the barriers to access adequate care during labour and delivery. Sixteen women were interviewed for the qualitative study and 151 women were included in the quantitative survey. All women were interviewed at the Comprehensive Community Based Rehabilitation Tanzania in Dar es Salaam and Bugando Medical Centre in Mwanza. Women experienced delays both before and after arriving at a health facility. Decisions on where to seek care were most often taken by husbands and mothers-in-law (60%). Access to health facilities providing emergency obstetric care was inadequate and transport was a major obstacle. About 20% reported that they had walked or were carried to the health facility. More than 50% had reported to a health facility after two or more days of labour at home. After arrival at a health facility women experienced lack of supportive care, neglect, poor assessment of labour and lack of supervision. Their birth accounts suggest unskilled birth care and poor referral routines. This study reveals major gaps in access to and provision of emergency obstetric care. It illustrates how poor quality of care at health facilities contributes to delays that lead to severe birth injuries, highlighting the need to ensure women's rights to accessible, acceptable and adequate quality services during labour and delivery.

Waiting for attention and care: birthing accounts of women in rural Tanzania who developed obstetric fistula as an outcome of labour

PubMed Central

2011-01-01

Background Obstetric fistula is a physically and socially disabling obstetric complication that affects about 3,000 women in Tanzania every year. The fistula, an opening that forms between the vagina and the bladder and/or the rectum, is most frequently caused by unattended prolonged labour, often associated with delays in seeking and receiving appropriate and adequate birth care. Using the availability, accessibility, acceptability and quality of care (AAAQ) concept and the three delays model, this article provides empirical knowledge on birth care experiences of women who developed fistula after prolonged labour. Methods We used a mixed methods approach to explore the birthing experiences of women affected by fistula and the barriers to access adequate care during labour and delivery. Sixteen women were interviewed for the qualitative study and 151 women were included in the quantitative survey. All women were interviewed at the Comprehensive Community Based Rehabilitation Tanzania in Dar es Salaam and Bugando Medical Centre in Mwanza. Results Women experienced delays both before and after arriving at a health facility. Decisions on where to seek care were most often taken by husbands and mothers-in-law (60%). Access to health facilities providing emergency obstetric care was inadequate and transport was a major obstacle. About 20% reported that they had walked or were carried to the health facility. More than 50% had reported to a health facility after two or more days of labour at home. After arrival at a health facility women experienced lack of supportive care, neglect, poor assessment of labour and lack of supervision. Their birth accounts suggest unskilled birth care and poor referral routines. Conclusions This study reveals major gaps in access to and provision of emergency obstetric care. It illustrates how poor quality of care at health facilities contributes to delays that lead to severe birth injuries, highlighting the need to ensure women's rights to accessible, acceptable and adequate quality services during labour and delivery. PMID:22013991

Configuration and Management of a Cluster Computing Facility in Undergraduate Student Computer Laboratories

ERIC Educational Resources Information Center

Cornforth, David; Atkinson, John; Spennemann, Dirk H. R.

2006-01-01

Purpose: Many researchers require access to computer facilities beyond those offered by desktop workstations. Traditionally, these are offered either through partnerships, to share the cost of supercomputing facilities, or through purpose-built cluster facilities. However, funds are not always available to satisfy either of these options, and…

Financing Public School Facilities in Texas: A Case Study.

ERIC Educational Resources Information Center

Dawn, Lisa

A case study is presented of a Texas educational facilities program that was developed to provide long-term state assistance to school districts for the construction or renovation of their facilities by providing equal access to revenue for the specific purpose of repaying debt issued to finance instructional facilities. This report presents a…

76 FR 62868 - Washington State University; Notice of Issuance of Renewed Facility Operating License No. R-76

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-11

...; Notice of Issuance of Renewed Facility Operating License No. R-76 AGENCY: Nuclear Regulatory Commission. ACTION: Notice of issuance of renewed facility operating license No. R- 76. ADDRESSES: You can access.... Nuclear Regulatory Commission (NRC, the Commission) has issued renewed Facility Operating License No. R-76...

45 CFR 84.22 - Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., welfare, or other social services at alternate accessible sites, alteration of existing facilities and... to make structural changes in existing facilities where other methods are effective in achieving... handicapped persons in the most integrated setting appropriate. (c) Small health, welfare, or other social...

40 CFR 271.12 - Requirements for hazardous waste management facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... and 266. These standards shall include: (a) Technical standards for tanks, containers, waste piles...-closure monitoring and maintenance; (e) Groundwater monitoring; (f) Security to prevent unauthorized access to the facility; (g) Facility personnel training; (h) Inspections, monitoring, recordkeeping, and...

40 CFR 271.12 - Requirements for hazardous waste management facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... and 266. These standards shall include: (a) Technical standards for tanks, containers, waste piles...-closure monitoring and maintenance; (e) Groundwater monitoring; (f) Security to prevent unauthorized access to the facility; (g) Facility personnel training; (h) Inspections, monitoring, recordkeeping, and...

40 CFR 271.12 - Requirements for hazardous waste management facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... and 266. These standards shall include: (a) Technical standards for tanks, containers, waste piles...-closure monitoring and maintenance; (e) Groundwater monitoring; (f) Security to prevent unauthorized access to the facility; (g) Facility personnel training; (h) Inspections, monitoring, recordkeeping, and...

40 CFR 271.12 - Requirements for hazardous waste management facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... and 266. These standards shall include: (a) Technical standards for tanks, containers, waste piles...-closure monitoring and maintenance; (e) Groundwater monitoring; (f) Security to prevent unauthorized access to the facility; (g) Facility personnel training; (h) Inspections, monitoring, recordkeeping, and...

40 CFR 271.12 - Requirements for hazardous waste management facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... and 266. These standards shall include: (a) Technical standards for tanks, containers, waste piles...-closure monitoring and maintenance; (e) Groundwater monitoring; (f) Security to prevent unauthorized access to the facility; (g) Facility personnel training; (h) Inspections, monitoring, recordkeeping, and...

45 CFR 84.22 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., welfare, or other social services at alternate accessible sites, alteration of existing facilities and... to make structural changes in existing facilities where other methods are effective in achieving... handicapped persons in the most integrated setting appropriate. (c) Small health, welfare, or other social...

Mano a Mano: Improving health in impoverished Bolivian communities through community-based participatory research.

PubMed

Velasquez, Joan; Knatterud-Hubinger, Nate; Narr, Dan; Mendenhall, Tai; Solheim, Catherine

2011-12-01

Mano a Mano (Spanish translation: "Hand to Hand") is a nonprofit organization that is working in partnership with underserved Bolivian communities to cocreate medical infrastructures and to improve health. Using community-based participatory research (CBPR) methods, Mano a Mano engages local government and community leaders, health care providers, educators, and ordinary citizens in a manner that taps local strengths and resources to allow all participants to work together to realize this mission. After describing Bolivia's call for improved access to high quality care in its poor and underserved rural areas, we outline the Mano a Mano's CBPR approach and sequence to answer this call, the culmination of its efforts to date (including the establishment of 119 health care facilities), lessons learned, and next steps in the formal evaluation and extension of this collaborative work.

A facile synthesis of lipid stabilized gold nanoparticles: a step towards biodegradable biosensors.

PubMed

Abraham, Sinoj; Narine, Suresh S

2011-08-01

A new class of polylactone was successfully synthesized and utilized for the encapsulation and stabilization of gold nanoparticles. Core/shell nanoparticle architecture, in which a layer of this polymer surrounds the nanoparticle core have been investigated both as a means to improve the stability and surface chemistry and as a way of accessing unique physical properties that are not possible from one nano-material alone. Given the fact that only few systems has so far been developed for the encapsulation of nanoparticles, our success in using a new biodegradable biopolymer with inbuilt functionality reveals the robustness of this work. The biodegradability of this polylactone was evaluated using scanning electron microscopy (SEM). The morphology and stability of these gold-polymer hybrids were evaluated by using the transmission electron microscopy (TEM) and UV-VIS spectroscopy.

Biosecurity measures in 48 isolation facilities managing highly infectious diseases.

PubMed

Puro, Vincenzo; Fusco, Francesco M; Schilling, Stefan; Thomson, Gail; De Iaco, Giuseppina; Brouqui, Philippe; Maltezou, Helena C; Bannister, Barbara; Gottschalk, René; Brodt, Hans-Rheinhard; Ippolito, Giuseppe

2012-06-01

Biosecurity measures are traditionally applied to laboratories, but they may also be usefully applied in highly specialized clinical settings, such as the isolation facilities for the management of patients with highly infectious diseases (eg, viral hemorrhagic fevers, SARS, smallpox, potentially severe pandemic flu, and MDR- and XDR-tuberculosis). In 2009 the European Network for Highly Infectious Diseases conducted a survey in 48 isolation facilities in 16 European countries to determine biosecurity measures for access control to the facility. Security personnel are present in 39 facilities (81%). In 35 facilities (73%), entrance to the isolation area is restricted; control methods include electronic keys, a PIN system, closed-circuit TV, and guards at the doors. In 25 facilities (52%), identification and registration of all staff entering and exiting the isolation area are required. Access control is used in most surveyed centers, but specific lacks exist in some facilities. Further data are needed to assess other biosecurity aspects, such as the security measures during the transportation of potentially contaminated materials and measures to address the risk of an "insider attack."

Clean Air Markets - Facility Attributes and Contacts Query Wizard

EPA Pesticide Factsheets

The Facility Attributes and Contacts Query Wizard is part of a suite of Clean Air Markets-related tools that are accessible at http://camddataandmaps.epa.gov/gdm/index.cfm. The Facility Attributes and Contact module gives the user access to current and historical facility, owner, and representative data using custom queries, via the Facility Attributes Query Wizard, or Quick Reports. In addition, data regarding EPA, State, and local agency staff are also available. The Query Wizard can be used to search for data about a facility or facilities by identifying characteristics such as associated programs, owners, representatives, locations, and unit characteristics, facility inventories, and classifications.EPA's Clean Air Markets Division (CAMD) includes several market-based regulatory programs designed to improve air quality and ecosystems. The most well-known of these programs are EPA's Acid Rain Program and the NOx Programs, which reduce emissions of sulfur dioxide (SO2) and nitrogen oxides (NOx)-compounds that adversely affect air quality, the environment, and public health. CAMD also plays an integral role in the development and implementation of the Clean Air Interstate Rule (CAIR).

Biosecurity Measures in 48 Isolation Facilities Managing Highly Infectious Diseases

PubMed Central

Puro, Vincenzo; Schilling, Stefan; Thomson, Gail; De Iaco, Giuseppina; Brouqui, Philippe; Maltezou, Helena C.; Bannister, Barbara; Gottschalk, René; Brodt, Hans-Rheinhard; Ippolito, Giuseppe

2012-01-01

Biosecurity measures are traditionally applied to laboratories, but they may also be usefully applied in highly specialized clinical settings, such as the isolation facilities for the management of patients with highly infectious diseases (eg, viral hemorrhagic fevers, SARS, smallpox, potentially severe pandemic flu, and MDR- and XDR-tuberculosis). In 2009 the European Network for Highly Infectious Diseases conducted a survey in 48 isolation facilities in 16 European countries to determine biosecurity measures for access control to the facility. Security personnel are present in 39 facilities (81%). In 35 facilities (73%), entrance to the isolation area is restricted; control methods include electronic keys, a PIN system, closed-circuit TV, and guards at the doors. In 25 facilities (52%), identification and registration of all staff entering and exiting the isolation area are required. Access control is used in most surveyed centers, but specific lacks exist in some facilities. Further data are needed to assess other biosecurity aspects, such as the security measures during the transportation of potentially contaminated materials and measures to address the risk of an “insider attack.” PMID:22571373

MicroGen: a MIAME compliant web system for microarray experiment information and workflow management.

PubMed

Burgarella, Sarah; Cattaneo, Dario; Pinciroli, Francesco; Masseroli, Marco

2005-12-01

Improvements of bio-nano-technologies and biomolecular techniques have led to increasing production of high-throughput experimental data. Spotted cDNA microarray is one of the most diffuse technologies, used in single research laboratories and in biotechnology service facilities. Although they are routinely performed, spotted microarray experiments are complex procedures entailing several experimental steps and actors with different technical skills and roles. During an experiment, involved actors, who can also be located in a distance, need to access and share specific experiment information according to their roles. Furthermore, complete information describing all experimental steps must be orderly collected to allow subsequent correct interpretation of experimental results. We developed MicroGen, a web system for managing information and workflow in the production pipeline of spotted microarray experiments. It is constituted of a core multi-database system able to store all data completely characterizing different spotted microarray experiments according to the Minimum Information About Microarray Experiments (MIAME) standard, and of an intuitive and user-friendly web interface able to support the collaborative work required among multidisciplinary actors and roles involved in spotted microarray experiment production. MicroGen supports six types of user roles: the researcher who designs and requests the experiment, the spotting operator, the hybridisation operator, the image processing operator, the system administrator, and the generic public user who can access the unrestricted part of the system to get information about MicroGen services. MicroGen represents a MIAME compliant information system that enables managing workflow and supporting collaborative work in spotted microarray experiment production.

Development and Use of a Virtual NMR Facility

NASA Astrophysics Data System (ADS)

Keating, Kelly A.; Myers, James D.; Pelton, Jeffrey G.; Bair, Raymond A.; Wemmer, David E.; Ellis, Paul D.

2000-03-01

We have developed a "virtual NMR facility" (VNMRF) to enhance access to the NMR spectrometers in Pacific Northwest National Laboratory's Environmental Molecular Sciences Laboratory (EMSL). We use the term virtual facility to describe a real NMR facility made accessible via the Internet. The VNMRF combines secure remote operation of the EMSL's NMR spectrometers over the Internet with real-time videoconferencing, remotely controlled laboratory cameras, real-time computer display sharing, a Web-based electronic laboratory notebook, and other capabilities. Remote VNMRF users can see and converse with EMSL researchers, directly and securely control the EMSL spectrometers, and collaboratively analyze results. A customized Electronic Laboratory Notebook allows interactive Web-based access to group notes, experimental parameters, proposed molecular structures, and other aspects of a research project. This paper describes our experience developing a VNMRF and details the specific capabilities available through the EMSL VNMRF. We show how the VNMRF has evolved during a test project and present an evaluation of its impact in the EMSL and its potential as a model for other scientific facilities. All Collaboratory software used in the VNMRF is freely available from http://www.emsl.pnl.gov:2080/docs/collab.

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

PubMed

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

2013-03-01

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

Patient-controlled sharing of medical imaging data across unaffiliated healthcare organizations

PubMed Central

Ahn, David K; Unde, Bhagyashree; Gage, H Donald; Carr, J Jeffrey

2013-01-01

Background Current image sharing is carried out by manual transportation of CDs by patients or organization-coordinated sharing networks. The former places a significant burden on patients and providers. The latter faces challenges to patient privacy. Objective To allow healthcare providers efficient access to medical imaging data acquired at other unaffiliated healthcare facilities while ensuring strong protection of patient privacy and minimizing burden on patients, providers, and the information technology infrastructure. Methods An image sharing framework is described that involves patients as an integral part of, and with full control of, the image sharing process. Central to this framework is the Patient Controlled Access-key REgistry (PCARE) which manages the access keys issued by image source facilities. When digitally signed by patients, the access keys are used by any requesting facility to retrieve the associated imaging data from the source facility. A centralized patient portal, called a PCARE patient control portal, allows patients to manage all the access keys in PCARE. Results A prototype of the PCARE framework has been developed by extending open-source technology. The results for feasibility, performance, and user assessments are encouraging and demonstrate the benefits of patient-controlled image sharing. Discussion The PCARE framework is effective in many important clinical cases of image sharing and can be used to integrate organization-coordinated sharing networks. The same framework can also be used to realize a longitudinal virtual electronic health record. Conclusion The PCARE framework allows prior imaging data to be shared among unaffiliated healthcare facilities while protecting patient privacy with minimal burden on patients, providers, and infrastructure. A prototype has been implemented to demonstrate the feasibility and benefits of this approach. PMID:22886546

Some thoughts on Mercurian resources

NASA Astrophysics Data System (ADS)

Gillett, Stephen L.

Virtually all scenarios on Solar System development ignore Mercury, but such inattention is probably undeserved. Once viable lunar and (probably) asteroidal facilities are established in the next century, Mercury warrants further investigation. Mercury's high solar energy density is a major potential advantage for space-based industries. Indeed, despite its higher gravity, Mercury is roughly twice as easy to leave as the Moon if the additional solar flux is taken into account. Moreover, with solar-driven technologies such as solar sails or electric propulsion, its depth in the Sun's gravity well is less important. Because Mercury is airless and almost certainly waterless, it will be an obvious place to export lunar technology, which will have been developed to deal with very similar conditions. Methods for extracting resources from anhydrous silicates will be particularly germane. Even without solar-powered propulsion, the discovery of low-delta-V access via multiple Venus and Earth encounters makes the planet easier to reach than had been thought. Technology developed for multi-year missions to asteroids and Mars should be readily adaptable to such Mercurian missions. Mercury will not be our first outpost in the Solar System. Nonetheless, as facilities are established in cis-Earth space, it probably merits attention as a next step for development.

Dismantling of Highly Contaminated Process Installations of the German Reprocessing Facility (WAK) - Status of New Remote Handling Technology - 13287

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

Dux, Joachim; Friedrich, Daniel; Lutz, Werner

2013-07-01

Decommissioning and dismantling of the former German Pilot Reprocessing Plant Karlsruhe (WAK) including the Vitrification Facility (VEK) is being executed in different Project steps related to the reprocessing, HLLW storage and vitrification complexes /1/. While inside the reprocessing building the total inventory of process equipment has already been dismantled and disposed of, the HLLW storage and vitrification complex has been placed out of operation since vitrification and tank rinsing procedures where finalized in year 2010. This paper describes the progress made in dismantling of the shielded boxes of the highly contaminated laboratory as a precondition to get access to themore » hot cells of the HLLW storage. The major challenges of the dismantling of this laboratory were the high dose rates up to 700 mSv/h and the locking technology for the removal of the hot cell installations. In parallel extensive prototype testing of different carrier systems and power manipulators to be applied to dismantle the HLLW-tanks and other hot cell equipment is ongoing. First experiences with the new manipulator carrier system and a new master slave manipulator with force reflection will be reported. (authors)« less

KiMoSys: a web-based repository of experimental data for KInetic MOdels of biological SYStems

PubMed Central

2014-01-01

Background The kinetic modeling of biological systems is mainly composed of three steps that proceed iteratively: model building, simulation and analysis. In the first step, it is usually required to set initial metabolite concentrations, and to assign kinetic rate laws, along with estimating parameter values using kinetic data through optimization when these are not known. Although the rapid development of high-throughput methods has generated much omics data, experimentalists present only a summary of obtained results for publication, the experimental data files are not usually submitted to any public repository, or simply not available at all. In order to automatize as much as possible the steps of building kinetic models, there is a growing requirement in the systems biology community for easily exchanging data in combination with models, which represents the main motivation of KiMoSys development. Description KiMoSys is a user-friendly platform that includes a public data repository of published experimental data, containing concentration data of metabolites and enzymes and flux data. It was designed to ensure data management, storage and sharing for a wider systems biology community. This community repository offers a web-based interface and upload facility to turn available data into publicly accessible, centralized and structured-format data files. Moreover, it compiles and integrates available kinetic models associated with the data. KiMoSys also integrates some tools to facilitate the kinetic model construction process of large-scale metabolic networks, especially when the systems biologists perform computational research. Conclusions KiMoSys is a web-based system that integrates a public data and associated model(s) repository with computational tools, providing the systems biology community with a novel application facilitating data storage and sharing, thus supporting construction of ODE-based kinetic models and collaborative research projects. The web application implemented using Ruby on Rails framework is freely available for web access at http://kimosys.org, along with its full documentation. PMID:25115331

36 CFR 71.3 - Designation.

Code of Federal Regulations, 2012 CFR

2012-07-01

...: Tent or trailer spaces, drinking water, access road, refuse containers, toilet facilities, personal fee..., roads, overlook sites, visitors' centers, scenic drives, toilet facilities, picnic tables, and boat...

36 CFR 71.3 - Designation.

Code of Federal Regulations, 2013 CFR

2013-07-01

...: Tent or trailer spaces, drinking water, access road, refuse containers, toilet facilities, personal fee..., roads, overlook sites, visitors' centers, scenic drives, toilet facilities, picnic tables, and boat...

36 CFR 71.3 - Designation.

Code of Federal Regulations, 2014 CFR

2014-07-01

...: Tent or trailer spaces, drinking water, access road, refuse containers, toilet facilities, personal fee..., roads, overlook sites, visitors' centers, scenic drives, toilet facilities, picnic tables, and boat...

Flow Induced Noise from Turbulent Flow over Steps and Gaps

DTIC Science & Technology

2010-05-04

Wall Jet Facility which is detailed in Figures 2.1 through 2.3. In this facility a Cincinnati Fan variable speed centrifugal fan with model number...the flow over the multiple backward steps considered in this study The following subsections will concentrate on the oil flow visualization performed ...NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Virginia Polytechnic Institute and State University

Creating a Clinical Video-Conferencing Facility in a Security-Constrained Environment Using Open-Source AccessGrid Software and Consumer Hardware

PubMed Central

Terrazas, Enrique; Hamill, Timothy R.; Wang, Ye; Channing Rodgers, R. P.

2007-01-01

The Department of Laboratory Medicine at the University of California, San Francisco (UCSF) has been split into widely separated facilities, leading to much time being spent traveling between facilities for meetings. We installed an open-source AccessGrid multi-media-conferencing system using (largely) consumer-grade equipment, connecting 6 sites at 5 separate facilities. The system was accepted rapidly and enthusiastically, and was inexpensive compared to alternative approaches. Security was addressed by aspects of the AG software and by local network administrative practices. The chief obstacles to deployment arose from security restrictions imposed by multiple independent network administration regimes, requiring a drastically reduced list of network ports employed by AG components. PMID:18693930

Creating a clinical video-conferencing facility in a security-constrained environment using open-source AccessGrid software and consumer hardware.

PubMed

Terrazas, Enrique; Hamill, Timothy R; Wang, Ye; Channing Rodgers, R P

2007-10-11

The Department of Laboratory Medicine at the University of California, San Francisco (UCSF) has been split into widely separated facilities, leading to much time being spent traveling between facilities for meetings. We installed an open-source AccessGrid multi-media-conferencing system using (largely) consumer-grade equipment, connecting 6 sites at 5 separate facilities. The system was accepted rapidly and enthusiastically, and was inexpensive compared to alternative approaches. Security was addressed by aspects of the AG software and by local network administrative practices. The chief obstacles to deployment arose from security restrictions imposed by multiple independent network administration regimes, requiring a drastically reduced list of network ports employed by AG components.

38 CFR 1.469 - Patient access and restrictions on use.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Patient access and... Sickle Cell Anemia § 1.469 Patient access and restrictions on use. (a) Patient access not prohibited. Sections 1.460 through 1.499 of this part do not prohibit a facility from giving a patient access to his or...

Measuring geographical accessibility to palliative and end of life (PEoLC) related facilities: a comparative study in an area with well-developed specialist palliative care (SPC) provision.

PubMed

Pearson, Clare; Verne, Julia; Wells, Claudia; Polato, Giovanna M; Higginson, Irene J; Gao, Wei

2017-01-26

Geographical accessibility is important in accessing healthcare services. Measuring it has evolved alongside technological and data analysis advances. High correlations between different methods have been detected, but no comparisons exist in the context of palliative and end of life care (PEoLC) studies. To assess how geographical accessibility can affect PEoLC, selection of an appropriate method to capture it is crucial. We therefore aimed to compare methods of measuring geographical accessibility of decedents to PEoLC-related facilities in South London, an area with well-developed SPC provision. Individual-level death registration data in 2012 (n = 18,165), from the Office for National Statistics (ONS) were linked to area-level PEoLC-related facilities from various sources. Simple and more complex measures of geographical accessibility were calculated using the residential postcodes of the decedents and postcodes of the nearest hospital, care home and hospice. Distance measures (straight-line, travel network) and travel times along the road network were compared using geographic information system (GIS) mapping and correlation analysis (Spearman rho). Borough-level maps demonstrate similarities in geographical accessibility measures. Strong positive correlation exist between straight-line and travel distances to the nearest hospital (rho = 0.97), care home (rho = 0.94) and hospice (rho = 0.99). Travel times were also highly correlated with distance measures to the nearest hospital (rho range = 0.84-0.88), care home (rho = 0.88-0.95) and hospice (rho = 0.93-0.95). All correlations were significant at p < 0.001 level. Distance-based and travel-time measures of geographical accessibility to PEoLC-related facilities in South London are similar, suggesting the choice of measure can be based on the ease of calculation.

34 CFR 75.610 - Access by the handicapped.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Access by the handicapped. 75.610 Section 75.610... by a Grantee? Construction § 75.610 Access by the handicapped. A grantee shall comply with the Federal regulations on access by the handicapped that apply to construction and alteration of facilities...

34 CFR 75.610 - Access by the handicapped.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 1 2012-07-01 2012-07-01 false Access by the handicapped. 75.610 Section 75.610... by a Grantee? Construction § 75.610 Access by the handicapped. A grantee shall comply with the Federal regulations on access by the handicapped that apply to construction and alteration of facilities...

34 CFR 75.610 - Access by the handicapped.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 1 2011-07-01 2011-07-01 false Access by the handicapped. 75.610 Section 75.610... by a Grantee? Construction § 75.610 Access by the handicapped. A grantee shall comply with the Federal regulations on access by the handicapped that apply to construction and alteration of facilities...