Probing Aircraft Flight Test Hazard Mitigation for the Alternative Fuel Effects on Contrails and Cruise Emissions (ACCESS) Research Team . Volume 2; Appendices

NASA Technical Reports Server (NTRS)

Kelly, Michael J.

2013-01-01

The Alternative Fuel Effects on Contrails and Cruise Emissions (ACCESS) Project Integration Manager requested in July 2012 that the NASA Engineering and Safety Center (NESC) form a team to independently assess aircraft structural failure hazards associated with the ACCESS experiment and to identify potential flight test hazard mitigations to ensure flight safety. The ACCESS Project Integration Manager subsequently requested that the assessment scope be focused predominantly on structural failure risks to the aircraft empennage (horizontal and vertical tail). This report contains the Appendices to Volume I.

Patents or patients? Global access to pharmaceuticals and social justice.

PubMed

de Wildt, Gilles; Khoon, Chan Chee

2008-01-01

Innovation, vaccine development, and world-wide equitable access to necessary pharmaceuticals are hindered by current patenting arrangements and the orientation of pharmaceutical research. Plausible alternatives exist, including instituting the right of national or international agencies to act in the public interest and to buy patents selectively with a view to innovation and equitable access. Alternatives could partly or wholly finance themselves and lower pharmaceutical prices globally. Countries, individuals or groups of patients could help promote alternatives by calling into question the current emphasis on commercialization and profit, and by demanding globally equitable arrangements when sharing data that are important for research or when individuals or communities volunteer as research participants.

Alternative Computer Access for Young Handicapped Children: A Systematic Selection Procedure.

ERIC Educational Resources Information Center

Morris, Karen J.

The paper describes the type of computer access products appropriate for use by handicapped children and presents a systematic procedure for selection of such input and output devices. Modification of computer input is accomplished by three strategies: modifying the keyboard, adding alternative keyboards, and attaching switches to the keyboard.…

14 CFR 161.205 - Required analysis of proposed restriction and alternatives.

Code of Federal Regulations, 2010 CFR

2010-01-01

... of the anticipated or actual costs and benefits of the proposed noise or access restriction; (2) A... not involve aircraft restrictions, and a comparison of the costs and benefits of such alternative measures to costs and benefits of the proposed noise or access restriction. (b) In preparing the analyses...

78 FR 14843 - Temporary Scope Expansion of the Post-Investigation Alternative Dispute Resolution Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-07

... Documents Access and Management System (ADAMS): You may access publicly available documents online in the... may examine and purchase copies of public documents at the NRC's PDR, Room O1-F21, One White Flint... Resolution Review Team (ART) Pilot Program Recommendations for Using Alternative Dispute Resolution (ADR...

Periplasmic orientation of nascent lipid A in the inner membrane of an Escherichia coli LptA mutant

PubMed Central

Ma, Bing; Reynolds, C. Michael; Raetz, Christian R. H.

2008-01-01

The core-lipid A domain of Escherichia coli lipopolysaccharide (LPS) is synthesized on the inner surface of the inner membrane (IM) and flipped to its outer surface by the ABC transporter MsbA. Recent studies with deletion mutants implicate the periplasmic protein LptA, the cytosolic protein LptB, and the IM proteins LptC, LptF, and LptG in the subsequent transport of nascent LPS to the outer membrane (OM), where the LptD/LptE complex flips LPS to the outer surface. We have isolated a temperature-sensitive mutant (MB1) harboring the S22C and Q111P substitutions in LptA. MB1 stops growing after 30 min at 42°C. 32Pi and [35S]methionine labeling show that export of newly synthesized phospholipids and proteins is not severely impaired, but export of LPS is defective. Using the lipid A 1-phosphatase LpxE as a periplasmic IM marker and the lipid A 3-O-deacylase PagL as an OM marker, we show that core-lipid A reaches the periplasmic side of the IM at 42°C in MB1 but not the outer surface of the OM. Electron microscopy of MB1 reveals dense periplasmic material and a smooth OM at 42°C, consistent with a role for LptA in shuttling LPS across the periplasm. PMID:18768814

Periplasmic orientation of nascent lipid A in the inner membrane of an Escherichia coli LptA mutant.

PubMed

Ma, Bing; Reynolds, C Michael; Raetz, Christian R H

2008-09-16

The core-lipid A domain of Escherichia coli lipopolysaccharide (LPS) is synthesized on the inner surface of the inner membrane (IM) and flipped to its outer surface by the ABC transporter MsbA. Recent studies with deletion mutants implicate the periplasmic protein LptA, the cytosolic protein LptB, and the IM proteins LptC, LptF, and LptG in the subsequent transport of nascent LPS to the outer membrane (OM), where the LptD/LptE complex flips LPS to the outer surface. We have isolated a temperature-sensitive mutant (MB1) harboring the S22C and Q111P substitutions in LptA. MB1 stops growing after 30 min at 42 degrees C. (32)P(i) and [(35)S]methionine labeling show that export of newly synthesized phospholipids and proteins is not severely impaired, but export of LPS is defective. Using the lipid A 1-phosphatase LpxE as a periplasmic IM marker and the lipid A 3-O-deacylase PagL as an OM marker, we show that core-lipid A reaches the periplasmic side of the IM at 42 degrees C in MB1 but not the outer surface of the OM. Electron microscopy of MB1 reveals dense periplasmic material and a smooth OM at 42 degrees C, consistent with a role for LptA in shuttling LPS across the periplasm.

Synthesis and Properties of Dodecyl Trehaloside Detergents for Membrane Protein Studies

PubMed Central

Tao, Houchao; Fu, Yu; Thompson, Aaron; Lee, Sung Chang; Mahoney, Nicholas; Stevens, Raymond C.; Zhang, Qinghai

2012-01-01

Sugar-based detergents, mostly derived from maltose or glucose, prevail in the extraction, solubilization, stabilization and crystallization of membrane proteins. Inspired by the broad use of trehalose for protecting biological macromolecules and lipid bilayer structures, we synthesized new trehaloside detergents for potential applications in membrane protein research. We devised an efficient synthesis of four dodecyl trehalosides, each with the 12-carboned alkyl chain attached to different hydroxyl groups of trehalose, thus presenting a structurally diverse but related family of detergents. The detergent physical properties, including solubility, hydrophobicity, critical micelle concentration (CMC) and size of micelles, were evaluated and compared with the most popular maltoside analog, β- D-dodecylmaltoside (DDM), which varied from each other due to distinct molecular geometries and possible polar group interactions in resulting micelles. Crystals of 2-dodecyl trehaloside (2-DDTre) were also obtained in methanol, and the crystal packing revealed multiple H-bonded interactions among adjacent trehalose groups. The few trehaloside detergents were tested for the solubilization and stabilization of the nociceptin/orphanin FQ peptide receptor (ORL1) and MsbA, which belong to the G-protein coupled receptor (GPCR) and ATP-binding cassette transporter families, respectively. Our results demonstrated the utility of trehaloside detergents as membrane protein solubilization reagents with the optimal detergents being protein dependent. Continuing development and investigations of trehaloside detergents are attractive given their interesting and unique chemical-physical properties and potential interactions with membrane lipids. PMID:22780816

Alternative Fuels Data Center

Science.gov Websites

Alternative Fuel Infrastructure Grants The Maryland Energy Administration administers the Maryland Alternative Fuel Infrastructure Program (AFIP), which provides grants to develop public access alternative fueling and charging infrastructure. Only Maryland-based private businesses are eligible, and projects

Automated analysis of timber access road alternatives.

Treesearch

Doyle Burke

1974-01-01

The evaluation of timber access road alternatives is one of the primary tasks in timber harvest planning and design. During the planning stages, it is also one of the most difficult to accomplish quantitatively because a basis for comparison is related to such values as grade, length, horizontal and vertical curvature, and volumes of excavation and embankment. Within...

NGO Provision of Basic Education: Alternative or Complementary Service Delivery to Support Access to the Excluded?

ERIC Educational Resources Information Center

Rose, Pauline

2009-01-01

This paper focuses on approaches by non-government organisations (NGOs) to reach primary school-aged children excluded from access to the conventional state education system. It highlights recent shifts in international literature and agency priorities from the portrayal of NGO provision as a (non-formal) "alternative" to (formal) state…

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

PubMed

Pérez-Urdiales, Iratxe; Goicolea, Isabel

2017-09-12

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

Ability or Access-Ability: Differential Item Functioning of Items on Alternate Performance-Based Assessment Tests for Students with Visual Impairments

ERIC Educational Resources Information Center

Zebehazy, Kim T.; Zigmond, Naomi; Zimmerman, George J.

2012-01-01

Introduction: This study investigated differential item functioning (DIF) of test items on Pennsylvania's Alternate System of Assessment (PASA) for students with visual impairments and severe cognitive disabilities and what the reasons for the differences may be. Methods: The Wilcoxon signed ranks test was used to analyze differences in the scores…

Widening Access to Higher Education: An Evaluative Case Study of a Foundation Year Alternative to Access

ERIC Educational Resources Information Center

Reddy, Peter A.; Moores, Elisabeth

2008-01-01

Universities are encouraged to widen access to a broad range of applicants, including mature students taking Access qualifications. Admissions tutors can find it difficult to compare and choose between Access and A-level applications, and Access applicants for popular courses may be disadvantaged relative to students with good A-levels. In this…

Open Access Alternatives

ERIC Educational Resources Information Center

Tenopir, Carol

2004-01-01

Open access publishing is a hot topic today. But open access publishing can have many different definitions, and pros and cons vary with the definitions. Open access publishing is especially attractive to companies and small colleges or universities that are likely to have many more readers than authors. A downside is that a membership fee sounds…

Website accessibility in the tourism industry: an analysis of official national tourism organization websites around the world.

PubMed

Domínguez Vila, Trinidad; Alén González, Elisa; Darcy, Simon

2017-08-09

To analyze the accessibility of official national tourism organization websites of countries around the world, in order to establish possible common patterns and rankings of those with exemplary practice through to those with the highest number of issues. The purpose for undertaking such an analysis is to provide a quasi-indicator of inclusive organizational practice for online accessibility for both destination managers and their accessible tourism consumers - domestic and overseas people with disability visiting the websites. The official tourism websites of 210 countries included in the latest World Tourism Organization report were analyzed. A website accessibility evaluation tool (website accessible test) was used in the analysis, according to AA and AAA levels of conformance to Web Content Accessibility Guidelines 2.0 requirements. Different patterns compliance to Web Content Accessibility Guidelines 2.0 were established for the clusters, which were rather similar for both AA and AAA conformance levels. The main issues in the least accessible websites were also identified, mainly focused on the following guidelines: navigable, compatible, adaptability, text alternatives and also referred to other assistive technologies. Once the main issues were established several alternatives are suggested to address them, such as implementing more prescriptive laws and regulations, complying with mandatory benchmark standards and/or having external agencies audit website designs. However, in addition to using benchmark standards, efforts to improve this situation should also be made by programmers, who should also rely on preexistent experiences and develop more dynamic knowledge. This knowledge may include text alternatives for any nontext content; creation of content that can be presented in different ways without losing information; provide ways to help users navigate, find content, determine where they are and navigate websites to maximize compatibility with assistive technologies and user agents. Implications for rehabilitation Access to information - in this case, online information - is an important factor in the process of rehabilitation for people with disability and those supporting them. Failure to apply homogeneous criteria for website accessibility around the world can hamper access to information by people with disabilities. Travel planning requires access to mainstream tourist distribution networks where online inclusive practice is a precursor to information searching. Documents for destination managers and programmers the main problems of accessibility to websites and examples of models or solutions to follow and not. Establish the main inclusive website design criteria on which to focus on improving the access of people with disabilities to websites (e.g., text alternatives, content presented in different ways, navigating and improving compatibility with assistive technologies etc.).

76 FR 45300 - Notice of Issuance of Materials License SUA-1597 and Record of Decision for Uranerz Energy...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-28

... considered but eliminated from detailed analysis include conventional uranium mining and milling, conventional mining and heap leach processing, alternative site location, alternate lixiviants, and alternate...'s Agencywide Document Access and Management System (ADAMS), which provides text and image files of...

On Hierarchical Threshold Access Structures

DTIC Science & Technology

2010-11-01

One of the recent generalizations of (t, n) secret sharing for hierarchical threshold access structures is given by Tassa, where he answers the...of theoretical background. We give a conceptually simpler alternative for the understanding of the realization of hierarchical threshold access

Atomistic modeling of alternating access of a mitochondrial ADP/ATP membrane transporter with molecular simulations

PubMed Central

Hayashi, Shigehiko

2017-01-01

The mitochondrial ADP/ATP carrier (AAC) is a membrane transporter that exchanges a cytosolic ADP for a matrix ATP. Atomic structures in an outward-facing (OF) form which binds an ADP from the intermembrane space have been solved by X-ray crystallography, and revealed their unique pseudo three-fold symmetry fold which is qualitatively different from pseudo two-fold symmetry of most transporters of which atomic structures have been solved. However, any atomic-level information on an inward-facing (IF) form, which binds an ATP from the matrix side and is fixed by binding of an inhibitor, bongkrekic acid (BA), is not available, and thus its alternating access mechanism for the transport process is unknown. Here, we report an atomic structure of the IF form predicted by atomic-level molecular dynamics (MD) simulations of the alternating access transition with a recently developed accelerating technique. We successfully obtained a significantly stable IF structure characterized by newly formed well-packed and -organized inter-domain interactions through the accelerated simulations of unprecedentedly large conformational changes of the alternating access without a prior knowledge of the target protein structure. The simulation also shed light on an atomistic mechanism of the strict transport selectivity of adenosine nucleotides over guanosine and inosine ones. Furthermore, the IF structure was shown to bind ATP and BA, and thus revealed their binding mechanisms. The present study proposes a qualitatively novel view of the alternating access of transporters having the unique three-fold symmetry in atomic details and opens the way for rational drug design targeting the transporter in the dynamic functional cycle. PMID:28727843

Are early cannulation arteriovenous grafts (ecAVG) a viable alternative to tunnelled central venous catheters (TCVCs)? An observational "virtual study" and budget impact analysis.

PubMed

Aitken, Emma; Iqbal, Kashfa; Thomson, Peter; Kasthuri, Ram; Kingsmore, David

2016-05-07

Early cannulation arteriovenous grafts (ecAVGs) are advocated as an alternative to tunnelled central venous catheters (TCVCs). A real-time observational "virtual study" and budget impact model was performed to evaluate a strategy of ecAVG as a replacement to TCVC as a bridge to definitive access creation. Data on complications and access-related bed days was collected prospectively for all TCVCs inserted over a six-month period (n = 101). The feasibility and acceptability of an alternative strategy (ecAVGs) was also evaluated. A budget impact model comparing the two strategies was performed. Autologous access in the form of native fistula was the goal wherever possible. We found 34.7% (n = 35) of TCVCs developed significant complications (including 17 culture-proven bacteraemia and one death from line sepsis). Patients spent an average of 11.9 days/patient/year in hospital as a result of access-related complications. The wait for TCVC insertion delayed discharge in 35 patients (median: 6 days). The ecAVGs were a practical and acceptable alternative to TCVCs in over 80% of patients. Over a 6-month period, total treatment costs per patient wereGBP5882 in the TCVC strategy and GBP4954 in the ecAVG strategy, delivering potential savings ofGBP927 per patient. The ecAVGs had higher procedure and re-intervention costs (GBP3014 vs. GBP1836); however, these were offset by significant reductions in septicaemia treatment costs (GBP1322 vs. GBP2176) and in-patient waiting time bed costs (GBP619 vs. GBP1870). Adopting ecAVGs as an alternative to TCVCs in patients requiring immediate access for haemodialysis may provide better individual patient care and deliver cost savings to the hospital.

Transit and trail connections: assessment of visitor access to National Wildlife Refuges

DOT National Transportation Integrated Search

2010-12-01

The purpose of the study is to characterize the use of transit and non-motorized transportation modes for visitor access to National Wildlife Refuges (NWRs), as well as identify opportunities for and constraints to alternative transportation access. ...

Free Web resources on alternatives.

PubMed

Donnelly, Thomas M

2004-03-01

Access to many online databases for alternatives searches requires a paid subscription and these fees may be expensive for small or not-for-profit institutions. The author provides a list of free sites that can be used to fulfill the legal requirement for an alternatives search.

Comparing the efficacy of xylitol-containing and conventional chewing gums in reducing salivary counts of Streptococcus mutans: An in vivo study

PubMed Central

Haghgoo, Rosa; Afshari, Elahe; Ghanaat, Tahere; Aghazadeh, Samaneh

2015-01-01

Objective: Dental caries is among the most common chronic diseases in humans. Streptococcus mutans is generally responsible for most cases of dental caries. The present study sought to compare the effects of xylitol-containing and conventional chewing gums on salivary levels of S. mutans. Materials and Methods: This study adopted a crossover design. Two type of chewing gums (one containing 70% xylitol and approved by the Iranian Dental Association, and another containing sucrose) were purchased. The participants were 32 individuals aged 18–35 years whose oral hygiene was categorized as moderate or poor based on a caries risk assessment table. Salivary levels of S. mutans were measured at baseline, after the first and second phases of chewing gums, and after the washout period. The measurements were performed on blood agar and mitis salivarius-bacitracin agar (MSBA). Pairwise comparisons were then used to analyze the collected data. Results: Salivary levels of S. mutans in both groups were significantly higher during the two stages of chewing gum than in the washout period or baseline. Moreover, comparisons between the two types of gums suggested that chewing xylitol-containing gums led to greater reductions in S. mutans counts. This effect was more apparent in subjects with poor oral hygiene than in those with moderate oral hygiene. Conclusions: Xylitol-containing chewing gums are more effective than conventional gums in reducing salivary levels of S. mutans in individuals with poor–moderate oral hygiene. PMID:26942114

Characterization of lptA and lptB, two essential genes implicated in lipopolysaccharide transport to the outer membrane of Escherichia coli.

PubMed

Sperandeo, Paola; Cescutti, Rachele; Villa, Riccardo; Di Benedetto, Cristiano; Candia, Daniela; Dehò, Gianni; Polissi, Alessandra

2007-01-01

The outer membrane (OM) of gram-negative bacteria is an asymmetric lipid bilayer that protects the cell from toxic molecules. Lipopolysaccharide (LPS) is an essential component of the OM in most gram-negative bacteria, and its structure and biosynthesis are well known. Nevertheless, the mechanisms of transport and assembly of this molecule in the OM are poorly understood. To date, the only proteins implicated in LPS transport are MsbA, responsible for LPS flipping across the inner membrane, and the Imp/RlpB complex, involved in LPS targeting to the OM. Here, we present evidence that two Escherichia coli essential genes, yhbN and yhbG, now renamed lptA and lptB, respectively, participate in LPS biogenesis. We show that mutants depleted of LptA and/or LptB not only produce an anomalous LPS form, but also are defective in LPS transport to the OM and accumulate de novo-synthesized LPS in a novel membrane fraction of intermediate density between the inner membrane (IM) and the OM. In addition, we show that LptA is located in the periplasm and that expression of the lptA-lptB operon is controlled by the extracytoplasmic sigma factor RpoE. Based on these data, we propose that LptA and LptB are implicated in the transport of LPS from the IM to the OM of E. coli.

Characterization of lptA and lptB, Two Essential Genes Implicated in Lipopolysaccharide Transport to the Outer Membrane of Escherichia coli▿

PubMed Central

Sperandeo, Paola; Cescutti, Rachele; Villa, Riccardo; Di Benedetto, Cristiano; Candia, Daniela; Dehò, Gianni; Polissi, Alessandra

2007-01-01

The outer membrane (OM) of gram-negative bacteria is an asymmetric lipid bilayer that protects the cell from toxic molecules. Lipopolysaccharide (LPS) is an essential component of the OM in most gram-negative bacteria, and its structure and biosynthesis are well known. Nevertheless, the mechanisms of transport and assembly of this molecule in the OM are poorly understood. To date, the only proteins implicated in LPS transport are MsbA, responsible for LPS flipping across the inner membrane, and the Imp/RlpB complex, involved in LPS targeting to the OM. Here, we present evidence that two Escherichia coli essential genes, yhbN and yhbG, now renamed lptA and lptB, respectively, participate in LPS biogenesis. We show that mutants depleted of LptA and/or LptB not only produce an anomalous LPS form, but also are defective in LPS transport to the OM and accumulate de novo-synthesized LPS in a novel membrane fraction of intermediate density between the inner membrane (IM) and the OM. In addition, we show that LptA is located in the periplasm and that expression of the lptA-lptB operon is controlled by the extracytoplasmic σ factor RpoE. Based on these data, we propose that LptA and LptB are implicated in the transport of LPS from the IM to the OM of E. coli. PMID:17056748

Understanding access to healthcare among Indigenous peoples: A comparative analysis of biomedical and postcolonial perspectives.

PubMed

Horrill, Tara; McMillan, Diana E; Schultz, Annette S H; Thompson, Genevieve

2018-03-25

As nursing professionals, we believe access to healthcare is fundamental to health and that it is a determinant of health. Therefore, evidence suggesting access to healthcare is problematic for many Indigenous peoples is concerning. While biomedical perspectives underlie our current understanding of access, considering alternate perspectives could expand our awareness of and ability to address this issue. In this paper, we critique how access to healthcare is understood through a biomedical lens, how a postcolonial theoretical lens can extend that understanding, and the subsequent implications this alternative view raises for the nursing profession. Drawing on peer-reviewed published and gray literature concerning healthcare access and Indigenous peoples to inform this critique, we focus on the underlying theoretical lens shaping our current understanding of access. A postcolonial analysis provides a way of understanding healthcare as a social space and social relationship, presenting a unique perspective on access to healthcare. The novelty of this finding is of particular importance for the profession of nursing, as we are well situated to influence these social aspects, improving access to healthcare services broadly, and among Indigenous peoples specifically. © 2018 The Authors Nursing Inquiry published by John Wiley & Sons Ltd.

GRID Alternatives: Solar Programs in Underserved Communities

EPA Pesticide Factsheets

Introduces GRID Alternatives: Solar Programs in Underserved Communities, a program that partners with a variety of organizations to help low-income communities access the benefits of solar technology.

77 FR 58416 - Comparative Environmental Evaluation of Alternatives for Handling Low-Level Radioactive Waste...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-20

... NUCLEAR REGULATORY COMMISSION [NRC-2012-0218] Comparative Environmental Evaluation of Alternatives... public comment the Draft Comparative Environmental Evaluation of Alternatives for Handling Low-Level.... Availability of Documents ADAMS Accession No. Document title ML12256A965 Draft Comparative Environmental...

Access to healthcare and alternative health-seeking strategies among undocumented migrants in Denmark

PubMed Central

2011-01-01

Background As in many European countries, undocumented migrants in Denmark have restricted access to healthcare. The aim of this study is to describe and analyse undocumented migrants' experiences of access to healthcare, use of alternative health-seeking strategies; and ER nurses' experiences in encounters with undocumented migrants. Methods Qualitative design using semi-structured interviews and observations. The participants included ten undocumented South Asian migrants and eight ER nurses. Results Undocumented migrants reported difficulties accessing healthcare. The barriers to healthcare were: limited medical rights, arbitrariness in healthcare professionals' attitudes, fear of being reported to the police, poor language skills, lack of network with Danish citizens, lack of knowledge about the healthcare system and lack of knowledge about informal networks of healthcare professionals. These barriers induced alternative health-seeking strategies, such as self-medication, contacting doctors in home countries and borrowing health insurance cards from Danish citizens. ER nurses expressed willingness to treat all patients regardless of their migratory status, but also reported challenges in the encounters with undocumented migrants. The challenges for ER nurses were: language barriers, issues of false identification, insecurities about the correct standard procedures and not always being able to provide appropriate care. Conclusions Undocumented migrants face formal and informal barriers to the Danish healthcare system, which lead to alternative health-seeking strategies that may have adverse effects on their health. This study shows the need for policies and guidelines, which in accordance with international human rights law, ensure access to healthcare for undocumented migrants and give clarity to healthcare professionals. PMID:21752296

Petersburg National Battlefield : alternative transportation feasibility study

DOT National Transportation Integrated Search

2012-11-13

This report studies the feasibility of alternative solutions to several transportation problems affecting Petersburg National Battlefield in Petersburg, Virginia. Current transportation problems include site-specific access issues, wayfinding and nav...

Technical Note [cmUse of a Snare Wire to Perform Nephrostomy Access in the Presence of Obstructive Staghorn Calculi

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

Nosher, John L.; Siegel, Randall L.; Bodner, Leonard J.

1996-05-15

We describe a technique for gaining access to the central collecting system via a chosen calyx, utilizing an alternative entry point to that calyx. An Amplatz nitinol loop snare is then used to convert this access to a traditional approach.

Enhancing Access to Situational Vocabulary by Leveraging Geographic Context

ERIC Educational Resources Information Center

Patel, Rupal; Radhakrishnan, Rajiv

2007-01-01

Users of augmentative and alternative communication (AAC) aids could benefit from novel methods for accelerating access to contextually relevant vocabulary. This paper describes our initial efforts toward improving access to situational vocabulary through the use of geographic context to predict vocabulary. A corpus of spoken data produced by one…

30 CFR 291.100 - What is the purpose of this part?

Code of Federal Regulations, 2011 CFR

2011-07-01

..., DEPARTMENT OF THE INTERIOR APPEALS OPEN AND NONDISCRIMINATORY ACCESS TO OIL AND GAS PIPELINES UNDER THE OUTER... transporter has denied a shipper of production from the OCS open and nondiscriminatory access to a pipeline... of resolving pipeline access disputes through either Hotline-assisted procedures or alternative...

Promising Practices for Providing Alternative Media to Postsecondary Students with Print Disabilities

ERIC Educational Resources Information Center

Wolfe, Gerri L.; Lee, Christopher

2007-01-01

For postsecondary students with disabilities influencing reading performance, printed class materials pose a substantial barrier and have a negative impact on academic achievement. Digital technologies offer alternative ways of accessing print materials for students with print-related disabilities. Alternative media is a broad term that…

75 FR 12505 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-16

... alternatives and Committee motions related to inclusion of alternatives in the DEIS. Other issues may be raised... physically accessible to people with disabilities. Requests for sign language interpretation or other...

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...

Beyond the Yellow Bus: Promising Practices for Maximizing Access to Opportunity through Innovations in Student Transportation

ERIC Educational Resources Information Center

Vincent, Jeffrey M.; Makarewicz, Carrie; Miller, Ruth; Ehrman, Julia; McKoy, Deborah L.

2014-01-01

Access to safe, affordable, and convenient transportation shapes the 'geography of opportunity' for many children and youth. This study looks at how ?localities acrossthe country are implementing new and innovative alternative approaches to student transportation that expand regionaltransportation access for K-12 students, improve…

Advanced Placement and Rural Schools: Access, Success, and Exploring Alternatives

ERIC Educational Resources Information Center

Gagnon, Douglas J.; Mattingly, Marybeth J.

2016-01-01

Completing Advanced Placement (AP) coursework is an important part of the selective college admissions process, and access to AP coursework can be viewed as a measure of equal opportunity. Relatively little research has fully examined how access to AP coursework is mediated by school characteristics. Rural schools are at a particular disadvantage…

Developing Guidelines for Evaluating the Adaptation of Accessible Web-Based Learning Materials

ERIC Educational Resources Information Center

Radovan, Marko; Perdih, Mojca

2016-01-01

E-learning is a rapidly developing form of education. One of the key characteristics of e-learning is flexibility, which enables easier access to knowledge for everyone. Information and communications technology (ICT), which is e-learning's main component, enables alternative means of accessing the web-based learning materials that comprise the…

Alternatives for Monitoring and Limiting Network Access to Students in Network-Connected Classrooms

ERIC Educational Resources Information Center

Almeroth, Kevin; Zhang, Hangjin

2013-01-01

With the advent of laptop computers and network technology, many classrooms are now being equipped with Internet connections, either through wired connections or wireless infrastructure. Internet access provides students an additional source from which to obtain course-related information. However, constant access to the Internet can be a…

Experiences with http/WebDAV protocols for data access in high throughput computing

NASA Astrophysics Data System (ADS)

Bernabeu, Gerard; Martinez, Francisco; Acción, Esther; Bria, Arnau; Caubet, Marc; Delfino, Manuel; Espinal, Xavier

2011-12-01

In the past, access to remote storage was considered to be at least one order of magnitude slower than local disk access. Improvement on network technologies provide the alternative of using remote disk. For those accesses one can today reach levels of throughput similar or exceeding those of local disks. Common choices as access protocols in the WLCG collaboration are RFIO, [GSI]DCAP, GRIDFTP, XROOTD and NFS. HTTP protocol shows a promising alternative as it is a simple, lightweight protocol. It also enables the use of standard technologies such as http caching or load balancing which can be used to improve service resilience and scalability or to boost performance for some use cases seen in HEP such as the "hot files". WebDAV extensions allow writing data, giving it enough functionality to work as a remote access protocol. This paper will show our experiences with the WebDAV door for dCache, in terms of functionality and performance, applied to some of the HEP work flows in the LHC Tier1 at PIC.

WDM-PON access network with lightwave source centralized full-duplex link based on SSB-OOFDM for wired and 60 GHz band wireless alternative accesses

NASA Astrophysics Data System (ADS)

Ma, Jianxin; Wang, Zhao; Zheng, Guoli

2014-04-01

A novel lightwave centralized full-duplex WDM-PON access network based on single sideband optical orthogonal frequency-division multiplexing (SSB-OOFDM) is proposed for providing wired and 60-GHz band wireless accesses alternately. At the OLT, the multi-channels with 10-Gb/s 4-QAM-RF-OFDM signals are SSB modulated on the optical local oscillators (OLOs). At the RN, one OOFDM signal along with two OLOs is abstracted and switched to the corresponding HONU, where the signal can be downconverted to the 10-GHz or 60-GHz band RF-OFDM signal by one OLO for wired or wireless access, while the other one is used to bear the uplink signal. Since the HONU is free from the light sources, the system complexity and cost are reduced. Full duplex transmission over 25 km fiber have been demonstrated that the error vector magnitude (EVM) of the down- and up-link signals are much below the FEC limit for both the wired and 60-GHz band wireless access services.

Sharing Resources In Mobile/Satellite Communications

NASA Technical Reports Server (NTRS)

Yan, Tsun-Yee; Sue, Miles K.

1992-01-01

Report presents preliminary theoretical analysis of several alternative schemes for allocation of satellite resource among terrestrial subscribers of landmobile/satellite communication system. Demand-access and random-access approaches under code-division and frequency-division concepts compared.

Alternative Middle School Models: An Exploratory Study

ERIC Educational Resources Information Center

Duffield, Stacy Kay

2018-01-01

A Midwestern state allocated grant funding to encourage more accessible alternative programming at the middle level. Seventeen schools were approved for this grant and used the funds to supplement the operation of a new or existing program. This study provides policymakers and educators with an overview of the various types of alternative middle…

Alternative Fueling Station Locator - Android

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

The Alternative Fueling Station Locator app helps users locate fueling stations that offer electricity, natural gas, biodiesel, E85, propane, or hydrogen. The users' current location or a custom location can be used to find the 20 closest stations within a 30-mile radius. View the stations on a map or see a list of stations ordered by distance from your location. Select your alternative fuel of choice and adjust the custom filters to fit your needs. Select a station from the map or list to view contact info and other details: address, phone number, and hours of operation; payment types accepted;more » public or private access; special services; compression (natural gas); vehicle size access (natural gas); number and types of chargers (electric); blends available (biodiesel); and blender pumps (ethanol) The app draws information from the U.S. Department of Energy's Alternative Fuels Data Center, which houses the most comprehensive, up-to-date database of alternative fueling stations in the United States. The database contains location information for more than 20,000 alternative fueling stations throughout the country.« less

Nantucket National Wildlife Refuge alternative transportation study

DOT National Transportation Integrated Search

2014-10-01

This study for the Fish and Wildlife Service (FWS) identifies and analyzes options for enhancing alternative transportation access to the Nantucket National Wildlife Refuge (Nantucket NWR) at Great Point in Nantucket, Massachusetts. The study team de...

Extended vs. brief intermittent access to palatable food differently promote binge-like intake, rejection of less preferred food, and weight cycling in female rats.

PubMed

Kreisler, A D; Garcia, M G; Spierling, S R; Hui, B E; Zorrilla, E P

2017-08-01

Palatable food access promotes obesity leading some to diet. Here, we modeled the roles of duration, intermittency and choice of access in bingeing, escalation of daily intake, and underacceptance of alternatives. Female rats with ("Choice") or without continuous chow access, received chow or continuous (Chocolate), intermittent (MWF) long (24h, Int-Long), or intermittent short (30min, Int-Short) access to a sucrose-rich, chocolate-flavored diet (CHOC). Int-Long rats showed cycling body weight; they overate CHOC, had increased feed efficiency on access days and underate chow and lost weight on non-access days, the latter correlating with their reduced brown fat. Int-Short rats had the greatest 30-min intake upon CHOC access, but did not underaccept chow or weight cycle. Individual vulnerability for intermittent access-induced feeding adaptations was seen. Continuous access rats gained fat disproportionate, but in direct relation, to their normalized energy intake and persistently underaccepted chow despite abstinence and return to normal weight. Abstinence reduced the binge-like CHOC intake of Int-Short rats and increased that of continuous access rats, but not to levels associated with intermittent access history. Choice increased daily CHOC intake under Continuous access and binge-like intake under Int-Short access. Intermittency and duration of past access to palatable food have dissociable, individually-vulnerable influences on its intake and that of alternatives. With extended access, daily intake reflects the palatability of available food, rather than metabolic need. Ongoing restrictedness of access or a history of intermittency each drive binge-like intake. Aspects of palatable food availability, similar and different to drug availability, promote disordered eating. Copyright © 2017 Elsevier Inc. All rights reserved.

DART: Delta Advanced Reusable Transport. An alternate manned space system proposal

NASA Technical Reports Server (NTRS)

1991-01-01

The Delta Advanced Reusable Transport (DART) craft is being developed to add, multiple, rapid, and cost effective space access to the U.S. capability and to further the efforts towards a permanent space presence. The DART craft provides an augmentative and an alternative system to the Shuttle. As a supplement launch vehicle, the DART adds low cost and easily accessible transport of crew and cargo to specific space destinations to the U.S. program. This adds significant opportunities for manned rated missions that do not require Shuttle capabilities. In its alternative role, the DART can provide emergency space access and satellite repair, the continuation of scientific research, and the furthering of U.S. manned efforts in the event of Shuttle incapabilities. In addition, the DART is being designed for Space Station Freedom compatibility, including its use as a 'lifeboat' emergency reentry craft for Freedom astronauts, as well as the transport of crew and cargo for station resupply.

Tibiopedal access for lower extremity arterial intervention: when to use and how to perform.

PubMed

Wiechmann, Bret N

2014-09-01

Tibiopedal artery access is being used with increasing frequency as an alternative access to facilitate procedural success in lower extremity arterial intervention. This technique is usually employed in the setting of critical limb ischemia and tibial artery intervention, but it may offer potential practical advantages for popliteal artery and even superficial femoral artery intervention in unique situations. As in all cases of lower extremity arterial intervention, consideration of access is important not only for initial approach to any obstructing lesion but also for exit strategy. The dorsalis pedis artery and posterior tibial artery can be readily accessed if necessary owing to their relatively superficial position in the foot or the ankle, yet their normal diameter and the presence of significant calcification (a common finding in patients with tibial occlusive disease and critical limb ischemia) can pose difficulties as well. In addition, the peroneal artery in the lower leg can be accessed percutaneously; however, its size and depth may present additional challenges. Meticulous attention to detail is paramount in avoiding complications in what may be the only distal vessel supplying the foot. This article describes common techniques in using tibiopedal artery access as a means of alternative access for successful infrainguinal intervention. Copyright © 2014 Elsevier Inc. All rights reserved.

High-fat hyperphagia in neurotrophin-4 deficient mice reveals potential role of vagal intestinal sensory innervation in long-term controls of food intake.

PubMed

Byerly, Mardi S; Fox, Edward A

2006-06-12

Neurotrophin-4 (NT-4) deficient mice exhibit substantial loss of intestinal vagal afferent innervation and short-term deficits in feeding behavior, suggesting reduced satiation. However, they do not show long-term changes in feeding or body weight because of compensatory behaviors. The present study examined whether high-fat hyperphagia induction would overcome compensation and reveal long-term effects associated with the reduced vagal sensory innervation of NT-4 mutants. First, modifications of a feeding schedule previously developed in rats were examined in wild-type mice to identify the regimen most effective at producing hyperphagia. The most successful schedule, which was run for 26 days, included access to a 43%-fat diet and pelleted chow every other day and access to only powdered chow on the alternate days. On high-fat access days mice consumed 25% more calories than mice with continuous daily access to the same high-fat diet and pelleted chow. This feeding regimen also induced hyperphagia in NT-4 deficient mice and their wild-type controls: on high-fat exposure days mutants consumed 35% more calories relative to continuous-access mutants, and wild types ate 25% more than continuous-access wild types. Moreover, on high-fat access days the alternating NT-4 mutants significantly increased caloric intake by 9% compared to alternating wild types. Thus, high-fat hyperphagia appeared to override compensation, permitting short-term changes in meal consumption by mutants that accrued into long-term changes in total daily food intake. This raises the possibility that intestinal vagal sensory innervation contributes to long-term, as well as to short-term regulation of food intake.

Modeling track access charge to enhance railway industry performance

NASA Astrophysics Data System (ADS)

Berawi, Mohammed Ali; Miraj, Perdana; Berawi, Abdur Rohim Boy; Susantono, Bambang; Leviakangas, Pekka; Radiansyah, Hendra

2017-11-01

Indonesia attempts to improve nation's competitiveness by increasing the quality and the availability of railway network. However, the infrastructure improperly managed by the operator in terms of the technical issue. One of the reasons for this problem is an unbalanced value of infrastructure charge. In 2000's track access charge and infrastructure maintenance and operation for Indonesia railways are equal and despite current formula of the infrastructure charge, issues of transparency and accountability still in question. This research aims to produce an alternative scheme of track access charge by considering marginal cost plus markup (MC+) approach. The research combines qualitative and quantitative method through an in-depth interview and financial analysis. The result will generate alternative formula of infrastructure charge in Indonesia's railway industry. The simulation also conducted to estimate track access charge for the operator and to forecast government support in terms of subsidy. The result is expected to enhance railway industry performance and competitiveness.

76 FR 410 - Notice of Final Federal Agency Actions on Proposed Highway in Alaska

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-04

... Number ACSTP-0001(277)/56047; Project Location: The KAC Project (Northern Access-Erickson Alternative... downtown Anchorage will go under Government Hill using the Erickson Street alternative with a cut and cover...

Roosevelt-Vanderbilt alternative transportation system planning study : phase 1

DOT National Transportation Integrated Search

2001-08-01

This plan identifies components of a sustainable and effective alternative transportation system that will provide improved access to, and connections among, the Roosevelt-Vanderbilt National Historic Site units. The goal is to reduce the congestion ...

Sediment management alternatives for the Port of Bienville.

DOT National Transportation Integrated Search

2010-02-01

The objective of this report is to present economical, environmentally friendly, and effective alternatives to maintenance : dredging for the Port of Bienville and its access channels. The Port of Bienville is located in Hancock County, directly off ...

Beyond the Yellow Bus: Promising Practices for Maximizing Access to Opportunity through Innovations in Student Transportation. Policy Brief 2014

ERIC Educational Resources Information Center

Center for Cities & Schools, 2014

2014-01-01

Access to safe, affordable, and convenient transportation shapes the "geography of opportunity" for many children and youth. This study looks at how ?localities across the country are implementing new and innovative alternative approaches to student transportation that expand regional transportation access for K-12 students, improve…

Access to What? Access, Diversity and Participation in India's Schools. Research Monograph No. 32

ERIC Educational Resources Information Center

Juneja, Nalini

2010-01-01

India has witnessed substantial diversification of provision to basic education. Policy changes from 1980s onwards, has seen the creation of para-formal delivery systems and the inclusion in the system of non state providers. The Education Guarantee Scheme and the Alternate Initiatives in Education programmes have generated new pathways to access.…

Free or Open Access to Scholarly Documentation: Google Scholar or Academic Libraries

ERIC Educational Resources Information Center

Burns, C. Sean

2013-01-01

Soon after the university movement started in the late 1800s, academic libraries became the dominant providers of the tools and services required to locate and access scholarly information. However, with the advent of alternate discovery services, such as Google Scholar, in conjunction with open access scholarly content, researchers now have the…

Alternative Fuels Data Center: U.S. Truck Stop Electrification Locations

Science.gov Websites

bays) Media: Internet, Wireless Payment: American Express, Cash, MasterCard, VISA Access: Public - see : Internet, Wireless Payment: American Express, Cash, MasterCard, VISA Access: Public - see hours Hours: 24 bays) Media: Internet Payment: Gift Card, MasterCard, VISA Access: Public - see hours Hours: 24 hours

Is the digitization of laparoscopic movement using accessible alternative technologies possible?

PubMed

Lorias Espinoza, Daniel; Gutiérrez Gnecchi, José Antonio; Martínez, Arturo Minor

2012-05-01

It is widely documented that laparoscopic surgeons require training, and an objective evaluation of the training that they receive. The most advanced evaluation systems integrate the digitization of the movement of laparoscopic tools. A great number of these systems, however, do not permit the use of real tools and their high cost limits their academic impact. Likewise, it is documented that new and accessible systems need to be developed. The aim of this article is to explore the possibility of digitizing the movement of laparoscopic tools in a three-dimensional workspace, using accessible alternative technology. Our proposal uses a commercial Wii video game control in conjunction with a program for determining kinematic variables during the execution of a recognition task.

78 FR 8582 - Final Environmental Impact Statement for Brooks River Visitor Access for Katmai National Park and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-06

... River floating bridge and sites to relocate the existing Naknek Lake barge landing area at the mouth of... barge landing site would be located approximately 200 feet south of the mouth of the Brooks River. A new... new Naknek Lake barge landing site. Alternative 4 (NPS Preferred Alternative): This alternative...

Are alternative investments the right approach for your organization?

PubMed

French, Charles J; Dodd, Thomas H

2010-04-01

The decision by a healthcare provider to implement and monitor an alternative investment program requires careful consideration and planning. There are several things an organization should do when making this decision: Begin slowly. Consider access and liquidity. Don't force the investment to fill a target allocation. View an alternative investment as an opportunity investment."

12 CFR 1235.5 - Record hold.

Code of Federal Regulations, 2014 CFR

2014-01-01

... alternative storage method. (d) Access to and retrieval of records during a record hold. The record retention program of each regulated entity or the Office of Finance shall ensure access to and retrieval of records... records and existing information technology. ...

12 CFR 1235.5 - Record hold.

Code of Federal Regulations, 2013 CFR

2013-01-01

... alternative storage method. (d) Access to and retrieval of records during a record hold. The record retention program of each regulated entity or the Office of Finance shall ensure access to and retrieval of records... records and existing information technology. ...

12 CFR 1235.5 - Record hold.

Code of Federal Regulations, 2012 CFR

2012-01-01

... alternative storage method. (d) Access to and retrieval of records during a record hold. The record retention program of each regulated entity or the Office of Finance shall ensure access to and retrieval of records... records and existing information technology. ...

Roosevelt-Vanderbilt alternative transportation system implementation plan : phase 2

DOT National Transportation Integrated Search

2004-12-01

This is the second phase of a plan to identify components of a sustainable and effective alternative transportation system that will provide improved access to, and connections among, the Roosevelt-Vanderbilt National Historic Site units. The goal is...

Repair of traumatic tricuspid insufficiency via minimally invasive port access.

PubMed

Kasahara, Hirofumi; Kudo, Mikihiko; Kawajiri, Hiroyuki; Yozu, Ryohei

2010-04-01

We report on a successful tricuspid valve plasty using port-access minimally invasive cardiac surgery (MICS) for severe traumatic tricuspid insufficiency caused by blunt chest trauma suffered 15 years previously. A combination repair procedure, consisting of cleft closures, plication of the anteroseptal commissure, and ring annuloplasty, was necessary to achieve valve competence and proved possible via port access without difficulty. Port-access MICS is an alternative approach for tricuspid valve surgery.

Optimizing multiple-choice tests as tools for learning.

PubMed

Little, Jeri L; Bjork, Elizabeth Ligon

2015-01-01

Answering multiple-choice questions with competitive alternatives can enhance performance on a later test, not only on questions about the information previously tested, but also on questions about related information not previously tested-in particular, on questions about information pertaining to the previously incorrect alternatives. In the present research, we assessed a possible explanation for this pattern: When multiple-choice questions contain competitive incorrect alternatives, test-takers are led to retrieve previously studied information pertaining to all of the alternatives in order to discriminate among them and select an answer, with such processing strengthening later access to information associated with both the correct and incorrect alternatives. Supporting this hypothesis, we found enhanced performance on a later cued-recall test for previously nontested questions when their answers had previously appeared as competitive incorrect alternatives in the initial multiple-choice test, but not when they had previously appeared as noncompetitive alternatives. Importantly, however, competitive alternatives were not more likely than noncompetitive alternatives to be intruded as incorrect responses, indicating that a general increased accessibility for previously presented incorrect alternatives could not be the explanation for these results. The present findings, replicated across two experiments (one in which corrective feedback was provided during the initial multiple-choice testing, and one in which it was not), thus strongly suggest that competitive multiple-choice questions can trigger beneficial retrieval processes for both tested and related information, and the results have implications for the effective use of multiple-choice tests as tools for learning.

77 FR 3017 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-20

... be charged on a per-Login ID basis. Firms may access C2 via either a CMI Client Application [[Page..., using different Login IDs, accessing the same CMI Client Application Server or FIX Port, allowing the firm to only pay the monthly fee once. Alternatively, a firm may use the same Login ID to access...

76 FR 63974 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-14

... charges to assess a fee for each CMI Login ID. Firms may access CBOEdirect via either a CMI Client... Login IDs, accessing the same CMI Client Application Server, allowing the firm to only pay the monthly fee once. Alternatively, a firm may use the same Login ID to access different CMI Client Application...

An Alternative Model of Music Learning and "Last Night's Fun": Participatory Music Making In/As Participatory Culture in Irish Traditional Music

ERIC Educational Resources Information Center

Waldron, Janice

2016-01-01

Exploring emergent music learning and teaching models facilitated by global Web access can reveal alternative music education practices and delivery systems not seen in "traditional" conservatories and schools. One example of an alternative music learning model comes from the Online Academy of Irish Music (OAIM), a community music…

Successful simultaneous ipsilateral stenting of common iliac artery stenosis and transfemoral aortic valve replacement.

PubMed

Aslan, Abdullah Nabi; Kasapkara, Hacı Ahmet; Sivri, Serkan; Güney, Murat Can; Bozkurt, Engin

2017-01-01

Transcatheter aortic valve replacement (TAVR) was designed to treat elderly patients with severe aortic stenosis at high risk for surgery, and is most commonly performed with retrograde approach through femoral arteries. However, in up to 30% of cases, it is either not possible to use this access route or it is considered to have high risk of vascular injury. Alternative approaches have been described for patients with no suitable femoral access: trans-subclavian, transaortic, or direct aortic access; however, since the introduction of new valves deployed with low-profile delivery systems, another alternative transcatheter approach has been discovered. Presently described is experience in 2 cases in which patients were treated with transfemoral TAVR using Edwards SAPIEN 3 transcatheter heart valves immediately following ipsilateral common iliac artery stenting.

Alternating-script priming in Japanese: Are Katakana and Hiragana characters interchangeable?

PubMed

Perea, Manuel; Nakayama, Mariko; Lupker, Stephen J

2017-07-01

Models of written word recognition in languages using the Roman alphabet assume that a word's visual form is quickly mapped onto abstract units. This proposal is consistent with the finding that masked priming effects are of similar magnitude from lowercase, uppercase, and alternating-case primes (e.g., beard-BEARD, BEARD-BEARD, and BeArD-BEARD). We examined whether this claim can be readily generalized to the 2 syllabaries of Japanese Kana (Hiragana and Katakana). The specific rationale was that if the visual form of Kana words is lost early in the lexical access process, alternating-script repetition primes should be as effective as same-script repetition primes at activating a target word. Results showed that alternating-script repetition primes were less effective at activating lexical representations of Katakana words than same-script repetition primes-indeed, they were no more effective than partial primes that contained only the Katakana characters from the alternating-script primes. Thus, the idiosyncrasies of each writing system do appear to shape the pathways to lexical access. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

38 CFR 18.422 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., reassignment of classes or other services to accessible buildings, assignment of aids to beneficiaries, home visits, delivery of health, or other social services at alternate accessible sites, alteration of... handicapped persons in the most integrated setting appropriate. (c) Small health, welfare or other social...

Wheel running, voluntary ethanol consumption, and hedonic substitution.

PubMed

Ozburn, Angela Renee; Harris, R Adron; Blednov, Yuri A

2008-08-01

Few studies have examined the relationship between naturally rewarding behaviors and ethanol drinking behaviors in mice. Although natural and drug reinforcers activate similar brain circuitry, there is behavioral evidence suggesting food and drug rewards differ in perceived value. The primary goal of the present study was to investigate the relationships between naturally reinforcing stimuli and consumption of ethanol in ethanol preferring C57BL/6J mice. Mouse behaviors were observed after the following environmental manipulations: standard or enhanced environment, accessible or inaccessible wheel, and presence or absence of ethanol. Using a high-resolution volumetric drinking monitor and wheel running monitor, we evaluated whether alternating access to wheel running modified ethanol-related behaviors and whether alternating access to ethanol modified wheel running or subsequent ethanol-related behaviors. We found that ethanol consumption remains stable with alternating periods of wheel running. Wheel running increases in the absence of ethanol and decreases upon reintroduction of ethanol. Upon reintroduction of ethanol, an alcohol deprivation effect was seen. Collectively, the results support theories of hedonic substitution and suggest that female C57BL/6J mice express ethanol seeking and craving under these specific conditions.

Alternative Practice Dental Hygiene in California: Past, Present, and Future

PubMed Central

MERTZ, ELIZABETH; GLASSMAN, PAUL

2012-01-01

This study examines the development of the registered dental hygienist in alternative practice in California through an analysis of archival documents, stakeholder interviews, and two surveys of the registered dental hygienist in alternative practice. Designing, testing and implementing a new practice model for dental hygienists took 23 years. Today, registered dental hygienists in alternative practice have developed viable alternative methods for delivering preventive oral health care services in a range of settings with patients who often have no other source of access to care. PMID:21337961

Food capacities and satisfaction in participants in food security community interventions in Montreal, Canada.

PubMed

Roncarolo, Federico; Adam, Caroline; Bisset, Sherri; Potvin, Louise

2016-12-01

Food insecurity is steadily increasing in Canada. The objective of this paper is to determine if food capacities and satisfaction of recently enrolled participants in food security interventions are associated with the intervention having either a traditional or an alternative type of approach. Participants having recently accessed traditional (n = 711) or alternative community interventions (n = 113) in the Montreal metropolitan area, Canada, were interviewed with a questionnaire. The categorizing variable was participation in a community organization providing either traditional interventions, aimed to help people cope with the urgent need of food, or alternative interventions, aimed at first assistance, in addition to the creation of long-term solutions such as social integration and skills development. Participants' food and nutrition-related capacities and food satisfaction are studied. Multilevel regression models were used to assess whether participants took part in a traditional or alternative interventions. These interventions do not reach the same population. Relative to participants in alternative food security interventions, participants in traditional interventions demonstrated less capacity for accessing information about food safety and healthiness, and perceived their diet as less healthy. Traditional food security participants also paid less attention to the nutritional properties of food and reported less satisfaction with quantity, variety and taste of the food they accessed. The reasons why individuals who may benefit the most from alternative interventions were unlikely to participate should be investigated. The potential that food security interventions may inadvertently reinforce social inequalities in health should be considered in future intervention research. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

PubMed

Naughton, Doreen K

2014-06-01

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

Mobile multiple access study

NASA Technical Reports Server (NTRS)

1977-01-01

Multiple access techniques (FDMA, CDMA, TDMA) for the mobile user and attempts to identify the current best technique are discussed. Traffic loading is considered as well as voice and data modulation and spacecraft and system design. Emphasis is placed on developing mobile terminal cost estimates for the selected design. In addition, design examples are presented for the alternative techniques of multiple access in order to compare with the selected technique.

Information Retrieval Systems Retrieved? An Alternative to Present Dial Access Systems

ERIC Educational Resources Information Center

Hofmann, Norbert

1976-01-01

The expense of a dial access information retrieval system (DIARS) is weighed against its benefits. Problems of usage and efficacy for the student are outlined. A fully automated system is proposed instead, and its cost-saving features are pointed out. (MS)

Information Graphic Classification, Decomposition and Alternative Representation

ERIC Educational Resources Information Center

Gao, Jinglun

2012-01-01

This thesis work is mainly focused on two problems related to improving accessibility of information graphics for visually impaired users. The first problem is automated analysis of information graphics for information extraction and the second problem is multi-modal representations for accessibility. Information graphics are graphical…

Theory of perceived access to breast health care in African American women.

PubMed

Garmon, Sandra C

2012-01-01

The theory presented in this article proposes an alternative view of access to care on the basis of an African American woman's perception of the necessity, availability, and appropriateness of breast health care. The theory of perceived access to breast health care in African American women may also be useful in framing future research studies exploring the relationship between access to care and utilization of primary, secondary, and tertiary clinical preventive services related to breast health care.

Novel Method for Exchange of Impella Circulatory Assist Catheter: The "Trojan Horse" Technique.

PubMed

Phillips, Colin T; Tamez, Hector; Tu, Thomas M; Yeh, Robert W; Pinto, Duane S

2017-07-01

Patients with an indwelling Impella may require escalation of hemodynamic support or exchange to another circulatory assistance platform. As such, preservation of vascular access is preferable in cases where anticoagulation cannot be discontinued or to facilitate exchange to an alternative catheter or closure device. Challenges exist in avoiding bleeding and loss of wire access in these situations. We describe a single-access "Trojan Horse" technique that minimizes bleeding while maintaining arterial access for rapid exchange of this percutaneous ventricular assist device.

Consideration of What May Influence Student Outcomes on Alternate Assessment.

ERIC Educational Resources Information Center

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

2003-01-01

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

Free-choice feeding of free-range meat chickens

USDA-ARS?s Scientific Manuscript database

Alternative feeding methods should be considered for free-range, organic, and other alternative poultry production. The number of small- and medium-scale producers raising specialty chickens for local and regional markets is growing and many of these producers do not have access to the nutritional ...

Community Access Video.

ERIC Educational Resources Information Center

Frederiksen, H. Allan

In the belief that "the spread of technological development and the attendant rapidly changing environment creates the necessity for multi-source feedback systems to maximize the alternatives available in dealing with global problems," the author shows how to participate in the process of alternate video. He offers detailed information…

Intron-mediated alternative splicing of Arabidopsis P5CS1 and its association with natural variation in proline and climate adaptation

PubMed Central

Kesari, Ravi; Lasky, Jesse R.; Villamor, Joji Grace; Des Marais, David L.; Chen, Ying-Jiun C.; Liu, Tzu-Wen; Juenger, Thomas E.; Verslues, Paul E.

2012-01-01

Drought-induced proline accumulation is widely observed in plants but its regulation and adaptive value are not as well understood. Proline accumulation of the Arabidopsis accession Shakdara (Sha) was threefold less than that of Landsberg erecta (Ler) and quantitative trait loci mapping identified a reduced function allele of the proline synthesis enzyme Δ1-pyrroline-5-carboxylate synthetase1 (P5CS1) as a basis for the lower proline of Sha. Sha P5CS1 had additional TA repeats in intron 2 and a G-to-T transversion in intron 3 that were sufficient to promote alternative splicing and production of a nonfunctional transcript lacking exon 3 (exon 3-skip P5CS1). In Sha, and additional accessions with the same intron polymorphisms, the nonfunctional exon 3-skip P5CS1 splice variant constituted as much as half of the total P5CS1 transcript. In a larger panel of Arabidopsis accessions, low water potential-induced proline accumulation varied by 10-fold and variable production of exon 3-skip P5CS1 among accessions was an important, but not the sole, factor underlying variation in proline accumulation. Population genetic analyses suggest that P5CS1 may have evolved under positive selection, and more extensive correlation of exon 3-skip P5CS1 production than proline abundance with climate conditions of natural accessions also suggest a role of P5CS1 in local adaptation to the environment. These data identify a unique source of alternative splicing in plants, demonstrate a role of exon 3-skip P5CS1 in natural variation of proline metabolism, and suggest an association of P5CS1 and its alternative splicing with environmental adaptation. PMID:22615385

The macroeconomic consequences of renouncing to universal access to antiretroviral treatment for HIV in Africa: a micro-simulation model.

PubMed

Ventelou, Bruno; Arrighi, Yves; Greener, Robert; Lamontagne, Erik; Carrieri, Patrizia; Moatti, Jean-Paul

2012-01-01

Previous economic literature on the cost-effectiveness of antiretroviral treatment (ART) programs has been mainly focused on the microeconomic consequences of alternative use of resources devoted to the fight against the HIV pandemic. We rather aim at forecasting the consequences of alternative scenarios for the macroeconomic performance of countries. We used a micro-simulation model based on individuals aged 15-49 selected from nationally representative surveys (DHS for Cameroon, Tanzania and Swaziland) to compare alternative scenarios : 1-freezing of ART programs to current levels of access, 2- universal access (scaling up to 100% coverage by 2015, with two variants defining ART eligibility according to previous or current WHO guidelines). We introduced an "artificial" ageing process by programming methods. Individuals could evolve through different health states: HIV negative, HIV positive (with different stages of the syndrome). Scenarios of ART procurement determine this dynamics. The macroeconomic impact is obtained using sample weights that take into account the resulting age-structure of the population in each scenario and modeling of the consequences on total growth of the economy. Increased levels of ART coverage result in decreasing HIV incidence and related mortality. Universal access to ART has a positive impact on workers' productivity; the evaluations performed for Swaziland and Cameroon show that universal access would imply net cost-savings at the scale of the society, when the full macroeconomic consequences are introduced in the calculations. In Tanzania, ART access programs imply a net cost for the economy, but 70% of costs are covered by GDP gains at the 2034 horizon, even in the extended coverage option promoted by WHO guidelines initiating ART at levels of 350 cc/mm(3) CD4 cell counts. Universal Access ART scaling-up strategies, which are more costly in the short term, remain the best economic choice in the long term. Renouncing or significantly delaying the achievement of this goal, due to "legitimate" short term budgetary constraints would be a misguided choice.

Research Investigation of Information Access Methods

ERIC Educational Resources Information Center

Heinrichs, John H.; Sharkey, Thomas W.; Lim, Jeen-Su

2006-01-01

This study investigates the satisfaction of library users at Wayne State University who utilize alternative information access methods. The LibQUAL+[TM] desired and perceived that satisfaction ratings are used to determine the user's "superiority gap." By focusing limited library resources to address "superiority gap" issues identified by each…

Test Design Considerations for Students with Significant Cognitive Disabilities

ERIC Educational Resources Information Center

Anderson, Daniel; Farley, Dan; Tindal, Gerald

2015-01-01

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

ARCHITECTURAL FLOOR PLAN OF PROCESS AND ACCESS AREAS HOT PILOT ...

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

ARCHITECTURAL FLOOR PLAN OF PROCESS AND ACCESS AREAS HOT PILOT PLANT (CPP-640). INL DRAWING NUMBER 200-0640-00-279-111679. ALTERNATE ID NUMBER 8952-CPP-640-A-2. - Idaho National Engineering Laboratory, Idaho Chemical Processing Plant, Fuel Reprocessing Complex, Scoville, Butte County, ID

45 CFR 1153.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE ARTS...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices...

45 CFR 1153.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE ARTS...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices...

45 CFR 1153.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE ARTS...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices...

45 CFR 1153.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE ARTS...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices...

45 CFR 1153.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE ARTS...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices...

Evaluation of innovative devices to control traffic entering from low-volume access points within a land closure.

DOT National Transportation Integrated Search

2014-04-01

This report describes the methodology and results of analyses performed to identify and evaluate : alternative methods to control traffic entering a lane closure on a two-lane, two-way road from low-volume : access points. Researchers documented the ...

77 FR 53194 - Combined Notice of Filings #1

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-31

... Market Based Tariff filings. Filed Date: 8/17/12. Accession Number: 20120817-5103. Comments Due: 5 p.m..., 2012 Application for market-based rate authorization. Filed Date: 8/17/12. Accession Number: 20120817... Wholesale, LLC. Description: Amendment to Application for Market-Based Rate Authority of Energy Alternatives...

45 CFR 153.330 - State alternate risk adjustment methodology.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false State alternate risk adjustment methodology. 153.330 Section 153.330 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS STANDARDS RELATED TO REINSURANCE, RISK CORRIDORS, AND RISK ADJUSTMENT UNDER THE...

45 CFR 153.330 - State alternate risk adjustment methodology.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false State alternate risk adjustment methodology. 153.330 Section 153.330 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS STANDARDS RELATED TO REINSURANCE, RISK CORRIDORS, AND RISK ADJUSTMENT UNDER THE...

45 CFR 153.330 - State alternate risk adjustment methodology.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false State alternate risk adjustment methodology. 153.330 Section 153.330 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS STANDARDS RELATED TO REINSURANCE, RISK CORRIDORS, AND RISK ADJUSTMENT UNDER THE...

75 FR 81972 - New England Fishery Management Council; Public Meeting; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-29

... Committee will continue development of catch monitoring alternatives for inclusion in Amendment 5 to the... management alternatives for inclusion in Amendment 5 Draft EIS (catch monitoring program, measures to address... physically accessible to people with disabilities. Requests for sign language interpretation or other...

75 FR 38463 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-02

... Committee will continue development of catch monitoring alternatives for inclusion in Amendment 5 to the... to developing catch monitoring alternatives for inclusion in Amendment 5 to the Atlantic Herring FMP... meeting is physically accessible to people with disabilities. Requests for sign language interpretation or...

Single-Sex Computer Classes: An Effective Alternative.

ERIC Educational Resources Information Center

Swain, Sandra L.; Harvey, Douglas M.

2002-01-01

Advocates single-sex computer instruction as a temporary alternative educational program to provide middle school and secondary school girls with access to computers, to present girls with opportunities to develop positive attitudes towards technology, and to make available a learning environment conducive to girls gaining technological skills.…

30 CFR 47.53 - Alternative for hazardous waste.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Alternative for hazardous waste. 47.53 Section... waste. If the mine produces or uses hazardous waste, the operator must provide potentially exposed miners and designated representatives access to available information for the hazardous waste that— (a...

Teachers' Work and Innovation in Alternative Schools

ERIC Educational Resources Information Center

Bascia, Nina; Maton, Rhiannon

2016-01-01

Toronto boasts a large and diverse system of public alternative schools: schools where democratic practices, student access and a commitment to public education are fundamental. There are academic schools; schools with thematically focused curricula; schools driven by social movement principles such as antiracism and global education; schools for…

National Surface Water Survey, western wilderness area lakes: environmental assessment. Draft

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

Not Available

1985-03-01

The US Environmental Protection Agency (EPA) is proposing to sample 498 lakes in federally designated wilderness areas and national parks during the western part of the National Surface Water Survey (NSW). The NSWS has been undertaken to provide high quality data for evaluating the nature and extent of acid deposition throughout the United States. Sampling protocols established for the national survey call for the use of helicopters to gain access to lakes for sampling. Helicopters have already been used in the eastern and midwestern parts of the survey. The US Forest Service (FS) and the National Park Service (NPS) willmore » have to decide which sampling plan for wilderness areas, if any, can be approved under the Wilderness Act of 1964. This Environmental Assessment (EA) has been prepared to evaluate the environmental consequences of alternative means of gaining access to wilderness areas to meet the objectives of the NSWS. Based on this evaluation, EPA has reviewed the possible sampling alternatives and reached a conclusion on the preferred alternative. This assessment is being provided to the FS and the NPS for their use in evaluating the alternatives, including EPA's preferred one. As a result of its evaluation, EPA believes that wilderness area lakes should be included in the survey and that the preferred means of access is using helicopters. 94 references, 14 figures, 18 tables.« less

Remedial Action Assessment System: A computer-based methodology for conducting feasibility studies

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

White, M.K.; Buelt, J.L.; Stottlemyre, J.A.

1991-02-01

Because of the complexity and number of potential waste sites facing the US Department of Energy (DOE) for potential cleanup, DOE is supporting the development of a computer-based methodology to streamline the remedial investigation/feasibility study process. The Remedial Action Assessment System (RAAS), can be used for screening, linking, and evaluating established technology processes in support of conducting feasibility studies. It is also intended to do the same in support of corrective measures studies. The user interface employs menus, windows, help features, and graphical information while RAAS is in operation. Object-oriented programming is used to link unit processes into sets ofmore » compatible processes that form appropriate remedial alternatives. Once the remedial alternatives are formed, the RAAS methodology can evaluate them in terms of effectiveness, implementability, and cost. RAAS will access a user-selected risk assessment code to determine the reduction of risk after remedial action by each recommended alternative. The methodology will also help determine the implementability of the remedial alternatives at a site and access cost estimating tools to provide estimates of capital, operating, and maintenance costs. This paper presents the characteristics of two RAAS prototypes currently being developed. These include the RAAS Technology Information System, which accesses graphical, tabular and textual information about technologies, and the main RAAS methodology, which screens, links, and evaluates remedial technologies. 4 refs., 3 figs., 1 tab.« less

Value-Based Payment Reform and the Medicare Access and Children's Health Insurance Program Reauthorization Act of 2015: A Primer for Plastic Surgeons.

PubMed

Squitieri, Lee; Chung, Kevin C

2017-07-01

In 2015, the U.S. Congress passed the Medicare Access and Children's Health Insurance Program Reauthorization Act, which effectively repealed the Centers for Medicare and Medicaid Services sustainable growth rate formula and established the Centers for Medicare and Medicaid Services Quality Payment Program. The Medicare Access and Children's Health Insurance Program Reauthorization Act represents an unparalleled acceleration toward value-based payment models and a departure from traditional volume-driven fee-for-service reimbursement. The Quality Payment Program includes two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. The Merit-Based Incentive Payment System pathway replaces existing quality reporting programs and adds several new measures to create a composite performance score for each provider (or provider group) that will be used to adjust reimbursed payment. The advanced alternative payment model pathway is available to providers who participate in qualifying Advanced Alternative Payment Models and is associated with an initial 5 percent payment incentive. The first performance period for the Merit-Based Incentive Payment System opens January 1, 2017, and closes on December 31, 2017, and is associated with payment adjustments in January of 2019. The Centers for Medicare and Medicaid Services estimates that the majority of providers will begin participation in 2017 through the Merit-Based Incentive Payment System pathway, but aims to have 50 percent of payments tied to quality or value through Advanced Alternative Payment Models by 2018. In this article, the authors describe key components of the Medicare Access and Children's Health Insurance Program Reauthorization Act to providers navigating through the Quality Payment Program and discuss how plastic surgeons may optimize their performance in this new value-based payment program.

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.

Peripheral arteriovenous fistula as vascular access for long-term chemotherapy.

PubMed

Kovalyov, Oleksiy O; Kostyuk, Oleksandr G; Tkachuk, Tetyana V

To provide long-term vascular access in clinical oncology peripheral forearm veins (up to 95% of patients in Ukraine), central venous access and "complete implanted vascular systems" are used most often. Many oncology patients have contraindications to catheterization of superior vena cava. Besides, exploitation of central veins is associated with potential technical and infectious complications. The aim - to study short-term and long-term results of arteriovenous fistula exploitation as vascular access for continuous anticancer therapy. Peripheral venous bed status in 41 oncology patients taking long-term chemotherapy treatment is analyzed in the article. Doppler sonography, morphologic and immune histochemical analyses were used in the study. Doppler sonography found qualitative and quantitative changes in forearm veins at different time periods after initiation of chemotherapy in the majority of patients. The major morphologic manifestations of venous wall damage were chemical phlebitis, local or extended hardening of venous wall, venous thrombosis and extravasations with necrosis and subsequent paravasal tissue sclerosis. Alternative vascular access created in 12 patients completely met the adequacy criteria (safety, multiple use, longevity, realization of the designed therapy program). The conclusion was made about inapplicability of forearm veins for long-term administration of cytostatic agents. If it is impossible to use central veins, arteriovenous fistula can become an alternative vascular access.

Accessibility and distribution of the Norwegian National Air Emergency Service: 1988-1998.

PubMed

Heggestad, Torhild; Børsheim, Knut Yngve

2002-01-01

To evaluate the accessibility and distribution of the Norwegian National Air Emergency Service in the 10-year period from 1988 to 1998. The primary material was annual standardized activity data that included all helicopter missions. A multivariate model of determinants for use of the helicopter service was computed by linear regression. Accessibility was measured as the percentage of the population reached in different flying times, and we evaluated the service using a simulation of alternative locations for the helicopter bases. The helicopter service (HEMS) has short access times, with a mean reaction time of 8 minutes and a mean response time of 26 minutes for acute missions. Nearly all patients (98%) are reached within 1 hour. A simulation that tested alternative locations of the helicopter bases compared with current locations showed no increase in accessibility. The use of the service shows large regional differences. Multivariate analyses showed that the distances of the patients from the nearest helicopter base and the nearest hospital are significant determinants for the use of HEMS. Establishment of a national service has given the Norwegian population better access to highly qualified prehospital emergency services. Furthermore, the HEMS has a compensating effect in adjusting for differences in traveling distances to a hospital. Safety, cost-containment, and gatekeeper functions remain challenges.

Defining alternative rules in water and sanitation.

PubMed

Robert, J

1995-11-01

While the conventional water and sanitation package remains most prominent, alternatives exist to conventional waterworks and sanitation practices. Some alternate courses of action are considered. Promising an unprecedented availability of piped water, water development projects foster a pump-and-dump mentality even before they are completed. Often simply announcing the impending implementation of such projects encourages the intention among future beneficiaries to waste water resources. Alternatives to the domestic waste of water must be sought and implemented. Disestablishing water development, styles of alternative water technologies, decision-making and decision-makers, water policy scale, regenerating community access to sources, and water pricing are discussed.

75 FR 25195 - Kake to Petersburg Transmission Line Intertie Project

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-07

... existing roads for construction and long-term maintenance access where possible. New road segments would be.... Both routes would use existing roads for construction and long-term maintenance access where possible...). Both alternative routes follow existing logging roads for the majority of their lengths. In addition...

Alternate Access Interface for Mouse and Touchpad Input. Final Report.

ERIC Educational Resources Information Center

Kelso, David; And Others

This final report describes a federally funded project (September 1987-August 1989) which developed the "Trace Transparent Access Module," a device which interfaces with standard computers thus allowing children with physical disabilities to participate fully with nondisabled children in classrooms. The module is a small, microprocessor…

Badging, Real ID

Science.gov Websites

. REAL ID LANL Impacts and Solutions The federal government has determined New Mexico is non-compliant Identification Cards whom will also become Non-Compliant. Access through LANL Vehicle Access Portals unaffected alternate ID if they are coming from "non-compliant" REAL-ID states LANS and the Field Office have

Fe-Catalyzed Cycloisomerization of Aryl Allenyl Ketones: Access to 3-Arylidene-indan-1-ones.

PubMed

Teske, Johannes; Plietker, Bernd

2018-04-20

A cycloisomerization of aryl allenyl ketones to 3-arylidene-indan-1-ones using a cationic Fe-complex as a catalyst is reported. The catalyst opens a synthetically interesting reaction pathway to this surprisingly underrepresented class of indanones that are not accessible using alternative catalytic systems.

78 FR 26663 - Exelon Generation Company, LLC, License Renewal of Nuclear Plants and Public Meetings for the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-07

... and reasonable alternative energy sources. DATES: Submit comments by June 27, 2013. Comments [email protected] . For technical questions, contact the individual(s) listed in the FOR FURTHER INFORMATION... accessing information and submitting comments, see ``Accessing Information and Submitting Comments'' in the...

Remote Patron Validation: Posting a Proxy Server at the Digital Doorway.

ERIC Educational Resources Information Center

Webster, Peter

2002-01-01

Discussion of remote access to library services focuses on proxy servers as a method for remote access, based on experiences at Saint Mary's University (Halifax). Topics include Internet protocol user validation; browser-directed proxies; server software proxies; vendor alternatives for validating remote users; and Internet security issues. (LRW)

75 FR 2565 - Northern States Power Company, LLC; Monticello Nuclear Generating Plant Final Environmental...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-15

... turbine, and components containing radioactive materials. Based on the licensee's evaluation, the annual... savings and still require additional generating capacity. Alternative energy sources such as wind energy.../adams.html . Persons who do not have access to ADAMS or who encounter problems in accessing the...

Writing for Change: Engaging Juveniles through Alternative Literacy Education

ERIC Educational Resources Information Center

Jacobi, Tobi

2008-01-01

Research on incarceration and educational access continues to reveal the stark reality for many adjudicated youth: without access to educational opportunities recidivism is probable. Yet conventional methods of teaching critical reading, writing, and thinking skills are not always successful for juveniles who have found little success (or hope) in…

PACE: A Browsable Graphical Interface.

ERIC Educational Resources Information Center

Beheshti, Jamshid; And Others

1996-01-01

Describes PACE (Public Access Catalogue Extension), an alternative interface designed to enhance online catalogs by simulating images of books and library shelves to help users browse through the catalog. Results of a test in a college library against a text-based online public access catalog, including student attitudes, are described.…

45 CFR 146.119 - HMO affiliation period as an alternative to a preexisting condition exclusion.

Code of Federal Regulations, 2012 CFR

2012-10-01

... preexisting condition exclusion. 146.119 Section 146.119 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE GROUP HEALTH INSURANCE MARKET Requirements Relating to Access and Renewability of Coverage, and Limitations on Preexisting Condition...

76 FR 64049 - Bank Secrecy Act Regulations: Definition of “Monetary Instrument”

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-17

..., and anti-money laundering program requirements on providers and sellers of prepaid access. While the..., stated: \\13\\ See Money Laundering Using New Payment Methods, Financial Action Task Force, October 2010... Money Laundering Strategy stated that prepaid access is ``* * * an emerging cash alternative for both...

78 FR 42026 - Petition for Rulemaking To Eliminate Accessible Cords on Window Covering Products

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-15

... [Docket No. CPSC-2013-0028] Petition for Rulemaking To Eliminate Accessible Cords on Window Covering... Commission to: promulgate a mandatory standard that prohibits any window covering cords, when a feasible cordless alternative exists; and require that all window covering cords be made inaccessible through the...

Educating Girls: Strategies To Increase Access, Persistence, and Achievement.

ERIC Educational Resources Information Center

Tietjen, Karen; Prather, Cynthia, Ed.

This document reviews the interventions, such as policies, programs, and projects, that have been implemented by governments, donors, and other institutions to increase girls' access, persistence, and achievement at the primary school level. It examines both the formal system of primary education and nontraditional, alternative approaches to reach…

75 FR 27056 - FTA Supplemental Fiscal Year 2010 Apportionments, Allocations, and Corrections

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-13

... notice to apportion the full amount of FY 2010 formula funds. In addition, this Notice revises the Job Access and Reverse Commute (JARC) and Alternatives Analysis program carryover tables, Small Transit... projects under the Alternative Analysis program. FOR FURTHER INFORMATION CONTACT: For general information...

76 FR 76640 - Telecommunications Act Accessibility Guidelines; Electronic and Information Technology...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-08

... benefits and costs, and recommended alternatives. The Board also invites the public to identify any gaps in... guidelines, alternative policies to those presented, and information on benefits and costs. After reviewing... with considerable potential cost in relation to the benefit. Because this requirement potentially would...

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

ERIC Educational Resources Information Center

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

2018-01-01

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

The 2% Transition: Supporting Access to State Assessments for Students with Disabilities

ERIC Educational Resources Information Center

Jamgochian, Elisa M.; Ketterlin-Geller, Leanne R.

2015-01-01

Most students with disabilities participate in state assessments with or without accommodations [based on each student's Individualized Education Program (IEP)]. A small number of students with the most severe or profound intellectual disabilities participate in an alternate assessment based on alternate achievement standards (AA-AAS). Until…

Alternative Models to Deliver Developmental Math: Issues of Use and Student Access

ERIC Educational Resources Information Center

Kosiewicz, Holly; Ngo, Federick; Fong, Kristen

2016-01-01

Objective: Changing how community colleges deliver developmental education has become a key policy lever to increase student achievement. Alternative development education models reduce the amount of time a student spends in remediation, provide students with supplemental instruction and support, and contextualize content to align with student…

Development of guidelines for operationally effective raised medians and the use of alternative movements on urban roadways.

DOT National Transportation Integrated Search

2012-10-01

The development of raised medians is an important access management technique commonly used in urban settings. It : can be used to control or restrict mid-block left turns, U-turns or crossing maneuvers for implementing of alternative : left-turn/U-t...

What Next? Promoting Alternatives to Ability Grouping.

ERIC Educational Resources Information Center

Wheelock, Anne; Hawley, Willis D.

1993-01-01

Suggests ways to eliminate ability grouping in the schools, and explores new alternatives to improve schooling for all students. Specific guidelines are given for the development of academically and racially heterogeneous schooling. The elimination of grouping practices that deny equal access to education is a goal worth pursuing. (SLD)

Tapping the potential of alternative medicine.

PubMed

La Puma, J; Eiler, G

1998-04-01

Interest in alternative medicine is growing among healthcare consumers. Health plans and healthcare organizations may be able to improve clinical outcomes and benefit financially by providing patients with access to alternative services. Organizations that can assess their communities' particular needs, draw on interested professional staff to help develop alternative medicine programs and protocols, and study quality outcomes will stand a better chance of making such programs successful. Educating medical staff, designing a credible program, and forging strategic alliances with respected partners can help organizations create a sharply focused brand identity in the community.

Laparoscopic access with a visualizing trocar.

PubMed

Wolf, J S

1997-01-01

Although useful in most situations, there are several inherent disadvantages of the standard laparoscopic access techniques of Veress needle insertion and Hasson-type cannula placement. Veress needle placement may be hazardous in patients at high risk for intraabdominal adhesions and difficult in patients who are obese. The usual alternative, the Hasson-type cannula, often does not provide a good gas seal. As another option, the use of a visualizing trocar (OPTIVIEW) has proven to be effective in the initial experience at the University of Michigan. The inner trocar of the visualizing trocar is hollow except for a clear plastic conical tip with two external ridges. The trocar-cannula assembly is passed through tissue layers to enter the operative space under direct vision from a 10-mm zero-degree laparoscope placed into the trocar. Results suggest that this technique is an excellent alternative to Veress needle placement when laparoscopic access is likely to be hazardous or difficult.

Breach Risk Magnitude: A Quantitative Measure of Database Security.

PubMed

Yasnoff, William A

2016-01-01

A quantitative methodology is described that provides objective evaluation of the potential for health record system breaches. It assumes that breach risk increases with the number of potential records that could be exposed, while it decreases when more authentication steps are required for access. The breach risk magnitude (BRM) is the maximum value for any system user of the common logarithm of the number of accessible database records divided by the number of authentication steps needed to achieve such access. For a one million record relational database, the BRM varies from 5.52 to 6 depending on authentication protocols. For an alternative data architecture designed specifically to increase security by separately storing and encrypting each patient record, the BRM ranges from 1.3 to 2.6. While the BRM only provides a limited quantitative assessment of breach risk, it may be useful to objectively evaluate the security implications of alternative database organization approaches.

An Alternative Option to Dedicated Braille Notetakers for People with Visual Impairments: Universal Technology for Better Access

ERIC Educational Resources Information Center

Hong, Sunggye

2012-01-01

Technology provides equal access to information and helps people with visual impairments to complete tasks more independently. Among various assistive technology options for people with visual impairments, braille notetakers have been considered the most significant because of their technological innovation. Braille notetakers allow users who are…

Marginalized Student Access to Technology Education

ERIC Educational Resources Information Center

Kurtcu, Wanda M.

2017-01-01

The purpose of this paper is to investigate how a teacher can disrupt an established curriculum that continues the cycle of inequity of access to science, technology, engineering, and math (STEM) curriculum by students in alternative education. For this paper, I will focus on the technology components of the STEM curriculum. Technology in the…

Increasing the Literacy Skills of Students Who Require AAC through Modified Direct Instruction and Specific Instructional Feedback

ERIC Educational Resources Information Center

Westover, Jennifer M.

2010-01-01

Literacy skills are fundamental for all learners. For students who require augmentative and alternative communication (AAC), strong literacy skills provide a gateway to generative communication, genuine social networking, improved access to academic opportunities, access to information technology and future employment opportunities. However, many…

Social Reproduction and College Access: Current Evidence, Context, and Potential Alternatives

ERIC Educational Resources Information Center

Serna, Gabriel R.; Woulfe, Rebecca

2017-01-01

Social reproduction theory identifies schooling as a primary means for the perpetuation of the dominant class's ideologies, values, and power. The ability to access college is so closely tied to these constructs that it contributes to this dominance and marginalization. Social stratification is not only mirrored in higher education, but the…

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…

78 FR 29151 - Notice of Availability of the Final Environmental Impact Statement for the Proposed Mohave County...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-17

.../energy/wind/mohave.html . The Project is proposed to consist of up to 283 turbines, access roads, and... be supplemented with internal access/service roads to each wind turbine. Proposed ancillary... all action alternatives, Project features within the wind-farm site would include turbines aligned...

The Inevitability of Open Access

ERIC Educational Resources Information Center

Lewis, David W.

2012-01-01

Open access (OA) is an alternative business model for the publication of scholarly journals. It makes articles freely available to readers on the Internet and covers the costs associated with publication through means other than subscriptions. This article argues that Gold OA, where all of the articles of a journal are available at the time of…

Alternative Uses for Course Management Systems: They Aren't Just for Classes Any More

ERIC Educational Resources Information Center

Ullmann, Jill

2009-01-01

Universities are quickly moving from brick and mortar toward online classroom settings. The online setting provides students with increased accessibility and flexibility to attend classes they would normally be unable to attend. Unfortunately, for those students who never attend classes on campus, many campus resources are not accessible. Students…

Information Resources on Online Public Access Catalogs. A Selected ERIC Bibliography.

ERIC Educational Resources Information Center

ERIC Clearinghouse on Information Resources, Syracuse, NY.

Sixteen articles, books, and reports published between 1978 and 1983 and cited in "Resources in Education" and "Current Index to Journals in Education" are listed in this bibliography on online public access catalogs (OPACs). Emphasis is on the movement toward computer-based alternatives to library card catalogs and user…

The Dynamics of Access to Groups in Working Memory

ERIC Educational Resources Information Center

Farrell, Simon; Lelievre, Anna

2012-01-01

The finding that participants leave a pause between groups when attempting serial recall of temporally grouped lists has been taken to indicate access to a hierarchical representation of the list in working memory. An alternative explanation is that the dynamics of serial recall solely reflect output (rather than memorial) processes, with the…

Children, Families and Interagency Work: Experiences of Partnership Work in Primary Education Settings

ERIC Educational Resources Information Center

Milbourne, Linda

2005-01-01

Despite UK government initiatives intended to address social exclusion, those with poor access to social and economic resources continue to experience unresponsive services. In these circumstances, small inter-agency projects may offer accessible alternatives. This article explores the implementation of inter-agency work at a local level, focusing…

Women Choose Their Careers: A Study of Natural Decision Making.

ERIC Educational Resources Information Center

Eisenhart, Margaret A.

1985-01-01

Ethnographic interviews with 23 college-aged women revealed most considered few career alternatives, relied on easily accessible information sources, made choices early in life, stayed with the choice, and decided to either "earn money" or "stay at home." The others considered several alternatives, pursued them, and linked them to relationships…

Tanning beds as an alternative for psoriasis when office-based phototherapy is not accessible.

PubMed

Yentzer, Brad A; Feldman, Steven R

2009-01-01

Many systemic therapies for psoriasis have significant toxicities. Office-based phototherapy is not always practical for many patients. We present a case report and review of using a tanning bed in conjunction with low-dose acitretin as an alternative treatment for moderate to severe plaque psoriasis.

Making Science Accessible to Students with Significant Cognitive Disabilities

ERIC Educational Resources Information Center

Andersen, Lori; Nash, Brooke

2016-01-01

The publication of A Framework for K-12 Science Education (National Research Council, 2012) and the Next Generation Science Standards (NGSS Lead States, 2013) have created a need for new alternate content standards and alternate assessments in science that are linked to the new general education science standards. This article describes how a…

77 FR 26572 - Notice of Availability of the Draft Environmental Impact Statement for the Proposed Mohave County...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-04

... be supplemented with internal access/service roads to each wind turbine. Proposed ancillary... action alternatives, project features within the wind-farm site would include turbines aligned within... maximum of 283 turbines. The Alternative B wind-farm site would encompass approximately 30,872 acres of...

A Study of Two Instructional Sequences Informed by Alternative Learning Progressions in Genetics

ERIC Educational Resources Information Center

Duncan, Ravit Golan; Choi, Jinnie; Castro-Faix, Moraima; Cavera, Veronica L.

2017-01-01

Learning progressions (LPs) are hypothetical models of how learning in a domain develops over time with appropriate instruction. In the domain of genetics, there are two independently developed alternative LPs. The main difference between the two progressions hinges on their assumptions regarding the accessibility of classical (Mendelian) versus…

77 FR 36573 - DRAFT General Management Plan and Draft Environmental Impact Statement, Fort Matanzas National...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-19

... Statement (EIS) for the General Management Plan (GMP) for Fort Matanzas National Monument (Monument... EIS/GMP describes the NPS preferred alternative--Alternative B--to guide the management of the... prescriptions to ensure protection, access and enjoyment of the Monument's resources. An up-to-date GMP is...

Early Sentence Productions of 5-Year-Old Children Who Use Augmentative and Alternative Communication

ERIC Educational Resources Information Center

Binger, Cathy; Kent-Walsh, Jennifer; King, Marika; Webb, Eliza; Buenviaje, Elijia

2017-01-01

Four 5-year-old children with receptive language within normal limits and who required augmentative and alternative communication (AAC) received instruction in producing six different semantic--syntactic structures (three treatment and three generalization targets). Participants accessed single-meaning graphic symbols using an AAC app on an iPad…

Medical tourism in the backcountry: alternative health and healing in the Arkansas Ozarks.

PubMed

Nolan, Justin M; Schneider, Mary Jo

2011-01-01

Tourists travel to Arkansas' mountain regions to experience, appreciate, and consume multiple aspects of otherness, including sacred sites and pristine and authentic peoples and environments. A largely unexplored aspect of this consumption of authenticity is alternative medicine, provided to tourists and day travelers in search of physical and emotional restoration. Traditional forms of medicine are deeply rooted in women's social roles as community healers in the region and are perpetuated in part because of the lack of readily accessible forms of so-called modern medicine. Contemporary medical tourism in Arkansas has promoted access to folk health systems, preserving them by incorporating them into tourists' health care services, and also has attracted new and dynamic alternative medical practices while encouraging the transformation of existing forms of traditional medicine. Ultimately, the blend of alternative, folk, and conventional medicine in the Arkansas highlands is evidence of globalizing forces at work in a regional culture. It also serves to highlight a renewed appreciation for the historic continuity and the efficacy of traditional knowledge in the upper South.

Facilitating Access to Emotions: Neural Signature of EMDR Stimulation

PubMed Central

Herkt, Deborah; Tumani, Visal; Grön, Georg; Kammer, Thomas; Hofmann, Arne; Abler, Birgit

2014-01-01

Background Eye Movement Desensitisation and Reprocessing (EMDR) is a method in psychotherapy effective in treating symptoms of posttraumatic stress disorder. The client attends to alternating bilateral visual, auditory or sensory stimulation while confronted with emotionally disturbing material. It is thought that the bilateral stimulation as a specific element of EMDR facilitates accessing and processing of negative material while presumably creating new associative links. We hypothesized that the putatively facilitated access should be reflected in increased activation of the amygdala upon bilateral EMDR stimulation even in healthy subjects. Methods We investigated 22 healthy female university students (mean 23.5 years) with fMRI. Subjects were scanned while confronted with blocks of disgusting and neutral picture stimuli. One third of the blocks was presented without any additional stimulation, one third with bilateral simultaneous auditory stimulation, and one third with bilateral alternating auditory stimulation as used in EMDR. Results Contrasting disgusting vs. neutral picture stimuli confirmed the expected robust effect of amygdala activation for all auditory stimulation conditions. The interaction analysis with the type of auditory stimulation revealed a specific increase in activation of the right amygdala for the bilateral alternating auditory stimulation. Activation of the left dorsolateral prefrontal cortex showed the opposite effect with decreased activation. Conclusions We demonstrate first time evidence for a putative neurobiological basis of the bilateral alternating stimulation as used in the EMDR method. The increase in limbic processing along with decreased frontal activation is in line with theoretical models of how bilateral alternating stimulation could help with therapeutic reintegration of information, and present findings may pave the way for future research on EMDR in the context of posttraumatic stress disorder. PMID:25165974

Upper limb grafts for hemodialysis access.

PubMed

Shemesh, David; Goldin, Ilya; Verstandig, Anthony; Berelowitz, Daniel; Zaghal, Ibrahim; Olsha, Oded

2015-01-01

Arteriovenous (AV) grafts are required for hemodialysis access when options for native fistulas have been fully exhausted, where they continue to play an important role in hemodialysis patients, offering a better alternative to central vein catheters. When planning autogenous accesses using Doppler ultrasound, adequate arterial inflow and venous outflow must be consciously preserved for future access creation with grafts. Efforts to improve graft patency include changing graft configuration, graft biology and hemodynamics. Industry offers early cannulation grafts to reduce central catheter use and a bioengineered graft is undergoing clinical studies. Although the outcome of AV grafts is inferior to fistulas, grafts can provide long-term hemodialysis access that is a better alternative to central venous catheters. AV grafts have significant drawbacks, mainly poor patency, infection and cost but also have some advantages: early maturation, ease of creation and needling and widespread availability. The outcome of AV graft surgery is variable from center to center. The primary patency rate for AV grafts is 58% at 6 months and the secondary patency rate is 76% at 6 months and 55% at 18 months. There are centers of excellence that report a 1 year secondary patency rate of up to 91%. In this review of the use of AV grafts for hemodialysis access in the upper extremities, technical issues involved in planning the access and performing the surgery in its different configurations are discussed and the role of surveillance and maintenance with their attendant surgical and radiological interventions is described.

Circadian Activity Rhythms and Voluntary Ethanol Intake in Male and Female Ethanol-Preferring Rats: Effects of Long-Term Ethanol Access

PubMed Central

Rosenwasser, Alan M.; McCulley, Walter D.; Fecteau, Matthew

2014-01-01

Chronic alcohol (ethanol) intake alters fundamental properties of the circadian clock. While previous studies have reported significant alterations in free-running circadian period during chronic ethanol access, these effects are typically subtle and appear to require high levels of intake. In the present study we examined the effects of long-term voluntary ethanol intake on ethanol consumption and free-running circadian period in male and female, selectively bred ethanol-preferring P and HAD2 rats. In light of previous reports that intermittent access can result in escalated ethanol intake, an initial 2-week water-only baseline was followed by either continuous or intermittent ethanol access (i.e., alternating 15-day epochs of ethanol access and ethanol deprivation) in separate groups of rats. Thus, animals were exposed to either 135 days of continuous ethanol access or to five 15-day access periods alternating with four 15-day periods of ethanol deprivation. Animals were maintained individually in running-wheel cages under continuous darkness throughout the experiment to allow monitoring of free-running activity and drinking rhythms, and 10% (v/v) ethanol and plain water were available continuously via separate drinking tubes during ethanol access. While there were no initial sex differences in ethanol drinking, ethanol preference increased progressively in male P and HAD2 rats under both continuous and intermittent-access conditions, and eventually exceeded that seen in females. Free-running period shortened during the initial ethanol-access epoch in all groups, but the persistence of this effect showed complex dependence on sex, breeding line, and ethanol-access schedule. Finally, while females of both breeding lines displayed higher levels of locomotor activity than males, there was little evidence for modulation of activity level by ethanol access. These results are consistent with previous findings that chronic ethanol intake alters free-running circadian period, and show further that the development of chronobiological tolerance to ethanol may vary by sex and genotype. PMID:25281289

Sex and menstrual cycle effects on chronic oral cocaine self-administration in rhesus monkeys: Effects of a nondrug alternative reward.

PubMed

Carroll, Marilyn E; Collins, Molly; Kohl, Emily A; Johnson, Seth; Dougen, Ben

2016-08-01

In previous studies, female monkeys self-administered more oral phencyclidine (PCP) than males, and PCP intake differed by phase of menstrual cycle. The purpose of this study was to examine sex and hormonal influences on oral cocaine self-administration in male and female rhesus monkeys in the follicular vs. luteal phases of the menstrual cycle, with concurrent access to an alternative nondrug reward, saccharin (SACC) vs. water. Concurrent access to cocaine (0.2, 0.4, and 0.8 mg/ml) and SACC or water was available from two drinking spouts under concurrent fixed-ratio (FR) 2, 4, and 8 schedules during daily 3-h sessions. Cocaine deliveries were similar in males and females in the females' luteal phase, but cocaine deliveries were higher in females during the follicular phase than the luteal phase and compared to males. When SACC was available, cocaine deliveries were reduced in females in the follicular phase of the cycle, and cocaine intake (mg/kg) was reduced in males and in females' follicular and luteal phases. Access to concurrent SACC (vs. water) reduced cocaine intake (mg/kg) in males and in females during both menstrual phases, and the magnitude of the reduction in cocaine intake was greatest during the females' follicular phase. Thus, a nondrug alternative reward, SACC, is a viable alternative treatment for reducing cocaine's rewarding effects on male and female monkeys, and reductions in cocaine seeking were optimal in the females' luteal phase.

Maternal Strategies to Access Food Differ by Food Security Status.

PubMed

Gorman, Kathleen S; McCurdy, Karen; Kisler, Tiffani; Metallinos-Katsaras, Elizabeth

2017-01-01

Household food insecurity is associated with health and behavior risk. Much less is known about how food insecurity is related to strategies that adults use in accessing food: how and where they shop, use of alternative food sources, and their ability to manage resources. To examine how maternal behaviors, including shopping, accessing alternative sources of food, and managing resources, are related to household food security status (HHFSS). Cross-sectional study collecting survey data on HHFSS, shopping behaviors, use of alternative food sources, and managing resources obtained from low-income mothers of preschool-aged children. One hundred sixty-four low-income mothers of young children (55% Hispanic) from two communities in Rhode Island. HHFSS was measured using 10 items from the 18-item Core Food Security Module to assess adult food security. Mothers were surveyed about where, when, and how often they shopped; the strategies they use when shopping; their use of alternative sources of food, including federal, state, and local assistance; and their ability to manage their resources. Analysis of variance and χ 2 analyses assessed the associations between demographic variables, shopping, accessing alternative food sources, and managing resources, and HHFSS. Multivariate logistic regression assessed the associations between HHFSS and maternal demographic variables, food shopping, strategies, alternative sources of food, and ability to manage resources. Maternal age and language spoken at home were significantly associated with HHFSS; food insecurity was 10% more likely among older mothers (adjusted odds ratio [aOR] 1.10, 95% CI 1.03 to 1.17) and 2.5 times more likely among Spanish-speaking households (compared with non-Spanish speaking [aOR 3.57, 95% CI 1.25 to 10.18]). Food insecurity was more likely among mothers reporting more informal strategies (aOR 1.98, 95% CI 1.28 to 3.01; P<0.05) and perceiving greater inability to manage resources (aOR 1.60, 95% CI 1.30 to 1.98; P<0.05). The results suggest that low-income mothers use a variety of strategies to feed their families and that the strategies they use vary by HHFSS. Community nutrition programs and providers will need to consider these strategies when counseling families at risk for food insecurity and provide guidance to minimize the influence on healthy food choices. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Maternal Strategies to Access Food Differ by Food Security Status

PubMed Central

Gorman, Kathleen S.; McCurdy, Karen; Kisler, Tiffani; Metallinos-Katsaras, Elizabeth

2016-01-01

Background Household food insecurity is associated with health and behavior risk. Much less is known about how food insecurity is related to strategies that adults use in accessing food: how and where they shop, use of alternative food sources and their ability to manage resources. Objective To examine how maternal behaviors including shopping, accessing alternative sources of food and managing resources are related to household food security status (HHFSS). Design Cross-sectional study collecting survey data on HHFSS, shopping behaviors, use of alternative food sources and managing resources obtained from low income mothers of preschoolers. Participants 164 low-income mothers of young children (55% Hispanic) from two communities in Rhode Island. Measures HHFSS was measured using ten items from the 18-item Core Food Security Module to assess adult food security. Mothers were surveyed about where, when and how often they shopped; the strategies they use when shopping; their use of alternative sources of food including federal, state and local assistance; and their ability to manage their resources. Statistical analyses Analysis of Variance and Chi-square analyses assessed the associations between demographic variables, shopping, accessing alternative food sources and managing resources, and HHFSS. Multivariate logistic regression assessed the associations between HHFSS and maternal demographic variables, food shopping strategies, alternative sources of food and ability to manage resources. Results Maternal age and language spoken at home were significantly associated with HHFSS; food insecurity was 10% more likely among older mothers (AOR=1.10; 95% CI 1.03-1.17) and 2.5 times more likely among Spanish speaking households (compared to non-Spanish speaking-AOR=3.57; 95% CI 1.25-10.18). Food insecurity was more likely among mothers reporting more informal strategies (AOR=1.98; 95% CI 1.28-3.01, p<.05) and perceiving greater inability to manage resources (AOR=1.60; 95% CI 1.30-1.98, p<.05). Conclusions The results suggest that low-income mothers use a variety of strategies in order to feed their families and that the strategies they use vary by HHFSS. Community nutrition programs and providers will need to consider these strategies when counseling families at risk for food insecurity and provide guidance to minimize the impact on healthy food choices. PMID:27614689

KENNEDY SPACE CENTER, FLA. - Key officials are poised to cut the ribbon officially dedicating the new Security gates on Kennedy Parkway (Gate 2) and NASA Parkway (Gate 3). From left are Wally Schroeder, with Jones, Edmunds & Associates; Bobby Porter, with Oneida Construction; Daniel Tweed, NASA project manager; Jim Kennedy, Center director; and William Sample, SGS deputy program manager. The new gates were activated Aug. 1, allowing the general public to have access to the new Space Commerce Way, which will provide access to the Research Park and KSC Visitor Complex, and providing an alternate route for the general public between Titusville and Merritt Island that is accessible 24 hours a day. The gates are staffed 24 hours daily.

NASA Image and Video Library

2003-08-27

KENNEDY SPACE CENTER, FLA. - Key officials are poised to cut the ribbon officially dedicating the new Security gates on Kennedy Parkway (Gate 2) and NASA Parkway (Gate 3). From left are Wally Schroeder, with Jones, Edmunds & Associates; Bobby Porter, with Oneida Construction; Daniel Tweed, NASA project manager; Jim Kennedy, Center director; and William Sample, SGS deputy program manager. The new gates were activated Aug. 1, allowing the general public to have access to the new Space Commerce Way, which will provide access to the Research Park and KSC Visitor Complex, and providing an alternate route for the general public between Titusville and Merritt Island that is accessible 24 hours a day. The gates are staffed 24 hours daily.

Extraction, integration and analysis of alternative splicing and protein structure distributed information

PubMed Central

D'Antonio, Matteo; Masseroli, Marco

2009-01-01

Background Alternative splicing has been demonstrated to affect most of human genes; different isoforms from the same gene encode for proteins which differ for a limited number of residues, thus yielding similar structures. This suggests possible correlations between alternative splicing and protein structure. In order to support the investigation of such relationships, we have developed the Alternative Splicing and Protein Structure Scrutinizer (PASS), a Web application to automatically extract, integrate and analyze human alternative splicing and protein structure data sparsely available in the Alternative Splicing Database, Ensembl databank and Protein Data Bank. Primary data from these databases have been integrated and analyzed using the Protein Identifier Cross-Reference, BLAST, CLUSTALW and FeatureMap3D software tools. Results A database has been developed to store the considered primary data and the results from their analysis; a system of Perl scripts has been implemented to automatically create and update the database and analyze the integrated data; a Web interface has been implemented to make the analyses easily accessible; a database has been created to manage user accesses to the PASS Web application and store user's data and searches. Conclusion PASS automatically integrates data from the Alternative Splicing Database with protein structure data from the Protein Data Bank. Additionally, it comprehensively analyzes the integrated data with publicly available well-known bioinformatics tools in order to generate structural information of isoform pairs. Further analysis of such valuable information might reveal interesting relationships between alternative splicing and protein structure differences, which may be significantly associated with different functions. PMID:19828075

Long-axis view for ultrasound-guided central venous catheter placement via the internal jugular vein.

PubMed

Mahan, Angel F; McEvoy, Matthew D; Gravenstein, Nikolaus

2016-04-01

In modern practice, real-time ultrasound guidance is commonly employed for the placement of internal jugular vein catheters. With a new tool, such as ultrasound, comes the opportunity to refine and further optimize the ultrasound view during jugular vein catheterization. We describe jugular vein access techniques and use the long-axis view as an alternative to the commonly employed short-axis cross-section view for internal jugular vein access and cannulation. The long-axis ultrasound-guided internal jugular vein approach for internal jugular vein cannulation is a useful alternative technique that can provide better needle tip and guidewire visualization than the more traditional short-axis ultrasound view.

Ultrasound-Guided Renal Access for Percutaneous Nephrolithotomy: A Description of Three Novel Ultrasound-Guided Needle Techniques

PubMed Central

Chu, Carissa; Masic, Selma; Usawachintachit, Manint; Hu, Weiguo; Yang, Wenzeng; Stoller, Marshall; Li, Jianxing

2016-01-01

Abstract Ultrasound-guided renal access for percutaneous nephrolithotomy (PCNL) is a safe, effective, and low-cost procedure commonly performed worldwide, but a technique underutilized by urologists in the United States. The purpose of this article is to familiarize the practicing urologist with methods for ultrasound guidance for percutaneous renal access. We discuss two alternative techniques for gaining renal access for PCNL under ultrasound guidance. We also describe a novel technique of using the puncture needle to reposition residual stone fragments to avoid additional tract dilation. With appropriate training, ultrasound-guided renal access for PCNL can lead to reduced radiation exposure, accurate renal access, and excellent stone-free success rates and clinical outcomes. PMID:26414304

The Macroeconomic Consequences of Renouncing to Universal Access to Antiretroviral Treatment for HIV in Africa: A Micro-Simulation Model

PubMed Central

Ventelou, Bruno; Arrighi, Yves; Greener, Robert; Lamontagne, Erik; Carrieri, Patrizia; Moatti, Jean-Paul

2012-01-01

Aim Previous economic literature on the cost-effectiveness of antiretroviral treatment (ART) programs has been mainly focused on the microeconomic consequences of alternative use of resources devoted to the fight against the HIV pandemic. We rather aim at forecasting the consequences of alternative scenarios for the macroeconomic performance of countries. Methods We used a micro-simulation model based on individuals aged 15–49 selected from nationally representative surveys (DHS for Cameroon, Tanzania and Swaziland) to compare alternative scenarios : 1-freezing of ART programs to current levels of access, 2- universal access (scaling up to 100% coverage by 2015, with two variants defining ART eligibility according to previous or current WHO guidelines). We introduced an “artificial” ageing process by programming methods. Individuals could evolve through different health states: HIV negative, HIV positive (with different stages of the syndrome). Scenarios of ART procurement determine this dynamics. The macroeconomic impact is obtained using sample weights that take into account the resulting age-structure of the population in each scenario and modeling of the consequences on total growth of the economy. Results Increased levels of ART coverage result in decreasing HIV incidence and related mortality. Universal access to ART has a positive impact on workers' productivity; the evaluations performed for Swaziland and Cameroon show that universal access would imply net cost-savings at the scale of the society, when the full macroeconomic consequences are introduced in the calculations. In Tanzania, ART access programs imply a net cost for the economy, but 70% of costs are covered by GDP gains at the 2034 horizon, even in the extended coverage option promoted by WHO guidelines initiating ART at levels of 350 cc/mm3 CD4 cell counts. Conclusion Universal Access ART scaling-up strategies, which are more costly in the short term, remain the best economic choice in the long term. Renouncing or significantly delaying the achievement of this goal, due to “legitimate” short term budgetary constraints would be a misguided choice. PMID:22514619

Upper Nasopharyngeal Corridor for Transnasal Endoscopic Drainage of Petroclival Cholesterol Granulomas: Alternative Access in Conchal Sphenoid Patients.

PubMed

Turan, Nefize; Baum, Griffin R; Holland, Christopher M; Ahmad, Faiz U; Henriquez, Oswaldo A; Pradilla, Gustavo

2016-03-01

Background Cholesterol granulomas arising at the petrous apex can be treated via traditional open surgical, endoscopic, and endoscopic-assisted approaches. Endoscopic approaches require access to the sphenoid sinus, which is technically challenging in patients with conchal sphenoidal anatomy. Clinical Presentation A 55-year-old woman presented with intermittent headaches and tinnitus. Formal audiometry demonstrated moderately severe bilateral hearing loss. CT of the temporal bones and sella revealed a well-demarcated expansile lytic mass. MRI of the face, orbit, and neck showed a right petrous apex mass measuring 22 × 18 × 19 mm that was hyperintense on T1- and T2-weighted images without enhancement, consistent with a cholesterol granuloma. The patient had a conchal sphenoidal anatomy. Operative Technique Herein, we present an illustrative case of a low-lying petroclival cholesterol granuloma in a patient with conchal sphenoidal anatomy to describe an alternative high nasopharyngeal corridor for endoscopic transnasal transclival access. Postoperative Course Postoperatively, the patient's symptoms recovered and no complications occurred. Follow-up imaging demonstrated a patent drainage tract without evidence of recurrence. Conclusion In patients with a conchal sphenoid sinus, endoscopic transnasal transclival access can be gained using a high nasopharyngeal approach. This corridor facilitates safe access to these lesions and others in this location.

The versatility of intraosseous vascular access in perioperative medicine: a case series.

PubMed

Anson, Jonathan A; Sinz, Elizabeth H; Swick, John T

2015-02-01

Intraosseous vascular access is a time-tested procedure that is reemerging in popularity. This is primarily a result of the emphasis on intraosseous access in the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Advanced Cardiac Life Support. Modern intraosseous insertion devices are easy to learn and use, suggesting the possibility of use beyond the resuscitation setting. We present a case series of recent intraosseous insertions for a variety of indications by anesthesiologists at our institution to demonstrate the potential utility of this alternative access technique. Copyright © 2014 Elsevier Inc. All rights reserved.

Male sexual polymorphism, alternative reproductive tactics, and androgens in combtooth blennies (pisces: blenniidae).

PubMed

Oliveira, R F; Canario, A V; Grober, M S

2001-09-01

In species in which intense intermale competition for the access to females is present males of lower competitive ability may adopt alternative reproductive tactics (ART) to get access to mates. These ART translate in many cases into male sexual polymorphism, with individuals following distinctly different tactics. Usually two alternative male morphs can be recognized in species with ART: (1) bourgeois males that compete for access to mates invest in typically male behaviors, such as building elaborated nests or displaying ornaments; and (2) parasitic males that take advantage of the success of the bourgeois males in attracting females and attempt "sneaker" fertilizations (e.g., sneaker and satellite males). In combtooth blennies (Blenniidae) the co-occurrence of ART and male sexual polymorphism has been described for two temperate species: the peacock blenny, Salaria pavo, and the Azorean rock-pool blenny, Parablennius sanguinolentus parvicornis. Interestingly, while in the peacock blenny the alternative male morph adopts a sneaker tactic, in the rock-pool blenny parasitic males act as satellites to nest-holder males. Thus, this variation in the ART expressed in these two closely related species allows for a comparative study of the proximate and ultimate factors affecting the expression of the two ART. In this article we summarize the available information on androgen levels in bourgeois and parasitic males of natural populations of the two species and of recent studies on the effect of exogenous administration of androgens on tactic switching in parasitic males of the two species. The information is discussed within the frame of the relative plasticity hypothesis, which predicts that plastic alternative morphs should show differences in hormone levels and that the administration of sex steroids should be effective in promoting the switch from the parasitic to bourgeois tactic. The evidence is only partly consistent with this hypothesis. Alternatively, a social transduction hypothesis that better fits the available data on androgens and ART in teleost is proposed. It states that the observed differences in androgen levels between alternative morphs should not be interpreted as an organization vs activation effect of steroids, but rather as the limited vs lifelong responsiveness of the neuroendocrine axis to social regulation. Copyright 2001 Academic Press.

Accommodating Those Most at Risk. Responding to a Mismatch in Programme Selection Criteria and Foundation Biology Performance

ERIC Educational Resources Information Center

Kirby, Nicola F.; Dempster, Edith R.

2015-01-01

In South Africa, foundation programmes are a well-established alternative access route to tertiary science study for educationally disadvantaged students. Student access to, and performance in, one such foundation programme has been researched by the authors seeking opportunities to improve student retention. The biology module in particular has…

Effects of Reinforcer Magnitude and Distribution on Preference for Work Schedules

ERIC Educational Resources Information Center

Ward-Horner, John C.; Pittenger, Alexis; Pace, Gary; Fienup, Daniel M.

2014-01-01

When the overall magnitude of reinforcement is matched between 2 alternative work schedules, some students prefer to complete all of their work for continuous access to a reinforcer (continuous work) rather than distributed access to a reinforcer while they work (discontinuous work). We evaluated a student's preference for continuous work by…

77 FR 60708 - Additional Waiver Granted to and Alternative Requirement for the Town of Union, New York's CDBG...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-04

.... Village of Endicott Water Plant ($150,000 budgeted) and Western Heights Blvd. Water Tank Access ($6,000... improvements so that water can be provided to the village of Endicott. Union, NY also carefully considered... Plant, Village of Endicott Water Plant, Western Heights Blvd. Water Tank Access, Westover Levee Repair...

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...

A Lexical Basis for N400 Context Effects: Evidence from MEG

ERIC Educational Resources Information Center

Lau, Ellen; Almeida, Diogo; Hines, Paul C.; Poeppel, David

2009-01-01

The electrophysiological response to words during the "N400" time window (approximately 300-500 ms post-onset) is affected by the context in which the word is presented, but whether this effect reflects the impact of context on "access" of the stored lexical information itself or, alternatively, post-access "integration" processes is still an open…

Access, Quality, and Opportunity: A Case Study of Zambia Open Community Schools (ZOCS)

ERIC Educational Resources Information Center

Mwalimu, Michelle

2011-01-01

Community schools and other approaches to Alternative Primary Education or APE have increased access to primary education for underserved populations in Africa, Asia, and Latin America as a major goal of the Education for All (EFA) movement. In Zambia, a country where an estimated 20 percent of the basic education enrollment now attends community…

Alternative Sources of Funding Early Childhood Education for School Effectiveness in Nigeria

ERIC Educational Resources Information Center

Olubor, Roseline O.; Inua, Ofe I.

2015-01-01

The authors examined the sources of funding early childhood education in existence in Nigeria with a view towards suggesting alternative sources to boost the revenue base for school effectiveness. The diminishing culture of the extended family system and the need for both parents to be in employment coupled with the need to provide access and…

Airpower Projection in the Anti-Access/Area Denial Environment: Dispersed Operations

DTIC Science & Technology

2015-02-01

Raptor Case Study.....................................................................6 Risks to Dispersed Operations...project airpower, this paper breaks down a case study of the Rapid Raptor concept. The risks with executing a dispersed model are analyzed and mitigation...will force leaders to look at alternative ways to project power. Alternative Option: Rapid Raptor Case Study The ability to defend forward operating

Implementation of Alternative Transport Networks in University Campuses: The Case of Aristotle University of Thessaloniki, Greece

ERIC Educational Resources Information Center

Pitsiava-Latinopoulou, Magda; Basbas, Socrates; Gavanas, Nikolaos

2013-01-01

Purpose: In order to alleviate the impacts of traffic congestion that undermine the mobility and accessibility conditions of the Aristotle University campus, the paper aims at the presentation and description of a complementary network of alternative modes (i.e. pedestrian and bicycle) and the discussion of the appropriate measures for its…

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

ERIC Educational Resources Information Center

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

2012-01-01

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

Alternation between Work and Education. A Study of Educational Leave of Absence at Enterprise Level.

ERIC Educational Resources Information Center

Organisation for Economic Cooperation and Development, Paris (France). Centre for Educational Research and Innovation.

The study reported here involves six countries (Germany, Italy, Yugoslavia, United Kingdom, United States, and Sweden) and focuses on the ways in which those who are actively employed have access to opportunities to alternate education and training with their employment. The first chapter discusses the study structure and defines the field covered…

Recommended Methodology for Inter-Service/Agency Automated Message Processing Exchange (I-S/A AMPE). Cost and Schedule Analysis of Security Alternatives.

DTIC Science & Technology

1982-02-23

segregate the computer and storage from the outside world 2. Administrative security to control access to secure computer facilities 3. Network security to...Classification Alternative A- 8 NETWORK KG GENSER DSSCS AMPE TERMINALS TP No. 022-4668-A Figure A-2. Dedicated Switching Architecture Alternative A- 9...communications protocol with the network and GENSER message transmission to the - I-S/A AMPE processor. 7. DSSCS TPU - Handles communications protocol with

Ever Enrolled Medicare Population Estimates from the MCBS Access to Care Files

PubMed Central

Petroski, Jason; Ferraro, David; Chu, Adam

2014-01-01

Objective The Medicare Current Beneficiary Survey’s (MCBS) Access to Care (ATC) file is designed to provide timely access to information on the Medicare population, yet because of the survey’s complex sampling design and expedited processing it is difficult to use the file to make both “always-enrolled” and “ever-enrolled” estimates on the Medicare population. In this study, we describe the ATC file and sample design, and we evaluate and review various alternatives for producing “ever-enrolled” estimates. Methods We created “ever enrolled” estimates for key variables in the MCBS using three separate approaches. We tested differences between the alternative approaches for statistical significance and show the relative magnitude of difference between approaches. Results Even when estimates derived from the different approaches were statistically different, the magnitude of the difference was often sufficiently small so as to result in little practical difference among the alternate approaches. However, when considering more than just the estimation method, there are advantages to using certain approaches over others. Conclusion There are several plausible approaches to achieving “ever-enrolled” estimates in the MCBS ATC file; however, the most straightforward approach appears to be implementation and usage of a new set of “ever-enrolled” weights for this file. PMID:24991484

Impacts on the Voltage Profile of DC Distribution Network with DG Access

NASA Astrophysics Data System (ADS)

Tu, J. J.; Yin, Z. D.

2017-07-01

With the development of electronic, more and more distributed generations (DGs) access into grid and cause the research fever of direct current (DC) distribution network. Considering distributed generation (DG) location and capacity have great impacts on voltage profile, so use IEEE9 and IEEE33 typical circuit as examples, with DGs access in centralized and decentralized mode, to compare voltage profile in alternating and direct current (AC/DC) distribution network. Introducing the voltage change ratio as an evaluation index, so gets the general results on voltage profile of DC distributed network with DG access. Simulation shows that, in the premise of reasonable location and capacity, DC distribution network is more suitable for DG access.

Traditional, complementary, and alternative medicine approaches to mental health care and psychological wellbeing in India and China.

PubMed

Thirthalli, Jagadisha; Zhou, Liang; Kumar, Kishore; Gao, Jie; Vaid, Henna; Liu, Huiming; Hankey, Alex; Wang, Guojun; Gangadhar, Bangalore N; Nie, Jing-Bao; Nichter, Mark

2016-07-01

India and China face the same challenge of having too few trained psychiatric personnel to manage effectively the substantial burden of mental illness within their population. At the same time, both countries have many practitioners of traditional, complementary, and alternative medicine who are a potential resource for delivery of mental health care. In our paper, part of The Lancet and Lancet Psychiatry's Series about the China-India Mental Health Alliance, we describe and compare types of traditional, complementary, and alternative medicine in India and China. Further, we provide a systematic overview of evidence assessing the effectiveness of these alternative approaches for mental illness and discuss challenges in research. We suggest how practitioners of traditional, complementary, and alternative medicine and mental health professionals might forge collaborative relationships to provide more accessible, affordable, and acceptable mental health care in India and China. A substantial proportion of individuals with mental illness use traditional, complementary, and alternative medicine, either exclusively or with biomedicine, for reasons ranging from faith and cultural congruence to accessibility, cost, and belief that these approaches are safe. Systematic reviews of the effectiveness of traditional, complementary, and alternative medicine find several approaches to be promising for treatment of mental illness, but most clinical trials included in these systematic reviews have methodological limitations. Contemporary methods to establish efficacy and safety-typically through randomised controlled trials-need to be complemented by other means. The community of practice built on collaborative relationships between practitioners of traditional, complementary, and alternative medicine and providers of mental health care holds promise in bridging the treatment gap in mental health care in India and China. Copyright © 2016 Elsevier Ltd. All rights reserved.

Investigating the over-representation of older persons in do-it-yourself home maintenance injury and barriers to prevention.

PubMed

Ashby, K; Ozanne-Smith, J; Fox, B

2007-10-01

To examine why older persons undertake high-risk do-it-yourself (DIY) home maintenance and under what circumstances, what constitutes acceptable low-risk alternatives to DIY, and to assess if alternatives are feasible in the current context. Exploratory qualitative study using focus-group methodology. Fifteen focus groups were conducted, involving 118 persons aged 60 years and older, in two Melbourne communities. Participants resided locally, participated in local seniors groups, or received treatment for a DIY injury at one of two public hospitals serving these communities. Older persons' involvement in DIY ranged from necessity to choice. A number chose DIY for general fitness enhancement, satisfaction and pride in a job well done, and giving meaning and enjoyment to daily tasks. However, some older, frailer seniors were forced into DIY because of difficulties in choosing appropriate alternatives; lack of knowledge of some available resources and services; the challenge of accessing cost-effective and reliable private service providers; and fear of vulnerability to overcharging, overservicing or their personal security. Preferred DIY alternatives were local government providers, local paper advertised services, recommendations to private service providers and family, friends or neighbors. Lack of knowledge of other existing alternatives was an impediment to preventing DIY injury, or accessing DIY alternatives. A number of potentially feasible alternatives to DIY were identified from our review. This research is an important first step in understanding issues facing community-dwelling seniors remaining at home, and provides a basis on which government agencies and other providers can develop services to meet increasing needs.

Sex and menstrual cycle effects on chronic oral cocaine self-administration in rhesus monkeys: Effects of a nondrug alternative reward

PubMed Central

Carroll, Marilyn E.; Collins, Molly; Kohl, Emily A.; Johnson, Seth; Dougen, Ben

2016-01-01

Background In previous studies female monkeys self-administered more oral phencyclidine (PCP) than males, and PCP intake differed by phase of menstrual cycle. Objectives The purpose of this study was to examine sex and hormonal influences on oral cocaine self-administration in male and female rhesus monkeys in the follicular vs. luteal phases of the menstrual cycle, with concurrent access to an alternative nondrug reward, saccharin (SACC) vs. water. Materials and methods Concurrent access to cocaine (0.2, 0.4 and 0.8 mg/ml) and SACC or water was available from two drinking spouts under concurrent fixed-ratio (FR) 2, 4, and 8 schedules during daily 3-h sessions. Results Cocaine deliveries were similar in males and females in the females’ luteal phase, but cocaine deliveries were higher in females during the follicular phase than the luteal phase and compared to males. When SACC was available cocaine deliveries were reduced in females in the follicular phase of the cycle, and cocaine intake (mg/kg) was reduced in males and in females’ follicular and luteal phases. Conclusions Access to concurrent SACC (vs. water) reduced cocaine intake (mg/kg) in males and in females during both menstrual phases, and the magnitude of the reduction in cocaine intake was greatest during the females’ follicular phase. Thus, a nondrug alternative reward, SACC, is a viable alternative treatment for reducing cocaine’s rewarding effects on male and female monkeys, and reductions in cocaine-seeking were optimal in the females’ luteal phase. PMID:27318989

Transcriptomes of Eight Arabidopsis thaliana Accessions Reveal Core Conserved, Genotype- and Organ-Specific Responses to Flooding Stress1[OPEN

PubMed Central

van Veen, Hans; Vashisht, Divya; Akman, Melis; Girke, Thomas; Mustroph, Angelika; Reinen, Emilie; Kooiker, Maarten; van Tienderen, Peter; Voesenek, Laurentius A.C.J.

2016-01-01

Climate change has increased the frequency and severity of flooding events, with significant negative impact on agricultural productivity. These events often submerge plant aerial organs and roots, limiting growth and survival due to a severe reduction in light reactions and gas exchange necessary for photosynthesis and respiration, respectively. To distinguish molecular responses to the compound stress imposed by submergence, we investigated transcriptomic adjustments to darkness in air and under submerged conditions using eight Arabidopsis (Arabidopsis thaliana) accessions differing significantly in sensitivity to submergence. Evaluation of root and rosette transcriptomes revealed an early transcriptional and posttranscriptional response signature that was conserved primarily across genotypes, although flooding susceptibility-associated and genotype-specific responses also were uncovered. Posttranscriptional regulation encompassed darkness- and submergence-induced alternative splicing of transcripts from pathways involved in the alternative mobilization of energy reserves. The organ-specific transcriptome adjustments reflected the distinct physiological status of roots and shoots. Root-specific transcriptome changes included marked up-regulation of chloroplast-encoded photosynthesis and redox-related genes, whereas those of the rosette were related to the regulation of development and growth processes. We identified a novel set of tolerance genes, recognized mainly by quantitative differences. These included a transcriptome signature of more pronounced gluconeogenesis in tolerant accessions, a response that included stress-induced alternative splicing. This study provides organ-specific molecular resolution of genetic variation in submergence responses involving interactions between darkness and low-oxygen constraints of flooding stress and demonstrates that early transcriptome plasticity, including alternative splicing, is associated with the ability to cope with a compound environmental stress. PMID:27208254

Growth performance of fast growing broilers reared under different types of production systems with outdoor access: Implications for organic and alternative production systems

USDA-ARS?s Scientific Manuscript database

Outdoor access is an important part of organic and free range poultry production, yet there is limited information on the impact of various housing and production systems on growth performance and colonization of foodborne pathogens. Therefore, the primary purpose of this study was to evaluate the ...

Use of certain alternative fuels in road transport in Poland

NASA Astrophysics Data System (ADS)

Gis, W.; Pielecha, J.; Waśkiewicz, J.; Gis, M.; Menes, M.

2016-09-01

The development of biomethane and hydrogen technology in the road transport in the EU countries is recommended, among the others, in the Directive of the European Parliament and of the Council 2014/94/EU of 22 October 2014. Under the provisions of the said Directive, it is recommended to EU countries to use biomethane and progressively ensure accessibility to hydrogen cars on their territories, and above all to ensure the possibility of driving hydrogen vehicles between the member States. The territorial accessibility for biomethane vehicles is determined by the availability of biomethane refuelling infrastructure in the first place in cities and then on the road network distances recommended in this directive. The territorial accessibility for hydrogen vehicles is determined by the availability of hydrogen refuelling infrastructure, in the first place along the TEN-T network. The article presents the possibilities of using these alternative fuels in Poland, presenting some of the results of research and analysis in this area.

77 FR 37707 - Draft Environmental Impact Statement on Brooks River Visitor Access for Katmai National Park and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-22

... floating bridge and sites to relocate the existing Naknek Lake barge landing area at the mouth of the... landing site on Naknek Lake. Alternative 3: This alternative evaluates construction of a new bridge and... barge landing site would be located approximately 200 feet south of the mouth of the Brooks River. A new...

Technology Learning Activities. Design Brief--Measuring Inaccessible Distances. Alternative Energy Sources: Designing a Wind Powered Generator. Alternative Energy Sources: Designing a Hot Dog Heater Using Solar Energy.

ERIC Educational Resources Information Center

Technology Teacher, 1991

1991-01-01

These three learning activities are on measuring accessible distances, designing a wind powered generator, and designing a hot dog heater using solar energy. Each activity includes description of context, objectives, list of materials and equipment, challenge to students, and evaluation questions. (SK)

Balancing Accession and Retention. Cost and Productivity Tradeoffs.

DTIC Science & Technology

1983-03-01

Alternative ...’ i :. :- : . - :’: .-- . .:. . ,. , . -.- - - i . . . , . . -. - - .- - - . ’ ’:- LIST OF TABLES Page I Rating groups...for bonus payments and second-term pay are more than offset by reductions in recruiting and training costs and first-term pay. Alternatively , holding...discounted value using a 10 percent discount rate. Costs for AFEES processing and training are taken from the Navy Comprehensive Compensation and Supply

Economic comparisons of haul road construction versus forwarding versus longer skid distances

Treesearch

Michael D. Erickson; Curt C. Hassler; Chris B. LeDoux

1992-01-01

There currently exists no set of basic guidelines for Appalachian loggers to use in the decision making process for selecting the best way to harvest a tract of timber. Specifically, guidelines are needed for deciding between the alternatives of constructing truck haul roads to access an area or other alternatives such as skidding or forwarding timber longer distances...

Alternative Pathways to Talent Development in Music: The Narrative of an Eminent Filipino Singer-Songwriter

ERIC Educational Resources Information Center

Garces-Bacsal, Rhoda Myra

2014-01-01

The narrative of an eminent Filipino singer-songwriter, Noel Cabangon, provides a description of an alternative pathway to musical talent development. Most theories on talent development assume that a young artist would have access to the resources required for one to advance in the domain. The results of multiple in-depth interviews suggested…

Accessing the Unsaid: The Role of Scalar Alternatives in Children's Pragmatic Inference

ERIC Educational Resources Information Center

Barner, David; Brooks, Neon; Bale, Alan

2011-01-01

When faced with a sentence like, "Some of the toys are on the table", adults, but not preschoolers, compute a scalar implicature, taking the sentence to imply that not all the toys are on the table. This paper explores the hypothesis that children fail to compute scalar implicatures because they lack knowledge of relevant scalar alternatives to…

Postsecondary Alternatives to Meet the Educational Needs of California's Adults. A Feasibility Study Prepared for the California Legislature. Final Report.

ERIC Educational Resources Information Center

Peterson, Richard E.; And Others

This report explains why California should invest in the continued education of its adult citizens and recommends 17 steps as the most urgently needed investment now. The report has two main themes: First, California should increasingly conceive of providing accessible and diversified postsecondary learning alternatives to meet the educational…

25 CFR 542.21 - What are the minimum internal control standards for drop and count for Tier A gaming operations?

Code of Federal Regulations, 2013 CFR

2013-04-01

.... Alternatively, it may be adequately secured (e.g., locked container to which only accounting personnel can gain... secured (e.g., locked container to which only accounting personnel can gain access) until retrieved by the...) Alternatively, a smart bucket system that electronically identifies and tracks the gaming machine number, and...

25 CFR 542.21 - What are the minimum internal control standards for drop and count for Tier A gaming operations?

Code of Federal Regulations, 2014 CFR

2014-04-01

.... Alternatively, it may be adequately secured (e.g., locked container to which only accounting personnel can gain... secured (e.g., locked container to which only accounting personnel can gain access) until retrieved by the...) Alternatively, a smart bucket system that electronically identifies and tracks the gaming machine number, and...

25 CFR 542.21 - What are the minimum internal control standards for drop and count for Tier A gaming operations?

Code of Federal Regulations, 2011 CFR

2011-04-01

.... Alternatively, it may be adequately secured (e.g., locked container to which only accounting personnel can gain... secured (e.g., locked container to which only accounting personnel can gain access) until retrieved by the...) Alternatively, a smart bucket system that electronically identifies and tracks the gaming machine number, and...

25 CFR 542.21 - What are the minimum internal control standards for drop and count for Tier A gaming operations?

Code of Federal Regulations, 2012 CFR

2012-04-01

.... Alternatively, it may be adequately secured (e.g., locked container to which only accounting personnel can gain... secured (e.g., locked container to which only accounting personnel can gain access) until retrieved by the...) Alternatively, a smart bucket system that electronically identifies and tracks the gaming machine number, and...

"It's the Best Thing I've Done in a Long While": Teenage Mothers' Experiences of Educational Alternatives

ERIC Educational Resources Information Center

Vincent, Kerry

2016-01-01

Pregnant and mothering schoolgirls have been identified as an educationally vulnerable group. Many are not welcomed in their mainstream schools and as a consequence, access a range of educational alternatives. This article presents the views and experiences of 14 young women in the English Midlands, who became pregnant while still of statutory…

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

Calm, J.M.

The Refrigerant Database is an information system on alternative refrigerants, associated lubricants, and their use in air conditioning and refrigeration. It consolidates and facilities access to property, compatibility, environmental, safety, application and other information. It provides corresponding information on older refrigerants, to assist manufacturers and those using alternative refrigerants, to make comparisons and determine differences. The underlying purpose is to accelerate phase out of chemical compounds of environmental concern.

Use of Vendedores (Mobile Food Vendors), Pulgas (Flea Markets), and Vecinos o Amigos (Neighbors or Friends) as Alternative Sources of Food for Purchase among Mexican-origin Households in Texas Border Colonias

PubMed Central

Sharkey, Joseph R.; Dean, Wesley R.; Johnson, Cassandra M.

2012-01-01

There is a paucity of studies acknowledging the existence of alternative food sources, and factors associated with food purchasing from three common alternative sources: vendedores (mobile food vendors), pulgas (flea markets), and vecinos/amigos (neighbors/friends). This analysis aims to examine the use of alternative food sources by Mexican-origin women from Texas-border colonias and determine factors associated with their use. The design was cross-sectional. Promotora-researchers (promotoras de salud trained in research methods) recruited 610 Mexican-origin women from 44 colonias and conducted in-person surveys. Surveys included participant characteristics and measures of food environment use and household food security. Statistical analyses included separate logistic regressions, modeled for food purchase from mobile food vendors, pulgas, or neighbors/friends (NFs). Child food insecurity was associated with purchasing food from mobile food vendors, while household food security was associated with using pulgas or NFs. School nutrition program participants were more likely to live in households that depend on alternative food sources. Efforts to increase healthful food consumption such as fruits and vegetables should acknowledge all potential food sources (traditional, convenience, non-traditional, and alternative), especially those preferred by colonia residents. Current findings support the conceptual broadening of the retail food environment, and the importance of linking use with spatial access (proximity) to more accurately depict access to food sources. PMID:22709775

Automatic computer subprogram selection from application program libraries

NASA Technical Reports Server (NTRS)

Drozdowski, J. M.

1972-01-01

The program ALTLIB (ALTernate LIBrary) which allows a user access to an alternate subprogram library with a minimum effort is discussed. The ALTLIB program selects subprograms from an alternate library file and merges them with the user's program load file. Only subprograms that are called for (directly or indirectly) by the user's programs and that are available on the alternate library file will be selected. ALTLIB eliminates the need for elaborate control-card manipulations to add subprograms from a subprogram file. ALTLIB returns to the user his binary file and the selected subprograms in correct order for a call to the loader. The user supplies the alternate library file. Subprogram requests which are not satisfied from the alternate library file will be satisfied at load time from the system library.

36 CFR 1192.87 - Public information system.

Code of Federal Regulations, 2011 CFR

2011-07-01

... COMPLIANCE BOARD AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY GUIDELINES FOR TRANSPORTATION VEHICLES... digitized human speech messages, to announce stations and provide other passenger information. Alternative...

36 CFR 1192.103 - Public information system.

Code of Federal Regulations, 2011 CFR

2011-07-01

... COMPLIANCE BOARD AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY GUIDELINES FOR TRANSPORTATION VEHICLES... speech messages, to announce stations and provide other passenger information. Alternative systems or...

Image contrast mechanisms in dynamic friction force microscopy: Antimony particles on graphite

NASA Astrophysics Data System (ADS)

Mertens, Felix; Göddenhenrich, Thomas; Dietzel, Dirk; Schirmeisen, Andre

2017-01-01

Dynamic Friction Force Microscopy (DFFM) is a technique based on Atomic Force Microscopy (AFM) where resonance oscillations of the cantilever are excited by lateral actuation of the sample. During this process, the AFM tip in contact with the sample undergoes a complex movement which consists of alternating periods of sticking and sliding. Therefore, DFFM can give access to dynamic transition effects in friction that are not accessible by alternative techniques. Using antimony nanoparticles on graphite as a model system, we analyzed how combined influences of friction and topography can effect different experimental configurations of DFFM. Based on the experimental results, for example, contrast inversion between fractional resonance and band excitation imaging strategies to extract reliable tribological information from DFFM images are devised.

Techno-Economic Analysis of FiWi Access Networks Based on 802.11ac WLAN and NG-PON2 Networks

NASA Astrophysics Data System (ADS)

Breskovic, Damir; Begusic, Dinko

2017-05-01

In this article, techno-economic analysis of a fiber-wireless access network is presented. With high bandwidth capacity of the gigabit passive optical network and with cost-effectiveness of very high throughput 802.11ac wireless local area networks that enable user mobility in the wireless segment, fiber-wireless access networks can be considered as an alternative to the fiber-to-the-home architecture for next generation access networks. Analysis based on the proposed scenario here, shows that a fiber-wireless access network is a more cost-effective solution in densely populated areas, but with some introduced improvements, even other geotypes can be considered as a commercially-viable solution.

Circadian activity rhythms and voluntary ethanol intake in male and female ethanol-preferring rats: effects of long-term ethanol access.

PubMed

Rosenwasser, Alan M; McCulley, Walter D; Fecteau, Matthew

2014-11-01

Chronic alcohol (ethanol) intake alters fundamental properties of the circadian clock. While previous studies have reported significant alterations in free-running circadian period during chronic ethanol access, these effects are typically subtle and appear to require high levels of intake. In the present study we examined the effects of long-term voluntary ethanol intake on ethanol consumption and free-running circadian period in male and female, selectively bred ethanol-preferring P and HAD2 rats. In light of previous reports that intermittent access can result in escalated ethanol intake, an initial 2-week water-only baseline was followed by either continuous or intermittent ethanol access (i.e., alternating 15-day epochs of ethanol access and ethanol deprivation) in separate groups of rats. Thus, animals were exposed to either 135 days of continuous ethanol access or to five 15-day access periods alternating with four 15-day periods of ethanol deprivation. Animals were maintained individually in running-wheel cages under continuous darkness throughout the experiment to allow monitoring of free-running activity and drinking rhythms, and 10% (v/v) ethanol and plain water were available continuously via separate drinking tubes during ethanol access. While there were no initial sex differences in ethanol drinking, ethanol preference increased progressively in male P and HAD2 rats under both continuous and intermittent-access conditions, and eventually exceeded that seen in females. Free-running period shortened during the initial ethanol-access epoch in all groups, but the persistence of this effect showed complex dependence on sex, breeding line, and ethanol-access schedule. Finally, while females of both breeding lines displayed higher levels of locomotor activity than males, there was little evidence for modulation of activity level by ethanol access. These results are consistent with previous findings that chronic ethanol intake alters free-running circadian period, and show further that the development of chronobiological tolerance to ethanol may vary by sex and genotype. Copyright © 2014 Elsevier Inc. All rights reserved.

Arterioarterial Prosthetic Loop as an Alternative Approach for Hemodialysis Access.

PubMed

Lei, Wenhui; Ji, Jiansong; Wang, Jian; Jin, Lie; Zou, Hai

2015-10-01

In the present study, we performed an arterioarterial prosthetic loop (AAPL) between the femoral artery and deep femoral artery as a new access in patients who did not have adequate vascular conditions for creating an arteriovenous fistula or graft.Between April 2005 and June 2014, 18 patients received AAPL as a vascular access. During the procedure, a polytetrafluoroethylene graft was anastomosed to the femoral artery and deep femoral artery and looped on the thigh. We assessed the reliability and safety of AAPLs by analyzing complication, primary and secondary patency rates, and postoperative blood flow.Eighteen patients (median age, 66 years; range, 43-96 years) underwent AAPL access placement under the general or local anesthesia. All patients were followed up for 3 to 38 months (mean, 24 months). Primary and secondary patency rates at 6 months were 94.5% and 88.8%, respectively, and at 3 years were 61% and 72%, respectively. After operation, one patient had infection, and another one had fat necrosis at the surgical incision site. To maintain the AAPL function, 5 surgical procedures in 4 grafts, including revision, thrombectomy, excision, and repair for bleeding were performed. More than 5000 hemodialyses were performed efficiently in our center.Our study shows that AAPL loop is an unusual but effective and safe procedure that may be a good alternative for the patients who do not allow the conventional hemodialysis access.

Wireless augmented reality communication system

NASA Technical Reports Server (NTRS)

Devereaux, Ann (Inventor); Agan, Martin (Inventor); Jedrey, Thomas (Inventor)

2006-01-01

The system of the present invention is a highly integrated radio communication system with a multimedia co-processor which allows true two-way multimedia (video, audio, data) access as well as real-time biomedical monitoring in a pager-sized portable access unit. The system is integrated in a network structure including one or more general purpose nodes for providing a wireless-to-wired interface. The network architecture allows video, audio and data (including biomedical data) streams to be connected directly to external users and devices. The portable access units may also be mated to various non-personal devices such as cameras or environmental sensors for providing a method for setting up wireless sensor nets from which reported data may be accessed through the portable access unit. The reported data may alternatively be automatically logged at a remote computer for access and viewing through a portable access unit, including the user's own.

Wireless Augmented Reality Communication System

NASA Technical Reports Server (NTRS)

Jedrey, Thomas (Inventor); Agan, Martin (Inventor); Devereaux, Ann (Inventor)

2014-01-01

The system of the present invention is a highly integrated radio communication system with a multimedia co-processor which allows true two-way multimedia (video, audio, data) access as well as real-time biomedical monitoring in a pager-sized portable access unit. The system is integrated in a network structure including one or more general purpose nodes for providing a wireless-to-wired interface. The network architecture allows video, audio and data (including biomedical data) streams to be connected directly to external users and devices. The portable access units may also be mated to various non-personal devices such as cameras or environmental sensors for providing a method for setting up wireless sensor nets from which reported data may be accessed through the portable access unit. The reported data may alternatively be automatically logged at a remote computer for access and viewing through a portable access unit, including the user's own.

Wireless Augmented Reality Communication System

NASA Technical Reports Server (NTRS)

Agan, Martin (Inventor); Devereaux, Ann (Inventor); Jedrey, Thomas (Inventor)

2016-01-01

The system of the present invention is a highly integrated radio communication system with a multimedia co-processor which allows true two-way multimedia (video, audio, data) access as well as real-time biomedical monitoring in a pager-sized portable access unit. The system is integrated in a network structure including one or more general purpose nodes for providing a wireless-to-wired interface. The network architecture allows video, audio and data (including biomedical data) streams to be connected directly to external users and devices. The portable access units may also be mated to various non-personal devices such as cameras or environmental sensors for providing a method for setting up wireless sensor nets from which reported data may be accessed through the portable access unit. The reported data may alternatively be automatically logged at a remote computer for access and viewing through a portable access unit, including the user's own.

Final priority; Rehabilitation Services Administration--Assistive Technology Alternative Financing Program. Final priority.

PubMed

2014-08-14

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Assistive Technology Alternative Financing Program administered by the Rehabilitation Services Administration (RSA). The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. This priority is designed to ensure that the Department funds high-quality assistive technology (AT) alternative financing programs (AFPs) that meet rigorous standards in order to enable individuals with disabilities to access and acquire assistive technology devices and services necessary to achieve education, community living, and employment goals.

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

Treesearch

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

1997-01-01

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

Educational Benefits Analysis. An Examination of the Effects of G.I. Bill Educational Benefits on Service Accessions.

ERIC Educational Resources Information Center

Eisenman, Richard L.; And Others

A study was done to (1) examine the impact of terminating the G.I. Bill in respect to the number, quality, and representativeness of Service accessions (supply of volunteers for military services), and (2) provide a means for measuring the relative costs and benefits of alternative educational programs which might be needed to sustain military…

Making Higher Education More Affordable, One Course Reading at a Time: Academic Libraries as Key Advocates for Open Access Textbooks and Educational Resources

ERIC Educational Resources Information Center

Okamoto, Karen

2013-01-01

Open access textbooks (OATs) and educational resources (OERs) are being lauded as a viable alternative to costly print textbooks. Some academic libraries are joining the OER movement by creating guides to open repositories. Others are promoting OATs and OERs, reviewing them, and even helping to create them. This article analyzes how academic…

Access to Educational Opportunity in Rural Communities: Alternative Patterns of Delivering Vocational Education in Sparsely Populated Areas. Volume 4: The Interdistrict Cooperative Center: A Centralized Center.

ERIC Educational Resources Information Center

Peterson, Roland L.; And Others

The centralized secondary center pattern of inter-school district cooperation is examined in this third of four case studies addressing access of rural students to vocational education. The report identifies essential features of this form of cooperation, details factors facilitating/impeding the operation/maintenance of the cooperative…

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…

Multinational Experiment 7: Protecting Access to Space

DTIC Science & Technology

2013-07-08

access to space cost to the design, engineering , production and operation of the spacecraft. They also have an impact on spacecraft mass, thermal...station and provide engineering support to receive data in the agreed format. Step 5 – Implementing interoperability. Once a framework has been...procedures or using alternative means (for example, high-altitude airships ). A7. The results support the view that better mitigation approaches need to

Squeezing the funding you need from today's capital sources.

PubMed

Gordon, Deborah C

2010-04-01

Healthcare providers need to understand traditional and nontraditional financing options and other potential strategies for accessing capital. Common financing options include bonds, commercial lending, acquisition financing, and financing through the Department of Housing and Urban Development's Section 232 program. Alternative strategies for accessing capital include joint ventures, equity, sale of assets, fund-raising, capital leases, internal capital, public grants, and grants from foundations.

The (Re)Construction of a Philosophical and Pedagogical Position for the Foundation Programme at UKZN with Particular Reference to the Biology Module

ERIC Educational Resources Information Center

Kirby, N. F.; Dempster, E. R.

2011-01-01

The Centre for Science Access Foundation Programme at the University of KwaZulu-Natal provides alternative access to tertiary science studies to educationally disadvantaged students. The philosophical basis for this Programme is that of constructivism, as adopted by the original Science Foundation Programme (SFP) which was initiated in 1991 on the…

17 CFR 240.15c3-5 - Risk management controls for brokers or dealers with market access.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 17 Commodity and Securities Exchanges 3 2013-04-01 2013-04-01 false Risk management controls for... Markets § 240.15c3-5 Risk management controls for brokers or dealers with market access. (a) For the... system provided by a broker-dealer operator of an alternative trading system to a non-broker-dealer. (2...

17 CFR 240.15c3-5 - Risk management controls for brokers or dealers with market access.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 17 Commodity and Securities Exchanges 4 2014-04-01 2014-04-01 false Risk management controls for... Markets § 240.15c3-5 Risk management controls for brokers or dealers with market access. (a) For the... system provided by a broker-dealer operator of an alternative trading system to a non-broker-dealer. (2...

Emissions Control in Swirl Stabilized Spray Combusters, an Experimental and Computational Study

DTIC Science & Technology

2007-02-01

dynamics and thus provide an attractive alternative for application in aircraft gas turbine engines. Triple Annular Research Swirler, which has been...octagonal combustor because it provided optical access for flame imaging while avoiding difficulty of drilling thermocouple access holes on the...indicated by the temperature distribution. c. OH* chemiluminescence image It is commonly accepted that CH* and OH* chemiluminescence represents reaction or

The Impact of Preoperative α-Adrenergic Antagonists on Ureteral Access Sheath Insertion Force and the Upper Limit of Force Required to Avoid Ureteral Mucosal Injury: A Randomized Controlled Study.

PubMed

Koo, Kyo Chul; Yoon, Jun-Ho; Park, No-Cheol; Lee, Hye Sun; Ahn, Hyun Kyu; Lee, Kwang Suk; Kim, Do Kyung; Cho, Kang Su; Chung, Byung Ha; Hong, Chang Hee

2018-06-01

Excessive bulking force during primary access of the ureteral access sheath may induce ureteral injury. We investigated the efficacy of preoperative α-blockade to reduce ureteral access sheath insertion force and determine the upper limit required to avoid ureteral injury. In this randomized controlled trial 135 patients from a single institution who had ureteropelvic junction or renal pelvis stones and were scheduled to undergo retrograde intrarenal surgery were prospectively enrolled from December 2015 to January 2017. Of the patients 41 and 42 were randomly assigned to the control and experimental groups, respectively. The experimental group received α-blockade preoperatively. The 21 patients who were pre-stented were assessed separately. We developed a homemade device to measure maximal ureteral access sheath insertion force. Our ureteral access sheath insertion force measurement device showed excellent reproducibility. Higher insertion velocity resulted in greater maximal sheath insertion force. Maximal insertion force in the α-blockade group was significantly lower than in the control group at the ureterovesical junction (p = 0.008) and the proximal ureter (p = 0.036). Maximal insertion force in the α-blockade group was comparable to that in pre-stented patients. Female patients and patients 70 years old or older showed a lower maximal ureteral access sheath insertion force than their counterparts. The rate of grade 2 or greater ureteral injury was lower in the α-blockade group than in controls (p = 0.038). No injury occurred in any case in which ureteral access sheath insertion force did not exceed 600 G. Preoperative α-blockade and slow sheath placement may reduce maximal ureteral access sheath insertion force. If the force exceeds 600 G, a smaller diameter sheath may be an alternative. Alternatively the procedure can be terminated and followed later by pre-stented retrograde intrarenal surgery. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Lessons From Recruitment to an Internet-Based Survey for Degenerative Cervical Myelopathy: Comparison of Free and Fee-Based Methods.

PubMed

Davies, Benjamin; Kotter, Mark

2018-02-05

Degenerative Cervical Myelopathy (DCM) is a syndrome of subacute cervical spinal cord compression due to spinal degeneration. Although DCM is thought to be common, many fundamental questions such as the natural history and epidemiology of DCM remain unknown. In order to answer these, access to a large cohort of patients with DCM is required. With its unrivalled and efficient reach, the Internet has become an attractive tool for medical research and may overcome these limitations in DCM. The most effective recruitment strategy, however, is unknown. To compare the efficacy of fee-based advertisement with alternative free recruitment strategies to a DCM Internet health survey. An Internet health survey (SurveyMonkey) accessed by a new DCM Internet platform (myelopathy.org) was created. Using multiple survey collectors and the website's Google Analytics, the efficacy of fee-based recruitment strategies (Google AdWords) and free alternatives (including Facebook, Twitter, and myelopathy.org) were compared. Overall, 760 surveys (513 [68%] fully completed) were accessed, 305 (40%) from fee-based strategies and 455 (60%) from free alternatives. Accounting for researcher time, fee-based strategies were more expensive ($7.8 per response compared to $3.8 per response for free alternatives) and identified a less motivated audience (Click-Through-Rate of 5% compared to 57% using free alternatives) but were more time efficient for the researcher (2 minutes per response compared to 16 minutes per response for free methods). Facebook was the most effective free strategy, providing 239 (31%) responses, where a single message to 4 existing communities yielded 133 (18%) responses within 7 days. The Internet can efficiently reach large numbers of patients. Free and fee-based recruitment strategies both have merits. Facebook communities are a rich resource for Internet researchers. ©Benjamin Davies, Mark Kotter. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 05.02.2018.

Lessons From Recruitment to an Internet-Based Survey for Degenerative Cervical Myelopathy: Comparison of Free and Fee-Based Methods

PubMed Central

2018-01-01

Background Degenerative Cervical Myelopathy (DCM) is a syndrome of subacute cervical spinal cord compression due to spinal degeneration. Although DCM is thought to be common, many fundamental questions such as the natural history and epidemiology of DCM remain unknown. In order to answer these, access to a large cohort of patients with DCM is required. With its unrivalled and efficient reach, the Internet has become an attractive tool for medical research and may overcome these limitations in DCM. The most effective recruitment strategy, however, is unknown. Objective To compare the efficacy of fee-based advertisement with alternative free recruitment strategies to a DCM Internet health survey. Methods An Internet health survey (SurveyMonkey) accessed by a new DCM Internet platform (myelopathy.org) was created. Using multiple survey collectors and the website’s Google Analytics, the efficacy of fee-based recruitment strategies (Google AdWords) and free alternatives (including Facebook, Twitter, and myelopathy.org) were compared. Results Overall, 760 surveys (513 [68%] fully completed) were accessed, 305 (40%) from fee-based strategies and 455 (60%) from free alternatives. Accounting for researcher time, fee-based strategies were more expensive ($7.8 per response compared to $3.8 per response for free alternatives) and identified a less motivated audience (Click-Through-Rate of 5% compared to 57% using free alternatives) but were more time efficient for the researcher (2 minutes per response compared to 16 minutes per response for free methods). Facebook was the most effective free strategy, providing 239 (31%) responses, where a single message to 4 existing communities yielded 133 (18%) responses within 7 days. Conclusions The Internet can efficiently reach large numbers of patients. Free and fee-based recruitment strategies both have merits. Facebook communities are a rich resource for Internet researchers. PMID:29402760

Distinct modes of DNA accessibility in plant chromatin.

PubMed

Shu, Huan; Wildhaber, Thomas; Siretskiy, Alexey; Gruissem, Wilhelm; Hennig, Lars

2012-01-01

The accessibility of DNA to regulatory proteins is a major property of the chromatin environment that favours or hinders transcription. Recent studies in flies reported that H3K9me2-marked heterochromatin is accessible while H3K27me3-marked chromatin forms extensive domains of low accessibility. Here we show that plants regulate DNA accessibility differently. H3K9me2-marked heterochromatin is the least accessible in the Arabidopsis thaliana genome, and H3K27me3-marked chromatin also has low accessibility. We see that very long genes without H3K9me2 or H3K27me3 are often inaccessible and generated significantly lower amounts of antisense transcripts than other genes, suggesting that reduced accessibility is associated with reduced recognition of alternative promoters. Low accessibility of H3K9me2-marked heterochromatin and long genes depend on cytosine methylation, explaining why chromatin accessibility differs between plants and flies. Together, we conclude that restriction of DNA accessibility is a local property of chromatin and not necessarily a consequence of microscopically visible compaction.

Disruption of the cytochrome c gene in xylose-utilizing yeast Pichia stipitis leads to higher ethanol production

Treesearch

Nian-Qing Shi; Brian Davis; Fred Sherman; Jose Cruz; Thomas W. Jeffries

1999-01-01

The xylose-utilizing yeast, Pichia stipitis, has a complex respiratory system that contains cytochrome and non-cytochrome alternative electron transport chains in its mitochondria. To gain primary insights into the alternative respiratory pathway, a cytochrome c gene (PsCYC1, Accession No. AF030426) was cloned from wild-type P. stipitis CBS 6054 by cross-hybridization...

ARTI refrigerant database

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

Calm, J.M.

1996-07-01

The Refrigerant Database is an information system on alternative refrigerants, associated lubricants, and their use in air conditioning and refrigeration. It consolidates and facilitates access to property, compatibility, environmental, safety, application and other information. It provides corresponding information on older refrigerants, to assist manufacturers and those using alternative refrigerants, to make comparisons and determine differences. The underlying purpose is to accelerate phase out of chemical compounds of environmental concern.

Parent-Child Relationships and Family Functioning of Children and Youth Discharged from Residential Mental Health Treatment or a Home-Based Alternative

ERIC Educational Resources Information Center

Preyde, Michele; Cameron, Gary; Frensch, Karen; Adams, Gerald

2011-01-01

This report stems from a larger study on the outcomes of children and youth who accessed residential treatment or a home-based alternative. In this report an analysis of family descriptive information, the nature of family relationships, and indicators of family functioning for children and youth who have participated in children's mental health…

An Analysis of Alternatives for Gaining Capacity So as to Maintain Access to the University of California. Research & Occasional Paper Series: CSHE.5.06

ERIC Educational Resources Information Center

King, C. Judson

2006-01-01

This paper analyzes the need for providing additional undergraduate enrollment capacity at the University of California (UC) and of alternatives for gaining such capacity at UC and, by extension, other public research universities. In addition to the creation of new campuses, other approaches are capable of giving significant additional capacity…

ARTI refrigerant database

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

Calm, J.M.

1996-11-15

The Refrigerant Database is an information system on alternative refrigerants, associated lubricants, and their use in air conditioning and refrigeration. It consolidates and facilitates access to property, compatibility, environmental, safety, application and other information. It provides corresponding information on older refrigerants, to assist manufacturers and those using alternative refrigerants, to make comparisons and determine differences. The underlying purpose is to accelerate phase out of chemical compounds of environmental concern.

ComputerTown: A Do-It-Yourself Community Computer Project. [Computer Town, USA and Other Microcomputer Based Alternatives to Traditional Learning Environments].

ERIC Educational Resources Information Center

Zamora, Ramon M.

Alternative learning environments offering computer-related instruction are developing around the world. Storefront learning centers, museum-based computer facilities, and special theme parks are some of the new concepts. ComputerTown, USA! is a public access computer literacy project begun in 1979 to serve both adults and children in Menlo Park…

Green Peace: Can Biofuels Accelerate Energy Security

DTIC Science & Technology

2013-02-14

http://www.navy.mil/features/Navy_EnergySecurity.pdf 6 James T. Bartis and Lawrence Van Bibber. Alternative Fuels for Military Applications, (Santa...2013) 28 James T. Bartis and Lawrence Van Bibber, Alternative Fuels for Military Applications, (Santa Monica, CA: RAND Corporation, 2011), http...research/algae-based-biofuels (accessed 18 November 2012). 55 John Laitner, Karen Ehrhardt-Martinez, and Vanessa McKinney, Examining the Scale of

Alternative Assessments in Practice Data Base. Project 1.2: Technical Assistance on Assessment Issues. Annual Report of Communication, Training and Dissemination Activities.

ERIC Educational Resources Information Center

Center for Research on Evaluation, Standards, and Student Testing, Los Angeles, CA.

The Center for Research on Evaluation, Standards, and Student Testing (CRESST) has developed an Alternative Assessments in Practice Data Base to support technical assistance needs and to promote the exchange of new assessment ideas. The database is designed to provide easy access and retrieval of information about ongoing and newly developed…

The Retrieval of Information in an Elementary School Library Media Center: An Alternative Method of Classification in the Common School Library, Amherst, Massachusetts.

ERIC Educational Resources Information Center

Cooper, Linda

1997-01-01

Discusses the problems encountered by elementary school children in retrieving information from a library catalog, either the traditional card catalog or an OPAC (online public access catalog). An alternative system of classification using colors and symbols is described that was developed in the Common School (Amherst, Massachusetts). (Author/LRW)

Trans-Splenic Portal Vein Embolization: A Technique to Avoid Damage to the Future Liver Remnant

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

Sarwar, Ammar, E-mail: asarwar@bidmc.harvard.edu; Brook, Olga R.; Weinstein, Jeffrey L.

2016-10-15

Portal vein embolization (PVE) induces hypertrophy of the future liver remnant (FLR) in patients undergoing extensive hepatic resection. Portal vein access for PVE via the ipsilateral hepatic lobe (designated for resection) places veins targeted for embolization at acute angles to the access site requiring reverse curve catheters for access. This approach also involves access close to tumors in the ipsilateral lobe and requires care to avoid traversing tumor. Alternatively, a contralateral approach (through the FLR) risks damage to the FLR due to iatrogenic trauma or non-target embolization. Two patients successfully underwent PVE via trans-splenic portal vein access, allowing easy accessmore » to the ipsilateral portal veins and eliminating risk of damage to FLR. Technique and advantages of trans-splenic portal vein access to perform PVE are described.« less

Formatting modifications in GRADE evidence profiles improved guideline panelists comprehension and accessibility to information. A randomized trial.

PubMed

Vandvik, Per Olav; Santesso, Nancy; Akl, Elie A; You, John; Mulla, Sohail; Spencer, Frederick A; Johnston, Bradley C; Brozek, Jan; Kreis, Julia; Brandt, Linn; Zhou, Qi; Schünemann, Holger J; Guyatt, Gordon

2012-07-01

To determine the effects of formatting alternatives in Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence profiles on guideline panelists' preferences, comprehension, and accessibility. We randomized 116 antithrombotic therapy guideline panelists to review one of two table formats with four formatting alternatives. After answering relevant questions, panelists reviewed the other format and reported their preferences for specific formatting alternatives. Panelists (88 of 116 invited [76%]) preferred presentation of study event rates over no study event rates (median 1 [interquartile range (IQR) 1] on 1-7 scale), absolute risk differences over absolute risks (median 2 [IQR 3]), and additional information in table cells over footnotes (median 1 [IQR 2]). Panelists presented with time frame information in the tables, and not only in footnotes, were more likely to correctly answer questions regarding time frame (58% vs. 11%, P<0.0001), and those presented with risk differences and not absolute risks were more likely to correctly interpret confidence intervals for absolute effects (95% vs. 54%, P<0.0001). Information was considered easy to find, easy to comprehend, and helpful in making recommendations regardless of table format (median 6, IQR 0-1). Panelists found information in GRADE evidence profiles accessible. Correct comprehension of some key information was improved by providing additional information in table and presenting risk differences. Copyright © 2012 Elsevier Inc. All rights reserved.

Efficacy of the EZ-IO needle driver for out-of-hospital intraosseous access--a preliminary, observational, multicenter study.

PubMed

Schalk, Richard; Schweigkofler, Uwe; Lotz, Gösta; Zacharowski, Kai; Latasch, Leo; Byhahn, Christian

2011-10-26

Intraosseous (IO) access represents a reliable alternative to intravenous vascular access and is explicitly recommended in the current guidelines of the European Resuscitation Council when intravenous access is difficult or impossible. We therefore aimed to study the efficacy of the intraosseous needle driver EZ-IO in the prehospital setting. During a 24-month period, all cases of prehospital IO access using the EZ-IO needle driver within three operational areas of emergency medical services were prospectively recorded by a standardized questionnaire that needed to be filled out by the rescuer immediately after the mission and sent to the primary investigator. We determined the rate of successful insertion of the IO needle, the time required, immediate procedure-related complications, the level of previous experience with IO access, and operator's subjective satisfaction with the device. 77 IO needle insertions were performed in 69 adults and five infants and children by emergency physicians (n = 72 applications) and paramedics (n = 5 applications). Needle placement was successful at the first attempt in all but 2 adults (one patient with unrecognized total knee arthroplasty, one case of needle obstruction after placement). The majority of users (92%) were relative novices with less than five previous IO needle placements. Of 22 responsive patients, 18 reported pain upon fluid administration via the needle. The rescuers' subjective rating regarding handling of the device and ease of needle insertion, as described by means of an analogue scale (0 = entirely unsatisfied, 10 = most satisfied), provided a median score of 10 (range 1-10). The EZ-IO needle driver was an efficient alternative to establish immediate out-of-hospital vascular access. However, significant pain upon intramedullary infusion was observed in the majority of responsive patients.

Full duplex fiber link for alternative wired and wireless access based on SSB optical millimeter-wave with 4-PAM signal

NASA Astrophysics Data System (ADS)

Ma, Jianxin; Zhang, Junjie

2015-03-01

A novel full-duplex fiber-wireless link based on single sideband (SSB) optical millimeter (mm)-wave with 10 Gbit/s 4-pulse amplitude modulation (PAM) signal is proposed to provide alternative wired and 40 GHz wireless accesses for the user terminals. The SSB optical mm-wave with 4-PAM signal consists of two tones: one bears the 4-PAM signal and the other is unmodulated with high power. After transmission over the fiber to the hybrid optical network unit (HONU), the SSB optical mm-wave signal can be decomposed by fiber Bragg gratings (FBGs) as the SSB optical mm-wave signal with reduced carrier-to-sideband ratio (the baseband 4-PAM optical signal) and the uplink optical carrier for the wireless (wired) access. This makes the HONU free from the laser source. For the uplink, since the wireless access signal is converted to the baseband by power detection, both the transmitter in the HONU and the receiver in optical line terminal (OLT) are co-shared for both wireless and wired accesses, which makes the full duplex link much simpler. In our scheme, the optical electrical field of the square-root increment level 4-PAM signal assures an equal level spacing receiving for both the downlink wired and wireless accesses. Since the downlink wireless signal is down-converted to the baseband by power detection, RF local oscillator is unnecessary. To confirm the feasibility of our proposed scheme, a simulation full duplex link with 40 GHz SSB optical mm-wave with 10 Gbit/s 4-PAM signal is built. The simulation results show that both down- and up-links for either wired or wireless access can keep good performance even if the link length of the SSMF is extended to 40 km.

ARTI Refrigerant Database

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

Calm, J.M.

The Refrigerant Database consolidates and facilitates access to information to assist industry in developing equipment using alternative refrigerants. The underlying purpose is to accelerate phase out of chemical compounds of environmental concern.

Investigating the over‐representation of older persons in do‐it‐yourself home maintenance injury and barriers to prevention

PubMed Central

Ashby, K; Ozanne‐Smith, J; Fox, B

2007-01-01

Objective To examine why older persons undertake high‐risk do‐it‐yourself (DIY) home maintenance and under what circumstances, what constitutes acceptable low‐risk alternatives to DIY, and to assess if alternatives are feasible in the current context. Design Exploratory qualitative study using focus‐group methodology. Setting and subjects Fifteen focus groups were conducted, involving 118 persons aged 60 years and older, in two Melbourne communities. Participants resided locally, participated in local seniors groups, or received treatment for a DIY injury at one of two public hospitals serving these communities. Results Older persons' involvement in DIY ranged from necessity to choice. A number chose DIY for general fitness enhancement, satisfaction and pride in a job well done, and giving meaning and enjoyment to daily tasks. However, some older, frailer seniors were forced into DIY because of difficulties in choosing appropriate alternatives; lack of knowledge of some available resources and services; the challenge of accessing cost‐effective and reliable private service providers; and fear of vulnerability to overcharging, overservicing or their personal security. Preferred DIY alternatives were local government providers, local paper advertised services, recommendations to private service providers and family, friends or neighbors. Lack of knowledge of other existing alternatives was an impediment to preventing DIY injury, or accessing DIY alternatives. A number of potentially feasible alternatives to DIY were identified from our review. Conclusions This research is an important first step in understanding issues facing community‐dwelling seniors remaining at home, and provides a basis on which government agencies and other providers can develop services to meet increasing needs. PMID:17916890

Alternative treatment technology information center computer database system

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

Sullivan, D.

1995-10-01

The Alternative Treatment Technology Information Center (ATTIC) computer database system was developed pursuant to the 1986 Superfund law amendments. It provides up-to-date information on innovative treatment technologies to clean up hazardous waste sites. ATTIC v2.0 provides access to several independent databases as well as a mechanism for retrieving full-text documents of key literature. It can be accessed with a personal computer and modem 24 hours a day, and there are no user fees. ATTIC provides {open_quotes}one-stop shopping{close_quotes} for information on alternative treatment options by accessing several databases: (1) treatment technology database; this contains abstracts from the literature on all typesmore » of treatment technologies, including biological, chemical, physical, and thermal methods. The best literature as viewed by experts is highlighted. (2) treatability study database; this provides performance information on technologies to remove contaminants from wastewaters and soils. It is derived from treatability studies. This database is available through ATTIC or separately as a disk that can be mailed to you. (3) underground storage tank database; this presents information on underground storage tank corrective actions, surface spills, emergency response, and remedial actions. (4) oil/chemical spill database; this provides abstracts on treatment and disposal of spilled oil and chemicals. In addition to these separate databases, ATTIC allows immediate access to other disk-based systems such as the Vendor Information System for Innovative Treatment Technologies (VISITT) and the Bioremediation in the Field Search System (BFSS). The user may download these programs to their own PC via a high-speed modem. Also via modem, users are able to download entire documents through the ATTIC system. Currently, about fifty publications are available, including Superfund Innovative Technology Evaluation (SITE) program documents.« less

An exploratory study of the perceived impact of raising the age of cigarette purchase on young smokers in Scotland.

PubMed

Borland, T; Amos, A

2009-10-01

To explore the perceived impact among a group of Scottish 16- and 17-year-old school leavers of the recent increase in age of sale of cigarettes (1 October 2007) from 16 to 18 years on their ability to purchase and access cigarettes. Qualitative interviews with friendship pairs. Twelve paired qualitative interviews conducted in June 2008. Participants were 16- and 17-year-old early school leavers undertaking a work skills programme in Lothian who smoked at least one cigarette per week. Data were analysed thematically. The increase in the age of sale affected participants' perceived ability to purchase cigarettes to differing extents. Three groups were identified: those who were unable to purchase cigarettes either before or after the change in the law, those who could purchase cigarettes before the change in the law but who found it very difficult to do so afterwards, and those who were relatively unaffected as they could purchase cigarettes both before and after the age was raised to 18 years, mostly from small corner shops. Smoking was embedded in participants' social lives and networks. Thus, there was only a limited impact upon their reported ability to access cigarettes due to the availability of alternative social sources of cigarettes from family, friends and others. This exploratory study raises questions about the nature and extent of the impact of raising the age of sale on young smokers' ability to purchase and access cigarettes. The importance of alternative social sources of cigarettes highlights the need for further research to investigate whether the change in legislation had less of an impact on more disadvantaged adolescent smokers, as they are likely to have greater access to alternative sources from their family, friends and community.

Recognition-induced forgetting is not due to category-based set size.

PubMed

Maxcey, Ashleigh M

2016-01-01

What are the consequences of accessing a visual long-term memory representation? Previous work has shown that accessing a long-term memory representation via retrieval improves memory for the targeted item and hurts memory for related items, a phenomenon called retrieval-induced forgetting. Recently we found a similar forgetting phenomenon with recognition of visual objects. Recognition-induced forgetting occurs when practice recognizing an object during a two-alternative forced-choice task, from a group of objects learned at the same time, leads to worse memory for objects from that group that were not practiced. An alternative explanation of this effect is that category-based set size is inducing forgetting, not recognition practice as claimed by some researchers. This alternative explanation is possible because during recognition practice subjects make old-new judgments in a two-alternative forced-choice task, and are thus exposed to more objects from practiced categories, potentially inducing forgetting due to set-size. Herein I pitted the category-based set size hypothesis against the recognition-induced forgetting hypothesis. To this end, I parametrically manipulated the amount of practice objects received in the recognition-induced forgetting paradigm. If forgetting is due to category-based set size, then the magnitude of forgetting of related objects will increase as the number of practice trials increases. If forgetting is recognition induced, the set size of exemplars from any given category should not be predictive of memory for practiced objects. Consistent with this latter hypothesis, additional practice systematically improved memory for practiced objects, but did not systematically affect forgetting of related objects. These results firmly establish that recognition practice induces forgetting of related memories. Future directions and important real-world applications of using recognition to access our visual memories of previously encountered objects are discussed.

KENNEDY SPACE CENTER, FLA. - Daniel L. Tweed, with the Facilities Division, NASA Spaceport Services, addresses attendees at the ribbon cutting for the KSC Security gates. Tweed was project manager. The two new Security gates on Kennedy Parkway (Gate 2) and NASA Parkway (Gate 3) were activated Aug. 1, allowing the general public to have access to the new Space Commerce Way, which will provide access to the Research Park and KSC Visitor Complex, and providing an alternate route for the general public between Titusville and Merritt Island that is accessible 24 hours a day. The gates are staffed 24 hours daily. Others taking part in the ribbon cutting were Center Director Jim Kennedy; Chief, Protective & Safe Guards Office, Calvin L. Burch; SGS Deputy Program Manager William A. Sample; and Bobby Porter, with Oneida Construction.

NASA Image and Video Library

2003-08-27

KENNEDY SPACE CENTER, FLA. - Daniel L. Tweed, with the Facilities Division, NASA Spaceport Services, addresses attendees at the ribbon cutting for the KSC Security gates. Tweed was project manager. The two new Security gates on Kennedy Parkway (Gate 2) and NASA Parkway (Gate 3) were activated Aug. 1, allowing the general public to have access to the new Space Commerce Way, which will provide access to the Research Park and KSC Visitor Complex, and providing an alternate route for the general public between Titusville and Merritt Island that is accessible 24 hours a day. The gates are staffed 24 hours daily. Others taking part in the ribbon cutting were Center Director Jim Kennedy; Chief, Protective & Safe Guards Office, Calvin L. Burch; SGS Deputy Program Manager William A. Sample; and Bobby Porter, with Oneida Construction.

Percutaneous management of vascular access in transfemoral transcatheter aortic valve implantation

PubMed Central

Dato, Ilaria; Burzotta, Francesco; Trani, Carlo; Crea, Filippo; Ussia, Gian Paolo

2014-01-01

Transcatheter aortic valve implantation (TAVI) using stent-based bioprostheses has recently emerged as a promising alternative to surgical valve replacement in selected patients. The main route for TAVI is retrograde access from the femoral artery using large sheaths (16-24 F). Vascular access complications are a clinically relevant issue in TAVI procedures since they are reported to occur in up to one fourth of patients and are strongly associated with adverse outcomes. In the present paper, we review the different types of vascular access site complications associated with transfemoral TAVI. Moreover, we discuss the possible optimal management strategies with particular attention to the relevance of early diagnosis and prompt treatment using endovascular techniques. PMID:25228962

Use of vendedores (mobile food vendors), pulgas (flea markets), and vecinos o amigos (neighbors or friends) as alternative sources of food for purchase among Mexican-origin households in Texas border colonias.

PubMed

Sharkey, Joseph R; Dean, Wesley R; Johnson, Cassandra M

2012-05-01

There is a paucity of studies acknowledging the existence of alternative food sources, and factors associated with food purchasing from three common alternative sources: vendedores (mobile food vendors), pulgas (flea markets), and vecinos/amigos (neighbors/friends). This analysis aims to examine the use of alternative food sources by Mexican-origin women from Texas-border colonias and determine factors associated with their use. The design was cross-sectional. Promotora-researchers (promotoras de salud trained in research methods) recruited 610 Mexican-origin women from 44 colonias and conducted in-person surveys. Surveys included participant characteristics and measures of food environment use and household food security. Statistical analyses included separate logistic regressions, modeled for food purchase from mobile food vendors, pulgas, or neighbors/friends. Child food insecurity was associated with purchasing food from mobile food vendors, while household food security was associated with using pulgas or neighbors/friends. School nutrition program participants were more likely to live in households that depend on alternative food sources. Efforts to increase healthful food consumption such as fruits and vegetables should acknowledge all potential food sources (traditional, convenience, nontraditional, and alternative), especially those preferred by colonia residents. Current findings support the conceptual broadening of the retail food environment, and the importance of linking use with spatial access (proximity) to more accurately depict access to food sources. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

An Interpretive Study of Yosemite National Park Visitors' Perspectives Toward Alternative Transportation in Yosemite Valley

NASA Astrophysics Data System (ADS)

White, Dave D.

2007-01-01

The National Park Service (NPS) is increasingly focusing on alternative transportation systems in national parks to address environmental and social problems arising from a historical reliance on personal automobiles as the primary means of visitor access. Despite the potential advantages, alternative transportation may require a reorientation in the way that Americans have experienced national parks since the advent of auto-tourism in the early twentieth century. Little research exists, however, on visitor perspectives towards alternative transportation or the rationale underlying their perspectives. It remains unclear how transportation systems affect visitors’ experiences of the park landscape or the factors influencing their travel behavior in the parks. This report presents an interpretive study of visitor perspectives toward transportation management in the Yosemite Valley area of Yosemite National Park, California. Qualitative analysis of 160 semi-structured interviews identified individual psychological factors as well as situational influences that affect visitors’ behavior and perspectives. Individual psychological factors include perceived freedom, environmental values and beliefs, prior experience with Yosemite National Park and other national parks, prior experience with alternative transportation in national parks, and sensitivity to subjective perceptions of crowding. Situational factors included convenience, access, and flexibility of travel modes, as well as type of visit, type of group, and park use level. Interpretive communication designed to encourage voluntary visitor use of alternative transportation should focus on these psychological and situational factors. Although challenges remain, the results of this study suggest approaches for shaping the way Americans visit and experience their national parks to encourage environmental sustainability.

An interpretive study of Yosemite National Park visitors' perspectives toward alternative transportation in Yosemite Valley.

PubMed

White, Dave D

2007-01-01

The National Park Service (NPS) is increasingly focusing on alternative transportation systems in national parks to address environmental and social problems arising from a historical reliance on personal automobiles as the primary means of visitor access. Despite the potential advantages, alternative transportation may require a reorientation in the way that Americans have experienced national parks since the advent of auto-tourism in the early twentieth century. Little research exists, however, on visitor perspectives towards alternative transportation or the rationale underlying their perspectives. It remains unclear how transportation systems affect visitors' experiences of the park landscape or the factors influencing their travel behavior in the parks. This report presents an interpretive study of visitor perspectives toward transportation management in the Yosemite Valley area of Yosemite National Park, California. Qualitative analysis of 160 semi-structured interviews identified individual psychological factors as well as situational influences that affect visitors' behavior and perspectives. Individual psychological factors include perceived freedom, environmental values and beliefs, prior experience with Yosemite National Park and other national parks, prior experience with alternative transportation in national parks, and sensitivity to subjective perceptions of crowding. Situational factors included convenience, access, and flexibility of travel modes, as well as type of visit, type of group, and park use level. Interpretive communication designed to encourage voluntary visitor use of alternative transportation should focus on these psychological and situational factors. Although challenges remain, the results of this study suggest approaches for shaping the way Americans visit and experience their national parks to encourage environmental sustainability.

Differential vulnerability to the punishment of cocaine related behaviours: effects of locus of punishment, cocaine taking history and alternative reinforcer availability.

PubMed

Pelloux, Yann; Murray, Jennifer E; Everitt, Barry J

2015-01-01

The availability of alternative reinforcement has been shown to reduce drug use, but it remains unclear whether it facilitates a reduction or cessation of drug seeking or taking. We compared the effects of punishment of cocaine seeking or taking behaviour after brief or extended cocaine-taking histories when behavioural reallocation was facilitated or not by making available an alternative ingestive reinforcer (sucrose). In the first experiment, punishment of either seeking or taking responses was introduced immediately after training on the seeking-taking chained schedule. In the second experiment, punishment of cocaine seeking was introduced after 12 additional days of either 1 or 6 h daily access to cocaine self-administration. In both experiments, beginning 1 week before the introduction of punishment, a subset of rats had concurrent nose poke access to sucrose while seeking or taking cocaine. The presence of an alternative source of reinforcement markedly facilitated behavioural reallocation from punished cocaine taking after acquisition. It also facilitated punishment-induced suppression of cocaine seeking after an extensive cocaine self-administration history likely by prompting goal-directed motivational control over drug use. However, a significant proportion of rats were deemed compulsive-maintaining drug use after an extensive cocaine history despite the presence of abstinence-promoting positive and negative incentives. Making available an alternative reinforcer facilitates disengagement from punished cocaine use through at least two different processes but remains ineffective in a subpopulation of vulnerable animals, which continued to seek cocaine despite the aversive consequence of punishment and the presence of the alternative positive reinforcer.

Alternative Level of Care: Canada's Hospital Beds, the Evidence and Options

PubMed Central

Sutherland, Jason M.; Crump, R. Trafford

2013-01-01

Patients designated as alternative level of care (ALC) are an ongoing concern for healthcare policy makers across Canada. These patients occupy valuable hospital beds and limit access to acute care services. The objective of this paper is to present policy alternatives to address underlying factors associated with ALC bed use. Three alternatives, and their respective limitations and structural challenges, are discussed. Potential solutions may require a mix of policy options proposed here. Inadequate policy jeopardizes new acute care activity-based funding schemes in British Columbia and Ontario. Failure to address this issue could exacerbate pressures on the existing bottlenecks in the community care system in these and other provinces. PMID:23968671

Health insurance and use of alternative medicine in Mexico

PubMed Central

van Gameren, Edwin

2014-01-01

Objectives I analyze the effect of coverage by health insurance on the use of alternative medicine such as folk healers and homeopaths, in particular if it complements or substitutes conventional services. Methods Panel data from the Mexican Health and Aging Study (MHAS) is used to estimate bivariate probit models in order to explain the use of alternative medicine while allowing the determinant of interest, access to health insurance, to be an endogenous factor. Results The findings indicate that households with insurance coverage less often use alternative medicine, and that the effect is much stronger among poor than among rich households. Conclusions Poor households substitute away from traditional medicine towards conventional medicine. PMID:20546965

Access and Success in Learning: Technologies for Scaling Up Open and Distance Learning Programme in the Institute of Distance Learning, KNUST, Kumasi, Ghana

ERIC Educational Resources Information Center

Essel, Rebecca; Owusu-Boateng, William

2011-01-01

ODL (Open and Distance Learning) has come to stay. In recent years, there has been some extra-ordinary increasing international interest in it and Ghana is no exception. Currently, new ways of providing education are inevitable and ODL provides an effective alternate way. It represents approaches that focus on opening access to education and…

Internet TV set-top devices for web-based projects: smooth sailing or rough surfing?

PubMed Central

Johnson, K. B.; Ravert, R. D.; Everton, A.

1999-01-01

BACKGROUND: The explosion of projects utilizing the World Wide Web in the home environment offer a select group of patients a tremendous tool for information management and health-related support. However, many patients do not have ready access to the Internet in their homes. For these patients, Internet TV set-top devices may provide a low cost alternative to PC-based web browsers. METHODS: As a part of a larger descriptive study providing adolescents with access to an on-line support group, we investigated the feasibility of using an Internet TV set-top device for those patients in need of Internet access. RESULTS: Although the devices required some configuration before being installed in the home environment, they required a minimum of support and were well accepted by these patients. However, these patients used the Internet less frequently than their peers with home personal computers--most likely due to a lack of easy availability of the telephone or television at all times. CONCLUSION: Internet TV set-top devices represent a feasible alternative access to the World Wide Web for some patients. Any attempt to use these devices should, however, be coupled with education to all family members, and an attempt at providing a dedicated television and phone line. Images p537-a Figure 2 PMID:10566416

Internet TV set-top devices for web-based projects: smooth sailing or rough surfing?

PubMed

Johnson, K B; Ravert, R D; Everton, A

1999-01-01

The explosion of projects utilizing the World Wide Web in the home environment offer a select group of patients a tremendous tool for information management and health-related support. However, many patients do not have ready access to the Internet in their homes. For these patients, Internet TV set-top devices may provide a low cost alternative to PC-based web browsers. As a part of a larger descriptive study providing adolescents with access to an on-line support group, we investigated the feasibility of using an Internet TV set-top device for those patients in need of Internet access. Although the devices required some configuration before being installed in the home environment, they required a minimum of support and were well accepted by these patients. However, these patients used the Internet less frequently than their peers with home personal computers--most likely due to a lack of easy availability of the telephone or television at all times. Internet TV set-top devices represent a feasible alternative access to the World Wide Web for some patients. Any attempt to use these devices should, however, be coupled with education to all family members, and an attempt at providing a dedicated television and phone line.

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

Millar, A. P.; Behrmann, G.; Bernardt, C.

With over ten years in production use dCache data storage system has evolved to match ever changing lansdcape of continually evolving storage technologies with new solutions to both existing problems and new challenges. In this paper, we present three areas of innovation in dCache: providing efficient access to data with NFS v4.1 pNFS, adoption of CDMI and WebDAV as an alternative to SRM for managing data, and integration with alternative authentication mechanisms.

Alternate concepts study extension. Volume 2: Part 4: Avionics

NASA Technical Reports Server (NTRS)

1971-01-01

A recommended baseline system is presented along with alternate avionics systems, Mark 2 avionics, booster avionics, and a cost summary. Analyses and discussions are included on the Mark 1 orbiter avionics subsystems, electrical ground support equipment, and the computer programs. Results indicate a need to define all subsystems of the baseline system, an installation study to determine the impact on the crew station, and a study on access for maintenance.

Alternative Press Index: An Index to the Publications Which Amplify the Cry for Social Change and Social Justice. Volume 2, Number 3.

ERIC Educational Resources Information Center

Radical Research Center, Northfield, Minn.

This quarterly index provides subject access to individual articles and reviews which appeared from July to September 1970 in 100 alternative periodicals. Since the last issue of the index, 30 new periodicals have been added. These additions reflect some of the areas which the index has not covered sufficiently in the past: gay liberation, womens'…

Trends in communicative access solutions for children with cerebral palsy.

PubMed

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

2014-08-01

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

Helical unwinding and side-chain unlocking unravel the outward open conformation of the melibiose transporter

NASA Astrophysics Data System (ADS)

Wang, Li-Ying; Ravi, Vidhya M.; Leblanc, Gérard; Padrós, Esteve; Cladera, Josep; Perálvarez-Marín, Alex

2016-09-01

Molecular dynamics simulations have been used to study the alternate access mechanism of the melibiose transporter from Escherichia coli. Starting from the outward-facing partially occluded form, 2 out of 12 simulations produced an outward full open form and one partially open, whereas the rest yielded fully or partially occluded forms. The shape of the outward-open form resembles other outward-open conformations of secondary transporters. During the transporter opening, conformational changes in some loops are followed by changes in the periplasm region of transmembrane helix 7. Helical curvature relaxation and unlocking of hydrophobic and ionic locks promote the outward opening of the transporter making accessible the substrate binding site. In particular, FRET studies on mutants of conserved aromatic residues of extracellular loop 4 showed lack of substrate binding, emphasizing the importance of this loop for making crucial interactions that control the opening of the periplasmic side. This study indicates that the alternate access mechanism for the melibiose transporter fits better into a flexible gating mechanism rather than the archetypical helical rigid-body rocker-switch mechanism.

Employees with Myasthenia Gravis

MedlinePlus

... of Disabilities Publications Resources Home | Accommodation and Compliance Series: Employees with Myasthenia Gravis By Linda Carter Batiste, ... rest breaks Fine Motor Impairment: Implement ergonomic workstation design Provide alternative computer and telephone access Provide arm ...

78 FR 22026 - Alternative Transportation in Parks and Public Lands Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-12

... appropriations and previously unallocated prior year funds. The Paul S. Sarbanes Transit in Parks program... cultural resources; reduce congestion and pollution; improve visitor mobility and accessibility; enhance...

Unlocking data: federated identity with LSDMA and dCache

NASA Astrophysics Data System (ADS)

Millar, AP; Behrmann, G.; Bernardt, C.; Fuhrmann, P.; Hardt, M.; Hayrapetyan, A.; Litvintsev, D.; Mkrtchyan, T.; Rossi, A.; Schwank, K.

2015-12-01

X.509, the dominant identity system from grid computing, has proved unpopular for many user communities. More popular alternatives generally assume the user is interacting via their web-browser. Such alternatives allow a user to authenticate with many services with the same credentials (user-name and password). They also allow users from different organisations form collaborations quickly and simply. Scientists generally require that their custom analysis software has direct access to the data. Such direct access is not currently supported by alternatives to X.509, as they require the use of a web-browser. Various approaches to solve this issue are being investigated as part of the Large Scale Data Management and Analysis (LSDMA) project, a German funded national R&D project. These involve dynamic credential translation (creating an X.509 credential) to allow backwards compatibility in addition to direct SAML- and OpenID Connect-based authentication. We present a summary of the current state of art and the current status of the federated identity work funded by the LSDMA project along with the future road map.

Settlement Relocation Modeling: Reacting to Merapi’s Eruption Incident

NASA Astrophysics Data System (ADS)

Pramitasari, A.; Buchori, I.

2018-02-01

Merapi eruption has made severe damages in Central Java Province. Klaten was one of the most affected area, specifically in Balerante Village. This research is made to comprehend GIS model on finding alternative locations for impacted settlement in hazardous zones of eruption. The principal objective of the research study is to identify and analyze physical condition, community characteristics, and local government regulation related to settlements relocation plan for impacted area of eruption. The output is location map which classified into four categories, i.e. not available, available with low accessibility, available with medium accessibility, and available with high accessibility.

Neoinfundibulotomy for the management of symptomatic caliceal diverticula.

PubMed

Auge, Brian K; Munver, Ravi; Kourambas, John; Newman, Glenn E; Wu, Ning Z; Preminger, Glenn M

2002-04-01

Direct percutaneous access provides effective treatment for complex caliceal diverticula. Yet, access into the diverticulum alone is usually tenuous and passage of a guide wire across a stenotic infundibulum is often impossible. An alternative technique is described which creates a "neoinfundibulum" to assist in the management of symptomatic caliceal diverticula. During a 6-year period 22 patients with symptomatic caliceal diverticula were treated via a percutaneous approach, of whom 21 had calculi within the diverticula. After accessing the diverticulum directly, it was impossible to pass a guide wire through the stenotic infundibulum in 18 (82%) patients, prompting advancement of the access needle through the diverticular wall into the renal pelvis. Once secure access was established, balloon dilation was performed to 30Fr to create the "neoinfundibulum." Percutaneous ultrasonic lithotripsy was performed in the usual fashion. A 22Fr Councill catheter was placed to keep the infundibular tract open for 5 to 7 days to allow complete epithelialization and drainage. Stone-free, symptom-free and complication rates were assessed. Pain, recurrent urinary tract infections and hematuria were the presenting complaints in the subgroup of patients undergoing "neoinfundibulotomy." Average stone burden was 11.7 x 12 mm. and average hospital stay was 2.8 days. Of the patients 94% were symptom-free at 6-week followup, and 80% were stone-free on followup excretory urography. The remaining patients had residual stone fragments less than 3 mm. in diameter. Complications related to access were identified in 2 patients who sustained a pneumothorax after a supra-11th rib access, which was successfully managed with tube thoracostomy. Percutaneous management of complex caliceal diverticula provides a safe and effective option for symptomatic patients. When the stenotic infundibulum cannot be traversed with a guide wire, creation of a new infundibulum offers a secure alternative for accessing the collecting system, while providing equally effective results.

Usage of Data-Encoded Web Maps with Client Side Color Rendering for Combined Data Access, Visualization and Modeling Purposes

NASA Technical Reports Server (NTRS)

Pliutau, Denis; Prasad, Narashimha S.

2013-01-01

Current approaches to satellite observation data storage and distribution implement separate visualization and data access methodologies which often leads to the need in time consuming data ordering and coding for applications requiring both visual representation as well as data handling and modeling capabilities. We describe an approach we implemented for a data-encoded web map service based on storing numerical data within server map tiles and subsequent client side data manipulation and map color rendering. The approach relies on storing data using the lossless compression Portable Network Graphics (PNG) image data format which is natively supported by web-browsers allowing on-the-fly browser rendering and modification of the map tiles. The method is easy to implement using existing software libraries and has the advantage of easy client side map color modifications, as well as spatial subsetting with physical parameter range filtering. This method is demonstrated for the ASTER-GDEM elevation model and selected MODIS data products and represents an alternative to the currently used storage and data access methods. One additional benefit includes providing multiple levels of averaging due to the need in generating map tiles at varying resolutions for various map magnification levels. We suggest that such merged data and mapping approach may be a viable alternative to existing static storage and data access methods for a wide array of combined simulation, data access and visualization purposes.

28 CFR 36.305 - Alternatives to barrier removal.

Code of Federal Regulations, 2010 CFR

2010-07-01

... shelves or racks; (3) Relocating activities to accessible locations; (c) Multiscreen cinemas. If it is not... theaters of a multiscreen cinema, the cinema shall establish a film rotation schedule that provides...

Patient-Centered Appointment Scheduling Using Agent-Based Simulation

PubMed Central

Turkcan, Ayten; Toscos, Tammy; Doebbeling, Brad N.

2014-01-01

Enhanced access and continuity are key components of patient-centered care. Existing studies show that several interventions such as providing same day appointments, walk-in services, after-hours care, and group appointments, have been used to redesign the healthcare systems for improved access to primary care. However, an intervention focusing on a single component of care delivery (i.e. improving access to acute care) might have a negative impact other components of the system (i.e. reduced continuity of care for chronic patients). Therefore, primary care clinics should consider implementing multiple interventions tailored for their patient population needs. We collected rapid ethnography and observations to better understand clinic workflow and key constraints. We then developed an agent-based simulation model that includes all access modalities (appointments, walk-ins, and after-hours access), incorporate resources and key constraints and determine the best appointment scheduling method that improves access and continuity of care. This paper demonstrates the value of simulation models to test a variety of alternative strategies to improve access to care through scheduling. PMID:25954423

Connecting AAC devices to the world of information technology.

PubMed

Caves, Kevin; Shane, Howard C; DeRuyter, Frank

2002-01-01

Modern day information technology (IT) is converging around wireless networks. It is now possible to check E-mail and view information from the World Wide Web from commercially available mobile phones. For individuals with disabilities, the ability to access multiple and different types of information not only promises convenience, but also can help to promote independence and facilitate access to public and private information systems. There are many barriers to access for people with disabilities, including technological hurdles, security, privacy, and access to these emerging wireless technologies. However, legislation, advocacy, standards, and research and development can ensure that users of augmentative and alternative communication (AAC) and assistive technology have access to these technologies. This article provides a historical context for the field of AAC and IT development, a review of the current state of these technologies, a glimpse of the potential of wireless information access for the lives of AAC users, and a description of some of the barriers and enablers to making access available to users of AAC and assistive technologies.

Methane Propulsion Elements for Mars

NASA Technical Reports Server (NTRS)

Percy, Tom; Polsgrove, Tara; Thomas, Dan

2017-01-01

Human exploration beyond LEO relies on a suite of propulsive elements to: (1) Launch elements into space, (2) Transport crew and cargo to and from various destinations, (3) Provide access to the surface of Mars, (4) Launch crew from the surface of Mars. Oxygen/Methane propulsion systems meet the unique requirements of Mars surface access. A common Oxygen/Methane propulsion system is being considered to reduce development costs and support a wide range of primary & alternative applications.

Pain (PDQ)

MedlinePlus

... to Cancer Off-Label Drug Use Access to Experimental Drugs Complementary & Alternative Medicine (CAM) CAM for Patients ... called acupuncture points . Acupuncture may be used to control pain, including pain related to ... Support groups help many patients. Religious counseling may ...

Inhalant Abuse: Is Your Child at Risk?

MedlinePlus

... a cheap and accessible alternative to alcohol or marijuana. Most inhalant users report starting using before age ... child is unconscious or not breathing, seek emergency medical help. If your child can't stop huffing, ...

Economic viability of access broadband multiservice networks

NASA Astrophysics Data System (ADS)

Castelli, Francesco; Dammicco, Giacinto; Mocci, Ugo

1995-02-01

In this paper the economic viability of alternative architectures for optical access networks providing broad band services to different subscriber classes in a metropolitan environment, is investigated by a specific tool, NEVE (Network Economic Viability Evaluator), developed for broad band multiservice network planning, service evolutionary scenarios assessment, evaluation of tariff strategies and other actions taken at stimulating the demand growth. As the viability target can be achieved in different ways, different studies can be carried out by NEVE. In the paper some of them are discussed, particularly the ones addressed: to evaluate the impact on viability of alternative service scenarios; to determine the critical mass of broad band subscribers and the critical joint service adoption cost; to evaluate cross subsidiary policies among different subscriber classes and services; to perform sensitivity analysis with respect to variations of demand parameters and tariffs.

Evolving bipartite authentication graph partitions

DOE PAGES

Pope, Aaron Scott; Tauritz, Daniel Remy; Kent, Alexander D.

2017-01-16

As large scale enterprise computer networks become more ubiquitous, finding the appropriate balance between user convenience and user access control is an increasingly challenging proposition. Suboptimal partitioning of users’ access and available services contributes to the vulnerability of enterprise networks. Previous edge-cut partitioning methods unduly restrict users’ access to network resources. This paper introduces a novel method of network partitioning superior to the current state-of-the-art which minimizes user impact by providing alternate avenues for access that reduce vulnerability. Networks are modeled as bipartite authentication access graphs and a multi-objective evolutionary algorithm is used to simultaneously minimize the size of largemore » connected components while minimizing overall restrictions on network users. Lastly, results are presented on a real world data set that demonstrate the effectiveness of the introduced method compared to previous naive methods.« less

Transpiring purging access probe for particulate laden or hazardous environments

DOEpatents

VanOsdol, John G

2013-12-03

An access probe for remote-sensing access through a viewing port, viewing volume, and access port into a vessel. The physical boundary around the viewing volume is partially formed by a porous sleeve lying between the viewing volume and a fluid conduit. In a first mode of operation, a fluid supplied to the fluid conduit encounters the porous sleeve and flows through the porous material to maintain the viewing volume free of ash or other matter. When additional fluid force is needed to clear the viewing volume, the pressure of the fluid flow is increased sufficiently to slidably translate the porous sleeve, greatly increasing the flow into the viewing volume. The porous sleeve is returned to position by an actuating spring. The access probe thereby provides for alternate modes of operation based on the pressure of an actuating fluid.

Evolving bipartite authentication graph partitions

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

Pope, Aaron Scott; Tauritz, Daniel Remy; Kent, Alexander D.

As large scale enterprise computer networks become more ubiquitous, finding the appropriate balance between user convenience and user access control is an increasingly challenging proposition. Suboptimal partitioning of users’ access and available services contributes to the vulnerability of enterprise networks. Previous edge-cut partitioning methods unduly restrict users’ access to network resources. This paper introduces a novel method of network partitioning superior to the current state-of-the-art which minimizes user impact by providing alternate avenues for access that reduce vulnerability. Networks are modeled as bipartite authentication access graphs and a multi-objective evolutionary algorithm is used to simultaneously minimize the size of largemore » connected components while minimizing overall restrictions on network users. Lastly, results are presented on a real world data set that demonstrate the effectiveness of the introduced method compared to previous naive methods.« less

A Real Alternative: The Final Report and Recommendations of the Community National Field Task Force on the Improvement and Reform of American Education.

ERIC Educational Resources Information Center

Office of Education (DHEW), Washington, DC.

This report is one of six to be released by as many task forces on educational improvement and reform. The main body of this report consists of five sections: (a) an introduction, which briefly describes the work of the task force; (b) a description of the alternative of community participation in education; (c) recommendations; (d) access to…

A Generalized DBMS to Support Diversified Data.

DTIC Science & Technology

1987-07-21

interest on bonds ). Hence. they require a definition of subtraction which yields 30 days as the answer to the above computation. Only a user-defined...STON85]. Alternately. one can follow the standard scheduler model [BERNS1] in which a module is callable by code in the access methods when a...direction for evolution . These could include when to cease investigating alternate plans. and the ability to specify one’s own optimizer parameters

Alternatives to the face-to-face consultation in general practice: focused ethnographic case study.

PubMed

Atherton, Helen; Brant, Heather; Ziebland, Sue; Bikker, Annemieke; Campbell, John; Gibson, Andy; McKinstry, Brian; Porqueddu, Tania; Salisbury, Chris

2018-04-01

NHS policy encourages general practices to introduce alternatives to the face-to-face consultation, such as telephone, email, e-consultation systems, or internet video. Most have been slow to adopt these, citing concerns about workload. This project builds on previous research by focusing on the experiences of patients and practitioners who have used one or more of these alternatives. To understand how, under what conditions, for which patients, and in what ways, alternatives to face-to-face consultations present benefits and challenges to patients and practitioners in general practice. Focused ethnographic case studies took place in eight UK general practices between June 2015 and March 2016. Non-participant observation, informal conversations with staff, and semi-structured interviews with staff and patients were conducted. Practice documents and protocols were reviewed. Data were analysed through charting and the 'one sheet of paper' mind-map method to identify the line of argument in each thematic report. Case study practices had different rationales for offering alternatives to the face-to-face consultation. Beliefs varied about which patients and health issues were suitable. Co-workers were often unaware of each other's practice; for example, practice policies for use of e-consultations systems with patients were not known about or followed. Patients reported benefits including convenience and access. Staff and some patients regarded the face-to-face consultation as the ideal. Experience of implementing alternatives to the face-to-face consultation suggests that changes in patient access and staff workload may be both modest and gradual. Practices planning to implement them should consider carefully their reasons for doing so and involve the whole practice team. © British Journal of General Practice 2018.

Alternatives to the face-to-face consultation in general practice: focused ethnographic case study

PubMed Central

Atherton, Helen; Brant, Heather; Ziebland, Sue; Bikker, Annemieke; Campbell, John; Gibson, Andy; McKinstry, Brian; Porqueddu, Tania; Salisbury, Chris

2018-01-01

Background NHS policy encourages general practices to introduce alternatives to the face-to-face consultation, such as telephone, email, e-consultation systems, or internet video. Most have been slow to adopt these, citing concerns about workload. This project builds on previous research by focusing on the experiences of patients and practitioners who have used one or more of these alternatives. Aim To understand how, under what conditions, for which patients, and in what ways, alternatives to face-to-face consultations present benefits and challenges to patients and practitioners in general practice. Design and setting Focused ethnographic case studies took place in eight UK general practices between June 2015 and March 2016. Method Non-participant observation, informal conversations with staff, and semi-structured interviews with staff and patients were conducted. Practice documents and protocols were reviewed. Data were analysed through charting and the ‘one sheet of paper’ mind-map method to identify the line of argument in each thematic report. Results Case study practices had different rationales for offering alternatives to the face-to-face consultation. Beliefs varied about which patients and health issues were suitable. Co-workers were often unaware of each other’s practice; for example, practice policies for use of e-consultations systems with patients were not known about or followed. Patients reported benefits including convenience and access. Staff and some patients regarded the face-to-face consultation as the ideal. Conclusion Experience of implementing alternatives to the face-to-face consultation suggests that changes in patient access and staff workload may be both modest and gradual. Practices planning to implement them should consider carefully their reasons for doing so and involve the whole practice team. PMID:29378697

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2017-01-01

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

The Geographic Distribution of Physicians Revisited

PubMed Central

Rosenthal, Meredith B; Zaslavsky, Alan; Newhouse, Joseph P

2005-01-01

Context While there is debate over whether the U.S. is training too many physicians, many seem to agree that physicians are geographically maldistributed, with too few in rural areas. Objective Official definitions of shortage areas assume the market for physician services is based on county boundaries. We wished to ascertain how the picture of a possible shortage changes using alternative measures of geographic access. We measure geographic access by the number of full-time equivalent physicians serving a community divided by the expected number of patients (possibly both from within the community and outside) receiving care from those physicians. Moreover, we wished to determine how the geographic distribution of physicians had changed since previous studies, in light of the large increase in physician numbers. Design Cross-sectional data analyses of alternative measures of geographic access to physicians in 23 states with low physician–population ratios. Results Between 1979 and 1999, the number of physicians doubled in the sample states. Although most specialties experienced greater diffusion everywhere, smaller specialties had not yet diffused to the smallest towns. Multiple measures of geographic access, including physician-to-population ratios, average distance traveled to the nearest physician, and projected average caseload per physician, confirm that residents of metropolitan areas have better geographic access to physicians. Physician-to-population ratios exhibit the largest degree of geographic disparity, but ratios in rural counties adjacent to metropolitan areas are smaller than in those not adjacent to metropolitan areas. Distance-traveled and caseload models that allow patients to cross county lines show less disparity and indicate that residents of isolated rural counties have less access than those living in counties adjacent to metropolitan areas. Conclusion Geographic access to physicians has continued to improve over the past two decades, although some smaller specialties have not diffused to the most rural areas. While substantial variation in the supply of physicians across communities remains, current measures of geographic access to physicians overstate the extent of maldistribution and yield an incorrect ranking of areas according to geographic accessibility of physicians. PMID:16336557

Low-cost rural surface alternatives : tech transfer summary.

DOT National Transportation Integrated Search

2013-12-01

Freezing-thawing action induces physical changes to granular surface : roads that can negatively impact public users, reduce emergency : responder access/time, and result in maintenance costs for secondary : road departments. Stabilization can help r...

75 FR 38549 - Recent Trends in U.S. Services Trade, 2011 Annual Report

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-02

... by accessing its Internet server ( http://www.usitc.gov ). Persons with mobility impairments who will... selected business and professional services, alternating with the focus of the 2010 report on...

Analytic Methods in Investigative Geometry.

ERIC Educational Resources Information Center

Dobbs, David E.

2001-01-01

Suggests an alternative proof by analytic methods, which is more accessible than rigorous proof based on Euclid's Elements, in which students need only apply standard methods of trigonometry to the data without introducing new points or lines. (KHR)

Government Search Tools: Evaluating Fee and Free Search Alternatives.

ERIC Educational Resources Information Center

Gordon-Murnane, Laura

1999-01-01

Examines four tools that provide access to federal government information: FedWorld, Usgovsearch.com, Google/Unclesam, and GovBot. Compares search features, size of collection, ease of use, and cost or subscription requirements. (LRW)

Incidence of Central Vein Stenosis and Occlusion Following Upper Extremity PICC and Port Placement

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

Gonsalves, Carin F., E-mail: Carin.Gonsalves@mail.tju.edu; Eschelman, David J.; Sullivan, Kevin L.

2003-04-15

The purpose of this study was to determine the incidence of central vein stenosis and occlusion following upper extremity placement of peripherally inserted central venous catheters(PICCs) and venous ports. One hundred fifty-four patients who underwent venography of the ipsilateral central veins prior to initial and subsequent venous access device insertion were retrospectively identified. All follow-up venograms were interpreted at the time of catheter placement by one interventional radiologist over a 5-year period and compared to the findings on initial venography. For patients with central vein abnormalities, hospital and home infusion service records and radiology reports were reviewed to determine cathetermore » dwelltime and potential alternative etiologies of central vein stenosis or occlusion. The effect of catheter caliber and dwell time on development of central vein abnormalities was evaluated. Venography performed prior to initial catheter placement showed that 150 patients had normal central veins. Three patients had central vein stenosis, and one had central vein occlusion. Subsequent venograms (n = 154)at the time of additional venous access device placement demonstrated 8 patients with occlusions and 10 with stenoses. Three of the 18 patients with abnormal follow-up venograms were found to have potential alternative causes of central vein abnormalities. Excluding these 3 patients and the 4 patients with abnormal initial venograms, a 7% incidence of central vein stenosis or occlusion was found in patients with prior indwelling catheters and normal initial venograms. Catheter caliber showed no effect on the subsequent development of central vein abnormalities. Patients who developed new or worsened central vein stenosis or occlusion had significantly (p =0.03) longer catheter dwell times than patients without central vein abnormalities. New central vein stenosis or occlusion occurred in 7% of patients following upper arm placement of venous access devices.Patients with longer catheter dwell time were more likely to develop central vein abnormalities. In order to preserve vascular access for dialysis fistulae and grafts and adhere to Dialysis Outcomes Quality Initiative guidelines, alternative venous access sites should be considered for patients with chronic renal insufficiency and end-stage renal disease.« less

A Cost Benefit Analysis of Fire Scout Vertical Takeoff and Landing Tactical Unmanned Aerial Vehicle (VTUAV) Operator Alternatives

DTIC Science & Technology

2012-03-01

mile mission radius.24 Like the MH-60R manned helicopter, the Fire Scout mission systems suite includes Infrared Imaging, Electro Optical Imaging...homecoming just as sweet." dcmilitary.com. February 21, 2008. http:// ww2 .dcmilitary.com/stories/022108/southpotomac_28121.shtml (accessed February 29... ww2 .dcmilitary.com/stories/022108/southpotomac_28121.shtml (accessed February 29, 2012). Tilghman, Andrew. "Fire Scout Program could open door for

Reply to "transforming oncology care": advancing value, accessing innovation.

PubMed

Paradis, Rebecca

2015-09-01

Alternative payment models in oncology are already successfully standardizing care, curbing costs, and improving the patient experience. Yet, it is unclear whether decision makers are adequately considering patient access to innovation when creating these models, which could have severe consequences for a robust innovation ecosystem and the lives of afflicted patients. The suggested chart includes recommendations on: Allowing for the adoption of new, promising therapies; Promoting the measurement of patient-centered outcomes; and Providing support for personalized medicine.

Emerging trends in health care finance.

PubMed

Sterns, J B

1994-01-01

Access to capital will become more difficult. Capital access is dependent on ability to repay debt, which, in turn, is dependent on internally generated cash flows. Under any health care reform proposal, revenue inflows will be slowed. The use of corporate finance techniques to limit financial risk and lower cost will be a permanent response to fundamental changes to the health care system. These changes will result in greater balance sheet management, centralized capital allocation, and alternative sources of capital.

Making information accessible and useful to practicing clinicians. Problem-knowledge coupling.

PubMed

Zimny, N J

1992-01-01

Assessments of health care technology will lead to improvements in patient services only if this information is actually used by clinicians. Traditional methods of planning treatment that rely solely on memory limit the clinician's access to and use of the full available body of knowledge in the field. An alternative approach using a computer-assisted methodology is presented as a way to overcome traditional limitations and promote the development and diffusion of knowledge.

Using a geographic information system to enhance patient access to point-of-care diagnostics in a limited-resource setting.

PubMed

Ferguson, William J; Kemp, Karen; Kost, Gerald

2016-03-01

Rapid and accurate diagnosis drives evidence-based care in health. Point-of-care testing (POCT) aids diagnosis by bringing advanced technologies closer to patients. Health small-world networks are constrained by natural connectivity in the interactions between geography of resources and social forces. Using a geographic information system (GIS) we can understand how populations utilize their health networks, visualize their inefficiencies, and compare alternatives. This project focuses on cardiac care resource in rural Isaan, Thailand. A health care access analysis was created using ArcGIS Network Analyst 10.1 from data representing aggregated population, roads, health resource facilities, and diagnostic technologies. The analysis quantified cardiac health care access and identified ways to improve it using both widespread and resource-limited strategies. Results indicated that having diagnostic technologies closer to populations streamlines critical care paths. GIS allowed us to compare the effectiveness of the implementation strategies and put into perspective the benefits of adopting rapid POCT within health networks. Geospatial analyses derive high impact by improving alternative diagnostic placement strategies in limited-resource settings and by revealing deficiencies in health care access pathways. Additionally, the GIS provides a platform for comparing relative costs, assessing benefits, and improving outcomes. This approach can be implemented effectively by health ministries seeking to enhance cardiac care despite limited resources.

Intentional intra-arterial injection of midazolam in a patient with status epilepticus in the Intensive Care Unit

PubMed Central

Ali, Muhammad Asghar; Yahya, Muhammad

2017-01-01

Fundamental medical care includes intravenous (IV) access which provides prompt resuscitation and reliable delivery of analgesics, antibiotics, and vasoactive medication. Difficult access populations, especially in critical area, continue to challenge providers to consider and utilize alternative means to provide IV access. Potential options under such circumstances include intramuscular, intraosseous, and intratracheal drug administration, but in extreme cases where no other options are available, intra-arterial route might be considered. We present a case where midazolam was intentionally injected intra-arterially to abort seizure activity in a patient with status epilepticus in the Intensive Care Unit. PMID:29033730

Research Technology

NASA Image and Video Library

1999-10-21

Travel to distant stars is a long-range goal of Marshall Space Flight Center's Advanced Concept Group. One of the many propulsion systems currently being studied is fusion power. The objective of this and many other alternative propulsion systems is to reduce the costs of space access and to reduce the travel time for planetary missions. One of the major factors is providing an alternate engery source for these missions. Pictured is an artist's concept of future interplanetary space flight using fusion power.

Tracheostomy: pediatric considerations.

PubMed

Deutsch, Ellen S

2010-08-01

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

Short- and Long-term Exposure to Low and High Dose Running Produce Differential Effects on Hippocampal Neurogenesis.

PubMed

Nguemeni, Carine; McDonald, Matthew W; Jeffers, Matthew S; Livingston-Thomas, Jessica; Lagace, Diane; Corbett, Dale

2018-01-15

Continuous running wheel (RW) exercise increases adult hippocampal neurogenesis in the dentate gyrus (DG) of rodents. Evidence suggests that greater amounts of RW exercise does not always equate to more adult-generated neurons in hippocampus. It can also be argued that continuous access to a RW results in exercise levels not representative of human exercise patterns. This study tested if RW paradigms that more closely represent human exercise patterns (e.g. shorter bouts, alternating daily exercise) alter neurogenesis. Neurogenesis was measured by examining the survival and fate of bromodeoxyuridine (BrdU)-labeled proliferating cells in the DG of male Sprague-Dawley rats after acute (14 days) or chronic (30 days) RW access. Rats were assigned to experimental groups based on the number of hours that they had access to a RW over two days: 0 h, 4 h, 8 h, 24 h, and 48 h. After acute RW access, rats that had unlimited access to the RW on alternating days (24 h) had a stronger neurogenic response compared to those rats that ran modest distances (4 h, 8 h) or not at all (0 h). In contrast, following chronic RW access, rats that ran a moderate amount (4 h, 8 h) had significantly more surviving cells compared to 0 h, 24 h, and 48 h. Linear regression analysis established a negative relationship between running distance and surviving BrdU+ cells in the chronic RW access cohort (R 2  = 0.40). These data demonstrate that in rats moderate amounts of RW exercise are superior to continuous daily RW exercise paradigms at promoting hippocampal neurogenesis in the long-term. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

Retroperitoneal access for robotic renal surgery.

PubMed

Anderson, Barrett G; Wright, Alec J; Potretzke, Aaron M; Figenshau, R Sherburne

2018-01-01

Retroperitoneal access for robotic renal surgery is an effective alternative to the commonly used transperitoneal approach. We describe our contemporary experience and technique for attaining retroperitoneal access. We outline our institutional approach to retroperitoneal access for the instruction of urologists at the beginning of the learning curve. The patient is placed in the lateral decubitus position. The first incision is made just inferior to the tip of the twelfth rib as described by Hsu, et al. After the lumbodorsal fascia is traversed, the retroperitoneal space is dilated with a round 10 millimeter AutoSutureTM (Covidien, Mansfield, MA) balloon access device. The following trocars are used: A 130 millimeter KiiR balloon trocar (Applied Medical, Rancho Santa Margarita, CA), three robotic, and one assistant. Key landmarks for the access and dissection are detailed. 177 patients underwent a retroperitoneal robotic procedure from 2007 to 2015. Procedures performed include 158 partial nephrectomies, 16 pyeloplasties, and three radical nephrectomies. The robotic fourth arm was utilized in all cases. When compared with the transperitoneal approach, the retroperitoneal approach was associated with shorter operative times and decreased length of stay (1). Selection bias and surgeon preference accounted for the higher proportion of patients who underwent partial nephrectomy off-camp via the retroperitoneal approach. Retroperitoneal robotic surgery may confer several advantages. In patients with previous abdominal surgery or intra-abdominal conditions, the retroperitoneum can be safely accessed while avoiding intraperitoneal injuries. The retroperitoneum also provides a confined space that may minimize the sequelae of potential complications including urine leak. Moreover, at our institution, retroperitoneal robotic surgery is associated with shorter operative times and a decreased length of stay when compared with the transperitoneal approach (2). In selected patients, the retroperitoneal approach is a viable alternative to the transperitoneal approach for a variety of renal procedures. Copyright® by the International Brazilian Journal of Urology.

Male dominance rank and reproductive success in chimpanzees, Pan troglodytes schweinfurthii.

PubMed

Wroblewski, Emily E; Murray, Carson M; Keele, Brandon F; Schumacher-Stankey, Joann C; Hahn, Beatrice H; Pusey, Anne E

2009-01-01

Competition for fertile females determines male reproductive success in many species. The priority of access model predicts that male dominance rank determines access to females, but this model has been difficult to test in wild populations, particularly in promiscuous mating systems. Tests of the model have produced variable results, probably because of the differing socioecological circumstances of individual species and populations. We tested the predictions of the priority of access model in the chimpanzees of Gombe National Park, Tanzania. Chimpanzees are an interesting species in which to test the model because of their fission-fusion grouping patterns, promiscuous mating system and alternative male mating strategies. We determined paternity for 34 offspring over a 22-year period and found that the priority of access model was generally predictive of male reproductive success. However, we found that younger males had higher success per male than older males, and low-ranking males sired more offspring than predicted. Low-ranking males sired offspring with younger, less desirable females and by engaging in consortships more often than high-ranking fathers. Although alpha males never sired offspring with related females, inbreeding avoidance of high-ranking male relatives did not completely explain the success of low-ranking males. While our work confirms that male rank typically predicts male chimpanzee reproductive success, other factors are also important; mate choice and alternative male strategies can give low-ranking males access to females more often than would be predicted by the model. Furthermore, the success of younger males suggests that they are more successful in sperm competition.

Estimating the waiting time of multi-priority emergency patients with downstream blocking.

PubMed

Lin, Di; Patrick, Jonathan; Labeau, Fabrice

2014-03-01

To characterize the coupling effect between patient flow to access the emergency department (ED) and that to access the inpatient unit (IU), we develop a model with two connected queues: one upstream queue for the patient flow to access the ED and one downstream queue for the patient flow to access the IU. Building on this patient flow model, we employ queueing theory to estimate the average waiting time across patients. Using priority specific wait time targets, we further estimate the necessary number of ED and IU resources. Finally, we investigate how an alternative way of accessing ED (Fast Track) impacts the average waiting time of patients as well as the necessary number of ED/IU resources. This model as well as the analysis on patient flow can help the designer or manager of a hospital make decisions on the allocation of ED/IU resources in a hospital.

77 FR 22312 - Access by EPA Contractors to Confidential Business Information Related to the Greenhouse Gas...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-13

... you used. Provide specific examples to illustrate your concerns and suggest alternatives. Explain your... International subcontractors: Abt Associates, 55 Wheeler Street, Cambridge, MA 02138-1168; AMEC, 4021 Stirrup...

FUNCTIONAL ANALYSIS AND TREATMENT OF COPROPHAGIA

PubMed Central

Ing, Anna D; Roane, Henry S; Veenstra, Rebecca A

2011-01-01

In the current investigation, functional analysis results suggested that coprophagia, the ingestion of fecal matter, was maintained by automatic reinforcement. Providing noncontingent access to alternative stimuli decreased coprophagia, and the intervention was generalized to two settings. PMID:21541128

An Inventory of Innovative Financing Plans to Help Pay for Higher Education.

ERIC Educational Resources Information Center

Merisotis, Jamie P.

1989-01-01

Creative ideas recently emerging to help families cope with rising educational costs are reviewed, including state and federal level savings plans, alternative loan programs, guaranteed access plans, and public service proposals. (Author/MSE)

Open access for the non-English-speaking world: overcoming the language barrier

PubMed Central

Fung, Isaac CH

2008-01-01

This editorial highlights the problem of language barrier in scientific communication in spite of the recent success of Open Access Movement. Four options for English-language journals to overcome the language barrier are suggested: 1) abstracts in alternative languages provided by authors, 2) Wiki open translation, 3) international board of translator-editors, and 4) alternative language version of the journal. The Emerging Themes in Epidemiology announces that with immediate effect, it will accept translations of abstracts or full texts by authors as Additional files. Editorial note: In an effort towards overcoming the language barrier in scientific publication, ETE will accept translations of abstracts or the full text of published articles. Each translation should be submitted separately as an Additional File in PDF format. ETE will only peer review English-language versions. Therefore, translations will not be scrutinized in the review-process and the responsibility for accurate translation rests with the authors. PMID:18173854

Rubber dam isolation of cervical lesions. Part 1: Alternative techniques which avoid injury to the periodontium.

PubMed

Liebenberg, W H

1994-01-01

While it is arguable that the operative procedures depicted in this article could have been done equally well with alternative forms of isolation, it is indisputable that rubber dam provides for the most thorough 'isolation' in the comprehensive sense of the term. It allows for the finite control over peripheral variables such as access and controlled gingival retraction. This in turn permits meticulous execution of restorative procedures within the luxury of 'true four-handed dentistry'. Most operative procedures are done within the limitations of single handed dentistry as the other 'three hands' are involved with retraction, fluid evacuation and access control. The rubber dam is indeed indispensable and with the increased awareness of infection control it is conceivable that rubber dam isolation will continue to be associated with quality patient care. Part 2 of this article will detail the application of the 'Modified Gingival Retractor' in the isolation of cervical lesions.

Random Access Frames (RAF): Alternative to Rack and Standoff for Deep Space Habitat Outfitting

NASA Technical Reports Server (NTRS)

Howe, A. Scott; Polit-Casillas, Raul

2014-01-01

A modular Random Access Frame (RAF) system is proposed as an alternative to the International Standard Payload Rack (ISPR) for internal module layout and outfitting in a Deep Space Habitat (DSH). The ISPR approach was designed to allow for efficient interchangeability of payload and experiments for the International Space Station (ISS) when frequent resupply missions were available (particularly the now-retired Space Shuttle). Though the standard interface approach to the ISPR system allowed integration of subsystems and hardware from a variety of sources and manufacturers, the heavy rack and standoff approach may not be appropriate when resupply or swap-out capabilities are not available, such as on deep space, long-duration missions. The lightweight RAF concept can allow a more dense packing of stowage and equipment, and may be easily broken down for repurposing or reuse. Several example layouts and workstations are presented.

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

PubMed

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

1998-04-01

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

Accessing Faith-Based Organizations Using Public Transportation.

PubMed

Lewinson, Terri; Maley, Olivia; Esnard, Ann-Margaret

2017-01-01

Nondriving aging adults are at risk of experiencing mobility barriers that inhibit access to important community resources for managing health and wellbeing. This multimethod study explores bus transportation experiences of older adults who live in extended stay hotels and use faith-based organizations to access resources. Interviews from 17 nondriving older adults were analyzed for perspectives about using faith-based organizations and residents' experiences navigating to faith-based organizations through available bus transportation in their communities. Residents described both favorable and unfavorable experiences when reaching out for help from faith-based organizations. Although they report reliance on faith-based organizations for a variety of resources, residents were challenged by an ineffective bus system that interfered with resource accessibility. Suggestions for improving bus transit systems and providing alternative, aging-friendly transportation options are discussed.

African American and Latino low income families' food shopping behaviors: promoting fruit and vegetable consumption and use of alternative healthy food options.

PubMed

Fish, Caitlin A; Brown, Jonisha R; Quandt, Sara A

2015-04-01

Minority families often reside in neighborhoods with few supermarkets or alternative healthy food options (e.g., farmers markets, community gardens), making fresh produce difficult to obtain. This qualitative study identified factors influencing fruit and vegetable shopping and use of alternative healthy food options. Forty-eight minority women with children completed interviews regarding food shopping habits and use of and attitudes toward alternative healthy food options. Interviews were subjected to thematic analysis. Produce shopping was motivated by costs and family preferences. For African American women, poor cooking skills restricted the variety of fruits and vegetables purchased. Latinas were receptive to alternative healthy food options, but did not use them because these sources were inconvenient. African American women were not receptive to them. Improving cooking skills and perceptions of acceptable foods may be as important as increased access to promote greater consumption of fruits and vegetables.

Upper extremity access for fenestrated endovascular aortic aneurysm repair is not associated with increased morbidity.

PubMed

Knowles, Martyn; Nation, David A; Timaran, David E; Gomez, Luis F; Baig, M Shadman; Valentine, R James; Timaran, Carlos H

2015-01-01

Fenestrated endovascular aortic aneurysm repair (FEVAR) is an alternative to open repair in patients with complex abdominal aortic aneurysms who are neither fit nor suitable for standard open or endovascular repair. Chimney and snorkel grafts are other endovascular alternatives but frequently require bilateral upper extremity access that has been associated with a 3% to 10% risk of stroke. However, upper extremity access is also frequently required for FEVAR because of the caudal orientation of the visceral vessels. The purpose of this study was to assess the use of upper extremity access for FEVAR and the associated morbidity. During a 5-year period, 148 patients underwent FEVAR, and upper extremity access for FEVAR was used in 98 (66%). Outcomes were compared between those who underwent upper extremity access and those who underwent femoral access alone. The primary end point was a cerebrovascular accident or transient ischemic attack, and the secondary end point was local access site complications. The mean number of fenestrated vessels was 3.07 ± 0.81 (median, 3) for a total of 457 vessels stented. Percutaneous upper extremity access was used in 12 patients (12%) and open access in 86 (88%). All patients who required a sheath size >7F underwent high brachial open access, with the exception of one patient who underwent percutaneous axillary access with a 12F sheath. The mean sheath size was 10.59F ± 2.51F (median, 12F), which was advanced into the descending thoracic aorta, allowing multiple wire and catheter exchanges. One hemorrhagic stroke (one of 98 [1%]) occurred in the upper extremity access group, and one ischemic stroke (one of 54 [2%]) occurred in the femoral-only access group (P = .67). The stroke in the upper extremity access group occurred 5 days after FEVAR and was related to uncontrolled hypertension, whereas the stroke in the femoral group occurred on postoperative day 3. Neither patient had signs or symptoms of a stroke immediately after FEVAR. The right upper extremity was accessed six times without a stroke (0%) compared with the left being accessed 92 times with one stroke (1%; P = .8). Four patients (4%) had local complications related to upper extremity access. One (1%) required exploration for an expanding hematoma after manual compression for a 7F sheath, one (1%) required exploration for hematoma and neurologic symptoms after open access for a 12F sheath, and two patients (2%) with small hematomas did not require intervention. Two (two of 12 [17%]) of these complications were in the percutaneous access group, which were significantly more frequent than in the open group (two of 86 [2%]; P = .02). Upper extremity access appears to be a safe and feasible approach for patients undergoing FEVAR. Open exposure in the upper extremity may be safer than percutaneous access during FEVAR. Unlike chimney and snorkel grafts, upper extremity access during FEVAR is not associated with an increased risk of stroke, despite the need for multiple visceral vessel stenting. Copyright © 2015 Society for Vascular Surgery. All rights reserved.

Can hydro-economic river basin models simulate water shadow prices under asymmetric access?

PubMed

Kuhn, A; Britz, W

2012-01-01

Hydro-economic river basin models (HERBM) based on mathematical programming are conventionally formulated as explicit 'aggregate optimization' problems with a single, aggregate objective function. Often unintended, this format implicitly assumes that decisions on water allocation are made via central planning or functioning markets such as to maximize social welfare. In the absence of perfect water markets, however, individually optimal decisions by water users will differ from the social optimum. Classical aggregate HERBMs cannot simulate that situation and thus might be unable to describe existing institutions governing access to water and might produce biased results for alternative ones. We propose a new solution format for HERBMs, based on the format of the mixed complementarity problem (MCP), where modified shadow price relations express spatial externalities resulting from asymmetric access to water use. This new problem format, as opposed to commonly used linear (LP) or non-linear programming (NLP) approaches, enables the simultaneous simulation of numerous 'independent optimization' decisions by multiple water users while maintaining physical interdependences based on water use and flow in the river basin. We show that the alternative problem format allows the formulation HERBMs that yield more realistic results when comparing different water management institutions.

Broad resistance to acetohydroxyacid-synthase-inhibiting herbicides in feral radish (Raphanus sativus L.) populations from Argentina.

PubMed

Pandolfo, Claudio E; Presotto, Alejandro; Moreno, Florencia; Dossou, Ida; Migasso, Juan P; Sakima, Ernesto; Cantamutto, Miguel

2016-02-01

Soon after the commercial release of sunflower cultivars resistant to imidazolinone herbicides, several uncontrolled feral radish (Raphanus sativus L.) populations were found in south-eastern Buenos Aires, Argentina. These populations were studied in field, glasshouse and laboratory experiments aiming to characterise their resistance profile and to develop management tools. Three feral radish accessions were highly resistant to ten active ingredients of five families of acetohydroxyacid synthase (AHAS)-inhibiting herbicides. Sequence analysis of the AHAS gene detected a Trp574Leu mutation in all resistant accessions. One accession with an intermediate level of resistance was heterozygous for this mutation, probably owing to gene exchange with a susceptible subpopulation located in the field margin. Herbicide-resistant and herbicide-susceptible radish could be controlled in sunflower by alternative herbicides. This is the first report of feral radish with resistance to herbicides belonging to all the AHAS-inhibiting herbicide families, conferred by Trp574Leu mutation in the AHAS gene. An appropriate herbicide rotation with alternative herbicides such as fluorochloridone or aclonifen and an increase in the diversity of cropping systems are important for minimising the prevalence of these biotypes. © 2015 Society of Chemical Industry.

Extreme cognitions are associated with diminished ability to use disconfirming evidence.

PubMed

Haigh, Matthew; Dodd, Alyson L

2017-03-01

An Integrative Cognitive Model of mood swings and bipolar disorder proposes that cognitive styles characterized by extreme self-referent appraisals of internal states (e.g., 'If I have a bad night's sleep it means that I am about to have a breakdown') interfere with mood regulation. The aim of this study is to determine whether strong endorsement of such appraisals is predicted by a diminished ability to access disconfirming counterexamples. We examined whether the ability to access two different categories of counterexample (known as Disabling Conditions and Alternative Causes) would predict endorsement of extreme appraisals (measured by the Hypomanic Attitudes and Positive Predictions Inventory; HAPPI) and mania risk (measured by the Hypomanic Personality Scale; HPS). A non-clinical sample of 150 students completed the HAPPI, the HPS and a conditional reasoning task that indexed the ability to access Disabling Conditions and Alternative Causes. Current mood was controlled for using the Internal States Scale. The ability to make use of disabling counterexamples during the reasoning task was inversely related with scores on the HAPPI (r = -.19, p < .05); participants that were less able to make use of disabling counterexamples endorsed extreme self-referent appraisals to a greater extent. There was no association between the use of alternative cause counterexamples and the HAPPI, and no association between either measure of counterexample generation and the HPS. A diminished ability to use disconfirming evidence when reasoning about the world may reinforce problematic cognitive styles such as extreme, personalized appraisals of experience, which can interfere with mood regulation. Problematic cognitive styles such as extreme, personalized appraisals of experience may be reinforced by the inability to produce or access evidence that disconfirms these maladaptive beliefs. This reasoning bias may be associated with cognitive styles underlying psychopathology. There may be clinical utility in exploring the use of disabler generation in psychological interventions, to help disconfirm maladaptive beliefs. © 2016 The British Psychological Society.

Heroin and saccharin demand and preference in rats.

PubMed

Schwartz, Lindsay P; Kim, Jung S; Silberberg, Alan; Kearns, David N

2017-09-01

Several recent studies have investigated the choice between heroin and a non-drug alternative reinforcer in rats. A common finding in these studies is that there are large individual differences in preference, with some rats preferring heroin and some preferring the non-drug alternative. The primary goal of the present study was to determine whether individual differences in how heroin or saccharin is valued, based on demand analysis, predicts choice. Rats lever-pressed for heroin infusions and saccharin reinforcers on fixed-ratio schedules. The essential value of each reinforcer was obtained from resulting demand curves. Rats were then trained on a mutually exclusive choice procedure where pressing one lever resulted in heroin and pressing another resulted in saccharin. After seven sessions of increased access to heroin or saccharin, rats were reexposed to the demand and choice procedures. Demand for heroin was more elastic than demand for saccharin (i.e., heroin had lower essential value than saccharin). When allowed to choose, most rats preferred saccharin. The essential value of heroin, but not saccharin, predicted preference. The essential value of both heroin and saccharin increased following a week of increased access to heroin, but similar saccharin exposure had no effect on essential value. Preference was unchanged after increased access to either reinforcer. Heroin-preferring rats differed from saccharin-preferring rats in how they valued heroin, but not saccharin. To the extent that choice models addiction-related behavior, these results suggest that overvaluation of opioids specifically, rather than undervaluation of non-drug alternatives, could identify susceptible individuals. Copyright © 2017 Elsevier B.V. All rights reserved.

Direct Endoscopic Intratumoral Injection of Onyx for the Preoperative Embolization of a Recurrent Juvenile Nasal Angiofibroma

PubMed Central

Hira, A.; Chao, K.

2011-01-01

Summary Percutaneous injection of embolization material within head and neck tumors is being described as an alternative or adjunct to transarterial embolization. Access in these reports is by computed tomography (CT) guidance, which is cumbersome given the need to transport the patient from the CT scanner to angiography suite. We describe a case of direct percutaneous onyx embolization of juvenile nasal angiofibroma following endoscopic access in the angiography suite including self-sustained onyx combustion during surgical electrocautery. PMID:22192553

An optically accessible pyrolysis microreactor

NASA Astrophysics Data System (ADS)

Baraban, J. H.; David, D. E.; Ellison, G. Barney; Daily, J. W.

2016-01-01

We report an optically accessible pyrolysis micro-reactor suitable for in situ laser spectroscopic measurements. A radiative heating design allows for completely unobstructed views of the micro-reactor along two axes. The maximum temperature demonstrated here is only 1300 K (as opposed to 1700 K for the usual SiC micro-reactor) because of the melting point of fused silica, but alternative transparent materials will allow for higher temperatures. Laser induced fluorescence measurements on nitric oxide are presented as a proof of principle for spectroscopic characterization of pyrolysis conditions.

Implementing a Facial Recognition System to Improve Accessibility and Increase Utilization of Entry Control Points at Military Installations

DTIC Science & Technology

2011-06-01

event simulation is used to model three alternatives to the ECP system. The baseline system which contains two manned kiosks, a fully automated system...experience is traffic delays in the morning for government employees accessing the bases. If one or two lanes were dedicated to 3 completely or even semi...purpose of clarity, the figure below displays only the two lowest levels of functions. This final functional decomposition identifies the sub functions

Xrootd in dCache - design and experiences

NASA Astrophysics Data System (ADS)

Behrmann, Gerd; Ozerov, Dmitry; Zangerl, Thomas

2011-12-01

dCache is a well established distributed storage solution used in both high energy physics computing and other disciplines. An overview of the implementation of the xrootd data access protocol within dCache is presented. The performance of various access mechanisms is studied and compared and it is concluded that our implementation is as perfomant as other protocols. This makes dCache a compelling alternative to the Scalla software suite implementation of xrootd, with added value from broad protocol support, including the IETF approved NFS 4.1 protocol.

Commentary: open access, open business, closed fairness!

PubMed

Moustafa, Khaled

2015-01-01

A strong trend to move from print to online publication is largely perceived in scientific and nonscientific fields. A growing number of publishers increasingly opt for online publication as an option or a compulsory alternative. From readers' perspective, this is a highly appreciated facility, but from the author's, things are different mainly because of excessive article processing charges (APC) that make the open access system sometimes as a hindrance for many authors but a lucrative enterprise for many shareholders, enticing the most traditional and conservative publishers.

An optically accessible pyrolysis microreactor

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

Baraban, J. H.; Ellison, G. Barney; David, D. E.

2016-01-15

We report an optically accessible pyrolysis micro-reactor suitable for in situ laser spectroscopic measurements. A radiative heating design allows for completely unobstructed views of the micro-reactor along two axes. The maximum temperature demonstrated here is only 1300 K (as opposed to 1700 K for the usual SiC micro-reactor) because of the melting point of fused silica, but alternative transparent materials will allow for higher temperatures. Laser induced fluorescence measurements on nitric oxide are presented as a proof of principle for spectroscopic characterization of pyrolysis conditions.

dCache: Big Data storage for HEP communities and beyond

NASA Astrophysics Data System (ADS)

Millar, A. P.; Behrmann, G.; Bernardt, C.; Fuhrmann, P.; Litvintsev, D.; Mkrtchyan, T.; Petersen, A.; Rossi, A.; Schwank, K.

2014-06-01

With over ten years in production use dCache data storage system has evolved to match ever changing lansdcape of continually evolving storage technologies with new solutions to both existing problems and new challenges. In this paper, we present three areas of innovation in dCache: providing efficient access to data with NFS v4.1 pNFS, adoption of CDMI and WebDAV as an alternative to SRM for managing data, and integration with alternative authentication mechanisms.

Confidence in the Efficacy and Safety of Dietary Supplements Among United States Active Duty Army Personnel

DTIC Science & Technology

2012-10-10

Alternative Medicine 2012, 12:182 doi:10.1186/1472-6882-12-182 Christina E Carvey (christina.carvey@us.army.mil) Emily K Farina (emily.k.farina@us.army.mil...www.biomedcentral.com/info/authors/ BMC Complementary and Alternative Medicine © 2012 Carvey et al. This is an open access article distributed under the terms of...U.S. Army Research Institute of Environmental Medicine ,Military Nutrition Division,Kansas Street, Natick,MA,01760 8. PERFORMING ORGANIZATION REPORT

Economic feasibility of alternative practitioners for provision of dental care to the underserved.

PubMed

Matthiesen, Anne

2012-01-01

This study assesses the viability of three alternative practitioner types for provision of dental care to the underserved. Key factors modeled include compensation, training and practice costs, productivity, and payer mix scenarios. Utilizing dental therapists or dental health aide therapists is cost-effective for enhancing access. However, to be sustainable, the practices will require a subsidy or a better reimbursement than modeled. Without tuition support, the debt burden will deter applicants mostlikely to treat the underserved.

Criteria for Comparing Children's Web Search Tools.

ERIC Educational Resources Information Center

Kuntz, Jerry

1999-01-01

Presents criteria for evaluating and comparing Web search tools designed for children. Highlights include database size; accountability; categorization; search access methods; help files; spell check; URL searching; links to alternative search services; advertising; privacy policy; and layout and design. (LRW)

Cardiopulmonary Syndrome Overview

MedlinePlus

... to Cancer Off-Label Drug Use Access to Experimental Drugs Complementary & Alternative Medicine (CAM) CAM for Patients ... pressure on the heart. Treatment may be to control the symptoms of ... vena cava syndrome (SVCS) is a group of signs and symptoms that occur when the ...

14 CFR 382.69 - What requirements must carriers meet concerning the accessibility of videos, DVDs, and other...

Code of Federal Regulations, 2010 CFR

2010-01-01

... carriers must use an equivalent non-video alternative for transmitting the briefing to passengers with... audio-visual displays played on aircraft for informational purposes that were created under your control...

14 CFR 382.69 - What requirements must carriers meet concerning the accessibility of videos, DVDs, and other...

Code of Federal Regulations, 2011 CFR

2011-01-01

... carriers must use an equivalent non-video alternative for transmitting the briefing to passengers with... audio-visual displays played on aircraft for informational purposes that were created under your control...

14 CFR 382.69 - What requirements must carriers meet concerning the accessibility of videos, DVDs, and other...

Code of Federal Regulations, 2014 CFR

2014-01-01

... carriers must use an equivalent non-video alternative for transmitting the briefing to passengers with... audio-visual displays played on aircraft for informational purposes that were created under your control...

National study of health insurance type and reasons for emergency department use.

PubMed

Capp, Roberta; Rooks, Sean P; Wiler, Jennifer L; Zane, Richard D; Ginde, Adit A

2014-04-01

The rates of emergency department (ED) utilization vary substantially by type of health insurance, but the association between health insurance type and patient-reported reasons for seeking ED care is unknown. We evaluated the association between health insurance type and self-perceived acuity or access issues among individuals discharged from the ED. This was a cross-sectional analysis of the 2011 National Health Interview Survey. Adults whose last ED visit did not result in hospitalization (n = 4,606) were asked structured questions about reasons for seeking ED care. We classified responses as 1) perceived need for immediate evaluation (acuity issues), or 2) barriers to accessing outpatient services (access issues). We analyzed survey-weighted data using multivariable logistic regression models to test the association between health insurance type and reasons for ED visits, while adjusting for sociodemographic characteristics. Overall, 65.0% (95% CI 63.0-66.9) of adults reported ≥ 1 acuity issue and 78.9% (95% CI 77.3-80.5) reported ≥ 1 access issue. Among those who reported no acuity issue leading to the most recent ED visit, 84.2% reported ≥ 1 access issue. Relative to those with private insurance, adults with Medicaid (OR 1.05; 95% CI 0.79-1.40) and those with Medicare (OR 0.98; 95% CI 0.66-1.47) were similarly likely to seek ED care due to an acuity issue. Adults with Medicaid (OR 1.50; 95% CI 1.06-2.13) and Medicaid + Medicare (dual eligible) (OR 1.94; 95% CI 1.18-3.19) were more likely than those with private insurance to seek ED care for access issues. Variability in reasons for seeking ED care among discharged patients by health insurance type may be driven more by lack of access to alternate care, rather than by differences in patient-perceived acuity. Policymakers should focus on increasing access to alternate sites of care, particularly for Medicaid beneficiaries, as well as strategies to increase care coordination that involve ED patients and providers.

Electronic doors to education: study of high school website accessibility in Iowa.

PubMed

Klein, David; Myhill, William; Hansen, Linda; Asby, Gary; Michaelson, Susan; Blanck, Peter

2003-01-01

The Americans with Disabilities Act (ADA), and Sections 504 and 508 of the Rehabilitation Act, prohibit discrimination against people with disabilities in all aspects of daily life, including education, work, and access to places of public accommodations. Increasingly, these antidiscrimination laws are used by persons with disabilities to ensure equal access to e-commerce, and to private and public Internet websites. To help assess the impact of the anti-discrimination mandate for educational communities, this study examined 157 website home pages of Iowa public high schools (52% of high schools in Iowa) in terms of their electronic accessibility for persons with disabilities. We predicted that accessibility problems would limit students and others in obtaining information from the web pages as well as limiting ability to navigate to other web pages. Findings show that although many web pages examined included information in accessible formats, none of the home pages met World Wide Web Consortium (W3C) standards for accessibility. The most frequent accessibility problem was lack of alternative text (ALT tags) for graphics. Technical sophistication built into pages was found to reduce accessibility. Implications are discussed for schools and educational institutions, and for laws, policies, and procedures on website accessibility. Copyright 2003 John Wiley & Sons, Ltd.

Adult Intraosseous Access by Advanced EMTs: A Statewide Non-Inferiority Study.

PubMed

Wolfson, Daniel L; Tandoh, Margaret A; Jindal, Mohit; Forgione, Patrick M; Harder, Valerie S

2017-01-01

Intraosseous (IO) access is increasingly being used as an alternative to peripheral intravenous access, which is often difficult or impossible to establish in critically ill patients in the prehospital setting. Until recently, only Paramedics performed adult IO access. In 2014, Vermont Emergency Medical Services (EMS) expanded the Advanced Emergency Medical Technicians (AEMTs) scope of practice to include IO access in adult patients. This study compares successful IO access in adults performed by AEMTs compared to Paramedics in the prehospital setting. All Vermont EMS patient encounters between January 1, 2013 and November 30, 2015 were examined, and 543 adult patients with a documented IO access insertion attempt were identified. The proportion of successful IO insertions was compared between AEMTs and Paramedics using a Chi-Squared statistic and a non-inferiority test. There was no significant difference in the percentage of successful IO access between AEMTs and Paramedics [95.2% and 95.6%, respectively; P = 0.84]. The confidence interval around this 0.4% difference (95% confidence interval = -4.2, 3.2) was within a pre-specified delta of ±10% indicating non-inferiority of AEMTs compared to Paramedics. This study's finding that successful IO access was not different among AEMTs and Paramedics lends evidence in support of expanding the scope of practice of AEMTs to include establishing IO access in adults.

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

PubMed

Harris, R V

2013-06-01

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

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

PubMed

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

2016-08-01

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

Enhancing healthcare accessibility measurements using GIS: A case study in Seoul, Korea

PubMed Central

Kim, Yeeun; Byon, Young-Ji

2018-01-01

With recent aging demographic trends, the needs for enhancing geo-spatial analysis capabilities and monitoring the status of accessibilities of its citizens with healthcare services have increased. The accessibility to healthcare is determined not only by geographic distances to service locations, but also includes travel time, available modes of transportation, and departure time. Having access to the latest and accurate information regarding the healthcare accessibility allows the municipal government to plan for improvements, including expansion of healthcare infrastructure, effective labor distribution, alternative healthcare options for the regions with low accessibilities, and redesigning the public transportation routes and schedules. This paper proposes a new method named, Seoul Enhanced 2-Step Floating Catchment Area (SE2SFCA), which is customized for the city of Seoul, where population density is higher and the average distance between healthcare-service locations tends to be shorter than the typical North American or European cities. The proposed method of SE2SFCA is found to be realistic and effective in determining the weak accessibility regions. It resolves the over-estimation issues of the past, arising from the assignment of high healthcare accessibility for the regions with large hospitals and high density of population and hospitals. PMID:29462194

Enhancing healthcare accessibility measurements using GIS: A case study in Seoul, Korea.

PubMed

Kim, Yeeun; Byon, Young-Ji; Yeo, Hwasoo

2018-01-01

With recent aging demographic trends, the needs for enhancing geo-spatial analysis capabilities and monitoring the status of accessibilities of its citizens with healthcare services have increased. The accessibility to healthcare is determined not only by geographic distances to service locations, but also includes travel time, available modes of transportation, and departure time. Having access to the latest and accurate information regarding the healthcare accessibility allows the municipal government to plan for improvements, including expansion of healthcare infrastructure, effective labor distribution, alternative healthcare options for the regions with low accessibilities, and redesigning the public transportation routes and schedules. This paper proposes a new method named, Seoul Enhanced 2-Step Floating Catchment Area (SE2SFCA), which is customized for the city of Seoul, where population density is higher and the average distance between healthcare-service locations tends to be shorter than the typical North American or European cities. The proposed method of SE2SFCA is found to be realistic and effective in determining the weak accessibility regions. It resolves the over-estimation issues of the past, arising from the assignment of high healthcare accessibility for the regions with large hospitals and high density of population and hospitals.

Excluding the poor from accessing biomedical literature: a rights violation that impedes global health.

PubMed

Yamey, Gavin

2008-01-01

Most biomedical journals charge readers a hefty access toll to read the full text version of a published research article. These tolls bring enormous profits to the traditional corporate publishing industry, but they make it impossible for most people worldwide--particularly in low and middle income countries--to access the biomedical literature. Traditional publishers also insist on owning the copyright on these articles, making it illegal for readers to freely distribute and photocopy papers, translate them, or create derivative educational works. This article argues that excluding the poor from accessing and freely using the biomedical research literature is harming global public health. Health care workers, for example, are prevented from accessing the information they need to practice effective medicine, while policymakers are prevented from accessing the essential knowledge they require to build better health care systems. The author proposes that the biomedical literature should be considered a global public good, basing his arguments upon longstanding and recent international declarations that enshrine access to scientific and medical knowledge as a human right. He presents an emerging alternative publishing model, called open access, and argues that this model is a more socially responsive and equitable approach to knowledge dissemination.

KSC-03PD-2453

NASA Technical Reports Server (NTRS)

2003-01-01

KENNEDY SPACE CENTER, FLA. Key officials are poised to cut the ribbon officially dedicating the new Security gates on Kennedy Parkway (Gate 2) and NASA Parkway (Gate 3). From left are Wally Schroeder, with Jones, Edmunds & Associates; Bobby Porter, with Oneida Construction; Daniel Tweed, NASA project manager; Jim Kennedy, Center director; and William Sample, SGS deputy program manager. The new gates were activated Aug. 1, allowing the general public to have access to the new Space Commerce Way, which will provide access to the Research Park and KSC Visitor Complex, and providing an alternate route for the general public between Titusville and Merritt Island that is accessible 24 hours a day. The gates are staffed 24 hours daily.

An Optically Accessible Pyrolysis Microreactor

NASA Astrophysics Data System (ADS)

Baraban, Joshua H.; David, Donald E.; Ellison, Barney; Daily, John W.

2016-06-01

We report an optically accessible pyrolysis micro-reactor suitable for in situ laser spectroscopic measurements. A radiative heating design allows for completely unobstructed views of the micro-reactor along two axes. The maximum temperature demonstrated here is only 1300 K (as opposed to 1700 K for the usual SiC micro-reactor) because of the melting point of fused silica, but alternative transparent materials will allow for higher temperatures. Laser induced fluorescence measurements on nitric oxide are presented as a proof of principle for spectroscopic characterization of pyrolysis conditions. (This work has been published in J. H. Baraban, D. E. David, G. B. Ellison, and J. W. Daily. An Optically Accessible Pyrolysis Micro-Reactor. Review of Scientific Instruments, 87(1):014101, 2016.)

Web accessibility support for visually impaired users using link content analysis.

PubMed

Iwata, Hajime; Kobayashi, Naofumi; Tachibana, Kenji; Shirogane, Junko; Fukazawa, Yoshiaki

2013-12-01

Web pages are used for a variety of purposes. End users must understand dynamically changing content and sequentially follow page links to find desired material, requiring significant time and effort. However, for visually impaired users using screen readers, it can be difficult to find links to web pages when link text and alternative text descriptions are inappropriate. Our method supports the discovery of content by analyzing 8 categories of link types, and allows visually impaired users to be aware of the content represented by links in advance. This facilitates end users access to necessary information on web pages. Our method of classifying web page links is therefore effective as a means of evaluating accessibility.

Cross-over endovascular retrieval of a lost guide wire from the subclavian vein.

PubMed

Struck, M F; Kaden, I; Heiser, A; Steen, M

2008-01-01

The lost guidewire in central venous catheterization is a commonly described complication. The percutaneous endovascular retrieval method is safe and has a very low complication rate. Guidewires extending to the inferior cava vein are usually retrieved via the femoral vein. Under special circumstances, femoral venous access may be impossible and alternative vascular approaches are required. We report a case in which we used an alternative vascular approach, from the subclavian site contralateral to the insertion, in a patient with extensive inguinal burn injuries. Cross-over subclavian retrieval can be an alternative approach for retrieval of a lost guidewire, but it involves an increased risk of puncture-related complications such as pneumothorax.

Alternative Architectures for Distributed Work in the National Airspace System

NASA Technical Reports Server (NTRS)

Smith, Philip J.; Billings, Charles E.; Chapman, Roger; Obradovich, Heintz; McCoy, C. Elaine; Orasanu, Judith

2000-01-01

The architecture for the National Airspace System (NAS) in the United States has evolved over time to rely heavily on the distribution of tasks and control authority in order to keep cognitive complexity manageable for any one individual. This paper characterizes a number of different subsystems that have been recently incorporated in the NAS. The goal of this discussion is to begin to identify the critical parameters defining the differences among alternative architectures in terms of the locus of control and in terms of access to relevant data and knowledge. At an abstract level, this analysis can be described as an effort to describe alternative "rules of the game" for the NAS.

7 CFR 650.24 - Scenic beauty (visual resource).

Code of Federal Regulations, 2010 CFR

2010-01-01

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

Post-16 Biology--Some Model Approaches?

ERIC Educational Resources Information Center

Lock, Roger

1997-01-01

Outlines alternative approaches to the teaching of difficult concepts in A-level biology which may help student learning by making abstract ideas more concrete and accessible. Examples include models, posters, and poems for illustrating meiosis, mitosis, genetic mutations, and protein synthesis. (DDR)

Dyspnea during Advanced Cancer

MedlinePlus

... to Cancer Off-Label Drug Use Access to Experimental Drugs Complementary & Alternative Medicine (CAM) CAM for Patients ... pressure on the heart. Treatment may be to control the symptoms of ... vena cava syndrome (SVCS) is a group of signs and symptoms that occur when the ...

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...

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...

Effects of intraosseous epinephrine in a cardiac arrest swine model.

PubMed

Wong, Marc R; Reggio, Matt J; Morocho, Freddy R; Holloway, Monica M; Garcia-Blanco, Jose C; Jenkins, Constance; Johnson, Arthur D

2016-04-01

Interruptions in cardiopulmonary resuscitation (CPR) to obtain vascular access reduces blood flow to vital organs. Tibial intraosseous (TIO) access may be a faster alternative to intravenous (IV) access for delivery of vasoactive medications. The purpose of this study was to examine the differences in pharmacokinetics and pharmacodynamics of TIO- and IV-delivered epinephrine. A prospective, between subjects, experimental design comparing Cmax, Tmax, return of spontaneous circulation (ROSC), and time to ROSC. Adult male swine were divided into three equal groups (n = 7) all received CPR and defibrillation: the second group received IV epinephrine and the third group received tibial intraosseous epinephrine. Swine were placed in cardiac arrest for 2 min before CPR was initiated. After 2 min of CPR, epinephrine was delivered by IV or TIO, and serial blood samples were collected over 4 min. There were no significant differences between IV versus TIO epinephrine in achieving ROSC, time to ROSC, and Cmax. A one-way analysis of variance demonstrated a significant difference between the IV and TIO groups in Tmax (P = 0.025). A Fisher exact test demonstrated a significant difference between IV epinephrine versus CPR/Defib only (P = 0.035) and TIO epinephrine versus CPR/Defib only (P = 0.010) in achieving ROSC. A multivariate analysis of variance showed significant differences in IV versus intraosseous epinephrine concentration at specific time intervals: 60 (P = 0.023), 90 (P = 0.001), and 120 (P < 0.000) sec. In the context of ROSC, epinephrine delivered via TIO route is a clinically relevant alternative to IV administration. When IV access cannot be immediately obtained in cardiac arrest patients, TIO access should be considered. Published by Elsevier Inc.

76 FR 17160 - Office of New Reactors; Final Interim Staff Guidance on the Review of Nuclear Power Plant Designs...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-28

...The NRC staff is issuing its Final Interim Staff Guidance (ISG) DC/COL-ISG-021 titled ``Interim Staff Guidance on the Review of Nuclear Power Plant Designs Using a Gas Turbine Driven Standby Emergency Alternating Current Power System,'' Agencywide Documents Access and Management System (ADAMS) Accession No. ML102510119 for DC/ COL-ISG-021 and ADAMS Accession No. ML102510164 for Attachment 1 to DC/ COL-ISG-021. This ISG provides new guidance for applicants submitting a combined license (COL) or design certification (DC) application for new nuclear power reactors under Title 10 of the Code of Federal Regulations, part 52. In addition, it supplements the guidance provided to the NRC staff in NUREG-0800, ``Standard Review Plan for the Review of Safety Analysis Reports for Nuclear Power Plants,'' March 2007, Standard Review Plan (SRP), Section 8.3.1 and Sections 9.5.4 through 9.5.8. The NRC staff issues DC/COL-ISGs to facilitate activities associated with NRC review of applications for DCs and COLs. The NRC staff intends to incorporate DC/COL-ISG-021 into the next revision of SRP Section 8.3.1 and Sections 9.5.4 through 9.5.8 and Regulatory Guide 1.206, ``Combined License Applications for Nuclear Power Plants (LWR Edition),'' June 2007. Disposition: On February 3, 2010, the NRC staff issued proposed DC/ COL-ISG-021 on ``Review of Nuclear Power Plant Designs Using a Gas Turbine Driven Standby Emergency Alternating Current Power System,'' ADAMS Accession No. ML092640035. The NRC staff received comments on the proposed guidance. This final issuance resolves the majority of the comments. The NRC staff responses to these comments can be found in ADAMS Accession No. ML102510176.

Future considerations for clinical dermatology in the setting of 21st century American policy reform: The Medicare Access and Children's Health Insurance Program Reauthorization Act and Alternative Payment Models in dermatology.

PubMed

Barbieri, John S; Miller, Jeffrey J; Nguyen, Harrison P; Forman, Howard P; Bolognia, Jean L; VanBeek, Marta J

2017-06-01

With the introduction of the Medicare Access and Children's Health Insurance Program Reauthorization Act, clinicians who are not eligible for an exemption must choose to participate in 1 of 2 new reimbursement models: the Merit-based Incentive Payment System or Alternative Payment Models (APMs). Although most dermatologists are expected to default into the Merit-based Incentive Payment System, some may have an interest in exploring APMs, which have associated financial incentives. However, for dermatologists interested in the APM pathway, there are currently no options other than joining a qualifying Accountable Care Organization, which make up only a small subset of Accountable Care Organizations overall. As a result, additional APMs relevant to dermatologists are needed to allow those interested in the APMs to explore this pathway. Fortunately, the Medicare Access and Children's Health Insurance Program Reauthorization Act establishes a process for new APMs to be approved and the creation of bundled payments for skin diseases may represent an opportunity to increase the number of APMs available to dermatologists. In this article, we will provide a detailed review of APMs under the Medicare Access and Children's Health Insurance Program Reauthorization Act and discuss the development and introduction of APMs as they pertain to dermatology. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Evaluating a NoSQL Alternative for Chilean Virtual Observatory Services

NASA Astrophysics Data System (ADS)

Antognini, J.; Araya, M.; Solar, M.; Valenzuela, C.; Lira, F.

2015-09-01

Currently, the standards and protocols for data access in the Virtual Observatory architecture (DAL) are generally implemented with relational databases based on SQL. In particular, the Astronomical Data Query Language (ADQL), language used by IVOA to represent queries to VO services, was created to satisfy the different data access protocols, such as Simple Cone Search. ADQL is based in SQL92, and has extra functionality implemented using PgSphere. An emergent alternative to SQL are the so called NoSQL databases, which can be classified in several categories such as Column, Document, Key-Value, Graph, Object, etc.; each one recommended for different scenarios. Within their notable characteristics we can find: schema-free, easy replication support, simple API, Big Data, etc. The Chilean Virtual Observatory (ChiVO) is developing a functional prototype based on the IVOA architecture, with the following relevant factors: Performance, Scalability, Flexibility, Complexity, and Functionality. Currently, it's very difficult to compare these factors, due to a lack of alternatives. The objective of this paper is to compare NoSQL alternatives with SQL through the implementation of a Web API REST that satisfies ChiVO's needs: a SESAME-style name resolver for the data from ALMA. Therefore, we propose a test scenario by configuring a NoSQL database with data from different sources and evaluating the feasibility of creating a Simple Cone Search service and its performance. This comparison will allow to pave the way for the application of Big Data databases in the Virtual Observatory.

How Complementary and Alternative Medicine Practitioners Use PubMed

PubMed Central

Quint-Rapoport, Mia

2007-01-01

Background PubMed is the largest bibliographic index in the life sciences. It is freely available online and is used by professionals and the public to learn more about medical research. While primarily intended to serve researchers, PubMed provides an array of tools and services that can help a wider readership in the location, comprehension, evaluation, and utilization of medical research. Objective This study sought to establish the potential contributions made by a range of PubMed tools and services to the use of the database by complementary and alternative medicine practitioners. Methods In this study, 10 chiropractors, 7 registered massage therapists, and a homeopath (N = 18), 11 with prior research training and 7 without, were taken through a 2-hour introductory session with PubMed. The 10 PubMed tools and services considered in this study can be divided into three functions: (1) information retrieval (Boolean Search, Limits, Related Articles, Author Links, MeSH), (2) information access (Publisher Link, LinkOut, Bookshelf ), and (3) information management (History, Send To, Email Alert). Participants were introduced to between six and 10 of these tools and services. The participants were asked to provide feedback on the value of each tool or service in terms of their information needs, which was ranked as positive, positive with emphasis, negative, or indifferent. Results The participants in this study expressed an interest in the three types of PubMed tools and services (information retrieval, access, and management), with less well-regarded tools including MeSH Database and Bookshelf. In terms of their comprehension of the research, the tools and services led the participants to reflect on their understanding as well as their critical reading and use of the research. There was universal support among the participants for greater access to complete articles, beyond the approximately 15% that are currently open access. The abstracts provided by PubMed were felt to be necessary in selecting literature to read but entirely inadequate for both evaluating and learning from the research. Thus, the restrictions and fees the participants faced in accessing full-text articles were points of frustration. Conclusions The study found strong indications of PubMed’s potential value in the professional development of these complementary and alternative medicine practitioners in terms of engaging with and understanding research. It provides support for the various initiatives intended to increase access, including a recommendation that the National Library of Medicine tap into the published research that is being archived by authors in institutional archives and through other websites. PMID:17613489

Rise of Human Intelligence: Comments on Howard (1999).

ERIC Educational Resources Information Center

Gobet, Fernand; Campitelli, Guillermo; Waters, Andrew J.

2002-01-01

Finds several difficulties with the theory advanced by R. Howard and shows that alternative explanations relating to changes in the chess environment, including increased access to chess knowledge, offer better explanations for the increased presence of young players at top-level chess. (SLD)

Gateway National Recreation Area, Jamaica Bay Unit alternative transportation feasibility study

DOT National Transportation Integrated Search

2013-07-31

The National Park Service Gateway National Recreation Area (GATE) was created to provide convenient access to outdoor recreation in the National Park System for residents and visitors to the New York City (NYC) area. The Volpe Center completed a numb...

Preparation of School District Budgets with Microcomputer Electronic Spreadsheets.

ERIC Educational Resources Information Center

Hinitz, Herman J.

1996-01-01

Preparing a microcomputer electronic spreadsheet containing all relevant school district budgetary information is possible with currently available hardware and software (such as Lotus 1-2-3), despite random-access-memory limitations. Spreadsheets can provide financial summaries, inventory-control listings, scheduling alternatives,…

40 CFR 142.43 - Disposition of a variance request.

Code of Federal Regulations, 2012 CFR

2012-07-01

... no access to an alternative raw water source, and can effect or anticipate no adequate improvement of....43 Section 142.43 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS IMPLEMENTATION Variances Issued by the...

Cape Cod National Seashore integrated parking and transit study

DOT National Transportation Integrated Search

2010-12-31

Beach parking adjacent to the ever changing coastline of the Lower/Outer Cape is subject to erosion. In order to maintain access to the beaches without paving over additional NPS land, this study looks at alternative parking locations and the feasibi...

MedlinePlus FAQ: Can I play videos on my phone or tablet?

MedlinePlus

... MedlinePlus also links to video content on the Internet. Some videos might not play on your mobile device. Text alternatives are available for video content licensed by MedlinePlus: Access closed captioning for health videos with the CC ...

34 CFR 104.22 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., delivery of health, welfare, or other social services at alternate accessible sites, alteration of existing... not required to make structural changes in existing facilities where other methods are effective in... handicapped persons in the most integrated setting appropriate. (c) Small health, welfare, or other social...

[Alternative medicine, beliefs, and management of people with HIV in Gabon].

PubMed

Yaba, W; Chippaux, J P; Obiang-Ndong, G P; Msellati, P

2013-01-01

According to WHO, 80% of the population in Africa has used alternative medicine for primary health care at least once. Gabon continues to have a high prevalence of HIV, estimated in 2011 at 5.2%. Overall, 22 253 PLWHA (people living with HIV/AIDS) - adults and children - are being treated, including 9976 on ARVs (antiretroviral drugs). The procedures for ARV initiation are very long, ARVs are frequently out of stock, and treatment in care centers for PLWHA is stigmatized: all these factors favor the development of alternative medicine for HIV care in Gabon. To analyze the impact of alternative medicine in the treatment of PLWHA in Gabon. This cross-sectional survey was conducted during a total of four months between May 2009 and September 2010 among PLWHA older than 18 years who had been receiving ARVs for at least 6 months and consented to participate (7 centers) and among physicians and other caregivers of these centers (8 centers). We used a simple random sample method. Epidata software was used for data collection, and the analyses were performed with SAS™ software. Of the 5752 patients on ARVs followed at the 7 study sites, 422 PLWHA were interviewed (58.3% of them women): 284 (67.29%) in Libreville and 138 (38.7) in the provinces. Christians accounted for 90.5% (including 21.5% from Protestant evangelical churches), and Muslins for 5.68%, while 4% stated that they had no religion. 12.5% of doctors referred their patients to religious or spiritual groups. Our study showed that half of PLWHA did not know the procedures for access to ARV treatment and that beliefs about HIV/AIDS differed strongly according to place of residence. Finally, the cultural context related to alternative medicine is very present in the PLWHA treatment settings in Gabon. Although PLWHAs have easy access to ARVs, their association with organized and controlled alternative medicine can be beneficial.

A Randomized Cadaver Study Comparing First-Attempt Success Between Tibial and Humeral Intraosseous Insertions Using NIO Device by Paramedics: A Preliminary Investigation.

PubMed

Szarpak, Lukasz; Truszewski, Zenon; Smereka, Jacek; Krajewski, Paweł; Fudalej, Marcin; Adamczyk, Piotr; Czyzewski, Lukasz

2016-05-01

Medical personnel may encounter difficulties in obtaining intravenous (IV) access during cardiac arrest. The 2015 American Heart Association guidelines and the 2015 European Resuscitation Council guidelines for cardiopulmonary resuscitation (CPR) suggest that rescuers establish intraosseous (IO) access if an IV line is not easily obtainable.The aim of the study was to compare the success rates of the IO proximal tibia and proximal humerus head access performed by paramedics using the New Intraosseous access device (NIO; Persys Medical, Houston, TX, USA) in an adult cadaver model during simulated CPR.In an interventional, randomized, crossover, single-center cadaver study, a semi-automatic spring-load driven NIO access device was investigated. In total, 84 paramedics with less than 5-year experience in Emergency Medical Service participated in the study. The trial was performed on 42 adult cadavers. In each cadaver, 2 IO accesses to the humerus head, and 2 IO accesses to the proximal tibia were obtained.The success rate of the first IO attempt was 89.3% (75/84) for tibial access, and 73.8% (62/84) for humeral access (P = 0.017). The procedure times were significantly faster for tibial access [16.8 (interquartile range, IQR, 15.1-19.9] s] than humeral access [26.7 (IQR, 22.1-30.9) s] (P < 0.001).Tibial IO access is easier and faster to put in place than humeral IO access. Humeral IO access can be an alternative method to tibial IO access. clinicaltrials.gov Identifier: NCT02700867.

Policy alternatives for reducing tobacco sales to minors: results from a national survey of retail chain and franchise stores.

PubMed

Altman, D G; Linzer, J; Kropp, R; Descheemaeker, N; Feighery, E; Fortmann, S P

1992-01-01

Minors' access to tobacco has become an important public health issue. Little is known, however, about the knowledge, attitudes, beliefs, and behavior toward access among executives from businesses that sell tobacco. This study examined access from the perspective of corporate and regional headquarters of retail chains and franchises that sell tobacco. A total of 148 U.S. companies with the largest overall retail sales volume that sold tobacco were asked to participate; 91 agreed. The sample included grocery stores, convenience stores, gas station mini-marts, liquor stores, and drug stores. Data revealed at least moderate support for policies limiting youth tobacco access. Although most companies reported having in place policies to prevent minors from purchasing tobacco, these policies did not seem intensive. In addition, executives underestimated the extent of youth access. We conclude that the time is right for passage of bold policies to protect young people from tobacco.

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

PubMed

Doebler, Stefanie

2016-05-01

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

An examination of within-session responding following access to reinforcing stimuli.

PubMed

Rispoli, Mandy; O'Reilly, Mark; Lang, Russell; Machalicek, Wendy; Kang, Soyeon; Davis, Tonya; Neely, Leslie

2016-01-01

Previous research has shown tangibly maintained challenging behavior can be temporarily decreased by providing presession access to the relevant tangible. However, the duration of this beneficial effect is unknown. We measured the subsequent duration of behavior reduction effects following presession access during extended classroom observation sessions by analyzing within-session patterns of responding in three children with autism. An alternating treatments design was used to analyze within- and across-session responding following presession access and presession restriction conditions. The cumulative frequency of challenging behavior was higher following the presession restriction condition for all participants and lower following presession access. Within-session analysis revealed the same basic pattern of responding across participants. Specifically, the first half of the sessions contained very little, if any, challenging behavior; however, after 60 min, the rate of challenging behavior began to increase rapidly for two of the three participants. Results are discussed in terms of implications for practitioners, satiation, habituation, and behavioral contrast. Copyright © 2015 Elsevier Ltd. All rights reserved.

Surfing the Net--information on the World Wide Web for persons with arthritis: patient empowerment or patient deceit?

PubMed

Suarez-Almazor, M E; Kendall, C J; Dorgan, M

2001-01-01

In the past few years access to the Internet has become readily available. Patients are increasingly seeking and obtaining health information through the Internet, most often the World Wide Web (WWW). We assessed the content, authorship, and scope of the information available on WWW in relation to rheumatoid arthritis. In an attempt to replicate use by the average person, a broad search of the Internet was conducted for the phrase "rheumatoid arthritis" using WebCrawler, a commonly used search engine. All the "hits" were critically assessed after visiting and collecting information from the respective Web sites in relation to relevance, scope, authorship, type of publication, and financial objectives. The search returned 537 hits. We evaluated 531-2 did not exist, 2 could not be contacted, one was not in English, and one required a membership to access. The 531 hits originated from 388 Web sites. Only 198 (51%) were considered to be relevant and 7 (2%) were of doubtful relevance. Thirty-four (17%) were posted by an individual, 57 (28%) by a nonprofit organization, 104 (51%) by a profit industry, and 10 (5%) by universities. Ninety-one (44%) promoted alternative therapies, the most common including cetyl-myristoleate, colloidal minerals, Pycnogenol, shark cartilage, and Tahitian Noni. Of the 107 sites with financial interests, 76 (71%) promoted alternative medicine. The first 100 hits only identified about a third of the nonprofit organizations or university owned Web pages. Many sites easily accessed by consumers appear to be profit based companies advertising an alternative product claimed to be effective for many conditions. These findings emphasize the need for critical evaluation of Web site contents.

Assistive device with conventional, alternative, and brain-computer interface inputs to enhance interaction with the environment for people with amyotrophic lateral sclerosis: a feasibility and usability study.

PubMed

Schettini, Francesca; Riccio, Angela; Simione, Luca; Liberati, Giulia; Caruso, Mario; Frasca, Vittorio; Calabrese, Barbara; Mecella, Massimo; Pizzimenti, Alessia; Inghilleri, Maurizio; Mattia, Donatella; Cincotti, Febo

2015-03-01

To evaluate the feasibility and usability of an assistive technology (AT) prototype designed to be operated with conventional/alternative input channels and a P300-based brain-computer interface (BCI) in order to provide users who have different degrees of muscular impairment resulting from amyotrophic lateral sclerosis (ALS) with communication and environmental control applications. Proof-of-principle study with a convenience sample. An apartment-like space designed to be fully accessible by people with motor disabilities for occupational therapy, placed in a neurologic rehabilitation hospital. End-users with ALS (N=8; 5 men, 3 women; mean age ± SD, 60 ± 12 y) recruited by a clinical team from an ALS center. Three experimental conditions based on (1) a widely validated P300-based BCI alone; (2) the AT prototype operated by a conventional/alternative input device tailored to the specific end-user's residual motor abilities; and (3) the AT prototype accessed by a P300-based BCI. These 3 conditions were presented to all participants in 3 different sessions. System usability was evaluated in terms of effectiveness (accuracy), efficiency (written symbol rate, time for correct selection, workload), and end-user satisfaction (overall satisfaction) domains. A comparison of the data collected in the 3 conditions was performed. Effectiveness and end-user satisfaction did not significantly differ among the 3 experimental conditions. Condition III was less efficient than condition II as expressed by the longer time for correct selection. A BCI can be used as an input channel to access an AT by persons with ALS, with no significant reduction of usability. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Should PGY-1 Be Mandatory in Dental Education? Two Viewpoints: Viewpoint 1: PGY-1 Provides Benefits That Support Making It Mandatory and Viewpoint 2: PGY-1 Should Be Available for Dental Graduates But Not Mandatory.

PubMed

Dhar, Vineet; Glascoe, Alison; Esfandiari, Shahrokh; Williams, Kelly B; McQuistan, Michelle R; Stevens, Mark R

2016-11-01

This Point/Counterpoint considers whether a general dentistry postgraduate year one (PGY-1) residency should be required for all new graduates who do not pursue specialty training. Currently, New York and Delaware require PGY-1 for dental licensure, while other states offer it as an alternative to a clinical examination for obtaining licensure. Viewpoint 1 supports the position that PGY-1 should be mandatory by presenting evidence that PGY-1 residencies fulfill new graduates' need for additional clinical training, enhance their professionalism and practice management skills, and improve access to care. The authors also discuss two barriers-the limited number of postdoctoral positions and the high cost-and suggest ways to overcome them. In contrast, Viewpoint 2 opposes mandatory PGY-1 training. While these authors consider the same core concepts as Viewpoint 1 (education and access to care), they present alternative methods for addressing perceived educational shortcomings in predoctoral curricula. They also examine the competing needs of underserved populations and residents and the resulting impact on access to care, and they discuss the potential conflict of interest associated with asking PGY-1 program directors to assess their residents' competence for licensure.

Comparisons of Prevention Programs for Homeless Youth

PubMed Central

Rotheram-Borus, Mary Jane

2014-01-01

There are six HIV prevention programs for homeless youth whose efficacy has been or is currently being evaluated: STRIVE, the Community Reinforcement Approach, Strengths-Based Case Management, Ecologically-Based Family Therapy, Street Smart, and AESOP (street outreach access to resources). Programs vary in their underlying framework and theoretical models for understanding homelessness. All programs presume that the youths’ families lack the ability to support their adolescent child. Some programs deemphasize family involvement while others focus on rebuilding connections among family members. The programs either normalize current family conflicts or, alternatively, provide education about the importance of parental monitoring. All programs aim to reduce HIV-related sexual and drug use acts. A coping skills approach is common across programs: Problem-solving skills are specifically addressed in four of the six programs; alternatively, parents in other programs are encouraged to contingently reward their children. Each program also engineers ongoing social support for the families and the youth, either by providing access to needed resources or by substituting a new, supportive relationship for the existing family caretaker. All of the interventions provide access to health and mental health services as basic program resources. A comparison of HIV prevention programs for homeless youth identifies the robust components of each and suggests which programs providers may choose to replicate. PMID:19067164

Comparisons of prevention programs for homeless youth.

PubMed

Arnold, Elizabeth Mayfield; Rotheram-Borus, Mary Jane

2009-03-01

There are six HIV prevention programs for homeless youth whose efficacy has been or is currently being evaluated: STRIVE, the Community Reinforcement Approach, Strengths-Based Case Management, Ecologically-Based Family Therapy, Street Smart, and AESOP (street outreach access to resources). Programs vary in their underlying framework and theoretical models for understanding homelessness. All programs presume that the youths' families lack the ability to support their adolescent child. Some programs deemphasize family involvement while others focus on rebuilding connections among family members. The programs either normalize current family conflicts or, alternatively, provide education about the importance of parental monitoring. All programs aim to reduce HIV-related sexual and drug use acts. A coping skills approach is common across programs: Problem-solving skills are specifically addressed in four of the six programs; alternatively, parents in other programs are encouraged to contingently reward their children. Each program also engineers ongoing social support for the families and the youth, either by providing access to needed resources or by substituting a new, supportive relationship for the existing family caretaker. All of the interventions provide access to health and mental health services as basic program resources. A comparison of HIV prevention programs for homeless youth identifies the robust components of each and suggests which programs providers may choose to replicate.

Understanding untreated hypertension from patients' point of view: A qualitative study in rural Yogyakarta province, Indonesia.

PubMed

Rahmawati, Riana; Bajorek, Beata

2017-01-01

Objectives This study aimed to explore perspectives about hypertension from patients who do not take anti-hypertensive medications. Factors that shape their perspectives as well as patients' expectations were also canvassed. Method Individual, face-to-face interviews were conducted with 30 people (≥45 years old) living in rural villages, diagnosed with hypertension, who had not taken any anti-hypertensive medications for at least one year. Interviews were audiotaped, transcribed verbatim and thematically analysed. Results Four themes emerged: (1) alternative medicines for managing high blood pressure; (2) accessing health care services; (3) the need for anti-hypertensive medications; and (4) existing support and patients' expectations. Reluctance to take anti-hypertensive medications was influenced by patients' beliefs in personal health threats and the effectiveness of anti-hypertensive medications, high self-efficacy for taking alternative medicines, the lack of recommendation regarding hypertension treatment, and barriers to accessing supplies of medicines. Conclusion Despite their awareness of being diagnosed with hypertension, patients undervalued visiting a health professional to control their high blood pressure. Health strategies need to consider patients' beliefs, concerns and expectations. Providing an accessible, affordable and adequate supply of hypertension medication is also key to any programs designed to optimise hypertension management.

Role of Alternative Donor Allogeneic Transplants in the Therapy of Acute Myeloid Leukemia.

PubMed

Elmariah, Hany; Pratz, Keith W

2017-07-01

Adult acute myeloid leukemia (AML) is often associated with a poor prognosis, with allogeneic transplantation representing the greatest chance of cure for eligible patients. Historically, the preferred donor source is a human leukocyte antigen-matched blood relative, although only approximately 30% of patients have access to such a donor. Alternative donor sources, including matched unrelated donors, umbilical cord blood, and haploidentical related donors, are available for almost every patient and are increasingly being used for patients without a matched related donor. Survival outcomes with these alternative donor sources now approximate those of matched related donor transplants. Given the safety and success of alternative donor transplants, comparative trials are needed to reassess the optimal donor source for patients with AML. This review summarizes the available data on these alternative donor transplants. Further investigation is needed to contemporize donor selection algorithms, but, in the current era, donor availability should no longer preclude a patient's eligibility for an allogeneic blood or marrow transplant. Copyright © 2017 by the National Comprehensive Cancer Network.

African American and Latino Low Income Families’ Food Shopping Behaviors: Promoting Fruit and Vegetable Consumption and Use of Alternative Healthy Food Options

PubMed Central

Fish, Caitlin A.; Brown, Jonisha R.; Quandt, Sara A.

2014-01-01

Introduction Minority families often reside in neighborhoods with few supermarkets or alternative healthy food options (e.g., farmers markets, community gardens), making fresh produce difficult to obtain. This qualitative study identified factors influencing fruit and vegetable shopping and use of alternative healthy food options. Methods Forty-eight minority women with children completed interviews regarding food shopping habits and use of and attitudes toward alternative healthy food options. Interviews were subjected to thematic analysis. Results Produce shopping was motivated by costs and family preferences. For African American women, poor cooking skills restricted the variety of fruits and vegetables purchased. Latinas were receptive to alternative healthy food options, but did not use them because these sources were inconvenient. African American women were not receptive to them. Conclusion Improving cooking skills and perceptions of acceptable foods may be as important as increased access to promote greater consumption of fruits and vegetables. PMID:24293075

Splicing-related genes are alternatively spliced upon changes in ambient temperatures in plants

PubMed Central

Bucher, Johan; Lammers, Michiel; Busscher-Lange, Jacqueline; Bonnema, Guusje; Rodenburg, Nicole; Proveniers, Marcel C. G.; Angenent, Gerco C.

2017-01-01

Plants adjust their development and architecture to small variations in ambient temperature. In a time in which temperatures are rising world-wide, the mechanism by which plants are able to sense temperature fluctuations and adapt to it, is becoming of special interest. By performing RNA-sequencing on two Arabidopsis accession and one Brassica species exposed to temperature alterations, we showed that alternative splicing is an important mechanism in ambient temperature sensing and adaptation. We found that amongst the differentially alternatively spliced genes, splicing related genes are enriched, suggesting that the splicing machinery itself is targeted for alternative splicing when temperature changes. Moreover, we showed that many different components of the splicing machinery are targeted for ambient temperature regulated alternative splicing. Mutant analysis of a splicing related gene that was differentially spliced in two of the genotypes showed an altered flowering time response to different temperatures. We propose a two-step mechanism where temperature directly influences alternative splicing of the splicing machinery genes, followed by a second step where the altered splicing machinery affects splicing of downstream genes involved in the adaptation to altered temperatures. PMID:28257507

Identification of Alternative Splice Variants Using Unique Tryptic Peptide Sequences for Database Searches.

PubMed

Tran, Trung T; Bollineni, Ravi C; Strozynski, Margarita; Koehler, Christian J; Thiede, Bernd

2017-07-07

Alternative splicing is a mechanism in eukaryotes by which different forms of mRNAs are generated from the same gene. Identification of alternative splice variants requires the identification of peptides specific for alternative splice forms. For this purpose, we generated a human database that contains only unique tryptic peptides specific for alternative splice forms from Swiss-Prot entries. Using this database allows an easy access to splice variant-specific peptide sequences that match to MS data. Furthermore, we combined this database without alternative splice variant-1-specific peptides with human Swiss-Prot. This combined database can be used as a general database for searching of LC-MS data. LC-MS data derived from in-solution digests of two different cell lines (LNCaP, HeLa) and phosphoproteomics studies were analyzed using these two databases. Several nonalternative splice variant-1-specific peptides were found in both cell lines, and some of them seemed to be cell-line-specific. Control and apoptotic phosphoproteomes from Jurkat T cells revealed several nonalternative splice variant-1-specific peptides, and some of them showed clear quantitative differences between the two states.

Evaluating the impact of climate policies on regional food availability and accessibility using an Integrated Assessment Model

NASA Astrophysics Data System (ADS)

Gilmore, E.; Cui, Y. R.; Waldhoff, S.

2015-12-01

Beyond 2015, eradicating hunger will remain a critical part of the global development agenda through the Sustainable Development Goals (SDG). Efforts to limit climate change through both mitigation of greenhouse gas emissions and land use policies may interact with food availability and accessibility in complex and unanticipated ways. Here, we develop projections of regional food accessibility to 2050 under the alternative futures outlined by the Shared Socioeconomic Pathways (SSPs) and under different climate policy targets and structures. We use the Global Change Assessment Model (GCAM), an integrated assessment model (IAM), for our projections. We calculate food access as the weighted average of consumption of five staples and the portion of income spend on those commodities and extend the GCAM calculated universal global producer price to regional consumer prices drawing on historical relationships of these prices. Along the SSPs, food access depends largely on expectations of increases in population and economic status. Under a more optimistic scenario, the pressures on food access from increasing demand and rising prices can be counterbalanced by faster economic development. Stringent climate policies that increase commodity prices, however, may hinder vulnerable regions, namely Sub-Saharan Africa, from achieving greater food accessibility.

Fly-by-Wireless Update

NASA Technical Reports Server (NTRS)

Studor, George

2010-01-01

The presentation reviews what is meant by the term 'fly-by-wireless', common problems and motivation, provides recent examples, and examines NASA's future and basis for collaboration. The vision is to minimize cables and connectors and increase functionality across the aerospace industry by providing reliable, lower cost, modular, and higher performance alternatives to wired data connectivity to benefit the entire vehicle/program life-cycle. Focus areas are system engineering and integration methods to reduce cables and connectors, vehicle provisions for modularity and accessibility, and a 'tool box' of alternatives to wired connectivity.

Medical approaches to suffering are limited, so why critique Improving Access to Psychological Therapies from the same ideology.

PubMed

Binnie, James

2018-04-01

Although the article by Scott rightly questions the dynamics of the Improving Access to Psychological Therapies system and re-examines the recovery rates, finding quite shocking results, his recommendations are ultimately flawed. There is a strong critique of the diagnostic procedures in Improving Access to Psychological Therapies services, but the answer is not to diagnose more rigorously and to adhere more strictly to a manualised approach to psychotherapy. The opposite may be required. Alternatives to the medical model of distress offer a less stigmatising and more human approach to helping people with their problems. Perhaps psychological therapists and the people they work alongside would be better served by a psychological approach rather than a psychiatric one.

[Laparoscopic hysterectomy--brief history, frequency, indications and contraindications].

PubMed

Tomov, S; Gorchev, G; Tzvetkov, Ch; Tanchev, L; Iliev, S

2012-01-01

Hysterectomy is the most common gynecological operation after Caesarean section and the laparoscopic access to uterus removal is one of the contemporary methods showing slow but steady growth in time. In reference to indications and contraindications for laparoscopic hysterectomy, the following directions emerge as controversial: malignant gynecological tumors, uterus size, and high body mass index. Laparoscopic hysterectomy can be taken into consideration at the first stage of endometrial, cervical and ovarian cancer. If there is doubt about an uterus sarcoma and a laparoscopic access is accomplished, a conversion to abdominal hysterectomy must be done. Obesity and big uteri are not a contrarindication for that minimally-invasive access. Today, laparoscopic hysterectomy is a reasonable alternative to total abdominal and vaginal hysterectomy.

Information campaign and advocacy efforts to promote access to emergency contraception in Mexico.

PubMed

Ellertson, Charlotte; Heimburger, Angela; Acevedo-Garcia, Dolores; Schiavon, Raffaela; Mejia, Guillermina; Corona, Georgina; del Castillo, Eduardo; Langer, Ana

2002-11-01

Emergency contraception (EC) has the potential to reduce unwanted pregnancy significantly, in Mexico as elsewhere. Recent years have seen tremendous growth in programs and research devoted to expanding access to emergency methods worldwide. In Mexico we developed a comprehensive model introduction effort that included four components: provider training, public information (through a dedicated hotline and website, free media, paid radio and TV spots, participation in talk shows, and alternative media channels), collaboration with the public sector to include EC in the official family planning norms, and assistance to partner with commercial firms to register a dedicated EC product. Ongoing efforts to combat misperceptions and overcome opposition are crucial to informing the public and ensuring greater access to the method.

Random-access technique for modular bathymetry data storage in a continental shelf wave refraction program

NASA Technical Reports Server (NTRS)

Poole, L. R.

1974-01-01

A study was conducted of an alternate method for storage and use of bathymetry data in the Langley Research Center and Virginia Institute of Marine Science mid-Atlantic continental-shelf wave-refraction computer program. The regional bathymetry array was divided into 105 indexed modules which can be read individually into memory in a nonsequential manner from a peripheral file using special random-access subroutines. In running a sample refraction case, a 75-percent decrease in program field length was achieved by using the random-access storage method in comparison with the conventional method of total regional array storage. This field-length decrease was accompanied by a comparative 5-percent increase in central processing time and a 477-percent increase in the number of operating-system calls. A comparative Langley Research Center computer system cost savings of 68 percent was achieved by using the random-access storage method.

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

PubMed

McGowan, James G

2013-09-01

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

JavaScript Access to DICOM Network and Objects in Web Browser.

PubMed

Drnasin, Ivan; Grgić, Mislav; Gogić, Goran

2017-10-01

Digital imaging and communications in medicine (DICOM) 3.0 standard provides the baseline for the picture archiving and communication systems (PACS). The development of Internet and various communication media initiated demand for non-DICOM access to PACS systems. Ever-increasing utilization of the web browsers, laptops and handheld devices, as opposed to desktop applications and static organizational computers, lead to development of different web technologies. The DICOM standard officials accepted those subsequently as tools of alternative access. This paper provides an overview of the current state of development of the web access technology to the DICOM repositories. It presents a different approach of using HTML5 features of the web browsers through the JavaScript language and the WebSocket protocol by enabling real-time communication with DICOM repositories. JavaScript DICOM network library, DICOM to WebSocket proxy and a proof-of-concept web application that qualifies as a DICOM 3.0 device were developed.

Tribal Energy Program for California Indian Tribes

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

Singer, S.

A strategic plan is needed to catalyze clean energy in the more than 100 California Indian tribal communities with varying needs and energy resources. We propose to conduct a scoping study to identify tribal lands with clean energy potential, as well as communities with lack of grid-tied energy and communications access. The research focus would evaluate the energy mixture and alternatives available to these tribal communities, and evaluate greenhouse gas emissions associated with accessing fossil fuel used for heat and power. Understanding the baseline of energy consumption and emissions of communities is needed to evaluate improvements and advances from technology.more » Based on this study, we will develop a strategic plan that assesses solutions to address high energy fuel costs due to lack of electricity access and inform actions to improve economic opportunities for tribes. This could include technical support for tribes to access clean energy technologies and supporting collaboration for on-site demonstrations.« less

STC synthesis of transportation funding sources and alternatives in the southeastern states now and in the future.

DOT National Transportation Integrated Search

2015-03-01

In recent years, the demand for reliable transportation access has increased, but this has been : accompanied by rising uncertainty over funding availability. The precarious fiscal situation : facing many states has ratcheted up pressure on transport...

Multifarenes: new modular cavitands.

PubMed

Parvari, Galit; Annamalai, Senthilmurugan; Borovoi, Iris; Chechik, Helena; Botoshansky, Mark; Pappo, Doron; Keinan, Ehud

2014-03-07

Multifarenes, a new class of macrocycles, which are constructed of alternating building blocks, are conveniently accessible by three complementary syntheses that provide modularity and scalability. In addition to metal-ion coordination, these cavitands show increased flexibility with increasing ring size, offering opportunities for induced fit to guest molecules.

43 CFR 36.13 - Special provisions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Arctic National Park and Preserve. (1) Access for surface transportation purposes across Gates of the Arctic National Park and Preserve (from the Ambler Mining District to the Alaska Pipeline Haul Road... economically feasible or otherwise reasonably available alternate route. (c) Oil and Gas Pipelines—Arctic Slope...

43 CFR 36.13 - Special provisions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Arctic National Park and Preserve. (1) Access for surface transportation purposes across Gates of the Arctic National Park and Preserve (from the Ambler Mining District to the Alaska Pipeline Haul Road... economically feasible or otherwise reasonably available alternate route. (c) Oil and Gas Pipelines—Arctic Slope...

Eddy Currents: Levitation, Metal Detectors, and Induction Heating

ERIC Educational Resources Information Center

Wouch, G.; Lord, A. E., Jr.

1978-01-01

A simple and accessible calculation is given of the effects of eddy currents for a sphere in the field of a single circular loop of alternating current. These calculations should help toward the inclusion of eddy current effects in upper undergraduate physics courses. (BB)

Substrate-bound outward-open state of the betaine transporter BetP provides insights into Na+ coupling

NASA Astrophysics Data System (ADS)

Perez, Camilo; Faust, Belinda; Mehdipour, Ahmad Reza; Francesconi, Kevin A.; Forrest, Lucy R.; Ziegler, Christine

2014-07-01

The Na+-coupled betaine symporter BetP shares a highly conserved fold with other sequence unrelated secondary transporters, for example, with neurotransmitter symporters. Recently, we obtained atomic structures of BetP in distinct conformational states, which elucidated parts of its alternating-access mechanism. Here, we report a structure of BetP in a new outward-open state in complex with an anomalous scattering substrate, adding a fundamental piece to an unprecedented set of structural snapshots for a secondary transporter. In combination with molecular dynamics simulations these structural data highlight important features of the sequential formation of the substrate and sodium-binding sites, in which coordinating water molecules play a crucial role. We observe a strictly interdependent binding of betaine and sodium ions during the coupling process. All three sites undergo progressive reshaping and dehydration during the alternating-access cycle, with the most optimal coordination of all substrates found in the closed state.

An alternative resource sharing scheme for land mobile satellite services

NASA Technical Reports Server (NTRS)

Yan, Tsun-Yee; Sue, Miles K.

1990-01-01

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

Side-chain mobility in the folded state of Myoglobin

NASA Astrophysics Data System (ADS)

Lammert, Heiko; Onuchic, Jose

We study the accessibility of alternative side-chain rotamer configurations in the native state of Myoglobin, using an all-atom structure-based model. From long, unbiased simulation trajectories we determine occupancies of rotameric states and also estimate configurational and vibrational entropies. Direct sampling of the full native-state dynamics, enabled by the simple model, reveals facilitation of side-chain motions by backbone dynamics. Correlations between different dihedral angles are quantified and prove to be weak. We confirm global trends in the mobilities of side-chains, following burial and also the chemical character of residues. Surface residues loose little configurational entropy upon folding; side-chains contribute significantly to the entropy of the folded state. Mobilities of buried side-chains vary strongly with temperature. At ambient temperature, individual side-chains in the core of the protein gain substantial access to alternative rotamers, with occupancies that are likely observable experimentally. Finally, the dynamics of buried side-chains may be linked to the internal pockets, available to ligand gas molecules in Myoglobin.

Assessing implicit models for nonpolar mean solvation forces: The importance of dispersion and volume terms

PubMed Central

Wagoner, Jason A.; Baker, Nathan A.

2006-01-01

Continuum solvation models provide appealing alternatives to explicit solvent methods because of their ability to reproduce solvation effects while alleviating the need for expensive sampling. Our previous work has demonstrated that Poisson-Boltzmann methods are capable of faithfully reproducing polar explicit solvent forces for dilute protein systems; however, the popular solvent-accessible surface area model was shown to be incapable of accurately describing nonpolar solvation forces at atomic-length scales. Therefore, alternate continuum methods are needed to reproduce nonpolar interactions at the atomic scale. In the present work, we address this issue by supplementing the solvent-accessible surface area model with additional volume and dispersion integral terms suggested by scaled particle models and Weeks–Chandler–Andersen theory, respectively. This more complete nonpolar implicit solvent model shows very good agreement with explicit solvent results and suggests that, although often overlooked, the inclusion of appropriate dispersion and volume terms are essential for an accurate implicit solvent description of atomic-scale nonpolar forces. PMID:16709675

Design Sketches For Optical Crossbar Switches Intended For Large-Scale Parallel Processing Applications

NASA Astrophysics Data System (ADS)

Hartmann, Alfred; Redfield, Steve

1989-04-01

This paper discusses design of large-scale (1000x 1000) optical crossbar switching networks for use in parallel processing supercom-puters. Alternative design sketches for an optical crossbar switching network are presented using free-space optical transmission with either a beam spreading/masking model or a beam steering model for internodal communications. The performances of alternative multiple access channel communications protocol-unslotted and slotted ALOHA and carrier sense multiple access (CSMA)-are compared with the performance of the classic arbitrated bus crossbar of conventional electronic parallel computing. These comparisons indicate an almost inverse relationship between ease of implementation and speed of operation. Practical issues of optical system design are addressed, and an optically addressed, composite spatial light modulator design is presented for fabrication to arbitrarily large scale. The wide range of switch architecture, communications protocol, optical systems design, device fabrication, and system performance problems presented by these design sketches poses a serious challenge to practical exploitation of highly parallel optical interconnects in advanced computer designs.

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.

An alternative resource sharing scheme for land mobile satellite services

NASA Astrophysics Data System (ADS)

Yan, Tsun-Yee; Sue, Miles K.

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

Building an alternative fuel refueling network: How many stations are needed and where should they be placed?

NASA Astrophysics Data System (ADS)

Nicholas, Michael Anselm

Gasoline stations are so numerous that the fear of running out of fuel is likely not a top concern among drivers. This may not be the case with the introduction of a new alternative fuel such as hydrogen or electricity. The next three chapters, originally written as peer reviewed journal papers[1,2,3], examine the characteristics of refueling in today's gasoline network and compares these characteristics to hypothetical new alternative fuel networks. Together, they suggest that alternative fuel networks with many fewer stations than exist in the gasoline network could be acceptable to future consumers. This acceptability is measured in three ways. The first chapter examines the distance from home to the nearest station and finds that if alternative fuel stations were one-third as numerous as gasoline stations, the travel time to the nearest station was virtually identical to that of gasoline stations. The results suggest that even for station networks numbering only one-twentieth the current number of outlets, the difference in travel time with respect to gasoline is relatively small. Acceptability was examined in the second chapter by analyzing the spatial refueling patterns of gasoline. This reveals that the volume of fuel sold is greater around the highways and that the route from home to the nearest highway entrance may account for a large portion of refueling. This suggests that the first alternative fuel stations could be sited along the highway near entrances and could provide acceptable access to fuel for those who use these highway entrances to access the wider region. Subsequent stations could be sited closer to the homes of customers. The third chapter estimates acceptability, measured in terms of initial vehicle purchase price, of refueling away from one's own town. A pilot survey using a map-based questionnaire was distributed to 20 respondents. Respondents chose ten stations locations to enable their most important destinations. The alternative fuel vehicle was then compared to the equivalent gasoline vehicle. The effect on initial purchase price of the vehicle is estimated when some or all of these stations are available. Single-vehicle households put a higher premium on station availability than multi-vehicle households.

A novel training approach to activate alternative behaviors for smoking in depressed smokers.

PubMed

Kopetz, Catalina; MacPherson, Laura; Mitchell, Avery D; Houston-Ludlam, Alexandra N; Wiers, Reinout W

2017-02-01

The current research developed and tested a novel training strategy to alter the implicit associations between alternative behaviors to smoking and negative affect, and explored its effects on depressive symptoms and on smoking behavior as part of a quit attempt. Using a joystick, participants identified as smokers with depressive symptoms were trained to approach alternative behaviors to smoking in the context of negative affect. Specifically, in the experimental condition, participants were trained to avoid smoking-related targets and to approach alternative activities. In the control condition, participants pushed and pulled an equal amount of smoking and alternative activity-related targets. Compared with the participants in the control condition, those in the experimental condition showed an increase in the accessibility of the alternative activity relative to smoking and a decrease in depressive symptoms. Smoking outcomes did not differ significantly across the 2 conditions. Taken together these results indicate that the value of alternative behaviors to smoking can be modified in the lab without participants' conscious intentions with implications for depressive symptomatology. Future research is required to explore the impact of such training on smoking outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

78 FR 32558 - Expedited Approval of Alternative Test Procedures for the Analysis of Contaminants Under the Safe...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-31

...This action announces the U.S. Environmental Protection Agency's (EPA's) approval of alternative testing methods for use in measuring the levels of contaminants in drinking water and determining compliance with national primary drinking water regulations. The Safe Drinking Water Act (SDWA) authorizes EPA to approve the use of alternative testing methods through publication in the Federal Register. EPA is using this streamlined authority to make 84 additional methods available for analyzing drinking water samples. This expedited approach provides public water systems, laboratories, and primacy agencies with more timely access to new measurement techniques and greater flexibility in the selection of analytical methods, thereby reducing monitoring costs while maintaining public health protection.

"Accept and Utilize": Alternative Medicine, Minimality, and Ethics in an Indonesian Healing Collective.

PubMed

Long, Nicholas J

2018-04-26

Cosmopolitan forms of alternative medicine have become very popular in contemporary Indonesia. Many healers have trained in an eclectic range of techniques, predicated on ontological claims so diverse that they call each other's legitimacy into question. This article explores how a collective of alternative healers in central Java navigated the quandaries presented by such therapeutic eclecticism over a six-year period. Healers' engagement with, or indifference toward, the principles underpinning therapeutic efficacy fluctuated in ways that allowed them to surmount the dilemmas of Islamization, the changing demographic of their collective's membership, and the threat of commercialization, thereby maintaining a medical landscape in which alternative healing was widely available and accessible. Transformations in their understanding, experience, and practice of healing should thus be understood in terms of how enduring ethical commitments are refracted through ongoing engagements with a changing social world. © 2018 by the American Anthropological Association.

Minority mothers' healthcare beliefs, commonly used alternative healthcare practices, and potential complications for infants and children.

PubMed

Hannan, Jean

2015-06-01

Complementary and alternative healthcare practices have increased substantially in the United States especially with low-income ethnic minority mothers. These mothers often have provider mistrust, language barriers, differing health belief systems, and as a result are less likely to seek preventive health screening, access healthcare services, and use alternative remedies for their infants and children that are potentially harmful or lethal. Therefore, the purpose of this article is to examine healthcare beliefs, commonly used alternative healthcare practices, and their potential complications for infants and children. A search of CINAHL and PubMed (1980-2012) was conducted using the following terms: alternative healthcare practice, mothers' health beliefs, cultural health beliefs, folk remedies, and infant health practices. Given the changing U.S. population and an increasing immigrant population, examining alternative healthcare practices mothers use for their infants and children is especially important for providers in addressing healthcare for this group. The use of alternative healthcare practices is rarely discussed by parents with healthcare providers for fear of disapproval. When interviewing ethnic minority mothers and caregivers questions should include the use of alternative healthcare practices for infants and children and information regarding the potential dangers should be provided to them. ©2014 American Association of Nurse Practitioners.

Extended Heroin Access Increases Heroin Choices Over a Potent Nondrug Alternative

PubMed Central

Lenoir, Magalie; Cantin, Lauriane; Vanhille, Nathalie; Serre, Fuschia; Ahmed, Serge H

2013-01-01

Epidemiological research shows that the proportion of drug users who become addicted to heroin is higher than to cocaine. Here we tested whether this difference could be due to a difference in the addiction liability between the two drugs. Addiction liability was assessed under a discrete-trials choice procedure by measuring the proportion of rats that prefer the drug over a potent alternative reward (ie, water sweetened with saccharin). Previous research on choice between self-administration of i.v. cocaine or sweet water showed that the proportion of cocaine-preferring rats remains relatively low and invariable (ie, 15%), even after extended drug access and regardless of past drug consumption (ie, total drug use before choice testing). By contrast, the present study shows that under similar choice conditions, the proportion of heroin-preferring rats considerably increases with extended heroin access (6–9 h per day for several weeks) and with past heroin consumption, from 11 to 51% at the highest past drug consumption level. At this level, the proportion of drug-preferring rats was about three times higher with heroin than with cocaine (51% vs 15%). This increase in the rate of heroin preference after extended heroin access persisted even after recovery from acute heroin withdrawal. Overall, these findings show that choice procedures are uniquely sensitive to different drugs and suggest that heroin is more addictive than cocaine. This higher addiction liability may contribute to explain why more drug users become addicted to heroin than to cocaine in epidemiological studies. PMID:23322185

Accommodating those Most at Risk. Responding to a Mismatch in Programme Selection Criteria and Foundation Biology Performance

NASA Astrophysics Data System (ADS)

Kirby, Nicola F.; Dempster, Edith R.

2015-12-01

In South Africa, foundation programmes are a well-established alternative access route to tertiary science study for educationally disadvantaged students. Student access to, and performance in, one such foundation programme has been researched by the authors seeking opportunities to improve student retention. The biology module in particular has been recognised to place students at risk of failing the foundation programme, thereby reducing throughput into mainstream science programmes. This study uses decision tree analysis to provide a detailed description of foundation biology student performance so that points of weakness and opportunities for remedial action may be pinpointed. While students' alternative-entry selection scores have previously been found to most effectively account for performance in the programme as a whole, no similar positive relationship was identified for any subgroup of students in the foundation biology module. Conversely, academic language proficiency in the medium of instruction (English), formerly found to play no role in overall student performance, was revealed as primary in explaining achievement in foundation biology, most adversely affecting students rendered particularly vulnerable by an additional academic and/or socio-economic disadvantage. A pass in the stand-alone foundation academic literacy module did not necessarily correspond to a pass in biology. Compromised by educational disadvantage, compounded by a mismatch in programme selection criteria and inadequate academic literacy support, discipline-specific, fundamental literacy development in the biology curriculum is proposed to enable students towards epistemic access in the module. Pending this intervention, formal access to mainstream study is unlikely for the foundation students most at risk of failure.

A qualitative case study of the legislative process of the hygienist-therapist bill in a large Midwestern state.

PubMed

Dollins, Haley E; Bray, Kimberly Krust; Gadbury-Amyot, Cynthia C

2013-10-01

Inequitable access to dental care contributes to oral health disparities. Midlevel dental provider models are utilized across the globe as a way to bridge the gap between preventive and restorative dental professionals and increase access to dental care. The purpose of this study was threefold: to examine lessons learned from the state legislative process related to creation of the hygienist-therapist in a Midwestern state, to improve understanding of the relationship between alternative oral health delivery models and public policy and to inform the development and passage of future policies aimed at addressing the unmet dental needs of the public. This research investigation utilized a qualitative research methodology to examine the process of legislation relating to an alternative oral health delivery model (hygienist-therapist) through the eyes of key stakeholders. Interview data was analyzed and then triangulated with 3 data sources: interviews with key stakeholders, documents and researcher participant field notes. Data analysis resulted in consensus on 3 emergent themes with accompanying categories. The themes that emerged included social justice, partnerships and coalitions, and the legislative process. This qualitative case study suggests that the creation of a new oral health workforce model was a long and arduous process involving multiple stakeholders and negotiation between the parties involved. The creation of this new workforce model was recognized as a necessary step to increasing access to dental care at the state and national level. The research in this case study may serve to inform advocates of access to oral health care as other states pursue their own workforce models.

Mentoring in a Distributed Learning Social Work Program

ERIC Educational Resources Information Center

Jensen, Donna

2017-01-01

Students in alternative education programs often experience differential access to faculty, advisors, university support systems, and the supportive culture established by being on campus. This study is a descriptive-exploratory program evaluation of the distributed learning social work mentoring program at California State University, Chico. The…

Designing Computer-Based Assessments: Multidisciplinary Findings and Student Perspectives

ERIC Educational Resources Information Center

Dembitzer, Leah; Zelikovitz, Sarah; Kettler, Ryan J.

2017-01-01

A partnership was created between psychologists and computer programmers to develop a computer-based assessment program. Psychometric concerns of accessibility, reliability, and validity were juxtaposed with core development concepts of usability and user-centric design. Phases of development were iterative, with evaluation phases alternating with…

FRED, a Front End for Databases.

ERIC Educational Resources Information Center

Crystal, Maurice I.; Jakobson, Gabriel E.

1982-01-01

FRED (a Front End for Databases) was conceived to alleviate data access difficulties posed by the heterogeneous nature of online databases. A hardware/software layer interposed between users and databases, it consists of three subsystems: user-interface, database-interface, and knowledge base. Architectural alternatives for this database machine…

Web-Based Training. ERIC Digest No. 218.

ERIC Educational Resources Information Center

Brown, Bettina Lankard

Reduced training costs, worldwide accessibility, and improved technological capabilities have made Web-based training (WBT) a viable alternative to classroom instruction. WBT enables businesses to cut their training costs. Efficiency of operation is another major advantage of WBT. The flexibility of time, place, and programs offered via WBT…

Alternative Fuels Data Center

Science.gov Websites

include at least 100 parking spaces must designate at least one parking space specifically for PEVs , provided that no parking spaces required by the Americans with Disabilities Act Accessibility Guidelines are reduced or displaced. Spaces must be clearly marked and equipped with electric vehicle supply

75 FR 33949 - Mandatory Reporting of Greenhouse Gases

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-15

.... The http://www.regulations.gov Web site is an ``anonymous access'' system, which means EPA will not.../emissions/ghgrulemaking.html . Alternatively, contact Carole Cook at 202-343-9263. Worldwide Web (WWW). In... greenhouse gas reporting rule Web site at http://www.epa.gov/climatechange/emissions/ghgrulemaking.html...

Acoustic Metadata Management and Transparent Access to Networked Oceanographic Data Sets

DTIC Science & Technology

2013-09-30

connectivity (ODBC) compliant data source for which drivers are available (e.g. MySQL , Oracle database, Postgres) can now be imported. Implementation...the possibility of speeding data transmission through compression (implemented) or the potential to use alternative data formats such as Java script

Rewriting the Journal

ERIC Educational Resources Information Center

Fredette, Michelle

2012-01-01

With faculty balking at the price of academic journals, can other digital publishing options get traction? University libraries are no strangers to one of the most popular online alternatives, the open-access archive. These archives enable scholars to upload work--including drafts of articles that are published later in subscription journals--so…

Alternatives for Young School-Leavers.

ERIC Educational Resources Information Center

Qamar, M. Kalim

1983-01-01

To produce skilled manpower and reduce its reliance on foreigners, Papua New Guinea has increased access to education. But the country has lately been facing the problem of youth leaving school, along with problems of mass unemployment, rural-urban migration, and crime. Strategies to solve these problems are discussed. (IS)

Mount Baker - Snoqualmie National Forest alternative transportation feasibility study : phase II final report

DOT National Transportation Integrated Search

2014-04-01

The Mount Baker-Snoqualmie National Forest is located near the Puget Sound metro area and is facing a number of transportation issues, such as increasing congestion and lack of access, which were identified in the Volpe Centers Phase I report. Thi...

Rural Women and Their Work: Dependence and Alternatives for Change.

ERIC Educational Resources Information Center

Ahmad, Zubeida

1984-01-01

Rural women engage in a wide range of income-generating activities, but their participation in the labor market is constrained by lack of access to land and other resources, lack of control over labor and income, and lack of physical and occupational mobility. (SK)

49 CFR 38.103 - Public information system.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Public information system. 38.103 Section 38.103... SPECIFICATIONS FOR TRANSPORTATION VEHICLES Commuter Rail Cars and Systems § 38.103 Public information system. (a... information. Alternative systems or devices which provide equivalent access are also permitted. (b) [Reserved] ...

49 CFR 38.61 - Public information system.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Public information system. 38.61 Section 38.61... SPECIFICATIONS FOR TRANSPORTATION VEHICLES Rapid Rail Vehicles and Systems § 38.61 Public information system. (a... other passenger information. Alternative systems or devices which provide equivalent access are also...

49 CFR 38.87 - Public information system.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Public information system. 38.87 Section 38.87... SPECIFICATIONS FOR TRANSPORTATION VEHICLES Light Rail Vehicles and Systems § 38.87 Public information system. (a... information. Alternative systems or devices which provide equivalent access are also permitted. (b) [Reserved] ...

Inexpensive News Sources.

ERIC Educational Resources Information Center

Briscoe, Ellen D.; Wall, Catherine

1992-01-01

Describes consumer or business-oriented online services that provide access to current news information and offers a less expensive alternative to standard online databases. Online clipping services are discussed, their costs are examined, and profiles of five services are compared: CompuServe, CompuServe as a gateway to IQuest, DELPHI, DIALCOM,…

An alternative and inexpensive percutaneous access needle in pediatric patients.

PubMed

Penbegul, Necmettin; Soylemez, Haluk; Bozkurt, Yasar; Sancaktutar, Ahmet Ali; Bodakci, Mehmet Nuri; Hatipoglu, Namik Kemal; Atar, Murat; Yildirim, Kadir

2012-10-01

The most important factor that increases the cost of percutaneous surgery is the disposable instruments used for the surgery. In this study we present the advantages of using an intravenous cannula instead of a percutaneous access needle for renal access. Recently, percutaneous stone surgery has grown in use in pediatric cases and is considered a minimally invasive surgery. The most important step in this surgery is access to the renal collecting systems. Although fluoroscopy has been used frequently at this stage, the use of ultrasound has recently increased. During percutaneous accesses under all types of imaging techniques, disposable 11- to 15-cm-long 18-ga needles are used. In pediatric cases, these longer needles are difficult to use. Using disposable materials in percutaneous nephrolithotomy increases the cost of the procedure. Therefore, we asserted that percutaneous access especially in pediatric cases could be performed using a 16-ga intravenous cannula (angiocath). Indeed, percutaneous access was performed successfully, especially in pediatric preschool patients. Shorter needle length, easy skin entry, comfort of manipulation, clear visualization of the metal needle on ultrasound, and wide availability can be considered advantages of this method. The angiocath is also less expensive than a percutaneous access needle. Angiocath is inexpensive, easily available, and practical, and it is the shortest needle to perform percutaneous access in pediatric patients. Copyright © 2012 Elsevier Inc. All rights reserved.

Evaluation of complementary and alternative medicine trials registered in clinicaltrials.gov database.

PubMed

Dizdar, Omer; Bilgin, Emre; Akin, Serkan; Kilickap, Saadettin; Hayran, Mutlu

2017-01-01

Complementary and alternative medicine (CAM) products are increasingly used because they are perceived as natural, relatively low-cost and probably effective therapies for various diseases including cancer. We aimed to determine the quantity and major characteristics of recent herbal/alternative medicine trials registered in clinicaltrials. gov in patients with cancer. "Cancer AND (herbal OR complementary OR alternative)" key words were used to query clinicaltrials. gov (access date 17 April 2015). From the results, 163 trials which have been conducted in patients with the diagnosis of cancer were identified and included in this analysis. At the date of access, 72 trials were completed, 37 trials were still recruiting patients and 10 trials had been withdrawn. Most common cancer type was breast cancer. Eighty-eight percent of trials were interventional and 60% of trials were randomized. The rate of new trial submission were similar for 5-year periods after 2000. The majority of the trials were conducted in United States of America (55%) and People's Republic of China (11%). Nine and 4 of 37 recruiting trials were recorded as phase II and phase III, respectively. When browsing was restricted to "recruiting" and "interventional" studies, the ratio of herbal/complementary treatment trials to all chemotherapy trials was 1.8 %. CAM research in patients with cancer is currently limited, both in terms of quantity and quality. Until high quality scientific and clinical research establishes safety and efficacy of CAM practices, physicians should rigorously inform patients and the public on potential risks and caveats associated with CAM practices.

Language acquisition for deaf children: Reducing the harms of zero tolerance to the use of alternative approaches.

PubMed

Humphries, Tom; Kushalnagar, Poorna; Mathur, Gaurav; Napoli, Donna Jo; Padden, Carol; Rathmann, Christian; Smith, Scott R

2012-04-02

Children acquire language without instruction as long as they are regularly and meaningfully engaged with an accessible human language. Today, 80% of children born deaf in the developed world are implanted with cochlear devices that allow some of them access to sound in their early years, which helps them to develop speech. However, because of brain plasticity changes during early childhood, children who have not acquired a first language in the early years might never be completely fluent in any language. If they miss this critical period for exposure to a natural language, their subsequent development of the cognitive activities that rely on a solid first language might be underdeveloped, such as literacy, memory organization, and number manipulation. An alternative to speech-exclusive approaches to language acquisition exists in the use of sign languages such as American Sign Language (ASL), where acquiring a sign language is subject to the same time constraints of spoken language development. Unfortunately, so far, these alternatives are caught up in an "either - or" dilemma, leading to a highly polarized conflict about which system families should choose for their children, with little tolerance for alternatives by either side of the debate and widespread misinformation about the evidence and implications for or against either approach. The success rate with cochlear implants is highly variable. This issue is still debated, and as far as we know, there are no reliable predictors for success with implants. Yet families are often advised not to expose their child to sign language. Here absolute positions based on ideology create pressures for parents that might jeopardize the real developmental needs of deaf children. What we do know is that cochlear implants do not offer accessible language to many deaf children. By the time it is clear that the deaf child is not acquiring spoken language with cochlear devices, it might already be past the critical period, and the child runs the risk of becoming linguistically deprived. Linguistic deprivation constitutes multiple personal harms as well as harms to society (in terms of costs to our medical systems and in loss of potential productive societal participation).

Peer-to-peer architecture for multi-departmental distributed PACS

NASA Astrophysics Data System (ADS)

Rosset, Antoine; Heuberger, Joris; Pysher, Lance; Ratib, Osman

2006-03-01

We have elected to explore peer-to-peer technology as an alternative to centralized PACS architecture for the increasing requirements for wide access to images inside and outside a radiology department. The goal being to allow users across the enterprise to access any study anytime without the need for prefetching or routing of images from central archive. Images can be accessed between different workstations and local storage nodes. We implemented "bonjour" a new remote file access technology developed by Apple allowing applications to share data and files remotely with optimized data access and data transfer. Our Open-source image display platform called OsiriX was adapted to allow sharing of local DICOM images through direct access of each local SQL database to be accessible from any other OsiriX workstation over the network. A server version of Osirix Core Data database also allows to access distributed archives servers in the same way. The infrastructure implemented allows fast and efficient access to any image anywhere anytime independently from the actual physical location of the data. It also allows benefiting from the performance of distributed low-cost and high capacity storage servers that can provide efficient caching of PACS data that was found to be 10 to 20 x faster that accessing the same date from the central PACS archive. It is particularly suitable for large hospitals and academic environments where clinical conferences, interdisciplinary discussions and successive sessions of image processing are often part of complex workflow or patient management and decision making.

Speaking across the Curriculum as an Alternative Assessment Process.

ERIC Educational Resources Information Center

Weiss, Robert O.

Speaking across the curriculum programs are a readily accessible venue for the assessment of oral communication competence and in some instances are already being used for such purposes. While so far the implementation of simple holistic judgments for quality assurance purposes has emerged as one practical procedure, further exploration should…

Cardiovascular Physiology Teaching: Computer Simulations vs. Animal Demonstrations.

ERIC Educational Resources Information Center

Samsel, Richard W.; And Others

1994-01-01

At the introductory level, the computer provides an effective alternative to using animals for laboratory teaching. Computer software can simulate the operation of multiple organ systems. Advantages of software include alteration of variables that are not easily changed in vivo, repeated interventions, and cost-effective hands-on student access.…

Student Loans: Problems and Policy Alternatives.

ERIC Educational Resources Information Center

Rice, Lois D., Ed.

Problems and concerns faced by the Carter Administration and the Congress regarding federal student loans are reviewed in this book. In individually authored chapters, focus is on student default, abuse, availability of capital, student access to loans, and possible new roles for states, institutions, and the federal government. A historical…

78 FR 60356 - Self-Regulatory Organizations; The Options Clearing Corporation; Order Approving Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-01

... choose an alternative reduction method. Third, in order to better reflect technological advancements as well as the decentralized operational structures and remote access adopted to address business... clear confirmed trades and otherwise conduct all of its business with OCC on any given day. Fourth, OCC...

76 FR 61761 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-05

... retained up to 3 years after the customer relationship ends. * * * * * 6. Records related to inquiries and.... These modifications reflect the changes that have been made in providing alternate access to customers... products and services when and where its customers want them. II. Rationale for Changes to USPS Privacy Act...

A Plan For a Publication Network For Rapid Dissemination of Technical Information.

ERIC Educational Resources Information Center

MacLachlan, James

This paper describes an alternative to current information dissemination systems (letter journals), computerized information systems, and clearinghouse operations) that would establish a network of depositories at universities and research organizations. The essence of the approach is to provide convenient access to working papers and technical…

Silent Policy Feedback through School Choice

ERIC Educational Resources Information Center

Little-Hunt, Catherine Cecchini

2017-01-01

Increasing numbers of Florida parents are withdrawing their children from traditional public schools in highly-rated school districts to enroll them in tuition-free, startup, charter schools. Since not all parents have equal access or are as equally motivated to elect school choice alternatives, the fiscal sustainability of the traditional public…

Teaching Photography without a Darkroom.

ERIC Educational Resources Information Center

McDole, Thomas L.

Alternative curriculum strategies can be used to conduct an effective photography program without the expense usually associated with a darkroom. Three methods can be used to eliminate the need for a darkroom facility: outside vendors, an emulsion that can be user-processed without access to a darkroom (slide or transparency film), and emulsions…

Application of Cloud Computing at KTU: MS Live@Edu Case

ERIC Educational Resources Information Center

Miseviciene, Regina; Budnikas, Germanas; Ambraziene, Danute

2011-01-01

Cloud computing is a significant alternative in today's educational perspective. The technology gives the students and teachers the opportunity to quickly access various application platforms and resources through the web pages on-demand. Unfortunately, not all educational institutions often have an ability to take full advantages of the newest…

19 CFR 212.27 - Agency review.

Code of Federal Regulations, 2010 CFR

2010-04-01

... IMPLEMENTATION OF THE EQUAL ACCESS TO JUSTICE ACT Procedures for Considering Applications § 212.27 Agency review... 19 Customs Duties 3 2010-04-01 2010-04-01 false Agency review. 212.27 Section 212.27 Customs... determination and alternative findings of fact and conclusions of law with the Commission. Upon receipt of the...

A Self-Service Approach to Promote Self-Sufficiency, Independence and Inclusion Amongst Disabled Students.

PubMed

Christensen, Lars Ballieu; Stevns, Tanja

2017-01-01

This paper presents how SensusAccess has been adapted and is being used in higher education to create inclusive educational environments. Reflecting on challenges of providing alternate versions of educational material to students with disabilities, it also discusses how the service can benefit mainstream learners.

Global Warming Threatens National Interests in the Arctic

DTIC Science & Technology

2009-03-26

Global warming has impacted the Arctic Ocean by significantly reducing the extent of the summer ice cover allowing greater access to the region...increased operations in the Arctic region, and DoD must continue to research and develop new and alternate energy sources for its forces. Global warming is

An Online Virtual Laboratory of Electricity

ERIC Educational Resources Information Center

Gómez Tejedor, J. A.; Moltó Martínez, G.; Barros Vidaurre, C.

2008-01-01

In this article, we describe a Java-based virtual laboratory, accessible via the Internet by means of a Web browser. This remote laboratory enables the students to build both direct and alternating current circuits. The program includes a graphical user interface which resembles the connection board, and also the electrical components and tools…

Exploring the Political Dimensions of Information Literacy through Popular Film

ERIC Educational Resources Information Center

Detmering, Robert

2010-01-01

Certain popular films contextualize the access, use, and interpretation of information within a political and social framework. As a result, these films function as alternative pedagogical sites for analysis and critique, facilitating critical thinking about information beyond the library and the classroom, and leading students to a deeper…

Dissertation Genre Change as a Result of Electronic Theses and Dissertation Programs

ERIC Educational Resources Information Center

Pantelides, Kate

2015-01-01

The increasing prevalence of mandatory Electronic Theses and Dissertations (ETDs) policies has ushered in rather dramatic dissertation genre change. The affordances of the medium offer expanded access and audience, availability of new compositional tools, and alternate formats, the implications of which are just beginning to appear in…

Can’t Get There From Here: Overcoming the Anti-Access Threat in 2035

DTIC Science & Technology

2012-02-15

iv Biography ...U.S. Alternate Basing Options in the Middle East/Europe ........................................... 20 v Biography Lieutenant... Jerusalem Issues Brief. June 20, 2006. http://www.jcpa.org/brief/brief005-26.htm Schantz, Marc V “AirSea Battle’s Turbulent Year.” Air Force

Information Literacy: An Online Course for Student Library Assistants

ERIC Educational Resources Information Center

Lincoln, Margaret

2009-01-01

As technology advances continue to impact K-12 schools, online education options offer alternative choices for both teaching and learning. Library media specialists, long committed to providing physical and intellectual access to instructional materials, have responded to changing needs in this online world. They had previously created a virtual…

Use of Inpatient Mental Health Services by Members of Ethnic Minority Groups.

ERIC Educational Resources Information Center

Snowden, Lonnie R.; Cheung, Freda K.

1990-01-01

Discusses the ethnic-related differences in mental hospitalization admittance rates, diagnoses, and length of treatment. Explores reasons other than ethnic origin that may account for these differences, including socioeconomic standing, access to alternative services, bias in practitioners' assignment of diagnostic labels, and differential stigma…

12 CFR 404.12 - General provisions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... and Banking EXPORT-IMPORT BANK OF THE UNITED STATES INFORMATION DISCLOSURE Access to Records Under the..., at the Export-Import Bank of the United States (Ex-Im Bank). (b) Relationship to the Freedom of... designated alternate. (e) Ex-Im Bank address. The Export-Import Bank of the United States is located at 811...

Minimal-Level Cataloging: A Look at the Issues--A Symposium.

ERIC Educational Resources Information Center

Horny, Karen L.; And Others

1986-01-01

Six articles on pros and cons of minimal-level cataloging (MLC) highlight patron access and browsability, time and cost savings, network and bibliographic utility cooperation, standards, alternatives to MLC, levels of records, online catalogs, experimental cataloging program at University of Michigan, and experiences at Kent State University…

Policy Route Map for Academic Libraries' Digital Content

ERIC Educational Resources Information Center

Koulouris, Alexandros; Kapidakis, Sarantos

2012-01-01

This paper presents a policy decision tree for digital information management in academic libraries. The decision tree is a policy guide, which offers alternative access and reproduction policy solutions according to the prevailing circumstances (for example acquisition method, copyright ownership). It refers to the digital information life cycle,…

Challenges to Augmentative and Alternative Communication Interventions with Autism Spectrum Disorder Students

ERIC Educational Resources Information Center

Singer-MacNair, Kristy

2017-01-01

Students with autism spectrum disorder (ASD) have challenges with communication, social interactions, and behavior, which can limit their functioning in school settings. They need to have functional communication skills to access the curriculum and have their needs met across all social environments. Special education teachers often experience…

76 FR 47391 - Mandatory Reporting of Greenhouse Gases

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-04

...://www.regulations.gov Web site is an ``anonymous access'' system, which means EPA will not know your... Rule Program Web site http://www.epa.gov/climatechange/emissions/ghgrulemaking.html . To submit a.../ghgrulemaking.html . Alternatively, contact Carole Cook at 202-343-9263. Worldwide Web (WWW). In addition to...

The BioMart community portal: an innovative alternative to large, centralized data repositories

USDA-ARS?s Scientific Manuscript database

The BioMart Community Portal (www.biomart.org) is a community-driven effort to provide a unified interface to biomedical databases that are distributed worldwide. The portal provides access to numerous database projects supported by 30 scientific organizations. It includes over 800 different biologi...

The Public School: Assaults on a Great Idea

ERIC Educational Resources Information Center

Butts, R. Freeman

1973-01-01

This article is a statement of support for free American public education. The development of the public education system is described. Note is taken of the struggles for control, financing problems, court decisions which provide for free access, and the divisive cultural conflicts which have spurred movements toward alternative systems. (SM)

Early Childhood Inclusion in Australia

ERIC Educational Resources Information Center

Kemp, Coral R.

2016-01-01

From the introduction of early intervention services in Australian in the mid-1970s, the families of children with intellectual and multiple disabilities have been encouraged to enroll their children in local preschools and childcare centers. Children with disabilities have also accessed a range of alternatives to full inclusion, such as reverse…

Diversity and Autonomy: The First Amendment in Broadcasting.

ERIC Educational Resources Information Center

Schmidt, Benno C., Jr.

In applying First Amendment protections to the broadcast industry, the Supreme Court has adopted a hands-off policy, but increased concentration and centralization has brought into question the diversity and freedom of flow of information. Market pricing, complete goverment regulation, and restricted access are three alternatives for regulatory…

78 FR 7334 - Port Authority Access to Facility Vulnerability Assessments and the Integration of Security Systems

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-01

... to Facility Vulnerability Assessments and the Integration of Security Systems AGENCY: Coast Guard...-sharing measures. Security System Integration Alternatives Require each MTSA-regulated facility owner or... other forms of security system integration. Information Requested 1. We request comments on the...

Environmental Controls.

ERIC Educational Resources Information Center

Schneiderman, Helen, Ed.

1994-01-01

Environmental control units, or ECUs, are devices or systems which allow for alternate access to electronic or electrical devices and those objects, like draperies and doors, which may be adapted for use with electricity. Such devices offer the person with a mobility limitation the opportunity to control his or her environment, thus enhancing the…

Scan This Book!

ERIC Educational Resources Information Center

Albanese, Andrew Richard

2007-01-01

In this article, the author presents an interview with Brewster Kahle, leader of the Open Content Alliance (OCA). OCA book scan program is an alternative to Google's library project that aims to make books accessible online. In this interview, Kahle discusses his views on the challenges of getting books on the Web, on Google's library…

Linking Automated Systems in North Bay Libraries.

ERIC Educational Resources Information Center

Bruman, Janet

This report addresses alternative means of interconnecting or providing access to the various automated systems within the 17-member North Bay Cooperative Library System (NBC), with emphasis on providing information on the availability of materials for loan, the principal objective of the NBC Telecommunications Project, Year Two. Advantages and…

Firearm Deaths among Children and Youth.

ERIC Educational Resources Information Center

O'Donnell, Clifford R.

1995-01-01

Examines the long- and short-term policy alternatives in reducing firearm deaths of children. The article advocates the need for multiple steps that include educational efforts such as conflict resolution; safety devices, such as trigger locks; security policies for schools to protect students; and gun access laws to reduce firearm acquisitions by…

Not Just Pretty Pictures

ERIC Educational Resources Information Center

Norman, Rebecca R.; Roberts, Kathryn L.

2013-01-01

Informational texts are filled with graphics that support and extend the written text. These graphics may provide an alternate way to access important information, and sometimes they are the only entry point to that information. However, just being able to see the graphics does not ensure that readers are paying attention to, let alone…

The Praeger Handbook of American High Schools. Volume 4

ERIC Educational Resources Information Center

Borman, Kathryn M., Ed.; Cahill, Spencer E., Ed.; Cotner, Bridget A., Ed.

2007-01-01

Written by an interdisciplinary group of experts in education, psychology, sociology, and other fields, this landmark handbook provides a thorough examination of U.S. secondary education from the private academies of Colonial America to the comprehensive high schools and alternative schools of today. This accessible compendium is a treasure trove…

The Praeger Handbook of American High Schools. Volume 2

ERIC Educational Resources Information Center

Borman, Kathryn M., Ed.; Cahill, Spencer E., Ed.; Cotner, Bridget A., Ed.

2007-01-01

Written by an interdisciplinary group of experts in education, psychology, sociology, and other fields, this landmark handbook provides a thorough examination of U.S. secondary education from the private academies of Colonial America to the comprehensive high schools and alternative schools of today. This accessible compendium is a treasure trove…

The Praeger Handbook of American High Schools. Volume 1

ERIC Educational Resources Information Center

Borman, Kathryn M., Ed.; Cahill, Spencer E., Ed.; Cotner, Bridget A., Ed.

2007-01-01

Written by an interdisciplinary group of experts in education, psychology, sociology, and other fields, this landmark handbook provides a thorough examination of U.S. secondary education from the private academies of Colonial America to the comprehensive high schools and alternative schools of today. This accessible compendium is a treasure trove…

Historical Literature and Democratic Education. Occasional Paper.

ERIC Educational Resources Information Center

Scott, John Anthony

This document discusses the movement to bring original historical sources into the classroom. Because students of history need access to sources of information that provide direct or primary evidence about reality, teachers must show that realistic alternatives to the traditional history text exist. In the first section of this paper, efforts to…

The Future of Women's Athletics: Entertainment or Education?

ERIC Educational Resources Information Center

Park, Roberta J.

A well-rounded program of extramural opportunities for females which provides experience between the intramural model and the existing male intercollegiate models is presently nonexistent. Five possible alternatives to guide the future of athletics are suggested: (a) women could demand access to the existing model of male athletics; (b) women…

The Impact of Exemplary Technology-Support Programs on Students with Disabilities.

ERIC Educational Resources Information Center

National Council on Disability, Washington, DC.

This report examines effects of technology-supported programs on students with disabilities at the postsecondary level, including issues of access to technology and alternatives for acquiring assistive technology devices and services. After an introduction, the first chapter presents the report's recommendations, which deal with full technological…

Describing Learning in An Advanced Online Case-Based Course in Environmental Science

ERIC Educational Resources Information Center

Missett, Tracy C.; Reed, Christine B.; Scot, Tammy P.; Callahan, Carolyn M.; Slade, Mary

2010-01-01

Researchers increasingly embrace online courses to compensate for lack of access to educational opportunities otherwise available in traditional school settings. Researchers also recommend alternatives to traditional AP coursework to better meet the diverse learning styles and needs of advanced learners. These recommendations have particular…

25 CFR 542.10 - What are the minimum internal control standards for keno?

Code of Federal Regulations, 2012 CFR

2012-04-01

... keno? (a) Computer applications. For any computer applications utilized, alternate documentation and/or... restricted transaction log or computer storage media concurrently with the generation of the ticket. (3) Keno personnel shall be precluded from having access to the restricted transaction log or computer storage media...

25 CFR 542.10 - What are the minimum internal control standards for keno?

Code of Federal Regulations, 2013 CFR

2013-04-01

... keno? (a) Computer applications. For any computer applications utilized, alternate documentation and/or... restricted transaction log or computer storage media concurrently with the generation of the ticket. (3) Keno personnel shall be precluded from having access to the restricted transaction log or computer storage media...

Seduction and Betrayal: An Insider's View of Insider Theft of Rare Materials.

ERIC Educational Resources Information Center

Traister, Daniel

1994-01-01

Discusses alternatives for dealing with insider theft of rare library materials, including publicizing losses and prosecuting. An example of insider theft is detailed. Ideas for preventing theft, including hiring practices and restricting access to materials, are considered. Suggestions for thinking through procedures to deal with the…

75 FR 20925 - Petition for Approval of Alternate Odometer Disclosure Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-22

... the online instructions for accessing the dockets. FOR FURTHER INFORMATION CONTACT: Andrew DiMarsico... provisions to limit odometer fraud and assure that the purchaser of a motor vehicle knows the true mileage of... statements did not necessarily deter odometer fraud employing altered documents, discarded titles, and title...

The Argument Is Not Compulsory Law, but How Attendance Is Recorded

ERIC Educational Resources Information Center

Watson, Michael; Hemmer, Lynn

2015-01-01

This paper examines attendance accounting policies and practices for students enrolled in public schools in Texas and in alternative schools of choice (ASC) in particular. Technology advancement allows students to complete their coursework virtually anywhere they have internet access; however, conventional state attendance policies still require…

Estimation of toxicity using a Java based software tool

EPA Science Inventory

A software tool has been developed that will allow a user to estimate the toxicity for a variety of endpoints (such as acute aquatic toxicity). The software tool is coded in Java and can be accessed using a web browser (or alternatively downloaded and ran as a stand alone applic...

High-Quality Preschool: The Socioeconomic Composition of Preschool Classrooms and Children's Learning

ERIC Educational Resources Information Center

Reid, Jeanne L.; Ready, Douglas D.

2013-01-01

Research Findings: As policymakers expand access to preschool, the sociodemographic composition of preschool classrooms will become increasingly important. These efforts may create programs that increase the concentration of children from low-income families or, alternatively, foster the creation of socioeconomically diverse preschool classrooms.…

Wishing for a World without "Theatre for Development": Demystifying the Case of Bangladesh.

ERIC Educational Resources Information Center

Ahmed, Syed Jamil

2002-01-01

Argues that Theatre for Development in Bangladesh practiced by Non-Governmental Organizations, which is almost entirely funded by international donor organizations, serves globalization in the name of poverty alleviation. Concludes by advocating for the necessity of exploring alternatives by which indigenous theatre performers may access directly…

Alternative Fuels Data Center

Science.gov Websites

Zero Emission Vehicle (ZEV) Promotion Plan All California state agencies must support and their stakeholders to accomplish the following: Update the 2016 ZEV Action plan, with a focus on low affordable and accessible to all drivers. The ZEV promotion plan additionally directs the state fleet to

A Decision Support System for Energy Policy Analysis.

DTIC Science & Technology

1980-07-01

new realities or hypothesized realities to the modeling system. Lack of a PDL would make the system inflexible and accessible only to a patient ... expert . Certainly, given the present ratio of costs of personnel to costs of computers, the alternative of presenting data in its raw form is acceptable

Inspired to Work

ERIC Educational Resources Information Center

Krumboltz, John D.; Babineaux, Ryan; Wientjes, Greg

2010-01-01

The supply of occupational information appears to exceed the demand. A website displaying over 100 videos about various occupations was created to help career searchers find attractive alternatives. Access to the videos was free for anyone in the world. It had been hoped that many thousands of people would make use of the resource. However, the…

Social Connectedness and Its Implication on Student-Teacher Relationships and Suspension

ERIC Educational Resources Information Center

Henderson, Dawn X.; Guy, Breonte

2017-01-01

Out-of-school suspension (OSS) disconnects students from accessing important school relationships and academic and social support. OSS contributes to a significant number of ethnic minority and economically disadvantaged students receiving short-term suspensions. Community-based organizations may step in as alternative spaces for short-term…

KSC-03PD-2451

NASA Technical Reports Server (NTRS)

2003-01-01

KENNEDY SPACE CENTER, FLA. Daniel L. Tweed, with the Facilities Division, NASA Spaceport Services, addresses attendees at the ribbon cutting for the KSC Security gates. Tweed was project manager. The two new Security gates on Kennedy Parkway (Gate 2) and NASA Parkway (Gate 3) were activated Aug. 1, allowing the general public to have access to the new Space Commerce Way, which will provide access to the Research Park and KSC Visitor Complex, and providing an alternate route for the general public between Titusville and Merritt Island that is accessible 24 hours a day. The gates are staffed 24 hours daily. Others taking part in the ribbon cutting were Center Director Jim Kennedy; Chief, Protective & Safe Guards Office, Calvin L. Burch; SGS Deputy Program Manager William A. Sample; and Bobby Porter, with Oneida Construction.

Automatic external defibrillators for public access defibrillation: recommendations for specifying and reporting arrhythmia analysis algorithm performance, incorporating new waveforms, and enhancing safety. A statement for health professionals from the American Heart Association Task Force on Automatic External Defibrillation, Subcommittee on AED and Efficacy.

PubMed

1997-01-01

These recommendations are presented to enhance the safety and efficacy of AEDs intended for public access. The task force recommends that manufacturers present developmental and validation data on their own devices, emphasizing high sensitivity for shockable rhythms and high specificity for nonshockable rhythms. Alternative defibrillation waveforms may reduce energy requirements, reducing the size and weight of the device. The highest levels of safety for public access defibrillation are needed. Safe and effective use of AEDs that are widely available and easily handled by non-medical personnel has the potential to dramatically increase survival from cardiac arrest.

A satellite-based personal communication system for the 21st century

NASA Technical Reports Server (NTRS)

Sue, Miles K.; Dessouky, Khaled; Levitt, Barry; Rafferty, William

1990-01-01

Interest in personal communications (PCOMM) has been stimulated by recent developments in satellite and terrestrial mobile communications. A personal access satellite system (PASS) concept was developed at the Jet Propulsion Laboratory (JPL) which has many attractive user features, including service diversity and a handheld terminal. Significant technical challenges addressed in formulating the PASS space and ground segments are discussed. PASS system concept and basic design features, high risk enabling technologies, an optimized multiple access scheme, alternative antenna coverage concepts, the use of non-geostationary orbits, user terminal radiation constraints, and user terminal frequency reference are covered.

Navigating the poverty of heroin addiction treatment and recovery opportunity in Kenya: access work, self-care and rationed expectations.

PubMed

Rhodes, Tim; Ndimbii, James; Guise, Andy; Cullen, Lucy; Ayon, Sylvia

2015-01-01

Drawing on the analyses of qualitative interview accounts of people who inject heroin in Kenya, we describe the narration of addiction treatment access and recovery desire in conditions characterised by a 'poverty of drug treatment opportunity'. We observe the performance of addiction recovery narrative in the face of heavy social constraints limiting access to care. Fee-based residential rehabilitation ('rehab') is the only treatment locally available and inaccessible to most. Its recovery potential is doubted, given normative expectations of relapse. Treating drug use is a product of tightly bounded agency. Individuals enact strategies to maximise their slim chances of treatment access ('access work'), develop self-care alternatives when these fail to materialise and ration their care expectations. The use of rehab as a primary means of respite and harm reduction rather than recovery and the individuation of care in the absence of an enabling recovery environment are key characteristics of drug treatment experience. The recent incorporation of 'harm reduction' into policy discourses may trouble the primacy of recovery narrative in addiction treatment and in how treatment desires are voiced. The diversification of drug treatments in combination with social interventions enabling their access are fundamental.

Accessible Earth: Enhancing diversity in the Geosciences through accessible course design

NASA Astrophysics Data System (ADS)

Bennett, R. A.; Lamb, D. A.

2017-12-01

The tradition of field-based instruction in the geoscience curriculum, which culminates in a capstone geological field camp, presents an insurmountable barrier to many disabled students who might otherwise choose to pursue geoscience careers. There is a widespread perception that success as a practicing geoscientist requires direct access to outcrops and vantage points available only to those able to traverse inaccessible terrain. Yet many modern geoscience activities are based on remotely sensed geophysical data, data analysis, and computation that take place entirely from within the laboratory. To challenge the perception of geoscience as a career option only for the non-disabled, we have created the capstone Accessible Earth Study Abroad Program, an alternative to geologic field camp for all students, with a focus on modern geophysical observation systems, computational thinking, data science, and professional development.In this presentation, we will review common pedagogical approaches in geosciences and current efforts to make the field more inclusive. We will review curricular access and inclusivity relative to a wide range of learners and provide examples of accessible course design based on our experiences in teaching a study abroad course in central Italy, and our plans for ongoing assessment, refinement, and dissemination of the effectiveness of our efforts.