Accessible triple-phase boundary length: A performance metric to account for transport pathways in heterogeneous electrochemical materials

NASA Astrophysics Data System (ADS)

Nakajo, A.; Cocco, A. P.; DeGostin, M. B.; Peracchio, A. A.; Cassenti, B. N.; Cantoni, M.; Van herle, J.; Chiu, W. K. S.

2016-09-01

The performance of materials for electrochemical energy conversion and storage depends upon the number of electrocatalytic sites available for reaction and their accessibility by the transport of reactants and products. For solid oxide fuel/electrolysis cell materials, standard 3-D measurements such as connected triple-phase boundary (TPB) length and effective transport properties partially inform on how local geometry and network topology causes variability in TPB accessibility. A new measurement, the accessible TPB, is proposed to quantify these effects in detail and characterize material performance. The approach probes the reticulated pathways to each TPB using an analytical electrochemical fin model applied to a 3-D discrete representation of the heterogeneous structure provided by skeleton-based partitioning. The method is tested on artificial and real structures imaged by 3-D x-ray and electron microscopy. The accessible TPB is not uniform and the pattern varies depending upon the structure. Connected TPBs can be even passivated. The sensitivity to manipulations of the local 3-D geometry and topology that standard measurements cannot capture is demonstrated. The clear presence of preferential pathways showcases a non-uniform utilization of the 3-D structure that potentially affects the performance and the resilience to alterations due to degradation phenomena. The concepts presented also apply to electrochemical energy storage and conversion devices such as other types of fuel cells, electrolyzers, batteries and capacitors.

Development of a Remote Accessibility Assessment System through three-dimensional reconstruction technology.

PubMed

Kim, Jong Bae; Brienza, David M

2006-01-01

A Remote Accessibility Assessment System (RAAS) that uses three-dimensional (3-D) reconstruction technology is being developed; it enables clinicians to assess the wheelchair accessibility of users' built environments from a remote location. The RAAS uses commercial software to construct 3-D virtualized environments from photographs. We developed custom screening algorithms and instruments for analyzing accessibility. Characteristics of the camera and 3-D reconstruction software chosen for the system significantly affect its overall reliability. In this study, we performed an accuracy assessment to verify that commercial hardware and software can construct accurate 3-D models by analyzing the accuracy of dimensional measurements in a virtual environment and a comparison of dimensional measurements from 3-D models created with four cameras/settings. Based on these two analyses, we were able to specify a consumer-grade digital camera and PhotoModeler (EOS Systems, Inc, Vancouver, Canada) software for this system. Finally, we performed a feasibility analysis of the system in an actual environment to evaluate its ability to assess the accessibility of a wheelchair user's typical built environment. The field test resulted in an accurate accessibility assessment and thus validated our system.

Merit-Based Incentive Payment System (MIPS): Harsh Choices For Interventional Pain Management Physicians.

PubMed

Manchikanti, Laxmaiah; Helm Ii, Standiford; Benyamin, Ramsin M; Hirsch, Joshua A

2016-01-01

The Merit-based Incentive Payment System (MIPS) was created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) to improve the health of all Americans by providing incentives and policies to improve patient health outcomes. MIPS combines 3 existing programs, Meaningful Use (MU), now called Advancing Care Information (ACI), contributing 25% of the composite score; Physician Quality Reporting System (PQRS), changed to Quality, contributing 50% of the composite score; and Value-based Payment (VBP) system to Resource Use or cost, contributing 10% of the composite score. Additionally, Clinical Practice Improvement Activities (CPIA), contributing 15% of the composite score, create multiple strategic goals to design incentives that drive movement toward delivery system reform principles with inclusion of Advanced Alternative Payment Models (APMs). Under the present proposal, the Centers for Medicare and Medicaid Services (CMS) has estimated approximately 30,000 to 90,000 providers from a total of over 761,000 providers will be exempt from MIPS. About 87% of solo practitioners and 70% of practitioners in groups of less than 10 will be subjected to negative payments or penalties ranging from 4% to 9%. In addition, MIPS also will affect a provider's reputation by making performance measures accessible to consumers and third-party physician rating Web sites.The MIPS composite performance scoring method, at least in theory, utilizes weights for each performance category, exceptional performance factors to earn bonuses, and incorporates the special circumstances of small practices.In conclusion, MIPS has the potential to affect practitioners negatively. Interventional Pain Medicine practitioners must understand the various MIPS measures and how they might participate in order to secure a brighter future. Medicare Access and CHIP Reauthorization Act of 2015, merit-based incentive payment system, quality performance measures, resource use, clinical practice improvement activities, advancing care information performance category.

Health Care Access for Adults With Intellectual and Developmental Disabilities: A Scoping Review.

PubMed

Williamson, Heather J; Contreras, Graciela M; Rodriguez, Erica S; Smith, Jennifer M; Perkins, Elizabeth A

2017-10-01

Adults with intellectual and/or developmental disabilities (IDD) often experience health disparities. To address disparities, Healthy People 2020 includes specific disability and health goals focused on improving health care access. The study's purpose was to review the literature exploring health care access for adults with IDD to identify opportunities for occupational therapy research and practice. A scoping review was completed of articles discussing health care access among adults with IDD in the United States. Thirty-seven articles met the inclusion criteria. Results are framed using the ecology of human performance theory identifying person and environmental issues affecting health care access of adults with IDD. Opportunities exist for occupational therapy to improve participation and health of adults with IDD through engaging in research and practice efforts addressing health care access. Occupational therapy could develop interventions to establish skills and abilities and recommend changes to the health care environment.

A CDMA system implementation with dimming control for visible light communication

NASA Astrophysics Data System (ADS)

Chen, Danyang; Wang, Jianping; Jin, Jianli; Lu, Huimin; Feng, Lifang

2018-04-01

Visible light communication (VLC), using solid-state lightings to transmit information, has become a complement technology to wireless radio communication. As a realistic multiple access scheme for VLC system, code division multiple access (CDMA) has attracted more and more attentions in recent years. In this paper, we address and implement an improved CDMA scheme for VLC system. The simulation results reveal that the improved CDMA scheme not only supports multi-users' transmission but also maintains dimming value at about 50% and enhances the system efficiency. It can also realize the flexible dimming control by adjusting some parameters of system structure, which rarely affects the system BER performance. A real-time experimental VLC system with improved CDMA scheme is performed based on field programmable gate array (FPGA), reaching a good BER performance.

Effects of Housing Systems on Behaviour, Performance and Welfare of Fast-growing Broilers

PubMed Central

Zhao, Zi-guang; Li, Jian-hong; Li, Xiang; Bao, Jun

2014-01-01

This experiment aimed to evaluate the effects of different housing systems on behavioral activities, welfare and meat quality of fast-growing broilers. Two hundred broilers were allocated into two housing systems: indoor housing vs indoor with outdoor access. Their general behavior (feeding, drinking, fighting, standing, lying, walking, investigating, dust-bathing and preening) was observed, and tonic immobility, fluctuating asymmetry of legs and wings were measured, and meat quality was analyzed. The results showed that the indoor-housed broilers with outdoor access had significant higher standing, walking, investigating, dust-bathing and preening than those indoor only. However, farming system was not found to significantly affect their feeding, drinking and fighting activities (p>0.05). The value of FA of tibia length of the broilers with outdoor access was significantly lower than that of the indoor-housed birds (1.57±1.30 vs 2.76±1.40, p<0.05), while no difference was found for the value of FA in tibia diameter and wing length (p>0.05). TI of the broilers with outdoor access was 165.5 that was significantly higher than that (147.2) of the indoor birds (p<0.05). However, death rate in the outdoor run groups was significantly higher than that of the indoor ones (2.0±0.81 vs 4.0±0.82, p<0.05). Meat quality was not affected by the two farming systems. It can be concluded that the results of this study may suggest that the indoor housing with outdoor access provides enriched environment for broilers and facilitates the expression of natural behaviors of the broilers but resulted in poorer performance and higher death rate. PMID:25049936

On the generalization of attitude accessibility after repeated attitude expression

PubMed Central

Spruyt, Adriaan; Fazio, Russell H.; Hermans, Dirk

2016-01-01

Abstract The more accessible an attitude is, the stronger is its influence on information processing and behavior. Accessibility can be increased through attitude rehearsal, but it remains unknown whether attitude rehearsal also affects the accessibility of related attitudes. To investigate this hypothesis, participants in an experimental condition repeatedly expressed their attitudes towards exemplars of several semantic categories during an evaluative categorization task. Participants in a control condition performed a non‐evaluative task with the same exemplars and evaluated unrelated attitude objects. After a 30‐minute interval, participants in the experimental condition were faster than controls to evaluate not only the original exemplars but also novel exemplars of the same categories. This finding suggests that the effect of attitude rehearsal on accessibility generalizes to attitudes towards untrained but semantically related attitude objects. © 2016 The Authors. European Journal of Social Psychology published by John Wiley & Sons, Ltd. PMID:28701803

Does Introductory Economic Course Venue Affect Economic Understanding?

ERIC Educational Resources Information Center

Baehler, Karen

2013-01-01

This study examines the level of a student's performance based on incoming knowledge in an intermediate macroeconomic and microeconomic course at a major mid-western university. Analysis of student understanding of specific economic concepts was accessed through the Test of Understanding College Economics, 4th Edition (TUCE) (Walstad,Watts &…

Digital Technology in the 21st Century: Considerations for Clinical Supervision in Rehabilitation Education

ERIC Educational Resources Information Center

Byrne, Andrew M.; Hartley, Michael T.

2010-01-01

Technological innovations are increasingly affecting the delivery of clinical supervision. Yet there is limited information on how supervisors can use digital technology to broaden settings in which students record client interviews, enhance evaluation of students' clinical performance, and increase accessibility for students with disabilities.…

Social Class Experiences of Working-Class Students: Transitioning out of College

ERIC Educational Resources Information Center

Treager Huber, Carey

2010-01-01

Issues surrounding social class are often overlooked and rarely discussed in higher education; however, they affect students and institutions in critical ways. Although research has demonstrated that social class is a predictor of access to college, retention, academic performance, overall undergraduate and graduate experience, and college…

Theoretical Perspectives on Factors Affecting the Academic Performance of Students

ERIC Educational Resources Information Center

Jama, M. P.; Mapesela, M. L. E.; Beylefeld, A. A.

2008-01-01

Whilst the government, higher education authorities and institutions, academics, academic development practitioners, researchers etc. recognize that there is an increasing number and diversity of students accessing higher education, do the stake-holders really know who these students are before even thinking of enhancing their learning and…

Emotional and cognitive influences in air traffic controller tasks: An investigation using a virtual environment?

PubMed

Truschzinski, Martina; Betella, Alberto; Brunnett, Guido; Verschure, Paul F M J

2018-05-01

Air traffic controllers are required to perform complex tasks which require attention and high precision. This study investigates how the difficulty of such tasks influences emotional states, cognitive workload and task performance. We use quantitative and qualitative measurements, including the recording of pupil dilation and changes in affect using questionnaires. Participants were required to perform a number of air traffic control tasks using the immersive human accessible Virtual Reality space in the "eXperience Induction Machine". Based on the data collected, we developed and validated a model which integrates personality, workload and affective theories. Our results indicate that the difficulty of an air traffic control task has a direct influence on cognitive workload as well as on the self-reported mood; whereas both mood and workload seem to change independently. In addition, we show that personality, in particular neuroticism, affects both mood and performance of the participants. Copyright © 2018 Elsevier Ltd. All rights reserved.

Classifying a Person's Degree of Accessibility From Natural Body Language During Social Human-Robot Interactions.

PubMed

McColl, Derek; Jiang, Chuan; Nejat, Goldie

2017-02-01

For social robots to be successfully integrated and accepted within society, they need to be able to interpret human social cues that are displayed through natural modes of communication. In particular, a key challenge in the design of social robots is developing the robot's ability to recognize a person's affective states (emotions, moods, and attitudes) in order to respond appropriately during social human-robot interactions (HRIs). In this paper, we present and discuss social HRI experiments we have conducted to investigate the development of an accessibility-aware social robot able to autonomously determine a person's degree of accessibility (rapport, openness) toward the robot based on the person's natural static body language. In particular, we present two one-on-one HRI experiments to: 1) determine the performance of our automated system in being able to recognize and classify a person's accessibility levels and 2) investigate how people interact with an accessibility-aware robot which determines its own behaviors based on a person's speech and accessibility levels.

Advanced Stent Graft Treatment of Venous Stenosis Affecting Hemodialysis Vascular Access: Case Illustrations

PubMed Central

Patel, Darshan; Ray, Charles E.; Lokken, R. Peter; Bui, James T.; Lipnik, Andrew J.; Gaba, Ron C.

2016-01-01

Surgically placed dialysis access is an important component of dialysis replacement therapy. The vast majority of patients undergoing dialysis will have surgically placed accesses at some point in the course of their disease, and for many patients these accesses may represent their definitive renal replacement option. Most, if not all, arteriovenous fistulae and grafts will require interventions at some point in time. Percutaneous angioplasty is the typical first treatment performed for venous stenoses, with stents and stent grafts being reserved for patients in whom angioplasty and surgical options are exhausted. In some salvage situations, stent graft placement may be the only or best option for patients. This article describes, using case illustrations, placement of stent grafts in such patients; a focus will also be made on the techniques utilized in such salvage situations. PMID:27011426

The Impact of Accountability Reforms on the Key Stage 4 Curriculum: How Have Changes to School and College Performance Tables Affected Pupil Access to Qualifications and Subjects in Secondary Schools in England?

ERIC Educational Resources Information Center

Parameshwaran, Meenakshi; Thomson, Dave

2015-01-01

The Conservative-Liberal Democrat Coalition Government's reforms to secondary school Performance Tables have changed how schools make decisions about the subjects and qualifications entered by their pupils. The National Pupil Database is used to explore these changes between 2005 and 2014. We find that schools are responding to accountability…

Received Signal Strength Recovery in Green WLAN Indoor Positioning System Using Singular Value Thresholding

PubMed Central

Ma, Lin; Xu, Yubin

2015-01-01

Green WLAN is a promising technique for accessing future indoor Internet services. It is designed not only for high-speed data communication purposes but also for energy efficiency. The basic strategy of green WLAN is that all the access points are not always powered on, but rather work on-demand. Though powering off idle access points does not affect data communication, a serious asymmetric matching problem will arise in a WLAN indoor positioning system due to the fact the received signal strength (RSS) readings from the available access points are different in their offline and online phases. This asymmetry problem will no doubt invalidate the fingerprint algorithm used to estimate the mobile device location. Therefore, in this paper we propose a green WLAN indoor positioning system, which can recover RSS readings and achieve good localization performance based on singular value thresholding (SVT) theory. By solving the nuclear norm minimization problem, SVT recovers not only the radio map, but also online RSS readings from a sparse matrix by sensing only a fraction of the RSS readings. We have implemented the method in our lab and evaluated its performances. The experimental results indicate the proposed system could recover the RSS readings and achieve good localization performance. PMID:25587977

Assessing English Language Learner Content Knowledge in the Mainstream Classroom

ERIC Educational Resources Information Center

Clark-Gareca, Beth

2013-01-01

In K-12 environments in the US, classroom tests are a central means by which teachers assess English Language Learner (ELL) content knowledge. Performance on routine classroom assessments is often a contributing criterion for school based decision-making and can affect decisions relating to academic tracking, retention, and access to academic…

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

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

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

2004-12-01

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

Securing Gender Equality through a Nexus of Energy Policy Performance and Relative Political Performance

NASA Astrophysics Data System (ADS)

Perkins-Ozuagiemhe, Andrea Christen

This dissertation presents what is believed to be the first empirical study that measures the effect of increasing access to modern household energy sources upon advancing gender equality within developing countries. As a powerful and fundamental public infrastructural socio-economic building block, improved access to modern energy in developing countries delivers the necessary economic ingredient of time as a major component of household production and consumption and captures the interdependence between market and household economies. Thus, because it has been empirically proven that men and women differ in their utilization of household energy with women spending more time engaged in non-market household labor than men, improving access to modern household energy in developing countries, especially in rural areas, theoretically would disproportionately affect women's lives. Essentially, the element of "time" not only extends the day for women to use towards more economically and educationally productive activities, but also lessens the burden of domestic chores from women with technological advancements in more time-efficient household appliances and cleaner modern energy sources. This dissertation introduces gender differentiation in a model in the form of a gender relative status composite measure comparing socio-economic achievements in secondary education, life expectancy, and labor force participation rates by varying degree of demographic transition, thereby, measuring the effect of improved access to modern household energy upon overall gender equality. Fixed effects panel regressions employing a Driscoll-Kraay non-parametric covariance matrix, and estimated and interpreted adjusted predictions and marginal effects of the two-way interaction between a country's available access to residential electric power (kWh per capita) and the level of relative political performance against predicted values of gender relative status are employed. The models confirm that, in fact, that women are not impacted equally by energy policy preferences as men and that women in developing countries benefit from increased access to modern household energy. Thus, gender-differentiated energy usage illustrates why treating population as a homogenous group fails to capture how energy policy preferences and energy policy performance can affect different subgroups of population in terms of individual choices and how those differences can affect an overall economic growth and development. Fundamental theoretical implications emerge from this dissertation's empirical findings. First, improving gender equality through technological advancements in household electricity facilitates the progress of demographic transition in terms of reducing fertility rates. Time altering effects of increased access and use of household electricity modify intra-household relations by diminishing differing roles between men and women. When women gain greater autonomy facilitated by increasing time via access to modern household electricity for more economically and educationally productive activities, fertility rates and child births tend to decrease by altering choice in family size with increased investments in children. The effect that the reduction in fertility generated by increased gender equality has upon demographic transition is that it alters the change in age structure in a developing country by decreasing youth dependency ratios generating the demographic dividend. Gender equality-generated fertility reductions may also facilitate the return to human capital by lessening the burden of non-SNA work and activities including reducing child care, increasing female labor force participation rates.

Interface methods for using intranet portal organizational memory information system.

PubMed

Ji, Yong Gu; Salvendy, Gavriel

2004-12-01

In this paper, an intranet portal is considered as an information infrastructure (organizational memory information system, OMIS) supporting organizational learning. The properties and the hierarchical structure of information and knowledge in an intranet portal OMIS was identified as a problem for navigation tools of an intranet portal interface. The problem relates to navigation and retrieval functions of intranet portal OMIS and is expected to adversely affect user performance, satisfaction, and usefulness. To solve the problem, a conceptual model for navigation tools of an intranet portal interface was proposed and an experiment using a crossover design was conducted with 10 participants. In the experiment, a separate access method (tabbed tree tool) was compared to an unified access method (single tree tool). The results indicate that each information/knowledge repository for which a user has a different structural knowledge should be handled separately with a separate access to increase user satisfaction and the usefulness of the OMIS and to improve user performance in navigation.

Delivery of Type 2 diabetes care in low- and middle-income countries: lessons from Lima, Peru.

PubMed

Cardenas, M K; Miranda, J J; Beran, D

2016-06-01

The health system's response is crucial to addressing the increasing burden of diabetes, particularly that affecting low- and middle-income countries. This study aims to assess the facilitators and barriers that help or hinder access to care for people with diabetes in Peru. We used a survey tool to design and collect qualitative and quantitative data from primary and secondary sources of information at different levels of the health system. We performed 111 interviews in Lima, the capital city of Peru, with patients with diabetes, healthcare providers and healthcare officials. We applied the six building blocks framework proposed by the World Health Organization in our analysis. We found low political commitment, as well as several barriers that directly affect access to medicines, regular laboratory check-ups and follow-up appointments for diabetes, especially at the primary healthcare level. Three major system-level barriers were identified: (1) the availability of information at different healthcare system levels that affects several processes in the healthcare provision; (2) insufficient financial resources; and (3) insufficient human resources trained in diabetes management. Despite an initial political commitment by the Peruvian government to improve the delivery of diabetes care, there exist several key limitations that affect access to adequate diabetes care, especially at the primary healthcare level. In a context in which various low- and middle-income countries are aiming to achieve universal health coverage, this study provides lessons for the implementation of strategies related to diabetes care delivery. © 2016 Diabetes UK.

Factors affecting access to head and neck cancer care after a natural disaster: a post-Hurricane Katrina survey.

PubMed

Loehn, Bridget; Pou, Anna M; Nuss, Daniel W; Tenney, Justin; McWhorter, Andrew; DiLeo, Michael; Kakade, Anagha C; Walvekar, Rohan R

2011-01-01

Our aim was to survey the factors affecting access to cancer care in patients with head and neck cancer after Hurricane Katrina. In this cross-sectional survey, 207 patients with head and neck cancer were identified post-Hurricane Katrina, but only 83 patients completed the questionnaires and were analyzed. Clinical, demographic, and socioeconomic data were recorded. Chi-square test and t test were used for comparisons. Patients who felt that there was a lack of access to cancer care would have sought treatment earlier had they had better access to cancer care (chi-square[1] = 32; p < .0001). Patients who felt that there was a lack of access to cancer care also had difficulty receiving treatment (chi-square[1] = 48; p < .0001). Availability of transportation affected access to cancer care in patients with early-stage cancers (chi-square[1] = 4; p < .035). In the postdisaster environment, patients who felt the lack of access to cancer care post-Hurricane Katrina would have sought treatment earlier with better access to cancer care. These patients also reported difficulty obtaining cancer treatment. Availability of transportation affected access to cancer care in patients with early-stage cancers. Clinical, demographic, and socioeconomic factors did not influence access to cancer care. © 2010 Wiley Periodicals, Inc. Head Neck, 2011.

Multiple-access relaying with network coding: iterative network/channel decoding with imperfect CSI

NASA Astrophysics Data System (ADS)

Vu, Xuan-Thang; Renzo, Marco Di; Duhamel, Pierre

2013-12-01

In this paper, we study the performance of the four-node multiple-access relay channel with binary Network Coding (NC) in various Rayleigh fading scenarios. In particular, two relay protocols, decode-and-forward (DF) and demodulate-and-forward (DMF) are considered. In the first case, channel decoding is performed at the relay before NC and forwarding. In the second case, only demodulation is performed at the relay. The contributions of the paper are as follows: (1) two joint network/channel decoding (JNCD) algorithms, which take into account possible decoding error at the relay, are developed in both DF and DMF relay protocols; (2) both perfect channel state information (CSI) and imperfect CSI at receivers are studied. In addition, we propose a practical method to forward the relays error characterization to the destination (quantization of the BER). This results in a fully practical scheme. (3) We show by simulation that the number of pilot symbols only affects the coding gain but not the diversity order, and that quantization accuracy affects both coding gain and diversity order. Moreover, when compared with the recent results using DMF protocol, our proposed DF protocol algorithm shows an improvement of 4 dB in fully interleaved Rayleigh fading channels and 0.7 dB in block Rayleigh fading channels.

Out of Reach, Out of Mind? Infants' Comprehension of References to Hidden Inaccessible Objects.

PubMed

Osina, Maria A; Saylor, Megan M; Ganea, Patricia A

2017-09-01

This study investigated the nature of infants' difficulty understanding references to hidden inaccessible objects. Twelve-month-old infants (N = 32) responded to the mention of objects by looking at, pointing at, or approaching them when the referents were visible or accessible, but not when they were hidden and inaccessible (Experiment I). Twelve-month-olds (N = 16) responded robustly when a container with the hidden referent was moved from a previously inaccessible position to an accessible position before the request, but failed to respond when the reverse occurred (Experiment II). This suggests that infants might be able to track the hidden object's dislocations and update its accessibility as it changes. Knowing the hidden object is currently inaccessible inhibits their responding. Older, 16-month-old (N = 17) infants' performance was not affected by object accessibility. © 2016 The Authors. Child Development © 2016 Society for Research in Child Development, Inc.

First-Year Seminar Intervention: Enhancing First-Year Mathematics Performance at the University of Johannesburg

ERIC Educational Resources Information Center

Jacobs, Melanie; Pretorius, Estherna

2016-01-01

South Africa has opened up access to higher education over the past 20 years. The massive increase in enrolments (with almost 70% first-generation students) substantially affects progress and graduation rates in Science programmes in higher education. First-year students in Science realise that university mathematics requires knowledge and skills…

Affective regulation of stereotype activation: It’s the (accessible) thought that counts

PubMed Central

Huntsinger, Jeffrey R.; Sinclair, Stacey; Dunn, Elizabeth; Clore, Gerald L.

2010-01-01

Extant research demonstrates that positive affect, compared to negative affect, increases stereotyping. In four experiments we explore whether the link between affect and stereotyping depends, critically, on the relative accessibility of stereotype-relevant thoughts and response tendencies. As well as manipulating mood, we measured or manipulated the accessibility of egalitarian response tendencies (Experiments 1-2) and counter-stereotypic thoughts (Experiments 3-4). In the absence of such response tendencies and thoughts, people in positive moods displayed greater stereotype activation —consistent with past research. By contrast, in the presence of accessible egalitarian response tendencies or counter-stereotypic thoughts, people in positive moods exhibited less stereotype activation than those in negative moods. PMID:20363909

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.

Novel Genes Affecting the Interaction between the Cabbage Whitefly and Arabidopsis Uncovered by Genome-Wide Association Mapping

PubMed Central

Broekgaarden, Colette; Bucher, Johan; Bac-Molenaar, Johanna; Keurentjes, Joost J. B.; Kruijer, Willem; Voorrips, Roeland E.; Vosman, Ben

2015-01-01

Plants have evolved a variety of ways to defend themselves against biotic attackers. This has resulted in the presence of substantial variation in defense mechanisms among plants, even within a species. Genome-wide association (GWA) mapping is a useful tool to study the genetic architecture of traits, but has so far only had limited exploitation in studies of plant defense. Here, we study the genetic architecture of defense against the phloem-feeding insect cabbage whitefly (Aleyrodes proletella) in Arabidopsis thaliana. We determined whitefly performance, i.e. the survival and reproduction of whitefly females, on 360 worldwide selected natural accessions and subsequently performed GWA mapping using 214,051 SNPs. Substantial variation for whitefly adult survival and oviposition rate (number of eggs laid per female per day) was observed between the accessions. We identified 39 candidate SNPs for either whitefly adult survival or oviposition rate, all with relatively small effects, underpinning the complex architecture of defense traits. Among the corresponding candidate genes, i.e. genes in linkage disequilibrium (LD) with candidate SNPs, none have previously been identified as a gene playing a role in the interaction between plants and phloem-feeding insects. Whitefly performance on knock-out mutants of a number of candidate genes was significantly affected, validating the potential of GWA mapping for novel gene discovery in plant-insect interactions. Our results show that GWA analysis is a very useful tool to gain insight into the genetic architecture of plant defense against herbivorous insects, i.e. we identified and validated several genes affecting whitefly performance that have not previously been related to plant defense against herbivorous insects. PMID:26699853

Impact of immediate access to the electronic medical record on anatomic pathology performance.

PubMed

Renshaw, Andrew A; Gould, Edwin W

2013-07-01

To assess the overall impact of access to the electronic medical record (EMR) on anatomic pathology performance. We reviewed the results of all use of the EMR by 1 pathologist over an 18-month period. Of the 10,107 cases (913 cytology and 9,194 surgical pathology) reviewed, the EMR (excluding anatomic pathology records) was accessed in 222 (2.2% of all cases, 6.5% of all cytology cases, and 1.8% of all surgical pathology cases). The EMR was used to evaluate a critical value in 20 (9.0%) cases and make a more specific diagnosis in 77 (34.7%) cases, a less specific diagnosis in 4 (1.8%) cases, and a systemic rather than localized diagnosis in 4 (1.8%) cases. The percentage of cases in which the physician was contacted decreased from 7.3% for the prior 18 months to 6.7%, but this change was not significant (P = .13). Twelve cases were subsequently sent for interinstitutional consultation, and no disagreements were identified. The EMR was accessed in 2.2% of all surgical pathology and cytology cases and affected the diagnosis in 48% of these cases.

Firearms in Frail Hands: An ADL or A Public Health Crisis!

PubMed

Patel, Dupal; Syed, Quratulain; Messinger-Rapport, Barbara J; Rader, Erin

2015-06-01

The incidence of neurocognitive disorders, which may impair the ability of older adults to perform activities of daily living (ADLs), rises with age. Depressive symptoms are also common in older adults and may affect ADLs. Safe storage and utilization of firearms are complex ADLs, which require intact judgment, executive function, and visuospatial ability, and may be affected by cognitive impairment. Depression or cognitive impairment may cause paranoia, delusions, disinhibition, apathy, or aggression and thereby limit the ability to safely utilize firearms. These problems may be superimposed upon impaired mobility, arthritis, visual impairment, or poor balance. Inadequate attention to personal protection may also cause hearing impairment and accidents. In this article, we review the data on prevalence of firearms access among older adults; safety concerns due to age-related conditions; barriers to addressing this problem; indications prompting screening for firearms access; and resources available to patients, caregivers, and health care providers. © The Author(s) 2014.

Rapid recovery from transient faults in the fault-tolerant processor with fault-tolerant shared memory

NASA Technical Reports Server (NTRS)

Harper, Richard E.; Butler, Bryan P.

1990-01-01

The Draper fault-tolerant processor with fault-tolerant shared memory (FTP/FTSM), which is designed to allow application tasks to continue execution during the memory alignment process, is described. Processor performance is not affected by memory alignment. In addition, the FTP/FTSM incorporates a hardware scrubber device to perform the memory alignment quickly during unused memory access cycles. The FTP/FTSM architecture is described, followed by an estimate of the time required for channel reintegration.

Patients struggle to access effective health care due to ongoing violence, distance, costs and health service performance in Afghanistan

PubMed Central

Nic Carthaigh, Niamh; De Gryse, Benoit; Esmati, Abdul Sattar; Nizar, Barak; Van Overloop, Catherine; Fricke, Renzo; Bseiso, Jehan; Baker, Corinne; Decroo, Tom; Philips, Mit

2015-01-01

Background The Afghan population suffers from a long standing armed conflict. We investigated patients’ experiences of their access to and use of the health services. Methods Data were collected in four clinics from different provinces. Mixed methods were applied. The questions focused on access obstacles during the current health problem and health seeking behaviour during a previous illness episode of a household member. Results To access the health facilities 71.8% (545/759) of patients experienced obstacles. The combination of long distances, high costs and the conflict deprived people of life-saving healthcare. The closest public clinics were underused due to perceptions regarding their lack of availability or quality of staff, services or medicines. For one in five people, a lack of access to health care had resulted in death among family members or close friends within the last year. Conclusions Violence continues to affect daily life and access to healthcare in Afghanistan. Moreover, healthcare provision is not adequately geared to meet medical and emergency needs. Impartial healthcare tailored to the context will be vital to increase access to basic and life-saving healthcare. PMID:25492948

Final summary report for 1989 inservice inspection (ISI) of SRS (Savannah River Site) 100-P Reactor tank

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

Morrison, J.M.; Loibl, M.W.

1989-12-15

The integrity of the SRS reactor tanks is a key factor affecting their suitability for continued service since, unlike the external piping system and components, the tanks are virtually irreplaceable. Cracking in various areas of the process water piping systems has occurred beginning in 1960 as a result of several degradation mechanisms, chiefly intergranular stress corrosion cracking (IGSCC) and chloride-induced transgranular cracking. IGSCC, currently the primary degradation mechanism, also occurred in the knuckle'' region (tank wall-to-bottom tube sheet transition piece) unique to C Reactor and was eventually responsible for that reactor being deactivated in 1985. A program of visual examinationsmore » of the SRS reactor tanks was initiated in 1968, which used a specially designed immersible periscope. Under that program the condition of the accessible tank welds and associated heat affected zones (HAZ) was evaluated on a five-year frequency. Prior to 1986, the scope of these inspections comprised approximately 20 percent of the accessible weld area. In late 1986 and early 1987 the scope of the inspections was expanded and a 100 percent visual inspection of accessible welds was performed of the P-, L-, and K-Reactor tanks. Supplemental dye penetrant examinations were performed in L Reactor on selected areas which showed visual indications. No evidence of cracking was detected in any of these inspections of the P-, L-, and K-Reactor tanks. 17 refs., 7 figs.« less

The effect of perches in cages during pullet rearing and egg laying on hen performance, foot health, and plumage

USDA-ARS?s Scientific Manuscript database

Our objective was to determine if perch availability during all or part of the life cycle of caged Hy-Line W-36 chickens affected egg traits, foot health, and feather condition. Using a 2 x 2 factorial arrangement, treatment 1 represented control chickens which never had access to perches during the...

Stumbling at the First Step: Efficiency Implications of Poor Performance in the Foundational First Five Years

ERIC Educational Resources Information Center

Crouch, Luis; Merseth, Katherine A.

2017-01-01

This paper highlights patterns in school enrollment indicators that affect the efficiency and effectiveness of education systems in a set of low-income countries: those that have expanded access quickly in the last decade or two, but have not yet absorbed that expansion efficiently. Although the patterns in these indicators are observable in the…

Factors affecting access to healthcare services by intermarried Filipino women in rural Tasmania: a qualitative study.

PubMed

Hannah, Chona T; Lê, Quynh

2012-10-01

Access to health care services is vital for every migrant's health and wellbeing. However, migrants' cultural health beliefs and views can hinder their ability to access available services. This study examined factors affecting access to healthcare services for intermarried Filipino women in rural Tasmania, Australia. A qualitative approach using semi-structured interviews was employed to investigate the factors affecting access to healthcare services for 30 intermarried Filipino women in rural Tasmania. The study used grounded theory and thematic analysis for its data analysis. Nvivo v8 (www.qsrinternational.com) was also used to assist the data coding process and analysis. Five influencing factors were identified: (1) language or communication barriers; (2) area of origin in the Philippines; (3) cultural barriers; (4) length of stay in Tasmania; and (5) expectations of healthcare services before and after migration. Factors affecting intermarried Filipino women in accessing healthcare services are shaped by their socio-demographic and cultural background. The insights gained from this study are useful to health policy-makers, healthcare professionals and to intermarried female migrants. The factors identified can serve as a guide to improve healthcare access for Filipino women and other migrants.

Transportation Statistics Annual Report 1997

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

Fenn, M.

1997-01-01

This document is the fourth Transportation Statistics Annual Report (TSAR) prepared by the Bureau of Transportation Statistics (BTS) for the President and Congress. As in previous years, it reports on the state of U.S. transportation system at two levels. First, in Part I, it provides a statistical and interpretive survey of the system—its physical characteristics, its economic attributes, aspects of its use and performance, and the scale and severity of unintended consequences of transportation, such as fatalities and injuries, oil import dependency, and environment impacts. Part I also explores the state of transportation statistics, and new needs of the rapidlymore » changing world of transportation. Second, Part II of the report, as in prior years, explores in detail the performance of the U.S. transportation system from the perspective of desired social outcomes or strategic goals. This year, the performance aspect of transportation chosen for thematic treatment is “Mobility and Access,” which complements past TSAR theme sections on “The Economic Performance of Transportation” (1995) and “Transportation and the Environment” (1996). Mobility and access are at the heart of the transportation system’s performance from the user’s perspective. In what ways and to what extent does the geographic freedom provided by transportation enhance personal fulfillment of the nation’s residents and contribute to economic advancement of people and businesses? This broad question underlies many of the topics examined in Part II: What is the current level of personal mobility in the United States, and how does it vary by sex, age, income level, urban or rural location, and over time? What factors explain variations? Has transportation helped improve people’s access to work, shopping, recreational facilities, and medical services, and in what ways and in what locations? How have barriers, such as age, disabilities, or lack of an automobile, affected these accessibility patterns? How are commodity flows and transportation services responding to global competition, deregulation, economic restructuring, and new information technologies? How do U.S. patterns of personal mobility and freight movement compare with other advanced industrialized countries, formerly centrally planned economies, and major newly industrializing countries? Finally, how is the rapid adoption of new information technologies influencing the patterns of transportation demand and the supply of new transportation services? Indeed, how are information technologies affecting the nature and organization of transportation services used by individuals and firms?« less

Exercise training effects on hypoxic and hypercapnic ventilatory responses in mice selected for increased voluntary wheel running.

PubMed

Kelly, Scott A; Rezende, Enrico L; Chappell, Mark A; Gomes, Fernando R; Kolb, Erik M; Malisch, Jessica L; Rhodes, Justin S; Mitchell, Gordon S; Garland, Theodore

2014-02-01

What is the central question of this study? We used experimental evolution to determine how selective breeding for high voluntary wheel running and exercise training (7-11 weeks) affect ventilatory chemoreflexes of laboratory mice at rest. What is the main finding and its importance? Selective breeding, although significantly affecting some traits, did not systematically alter ventilation across gas concentrations. As with most human studies, our findings support the idea that endurance training attenuates resting ventilation. However, little evidence was found for a correlation between ventilatory chemoreflexes and the amount of individual voluntary wheel running. We conclude that exercise 'training' alters respiratory behaviours, but these changes may not be necessary to achieve high levels of wheel running. Ventilatory control is affected by genetics, the environment and gene-environment and gene-gene interactions. Here, we used an experimental evolution approach to test whether 37 generations of selective breeding for high voluntary wheel running (genetic effects) and/or long-term (7-11 weeks) wheel access (training effects) alter acute respiratory behaviour of mice resting in normoxic, hypoxic and hypercapnic conditions. As the four replicate high-runner (HR) lines run much more than the four non-selected control (C) lines, we also examined whether the amount of exercise among individual mice was a quantitative predictor of ventilatory chemoreflexes at rest. Selective breeding and/or wheel access significantly affected several traits. In normoxia, HR mice tended to have lower mass-adjusted rates of oxygen consumption and carbon dioxide production. Chronic wheel access increased oxygen consumption and carbon dioxide production in both HR and C mice during hypercapnia. Breathing frequency and minute ventilation were significantly reduced by chronic wheel access in both HR and C mice during hypoxia. Selection history, while significantly affecting some traits, did not systematically alter ventilation across all gas concentrations. As with most human studies, our findings support the idea that endurance training (access to wheel running) attenuates resting ventilation. However, little evidence was found for a correlation at the level of the individual variation between ventilatory chemoreflexes and performance (amount of individual voluntary wheel running). We tentatively conclude that exercise 'training' alters respiratory behaviours, but these changes may not be necessary to achieve high levels of wheel running.

Exercise reward induces appetitive 50-kHz calls in rats.

PubMed

Heyse, Natalie C; Brenes, Juan C; Schwarting, Rainer K W

2015-08-01

Rats express affective states by visible behaviors (like approach or flight) and through different kinds of ultrasonic vocalizations (USV). 50-kHz calls are thought to reflect positive affective states since they occur during rewarding situations like social play or palatable food. However, the effects of voluntary exercise on USV have not been investigated yet, although such exercise can serve as reward. To this aim, we gave young adult rats restricted daily access to a runway maze, where they could interact with either a movable (experimental group) or locked wheel (sedentary group) for 14days and we tested USV in anticipation of and during subsequent running. We also studied inter-individual differences in running, and relationships with USV, and rat-typical trait measures. The results showed that the experimental rats had to be separated into "runners" and "pseudorunners" since only runners performed true running, whereas pseudorunners hardly entered the wheel and turned it only with their forelimbs. This outcome seems to be related to subject-dependent differences in responding to novelty and in reward sensitivity, as indicated by pertinent screening tests, which we had performed prior to the 14days of wheel access. In the runway, our experimental and control groups did not differ in visible anticipatory behavior, like approach. Yet, only runners and sedentary rats displayed an increasing but similar amount of anticipatory USV, which is suggestive of a state of incentive anticipation of the coming wheel access. During exercise, only runners increased USV, probably indicating a highly positive emotional state. To conclude, voluntary exercise provides a promising tool to induce 50-kHz USV during and in anticipation of exercise. When performing such studies, possible individual differences between subjects have to be taken into account, and the actual wheel performance should carefully be controlled. Copyright © 2015 Elsevier Inc. All rights reserved.

Affective Support for Intellectual Access: Preventing Accidents on the On-Ramp.

ERIC Educational Resources Information Center

Havener, W. Michael; Latrobe, Kathy

1995-01-01

Discussion of how students can successfully enter the information highway focuses on the role of the school media specialist. Topics include information-seeking behavior; missions and goals of library media programs; affective access, including interpersonal communication, physical and affective ergonomics, and social interaction; and global…

Investigating effects of communications modulation technique on targeting performance

NASA Astrophysics Data System (ADS)

Blasch, Erik; Eusebio, Gerald; Huling, Edward

2006-05-01

One of the key challenges facing the global war on terrorism (GWOT) and urban operations is the increased need for rapid and diverse information from distributed sources. For users to get adequate information on target types and movements, they would need reliable data. In order to facilitate reliable computational intelligence, we seek to explore the communication modulation tradeoffs affecting information distribution and accumulation. In this analysis, we explore the modulation techniques of Orthogonal Frequency Division Multiplexing (OFDM), Direct Sequence Spread Spectrum (DSSS), and statistical time-division multiple access (TDMA) as a function of the bit error rate and jitter that affect targeting performance. In the analysis, we simulate a Link 16 with a simple bandpass frequency shift keying (PSK) technique using different Signal-to-Noise ratios. The communications transfer delay and accuracy tradeoffs are assessed as to the effects incurred in targeting performance.

Humans do not have direct access to retinal flow during walking

PubMed Central

Souman, Jan L.; Freeman, Tom C.A.; Eikmeier, Verena; Ernst, Marc O.

2013-01-01

Perceived visual speed has been reported to be reduced during walking. This reduction has been attributed to a partial subtraction of walking speed from visual speed (Durgin & Gigone, 2007; Durgin, Gigone, & Scott, 2005). We tested whether observers still have access to the retinal flow before subtraction takes place. Observers performed a 2IFC visual speed discrimination task while walking on a treadmill. In one condition, walking speed was identical in the two intervals, while in a second condition walking speed differed between intervals. If observers have access to the retinal flow before subtraction, any changes in walking speed across intervals should not affect their ability to discriminate retinal flow speed. Contrary to this “direct-access hypothesis”, we found that observers were worse at discrimination when walking speed differed between intervals. The results therefore suggest that observers do not have access to retinal flow before subtraction. We also found that the amount of subtraction depended on the visual speed presented, suggesting that the interaction between the processing of visual input and of self-motion is more complex than previously proposed. PMID:20884509

Age Acquisition Norms from Elderly Spanish People: Characteristics and the Prediction of Word Recognition Performance in Alzheimer's Disease

ERIC Educational Resources Information Center

Cuetos, Fernando; Samartino, Tamara; Ellis, Andrew W.

2012-01-01

Age of acquisition is possibly the single most potent variable affecting lexical access. It is also a variable that determines the retention or loss of words in patients who have suffered brain injury, and in patients with Alzheimer's disease. But the norms of age of acquisition currently available have largely been obtained from university…

The impact of oral health on the academic performance of disadvantaged children.

PubMed

Seirawan, Hazem; Faust, Sharon; Mulligan, Roseann

2012-09-01

We measured the impact of dental diseases on the academic performance of disadvantaged children by sociodemographic characteristics and access to care determinants We performed clinical dental examinations on 1495 disadvantaged elementary and high school students from Los Angeles County public schools. We matched data with academic achievement and attendance data provided by the school district and linked these to the child's social determinants of oral health and the impact of oral health on the child's school and the parents' school or work absences. Students with toothaches were almost 4 times more likely to have a low grade point average. About 11% of students with inaccessible needed dental care missed school compared with 4% of those with access. Per 100 elementary and high school-aged children, 58 and 80 school hours, respectively, are missed annually. Parents averaged 2.5 absent days from work or school per year because of their children's dental problems. Oral health affects students' academic performance. Studies are needed that unbundle the clinical, socioeconomic, and cultural challenges associated with this epidemic of dental disease in children.

A Novel Dynamic Spectrum Access Framework Based on Reinforcement Learning for Cognitive Radio Sensor Networks.

PubMed

Lin, Yun; Wang, Chao; Wang, Jiaxing; Dou, Zheng

2016-10-12

Cognitive radio sensor networks are one of the kinds of application where cognitive techniques can be adopted and have many potential applications, challenges and future research trends. According to the research surveys, dynamic spectrum access is an important and necessary technology for future cognitive sensor networks. Traditional methods of dynamic spectrum access are based on spectrum holes and they have some drawbacks, such as low accessibility and high interruptibility, which negatively affect the transmission performance of the sensor networks. To address this problem, in this paper a new initialization mechanism is proposed to establish a communication link and set up a sensor network without adopting spectrum holes to convey control information. Specifically, firstly a transmission channel model for analyzing the maximum accessible capacity for three different polices in a fading environment is discussed. Secondly, a hybrid spectrum access algorithm based on a reinforcement learning model is proposed for the power allocation problem of both the transmission channel and the control channel. Finally, extensive simulations have been conducted and simulation results show that this new algorithm provides a significant improvement in terms of the tradeoff between the control channel reliability and the efficiency of the transmission channel.

A Novel Dynamic Spectrum Access Framework Based on Reinforcement Learning for Cognitive Radio Sensor Networks

PubMed Central

Lin, Yun; Wang, Chao; Wang, Jiaxing; Dou, Zheng

2016-01-01

Cognitive radio sensor networks are one of the kinds of application where cognitive techniques can be adopted and have many potential applications, challenges and future research trends. According to the research surveys, dynamic spectrum access is an important and necessary technology for future cognitive sensor networks. Traditional methods of dynamic spectrum access are based on spectrum holes and they have some drawbacks, such as low accessibility and high interruptibility, which negatively affect the transmission performance of the sensor networks. To address this problem, in this paper a new initialization mechanism is proposed to establish a communication link and set up a sensor network without adopting spectrum holes to convey control information. Specifically, firstly a transmission channel model for analyzing the maximum accessible capacity for three different polices in a fading environment is discussed. Secondly, a hybrid spectrum access algorithm based on a reinforcement learning model is proposed for the power allocation problem of both the transmission channel and the control channel. Finally, extensive simulations have been conducted and simulation results show that this new algorithm provides a significant improvement in terms of the tradeoff between the control channel reliability and the efficiency of the transmission channel. PMID:27754316

Age-sensitive design of online health information: comparative usability study.

PubMed

Pak, Richard; Price, Margaux M; Thatcher, Jason

2009-11-16

Older adults' health maintenance may be enhanced by having access to online health information. However, usability issues may prevent older adults from easily accessing such information. Prior research has shown that aging is associated with a unique pattern of cognitive changes, and knowledge of these changes may be used in the design of health websites for older adults. The goal of the current study was to examine whether older adults use of a health information website was affected by an alternative information architecture and access interface (hierarchical versus tag-based). Fifty younger adults (aged 18-23) and 50 older adults (aged 60-80) navigated a health information website, which was organized hierarchically or used tags/keywords, to find answers to health-related questions while their performance was tracked. We hypothesized that older adults would perform better in the tag-based health information website because it placed greater demands on abilities that remain intact with aging (verbal ability and vocabulary). The pattern of age-related differences in computer use was consistent with prior research with older adults. We found that older adults had been using computers for less time (F(1,98)= 10.6, P= .002) and used them less often (F(1,98)= 11.3, P= .001) than younger adults. Also consistent with the cognitive aging literature, younger adults had greater spatial visualization and orientation abilities (F(1,98)= 34.6, P< .001 and F(1,98)= 6.8, P= .01) and a larger memory span (F(1,98)= 5.7, P= .02) than older adults, but older adults had greater vocabulary (F(1,98)= 11.4, P= .001). Older adults also took significantly more medications than younger adults (F(1,98)= 57.7, P< .001). In the information search task, older adults performed worse than younger adults (F(1,96)= 18.0, P< .001). However, there was a significant age x condition interaction indicating that while younger adults outperformed older adults in the hierarchical condition (F(1,96)= 25.2, P< .001), there were no significant age-related differences in the tag-based condition, indicating that older adults performed as well as younger adults in this condition. Access to online health information is increasing in popularity and can lead to a more informed health consumer. However, usability barriers may differentially affect older adults. The results of the current study suggest that the design of health information websites that take into account age-related changes in cognition can enhance older adults' access to such information.

Accessible magnetic resonance imaging.

PubMed

Kaufman, L; Arakawa, M; Hale, J; Rothschild, P; Carlson, J; Hake, K; Kramer, D; Lu, W; Van Heteren, J

1989-10-01

The cost of magnetic resonance imaging (MRI) is driven by magnetic field strength. Misperceptions as to the impact of field strength on performance have led to systems that are more expensive than they need to be. Careful analysis of all the factors that affect diagnostic quality lead to the conclusion that field strength per se is not a strong determinant of system performance. Freed from the constraints imposed by high-field operation, it is possible to exploit a varied set of opportunities afforded by low-field operation. In addition to lower costs and easier siting, we can take advantage of shortened T1 times, higher contrast, reduced sensitivity to motion, and reduced radiofrequency power deposition. These conceptual advantages can be made to coalesce onto practical imaging systems. We describe a low-cost MRI system that utilizes a permanent magnet of open design. Careful optimization of receiving antennas and acquisition sequences permit performance levels consistent with those needed for an effective diagnostic unit. Ancillary advantages include easy access to the patient, reduced claustrophobia, quiet and comfortable operation, and absence of a missile effect. The system can be sited in 350 sq ft and consumes a modest amount of electricity. MRI equipment of this kind can widen the population base than can access this powerful and beneficial diagnostic modality.

Patients struggle to access effective health care due to ongoing violence, distance, costs and health service performance in Afghanistan.

PubMed

Nic Carthaigh, Niamh; De Gryse, Benoit; Esmati, Abdul Sattar; Nizar, Barak; Van Overloop, Catherine; Fricke, Renzo; Bseiso, Jehan; Baker, Corinne; Decroo, Tom; Philips, Mit

2015-05-01

The Afghan population suffers from a long standing armed conflict. We investigated patients' experiences of their access to and use of the health services. Data were collected in four clinics from different provinces. Mixed methods were applied. The questions focused on access obstacles during the current health problem and health seeking behaviour during a previous illness episode of a household member. To access the health facilities 71.8% (545/759) of patients experienced obstacles. The combination of long distances, high costs and the conflict deprived people of life-saving healthcare. The closest public clinics were underused due to perceptions regarding their lack of availability or quality of staff, services or medicines. For one in five people, a lack of access to health care had resulted in death among family members or close friends within the last year. Violence continues to affect daily life and access to healthcare in Afghanistan. Moreover, healthcare provision is not adequately geared to meet medical and emergency needs. Impartial healthcare tailored to the context will be vital to increase access to basic and life-saving healthcare. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Accessibility and content of individualized adult reconstructive hip and knee/musculoskeletal oncology fellowship web sites.

PubMed

Young, Bradley L; Cantrell, Colin K; Patt, Joshua C; Ponce, Brent A

2018-06-01

Accessible, adequate online information is important to fellowship applicants. Program web sites can affect which programs applicants apply to, subsequently altering interview costs incurred by both parties and ultimately impacting rank lists. Web site analyses have been performed for all orthopaedic subspecialties other than those involved in the combined adult reconstruction and musculoskeletal (MSK) oncology fellowship match. A complete list of active programs was obtained from the official adult reconstruction and MSK oncology society web sites. Web site accessibility was assessed using a structured Google search. Accessible web sites were evaluated based on 21 previously reported content criteria. Seventy-four adult reconstruction programs and 11 MSK oncology programs were listed on the official society web sites. Web sites were identified and accessible for 58 (78%) adult reconstruction and 9 (82%) MSK oncology fellowship programs. No web site contained all content criteria and more than half of both adult reconstruction and MSK oncology web sites failed to include 12 of the 21 criteria. Several programs participating in the combined Adult Reconstructive Hip and Knee/Musculoskeletal Oncology Fellowship Match did not have accessible web sites. Of the web sites that were accessible, none contained comprehensive information and the majority lacked information that has been previously identified as being important to perspective applicants.

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

PubMed

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

2017-02-20

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

Effects of Affordable Care Act Marketplaces and Medicaid Eligibility Expansion on Access to Cancer Care.

PubMed

Graves, John A; Swartz, Katherine

The aim of this study was to inform oncologists about how repealing the Affordable Care Act (ACA) may affect their ability to provide cancer therapies for people with cancer enrolled in ACA health plans and why proposals to change Medicaid funding may make it even more difficult for Medicaid beneficiaries to access cancer treatments. We examined the regulations and provisions of the ACA related to how health insurance impacts access to diagnostic testing and treatments for people with cancer, including access to clinical trials. Similarly, we examined federal and state rules affecting Medicaid beneficiaries' access to cancer treatments. Repealing various provisions of the ACA will restrict who has access to both current and new cancer treatments. Such changes also will impact oncology research that depends on having heterogeneous people in clinical trials. Significant changes to the ACA will affect oncology treatment choices of everyone with health insurance-not only the 10 million people newly covered by ACA health plans and the 70 million people with Medicaid coverage.

Effects of Affordable Care Act Marketplaces and Medicaid Eligibility Expansion on Access to Cancer Care

PubMed Central

Graves, John A.; Swartz, Katherine

2017-01-01

Purpose To inform oncologists about how repealing the ACA may affect their ability to provide cancer therapies for people with cancer enrolled in ACA health plans, and why proposals to change Medicaid funding may make it even more difficult for Medicaid beneficiaries to access cancer treatments. Methods We examined the regulations and provisions of the ACA related to how health insurance impacts access to diagnostic testing and treatments for people with cancer, including access to clinical trials. Similarly, we examined federal and state rules affecting Medicaid beneficiaries’ access to cancer treatments. Results Repealing various provisions of the ACA will restrict who has access to both current and new cancer treatments. Such changes also will impact oncology research that depends on having heterogeneous people in clinical trials. Discussion Significant changes to the ACA will affect oncology treatment choices of everyone with health insurance – not just the 10 million people newly covered by ACA health plans and the 70 million people with Medicaid coverage. PMID:28537962

38 CFR 1.552 - Public access to information that affects the public when not published in the Federal Register...

Code of Federal Regulations, 2010 CFR

2010-07-01

... information that affects the public when not published in the Federal Register as constructive notice. 1.552... Public access to information that affects the public when not published in the Federal Register as... Affairs but not published in the Federal Register, and administrative manuals and staff instructions that...

Phenomenal and access consciousness in olfaction.

PubMed

Stevenson, Richard J

2009-12-01

Contemporary literature on consciousness, with some exceptions, rarely considers the olfactory system. In this article the characteristics of olfactory consciousness, viewed from the standpoint of the phenomenal (P)/access (A) distinction, are examined relative to the major senses. The review details several qualitative differences in both olfactory P consciousness (shifts in the felt location, universal synesthesia-like and affect-rich experiences, and misperceptions) and A consciousness (recovery from habituation, capacity for conscious processing, access to semantic and episodic memory, learning, attention, and in the serial-unitary nature of olfactory percepts). The basis for these differences is argued to arise from the functions that the olfactory system performs and from the unique neural architecture needed to instantiate them. These data suggest, at a minimum, that P and A consciousness are uniquely configured in olfaction and an argument can be made that the P and A distinction may not hold for this sensory system.

The (political) economics of antiretroviral treatment in developing countries.

PubMed

Nattrass, Nicoli J

2008-12-01

Despite unprecedented international mobilisation to support universal provision of highly active antiretroviral therapy (HAART), national governments continue to play the key role in determining access to treatment. Whereas some AIDS-affected countries have performed as well as or better than expected given their level of development, institutional characteristics and demographic challenges (e.g. Thailand and Brazil), others (notably South Africa) have not. This article argues that the 'economics' of antiretroviral drug delivery is at heart a political-economy of access to treatment. It depends on commitment on the part of national governments to negotiate with pharmaceutical companies over patented antiretroviral drug prices, on their policy towards compulsory licensing, and on the approach they adopt to delivering HAART. Civil society has an important role to play in encouraging governments to become, and remain, committed to taking action to ensure sustainable and widespread access to HAART.

Experiences with using a pushrim-activated power-assisted wheelchair for community-based occupations: a qualitative exploration.

PubMed

Giesbrecht, Ed M; Ripat, Jacquie D; Cooper, Juliette E; Quanbury, Arthur O

2011-04-01

Occupational therapists strive to engage individuals in occupation and enhance community access through wheelchair prescription. Previous research with pushrim-activated, power-assisted wheelchairs identifies a reduction in the physical demands of manual wheelchair propulsion but limited evidence exists regarding user evaluation in context. This study explored the experience of using a power-assisted wheelchair in the community. Eight individuals who used both a power and manual device participated in focus groups after trialing a power-assist wheelchair for three weeks. Data were analyzed using a qualitative description approach. Three themes emerged from our analysis: relative advantages and disadvantages; environmental factors that affect accessibility; and evaluation of mobility device. Participants perceived the power-assist as improving performance and accessibility compared with the manual wheelchair, increasing the potential scope of occupations and environments, but not replacing their power mobility device. Sufficient time for adjustment of both user and device was important.

Being Single as a Social Barrier to Access Reproductive Healthcare Services by Iranian Girls

PubMed Central

Kohan, Shahnaz; Mohammadi, Fatemeh; Mostafavi, Firoozeh; Gholami, Ali

2017-01-01

Background: Iranian single women are deprived of reproductive healthcare services, though the provision of such services to the public has increased. This study aimed to explore the experiences of Iranian single women on their access to reproductive health services. Methods: A qualitative design using a conventional content analysis method was used. Semi-structured interviews were held with 17 single women and nine health providers chosen using the purposive sampling method. Results: Data analysis resulted in the development of three categories: ‘family’s attitudes and performance about single women’s reproductive healthcare,’ ‘socio-cultural factors influencing reproductive healthcare,’ and ‘cultural factors influencing being a single woman.’ Conclusion: Cultural and contextual factors affect being a single woman in every society. Therefore, healthcare providers need to identify such factors during the designing of strategies for improving the facilitation of access to reproductive healthcare services. PMID:28812794

Influence of hospital-level practice patterns on variation in the application of minimally invasive surgery in United States pediatric patients.

PubMed

Train, Arianne T; Harmon, Carroll M; Rothstein, David H

2017-10-01

Although disparities in access to minimally invasive surgery are thought to exist in pediatric surgical patients in the United States, hospital-level practice patterns have not been evaluated as a possible contributing factor. Retrospective cohort study using the Kids' Inpatient Database, 2012. Odds ratios of undergoing a minimally invasive compared to open operation were calculated for six typical pediatric surgical operations after adjustment for multiple patient demographic and hospital-level variables. Further adjustment to the regression model was made by incorporating hospital practice patterns, defined as operation-specific minimally invasive frequency and volume. Age was the most significant patient demographic factor affecting application of minimally invasive surgery for all procedures. For several procedures, adjusting for individual hospital practice patterns removed race- and income-based disparities seen in performance of minimally invasive operations. Disparities related to insurance status were not affected by the same adjustment. Variation in the application of minimally invasive surgery in pediatric surgical patients is primarily influenced by patient age and the type of procedure performed. Perceived disparities in access related to some socioeconomic factors are decreased but not eliminated by accounting for individual hospital practice patterns, suggesting that complex underlying factors influence application of advanced surgical techniques. II. Copyright © 2017 Elsevier Inc. All rights reserved.

Healthcare organizational change: implications for access to care and its measurement.

PubMed Central

Miller, R. H.

1998-01-01

OBJECTIVES: To summarize evidence from peer-reviewed literature on access to care for vulnerable HMO enrollee populations; to discuss the potential effect of recent HMO and physician organization changes on access to care and its measurement. STUDY DESIGN: Review and summary of peer-reviewed literature for two HMO populations: those with chronic conditions and diseases, and those subject to discrimination due to income, color, or ethnic background. I also reviewed and summarized literature on three major changes in capitated organizations (HMOs and capitated physician organizations) that could affect access to care for vulnerable populations, and summarized findings from healthcare manager interviews conducted for several recent research projects on health system change. PRINCIPAL FINDINGS: Although mixed, there are enough negative results to raise some concerns about access to care for HMO enrollees with chronic conditions and diseases. Several emerging organizational changes have the potential to change access to care for the vulnerable HMO enrollees. The shift in cost-cutting from fragmented clinical management of specific services at a point in time toward more integrated clinical management of all services for specific types of patients across time may improve access to care, as may increased efforts to attract and retain HMO enrollees. The increased importance of capitated provider organizations within the health system may restrict access in some ways, and expand access in others. CONCLUSIONS: Organizational changes can affect both access to care and its measurement. More research is needed on the effects of these changes on access to care and quality of care. For researchers examining access to care for vulnerable HMO enrollee populations, these changes create challenges to determine the most appropriate measures of access to care, and the most appropriate organizations and organizational characteristics to measure. RELEVANCE TO CLINICAL PRACTICE, MANAGEMENT, AND/OR POLICY: Changes in market competition are leading to organizational changes that affect access to care for vulnerable HMO enrollee populations. Public and/or private policies that improve measurement and reporting can affect market competition and improve access to care. PMID:9685111

Spread of hatch and delayed feed access affect post hatch performance of female broiler chicks up to day 5.

PubMed

Wang, Y; Li, Y; Willems, E; Willemsen, H; Franssens, L; Koppenol, A; Guo, X; Tona, K; Decuypere, E; Buyse, J; Everaert, N

2014-04-01

It is not rare that newly hatched chicks remain without feed for about 24 to 48 h before they are placed on farms due to a series of logistic operations. Furthermore, the spread in hatching time can also mount up to 30 to 48 h for late v. early hatchers. In other words, the practice is a complex combination of spread of hatch and delayed feed access. The present study was aimed to investigate the combined effects of hatching time with a delay in feed access of 48 h, starting from their hatch-time (biological age). When chicks had access to feed immediately after hatch, late hatchers had a higher feed intake and relative growth rate up to day 5 compared with their early hatched counterparts. Feed deprivation during the first 48 h resulted in retarded early growth rate, which was further aggravated by an impaired feed intake after refeeding. In addition, the differential effects of hatching time on relative growth rate and feed intake observed in immediately fed chicks were eliminated by the 48 h feed delay. The yolk utilization after hatch was faster for the late hatchers up to biological day 2 regardless of the feeding treatments. Hatching muscle glycogen content was higher in the late hatchers compared with that of their early counterparts at hatch and at biological day 2 independent of feeding treatment. Moreover, the liver glycogen content of the late hatchers was also higher at hatch. For the immediately fed chicks, the proportional breast muscle weight of the late hatchers was higher at biological day 2 and 5. For the starved chicks, on the other hand, this effect was only observed after they had access to feed (biological day 5). The different plasma T3 levels at hatch may have contributed to the different post hatch performance. It is concluded that the spread of hatch influenced post hatch performance, especially appetite and growth at least until day 5. Moreover, the delay in feed access interacted with the hatching time and caused adverse effects on the post hatch performance.

Effects of accessible website design on nondisabled users: age and device as moderating factors.

PubMed

Schmutz, Sven; Sonderegger, Andreas; Sauer, Juergen

2018-05-01

This study examined how implementing recommendations from Web accessibility guidelines affects nondisabled people in different age groups using different technical devices. While recent research showed positive effects of implementing such recommendations for nondisabled users, it remains unclear whether such effects would apply to different age groups and kind of devices. A 2 × 2 × 2 design was employed with website accessibility (high accessibility vs. very low accessibility), age (younger adults vs. older adults) and type of device (laptop vs. tablet) as independent variables. 110 nondisabled participants took part in a usability test, in which performance and satisfaction were measured as dependent variables. The results showed that higher accessibility increased task completion rate, task completion time and satisfaction ratings of nondisabled users. While user age did not have any effects, users showed faster task completion time under high accessibility when using a tablet rather than a laptop. The findings confirmed previous findings, which showed benefits of accessible websites for nondisabled users. These beneficial effects may now be generalised to a wide age range and across different devices. Practitioner Summary: This work is relevant to the design of websites since it emphasises the need to consider the characteristics of different user groups. Accessible website design (aimed at users with disabilities) leads to benefits for nondisabled users across different ages. These findings provide further encouragement for practitioners to apply WCAG 2.0.

Diagnosing students' misconceptions in algebra: results from an experimental pilot study.

PubMed

Russell, Michael; O'Dwyer, Laura M; Miranda, Helena

2009-05-01

Computer-based diagnostic assessment systems hold potential to help teachers identify sources of poor performance and to connect teachers and students to learning activities designed to help advance students' conceptual understandings. The present article presents findings from a study that examined how students' performance in algebra and their overcoming of common algebraic misconceptions were affected by the use of a diagnostic assessment system that focused on important algebra concepts. This study used a four-group randomized cluster trial design in which teachers were assigned randomly to one of four groups: a "business as usual" control group, a partial intervention group that was provided with access to diagnostic tests results, a partial intervention group that was provided with access to the learning activities, and a full intervention group that was given access to the test results and learning activities. Data were collected from 905 students (6th-12th grade) nested within 44 teachers. We used hierarchical linear modeling techniques to compare the effects of full, partial, and no (control) intervention on students' algebraic ability and misconceptions. The analyses indicate that full intervention had a net positive effect on ability and misconception measures.

Kidney Biopsy Adequacy: A Metric-based Study.

PubMed

Ferrer, German; Andeen, Nicole K; Lockridge, Joseph; Norman, Douglas; Foster, Bryan R; Houghton, Donald C; Troxell, Megan L

2018-06-05

There are differences in renal biopsy yield related to on-site evaluation, tissue division, and operator, among others. To understand these variations, we collected adequacy-associated data (%cortex, glomeruli, arteries, length) from consecutive native and allograft kidney biopsies over a 22-month period. In total, 1332 biopsies (native: 873, allograft: 459) were included, 617 obtained by nephrologists, 663 by radiologists, and 559 with access to on-site division. Proceduralists with access to on-site evaluation had significantly lower inadequacy rates and better division of tissue for light microscopy (LM), immunofluorescence, and electron microscopy than those without access to on-site evaluation. Radiologists in our region were significantly less likely to have access to on-site evaluation than nephrologists. On multivariate analysis for native kidney biopsies, the effect of having a radiologist perform the biopsy and having access to on-site division were both significant predictors of obtaining greater calculated amount of cortex for LM. Despite the trend for radiologists to obtain more tissue in general, biopsies from nephrologists contained a greater percentage of cortex and were more likely to be considered adequate for LM (native kidney inadequacy rate for LM: 1.11% vs. 5.41%, P=0.0086). Biopsies in which inadequate or marginal cortical tissue was submitted for LM had only minor decreases in the amount of cortex submitted for immunofluorescence and electron microscopy, revealing an opportunity for improved specimen triaging when limited tissue is obtained. In conclusion, both on-site evaluation/division and proceduralist significantly affect quantitative kidney biopsy metrics, which in turn affects the pathologist's ability to render an accurate diagnosis with appropriate prognostic information for the patient and treating nephrologist.

48 CFR 2452.239-70 - Access to HUD systems.

Code of Federal Regulations, 2013 CFR

2013-10-01

... information of which the loss, misuse, or unauthorized access to, or modification of, could adversely affect... normally includes hardware, software, information, data, applications, communications, and people (see OMB..., using, or operating the system or applications(s). (c) Citizenship-related requirements. Each affected...

Running increases ethanol preference.

PubMed

Werme, Martin; Lindholm, Sara; Thorén, Peter; Franck, Johan; Brené, Stefan

2002-07-18

Wheel running performed by rats is reinforcing, rewarding and possibly addictive. In this study we analyzed if wheel running could affect ethanol preference. Lewis rats, known to be both addiction-prone and to develop an excessive wheel running behavior, were given access to ethanol in a two-bottle free-choice paradigm. The animals reached a high and stable ethanol intake after 5 weeks. In the next phase, rats were subjected to ethanol withdrawal for 1, 2 or 4 weeks with or without access to running wheels. Finally animals were again given access to ethanol in the same two-bottle free-choice paradigm, combined with access to running wheels. The rats that ran in running wheels during 1 or 2, but not 4, weeks of ethanol withdrawal increased both ethanol intake and preference as compared with the control group that did not have access to the wheels. Previous studies have demonstrated that low doses of morphine increases ethanol preference. Here we show that also running potentiates ethanol intake and preference. Thus, running which shares many of the reinforcing properties with addictive drugs appears to potentiate rats to an increased preference for ethanol. Our results describe a behavioral interaction where running increases ethanol consumption.

Organ Procurement Organizations and the Electronic Health Record.

PubMed

Howard, R J; Cochran, L D; Cornell, D L

2015-10-01

The adoption of electronic health records (EHRs) has adversely affected the ability of organ procurement organizations (OPOs) to perform their federally mandated function of honoring the donation decisions of families and donors who have signed the registry. The difficulties gaining access to potential donor medical record has meant that assessment, evaluation, and management of brain dead organ donors has become much more difficult. Delays can occur that can lead to potential recipients not receiving life-saving organs. For over 40 years, OPO personnel have had ready access to paper medical records. But the widespread adoption of EHRs has greatly limited the ability of OPO coordinators to readily gain access to patient medical records and to manage brain dead donors. Proposed solutions include the following: (1) hospitals could provide limited access to OPO personnel so that they could see only the potential donor's medical record; (2) OPOs could join with other transplant organizations to inform regulators of the problem; and (3) hospital organizations could be approached to work with Center for Medicare and Medicaid Services (CMS) to revise the Hospital Conditions of Participation to require OPOs be given access to donor medical records. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

How Funding and Policy Affect Access to and Modernization of Major Air Force Ground Test Infrastructure Assets

DTIC Science & Technology

2017-04-06

center’s wind tunnels, gas turbine sea level and altitude test cells, space chambers, altitude rocket cells, ballistic ranges, arc heaters and other...number of programs, and the difficulty getting new programs approved, the services are reluctant to delay or cancel programs. Performance problems in...manpower as an indirect cost would alleviate problems with maintaining expertise. The indirect costs provide for security, base infrastructure

Retroperitoneal versus direct femoral artery approach for thoracic endovascular aortic repair access: a case-control study.

PubMed

Etezadi, Vahid; Katzen, Barry T; Benenati, James F; Alehashemi, Sara; Tsoukas, Athanassios I; Puente, Orlando A

2011-04-01

Many individuals who are candidates for thoracic endovascular aortic repair (TEVAR) are found to have iliac artery anatomy and/or disease that preclude transfemoral endovascular access and require retroperitoneal surgical approach through more proximal arteries. This relatively more invasive technique could potentially affect the procedural outcomes. This study compares the retroperitoneal with transfemoral access used for TEVAR in a single center. In this study, 133 consecutive patients (96 men; mean age ± SD: 69.5 ± 14.7 years) who underwent TEVAR between 1994 and 2009 in a single center were retrospectively evaluated. The type of endovascular access was identified in all the patients. The basic demographics, access method, endograft type, 30-day morbidity and mortality rates, as well as procedure recordings including fluoroscopic and procedure duration, estimated blood loss, and duration of hospitalization were compared between the TEVAR procedures performed using a surgical retroperitoneal approach and those using the standard femoral access. Retroperitoneal access was used in 19 (14.3%; 13 women; mean age ± SD: 71 ± 12.2 years) and direct femoral access in 114 (85.7%; 24 women; mean age ± SD: 69 ± 15.4 years) patients. Two of the retroperitoneal accesses were obtained after failure of femoral approach. Techniques that were used included iliac artery conduit (seven patients), aortic artery conduit (eight patients), aortobifemoral artery graft conduit (one patient), and direct sheath introduction through the distal aorta (two patients) or common iliac artery (one patient). Retroperitoneal approach was used more frequently in women (35%) as compared with men (6%) (p = 0.0001). In all, 79% of the retroperitoneal approaches were associated with use of delivery sheath sizes larger than 24F (p = 0.049). TEVAR technical success was 100% with retroperitoneal and 97.3% with femoral access (p > 0.05). Thirty-day mortality rates were 0% and 8.8% and the rates of access artery injury were 5.3% and 4.4% in retroperitoneal and femoral access groups, respectively (p > 0.05). The incidence of retroperitoneal hematoma was significantly higher with retroperitoneal access (21% vs. 2.6%, p = 0.008). Additionally, retroperitoneal access was associated with significant increase in estimated blood loss and duration of hospitalization (p < 0.05). Type of access does not affect TEVAR success and the early mortality rate. Retroperitoneal approach is a valuable alternative technique in cases involving failed or impossible femoral access. However, this approach is associated with higher chances of retroperitoneal bleeding and longer procedural time and duration of hospitalization. Thoracic endografts with smaller delivery systems could minimize the need for this approach in the future. Copyright © 2011 Annals of Vascular Surgery Inc. All rights reserved.

Discrimination, work and health in immigrant populations in Spain.

PubMed

Agudelo-Suárez, Andrés; Gil-González, Diana; Ronda-Pérez, Elena; Porthé, Victoria; Paramio-Pérez, Gema; García, Ana M; Garí, Aitana

2009-05-01

One of the most important social phenomena in the global context is the flow of immigration from developing countries, motivated by economic and employment related issues. Discrimination can be approached as a health risk factor within the immigrant population's working environment, especially for those immigrants at greater risk from social exclusion and marginalisation. The aim of this study is to research perceptions of discrimination and the specific relationship between discrimination in the workplace and health among Spain's immigrant population. A qualitative study was performed by means of 84 interviews and 12 focus groups held with immigrant workers in five cities in Spain receiving a large influx of immigrants (Madrid, Barcelona, Valencia, Alicante and Huelva), covering representative immigrant communities in Spain (Romanians, Moroccans, Ecuadorians, Colombians and Sub-Saharan Africans). Discourse narrative content analysis was performed using pre-established categories and gradually incorporating other emerging categories from the immigrant interviewees themselves. The participants reported instances of discrimination in their community and working life, characterised by experiences of racism, mistreatment and precarious working conditions in comparison to the Spanish-born population. They also talked about limitations in terms of accessible occupations (mainly construction, the hotel and restaurant trade, domestic service and agriculture), and described major difficulties accessing other types of work (for example public administration). They also identified political and legal structural barriers related with social institutions. Experiences of discrimination can affect their mental health and are decisive factors regarding access to healthcare services. Our results suggest the need to adopt integration policies in both the countries of origin and the host country, to acknowledge labour and social rights, and to conduct further research into individual and social factors that affect the health of the immigrant populations.

A comprehensive review of HIV/STI prevention and sexual and reproductive health services among sex Workers in Conflict-Affected Settings: call for an evidence- and rights-based approach in the humanitarian response.

PubMed

Ferguson, Alyssa; Shannon, Kate; Butler, Jennifer; Goldenberg, Shira M

2017-01-01

While the conditions in emergency humanitarian and conflict-affected settings often result in significant sex work economies, there is limited information on the social and structural conditions of sex work in these settings, and the impacts on HIV/STI prevention and access to sexual and reproductive health (SRH) services for sex workers. Our objective was to comprehensively review existing evidence on HIV/STI prevention and access to SRH services for sex workers in conflict-affected settings globally. We conducted a comprehensive review of all peer review (both epidemiological and qualitative) and grey literature published in the last 15 years (2000-2015), focusing on 1) HIV/STI vulnerability or prevention, and/or 2) access to SRH services for sex workers in conflict-affected settings. Five databases were searched, using combinations of sex work, conflict/mobility, HIV/STI, and SRH service terms. Relevant peer-reviewed and grey literature were also hand-searched, and key papers were cross-referenced for additional material. Five hundred fifty one records were screened and 416 records reviewed. Of 33 records describing HIV/STI prevention and/or access to SRH services among sex workers in conflict-affected settings, 24 were from sub-Saharan Africa; 18 studies described the results of primary research (13 quantitative, 3 qualitative, 2 mixed-methods) and 15 were non-primary research (e.g., commentaries, policy reports, programmatic manuals). Available evidence indicated that within conflict-affected settings, SWs' capacity to engage in HIV/STI prevention and access SRH services is severely undermined by social and structural determinants including widespread violence and human rights violations, the collapse of livelihoods and traditional social structures, high levels of displacement, and difficulties accessing already scant health services due to stigma, discrimination and criminalization. This review identified significant gaps in HIV/STI and SRH research, policy, and programming for conflict-affected sex workers, highlighting a critical gap in the humanitarian response. Sex worker-informed policies and interventions to promote HIV/STI prevention and access to HIV and SRH services using a rights-based approach are recommended, and further research on the degree to which conflict-affected sex workers are accessing HIV/STI and SRH services is recommended.A paradigm shift from the behavioural and biomedical approach to a human rights-based approach to HIV/STI prevention and SRH is strongly recommended.

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

PubMed

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

2017-10-01

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

Version pressure feedback mechanisms for speculative versioning caches

DOEpatents

Eichenberger, Alexandre E.; Gara, Alan; O& #x27; Brien, Kathryn M.; Ohmacht, Martin; Zhuang, Xiaotong

2013-03-12

Mechanisms are provided for controlling version pressure on a speculative versioning cache. Raw version pressure data is collected based on one or more threads accessing cache lines of the speculative versioning cache. One or more statistical measures of version pressure are generated based on the collected raw version pressure data. A determination is made as to whether one or more modifications to an operation of a data processing system are to be performed based on the one or more statistical measures of version pressure, the one or more modifications affecting version pressure exerted on the speculative versioning cache. An operation of the data processing system is modified based on the one or more determined modifications, in response to a determination that one or more modifications to the operation of the data processing system are to be performed, to affect the version pressure exerted on the speculative versioning cache.

Globalization of Access to Higher Education: Lessons for Nigeria

ERIC Educational Resources Information Center

Uchendu, C. C.

2013-01-01

Education is such a powerful instrument for national transformation and development such that anything that affects an educational system negatively affects the national development. This study investigated the extent to which access to higher education is globalized and the implications for Nigeria. An ex-post facto research design was adopted…

Modeling coding-sequence evolution within the context of residue solvent accessibility.

PubMed

Scherrer, Michael P; Meyer, Austin G; Wilke, Claus O

2012-09-12

Protein structure mediates site-specific patterns of sequence divergence. In particular, residues in the core of a protein (solvent-inaccessible residues) tend to be more evolutionarily conserved than residues on the surface (solvent-accessible residues). Here, we present a model of sequence evolution that explicitly accounts for the relative solvent accessibility of each residue in a protein. Our model is a variant of the Goldman-Yang 1994 (GY94) model in which all model parameters can be functions of the relative solvent accessibility (RSA) of a residue. We apply this model to a data set comprised of nearly 600 yeast genes, and find that an evolutionary-rate ratio ω that varies linearly with RSA provides a better model fit than an RSA-independent ω or an ω that is estimated separately in individual RSA bins. We further show that the branch length t and the transition-transverion ratio κ also vary with RSA. The RSA-dependent GY94 model performs better than an RSA-dependent Muse-Gaut 1994 (MG94) model in which the synonymous and non-synonymous rates individually are linear functions of RSA. Finally, protein core size affects the slope of the linear relationship between ω and RSA, and gene expression level affects both the intercept and the slope. Structure-aware models of sequence evolution provide a significantly better fit than traditional models that neglect structure. The linear relationship between ω and RSA implies that genes are better characterized by their ω slope and intercept than by just their mean ω.

A Pilot Study of the Effects of Internet-Based Cognitive Stimulation on Neuropsychological Function in HIV Disease

PubMed Central

Becker, James T.; Dew, Mary Amanda; Aizenstein, Howard J.; Lopez, Oscar L.; Morrow, Lisa; Saxton, Judith; Tarraga, Lluis

2012-01-01

Purpose Mild cognitive deficits associated with HIV disease can affect activities of daily living, so interventions that reduce them may have a long-term effect on quality of life. We evaluated the feasibility of a cognitive stimulation program (CSP) to improve neuropsychological test performance in HIV disease. Methods 60 volunteers (30 HIV-infected) participated. The primary outcome was the change in neuropsychological test performance as indexed by the Global Impairment Rating; secondary outcomes included mood (Brief Symptom Inventory subscales) and quality of life rating (Medical Outcomes Survey-HIV) scales. Results 52 participants completed all 24 weeks of the study, and 54% of the participants in the CSP group successfully used the system via internet access from their home or other location. There was a significant interaction between usage and study visit such that the participants who used the program most frequently showed significantly greater improvements in cognitive functioning (F(3,46.4)=3.26, p =.030); none of the secondary outcomes were affected by the dose of CSP. Conclusions We found it possible to complete an internet-based CSP in HIV-infected individuals; ease of internet access was a key component for success. Participants who used the program most showed improvements in cognitive function over the 24-week period, suggesting that a larger clinical trial of CSP may be warranted. PMID:22458375

[Health impact assessment of "white-collar exemption" in Japan].

PubMed

Fujino, Yoshihisa; Matsuda, Shinya

2007-03-01

This work conducted a health impact assessment (HIA) of the Japanese Government's proposal concerning the introduction of so called "white-collar exemption" into the Japanese labor market. We adopted the Merseyside model and performed a rapid health impact assessment to assess the potential health effects of white-collar exemption. In this HIA, several health determinants which may possibly be affected, both positively and negatively, were identified based on experts' judgments. Literature evidence was assessed using PubMed and other databases. In addition, we searched for the opinions of those affected by white-collar exemption from internet web sites, and six concerns were identified. Long working hours were identified as the most serious concern by both experts and those affected. White-collar exemption may increase irregular working patterns which may be related to sleep disorder, stress, and cardiovascular disease. Family function and social participation will also be affected by irregular working patterns. On the other hand, in terms of stress, white-collar exemption may benefit from a higher degree of job control. There are possibilities that white-collar exemption may enable an improved work-life balance and enable access of some groups of the population, such as people with disabilities or parents looking after children, greater access to the labour market. However, it is uncertain whether the benefits of white-collar exemption would overcome those of the current free-time or flex-time systems. The present work provides a wide range of health impacts of white-collar exemption, and will hopefully attract the attentions of decision-makers and those likely to be affected in order to contribute to policy-making.

Factors Involved in Access and Utilization of Adult Hearing Healthcare: A Systematic Review

PubMed Central

Barnett, Margaret; Hixon, Brian; Okwiri, Neville; Irungu, Catherine; Ayugi, John; Thompson, Robin; Shinn, Jennifer B.; Bush, Matthew L.

2016-01-01

Objective/Hypothesis Hearing loss is a public health concern yet hearing healthcare disparities exist and influence utilization of rehabilitation services. The objective of this review was to systematically analyze the published literature on motivators, barriers, and compliance factors affecting adult patient access and utilization of hearing rehabilitation healthcare. Data Sources and Study Eligibility Criteria Pubmed, PsychINFO, CINAHL, Web of Science were searched for relevant articles. Eligible studies were those containing original, peer-reviewed research in English pertaining to factors affecting adult hearing healthcare access and utilization of hearing aids and cochlear implantation. The search encompassed 1990-2015. Study Appraisal and Synthesis Methods Two investigators independently reviewed all articles and extracted data. Specific variables regarding access to care and compliance to recommended care were extracted from each study. Results Thirty articles were reviewed. The factors affecting access and utilization of hearing rehabilitation could be classified into motivators, barriers, and compliance in treatment or device use. The key motivators to seek care include degree of hearing loss, self-efficacy, family support, and self-recognition of hearing loss. The primary barriers to care were financial limitations, stigma of hearing devices, inconvenience, competing chronic health problems, and unrealistic expectations. Compliance is most affected by self-efficacy, education level, and engagement in the rehabilition process. Conclusion Accessing hearing healthcare is complicated by multiple factors. Considering the current climate in healthcare policy and legislation towards improved access of care, a deeper understanding of motivators, barriers and compliance factors can aid in delivery of effective and efficient hearing healthcare. PMID:27545324

Factors involved in access and utilization of adult hearing healthcare: A systematic review.

PubMed

Barnett, Margaret; Hixon, Brian; Okwiri, Neville; Irungu, Catherine; Ayugi, John; Thompson, Robin; Shinn, Jennifer B; Bush, Matthew L

2017-05-01

Hearing loss is a public health concern, yet hearing healthcare disparities exist and influence utilization of rehabilitation services. The objective of this review was to systematically analyze the published literature on motivators, barriers, and compliance factors affecting adult patient access and utilization of hearing rehabilitation healthcare. Pubmed, PsychINFO, CINAHL, and Web of Science were searched for relevant articles. Eligible studies were those containing original, peer-reviewed research in English pertaining to factors affecting adult hearing healthcare access and utilization of hearing aids and cochlear implantation. The search encompassed 1990 to 2015. Two investigators independently reviewed all articles and extracted data. Specific variables regarding access to care and compliance to recommended care were extracted from each study. Thirty articles were reviewed. The factors affecting access and utilization of hearing rehabilitation could be classified into motivators, barriers, and compliance in treatment or device use. The key motivators to seek care include degree of hearing loss, self-efficacy, family support, and self-recognition of hearing loss. The primary barriers to care were financial limitations, stigma of hearing devices, inconvenience, competing chronic health problems, and unrealistic expectations. Compliance is most affected by self-efficacy, education level, and engagement in the rehabilitation process. Accessing hearing healthcare is complicated by multiple factors. Considering the current climate in healthcare policy and legislation toward improved access of care, a deeper understanding of motivators, barriers, and compliance factors can aid in delivery of effective and efficient hearing healthcare. Laryngoscope, 127:1187-1194, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Dose-dependent effects of hydrocortisone infusion on autobiographical memory recall

PubMed Central

Young, Kymberly; Drevets, Wayne C.; Schulkin, Jay; Erickson, Kristine

2011-01-01

The glucocorticoid hormone cortisol has been shown to impair episodic memory performance. The present study examined the effect of two doses of hydrocortisone (synthetic cortisol) administration on autobiographical memory retrieval. Healthy volunteers (n=66) were studied on two separate visits, during which they received placebo and either moderate-dose (0.15 mg/kg IV; n=33) or high-dose (0.45 mg/kg IV; n=33) hydrocortisone infusion. From 75 to 150 min post-infusion subjects performed an Autobiographical Memory Test and the California Verbal Learning Test (CVLT). The high-dose hydrocortisone administration reduced the percent of specific memories recalled (p = 0.04), increased the percent of categorical (nonspecific) memories recalled, and slowed response times for categorical memories (p <0.001), compared to placebo performance (p < 0.001). Under moderate-dose hydrocortisone the autobiographical memory performance did not change significantly with respect to percent of specific or categorical memories recalled or reaction times. Performance on the CVLT was not affected by hydrocortisone. These findings suggest that cortisol affects accessibility of autobiographical memories in a dose-dependent manner. Specifically, administration of hydrocortisone at doses analogous to those achieved under severe psychosocial stress impaired the specificity and speed of retrieval of autobiographical memories. PMID:21942435

Elements of well-being affected by criminalizing the drug user.

PubMed Central

Iguchi, Martin Y.; London, Jennifer A.; Forge, Nell Griffith; Hickman, Laura; Fain, Terry; Riehman, Kara

2002-01-01

OBJECTIVE: The authors examine the possible adverse consequences of incarceration on drug offenders, their families, and their communities. OBSERVATIONS: State and federal policies on drug felons may affect eight elements of personal and community well-being: children and families, access to health benefits, access to housing benefits, access to assistance for higher education, immigration status, employment, eligibility to vote, and drug use or recidivism. CONCLUSIONS: Minorities have a high chance of felony conviction and an increasing lack of access to resources, suggesting that patterns of drug conviction and health disparities may be mutually reinforcing. Large numbers of people sent to prison for drug offenses are now completing their terms and reentering communities. Their reentry will disproportionately affect minority communities. Without resources (education, job opportunities, insurance, health care, housing, and the right to vote) drug abusers face a higher risk of recidivism and increase the burden on their communities. PMID:12435838

The effect of concurrent semantic categorization on delayed serial recall.

PubMed

Acheson, Daniel J; MacDonald, Maryellen C; Postle, Bradley R

2011-01-01

The influence of semantic processing on the serial ordering of items in short-term memory was explored using a novel dual-task paradigm. Participants engaged in 2 picture-judgment tasks while simultaneously performing delayed serial recall. List material varied in the presence of phonological overlap (Experiments 1 and 2) and in semantic content (concrete words in Experiment 1 and 3; nonwords in Experiments 2 and 3). Picture judgments varied in the extent to which they required accessing visual semantic information (i.e., semantic categorization and line orientation judgments). Results showed that, relative to line-orientation judgments, engaging in semantic categorization judgments increased the proportion of item-ordering errors for concrete lists but did not affect error proportions for nonword lists. Furthermore, although more ordering errors were observed for phonologically similar relative to dissimilar lists, no interactions were observed between the phonological overlap and picture-judgment task manipulations. These results demonstrate that lexical-semantic representations can affect the serial ordering of items in short-term memory. Furthermore, the dual-task paradigm provides a new method for examining when and how semantic representations affect memory performance.

The Effect of Concurrent Semantic Categorization on Delayed Serial Recall

PubMed Central

Acheson, Daniel J.; MacDonald, Maryellen C.; Postle, Bradley R.

2010-01-01

The influence of semantic processing on the serial ordering of items in short-term memory was explored using a novel dual-task paradigm. Subjects engaged in two picture judgment tasks while simultaneously performing delayed serial recall. List material varied in the presence of phonological overlap (Experiments 1 and 2) and in semantic content (concrete words in Experiment 1 and 3; nonwords in Experiments 2 and 3). Picture judgments varied in the extent to which they required accessing visual semantic information (i.e., semantic categorization and line orientation judgments). Results showed that, relative to line orientation judgments, engaging in semantic categorization judgments increased the proportion of item ordering errors for concrete lists but did not affect error proportions for nonword lists. Furthermore, although more ordering errors were observed for phonologically similar relative to dissimilar lists, no interactions were observed between the phonological overlap and picture judgment task manipulations. These results thus demonstrate that lexical-semantic representations can affect the serial ordering of items in short-term memory. Furthermore, the dual-task paradigm provides a new method for examining when and how semantic representations affect memory performance. PMID:21058880

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

PubMed

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

2016-02-01

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

Emotional task management: neural correlates of switching between affective and non-affective task-sets

PubMed Central

Reeck, Crystal

2015-01-01

Although task-switching has been investigated extensively, its interaction with emotionally salient task content remains unclear. Prioritized processing of affective stimulus content may enhance accessibility of affective task-sets and generate increased interference when switching between affective and non-affective task-sets. Previous research has demonstrated that more dominant task-sets experience greater switch costs, as they necessitate active inhibition during performance of less entrenched tasks. Extending this logic to the affective domain, the present experiment examined (a) whether affective task-sets are more dominant than non-affective ones, and (b) what neural mechanisms regulate affective task-sets, so that weaker, non-affective task-sets can be executed. While undergoing functional magnetic resonance imaging, participants categorized face stimuli according to either their gender (non-affective task) or their emotional expression (affective task). Behavioral results were consistent with the affective task dominance hypothesis: participants were slower to switch to the affective task, and cross-task interference was strongest when participants tried to switch from the affective to the non-affective task. These behavioral costs of controlling the affective task-set were mirrored in the activation of a right-lateralized frontostriatal network previously implicated in task-set updating and response inhibition. Connectivity between amygdala and right ventrolateral prefrontal cortex was especially pronounced during cross-task interference from affective features. PMID:25552571

Children's Access to Dental Care Affected by Reimbursement Rates, Dentist Density, and Dentist Participation in Medicaid.

PubMed

Chalmers, Natalia I; Compton, Robert D

2017-10-01

To assess the relation between Medicaid reimbursement rates and access to dental care services in the context of dentist density and dentist participation in Medicaid in each state. Data were from Early and Periodic Screening, Diagnostic, and Treatment reports for 2014, Medicaid reimbursement rate in 2013, dentist density in 2014, and dentist participation in Medicaid in 2014. We assessed patterns of mediation or moderation. Reimbursement rates and access to dental care were directly related at the state level, but no evidence indicated that higher reimbursement rates resulted in overuse of dental services for those who had access. The relation between reimbursement rates and access to care was moderated by dentist density and dentist participation in Medicaid. We estimate that more than 1.8 million additional children would have had access to dental care if reimbursement rates were higher in states with low rates. Children who access the dental care system receive care, but reimbursement may significantly affect access. States with low dentist density and low dentist participation in Medicaid may be able to improve access to dental services significantly by increasing reimbursement rates.

An amorphous titanium dioxide metal insulator metal selector device for resistive random access memory crossbar arrays with tunable voltage margin

NASA Astrophysics Data System (ADS)

Cortese, Simone; Khiat, Ali; Carta, Daniela; Light, Mark E.; Prodromakis, Themistoklis

2016-01-01

Resistive random access memory (ReRAM) crossbar arrays have become one of the most promising candidates for next-generation non volatile memories. To become a mature technology, the sneak path current issue must be solved without compromising all the advantages that crossbars offer in terms of electrical performances and fabrication complexity. Here, we present a highly integrable access device based on nickel and sub-stoichiometric amorphous titanium dioxide (TiO2-x), in a metal insulator metal crossbar structure. The high voltage margin of 3 V, amongst the highest reported for monolayer selector devices, and the good current density of 104 A/cm2 make it suitable to sustain ReRAM read and write operations, effectively tackling sneak currents in crossbars without compromising fabrication complexity in a 1 Selector 1 Resistor (1S1R) architecture. Furthermore, the voltage margin is found to be tunable by an annealing step without affecting the device's characteristics.

Multiple memory stores and operant conditioning: a rationale for memory's complexity.

PubMed

Meeter, Martijn; Veldkamp, Rob; Jin, Yaochu

2009-02-01

Why does the brain contain more than one memory system? Genetic algorithms can play a role in elucidating this question. Here, model animals were constructed containing a dorsal striatal layer that controlled actions, and a ventral striatal layer that controlled a dopaminergic learning signal. Both layers could gain access to three modeled memory stores, but such access was penalized as energy expenditure. Model animals were then selected on their fitness in simulated operant conditioning tasks. Results suggest that having access to multiple memory stores and their representations is important in learning to regulate dopamine release, as well as in contextual discrimination. For simple operant conditioning, as well as stimulus discrimination, hippocampal compound representations turned out to suffice, a counterintuitive result given findings that hippocampal lesions tend not to affect performance in such tasks. We argue that there is in fact evidence to support a role for compound representations and the hippocampus in even the simplest conditioning tasks.

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

ERIC Educational Resources Information Center

Martinson, David L.

2007-01-01

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

Does Question Structure Affect Exam Performance in the Geosciences?

NASA Astrophysics Data System (ADS)

Day, E. A.; D'Arcy, M. K.; Craig, L.; Streule, M. J.; Passmore, E.; Irving, J. C. E.

2015-12-01

The jump to university level exams can be challenging for some students, often resulting in poor marks, which may be detrimental to their confidence and ultimately affect their overall degree class. Previous studies have found that question structure can have a strong impact on the performance of students in college level exams (see Gibson et al., 2015, for a discussion of its impact on physics undergraduates). Here, we investigate the effect of question structure on the exam results of geology and geophysics undergraduate students. Specifically, we analyse the performance of students in questions that have a 'scaffolded' framework and compare them to their performance in open-ended questions and coursework. We also investigate if observed differences in exam performance are correlated with the educational background and gender of students, amongst other factors. It is important for all students to be able to access their degree courses, no matter what their backgrounds may be. Broadening participation in the geosciences relies on removing systematic barriers to achievement. Therefore we recommend that exams are either structured with scaffolding in questions at lower levels, or students are explicitly prepared for this transition. We also recommend that longitudinal studies of exam performance are conducted within individual departments, and this work outlines one approach to analysing performance data.

Annuity payments can increase patient access to innovative cell and gene therapies under England’s net budget impact test

PubMed Central

Jørgensen, Jesper; Kefalas, Panos

2017-01-01

ABSTRACT Background: Cell and gene therapies have the potential to provide therapeutic breakthroughs, but the high costs of researching, developing, manufacturing and delivering them translate into prices that may challenge healthcare budgets. Various measures exist that aim to address the affordability challenge, including reducing price, limiting patient numbers and/or linking remuneration to product performance. Objective: To explore how the net budget impact test recently introduced in England can affect patient access to high-value, one-off cell and gene therapies, and how managed entry agreements can improve access. Methods: We use a hypothetical example where a new high-value, one-off therapy launches in an indication where it displaces a relatively low cost chronic treatment. We calculate the number of patients that can be treated without exceeding the £20 million net budget impact threshold, and compare results for scenarios where a full upfront payment is used, and where annuity-based payments are used. Results: Charging a full upfront payment at the time of treatment can lead to suboptimal patient access. Conclusion: Annuity-based payments in combination with an outcomes-based remuneration scheme reduce consequences of decision uncertainty and can increase patient access, without exceeding the net budget impact test. PMID:28839525

Effect of perceptual load on semantic access by speech in children.

PubMed

Jerger, Susan; Damian, Markus F; Mills, Candice; Bartlett, James; Tye-Murray, Nancy; Abdi, Hervé

2013-04-01

To examine whether semantic access by speech requires attention in children. Children (N = 200) named pictures and ignored distractors on a cross-modal (distractors: auditory-no face) or multimodal (distractors: auditory-static face and audiovisual-dynamic face) picture word task. The cross-modal task had a low load, and the multimodal task had a high load (i.e., respectively naming pictures displayed on a blank screen vs. below the talker's face on his T-shirt). Semantic content of distractors was manipulated to be related vs. unrelated to the picture (e.g., picture "dog" with distractors "bear" vs. "cheese"). If irrelevant semantic content manipulation influences naming times on both tasks despite variations in loads, Lavie's (2005) perceptual load model proposes that semantic access is independent of capacity-limited attentional resources; if, however, irrelevant content influences naming only on the cross-modal task (low load), the perceptual load model proposes that semantic access is dependent on attentional resources exhausted by the higher load task. Irrelevant semantic content affected performance for both tasks in 6- to 9-year-olds but only on the cross-modal task in 4- to 5-year-olds. The addition of visual speech did not influence results on the multimodal task. Younger and older children differ in dependence on attentional resources for semantic access by speech.

Factors associated with stocked cutthroat trout populations in high-mountain lakes

USGS Publications Warehouse

Bailey, Paul E.; Hubert, W.A.

2003-01-01

High-mountain lakes provide important fisheries in the Rocky Mountains; therefore we sought to gain an understanding of the relationships among environmental factors, accessibility to anglers, stocking rates, and features of stocks of cutthroat trout Oncorhynchus clarki in high-mountain lakes of the Bighorn Mountains, Wyoming. We sampled fish with experimental gill nets, measured lake habitat features, and calculated factors affecting angler access among 19 lakes that lacked sufficient natural reproduction to support salmonid fisheries and that were stocked at 1-, 2-, or 4-year intervals with fingerling cutthroat trout. We found that angler accessibility was probably the primary factor affecting stock structure, whereas stocking rates affected the densities of cutthroat trout among lakes. The maximum number of years survived after stocking appeared to have the greatest affect on biomass and population structure. Our findings suggest that control of harvest and manipulation of stocking densities can affect the density, biomass, and structure of cutthroat trout stocks in high-elevation lakes.

pyBSM: A Python package for modeling imaging systems

NASA Astrophysics Data System (ADS)

LeMaster, Daniel A.; Eismann, Michael T.

2017-05-01

There are components that are common to all electro-optical and infrared imaging system performance models. The purpose of the Python Based Sensor Model (pyBSM) is to provide open source access to these functions for other researchers to build upon. Specifically, pyBSM implements much of the capability found in the ERIM Image Based Sensor Model (IBSM) V2.0 along with some improvements. The paper also includes two use-case examples. First, performance of an airborne imaging system is modeled using the General Image Quality Equation (GIQE). The results are then decomposed into factors affecting noise and resolution. Second, pyBSM is paired with openCV to evaluate performance of an algorithm used to detect objects in an image.

Improving patient access and streamlining processes through enterprise intelligence systems.

PubMed

Dunn, Ronald L

2014-01-01

This article demonstrates how enterprise intelligence systems can be used to improve operational efficiency in hospitals. Enterprise intelligence systems mine raw data from disparate systems and transform the data into actionable information, which when used appropriately, support streamlined processes, optimize resources, and positively affect staff efficiency and the quality of patient care. Case studies on the implementation of McKesson Performance Visibility and Capacity Planner enterprise intelligence solutions at the Southlake Regional Health Centre and Lions Gate and Richmond Hospitals are provided.

Arteriovenous Hybrid Graft with Outflow in the Proximal Axillary Vein.

PubMed

Murga, Allen G; Chiriano, Jason; Kiang, Sharon C; Patel, Sheela; Bianchi, Christian; Abou-Zamzam, Ahmed M; Teruya, Theodore H

2017-07-01

The patency of long-term hemodialysis access in end-stage renal disease patients remains a significant challenge. Often these patients are affected with limited venous outflow options, requiring limb abandonment, and creation of new access in the contralateral arm. Vascular surgeons are familiar with the exposure of the proximal axillary artery via an infraclavicular incision. The axillary vein is easily exposed through this technique. The use of the hybrid Gore graft can make the venous anastomosis easier. A hybrid graft with its venous outflow placed in the proximal axillary vein can extend the options of upper extremity access procedures. We reviewed our early experience with this technique. A review of dialysis procedures at the Loma Linda VA was performed. All patients undergoing placement of arteriovenous grafts utilizing the Gore hybrid placed into the proximal axillary vein for outflow were identified. Outcomes in terms of primary and secondary patency rates were determined. Eight patients had placement of an arteriovenous hybrid graft in the proximal axillary vein via an infraclavicular incision. All patients had exhausted other options for hemodialysis access in the ipsilateral upper extremity. All grafts were used successfully for dialysis. The mean primary and secondary patency rates at 6 months were 37.5% and 62.5%, respectively. One patient developed steal syndrome, requiring proximalization of the graft. Seven out of the 8 patients required secondary procedures including thrombectomy (n = 16) and angioplasty (n = 17). Placement of a hybrid graft in the proximal axillary vein is an effective and suitable option for patients who have exhausted arteriovenous access sites in the arm. This procedure can easily be performed in an outpatient setting with a low complication rate and allowing for preservation of the contralateral upper extremity for future use. Published by Elsevier Inc.

Factors Affecting the Delivery, Access, and Use of Interventions to Prevent Malaria in Pregnancy in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

PubMed Central

Hill, Jenny; Hoyt, Jenna; van Eijk, Anna Maria; D'Mello-Guyett, Lauren; ter Kuile, Feiko O.; Steketee, Rick; Smith, Helen; Webster, Jayne

2013-01-01

Background Malaria in pregnancy has important consequences for mother and baby. Coverage with the World Health Organization–recommended prevention strategy for pregnant women in sub-Saharan Africa of intermittent preventive treatment in pregnancy (IPTp) and insecticide-treated nets (ITNs) is low. We conducted a systematic review to explore factors affecting delivery, access, and use of IPTp and ITNs among healthcare providers and women. Methods and Results We searched the Malaria in Pregnancy Library and Global Health Database from 1 January 1990 to 23 April 2013, without language restriction. Data extraction was performed by two investigators independently, and data was appraised for quality and content. Data on barriers and facilitators, and the effect of interventions, were explored using content analysis and narrative synthesis. We conducted a meta-analysis of determinants of IPTp and ITN uptake using random effects models, and performed subgroup analysis to evaluate consistency across interventions and study populations, countries, and enrolment sites. We did not perform a meta-ethnography of qualitative data. Ninety-eight articles were included, of which 20 were intervention studies. Key barriers to the provision of IPTp and ITNs were unclear policy and guidance on IPTp; general healthcare system issues, such as stockouts and user fees; health facility issues stemming from poor organisation, leading to poor quality of care; poor healthcare provider performance, including confusion over the timing of each IPTp dose; and women's poor antenatal attendance, affecting IPTp uptake. Key determinants of IPTp coverage were education, knowledge about malaria/IPTp, socio-economic status, parity, and number and timing of antenatal clinic visits. Key determinants of ITN coverage were employment status, education, knowledge about malaria/ITNs, age, and marital status. Predictors showed regional variations. Conclusions Delivery of ITNs through antenatal clinics presents fewer problems than delivery of IPTp. Many obstacles to IPTp delivery are relatively simple barriers that could be resolved in the short term. Other barriers are more entrenched within the overall healthcare system or socio-economic/cultural contexts, and will require medium- to long-term strategies. Please see later in the article for the Editors' Summary PMID:23935459

Direct access: factors that affect physical therapist practice in the state of Ohio.

PubMed

McCallum, Christine A; DiAngelis, Tom

2012-05-01

Direct access to physical therapist services is permitted by law in the majority of states and across all practice settings. Ohio enacted such legislation in 2004; however, it was unknown how direct access had affected actual clinical practice. The purpose of this study was to describe physical therapist and physical therapist practice environment factors that affect direct access practice. A 2-phase, mixed-method descriptive study was conducted. In the first phase, focus group interviews with 32 purposively selected physical therapists were completed, which resulted in 8 themes for an electronically distributed questionnaire. In the second phase, survey questionnaires were distributed to physical therapists with an e-mail address on file with the Ohio licensing board. An adjusted return rate of 23% was achieved. Data were analyzed for descriptive statistics. A constant comparative method assessed open-ended questions for common themes and patterns. Thirty-one percent of the respondents reported using direct access in physical therapist practice; however, 80% reported they would practice direct access if provided the opportunity. Physical therapists who practiced direct access were more likely to be in practice 6 years or more and hold advanced degrees beyond the entry level, were American Physical Therapy Association members, and had supportive management and organizational practice policies. The direct access physical therapist practice was generally a locally owned suburban private practice or a school-based clinic that saw approximately 6% to 10% of its patients by direct access. The majority of patients treated were adults with musculoskeletal or neuromuscular impairments. Nonresponse from e-mail may be associated with sample frame bias. Implementation of a direct access physical therapist practice model is evident in Ohio. Factors related to reimbursement and organizational policy appear to impede the process.

A Comparison of Mobile and Fixed Device Access on User Engagement Associated With Women, Infants, and Children (WIC) Online Nutrition Education

PubMed Central

2016-01-01

Background Online health education has expanded its reach due to cost-effective implementation and demonstrated effectiveness. However, a limitation exists with the evaluation of online health education implementations and how the impact of the system is attenuated by the extent to which a user engages with it. Moreover, the current online health education research does not consider how this engagement has been affected by the transition from fixed to mobile user access over the last decade. Objective This paper focuses on comparing the impact mobile versus fixed devices have on user engagement key performance indicators (KPI) associated with the wichealth website (.org), an Internet-based parent-child feeding intervention offered to clients associated with the US Department of Agriculture’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Methods Data were collected from 612,201 nutrition education lessons completed by 305,735 unique WIC participants in 21 states over a 1-year period. Data consisted of system-collected measures, profile items, and items from an exit survey administered at the conclusion of each lesson. User engagement was defined based on 3 KPIs associated with usage of the wichealth website: number of link views, link view time, and progression in stage of readiness to change. Independent samples t tests were used to compare KPIs between fixed only and mobile only device users and paired samples t tests were used to compare KPIs within users who completed at least one lesson each on both a fixed and mobile device. A logistic regression was performed to estimate the odds of KPI performance thresholds in the independent samples study group given access device type while controlling for confounding of user characteristics associated with these KPIs. Results Analysis of 8 user characteristics (lessons completed, race, ethnicity, language, state of residence, pregnancy status, beginning stage of change, and preferred nutrition education method) were significantly (P<.001) related to various KPI differences between mobile and fixed device access. Non-mobile users were significantly (P<.001) more likely to engage based on all 3 KPIs, even after logistic regression control for the potential confounding related to the strongly associated user characteristics identified. Conclusions The findings of this study support the idea that online health education developers need to seriously consider access device when creating programs. Online health education developers need to take extra effort to truly understand access patterns of populations being served, and whether or not access device will influence user engagement performance indicators. PMID:27847351

Children's Access to Public Library Services: Prince George's County Memorial Public Library, Maryland, 1980.

ERIC Educational Resources Information Center

Gerhardt, Lillian N.

1981-01-01

Evaluates the Prince George's County Memorial Public Library's approach to providing access to its services for children, and examines policies, regulations, practices, and conditions that affect such access. Six references are cited. (FM)

Inadequate performance measures affecting practices, organizations and outcomes of Ontario's family health teams.

PubMed

Ashcroft, Rachelle

2014-01-01

Emphasis on quantity as the main performance measure may be posing challenges for Family Health Team (FHT) practices and organizational structures. This study asked: What healthcare practices and organizational structures are encouraged by the FHT model? An exploratory qualitative design guided by discourse analysis was used. This paper presents findings from in-depth semi-structured interviews conducted with seven policy informants and 29 FHT leaders. Participants report that performance measures value quantity and are not inclusive of the broad scope of attributes that comprise primary healthcare. Performance measures do not appear to be accurately capturing the demand for healthcare services, or the actual amount of services being provided by FHTs. RESULTS suggest that unintended consequences of performance measures may be posing challenges to access and health outcomes. It is recommended that performance measures be developed and used to measure, support and encourage FHTs to achieve the goals of PHC. Copyright © 2014 Longwoods Publishing.

Being Single as a Social Barrier to Access Reproductive Healthcare Services by Iranian Girls.

PubMed

Kohan, Shahnaz; Mohammadi, Fatemeh; Mostafavi, Firoozeh; Gholami, Ali

2016-08-17

Iranian single women are deprived of reproductive healthcare services, though the provision of such services to the public has increased. This study aimed to explore the experiences of Iranian single women on their access to reproductive health services. A qualitative design using a conventional content analysis method was used. Semi-structured interviews were held with 17 single women and nine health providers chosen using the purposive sampling method. Data analysis resulted in the development of three categories: 'family's attitudes and performance about single women's reproductive healthcare,' 'socio-cultural factors influencing reproductive healthcare,' and 'cultural factors influencing being a single woman.' Cultural and contextual factors affect being a single woman in every society. Therefore, healthcare providers need to identify such factors during the designing of strategies for improving the facilitation of access to reproductive healthcare services. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Italian Percutaneous EVAR (IPER) Registry: outcomes of 2381 percutaneous femoral access sites' closure for aortic stent-graft.

PubMed

Pratesi, G; Barbante, M; Pulli, R; Fargion, A; Dorigo, W; Bisceglie, R; Ippoliti, A; Pratesi, C

2015-12-01

The aim of this paper was to report outcomes of endovascular aneurysm repair with percutaneous femoral access (pEVAR) using Prostar XL and Proglide closure systems (Abbot Vascular, Santa Clara, CA, USA), from the multicenter Italian Percutaneous EVAR (IPER) registry. Consecutive patients affected by aortic pathology treated by EVAR with percutaneous access (pEVAR) between January 2010 and December 2014 at seven Italian centers were enrolled in this multicenter registry. All the operators had an experience of at least 50 percutaneous femoral access procedures. Data were prospectively collected into a dedicated online database including patient's demographics, anatomical features, intra- and postoperative outcomes. A retrospective analysis was carried out to report intraoperative and 30-day technical success and access-related complication rate. Uni- and multivariate analyses were performed to identify factors potentially associated with an increased risk of percutaneous pEVAR failure. A total of 2381 accesses were collected in 1322 patients, 1249 (94.4%) male with a mean age of 73.5±8.3 years (range 45-97). The overall technical success rate was 96.8% (2305/2381). Major intraoperative access-related complications requiring conversion to surgical cut-down were observed in 3.2% of the cases (76/2381). One-month pEVAR failure-rate was 0.25% (6/2381). Presence of femoral artery calcifications resulted to be a significant predictor of technical failure (OR: 1.69; 95% CI: 1.03-2.77; P=0.036) at multivariate analysis. No significant association was observed with sex (P=0.28), obesity (P=0.64), CFA diameter (P=0.32), level of CFA bifurcation (P=0.94) and sheath size >18 F (P=0.24). The use of Proglide was associated with a lower failure rate compared to Prostar XL (2.5% vs. 3.3%) despite not statistically significant (P=0.33). The results of the IPER registry confirm the high technical success rate of percutaneous EVAR when performed by experienced operators, even in presence of demanding anatomies. Femoral calcification represents the only predictor of percutaneous access failure.

SU-E-T-11: A Cloud Based CT and LINAC QA Data Management System

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

Wiersma, R; Grelewicz, Z; Belcher, A

Purpose: The current status quo of QA data management consists of a mixture of paper-based forms and spreadsheets for recording the results of daily, monthly, and yearly QA tests for both CT scanners and LINACs. Unfortunately, such systems suffer from a host of problems as, (1) records can be easily lost or destroyed, (2) data is difficult to access — one must physically hunt down records, (3) poor or no means of historical data analysis, and (4) no remote monitoring of machine performance off-site. To address these issues, a cloud based QA data management system was developed and implemented. Methods:more » A responsive tablet interface that optimizes clinic workflow with an easy-to-navigate interface accessible from any web browser was implemented in HTML/javascript/CSS to allow user mobility when entering QA data. Automated image QA was performed using a phantom QA kit developed in Python that is applicable to any phantom and is currently being used with the Gammex ACR, Las Vegas, Leeds, and Catphan phantoms for performing automated CT, MV, kV, and CBCT QAs, respectively. A Python based resource management system was used to distribute and manage intensive CPU tasks such as QA phantom image analysis or LaTeX-to-PDF QA report generation to independent process threads or different servers such that website performance is not affected. Results: To date the cloud QA system has performed approximately 185 QA procedures. Approximately 200 QA parameters are being actively tracked by the system on a monthly basis. Electronic access to historical QA parameter information was successful in proactively identifying a Linac CBCT scanner’s performance degradation. Conclusion: A fully comprehensive cloud based QA data management system was successfully implemented for the first time. Potential machine performance issues were proactively identified that would have been otherwise missed by a paper or spreadsheet based QA system.« less

Characterizing parameters of Jatropha curcas cell cultures for microgravity studies

NASA Astrophysics Data System (ADS)

Vendrame, Wagner A.; Pinares, Ania

2013-06-01

Jatropha (Jatropha curcas) is a tropical perennial species identified as a potential biofuel crop. The oil is of excellent quality and it has been successfully tested as biodiesel and in jet fuel mixes. However, studies on breeding and genetic improvement of jatropha are limited. Space offers a unique environment for experiments aiming at the assessment of mutations and differential gene expression of crops and in vitro cultures of plants are convenient for studies of genetic variation as affected by microgravity. However, before microgravity studies can be successfully performed, pre-flight experiments are necessary to characterize plant material and validate flight hardware environmental conditions. Such preliminary studies set the ground for subsequent spaceflight experiments. The objectives of this study were to compare the in vitro growth of cultures from three explant sources (cotyledon, leaf, and stem sections) of three jatropha accessions (Brazil, India, and Tanzania) outside and inside the petriGAP, a modified group activation pack (GAP) flight hardware to fit petri dishes. In vitro jatropha cell cultures were established in petri dishes containing a modified MS medium and maintained in a plant growth chamber at 25 ± 2 °C in the dark. Parameters evaluated were surface area of the explant tissue (A), fresh weight (FW), and dry weight (DW) for a period of 12 weeks. Growth was observed for cultures from all accessions at week 12, including subsequent plantlet regeneration. For all accessions differences in A, FW and DW were observed for inside vs. outside the PetriGAPs. Growth parameters were affected by accession (genotype), explant type, and environment. The type of explant influenced the type of cell growth and subsequent plantlet regeneration capacity. However, overall cell growth showed no abnormalities. The present study demonstrated that jatropha in vitro cell cultures are suitable for growth inside PetriGAPs for a period of 12 weeks. The parameters evaluated in this study provide the basic ground work and pre-flight assessment needed to justify a model for microgravity studies with jatropha in vitro cell cultures. Future studies should focus on results of experiments performed with jatropha in vitro cultures in microgravity.

Frontage Roads in Texas: Legal Issues, Operational Issues, and Land Use Distinctions

DOT National Transportation Integrated Search

2000-08-01

This research project investigates frontage roads as an element of limited-access highway design. The discussion in this paper reviews legal statutes affecting public access to roadways, summarizes studies on access-right valuation, and considers a v...

Access and completion of a Web-based treatment in a population-based sample of tornado-affected adolescents.

PubMed

Price, Matthew; Yuen, Erica K; Davidson, Tatiana M; Hubel, Grace; Ruggiero, Kenneth J

2015-08-01

Although Web-based treatments have significant potential to assess and treat difficult-to-reach populations, such as trauma-exposed adolescents, the extent that such treatments are accessed and used is unclear. The present study evaluated the proportion of adolescents who accessed and completed a Web-based treatment for postdisaster mental health symptoms. Correlates of access and completion were examined. A sample of 2,000 adolescents living in tornado-affected communities was assessed via structured telephone interview and invited to a Web-based treatment. The modular treatment addressed symptoms of posttraumatic stress disorder, depression, and alcohol and tobacco use. Participants were randomized to experimental or control conditions after accessing the site. Overall access for the intervention was 35.8%. Module completion for those who accessed ranged from 52.8% to 85.6%. Adolescents with parents who used the Internet to obtain health-related information were more likely to access the treatment. Adolescent males were less likely to access the treatment. Future work is needed to identify strategies to further increase the reach of Web-based treatments to provide clinical services in a postdisaster context. (c) 2015 APA, all rights reserved).

Access and Completion of a Web-Based Treatment in a Population-Based Sample of Tornado-Affected Adolescents

PubMed Central

Price, Matthew; Yuen, Erica; Davidson, Tatiana M.; Hubel, Grace; Ruggiero, Kenneth J.

2015-01-01

Although web-based treatments have significant potential to assess and treat difficult to reach populations, such as trauma-exposed adolescents, the extent that such treatments are accessed and used is unclear. The present study evaluated the proportion of adolescents who accessed and completed a web-based treatment for post-disaster mental health symptoms. Correlates of access and completion were examined. A sample of 2,000 adolescents living in tornado-affected communities was assessed via structured telephone interview and invited to a web-based treatment. The modular treatment addressed symptoms of PTSD, depression, and alcohol and tobacco use. Participants were randomized to experimental or control conditions after accessing the site. Overall access for the intervention was 35.8%. Module completion for those who accessed ranged from 52.8% to 85.6%. Adolescents with parents who used the Internet to obtain health-related information were more likely to access the treatment. Adolescent males were less likely to access the treatment. Future work is needed to identify strategies to further increase the reach of web-based treatments to provide clinical services in a post-disaster context. PMID:25622071

Seabird bycatch mitigation trials in artisanal demersal longliners of the Western Mediterranean.

PubMed

Cortés, Verónica; González-Solís, Jacob

2018-01-01

High numbers of seabirds are killed annually worldwide in longline fisheries. In the Mediterranean, this mortality is seriously affecting the viability of seabird populations, in particular of the three endemic shearwaters. Even so, there is currently no specific seabird mitigation requirements for the longline fleet operating in this area. From 2013 to 2014, we assessed the efficiency and practical applicability of four mitigation measures on artisanal demersal longliners targeting European hake (Merluccius merluccius) in the western Mediterranean: night setting, tori line, weighted lines and artificial baits. We performed fifty-two pairs of experimental (with the tested mitigation measure) and control settings (without any measure), and compared their effects on seabird interactions and fish catches. In addition, we estimated the longline sink rates and the seabird access area to baited hooks in different longline configurations. Night setting reduced bycatch risk without affecting target and non-commercial fish catches. The tori line may have reduced the bycatch risk by displacing bait attacks beyond the end of the line, but at this distance shearwaters could still access to the baits and the streamers did not deter birds under calm wind conditions. Weighted lines increased sink rate, but it resulted in only a minor reduction of the seabird access window to baited hooks and led to some operational problems during the setting. Artificial baits substantially reduced commercial catches. Moreover, the seabird access to the baited hooks was influenced by the longline configuration, the setting speed and the relative position to the floats and weights. So far, night setting stands out as the best mitigation measure for reducing bycatch levels without compromising target catches in demersal longliners. Ideally, these results should be confirmed in longliners targeting species other than European hake.

The promise of PROMIS(®) for addiction.

PubMed

Hilton, Thomas F

2011-12-15

The field of addiction treatment has a measurement problem that pervades efforts to help patients achieve self-sustainable recovery. The impact of using older measurement technology has increased the measurement burden on both service providers and patients, while at the same time limiting the scope and frequency of measurement. The resulting burden can affect provider performance, patient access, and addiction recovery. This paper underscores the need for applying modern measurement theory techniques to reduce the measurement burden currently affecting most if not all major aspects of treatment and recovery. It is currently possible to obtain information more precisely, over a broad spectrum of recovery-oriented domains, faster and at lower cost than current measurement practices allow. However, a persistent research effort will be necessary to achieve that goal.

Effects of a reduced dose of injected iron on health, iron status and growth of suckling piglets with access to iron enriched soil.

PubMed

Thanner, S; Gutzwiller, A

2018-02-01

The effects of the recommended dose of 200 mg iron and of half that dose injected on the first day of life on health, iron status and performance during the 4 week suckling period were studied in 2'123 piglets. All piglets received creep feed and soil which was supplemented with 14 g iron per kg. Neither mortality nor the prevalence of arthritis, meningitis and foot abscess (each disease affecting about 1% of the piglets) differed between the two groups. The low dose of 100 mg iron decreased blood haemoglobin concentration at weaning (110 ± 19 vs.120 ± 15 g/l), but did not affect growth rate.

Judgements of agency in schizophrenia: an impairment in autonoetic metacognition

PubMed Central

Metcalfe, Janet; Van Snellenberg, Jared X.; DeRosse, Pamela; Balsam, Peter; Malhotra, Anil K.

2012-01-01

We investigated judgements of agency in participants with schizophrenia and healthy controls. Participants engaged in a computer game in which they attempted to touch downward falling Xs and avoid touching Os. On some trials, participants were objectively in perfect control. On other trials, they were objectively not in complete control because the movement of the cursor on the screen was distorted with respect to the position of the mouse by random noise (turbulence), or it was lagged by 250 or 500 ms. Participants made metacognitive judgements of agency as well as judgements of performance. Control participants' judgements of agency were affected by the turbulence and lag variables—indicating that they knew they were objectively not in control in those conditions, and they were also influenced by their assessments of performance. The patients also used their assessments of performance but neither turbulence nor lag affected their judgements of agency. This indicated an impairment in agency monitoring. The patients, unlike the healthy controls, used only publically available external cues about performance in making judgements of ‘agency’ and did not rely on any additional access to internal self-relevant cues that were diagnostic in indicating whether or not they were, in fact, in control. PMID:22492755

Judgements of agency in schizophrenia: an impairment in autonoetic metacognition.

PubMed

Metcalfe, Janet; Van Snellenberg, Jared X; DeRosse, Pamela; Balsam, Peter; Malhotra, Anil K

2012-05-19

We investigated judgements of agency in participants with schizophrenia and healthy controls. Participants engaged in a computer game in which they attempted to touch downward falling Xs and avoid touching Os. On some trials, participants were objectively in perfect control. On other trials, they were objectively not in complete control because the movement of the cursor on the screen was distorted with respect to the position of the mouse by random noise (turbulence), or it was lagged by 250 or 500 ms. Participants made metacognitive judgements of agency as well as judgements of performance. Control participants' judgements of agency were affected by the turbulence and lag variables-indicating that they knew they were objectively not in control in those conditions, and they were also influenced by their assessments of performance. The patients also used their assessments of performance but neither turbulence nor lag affected their judgements of agency. This indicated an impairment in agency monitoring. The patients, unlike the healthy controls, used only publically available external cues about performance in making judgements of 'agency' and did not rely on any additional access to internal self-relevant cues that were diagnostic in indicating whether or not they were, in fact, in control.

Genome-wide association study reveals novel players in defense hormone crosstalk in Arabidopsis.

PubMed

Proietti, Silvia; Caarls, Lotte; Coolen, Silvia; Van Pelt, Johan A; Van Wees, Saskia C M; Pieterse, Corné M J

2018-05-31

Jasmonic acid (JA) regulates plant defenses against necrotrophic pathogens and insect herbivores. Salicylic acid (SA) and abscisic acid (ABA) can antagonize JA-regulated defenses, thereby modulating pathogen or insect resistance. We performed a genome-wide association (GWA) study on natural genetic variation in Arabidopsis thaliana for the effect of SA and ABA on the JA pathway. We treated 349 Arabidopsis accessions with methyl JA (MeJA), or a combination of MeJA and either SA or ABA, after which expression of the JA-responsive marker gene PDF1.2 was quantified as a readout for GWA analysis. Both hormones antagonized MeJA-induced PDF1.2 in the majority of the accessions, but with a large variation in magnitude. GWA mapping of the SA- and ABA-affected PDF1.2 expression data revealed loci associated with crosstalk. GLYI4 (encoding a glyoxalase) and ARR11 (encoding an Arabidopsis response regulator involved in cytokinin signaling) were confirmed by T-DNA insertion mutant analysis to affect SA-JA crosstalk and resistance against the necrotroph Botrytis cinerea. In addition, At1g16310 (encoding a cation efflux family protein) was confirmed to affect ABA-JA crosstalk and susceptibility to Mamestra brassicae herbivory. Collectively, this GWA study identified novel players in JA hormone crosstalk with potential roles in the regulation of pathogen or insect resistance. This article is protected by copyright. All rights reserved.

Subliminal smells can guide social preferences.

PubMed

Li, Wen; Moallem, Isabel; Paller, Ken A; Gottfried, Jay A

2007-12-01

It is widely accepted that unconscious processes can modulate judgments and behavior, but do such influences affect one's daily interactions with other people? Given that olfactory information has relatively direct access to cortical and subcortical emotional circuits, we tested whether the affective content of subliminal odors alters social preferences. Participants rated the likeability of neutral faces after smelling pleasant, neutral, or unpleasant odors delivered below detection thresholds. Odor affect significantly shifted likeability ratings only for those participants lacking conscious awareness of the smells, as verified by chance-level trial-by-trial performance on an odor-detection task. Across participants, the magnitude of this priming effect decreased as sensitivity for odor detection increased. In contrast, heart rate responses tracked odor valence independently of odor awareness. These results indicate that social preferences are subject to influences from odors that escape awareness, whereas the availability of conscious odor information may disrupt such effects.

Good progress for children coupled with recalcitrant inequalities for adults in New Zealand's journey towards Universal Health Coverage over the last decade.

PubMed

Matheson, Don; Reidy, Johanna; Tan, Lee; Carr, Julia

2015-05-29

This article explores how primary health care policy changes in New Zealand over the last decade have impacted on primary care access equity and avoidable hospital admissions. The national Ambulatory Sensitive Hospitalisations (ASH) data trends by age, ethnicity and area level deprivation were analysed in relation to the Primary Health Care policy initiatives for the period 2002 to 2014. Changes in primary care access over the decade have led to improvement in ASH indicators for parts of the population, but not for others. ASH rates decreased very significantly for children, especially in the 0-4 age group. These trends began in 2004, with decreases most marked for Pacific children, and those from the most deprived neighbourhoods. Inequalities in ASH rates for children between ethnic groups and levels of deprivation have substantially decreased. On the other hand, there has been a significant increase in ASH rates and inequalities for Pacific peoples in the 45 to 64 age group. Māori in the same age band show a modest reduction in ASH rates, with inequalities compared with the rest of the population remaining unchanged. Inequalities in ASH rates between 45-65 year olds living in different levels of deprivation remain large and unchanged, indicative of the recalcitrant nature of inequalities in primary care access for the adult population. Major policy initiatives undertaken by the government during this period have significantly affected primary care access. These include the New Zealand Health Strategy, the Primary Health Care Strategy, the creation of District Health Boards and Primary Health Organisations, and free care to under 6-year-olds. In the latter part of the decade, high-level target setting by successive Ministers is also affecting system performance. We conclude that the success in reducing inequality in access to primary care for children needs to be intensified, and the same principles applied to the adult population groups.

Reimbursement of Drugs for Rare Diseases through the Public Healthcare System in Canada: Where Are We Now?

PubMed

Menon, Devidas; Clark, Derek; Stafinski, Tania

2015-08-01

Over the past 20 years, the number of therapies developed for rare diseases has rapidly increased. Often, these therapies represent the only active treatment for debilitating and/or life-threatening conditions. However, they create significant challenges for public and private payers. Because they target small patient populations, clinical evidence of efficacy/effectiveness is typically limited, while the cost per patient is high. In Canada, each province/territory establishes its own mechanisms for determining which drugs for rare diseases (DRDs) to provide. To compare current mechanisms across provinces and territories, and explore their impact on access. A systematic review of relevant published and unpublished documents was performed. Electronic bibliographic databases, the internet, and government websites were scanned using structured search strategies. Information was extracted independently by two researchers, and included aspects such as program type, condition/patient/therapy eligibility criteria, role of health technology assessment (HTA), decision options, ethical assumptions, and stakeholder input. It was validated through member-checking with provincial/territorial policy experts and tabulated to facilitate qualitative analyses. Impact on access was assessed through a cross-province/territory comparison of the coverage status of all non-cancer therapies reviewed by the Common Drug Review for indications affecting <1/2,000 Canadians using the Kappa statistic. Reasons for variations were explored using qualitative techniques. Each province/territory has formal and informal mechanisms through which such therapies may be accessed. In most cases, formal mechanisms constitute the centralized HTA processes that also apply to common therapies. While several provinces have established dedicated processes/programs, whether they have affected access is not clear. Despite broadly comparable approaches, there is less than perfect agreement on publicly funded DRDs across jurisdictions. Individual jurisdictions have developed different approaches to providing access to these therapies. However, as the number increases, a more systematic approach to decision-making may be needed. Copyright © 2015 Longwoods Publishing.

Native pears of Sardinia affect Penicillium expansum pathogenesis.

PubMed

Cubaiu, L; Azara, E; Ladu, G; Venditti, T; D'Hallewin, G

2013-01-01

Penicillium expansum causes blue mould rot, a serious post-harvest disease of pome fruits and is the main producer of the mycotoxin patulin. The occurrence of natural resistance against different hostpathogens, has been evidenced in some pear accessions of the Sardinian germoplasm. The aim of this research was to correlate P. expansum growth and patulin production on these indigenous pear accessions. In vitro and in vivo experiments were carried out with seven accessions ('Sarmentina', 'Vacchesa', 'De Puleu', 'De su Duca', 'Natalina', 'Oliena', 'Laconi 5') belonging to the CNR-ISPA ex situ collection and one national control cultivar ('Abate'). A wild type P. expansum from our collection was isolated from blue mould-decayed Sardinian pear fruit and selected for its aggressiveness and patulin production. The in vivo assay was carried out using 5 x 2 cm (Ø x thickness) sterilized fruit discs wounded and inoculated by a 10(5)UFC/mL concentration of P. expansum. Fruit discs were incubated at 23 degrees C for 7 days before analysis. The in vitro experiments, aimed at monitoring over time P. expansum mycelial growth and patulin accumulation, were performed with a standard medium (PDA) and a pear puree Agar Medium (PAM). Petri dishes with PDA and PAM were inoculated centrally with P. expansum conidia (10(5)UFC/ml) and then incubated at 23 degrees C for 7 days. Mycelial growth on Sardinian PAMs was inhibited in comparison to 'Abate' PAM and PDA. In particular, the accessions 'Sarmentina' and 'Vacchesa' showed the maximum inhibitory activity both in vitro and in vivo. Patulin production was detected by high-pressure liquid chromatography-mass spectrometry. The mycotoxin concentration in Sardinian PAMs was lower than that detected in PDA medium, pointing out a positive correlation between fungal growth inhibition and patulin production. The lowest concentration of patulin was found in 'Sarmentina' PAM. Based on these findings, some of Sardinian pear accessions seems to affect P. expansum pathogenesis and inhibit patulin production. Further researches are necessary to assess the mechanism of this biocontrol activity.

Exploring Factors that Affect the Accessibility of Reading Comprehension Assessments for Students with Disabilities: A Study of Segmented Text. CRESST Report 746

ERIC Educational Resources Information Center

Abedi, Jamal; Kao, Jenny C.; Leon, Seth; Sullivan, Lisa; Herman, Joan L.; Pope, Rita; Nambiar, Veena; Mastergeorge, Ann M.

2008-01-01

This study sought to explore factors that affect the accessibility of reading comprehension assessments for students with disabilities. The study consisted of testing students using reading comprehension passages that were broken down into shorter "segments" or "chunks." The results of the segmenting study indicated that: (a)…

A Qualitative Study on the Interconnected Nature of HIV, Water, and Family.

PubMed

Ramirez-Ortiz, Daisy; Zolnikov, Tara Rava

2017-03-01

Human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) and poor access to water are two primary global health issues. Poor access to water may significantly affect families infected with HIV and result in adverse social and health consequences. A qualitative study used semi-structured interviews to understand health and social outcomes of families after the implementation of water interventions in rural Kenya. One major sub-theme emerged during this research, which included the effects of water on an HIV-affected family. Prior to the water interventions, common adverse health effects from lack of nutrition, water, and poor hygiene were experienced. After receiving access to water, nutrition and hygiene were improved and additional time was gained and used to reinforce relationships and spread awareness about HIV/AIDS. This study provides need-based evidence for access to safe drinking water in order to decrease adverse health outcomes and improve the quality of life for HIV-affected individuals.

Emotional task management: neural correlates of switching between affective and non-affective task-sets.

PubMed

Reeck, Crystal; Egner, Tobias

2015-08-01

Although task-switching has been investigated extensively, its interaction with emotionally salient task content remains unclear. Prioritized processing of affective stimulus content may enhance accessibility of affective task-sets and generate increased interference when switching between affective and non-affective task-sets. Previous research has demonstrated that more dominant task-sets experience greater switch costs, as they necessitate active inhibition during performance of less entrenched tasks. Extending this logic to the affective domain, the present experiment examined (a) whether affective task-sets are more dominant than non-affective ones, and (b) what neural mechanisms regulate affective task-sets, so that weaker, non-affective task-sets can be executed. While undergoing functional magnetic resonance imaging, participants categorized face stimuli according to either their gender (non-affective task) or their emotional expression (affective task). Behavioral results were consistent with the affective task dominance hypothesis: participants were slower to switch to the affective task, and cross-task interference was strongest when participants tried to switch from the affective to the non-affective task. These behavioral costs of controlling the affective task-set were mirrored in the activation of a right-lateralized frontostriatal network previously implicated in task-set updating and response inhibition. Connectivity between amygdala and right ventrolateral prefrontal cortex was especially pronounced during cross-task interference from affective features. © The Author (2014). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Physical and Visual Accessibilities in Intensive Care Units: A Comparative Study of Open-Plan and Racetrack Units.

PubMed

Rashid, Mahbub; Khan, Nayma; Jones, Belinda

2016-01-01

This study compared physical and visual accessibilities and their associations with staff perception and interaction behaviors in 2 intensive care units (ICUs) with open-plan and racetrack layouts. For the study, physical and visual accessibilities were measured using the spatial analysis techniques of Space Syntax. Data on staff perception were collected from 81 clinicians using a questionnaire survey. The locations of 2233 interactions, and the location and length of another 339 interactions in these units were collected using systematic field observation techniques. According to the study, physical and visual accessibilities were different in the 2 ICUs, and clinicians' primary workspaces were physically and visually more accessible in the open-plan ICU. Physical and visual accessibilities affected how well clinicians' knew their peers and where their peers were located in these units. Physical and visual accessibilities also affected clinicians' perception of interaction and communication and of teamwork and collaboration in these units. Additionally, physical and visual accessibilities showed significant positive associations with interaction behaviors in these units, with the open-plan ICU showing stronger associations. However, physical accessibilities were less important than visual accessibilities in relation to interaction behaviors in these ICUs. The implications of these findings for ICU design are discussed.

The affect heuristic, mortality salience, and risk: domain-specific effects of a natural disaster on risk-benefit perception.

PubMed

Västfjäll, Daniel; Peters, Ellen; Slovic, Paul

2014-12-01

We examine how affect and accessible thoughts following a major natural disaster influence everyday risk perception. A survey was conducted in the months following the 2004 south Asian Tsunami in a representative sample of the Swedish population (N = 733). Respondents rated their experienced affect as well as the perceived risk and benefits of various everyday decision domains. Affect influenced risk and benefit perception in a way that could be predicted from both the affect-congruency and affect heuristic literatures (increased risk perception and stronger risk-benefit correlations). However, in some decision domains, self-regulation goals primed by the natural disaster predicted risk and benefit ratings. Together, these results show that affect, accessible thoughts and motivational states influence perceptions of risks and benefits. © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Assessing the feasibility of integration of self-care for filarial lymphoedema into existing community leprosy self-help groups in Nepal.

PubMed

Pryce, Joseph; Mableson, Hayley E; Choudhary, Ramesh; Pandey, Basu Dev; Aley, Dambar; Betts, Hannah; Mackenzie, Charles D; Kelly-Hope, Louise A; Cross, Hugh

2018-01-30

Lymphatic filariasis (LF) and leprosy are disabling infectious diseases endemic in Nepal. LF infection can lead to lymphoedema and hydrocoele, while secondary effects of leprosy infection include impairments to hands, eyes and feet. The disabling effects of both conditions can be managed through self-care and the supportive effects of self-help groups (SHGs). A network of SHGs exists for people affected by leprosy in four districts in Nepal's Central Development Region, however no such service exists for people affected by LF. The aim of this study was to determine the feasibility of integrating LF affected people into existing leprosy SHGs in this area. A survey was conducted using a semi-structured questionnaire to elicit information on: (i) participant characteristics, clinical manifestation and disease burden; (ii) participants' knowledge of management of their condition and access to services; and (iii) participants' knowledge and perceptions of the alternate condition (LF affected participants' knowledge of leprosy and vice versa) and attitudes towards integration. A total of 52 LF affected and 53 leprosy affected participants were interviewed from 14 SHGs. On average, leprosy affected participants were shown to have 1.8 times greater knowledge of self-care techniques, and practiced 2.5 times more frequently than LF affected participants. Only a quarter of LF affected participants had accessed a health service for their condition, compared with 94.3% of leprosy affected people accessing a service (including SHGs), at least once a week. High levels of stigma were perceived by both groups towards the alternate condition, however, the majority of LF (79%) and leprosy (94.3%) affected participants stated that they would consider attending an integrated SHG. LF affected participants need to increase their knowledge of self-care and access to health services. Despite stigma being a potential barrier, attitudes towards integration were positive, suggesting that the SHGs may be a good platform for LF affected people to start self-care in this area. This is not a registered trial.

The effect of perches in cages during pullet rearing and egg laying on hen performance, foot health, and plumage.

PubMed

Hester, P Y; Enneking, S A; Jefferson-Moore, K Y; Einstein, M E; Cheng, H W; Rubin, D A

2013-02-01

Enrichment of pullet cages with perches has not been studied. Our objective was to determine if access to metal perches during all or part of the life cycle of caged White Leghorns affected egg traits, foot health, and feather condition. Treatment 1 represented control chickens that never had access to perches during their life cycle. Treatment 2 hens had perches only during the egg laying phase of the life cycle (17 to 71 wk of age), whereas treatment 3 chickens had perches during the pullet phase (0 to 16.9 wk of age). Treatment 4 chickens always had access to perches (0 to 71 wk of age). Comparisons between chickens that always had perches with controls that never had perches showed similar performance relative to egg production, cracked eggs, egg weight, shell weight, % shell, and shell thickness. More dirty eggs occurred in laying cages with perches. Feed usage increased resulting in poorer feed efficiency in hens with perch exposure during the pullet phase with no effect during egg laying. Perches did not affect hyperkeratosis of toes and feet. The back claw at 71 wk of age broke less if hens had prior experience with perches during the pullet phase. In contrast, during egg laying, the back claw at 71 wk of age broke more due to the presence of perches in laying cages. Perches in laying cages resulted in shorter trimmed claws and improved back feather scores, but caused poorer breast and tail feather scores. In conclusion, enriching conventional cages with perches during the entire life cycle resulted in similar hen performance compared with controls. Fewer broken back claws but poorer feed efficiency occurred because of prior experience with perches as pullets. Perch presence during egg laying improved back feather scores with more trimmed nails but caused more dirty eggs, broken back claws, and poorer breast and tail feather scores. Although perches allow chickens to express their natural perching instinct, it was not without causing welfare problems.

Gender dynamics affecting maternal health and health care access and use in Uganda.

PubMed

Morgan, Rosemary; Tetui, Moses; Muhumuza Kananura, Rornald; Ekirapa-Kiracho, Elizabeth; George, A S

2017-12-01

Despite its reduction over the last decade, the maternal mortality rate in Uganda remains high, due to in part a lack of access to maternal health care. In an effort to increase access to care, a quasi-experimental trial using vouchers was implemented in Eastern Uganda between 2009 and 2011. Findings from the trial reported a dramatic increase in pregnant women's access to institutional delivery. Sustainability of such interventions, however, is an important challenge. While such interventions are able to successfully address immediate access barriers, such as lack of financial resources and transportation, they are reliant on external resources to sustain them and are not designed to address the underlying causes contributing to women's lack of access, including those related to gender. In an effort to examine ways to sustain the intervention beyond external financial resources, project implementers conducted a follow-up qualitative study to explore the root causes of women's lack of maternal health care access and utilization. Based on emergent findings, a gender analysis of the data was conducted to identify key gender dynamics affecting maternal health and maternal health care. This paper reports the key gender dynamics identified during the analysis, by detailing how gender power relations affect maternal health care access and utilization in relation to: access to resources; division of labour, including women's workload during and after pregnancy and lack of male involvement at health facilities; social norms, including perceptions of women's attitudes and behaviour during pregnancy, men's attitudes towards fatherhood, attitudes towards domestic violence, and health worker attitudes and behaviour; and decision-making. It concludes by discussing the need for integrating gender into maternal health care interventions if they are to address the root causes of barriers to maternal health access and utilization and improve access to and use of maternal health care in the long term. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Regulatory changes raise troubling questions for genomic testing.

PubMed

Evans, Barbara J; Dorschner, Michael O; Burke, Wylie; Jarvik, Gail P

2014-11-01

By 6 October 2014, many laboratories in the United States must begin honoring new individual data access rights created by recent changes to federal privacy and laboratory regulations. These access rights are more expansive than has been widely understood and pose complex challenges for genomic testing laboratories. This article analyzes regulatory texts and guidances to explore which laboratories are affected. It offers the first published analysis of which parts of the vast trove of data generated during next-generation sequencing will be accessible to patients and research subjects. Persons tested at affected laboratories seemingly will have access, upon request, to uninterpreted gene variant information contained in their stored variant call format, binary alignment/map, and FASTQ files. A defect in the regulations will subject some non-CLIA-regulated research laboratories to these new access requirements unless the Department of Health and Human Services takes swift action to avert this apparently unintended consequence. More broadly, all affected laboratories face a long list of daunting operational, business, compliance, and bioethical issues as they adapt to this change and to the Food and Drug Administration's recently announced plan to publish draft guidance outlining a new oversight framework for lab-developed tests.

Impact of the titania nanostructure on charge transport and its application in hybrid solar cells

NASA Astrophysics Data System (ADS)

Koffman-Frischknecht, Alejandro; Gonzalez, Fernando; Plá, Juan; Violi, Ianina; Soler-Illia, Galo J. A. A.; Perez, M. Dolores

2018-02-01

Porous titania films are widely studied in a number of optoelectronic applications due to its favorable optical and electronic characteristics. Mesoporous titania thin films (MTTFs) with tunable pore size, pore order, accessibility and crystallinity are of interest in electronic devices due to the potential for optimization of the desired characteristics for charge separation and carrier transport. In this work, several MTTFs were prepared by sol-gel chemistry with different structural properties tuned by post-synthesis thermal treatment. The effect of the structural properties (pore diameter, order and accessibility) on the electrical properties of the material was studied by films fabrication onto a transparent conducting electrode, ITO, such that it enables optoelectronic applications. The performance as photoanode was explored by the fabrication of hybrid polymer (P3HT): titania solar cells. Not only does structural properties affect polymer impregnation inside the titania pores as expected and hence impacts charge separation at the interface, but also the thermal treatment affects crystallinity and the films electronic properties. A more complete picture about the electronic properties of the different MTTFs prepared in this work was studied by mobility measurement by space charge limited current and impedance spectroscopy.

A novel approach for supercapacitors degradation characterization

NASA Astrophysics Data System (ADS)

Oz, Alon; Gelman, Danny; Goren, Emanuelle; Shomrat, Neta; Baltianski, Sioma; Tsur, Yoed

2017-07-01

A novel approach to analyze electrochemical impedance spectroscopy (EIS), based on evolutionary programming, has been utilized to characterize supercapacitors operation mechanism and degradation processes. This approach poses the ability of achieving a comprehensive study of supercapacitors via solely AC measurements. Commercial supercapacitors were examined during accelerated degradation. The microstructure of the electrode-electrolyte interface changes upon degradation; electrolyte parasitic reactions yield the formation of precipitates on the porous surface, which limit the access of the electrolyte ions to the active area and thus reduces performance. EIS analysis using Impedance Spectroscopy Genetic Programming (ISGP) technique enables identifying how the changing microstructure is affecting the operation mechanism of supercapacitors, in terms of each process effective capacitance and time constant. The most affected process is the transport of electrolyte ions at the porous electrode. Their access to the whole active area is hindered, which is shown in our analysis by the decrease of the capacitance gained in the transport and the longer time it takes to penetrate the entire pores depth. Early failure detection is also demonstrated, in a way not readily possible via conventional indicators. ISGP advanced analysis method has been verified using conventional and proven techniques: cyclic voltammetry and post mortem measurements.

Comparison of 3 airway access techniques during suspected spine injury management in American football.

PubMed

Toler, Julianne D; Petschauer, Meredith A; Mihalik, Jason P; Oyama, Sakiko; Halverson, S Doug; Guskiewicz, Kevin M

2010-03-01

To determine how head movement and time to access airway were affected by 3 emergency airway access techniques used in American football. Prospective counterbalanced design. University research laboratory. Eighteen certified athletic trainers (ATCs) and 18 noncertified students (NCSs). Each participant performed 1 trial of each of the 3 after airway access techniques: quick release mechanism (QRM), cordless screwdriver (CSD), and pocket mask insertion (PMI). Time to task completion in seconds, head movement in each plane (sagittal, frontal, and transverse), maximum head movement in each plane, helmet movement in each plane, and maximum helmet movement in each plane. We observed a significant difference between all 3 techniques with respect to time required to achieve airway access (F(2,68) = 263.88; P < 0.001). The PMI allowed for the quickest access followed by the QRM and CSD techniques, respectively. The PMI technique also resulted in significantly less head movement (F(2,68) = 9.06; P = 0.001) and less maximum head movement (F(2,68) = 13.84; P < 0.001) in the frontal plane compared with the QRM and CSD techniques. The PMI technique should be used to gain rapid airway access when managing a football athlete experiencing respiratory arrest in the presence of a suspected cervical spine injury. In the event the athlete does not present with respiratory arrest, the facemask may be removed carefully with a pocket mask ready. Medical professionals must be familiar with differences in equipment and the effects these may have on the management of the spine-injured athlete.

The provision and impact of online patient access to their electronic health records (EHR) and transactional services on the quality and safety of health care: systematic review protocol.

PubMed

Mold, Freda; Ellis, Beverley; de Lusignan, Simon; Sheikh, Aziz; Wyatt, Jeremy C; Cavill, Mary; Michalakidis, Georgios; Barker, Fiona; Majeed, Azeem; Quinn, Tom; Koczan, Phil; Avanitis, Theo; Gronlund, Toto Anne; Franco, Christina; McCarthy, Mary; Renton, Zoë; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Jones, Simon; Rafi, Imran

2012-01-01

Innovators have piloted improvements in communication, changed patterns of practice and patient empowerment from online access to electronic health records (EHR). International studies of online services, such as prescription ordering, online appointment booking and secure communications with primary care, show good uptake of email consultations, accessing test results and booking appointments; when technologies and business process are in place. Online access and transactional services are due to be rolled out across England by 2015; this review seeks to explore the impact of online access to health records and other online services on the quality and safety of primary health care. To assess the factors that may affect the provision of online patient access to their EHR and transactional services, and the impact of such access on the quality and safety of health care. Two reviewers independently searched 11 international databases during the period 1999-2012. A range of papers including descriptive studies using qualitative or quantitative methods, hypothesis-testing studies and systematic reviews were included. A detailed eligibility criterion will be used to shape study inclusion. A team of experts will review these papers for eligibility, extract data using a customised extraction form and use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument to determine the quality of the evidence and the strengths of any recommendation. Data will then be descriptively summarised and thematically synthesised. Where feasible, we will perform a quantitative meta-analysis. Prospero (International Prospective Register of Systematic Reviews) registration number: crd42012003091.

Differences between Roma and non-Roma in how social support from family and friends helps to overcome health care accessibility problems.

PubMed

Bobakova, Daniela; Dankulincova Veselska, Zuzana; Babinska, Ingrid; Klein, Daniel; Madarasova Geckova, Andrea; Cislakova, Lydia

2015-04-14

Roma are the most deprived ethnic minority in Slovakia, suffering from discrimination, poverty and social exclusion. Problematic access to good quality health care as result of institutional and interpersonal discrimination affects their health; therefore, factors which affect health care accessibility of Roma are of high importance for public health and policy makers. The aim of this study was to explore the association between health care accessibility problems and ethnicity and how different levels of social support from family and friends affect this association. We used data from the cross-sectional HepaMeta study conducted in 2011 in Slovakia. The final sample comprised 452 Roma (mean age = 34.7; 35.2% men) and 403 (mean age = 33.5; 45.9% men) non-Roma respondents. Roma in comparison with non-Roma have a more than 3-times higher chance of reporting health care accessibility problems. Social support from family and friends significantly decreases the likelihood of reporting health care accessibility problems in both Roma and non-Roma, while the family seems to be the more important factor. The worse access to health care of Roma living in so-called settlements seems to be partially mediated by social support. Interventions should focus on Roma health mediators and community workers who can identify influential individuals who are able to change a community's fear and distrust and persuade and teach Roma to seek and appropriately use health care services.

Optimizing NEURON Simulation Environment Using Remote Memory Access with Recursive Doubling on Distributed Memory Systems.

PubMed

Shehzad, Danish; Bozkuş, Zeki

2016-01-01

Increase in complexity of neuronal network models escalated the efforts to make NEURON simulation environment efficient. The computational neuroscientists divided the equations into subnets amongst multiple processors for achieving better hardware performance. On parallel machines for neuronal networks, interprocessor spikes exchange consumes large section of overall simulation time. In NEURON for communication between processors Message Passing Interface (MPI) is used. MPI_Allgather collective is exercised for spikes exchange after each interval across distributed memory systems. The increase in number of processors though results in achieving concurrency and better performance but it inversely affects MPI_Allgather which increases communication time between processors. This necessitates improving communication methodology to decrease the spikes exchange time over distributed memory systems. This work has improved MPI_Allgather method using Remote Memory Access (RMA) by moving two-sided communication to one-sided communication, and use of recursive doubling mechanism facilitates achieving efficient communication between the processors in precise steps. This approach enhanced communication concurrency and has improved overall runtime making NEURON more efficient for simulation of large neuronal network models.

Optimizing NEURON Simulation Environment Using Remote Memory Access with Recursive Doubling on Distributed Memory Systems

PubMed Central

Bozkuş, Zeki

2016-01-01

Increase in complexity of neuronal network models escalated the efforts to make NEURON simulation environment efficient. The computational neuroscientists divided the equations into subnets amongst multiple processors for achieving better hardware performance. On parallel machines for neuronal networks, interprocessor spikes exchange consumes large section of overall simulation time. In NEURON for communication between processors Message Passing Interface (MPI) is used. MPI_Allgather collective is exercised for spikes exchange after each interval across distributed memory systems. The increase in number of processors though results in achieving concurrency and better performance but it inversely affects MPI_Allgather which increases communication time between processors. This necessitates improving communication methodology to decrease the spikes exchange time over distributed memory systems. This work has improved MPI_Allgather method using Remote Memory Access (RMA) by moving two-sided communication to one-sided communication, and use of recursive doubling mechanism facilitates achieving efficient communication between the processors in precise steps. This approach enhanced communication concurrency and has improved overall runtime making NEURON more efficient for simulation of large neuronal network models. PMID:27413363

Factors influencing the priority of access to food and their effects on the carcass traits for Japanese Black (Wagyu) cattle.

PubMed

Takanishi, N; Oishi, K; Kumagai, H; Uemura, M; Hirooka, H

2015-12-01

The factors influencing the priority of access to food and the effects of the priority of access to food on their carcass traits were analyzed for Japanese Black (Wagyu) cattle in a semi-intensive fattening production system. The records of 96 clinically healthy steers and heifers were analyzed. The calves at ∼3 to 4 months of age were allocated to pens with four animals per pen; all four animals in the same pen were of the same sex and of similar body size. The ranking of the animals' priority of access to food (1st, 2nd, 3rd and 4th), which was determined by the farm manager, was used as an indicator of social dominance in the present study. Four models including sire line, maternal grandsire line and the difference in the animals' birth dates as fixed effects were used to analyze factors influencing the priority of access to food. Ranking was represented by ordinal scores (highest=4, lowest=1) in Model 1, and the binary scores were assigned in Model 2 (highest=1; 2nd, 3rd and 4th=0), Model 3 (1st and 2nd=1; 3rd and 4th=0) and Model 4 (1st, 2nd and 3rd=1; lowest=0). The results showed that the difference in the animals' birth dates had a significant effect on the establishment of the priority of access to food in Model 3 (P<0.05), suggesting that animals born earlier may become more dominant in the pen. The maternal grandsire line tended to affect the social rank score in Models 2 and 3 (P<0.10). Our results indicated that the maternal grandsire line may affect the temperament of calves through their mothers' genetic performance and thereby more aggressive calves may be more dominant and have higher priority of access to food. On the other hand, there was a significant effect of the priority of access to food on beef marbling score (BMS; P<0.05), and the priority of access to food also tended to influence the carcass weight (P=0.09). The highest BMS was observed for animals with the first rank of the priority of access to food (P<0.05), and the higher-ranking animals had the tendency to be heavier carcass than the lower-ranking animals. Our findings emphasized the importance of information about the priority of access to food determined by farmers' own observation on implementing best management practices in small-scaled semi-intensive beef cattle production systems.

Globalization, global health, and access to healthcare.

PubMed

Collins, Téa

2003-01-01

It is now commonly realized that the globalization of the world economy is shaping the patterns of global health, and that associated morbidity and mortality is affecting countries' ability to achieve economic growth. The globalization of public health has important implications for access to essential healthcare. The rise of inequalities among and within countries negatively affects access to healthcare. Poor people use healthcare services less frequently when sick than do the rich. The negative impact of globalization on access to healthcare is particularly well demonstrated in countries of transitional economies. No longer protected by a centralized health sector that provided free universal access to services for everyone, large segments of the populations in the transition period found themselves denied even the most basic medical services. Only countries where regulatory institutions are strong, domestic markets are competitive and social safety nets are in place, have a good chance to enjoy the health benefits of globalization.

Frequency Hopping, Multiple Frequency-Shift Keying, Coding, and Optimal Partial-Band Jamming.

DTIC Science & Technology

1982-08-01

receivers appropriate for these two strategies. Each receiver is noncoherent (a coherent receiver is generally impractical) and implements hard...Advances in Coding and Modulation for Noncoherent Channels Affected by Fading, Partial Band, and Multiple- . Access Interference, in A. J. Viterbi...Modulation for Noncoherent Channels Affected by Fading, Partial Band, and Multiple-Access interference, in A. J. Viterbi, ed., Advances in Coumunication

Access to primary healthcare services for the Roma population in Serbia: a secondary data analysis

PubMed Central

2011-01-01

Background Serbia has proclaimed access to healthcare as a human right. In a context wherein the Roma population are disadvantaged, the aim of this study was to assess whether the Roma population are able to effectively access primary care services, and if not, what barriers prevent them from doing so. The history of the Roma in Serbia is described in detail so as to provide a context for their current vulnerable position. Methods Disaggregated data were analyzed from three population groups in Serbia; the general population, the Roma population, and the poorest quintile of the general population not including the Roma. The effective coverage framework, which incorporates availability, affordability, accessibility, acceptability, and effectiveness of health services, was used to structure the secondary data analysis. Acute respiratory infection (ARI) in children less than five years of age was used as an example as this is the leading cause of death in children under 5 years old in Serbia. Results Roma children were significantly more likely to experience an ARI than either the general population or the poorest quintile of the general population, not including the Roma. All three population groups were equally likely to not receive the correct treatment regime of antibiotics. An analysis of the factors that affect quality of access to health services reveal that personal documentation is a statistically significant problem; availability of health services is not an issue that disproportionately affects the Roma; however the geographical accessibility and affordability are substantive issues that disproportionately affect the Roma population. Affordability of services affected the Roma and the poorest quintile and affordability of medications significantly affected all three population groups. With regards to acceptability, mothers from all three population groups are equally likely to recognize the importance of seeking treatment. Conclusions The Roma should be assisted in applying for personal documentation, the geographical accessibility of clinics needs to be addressed, and the costs of healthcare visits and medications should be reviewed. Areas for improvement specific to ARI are the costs of antibiotics and the diagnostic accuracy of providers. A range of policy recommendations are outlined. PMID:21851632

Barriers and facilitators to public access defibrillation in out-of-hospital cardiac arrest: a systematic review.

PubMed

Smith, Christopher M; Lim Choi Keung, Sarah N; Khan, Mohammed O; Arvanitis, Theodoros N; Fothergill, Rachael; Hartley-Sharpe, Christopher; Wilson, Mark H; Perkins, Gavin D

2017-10-01

Public access defibrillation initiatives make automated external defibrillators available to the public. This facilitates earlier defibrillation of out-of-hospital cardiac arrest victims and could save many lives. It is currently only used for a minority of cases. The aim of this systematic review was to identify barriers and facilitators to public access defibrillation. A comprehensive literature review was undertaken defining formal search terms for a systematic review of the literature in March 2017. Studies were included if they considered reasons affecting the likelihood of public access defibrillation and presented original data. An electronic search strategy was devised searching MEDLINE and EMBASE, supplemented by bibliography and related-article searches. Given the low-quality and observational nature of the majority of articles, a narrative review was performed. Sixty-four articles were identified in the initial literature search. An additional four unique articles were identified from the electronic search strategies. The following themes were identified related to public access defibrillation: knowledge and awareness; willingness to use; acquisition and maintenance; availability and accessibility; training issues; registration and regulation; medicolegal issues; emergency medical services dispatch-assisted use of automated external defibrillators; automated external defibrillator-locator systems; demographic factors; other behavioural factors. In conclusion, several barriers and facilitators to public access defibrillation deployment were identified. However, the evidence is of very low quality and there is not enough information to inform changes in practice. This is an area in urgent need of further high-quality research if public access defibrillation is to be increased and more lives saved. PROSPERO registration number CRD42016035543. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

The Effect of Haemodialysis Access Types on Cardiac Performance and Morbidities in Patients with Symptomatic Heart Disease.

PubMed

Chuang, Min-Kai; Chang, Chin-Hao; Chan, Chih-Yang

2016-01-01

Little is known about whether the arteriovenous type haemodialysis access affects cardiac function and whether it is still advantageous to the uremic patient with symptomatic heart disease. We conducted a retrospective comparative study. Patients with heart disease and end-stage renal disease that had a new chronic access created between January 2007 and December 2008 and met the inclusion criteria were assessed. The endpoint was major adverse event (MAE)-free survivals of arteriovenous access (AVA) and tunneled cuffed double-lumen central venous catheter (CVC) groups. Whether accesses worsened heart failure was also evaluated. There were 43 CVC patients and 60 AVA patients. The median follow-up time from access creation was 27.6 months (IQR 34.7, 10.9~45.6). Although CVC patients were older than AVA patients (median age 78.0, IQR 14.0 vs. 67.5, IQR 16.0, respectively, p = .009), they manifested non-inferior MAE-free survival (mean 17.1, 95% CI 10.3~24.0 vs. 12.9, 95% CI 8.5~17.4 months in CVC and AVA patients, respectively, p = .290). During follow-up, more patients in the AVA group than in the CVC group deteriorated in heart failure status (35 of 57 vs. 10 of 42, respectively, odds ratio 5.1, p < .001). Preoperative-postoperative pairwise comparison of echocardiographic scans revealed an increased number of abnormal findings in the AVA group (Z = 3.91, p < .001), but not in the CVC group. In patients with both symptomatic heart disease and end stage renal disease (ESRD), CVC patients showed non-inferior MAE-free survival in comparison to those in the AVA group. AV type access could deteriorate heart failure. Accordingly, uremic patients with symptomatic heart disease are not ideal candidates for AV type access creation.

The pervasive crisis of diminishing radiation therapy access for vulnerable populations in the United States-part 3: Hispanic-American patients.

PubMed

McClelland, Shearwood; Perez, Carmen A

2018-01-01

Health disparities have profoundly affected underrepresented minorities throughout the United States, particularly with regard to access to evidence-based interventions such as surgery or medication. The degree of disparity in access to radiation therapy (RT) for Hispanic-American patients with cancer has not been previously examined in an extensive manner. An extensive literature search was performed using the PubMed database to examine studies investigating disparities in RT access for Hispanic-Americans. A total of 34 studies were found, spanning 10 organ systems. Disparities in access to RT for Hispanic-Americans were most prominently studied in cancers of the breast (15 studies), prostate (4 studies), head and neck (4 studies), and gynecologic system (3 studies). Disparities in RT access for Hispanic-Americans were prevalent regardless of the organ system studied and were compounded by limited English proficiency and/or birth outside of the United States. A total of 26 of 34 studies (77%) involved analysis of a population-based database, such as Surveillance, Epidemiology and End Result (15 studies); Surveillance, Epidemiology and End Result-Medicare (4 studies); National Cancer Database (3 studies); or a state tumor registry (4 studies). Hispanic-Americans in the United States have diminished RT access compared with Caucasian patients but are less likely to experience concomitant disparities in mortality than other underrepresented minorities that experience similar disparities (ie, African-Americans). Hispanic-Americans who are born outside of the United States and/or have limited English proficiency may be more likely to experience substandard RT access. These results underscore the importance of finding nationwide solutions to address such inequalities that hinder Hispanic-Americans and other underrepresented minorities throughout the United States.

Social Inequality in Access to Higher Education: Grade Inflation in Private Schools and the Ineffectiveness of Compensatory Education

ERIC Educational Resources Information Center

Neves, Tiago; Ferraz, Hélder; Nata, Gil

2016-01-01

Access to higher education is affected by inequalities worldwide. Here we present a longitudinal study based on large databases of scores in upper secondary education and access to higher education in Portugal. Our findings show how access to higher education builds on and reinforces social inequalities: (1) private, fee-paying secondary schools…

77 FR 37786 - Airworthiness Directives; Bombardier, Inc. Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-25

... cracking of certain fuel access panels of the outer wing. This AD requires an external inspection, and if necessary an internal inspection, to determine if certain fuel access panels are installed, and replacement... if necessary, would defer the internal inspection; and eventual replacement of affected fuel access...

77 FR 18135 - Airworthiness Directives; Bombardier, Inc., Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-27

... access panels of the outer wing. This proposed AD would require an external inspection, and if necessary an internal inspection, to determine if certain fuel access panels are installed, and replacement if... necessary, would defer the internal inspection; and eventual replacement of affected fuel access panels with...

47 CFR 76.1204 - Availability of equipment performing conditional access or security functions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Availability of equipment performing... Availability of Navigation Devices § 76.1204 Availability of equipment performing conditional access or... perform conditional access functions shall make available equipment that incorporates only the conditional...

Aspirex Thrombectomy in Occluded Dialysis Access: A Retrospective Study

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

Dyer, Jules, E-mail: Jules.Dyer@nhs.net; Rosa, Joao; Chachlani, Menka

PurposeThis study is the first to present the outcomes of the Straub Aspirex device for the salvage of occluded renal dialysis access fistulae.Materials and MethodsThis is a retrospective study, using data from the Renal Unit and Radiology Department database. It included all the patients between 2010 and 2014 who underwent percutaneous mechanical thrombectomy (PMT) treated by JD. Aspirex is an over-the-wire, 6–10 French catheter within which is a rapidly rotating helix which draws thrombus into a window near the tip which it then macerates and removes. Access survival was assessed using the Kaplan–Meier method, and multi-variant analysis was performed usingmore » the Cox proportional hazards model. Significance was considered if p < 0.05.ResultsA total of 27 procedures were performed for 19 patients. 13 had autologous arterio-venous fistulae, and 14 had synthetic (PTFE) arterio-venous grafts. 15 were males, 4 females. 100 % of the patients successfully had a channel of thrombus removed. This resulted in an 81.5 % initial clinical success, with primary patency rates of 53.6, 44.3 and 33 % by days 30, 90 and 480, respectively, without significant difference of any analysed covariates. No major complication (pulmonary embolus, paradoxical cerebral infarction, limb ischaemia or significant haemorrhage) occurred.ConclusionAspirex has rates of patency and complication similar to other PMT devices. No covariant studied affected outcome.« less

Memory inhibition as a critical factor preventing creative problem solving.

PubMed

Gómez-Ariza, Carlos J; Del Prete, Francesco; Prieto Del Val, Laura; Valle, Tania; Bajo, M Teresa; Fernandez, Angel

2017-06-01

The hypothesis that reduced accessibility to relevant information can negatively affect problem solving in a remote associate test (RAT) was tested by using, immediately before the RAT, a retrieval practice procedure to hinder access to target solutions. The results of 2 experiments clearly showed that, relative to baseline, target words that had been competitors during selective retrieval were much less likely to be provided as solutions in the RAT, demonstrating that performance in the problem-solving task was strongly influenced by the predetermined accessibility status of the solutions in memory. Importantly, this was so even when participants were unaware of the relationship between the memory and the problem-solving procedures in the experiments. This finding is consistent with an inhibitory account of retrieval-induced forgetting effects and, more generally, constitutes support for the idea that the activation status of mental representations originating in a given task (e.g., episodic memory) can unwittingly have significant consequences for a different, unrelated task (e.g., problem solving). (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Correlation between clinical performance and degree of conversion of resin cements: a literature review

PubMed Central

DE SOUZA, Grace; BRAGA, Roberto Ruggiero; CESAR, Paulo Francisco; LOPES, Guilherme Carpena

2015-01-01

Resin-based cements have been frequently employed in clinical practice to lute indirect restorations. However, there are numerous factors that may compromise the clinical performance of those cements. The aim of this literature review is to present and discuss some of the clinical factors that may affect the performance of current resin-based luting systems. Resin cements may have three different curing mechanisms: chemical curing, photo curing or a combination of both. Chemically cured systems are recommended to be used under opaque or thick restorations, due to the reduced access of the light. Photo-cured cements are mainly indicated for translucent veneers, due to the possibility of light transmission through the restoration. Dual-cured are more versatile systems and, theoretically, can be used in either situation, since the presence of both curing mechanisms might guarantee a high degree of conversion (DC) under every condition. However, it has been demonstrated that clinical procedures and characteristics of the materials may have many different implications in the DC of currently available resin cements, affecting their mechanical properties, bond strength to the substrate and the esthetic results of the restoration. Factors such as curing mechanism, choice of adhesive system, indirect restorative material and light-curing device may affect the degree of conversion of the cement and, therefore, have an effect on the clinical performance of resin-based cements. Specific measures are to be taken to ensure a higher DC of the luting system to be used. PMID:26398507

Internet Access in the European Union and in the United States.

ERIC Educational Resources Information Center

Bauer, Johannes M.; Berne, Michel; Maitland, Carleen F.

2002-01-01

Examines the effects of public policies towards traditional communications infrastructures on Internet access in Europe and the United States. Discusses competitive strategies and describes the influence of regulatory policies affecting market entry and the pricing of services on Internet access, based on empirical findings. (Author/LRW)

Access to Higher Education in the European Community: Synthesis Report (Volume 1) and Country Reports (Volume 2).

ERIC Educational Resources Information Center

de Jonge, J. F. M.; And Others

This report examines, country by country, the present state of student access to higher education institutions in the Member States of the European Community (EC), as well as the elements which affect access directly and the elements which can potentially have an effect on access. Volume 1 of the report gives an overview of the methods of data…

Measurement of the effect of physical exercise on the concentration of individuals with ADHD.

PubMed

Silva, Alessandro P; Prado, Sueli O S; Scardovelli, Terigi A; Boschi, Silvia R M S; Campos, Luiz C; Frère, Annie F

2015-01-01

Attention Deficit Hyperactivity Disorder (ADHD) mainly affects the academic performance of children and adolescents. In addition to bringing physical and mental health benefits, physical activity has been used to prevent and improve ADHD comorbidities; however, its effectiveness has not been quantified. In this study, the effect of physical activity on children's attention was measured using a computer game. Intense physical activity was promoted by a relay race, which requires a 5-min run without a rest interval. The proposed physical stimulus was performed with 28 volunteers: 14 with ADHD (GE-EF) and 14 without ADHD symptoms (GC-EF). After 5 min of rest, these volunteers accessed the computer game to accomplish the tasks in the shortest time possible. The computer game was also accessed by another 28 volunteers: 14 with ADHD (GE) and 14 without these symptoms (GC). The response time to solve the tasks that require attention was recorded. The results of the four groups were analyzed using D'Agostino statistical tests of normality, Kruskal-Wallis analyses of variance and post-hoc Dunn tests. The groups of volunteers with ADHD who performed exercise (GE-EF) showed improved performance for the tasks that require attention with a difference of 30.52% compared with the volunteers with ADHD who did not perform the exercise (GE). The (GE-EF) group showed similar performance (2.5% difference) with the volunteers in the (GC) group who have no ADHD symptoms and did not exercise. This study shows that intense exercise can improve the attention of children with ADHD and may help their school performance.

A Comparison of Mobile and Fixed Device Access on User Engagement Associated With Women, Infants, and Children (WIC) Online Nutrition Education.

PubMed

Brusk, John J; Bensley, Robert J

2016-11-15

Online health education has expanded its reach due to cost-effective implementation and demonstrated effectiveness. However, a limitation exists with the evaluation of online health education implementations and how the impact of the system is attenuated by the extent to which a user engages with it. Moreover, the current online health education research does not consider how this engagement has been affected by the transition from fixed to mobile user access over the last decade. This paper focuses on comparing the impact mobile versus fixed devices have on user engagement key performance indicators (KPI) associated with the wichealth website (.org), an Internet-based parent-child feeding intervention offered to clients associated with the US Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Data were collected from 612,201 nutrition education lessons completed by 305,735 unique WIC participants in 21 states over a 1-year period. Data consisted of system-collected measures, profile items, and items from an exit survey administered at the conclusion of each lesson. User engagement was defined based on 3 KPIs associated with usage of the wichealth website: number of link views, link view time, and progression in stage of readiness to change. Independent samples t tests were used to compare KPIs between fixed only and mobile only device users and paired samples t tests were used to compare KPIs within users who completed at least one lesson each on both a fixed and mobile device. A logistic regression was performed to estimate the odds of KPI performance thresholds in the independent samples study group given access device type while controlling for confounding of user characteristics associated with these KPIs. Analysis of 8 user characteristics (lessons completed, race, ethnicity, language, state of residence, pregnancy status, beginning stage of change, and preferred nutrition education method) were significantly (P<.001) related to various KPI differences between mobile and fixed device access. Non-mobile users were significantly (P<.001) more likely to engage based on all 3 KPIs, even after logistic regression control for the potential confounding related to the strongly associated user characteristics identified. The findings of this study support the idea that online health education developers need to seriously consider access device when creating programs. Online health education developers need to take extra effort to truly understand access patterns of populations being served, and whether or not access device will influence user engagement performance indicators. ©John J Brusk, Robert J Bensley. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 15.11.2016.

Medical education and information literacy in the era of open access.

PubMed

Brower, Stewart M

2010-01-01

The Open Access movement in scholarly communications poses new issues and concerns for medical education in general and information literacy education specifically. For medical educators, Open Access can affect the availability of new information, instructional materials, and scholarship in medical education. For students, Open Access materials continue to be available to them post-graduation, regardless of affiliation. Libraries and information literacy librarians are challenged in their responses to the Open Access publishing movement in how best to support Open Access endeavors within their own institutions, and how best to educate their user base about Open Access in general.

Checking an integrated model of web accessibility and usability evaluation for disabled people.

PubMed

Federici, Stefano; Micangeli, Andrea; Ruspantini, Irene; Borgianni, Stefano; Corradi, Fabrizio; Pasqualotto, Emanuele; Olivetti Belardinelli, Marta

2005-07-08

A combined objective-oriented and subjective-oriented method for evaluating accessibility and usability of web pages for students with disability was tested. The objective-oriented approach is devoted to verifying the conformity of interfaces to standard rules stated by national and international organizations responsible for web technology standardization, such as W3C. Conversely, the subjective-oriented approach allows assessing how the final users interact with the artificial system, accessing levels of user satisfaction based on personal factors and environmental barriers. Five kinds of measurements were applied as objective-oriented and subjective-oriented tests. Objective-oriented evaluations were performed on the Help Desk web page for students with disability, included in the website of a large Italian state university. Subjective-oriented tests were administered to 19 students labeled as disabled on the basis of their own declaration at the University enrolment: 13 students were tested by means of the SUMI test and six students by means of the 'Cooperative evaluation'. Objective-oriented and subjective-oriented methods highlighted different and sometimes conflicting results. Both methods have pointed out much more consistency regarding levels of accessibility than of usability. Since usability is largely affected by individual differences in user's own (dis)abilities, subjective-oriented measures underscored the fact that blind students encountered much more web surfing difficulties.

Effect of perceptual load on semantic access by speech in children

PubMed Central

Jerger, Susan; Damian, Markus F.; Mills, Candice; Bartlett, James; Tye-Murray, Nancy; Abdi, Hervè

2013-01-01

Purpose To examine whether semantic access by speech requires attention in children. Method Children (N=200) named pictures and ignored distractors on a cross-modal (distractors: auditory-no face) or multi-modal (distractors: auditory-static face and audiovisual-dynamic face) picture word task. The cross-modal had a low load, and the multi-modal had a high load [i.e., respectively naming pictures displayed 1) on a blank screen vs 2) below the talker’s face on his T-shirt]. Semantic content of distractors was manipulated to be related vs unrelated to picture (e.g., picture dog with distractors bear vs cheese). Lavie's (2005) perceptual load model proposes that semantic access is independent of capacity limited attentional resources if irrelevant semantic-content manipulation influences naming times on both tasks despite variations in loads but dependent on attentional resources exhausted by higher load task if irrelevant content influences naming only on cross-modal (low load). Results Irrelevant semantic content affected performance for both tasks in 6- to 9-year-olds, but only on cross-modal in 4–5-year-olds. The addition of visual speech did not influence results on the multi-modal task. Conclusion Younger and older children differ in dependence on attentional resources for semantic access by speech. PMID:22896045

Regional consolidation of orthopedic surgery: impacts on hip fracture surgery access and outcomes.

PubMed

Kreindler, Sara A; Siragusa, Lanette; Bohm, Eric; Rudnick, Wendy; Metge, Colleen J

2017-09-01

Timely access to orthopedic trauma surgery is essential for optimal outcomes. Regionalization of some types of surgery has shown positive effects on access, timeliness and outcomes. We investigated how the consolidation of orthopedic surgery in 1 Canadian health region affected patients requiring hip fracture surgery. We retrieved administrative data on all regional emergency department visits for lower-extremity injury and all linked inpatient stays from January 2010 through March 2013, identifying 1885 hip-fracture surgeries. Statistical process control and interrupted time series analysis controlling for demographics and comorbidities were used to assess impacts on access (receipt of surgery within 48-h benchmark) and surgical outcomes (complications, in-hospital/30-d mortality, length of stay). There was a significant increase in the proportion of patients receiving surgery within the benchmark. Complication rates did not change, but there appeared to be some decrease in mortality (significant at 6 mo). Length of stay increased at a hospital that experienced a major increase in patient volume, perhaps reflecting challenges associated with patient flow. Regionalization appeared to improve the timeliness of surgery and may have reduced mortality. The specific features of the present consolidation (including pre-existing interhospital performance variation and the introduction of daytime slates at the referral hospital) should be considered when interpreting the findings.

Regional consolidation of orthopedic surgery: impacts on hip fracture surgery access and outcomes

PubMed Central

Kreindler, Sara A.; Siragusa, Lanette; Bohm, Eric; Rudnick, Wendy; Metge, Colleen J.

2017-01-01

Background Timely access to orthopedic trauma surgery is essential for optimal outcomes. Regionalization of some types of surgery has shown positive effects on access, timeliness and outcomes. We investigated how the consolidation of orthopedic surgery in 1 Canadian health region affected patients requiring hip fracture surgery. Methods We retrieved administrative data on all regional emergency department visits for lower-extremity injury and all linked inpatient stays from January 2010 through March 2013, identifying 1885 hip-fracture surgeries. Statistical process control and interrupted time series analysis controlling for demographics and comorbidities were used to assess impacts on access (receipt of surgery within 48-h benchmark) and surgical outcomes (complications, in-hospital/30-d mortality, length of stay). Results There was a significant increase in the proportion of patients receiving surgery within the benchmark. Complication rates did not change, but there appeared to be some decrease in mortality (significant at 6 mo). Length of stay increased at a hospital that experienced a major increase in patient volume, perhaps reflecting challenges associated with patient flow. Conclusion Regionalization appeared to improve the timeliness of surgery and may have reduced mortality. The specific features of the present consolidation (including pre-existing interhospital performance variation and the introduction of daytime slates at the referral hospital) should be considered when interpreting the findings. PMID:28930037

The extent of variation in salinity tolerance of the minicore collection of finger millet (Eleusine coracana L. Gaertn.) germplasm.

PubMed

Krishnamurthy, Lakshmanan; Upadhyaya, Hari Deo; Purushothaman, Ramamoorthy; Gowda, Cholenahalli Lakkegowda Laxmipathi; Kashiwagi, Junichi; Dwivedi, Sangam Lal; Singh, Sube; Vadez, Vincent

2014-10-01

Finger millet (Eleusine coracana L. Gaertn.) ranks third in production among the dry land cereals. It is widely cultivated in Africa and South Asia where soil salinization is a major production constraint. It is a potential crop for salt affected soils. To identify salt tolerant germplasm, the minicore finger millet germplasm (n=80) was screened for grain yield performance in a soil saturated with NaCl solution of 100 or 125mM. Genotype effect was significant for most traits, while salinity×genotype interaction was significant only in one year. Salinity delayed phenology, marginally reduced shoot biomass and grain yield. There was a large range of genotypic variation in grain yield under salinity and other traits. The yield loss was higher in accessions with prolific growth and yield potential was associated with saline yields. Based on saline yields, accessions were grouped in to four groups and the top tolerant group had 22 accessions with IE 4797 remaining at the top. Salinity had no adverse impact on grain yield of five accessions. Root anatomy in selected genotype of pearl and finger millet showed presence of porous cortex and well fortified endodermis in finger millet that can exclude Na(+) and enhance N absorption. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Effect of Ankle Position and Noninvasive Distraction on Arthroscopic Accessibility of the Distal Tibial Plafond.

PubMed

Akoh, Craig C; Dibbern, Kevin; Amendola, Annuziato; Sittapairoj, Tinnart; Anderson, Donald D; Phisitkul, Phinit

2017-10-01

Osteochondral lesions of the tibial plafond (OLTPs) can lead to chronic ankle pain and disability. It is not known how limited ankle motion or joint distraction affects arthroscopic accessibility of these lesions. The purpose of this study was to determine the effects of different fixed flexion angles and distraction on accessibility of the distal tibial articular surface during anterior and posterior arthroscopy. Fourteen below-knee cadaver specimens underwent anterior and posterior ankle arthroscopy using a 30-degree 2.7-mm arthroscopic camera. Intra-articular working space was measured with a precision of 1 mm using sizing rods. The accessible areas at the plafond were marked under direct visualization at varying fixed ankle flexion positions. Arthroscopic accessibilities were normalized as percent area using a surface laser scan. Statistical analyses were performed to assess the relationship between preoperative ankle range of motion, amount of distraction, arthroscopic approach, and arthroscopic plafond visualization. There was significantly greater accessibility during posterior arthroscopy (73.5%) compared with anterior arthroscopy (51.2%) in the neutral ankle position ( P = .007). There was no difference in accessibility for anterior arthroscopy with increasing level of plantarflexion ( P > .05). Increasing dorsiflexion during posterior arthroscopy significantly reduced ankle accessibility ( P = .028). There was a significant increase in accessibility through the anterior and posterior approach with increasing amount of intra-articular working space (parameter estimates ± SE): anterior = 14.2 ± 3.34 ( P < .01) and posterior = 10.6 ± 3.7 ( P < .05). Frequency data showed that the posterior third of the plafond was completely inaccessible in 33% of ankles during anterior arthroscopy. The frequency of inaccessible anterior plafond during posterior arthroscopy was 12%. Intra-articular working space and arthroscopic accessibility were greater during posterior arthroscopy compared with anterior arthroscopy. Improved accessibility of OLTPs may be achieved from posterior arthroscopy. Arthroscopic accessibility was heavily dependent on the amount of intraoperative joint working space achieved and not on ankle position. OLTPs are often encountered in tandem with talar lesions, and safely achieving intra-articular working space through noninvasive distraction greatly improved arthroscopic accessibility.

Optically intraconnected computer employing dynamically reconfigurable holographic optical element

NASA Technical Reports Server (NTRS)

Bergman, Larry A. (Inventor)

1992-01-01

An optically intraconnected computer and a reconfigurable holographic optical element employed therein. The basic computer comprises a memory for holding a sequence of instructions to be executed; logic for accessing the instructions in sequence; logic for determining for each the instruction the function to be performed and the effective address thereof; a plurality of individual elements on a common support substrate optimized to perform certain logical sequences employed in executing the instructions; and, element selection logic connected to the logic determining the function to be performed for each the instruction for determining the class of each function and for causing the instruction to be executed by those the elements which perform those associated the logical sequences affecting the instruction execution in an optimum manner. In the optically intraconnected version, the element selection logic is adapted for transmitting and switching signals to the elements optically.

To push or not to push? Affective influences on moral judgment depend on decision frame.

PubMed

Pastötter, Bernhard; Gleixner, Sabine; Neuhauser, Theresa; Bäuml, Karl-Heinz T

2013-03-01

People's moods can influence moral judgment. Such influences may arise because moods affect moral emotion, or because moods affect moral thought. The present study provides evidence that, at least in the footbridge dilemma, moods affect moral thought. The results of two experiments are reported in which, after induction of positive, negative, or neutral moods and presentation of the footbridge scenario, participants were asked one of two differentially framed closing questions. In the active frame, participants were asked whether they would be active and push the man, making thoughts about pushing accessible; in the passive frame, they were asked whether they would be passive and not push the man, making thoughts about not pushing accessible. The results show that affective influences on moral judgment depended on participants' decision frame. Compared to neutral moods, positive moods induced utilitarian responding - i.e., deciding to push - in the active decision frame, but induced nonutilitarian responding - i.e., deciding to not push - in the passive decision frame; in negative moods, exactly the opposite picture arose. The results suggest that people's moods affect moral judgment by conferring value on moral thought. Positive moods promote and negative moods inhibit accessible thoughts. Copyright © 2012 Elsevier B.V. All rights reserved.

A National Study of the Relationship between Home Access to a Computer and Academic Performance Scores of Grade 12 U.S. Science Students: An Analysis of the 2009 NAEP Data

NASA Astrophysics Data System (ADS)

Coffman, Mitchell Ward

The purpose of this dissertation was to examine the relationship between student access to a computer at home and academic achievement. The 2009 National Assessment of Educational Progress (NAEP) dataset was probed using the National Data Explorer (NDE) to investigate correlations in the subsets of SES, Parental Education, Race, and Gender as it relates to access of a home computer and improved performance scores for U.S. public school grade 12 science students. A causal-comparative approach was employed seeking clarity on the relationship between home access and performance scores. The influence of home access cannot overcome the challenges students of lower SES face. The achievement gap, or a second digital divide, for underprivileged classes of students, including minorities does not appear to contract via student access to a home computer. Nonetheless, in tests for significance, statistically significant improvement in science performance scores was reported for those having access to a computer at home compared to those not having access. Additionally, regression models reported evidence of correlations between and among subsets of controls for the demographic factors gender, race, and socioeconomic status. Variability in these correlations was high; suggesting influence from unobserved factors may have more impact upon the dependent variable. Having access to a computer at home increases performance scores for grade 12 general science students of all races, genders and socioeconomic levels. However, the performance gap is roughly equivalent to the existing performance gap of the national average for science scores, suggesting little influence from access to a computer on academic achievement. The variability of scores reported in the regression analysis models reflects a moderate to low effect, suggesting an absence of causation. These statistical results are accurate and confirm the literature review, whereby having access to a computer at home and the predictor variables were found to have a significant impact on performance scores, although the data presented suggest computer access at home is less influential upon performance scores than poverty and its correlates.

Evaluating the Effects of Flexible Learning about Aseptic Compounding on First-year Students in a Pharmacy Skills Laboratory.

PubMed

Neville, Michael W; Palmer, Russ; Elder, Deborah; Fulford, Michael; Morris, Steve; Sappington, Kellie

2015-08-25

To evaluate how flexible learning via online video review affects the ability and confidence of first-year (P1) pharmacy students to accurately compound aseptic preparations. Customary instructions and assignments for aseptic compounding were provided to students, who were given unlimited access to 5 short review videos in addition to customary instruction. Student self-confidence was assessed online, and faculty members evaluated students' aseptic technique at the conclusion of the semester. No significant difference on final assessment scores was observed between those who viewed videos and those who did not. Student self-confidence scores increased significantly from baseline, but were not significantly higher for those who viewed videos than for those who did not. First-year students performed well on final aseptic compounding assessments, and those who viewed videos had a slight advantage. Student self-confidence improved over the semester regardless of whether or not students accessed review videos.

Protecting core networks with dual-homing: A study on enhanced network availability, resource efficiency, and energy-savings

NASA Astrophysics Data System (ADS)

Abeywickrama, Sandu; Furdek, Marija; Monti, Paolo; Wosinska, Lena; Wong, Elaine

2016-12-01

Core network survivability affects the reliability performance of telecommunication networks and remains one of the most important network design considerations. This paper critically examines the benefits arising from utilizing dual-homing in the optical access networks to provide resource-efficient protection against link and node failures in the optical core segment. Four novel, heuristic-based RWA algorithms that provide dedicated path protection in networks with dual-homing are proposed and studied. These algorithms protect against different failure scenarios (i.e. single link or node failures) and are implemented with different optimization objectives (i.e., minimization of wavelength usage and path length). Results obtained through simulations and comparison with baseline architectures indicate that exploiting dual-homed architecture in the access segment can bring significant improvements in terms of core network resource usage, connection availability, and power consumption.

Design of the optical system for FSO access

NASA Astrophysics Data System (ADS)

Xu, Xiaojing; Yuan, Xiuhua; Huang, Dexiu

2002-08-01

Free space optics (FSO) is attractive for the 'last mile' communication in recent years for many combining advantages of fiber communication and other wireless technologies. FSO can provide high data rate with low power consumption, high immunity to interference, convenient deployment and flexibility. Optical system is an important section in the FSO transceiver terminal. In this paper the design of optical system based on a single Galileo telescope for both transmit and receive is proposed, and a polarization beam splitter is adopted to apart the receiving light from transmitting light. The configuration can avoid interference from the retroreflecting light of the ocular effectively. Some factors that affect the performance of the optical system are analyzed, such as the geometrical spreading loss and the loss increment according to pointing error and telescope maladjustment. Power budget shows that the system can satisfy the need of access for 1km in the light fog, and 2km in the thin fog.

Promoting Food Security for All Children.

PubMed

2015-11-01

Sixteen million US children (21%) live in households without consistent access to adequate food. After multiple risk factors are considered, children who live in households that are food insecure, even at the lowest levels, are likely to be sick more often, recover from illness more slowly, and be hospitalized more frequently. Lack of adequate healthy food can impair a child's ability to concentrate and perform well in school and is linked to higher levels of behavioral and emotional problems from preschool through adolescence. Food insecurity can affect children in any community, not only traditionally underserved ones. Pediatricians can play a central role in screening and identifying children at risk for food insecurity and in connecting families with needed community resources. Pediatricians should also advocate for federal and local policies that support access to adequate healthy food for an active and healthy life for all children and their families. Copyright © 2015 by the American Academy of Pediatrics.

Day labor and occupational health: time to take a closer look.

PubMed

Buchanan, Susan

2004-01-01

The term "day labor" refers to work performed by individuals who are hired on a temporary basis, often for one day at a time. This type of employment has increased in North America as informal work arrangements and immigration have increased. Research on the occupational health of day laborers is minimal. The objectives of this article are to review the current literature pertaining to occupational health in day laborers, and to characterize the issues that affect this population's access to occupational health services. Surveys of day laborers and other immigrant, low-wage workers show that they are at elevated risk for occupational injury and are often unable to access medical care when injured on the job. Reasons include workers' reluctance to complain about unsafe work conditions, inadequate safety training, and lack of incentive for employers to reduce workplace injuries. More research is needed to better characterize the occupational health of this population.

The Impact of Affect on Out-Group Judgments Depends on Dominant Information-Processing Styles: Evidence From Incidental and Integral Affect Paradigms.

PubMed

Isbell, Linda M; Lair, Elicia C; Rovenpor, Daniel R

2016-04-01

Two studies tested the affect-as-cognitive-feedback model, in which positive and negative affective states are not uniquely associated with particular processing styles, but rather serve as feedback about currently accessible processing styles. The studies extend existing work by investigating (a) both incidental and integral affect, (b) out-group judgments, and (c) downstream consequences. We manipulated processing styles and either incidental (Study 1) or integral (Study 2) affect and measured perceptions of out-group homogeneity. Positive (relative to negative) affect increased out-group homogeneity judgments when global processing was primed, but under local priming, the effect reversed (Studies 1 and 2). A similar interactive effect emerged on attributions, which had downstream consequences for behavioral intentions (Study 2). These results demonstrate that both incidental and integral affect do not directly produce specific processing styles, but rather influence thinking by providing feedback about currently accessible processing styles. © 2016 by the Society for Personality and Social Psychology, Inc.

The Internet and the First Amendment: School and Sexually Explicit Expression.

ERIC Educational Resources Information Center

Cate, Fred H.

Rather than focus on "who" makes the determination about students' access to sexually explicit expression, this volume examines the legal issues affecting "whether" to permit that access and "how much" access to allow. In sum, this book is intended to facilitate meaningful discussion about the regulation of minors'…

Delivery Complications Associated With Prenatal Care Access for Medicaid-Insured Mothers in Rural and Urban Hospitals

ERIC Educational Resources Information Center

Laditka, Sarah B.; Laditka, James N.; Bennett, Kevin J.; Probst, Janice C.

2005-01-01

Pregnancy complications affect many women. It is likely that some complications can be avoided through routine primary and prenatal care of reasonable quality. The authors examined access to health care during pregnancy for mothers insured by Medicaid. The access indicator is potentially avoidable maternity complications (PAMCs). Potentially…

Globalizing Higher Education Access in South-West Nigeria

ERIC Educational Resources Information Center

Olayiwola, Mohammed Mubashiru; Kolawole, Oladipupo Fatai; Moyosore, Onabanjo Florence

2013-01-01

Education is central to national interest and cannot be solely determined by market forces. Thus, the role of the state in making education policy and funding education to embrace access cannot be overemphasized. The influence of globalization on Higher Education access in Southwest Nigeria as it affects policy making was investigated through the…

Supporting Access to Open Online Courses for Learners of Developing Countries

ERIC Educational Resources Information Center

Nti, Kwame

2015-01-01

This paper examines how access to, and use of, open online courses may be enhanced for learners of developing countries from a learner perspective. Using analysis of the open education concept, factors that affect access to open educational resources content, and universal standards for delivering online learning, the author demonstrates that the…

Accessible Adult Learning in the Health Professions: Interactive Uses of Distance Technology.

ERIC Educational Resources Information Center

Townsend, Elizabeth; Curran-Smith, Janet

This paper describes a study of students' perceptions of the impact of accessibility and interactivity on successful distance education in the Health Professions. The study utilized both quantitative and qualitative data to determine how students perceived issues of accessibility and interactivity affecting their success in distance courses. The…

15 CFR 784.1 - Complementary access: General information on the purpose of complementary access, affected...

Code of Federal Regulations, 2010 CFR

2010-01-01

... may be conducted, on a selective basis, to verify the absence of undeclared nuclear material and nuclear related activities at reportable uranium hard-rock mines and ore beneficiation plants (see § 783.1... OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE ADDITIONAL PROTOCOL REGULATIONS COMPLEMENTARY ACCESS...

50 CFR 648.92 - Effort-control program for monkfish limited access vessels.

Code of Federal Regulations, 2011 CFR

2011-10-01

.... Limited access NE multispecies and limited access sea scallop permit holders who also possess a limited... Regional Administrator within 24 hours after tags have been discovered lost, destroyed, or missing. (iv... § 648.92, see the List of CFR Sections Affected, which appears in the Finding Aids section of the...

A Framework for Orbital Performance Evaluation in Distributed Space Missions for Earth Observation

NASA Technical Reports Server (NTRS)

Nag, Sreeja; LeMoigne-Stewart, Jacqueline; Miller, David W.; de Weck, Olivier

2015-01-01

Distributed Space Missions (DSMs) are gaining momentum in their application to earth science missions owing to their unique ability to increase observation sampling in spatial, spectral and temporal dimensions simultaneously. DSM architectures have a large number of design variables and since they are expected to increase mission flexibility, scalability, evolvability and robustness, their design is a complex problem with many variables and objectives affecting performance. There are very few open-access tools available to explore the tradespace of variables which allow performance assessment and are easy to plug into science goals, and therefore select the most optimal design. This paper presents a software tool developed on the MATLAB engine interfacing with STK, for DSM orbit design and selection. It is capable of generating thousands of homogeneous constellation or formation flight architectures based on pre-defined design variable ranges and sizing those architectures in terms of predefined performance metrics. The metrics can be input into observing system simulation experiments, as available from the science teams, allowing dynamic coupling of science and engineering designs. Design variables include but are not restricted to constellation type, formation flight type, FOV of instrument, altitude and inclination of chief orbits, differential orbital elements, leader satellites, latitudes or regions of interest, planes and satellite numbers. Intermediate performance metrics include angular coverage, number of accesses, revisit coverage, access deterioration over time at every point of the Earth's grid. The orbit design process can be streamlined and variables more bounded along the way, owing to the availability of low fidelity and low complexity models such as corrected HCW equations up to high precision STK models with J2 and drag. The tool can thus help any scientist or program manager select pre-Phase A, Pareto optimal DSM designs for a variety of science goals without having to delve into the details of the engineering design process.

Nature's inordinate fondness for metabolic enzymes: why metabolic enzyme loci are so frequently targets of selection.

PubMed

Marden, James H

2013-12-01

Metabolic enzyme loci were some of the first genes accessible for molecular evolution and ecology research. New technologies now make the whole genome, transcriptome or proteome readily accessible, allowing unbiased scans for loci exhibiting significant differences in allele frequency or expression level and associated with phenotypes and/or responses to natural selection. With surprising frequency and in many cases in proportions greater than chance relative to other genes, glycolysis and TCA cycle enzyme loci appear among the genes with significant associations in these studies. Hence, there is an ongoing need to understand the basis for fitness effects of metabolic enzyme polymorphisms. Allele-specific effects on the binding affinity and catalytic rate of individual enzymes are well known, but often of uncertain significance because metabolic control theory and in vivo studies indicate that many individual metabolic enzymes do not affect pathway flux rate. I review research, so far little used in evolutionary biology, showing that metabolic enzyme substrates affect signalling pathways that regulate cell and organismal biology, and that these enzymes have moonlighting functions. To date there is little knowledge of how alleles in natural populations affect these phenotypes. I discuss an example in which alleles of a TCA enzyme locus associate with differences in a signalling pathway and development, organismal performance, and ecological dynamics. Ultimately, understanding how metabolic enzyme polymorphisms map to phenotypes and fitness remains a compelling and ongoing need for gaining robust knowledge of ecological and evolutionary processes. © 2013 John Wiley & Sons Ltd.

Voluntary drinking behaviour, fluid balance and psychological affect when ingesting water or a carbohydrate-electrolyte solution during exercise.

PubMed

Peacock, Oliver J; Thompson, Dylan; Stokes, Keith A

2012-02-01

This study investigated the effects of drink composition on voluntary intake, hydration status, selected physiological responses and affective states during simulated gymnasium-based exercise. In a randomised counterbalanced design, 12 physically active adults performed three 20-min intervals of cardiovascular exercise at 75% heart rate maximum, one 20-min period of resistance exercise and 20 min of recovery with ad libitum access to water (W), a carbohydrate-electrolyte solution (CES) or with no access to fluids (NF). Fluid intake was greater with CES than W (1706±157 vs. 1171±152 mL; P<0.01) and more adequate hydration was achieved in CES trials (NF vs. W vs. CES: -1668±73 vs. -700±99 vs. -273±78 g; P<0.01). Plasma glucose concentrations were highest with CES (CES vs. NF vs. W: 4.26±0.12 vs. 4.06±0.08 vs. 3.97±0.10 mmol/L; P<0.05). Pleasure ratings were better maintained with ad libitum intake of CES (CES vs. NF vs. W: 2.72±0.23 vs. 1.09±0.20 vs. 1.74±0.33; P<0.01). Under conditions of voluntary drinking, CES resulted in more adequate hydration and a better maintenance of affective states than W or NF during gymnasium-based exercise. Copyright © 2011 Elsevier Ltd. All rights reserved.

Achieving the Dream in Connecticut: State Policies Affecting Access to, and Success in, Community Colleges for Students of Color and Low-Income Students

ERIC Educational Resources Information Center

Dougherty, Kevin J.; Reid, Monica

2006-01-01

This report provides an audit of state policies in Connecticut affecting access to, and success in, community colleges for students of color and low-income students. It was commissioned by Lumina Foundation for Education as part of a series of policy audits of the states involved in Achieving the Dream. Lumina Foundation is the primary funder of…

Achieving the Dream in Ohio: State Policies Affecting Access to, and Success in, Community Colleges for Students of Color and Low-Income Students

ERIC Educational Resources Information Center

Dougherty, Kevin J.; Marshall, James; Soonachan, Andrea

2006-01-01

This report provides an audit of state policies in Ohio affecting access to, and success in, community colleges for students of color and low-income students. It was commissioned by Lumina Foundation for Education as part of a series of policy audits of the states involved in Achieving the Dream. Lumina Foundation is the primary funder of the…

Difficulties in emotion regulation mediate negative and positive affects and craving in alcoholic patients.

PubMed

Khosravani, Vahid; Sharifi Bastan, Farangis; Ghorbani, Fatemeh; Kamali, Zoleikha

2017-08-01

The aim of this study was to assess the mediating effects of difficulties in emotion regulation (DER) on the relations of negative and positive affects to craving in alcoholic patients. 205 treatment-seeking alcoholic outpatients were included. DER, positive and negative affects as well as craving were evaluated by the Difficulties in Emotion Regulation Scale (DERS), the Positive/Negative Affect Scales, and the Obsessive Compulsive Drinking Scale (OCDS) respectively. Clinical factors including depression and severity of alcohol dependence were investigated by the Alcohol Use Disorders Identification Test (AUDIT) and the Beck Depression Inventory-II (BDI-II) respectively. Results revealed that both increased negative affect and decreased positive affect indirectly influenced craving through limited access to emotion regulation strategies. It was concluded that limited access to emotion regulation strategies may be important in predicting craving for alcoholics who experience both increased negative affect and decreased positive affect. This suggests that treatment and prevention efforts focused on increasing positive affect, decreasing negative affect and teaching effective regulation strategies may be critical in reducing craving in alcoholic patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

13 CFR 113.3-3 - Structural accommodations for handicapped clients.

Code of Federal Regulations, 2011 CFR

2011-01-01

... accessible to and usable by persons with handicaps. Alterations to existing facilities that affect usability... permitted where substantially equivalent or greater access to and usability of the building is provided. (2...

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

PubMed

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

2017-06-01

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

Health Care Access and Utilization after the 2010 Pakistan Floods.

PubMed

Jacquet, Gabrielle A; Kirsch, Thomas; Durrani, Aqsa; Sauer, Lauren; Doocy, Shannon

2016-10-01

Introduction The 2010 floods submerged more than one-fifth of Pakistan's land area and affected more than 20 million people. Over 1.6 million homes were damaged or destroyed and 2,946 direct injuries and 1,985 deaths were reported. Infrastructure damage was widespread, including critical disruptions to the power and transportation networks. Hypothesis Damage and loss of critical infrastructure will affect the population's ability to seek and access adequate health care for years to come. This study sought to evaluate factors associated with access to health care in the aftermath of the 2010 Pakistan floods. A population-proportional, randomized cluster-sampling survey method with 80 clusters of 20 (1,600) households of the flood-affected population was used. Heads of households were surveyed approximately six months after flood onset. Multivariate analysis was used to determine significance. A total of 77.8% of households reported needing health services within the first month after the floods. Household characteristics, including rural residence location, large household size, and lower pre- and post-flood income, were significantly associated (P<.05) with inadequate access to health care after the disaster. Households with inadequate access to health care were more likely to have a death or injury in the household. Significantly higher odds of inadequate access to health care were observed in rural populations (adjusted OR 4.26; 95% CI, 1.89-9.61). Adequate health care access after the 2010 Pakistani floods was associated with urban residence location, suggesting that locating health care providers in rural areas may be difficult. Access to health services also was associated with post-flood income level, suggesting health resources are not readily available to households suffering great income losses. Jacquet GA , Kirsch T , Durrani A , Sauer L , Doocy S . Health care access and utilization after the 2010 Pakistan floods. Prehosp Disaster Med. 2016;31(5):485-491.

Seasonal Variation in Pigeon Body Weight and Delayed Matching-to-sample Performance

PubMed Central

Sargisson, Rebecca J; McLean, Ian G; Brown, Glenn S; White, K Geoffrey

2007-01-01

The weights of 5 pigeons with free access to food, monitored over 3 calendar years in the laboratory, were found to fluctuate with season. All pigeons were at their heaviest in the winter and were lightest in the summer. Five different pigeons performed a standard delayed matching-to-sample task for 44 weeks from January to November. Their weights were held at 85% of their summer free-feeding weights, making their predicted deprivation level higher in the winter relative to predicted winter free-feeding weights. Slopes of forgetting functions fit to weekly response totals for each pigeon were shallower in winter, showing an improvement in accuracy with longer delays. Thus, delayed matching-to-sample performance may have been affected by the practice of maintaining the pigeons at a constant body weight throughout the calendar year. PMID:18047229

The impact of negative emotions on self-concept abstraction depends on accessible information processing styles.

PubMed

Isbell, Linda M; Rovenpor, Daniel R; Lair, Elicia C

2016-10-01

Research suggests that anger promotes global, abstract processing whereas sadness and fear promote local, concrete processing (see Schwarz & Clore, 2007 for a review). Contrary to a large and influential body of work suggesting that specific affective experiences are tethered to specific cognitive outcomes, the affect-as-cognitive-feedback account maintains that affective experiences confer positive or negative value on currently dominant processing styles, and thus can lead to either global or local processing (Huntsinger, Isbell, & Clore, 2014). The current work extends this theoretical perspective by investigating the impact of discrete negative emotions on the self-concept. By experimentally manipulating information processing styles and discrete negative emotions that vary in appraisals of certainty, we demonstrate that the impact of discrete negative emotions on the spontaneous self-concept depends on accessible processing styles. When global processing was accessible, individuals in angry (negative, high certainty) states generated more abstract statements about themselves than individuals in either sad (Experiment 1) or fearful (Experiment 2; negative, low certainty) states. When local processing was made accessible, however, the opposite pattern emerged, whereby individuals in angry states generated fewer abstract statements than individuals in sad or fearful states. Together these studies provide new insights into the mechanisms through which discrete emotions influence cognition. In contrast to theories assuming a dedicated link between emotions and processing styles, these results suggest that discrete emotions provide feedback about accessible ways of thinking, and are consistent with recent evidence suggesting that the impact of affect on cognition is highly context-dependent. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Highly palatable food access during adolescence increased anxiety-/depression-like behaviors in male, but not in female, rats.

PubMed

Kim, Jin Young; Kim, Doyun; Park, Kyungpyo; Lee, Jong-Ho; Jahng, Jeong Won

2017-04-11

This study was conducted to examine the sexual dimorphic effects of highly palatable food (HPF) access during adolescence on the neurochemistry and depression-/anxiety-like behaviors of rats. Male and female Sprague-Dawley pups had free access to chocolate cookie rich in fat (HPF) from postnatal day 28 in addition to ad libitum chow, and the control groups received only chow. The food conditions were continued throughout the entire experimental period, and the neurochemical and behavioral measurements were performed during young adulthood. Rats were subjected to the ambulatory activity, elevated plus maze, and forced swim tests. Corticosterone levels during 2 h of restraint stress were analyzed with radioimmunoassay, and ΔFosB and brain-derived neurotrophic factor (BDNF) expression in the nucleus accumbens (NAc) with Western blot analysis. Cookie access did not affect body weight gain and total caloric intake in both sexes; however, it increased retroperitoneal fat depot only in males. The time spent in open arms during elevated plus maze test was decreased and immobility during forced swim test was increased in cookie-fed males, but not in cookie-fed females. Main effect of food condition on the stress-induced corticosterone increase was observed in males, but not in females, and cookie access increased BDNF expression in the NAc only in males. Increased BDNF expression in the NAc and fat depot, in addition to the stress axis dysfunction, may play roles in the pathophysiology of depression- and/or anxiety-like behaviors induced by cookie access.

[Students Having Parents with Mental Health Issues and Teachers' Mental Health Literacy].

PubMed

Bruland, Dirk; Kornblum, Katharina; Harsch, Stefanie; Bröder, Janine; Okan, Orkan; Bauer, Ullrich

2017-12-01

Students Having Parents with Mental Health Issues and Teachers' Mental Health Literacy Mental health issues of parents of school children often negatively affects the children as well, including their school performance and social behavior in the school setting. Teachers are then required to take actions with regards to supporting children in their coping with and mastering of their home situation and their responds to educational demands. As such, schools' and teachers' actions can either support affected children and fulfill a protective function or respond inappropriately, with negative impact on the affected children. Although the societal discussion about and acceptance of mental illnesses have increased in recent years, scientific knowledge on how well teachers are prepared for meeting the needs of affected students remains insufficient. Therefore, this research study examines teachers' attitudes towards, knowledge about, and competencies regarding children affected by a mentally ill parent. 15 in-depth interviews and 3 focus groups (n = 11) with teachers from primary and secondary schools were conducted and systematically analyzed. Although burdens in the family are perceived as major influences on children's school day and performance, teachers report to not feel sufficiently prepared for and uncertain about supporting and coping with the special needs of affected students. Instead they report to "learn from a case to case" basis. Recognizing the family situation of children with mentally ill parents is reported to be especially difficult for teachers. Responding inadequately and insensitive to the needs of affected children was perceived as a serious burden for teachers themselves. While schools can function as entry points to professional social help systems, teachers frequently reported barriers and challenges in accessing, communicating, and collaborating with these systems. The practical implications of these results regarding the "Mental Health Literacy" of teachers are being discussed.

Factors affecting computer mouse use for young children: implications for AAC.

PubMed

Costigan, F Aileen; Light, Janice C; Newell, Karl M

2012-06-01

More than 12% of preschoolers receiving special education services have complex communication needs, including increasing numbers of children who do not have significant motor impairments (e.g., children with autism spectrum disorders, Down syndrome, etc.). In order to meet their diverse communication needs (e.g., face-to-face, written, Internet, telecommunication), these children may use mainstream technologies accessed via the mouse, yet little is known about factors that affect the mouse performance of young children. This study used a mixed factorial design to investigate the effects of age, target size, and angle of approach on accuracy and time required for accurate target selection with a mouse for 20 3-year-old and 20 4-year-old children. The 4-year-olds were generally more accurate and faster than the 3-year-olds. Target size and angle mediated differences in performance within age groups. The 3-year-olds were more accurate and faster in selecting the medium and large targets relative to the small target, were faster in selecting the large relative to the medium target, and were faster in selecting targets along the vertical relative to the diagonal angle. The 4-year-olds were faster in selecting the medium and large targets relative to the small target. Implications for improving access to AAC include the preliminary suggestion of age-related threshold target sizes that support sufficient accuracy, the possibility of efficiency benefits when target size is increased up to an age-related threshold, and identification of the potential utility of the vertical angle as a context for training navigational input device use.

e-Learning in Advanced Life Support-What factors influence assessment outcome?

PubMed

Thorne, C J; Lockey, A S; Kimani, P K; Bullock, I; Hampshire, S; Begum-Ali, S; Perkins, G D

2017-05-01

To establish variables which are associated with favourable Advanced Life Support (ALS) course assessment outcomes, maximising learning effect. Between 1 January 2013 and 30 June 2014, 8218 individuals participated in a Resuscitation Council (UK) e-learning Advanced Life Support (e-ALS) course. Participants completed 5-8h of online e-learning prior to attending a one day face-to-face course. e-Learning access data were collected through the Learning Management System (LMS). All participants were assessed by a multiple choice questionnaire (MCQ) before and after the face-to-face aspect alongside a practical cardiac arrest simulation (CAS-Test). Participant demographics and assessment outcomes were analysed. The mean post e-learning MCQ score was 83.7 (SD 7.3) and the mean post-course MCQ score was 87.7 (SD 7.9). The first attempt CAS-Test pass rate was 84.6% and overall pass rate 96.6%. Participants with previous ALS experience, ILS experience, or who were a core member of the resuscitation team performed better in the post-course MCQ, CAS-Test and overall assessment. Median time spent on the e-learning was 5.2h (IQR 3.7-7.1). There was a large range in the degree of access to e-learning content. Increased time spent accessing e-learning had no effect on the overall result (OR 0.98, P=0.367) on simulated learning outcome. Clinical experience through membership of cardiac arrest teams and previous ILS or ALS training were independent predictors of performance on the ALS course whilst time spent accessing e-learning materials did not affect course outcomes. This supports the blended approach to e-ALS which allows participants to tailor their e-learning experience to their specific needs. Copyright © 2017 Elsevier B.V. All rights reserved.

Some old drugs improve late primary patency rate of native arteriovenous fistulas in hemodialysis patients.

PubMed

Righetti, Marco; Ferrario, GianMichele; Serbelloni, Paola; Milani, Silvana; Tommasi, Adalberto

2009-01-01

Vascular access failure causes 20% of all hospitalizations of dialysis patients. Native arteriovenous fistulas, the best type of dialysis vascular access, have a 1-year primary patency rate that is extremely variable, ranging 40-80%. Neointimal hyperplasia is the most important cause of arteriovenous fistula late primary dysfunction. In recent years the arteriovenous fistula late primary patency rate has not improved because of the increase of old uremic patients with a high number of comorbidities and the lack of new therapeutic interventions. Therefore, we performed a long-term case-control study to analyze which factors or drugs may affect native arteriovenous fistula late primary patency rate in 60 incident hemodialysis patients. The arteriovenous fistula late primary patency rate was 75.1% after 12 months, 58.5% after 24 months, and 50% after 987 days. Homocysteine levels during follow-up had a significant direct association with vascular access failure (event vs. event-free 28.5+/-1.9 vs. 22.3+/-1.2 micromol/L, p<0.01). Folate values had a trend toward an inverse relationship with arteriovenous fistula failure (event vs. event-free 11.5+/-1.2 vs. 14.6 vs. 1.1 ng/mL, p=0.06). Patients treated with folic acid and/or statin had an arteriovenous fistula late primary patency rate significantly higher than patients without folic acid and statin therapy, respectively, 81.7% vs. 66% after 1 year and 71.5% vs. 39.1% after 2 years (p=0.02). Many other factors were not associated with vascular access failure. Statin and homocysteine-lowering folic acid therapy is associated with prolonged arteriovenous fistula survival. It is important to perform randomized trials to verify our observation.

Access to dialysis services: A systematic mapping review based on geographical information systems.

PubMed

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

2018-05-07

Equitable access to healthcare services constitutes one of the leading priorities of healthcare provision and access to dialysis services (ADS) has an essential impact on patients depending on renal dialysis. The many existing GIS-based ADS evaluations include various spatial and non-spatial factors affecting ADS. We systematically mapped and reviewed the available literature with reference to this area identifying gaps in current GIS-based ADS measurements and developing recommendations for future studies. A threestep, systematic mapping review of the available GIS-related evidence in PubMed, Embase, Web of science, Scopus, Science Direct and IEEE Xplore was performed in May 2016 and the information collected updated October 2017 by two independent selection processes. The quality of the studies was assessed using an informal, mixed-approach scoring system. Out of 1119 literature references identified, 36 were identified and used for final review after removal of duplicates, study screenings and applying inclusion/exclusion criteria. Given the contents of the selected studies, three study groups were identified and 41 factors with potential effects on ADS determined. These studies mainly addressed the potential and/or spatial aspects of ADS. Our systematic mapping review of the evidence revealed that current GIS-based measures of ADS tend to calculate potential ADS instead of a realized one. It was also noted that listed factors affecting ADS were mainly nonspatial bringing forth the hypothesis that designing an integrated ADS index could possibly produce better ADS score than those currently advocated. Some primary and secondary research suggestions are made and a list of recommendations offered.

Development of access management performance measures.

DOT National Transportation Integrated Search

2009-05-01

In 2007, the Virginia General Assembly passed legislation calling for Access Management, the : regulation of entrances and intersections along highway corridors in Virginia. Some property owners may oppose : access management. Therefore, performance ...

Safety Benefits of Access Spacing

DOT National Transportation Integrated Search

1997-01-01

The spacing of driveways and streets is an important element in roadway planning, design, and operation. Access points are the main source of accidents and congestion. Their location and spacing affects the safety and functional integrity of streets ...

75 FR 80481 - Advisory Commission on Accessible Instructional Materials in Postsecondary Education for Students...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-22

...) conduct a comprehensive study, which will--(I) assess the barriers and systemic issues that may affect... approach to improve the opportunities for postsecondary students with print disabilities to access...

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

PubMed

McPhedran, Samara

2018-05-01

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

Acceptance and Adoption of Open Access Publication (OAP) in University Libraries in South East Nigeria

ERIC Educational Resources Information Center

Sambe, Manasseh Tyungu; Raphael, Gabriel Okplogidi

2015-01-01

This study examines the kinds of open access scholarly publication or information resources accepted and adopted by federal university libraries in South East Nigeria. The purpose was to determine the factors that affect open access scholarly publication or information resources acceptance and adoption in university libraries. The study adopted…

The Physical Accessibility of Public Libraries to Users: A GIS Study

ERIC Educational Resources Information Center

Park, Sung Jae

2011-01-01

The purpose of this study is to gain a finer-grained picture and better understanding of the travel patterns of library users, and the activities, demographics, and other factors that affect library access. Previous studies of physical accessibility of public libraries, which have focused on library users' single-destination trips and their travel…

Ecological Factors Affecting Access to General Education Content and Contexts for Students with Significant Disabilities

ERIC Educational Resources Information Center

Ruppar, Andrea L.; Allcock, Heather; Gonsier-Gerdin, Jean

2017-01-01

In this review, we applied Bronfenbrenner's ecological systems theory to examine factors that support or restrict access to the general curriculum for students with significant disabilities. We organize the literature in relationship to factors within the micro-, meso-, macro-, exo-, and chronosystems that influence decisions about access to the…

Dropping out from School. Policy Brief Number 8

ERIC Educational Resources Information Center

Hunt, Frances

2009-01-01

While initial access to education is increasing in many countries, drop out rates continue to be high. This seriously affects MDG and EFA goals around educational access. This briefing paper looks at the issue of dropping out from school. It is based on the CREATE Pathways to Access Research Monograph, "Dropping out from school: a cross…

National Health Care Reform, Medicaid, and Children in Foster Care.

ERIC Educational Resources Information Center

Halfon, Neal; And Others

1994-01-01

Outlines access to health care for children in out-of-home care under current law, reviews how health care access for these children would be affected by President Clinton's health care reform initiative, and proposes additional measures that could be considered to improve access and service coordination for children in the child welfare system.…

Testing the Digital Divide: Does Access to High-Quality Use of Technology in Schools Affect Student Achievement?

ERIC Educational Resources Information Center

Talley, Gregory Keith

2012-01-01

This study investigates the relationship between access, use of technology and student achievement in public middle schools in Maryland. The objective of this study was to determine whether a digital divide (differences in access and utilization of technology based on student characteristics of race, socioeconomic status, and gender) exists among…

The role and benefits of accessing primary care patient records during unscheduled care: a systematic review.

PubMed

Bowden, Tom; Coiera, Enrico

2017-09-22

The purpose of this study was to assess the impact of accessing primary care records on unscheduled care. Unscheduled care is typically delivered in hospital Emergency Departments. Studies published to December 2014 reporting on primary care record access during unscheduled care were retrieved. Twenty-two articles met inclusion criteria from a pool of 192. Many shared electronic health records (SEHRs) were large in scale, servicing many millions of patients. Reported utilization rates by clinicians was variable, with rates >20% amongst health management organizations but much lower in nation-scale systems. No study reported on clinical outcomes or patient safety, and no economic studies of SEHR access during unscheduled care were available. Design factors that may affect utilization included consent and access models, SEHR content, and system usability and reliability. Despite their size and expense, SEHRs designed to support unscheduled care have been poorly evaluated, and it is not possible to draw conclusions about any likely benefits associated with their use. Heterogeneity across the systems and the populations they serve make generalization about system design or performance difficult. None of the reviewed studies used a theoretical model to guide evaluation. Value of Information models may be a useful theoretical approach to design evaluation metrics, facilitating comparison across systems in future studies. Well-designed SEHRs should in principle be capable of improving the efficiency, quality and safety of unscheduled care, but at present the evidence for such benefits is weak, largely because it has not been sought.

Complication with Intraosseous Access: Scandinavian Users’ Experience

PubMed Central

Hallas, Peter; Brabrand, Mikkel; Folkestad, Lars

2013-01-01

Introduction: Intraosseous access (IO) is indicated if vascular access cannot be quickly established during resuscitation. Complication rates are estimated to be low, based on small patient series, model or cadaver studies, and case reports. However, user experience with IO use in real-life emergency situations might differ from the results in the controlled environment of model studies and small patient series. We performed a survey of IO use in real-life emergency situations to assess users’ experiences of complications. Methods: An online questionnaire was sent to Scandinavian emergency physicians, anesthesiologists and pediatricians. Results: 1,802 clinical cases of IO use was reported by n=386 responders. Commonly reported complications with establishing IO access were patient discomfort/pain (7.1%), difficulties with penetration of periosteum with IO needle (10.3%), difficulties with aspiration of bone marrow (12.3%), and bended/broken needle (4.0%). When using an established IO access the reported complications were difficulties with injection fluid and drugs after IO insertion (7.4%), slow infusion (despite use of pressure bag) (8.8%), displacement after insertion (8.5%), and extravasation (3.7%). Compartment syndrome and osteomyelitis occurred in 0.6% and 0.4% of cases respectively. Conclusion: In users’ recollection of real-life IO use, perceived complications were more frequent than usually reported from model studies. The perceived difficulties with using IO could affect the willingness of medical staff to use IO. Therefore, user experience should be addressed both in education of how to use, and research and development of IOs. PMID:24106537

Engineering Trade-off Considerations Regarding Design-for-Security, Design-for-Verification, and Design-for-Test

NASA Technical Reports Server (NTRS)

Berg, Melanie; Label, Kenneth

2018-01-01

The United States government has identified that application specific integrated circuit (ASIC) and field programmable gate array (FPGA) hardware are at risk from a variety of adversary attacks. This finding affects system security and trust. Consequently, processes are being developed for system mitigation and countermeasure application. The scope of this tutorial pertains to potential vulnerabilities and countermeasures within the ASIC/FPGA design cycle. The presentation demonstrates how design practices can affect the risk for the adversary to: change circuitry, steal intellectual property, and listen to data operations. An important portion of the design cycle is assuring the design is working as specified or as expected. This is accomplished by exhaustive testing of the target design. Alternatively, it has been shown that well established schemes for test coverage enhancement (design-for-verification (DFV) and design-for-test (DFT)) can create conduits for adversary accessibility. As a result, it is essential to perform a trade between robust test coverage versus reliable design implementation. The goal of this tutorial is to explain the evolution of design practices; review adversary accessibility points due to DFV and DFT circuitry insertion (back door circuitry); and to describe common engineering trade-off considerations for test versus adversary threats.

Virtual memory support for distributed computing environments using a shared data object model

NASA Astrophysics Data System (ADS)

Huang, F.; Bacon, J.; Mapp, G.

1995-12-01

Conventional storage management systems provide one interface for accessing memory segments and another for accessing secondary storage objects. This hinders application programming and affects overall system performance due to mandatory data copying and user/kernel boundary crossings, which in the microkernel case may involve context switches. Memory-mapping techniques may be used to provide programmers with a unified view of the storage system. This paper extends such techniques to support a shared data object model for distributed computing environments in which good support for coherence and synchronization is essential. The approach is based on a microkernel, typed memory objects, and integrated coherence control. A microkernel architecture is used to support multiple coherence protocols and the addition of new protocols. Memory objects are typed and applications can choose the most suitable protocols for different types of object to avoid protocol mismatch. Low-level coherence control is integrated with high-level concurrency control so that the number of messages required to maintain memory coherence is reduced and system-wide synchronization is realized without severely impacting the system performance. These features together contribute a novel approach to the support for flexible coherence under application control.

MyEnviroMapper

EPA Pesticide Factsheets

EnviroMapper for Envirofacts is a single point of access to select U.S. EPA environmental data. This Web site provides access to several EPA databases to provide you with information about environmental activities that may affect air, water, and l

Does the Use of a Classification for Nursing Diagnoses Affect Nursing Students’ Choice of Nursing Interventions?

PubMed Central

Falk, Joakim; Björvell, Catrin

2012-01-01

The Swedish health care system stands before an implementation of standardized language. The first classification of nursing diagnoses translated into Swedish, The NANDA, was released in January 2011. The aim of the present study was to examine whether the usage of the NANDA classification affected nursing students’ choice of nursing interventions. Thirty-three nursing students in a clinical setting were divided into two groups. The intervention group had access to the NANDA classification text book, while the comparison group did not. In total 78 nursing assessments were performed and 218 nursing interventions initiated. The principle findings show that there were no statistical significant differences between the groups regarding the amount, quality or category of nursing interventions when using the NANDA classification compared to free text format nursing diagnoses. PMID:24199065

Framework for developing hybrid process-driven, artificial neural network and regression models for salinity prediction in river systems

NASA Astrophysics Data System (ADS)

Hunter, Jason M.; Maier, Holger R.; Gibbs, Matthew S.; Foale, Eloise R.; Grosvenor, Naomi A.; Harders, Nathan P.; Kikuchi-Miller, Tahali C.

2018-05-01

Salinity modelling in river systems is complicated by a number of processes, including in-stream salt transport and various mechanisms of saline accession that vary dynamically as a function of water level and flow, often at different temporal scales. Traditionally, salinity models in rivers have either been process- or data-driven. The primary problem with process-based models is that in many instances, not all of the underlying processes are fully understood or able to be represented mathematically. There are also often insufficient historical data to support model development. The major limitation of data-driven models, such as artificial neural networks (ANNs) in comparison, is that they provide limited system understanding and are generally not able to be used to inform management decisions targeting specific processes, as different processes are generally modelled implicitly. In order to overcome these limitations, a generic framework for developing hybrid process and data-driven models of salinity in river systems is introduced and applied in this paper. As part of the approach, the most suitable sub-models are developed for each sub-process affecting salinity at the location of interest based on consideration of model purpose, the degree of process understanding and data availability, which are then combined to form the hybrid model. The approach is applied to a 46 km reach of the Murray River in South Australia, which is affected by high levels of salinity. In this reach, the major processes affecting salinity include in-stream salt transport, accession of saline groundwater along the length of the reach and the flushing of three waterbodies in the floodplain during overbank flows of various magnitudes. Based on trade-offs between the degree of process understanding and data availability, a process-driven model is developed for in-stream salt transport, an ANN model is used to model saline groundwater accession and three linear regression models are used to account for the flushing of the different floodplain storages. The resulting hybrid model performs very well on approximately 3 years of daily validation data, with a Nash-Sutcliffe efficiency (NSE) of 0.89 and a root mean squared error (RMSE) of 12.62 mg L-1 (over a range from approximately 50 to 250 mg L-1). Each component of the hybrid model results in noticeable improvements in model performance corresponding to the range of flows for which they are developed. The predictive performance of the hybrid model is significantly better than that of a benchmark process-driven model (NSE = -0.14, RMSE = 41.10 mg L-1, Gbench index = 0.90) and slightly better than that of a benchmark data-driven (ANN) model (NSE = 0.83, RMSE = 15.93 mg L-1, Gbench index = 0.36). Apart from improved predictive performance, the hybrid model also has advantages over the ANN benchmark model in terms of increased capacity for improving system understanding and greater ability to support management decisions.

A systematic review of factors affecting driving and public transportation among youth and young adults with acquired brain injury.

PubMed

Lindsay, Sally; Stoica, Andrei

2017-01-01

Although many people with an acquired brain injury (ABI) encounter difficulties with executive functioning and memory which could negatively affect driving, few people are assessed for fitness to drive after injury. The purpose of this systematic review was to synthesize the literature on factors affecting driving and public transportation among youth and young adults with ABI, post injury. Seven databases were systematically searched for articles from 1980 to 2016. Studies were screened independently by two researchers who performed the data extraction. Study quality was appraised using the Standard Quality Assessment Criteria (Kmet) for evaluating primary research from a variety of fields. Of the 6577 studies identified in the search, 25 met the inclusion criteria, which involved 1527 participants with ABI (mean age = 25.1) across eight countries. Six studies focused on driving assessment and fitness to drive, ten on driving performance or risk of accidents and nine studies explored issues related to accessing or navigating public transportation. Quality assessment of the included studies ranged from 0.60 to 0.95. Our findings highlight several gaps in clinical practice and research along with a critical need for enhanced fitness to drive assessments and transportation-related training for young people with ABI.

AccessScope project: Accessible light microscope for users with upper limb mobility or visual impairments.

PubMed

Mansoor, Awais; Ahmed, Wamiq M; Samarapungavan, Ala; Cirillo, John; Schwarte, David; Robinson, J Paul; Duerstock, Bradley S

2010-01-01

A web-based application was developed to remotely view slide specimens and control all functions of a research-level light microscopy workstation, called AccessScope. Students and scientists with upper limb mobility and visual impairments are often unable to use a light microscope by themselves and must depend on others in its operation. Users with upper limb mobility impairments and low vision were recruited to assist in the design process of the AccessScope personal computer (PC) user interface. Participants with these disabilities were evaluated in their ability to use AccessScope to perform microscopical tasks. AccessScope usage was compared with inspecting prescanned slide images by grading participants' identification and understanding of histological features and knowledge of microscope operation. With AccessScope subjects were able to independently perform common light microscopy functions through an Internet browser by employing different PC pointing devices or accessibility software according to individual abilities. Subjects answered more histology and microscope usage questions correctly after first participating in an AccessScope test session. AccessScope allowed users with upper limb or visual impairments to successfully perform light microscopy without assistance. This unprecedented capability is crucial for students and scientists with disabilities to perform laboratory coursework or microscope-based research and pursue science, technology, engineering, and mathematics fields.

Effects of free-range access on production parameters and meat quality, composition and taste in slow-growing broiler chickens.

PubMed

Stadig, Lisanne M; Rodenburg, T Bas; Reubens, Bert; Aerts, Johan; Duquenne, Barbara; Tuyttens, Frank A M

2016-12-01

Demand for meat from free-range broiler chickens is increasing in several countries. Consumers are motivated by better animal welfare and other product attributes such as quality and taste. However, scientific literature is not unanimous about whether free-range access influences quality, composition, and taste of the meat. Because chickens normally do not use free-range areas optimally, it is possible that provision of more suitable shelter will lead to more pronounced differences between chickens raised indoors and outdoors. In this study, an experiment with 2 production rounds of 600 slow-growing broilers each was performed. In each round, 200 chickens were raised indoors (IN), 200 had free-range access to grassland with artificial shelter (AS), and 200 had free-range access to short-rotation coppice with willow (SRC). Free-range use, feed intake, and growth were monitored, and after slaughter (d72) meat quality, composition, and taste were assessed. Free-range use was higher in SRC than in AS chickens (42.8 vs. 35.1%, P < 0.001). IN chickens were heavier at d70 than AS and SRC chickens (2.79 vs. 2.66 and 2.68 kg, P = 0.005). However, feed intake and conversion did not differ. Breast meat of chickens with free-range access was darker (P = 0.021) and yellower (P = 0.001) than that of IN chickens. Ultimate pH was lower (5.73 vs. 5.79; P = 0.006) and drip loss higher (1.29 vs. 1.09%; P = 0.05) in IN versus AS chickens. The percentage of polyunsaturated fatty acids was higher in AS than in IN meat (35.84 vs. 34.59%; P = 0.021). The taste panel judged breast meat of SRC chickens to be more tender (P = 0.003) and less fibrous (P = 0.013) compared to that of AS and IN chickens, and juicier compared to the IN chickens (P = 0.017). Overall, free-range access negatively affected slaughter weight, but positively affected meat quality, taste, and composition. Only a few differences between AS and SRC were found, possibly due to limited differences in free-range use. © 2016 Poultry Science Association Inc.

Helium: lifting high-performance stencil kernels from stripped x86 binaries to halide DSL code

DOE PAGES

Mendis, Charith; Bosboom, Jeffrey; Wu, Kevin; ...

2015-06-03

Highly optimized programs are prone to bit rot, where performance quickly becomes suboptimal in the face of new hardware and compiler techniques. In this paper we show how to automatically lift performance-critical stencil kernels from a stripped x86 binary and generate the corresponding code in the high-level domain-specific language Halide. Using Halide's state-of-the-art optimizations targeting current hardware, we show that new optimized versions of these kernels can replace the originals to rejuvenate the application for newer hardware. The original optimized code for kernels in stripped binaries is nearly impossible to analyze statically. Instead, we rely on dynamic traces to regeneratemore » the kernels. We perform buffer structure reconstruction to identify input, intermediate and output buffer shapes. Here, we abstract from a forest of concrete dependency trees which contain absolute memory addresses to symbolic trees suitable for high-level code generation. This is done by canonicalizing trees, clustering them based on structure, inferring higher-dimensional buffer accesses and finally by solving a set of linear equations based on buffer accesses to lift them up to simple, high-level expressions. Helium can handle highly optimized, complex stencil kernels with input-dependent conditionals. We lift seven kernels from Adobe Photoshop giving a 75 % performance improvement, four kernels from Irfan View, leading to 4.97 x performance, and one stencil from the mini GMG multigrid benchmark netting a 4.25 x improvement in performance. We manually rejuvenated Photoshop by replacing eleven of Photoshop's filters with our lifted implementations, giving 1.12 x speedup without affecting the user experience.« less

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

Roberts, Barry L; Lord, David; Lord, Anna C. Snider

This report summarizes the work performed in the prioritization of cavern access wells for remediation and monitoring at the West Hackberry Strategic Petroleum Reserve site. The grading included consideration of all 31 wells at the West Hackberry site, with each well receiving a separate grade for remediation and monitoring. Numerous factors affecting well integrity were incorporated into the grading including casing survey results, cavern pressure history, results from geomechanical simulations, and site geologic factors. The factors and grading framework used here are the same as those used in developing similar well remediation and monitoring priorities at the Big Hill andmore » Bryan Mound Strategic Petroleum Reserve Sites.« less

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

Roberts, Barry L; Lord, David; Lord, Anna C. Snider

This report summarizes the work performed in the prioritization of cavern access wells for remediation and monitoring at the Bryan Mound Strategic Petroleum Reserve site. The grading included consideration of all 47 wells at the Bryan Mound site, with each well receiving a separate grade for remediation and monitoring. Numerous factors affecting well integrity were incorporated into the grading including casing survey results, cavern pressure history, results from geomechanical simulations, and site geologic factors. The factors and grading framework used here are the same as those used in developing similar well remediation and monitoring priorities at the Big Hill Strategicmore » Petroleum Reserve Site.« less

2013 strategic petroleum reserve big hill well integrity grading report.

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

Lord, David L.; Roberts, Barry L.; Lord, Anna C. Snider

2014-02-01

This report summarizes the work performed in developing a framework for the prioritization of cavern access wells for remediation and monitoring at the Big Hill Strategic Petroleum Reserve site. This framework was then applied to all 28 wells at the Big Hill site with each well receiving a grade for remediation and monitoring. Numerous factors affecting well integrity were incorporated into the grading framework including casing survey results, cavern pressure history, results from geomechanical simulations, and site geologic factors. The framework was developed in a way as to be applicable to all four of the Strategic Petroleum Reserve sites.

Beyond Section 508: The Spectrum of Legal Requirements for Accessible e-Government Web Sites in the United States

ERIC Educational Resources Information Center

Jaeger, Paul T.

2004-01-01

In the United States, a number of federal laws establish requirements that electronic government (e-government) information and services be accessible to individuals with disabilities. These laws affect e-government Web sites at the federal, state, and local levels. To this point, research about the accessibility of e-government Web sites has…

Region, Locality Characteristics, High School Tracking and Equality in Access to Educational Credentials: The Case of Palestinian Arab Communities in Israel.

ERIC Educational Resources Information Center

Mazawi, Andre Elias

1998-01-01

Examines the effects of regional, locality, and high school characteristics on access opportunities to educational credentials of Palestinian Arab students in Israel. Reveals that while tracking patterns are affected by high school variables at the community level, access to educational credentials is determined by community-level, socioeconomic…

Staff Report on the Hispanic Access to Higher Education of the Committee on Education and Labor. House of Representatives, Ninety-Ninth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Education and Labor.

Key issues affecting Hispanic participation in higher education are evaluated, with attention to access, retention, and transfer. Societal factors influencing access are also covered: migration, technology, employment and income levels, and secondary schooling. In addition, postsecondary education in Puerto Rico is addressed. Hispanics constitute…

The Impact Factor: Implications of Open Access on Quality

ERIC Educational Resources Information Center

Grozanick, Sara E.

2010-01-01

There has been debate about the extent to which open access affects the quality of scholarly work. At the same time, researchers have begun to look for ways to evaluate the quality of open access publications. Dating back to the growth of citation indexes during the 1960s and 1970s, citation analysis--examining citation statistics--has since been…

75 FR 38758 - Pacific Halibut Fisheries; Limited Access for Guided Sport Charter Vessels in Alaska

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-06

.... 100503209-0215-01] RIN 0648-AY85 Pacific Halibut Fisheries; Limited Access for Guided Sport Charter Vessels... that would amend the limited access program for charter vessels in the guided sport fishery for Pacific... 13024). IPHC regulations affecting sport fishing for halibut and charter vessels in IPHC Areas 2C and 3A...

Essential, Desirable or Optional? Making Distance E-Learning Courses Available to Those without Internet Access

ERIC Educational Resources Information Center

Hancock, Val

2010-01-01

The Open University, an open distance learning institution, is increasingly using a Virtual Learning Environment (VLE) that requires internet access. This paper investigates how the move to a VLE has affected one group of students who do not have internet access--offender learners studying in prison. Members of the armed forces and secure hospital…

Link Scheduling Algorithm with Interference Prediction for Multiple Mobile WBANs

PubMed Central

Le, Thien T. T.

2017-01-01

As wireless body area networks (WBANs) become a key element in electronic healthcare (e-healthcare) systems, the coexistence of multiple mobile WBANs is becoming an issue. The network performance is negatively affected by the unpredictable movement of the human body. In such an environment, inter-WBAN interference can be caused by the overlapping transmission range of nearby WBANs. We propose a link scheduling algorithm with interference prediction (LSIP) for multiple mobile WBANs, which allows multiple mobile WBANs to transmit at the same time without causing inter-WBAN interference. In the LSIP, a superframe includes the contention access phase using carrier sense multiple access with collision avoidance (CSMA/CA) and the scheduled phase using time division multiple access (TDMA) for non-interfering nodes and interfering nodes, respectively. For interference prediction, we define a parameter called interference duration as the duration during which disparate WBANs interfere with each other. The Bayesian model is used to estimate and classify the interference using a signal to interference plus noise ratio (SINR) and the number of neighboring WBANs. The simulation results show that the proposed LSIP algorithm improves the packet delivery ratio and throughput significantly with acceptable delay. PMID:28956827

Limiting the access to direct-acting antivirals against HCV: an ethical dilemma.

PubMed

Gentile, Ivan; Maraolo, Alberto E; Niola, Massimo; Graziano, Vincenzo; Borgia, Guglielmo; Paternoster, Mariano

2016-11-01

Hepatitis C virus (HCV) infection affects about 200 million people worldwide and represents a leading cause of liver-related mortality. Eradication of HCV infection, achieved mainly through direct-acting antivirals (DAA), results in a decrease of mortality and an improvement of quality of life. These drugs have a maximal efficacy and an optimal tolerability. However, their high cost precludes a universal access even in wealthy countries. Areas covered: This article deals with the policies adopted for the use of the new anti-HCV drugs, especially in Europe and most of all in Italy, supposedly the developed country with the highest HCV prevalence. The literature search was performed using Pubmed and Web of Science. Moreover, national regulatory institutional websites were consulted. Expert commentary: The current policy of limitation to the access of the DAA presents a series of ethical issues that makes it non-applicable. A 'treat-all' strategy should resolve all ethical dilemmas, by virtue of the wide benefits of anti-HCV treatment not only for the advanced stage of infection, but also for the initial stages. A reduction in price of the drugs is the actual condition to achieve such a change.

Implications of Intermodal Freight Movements for Infrastructure Access, Capacity, and Productivity

DOT National Transportation Integrated Search

1996-03-31

This report evaluates the status of intermodal freight in the U.S. with reference to infrastructure access problems such as inadequate highway connectors and facility clearance, and terminal capacity constraints affecting levels of service. Though th...

Atypical Face Perception in Autism: A Point of View?

PubMed

Morin, Karine; Guy, Jacalyn; Habak, Claudine; Wilson, Hugh R; Pagani, Linda; Mottron, Laurent; Bertone, Armando

2015-10-01

Face perception is the most commonly used visual metric of social perception in autism. However, when found to be atypical, the origin of face perception differences in autism is contentious. One hypothesis proposes that a locally oriented visual analysis, characteristic of individuals with autism, ultimately affects performance on face tasks where a global analysis is optimal. The objective of this study was to evaluate this hypothesis by assessing face identity discrimination with synthetic faces presented with and without changes in viewpoint, with the former condition minimizing access to local face attributes used for identity discrimination. Twenty-eight individuals with autism and 30 neurotypical participants performed a face identity discrimination task. Stimuli were synthetic faces extracted from traditional face photographs in both front and 20° side viewpoints, digitized from 37 points to provide a continuous measure of facial geometry. Face identity discrimination thresholds were obtained using a two-alternative, temporal forced choice match-to-sample paradigm. Analyses revealed an interaction between group and condition, with group differences found only for the viewpoint change condition, where performance in the autism group was decreased compared to that of neurotypical participants. The selective decrease in performance for the viewpoint change condition suggests that face identity discrimination in autism is more difficult when access to local cues is minimized, and/or when dependence on integrative analysis is increased. These results lend support to a perceptual contribution of atypical face perception in autism. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

Implementing Access to Data Distributed on Many Processors

NASA Technical Reports Server (NTRS)

James, Mark

2006-01-01

A reference architecture is defined for an object-oriented implementation of domains, arrays, and distributions written in the programming language Chapel. This technology primarily addresses domains that contain arrays that have regular index sets with the low-level implementation details being beyond the scope of this discussion. What is defined is a complete set of object-oriented operators that allows one to perform data distributions for domain arrays involving regular arithmetic index sets. What is unique is that these operators allow for the arbitrary regions of the arrays to be fragmented and distributed across multiple processors with a single point of access giving the programmer the illusion that all the elements are collocated on a single processor. Today's massively parallel High Productivity Computing Systems (HPCS) are characterized by a modular structure, with a large number of processing and memory units connected by a high-speed network. Locality of access as well as load balancing are primary concerns in these systems that are typically used for high-performance scientific computation. Data distributions address these issues by providing a range of methods for spreading large data sets across the components of a system. Over the past two decades, many languages, systems, tools, and libraries have been developed for the support of distributions. Since the performance of data parallel applications is directly influenced by the distribution strategy, users often resort to low-level programming models that allow fine-tuning of the distribution aspects affecting performance, but, at the same time, are tedious and error-prone. This technology presents a reusable design of a data-distribution framework for data parallel high-performance applications. Distributions are a means to express locality in systems composed of large numbers of processor and memory components connected by a network. Since distributions have a great effect on the performance of applications, it is important that the distribution strategy is flexible, so its behavior can change depending on the needs of the application. At the same time, high productivity concerns require that the user be shielded from error-prone, tedious details such as communication and synchronization.

Achieving QoS for TCP Traffic in Satellite Networks with Differentiated Services

NASA Technical Reports Server (NTRS)

Durresi, Arjan; Kota, Sastri; Goyal, Mukul; Jain, Raj; Bharani, Venkata

2001-01-01

Satellite networks play an indispensable role in providing global Internet access and electronic connectivity. To achieve such a global communications, provisioning of quality of service (QoS) within the advanced satellite systems is the main requirement. One of the key mechanisms of implementing the quality of service is traffic management. Traffic management becomes a crucial factor in the case of satellite network because of the limited availability of their resources. Currently, Internet Protocol (IP) only has minimal traffic management capabilities and provides best effort services. In this paper, we presented a broadband satellite network QoS model and simulated performance results. In particular, we discussed the TCP flow aggregates performance for their good behavior in the presence of competing UDP flow aggregates in the same assured forwarding. We identified several factors that affect the performance in the mixed environments and quantified their effects using a full factorial design of experiment methodology.

A qualitative study examining methods of accessing and identifying research relevant to clinical practice among rehabilitation clinicians.

PubMed

Patel, Drasti; Koehmstedt, Christine; Jones, Rebecca; Coffey, Nathan T; Cai, Xinsheng; Garfinkel, Steven; Shaewitz, Dahlia M; Weinstein, Ali A

2017-01-01

Research examining the utilization of evidence-based practice (EBP) specifically among rehabilitation clinicians is limited. The objective of this study was to examine how various rehabilitative clinicians including physical therapists, occupational therapists, rehabilitation counselors, and physiatrists are gaining access to literature and whether they are able to implement the available research into practice. A total of 21 total clinicians were interviewed via telephone. Using NVivo, a qualitative analysis of the responses was performed. There were similarities found with respect to the information-seeking behaviors and translation of research across the different clinician types. Lack of time was reported to be a barrier for both access to literature and implementation of research across all clinician types. The majority of clinicians who reported having difficulty with utilizing the published literature indicated that the literature was not applicable to their practice, the research was not specific enough to be put into practice, or the research found was too outdated to be relevant. In addition, having a supportive work environment aided in the search and utilization of research through providing resources central to assisting clinicians in gaining access to health information. Our study identified several barriers that affect EBP for rehabilitation clinicians. The findings suggest the need for researchers to ensure that their work is applicable and specific to clinical practice for implementation to occur.

Analyzing the effect of routing protocols on media access control protocols in radio networks

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

Barrett, C. L.; Drozda, M.; Marathe, A.

2002-01-01

We study the effect of routing protocols on the performance of media access control (MAC) protocols in wireless radio networks. Three well known MAC protocols: 802.11, CSMA, and MACA are considered. Similarly three recently proposed routing protocols: AODV, DSR and LAR scheme 1 are considered. The experimental analysis was carried out using GloMoSim: a tool for simulating wireless networks. The main focus of our experiments was to study how the routing protocols affect the performance of the MAC protocols when the underlying network and traffic parameters are varied. The performance of the protocols was measured w.r.t. five important parameters: (i)more » number of received packets, (ii) average latency of each packet, (iii) throughput (iv) long term fairness and (v) number of control packets at the MAC layer level. Our results show that combinations of routing and MAC protocols yield varying performance under varying network topology and traffic situations. The result has an important implication; no combination of routing protocol and MAC protocol is the best over all situations. Also, the performance analysis of protocols at a given level in the protocol stack needs to be studied not locally in isolation but as a part of the complete protocol stack. A novel aspect of our work is the use of statistical technique, ANOVA (Analysis of Variance) to characterize the effect of routing protocols on MAC protocols. This technique is of independent interest and can be utilized in several other simulation and empirical studies.« less

Access site-related complications after transradial catheterization can be reduced with smaller sheath size and statins.

PubMed

Honda, Tsuyoshi; Fujimoto, Kazuteru; Miyao, Yuji; Koga, Hidenobu; Hirata, Yoshihiro

2012-09-01

The aim of this study was to investigate the risk factors for access site-related complications after transradial coronary angiography (CAG) or percutaneous coronary intervention (PCI). Transradial PCI has been shown to reduce access site-related bleeding complications compared with procedures performed through a femoral approach. Although previous studies focused on risk factors for access site-related complications after a transfemoral approach or transfemoral and transradial approaches, it is uncertain which factors affect vascular complications after transradial catheterization. We enrolled 500 consecutive patients who underwent transradial CAG or PCI. We determined the incidence and risk factors for access site-related complications such as radial artery occlusion and bleeding complications. Age, sheath size, the dose of heparin and the frequency of PCI (vs. CAG) were significantly greater in patients with than without bleeding complications. However, body mass index (BMI) was significantly lower in patients with than without bleeding complications. Sheath size was significantly higher and the frequency of statin use was significantly lower in patients with than without radial artery occlusion. Multiple logistic analysis revealed that sheath size [odds ratio (OR) 5.5; P < 0.05] and BMI (OR 0.86; P < 0.01) were risk factors for bleeding complications; and sheath size (OR 5.2; P < 0.05) and the lack of statin pretreatment (OR 0.50; P < 0.05) were risk factors for occlusive complications. In conclusion, these findings indicate that down-sizing of the devices used in transradial procedures might attenuate access site-related complications after transradial CAG or PCI. Statin pretreatment might also be a strategy that could prevent radial artery occlusion after transradial procedures.

The challenges and possibilities of public access defibrillation.

PubMed

Ringh, M; Hollenberg, J; Palsgaard-Moeller, T; Svensson, L; Rosenqvist, M; Lippert, F K; Wissenberg, M; Malta Hansen, C; Claesson, A; Viereck, S; Zijlstra, J A; Koster, R W; Herlitz, J; Blom, M T; Kramer-Johansen, J; Tan, H L; Beesems, S G; Hulleman, M; Olasveengen, T M; Folke, F

2018-03-01

Out-of-hospital cardiac arrest (OHCA) is a major health problem that affects approximately four hundred and thousand patients annually in the United States alone. It is a major challenge for the emergency medical system as decreased survival rates are directly proportional to the time delay from collapse to defibrillation. Historically, defibrillation has only been performed by physicians and in-hospital. With the development of automated external defibrillators (AEDs), rapid defibrillation by nonmedical professionals and subsequently by trained or untrained lay bystanders has become possible. Much hope has been put to the concept of Public Access Defibrillation with a massive dissemination of public available AEDs throughout most Western countries. Accordingly, current guidelines recommend that AEDs should be deployed in places with a high likelihood of OHCA. Despite these efforts, AED use is in most settings anecdotal with little effect on overall OHCA survival. The major reasons for low use of public AEDs are that most OHCAs take place outside high incidence sites of cardiac arrest and that most OHCAs take place in residential settings, currently defined as not suitable for Public Access Defibrillation. However, the use of new technology for identification and recruitment of lay bystanders and nearby AEDs to the scene of the cardiac arrest as well as new methods for strategic AED placement redefines and challenges the current concept and definitions of Public Access Defibrillation. Existing evidence of Public Access Defibrillation and knowledge gaps and future directions to improve outcomes for OHCA are discussed. In addition, a new definition of the different levels of Public Access Defibrillation is offered as well as new strategies for increasing AED use in the society. © 2018 The Association for the Publication of the Journal of Internal Medicine.

Ultrasound Vein and Artery Mapping by General Surgery Residents During Initial Consult Can Decrease Time to Dialysis Access Creation.

PubMed

Gray, Kelsey; Korn, Abraham; Zane, Joshua; Gonzalez, Gabriel; Kaji, Amy; Bowens, Nina; de Virgilio, Christian

2018-05-01

Formal preoperative ultrasound (US) mapping of vascular anatomy by radiology is recommended before hemodialysis access surgery. We hypothesized that US performed by general surgery residents in place of formal US would decrease the time from initial consult to creation of dialysis access without affecting patient outcomes. This is a retrospective review of all patients who underwent dialysis access surgery from November 2014 to July 2016 and received preoperative upper extremity US vein and artery evaluation by either radiology or general surgery residents. The primary endpoints were days from initial consult to dialysis access creation, rate of arteriovenous fistula (AVF) creation, fistula maturation, and 1-year primary assisted patency. Of 242 patients, 167 (69%) had formal US, and 75 (31%) had only a resident US. The resident US group had 100% AVF creation compared with the formal US group with 92.2% AVF creation (P = 0.01). There was no difference between the groups in rate of fistula maturation (P = 0.1) and 1-year assisted patency (P = 0.9). Of the resident US 90.7% occurred in the outpatient setting. On multivariable analysis controlling for outpatient consult, the average time to the operating room was 13.7 days longer for the formal US group in the outpatient setting (P = 0.0006). Ultrasound vein and artery evaluation at the time of the initial consult by general surgery residents can decrease the time to dialysis access creation by bypassing the need for formal US with a higher rate of AVF creation and no difference in fistula maturation or 1-year primary assisted patency. Copyright © 2018 Elsevier Inc. All rights reserved.

Increasing access to prevention of mother-to-child transmission of HIV services through the private sector in Uganda.

PubMed

Mbonye, A K; Hansen, K S; Wamono, F; Magnussen, P

2009-12-01

To explore whether private midwives can perform HIV counselling and testing, provide antiretroviral treatment and contraceptives, and how this affects access to services especially among young and HIV-positive women. A formative study was conducted between January and April 2009 to assess care-seeking practices and perceptions on the prevention of mother-to-child transmission (PMTCT) and family planning services in Wakiso district, central Uganda. A household survey supplemented by 12 focus group discussions and 66 key informant interviews was carried out between January and April 2009. 10,706 women, mean age 25.8 years (14-49 years) were interviewed. The majority of women, 4786 (57%) were in the lowest wealth quintile; 62.0% were not using family planning (p<0.000); 56.2% did not access HIV counselling and testing because they feared knowing their HIV status (p<0.013), while 66.5% feared spouses knowing their HIV status (p<0.013). Access to these services among the young women and those with no education was also poor. Private midwives provide HIV testing to 7.8% of their clients; 5.9% received antiretroviral drugs and 8.6% received contraceptives. Client satisfaction with services at private midwifery practices was high. Private midwives are trusted and many clients confide in them. An intervention through private midwives was perceived to improve access because of short distances and no transport costs. Adolescents prioritized confidentiality, while subsidizing costs, community sensitisation and focusing on male spouses were overwhelmingly recommended. Private midwives clinics are potential delivery outlets for PMTCT in Uganda. A well-designed intervention linking them to the public sector and the community could increase access to services.

Java-based cryptosystem for PACS and tele-imaging

NASA Astrophysics Data System (ADS)

Tjandra, Donny; Wong, Stephen T. C.; Yu, Yuan-Pin

1998-07-01

Traditional PACS systems are based on two-tier client server architectures, and require the use of costly, high-end client workstations for image viewing. Consequently, PACS systems using the two-tier architecture do not scale well as data increases in size and complexity. Furthermore, use of dedicated viewing workstations incurs costs in deployment and maintenance. To address these issues, the use of digital library technologies, such as the World Wide Web, Java, and CORBA, is being explored to distribute PACS data to serve a broader range of healthcare providers in an economic and efficient manner. Integration of PACS systems with digital library technologies allows access to medical information through open networks such as the Internet. However, use of open networks to transmit medical data introduces problems with maintaining privacy and integrity of patient information. Cryptography and digital timestamping is used to protect sensitive information from unauthorized access or tampering. A major concern when using cryptography and digital timestamping is the performance degradation associated with the mathematical calculations needed to encrypt/decrypt an image dataset, or to calculate the hash value of an image. The performance issue is compounded by the extra layer associated with the CORBA middleware, and the use of programming languages interpreted at the client side, such as Java. This paper study the extent to which Java-based cryptography and digital timestamping affects performance in a PACS system integrated with digital library technologies.

The Dissemination and Accessibility of Canadian Government Information.

ERIC Educational Resources Information Center

Morton, Bruce; Zink, Steven D.

1992-01-01

Discusses information agencies and issues that affect the dissemination and accessibility of Canadian government information, including the Canada Communication Group, depository libraries, the National Library, bibliographic control of government information, the Canada Institute for Scientific and Technical Information, Statistics Canada,…

Protecting Pharmaceutical Patents and Test Data: How the Trans-Pacific Partnership Agreement Could Affect Access to Medicines in the US and Abroad.

PubMed

Luo, Jing; Kesselheim, Aaron S

2016-07-01

The Trans-Pacific Partnership (TPP) Agreement is a proposed free trade agreement between the US and 11 other countries in Asia and South America covering many consumer goods, including prescription medicines. This review describes how the TPP could affect international laws governing intellectual property rights for prescription drugs, focusing on patents and exclusivity protections for test data, including their effect on reimbursement decisions by national health care authorities responsible for health priority setting. We conclude that the TPP could affect low-income patients' access to medicines in signatory countries. © 2016 American Medical Association. All Rights Reserved. ISSN 2376-6980.

Configuration of the thermal landscape determines thermoregulatory performance of ectotherms

PubMed Central

Sears, Michael W.; Angilletta, Michael J.; Schuler, Matthew S.; Borchert, Jason; Dilliplane, Katherine F.; Stegman, Monica; Rusch, Travis W.; Mitchell, William A.

2016-01-01

Although most organisms thermoregulate behaviorally, biologists still cannot easily predict whether mobile animals will thermoregulate in natural environments. Current models fail because they ignore how the spatial distribution of thermal resources constrains thermoregulatory performance over space and time. To overcome this limitation, we modeled the spatially explicit movements of animals constrained by access to thermal resources. Our models predict that ectotherms thermoregulate more accurately when thermal resources are dispersed throughout space than when these resources are clumped. This prediction was supported by thermoregulatory behaviors of lizards in outdoor arenas with known distributions of environmental temperatures. Further, simulations showed how the spatial structure of the landscape qualitatively affects responses of animals to climate. Biologists will need spatially explicit models to predict impacts of climate change on local scales. PMID:27601639

Effects of Individual Health Topic Familiarity on Activity Patterns During Health Information Searches

PubMed Central

Moriyama, Koichi; Fukui, Ken–ichi; Numao, Masayuki

2015-01-01

Background Non-medical professionals (consumers) are increasingly using the Internet to support their health information needs. However, the cognitive effort required to perform health information searches is affected by the consumer’s familiarity with health topics. Consumers may have different levels of familiarity with individual health topics. This variation in familiarity may cause misunderstandings because the information presented by search engines may not be understood correctly by the consumers. Objective As a first step toward the improvement of the health information search process, we aimed to examine the effects of health topic familiarity on health information search behaviors by identifying the common search activity patterns exhibited by groups of consumers with different levels of familiarity. Methods Each participant completed a health terminology familiarity questionnaire and health information search tasks. The responses to the familiarity questionnaire were used to grade the familiarity of participants with predefined health topics. The search task data were transcribed into a sequence of search activities using a coding scheme. A computational model was constructed from the sequence data using a Markov chain model to identify the common search patterns in each familiarity group. Results Forty participants were classified into L1 (not familiar), L2 (somewhat familiar), and L3 (familiar) groups based on their questionnaire responses. They had different levels of familiarity with four health topics. The video data obtained from all of the participants were transcribed into 4595 search activities (mean 28.7, SD 23.27 per session). The most frequent search activities and transitions in all the familiarity groups were related to evaluations of the relevancy of selected web pages in the retrieval results. However, the next most frequent transitions differed in each group and a chi-squared test confirmed this finding (P<.001). Next, according to the results of a perplexity evaluation, the health information search patterns were best represented as a 5-gram sequence pattern. The most common patterns in group L1 were frequent query modifications, with relatively low search efficiency, and accessing and evaluating selected results from a health website. Group L2 performed frequent query modifications, but with better search efficiency, and accessed and evaluated selected results from a health website. Finally, the members of group L3 successfully discovered relevant results from the first query submission, performed verification by accessing several health websites after they discovered relevant results, and directly accessed consumer health information websites. Conclusions Familiarity with health topics affects health information search behaviors. Our analysis of state transitions in search activities detected unique behaviors and common search activity patterns in each familiarity group during health information searches. PMID:25783222

LAPAROSCOPIC SALPINGECTOMY IN TWO CAPTIVE LEOPARDS (PANTHERA PARDUS) USING A SINGLE PORTAL ACCESS SYSTEM.

PubMed

Hartman, Marthinus J; Monnet, Eric; Kirberger, Robert M; Schoeman, Johan P

2015-12-01

Laparoscopic salpingectomy was performed in two adult leopards (Panthera pardus) using a single portal access system, with a multicannulated single-incision laparoscopic surgery port, without any complications. The poorly developed ovarian bursa provided easy access to the uterine tube for salpingectomy. Laparoscopic salpingectomy can be safely performed in the leopard using a single portal access system.

Do Low-Income Students Have Equal Access to the Highest-Performing Teachers? Technical Appendix. NCEE 2011-4016

ERIC Educational Resources Information Center

Glazerman, Steven; Max, Jeffrey

2011-01-01

This appendix describes the methods and provides further detail to support the evaluation brief, "Do Low-Income Students Have Equal Access to the Highest-Performing Teachers?" (Contains 8 figures, 6 tables and 5 footnotes.) [For the main report, "Do Low-Income Students Have Equal Access to the Highest-Performing Teachers? NCEE…

Relationship between human resource ability and market access capacity on business performance. (case study of wood craft micro- and small-scale industries in Gianyar Regency, Bali)

NASA Astrophysics Data System (ADS)

Sukartini, N. W.; Sudarmini, N. M.; Lasmini, N. K.

2018-01-01

The aims of this research are to: (1) analyze the influence of Human Resource Ability on market access capacity in Wood Craft Micro and Small Industry; (2) to analyze the effect of market access capacity on business performance; (3) analyze the influence of Human Resources ability on business performance. Data were collected using questionnaires, interviews, observations, and literature studies. The resulting data were analyzed using Struture Equation Modeling (SEM). The results of the analysis show that (1) there is a positive and significant influence of the ability of Human Resources on market access capacity in Wood Craft Micro-and Small-Scale Industries in Gianyar; (2) there is a positive and significant influence of market access capacity on business performance; and (3) there is a positive and significant influence of Human Resource ability on business performance. To improve the ability to access the market and business performance, it is recommended that human resource ability need to be improved through training; government and higher education institutions are expected to play a role in improving the ability of human resources (craftsmen) through provision of training programs

What Is the Impact of Full Access to Technology on the Achievement of the Hispanic Student?

ERIC Educational Resources Information Center

Carr, John E., Jr.

2013-01-01

The problem studied in this research was whether the impact of full access to technology both at home and in school would affect the achievement of Hispanic students. The purpose of this study was to examine the relationship between the access to technology and the achievement of the Hispanic students at a suburban middle school. What are the…

Student Empowerment. The Influence of High Computer Access on Student Empowerment (An Exploratory Study of the Nashville ACOT Site). ACOT Report #1.

ERIC Educational Resources Information Center

Fisher, Charles W.

This study identifies classroom conditions that affect student empowerment and examines the relationship between student empowerment and high computer access (HCA). The study involved observation in two fourth grade classrooms--one week in an ACOT classroom (with high computer access), and one week in a non-ACOT classroom (without high computer…

WWC Review of the Report "Looking beyond Enrollment: The Causal Effect of Need-Based Grants on College Access, Persistence, and Graduation." What Works Clearinghouse Single Study Review

ERIC Educational Resources Information Center

What Works Clearinghouse, 2014

2014-01-01

The 2013 study, "Looking Beyond Enrollment: The Causal Effect of Need-Based Grants on College Access, Persistence, and Graduation," examined whether eligibility for the Florida Student Access Grant (FSAG), a need-based grant for low-income students in Florida, affects college enrollment, credit accumulation, persistence over time in…

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

PubMed

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

2012-07-02

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

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

PubMed Central

2012-01-01

Background The purpose of the research was to assess access to sexual and reproductive health services for migrant women who work as beer promoters. This mixed methods research was conducted in Phnom Penh, Cambodia, Bangkok, Thailand, Vientiane, Laos, and Hanoi, Vietnam during 2010 to 2011. Methods Focus groups were held with beer promoters and separate focus groups or interviews with key informants to explore the factors affecting beer promoters’ access to health care institutions for reproductive health care. The findings of the focus groups were used to develop a survey for beer promoters. This survey was conducted in popular health institutions for these women in each of the four Asian cities. Results Several common themes were evident. Work demands prevented beer promoters from accessing health care. Institutional factors affecting care included cost, location, environmental factors (e.g. waiting times, cleanliness and confidentiality) and service factors (e.g. staff attitudes, clinic hours, and availability of medications). Personal factors affecting access were shyness and fear, lack of knowledge, and support from family and friends. The survey of the beer promoters confirmed that cost, location and both environmental and service factors impact on access to health care services for beer promoters. Many beer promoters are sexually active, and a significant proportion of those surveyed rely on sex work to supplement their income. Many also drink with their clients. Despite a few differences amongst the surveyed population, the findings were remarkably similar across the four research sites. Conclusions Recommendations from the research include the provision of evening and weekend clinic hours to facilitate access, free or low cost clinics, and health insurance through employer or government plans which are easy to access for migrants. Other improvements that would facilitate the access of beer promoters to these services include increased funding to hire more staff (reducing waiting times) and to stock more needed medications, mobile clinics to come to the workplace or free transportation for beer promoters to the clinics, improved training to reduce health care provider stigma against beer promoters, and public education about the importance of reproductive health care, including preventative services. PMID:22747607

Design Alternatives to Improve Access Time Performance of Disk Drives Under DOS and UNIX

NASA Astrophysics Data System (ADS)

Hospodor, Andy

For the past 25 years, improvements in CPU performance have overshadowed improvements in the access time performance of disk drives. CPU performance has been slanted towards greater instruction execution rates, measured in millions of instructions per second (MIPS). However, the slant for performance of disk storage has been towards capacity and corresponding increased storage densities. The IBM PC, introduced in 1982, processed only a fraction of a MIP. Follow-on CPUs, such as the 80486 and 80586, sported 5-10 MIPS by 1992. Single user PCs and workstations, with one CPU and one disk drive, became the dominant application, as implied by their production volumes. However, disk drives did not enjoy a corresponding improvement in access time performance, although the potential still exists. The time to access a disk drive improves (decreases) in two ways: by altering the mechanical properties of the drive or by adding cache to the drive. This paper explores the improvement to access time performance of disk drives using cache, prefetch, faster rotation rates, and faster seek acceleration.

Access management performance measures for Virginia : a practical approach for public accountability.

DOT National Transportation Integrated Search

2010-04-01

In order to develop performance measures to communicate the effect of Virginias access management program, five : tasks were performed: (1) the appropriate literature was reviewed, (2) a catalog of potential performance measures was : developed, (...

Local multipoint distribution system (LDMS) versus free-space optical (FSO) networks

NASA Astrophysics Data System (ADS)

Willebrand, Heinz A.; Clark, Gerald R.; Willson, Bryan; Andreu von Euw, Christian G.; Roy, Joe; Mayhew, Laurel M.

2001-11-01

This paper compares two emerging broadband access methodologies, Free Space Optics (FSO) and Local Multipoint Distribution System (LMDS) and the atmospheric propagation characteristics of each when exposed to a dynamically changing channel. The comparison focuses on bandwidth, availability, and distance requirements for the new broadband market and how LMDS and FSO can be used to meet these requirements. Possible network topologies and their associated costs are examined. This comparison takes into account the total cost of deployment, including equipment costs, installation fees, access fees, and spectrum licensing fees. LMDS and FSO are compared on speed of deployment, scalability, aggregate bandwidth, and bandwidth per customer. Present and projected capabilities of each technology are considered for their suitability in different locations in the network, from the Wide Area Network (WAN), to the Metropolitan Area Network (MAN), all the way to Last Mile Access. There is a discussion on the relative performance of LMDS and FSO, focusing on the different factors that can affect link availability. Since network design is a large factor in assuring overall reliability, the flexibility of each technology with regard to network design is compared. LMDS and FSO are both line of sight, space-propagated technologies, and as such, they are both susceptible to path impediments and atmospheric attenuation, dispersion, scattering, and absorption. LMDS and FSO are affected very differently by different meteorological phenomena. Problematic atmospheric conditions are, specifically scintillation, rainfall, and fog, are examined. In addition to a discussion of these conditions, various techniques for minimizing atmospheric and environmental effects are investigated. The paper concludes with a summary of findings and recommendations for a number of broadband wireless applications.

34 CFR 104.23 - New construction.

Code of Federal Regulations, 2011 CFR

2011-07-01

... effective date of this part in a manner that affects or could affect the usability of the facility or part... use of other methods are permitted where substantially equivalent or greater access to and usability...

10 CFR 1040.73 - New construction.

Code of Federal Regulations, 2011 CFR

2011-01-01

... effective date of this subpart in a manner that affects or could affect the usability of the facility or... use of other methods are permitted where substantially equivalent or greater access to and usability...

43 CFR 17.218 - New construction.

Code of Federal Regulations, 2011 CFR

2011-10-01

... subpart, in a manner that affects or could affect the usability of the facility or part of the facility... of other methods are permitted where substantially equivalent or greater access to and usability of...

34 CFR 104.23 - New construction.

Code of Federal Regulations, 2010 CFR

2010-07-01

... effective date of this part in a manner that affects or could affect the usability of the facility or part... use of other methods are permitted where substantially equivalent or greater access to and usability...

38 CFR 18.423 - New construction.

Code of Federal Regulations, 2011 CFR

2011-07-01

... that affects or could affect the usability of the facility or part of the facility shall, to the... permitted where substantially equivalent or greater access to and usability of the building is provided. (2...

38 CFR 18.423 - New construction.

Code of Federal Regulations, 2010 CFR

2010-07-01

... that affects or could affect the usability of the facility or part of the facility shall, to the... permitted where substantially equivalent or greater access to and usability of the building is provided. (2...

45 CFR 84.23 - New construction.

Code of Federal Regulations, 2010 CFR

2010-10-01

... manner that affects or could affect the usability of the facility or part of the facility shall, to the... are permitted where substantial equivalent or greater access to and usability of the building is...

45 CFR 84.23 - New construction.

Code of Federal Regulations, 2011 CFR

2011-10-01

... manner that affects or could affect the usability of the facility or part of the facility shall, to the... are permitted where substantial equivalent or greater access to and usability of the building is...

10 CFR 1040.73 - New construction.

Code of Federal Regulations, 2010 CFR

2010-01-01

... effective date of this subpart in a manner that affects or could affect the usability of the facility or... use of other methods are permitted where substantially equivalent or greater access to and usability...

43 CFR 17.218 - New construction.

Code of Federal Regulations, 2010 CFR

2010-10-01

... subpart, in a manner that affects or could affect the usability of the facility or part of the facility... of other methods are permitted where substantially equivalent or greater access to and usability of...

38 CFR 18.423 - New construction.

Code of Federal Regulations, 2013 CFR

2013-07-01

... that affects or could affect the usability of the facility or part of the facility shall, to the... permitted where substantially equivalent or greater access to and usability of the building is provided. (2...

38 CFR 18.423 - New construction.

Code of Federal Regulations, 2014 CFR

2014-07-01

... that affects or could affect the usability of the facility or part of the facility shall, to the... permitted where substantially equivalent or greater access to and usability of the building is provided. (2...

45 CFR 84.23 - New construction.

Code of Federal Regulations, 2014 CFR

2014-10-01

... manner that affects or could affect the usability of the facility or part of the facility shall, to the... are permitted where substantial equivalent or greater access to and usability of the building is...

The nonconscious cessation of goal pursuit: when goals and negative affect are coactivated.

PubMed

Aarts, Henk; Custers, Ruud; Holland, Rob W

2007-02-01

Extending on the recent investigation into the implicit affective processes underlying motivation and decision making, 5 studies examined the role of negative affect in moderating goal priming effects. Specifically, experimental effects on measures that typify motivational qualities of goal systems, such as keeping a goal at a heightened level of mental accessibility and exerting effort to work for a goal and experiencing desire to attain the goal, showed that the motivation and resultant operation of social goals cease when these goals are primed in temporal proximity of negatively valenced information. These goal cessation effects resulting from the mere coactivation of a goal and negative affect are discussed against the background of present research on nonconscious goal pursuit and the role of accessibility and desirability in the regulation of automatic goal-directed behavior. ((c) 2007 APA, all rights reserved).

22 CFR 212.51 - General policy.

Code of Federal Regulations, 2010 CFR

2010-04-01

... affecting the national security, the maintenance of friendly relations with other nations, the efficient operation of the Agency, or the administrative feasibility of servicing requests for access to such records. (b) Access for research purposes to the classified foreign policy records in the Agency's custody...

Performance of private sector health care: implications for universal health coverage.

PubMed

Morgan, Rosemary; Ensor, Tim; Waters, Hugh

2016-08-06

Although the private sector is an important health-care provider in many low-income and middle-income countries, its role in progress towards universal health coverage varies. Studies of the performance of the private sector have focused on three main dimensions: quality, equity of access, and efficiency. The characteristics of patients, the structures of both the public and private sectors, and the regulation of the sector influence the types of health services delivered, and outcomes. Combined with characteristics of private providers-including their size, objectives, and technical competence-the interaction of these factors affects how the sector performs in different contexts. Changing the performance of the private sector will require interventions that target the sector as a whole, rather than individual providers alone. In particular, the performance of the private sector seems to be intrinsically linked to the structure and performance of the public sector, which suggests that deriving population benefit from the private health-care sector requires a regulatory response focused on the health-care sector as a whole. Copyright © 2016 Elsevier Ltd. All rights reserved.

Intraspecific variation in aphid resistance and constitutive phenolics exhibited by the wild blueberry Vaccinium darrowi.

PubMed

Ranger, C M; Singh, A P; Johnson-Cicalese, J; Polavarapu, S; Vorsa, N

2007-04-01

Illinoia pepperi (MacGillivray) infests cultivated highbush blueberries, Vaccinium corymbosum L., in the Northeastern United States. Allopatric resistance to I. pepperi was examined in Vaccinium darrowi Camp, which evolved in the absence of I. pepperi in the Southeastern U.S. V. corymbosum cv. "Elliott", was used as a susceptible control. Between population variability in I. pepperi resistance was assessed by measuring length of the prereproductive period, fecundity, and survivorship on 14 V. darrowi accessions representing 11 discrete wild populations. Length of I. pepperi's prereproductive period and survivorship were not significantly affected. However, differences were detected in fecundity and the intrinsic rate of increase (r ( m )). Within population variability in resistance was measured by confining first instars to 24 accessions from a single wild population of V. darrowi (NJ88-06). Significant differences in the mean total number of aphids occurring after 20 d were only detected between 2 of the 24 V. darrowi accessions. A greater degree of diversity in I. pepperi resistance exists between populations of V. darrowi compared to within a population. Constitutive leaf and stem polyphenolics were identified by HPLC-MS and quantified from 14 of the V. darrowi accessions. The accessions varied in concentrations of five phenolic acids and seven flavonol glycosides, but a correlation was not found between individual or total phenolics and aphid performance. Overall, screening within and between populations of V. darrowi identified promising sources of aphid resistance, but phenolic acid and flavonol glycoside profiles did not predict resistance levels. The mechanism of resistance remains to be identified.

Insertion side, body position and circuit life during continuous renal replacement therapy with femoral vein access.

PubMed

Kim, In Byung; Fealy, Nigel; Baldwin, Ian; Bellomo, Rinaldo

2011-01-01

Choice of insertion side and patient position during continuous renal replacement therapy (CRRT) with femoral vein vascular access may affect circuit life. We investigated if there is an association between choice of insertion side and body position and its changes and circuit life during CRRT with femoral vein access. We studied 50 patients receiving CRRT via femoral vein access with a sequential retrospective study in a tertiary intensive care unit. We defined two groups: patients with right or left femoral vein access. We then obtained information on age, gender, circuit life, total heparin dose, hemoglobin concentration and coagulation variables (platelet count, international normalized ratio, and activated partial thromboplastin time) and percentage of time each patient spent in the supine, left lying, right lying, and sitting position during treatment. We studied 341 circuits in 50 patients. Mean circuit life was 13.9 h. Of these circuits, 251 (73.6%) were treated with right femoral vein access. Mean circuit life in this group was significantly longer compared with left femoral vein access (15.0 ± 14.3 vs. 10.6 ± 7.4; p = 0.019). Percentage spent in a particular position during CRRT was not significantly different between two groups. On multivariable linear regression analysis, mean circuit life was significantly and positively correlated with right vascular access site (p = 0.03) and lower platelet count (p = 0.03), but not with patient position. Right-sided insertion but not time spent in a particular position significantly affects circuit life during CRRT with femoral vein access. Copyright © 2010 S. Karger AG, Basel.

Levetiracetam Results in Increased and Decreased Alcohol Drinking with Different Access Procedures in C57BL/6J Mice

PubMed Central

Fish, Eric W.; Agoglia, Abigail E.; Krouse, Michael C.; Muller, R. Grant; Robinson, J. Elliott; Malanga, C.J.

2013-01-01

The antiepileptic, levetiracetam (LEV), has been investigated for the treatment of alcohol abuse. However, little is known about how LEV alters the behavioral effects of alcohol in laboratory animals. The acute effects of LEV on alcohol drinking by male C57BL/6J mice were investigated using two different drinking procedures, limited access (drinking-in-the-dark, or DID) and intermittent access (IA) drinking. In the first experiment (DID), mice had access to a single bottle containing alcohol or sucrose for four hours every-other day. In the second experiment (IA), mice had intermittent access to two bottles, one containing alcohol or sucrose and one containing water, for 24 h on Mon/Wed/Fri. In both experiments, mice were administered LEV (0.3 – 100 mg/kg i.p.) or vehicle 30 min before access to the drinking solutions. In the DID mice, LEV increased alcohol intake from 4.3 to 5.4 g/kg, while in the IA mice LEV decreased alcohol intake from 4.8 to 3.0 g/kg in the first 4 h of access and decreased 24 h alcohol intake from 20 g/kg to approximately 15 g/kg. These effects appear specific to alcohol, as LEV did not affect sucrose intake in either experiment. LEV appears to differentially affect drinking in animal models of moderate and heavier alcohol consumption. PMID:24322822

Evolution of hut access facing glacier shrinkage in the Mer de Glace basin (Mont Blanc massif, France)

NASA Astrophysics Data System (ADS)

Mourey, Jacques; Ravanel, Ludovic

2016-04-01

Given the evolution of high mountain environment due to global warming, mountaineering routes and huts accesses are more and more strongly affected by glacial shrinkage and concomitant gravity processes, but almost no studies have been conducted on this relationship. The aim of this research is to describe and explain the evolution over the last century of the access to the five alpine huts around the Mer de Glace glacier (Mont Blanc massif), the larger French glacier (length = 11.5 km, area = 30 km²), a major place for Alpine tourism since 1741 and the birthplace of mountaineering, by using several methods (comparing photographs, surveying, collecting historical documents). While most of the 20th century shows no marked changes, loss of ice thickness and associated erosion of lateral moraines generate numerous and significant changes since the 1990s. Boulder falls, rockfalls and landslides are the main geomorphological processes that affect the access, while the glacier surface lowering makes access much longer and more unstable. The danger is then greatly increased and the access must be relocated and/or equipped more and more frequently (e.g. a total of 520 m of ladders has been added). This questions the future accessibility to the huts, jeopardizing an important part of mountaineering and its linked economy in the Mer de Glace area.

Does Rural Residence Affect Access to Prenatal Care in Oregon?

ERIC Educational Resources Information Center

Epstein, Beth; Grant, Therese; Schiff, Melissa; Kasehagen, Laurin

2009-01-01

Context: Identifying how maternal residential location affects late initiation of prenatal care is important for policy planning and allocation of resources for intervention. Purpose: To determine how rural residence and other social and demographic characteristics affect late initiation of prenatal care, and how residence status is associated…

Legislation: Legislation and Regulations Affecting Libraries in 2002; Legislation and Regulations Affecting Publishing in 2002.

ERIC Educational Resources Information Center

Sheketoff, Emily; Costabile, Mary R.; Adler, Allan

2003-01-01

Reviews legislation and regulations affecting libraries and the publishing industry, including the Museum and Library Services Act; Office of Educational Research and Improvement (OERI); copyright; access to electronic government information; telecommunications and technology; electronic surveillance and privacy, including the USA Patriot Act;…

Organizational and Market Influences on Physician Performance on Patient Experience Measures

PubMed Central

Rodriguez, Hector P; von Glahn, Ted; Rogers, William H; Safran, Dana Gelb

2009-01-01

Objective To examine the extent to which medical group and market factors are related to individual primary care physician (PCP) performance on patient experience measures. Data Sources This study employs Clinician and Group CAHPS survey data (n=105,663) from 2,099 adult PCPs belonging to 34 diverse medical groups across California. Medical group directors were interviewed to assess the magnitude and nature of financial incentives directed at individual physicians and the adoption of patient experience improvement strategies. Primary care services area (PCSA) data were used to characterize the market environment of physician practices. Study Design We used multilevel models to estimate the relationship between medical group and market factors and physician performance on each Clinician and Group CAHPS measure. Models statistically controlled for respondent characteristics and accounted for the clustering of respondents within physicians, physicians within medical groups, and medical groups within PCSAs using random effects. Principal Findings Compared with physicians belonging to independent practice associations, physicians belonging to integrated medical groups had better performance on the communication (p=.007) and care coordination (p=.03) measures. Physicians belonging to medical groups with greater numbers of PCPs had better performance on all measures. The use of patient experience improvement strategies was not associated with performance. Greater emphasis on productivity and efficiency criteria in individual physician financial incentive formulae was associated with worse access to care (p=.04). Physicians located in PCSAs with higher area-level deprivation had worse performance on the access to care (p=.04) and care coordination (p<.001) measures. Conclusions Physicians from integrated medical groups and groups with greater numbers of PCPs performed better on several patient experience measures, suggesting that organized care processes adopted by these groups may enhance patients' experiences. Physicians practicing in markets with high concentrations of vulnerable populations may be disadvantaged by constraints that affect performance. Future studies should clarify the extent to which performance deficits associated with area-level deprivation are modifiable. PMID:19674429

Organizational and market influences on physician performance on patient experience measures.

PubMed

Rodriguez, Hector P; von Glahn, Ted; Rogers, William H; Safran, Dana Gelb

2009-06-01

To examine the extent to which medical group and market factors are related to individual primary care physician (PCP) performance on patient experience measures. This study employs Clinician and Group CAHPS survey data (n=105,663) from 2,099 adult PCPs belonging to 34 diverse medical groups across California. Medical group directors were interviewed to assess the magnitude and nature of financial incentives directed at individual physicians and the adoption of patient experience improvement strategies. Primary care services area (PCSA) data were used to characterize the market environment of physician practices. We used multilevel models to estimate the relationship between medical group and market factors and physician performance on each Clinician and Group CAHPS measure. Models statistically controlled for respondent characteristics and accounted for the clustering of respondents within physicians, physicians within medical groups, and medical groups within PCSAs using random effects. Compared with physicians belonging to independent practice associations, physicians belonging to integrated medical groups had better performance on the communication ( p=.007) and care coordination ( p=.03) measures. Physicians belonging to medical groups with greater numbers of PCPs had better performance on all measures. The use of patient experience improvement strategies was not associated with performance. Greater emphasis on productivity and efficiency criteria in individual physician financial incentive formulae was associated with worse access to care ( p=.04). Physicians located in PCSAs with higher area-level deprivation had worse performance on the access to care ( p=.04) and care coordination ( p<.001) measures. Physicians from integrated medical groups and groups with greater numbers of PCPs performed better on several patient experience measures, suggesting that organized care processes adopted by these groups may enhance patients' experiences. Physicians practicing in markets with high concentrations of vulnerable populations may be disadvantaged by constraints that affect performance. Future studies should clarify the extent to which performance deficits associated with area-level deprivation are modifiable.

"There's no kind of respect here" A qualitative study of racism and access to maternal health care among Romani women in the Balkans.

PubMed

Janevic, Teresa; Sripad, Pooja; Bradley, Elizabeth; Dimitrievska, Vera

2011-11-17

Roma, the largest minority group in Europe, face widespread racism and health disadvantage. Using qualitative data from Serbia and Macedonia, our objective was to develop a conceptual framework showing how three levels of racism--personal, internalized, and institutional--affect access to maternal health care among Romani women. Eight focus groups of Romani women aged 14-44 (n = 71), as well as in-depth semi-structured interviews with gynecologists (n = 8) and key informants from NGOs and state institutions (n = 11) were conducted on maternal health care seeking, experiences during care, and perceived health care discrimination. Transcripts were coded, and analyzed using a grounded theory approach. Themes were categorized into domains. Twenty-two emergent themes identified barriers that reflected how racism affects access to maternal health care. The domains into which the themes were classified were perceptions and interactions with health system, psychological factors, social environment and resources, lack of health system accountability, financial needs, and exclusion from education. The experiences of Romani women demonstrate psychosocial and structural pathways by which racism and discrimination affect access to prenatal and maternity care. Interventions to address maternal health inequalities should target barriers within all three levels of racism.

"There's no kind of respect here" A qualitative study of racism and access to maternal health care among Romani women in the Balkans

PubMed Central

2011-01-01

Introduction Roma, the largest minority group in Europe, face widespread racism and health disadvantage. Using qualitative data from Serbia and Macedonia, our objective was to develop a conceptual framework showing how three levels of racism--personal, internalized, and institutional--affect access to maternal health care among Romani women. Methods Eight focus groups of Romani women aged 14-44 (n = 71), as well as in-depth semi-structured interviews with gynecologists (n = 8) and key informants from NGOs and state institutions (n = 11) were conducted on maternal health care seeking, experiences during care, and perceived health care discrimination. Transcripts were coded, and analyzed using a grounded theory approach. Themes were categorized into domains. Results Twenty-two emergent themes identified barriers that reflected how racism affects access to maternal health care. The domains into which the themes were classified were perceptions and interactions with health system, psychological factors, social environment and resources, lack of health system accountability, financial needs, and exclusion from education. Conclusions The experiences of Romani women demonstrate psychosocial and structural pathways by which racism and discrimination affect access to prenatal and maternity care. Interventions to address maternal health inequalities should target barriers within all three levels of racism. PMID:22094115

Optimizing Air Transportation Service to Metroplex Airports. Par 2; Analysis Using the Airline Schedule Optimization Model (ASOM)

NASA Technical Reports Server (NTRS)

Donoue, George; Hoffman, Karla; Sherry, Lance; Ferguson, John; Kara, Abdul Qadar

2010-01-01

The air transportation system is a significant driver of the U.S. economy, providing safe, affordable, and rapid transportation. During the past three decades airspace and airport capacity has not grown in step with demand for air transportation; the failure to increase capacity at the same rate as the growth in demand results in unreliable service and systemic delay. This report describes the results of an analysis of airline strategic decision-making that affects geographic access, economic access, and airline finances, extending the analysis of these factors using historic data (from Part 1 of the report). The Airline Schedule Optimization Model (ASOM) was used to evaluate how exogenous factors (passenger demand, airline operating costs, and airport capacity limits) affect geographic access (markets-served, scheduled flights, aircraft size), economic access (airfares), airline finances (profit), and air transportation efficiency (aircraft size). This analysis captures the impact of the implementation of airport capacity limits, as well as the effect of increased hedged fuel prices, which serve as a proxy for increased costs per flight that might occur if auctions or congestion pricing are imposed; also incorporated are demand elasticity curves based on historical data that provide information about how passenger demand is affected by airfare changes.

Cost-sensitive learning for emotion robust speaker recognition.

PubMed

Li, Dongdong; Yang, Yingchun; Dai, Weihui

2014-01-01

In the field of information security, voice is one of the most important parts in biometrics. Especially, with the development of voice communication through the Internet or telephone system, huge voice data resources are accessed. In speaker recognition, voiceprint can be applied as the unique password for the user to prove his/her identity. However, speech with various emotions can cause an unacceptably high error rate and aggravate the performance of speaker recognition system. This paper deals with this problem by introducing a cost-sensitive learning technology to reweight the probability of test affective utterances in the pitch envelop level, which can enhance the robustness in emotion-dependent speaker recognition effectively. Based on that technology, a new architecture of recognition system as well as its components is proposed in this paper. The experiment conducted on the Mandarin Affective Speech Corpus shows that an improvement of 8% identification rate over the traditional speaker recognition is achieved.

Cost-Sensitive Learning for Emotion Robust Speaker Recognition

PubMed Central

Li, Dongdong; Yang, Yingchun

2014-01-01

In the field of information security, voice is one of the most important parts in biometrics. Especially, with the development of voice communication through the Internet or telephone system, huge voice data resources are accessed. In speaker recognition, voiceprint can be applied as the unique password for the user to prove his/her identity. However, speech with various emotions can cause an unacceptably high error rate and aggravate the performance of speaker recognition system. This paper deals with this problem by introducing a cost-sensitive learning technology to reweight the probability of test affective utterances in the pitch envelop level, which can enhance the robustness in emotion-dependent speaker recognition effectively. Based on that technology, a new architecture of recognition system as well as its components is proposed in this paper. The experiment conducted on the Mandarin Affective Speech Corpus shows that an improvement of 8% identification rate over the traditional speaker recognition is achieved. PMID:24999492

Organizational context and taxonomy of health care databases.

PubMed

Shatin, D

2001-01-01

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

What factors affect patient access and engagement with clubfoot treatment in low- and middle-income countries? Meta-synthesis of existing qualitative studies using a social ecological model.

PubMed

Drew, Sarah; Lavy, Christopher; Gooberman-Hill, Rachael

2016-05-01

To conduct a systematic synthesis of previous research to identify factors that affect treatment-seeking for clubfoot and community-level interventions to improve engagement in low- and middle-income counties. A search of five databases was conducted, and articles screened using six criteria. Quality was appraised using the Critical Appraisal Skills Programme checklist. Eleven studies were identified for inclusion. Analysis was informed by a social ecological model, which specifies five inter-related factors that may affect treatment-seeking: intrapersonal, interpersonal, institutional, community or socio-cultural factors and public policy. Intrapersonal barriers experienced were a lack of income and additional responsibilities. At the interpersonal level, support from fathers, the extended family and wider community affected on treatment-seeking. Institutional or organisational factors included long distances to treatment centres, insufficient information about treatments and challenges following treatment. Guardians' beliefs about the causes of clubfoot shaped behaviour. At the level of public policy, two-tiered healthcare systems made it difficult for some groups to access timely care. Interventions to address these challenges included counselling sessions, outreach clinics, brace recycling and a range of education programmes. This study identifies factors that affect access and engagement with clubfoot treatment across diverse settings and strategies to address them. © 2016 John Wiley & Sons Ltd.

Large-Scale ATP-Independent Nucleosome Unfolding by a Histone Chaperone

PubMed Central

Valieva, Maria E.; Armeev, Grigoriy A.; Kudryashova, Kseniya S.; Gerasimova, Nadezhda S.; Shaytan, Alexey K.; Kulaeva, Olga I.; McCullough, Laura L.; Formosa, Tim; Georgiev, Pavel G.; Kirpichnikov, Mikhail P.; Studitsky, Vasily M.; Feofanov, Alexey V.

2017-01-01

DNA accessibility to regulatory proteins is significantly affected by nucleosome structure and dynamics. FACT (facilitates chromatin transcription) increases the accessibility of nucleosomal DNA but the mechanism and extent of this nucleosome reorganization are unknown. We report here the effects of FACT on single nucleosomes revealed with spFRET microscopy. FACT binding results in a dramatic, ATP-independent, and reversible uncoiling of DNA that affects at least 70% of the DNA in a nucleosome. A mutated version of FACT is defective in this uncoiling, and a histone mutation that suppresses phenotypes caused by this FACT mutation in vivo restores the uncoiling activity in vitro. Thus FACT-dependent nucleosome unfolding modulates the accessibility of nucleosomal DNA, and this is an important function of FACT in vivo. PMID:27820806

Evaluating the Effects of Flexible Learning about Aseptic Compounding on First-year Students in a Pharmacy Skills Laboratory

PubMed Central

Palmer, Russ; Elder, Deborah; Fulford, Michael; Morris, Steve; Sappington, Kellie

2015-01-01

Objective. To evaluate how flexible learning via online video review affects the ability and confidence of first-year (P1) pharmacy students to accurately compound aseptic preparations. Design. Customary instructions and assignments for aseptic compounding were provided to students, who were given unlimited access to 5 short review videos in addition to customary instruction. Student self-confidence was assessed online, and faculty members evaluated students’ aseptic technique at the conclusion of the semester. Assessment. No significant difference on final assessment scores was observed between those who viewed videos and those who did not. Student self-confidence scores increased significantly from baseline, but were not significantly higher for those who viewed videos than for those who did not. Conclusion. First-year students performed well on final aseptic compounding assessments, and those who viewed videos had a slight advantage. Student self-confidence improved over the semester regardless of whether or not students accessed review videos. PMID:26430278

Block-Based Connected-Component Labeling Algorithm Using Binary Decision Trees

PubMed Central

Chang, Wan-Yu; Chiu, Chung-Cheng; Yang, Jia-Horng

2015-01-01

In this paper, we propose a fast labeling algorithm based on block-based concepts. Because the number of memory access points directly affects the time consumption of the labeling algorithms, the aim of the proposed algorithm is to minimize neighborhood operations. Our algorithm utilizes a block-based view and correlates a raster scan to select the necessary pixels generated by a block-based scan mask. We analyze the advantages of a sequential raster scan for the block-based scan mask, and integrate the block-connected relationships using two different procedures with binary decision trees to reduce unnecessary memory access. This greatly simplifies the pixel locations of the block-based scan mask. Furthermore, our algorithm significantly reduces the number of leaf nodes and depth levels required in the binary decision tree. We analyze the labeling performance of the proposed algorithm alongside that of other labeling algorithms using high-resolution images and foreground images. The experimental results from synthetic and real image datasets demonstrate that the proposed algorithm is faster than other methods. PMID:26393597

Impact analysis of freight vehicle access restriction (A case study of Jakarta Intra Urban Toll way)

NASA Astrophysics Data System (ADS)

Irbany, Ferdian; Hadiwardoyo, Sigit P.; Nahry, Nahdalina

2017-06-01

Since the access restriction policy on freight vehicles was implemented in some parts of Jakarta Intra-Urban Tollway (JIUT) in 2011, i.e. section Cawang - Tomang - Pluit, several sections had an improved performance. However, there were sections that showed the opposite effect. The purpose of this research was to analyze the impact of the policy on JIUT as a whole by using the parameters based on sustainable transportation indicators. The study area was divided into the statutory segment (Cawang - Tomang - Pluit) and the affected segment (Cawang - Tanjung Priok - Pluit). The assessment results of five parameters including travel time, fuel consumption, fatality rate, CO2 emissions, and noise level indicated that the implementation of the policy provided an advantage to the traffic smoothness priority at the statutory segment, but it did not support the sustainable urban transportation priority of the entire JIUT system. The proposed solution to maintain the sustainable condition of urban transportation is to complement the statutory system with the advisory system within Jakarta's territory.

The DNA Bank: High-Security Bank Accounts to Protect and Share Your Genetic Identity.

PubMed

den Dunnen, Johan T

2015-07-01

With the cost of genome sequencing decreasing every day, DNA information has the potential of affecting the lives of everyone. Surprisingly, an individual has little knowledge about his own DNA information, can rarely access it, and has hardly any control over its use. This may result in preventable, life-threatening situations, and also significantly inhibits scientific progress. What we urgently need is a "DNA bank," a resource providing a secure personal account where, similar to a financial institution, you can store your DNA sequence. Using this private and secure DNA bank account, you govern your sequence-related business. For any genetic study performed, the data generated must be transferred (paid) to your DNA account. Using your account, you regulate access, knowing for what purpose (informed consent) and only for the genetic data you are willing to share. The DNA account ensures you are in the driver's seat, know what is known, and control what is happening with it. © 2015 WILEY PERIODICALS, INC.

Effect of Pointing Error on the BER Performance of an Optical CDMA FSO Link with SIK Receiver

NASA Astrophysics Data System (ADS)

Nazrul Islam, A. K. M.; Majumder, S. P.

2017-12-01

An analytical approach is presented for an optical code division multiple access (OCDMA) system over free space optical (FSO) channel considering the effect of pointing error between the transmitter and the receiver. Analysis is carried out with an optical sequence inverse keying (SIK) correlator receiver with intensity modulation and direct detection (IM/DD) to find the bit error rate (BER) with pointing error. The results are evaluated numerically in terms of signal-to-noise plus multi-access interference (MAI) ratio, BER and power penalty due to pointing error. It is noticed that the OCDMA FSO system is highly affected by pointing error with significant power penalty at a BER of 10-6 and 10-9. For example, penalty at BER 10-9 is found to be 9 dB corresponding to normalized pointing error of 1.4 for 16 users with processing gain of 256 and is reduced to 6.9 dB when the processing gain is increased to 1,024.

A life-cycle approach to food and nutrition security in India.

PubMed

Rai, Rajesh Kumar; Kumar, Sandhya; Sekher, Madhushree; Pritchard, Bill; Rammohan, Anu

2015-04-01

India's poor performance on critical food and nutrition security indicators despite substantial economic prosperity has been widely documented. These failings not only hamper national progress, but also contribute significantly to the global undernourished population, particularly children. While the recently passed National Food Security Act 2013 adopts a life-cycle approach to expand coverage of subsidized food grains to the most vulnerable households and address food security, there remains much to be desired in the legislation. Access to adequate food for 1.24 billion people is a multifaceted problem requiring an interconnected set of policy measures to tackle the various factors affecting food and nutrition security in India. In the present opinion paper, we discuss a fivefold strategy that incorporates a life-cycle approach, spanning reproductive health, bolstering citizen participation in existing national programmes, empowering women, advancing agriculture and better monitoring the Public Distribution System in order to fill the gaps in both access and adequacy of food and nutrition.

Invasive plant species how they can affect trail access (and how you can help prevent their access)

Treesearch

James H. Miller

2004-01-01

The natural beauty of our southern forest landscapes is under attack and our access to lands and trails are becoming increasingly restricted. Alien invasive plants are the culprits and they are spreading, occupying and controlling our lands like armies of invaders that they are. Kudzu is a world-wide recognized invader of the South, but few people sense the threat from...

Case Study: South Texas Veterans Health Care System’s Communication Center

DTIC Science & Technology

2008-07-14

appropriate access to health care; technical quality is providing world-class care to our veterans; customer satisfaction is ensuring the STVHCS patients and...were not called. These results not only improved access to health care, but also positively affected customer service. 111 Case Study: South Texas...increased waiting times for the patient . With current regulatory requirements calling for improved access to health care services, many hospital and

The ATS Web Page Provides "Tool Boxes" for: Access Opportunities, Performance, Interfaces, Volume, Environments, "Wish List" Entry and Educational Outreach

NASA Technical Reports Server (NTRS)

1999-01-01

This viewgraph presentation gives an overview of the Access to Space website, including information on the 'tool boxes' available on the website for access opportunities, performance, interfaces, volume, environments, 'wish list' entry, and educational outreach.

Access to Awareness for Faces during Continuous Flash Suppression Is Not Modulated by Affective Knowledge

PubMed Central

Rabovsky, Milena; Stein, Timo; Abdel Rahman, Rasha

2016-01-01

It is a controversially debated topic whether stimuli can be analyzed up to the semantic level when they are suppressed from visual awareness during continuous flash suppression (CFS). Here, we investigated whether affective knowledge, i.e., affective biographical information about faces, influences the time it takes for initially invisible faces with neutral expressions to overcome suppression and break into consciousness. To test this, we used negative, positive, and neutral famous faces as well as initially unfamiliar faces, which were associated with negative, positive or neutral biographical information. Affective knowledge influenced ratings of facial expressions, corroborating recent evidence and indicating the success of our affective learning paradigm. Furthermore, we replicated shorter suppression durations for upright than for inverted faces, demonstrating the suitability of our CFS paradigm. However, affective biographical information did not modulate suppression durations for newly learned faces, and even though suppression durations for famous faces were influenced by affective knowledge, these effects did not differ between upright and inverted faces, indicating that they might have been due to low-level visual differences. Thus, we did not obtain unequivocal evidence for genuine influences of affective biographical information on access to visual awareness for faces during CFS. PMID:27119743

Does engagement predict research use? An analysis of The Conversation Annual Survey 2016.

PubMed

Zardo, Pauline; Barnett, Adrian G; Suzor, Nicolas; Cahill, Tim

2018-01-01

The impact of research on the world beyond academia has increasingly become an area of focus in research performance assessments internationally. Impact assessment is expected to incentivise researchers to increase engagement with industry, government and the public more broadly. Increased engagement is in turn expected to increase translation of research so decision-makers can use research to inform development of policies, programs, practices, processes, products, and other mechanisms, through which impact can be realised. However, research has shown that various factors affect research use, and evidence on 'what works' to increase decision-makers' use of research is limited. The Conversation is an open access research communication platform, published under Creative Commons licence, which translates research into news articles to engage a general audience, aiming to improve understanding of current issues and complex social problems. To identify factors that predict use of academic research and expertise reported in The Conversation, regression analyses were performed using The Conversation Australia 2016 Annual Survey data. A broad range of factors predicted use, with engagement actions being the most common. Interestingly, different types of engagement actions predicted different types of use. This suggests that to achieve impact through increased engagement, a deeper understanding of how and why different engagement actions elicit different types of use is needed. Findings also indicate The Conversation is overcoming some of the most commonly identified barriers to the use of research: access, relevance, actionable outcomes, and timeliness. As such, The Conversation offers an effective model for providing access to and communicating research in a way that enables use, a necessary precursor to achieving research impact.

Components of the airport access system

NASA Technical Reports Server (NTRS)

1978-01-01

The organizations and agencies which make up or influence the airport access system are examined. These include the airport, the airline industry, the public and private transit agencies which provide ground access to the airport, and the regulatory agencies which affect all of these organizations and their actions. Each component, with the exception of the regulatory agencies is described in terms of its legal status, its sources of funds, and the nature of its relationship with the other components. Conclusions regarding the system components' effects on airport access and recommendations for changes which appear practical are presented.

Application Performance Analysis and Efficient Execution on Systems with multi-core CPUs, GPUs and MICs: A Case Study with Microscopy Image Analysis

PubMed Central

Teodoro, George; Kurc, Tahsin; Andrade, Guilherme; Kong, Jun; Ferreira, Renato; Saltz, Joel

2015-01-01

We carry out a comparative performance study of multi-core CPUs, GPUs and Intel Xeon Phi (Many Integrated Core-MIC) with a microscopy image analysis application. We experimentally evaluate the performance of computing devices on core operations of the application. We correlate the observed performance with the characteristics of computing devices and data access patterns, computation complexities, and parallelization forms of the operations. The results show a significant variability in the performance of operations with respect to the device used. The performances of operations with regular data access are comparable or sometimes better on a MIC than that on a GPU. GPUs are more efficient than MICs for operations that access data irregularly, because of the lower bandwidth of the MIC for random data accesses. We propose new performance-aware scheduling strategies that consider variabilities in operation speedups. Our scheduling strategies significantly improve application performance compared to classic strategies in hybrid configurations. PMID:28239253

77 FR 20743 - Protective Force Personnel Medical, Physical Readiness, Training, and Access Authorization Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-06

...-HQ-2012-0002] RIN 1992-AA40 Protective Force Personnel Medical, Physical Readiness, Training, and... the proposed rule to amend the standards for medical, physical performance, training, and access... proposed rule to revise the standards for medical, physical performance, training, and access...

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

PubMed

Augustin, J; Austermann, J; Erasmi, S

2016-10-18

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

Physical Medicine and Rehabilitation Resident Use of iPad Mini Mobile Devices.

PubMed

Niehaus, William; Boimbo, Sandra; Akuthota, Venu

2015-05-01

Previous research on the use of tablet devices in residency programs has been undertaken in radiology and medicine or with standard-sized tablet devices. With new, smaller tablet devices, there is an opportunity to assess their effect on resident behavior. This prospective study attempts to evaluate resident behavior after receiving a smaller tablet device. To evaluate whether smaller tablet computers facilitate residents' daily tasks. Prospective study that administered surveys to evaluate tablet computer use. Residency program. Thirteen physical medicine and rehabilitation residents. Residents were provided 16-GB iPad Minis and surveyed with Redcap to collect usage information at baseline, 3, and 6 months. Survey analysis was conducted using SAS (SAS, Cary, NC) for descriptive analysis. To evaluate multiple areas of resident education, the following tasks were selected: accessing e-mail, logging duty hours, logging procedures, researching clinical information, accessing medical journals, reviewing didactic presentations, and completing evaluations. Then, measurements were taken of: (1) residents' response to how tablet computers made it easier to access the aforementioned tasks; and (2) residents' response to how tablet computers affected the frequency they performed the aforementioned tasks. After being provided tablet computers, our physical medicine and rehabilitation residents reported significantly greater access to e-mail, medical journals, and didactic material. Also, receiving tablet computers was reported to increase the frequency that residents accessed e-mail, researched clinical information, accessed medical journals, reviewed didactic presentations, and completed evaluations. After receiving a tablet computer, residents reported an increase in the use of calendar programs, note-taking programs, PDF readers, online storage programs, and file organization programs. These physical medicine and rehabilitation residents reported tablet computers increased access to e-mail, presentation material, and medical journals. Tablet computers also were reported to increase the frequency residents were able to complete tasks associated with residency training. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Effects of Information Access Cost and Accountability on Medical Residents' Information Retrieval Strategy and Performance During Prehandover Preparation: Evidence From Interview and Simulation Study.

PubMed

Yang, X Jessie; Wickens, Christopher D; Park, Taezoon; Fong, Liesel; Siah, Kewin T H

2015-12-01

We aimed to examine the effects of information access cost and accountability on medical residents' information retrieval strategy and performance during prehandover preparation. Prior studies observing doctors' prehandover practices witnessed the use of memory-intensive strategies when retrieving patient information. These strategies impose potential threats to patient safety as human memory is prone to errors. Of interest in this work are the underlying determinants of information retrieval strategy and the potential impacts on medical residents' information preparation performance. A two-step research approach was adopted, consisting of semistructured interviews with 21 medical residents and a simulation-based experiment with 32 medical residents. The semistructured interviews revealed that a substantial portion of medical residents (38%) relied largely on memory for preparing handover information. The simulation-based experiment showed that higher information access cost reduced information access attempts and access duration on patient documents and harmed information preparation performance. Higher accountability led to marginally longer access to patient documents. It is important to understand the underlying determinants of medical residents' information retrieval strategy and performance during prehandover preparation. We noted the criticality of easy access to patient documents in prehandover preparation. In addition, accountability marginally influenced medical residents' information retrieval strategy. Findings from this research suggested that the cost of accessing information sources should be minimized in developing handover preparation tools. © 2015, Human Factors and Ergonomics Society.

Neurotic disorders and the receipt of psychiatric treatment.

PubMed

Bebbington, P E; Brugha, T S; Meltzer, H; Jenkins, R; Ceresa, C; Farrell, M; Lewis, G

2000-11-01

Access to psychiatric treatment by people with neurotic disorders in the general population is likely to be affected both by the severity of disorder and by sociodemographic differences. In the household component of the National Surveys of Psychiatric Morbidity > 10,000 subjects in Great Britain with psychiatric symptoms were interviewed using the CIS-R. They were also asked about difficulties experienced in performing seven types of everyday activity. All subjects classed as having an ICD-10 disorder were questioned about their experience of treatment with antidepressants, hypnotics, and counselling or psychotherapy. Less than 14% of people with current neurotic disorders were receiving treatment for them. Within the previous year, only a third had made contact with their primary care physician for their mental problem: of these < 30% were receiving treatment. Overall, 9% of people with disorders were given medication and 8% counselling or psychotherapy. A diagnosis of depressive episode was that most associated with antidepressant medication. Treatment access was affected by employment status, marital status, and age, but the major determinant was symptom severity. Neither sex nor social class influenced which people received treatment. People with psychiatric disorders seldom receive treatment, even when they have consulted their primary care physician about them. In many cases, this must represent unmet needs with a strong claim on health resources. There are also inequalities in the receipt of treatment, although the major influence is the severity of disorder.

Neurotic disorders and the receipt of psychiatric treatment.

PubMed

Bebbington, P; Brugha, T; Meltzer, H; Jenkins, R; Ceresa, C; Farrell, M; Lewis, G

2003-01-01

Access to psychiatric treatment by people with neurotic disorders in the general population is likely to be affected both by the severity of disorder and by sociodemographic differences. In the household component of the National Surveys of Psychiatric Morbidity >10,000 subjects in Great Britain with psychiatric symptoms were interviewed using the CIS-R. They were also asked about difficulties experienced in performing seven types of everyday activity. All subjects classed as having an ICD-10 disorder were questioned about their experience of treatment with antidepressants, hypnotics, and counselling or psychotherapy. Less than 14% of people with current neurotic disorders were receiving treatment for them. Within the previous year, only a third had made contact with their primary care physician for their mental problem: of these <30% were receiving treatment. Overall, 9% of people with disorders were given medication and 8% counselling or psychotherapy. A diagnosis of depressive episode was that most associated with antidepressant medication. Treatment access was affected by employment status, marital status, and age, but the major determinant was symptom severity. Neither sex nor social class influenced which people received treatment. People with psychiatric disorders seldom receive treatment, even when they have consulted their primary care physician about them. In many cases, this must represent unmet needs with a strong claim on health resources. There are also inequalities in the receipt of treatment, although the major influence is the severity of disorder.

Employer-sponsored health insurance coverage limitations: results from the Childhood Cancer Survivor Study.

PubMed

Kirchhoff, Anne C; Kuhlthau, Karen; Pajolek, Hannah; Leisenring, Wendy; Armstrong, Greg T; Robison, Leslie L; Park, Elyse R

2013-02-01

The Affordable Care Act (ACA) will expand health insurance options for cancer survivors in the USA. It is unclear how this legislation will affect their access to employer-sponsored health insurance (ESI). We describe the health insurance experiences for survivors of childhood cancer with and without ESI. We conducted a series of qualitative interviews with 32 adult survivors from the Childhood Cancer Survivor Study to assess their employment-related concerns and decisions regarding health insurance coverage. Interviews were performed from August to December 2009 and were recorded, transcribed, and content analyzed using NVivo 8. Uninsured survivors described ongoing employment limitations, such as being employed at part-time capacity, which affected their access to ESI coverage. These survivors acknowledged they could not afford insurance without employer support. Survivors on ESI had previously been denied health insurance due to their preexisting health conditions until they obtained coverage through an employer. Survivors feared losing their ESI coverage, which created a disincentive to making career transitions. Others reported worries about insurance rescission if their cancer history was discovered. Survivors on ESI reported financial barriers in their ability to pay for health care. Childhood cancer survivors face barriers to obtaining ESI. While ACA provisions may mitigate insurance barriers for cancer survivors, many will still face cost barriers to affording health care without employer support.

Employer-Sponsored Health Insurance Coverage Limitations: Results from the Childhood Cancer Survivor Study

PubMed Central

Kirchhoff, Anne C.; Kuhlthau, Karen; Pajolek, Hannah; Leisenring, Wendy; Armstrong, Greg T.; Robison, Leslie L.; Park, Elyse R.

2013-01-01

Purpose The Affordable Care Act (ACA) will expand health insurance options for cancer survivors in the United States. It is unclear how this legislation will affect their access to employer-sponsored health insurance (ESI). We describe the health insurance experiences for survivors of childhood cancer with and without ESI. Methods We conducted a series of qualitative interviews with 32 adult survivors from the Childhood Cancer Survivor Study to assess their employment-related concerns and decisions regarding health insurance coverage. Interviews were performed from August to December 2009 and were recorded, transcribed, and content analyzed using NVivo 8. Results Uninsured survivors described ongoing employment limitations, such as being employed at part-time capacity, which affected their access to ESI coverage. These survivors acknowledged they could not afford insurance without employer support. Survivors on ESI had previously been denied health insurance due to their pre-existing health conditions until they obtained coverage through an employer. Survivors feared losing their ESI coverage, which created a disincentive to making career transitions. Others reported worries about insurance rescission if their cancer history was discovered. Survivors on ESI reported financial barriers in their ability to pay for health care. Conclusions Childhood cancer survivors face barriers to obtaining employer-sponsored health insurance. While Affordable Care Act provisions may mitigate insurance barriers for cancer survivors, many will still face cost barriers to affording health care without employer support. PMID:22717916

Transcolonic Perirectal NOTES Access (PNA): A feasibility study with survival in swine model.

PubMed

Oliveira, André L A; Zorron, Ricardo; Oliveira, Flavio M M DE; Santos, Marcelo B Dos; Scheffer, Jussara P; Rios, Marcelo; Antunes, Fernanda

2017-05-01

Transrectal access still has some unsolved issues such as spatial orientation, infection, access and site closure. This study presents a simple technique to perform transcolonic access with survival in a swine model series. A new technique for NOTES perirectal access to perform retroperitoneoscopy, peritoneoscopy, liver and lymphnode biopsies was performed in 6 pigs, using Totally NOTES technique. The specimens were extracted transanally. The flexible endoscope was inserted through a posterior transmural incision and the retrorectal space. Cultures of bacteria were documented for the retroperitoneal space and intra abdominal cavity after 14 days. Rectal site was closed using non-absorbable sutures. There was no bowel cleansing, nor preoperative fasting. The procedures were performed in 6 pigs through transcolonic natural orifice access using available endoscopic flexible instruments. All animals survived 14 days without complications, and cultures were negative. Histopathologic examination of the rectal closure site showed adequate healing of suture line and no micro abscesses. The results of feasibility and safety of experimental Transcolonic NOTES potentially brings new frontiers and future wider applications for minimally invasive surgery. The treatment of colorectal, abdominal and retroperitoneal diseases through a flexible Perirectal NOTES Access (PNA) is a promising new approach.

A Telecommunications Policy Agenda for Latinos en la Edad de Informacion.

ERIC Educational Resources Information Center

Schement, Jorge Reina

2001-01-01

Discusses telecommunications developments affecting Latino access and participation. Examines telecommunications policy as political discourse. Presents elements of a telecommunications policy agenda drawn from that of the Congressional Hispanic Caucus and focusing on access to services, education for digital literacy, needs of small businesses…

Everyday Inclusive Web Design: An Activity Perspective

ERIC Educational Resources Information Center

Kane, Shaun K.

2007-01-01

Introduction: Website accessibility is a problem that affects millions of people with disabilities. While most current accessibility initiatives target government or commercial sites, a growing segment of online content is being created by non-professionals. This content is often inaccessible to users with disabilities. Everyday inclusive Web…

Evaluation of a palliative and hospice care telephone hotline for patients severely affected by multiple sclerosis and their caregivers.

PubMed

Strupp, J; Groebe, B; Knies, A; Mai, M; Voltz, R; Golla, H

2017-12-01

Palliative and hospice care (PHC) still mainly focuses on patients with cancer. In order to connect patients severely affected by multiple sclerosis (MS) and caregivers to PHC, a nationwide hotline was implemented to facilitate access to PHC. The hotline was designed in cooperation with the German Multiple Sclerosis Society. Self-disclosed information given by callers was documented using case-report forms supplemented by personal notes. Data were analysed descriptively. A total of 222 calls were documented in 27 months. The patients' mean age was 51.12 years (range 27-84 years) and mean illness duration was 18 years (range 1 month to 50 years). Inquiries included information on PHC (28.8%) and access to PHC (due to previous refusal of PHC, 5.4%), general care for MS (36.1%), adequate housing (9.0%) and emotional support in crisis (4.5%). A total of 31.1% of callers reported 'typical' palliative symptoms (e.g. pain, 88.4%), 50.5% reported symptoms evolving from MS and 35.6% reported psychosocial problems. For 67 callers (30.2%), PHC services were recommended as indicated. The hotline provided insight into the needs and problems of patients severely affected by MS and their caregivers, some of which may be met by PHC. Future follow-up calls will demonstrate if the hotline helped to improve access to PHC beyond providing information. Overall, the hotline seemed to be easily accessible for patients severely affected by MS whose mobility is limited. © 2017 EAN.

Integrated Performance Testing Workshop, Modules 6 - 11

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

Leach, Janice; Torres, Teresa M.

These modules cover performance testing of: Interior Detection Systems; Access Controls; Exterior Detection Systems; Video Assessment Systems; SNM / Contraband Detection Systems; Access Delay Elements

Cyberbullying: implications for the psychiatric nurse practitioner.

PubMed

Carpenter, Lindsey M; Hubbard, Grace B

2014-08-01

The purpose of this article is to inform and educate psychiatric nurse practitioners about the pervasiveness of the rapidly increasing problem of cyberbullying. As more children and adolescents obtain access to the Internet, mobile devices, and social networking sites, the exposure to bullying in the virtual format increases. Cyberbullying is a growing public health concern and can affect mental health and school performance. Cyberbullying often results in a range of psychiatric symptoms and has been linked to suicide attempts and completions. The psychiatric nurse practitioner is uniquely prepared to provide a range of interventions for patients, families, and communities who have experienced cyberbullying. © 2014 Wiley Periodicals, Inc.

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

Roberts, Barry L; Lord, David; Lord, Anna C. Snider

This report summarizes the work performed in the prioritization of cavern access wells for remediation and monitoring at the Bayou Choctaw Strategic Petroleum Reserve site. The grading included consideration of all 15 wells at the Bayou Choctaw site, with each active well receiving a separate grade for remediation and monitoring. Numerous factors affecting well integrity were incorporated into the grading including casing survey results, cavern pressure history, results from geomechanical simulations, and site geologic factors. The factors and grading framework used here are the same as those used in developing similar well remediation and monitoring priorities at the Big Hill,more » Bryan Mound, and West Hackberry Strategic Petroleum Reserve Sites.« less

Transoral endoscopic thyroidectomy vestibular approach: a preliminary framework for assessment and safety.

PubMed

Russell, Jonathon; Anuwong, Angkoon; Dionigi, Gianlorenzo; Inabnet, William B; Kim, Hoon Yub; Randolph, Gregory W; Richmon, Jeremy D; Tufano, Ralph P

2018-05-23

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a new approach to the central neck that avoids an anterior cervical incision. This approach can be performed with endoscopic or robotic assistance and offers access to the bilateral central neck. It has been completed safely in both North American and, even more extensively, international populations. With any new technology or approach, complications during the learning curve, expense, instrument limitations, and overall safety may affect its ultimate adoption and utility. To ensure patient safety, it is imperative to define steps that should be considered by any surgeon or group before adoption of this new approach.

Pilot Performance With Predictive System Status Information

NASA Technical Reports Server (NTRS)

Trujillo, Anna C.

1997-01-01

Research has shown a strong pilot preference for predictive information of aircraft system status in the flight deck. However, the benefits of predictive information have not been quantitatively demonstrated. The study described here attempted to identify and quantify these benefits if they existed. In this simulator experiment, three types of predictive information (none, whether a parameter was changing abnormally, and the time for a parameter to reach an alert range) and four initial times to an alert (1 minute, 5 minutes, 15 minutes, and ETA+ 45 minutes) were found to affect when subjects accomplished certain actions, such as accessing pertinent checklists, declaring emergencies, diverting, and calling the flight attendant and dispatch.

The effect of four user interface concepts on visual scan pattern similarity and information foraging in a complex decision making task.

PubMed

Starke, Sandra D; Baber, Chris

2018-07-01

User interface (UI) design can affect the quality of decision making, where decisions based on digitally presented content are commonly informed by visually sampling information through eye movements. Analysis of the resulting scan patterns - the order in which people visually attend to different regions of interest (ROIs) - gives an insight into information foraging strategies. In this study, we quantified scan pattern characteristics for participants engaging with conceptually different user interface designs. Four interfaces were modified along two dimensions relating to effort in accessing information: data presentation (either alpha-numerical data or colour blocks), and information access time (all information sources readily available or sequential revealing of information required). The aim of the study was to investigate whether a) people develop repeatable scan patterns and b) different UI concepts affect information foraging and task performance. Thirty-two participants (eight for each UI concept) were given the task to correctly classify 100 credit card transactions as normal or fraudulent based on nine transaction attributes. Attributes varied in their usefulness of predicting the correct outcome. Conventional and more recent (network analysis- and bioinformatics-based) eye tracking metrics were used to quantify visual search. Empirical findings were evaluated in context of random data and possible accuracy for theoretical decision making strategies. Results showed short repeating sequence fragments within longer scan patterns across participants and conditions, comprising a systematic and a random search component. The UI design concept showing alpha-numerical data in full view resulted in most complete data foraging, while the design concept showing colour blocks in full view resulted in the fastest task completion time. Decision accuracy was not significantly affected by UI design. Theoretical calculations showed that the difference in achievable accuracy between very complex and simple decision making strategies was small. We conclude that goal-directed search of familiar information results in repeatable scan pattern fragments (often corresponding to information sources considered particularly important), but no repeatable complete scan pattern. The underlying concept of the UI affects how visual search is performed, and a decision making strategy develops. This should be taken in consideration when designing for applied domains. Copyright © 2018 Elsevier Ltd. All rights reserved.

Socio-economic and locational determinants of accessibility and utilization of primary health-care.

PubMed

Field, K S; Briggs, D J

2001-09-01

Differences in levels of utilization vary and are a function of socio-economic and geographical factors. This paper presents the results of a questionnaire study involving twelve GP practices in Northamptonshire, UK, of factors which affect access and utilization in asthmatics and diabetics; these groups were selected to control for differences in utilization behaviour, as a result of different aetiologies. The questionnaire sought data on: residential location of patients, utilization characteristics of primary health-care, personal circumstances and mobility and hindrances to access and utilization. Key themes were identified relating to age, gender, social class, employment, ethnicity and proximity to the GP surgery. The young, elderly and females report higher rates of utilization, as do nonmanual workers and those who are unemployed. However, accessibility and utilization vary greatly in response to mobility and locational characteristics; these variations tend to be masked by data on overall rates of usage. Optimal scaling techniques were used to investigate the interactions between the factors affecting accessibility and utilization, and to characterize patients in terms of their levels of utilization. Results confirmed that current service provision afforded a differential level of service to patients, which does not directly reflect their level of need.

Socioieconomic outcomes of restricted access to abortion.

PubMed

Muller, C

1971-06-01

Such questions as the extent to which greater accessibility to abortion services affects poverty and its problems are analyzed, and proposals for identifying the socioeconomic impact of liberalized abortion laws and accessible services are developed. The number of unwanted children born is directly affected by the barriers to legal abortion. In countries that have improved access to legal abortion, the demand for the service has risen among all socioeconomic groups. Long-time family earning potential is severely effected by the defects in the timing and spacing of the birth of children, which often leads to young men and pregnant teen-agers leaving school because of the burdens of pregnancy and child support. Large family size was found in 35% of families in 1965 where the head of the household was a fully employed worker. Children born and living as psychologically rejected or unwanted children risk impaired learning and development which in turn limits future economic achievments. Research into the access of and financing of abortion services should deal with the financial needs of patient groups. The effects of nonhospital service programs, manpower needs, and the surveillance of gaps and coverage of the service needs should be prime research targets.

The Aortic Bifurcation Angle as a Factor in Application of the Outback for Femoropopliteal Lesions in Ipsilateral Versus Contralateral Approaches.

PubMed

Raskin, Daniel; Khaitovich, Boris; Balan, Shmuel; Silverberg, Daniel; Halak, Moshe; Rimon, Uri

2018-01-01

To assess the technical success of the Outback reentry device in contralateral versus ipsilateral approaches for femoropopliteal arterial occlusion. A retrospective review of patients treated for critical limb ischemia (CLI) using the Outback between January 2013 and July 2016 was performed. Age, gender, length and site of the occlusion, approach site, aortic bifurcation angle, and reentry site were recorded. Calcification score was assigned at both aortic bifurcation and reentry site. Technical success was assessed. During the study period, a total of 1300 endovascular procedures were performed on 489 patients for CLI. The Outback was applied on 50 femoropopliteal chronic total occlusions. Thirty-nine contralateral and 11 ipsilateral antegrade femoral were accessed. The device was used successfully in 41 patients (82%). There were nine failures, all in the contralateral approach group. Six due to inability to deliver the device due to acute aortic bifurcation angle and three due to failure to achieve luminal reentry. Procedural success was significantly affected by the aortic bifurcation angle (p = 0.013). The Outback has high technical success rates in treatment of femoropopliteal occlusion, when applied from either an ipsi- or contralateral approach. When applied in contralateral access, acute aortic bifurcation angle predicts procedural failure.

The role of selected lexical factors on confrontation naming accuracy, speed, and fluency in adults who do and do not stutter.

PubMed

Newman, Rochelle S; Bernstein Ratner, Nan

2007-02-01

The purpose of this study was to investigate whether lexical access in adults who stutter (AWS) differs from that in people who do not stutter. Specifically, the authors examined the role of 3 lexical factors on naming speed, accuracy, and fluency: word frequency, neighborhood density, and neighborhood frequency. If stuttering results from an impairment in lexical access, these factors were hypothesized to differentially affect AWS performance on a confrontation naming task. Twenty-five AWS and 25 normally fluent comparison speakers, matched for age and education, participated in a confrontation naming task designed to explore within-speaker performance on naming accuracy, speed, and fluency based on stimulus word frequency and neighborhood characteristics. Accuracy, fluency, and reaction time (from acoustic waveform analysis) were computed. In general, AWS demonstrated the same effects of lexical factors on their naming as did adults who do not stutter. However, accuracy of naming was reduced for AWS. Stuttering rate was influenced by word frequency but not other factors. Results suggest that AWS could have a fundamental deficit in lexical retrieval, but this deficit is unlikely to be at the level of the word's abstract phonological representation. Implications for further research are discussed.

The Apollo Medical Operations Project: Recommendations to Improve Crew Health and Performance for Future Exploration Missions and Lunar Surface Operations

NASA Technical Reports Server (NTRS)

Scheuring, Richard A.; Jones, Jeffrey A.; Jones, Jeffrey A.; Novak, Joseph D.; Polk, James D.; Gillis, David B.; Schmid, Josef; Duncan, James M.; Davis, Jeffrey R.

2007-01-01

Medical requirements for the future Crew Exploration Vehicle (CEV), Lunar Surface Access Module (LSAM), advanced Extravehicular Activity (EVA) suits and Lunar habitat are currently being developed. Crews returning to the lunar surface will construct the lunar habitat and conduct scientific research. Inherent in aggressive surface activities is the potential risk of injury to crewmembers. Physiological responses and the operational environment for short forays during the Apollo lunar missions were studied and documented. Little is known about the operational environment in which crews will live and work and the hardware will be used for long-duration lunar surface operations. Additional information is needed regarding productivity and the events that affect crew function such as a compressed timeline. The Space Medicine Division at the NASA Johnson Space Center (JSC) requested a study in December 2005 to identify Apollo mission issues relevant to medical operations that had impact to crew health and/or performance. The operationally oriented goals of this project were to develop or modify medical requirements for new exploration vehicles and habitats, create a centralized database for future access, and share relevant Apollo information with the multiple entities at NASA and abroad participating in the exploration effort.

The Apollo Medical Operations Project: Recommendations to Improve Crew Health and Performance for Future Exploration Missions and Lunar Surface Operations

NASA Technical Reports Server (NTRS)

Scheuring, Richard A.; Jones, Jeffrey A.; Polk, James D.; Gillis, David B.; Schmid, Joseph; Duncan, James M.; Davis, Jeffrey R.; Novak, Joseph D.

2007-01-01

Medical requirements for the future Crew Exploration Vehicle (CEV), Lunar Surface Access Module (LSAM), advanced Extravehicular Activity (EVA) suits and Lunar habitat are currently being developed. Crews returning to the lunar surface will construct the lunar habitat and conduct scientific research. Inherent in aggressive surface activities is the potential risk of injury to crewmembers. Physiological responses to and the operational environment of short forays during the Apollo lunar missions were studied and documented. Little is known about the operational environment in which crews will live and work and the hardware that will be used for long-duration lunar surface operations.Additional information is needed regarding productivity and the events that affect crew function such as a compressed timeline. The Space Medicine Division at the NASA Johnson Space Center (JSC) requested a study in December 2005 to identify Apollo mission issues relevant to medical operations that had impact to crew health and/or performance. The operationally oriented goals of this project were to develop or modify medical requirements for new exploration vehicles and habitats, create a centralized database for future access, and share relevant Apollo information with the multiple entities at NASA and abroad participating in the exploration effort.

The Legal Past, Present and Future of Prenatal Genetic Testing: Professional Liability and Other Legal Challenges Affecting Patient Access to Services.

PubMed

Pergament, Deborah; Ilijic, Katie

2014-12-15

This chapter is an overview of the current status of the law in the United States regarding prenatal genetic testing with an emphasis on issues related to professional liability and other challenges affecting patient access to prenatal genetic testing. The chapter discusses the roles that federal regulations, promulgated by the Centers for Medicare and Medicaid Services (CMS), the Food and Drug Administration (FDA) and the Federal Trade Commission (FTC), play in the regulation of prenatal genetic tests. The chapter discusses tort litigation based on allegations of malpractice in the provision of prenatal genetic testing and how courts have analyzed issues related to causation, damages and mitigation of damages. The chapter provides reference information regarding how individual states address causes of action under the tort theories of wrongful birth and wrongful life. The chapter concludes with a discussion of future legal issues that may affect clinical prenatal genetic testing services arising from the continued expansion of prenatal genetic testing, legal restrictions on access to abortion and the potential development of embryonic treatments.

The Legal Past, Present and Future of Prenatal Genetic Testing: Professional Liability and Other Legal Challenges Affecting Patient Access to Services

PubMed Central

Pergament, Deborah; Ilijic, Katie

2014-01-01

This chapter is an overview of the current status of the law in the United States regarding prenatal genetic testing with an emphasis on issues related to professional liability and other challenges affecting patient access to prenatal genetic testing. The chapter discusses the roles that federal regulations, promulgated by the Centers for Medicare and Medicaid Services (CMS), the Food and Drug Administration (FDA) and the Federal Trade Commission (FTC), play in the regulation of prenatal genetic tests. The chapter discusses tort litigation based on allegations of malpractice in the provision of prenatal genetic testing and how courts have analyzed issues related to causation, damages and mitigation of damages. The chapter provides reference information regarding how individual states address causes of action under the tort theories of wrongful birth and wrongful life. The chapter concludes with a discussion of future legal issues that may affect clinical prenatal genetic testing services arising from the continued expansion of prenatal genetic testing, legal restrictions on access to abortion and the potential development of embryonic treatments. PMID:26237611

Malaria treatment-seeking behaviour and related factors of Wa ethnic minority in Myanmar: a cross-sectional study

PubMed Central

2012-01-01

Background In Southeast Asia, data on malaria treatment-seeking behaviours and related affecting factors are rare. The population of the Wa ethnic in Myanmar has difficulty in accessing formal health care. To understand malaria treatment-seeking behaviour and household-affecting factors of the Wa people, a cross-sectional study carried out in Shan Special Region II, Myanmar. Methods The two methods, questionnaire-based household surveys to household heads and in-depth interviews to key informants, were carried out independently. The proportion of treatment-seeking patterns was calculated. Logistic regression was used to determine affecting factors of treatment-seeking. Qualitative data were analysed by using Text Analysis Markup System. Results Overall, 87.5% of the febrile population sought treatment, but only 32.0% did so within 24 hours. The proportion accessing the retail sector (79.6%) was statistically significant higher (P<0.0001) than accessing the public sector (10.6%). Multivariable logistic regression analysis identified family income, distances from a health facility, family decision and patient characteristics being independently associated with delayed malaria treatment. Conclusion Malaria treatment-seeking behaviour is not appropriate, and affecting factors include health service systems, social and cultural factors in Wa State of Myanmar. PMID:23237576

Using shadow page cache to improve isolated drivers performance.

PubMed

Zheng, Hao; Dong, Xiaoshe; Wang, Endong; Chen, Baoke; Zhu, Zhengdong; Liu, Chengzhe

2015-01-01

With the advantage of the reusability property of the virtualization technology, users can reuse various types and versions of existing operating systems and drivers in a virtual machine, so as to customize their application environment. In order to prevent users' virtualization environments being impacted by driver faults in virtual machine, Chariot examines the correctness of driver's write operations by the method of combining a driver's write operation capture and a driver's private access control table. However, this method needs to keep the write permission of shadow page table as read-only, so as to capture isolated driver's write operations through page faults, which adversely affect the performance of the driver. Based on delaying setting frequently used shadow pages' write permissions to read-only, this paper proposes an algorithm using shadow page cache to improve the performance of isolated drivers and carefully study the relationship between the performance of drivers and the size of shadow page cache. Experimental results show that, through the shadow page cache, the performance of isolated drivers can be greatly improved without impacting Chariot's reliability too much.

Using Shadow Page Cache to Improve Isolated Drivers Performance

PubMed Central

Dong, Xiaoshe; Wang, Endong; Chen, Baoke; Zhu, Zhengdong; Liu, Chengzhe

2015-01-01

With the advantage of the reusability property of the virtualization technology, users can reuse various types and versions of existing operating systems and drivers in a virtual machine, so as to customize their application environment. In order to prevent users' virtualization environments being impacted by driver faults in virtual machine, Chariot examines the correctness of driver's write operations by the method of combining a driver's write operation capture and a driver's private access control table. However, this method needs to keep the write permission of shadow page table as read-only, so as to capture isolated driver's write operations through page faults, which adversely affect the performance of the driver. Based on delaying setting frequently used shadow pages' write permissions to read-only, this paper proposes an algorithm using shadow page cache to improve the performance of isolated drivers and carefully study the relationship between the performance of drivers and the size of shadow page cache. Experimental results show that, through the shadow page cache, the performance of isolated drivers can be greatly improved without impacting Chariot's reliability too much. PMID:25815373

Group-Level EEG-Processing Pipeline for Flexible Single Trial-Based Analyses Including Linear Mixed Models.

PubMed

Frömer, Romy; Maier, Martin; Abdel Rahman, Rasha

2018-01-01

Here we present an application of an EEG processing pipeline customizing EEGLAB and FieldTrip functions, specifically optimized to flexibly analyze EEG data based on single trial information. The key component of our approach is to create a comprehensive 3-D EEG data structure including all trials and all participants maintaining the original order of recording. This allows straightforward access to subsets of the data based on any information available in a behavioral data structure matched with the EEG data (experimental conditions, but also performance indicators, such accuracy or RTs of single trials). In the present study we exploit this structure to compute linear mixed models (LMMs, using lmer in R) including random intercepts and slopes for items. This information can easily be read out from the matched behavioral data, whereas it might not be accessible in traditional ERP approaches without substantial effort. We further provide easily adaptable scripts for performing cluster-based permutation tests (as implemented in FieldTrip), as a more robust alternative to traditional omnibus ANOVAs. Our approach is particularly advantageous for data with parametric within-subject covariates (e.g., performance) and/or multiple complex stimuli (such as words, faces or objects) that vary in features affecting cognitive processes and ERPs (such as word frequency, salience or familiarity), which are sometimes hard to control experimentally or might themselves constitute variables of interest. The present dataset was recorded from 40 participants who performed a visual search task on previously unfamiliar objects, presented either visually intact or blurred. MATLAB as well as R scripts are provided that can be adapted to different datasets.

The importance of aerodynamics for prosthetic limb design used by competitive cyclists with an amputation: An introduction.

PubMed

Dyer, Bryce

2015-06-01

This study introduces the importance of the aerodynamics to prosthetic limb design for athletes with either a lower-limb or upper-limb amputation. The study comprises two elements: 1) An initial experiment investigating the stability of outdoor velodrome-based field tests, and 2) An experiment evaluating the application of outdoor velodrome aerodynamic field tests to detect small-scale changes in aerodynamic drag respective of prosthetic limb componentry changes. An outdoor field-testing method is used to detect small and repeatable changes in the aerodynamic drag of an able-bodied cyclist. These changes were made at levels typical of alterations in prosthetic componentry. The field-based test method of assessment is used at a smaller level of resolution than previously reported. With a carefully applied protocol, the field test method proved to be statistically stable. The results of the field test experiments demonstrate a noticeable change in overall athlete performance. Aerodynamic refinement of artificial limbs is worthwhile for athletes looking to maximise their competitive performance. A field-testing method illustrates the importance of the aerodynamic optimisation of prosthetic limb components. The field-testing protocol undertaken in this study gives an accessible and affordable means of doing so by prosthetists and sports engineers. Using simple and accessible field-testing methods, this exploratory experiment demonstrates how small changes to riders' equipment, consummate of the scale of a small change in prosthetics componentry, can affect the performance of an athlete. Prosthetists should consider such opportunities for performance enhancement when possible. © The International Society for Prosthetics and Orthotics 2014.

Performance study on the effect of filter curve in CWDM System for the access network

NASA Astrophysics Data System (ADS)

Ali, N.; Rahman, N. A.; Hambali, N. A. M. Ahmad; Rashidi, C. B. M.

2017-11-01

This paper presents the study on the effect of filter variation on the coarse wavelength division multiplexing (CWDM) system. The filter curve will affect the performance of the CWDM system due to changes of received power lever and isolation of the signal. The significant impact on the received power level and isolation can be found when the required signal is isolated from unwanted signal by the steep curve of filter. As a result, BER of 1.0x 10-12 was obtained corresponding to receive power level of -24.27 dBm with isolation of 23.22 dB. When the wavelength spacing is reduced to 1nm, the isolation is only 11.30 dB and BER increased to 5.49x10-7 with a received power of -15.39 dBm.

Calibrating and training of neutron based NSA techniques with less SNM standards

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

Geist, William H; Swinhoe, Martyn T; Bracken, David S

2010-01-01

Accessing special nuclear material (SNM) standards for the calibration of and training on nondestructive assay (NDA) instruments has become increasingly difficult in light of enhanced safeguards and security regulations. Limited or nonexistent access to SNM has affected neutron based NDA techniques more than gamma ray techniques because the effects of multiplication require a range of masses to accurately measure the detector response. Neutron based NDA techniques can also be greatly affected by the matrix and impurity characteristics of the item. The safeguards community has been developing techniques for calibrating instrumentation and training personnel with dwindling numbers of SNM standards. Montemore » Carlo methods have become increasingly important for design and calibration of instrumentation. Monte Carlo techniques have the ability to accurately predict the detector response for passive techniques. The Monte Carlo results are usually benchmarked to neutron source measurements such as californium. For active techniques, the modeling becomes more difficult because of the interaction of the interrogation source with the detector and nuclear material; and the results cannot be simply benchmarked with neutron sources. A Monte Carlo calculated calibration curve for a training course in Indonesia of material test reactor (MTR) fuel elements assayed with an active well coincidence counter (AWCC) will be presented as an example. Performing training activities with reduced amounts of nuclear material makes it difficult to demonstrate how the multiplication and matrix properties of the item affects the detector response and limits the knowledge that can be obtained with hands-on training. A neutron pulse simulator (NPS) has been developed that can produce a pulse stream representative of a real pulse stream output from a detector measuring SNM. The NPS has been used by the International Atomic Energy Agency (IAEA) for detector testing and training applications at the Agency due to the lack of appropriate SNM standards. This paper will address the effect of reduced access to SNM for calibration and training of neutron NDA applications along with the advantages and disadvantages of some solutions that do not use standards, such as the Monte Carlo techniques and the NPS.« less

Agriculture and malnutrition in India.

PubMed

Gulati, Ashok; Ganesh-Kumar, A; Shreedhar, Ganga; Nandakumar, T

2012-03-01

Despite the high and relatively stable overall growth of the economy, India's agriculture sector is underperforming and a vast section of the population remains undernourished. To explore the possible interplay between agricultural performance and malnutrition indicators to see whether states that perform better in agriculture record better nutritional outcomes. Correlation analysis and a simple linear regression model were used to study the relationship between agricultural performance and malnutrition among children under 5 years of age and adults from 15 to 49 years of age at 20 major states using data from the National Family Health Survey-3 for the year 2005/06 and the national accounts. Indicators of the level of agricultural performance or income have a strong and significant negative relationship with indices of undernutrition among adults and children, a result suggesting that improvement of agricultural productivity can be a powerful tool to reduce undernutrition across the vast majority of the population. In addition to agriculture, access to sanitation facilities and women's literacy were also found to be strong factors affecting malnutrition. Access to healthcare for women and child-care practices, in particular breastfeeding within 1 hour after birth, are other important determinants of malnutrition among adults and children. Malnutrition is a multidimensional problem that requires multisectoral interventions. The findings show that improving agricultural performance can have a positive impact on nutritional outcomes. However, improvements in agriculture alone cannot be effective in combating malnutrition if several other mediating factors are not in place. Interventions to improve education, health, sanitation and household infrastructure, and care and feeding practices are critical. Innovative strategies that integrate agriculture and nutrition programs stand a better chance of combating the malnutrition problem.

Effects of urbanization on direct and indirect interactions in a tri-trophic system.

PubMed

Tabea, Turrini; Dirk, Sanders; Eva, Knop

2016-04-01

While effects of urbanization on species assemblages are receiving increasing attention, effects on ecological interactions remain largely unexplored. We investigated how urbanization influences the strength of direct and indirect trophic interactions in a tri- trophic system. In a field experiment including five cities and nearby farmed areas, we used potted Vicia faba plants and manipulated the presence of Megoura viciae aphids and that of naturally occurring aphid predators. When predators could access aphids, they reduced their abundance less in the urban than in the agricultural ecosystem. Compared to aphid abundance on plants without predator access, abundance on plants with predator access was 2.58 times lower in urban and 5.27 times lower in agricultural areas. This indicates that urbanization limited top-down control of aphids by predators. In both ecosystems, plant biomass was negatively affected by herbivores and positively affected by predators, but the positive indirect predator effect was weaker in cities. Compared to aphid-infested plants without predator access, plants with predator access were 1.89 times heavier in urban and 2.12 times heavier in agricultural areas. Surprisingly, differences between ecosystems regarding the indirect predator effect on plants were not explained by the differentially strong herbivore suppression. Instead, the urban environment limited plant biomass per se, thereby mitigating the scope of a positive predator effect. Our results show that urbanization can influence direct and indirect trophic interactions through effects on biotic top-down forces and on plant growth. In order to understand how urbanization affects biodiversity and ecosystem functioning, it is fundamental to not only consider species assemblages, but also species interactions.

77 FR 18797 - Notice of Submission for OMB Review; Office of Postsecondary Education; Child Care Access Means...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-28

...; Child Care Access Means Parents in School Program Annual Performance Report Summary: This is a revision of the Child Care Access Means Parent In School Program (CCAMPIS) Annual Performance Report (APR... information technology. Please note that written comments received in response to this notice will be...

Community College Selective Enrollment and the Challenge to Open Access

ERIC Educational Resources Information Center

Morris, David Brian

2012-01-01

The open access mission is central to the community college role and mission in higher education. Although initially implemented by four-year colleges and universities, adoption of formal enrollment management initiatives in community colleges is on the increase. Admission, matriculation, retention, and persistence are affected by enrollment…

Community College Retention and Access Issues: A View from the Field

ERIC Educational Resources Information Center

Rankin, Kristie R.; Katsinas, Stephen G.; Hardy, David E.

2011-01-01

Drawing on Rankin's 2008 study and literature on retention and community colleges, this study presents perceptions of community college Chief Executive Officers (CEOs) and Chief Academic Officers (CAOs) in relation to issues affecting retention and access. Childcare, transportation, and funding concerns are examined. (Contains 2 tables.)

Affected Decisions: Aversive Disablism, Accessible Information and Technologies in an Institution of Higher Education

ERIC Educational Resources Information Center

Flanagin, Jimmie

2013-01-01

Students with print disabilities continue to face inaccessible information and information technologies in higher education institutions despite federal and state legislation and local policies. Although most individuals responsible for making their course materials accessible often express support for the egalitarian principles of such policies,…

75 FR 33683 - Indoor Tanning Services; Cosmetic Services; Excise Taxes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-15

..., pedicures and other cosmetic or spa treatments; and access to sport or exercise facilities) in addition to..., and tanning lotions; manicures, pedicures and other cosmetic or spa treatments; and access to sport or...); (ii) Sleep disorders; (iii) Seasonal affective disorder or other psychiatric disorder; (iv) Neonatal...

75 FR 37971 - Providing Stability and Security for Medicare Reimbursements

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-30

... disruption to, or administrative burden on, Medicare physicians and other affected providers and to minimize any disruption in the ability of Medicare beneficiaries to access necessary services: (a) Direct the... beneficiaries from any disruption to their access to services that may be occasioned by the reprocessing of...

E-Democracy and E-Government: How Will These Affect Libraries?

ERIC Educational Resources Information Center

Pare, Richard

In the late 1980s, when few Canadian citizens had Internet access, federal departments and agencies in Canada were already preparing for the future by putting information and documentation online. This paper outlines several government-sponsored programs--SchoolNet, the Canadian Investment Fund, Community Access Program, Canada Foundation for…

76 FR 22947 - Truth in Lending

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-25

...-end (not home-secured) credit, including amendments that affected all of the five major types of... can be used to access an open-end line of credit to purchase goods or services, it would be... online purchases that function like a traditional credit card account but can only be accessed using an...

Developmental Education: A Twenty-First Century Social and Economic Imperative.

ERIC Educational Resources Information Center

McCabe, Robert H., Ed.; Day, Philip R., Jr., Ed.

This monograph addresses developmental education in the 21st Century, identifying the major issues and providing examples of successful developmental programs. The first chapter, "Access and the New America of the Twenty-First Century," emphasizes several changes in American society that have affected access to education and…

Duration of extinction trials as a determinant of instrumental extinction in terrestrial toads (Rhinella arenarum).

PubMed

Puddington, Martín M; Papini, Mauricio R; Muzio, Rubén N

2018-01-01

Instrumental learning guides behavior toward resources. When such resources are no longer available, approach to previously reinforced locations is reduced, a process called extinction. The present experiments are concerned with factors affecting the extinction of acquired behaviors in toads. In previous experiments, total reward magnitude in acquisition and duration of extinction trials were confounded. The present experiments were designed to test the effects of these factors in factorial designs. Experiment 1 varied reward magnitude (900, 300, or 100 s of water access per trial) and amount of acquisition training (5 or 15 daily trials). With total amount of water access equated in acquisition, extinction with large rewards was faster (longer latencies in 900/5 than 300/15), but with total amount of training equated, extinction with small rewards was faster (longer latencies in 100/15 than 300/15). Experiment 2 varied reward magnitude (1200 or 120 s of water access per trial) while holding constant the number of acquisition trials (5 daily trials) and the duration of extinction trials (300 s). Extinction performance was lower with small, rather than large reward magnitude (longer latencies in 120/300 than in 1200/300). Thus, instrumental extinction depends upon the amount of time toads are exposed to the empty goal compartment during extinction trials.

Geographic access to high capability severe acute respiratory failure centers in the United States.

PubMed

Wallace, David J; Angus, Derek C; Seymour, Christopher W; Yealy, Donald M; Carr, Brendan G; Kurland, Kristen; Boujoukos, Arthur; Kahn, Jeremy M

2014-01-01

Optimal care of adults with severe acute respiratory failure requires specific resources and expertise. We sought to measure geographic access to these centers in the United States. Cross-sectional analysis of geographic access to high capability severe acute respiratory failure centers in the United States. We defined high capability centers using two criteria: (1) provision of adult extracorporeal membrane oxygenation (ECMO), based on either 2008-2013 Extracorporeal Life Support Organization reporting or provision of ECMO to 2010 Medicare beneficiaries; or (2) high annual hospital mechanical ventilation volume, based 2010 Medicare claims. Nonfederal acute care hospitals in the United States. We defined geographic access as the percentage of the state, region and national population with either direct or hospital-transferred access within one or two hours by air or ground transport. Of 4,822 acute care hospitals, 148 hospitals met our ECMO criteria and 447 hospitals met our mechanical ventilation criteria. Geographic access varied substantially across states and regions in the United States, depending on center criteria. Without interhospital transfer, an estimated 58.5% of the national adult population had geographic access to hospitals performing ECMO and 79.0% had geographic access to hospitals performing a high annual volume of mechanical ventilation. With interhospital transfer and under ideal circumstances, an estimated 96.4% of the national adult population had geographic access to hospitals performing ECMO and 98.6% had geographic access to hospitals performing a high annual volume of mechanical ventilation. However, this degree of geographic access required substantial interhospital transfer of patients, including up to two hours by air. Geographic access to high capability severe acute respiratory failure centers varies widely across states and regions in the United States. Adequate referral center access in the case of disasters and pandemics will depend highly on local and regional care coordination across political boundaries.

What Remains on Your Mind After You Are Done?: Flexible Regulation of Knowledge Accessibility

PubMed Central

Hedberg, Per H.; Higgins, E. Tory

2011-01-01

The accessibility of stored knowledge has been found to decline over time after activation without further stimulation. A special case is goal pursuit; goal-related knowledge remains accessible until goal completion, and then its accessibility declines rapidly. We hypothesized that after goal completion the decline in accessibility of goal-related knowledge would be especially rapid for strong promotion-focused individuals because their motivation to eagerly advance beyond the status quo would make accessibility of this knowledge an irrelevant detriment. We hypothesized an opposite effect for strongly prevention-predominant individuals because their motivation to vigilantly maintain a satisfactory state would make accessibility of this knowledge continually relevant. The results of two studies supported both these predicted moderators of accessibility change. Indeed, we found that for strongly prevention-predominant participants, knowledge accessibility actually increased over time after goal completion. We discuss how even basic cognitive mechanisms, like changes in accessibility, can be affected by general motivational concerns. PMID:21765541

Automating expert role to determine design concept in Kansei Engineering

NASA Astrophysics Data System (ADS)

Lokman, Anitawati Mohd; Haron, Mohammad Bakri Che; Abidin, Siti Zaleha Zainal; Khalid, Noor Elaiza Abd

2016-02-01

Affect has become imperative in product quality. In affective design field, Kansei Engineering (KE) has been recognized as a technology that enables discovery of consumer's emotion and formulation of guide to design products that win consumers in the competitive market. Albeit powerful technology, there is no rule of thumb in its analysis and interpretation process. KE expertise is required to determine sets of related Kansei and the significant concept of emotion. Many research endeavors become handicapped with the limited number of available and accessible KE experts. This work is performed to simulate the role of experts with the use of Natphoric algorithm thus providing sound solution to the complexity and flexibility in KE. The algorithm is designed to learn the process by implementing training datasets taken from previous KE research works. A framework for automated KE is then designed to realize the development of automated KE system. A comparative analysis is performed to determine feasibility of the developed prototype to automate the process. The result shows that the significant Kansei is determined by manual KE implementation and the automated process is highly similar. KE research advocates will benefit this system to automatically determine significant design concepts.

[Socioeconomic inequality and health in Mexico].

PubMed

Ortiz-Hernández, Luis; Pérez-Salgado, Diana; Tamez-González, Silvia

2015-01-01

To establish the relationship between socioeconomic inequality and health problems amongst Mexican population reviewing studies with national or regional representation. A literature search was performed at national and international databases using the following keywords: health, disease, mental disorders, nutrition, food, social class, social status, unemployment, employment, occupation, income, wage, poverty and socioeconomic status. Reports of national or regional surveys conducted from the nineties were included. Mostly, diseases events were more common among people from low socioeconomic status: anencephaly, viral infections, anemia, transit accidents by run over, metabolic syndrome, hypertension, affective disorder, anxiety and substances abuse; some malignancies, difficulties to perform activities of daily living, and poor perceived health status. On the opposite, as it goes down in the social scale, are less frequent some protective factors (e.g. fruits or vegetables intake and physical activity) and there is less access to medical aid and preventive interventions (e.g. condom use or diagnosis and treatment for HIV infection, hypertension or obesity). Socioeconomic status affects all living conditions; therefore, its effects are not confined to certain diseases, but a general precarious state of health. The conceptual and public policy implications related with social inequalities in health are discussed.

Cigarette access and pupil smoking rates: a circular relationship?

PubMed

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

2004-12-01

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

Predicting subcontractor performance using web-based Evolutionary Fuzzy Neural Networks.

PubMed

Ko, Chien-Ho

2013-01-01

Subcontractor performance directly affects project success. The use of inappropriate subcontractors may result in individual work delays, cost overruns, and quality defects throughout the project. This study develops web-based Evolutionary Fuzzy Neural Networks (EFNNs) to predict subcontractor performance. EFNNs are a fusion of Genetic Algorithms (GAs), Fuzzy Logic (FL), and Neural Networks (NNs). FL is primarily used to mimic high level of decision-making processes and deal with uncertainty in the construction industry. NNs are used to identify the association between previous performance and future status when predicting subcontractor performance. GAs are optimizing parameters required in FL and NNs. EFNNs encode FL and NNs using floating numbers to shorten the length of a string. A multi-cut-point crossover operator is used to explore the parameter and retain solution legality. Finally, the applicability of the proposed EFNNs is validated using real subcontractors. The EFNNs are evolved using 22 historical patterns and tested using 12 unseen cases. Application results show that the proposed EFNNs surpass FL and NNs in predicting subcontractor performance. The proposed approach improves prediction accuracy and reduces the effort required to predict subcontractor performance, providing field operators with web-based remote access to a reliable, scientific prediction mechanism.

Predicting Subcontractor Performance Using Web-Based Evolutionary Fuzzy Neural Networks

PubMed Central

2013-01-01

Subcontractor performance directly affects project success. The use of inappropriate subcontractors may result in individual work delays, cost overruns, and quality defects throughout the project. This study develops web-based Evolutionary Fuzzy Neural Networks (EFNNs) to predict subcontractor performance. EFNNs are a fusion of Genetic Algorithms (GAs), Fuzzy Logic (FL), and Neural Networks (NNs). FL is primarily used to mimic high level of decision-making processes and deal with uncertainty in the construction industry. NNs are used to identify the association between previous performance and future status when predicting subcontractor performance. GAs are optimizing parameters required in FL and NNs. EFNNs encode FL and NNs using floating numbers to shorten the length of a string. A multi-cut-point crossover operator is used to explore the parameter and retain solution legality. Finally, the applicability of the proposed EFNNs is validated using real subcontractors. The EFNNs are evolved using 22 historical patterns and tested using 12 unseen cases. Application results show that the proposed EFNNs surpass FL and NNs in predicting subcontractor performance. The proposed approach improves prediction accuracy and reduces the effort required to predict subcontractor performance, providing field operators with web-based remote access to a reliable, scientific prediction mechanism. PMID:23864830

Perspective: A new model of leadership performance in health care.

PubMed

Souba, Wiley

2011-10-01

Current leadership models are based largely on concepts and explanations, which provide limited access to the being and actions of an effective leader in health care. Rather than teaching leadership from a theoretical vantage point, the ontological perspective teaches leadership as it is lived and experienced. When one exercises leadership "as lived," concurrently informed by theories, one performs at one's best. A distinctive feature of the ontological approach resides in its capacity to disclose human ways of being and acting that limit our freedom to lead effectively as our natural self-expression. Ontological leadership maintains that our worldviews and mental maps affect the way we lead and are shaped by and accessible through language--hence, to lead more effectively, mastery of a new conversational domain of leadership is required. This emerging model of leadership performance reveals that (1) our actions as leaders are correlated with the way in which the leadership situation we are dealing with occurs for us, and (2) this "occurring" is shaped by the context we bring to that situation. Master leaders use language to recontextualize their leadership challenges so that their naturally correlated ways of being and acting can emerge, resulting in effective leadership. When leaders linguistically unveil limiting contexts, they are freed up to create new contexts that shift the way leadership challenges occur for them. This provides leaders--physicians, scientists, educators, executives--with new opportunity sets (previously unavailable) for exercising exemplary leadership. The ontological approach to leadership offers a powerful framework for tackling health care's toughest challenges.

Healthcare resource allocation decisions affecting uninsured services

PubMed Central

Harrison, Krista Lyn; Taylor, Holly A.

2017-01-01

Purpose Using the example of community access programs (CAPs), the purpose of this paper is to describe resource allocation and policy decisions related to providing health services for the uninsured in the USA and the organizational values affecting these decisions. Design/methodology/approach The study used comparative case study methodology at two geographically diverse sites. Researchers collected data from program documents, meeting observations, and interviews with program stakeholders. Findings Five resource allocation or policy decisions relevant to providing healthcare services were described at each site across three categories: designing the health plan, reacting to funding changes, and revising policies. Organizational values of access to care and stewardship most frequently affected resource allocation and policy decisions, while economic and political pressures affect the relative prioritization of values. Research limitations/implications Small sample size, the potential for social desirability or recall bias, and the exclusion of provider, member or community perspectives beyond those represented among participating board members. Practical implications Program directors or researchers can use this study to assess the extent to which resource allocation and policy decisions align with organizational values and mission statements. Social implications The description of how healthcare decisions are actually made can be matched with literature that describes how healthcare resource decisions ought to be made, in order to provide a normative grounding for future decisions. Originality/value This study addresses a gap in literature regarding how CAPs actually make resource allocation decisions that affect access to healthcare services. PMID:27934550

High-Performance Computing User Facility | Computational Science | NREL

Science.gov Websites

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

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

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

Chen, Yong; Lu, Yin; Amritkar, Prathamesh

2014-09-10

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

Age-Related Differences in Lexical Access Relate to Speech Recognition in Noise

PubMed Central

Carroll, Rebecca; Warzybok, Anna; Kollmeier, Birger; Ruigendijk, Esther

2016-01-01

Vocabulary size has been suggested as a useful measure of “verbal abilities” that correlates with speech recognition scores. Knowing more words is linked to better speech recognition. How vocabulary knowledge translates to general speech recognition mechanisms, how these mechanisms relate to offline speech recognition scores, and how they may be modulated by acoustical distortion or age, is less clear. Age-related differences in linguistic measures may predict age-related differences in speech recognition in noise performance. We hypothesized that speech recognition performance can be predicted by the efficiency of lexical access, which refers to the speed with which a given word can be searched and accessed relative to the size of the mental lexicon. We tested speech recognition in a clinical German sentence-in-noise test at two signal-to-noise ratios (SNRs), in 22 younger (18–35 years) and 22 older (60–78 years) listeners with normal hearing. We also assessed receptive vocabulary, lexical access time, verbal working memory, and hearing thresholds as measures of individual differences. Age group, SNR level, vocabulary size, and lexical access time were significant predictors of individual speech recognition scores, but working memory and hearing threshold were not. Interestingly, longer accessing times were correlated with better speech recognition scores. Hierarchical regression models for each subset of age group and SNR showed very similar patterns: the combination of vocabulary size and lexical access time contributed most to speech recognition performance; only for the younger group at the better SNR (yielding about 85% correct speech recognition) did vocabulary size alone predict performance. Our data suggest that successful speech recognition in noise is mainly modulated by the efficiency of lexical access. This suggests that older adults’ poorer performance in the speech recognition task may have arisen from reduced efficiency in lexical access; with an average vocabulary size similar to that of younger adults, they were still slower in lexical access. PMID:27458400

Age-Related Differences in Lexical Access Relate to Speech Recognition in Noise.

PubMed

Carroll, Rebecca; Warzybok, Anna; Kollmeier, Birger; Ruigendijk, Esther

2016-01-01

Vocabulary size has been suggested as a useful measure of "verbal abilities" that correlates with speech recognition scores. Knowing more words is linked to better speech recognition. How vocabulary knowledge translates to general speech recognition mechanisms, how these mechanisms relate to offline speech recognition scores, and how they may be modulated by acoustical distortion or age, is less clear. Age-related differences in linguistic measures may predict age-related differences in speech recognition in noise performance. We hypothesized that speech recognition performance can be predicted by the efficiency of lexical access, which refers to the speed with which a given word can be searched and accessed relative to the size of the mental lexicon. We tested speech recognition in a clinical German sentence-in-noise test at two signal-to-noise ratios (SNRs), in 22 younger (18-35 years) and 22 older (60-78 years) listeners with normal hearing. We also assessed receptive vocabulary, lexical access time, verbal working memory, and hearing thresholds as measures of individual differences. Age group, SNR level, vocabulary size, and lexical access time were significant predictors of individual speech recognition scores, but working memory and hearing threshold were not. Interestingly, longer accessing times were correlated with better speech recognition scores. Hierarchical regression models for each subset of age group and SNR showed very similar patterns: the combination of vocabulary size and lexical access time contributed most to speech recognition performance; only for the younger group at the better SNR (yielding about 85% correct speech recognition) did vocabulary size alone predict performance. Our data suggest that successful speech recognition in noise is mainly modulated by the efficiency of lexical access. This suggests that older adults' poorer performance in the speech recognition task may have arisen from reduced efficiency in lexical access; with an average vocabulary size similar to that of younger adults, they were still slower in lexical access.

Effect of survey design and catch rate estimation on total catch estimates in Chinook salmon fisheries

USGS Publications Warehouse

McCormick, Joshua L.; Quist, Michael C.; Schill, Daniel J.

2012-01-01

Roving–roving and roving–access creel surveys are the primary techniques used to obtain information on harvest of Chinook salmon Oncorhynchus tshawytscha in Idaho sport fisheries. Once interviews are conducted using roving–roving or roving–access survey designs, mean catch rate can be estimated with the ratio-of-means (ROM) estimator, the mean-of-ratios (MOR) estimator, or the MOR estimator with exclusion of short-duration (≤0.5 h) trips. Our objective was to examine the relative bias and precision of total catch estimates obtained from use of the two survey designs and three catch rate estimators for Idaho Chinook salmon fisheries. Information on angling populations was obtained by direct visual observation of portions of Chinook salmon fisheries in three Idaho river systems over an 18-d period. Based on data from the angling populations, Monte Carlo simulations were performed to evaluate the properties of the catch rate estimators and survey designs. Among the three estimators, the ROM estimator provided the most accurate and precise estimates of mean catch rate and total catch for both roving–roving and roving–access surveys. On average, the root mean square error of simulated total catch estimates was 1.42 times greater and relative bias was 160.13 times greater for roving–roving surveys than for roving–access surveys. Length-of-stay bias and nonstationary catch rates in roving–roving surveys both appeared to affect catch rate and total catch estimates. Our results suggest that use of the ROM estimator in combination with an estimate of angler effort provided the least biased and most precise estimates of total catch for both survey designs. However, roving–access surveys were more accurate than roving–roving surveys for Chinook salmon fisheries in Idaho.

Transradial access for visceral endovascular interventions in morbidly obese patients: safety and feasibility.

PubMed

Biederman, Derek M; Marinelli, Brett; O'Connor, Paul J; Titano, Joseph J; Patel, Rahul S; Kim, Edward; Tabori, Nora E; Nowakowski, Francis S; Lookstein, Robert A; Fischman, Aaron M

2016-05-07

Transradial access (TRA) has been shown to lower morbidity and bleeding complications compared to transfemoral access in percutaneous coronary interventions. Morbid obesity, commonly defined as a body mass index (BMI) ≥40 kg/m2, has been shown to be a risk factor for access site complications irrespective of access site. This study evaluates the safety and feasibility of performing visceral endovascular interventions in morbidly obese patients via TRA. Procedural details, technical success, and 30-day major and minor access site, bleeding, and neurological adverse events were prospectively recorded in a database of 1057 procedures performed via the radial artery. From this database we identified 22 visceral interventions performed with TRA in 17 morbidly obese patients (age: 53 ± 11 years, female: 71%) with a median BMI of 42.7 kg/m2. Interventions included radio-embolization (n = 7, 31.8%), chemo-embolization (n = 6, 27.3%), uterine fibroid embolization (n = 4, 18.2%), renal embolization (n = 2, 9.1%), hepatic embolization (n = 1, 4.5%), lumbar artery embolization (n = 1, 4.5%), and renal angioplasty (n = 1, 4.5%). The technical success was 100%. There were no major or minor adverse access site, bleeding, or neurological complications at 30 days. This study suggests visceral endovascular interventions performed in morbidly obese patients are safe and feasible.

Exploring the interaction of activity limitations with context, systems, community and personal factors in accessing public health care services: A presentation of South African case studies.

PubMed

Mji, Gubela; Braathen, Stine H; Vergunst, Richard; Scheffler, Elsje; Kritzinger, Janis; Mannan, Hasheem; Schneider, Marguerite; Swartz, Leslie; Visagie, Surona

2017-02-08

There are many factors that influence access to public health services, such as the context people live in, the existing health services, and personal, cultural and community factors. People with disabilities (activity limitations), through their experience of health services, may offer a particular understanding of the performance of the health services, thus exposing health system limitations more clearly than perhaps any other health service user. This article explores how activity limitations interact with factors related to context, systems, community and personal factors in accessing public health care services in South Africa. We present four case studies of people with disabilities from four low-resource diverse contexts in South Africa (rural, semi-rural, farming community and peri-urban) to highlight challenges of access to health services experienced by people with activity limitations in a variety of contexts. One case study of a person with disabilities was chosen from each study setting to build evidence using an intensive qualitative case study methodology to elucidate individual and household experiences of challenges experienced by people with activity limitations when attempting to access public health services. In-depth interviews were used to collect data, using an interview guide. The analysis was conducted in the form of a thematic analysis using the interview topics as a starting point. First, these four case studies demonstrate that equitable access to health services for people with activity limitations is influenced by a complex interplay of a variety of factors for a single individual in a particular context. Secondly, that while problems with access to public health services are experienced by everyone, people with activity limitations are affected in particular ways making them particularly vulnerable in using public health services. The revitalisation of primary health care and the introduction of national health insurance by the Health Department of South Africa open a window of opportunity for policy makers and policy implementers to revisit and address the areas of access to public health services for people with activity limitations.

Open Access Journal Policies: A Systematic Analysis of Radiology Journals.

PubMed

Narayan, Anand; Lobner, Katie; Fritz, Jan

2018-02-01

The open access movement has pushed for greater access to scientific knowledge by expanding access to scientific journal articles. There is limited information about the extent to which open access policies have been adopted by radiology journals. We performed a systematic analysis to ascertain the proportion of radiology journals with open access options. A search was performed with the assistance of a clinical informationist. Full and mixed English-language diagnostic and interventional radiology Web of Science journals (impact factors > 1.0) were included. Nuclear medicine, radiation oncology, physics, and solicitation-only journals were excluded. Primary outcome was open access option (yes or no) with additional outcomes including presence or absence of embargo, complete or partial copyright transfer, publication fees, and self-archiving policies. Secondary outcomes included journal citations, journal impact factors, immediacy, Eigenfactor, and article influence scores. Independent double readings were performed with differences resolved by consensus, supplemented by contacting editorial staff at each journal. In all, 125 journals were identified; review yielded 49 journals (39%, mean impact factor of 2.61). Thirty-six of the journals had open access options (73.4%), and four journals were exclusively open access (8.2%). Twelve-month embargoes were most commonly cited (90.6%) with 28.6% of journals stating that they did not require a complete transfer of copyright. Prices for open access options ranged from $750 to $4,000 (median $3,000). No statistically significant differences were found in journal impact measures comparing journals with open access options to journals without open access options. Diagnostic and interventional radiology journals have widely adopted open access options with a few radiology journals being exclusively open access. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Evaluation of analytical performance of a new high-sensitivity immunoassay for cardiac troponin I.

PubMed

Masotti, Silvia; Prontera, Concetta; Musetti, Veronica; Storti, Simona; Ndreu, Rudina; Zucchelli, Gian Carlo; Passino, Claudio; Clerico, Aldo

2018-02-23

The study aim was to evaluate and compare the analytical performance of the new chemiluminescent immunoassay for cardiac troponin I (cTnI), called Access hs-TnI using DxI platform, with those of Access AccuTnI+3 method, and high-sensitivity (hs) cTnI method for ARCHITECT platform. The limits of blank (LoB), detection (LoD) and quantitation (LoQ) at 10% and 20% CV were evaluated according to international standardized protocols. For the evaluation of analytical performance and comparison of cTnI results, both heparinized plasma samples, collected from healthy subjects and patients with cardiac diseases, and quality control samples distributed in external quality assessment programs were used. LoB, LoD and LoQ at 20% and 10% CV values of the Access hs-cTnI method were 0.6, 1.3, 2.1 and 5.3 ng/L, respectively. Access hs-cTnI method showed analytical performance significantly better than that of Access AccuTnI+3 method and similar results to those of hs ARCHITECT cTnI method. Moreover, the cTnI concentrations measured with Access hs-cTnI method showed close linear regressions with both Access AccuTnI+3 and ARCHITECT hs-cTnI methods, although there were systematic differences between these methods. There was no difference between cTnI values measured by Access hs-cTnI in heparinized plasma and serum samples, whereas there was a significant difference between cTnI values, respectively measured in EDTA and heparin plasma samples. Access hs-cTnI has analytical sensitivity parameters significantly improved compared to Access AccuTnI+3 method and is similar to those of the high-sensitivity method using ARCHITECT platform.

Memory Inhibition as a Critical Factor Preventing Creative Problem Solving

ERIC Educational Resources Information Center

Gómez-Ariza, Carlos J.; del Prete, Francesco; Prieto del Val, Laura; Valle, Tania; Bajo, M. Teresa; Fernandez, Angel

2017-01-01

The hypothesis that reduced accessibility to relevant information can negatively affect problem solving in a remote associate test (RAT) was tested by using, immediately before the RAT, a retrieval practice procedure to hinder access to target solutions. The results of 2 experiments clearly showed that, relative to baseline, target words that had…

Phonological Phrase Boundaries Constrain Lexical Access II. Infant Data

ERIC Educational Resources Information Center

Gout, A.; Christophe, A.; Morgan, J. L.

2004-01-01

The location of phonological phrase boundaries was shown to affect lexical access by English-learning infants of 10 and 13 months of age. Experiments 1 and 2 used the head-turn preference procedure: infants were familiarized with two bisyllabic words, then presented with sentences that either contained the familiarized words or contained both…

Accessing Science Courses in Rural BC: A Cultural Border-Crossing Metaphor

ERIC Educational Resources Information Center

Nielsen, Wendy S.; Nashon, Samson Madera

2007-01-01

Students in small rural schools in British Columbia face barriers to accessing senior science courses. A case study employing questionnaire and interview methods sought the perspectives of principals, teachers, and students in the affected schools on this issue. Interpretive data analysis revealed the following barriers as key factors that affect…

Access, Equity, and Capacity in Asia-Pacific Higher Education. International and Development Education

ERIC Educational Resources Information Center

Neubauer, Deane, Ed.; Tanaka, Yoshiro, Ed.

2011-01-01

Access, equity and capacity are elements within the higher education environment that interact in complex ways to affect virtually all other aspects of such institutions. This volume examines various features of how these concepts are generated, transformed throughout policy environments, and deployed across the complex differences of higher…

Wages and Unequal Access to Organizational Power: An Empirical Test of Gender Discrimination.

ERIC Educational Resources Information Center

Hultin, Mia; Szulkin, Ryszard

1999-01-01

A study of Swedish workers investigated whether earnings are affected by the gender composition of firms' managerial staff. Gender-differentiated access to organizational power structures proved essential to explaining women's relatively low wages. Women working in male-dominated establishments had lower wages than firms with more women managers.…

The Relationship between Web Accessibility Policy and Practice in Postsecondary Institutions

ERIC Educational Resources Information Center

Whitney, Michael P.

2009-01-01

From computer workstations to the world of the web, statutes and policies have afforded students with disabilities the right to participate in postsecondary education in a non-discriminatory manner. Automatic doors and adjustable tables are a commonplace on campuses and represent prime examples of accessible policy adherence, but what affect do…

Provider Perspectives about Latino Patients: Determinants of Care and Implications for Treatment

ERIC Educational Resources Information Center

Valdez, Carmen R.; Dvorscek, Michael J.; Budge, Stephanie L.; Esmond, Sarah

2011-01-01

Primary care settings are the gateway through which the majority of Latinos access care for their physical and mental health concerns. This study explored the perspectives of primary care providers concerning their Latino patients, in particular issues affecting their patients' access to and utilization of services. Interviews were conducted with…

Exploring Adolescent-Parent Interaction Strategies for Accessing Alcohol at Home

ERIC Educational Resources Information Center

Dresler, Emma; Whitehead, Dean; Weaver, Kelly

2017-01-01

Purpose: The purpose of this paper is to determine the extent to which youth have ready access to alcohol and the extent to which immediate family influence affects consumption. Design/methodology/approach: This qualitative descriptive exploratory study undertook semi-structured peer-group interviews with 20 participants from four New Zealand high…

Domestic Violence Survivors' Access of Career Counseling Services: A Qualitative Investigation

ERIC Educational Resources Information Center

Chronister, Krista M.; Linville, Deanna; Kaag, Kristi Palmer

2008-01-01

The present study was a qualitative investigation of the impact of domestic violence on women's career development and the contextual barriers and supports that affect women's ability to access career counseling services. Our sample included 11 women who completed various stages of a community-based career counseling intervention program. The…

Training Concerns for an Online Public Access Catalog.

ERIC Educational Resources Information Center

Rockman, Ilene F.; Adalian, Paul T., Jr.

This report is designed to raise issues and concerns which will affect the successful implementation of an education and training program once an online public access catalog (OLPAC) has been installed in the Kennedy Library at California Polytechnic State University (Cal Poly), San Luis Obispo. Information presented in the document was gathered…

Where We Stand: Early Childhood Education.

ERIC Educational Resources Information Center

American Federation of Teachers, Washington, DC.

This document details the position of the American Federation of Teachers (AFT) regarding universal access to early childhood education as represented in a resolution of the AFT convention in 2003. The document points out that the lack of access to high-quality preschool programs is a major problem affecting nearly every working family, and as the…

Quantification of the benefits of access management for Kentucky : final report.

DOT National Transportation Integrated Search

2006-07-01

This report describes the benefits quantification performed for the proposed access management plan for Kentucky. This study evaluates the capacity, safety and economic impacts associated with access management programs. The proposed Kentucky access ...

Influence of architecture and material properties on vanadium redox flow battery performance

NASA Astrophysics Data System (ADS)

Houser, Jacob; Clement, Jason; Pezeshki, Alan; Mench, Matthew M.

2016-01-01

This publication reports a design optimization study of all-vanadium redox flow batteries (VRBs), including performance testing, distributed current measurements, and flow visualization. Additionally, a computational flow simulation is used to support the conclusions made from the experimental results. This study demonstrates that optimal flow field design is not simply related to the best architecture, but is instead a more complex interplay between architecture, electrode properties, electrolyte properties, and operating conditions which combine to affect electrode convective transport. For example, an interdigitated design outperforms a serpentine design at low flow rates and with a thin electrode, accessing up to an additional 30% of discharge capacity; but a serpentine design can match the available discharge capacity of the interdigitated design by increasing the flow rate or the electrode thickness due to differing responses between the two flow fields. The results of this study should be useful to design engineers seeking to optimize VRB systems through enhanced performance and reduced pressure drop.

Attitude towards statistics and performance among post-graduate students

NASA Astrophysics Data System (ADS)

Rosli, Mira Khalisa; Maat, Siti Mistima

2017-05-01

For student to master Statistics is a necessity, especially for those post-graduates that are involved in the research field. The purpose of this research was to identify the attitude towards Statistics among the post-graduates and to determine the relationship between the attitude towards Statistics and post-graduates' of Faculty of Education, UKM, Bangi performance. 173 post-graduate students were chosen randomly to participate in the study. These students registered in Research Methodology II course that was introduced by faculty. A survey of attitude toward Statistics using 5-points Likert scale was used for data collection purposes. The instrument consists of four components such as affective, cognitive competency, value and difficulty. The data was analyzed using the SPSS version 22 in producing the descriptive and inferential Statistics output. The result of this research showed that there is a medium and positive relation between attitude towards statistics and students' performance. As a conclusion, educators need to access students' attitude towards the course to accomplish the learning outcomes.

Substrate milling pretreatment as a key parameter for Solid-State Anaerobic Digestion optimization.

PubMed

Motte, J-C; Escudié, R; Hamelin, J; Steyer, J-P; Bernet, N; Delgenes, J-P; Dumas, C

2014-12-01

The effect of milling pretreatment on performances of Solid-State Anaerobic Digestion (SS-AD) of raw lignocellulosic residue is still controverted. Three batch reactors treating different straw particle sizes (milled 0.25 mm, 1 mm and 10 mm) were followed during 62 days (6 sampling dates). Although a fine milling improves substrate accessibility and conversion rate (up to 30% compared to coarse milling), it also increases the risk of media acidification because of rapid and high acids production during fermentation of the substrate soluble fraction. Meanwhile, a gradual adaptation of microbial communities, were observed according to both reaction progress and methanogenic performances. The study concluded that particle size reduction affected strongly the performances of the reaction due to an increase of substrate bioaccessibility. An optimization of SS-AD processes thanks to particle size reduction could therefore be applied at farm or industrial scale only if a specific management of the soluble compounds is established. Copyright © 2014 Elsevier Ltd. All rights reserved.

Interlibrary loan in primary access libraries: challenging the traditional view.

PubMed

Dudden, R F; Coldren, S; Condon, J E; Katsh, S; Reiter, C M; Roth, P L

2000-10-01

Primary access libraries serve as the foundation of the National Network of Libraries of Medicine (NN/LM) interlibrary loan (ILL) hierarchy, yet few published reports directly address the important role these libraries play in the ILL system. This may reflect the traditional view that small, primary access libraries are largely users of ILL, rather than important contributors to the effectiveness and efficiency of the national ILL system. This study was undertaken to test several commonly held beliefs regarding ILL system use by primary access libraries. Three hypotheses were developed. HI: Colorado and Wyoming primary access libraries comply with the recommended ILL guideline of adhering to a hierarchical structure, emphasizing local borrowing. H2: The closures of two Colorado Council of Medical Librarians (CCML) primary access libraries in 1996 resulted in twenty-three Colorado primary access libraries' borrowing more from their state resource library in 1997. H3: The number of subscriptions held by Colorado and Wyoming primary access libraries is positively correlated with the number of items they loan and negatively correlated with the number of items they borrow. The hypotheses were tested using the 1992 and 1997 DOCLINE and OCLC data of fifty-four health sciences libraries, including fifty primary access libraries, two state resource libraries, and two general academic libraries in Colorado and Wyoming. The ILL data were obtained electronically and analyzed using Microsoft Word 98, Microsoft Excel 98, and JMP 3.2.2. CCML primary access libraries comply with the recommended guideline to emphasize local borrowing by supplying each other with the majority of their ILLs, instead of overburdening libraries located at higher levels in the ILL hierarchy (H1). The closures of two CCML primary access libraries appear to have affected the entire ILL system, resulting in a greater volume of ILL activity for the state resource library and other DOCLINE libraries higher up in the ILL hierarchy and highlighting the contribution made by CCML primary access libraries (H2). CCML primary access libraries borrow and lend in amounts that are proportional to their collection size, rather than overtaxing libraries at higher levels in the ILL hierarchy with large numbers of requests (H3). The main limitations of this study were the small sample size and the use of data collected for another purpose, the CCML ILL survey. The findings suggest that there is little evidence to support several commonly held beliefs regarding ILL system use by primary access libraries. In addition to validating the important contributions made by primary access libraries to the national ILL system, baseline data that can be used to benchmark current practice performance are provided.

Interlibrary loan in primary access libraries: challenging the traditional view

PubMed Central

Dudden, Rosalind Farnam; Coldren, Sue; Condon, Joyce Elizabeth; Katsh, Sara; Reiter, Catherine Morton; Roth, Pamela Lynn

2000-01-01

Introduction: Primary access libraries serve as the foundation of the National Network of Libraries of Medicine (NN/LM) interlibrary loan (ILL) hierarchy, yet few published reports directly address the important role these libraries play in the ILL system. This may reflect the traditional view that small, primary access libraries are largely users of ILL, rather than important contributors to the effectiveness and efficiency of the national ILL system. Objective: This study was undertaken to test several commonly held beliefs regarding ILL system use by primary access libraries. Hypotheses: Three hypotheses were developed. H1: Colorado and Wyoming primary access libraries comply with the recommended ILL guideline of adhering to a hierarchical structure, emphasizing local borrowing. H2: The closures of two Colorado Council of Medical Librarians (CCML) primary access libraries in 1996 resulted in twenty-three Colorado primary access libraries' borrowing more from their state resource library in 1997. H3: The number of subscriptions held by Colorado and Wyoming primary access libraries is positively correlated with the number of items they loan and negatively correlated with the number of items they borrow. Methods: The hypotheses were tested using the 1992 and 1997 DOCLINE and OCLC data of fifty-four health sciences libraries, including fifty primary access libraries, two state resource libraries, and two general academic libraries in Colorado and Wyoming. The ILL data were obtained electronically and analyzed using Microsoft Word 98, Microsoft Excel 98, and JMP 3.2.2. Results: CCML primary access libraries comply with the recommended guideline to emphasize local borrowing by supplying each other with the majority of their ILLs, instead of overburdening libraries located at higher levels in the ILL hierarchy (H1). The closures of two CCML primary access libraries appear to have affected the entire ILL system, resulting in a greater volume of ILL activity for the state resource library and other DOCLINE libraries higher up in the ILL hierarchy and highlighting the contribution made by CCML primary access libraries (H2). CCML primary access libraries borrow and lend in amounts that are proportional to their collection size, rather than overtaxing libraries at higher levels in the ILL hierarchy with large numbers of requests (H3). Limitations: The main limitations of this study were the small sample size and the use of data collected for another purpose, the CCML ILL survey. Conclusions: The findings suggest that there is little evidence to support several commonly held beliefs regarding ILL system use by primary access libraries. In addition to validating the important contributions made by primary access libraries to the national ILL system, baseline data that can be used to benchmark current practice performance are provided. PMID:11055297

Traffic handling capability of a broadband indoor wireless network using CDMA multiple access

NASA Astrophysics Data System (ADS)

Zhang, Chang G.; Hafez, H. M.; Falconer, David D.

1994-05-01

CDMA (code division multiple access) may be an attractive technique for wireless access to broadband services because of its multiple access simplicity and other appealing features. In order to investigate traffic handling capabilities of a future network providing a variety of integrated services, this paper presents a study of a broadband indoor wireless network supporting high-speed traffic using CDMA multiple access. The results are obtained through the simulation of an indoor environment and the traffic capabilities of the wireless access to broadband 155.5 MHz ATM-SONET networks using the mm-wave band. A distributed system architecture is employed and the system performance is measured in terms of call blocking probability and dropping probability. The impacts of the base station density, traffic load, average holding time, and variable traffic sources on the system performance are examined. The improvement of system performance by implementing various techniques such as handoff, admission control, power control and sectorization are also investigated.

Promoting Responsible Fatherhood Programming: Factors Affecting Low-Income Fathers' Involvement in Child Protection Services and Court-Restricted Access to Their Children

PubMed Central

Gordon, Derrick M.; Iwamoto, Derek; Watkins, Natasha D.; Kershaw, Trace; Mason, Diana; Judkins, Anthony

2013-01-01

This study investigates how unemployment, traumatic sexual experiences, substance use, intimate partner violence, and parental involvement collectively contribute to involvement with child protective system (CPS) and court-restricted access to children among low-income, ethnically diverse fathers. Participants were 164 fathers involved in a statewide fatherhood program. The majority of the fathers in the program were unemployed (76%) and ethnic minorities (66%). Logistic regression revealed that traumatic sexual experiences and number of children were significant predictors of CPS involvement, whereas employment and traumatic sexual experience were associated with court-restricted access to their children. The results elucidate that clinicians and father-hood programs may need to attend to the history of traumatic experiences, as well as other contextual factors, of fathers and identify how, through trauma-focused interventions, to positively affect them and their children. PMID:24273406

Climate Change and Global Food Security: Food Access, Utilization, and the US Food System

NASA Astrophysics Data System (ADS)

Brown, M. E.; Antle, J. M.; Backlund, P. W.; Carr, E. R.; Easterling, W. E.; Walsh, M.; Ammann, C. M.; Attavanich, W.; Barrett, C. B.; Bellemare, M. F.; Dancheck, V.; Funk, C.; Grace, K.; Ingram, J. S. I.; Jiang, H.; Maletta, H.; Mata, T.; Murray, A.; Ngugi, M.; Ojima, D. S.; O'Neill, B. C.; Tebaldi, C.

2015-12-01

This paper will summarize results from the USDA report entitled 'Climate change, Global Food Security and the U.S. Food system'. The report focuses on the impact of climate change on global food security, defined as "when all people at all times have physical, social, and economic access to sufficient, safe, and nutritious food to meet their dietary needs and food preferences for an active and healthy life". The assessment brought together authors and contributors from twenty federal, academic, nongovernmental, intergovernmental, and private organizations in four countries to identify climate change effects on food security through 2100, and analyze the U.S.'s likely connections with that world. This talk will describe how climate change will likely affect food access and food utilization, and summarize how the U.S. food system contributes to global food security, and will be affected by climate change.

Methylphenidate mediated change in prosody is specific to the performance of a cognitive task in female adult ADHD patients.

PubMed

Bloch, Yuval; Aviram, Shai; Neeman, Ronnie; Braw, Yoram; Nitzan, Uriel; Maoz, Hagai; Mimouni-Bloch, Aviva

2015-01-01

Prosody production is highly personalized, related to both the emotional and cognitive state of the speaker and to the task being performed. Fundamental frequency (F main) is a central measurable feature of prosody, associated with having an attention deficit hyperactive disorder (ADHD). Since methylphenidate is an effective therapy for ADHD, we hypothesized that it will affect the fundamental frequency of ADHD patients. The answers of 32 adult ADHD patients were recorded while performing two computerized tasks (cognitive and emotional). Evaluations were performed at baseline and an hour after patients received methylphenidate. A significant effect of methylphenidate was observed on the fundamental frequency, as opposed to other parameters, of prosody. This change was evident while patients performed a cognitive, as opposed to an emotional, task. This change was seen in the 14 female ADHD patients but not in the 18 male ADHD patients. The fundamental frequency while performing a cognitive task without methylphenidate was not different in the female ADHD group, from 22 female controls. This pilot study supports prosodic changes as possible objective and accessible dynamic biological marker of treatment responses specifically in female ADHD.

Return Migrants' Experience of Access to Care in Corrupt Healthcare Systems: The Bosnian Example.

PubMed

Neerup Handlos, Line; Fog Olwig, Karen; Bygbjerg, Ib Christian; Norredam, Marie

2016-09-19

Equal and universal access to healthcare services is a core priority for a just health system. A key societal determinant seen to create inequality in access to healthcare is corruption in the healthcare system. How return migrants' access to healthcare is affected by corruption is largely unstudied, even though return migrants may be particularly vulnerable to problems related to corruption due to their period of absence from their country of origin. This article investigates how corruption in the healthcare sector affects access to healthcare for refugees who repatriated to Bosnia, a country with a high level of corruption, from Denmark, a country with a low level of corruption. The study is based on 18 semi-structured interviews with 33 refugees who returned after long-term residence in Denmark. We found that the returned refugees faced greater problems with corruption than was the case for those who had not left the country, as doctors considered them to be better endowed financially and therefore demanded larger bribes from them than they did from those who had remained in Bosnia. Moreover, during their stay abroad the returnees had lost the connections that could have helped them sidestep the corruption. Returned refugees are thus particularly vulnerable to the effects of corruption.

Return Migrants’ Experience of Access to Care in Corrupt Healthcare Systems: The Bosnian Example

PubMed Central

Neerup Handlos, Line; Fog Olwig, Karen; Bygbjerg, Ib Christian; Norredam, Marie

2016-01-01

Equal and universal access to healthcare services is a core priority for a just health system. A key societal determinant seen to create inequality in access to healthcare is corruption in the healthcare system. How return migrants’ access to healthcare is affected by corruption is largely unstudied, even though return migrants may be particularly vulnerable to problems related to corruption due to their period of absence from their country of origin. This article investigates how corruption in the healthcare sector affects access to healthcare for refugees who repatriated to Bosnia, a country with a high level of corruption, from Denmark, a country with a low level of corruption. The study is based on 18 semi-structured interviews with 33 refugees who returned after long-term residence in Denmark. We found that the returned refugees faced greater problems with corruption than was the case for those who had not left the country, as doctors considered them to be better endowed financially and therefore demanded larger bribes from them than they did from those who had remained in Bosnia. Moreover, during their stay abroad the returnees had lost the connections that could have helped them sidestep the corruption. Returned refugees are thus particularly vulnerable to the effects of corruption. PMID:27657096

Welfare of organic laying hens kept at different indoor stocking densities in a multi-tier aviary system. II: live weight, health measures and perching.

PubMed

Steenfeldt, S; Nielsen, B L

2015-09-01

Multi-tier aviary systems, where conveyor belts below the tiers remove the manure at regular intervals, are becoming more common in organic egg production. The area on the tiers can be included in the net area available to the hens (also referred to as usable area) when calculating maximum indoor stocking densities in organic systems within the EU. In this article, results on live weight, health measures and perching are reported for organic laying hens housed in a multi-tier system with permanent access to a veranda and kept at stocking densities (D) of 6, 9 and 12 hens/m2 available floor area, with concomitant increases in the number of hens per trough, drinker, perch and nest space. In a fourth treatment, access to the top tier was blocked reducing vertical, trough, and perch access at the lowest stocking density (D6x). In all other aspects than stocking density, the experiment followed the EU regulations on the keeping of organic laying hens. Hen live weight, mortality and foot health were not affected by the stocking densities used in the present study. Other variables (plumage condition, presence of breast redness and blisters, pecked tail feathers, and perch use) were indirectly affected by the increase in stocking density through the simultaneous reduction in access to other resources, mainly perches and troughs. The welfare of the hens was mostly affected by these associated constraints, despite all of them being within the allowed minimum requirements for organic production in the EU. Although the welfare consequences reported here were assessed to be moderate to minor, it is important to take into account concurrent constraints on access to other resources when higher stocking densities are used in organic production.

Adherence to antiretroviral therapy and treatment outcomes among conflict-affected and forcibly displaced populations: a systematic review

PubMed Central

2012-01-01

Background Optimal adherence to highly active antiretroviral therapy (HAART) is required to promote viral suppression and to prevent disease progression and mortality. Forcibly displaced and conflict-affected populations may face challenges succeeding on HAART. We performed a systematic review of the literature on adherence to HAART and treatment outcomes in these groups, including refugees and internally-displaced persons (IDPs), assessed the quality of the evidence and suggest a future research program. Methods Medline, Embase, and Global Health databases for 1995–2011 were searched using the Ovid platform. A backward citation review of subsequent work that had cited the Ovid results was performed using the Web of Science database. ReliefWeb and Médecins Sans Frontières (MSF) websites were searched for additional grey literature. Results and conclusion We screened 297 records and identified 17 reports covering 15 quantitative and two qualitative studies from 13 countries. Three-quarters (11/15) of the quantitative studies were retrospective studies based on chart review; five studies included <100 clients. Adherence or treatment outcomes were reported in resettled refugees, conflict-affected persons, internally-displaced persons (IDPs), and combinations of refugees, IDPs and other foreign-born persons. The reviewed reports showed promise for conflict-affected and forcibly-displaced populations; the range of optimal adherence prevalence reported was 87–99.5%. Treatment outcomes, measured using virological, immunological and mortality estimates, were good in relation to non-affected groups. Given the diversity of settings where forcibly-displaced and conflict-affected persons access ART, further studies on adherence and treatment outcomes are needed to support scale-up and provide evidence-based justifications for inclusion of these vulnerable groups in national treatment plans. Future studies and program evaluations should focus on systematic monitoring of adherence and treatment interruptions by using facility-based pharmacy records, understanding threats to optimal adherence and timely linkage to care throughout the displacement cycle, and testing interventions designed to support adherence and treatment outcomes in these settings. PMID:23110782

Digital mapping in extreme and remote environments

NASA Astrophysics Data System (ADS)

Andersson, Joel; Bauer, Tobias; Sarlus, Zimer; Zainy, Maher; Brethes, Anais

2017-04-01

During the last few years, Luleå University of Technology has performed a series of research projects in remote areas with extreme climatic conditions using digital mapping technologies. The majority of past and ongoing research projects focus on the arctic regions of the Fennoscandian Shield and Greenland but also on the Zagros fold-and-thrust belt in northern Iraq. Currently, we use the Midland Valley application FieldMove on iPad mini devices with ruggedized casings. As all projects have a strong focus on geological field work, harsh climatic conditions are a challenge not only for the geologists but also for the digital mapping hardware. In the arctic regions especially cold temperatures affect battery lifetime and performance of the screens. But also high temperatures are restricting digital mapping. From experience, a typical temperature range where digital mapping, using iPad tablets, is possible lies between -20 and +40 degrees. Furthermore, the remote character of field areas complicates access but also availability of electricity. By a combination of robust solar chargers and ruggedized batteries we are able to work entirely autarkical. Additionally, we are currently installing a drone system that allows us to map outcrops normally inaccessible because of safety reasons or time deficiency. The produced data will subsequently be taken into our Virtual Reality studio for interpretation and processing. There we will be able to work also with high resolution DEM data from Lidar scanning allowing us to interpret structural features such as post-glacial faults in areas that are otherwise only accessible by helicopter. By combining digital field mapping with drone technique and a Virtual Reality studio we are able to work in hardly accessible areas, improve safety during field work and increase efficiency substantially.

I'll See You on "Facebook": The Effects of Computer-Mediated Teacher Self-Disclosure on Student Motivation, Affective Learning, and Classroom Climate

ERIC Educational Resources Information Center

Mazer, Joseph P.; Murphy, Richard E.; Simonds, Cheri J.

2007-01-01

This experimental study examined the effects of teacher self-disclosure via Facebook on anticipated college student motivation, affective learning, and classroom climate. Participants who accessed the Facebook website of a teacher high in self-disclosure anticipated higher levels of motivation and affective learning and a more positive classroom…

Memory availability and referential access

PubMed Central

Johns, Clinton L.; Gordon, Peter C.; Long, Debra L.; Swaab, Tamara Y.

2013-01-01

Most theories of coreference specify linguistic factors that modulate antecedent accessibility in memory; however, whether non-linguistic factors also affect coreferential access is unknown. Here we examined the impact of a non-linguistic generation task (letter transposition) on the repeated-name penalty, a processing difficulty observed when coreferential repeated names refer to syntactically prominent (and thus more accessible) antecedents. In Experiment 1, generation improved online (event-related potentials) and offline (recognition memory) accessibility of names in word lists. In Experiment 2, we manipulated generation and syntactic prominence of antecedent names in sentences; both improved online and offline accessibility, but only syntactic prominence elicited a repeated-name penalty. Our results have three important implications: first, the form of a referential expression interacts with an antecedent’s status in the discourse model during coreference; second, availability in memory and referential accessibility are separable; and finally, theories of coreference must better integrate known properties of the human memory system. PMID:24443621

Factors associated with health care access and outcome.

PubMed

Paek, Min-So; Lim, Jung-Won

2012-01-01

This study aims to (1) assess ethnic differences in health care access and health outcome between Asian Americans and whites and between Asian American subgroups, (2) examine effects of cultural factors, and (3) investigate moderating effects of health risk behaviors between cultural characteristics and health care access and outcome. Data were derived from the 2007 California Health Interview Survey. Asian Americans (n = 4,462) and whites (n = 4,470) were included. There were significant ethnic differences in health care access and health perception between Asian Americans and Whites and across Asian American subgroups. Health risk behaviors moderated relationships between cultural factors and health care access and outcome. Findings reveal that ethnicity affects an individual's health care access and health perception, and their health behaviors are an important factor that may improve or worsen outcomes. This study may increase our knowledge base of research and interventions to enhance ethnic minority populations' health care accessibility and perceptions.

The experience of foot problems and decisions to access foot care in patients with rheumatoid arthritis: a qualitative study.

PubMed

Wilson, Oonagh; Kirwan, John; Dures, Emma; Quest, Enid; Hewlett, Sarah

2017-01-01

Although foot problems are common in rheumatoid arthritis (RA), the consequences of foot problems from the patient perspective have not been fully explored. The aims of this study were to explore the experience of foot problems and decisions to access foot care services or not in patients with RA. Semi structured, one-to-one interviews with patients recruited from 2 UK rheumatology units, purposively sampled for self-reported foot problems and a range of personal/disease characteristics. Inductive thematic analysis was used, with rigour provided by multiple independent analysers. Emerging themes were discussed and agreed by all authors. Twelve patients participated: 7 female; mean age 56 years (29-72); mean disease duration 12 years (2-27), 5 had accessed foot care services. The 'Impact' of foot problems was substantial and formed the underpinning theme, comprising three organising themes: 'Foot symptoms'; 'Consequences'; and 'Cost'. Foot symptoms such as pain and numbness required self-management, and affected daily life (walking, working) leading to social and emotional costs. The global theme, 'Decision to access foot care or not', also comprised three organising themes: 'Access perceived unnecessary' (no problem, can cope); 'Access hindered by patients' perception'; and 'Access supported by patient and clinician'. Decisions to access foot care or not were complex and influenced by patient beliefs regarding possible treatments and how to access these, and hindered by patient perceptions that their feet were ignored by rheumatology clinicians. Positive experience of foot care encouraged continued utilisation but negative experiences contributed to patients' decisions to discontinue foot care services. Foot problems are important issues for patients and impact on many aspects of their physical, social and emotional lives. Patients who had accessed foot care services prioritised their foot problems as an important health care need. However, for others who would like foot care services, personal knowledge and values, and perceived barriers in clinical practice, appear to interact to inhibit foot care access. The extent which these interactions affect overall access to foot care in RA patients in general now needs to be quantified to help to inform and improve the effectiveness of the organisation and delivery of foot care.

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

PubMed

Boissonnault, William G; Lovely, Karen

2016-11-01

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

48 CFR 642.1503-70 - Contractor Performance System (CPS).

Code of Federal Regulations, 2011 CFR

2011-10-01

... Performance System (CPS) maintained by the National Institutes of Health. CPS is an Internet-based tool... with access to the Internet shall use CPS to evaluate contractor's past performance for all contracts... the CPS; or (2) At overseas locations where access to the Internet is not practicable. (d) Heads of...

77 FR 197 - Federal Acquisition Regulation; Public Access to the Federal Awardee Performance and Integrity...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-03

...), excluding past performance reviews, shall be made publicly available. The interim rule notified contractors... not making ``past performance information'' available. Further, the respondent feared that it is only a matter of time before the Government also allows the public access to Government contractor ``past...

Analysis on factors affecting consumers decision on purchasing simple-type houses

NASA Astrophysics Data System (ADS)

Rumintang, A.; Sholichin, I.

2018-01-01

In line with the increase of the population and the need of comfortable houses, as affected by modernization era, the house demand is getting higher. Hence, conducting a research on consumers need and want in buying a house should be seriously attempted to succeed marketing activity. Using an analysis consumers’ behavior, the researcher will know few affecting factors related to consumers’ satisfaction in buying a house. Among other, the factors in question include: house price, house condition, facilities, location and accessability. The sample of this research was drawn from the residents of Graha Asri Housing, Taman Bulang Permai, and Sukodono Permai. Based on the analysis and discussion, some conclusions are made as follow: the factors and variables affecting the consumers’ decision on each choice of house is different and also the same variables on three sources of data include housing atmosphere, cleaning service, ease of access to shopping center, health clinics or hospitals, tourism spot, schools, and the bus station.

Knowledge, Attitudes, and Practices Related to Leptospirosis among Urban Slum Residents in Brazil

PubMed Central

Navegantes de Araújo, Wildo; Finkmoore, Brooke; Ribeiro, Guilherme S.; Reis, Renato B.; Felzemburgh, Ridalva D. M.; Hagan, José E.; Reis, Mitermayer G.; Ko, Albert I.; Costa, Federico

2013-01-01

Leptospirosis disproportionately affects residents of urban slums. To understand the knowledge, attitudes, and practices regarding leptospirosis, we conducted a cross-sectional study among residents of an urban slum community in Salvador, Brazil. Of the 257 residents who were interviewed, 225 (90%) were aware of leptospirosis and more than two-thirds of respondents correctly identified the modes of disease transmission and ways to reduce exposure. However, study participants who performed risk activities such as cleaning open sewers had limited access to protective clothing such as boots (33%) or gloves (35%). Almost all respondents performed at least one activity to prevent household rat infestation, which often included use of an illegal poison. Our findings support the need for interventions targeted at the individual and household levels to reduce risk of leptospirosis until large-scale structural interventions are available to residents of urban slum communities. PMID:23269657

Access to Housing in Urban China

PubMed Central

Logan, John R.; Fang, Yiping; Zhang, Zhanxin

2013-01-01

Like income inequality, housing inequality in urban China is strongly affected by state policies that give preferential treatment to insiders. In this case, the key policies are related to their residence status, which involves not only their migration history but also their legal position. Using data from the Chinese census of 2000 for eight large cities, this study shows how residence status affects access to various pathways to housing. In addition to the well-known marginal housing situation of the recent ‘floating population’, it documents surprising advantages for migrants with urban registration status and persistent disadvantages for rural migrants regardless of how long they have lived in the city. PMID:23976818

PubMed

de Quadros, Ronice Müller; Cruz, Carina Rebello; Pizzio, Aline Lemos

2012-01-01

This study compared the performance in phonological memory tasks of bimodal bilíngual hearing children (children of deaf parents) and deaf children with cochlear implant (children of deaf parents and hearing parents), with different contexts of access to Brazilian Sign Language (Libras). We used two tests: Portuguêse Pseudowords (Santos and Bueno, 2003) and Libras Pseudosigns (developed by researchers from Development Bimodal Bilíngual Project). Moreover, we included two control groups, one of deaf children, growing up with Libras, with deaf parents, and the other of hearing adults Codas, bimodal bilínguals, with deaf parents. In the analysis of the results, initially, in regard to the performance among the groups tested, it was found that the bimodal bilíngual children had higher scores in both tests. However, when we analyzed the performance of the deaf child with cochlear implant, with deaf parents, with full access to sign language, compared to the other children with cochlear implant, with restricted access to Libras, we found that this child has a similar performance to the Coda children. The cochlear-implanted children with restricted access to Libras, therefore with more access to Portuguêse, had lower scores in both tests, being the worst score for the Portuguêse test. The results shown that children with cochlear implant can have benefits when they have access to Libras, having similar performances to hearing bimodal bilíngual children.

FreeDam - A webtool for free-electron laser-induced damage in femtosecond X-ray crystallography

NASA Astrophysics Data System (ADS)

Jönsson, H. Olof; Östlin, Christofer; Scott, Howard A.; Chapman, Henry N.; Aplin, Steve J.; Tîmneanu, Nicuşor; Caleman, Carl

2018-03-01

Over the last decade X-ray free-electron laser (XFEL) sources have been made available to the scientific community. One of the most successful uses of these new machines has been protein crystallography. When samples are exposed to the intense short X-ray pulses provided by the XFELs, the sample quickly becomes highly ionized and the atomic structure is affected. Here we present a webtool dubbed FreeDam based on non-thermal plasma simulations, for estimation of radiation damage in free-electron laser experiments in terms of ionization, temperatures and atomic displacements. The aim is to make this tool easily accessible to scientists who are planning and performing experiments at XFELs.

KSC-2009-4064

NASA Image and Video Library

2009-07-15

CAPE CANAVERAL, Fla. – Engineers at Astrotech Space Operations in Titusville, Fla., lower the high-gain antenna on the Solar Dynamics Observatory to gain access to the battery compartment for installation of the flight battery. SDO is the first space weather research network mission in NASA's Living With a Star Program. The spacecraft's long-term measurements will give solar scientists in-depth information about changes in the sun's magnetic field and insight into how they affect Earth. In preparation for its anticipated November launch, engineers will perform a battery of comprehensive tests to ensure SDO can withstand the stresses and vibrations of the launch itself, as well as what it will encounter in the space environment after launch. Photo credit: NASA/Jack Pfaller

KSC-2009-4063

NASA Image and Video Library

2009-07-15

CAPE CANAVERAL, Fla. – Engineers at Astrotech Space Operations in Titusville, Fla., begin lowering the high-gain antenna on the Solar Dynamics Observatory to gain access to the battery compartment for installation of the flight battery. SDO is the first space weather research network mission in NASA's Living With a Star Program. The spacecraft's long-term measurements will give solar scientists in-depth information about changes in the sun's magnetic field and insight into how they affect Earth. In preparation for its anticipated November launch, engineers will perform a battery of comprehensive tests to ensure SDO can withstand the stresses and vibrations of the launch itself, as well as what it will encounter in the space environment after launch. Photo credit: NASA/Jack Pfaller

KSC-2009-4067

NASA Image and Video Library

2009-07-15

CAPE CANAVERAL, Fla. – At Astrotech Space Operations in Titusville, Fla., the lowered high-gain antenna on the Solar Dynamics Observatory will allow engineers access to the battery compartment in order to install the flight battery. SDO is the first space weather research network mission in NASA's Living With a Star Program. The spacecraft's long-term measurements will give solar scientists in-depth information about changes in the sun's magnetic field and insight into how they affect Earth. In preparation for its anticipated November launch, engineers will perform a battery of comprehensive tests to ensure SDO can withstand the stresses and vibrations of the launch itself, as well as what it will encounter in the space environment after launch. Photo credit: NASA/Jack Pfaller

KSC-2009-4066

NASA Image and Video Library

2009-07-15

CAPE CANAVERAL, Fla. – Engineers at Astrotech Space Operations in Titusville, Fla., support the high-gain antenna lowered to allow access to the battery compartment for installation of the flight battery. SDO is the first space weather research network mission in NASA's Living With a Star Program. The spacecraft's long-term measurements will give solar scientists in-depth information about changes in the sun's magnetic field and insight into how they affect Earth. In preparation for its anticipated November launch, engineers will perform a battery of comprehensive tests to ensure SDO can withstand the stresses and vibrations of the launch itself, as well as what it will encounter in the space environment after launch. Photo credit: NASA/Jack Pfaller

KSC-2009-4065

NASA Image and Video Library

2009-07-15

CAPE CANAVERAL, Fla. – Engineers at Astrotech Space Operations in Titusville, Fla., lower the high-gain antenna on the Solar Dynamics Observatory to gain access to the battery compartment for installation of the flight battery. SDO is the first space weather research network mission in NASA's Living With a Star Program. The spacecraft's long-term measurements will give solar scientists in-depth information about changes in the sun's magnetic field and insight into how they affect Earth. In preparation for its anticipated November launch, engineers will perform a battery of comprehensive tests to ensure SDO can withstand the stresses and vibrations of the launch itself, as well as what it will encounter in the space environment after launch. Photo credit: NASA/Jack Pfaller

A highly efficient 3D level-set grain growth algorithm tailored for ccNUMA architecture

NASA Astrophysics Data System (ADS)

Mießen, C.; Velinov, N.; Gottstein, G.; Barrales-Mora, L. A.

2017-12-01

A highly efficient simulation model for 2D and 3D grain growth was developed based on the level-set method. The model introduces modern computational concepts to achieve excellent performance on parallel computer architectures. Strong scalability was measured on cache-coherent non-uniform memory access (ccNUMA) architectures. To achieve this, the proposed approach considers the application of local level-set functions at the grain level. Ideal and non-ideal grain growth was simulated in 3D with the objective to study the evolution of statistical representative volume elements in polycrystals. In addition, microstructure evolution in an anisotropic magnetic material affected by an external magnetic field was simulated.

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.

Patent law--balancing profit maximization and public access to technology.

PubMed

Beckerman-Rodau, Andrew

2003-01-01

This article addresses the contemporary issue of balancing the need for patent protection for intellectual property with the resulting restriction of public access to new technology. The author argues that patent law protects private property rights rather than creating monopolies. Additionally, the author discusses how restricting access to patented technology, such as pharmaceuticals, can affect public health problems, such as the HIV/AIDS epidemic in developing nations. The author then concludes with some proposals for making patented technology available to people in developing nations who need access to such technology but who are unable to afford its high costs due to patent protection.

Factors Associated With Utilization of Cardiac Rehabilitation Among Patients With Ischemic Heart Disease in the Veterans Health Administration: A QUALITATIVE STUDY.

PubMed

Schopfer, David W; Priano, Susan; Allsup, Kelly; Helfrich, Christian D; Ho, P Michael; Rumsfeld, John S; Forman, Daniel E; Whooley, Mary A

2016-01-01

Cardiac rehabilitation (CR) programs reduce morbidity and mortality in patients with ischemic heart disease but are vastly underutilized in the United States, including the Veterans Health Administration (VA) Healthcare System. Numerous barriers affecting utilization have been identified in other health care systems, but the specific factors affecting Veterans are unknown. We sought to identify barriers and facilitators associated with utilization of CR in VA facilities. We performed a qualitative study of 56 VA patients, providers, and CR program managers at 30 VA facilities across the United States. We conducted semistructured interviews with key informants to explore their attitudes and knowledge toward CR. Interviews were conducted until thematic saturation occurred. Analyses using grounded theory to identify key themes were conducted using the qualitative data analysis package ATLAS.ti. We identified 6 themes as barriers and 5 as facilitators. The most common barriers to participation in CR were patient transportation issues (68%), lack of patient willingness to participate (41%), and no access to a nearby VA hospital with a CR program (30%). The most common facilitators were involvement of a dedicated provider or "clinical champion" (50%), provider knowledge of or experience with CR (48%), and patient desire for additional medical support (32%). Our findings suggest that addressing access issues and educating and activating providers on CR may increase utilization of CR programs. Targeting these specific factors may improve utilization of CR programs.

Who's Surfing? Internet Access and Computer Use by Visually Impaired Youths and Adults.

ERIC Educational Resources Information Center

Gerber, Elaine; Kirchner, Corinne

2001-01-01

The Census Bureau's 1999 Survey of Income and Program Participation found that Internet access and computer use by people with visual impairments is substantially (30 percent) less than that for people with no disabilities. Age, employment, and the presence of additional impairments also affected computer use. Results suggest over a million…

Exploring Teacher Pedagogy, Stages of Concern and Accessibility as Determinants of Technology Adoption

ERIC Educational Resources Information Center

Burke, Paul F.; Schuck, Sandy; Aubusson, Peter; Kearney, Matthew; Frischknecht, Bart

2018-01-01

This research examines how the pedagogical orientations of teachers affect technology adoption in the classroom. At the same time, the authors account for the stage of concern that teachers are experiencing regarding the use of the technology, their access to the technology and the level of schooling at which they teach.The authors' investigation…

High School Teachers' Perspectives on Supporting Students with Visual Impairments toward Higher Education: Access, Barriers, and Success

ERIC Educational Resources Information Center

Reed, Maureen; Curtis, Kathryn

2011-01-01

The objective of the study presented here was to understand the experiences of teachers in assisting students with visual impairments in making the transition to higher education. The teachers reported barriers in high school that affect students' access to and success in higher education. Furthermore, institutions of higher education provided…

Factors Affecting School Participation in Turkey: An Analysis of Regional Differences

ERIC Educational Resources Information Center

Gumus, Sedat; Chudgar, Amita

2016-01-01

There are thousands of children who remain out of school at both primary and secondary levels in Turkey. The current disparities in access to education in Turkey are mostly driven by systematic regional differences and high gender inequalities. Although several existing studies have paid close attention to gender-based inequities in school access,…

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…

17 CFR 269.7 - Form ID, uniform application for access codes to file on EDGAR.

Code of Federal Regulations, 2010 CFR

2010-04-01

... on to the EDGAR system, submit filings, and change its CCC. (d) Password Modification Authorization Code (PMAC)—allows a filer, filing agent or training agent to change its Password. [69 FR 22710, Apr... Sections Affected, which appears in the Finding Aids section of the printed volume and on GPO Access. ...

17 CFR 249.446 - Form ID, uniform application for access codes to file on EDGAR.

Code of Federal Regulations, 2010 CFR

2010-04-01

... log on to the EDGAR system, submit filings, and change its CCC. (d) Password Modification Authorization Code (PMAC)—allows a filer, filing agent or training agent to change its Password. [69 FR 22710... Sections Affected, which appears in the Finding Aids section of the printed volume and on GPO Access. ...

Defective Number Sense or Impaired Access? Differential Impairments in Different Subgroups of Children with Mathematics Difficulties

ERIC Educational Resources Information Center

Wong, Terry T.-Y.; Ho, Connie S.-H.; Tang, Joey

2017-01-01

Developmental dyscalculia (DD) is a specific learning disability in mathematics that affects around 6% of the population. Currently, the core deficit of DD remains unknown. While the number sense deficit hypothesis suggests that the core deficit of DD lies in the inability to represent nonsymbolic numerosity, the access deficit hypothesis suggests…

Malaria diagnosis and mapping with m-Health and geographic information systems (GIS): evidence from Uganda.

PubMed

Larocca, Alberto; Moro Visconti, Roberto; Marconi, Michele

2016-10-24

Rural populations experience several barriers to accessing clinical facilities for malaria diagnosis. Increasing penetration of ICT and mobile-phones and subsequent m-Health applications can contribute overcoming such obstacles. GIS is used to evaluate the feasibility of m-Health technologies as part of anti-malaria strategies. This study investigates where in Uganda: (1) malaria affects the largest number of people; (2) the application of m-Health protocol based on the mobile network has the highest potential impact. About 75% of the population affected by Plasmodium falciparum malaria have scarce access to healthcare facilities. The introduction of m-Health technologies should be based on the 2G protocol, as 3G mobile network coverage is still limited. The western border and the central-Southeast are the regions where m-Health could reach the largest percentage of the remote population. Six districts (Arua, Apac, Lira, Kamuli, Iganga, and Mubende) could have the largest benefit because they account for about 28% of the remote population affected by falciparum malaria with access to the 2G mobile network. The application of m-Health technologies could improve access to medical services for distant populations. Affordable remote malaria diagnosis could help to decongest health facilities, reducing costs and contagion. The combination of m-Health and GIS could provide real-time and geo-localized data transmission, improving anti-malarial strategies in Uganda. Scalability to other countries and diseases looks promising.

Quantitative effects of cyanogenesis on an adapted herbivore.

PubMed

Ballhorn, D J; Heil, M; Pietrowski, A; Lieberei, R

2007-12-01

Plant cyanogenesis means the release of gaseous hydrogen cyanide (HCN) in response to cell damage and is considered as an effective defense against generalist herbivores. In contrast, specialists are generally believed not to be affected negatively by this trait. However, quantitative data on long-term effects of cyanogenesis on specialists are rare. In this study, we used lima bean accessions (Fabaceae: Phaseolus lunatus L.) with high quantitative variability of cyanogenic features comprising cyanogenic potential (HCNp; concentration of cyanogenic precursors) and cyanogenic capacities (HCNc; release of gaseous HCN per unit time). In feeding trials, we analyzed performance of herbivorous Mexican bean beetle (Coleoptera: Coccinellidae: Epilachna varivestis Mulsant) on selected lines characterized by high (HC-plants) and low HCNp (LC-plants). Larval and adult stages of this herbivore feed on a narrow range of legumes and prefer cyanogenic lima bean as host plant. Nevertheless, we found that performance of beetles (larval weight gain per time and body mass of adult beetles) was significantly affected by lima bean HCNp: Body weight decreased and developmental period of larvae and pupae increased on HC-plants during the first generation of beetles and then remained constant for four consecutive generations. In addition, we found continuously decreasing numbers of eggs and larval hatching as inter-generational effects on HC-plants. In contrast to HC-plants, constantly high performance was observed among four generations on LC-plants. Our results demonstrate that Mexican bean beetle, although preferentially feeding on lima bean, is quantitatively affected by the HCNp of its host plant. Effects can only be detected when considering more than one generation. Thus, cyanide-containing precursors can have negative effects even on herbivores adapted to feed on cyanogenic plants.

Design features that affect the maneuverability of wheelchairs and scooters.

PubMed

Koontz, Alicia M; Brindle, Eric D; Kankipati, Padmaja; Feathers, David; Cooper, Rory A

2010-05-01

To determine the minimum space required for wheeled mobility device users to perform 4 maneuverability tasks and to investigate the impact of selected design attributes on space. Case series. University laboratory, Veterans Affairs research facility, vocational training center, and a national wheelchair sport event. The sample of convenience included manual wheelchair (MWC; n=109), power wheelchair (PWC; n=100), and scooter users (n=14). A mock environment was constructed to create passageways to form an L-turn, 360 degrees -turn in place, and a U-turn with and without a barrier. Passageway openings were increased in 5-cm increments until the user could successfully perform each task without hitting the walls. Structural dimensions of the device and user were collected using an electromechanical probe. Mobility devices were grouped into categories based on design features and compared using 1-way analysis of variance and post hoc pairwise Bonferroni-corrected tests. Minimum passageway widths for the 4 maneuverability tasks. Ultralight MWCs with rear axles posterior to the shoulder had the shortest lengths and required the least amount of space compared with all other types of MWCs (P<.05). Mid-wheel-drive PWCs required the least space for the 360 degrees -turn in place compared with front-wheel-drive and rear-wheel-drive PWCs (P<.01) but performed equally as well as front-wheel-drive models on all other turning tasks. PWCs with seat functions required more space to perform the tasks. Between 10% and 100% of users would not be able to maneuver in spaces that meet current Accessibility Guidelines for Buildings and Facilities specifications. This study provides data that can be used to support wheelchair prescription and home modifications and to update standards to improve the accessibility of public areas.

Group-Level EEG-Processing Pipeline for Flexible Single Trial-Based Analyses Including Linear Mixed Models

PubMed Central

Frömer, Romy; Maier, Martin; Abdel Rahman, Rasha

2018-01-01

Here we present an application of an EEG processing pipeline customizing EEGLAB and FieldTrip functions, specifically optimized to flexibly analyze EEG data based on single trial information. The key component of our approach is to create a comprehensive 3-D EEG data structure including all trials and all participants maintaining the original order of recording. This allows straightforward access to subsets of the data based on any information available in a behavioral data structure matched with the EEG data (experimental conditions, but also performance indicators, such accuracy or RTs of single trials). In the present study we exploit this structure to compute linear mixed models (LMMs, using lmer in R) including random intercepts and slopes for items. This information can easily be read out from the matched behavioral data, whereas it might not be accessible in traditional ERP approaches without substantial effort. We further provide easily adaptable scripts for performing cluster-based permutation tests (as implemented in FieldTrip), as a more robust alternative to traditional omnibus ANOVAs. Our approach is particularly advantageous for data with parametric within-subject covariates (e.g., performance) and/or multiple complex stimuli (such as words, faces or objects) that vary in features affecting cognitive processes and ERPs (such as word frequency, salience or familiarity), which are sometimes hard to control experimentally or might themselves constitute variables of interest. The present dataset was recorded from 40 participants who performed a visual search task on previously unfamiliar objects, presented either visually intact or blurred. MATLAB as well as R scripts are provided that can be adapted to different datasets. PMID:29472836

Method and apparatus for managing access to a memory

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

DeBenedictis, Erik

A method and apparatus for managing access to a memory of a computing system. A controller transforms a plurality of operations that represent a computing job into an operational memory layout that reduces a size of a selected portion of the memory that needs to be accessed to perform the computing job. The controller stores the operational memory layout in a plurality of memory cells within the selected portion of the memory. The controller controls a sequence by which a processor in the computing system accesses the memory to perform the computing job using the operational memory layout. The operationalmore » memory layout reduces an amount of energy consumed by the processor to perform the computing job.« less

Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and performance of everyday life tasks: Actual Reality.

PubMed

Goverover, Yael; Chiaravalloti, Nancy; DeLuca, John

2016-04-01

Recently, a brief cognitive assessment (Brief International Cognitive Assessment for Multiple Sclerosis: BICAMS) has been recommended for use with patients diagnosed with multiple sclerosis (MS) to screen for cognitive impairments. However, the relationship between the BICAMS and everyday life activity has not been examined. The aim of this study was to examine whether the BICAMS can predict performance of activities of daily living using Actual Reality(TM) (AR) in persons with MS. A between-subjects design was utilized to compare 41 individuals with MS and 32 healthy controls (HC) performing BICAMS and an AR task. Participants were asked to access the internet to purchase a flight ticket or cookies, and were administered the BICAMS and questionnaires to assess quality of life (QOL), affect symptomatology, and prior internet experience. Participants with MS performed significantly worse than HC on the BICAMS and the AR. Additionally, better BICAMS performance was associated with more independent AR performance. Self-reports of QOL were not correlated with AR or BICAMS performance. Individuals with MS have greater problems with actual everyday life tasks as compared to HC. The BICAMS is a promising cognitive screening tool to predict actual functional performance in participants with MS. © The Author(s), 2015.

Functional requirements for Waste Area Grouping 6 Monitoring Station 3 upgrade

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

Fiuzat, A.A.

1991-06-01

The surface Waste Area Grouping (WAG)6 at ORNL may undergo many changes in the future as part of the closure activities. Changes in surface characteristics will cause changes in runoff characteristics of the MS 3 watershed. Appropriate assumptions are to be made in this project regarding the future surface conditions of the watershed. The extent to which the assumed surface conditions will affect the project objectives (defined in Section 1.0) is to be identified. The purpose of this FRD is to establish performance requirements for MS 3 consisting of the following: (1) The expected range of discharges passing through themore » station and the required accuracy levels for discharge measurements. (2) The equipment required to measure the expected discharges at the required accuracy levels. (3) The sampling requirements for monitoring water quality. (4) The hydraulic requirements for the discharge conveyance structure to be located under the IWMF access road. (5) The design loads to be used for the bridge over the IWMF access road. 12 refs., 5 figs.« less

Defective Number Sense or Impaired Access? Differential Impairments in Different Subgroups of Children With Mathematics Difficulties.

PubMed

Wong, Terry T-Y; Ho, Connie S-H; Tang, Joey

2017-01-01

Developmental dyscalculia (DD) is a specific learning disability in mathematics that affects around 6% of the population. Currently, the core deficit of DD remains unknown. While the number sense deficit hypothesis suggests that the core deficit of DD lies in the inability to represent nonsymbolic numerosity, the access deficit hypothesis suggests that the origin of this disability lies in the inability to associate numbers with the underlying magnitude representation. The present study compared the performance of DDs with their low-achieving (LA) and normally achieving peers in nonsymbolic numerosity processing and number-magnitude mapping over 1 year (from kindergarten to 1st grade). The results demonstrated differential impairments in different subgroups of children with mathematics difficulties. While DDs showed deficits in both nonsymbolic numerosity processing and number-magnitude mapping, LAs showed deficit only in the number-magnitude mapping. Furthermore, the deficit in number-magnitude mapping among the DD group was partially explained by their number sense deficit. The number sense deficit hypothesis is supported. Theoretical and practical implications are discussed. © Hammill Institute on Disabilities 2015.

Data handling and visualization for NASA's science programs

NASA Technical Reports Server (NTRS)

Bredekamp, Joseph H. (Editor)

1995-01-01

Advanced information systems capabilities are essential to conducting NASA's scientific research mission. Access to these capabilities is no longer a luxury for a select few within the science community, but rather an absolute necessity for carrying out scientific investigations. The dependence on high performance computing and networking, as well as ready and expedient access to science data, metadata, and analysis tools is the fundamental underpinning for the entire research endeavor. At the same time, advances in the whole range of information technologies continues on an almost explosive growth path, reaching beyond the research community to affect the population as a whole. Capitalizing on and exploiting these advances are critical to the continued success of space science investigations. NASA must remain abreast of developments in the field and strike an appropriate balance between being a smart buyer and a direct investor in the technology which serves its unique requirements. Another key theme deals with the need for the space and computer science communities to collaborate as partners to more fully realize the potential of information technology in the space science research environment.

Analysis of the morphology, stability, and folding pathways of ring polymers with supramolecular topological constraints using molecular simulation and nonlinear manifold learning

NASA Astrophysics Data System (ADS)

Wang, Jiang; Ferguson, Andrew

Ring polymers offer a wide range of natural and engineered functions and applications, including as circular bacterial DNA, crown ethers for cation chelation, and ``molecular machines'' such as mechanical nanoswitches. The morphology and dynamics of ring polymers are governed by the chemistry and degree of polymerization of the ring, and intramolecular and supramolecular topological constraints such as knots or mechanically-interlocked rings. We perform molecular dynamics simulations of polyethylene ring polymers as a function of degree of polymerization and in different topological states, including a knotted state, catenane state (two interlocked rings), and borromean state (three interlocked rings). Applying nonlinear manifold learning to our all-atom simulation trajectories, we extract low-dimensional free energy surfaces governing the accessible conformational states and their relative thermodynamic stability. The free energy surfaces reveal how degree of polymerization and topological constraints affect the thermally accessible conformations, chiral symmetry breaking, and folding and collapse pathways of the rings, and present a means to rationally engineer ring size and topology to preferentially stabilize particular conformational states.

The Impact of Disasters on Populations With Health and Health Care Disparities

PubMed Central

Davis, Jennifer R.; Wilson, Sacoby; Brock-Martin, Amy; Glover, Saundra; Svendsen, Erik R.

2010-01-01

Context A disaster is indiscriminate in whom it affects. Limited research has shown that the poor and medically underserved, especially in rural areas, bear an inequitable amount of the burden. Objective To review the literature on the combined effects of a disaster and living in an area with existing health or health care disparities on a community’s health, access to health resources, and quality of life. Methods We performed a systematic literature review using the following search terms: disaster, health disparities, health care disparities, medically underserved, and rural. Our inclusion criteria were peer-reviewed, US studies that discussed the delayed or persistent health effects of disasters in medically underserved areas. Results There has been extensive research published on disasters, health disparities, health care disparities, and medically underserved populations individually, but not collectively. Conclusions The current literature does not capture the strain of health and health care disparities before and after a disaster in medically underserved communities. Future disaster studies and policies should account for differences in health profiles and access to care before and after a disaster. PMID:20389193

Plasticity in response to feed availability: Does feeding regime influence the relative growth performance of domesticated, wild and hybrid Atlantic salmon Salmo salar parr?

PubMed

Harvey, A C; Solberg, M F; Glover, K A; Taylor, M I; Creer, S; Carvalho, G R

2016-09-01

Growth of farmed, wild and F1 hybrid Atlantic salmon parr Salmo salar was investigated under three contrasting feeding regimes in order to understand how varying levels of food availability affects relative growth. Treatments consisted of standard hatchery feeding (ad libitum), access to feed for 4 h every day, and access to feed for 24 h on three alternate days weekly. Mortality was low in all treatments, and food availability had no effect on survival of all groups. The offspring of farmed S. salar significantly outgrew the wild S. salar, while hybrids displayed intermediate growth. Furthermore, the relative growth differences between the farmed and wild S. salar did not change across feeding treatments, indicating a similar plasticity in response to feed availability. Although undertaken in a hatchery setting, these results suggest that food availability may not be the sole driver behind the observed reduced growth differences found between farmed and wild fishes under natural conditions. © 2016 The Fisheries Society of the British Isles.

Current Hale ROA Voice and Control Communication Practices and Performance: White Paper

NASA Technical Reports Server (NTRS)

2007-01-01

The objective of this white paper is to help achieve the ACCESS 5 goal by sharing the UNITE members knowledge of current HALE ROA communication systems with other ACCESS 5 participants so that all interested parties start from a common understanding as we begin the clarification of requirements for voice and C2 communication. This white paper is also intended to describe the point of departure for any future developments that need to be realized to achieve the long term ACCESS 5 goal. Although this white paper describes the current systems, the functional and performance requirements that are also being developed under ACCESS 5 may not require the same levels of functionality and performance as currently exist. The paper addresses the following: 1) A description of a typical current HALE ROA communications system, 2) HALE ROA communications systems performance metrics, 3) HALE ROA communications systems performance, and 5) A comparison of current HALE ROA communications systems with current regulations.

Comparison of medicines management strategies in insurance schemes in middle-income countries: four case studies.

PubMed

Kaplan, Warren A; Ashigbie, Paul G; Brooks, Mohamad I; Wirtz, Veronika J

2017-01-01

Many middle-income countries are scaling up health insurance schemes to provide financial protection and access to affordable medicines to poor and uninsured populations. Although there is a wealth of evidence on how high income countries with mature insurance schemes manage cost-effective use of medicines, there is limited evidence on the strategies used in middle-income countries. This paper compares the medicines management strategies that four insurance schemes in middle-income countries use to improve access and cost-effective use of medicines among beneficiaries. We compare key strategies promoting cost-effective medicines use in the New Rural Cooperative Medical Scheme (NCMS) in China, National Health Insurance Scheme in Ghana, Jamkesmas in Indonesia and Seguro Popular in Mexico. Through the peer-reviewed and grey literature as of late 2013, we identified strategies that met our inclusion criteria as well as any evidence showing if, and/or how, these strategies affected medicines management. Stakeholders involved and affected by medicines coverage policies in these insurance schemes were asked to provide relevant documents describing the medicines related aspects of these insurance programs. We also asked them specifically to identify publications discussing the unintended consequences of the strategies implemented. Use of formularies, bulk procurement, standard treatment guidelines and separation of prescribing and dispensing were present in all four schemes. Also, increased transparency through publication of tender agreements and procurement prices was introduced in all four. Common strategies shared by three out of four schemes were medicine price negotiation or rebates, generic reference pricing, fixed salaries for prescribers, accredited preferred provider network, disease management programs, and monitoring of medicines purchases. Cost-sharing and payment for performance was rarely used. There was a lack of performance monitoring strategies in all schemes. Most of the strategies used in the insurance schemes focus on containing expenditure growth, including budget caps on pharmaceutical expenditures (Mexico) and ceiling prices on medicines (all four countries). There were few strategies targeting quality improvement as healthcare providers are mostly paid through fixed salaries, irrespective of the quality of their prescribing or the health outcomes actually achieved. Monitoring healthcare system performance has received little attention.

Correlates of perceived access and implications for health system strengthening – lessons from HIV/AIDS treatment and care services in Ethiopia

PubMed Central

Ncama, Busisiwe Purity

2016-01-01

Background Access to healthcare is an important public health concept and has been traditionally measured by using population level parameters, such as availability, distribution and proximity of the health facilities in relation to the population. However, client based factors such as their expectations, experiences and perceptions which impact their evaluations of health care access were not well studied and integrated into health policy frameworks and implementation programs. Objective This study aimed to investigate factors associated with perceived access to HIV/AIDS Treatment and care services in Wolaita Zone, Ethiopia. Methods A cross-sectional survey was conducted on 492 people living with HIV, with 411 using ART and 81 using pre-ART services accessed at six public sector health facilities from November 2014 to March 2015. Data were analyzed using the ologit function of STATA. The variables explored consisted of socio-demographic and health characteristics, type of health facility, type of care, distance, waiting time, healthcare responsiveness, transportation convenience, satisfaction with service, quality of care, financial fairness, out of pocket expenses and HIV disclosure. Results Of the 492 participants, 294 (59.8%) were females and 198 (40.2%) were males, with a mean age of 38.8 years. 23.0% and 12.2% believed they had ‘good’ or ‘very good’ access respectively, and 64.8% indicated lower ratings. In the multivariate analysis, distance from the health facility, type of care, HIV clinical stage, out of pocket expenses, employment status, type of care, HIV disclosure and perceived transportation score were not associated with the perceived access (PA). With a unit increment in satisfaction, perceived quality of care, health system responsiveness, transportation convenience and perceived financial fairness scores, the odds of providing higher rating of PA increased by 29.0% (p<0.001), 6.0%(p<0.01), 100.0% (p<0.001), 9.0% (p<0.05) and 6.0% (p<0.05) respectively. Conclusion Perceived quality of care, health system responsiveness, perceived financial fairness, transportation convenience and satisfaction with services were correlates of perceived access and affected healthcare performance. Interventions targeted at improving access to HIV/AIDS treatment and care services should address these factors. Further studies may be needed to confirm the findings. PMID:27548753

Correlates of Strengthening Lessons from HIV/AIDS Treatment and Care Services in Ethiopia Perceived Access and Implications for Health System.

PubMed

Yakob, Bereket; Ncama, Busisiwe Purity

2016-01-01

Access to healthcare is an important public health concept and has been traditionally measured by using population level parameters, such as availability, distribution and proximity of the health facilities in relation to the population. However, client based factors such as their expectations, experiences and perceptions which impact their evaluations of health care access were not well studied and integrated into health policy frameworks and implementation programs. This study aimed to investigate factors associated with perceived access to HIV/AIDS Treatment and care services in Wolaita Zone, Ethiopia. A cross-sectional survey was conducted on 492 people living with HIV, with 411 using ART and 81 using pre-ART services accessed at six public sector health facilities from November 2014 to March 2015. Data were analyzed using the ologit function of STATA. The variables explored consisted of socio-demographic and health characteristics, type of health facility, type of care, distance, waiting time, healthcare responsiveness, transportation convenience, satisfaction with service, quality of care, financial fairness, out of pocket expenses and HIV disclosure. Of the 492 participants, 294 (59.8%) were females and 198 (40.2%) were males, with a mean age of 38.8 years. 23.0% and 12.2% believed they had 'good' or 'very good' access respectively, and 64.8% indicated lower ratings. In the multivariate analysis, distance from the health facility, type of care, HIV clinical stage, out of pocket expenses, employment status, type of care, HIV disclosure and perceived transportation score were not associated with the perceived access (PA). With a unit increment in satisfaction, perceived quality of care, health system responsiveness, transportation convenience and perceived financial fairness scores, the odds of providing higher rating of PA increased by 29.0% (p<0.001), 6.0%(p<0.01), 100.0% (p<0.001), 9.0% (p<0.05) and 6.0% (p<0.05) respectively. Perceived quality of care, health system responsiveness, perceived financial fairness, transportation convenience and satisfaction with services were correlates of perceived access and affected healthcare performance. Interventions targeted at improving access to HIV/AIDS treatment and care services should address these factors. Further studies may be needed to confirm the findings.

Disaster Planning and Risk Communication With Vulnerable Communities: Lessons From Hurricane Katrina

PubMed Central

Eisenman, David P.; Cordasco, Kristina M.; Asch, Steve; Golden, Joya F.; Glik, Deborah

2007-01-01

Objectives. We studied the experience of Hurricane Katrina evacuees to better understand factors influencing evacuation decisions in impoverished, mainly minority communities that were most severely affected by the disaster. Methods. We performed qualitative interviews with 58 randomly selected evacuees living in Houston’s major evacuation centers from September 9 to 12, 2005. Transcripts were content analyzed using grounded theory methodology. Results. Participants were mainly African American, had low incomes, and were from New Orleans. Participants’ strong ties to extended family, friends, and community groups influenced other factors affecting evacuation, including transportation, access to shelter, and perception of evacuation messages. These social connections cut both ways, which facilitated and hindered evacuation decisions. Conclusions. Effective disaster plans must account for the specific obstacles encountered by vulnerable and minority communities. Removing the more apparent obstacles of shelter and transportation will likely be insufficient for improving disaster plans for impoverished, minority communities. The important influence of extended families and social networks demand better community-based communication and preparation strategies. PMID:17413069

[Case histories and other stories in the multimedia era... but was there something else?...].

PubMed

Kohler, Hans-Peter

2010-12-01

The multimedia era is fascinating and limitless! The advances in the field of consumer and entertainment electronics are impressive. Our private as well as business life is very much accompanied and influenced by numerous technical gadgets. These advancements should have many positive implications on our clinical work. Do they? Using modern personal computers and clinic information systems (CIS) the access to patients' data, the prescription of drugs, or x-ray diagnostics on high-resolution laptop screens became as easy as pie. This affects the doctor-patient relationship but also the communication between physicians and nurses. Computers also affect our daily clinical work and therefore the treatment of our patients. Do our patients take benefit from these technical achievements? Does the use of clinic information systems positively influence diagnosis, treatment and finally patient outcome but also doctors' performances? What has really changed in the last couples of years? The present article tries to critically review these major changes in patient care.

Treatment of Superior Vena Cava (SVC) Syndrome and Inferior Vena Cava (IVC) Thrombosis in a Patient with Colorectal Cancer: Combination of SVC Stenting and IVC Filter Placement to Palliate Symptoms and Pave the Way for Port Implantation

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

Sauter, Alexander; Triller, Juergen; Schmidt, Felix

Thrombosis of the inferior vena cava is a life-threatening complication in cancer patients leading to pulmonary embolism. These patients can also be affected by superior vena cava syndrome causing dyspnea followed by trunk or extremity swelling. We report the case of a 61-year-old female suffering from an extended colorectal tumor who became affected by both of the mentioned complications. Due to thrombus formation within the right vena jugularis interna, thrombosis of the inferior vena cava, and superior vena cava syndrome, a combined interventional procedure via a left jugular access with stenting of the superior vena cava and filter placement intomore » the inferior vena cava was performed As a consequence, relief of the patient's symptoms, prevention of pulmonary embolism, and paving of the way for further venous chemotherapy were achieved.« less

Grain sorghum proteomics: integrated approach toward characterization of endosperm storage proteins in kafirin allelic variants.

PubMed

Cremer, Julia E; Bean, Scott R; Tilley, Michael M; Ioerger, Brian P; Ohm, Jae B; Kaufman, Rhett C; Wilson, Jeff D; Innes, David J; Gilding, Edward K; Godwin, Ian D

2014-10-08

Grain protein composition determines quality traits, such as value for food, feedstock, and biomaterials uses. The major storage proteins in sorghum are the prolamins, known as kafirins. Located primarily on the periphery of the protein bodies surrounding starch, cysteine-rich β- and γ-kafirins may limit enzymatic access to internally positioned α-kafirins and starch. An integrated approach was used to characterize sorghum with allelic variation at the kafirin loci to determine the effects of this genetic diversity on protein expression. Reversed-phase high performance liquid chromatography and lab-on-a-chip analysis showed reductions in alcohol-soluble protein in β-kafirin null lines. Gel-based separation and liquid chromatography-tandem mass spectrometry identified a range of redox active proteins affecting storage protein biochemistry. Thioredoxin, involved in the processing of proteins at germination, has reported impacts on grain digestibility and was differentially expressed across genotypes. Thus, redox states of endosperm proteins, of which kafirins are a subset, could affect quality traits in addition to the expression of proteins.

Effects of Plant-Community Composition on the Vectorial Capacity and Fitness of the Malaria Mosquito Anopheles gambiae

PubMed Central

Stone, Christopher M.; Jackson, Bryan T.; Foster, Woodbridge A.

2012-01-01

Dynamics of Anopheles gambiae abundance and malaria transmission potential rely strongly on environmental conditions. Female and male An. gambiae use sugar and are affected by its absence, but how the presence or absence of nectariferous plants affects An. gambiae abundance and vectorial capacity has not been studied. We report on four replicates of a cohort study performed in mesocosms with sugar-poor and sugar-rich plants, in which we measured mosquito survival, biting rates, and fecundity. Survivorship was greater with access to sugar-rich plant species, and mortality patterns were age-dependent. Sugar-poor populations experienced Weibull mortality patterns, and of four populations in the sugar-rich environment, two female and three male subpopulations were better fitted by Gompertz functions. A tendency toward higher biting rates in sugar-poor mesocosms, particularly for young females, was found. Therefore, vectorial capacity was pulled in opposing directions by nectar availability, resulting in highly variable vectorial capacity values. PMID:22927493

Outcomes of an Innovative Evidence-Based Practice Project: Building a Difficult-Access Team in the Emergency Department.

PubMed

Whalen, Madeleine; Maliszewski, Barbara; Sheinfeld, Rebecca; Gardner, Heather; Baptiste, Diana

2018-04-25

Difficult venous access is a common problem in health care-especially in the emergency setting-that relies on quick diagnostics to differentiate patient acuities and administer critical medications. The creation of a dedicated team to address difficult venous access (DVA) is a possible solution to the problems of delayed venous access, yet no studies have been published on implementing such a team in the emergency department. This was a quasi-experimental study in an urban emergency department. Researchers performed chart audits of staff-identified patients with DVA to gather baseline data. A DVA team was subsequently implemented 16 hours a day, 7 days a week. Data were recorded on patients referred to the team and included time, number of IV attempts, and patient characteristics. Baseline data were collected on 53 patients, and postintervention data included 135 patients. The implementation of a DVA team decreased the mean lab order-to-lab completion time by 115 minutes (P < 0.0001). Decreases in the number of attempts were not statistically significant. Patients requiring increased numbers of IV attempts also had many common characteristics including history of multiple attempts, poor skin quality, and IV drug use. The use of a dedicated team for DVA reduces the lag time from physician orders to actionable diagnostics or administration of medication. A dedicated DVA technician is a concrete solution to threats of patient safety, as well as ED crowding, and has the potential to affect both patient- and department-level care. Copyright © 2018 Elsevier Inc. All rights reserved.

Reduced invasive and muscle-sparing operative approaches to the posterolateral chest wall provide an excellent accessibility for the operative stabilization! : Minimized approaches to the posterolateral chest wall.

PubMed

Langenbach, A; Oppel, Pascal; Grupp, Sina; Krinner, Sebastian; Pachowsky, Milena; Buder, Thomas; Schulz-Drost, Melanie; Hennig, Friedrich F; Schulz-Drost, Stefan

2017-11-09

Stabilizing techniques for flail chest injuries are described through wide surgical approaches to the chest wall, especially in the most affected posterior and lateral regions. Severe morbidity due to these invasive approaches needs to be considered due to dissection of the scapular guiding muscles and the risk of injuries to neurovascular bundles. This study discusses possibilities for minimized approaches to the posterior and lateral regions. Ten fresh-frozen cadavers in lateral decubitus position were observed on both sides. Each surgical arm was kept mobile during the procedure. Approaches were performed following a standard protocol with muscle-sparing incisions starting with 5 cm in length and extending to 10 and 15 cm. The accessible surface comparing the extensions was measured. Visible ribs were counted. In a next step, MatrixRib ® Plates were fixed to those ribs to prove the feasibility of rib stabilization through limited approaches. Combinations of the posterior and lateral minimized approaches allow surgical fixation of 6-9 and 7-11 ribs through 5 and 10 cm incisions, respectively. In the case of an extreme expansion of a rib fracture series, an access extension can be made to 15 cm to be able to adequately supply the entire hemithorax using two approaches. Extensive invasive surgical approaches to the thoracic wall can be replaced by reduced invasive and muscle-sparing access combinations. A free-moving positioning of the arm and an accurate preoperative plan for minimizing approaches are essential. Minimally invasive plate techniques are very helpful adjuncts.

Mapping Population-Level Spatial Access to Essential Surgical Care in Ghana Using Availability of Bellwether Procedures.

PubMed

Stewart, Barclay T; Tansley, Gavin; Gyedu, Adam; Ofosu, Anthony; Donkor, Peter; Appiah-Denkyira, Ebenezer; Quansah, Robert; Clarke, Damian L; Volmink, Jimmy; Mock, Charles

2016-08-17

Conditions that can be treated by surgery comprise more than 16% of the global disease burden. However, 5 billion people do not have access to essential surgical care. An estimated 90% of the 87 million disability-adjusted life-years incurred by surgical conditions could be averted by providing access to timely and safe surgery in low-income and middle-income countries. Population-level spatial access to essential surgery in Ghana is not known. To assess the performance of bellwether procedures (ie, open fracture repair, emergency laparotomy, and cesarean section) as a proxy for performing essential surgery more broadly, to map population-level spatial access to essential surgery, and to identify first-level referral hospitals that would most improve access to essential surgery if strengthened in Ghana. Population-based study among all households and public and private not-for-profit hospitals in Ghana. Households were represented by georeferenced census data. First-level and second-level referral hospitals managed by the Ministry of Health and all tertiary hospitals were included. Surgical data were collected from January 1 to December 31, 2014. All procedures performed at first-level referral hospitals in Ghana in 2014 were used to sort each facility into 1 of the following 3 hospital groups: those without capability to perform all 3 bellwether procedures, those that performed 1 to 11 of each procedure, and those that performed at least 12 of each procedure. Candidates for targeted capability improvement were identified by cost-distance and network analysis. Of 155 first-level referral hospitals managed by the Ghana Health Service and the Christian Health Association of Ghana, 123 (79.4%) reported surgical data. Ninety-five (77.2%) did not have the capability in 2014 to perform all 3 bellwether procedures, 24 (19.5%) performed 1 to 11 of each bellwether procedure, and 4 (3.3%) performed at least 12. The essential surgical procedure rate was greater in bellwether procedure-capable first-level referral hospitals than in noncapable hospitals (median, 638; interquartile range, 440-1418 vs 360; interquartile range, 0-896 procedures per 100 000 population; P = .03). Population-level spatial access within 2 hours to a hospital that performed 1 to 11 and at least 12 of each bellwether procedure was 83.2% (uncertainty interval [UI], 82.2%-83.4%) and 71.4% (UI, 64.4%-75.0%), respectively. Five hospitals were identified for targeted capability improvement. Almost 30% of Ghanaians cannot access essential surgery within 2 hours. Bellwether capability is a useful metric for essential surgery more broadly. Similar strategic planning exercises might be useful for other low-income and middle-income countries aiming to improve access to essential surgery.

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

PubMed

Sucurovic, Snezana; Milutinovic, Veljko

2008-01-01

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

Channel MAC Protocol for Opportunistic Communication in Ad Hoc Wireless Networks

NASA Astrophysics Data System (ADS)

Ashraf, Manzur; Jayasuriya, Aruna; Perreau, Sylvie

2008-12-01

Despite significant research effort, the performance of distributed medium access control methods has failed to meet theoretical expectations. This paper proposes a protocol named "Channel MAC" performing a fully distributed medium access control based on opportunistic communication principles. In this protocol, nodes access the channel when the channel quality increases beyond a threshold, while neighbouring nodes are deemed to be silent. Once a node starts transmitting, it will keep transmitting until the channel becomes "bad." We derive an analytical throughput limit for Channel MAC in a shared multiple access environment. Furthermore, three performance metrics of Channel MAC—throughput, fairness, and delay—are analysed in single hop and multihop scenarios using NS2 simulations. The simulation results show throughput performance improvement of up to 130% with Channel MAC over IEEE 802.11. We also show that the severe resource starvation problem (unfairness) of IEEE 802.11 in some network scenarios is reduced by the Channel MAC mechanism.

Sequential data access with Oracle and Hadoop: a performance comparison

NASA Astrophysics Data System (ADS)

Baranowski, Zbigniew; Canali, Luca; Grancher, Eric

2014-06-01

The Hadoop framework has proven to be an effective and popular approach for dealing with "Big Data" and, thanks to its scaling ability and optimised storage access, Hadoop Distributed File System-based projects such as MapReduce or HBase are seen as candidates to replace traditional relational database management systems whenever scalable speed of data processing is a priority. But do these projects deliver in practice? Does migrating to Hadoop's "shared nothing" architecture really improve data access throughput? And, if so, at what cost? Authors answer these questions-addressing cost/performance as well as raw performance- based on a performance comparison between an Oracle-based relational database and Hadoop's distributed solutions like MapReduce or HBase for sequential data access. A key feature of our approach is the use of an unbiased data model as certain data models can significantly favour one of the technologies tested.

Valorization of genetic variability for the qualitative improvement of autochthonous grape cultivars of Cirò's terroir through the self-fertilization.

PubMed

Meneghetti, Stefano; Gaiotti, Federica; Giust, Mirella; Belfiore, Nicola; Tomasi, Diego

2015-03-01

This study uses PCR-derived marker systems to investigate the genetic differences of 22 grapevine accessions obtained through a self-fertilization program using Gaglioppo and Magliocco dolce. The aim of the study was to improve some qualitative parameters, while preserving the adaptive characteristics of these two cultivars to the adverse environmental conditions of the Calabria region (southern Italy). These two Calabrian grapevines have been cultivated within a restricted area and have been placed under a strong anthropic pressure which has limited their phenotypical variability with no selection of higher performant biotypes. Therefore, to have accessions with improved qualitative traits, a program of genetic improvement based on the self-fertilization of Gaglioppo and Magliocco dolce cultivars was performed in 1998, producing 3,122 accessions. Selection cycles were performed in 14 years. A first selection cycle (1998-2000), based on visual inspection of vegetative traits, selected 1,320 accessions, planted in an experimental vineyard in 2000. A second selection cycle (2000-2008), based on phenotypic traits, sanitary aspects, and chemical composition of the grapes, selected 42 accessions, planted in a new experimental vineyard in 2008. A final selection cycle (2008-2012), produced 22 accessions (virus free), with the best agronomic, sanitary, and qualitative aspects: two accessions obtained from Gaglioppo have been selected by color characteristics (i.e., anthocyanin total content and stability); 20 genotypes obtained from Magliocco dolce had a better macro-composition of the grape (i.e., good sugar content with a balanced acidity). SSR analyses were performed to check the self-fertilization process. The study of genetic differences between accessions was performed by AFLPs, SAMPLs, and M-AFLPs. The application of the above-mentioned techniques allowed both to discriminate molecularly the 22 accessions grouped these accessions according to their genetic similarity. The self-fertilization approach has enabled improvement in the quality of the grapes, while preserving the high degree of adaptation to the environment of these two native Calabrian cultivars in southern Italy.

U.S. Navy Climate Change Roadmap

DTIC Science & Technology

2010-04-01

Climate change is a national security challenge with strategic implications for the Navy. Climate change will lead to increased tensions in nations...with weak economies and political institutions. While climate change alone is not likely to lead to future conflict, it may be a contributing factor... Climate change is affecting, and will continue to affect, U.S. military installations and access to natural resources worldwide. It will affect the

Understanding genetic control of root system architecture in soybean: Insights into the genetic basis of lateral root number.

PubMed

Prince, Silvas J; Valliyodan, Babu; Ye, Heng; Yang, Ming; Tai, Shuaishuai; Hu, Wushu; Murphy, Mackensie; Durnell, Lorellin A; Song, Li; Joshi, Trupti; Liu, Yang; Van de Velde, Jan; Vandepoele, Klaas; Grover Shannon, J; Nguyen, Henry T

2018-05-10

Developing crops with better root systems is a promising strategy to ensure productivity in both optimum and stress environments. Root system architectural (RSA) traits in 397 soybean accessions were characterized and a high-density single nucleotide polymorphisms (SNP) based genome-wide association study was performed to identify the underlying genes associated with root structure. SNPs associated with root architectural traits specific to landraces and elite germplasm pools were detected. Four loci were detected in landraces for lateral root number (LRN) and distribution of root thickness in diameter class I with a major locus on chromosome 16. This major loci was detected in the coding region of unknown protein, and subsequent analyses demonstrated that root traits are affected with mutated haplotypes of the gene. In elite germplasm pool, three significant SNPs in alanine-glyoxalate aminotransferase, Leucine-Rich Repeat receptor/No apical meristem and unknown functional genes were found to govern multiple traits including root surface area and volume. However, no major loci were detected for LRN in elite germplasm. Nucleotide diversity analysis found evidence of selective sweeps around the landraces LRN gene. Soybean accessions with minor and mutated allelic variants of LRN gene were found to perform better in both water-limited and optimal field conditions. This article is protected by copyright. All rights reserved.

Single-side renal sympathetic denervation to treat malignant refractory hypertension in a solitary kidney patient.

PubMed

Ribichini, Flavio; Ferrara, Angela; Pighi, Michele; Pesarini, Gabriele; Gambaro, Alessia; Valvo, Enrico; Lupo, Antonio; Vassanelli, Corrado

2014-12-01

Renal sympathetic denervation (RSD) is emerging as a new therapeutic option for patients with severe hypertension refractory to medical therapy. Patients affected by renovascular or anatomical abnormalities have hitherto been systematically excluded from clinical trials with RSD because of concern about safety and the unknown efficacy of the procedure in this subgroup of patients. We describe the management of a case of RSD in a single-kidney patient with refractory hypertension; the patient had had a previous surgical right nephrectomy for renal cell carcinoma that subsequently required no other oncologic treatment. After multidisciplinary assessment, the patient underwent RSD. The procedure was performed through a 6F femoral access using the Symplicity™ RSD system (Medtronic, Mountain View, CA, USA). Radiofrequency was applied to the renal artery wall in 6 different points under general sedation with midazolam to control back pain caused by the procedure, that was performed without periprocedural complications. The patient was discharged 2 days later after a control of the vascular access site and routine biochemical examinations. The following 9-month follow up showed a significant reduction in blood pressure and stable renal function, without signs of renal damage. Our report confirms the feasibility of RSD in this delicate context, without evident negative effects on kidney function and with a significant reduction in blood pressure. Future studies are needed to fully clarify the value of RSD in single-kidney patients.

The Motivating Power of Visionary Images: Effects on Motivation, Affect, and Behavior.

PubMed

Rawolle, Maika; Schultheiss, Oliver C; Strasser, Alexandra; Kehr, Hugo M

2017-12-01

Visionary images are identity-relevant, picture-like mental representations of a desirable and attainable future appearing regularly in a person's stream of thought. Prior research indicates that both mental and real images provide access to implicit motives. We therefore proposed that visionary images motivate people by arousing their implicit motives and tested this hypothesis in two experimental studies. We used guided visualizations to administer motive-domain-specific visionary images (Study 1: achievement and neutral, M age  = 24.4, 51 participants, 34 women; Study 2: affiliation and power, M age  = 24.01, 51 participants, 28 women) to arouse the respective implicit motive. Motivation was measured via residual changes in affective (i.e., changes in affective arousal), behavioral (i.e., performance on a concentration task, behavioral choices in a prisoner's dilemma), and mental (i.e., motive imagery in the Picture Story Exercise) indicators of motivation. The results largely confirmed our hypothesis. Visionary images increased motivation in the targeted domain. Some effects were moderated by participants' implicit motives. The findings underscore the role of implicit motives in understanding the motivational effectiveness of visionary images. © 2016 Wiley Periodicals, Inc.

The effects of bilateral presentations on lateralized lexical decision.

PubMed

Fernandino, Leonardo; Iacoboni, Marco; Zaidel, Eran

2007-06-01

We investigated how lateralized lexical decision is affected by the presence of distractors in the visual hemifield contralateral to the target. The study had three goals: first, to determine how the presence of a distractor (either a word or a pseudoword) affects visual field differences in the processing of the target; second, to identify the stage of the process in which the distractor is affecting the decision about the target; and third, to determine whether the interaction between the lexicality of the target and the lexicality of the distractor ("lexical redundancy effect") is due to facilitation or inhibition of lexical processing. Unilateral and bilateral trials were presented in separate blocks. Target stimuli were always underlined. Regarding our first goal, we found that bilateral presentations (a) increased the effect of visual hemifield of presentation (right visual field advantage) for words by slowing down the processing of word targets presented to the left visual field, and (b) produced an interaction between visual hemifield of presentation (VF) and target lexicality (TLex), which implies the use of different strategies by the two hemispheres in lexical processing. For our second goal of determining the processing stage that is affected by the distractor, we introduced a third condition in which targets were always accompanied by "perceptual" distractors consisting of sequences of the letter "x" (e.g., xxxx). Performance on these trials indicated that most of the interaction occurs during lexical access (after basic perceptual analysis but before response programming). Finally, a comparison between performance patterns on the trials containing perceptual and lexical distractors indicated that the lexical redundancy effect is mainly due to inhibition of word processing by pseudoword distractors.

Accompaniment of second-trimester abortions: the model of the feminist Socorrista network of Argentina.

PubMed

Zurbriggen, Ruth; Keefe-Oates, Brianna; Gerdts, Caitlin

2018-02-01

Legal restrictions on abortion access impact the safety and timing of abortion. Women affected by these laws face barriers to safe care that often result in abortion being delayed. Second-trimester abortion affects vulnerable groups of women disproportionately and is often more difficult to access. In Argentina, where abortion is legally restricted except in cases of rape or threat to the health of the woman, the Socorristas en Red, a feminist network, offers a model of accompaniment wherein they provide information and support to women seeking second-trimester abortions. This qualitative analysis aimed to understand Socorristas' experiences supporting women who have second-trimester medication abortion outside the formal health care system. We conducted 2 focus groups with 16 Socorristas in total to understand experiences accompanying women having second-trimester medication abortion who were at 14-24 weeks' gestational age. We performed a thematic analysis of the data and present key themes in this article. The Socorristas strived to ensure that women had the power of choice in every step of their abortion. These cases required more attention and logistical, legal and medical risks than first-trimester care. The Socorristas learned how to help women manage the possibility of these risks and were comfortable providing this support. They understood their work as activism through which they aim to destigmatize abortion and advocate against patriarchal systems denying the right to abortion. Socorrista groups have shown that they can provide supportive, women-centered accompaniment during second-trimester medication abortions outside the formal health care system in a setting where abortion access is legally restricted. Second-trimester self-use of medication abortion outside of the formal health system supported by feminist activist groups could provide an alternative model for second-trimester care worldwide. More research is needed to document the safety and effectiveness of this accompaniment service-provision model. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Accessibility to primary health care in Belgium: an evaluation of policies awarding financial assistance in shortage areas.

PubMed

Dewulf, Bart; Neutens, Tijs; De Weerdt, Yves; Van de Weghe, Nico

2013-08-22

In many countries, financial assistance is awarded to physicians who settle in an area that is designated as a shortage area to prevent unequal accessibility to primary health care. Today, however, policy makers use fairly simple methods to define health care accessibility, with physician-to-population ratios (PPRs) within predefined administrative boundaries being overwhelmingly favoured. Our purpose is to verify whether these simple methods are accurate enough for adequately designating medical shortage areas and explore how these perform relative to more advanced GIS-based methods. Using a geographical information system (GIS), we conduct a nation-wide study of accessibility to primary care physicians in Belgium using four different methods: PPR, distance to closest physician, cumulative opportunity, and floating catchment area (FCA) methods. The official method used by policy makers in Belgium (calculating PPR per physician zone) offers only a crude representation of health care accessibility, especially because large contiguous areas (physician zones) are considered. We found substantial differences in the number and spatial distribution of medical shortage areas when applying different methods. The assessment of spatial health care accessibility and concomitant policy initiatives are affected by and dependent on the methodology used. The major disadvantage of PPR methods is its aggregated approach, masking subtle local variations. Some simple GIS methods overcome this issue, but have limitations in terms of conceptualisation of physician interaction and distance decay. Conceptually, the enhanced 2-step floating catchment area (E2SFCA) method, an advanced FCA method, was found to be most appropriate for supporting areal health care policies, since this method is able to calculate accessibility at a small scale (e.g., census tracts), takes interaction between physicians into account, and considers distance decay. While at present in health care research methodological differences and modifiable areal unit problems have remained largely overlooked, this manuscript shows that these aspects have a significant influence on the insights obtained. Hence, it is important for policy makers to ascertain to what extent their policy evaluations hold under different scales of analysis and when different methods are used.

Accessibility to primary health care in Belgium: an evaluation of policies awarding financial assistance in shortage areas

PubMed Central

2013-01-01

Background In many countries, financial assistance is awarded to physicians who settle in an area that is designated as a shortage area to prevent unequal accessibility to primary health care. Today, however, policy makers use fairly simple methods to define health care accessibility, with physician-to-population ratios (PPRs) within predefined administrative boundaries being overwhelmingly favoured. Our purpose is to verify whether these simple methods are accurate enough for adequately designating medical shortage areas and explore how these perform relative to more advanced GIS-based methods. Methods Using a geographical information system (GIS), we conduct a nation-wide study of accessibility to primary care physicians in Belgium using four different methods: PPR, distance to closest physician, cumulative opportunity, and floating catchment area (FCA) methods. Results The official method used by policy makers in Belgium (calculating PPR per physician zone) offers only a crude representation of health care accessibility, especially because large contiguous areas (physician zones) are considered. We found substantial differences in the number and spatial distribution of medical shortage areas when applying different methods. Conclusions The assessment of spatial health care accessibility and concomitant policy initiatives are affected by and dependent on the methodology used. The major disadvantage of PPR methods is its aggregated approach, masking subtle local variations. Some simple GIS methods overcome this issue, but have limitations in terms of conceptualisation of physician interaction and distance decay. Conceptually, the enhanced 2-step floating catchment area (E2SFCA) method, an advanced FCA method, was found to be most appropriate for supporting areal health care policies, since this method is able to calculate accessibility at a small scale (e.g. census tracts), takes interaction between physicians into account, and considers distance decay. While at present in health care research methodological differences and modifiable areal unit problems have remained largely overlooked, this manuscript shows that these aspects have a significant influence on the insights obtained. Hence, it is important for policy makers to ascertain to what extent their policy evaluations hold under different scales of analysis and when different methods are used. PMID:23964751

A numerical study of the effect of catheter angle on the blood flow characteristics in a graft during hemodialysis

NASA Astrophysics Data System (ADS)

Ryou, Hong Sun; Kim, Soyoon; Ro, Kyoungchul

2013-02-01

For patients with renal failure, renal replacement therapies are needed. Hemodialysis is a widely used renal replacement method to remove waste products. It is important to improve the patency rate of the vascular access for efficient dialysis. Since some complications such as an intimal hyperplasia are associated with the flow pattern, the hemodynamics in the vascular access must be considered to achieve a high patency rate. In addition, the blood flow from an artificial kidney affects the flow in the vascular access. Generally, the clinical techniques of hemodialysis such as the catheter angle or dialysis dose have been set up empirically. In this study, a numerical analysis is performed on the effect of the catheter angle on the flow in the graft. Blood is assumed to be a non-Newtonian fluid. According to the high average wall shear stress value, the leucocytes and platelets can be activated not only at the arterial anastomosis, but also at the bottom of the venous graft, when the catheter angle is not zero. For a catheter angle less than five degrees, there is a low shear and high oscillatory shear index region that appears at the venous graft and the venous anastomosis. Thus, a catheter angle less than five degrees should be avoided to prevent graft failure.

Predictors of completed childhood vaccination in Bolivia.

PubMed

Osetinsky, Brianna; Gaydos, Laura M; Leon, Juan S

This project examines how access issues, ethnicity, and geographic region affect vaccination of children by two years of age in Bolivia. Bolivia's rich variation in culture and geography results in unequal healthcare utilization even for basic interventions such as childhood vaccination. This study utilizes secondary data from the 2008 Demographic and Health Survey for Bolivia to examine predictors of vaccination completion in children by two years of age. Using logistic regression methods, we control for health system variables (difficulty getting to a health center and type of health center as well as demographic and socio-economic covariates). The results indicated that children whose parents reported distance as a problem in obtaining health care were less likely to have completed all vaccinations. Ethnicity was not independently statistically significant, however, in a sub-analysis, people from the Quechua ethnic group were more likely to report 'distance as a problem in obtaining healthcare.' Surprisingly, living in a rural environment has a protective effect on completed vaccinations. However, geographic region did predict significant differences in the probability that children would be fully vaccinated; children in the region with the lowest vaccination completion coverage were 80% less likely to have completed vaccination compared to children in the best performing region, which may indicate unequal access and utilization of health services nationally. Further study of regional differences, urbanicity, and distance as a healthcare access problem will help refine implications for the Bolivian health system.

Finding Food Deserts: A Comparison of Methods Measuring Spatial Access to Food Stores.

PubMed

Jaskiewicz, Lara; Block, Daniel; Chavez, Noel

2016-05-01

Public health research has increasingly focused on how access to resources affects health behaviors. Mapping environmental factors, such as distance to a supermarket, can identify intervention points toward improving food access in low-income and minority communities. However, the existing literature provides little guidance on choosing the most appropriate measures of spatial access. This study compared the results of different measures of spatial access to large food stores and the locations of high and low access identified by each. The data set included U.S. Census population data and the locations of large food stores in the six-county area around Chicago, Illinois. Six measures of spatial access were calculated at the census block group level and the results compared. The analysis found that there was little agreement in the identified locations of high or low access between measures. This study illustrates the importance of considering the access measure used when conducting research, interpreting results, or comparing studies. Future research should explore the correlation of different measures with health behaviors and health outcomes. © 2015 Society for Public Health Education.

15 CFR 930.33 - Identifying Federal agency activities affecting any coastal use or resource.

Code of Federal Regulations, 2014 CFR

2014-01-01

... public access and recreational opportunities, protection of historic property) or a coastal resource, if... affecting any coastal use or resource. 930.33 Section 930.33 Commerce and Foreign Trade Regulations Relating... OF COMMERCE OCEAN AND COASTAL RESOURCE MANAGEMENT FEDERAL CONSISTENCY WITH APPROVED COASTAL...

15 CFR 930.33 - Identifying Federal agency activities affecting any coastal use or resource.

Code of Federal Regulations, 2012 CFR

2012-01-01

... public access and recreational opportunities, protection of historic property) or a coastal resource, if... affecting any coastal use or resource. 930.33 Section 930.33 Commerce and Foreign Trade Regulations Relating... OF COMMERCE OCEAN AND COASTAL RESOURCE MANAGEMENT FEDERAL CONSISTENCY WITH APPROVED COASTAL...

15 CFR 930.33 - Identifying Federal agency activities affecting any coastal use or resource.

Code of Federal Regulations, 2011 CFR

2011-01-01

... public access and recreational opportunities, protection of historic property) or a coastal resource, if... affecting any coastal use or resource. 930.33 Section 930.33 Commerce and Foreign Trade Regulations Relating... OF COMMERCE OCEAN AND COASTAL RESOURCE MANAGEMENT FEDERAL CONSISTENCY WITH APPROVED COASTAL...

15 CFR 930.33 - Identifying Federal agency activities affecting any coastal use or resource.

Code of Federal Regulations, 2010 CFR

2010-01-01

... public access and recreational opportunities, protection of historic property) or a coastal resource, if... affecting any coastal use or resource. 930.33 Section 930.33 Commerce and Foreign Trade Regulations Relating... OF COMMERCE OCEAN AND COASTAL RESOURCE MANAGEMENT FEDERAL CONSISTENCY WITH APPROVED COASTAL...

15 CFR 930.33 - Identifying Federal agency activities affecting any coastal use or resource.

Code of Federal Regulations, 2013 CFR

2013-01-01

... public access and recreational opportunities, protection of historic property) or a coastal resource, if... affecting any coastal use or resource. 930.33 Section 930.33 Commerce and Foreign Trade Regulations Relating... OF COMMERCE OCEAN AND COASTAL RESOURCE MANAGEMENT FEDERAL CONSISTENCY WITH APPROVED COASTAL...

Children's Search Engines from an Information Search Process Perspective.

ERIC Educational Resources Information Center

Broch, Elana

2000-01-01

Describes cognitive and affective characteristics of children and teenagers that may affect their Web searching behavior. Reviews literature on children's searching in online public access catalogs (OPACs) and using digital libraries. Profiles two Web search engines. Discusses some of the difficulties children have searching the Web, in the…

Exposure to activity-based anorexia impairs contextual learning in weight-restored rats without affecting spatial learning, taste, anxiety, or dietary-fat preference.

PubMed

Boersma, Gretha J; Treesukosol, Yada; Cordner, Zachary A; Kastelein, Anneke; Choi, Pique; Moran, Timothy H; Tamashiro, Kellie L

2016-02-01

Relapse rates are high amongst cases of anorexia nervosa (AN) suggesting that some alterations induced by AN may remain after weight restoration. To study the consequences of AN without confounds of environmental variability, a rodent model of activity-based anorexia (ABA) can be employed. We hypothesized that exposure to ABA during adolescence may have long-term consequences in taste function, cognition, and anxiety-like behavior after weight restoration. To test this hypothesis, we exposed adolescent female rats to ABA (1.5 h food access, combined with voluntary running wheel access) and compared their behavior to that of control rats after weight restoration was achieved. The rats were tested for learning/memory, anxiety, food preference, and taste in a set of behavioral tests performed during the light period. Our data show that ABA exposure leads to reduced performance during the novel object recognition task, a test for contextual learning, without altering performance in the novel place recognition task or the Barnes maze, both tasks that test spatial learning. Furthermore, we do not observe alterations in unconditioned lick responses to sucrose nor quinine (described by humans as "sweet" and "bitter," respectively). Nor Do we find alterations in anxiety-like behavior during an elevated plus maze or an open field test. Finally, preference for a diet high in fat is not altered. Overall, our data suggest that ABA exposure during adolescence impairs contextual learning in adulthood without altering spatial leaning, taste, anxiety, or fat preference. © 2015 Wiley Periodicals, Inc.

Electronic access to scientific nursing knowledge: the Virginia Henderson International Nursing Library.

PubMed

Graves, J R

2001-02-01

To inform oncology nurses about the electronic knowledge resources offered by the Sigma Theta Tau International Virginia Henderson International Nursing Library. Published articles and research studies. Clinical nursing research dissemination has been seriously affected by publication bias. The Virginia Henderson International Nursing Library has introduced both a new publishing paradigm for research and a new knowledge indexing strategy for improving electronic access to research knowledge (findings). The ability of oncology nursing to evolve, as an evidence-based practice, is largely dependent on access to research findings.

Using Technology to Improve Access to Mental Health Services.

PubMed

Cortelyou-Ward, Kendall; Rotarius, Timothy; Honrado, Jed C

Mental ill-health is a public health threat that is prevalent throughout the United States. Tens of millions of Americans have been diagnosed along the continuum of mental ill-health, and many more millions of family members and friends are indirectly affected by the pervasiveness of mental ill-health. Issues such as access and the societal stigma related to mental health issues serve as deterrents to patients receiving their necessary care. However, technological advances have shown the potential to increase access to mental health services for many patients.

The Every Student Succeeds Act, State Efforts to Improve Access to Effective Educators, and the Importance of School Leadership

ERIC Educational Resources Information Center

Fuller, Edward J.; Hollingworth, Liz; Pendola, Andrew

2017-01-01

Purpose: Our primary purpose is to examine the degree to which state equity plans identify the distribution of principals and principal turnover as factors influencing three leadership mechanisms that affect student access to effective teachers--namely, hiring of teachers, building instructional capacity of teachers, and managing teacher turnover.…

Meth mouth severity in response to drug-use patterns and dental access in methamphetamine users.

PubMed

Brown, Ronni E; Morisky, Donald E; Silverstein, Steven J

2013-06-01

Meth mouth is the rapid development of tooth decay in methamphetamine users. Our study questioned whether drug-use patterns and dental care access are risk factors affecting the severity of meth mouth. Participants received dental examinations, and the number of decayed, missing and filled teeth (DMFT) were counted and used to measure meth mouth severity.

Subject Access to Government Documents in an Era of Globalization: Intellectual Bundling of Entities Affected by the Decisions of Supranational Organizations.

ERIC Educational Resources Information Center

Dilevko, Juris

2002-01-01

Discusses the need for a new model for subject access to government information in academic libraries as a result of the growing influence of supranational organizations. Highlights include the World Trade Organization (WT); ruling under transnational economic agreements such as the North American Free Trade Agreement (NAFTA); private sector…

Access to Institutional Resources as a Measure of Social Exclusion: Relations with Family Process and Cognitive Development in the Context of Immigration

ERIC Educational Resources Information Center

Yoshikawa, Hirokazu; Godfrey, Erin B.; Rivera, Ann C.

2008-01-01

Few studies have examined how experiences associated with being an undocumented immigrant parent affects children's development. In this article, the authors apply social exclusion theory to examine how access to institutional resources that require identification may matter for parents and children in immigrant families. As hypothesized, groups…

Water sources and controls on water-loss rates of epigeous ectomycorrhizal fungal sporocarps during summer drought

Treesearch

Erik A. Lilleskov; Thomas D. Bruns; Todd E. Dawson; Francisco J. Camacho

2009-01-01

Access to deeper soil water and water-conserving traits should reduce water stress for ectomycorrhizal fungi, permitting function during drought. Here, we explored whether epigeous fruiting of ectomycorrhizal fungi during drought was facilitated by access to deep soil water, how much water was lost from sporocarps, and how sporocarp surface to volume ratios affected...

Neighbourhood Deprivation, Health Inequalities and Service Access by Adults with Intellectual Disabilities: A Cross-Sectional Study

ERIC Educational Resources Information Center

Cooper, S. A.; McConnachie, A.; Allan, L. M.; Melville, C.; Smiley, E.; Morrison, J.

2011-01-01

Background: Adults with intellectual disabilities (IDs) experience health inequalities and are more likely to live in deprived areas. The aim of this study was to determine whether the extent of deprivation of the area a person lives in affects their access to services, hence contributing to health inequalities. Method: A cross-sectional study…

Exploring the Design, Development and Use of Websites through Accessibility and Usability Studies

ERIC Educational Resources Information Center

Foley, Alan

2011-01-01

In this paper, data obtained from a university website accessibility and usability validation process are analyzed and used to demonstrate how the design process can affect the online experience for users with disabilities. Interviews, observations, and use data (e.g. where users clicked on a page or what path taken through a site) were collected.…

Impact of Alabama's immigration law on access to health care among Latina immigrants and children: implications for national reform.

PubMed

White, Kari; Yeager, Valerie A; Menachemi, Nir; Scarinci, Isabel C

2014-03-01

We conducted in-depth interviews in May to July 2012 to evaluate the effect of Alabama's 2011 omnibus immigration law on Latina immigrants and their US- and foreign-born children's access to and use of health services. The predominant effect of the law on access was a reduction in service availability. Affordability and acceptability of care were adversely affected because of economic insecurity and women's increased sense of discrimination. Nonpregnant women and foreign-born children experienced the greatest barriers, but pregnant women and mothers of US-born children also had concerns about accessing care. The implications of restricting access to health services and the potential impact this has on public health should be considered in local and national immigration reform discussions.

Marginalization and health service coverage among indigenous, rural, and urban populations: a public health problem in Mexico.

PubMed

Roldán, José; Álvarez, Marsela; Carrasco, María; Guarneros, Noé; Ledesma, José; Cuchillo-Hilario, Mario; Chávez, Adolfo

2017-12-01

  Marginalization is a significant issue in Mexico, involving a lack of access to health services with differential impacts on Indigenous, rural and urban populations. The objective of this study was to understand Mexico’s public health problem across three population areas, Indigenous, rural and urban, in relation to degree of marginalization and health service coverage.   The sampling universe of the study consisted of 107 458 geographic locations in the country. The study was retrospective, comparative and confirmatory. The study applied analysis of variance, parametric and non-parametric, correlation and correspondence analyses.   Significant differences were identified between the Indigenous, rural and urban populations with respect to their level of marginalization and access to health services. The most affected area was Indigenous, followed by rural areas. The sector that was least affected was urban.   Although health coverage is highly concentrated in urban areas in Mexico, shortages are mostly concentrated in rural areas where Indigenous groups represent the extreme end of marginalization and access to medical coverage. Inadequate access to health services in the Indigenous and rural populations throws the gravity of the public health problem into relief.

ACStor: Optimizing Access Performance of Virtual Disk Images in Clouds

DOE PAGES

Wu, Song; Wang, Yihong; Luo, Wei; ...

2017-03-02

In virtualized data centers, virtual disk images (VDIs) serve as the containers in virtual environment, so their access performance is critical for the overall system performance. Some distributed VDI chunk storage systems have been proposed in order to alleviate the I/O bottleneck for VM management. As the system scales up to a large number of running VMs, however, the overall network traffic would become unbalanced with hot spots on some VMs inevitably, leading to I/O performance degradation when accessing the VMs. Here, we propose an adaptive and collaborative VDI storage system (ACStor) to resolve the above performance issue. In comparisonmore » with the existing research, our solution is able to dynamically balance the traffic workloads in accessing VDI chunks, based on the run-time network state. Specifically, compute nodes with lightly loaded traffic will be adaptively assigned more chunk access requests from remote VMs and vice versa, which can effectively eliminate the above problem and thus improves the I/O performance of VMs. We also implement a prototype based on our ACStor design, and evaluate it by various benchmarks on a real cluster with 32 nodes and a simulated platform with 256 nodes. Experiments show that under different network traffic patterns of data centers, our solution achieves up to 2-8 performance gain on VM booting time and VM’s I/O throughput, in comparison with the other state-of-the-art approaches.« less

Assessment of universal health coverage for adults aged 50 years or older with chronic illness in six middle-income countries

PubMed Central

Frenz, Patricia; Grabenhenrich, Linus; Keil, Thomas; Tinnemann, Peter

2016-01-01

Abstract Objective To assess universal health coverage for adults aged 50 years or older with chronic illness in China, Ghana, India, Mexico, the Russian Federation and South Africa. Methods We obtained data on 16 631 participants aged 50 years or older who had at least one diagnosed chronic condition from the World Health Organization Study on Global Ageing and Adult Health. Access to basic chronic care and financial hardship were assessed and the influence of health insurance and rural or urban residence was determined by logistic regression analysis. Findings The weighted proportion of participants with access to basic chronic care ranged from 20.6% in Mexico to 47.6% in South Africa. Access rates were unequally distributed and disadvantaged poor people, except in South Africa where primary health care is free to all. Rural residence did not affect access. The proportion with catastrophic out-of-pocket expenditure for the last outpatient visit ranged from 14.5% in China to 54.8% in Ghana. Financial hardship was more common among the poor in most countries but affected all income groups. Health insurance generally increased access to care but gave insufficient protection against financial hardship. Conclusion No country provided access to basic chronic care for more than half of the participants with chronic illness. The poor were less likely to receive care and more likely to face financial hardship in most countries. However, inequity of access was not fully determined by the level of economic development or insurance coverage. Future health reforms should aim to improve service quality and increase democratic oversight of health care. PMID:27034521

The evaluation of radiologic methods for access guidance in percutaneous nephrolithotomy: a systematic review of the literature.

PubMed

Breda, Alberto; Territo, Angelo; Scoffone, Cesare; Seitz, Christian; Knoll, Thomas; Herrmann, Thomas; Brehmer, Mariannhe; Osther, Palle J S; Liatsikos, Evangelos

2017-11-12

Percutaneous nephrolithotomy (PNL) is the treatment of choice for larger and complex renal calculi. First step in performing PNL is to obtain access to the renal cavity using either fluoroscopy or ultrasound (US) guidance or a combination of both. Which guiding method to choose is controversial? A systematic review of the literature was performed comparing image guidance modalities for obtaining access in PNL. Evidence acquisition and synthesis: A PubMed, Scopus and Cochrane search for peer-reviewed studies was performed using the keywords "ultrasound" AND "fluoroscopy" AND "Percutaneous nephrolithotomy". Eligible articles were reviewed according to PRISMA criteria. Two hundred and forty records were identified using the keywords. Of these twelve studies were considered relevant. US guidance seems to be associated with a slightly lower complication rate, which may be related to fewer puncture attempts needed for obtaining access and to better peri-renal organ visualization. On the other hand, US-guidance alone needs the adjunct of fluoroscopy in a significant number of cases for achieving access. Stone free rate (SFR) was comparable between groups. Using US for renal access unequivocally reduces radiation exposure. Current evidence indicates that both fluoroscopy and US guidance may be successfully used for obtaining percutaneous renal access. Combining the image-guiding modalities - US and fluoroscopy - seems to increase outcome in PNL both with regard to success in achieving access and reducing complications. Furthermore, including US in the access strategy of PNL reduces radiation exposure to surgeon and staff as well as patients.

Acceptable Care? Illness Constructions, Healthworlds, and Accessible Chronic Treatment in South Africa

PubMed Central

Harris, Bronwyn; Eyles, John; Moshabela, Mosa

2015-01-01

Achieving equitable access to health care is an important policy goal, with access influenced by affordability, availability, and acceptability of specific services. We explore patient narratives from a 5-year program of research on health care access to examine relationships between social constructions of illness and the acceptability of health services in the context of tuberculosis treatment and antiretroviral therapy in South Africa. Acceptability of services seems particularly important to the meanings patients attach to illness and care, whereas—conversely—these constructions appear to influence what constitutes acceptability and hence affect access to care. We highlight the underestimated role of individually, socially, and politically constructed healthworlds; traditional and biomedical beliefs; and social support networks. Suggested policy implications for improving acceptability and hence overall health care access include abandoning patronizing approaches to care and refocusing from treating “disease” to responding to “illness” by acknowledging and incorporating patients’ healthworlds in patient–provider interactions. PMID:25829509

One-fifth of nonelderly Californians do not have access to job-based health insurance coverage.

PubMed

Lavarreda, Shana Alex; Cabezas, Livier

2010-11-01

Lack of job-based health insurance does not affect just workers, but entire families who depend on job-based coverage for their health care. This policy brief shows that in 2007 one-fifth of all Californians ages 0-64 who lived in households where at least one family member was employed did not have access to job-based coverage. Among adults with no access to job-based coverage through their own or a spouse's job, nearly two-thirds remained uninsured. In contrast, the majority of children with no access to health insurance through a parent obtained public health insurance, highlighting the importance of such programs. Low-income, Latino and small business employees were more likely to have no access to job-based insurance. Provisions enacted under national health care reform (the Patient Protection and Affordable Care Act of 2010) will aid some of these populations in accessing health insurance coverage.

Exploring the Association of Homicides in Northern Mexico and Healthcare Access for US Residents.

PubMed

Geissler, Kimberley H; Becker, Charles; Stearns, Sally C; Thirumurthy, Harsha; Holmes, George M

2015-08-01

Many legal residents in the United States (US)-Mexico border region cross from the US into Mexico for medical treatment and pharmaceuticals. We analyzed whether recent increases in homicides in Mexico are associated with reduced healthcare access for US border residents. We used data on healthcare access, legal entries to the US from Mexico, and Mexican homicide rates (2002-2010). Poisson regression models estimated associations between homicide rates and total legal US entries. Multivariate difference-in-difference linear probability models evaluated associations between Mexican homicide rates and self-reported measures of healthcare access for US residents. Increased homicide rates were associated with decreased legal entries to the US from Mexico. Contrary to expectations, homicides did not have significant associations with healthcare access measures for legal residents in US border counties. Despite a decrease in border crossings, increased violence in Mexico did not appear to negatively affect healthcare access for US border residents.

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

PubMed Central

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

2012-01-01

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

Lexical Access and Dual-Task Performance: Determining the Locus of the Bottleneck

NASA Technical Reports Server (NTRS)

Allen, Phil

2004-01-01

During the two years of funding for NASA Grant "NCC21325, Lexical access and dual-task performance: Determining the locus of the bottleneck," we completed three experiments involving the psychological refractory period (PRP) and word frequency.

12 CFR 573.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2014 CFR

2014-01-01

... access number or access code, does not include a number or code in an encrypted form, as long as you do... account number or similar form of access number or access code for a consumer's credit card account... or access code: (1) To your agent or service provider solely in order to perform marketing for your...

12 CFR 573.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2012 CFR

2012-01-01

... access number or access code, does not include a number or code in an encrypted form, as long as you do... reporting agency, an account number or similar form of access number or access code for a consumer's credit... number or access code: (1) To your agent or service provider solely in order to perform marketing for...