PIPELINES, TRANSMISSION LINES, AND MISCELLANEOUS TRANSPORTATION FEATURES DIGITAL LINE GRAPHS FOR THE MID-ATLANTIC INTEGRATED ASSESSMENT (MAIA) STUDY AREA

EPA Science Inventory

This data set is a geographic information system (GIS) coverage of pipelines, transmission lines, and miscellaneous transportation features for the United States Environmental Protection Agency (USEPA) Mid-Atlantic Integrated Assessment (MAIA) Project region. The coverage was p...

ROAD CLASS 3 TRANSPORTATION DIGITAL LINE GRAPHS FOR THE MID-ATLANTIC INTEGRATED ASSESSMENT (MAIA) STUDY AREA

EPA Science Inventory

This data set is a geographic information system (GIS) coverage of the lower level divided roads and streets (Class 3 Roads) for the United States Environmental Protection Agency (USEPA) Mid-Atlantic Integrated Assessment (MAIA) Project region. The coverage was produced using U...

ROAD CLASS 1 TRANSPORTATION DIGITAL LINE GRAPHS FOR THE MID-ATLANTIC INTEGRATED ASSESSMENT (MAIA) STUDY AREA

EPA Science Inventory

This data set is a geographic information system (GIS) coverage of the Interstate and United States Highways (Class 1 Roads) for the United States Environmental Protection Agency (USEPA) Mid-Atlantic Integrated Assessment (MAIA) Project region. The coverage was produced using U...

ROAD CLASS 4 TRANSPORTATION DIGITAL LINE GRAPHS FOR THE MID-ATLANTIC INTEGRATED ASSESSMENT (MAIA) STUDY AREA

EPA Science Inventory

This data set is a geographic information system (GIS) coverage of the lower level roads and streets (Class 4 Roads) for the United States Environmental Protection Agency (USEPA) Mid-Atlantic Integrated Assessment (MAIA) Project region. The coverage was produced using US Geolog...

ROAD CLASS 2 TRANSPORTATION DIGITAL LINE GRAPHS FOR THE MID-ATLANTIC INTEGRATED ASSESSMENT (MAIA) STUDY AREA

EPA Science Inventory

This data set is a geographic information system (GIS) coverage of the state and county highways (Class 2 Roads) for the United States Environmental Protection Agency (USEPA) Mid-Atlantic Integrated Assessment (MAIA) Project region. The coverage was produced using US Geological...

Value for money: protecting endangered species on Danish heathland.

PubMed

Strange, Niels; Jacobsen, Jette B; Thorsen, Bo J; Tarp, Peter

2007-11-01

Biodiversity policies in the European Union (EU) are mainly implemented through the Birds and Habitats Directives as well as the establishment of Natura 2000, a network of protected areas throughout the EU. Considerable resources must be allocated for fulfilling the Directives and the question of optimal allocation is as important as it is difficult. In general, economic evaluations of conservation targets at most consider the costs and seldom the welfare economic benefits. In the present study, we use welfare economic benefit estimates concerning the willingness-to-pay for preserving endangered species and for the aggregate area of heathland preserved in Denmark. Similarly, we obtain estimates of the welfare economic cost of habitat restoration and maintenance. Combining these welfare economic measures with expected species coverage, we are able to estimate the potential welfare economic contribution of a conservation network. We compare three simple nonprobabilistic strategies likely to be used in day-to-day policy implementation: i) a maximum selected area strategy, ii) a hotspot selection strategy, and iii) a minimizing cost strategy, and two more advanced and informed probabilistic strategies: i) a maximum expected coverage strategy and ii) a strategy for maximum expected welfare economic gain. We show that the welfare economic performance of the strategies differ considerably. The comparison between the expected coverage and expected welfare shows that for the case considered, one may identify an optimal protection level above which additional coverage only comes at increasing welfare economic loss.

How Much Does Malaria Vector Control Quality Matter: The Epidemiological Impact of Holed Nets and Inadequate Indoor Residual Spraying

PubMed Central

Rehman, Andrea M.; Coleman, Mike; Schwabe, Christopher; Baltazar, Giovanna; Matias, Abrahan; Roncon Gomes, Irina; Yellott, Lee; Aragon, Cynthia; Nseng Nchama, Gloria; Mzilahowa, Themba; Rowland, Mark; Kleinschmidt, Immo

2011-01-01

Background Insecticide treated nets (ITN) and indoor residual spraying (IRS) are the two pillars of malaria vector control in Africa, but both interventions are beset by quality and coverage concerns. Data from three control programs were used to investigate the impact of: 1) the physical deterioration of ITNs, and 2) inadequate IRS spray coverage, on their respective protective effectiveness. Methods Malaria indicator surveys were carried out in 2009 and 2010 in Bioko Island, mainland Equatorial Guinea and Malawi to monitor infection with P.falciparum in children, mosquito net use, net condition and spray status of houses. Nets were classified by their condition. The association between infection and quality and coverage of interventions was investigated. Results There was reduced odds of infection with P.falciparum in children sleeping under ITNs that were intact (Odds ratio (OR): 0.65, 95% CI: 0.55–0.77 and OR: 0.81, 95% CI: 0.56–1.18 in Equatorial Guinea and in Malawi respectively), but the protective effect became less with increasingly worse condition of the net. There was evidence for a linear trend in infection per category increase in deterioration of nets. In Equatorial Guinea IRS offered protection to those in sprayed and unsprayed houses alike when neighbourhood spray coverage was high (≥80%) compared to those living in areas of low IRS coverage (<20%), regardless of whether the house they lived in was sprayed or not (adjusted OR = 0.54, 95% CI 0.33–0.89). ITNs provided only personal protection, offering no protection to non users. Although similar effects were seen in Malawi, the evidence was much weaker than in Equatorial Guinea. Conclusions Universal coverage strategies should consider policies for repair and replacement of holed nets and promote the care of nets by their owners. IRS programs should ensure high spray coverage since inadequate coverage gives little or no protection at all. PMID:21559436

47 CFR 73.525 - TV Channel 6 protection.

Code of Federal Regulations, 2012 CFR

2012-10-01

... interference area and population. Predictions of interference required under this section and calculations to... specified in § 73.684, “Prediction of coverage,” using the F(50,50) curves in Figure 9, § 73.699. (ii) For... procedures specified in § 73.313, “Prediction of Coverage,” using the proposed antenna height and...

47 CFR 73.525 - TV Channel 6 protection.

Code of Federal Regulations, 2013 CFR

2013-10-01

... interference area and population. Predictions of interference required under this section and calculations to... specified in § 73.684, “Prediction of coverage,” using the F(50,50) curves in Figure 9, § 73.699. (ii) For... procedures specified in § 73.313, “Prediction of Coverage,” using the proposed antenna height and...

47 CFR 73.525 - TV Channel 6 protection.

Code of Federal Regulations, 2014 CFR

2014-10-01

... interference area and population. Predictions of interference required under this section and calculations to... specified in § 73.684, “Prediction of coverage,” using the F(50,50) curves in Figure 9, § 73.699. (ii) For... procedures specified in § 73.313, “Prediction of Coverage,” using the proposed antenna height and...

Gaps and opportunities for the World Heritage Convention to contribute to global wilderness conservation.

PubMed

Allan, James R; Kormos, Cyril; Jaeger, Tilman; Venter, Oscar; Bertzky, Bastian; Shi, Yichuan; Mackey, Brendan; van Merm, Remco; Osipova, Elena; Watson, James E M

2018-02-01

Wilderness areas are ecologically intact landscapes predominantly free of human uses, especially industrial-scale activities that result in substantial biophysical disturbance. This definition does not exclude land and resource use by local communities who depend on such areas for subsistence and bio-cultural connections. Wilderness areas are important for biodiversity conservation and sustain key ecological processes and ecosystem services that underpin planetary life-support systems. Despite these widely recognized benefits and values of wilderness, they are insufficiently protected and are consequently being rapidly eroded. There are increasing calls for multilateral environmental agreements to make a greater and more systematic contribution to wilderness conservation before it is too late. We created a global map of remaining terrestrial wilderness following the established last-of-the-wild method, which identifies the 10% of areas with the lowest human pressure within each of Earth's 62 biogeographic realms and identifies the 10 largest contiguous areas and all contiguous areas >10,000 km 2 . We used our map to assess wilderness coverage by the World Heritage Convention and to identify gaps in coverage. We then identified large nationally designated protected areas with good wilderness coverage within these gaps. One-quarter of natural and mixed (i.e., sites of both natural and cultural value) World Heritage Sites (WHS) contained wilderness (total of 545,307 km 2 ), which is approximately 1.8% of the world's wilderness extent. Many WHS had excellent wilderness coverage, for example, the Okavango Delta in Botswana (11,914 km 2 ) and the Central Suriname Nature Reserve (16,029 km 2 ). However, 22 (35%) of the world's terrestrial biorealms had no wilderness representation within WHS. We identified 840 protected areas of >500 km 2 that were predominantly wilderness (>50% of their area) and represented 18 of the 22 missing biorealms. These areas offer a starting point for assessing the potential for the designation of new WHSs that could help increase wilderness representation on the World Heritage list. We urge the World Heritage Convention to ensure that the ecological integrity and outstanding universal value of existing WHS with wilderness values are preserved. © 2017 Society for Conservation Biology.

Analysing biodiversity and conservation knowledge products to support regional environmental assessments

PubMed Central

Brooks, Thomas M.; Akçakaya, H. Resit; Burgess, Neil D.; Butchart, Stuart H.M.; Hilton-Taylor, Craig; Hoffmann, Michael; Juffe-Bignoli, Diego; Kingston, Naomi; MacSharry, Brian; Parr, Mike; Perianin, Laurence; Regan, Eugenie C.; Rodrigues, Ana S.L.; Rondinini, Carlo; Shennan-Farpon, Yara; Young, Bruce E.

2016-01-01

Two processes for regional environmental assessment are currently underway: the Global Environment Outlook (GEO) and Intergovernmental Platform on Biodiversity and Ecosystem Services (IPBES). Both face constraints of data, time, capacity, and resources. To support these assessments, we disaggregate three global knowledge products according to their regions and subregions. These products are: The IUCN Red List of Threatened Species, Key Biodiversity Areas (specifically Important Bird & Biodiversity Areas [IBAs], and Alliance for Zero Extinction [AZE] sites), and Protected Planet. We present fourteen Data citations: numbers of species occurring and percentages threatened; numbers of endemics and percentages threatened; downscaled Red List Indices for mammals, birds, and amphibians; numbers, mean sizes, and percentage coverages of IBAs and AZE sites; percentage coverage of land and sea by protected areas; and trends in percentages of IBAs and AZE sites wholly covered by protected areas. These data will inform the regional/subregional assessment chapters on the status of biodiversity, drivers of its decline, and institutional responses, and greatly facilitate comparability and consistency between the different regional/subregional assessments. PMID:26881749

Deficiencies in Natura 2000 for protecting recovering large carnivores: A spotlight on the wolf Canis lupus in Poland.

PubMed

Diserens, Tom A; Borowik, Tomasz; Nowak, Sabina; Szewczyk, Maciej; Niedźwiecka, Natalia; Mysłajek, Robert W

2017-01-01

If protected areas are to remain relevant in our dynamic world they must be adapted to changes in species ranges. In the EU one of the most notable such changes is the recent recovery of large carnivores, which are protected by Natura 2000 at the national and population levels. However, the Natura 2000 network was designed prior to their recent recovery, which raises the question whether the network is sufficient to protect the contemporary ranges of large carnivores. To investigate this question we evaluated Natura 2000 coverage of the three wolf Canis lupus populations in Poland. Wolf tracking data showed that wolves have recolonised almost all suitable habitat in Poland (as determined by a recent habitat suitability model), so we calculated the overlap between the Natura 2000 network and all wolf habitat in Poland. On the basis of published Natura 2000 criteria, we used 20% as the minimum required coverage. At the national level, wolves are sufficiently protected (22% coverage), but at the population level, the Baltic and Carpathian populations are far better protected (28 and 47%, respectively) than the endangered Central European Lowland population (12%). As Natura 2000 insufficiently protects the most endangered wolf population in Poland, we recommend expansion of Natura 2000 to protect at least an additional 8% of wolf habitat in western Poland, and discuss which specific forests are most in need of additional coverage. Implementation of these actions will have positive conservation implications and help Poland to fulfil its Habitats Directive obligations. As it is likely that similar gaps in Natura 2000 are arising in other EU member states experiencing large carnivore recoveries, particularly in Central Europe, we make the case for a flexible approach to Natura 2000 and suggest that such coverage evaluations may be beneficial elsewhere.

Infralittoral mapping around an oceanic archipelago using MERIS FR satellite imagery and deep kelp observations: A new tool for assessing MPA coverage targets

NASA Astrophysics Data System (ADS)

Amorim, Patrícia; Atchoi, Elizabeth; Berecibar, Estibaliz; Tempera, Fernando

2015-06-01

This work presents the first climatologic maps of diffuse attenuation of down-welling solar radiation (KdPAR and Kd490 coefficients) for the Azores derived from full resolution (FR) MERIS satellite imagery. Associating this information with a new mesoscale bathymetry compilation permits estimating the percentage of surface light reaching the seabed. A video annotation dataset derived from a deep kelp survey conducted on the Formigas Bank is subsequently used to estimate the light levels experienced by these bionomically-crucial frondose algae. Empirical light-based thresholds for the lower infralittoral boundary in the Azores are derived from the deepest kelp occurrences. This information is eventually used to map the geographical extent of this major marine biological zone in the archipelago, yielding an area estimate of 894.7 km2. The average depth of the infralittoral limit in the Azores is established at 69 m. It is determined that the present Azores marine protected area (MPA) network already covers 28.9% of the region's infralittoral grounds. However, island-specific values highlight that MPA percentage coverage varies between islands with values ranging from a marginal coverage of 7.3% (on Terceira Island) to 100% coverage around the island of Corvo and the Formigas Bank. These results suggest that conservation managers may make use of the current spatially-based protection framework of the archipelago to, on the whole and for this specific major habitat, surpass the goals suggested by international conventions and conservation fora for MPA coverage. However, an analysis of the statutory MPA regulations further reveals that measures in place are insufficient to provide a no-take and no-disturbance protection of infralittoral biotopes. In order to achieve the recommended strict protection of the currently protected infralittoral zones, conservation measures ought to be enhanced.

A comprehensive approach to evaluating and classifying sun-protective clothing.

PubMed

Downs, N J; Harrison, S L

2018-04-01

National standards for clothing designed to protect the wearer from the harmful effects of solar ultraviolet radiation (UVR) have been implemented in Australia/New Zealand, Europe and the U.S.A. Industry standards reflect the need to protect the skin by covering a considerable proportion of the potentially exposed body surface area (BSA) and by reducing UVR-transmission through fabric (the Ultraviolet Protection Factor; UPF). This research aimed to develop a new index for rating sun-protective clothing that incorporates the BSA coverage of the garment in addition to the UPF of the fabric. A mannequin model was fixed to an optical bench and marked with horizontal lines at 1-cm intervals. An algorithm (the Garment Protector Factor; GPF) was developed based on the number of lines visible on the clothed vs. unclothed mannequin and the UPF of the garment textile. This data was collected in 2015/16 and analysed in 2016. The GPF weights fabric UPF by BSA coverage above the minimum required by international sun-protective clothing standards for upper-body, lower-body and full-body garments. The GPF increases with BSA coverage of the garment and fabric UPF. Three nominal categories are proposed for the GPF: 0 ≤ GPF < 3 for garments that 'meet' minimum standards; 3 ≤ GPF < 6 for garments providing 'good' sun protection; and GPF ≥ 6 indicating 'excellent' protection. Adoption of the proposed rating scheme should encourage manufacturers to design sun-protective garments that exceed the minimum standard for BSA coverage, with positive implications for skin cancer prevention, consumer education and sun-protection awareness. © 2017 British Association of Dermatologists.

Financial risk protection and universal health coverage: evidence and measurement challenges.

PubMed

Saksena, Priyanka; Hsu, Justine; Evans, David B

2014-09-01

Financial risk protection is a key component of universal health coverage (UHC), which is defined as access to all needed quality health services without financial hardship. As part of the PLOS Medicine Collection on measurement of UHC, the aim of this paper is to examine and to compare and contrast existing measures of financial risk protection. The paper presents the rationale behind the methodologies for measuring financial risk protection and how this relates to UHC as well as some empirical examples of the types of measures. Additionally, the specific challenges related to monitoring inequalities in financial risk protection are discussed. The paper then goes on to examine and document the practical challenges associated with measurement of financial risk protection. This paper summarizes current thinking on the area of financial risk protection, provides novel insights, and suggests future developments that could be valuable in the context of monitoring progress towards UHC.

Financial Risk Protection and Universal Health Coverage: Evidence and Measurement Challenges

PubMed Central

Saksena, Priyanka; Hsu, Justine; Evans, David B.

2014-01-01

Financial risk protection is a key component of universal health coverage (UHC), which is defined as access to all needed quality health services without financial hardship. As part of the PLOS Medicine Collection on measurement of UHC, the aim of this paper is to examine and to compare and contrast existing measures of financial risk protection. The paper presents the rationale behind the methodologies for measuring financial risk protection and how this relates to UHC as well as some empirical examples of the types of measures. Additionally, the specific challenges related to monitoring inequalities in financial risk protection are discussed. The paper then goes on to examine and document the practical challenges associated with measurement of financial risk protection. This paper summarizes current thinking on the area of financial risk protection, provides novel insights, and suggests future developments that could be valuable in the context of monitoring progress towards UHC. PMID:25244520

Vaccination coverage among children in kindergarten - United States, 2013-14 school year.

PubMed

Seither, Ranee; Masalovich, Svetlana; Knighton, Cynthia L; Mellerson, Jenelle; Singleton, James A; Greby, Stacie M

2014-10-17

State and local vaccination requirements for school entry are implemented to maintain high vaccination coverage and protect schoolchildren from vaccine-preventable diseases. Each year, to assess state and national vaccination coverage and exemption levels among kindergartners, CDC analyzes school vaccination data collected by federally funded state, local, and territorial immunization programs. This report describes vaccination coverage in 49 states and the District of Columbia (DC) and vaccination exemption rates in 46 states and DC for children enrolled in kindergarten during the 2013-14 school year. Median vaccination coverage was 94.7% for 2 doses of measles, mumps, and rubella (MMR) vaccine; 95.0% for varying local requirements for diphtheria, tetanus toxoid, and acellular pertussis (DTaP) vaccine; and 93.3% for 2 doses of varicella vaccine among those states with a 2-dose requirement. The median total exemption rate was 1.8%. High exemption levels and suboptimal vaccination coverage leave children vulnerable to vaccine-preventable diseases. Although vaccination coverage among kindergartners for the majority of reporting states was at or near the 95% national Healthy People 2020 targets for 4 doses of DTaP, 2 doses of MMR, and 2 doses of varicella vaccine, low vaccination coverage and high exemption levels can cluster within communities. Immunization programs might have access to school vaccination coverage and exemption rates at a local level for counties, school districts, or schools that can identify areas where children are more vulnerable to vaccine-preventable diseases. Health promotion efforts in these local areas can be used to help parents understand the risks for vaccine-preventable diseases and the protection that vaccinations provide to their children.

Effectiveness of protected areas for vertebrates based on taxonomic and phylogenetic diversity.

PubMed

Quan, Qing; Che, Xianli; Wu, Yongjie; Wu, Yuchun; Zhang, Qiang; Zhang, Min; Zou, Fasheng

2018-04-01

Establishing protected areas is the primary goal and tool for preventing irreversible biodiversity loss. However, the effectiveness of protected areas that target specific species has been questioned for some time because targeting key species for conservation may impair the integral regional pool of species diversity and phylogenetic and functional diversity are seldom considered. We assessed the efficacy of protected areas in China for the conservation of phylogenetic diversity based on the ranges and phylogenies of 2279 terrestrial vertebrates. Phylogenetic and taxonomic diversity were strongly and positively correlated, and only 12.1-43.8% of priority conservation areas are currently protected. However, the patterns and coverage of phylogenetic diversity were affected when weighted by species richness. These results indicated that in China, protected areas targeting high species richness protected phylogenetic diversity well overall but failed to do so in some regions with more unique or threatened communities (e.g., coastal areas of eastern China, where severely threatened avian communities were less protected). Our results suggest that the current distribution of protected areas could be improved, although most protected areas protect both taxonomic and phylogenetic diversity. © 2017 Society for Conservation Biology.

Protection of mammal diversity in Central America

USGS Publications Warehouse

Jenkins, Clinton N.; Giri, Chandra

2008-01-01

Central America is exceptionally rich in biodiversity, but varies widely in the attention its countries devote to conservation. Protected areas, widely considered the cornerstone of conservation, were not always created with the intent of conserving that biodiversity. We assessed how well the protected-area system of Central America includes the region's mammal diversity. This first required a refinement of existing range maps to reduce their extensive errors of commission (i.e., predicted presences in places where species do not occur). For this refinement, we used the ecological limits of each species to identify and remove unsuitable areas from the range. We then compared these maps with the locations of protected areas to measure the habitat protected for each of the region's 250 endemic mammals. The species most vulnerable to extinction—those with small ranges—were largely outside protected areas. Nevertheless, the most strictly protected areas tended toward areas with many small-ranged species. To improve the protection coverage of mammal diversity in the region, we identified a set of priority sites that would best complement the existing protected areas. Protecting these new sites would require a relatively small increase in the total area protected, but could greatly enhance mammal conservation.

Genetic conservation planning for forest tree species in Western North America under future climate change: Employing a novel approach to identify conservation gaps

Treesearch

L.K. Gray; E.J. Russell; Q.E. Barber; A. Hamann

2017-01-01

Among the 17 provinces, territories, and states that comprise western North America, approximately 18 percent of the 8.4 million km2 of forested land base is designated as protected areas to ensure the in situ conservation of forest biodiversity. Jurisdictions vary substantially however, in their responsibilities, protected area coverage, and conservation policies....

Is U.S. climatic diversity well represented within the existing federal protection network?

PubMed

Batllori, Enric; Miller, Carol; Parisien, Marc-Andre; Parks, Sean A; Moritz, Max A

Establishing protection networks to ensure that biodiversity and associated ecosystem services persist under changing environments is a major challenge for conservation planning. The potential consequences of altered climates for the structure and function of ecosystems necessitates new and complementary approaches be incorporated into traditional conservation plans. The conterminous United States of America (CONUS) has an extensive system of protected areas managed by federal agencies, but a comprehensive assessment of how this network represents CONUS climate is lacking. We present a quantitative classification of the climate space that is independent from the geographic locations to evaluate the climatic representation of the existing protected area network. We use this classification to evaluate the coverage of each agency's jurisdiction and to identify current conservation deficits. Our findings reveal that the existing network poorly represents CONUS climatic diversity. Although rare climates are generally well represented by the network, the most common climates are particularly underrepresented. Overall, 83% of the area of the CONUS corresponds to climates underrepresented by the network. The addition of some currently unprotected federal lands to the network would enhance the coverage of CONUS climates. However, to fully palliate current conservation deficits, large-scale private-land conservation initiatives will be critical.

Protecting Important Sites for Biodiversity Contributes to Meeting Global Conservation Targets

PubMed Central

Butchart, Stuart H. M.; Scharlemann, Jörn P. W.; Evans, Mike I.; Quader, Suhel; Aricò, Salvatore; Arinaitwe, Julius; Balman, Mark; Bennun, Leon A.; Bertzky, Bastian; Besançon, Charles; Boucher, Timothy M.; Brooks, Thomas M.; Burfield, Ian J.; Burgess, Neil D.; Chan, Simba; Clay, Rob P.; Crosby, Mike J.; Davidson, Nicholas C.; De Silva, Naamal; Devenish, Christian; Dutson, Guy C. L.; Fernández, David F. Día z; Fishpool, Lincoln D. C.; Fitzgerald, Claire; Foster, Matt; Heath, Melanie F.; Hockings, Marc; Hoffmann, Michael; Knox, David; Larsen, Frank W.; Lamoreux, John F.; Loucks, Colby; May, Ian; Millett, James; Molloy, Dominic; Morling, Paul; Parr, Mike; Ricketts, Taylor H.; Seddon, Nathalie; Skolnik, Benjamin; Stuart, Simon N.; Upgren, Amy; Woodley, Stephen

2012-01-01

Protected areas (PAs) are a cornerstone of conservation efforts and now cover nearly 13% of the world's land surface, with the world's governments committed to expand this to 17%. However, as biodiversity continues to decline, the effectiveness of PAs in reducing the extinction risk of species remains largely untested. We analyzed PA coverage and trends in species' extinction risk at globally significant sites for conserving birds (10,993 Important Bird Areas, IBAs) and highly threatened vertebrates and conifers (588 Alliance for Zero Extinction sites, AZEs) (referred to collectively hereafter as ‘important sites’). Species occurring in important sites with greater PA coverage experienced smaller increases in extinction risk over recent decades: the increase was half as large for bird species with>50% of the IBAs at which they occur completely covered by PAs, and a third lower for birds, mammals and amphibians restricted to protected AZEs (compared with unprotected or partially protected sites). Globally, half of the important sites for biodiversity conservation remain unprotected (49% of IBAs, 51% of AZEs). While PA coverage of important sites has increased over time, the proportion of PA area covering important sites, as opposed to less important land, has declined (by 0.45–1.14% annually since 1950 for IBAs and 0.79–1.49% annually for AZEs). Thus, while appropriately located PAs may slow the rate at which species are driven towards extinction, recent PA network expansion has under-represented important sites. We conclude that better targeted expansion of PA networks would help to improve biodiversity trends. PMID:22457717

Accuracy and impact of spatial aids based upon satellite enumeration to improve indoor residual spraying spatial coverage.

PubMed

Bridges, Daniel J; Pollard, Derek; Winters, Anna M; Winters, Benjamin; Sikaala, Chadwick; Renn, Silvia; Larsen, David A

2018-02-23

Indoor residual spraying (IRS) is a key tool in the fight to control, eliminate and ultimately eradicate malaria. IRS protection is based on a communal effect such that an individual's protection primarily relies on the community-level coverage of IRS with limited protection being provided by household-level coverage. To ensure a communal effect is achieved through IRS, achieving high and uniform community-level coverage should be the ultimate priority of an IRS campaign. Ensuring high community-level coverage of IRS in malaria-endemic areas is challenging given the lack of information available about both the location and number of households needing IRS in any given area. A process termed 'mSpray' has been developed and implemented and involves use of satellite imagery for enumeration for planning IRS and a mobile application to guide IRS implementation. This study assessed (1) the accuracy of the satellite enumeration and (2) how various degrees of spatial aid provided through the mSpray process affected community-level IRS coverage during the 2015 spray campaign in Zambia. A 2-stage sampling process was applied to assess accuracy of satellite enumeration to determine number and location of sprayable structures. Results indicated an overall sensitivity of 94% for satellite enumeration compared to finding structures on the ground. After adjusting for structure size, roof, and wall type, households in Nchelenge District where all types of satellite-based spatial aids (paper-based maps plus use of the mobile mSpray application) were used were more likely to have received IRS than Kasama district where maps used were not based on satellite enumeration. The probability of a household being sprayed in Nchelenge district where tablet-based maps were used, did not differ statistically from that of a household in Samfya District, where detailed paper-based spatial aids based on satellite enumeration were provided. IRS coverage from the 2015 spray season benefited from the use of spatial aids based upon satellite enumeration. These spatial aids can guide costly IRS planning and implementation leading to attainment of higher spatial coverage, and likely improve disease impact.

Vegetation mapping of the Mond Protected Area of Bushehr Province (south-west Iran).

PubMed

Mehrabian, Ahmadreza; Naqinezhad, Alireza; Mahiny, Abdolrassoul Salman; Mostafavi, Hossein; Liaghati, Homan; Kouchekzadeh, Mohsen

2009-03-01

Arid regions of the world occupy up to 35% of the earth's surface, the basis of various definitions of climatic conditions, vegetation types or potential for food production. Due to their high ecological value, monitoring of arid regions is necessary and modern vegetation studies can help in the conservation and management of these areas. The use of remote sensing for mapping of desert vegetation is difficult due to mixing of the spectral reflectance of bright desert soils with the weak spectral response of sparse vegetation. We studied the vegetation types in the semiarid to arid region of Mond Protected Area, south-west Iran, based on unsupervised classification of the Spot XS bands and then produced updated maps. Sixteen map units covering 12 vegetation types were recognized in the area based on both field works and satellite mapping. Halocnemum strobilaceum and Suaeda fruticosa vegetation types were the dominant types and Ephedra foliata, Salicornia europaea-Suaeda heterophylla vegetation types were the smallest. Vegetation coverage decreased sharply with the increase in salinity towards the coastal areas of the Persian Gulf. The highest vegetation coverage belonged to the riparian vegetation along the Mond River, which represents the northern boundary of the protected area. The location of vegetation types was studied on the separate soil and habitat diversity maps of the study area, which helped in final refinements of the vegetation map produced.

Deficiencies in Natura 2000 for protecting recovering large carnivores: A spotlight on the wolf Canis lupus in Poland

PubMed Central

Borowik, Tomasz; Nowak, Sabina; Szewczyk, Maciej; Niedźwiecka, Natalia; Mysłajek, Robert W.

2017-01-01

If protected areas are to remain relevant in our dynamic world they must be adapted to changes in species ranges. In the EU one of the most notable such changes is the recent recovery of large carnivores, which are protected by Natura 2000 at the national and population levels. However, the Natura 2000 network was designed prior to their recent recovery, which raises the question whether the network is sufficient to protect the contemporary ranges of large carnivores. To investigate this question we evaluated Natura 2000 coverage of the three wolf Canis lupus populations in Poland. Wolf tracking data showed that wolves have recolonised almost all suitable habitat in Poland (as determined by a recent habitat suitability model), so we calculated the overlap between the Natura 2000 network and all wolf habitat in Poland. On the basis of published Natura 2000 criteria, we used 20% as the minimum required coverage. At the national level, wolves are sufficiently protected (22% coverage), but at the population level, the Baltic and Carpathian populations are far better protected (28 and 47%, respectively) than the endangered Central European Lowland population (12%). As Natura 2000 insufficiently protects the most endangered wolf population in Poland, we recommend expansion of Natura 2000 to protect at least an additional 8% of wolf habitat in western Poland, and discuss which specific forests are most in need of additional coverage. Implementation of these actions will have positive conservation implications and help Poland to fulfil its Habitats Directive obligations. As it is likely that similar gaps in Natura 2000 are arising in other EU member states experiencing large carnivore recoveries, particularly in Central Europe, we make the case for a flexible approach to Natura 2000 and suggest that such coverage evaluations may be beneficial elsewhere. PMID:28873090

Upgrading protected areas to conserve wild biodiversity.

PubMed

Pringle, Robert M

2017-05-31

International agreements mandate the expansion of Earth's protected-area network as a bulwark against the continued extinction of wild populations, species, and ecosystems. Yet many protected areas are underfunded, poorly managed, and ecologically damaged; the conundrum is how to increase their coverage and effectiveness simultaneously. Innovative restoration and rewilding programmes in Costa Rica's Área de Conservación Guanacaste and Mozambique's Parque Nacional da Gorongosa highlight how degraded ecosystems can be rehabilitated, expanded, and woven into the cultural fabric of human societies. Worldwide, enormous potential for biodiversity conservation can be realized by upgrading existing nature reserves while harmonizing them with the needs and aspirations of their constituencies.

Diversity, distribution and conservation of the terrestrial reptiles of Oman (Sauropsida, Squamata).

PubMed

Carranza, Salvador; Xipell, Meritxell; Tarroso, Pedro; Gardner, Andrew; Arnold, Edwin Nicholas; Robinson, Michael D; Simó-Riudalbas, Marc; Vasconcelos, Raquel; de Pous, Philip; Amat, Fèlix; Šmíd, Jiří; Sindaco, Roberto; Metallinou, Margarita; Els, Johannes; Pleguezuelos, Juan Manuel; Machado, Luis; Donaire, David; Martínez, Gabriel; Garcia-Porta, Joan; Mazuch, Tomáš; Wilms, Thomas; Gebhart, Jürgen; Aznar, Javier; Gallego, Javier; Zwanzig, Bernd-Michael; Fernández-Guiberteau, Daniel; Papenfuss, Theodore; Al Saadi, Saleh; Alghafri, Ali; Khalifa, Sultan; Al Farqani, Hamed; Bait Bilal, Salim; Alazri, Iman Sulaiman; Al Adhoobi, Aziza Saud; Al Omairi, Zeyana Salim; Al Shariani, Mohammed; Al Kiyumi, Ali; Al Sariri, Thuraya; Al Shukaili, Ahmed Said; Al Akhzami, Suleiman Nasser

2018-01-01

In the present work, we use an exceptional database including 5,359 records of 101 species of Oman's terrestrial reptiles together with spatial tools to infer the spatial patterns of species richness and endemicity, to infer the habitat preference of each species and to better define conservation priorities, with especial focus on the effectiveness of the protected areas in preserving this unique arid fauna. Our results indicate that the sampling effort is not only remarkable from a taxonomic point of view, with multiple observations for most species, but also for the spatial coverage achieved. The observations are distributed almost continuously across the two-dimensional climatic space of Oman defined by the mean annual temperature and the total annual precipitation and across the Principal Component Analysis (PCA) of the multivariate climatic space and are well represented within 17 out of the 20 climatic clusters grouping 10% of the explained climatic variance defined by PC1 and PC2. Species richness is highest in the Hajar and Dhofar Mountains, two of the most biodiverse areas of the Arabian Peninsula, and endemic species richness is greatest in the Jebel Akhdar, the highest part of the Hajar Mountains. Oman's 22 protected areas cover only 3.91% of the country, including within their limits 63.37% of terrestrial reptiles and 50% of all endemics. Our analyses show that large areas of the climatic space of Oman lie outside protected areas and that seven of the 20 climatic clusters are not protected at all. The results of the gap analysis indicate that most of the species are below the conservation target of 17% or even the less restrictive 12% of their total area within a protected area in order to be considered adequately protected. Therefore, an evaluation of the coverage of the current network of protected areas and the identification of priority protected areas for reptiles using reserve design algorithms are urgently needed. Our study also shows that more than half of the species are still pending of a definitive evaluation by the International Union for Conservation of Nature (IUCN).

Diversity, distribution and conservation of the terrestrial reptiles of Oman (Sauropsida, Squamata)

PubMed Central

Xipell, Meritxell; Tarroso, Pedro; Gardner, Andrew; Arnold, Edwin Nicholas; Robinson, Michael D.; Simó-Riudalbas, Marc; Vasconcelos, Raquel; de Pous, Philip; Amat, Fèlix; Šmíd, Jiří; Sindaco, Roberto; Els, Johannes; Pleguezuelos, Juan Manuel; Machado, Luis; Donaire, David; Martínez, Gabriel; Garcia-Porta, Joan; Mazuch, Tomáš; Wilms, Thomas; Gebhart, Jürgen; Aznar, Javier; Gallego, Javier; Zwanzig, Bernd-Michael; Fernández-Guiberteau, Daniel; Papenfuss, Theodore; Al Saadi, Saleh; Alghafri, Ali; Khalifa, Sultan; Al Farqani, Hamed; Bait Bilal, Salim; Alazri, Iman Sulaiman; Al Adhoobi, Aziza Saud; Al Omairi, Zeyana Salim; Al Shariani, Mohammed; Al Kiyumi, Ali; Al Sariri, Thuraya; Al Shukaili, Ahmed Said; Al Akhzami, Suleiman Nasser

2018-01-01

In the present work, we use an exceptional database including 5,359 records of 101 species of Oman’s terrestrial reptiles together with spatial tools to infer the spatial patterns of species richness and endemicity, to infer the habitat preference of each species and to better define conservation priorities, with especial focus on the effectiveness of the protected areas in preserving this unique arid fauna. Our results indicate that the sampling effort is not only remarkable from a taxonomic point of view, with multiple observations for most species, but also for the spatial coverage achieved. The observations are distributed almost continuously across the two-dimensional climatic space of Oman defined by the mean annual temperature and the total annual precipitation and across the Principal Component Analysis (PCA) of the multivariate climatic space and are well represented within 17 out of the 20 climatic clusters grouping 10% of the explained climatic variance defined by PC1 and PC2. Species richness is highest in the Hajar and Dhofar Mountains, two of the most biodiverse areas of the Arabian Peninsula, and endemic species richness is greatest in the Jebel Akhdar, the highest part of the Hajar Mountains. Oman’s 22 protected areas cover only 3.91% of the country, including within their limits 63.37% of terrestrial reptiles and 50% of all endemics. Our analyses show that large areas of the climatic space of Oman lie outside protected areas and that seven of the 20 climatic clusters are not protected at all. The results of the gap analysis indicate that most of the species are below the conservation target of 17% or even the less restrictive 12% of their total area within a protected area in order to be considered adequately protected. Therefore, an evaluation of the coverage of the current network of protected areas and the identification of priority protected areas for reptiles using reserve design algorithms are urgently needed. Our study also shows that more than half of the species are still pending of a definitive evaluation by the International Union for Conservation of Nature (IUCN). PMID:29414999

Barriers and facilitators to influenza vaccination and vaccine coverage in a cohort of health care personnel.

PubMed

Naleway, Allison L; Henkle, Emily M; Ball, Sarah; Bozeman, Sam; Gaglani, Manjusha J; Kennedy, Erin D; Thompson, Mark G

2014-04-01

Annual influenza vaccination is recommended for health care personnel (HCP). We describe influenza vaccination coverage among HCP during the 2010-2011 season and present reported facilitators of and barriers to vaccination. We enrolled HCP 18 to 65 years of age, working full time, with direct patient contact. Participants completed an Internet-based survey at enrollment and the end of influenza season. In addition to self-reported data, we collected information about the 2010-2011 influenza vaccine from electronic employee health and medical records. Vaccination coverage was 77% (1,307/1,701). Factors associated with higher vaccination coverage include older age, being married or partnered, working as a physician or dentist, prior history of influenza vaccination, more years in patient care, and higher job satisfaction. Personal protection was reported as the most important reason for vaccination followed closely by convenience, protection of patients, and protection of family and friends. Concerns about perceived vaccine safety and effectiveness and low perceived susceptibility to influenza were the most commonly reported barriers to vaccination. About half of the unvaccinated HCP said they would have been vaccinated if required by their employer. Influenza vaccination in this cohort was relatively high but still fell short of the recommended target of 90% coverage for HCP. Addressing concerns about vaccine safety and effectiveness are possible areas for future education or intervention to improve coverage among HCP. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

Effectiveness of Protected Areas for Representing Species and Populations of Terrestrial Mammals in Costa Rica

PubMed Central

González-Maya, José F.; Víquez-R, Luis R.; Belant, Jerrold L.; Ceballos, Gerardo

2015-01-01

Costa Rica has one of the greatest percentages (26%) of protected land in the world. The National Protected Areas System (NPAS) of Costa Rica was established in 1976 and currently includes >190 protected areas within seven different protection categories. The effectiveness of the NPAS to represent species, populations, and areas with high species richness has not been properly evaluated. Such evaluations are fundamental to understand what is necessary to strengthen the NPAS and better protect biodiversity. We present a novel assessment of NPAS effectiveness in protecting mammal species. We compiled the geographical ranges of all terrestrial Costa Rican mammals then determined species lists for all protected areas and the estimated proportion of each species’ geographic range protected. We also classified mammal species according to their conservation status using the IUCN Red List of Threatened Species. We found almost complete representation of mammal species (98.5%) in protected areas, but low relative coverage (28.3% on average) of their geographic ranges in Costa Rica and 25% of the species were classified as underprotected according to a priori representation targets. Interestingly, many species-rich areas are not protected, and at least 43% of cells covering the entire country are not included in protected areas. Though protected areas in Costa Rica represent species richness well, strategic planning for future protected areas to improve species complementarity and range protection is necessary. Our results can help to define sites where new protected areas can have a greater impact on mammal conservation, both in terms of species richness and range protection. PMID:25970293

Effectiveness of protected areas for representing species and populations of terrestrial mammals in Costa Rica.

PubMed

González-Maya, José F; Víquez-R, Luis R; Belant, Jerrold L; Ceballos, Gerardo

2015-01-01

Costa Rica has one of the greatest percentages (26%) of protected land in the world. The National Protected Areas System (NPAS) of Costa Rica was established in 1976 and currently includes >190 protected areas within seven different protection categories. The effectiveness of the NPAS to represent species, populations, and areas with high species richness has not been properly evaluated. Such evaluations are fundamental to understand what is necessary to strengthen the NPAS and better protect biodiversity. We present a novel assessment of NPAS effectiveness in protecting mammal species. We compiled the geographical ranges of all terrestrial Costa Rican mammals then determined species lists for all protected areas and the estimated proportion of each species' geographic range protected. We also classified mammal species according to their conservation status using the IUCN Red List of Threatened Species. We found almost complete representation of mammal species (98.5%) in protected areas, but low relative coverage (28.3% on average) of their geographic ranges in Costa Rica and 25% of the species were classified as underprotected according to a priori representation targets. Interestingly, many species-rich areas are not protected, and at least 43% of cells covering the entire country are not included in protected areas. Though protected areas in Costa Rica represent species richness well, strategic planning for future protected areas to improve species complementarity and range protection is necessary. Our results can help to define sites where new protected areas can have a greater impact on mammal conservation, both in terms of species richness and range protection.

Complementarity and Area-Efficiency in the Prioritization of the Global Protected Area Network.

PubMed

Kullberg, Peter; Toivonen, Tuuli; Montesino Pouzols, Federico; Lehtomäki, Joona; Di Minin, Enrico; Moilanen, Atte

2015-01-01

Complementarity and cost-efficiency are widely used principles for protected area network design. Despite the wide use and robust theoretical underpinnings, their effects on the performance and patterns of priority areas are rarely studied in detail. Here we compare two approaches for identifying the management priority areas inside the global protected area network: 1) a scoring-based approach, used in recently published analysis and 2) a spatial prioritization method, which accounts for complementarity and area-efficiency. Using the same IUCN species distribution data the complementarity method found an equal-area set of priority areas with double the mean species ranges covered compared to the scoring-based approach. The complementarity set also had 72% more species with full ranges covered, and lacked any coverage only for half of the species compared to the scoring approach. Protected areas in our complementarity-based solution were on average smaller and geographically more scattered. The large difference between the two solutions highlights the need for critical thinking about the selected prioritization method. According to our analysis, accounting for complementarity and area-efficiency can lead to considerable improvements when setting management priorities for the global protected area network.

42 CFR 435.340 - Protected medically needy coverage for blind and disabled individuals eligible in December 1973.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Protected medically needy coverage for blind and disabled individuals eligible in December 1973. 435.340 Section 435.340 Public Health CENTERS FOR MEDICARE... Coverage of the Medically Needy § 435.340 Protected medically needy coverage for blind and disabled...

42 CFR 435.340 - Protected medically needy coverage for blind and disabled individuals eligible in December 1973.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Protected medically needy coverage for blind and disabled individuals eligible in December 1973. 435.340 Section 435.340 Public Health CENTERS FOR MEDICARE... Coverage of the Medically Needy § 435.340 Protected medically needy coverage for blind and disabled...

42 CFR 435.340 - Protected medically needy coverage for blind and disabled individuals eligible in December 1973.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Protected medically needy coverage for blind and disabled individuals eligible in December 1973. 435.340 Section 435.340 Public Health CENTERS FOR MEDICARE... Coverage of the Medically Needy § 435.340 Protected medically needy coverage for blind and disabled...

42 CFR 435.340 - Protected medically needy coverage for blind and disabled individuals eligible in December 1973.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Protected medically needy coverage for blind and disabled individuals eligible in December 1973. 435.340 Section 435.340 Public Health CENTERS FOR MEDICARE... Coverage of the Medically Needy § 435.340 Protected medically needy coverage for blind and disabled...

42 CFR 435.340 - Protected medically needy coverage for blind and disabled individuals eligible in December 1973.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Protected medically needy coverage for blind and disabled individuals eligible in December 1973. 435.340 Section 435.340 Public Health CENTERS FOR MEDICARE... Coverage of the Medically Needy § 435.340 Protected medically needy coverage for blind and disabled...

Factors affecting frequency and orbit utilization by high power transmission satellite systems.

NASA Technical Reports Server (NTRS)

Kuhns, P. W.; Miller, E. F.; O'Malley, T. A.

1972-01-01

The factors affecting the sharing of the geostationary orbit by high power (primarily television) satellite systems having the same or adjacent coverage areas and by satellites occupying the same orbit segment are examined and examples using the results of computer computations are given. The factors considered include: required protection ratio, receiver antenna patterns, relative transmitter power, transmitter antenna patterns, satellite grouping, and coverage pattern overlap. The results presented indicate the limits of system characteristics and orbit deployment which can result from mixing systems.

Factors affecting frequency and orbit utilization by high power transmission satellite systems

NASA Technical Reports Server (NTRS)

Kuhns, P. W.; Miller, E. F.; Malley, T. A.

1972-01-01

The factors affecting the sharing of the geostationary orbit by high power (primarily television) satellite systems having the same or adjacent coverage areas and by satellites occupying the same orbit segment are examined and examples using the results of computer computations are given. The factors considered include: required protection ratio, receiver antenna patterns, relative transmitter power, transmitter antenna patterns, satellite grouping, and coverage pattern overlap. The results presented indicated the limits of system characteristics and orbit deployment which can result from mixing systems.

42 CFR 457.810 - Premium assistance programs: Required protections against substitution.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., must provide the protections against substitution of CHIP coverage for coverage under group health... under premium assistance programs must not be greater than the cost of other CHIP coverage for these... of coverage for children under premium assistance programs to the cost of other CHIP coverage for...

42 CFR 457.810 - Premium assistance programs: Required protections against substitution.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., must provide the protections against substitution of CHIP coverage for coverage under group health... under premium assistance programs must not be greater than the cost of other CHIP coverage for these... of coverage for children under premium assistance programs to the cost of other CHIP coverage for...

42 CFR 457.810 - Premium assistance programs: Required protections against substitution.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., must provide the protections against substitution of CHIP coverage for coverage under group health... under premium assistance programs must not be greater than the cost of other CHIP coverage for these... of coverage for children under premium assistance programs to the cost of other CHIP coverage for...

42 CFR 457.810 - Premium assistance programs: Required protections against substitution.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., must provide the protections against substitution of CHIP coverage for coverage under group health... under premium assistance programs must not be greater than the cost of other CHIP coverage for these... of coverage for children under premium assistance programs to the cost of other CHIP coverage for...

Ecological effects of full and partial protection in the crowded Mediterranean Sea: a regional meta-analysis.

PubMed

Giakoumi, Sylvaine; Scianna, Claudia; Plass-Johnson, Jeremiah; Micheli, Fiorenza; Grorud-Colvert, Kirsten; Thiriet, Pierre; Claudet, Joachim; Di Carlo, Giuseppe; Di Franco, Antonio; Gaines, Steven D; García-Charton, José A; Lubchenco, Jane; Reimer, Jessica; Sala, Enric; Guidetti, Paolo

2017-08-21

Marine protected areas (MPAs) are a cornerstone of marine conservation. Globally, the number and coverage of MPAs are increasing, but MPA implementation lags in many human-dominated regions. In areas with intense competition for space and resources, evaluation of the effects of MPAs is crucial to inform decisions. In the human-dominated Mediterranean Sea, fully protected areas occupy only 0.04% of its surface. We evaluated the impacts of full and partial protection on biomass and density of fish assemblages, some commercially important fishes, and sea urchins in 24 Mediterranean MPAs. We explored the relationships between the level of protection and MPA size, age, and enforcement. Results revealed significant positive effects of protection for fisheries target species and negative effects for urchins as their predators benefited from protection. Full protection provided stronger effects than partial protection. Benefits of full protection for fish biomass were only correlated with the level of MPA enforcement; fish density was higher in older, better enforced, and -interestingly- smaller MPAs. Our finding that even small, well-enforced, fully protected areas can have significant ecological effects is encouraging for "crowded" marine environments. However, more data are needed to evaluate sufficient MPA sizes for protecting populations of species with varying mobility levels.

40 CFR 141.3 - Coverage.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 23 2011-07-01 2011-07-01 false Coverage. 141.3 Section 141.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS General § 141.3 Coverage. This part shall apply to each public water...

40 CFR 141.3 - Coverage.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 24 2013-07-01 2013-07-01 false Coverage. 141.3 Section 141.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS General § 141.3 Coverage. This part shall apply to each public water...

40 CFR 141.3 - Coverage.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 24 2012-07-01 2012-07-01 false Coverage. 141.3 Section 141.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS General § 141.3 Coverage. This part shall apply to each public water...

40 CFR 141.3 - Coverage.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 23 2014-07-01 2014-07-01 false Coverage. 141.3 Section 141.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS General § 141.3 Coverage. This part shall apply to each public water...

40 CFR 141.3 - Coverage.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Coverage. 141.3 Section 141.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS General § 141.3 Coverage. This part shall apply to each public water...

Comparison of marine spatial planning methods in Madagascar demonstrates value of alternative approaches.

PubMed

Allnutt, Thomas F; McClanahan, Timothy R; Andréfouët, Serge; Baker, Merrill; Lagabrielle, Erwann; McClennen, Caleb; Rakotomanjaka, Andry J M; Tianarisoa, Tantely F; Watson, Reg; Kremen, Claire

2012-01-01

The Government of Madagascar plans to increase marine protected area coverage by over one million hectares. To assist this process, we compare four methods for marine spatial planning of Madagascar's west coast. Input data for each method was drawn from the same variables: fishing pressure, exposure to climate change, and biodiversity (habitats, species distributions, biological richness, and biodiversity value). The first method compares visual color classifications of primary variables, the second uses binary combinations of these variables to produce a categorical classification of management actions, the third is a target-based optimization using Marxan, and the fourth is conservation ranking with Zonation. We present results from each method, and compare the latter three approaches for spatial coverage, biodiversity representation, fishing cost and persistence probability. All results included large areas in the north, central, and southern parts of western Madagascar. Achieving 30% representation targets with Marxan required twice the fish catch loss than the categorical method. The categorical classification and Zonation do not consider targets for conservation features. However, when we reduced Marxan targets to 16.3%, matching the representation level of the "strict protection" class of the categorical result, the methods show similar catch losses. The management category portfolio has complete coverage, and presents several management recommendations including strict protection. Zonation produces rapid conservation rankings across large, diverse datasets. Marxan is useful for identifying strict protected areas that meet representation targets, and minimize exposure probabilities for conservation features at low economic cost. We show that methods based on Zonation and a simple combination of variables can produce results comparable to Marxan for species representation and catch losses, demonstrating the value of comparing alternative approaches during initial stages of the planning process. Choosing an appropriate approach ultimately depends on scientific and political factors including representation targets, likelihood of adoption, and persistence goals.

Quantifying the erosion of natural darkness in the global protected area system.

PubMed

Gaston, Kevin J; Duffy, James P; Bennie, Jonathan

2015-08-01

The nighttime light environment of much of the earth has been transformed by the introduction of electric lighting. This impact continues to spread with growth in the human population and extent of urbanization. This has profound consequences for organismal physiology and behavior and affects abundances and distributions of species, community structure, and likely ecosystem functions and processes. Protected areas play key roles in buffering biodiversity from a wide range of anthropogenic pressures. We used a calibration of a global satellite data set of nighttime lights to determine how well they are fulfilling this role with regard to artificial nighttime lighting. Globally, areas that are protected tend to be darker at night than those that are not, and, with the exception of Europe, recent regional declines in the proportion of the area that is protected and remains dark have been small. However, much of these effects result from the major contribution to overall protected area coverage by the small proportion of individual protected areas that are very large. Thus, in Europe and North America high proportions of individual protected areas (>17%) have exhibited high levels of nighttime lighting in all recent years, and in several regions (Europe, Asia, South and Central America) high proportions of protected areas (32-42%) have had recent significant increases in nighttime lighting. Limiting and reversing the erosion of nighttime darkness in protected areas will require routine consideration of nighttime conditions when designating and establishing new protected areas; establishment of appropriate buffer zones around protected areas where lighting is prohibited; and landscape level reductions in artificial nighttime lighting, which is being called for in general to reduce energy use and economic costs. © 2015 Society for Conservation Biology.

Expanding Kenya's protected areas under the Convention on Biological Diversity to maximize coverage of plant diversity.

PubMed

Scherer, Laura; Curran, Michael; Alvarez, Miguel

2017-04-01

Biodiversity is highly valuable and critically threatened by anthropogenic degradation of the natural environment. In response, governments have pledged enhanced protected-area coverage, which requires scarce biological data to identify conservation priorities. To assist this effort, we mapped conservation priorities in Kenya based on maximizing alpha (species richness) and beta diversity (species turnover) of plant communities while minimizing economic costs. We used plant-cover percentages from vegetation surveys of over 2000 plots to build separate models for each type of diversity. Opportunity and management costs were based on literature data and interviews with conservation organizations. Species richness was predicted to be highest in a belt from Lake Turkana through Mount Kenya and in a belt parallel to the coast, and species turnover was predicted to be highest in western Kenya and along the coast. Our results suggest the expanding reserve network should focus on the coast and northeastern provinces of Kenya, where new biological surveys would also fill biological data gaps. Meeting the Convention on Biological Diversity target of 17% terrestrial coverage by 2020 would increase representation of Kenya's plant communities by 75%. However, this would require about 50 times more funds than Kenya has received thus far from the Global Environment Facility. © 2016 Society for Conservation Biology.

STREAM FLOW BASIN CHARACTERISTICS FOR THE MID-ATLANTIC INTEGRATED ASSESSMENT (MAIA) STUDY AREA

EPA Science Inventory

This data set is a GIS coverage of the stream flow basin characteristics for drainage basins of selected US Geological Survey (USGS) gauging stations the United States Environmental Protection Agency (USEPA) Mid-Atlantic Integrated Assessment (MAIA) Project region. This data se...

The varicella vaccination pattern among children under 5 years old in selected areas in China.

PubMed

Yue, Chenyan; Li, Yan; Wang, Yamin; Liu, Yan; Cao, Linsheng; Zhu, Xu; Martin, Kathryn; Wang, Huaqing; An, Zhijie

2017-07-11

Vaccine is the most effective way to protect susceptible children from varicella. Few published literature or reports on varicella vaccination of Chinese children exist. Thus, in order to obtain specific information on varicella vaccination of this population, we conducted this survey. We first used purposive sampling methods to select 6 provinces 10 counties from eastern, middle and western parts of China with high quality of Immunization Information Management System (IIMS), and then randomly select children from population in the IIMS, then we checked vaccination certificate on-site. Based on the varicella vaccination information collected from 481 children's vaccination certificates from all ten selected counties in China, overall coverage of the first dose of varicella vaccine was 73.6%. There is a positive linear correlation between per capita GDP and vaccine coverage at county level (r=0.929, P < 0.01). The cumulative vaccine coverage among children at 1 year, 2 years and ≥3 years old were 67.6%, 71.9% and 73.6% respectively (X2=4.53, P =0.10). The age of vaccination was mainly concentrated in 12-17 months. The coverage rate of the first dose of varicella vaccine in selected areas was lower than that recommended by WHO position paper. The coverage rate was relatively low in areas of low social-economic status. The cumulative coverage had no significant statistical difference among different age group. Most children received varicella vaccine before 3 years old. We suggest introducing the varicella vaccine into routine immunization program, to ensure universal high coverage among children in China. We also suggest that varicella vaccination information should be checked before entering school, in order to control and prevent varicella outbreaks in schools.

Spatial-temporal Evolution of Vegetation Coverage and Analysis of it’s Future Trends in Wujiang River Basin

NASA Astrophysics Data System (ADS)

Xiao, Jianyong; Bai, Xiaoyong; Zhou, Dequan; Qian, Qinghuan; Zeng, Cheng; Chen, Fei

2018-01-01

Vegetation coverage dynamics is affected by climatic, topography and human activities, which is an important indicator reflecting the regional ecological environment. Revealing the spatial-temporal characteristics of vegetation coverage is of great significance to the protection and management of ecological environment. Based on MODIS NDVI data and the Maximum Value Composites (MVC), we excluded soil spectrum interference to calculate Fractional Vegetation Coverage (FVC). Then the long-term FVC was used to calculate the spatial pattern and temporal variation of vegetation in Wujiang River Basin from 2000 to 2016 by using Trend analysis and Hurst index. The relationship between topography and spatial distribution of FVC was analyzed. The main conclusions are as follows: (1) The multi-annual mean vegetation coverage reveals a spatial distribution variation characteristic of low value in midstream and high level in other parts of the basin, owing a mean value of 0.6567. (2) From 2000 to 2016, the FVC of the Wujiang River Basin fluctuated between 0.6110 and 0.7380, and the overall growth rate of FVC was 0.0074/a. (3) The area of vegetation coverage tending to improve is more than that going to degrade in the future. Grass land, Arable land and Others improved significantly; karst rocky desertification comprehensive management project lead to persistent vegetation coverage improvement of Grass land, Arable land and Others. Residential land is covered with obviously degraded vegetation, resulting of urban sprawl; (4) The spatial distribution of FVC is positively correlated with TNI. Researches of spatial-temporal evolution of vegetation coverage have significant meaning for the ecological environment protection and management of the Wujiang River Basin.

Spatio-Temporal Change of Vegetation Coverage and its Driving Forces Based on Landsat Images: a Case Study of Changchun City

NASA Astrophysics Data System (ADS)

Dong, L.; Jiang, H.; Yang, L.

2018-04-01

Based on the Landsat images in 2006, 2011 and 2015, and the method of dimidiate pixel model, the Normalized Difference Vegetation Index (NDVI) and the vegetation coverage, this paper analyzes the spatio-temporal variation of vegetation coverage in Changchun, China from 2006 to 2015, and investigates the response of vegetation coverage change to natural and artificial factors. The research results show that in nearly 10 years, the vegetation coverage in Changchun dropped remarkably, and reached the minimum in 2011. Moreover, the decrease of maximum NDVI was significant, with a decrease of about 27.43 %, from 2006 to 2015. The vegetation coverage change in different regions of the research area was significantly different. Among them, the vegetation change in Changchun showed a little drop, and it decreased firstly and then increased slowly in Yushu, Nong'an and Dehui. In addition, the temperature and precipitation change, land reclamation all affect the vegetation coverage. In short, the study of vegetation coverage change contributes scientific and technical support to government and environmental protection department, so as to promote the coordinated development of ecology and economy.

42 CFR 457.810 - Premium assistance programs: Required protections against substitution.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., must provide the protections against substitution of CHIP coverage for coverage under group health... assistance programs must not be greater than the cost of other CHIP coverage for these children; and (2) The... children under premium assistance programs to the cost of other CHIP coverage for these children, done on a...

Successful conservation of global waterbird populations depends on effective governance.

PubMed

Amano, Tatsuya; Székely, Tamás; Sandel, Brody; Nagy, Szabolcs; Mundkur, Taej; Langendoen, Tom; Blanco, Daniel; Soykan, Candan U; Sutherland, William J

2018-01-11

Understanding global patterns of biodiversity change is crucial for conservation research, policies and practices. However, for most ecosystems, the lack of systematically collected data at a global level limits our understanding of biodiversity changes and their local-scale drivers. Here we address this challenge by focusing on wetlands, which are among the most biodiverse and productive of any environments and which provide essential ecosystem services, but are also amongst the most seriously threatened ecosystems. Using birds as an indicator taxon of wetland biodiversity, we model time-series abundance data for 461 waterbird species at 25,769 survey sites across the globe. We show that the strongest predictor of changes in waterbird abundance, and of conservation efforts having beneficial effects, is the effective governance of a country. In areas in which governance is on average less effective, such as western and central Asia, sub-Saharan Africa and South America, waterbird declines are particularly pronounced; a higher protected area coverage of wetland environments facilitates waterbird increases, but only in countries with more effective governance. Our findings highlight that sociopolitical instability can lead to biodiversity loss and undermine the benefit of existing conservation efforts, such as the expansion of protected area coverage. Furthermore, data deficiencies in areas with less effective governance could lead to underestimations of the extent of the current biodiversity crisis.

Successful conservation of global waterbird populations depends on effective governance

NASA Astrophysics Data System (ADS)

Amano, Tatsuya; Székely, Tamás; Sandel, Brody; Nagy, Szabolcs; Mundkur, Taej; Langendoen, Tom; Blanco, Daniel; Soykan, Candan U.; Sutherland, William J.

2018-01-01

Understanding global patterns of biodiversity change is crucial for conservation research, policies and practices. However, for most ecosystems, the lack of systematically collected data at a global level limits our understanding of biodiversity changes and their local-scale drivers. Here we address this challenge by focusing on wetlands, which are among the most biodiverse and productive of any environments and which provide essential ecosystem services, but are also amongst the most seriously threatened ecosystems. Using birds as an indicator taxon of wetland biodiversity, we model time-series abundance data for 461 waterbird species at 25,769 survey sites across the globe. We show that the strongest predictor of changes in waterbird abundance, and of conservation efforts having beneficial effects, is the effective governance of a country. In areas in which governance is on average less effective, such as western and central Asia, sub-Saharan Africa and South America, waterbird declines are particularly pronounced; a higher protected area coverage of wetland environments facilitates waterbird increases, but only in countries with more effective governance. Our findings highlight that sociopolitical instability can lead to biodiversity loss and undermine the benefit of existing conservation efforts, such as the expansion of protected area coverage. Furthermore, data deficiencies in areas with less effective governance could lead to underestimations of the extent of the current biodiversity crisis.

Effect of stone coverage on soil erosion

NASA Astrophysics Data System (ADS)

Jomaa, S.; Barry, D. A.; Heng, B. P.; Brovelli, A.; Sander, G. C.; Parlange, J.

2010-12-01

Soil surface coverage has a significant impact on water infiltration, runoff and soil erosion yields. In particular, surface stones protect the soils from raindrop detachment, they retard the overland flow therefore decreasing its sediment transport capacity, and they prevent surface sealing. Several physical and environmental factors control to what extent stones on the soil surface modify the erosion rates and the related hydrological response. Among the most important factors are the moisture content of the topsoil, stone size, emplacement, coverage density and soil texture. Owing to the different inter-related processes, there is ambiguity concerning the quantitative effect of stones, and process-based understanding is limited. Experiments were performed (i) to quantify how stone features affect sediment yields, (ii) to understand the local effect of isolated surface stones, that is, the changes of the soil particle size distribution in the vicinity of a stone and (iii) to determine how stones attenuate the development of surface sealing and in turn how this affects the local infiltration rate. A series of experiments using the EPFL 6-m × 2-m erosion flume were conducted at different rainfall intensities (28 and 74 mm h-1) and stone coverage (20 and 40%). The total sediment concentration, the concentration of the individual size classes and the flow discharge were measured. In order to analyze the measurements, the Hairsine and Rose (HR) erosion model was adapted to account for the shielding effect of the stone cover. This was done by suitably adjusting the parameters based on the area not covered by stones. It was found that the modified HR model predictions agreed well with the measured sediment concentrations especially for the long time behavior. Changes in the bulk density of the topsoil due to raindrop-induced compaction with and without stone protection revealed that the stones protect the upper soil surface against the structural seals resulting in negligible changes in the bulk density during the erosion event. Since the main process contributing to surface sealing development is the compaction due to the raindrop kinetic energy and associated physico-chemical changes, the protection provided by the stone cover is consistent with the area-averaging approach used in applying the HR model.

Estimation of the herd protection of Haemophilus influenzae type b conjugate vaccine against radiologically confirmed pneumonia in children under 2 years old in Dhaka, Bangladesh.

PubMed

Chen, Wei-Ju; Moulton, Lawrence H; Saha, Samir K; Mahmud, Abdullah Al; Arifeen, Shams El; Baqui, Abdullah H

2014-02-12

Herd protection of Haemophilus influenzae type b (Hib) conjugate vaccine has been associated with excessive decrease of invasive Hib diseases, i.e., pneumonia and meningitis, with increased national or regional Hib vaccine coverage. Only a few studies have examined herd protection at the individual level and even less evidence is available from Asia. We examined Hib vaccine herd protection against radiologically confirmed pneumonia among children less than 2 years old. We incorporated data from a matched case-control study and a vaccine coverage survey in Dhaka, Bangladesh. Pneumonia cases (n=343) were confirmed by radiology. For each case, two controls with conditions other than pneumonia or meningitis were selected from the same hospital. Hib vaccine coverage was calculated as percentages of children who received at least 2 doses of Hib vaccine from a survey in the neighborhood centered on each case and control. Conditional logistic regression was fit to examine the association between vaccine coverage and risk of radiologically confirmed pneumonia. Neighborhood Hib vaccine coverage varied from 0% to 63.5% for cases and from 8.7% to 61.5% for controls, respectively. Cases were less likely to have neighborhood coverage higher than 20% (OR=0.49, 0.52, 0.55, and 0.69 for coverage 20-29%, 30-39%, 40-49%, and ≥50%, respectively) than coverage <20%, compared to controls, although the estimates for coverage 40-49% and ≥50% were not statistically significant. The study indicates that Hib vaccine may provide herd protection, even when the coverage is as low as 20-39%, in a low-income country. Asian countries should consider herd protection in implementing effective vaccine policy with limited resources. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Changes in mangrove coverage in Culebra Bay, North Pacific of Costa Rica (1945-2010)].

PubMed

Benavides-Varela, Catalina; Samper-Villareal, Jimena; Cortés, Jorge

2016-09-01

Despite the economic and environmental services that mangroves provide, they continue to be threatened by overexploitation, pollution, and land use change. Costa Rica has mangrove areas on the Pacific and Caribbean coasts, and cover has been declining since the 1980s. However, data on mangrove coverage are not continually updated and are often based on inaccurate estimates. It is therefore necessary to assess the current extension and variation of the mangrove cover in recent years, to determine changes. The mangrove cover was analyzed in two mangrove forests located in Bahía Culebra, North Pacific: Iguanita and Playa Panamá. For this, aerial photographs and satellite imagery were used to study changes for a 65 year period (1945-2010). Spatio-temporal changes were found in mangroves coverage, and adjacent forests and areas without vegetation. Lower mangrove cover occurred during the 1970s (28.4 ha in Iguanita and 4.8 ha in Playa Panamá); but increased in recent years (38.9 ha in Iguanita and 12.0 ha in Panamá). Changes in forest cover by the Iguanita and Playa Panama mangroves were related to the history of land use around Bahía Culebra. Before 1980, there was extensive and intensive cattle ranching, increasing the deforestation rate; after that year, these practices were abandoned and secondary forest coverage increased until 2000. To ensure the adequate protection of mangroves, it is not only important to protect mangrove forests, but it is also necessary to establish buffer zones on their surroundings, to mitigate and/or reduce possible impacts.

Reputation-Based Trust for a Cooperative, Agent-Based Backup Protection Scheme for Power Networks

DTIC Science & Technology

2010-03-01

85 Appendix B . Performance Charts for Data by Scenario...protection for that line. For example Relay 3 provides zone 1 coverage for line B and zone 3 coverage for line C. Relay 4 would also provide zone 1...coverage for line B but zone 3 coverage for line A instead since it is directional. Relay 1 and relay 6 would provide zone 3 coverage for line B . A

Measuring impact of protected area management interventions: current and future use of the Global Database of Protected Area Management Effectiveness

PubMed Central

Coad, Lauren; Leverington, Fiona; Knights, Kathryn; Geldmann, Jonas; Eassom, April; Kapos, Valerie; Kingston, Naomi; de Lima, Marcelo; Zamora, Camilo; Cuardros, Ivon; Nolte, Christoph; Burgess, Neil D.; Hockings, Marc

2015-01-01

Protected areas (PAs) are at the forefront of conservation efforts, and yet despite considerable progress towards the global target of having 17% of the world's land area within protected areas by 2020, biodiversity continues to decline. The discrepancy between increasing PA coverage and negative biodiversity trends has resulted in renewed efforts to enhance PA effectiveness. The global conservation community has conducted thousands of assessments of protected area management effectiveness (PAME), and interest in the use of these data to help measure the conservation impact of PA management interventions is high. Here, we summarize the status of PAME assessment, review the published evidence for a link between PAME assessment results and the conservation impacts of PAs, and discuss the limitations and future use of PAME data in measuring the impact of PA management interventions on conservation outcomes. We conclude that PAME data, while designed as a tool for local adaptive management, may also help to provide insights into the impact of PA management interventions from the local-to-global scale. However, the subjective and ordinal characteristics of the data present significant limitations for their application in rigorous scientific impact evaluations, a problem that should be recognized and mitigated where possible. PMID:26460133

Measuring the extent of overlaps in protected area designations

PubMed Central

Arnell, Andy; Juffe-Bignoli, Diego; Shi, Yichuan; Bingham, Heather; MacSharry, Brian; Kingston, Naomi

2017-01-01

Over the past decades, a number of national policies and international conventions have been implemented to promote the expansion of the world’s protected area network, leading to a diversification of protected area strategies, types and designations. As a result, many areas are protected by more than one convention, legal instrument, or other effective means which may result in a lack of clarity around the governance and management regimes of particular locations. We assess the degree to which different designations overlap at global, regional and national levels to understand the extent of this phenomenon at different scales. We then compare the distribution and coverage of these multi-designated areas in the terrestrial and marine realms at the global level and among different regions, and we present the percentage of each county’s protected area extent that is under more than one designation. Our findings show that almost a quarter of the world’s protected area network is protected through more than one designation. In fact, we have documented up to eight overlapping designations. These overlaps in protected area designations occur in every region of the world, both in the terrestrial and marine realms, but are more common in the terrestrial realm and in some regions, notably Europe. In the terrestrial realm, the most common overlap is between one national and one international designation. In the marine realm, the most common overlap is between any two national designations. Multi-designations are therefore a widespread phenomenon but its implications are not well understood. This analysis identifies, for the first time, multi-designated areas across all designation types. This is a key step to understand how these areas are managed and governed to then move towards integrated and collaborative approaches that consider the different management and conservation objectives of each designation. PMID:29176888

Measuring the extent of overlaps in protected area designations.

PubMed

Deguignet, Marine; Arnell, Andy; Juffe-Bignoli, Diego; Shi, Yichuan; Bingham, Heather; MacSharry, Brian; Kingston, Naomi

2017-01-01

Over the past decades, a number of national policies and international conventions have been implemented to promote the expansion of the world's protected area network, leading to a diversification of protected area strategies, types and designations. As a result, many areas are protected by more than one convention, legal instrument, or other effective means which may result in a lack of clarity around the governance and management regimes of particular locations. We assess the degree to which different designations overlap at global, regional and national levels to understand the extent of this phenomenon at different scales. We then compare the distribution and coverage of these multi-designated areas in the terrestrial and marine realms at the global level and among different regions, and we present the percentage of each county's protected area extent that is under more than one designation. Our findings show that almost a quarter of the world's protected area network is protected through more than one designation. In fact, we have documented up to eight overlapping designations. These overlaps in protected area designations occur in every region of the world, both in the terrestrial and marine realms, but are more common in the terrestrial realm and in some regions, notably Europe. In the terrestrial realm, the most common overlap is between one national and one international designation. In the marine realm, the most common overlap is between any two national designations. Multi-designations are therefore a widespread phenomenon but its implications are not well understood. This analysis identifies, for the first time, multi-designated areas across all designation types. This is a key step to understand how these areas are managed and governed to then move towards integrated and collaborative approaches that consider the different management and conservation objectives of each designation.

Combating Child Homicide: Preventive Policing for the New Millennium

ERIC Educational Resources Information Center

Boudreaux, Monique C.; Lord, Wayne D.

2005-01-01

High-profile media coverage of crimes against children has heightened public awareness of critical child safety needs and issues. However, numerous research studies in the area of child homicide have illustrated the importance of the power of science to correct false perceptions and misinformation, improving how to best serve and protect our…

Preventing Childhood Malaria in Africa by Protecting Adults from Mosquitoes with Insecticide-Treated Nets

PubMed Central

Killeen, Gerry F; Smith, Tom A; Ferguson, Heather M; Mshinda, Hassan; Abdulla, Salim; Lengeler, Christian; Kachur, Steven P

2007-01-01

Background Malaria prevention in Africa merits particular attention as the world strives toward a better life for the poorest. Insecticide-treated nets (ITNs) represent a practical means to prevent malaria in Africa, so scaling up coverage to at least 80% of young children and pregnant women by 2010 is integral to the Millennium Development Goals (MDG). Targeting individual protection to vulnerable groups is an accepted priority, but community-level impacts of broader population coverage are largely ignored even though they may be just as important. We therefore estimated coverage thresholds for entire populations at which individual- and community-level protection are equivalent, representing rational targets for ITN coverage beyond vulnerable groups. Methods and Findings Using field-parameterized malaria transmission models, we show that high (80% use) but exclusively targeted coverage of young children and pregnant women (representing <20% of the population) will deliver limited protection and equity for these vulnerable groups. In contrast, relatively modest coverage (35%–65% use, with this threshold depending on ecological scenario and net quality) of all adults and children, rather than just vulnerable groups, can achieve equitable community-wide benefits equivalent to or greater than personal protection. Conclusions Coverage of entire populations will be required to accomplish large reductions of the malaria burden in Africa. While coverage of vulnerable groups should still be prioritized, the equitable and communal benefits of wide-scale ITN use by older children and adults should be explicitly promoted and evaluated by national malaria control programmes. ITN use by the majority of entire populations could protect all children in such communities, even those not actually covered by achieving existing personal protection targets of the MDG, Roll Back Malaria Partnership, or the US President's Malaria Initiative. PMID:17608562

RCT: Module 2.11, Radiological Work Coverage, Course 8777

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

Hillmer, Kurt T.

2017-07-20

Radiological work is usually approved and controlled by radiation protection personnel by using administrative and procedural controls, such as radiological work permits (RWPs). In addition, some jobs will require working in, or will have the potential for creating, very high radiation, contamination, or airborne radioactivity areas. Radiological control technicians (RCTs) providing job coverage have an integral role in controlling radiological hazards. This course will prepare the student with the skills necessary for RCT qualification by passing quizzes, tests, and the RCT Comprehensive Phase 1, Unit 2 Examination (TEST 27566) and will provide in-the-field skills.

Is It More Important to Address the Issue of Patient Mobility or to Guarantee Universal Health Coverage in Europe?

PubMed Central

Legido-Quigley, Helena

2016-01-01

This paper discusses whether European institutions should devote so much attention and funding to cross-border healthcare or they should instead prioritise guaranteeing universal health coverage (UHC), “addressing inequalities” and tackling the effects of austerity measures. The paper argues through providing the evidence in both areas of research, that the priority at European level from a public health and social justice perspective should be to guarantee UHC for all the population living in Europe and prioritise protective action for those who are most in need. PMID:26673649

Comparison of Marine Spatial Planning Methods in Madagascar Demonstrates Value of Alternative Approaches

PubMed Central

Allnutt, Thomas F.; McClanahan, Timothy R.; Andréfouët, Serge; Baker, Merrill; Lagabrielle, Erwann; McClennen, Caleb; Rakotomanjaka, Andry J. M.; Tianarisoa, Tantely F.; Watson, Reg; Kremen, Claire

2012-01-01

The Government of Madagascar plans to increase marine protected area coverage by over one million hectares. To assist this process, we compare four methods for marine spatial planning of Madagascar's west coast. Input data for each method was drawn from the same variables: fishing pressure, exposure to climate change, and biodiversity (habitats, species distributions, biological richness, and biodiversity value). The first method compares visual color classifications of primary variables, the second uses binary combinations of these variables to produce a categorical classification of management actions, the third is a target-based optimization using Marxan, and the fourth is conservation ranking with Zonation. We present results from each method, and compare the latter three approaches for spatial coverage, biodiversity representation, fishing cost and persistence probability. All results included large areas in the north, central, and southern parts of western Madagascar. Achieving 30% representation targets with Marxan required twice the fish catch loss than the categorical method. The categorical classification and Zonation do not consider targets for conservation features. However, when we reduced Marxan targets to 16.3%, matching the representation level of the “strict protection” class of the categorical result, the methods show similar catch losses. The management category portfolio has complete coverage, and presents several management recommendations including strict protection. Zonation produces rapid conservation rankings across large, diverse datasets. Marxan is useful for identifying strict protected areas that meet representation targets, and minimize exposure probabilities for conservation features at low economic cost. We show that methods based on Zonation and a simple combination of variables can produce results comparable to Marxan for species representation and catch losses, demonstrating the value of comparing alternative approaches during initial stages of the planning process. Choosing an appropriate approach ultimately depends on scientific and political factors including representation targets, likelihood of adoption, and persistence goals. PMID:22359534

Shortfalls in the global protected area network at representing marine biodiversity

PubMed Central

Klein, Carissa J.; Brown, Christopher J.; Halpern, Benjamin S.; Segan, Daniel B.; McGowan, Jennifer; Beger, Maria; Watson, James E.M.

2015-01-01

The first international goal for establishing marine protected areas (MPAs) to conserve the ocean’s biodiversity was set in 2002. Since 2006, the Convention on Biological Diversity (CBD) has driven MPA establishment, with 193 parties committed to protecting >10% of marine environments globally by 2020, especially ‘areas of particular importance for biodiversity’ (Aichi target 11). This has resulted in nearly 10 million km2 of new MPAs, a growth of ~360% in a decade. Unlike on land, it is not known how well protected areas capture marine biodiversity, leaving a significant gap in our understanding of existing MPAs and future protection requirements. We assess the overlap of global MPAs with the ranges of 17,348 marine species (fishes, mammals, invertebrates), and find that 97.4% of species have <10% of their ranges represented in stricter conservation classes. Almost all (99.8%) of the very poorly represented species (<2% coverage) are found within exclusive economic zones, suggesting an important role for particular nations to better protect biodiversity. Our results offer strategic guidance on where MPAs should be placed to support the CBD’s overall goal to avert biodiversity loss. Achieving this goal is imperative for nature and humanity, as people depend on biodiversity for important and valuable services. PMID:26631984

Shortfalls in the global protected area network at representing marine biodiversity.

PubMed

Klein, Carissa J; Brown, Christopher J; Halpern, Benjamin S; Segan, Daniel B; McGowan, Jennifer; Beger, Maria; Watson, James E M

2015-12-03

The first international goal for establishing marine protected areas (MPAs) to conserve the ocean's biodiversity was set in 2002. Since 2006, the Convention on Biological Diversity (CBD) has driven MPA establishment, with 193 parties committed to protecting >10% of marine environments globally by 2020, especially 'areas of particular importance for biodiversity' (Aichi target 11). This has resulted in nearly 10 million km(2) of new MPAs, a growth of ~360% in a decade. Unlike on land, it is not known how well protected areas capture marine biodiversity, leaving a significant gap in our understanding of existing MPAs and future protection requirements. We assess the overlap of global MPAs with the ranges of 17,348 marine species (fishes, mammals, invertebrates), and find that 97.4% of species have <10% of their ranges represented in stricter conservation classes. Almost all (99.8%) of the very poorly represented species (<2% coverage) are found within exclusive economic zones, suggesting an important role for particular nations to better protect biodiversity. Our results offer strategic guidance on where MPAs should be placed to support the CBD's overall goal to avert biodiversity loss. Achieving this goal is imperative for nature and humanity, as people depend on biodiversity for important and valuable services.

Is Neighborhood Green Space Protective against Associations between Child Asthma, Neighborhood Traffic Volume and Perceived Lack of Area Safety? Multilevel Analysis of 4447 Australian Children.

PubMed

Feng, Xiaoqi; Astell-Burt, Thomas

2017-05-19

Heavy traffic is a source of air pollution and a safety concern with important public health implications. We investigated whether green space lowers child asthma risk by buffering the effects of heavy traffic and a lack of neighborhood safety. Multilevel models were used to analyze affirmative asthma cases in nationally representative cross-sectional data from 4447 children aged 6-7 years old in Australia. Case-finding was based upon a triangulation of affirmative responses to three questions on doctor-diagnosed asthma, asthma-related medications and illness with wheezing lasting for at least 1 week within the 12 months prior. Among children considered to be exposed to high traffic volumes and areas with 0 to 20% green space quantity, the odds ratio of affirmative asthma was 1.87 (95% CI 1.37 to 2.55). However, the association between heavy traffic and asthma was significantly lower for participants living in areas with over 40% green space coverage (odds ratio for interaction 0.32, 95% CI 0.12 to 0.84). No association between affirmative asthma and green space coverage was observed for participants not exposed to heavy traffic, nor for the area safety variable. Protecting existing and investing in new green space may help to promote child respiratory health through the buffering of traffic-related air pollution.

Environmental Implications of Maritime Vessel Intensification in Arctic Waters

NASA Astrophysics Data System (ADS)

Stevenson, T. C.; Banis, D.; Sheard, W.

2016-12-01

In 2016, the Arctic experienced some of the warmest monthly temperatures on record. Record high temperatures in the Arctic continue to cause rapid sea ice declines, opening new areas of ocean to commercial exploitation and transportation and causing significant reductions in critical sea ice habitats used by iconic species. Elevated maritime vessel traffic in the Arctic is projected to increase black carbon emissions, encourage the spread of invasive species, increase mammal strikes, intensify conflict with smaller subsistence boats, and heighten oil spill risks. The Arctic Council, an intergovernmental organization concerned with sustainable development and environmental protection, is working with member countries, indigenous participants and other groups on developing networks of marine protected areas within ecologically or biologically important areas. To help inform that process, we analyzed vessel traffic and marine protected area coverage occurring within ecologically or biologically significant areas in the circumpolar Arctic. Our preliminary findings suggest vessel traffic within ecologically or biologically significant areas were highest around Iceland, Norway, Russia and United States but differed by vessel type. The density of fishing vessels occurring within ecologically or biologically important areas were highest near Norway, Iceland, Faroe Islands, parts of Greenland and United States, whereas vessels carrying liquefied natural gas and oil were concentrated near Norway and Russia. The percentage of area covered by marine protected areas within ecologically or biologically significant areas was low, with the exception of places like Wrangel Island, Svalbard, and areas around Greenland. These findings are important because it illustrates ecologically or biologically significant areas in the Arctic are vulnerable to projected vessel traffic intensification and the level of protection afforded by marine protected areas is relatively low.

ENVIRONMENTAL IMPACT ASSESSMENT TAXONOMY PROVIDING COMPREHENSIVE COVERAGE OF MIDPOINTS, ENDPOINTS, DAMAGES, AND AREAS OF PROTECTION

EPA Science Inventory

Prior to conducting a comprehensive impact assessment, such as a Life Cycle Impact Assessment (LCIA), there is a need to discuss the range of impacts which could and should be included. Up to this point in time, there has not been available a comprehensive list of impacts for po...

Coverage and Financial Risk Protection for Institutional Delivery: How Universal Is Provision of Maternal Health Care in India?

PubMed

Prinja, Shankar; Bahuguna, Pankaj; Gupta, Rakesh; Sharma, Atul; Rana, Saroj Kumar; Kumar, Rajesh

2015-01-01

India aims to achieve universal access to institutional delivery. We undertook this study to estimate the universality of institutional delivery care for pregnant women in Haryana state in India. To assess the coverage of institutional delivery, we analyze service coverage (coverage of public sector institutional delivery), population coverage (coverage among different districts and wealth quintiles of the population) and financial risk protection (catastrophic health expenditure and impoverishment as a result of out-of-pocket expenditure for delivery). We analyzed cross-sectional data collected from a randomly selected sample of 12,191 women who had delivered a child in the last one year from the date of data collection in Haryana state. Five indicators were calculated to evaluate coverage and financial risk protection for institutional delivery--proportion of public sector deliveries, out-of-pocket expenditure, percentage of women who incurred no expenses, prevalence of catastrophic expenditure for institutional delivery and incidence of impoverishment due to out-of-pocket expenditure for delivery. These indicators were calculated for the public and private sectors for 5 wealth quintiles and 21 districts of the state. The coverage of institutional delivery in Haryana state was 82%, of which 65% took place in public sector facilities. Approximately 63% of the women reported no expenditure on delivery in the public sector. The mean out-of-pocket expenditures for delivery in the public and private sectors in Haryana were INR 771 (USD 14.2) and INR 12,479 (USD 229), respectively, which were catastrophic for 1.6% and 22% of households, respectively. Our findings suggest that there is considerably high coverage of institutional delivery care in Haryana state, with significant financial risk protection in the public sector. However, coverage and financial risk protection for institutional delivery vary substantially across districts and among different socio-economic groups and must be strengthened. The success of the public sector in providing high coverage and financial risk protection in maternal health provides encouragement for the role that the public sector can play in universalizing health care.

Coverage and Financial Risk Protection for Institutional Delivery: How Universal Is Provision of Maternal Health Care in India?

PubMed Central

Prinja, Shankar; Bahuguna, Pankaj; Gupta, Rakesh; Sharma, Atul; Rana, Saroj Kumar; Kumar, Rajesh

2015-01-01

Background India aims to achieve universal access to institutional delivery. We undertook this study to estimate the universality of institutional delivery care for pregnant women in Haryana state in India. To assess the coverage of institutional delivery, we analyze service coverage (coverage of public sector institutional delivery), population coverage (coverage among different districts and wealth quintiles of the population) and financial risk protection (catastrophic health expenditure and impoverishment as a result of out-of-pocket expenditure for delivery). Methods We analyzed cross-sectional data collected from a randomly selected sample of 12,191 women who had delivered a child in the last one year from the date of data collection in Haryana state. Five indicators were calculated to evaluate coverage and financial risk protection for institutional delivery—proportion of public sector deliveries, out-of-pocket expenditure, percentage of women who incurred no expenses, prevalence of catastrophic expenditure for institutional delivery and incidence of impoverishment due to out-of-pocket expenditure for delivery. These indicators were calculated for the public and private sectors for 5 wealth quintiles and 21 districts of the state. Results The coverage of institutional delivery in Haryana state was 82%, of which 65% took place in public sector facilities. Approximately 63% of the women reported no expenditure on delivery in the public sector. The mean out-of-pocket expenditures for delivery in the public and private sectors in Haryana were INR 771 (USD 14.2) and INR 12,479 (USD 229), respectively, which were catastrophic for 1.6% and 22% of households, respectively. Conclusion Our findings suggest that there is considerably high coverage of institutional delivery care in Haryana state, with significant financial risk protection in the public sector. However, coverage and financial risk protection for institutional delivery vary substantially across districts and among different socio-economic groups and must be strengthened. The success of the public sector in providing high coverage and financial risk protection in maternal health provides encouragement for the role that the public sector can play in universalizing health care. PMID:26348921

7 CFR 1737.31 - Area Coverage Survey (ACS).

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 11 2011-01-01 2011-01-01 false Area Coverage Survey (ACS). 1737.31 Section 1737.31... Studies-Area Coverage Survey and Loan Design § 1737.31 Area Coverage Survey (ACS). (a) The Area Coverage Survey (ACS) is a market forecast of service requirements of subscribers in a proposed service area. (b...

7 CFR 1737.31 - Area Coverage Survey (ACS).

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Area Coverage Survey (ACS). 1737.31 Section 1737.31... Studies-Area Coverage Survey and Loan Design § 1737.31 Area Coverage Survey (ACS). (a) The Area Coverage Survey (ACS) is a market forecast of service requirements of subscribers in a proposed service area. (b...

7 CFR 1737.31 - Area Coverage Survey (ACS).

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 11 2013-01-01 2013-01-01 false Area Coverage Survey (ACS). 1737.31 Section 1737.31... Studies-Area Coverage Survey and Loan Design § 1737.31 Area Coverage Survey (ACS). (a) The Area Coverage Survey (ACS) is a market forecast of service requirements of subscribers in a proposed service area. (b...

7 CFR 1737.31 - Area Coverage Survey (ACS).

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 11 2012-01-01 2012-01-01 false Area Coverage Survey (ACS). 1737.31 Section 1737.31... Studies-Area Coverage Survey and Loan Design § 1737.31 Area Coverage Survey (ACS). (a) The Area Coverage Survey (ACS) is a market forecast of service requirements of subscribers in a proposed service area. (b...

7 CFR 1737.31 - Area Coverage Survey (ACS).

Code of Federal Regulations, 2014 CFR

2014-01-01

... Studies-Area Coverage Survey and Loan Design § 1737.31 Area Coverage Survey (ACS). (a) The Area Coverage Survey (ACS) is a market forecast of service requirements of subscribers in a proposed service area. (b... 7 Agriculture 11 2014-01-01 2014-01-01 false Area Coverage Survey (ACS). 1737.31 Section 1737.31...

Tetanus toxoid coverage as an indicator of serological protection against neonatal tetanus.

PubMed Central

Deming, Michael S.; Roungou, Jean-Baptiste; Kristiansen, Max; Heron, Iver; Yango, Alphonse; Guenengafo, Alexis; Ndamobissi, Robert

2002-01-01

OBJECTIVE: A Multiple-Indicator Cluster Survey (MICS) was conducted at mid-decade in more than 60 developing countries to measure progress towards the year 2000 World Summit for Children goals. These goals included the protection of at least 90% of children against neonatal tetanus through the immunization of their mothers, as measured by tetanus toxoid (TT) coverage. In the Central African Republic (CAR), serological testing was added to the MICS to understand better the relationship between survey estimates of TT coverage and the prevalence of serological protection. METHODS: In the CAR MICS, mothers of children younger than one year of age gave verbal histories of the TT vaccinations they had received, using the MICS TT questionnaire. A subsample of mothers was tested for tetanus antitoxin, using a double-antigen enzyme-linked immunoadsorbent assay (ELISA). Seropositivity was defined as a titre of > or =0.01 IU/ml, and TT coverage was defined as the proportion of mothers protected at delivery, according to their history of TT vaccinations. FINDINGS: Among the 222 mothers in the subsample, weighted TT coverage was 74.4% (95% Confidence Interval (CI); 67.0% - 81.7%) and tetanus antitoxin seroprevalence was 88.7% (95% CI; 83.2% - 94.2%). The weighted median antitoxin titre was 0.35 IU/ml. CONCLUSIONS: Tetanus toxoid coverage in the CAR was lower than the prevalence of serological protection against neonatal tetanus. If this relationship holds for other countries, TT coverage estimates from the MICS may underestimate the extent to which the year 2000 goal for protecting children against neonatal tetanus was reached. We also showed that a high level of serological protection had been achieved in a country facing major public health challenges and resource constraints. PMID:12378286

Comparative assessment of immunization coverage of migrant children between national immunization program vaccines and non-national immunization program vaccines in East China

PubMed Central

Hu, Yu; Luo, Shuying; Tang, Xuewen; Lou, Linqiao; Chen, Yaping; Guo, Jing

2015-01-01

This study aimed to describe the disparities in immunization coverage between National Immunization Program (NIP) vaccines and non-NIP vaccines in Yiwu and to identify potential determinants. A face-to-face interview-based questionnaire survey among 423 migrant children born from 1 June 2010 to 31 May 2013 was conducted. Immunization coverage was estimated according to the vaccines scheduled at different age, the birth cohorts, and socio- demographic characteristics. Single-level logistic regression analysis was applied to identify the determinants of coverage of non-NIP vaccines. We found that NIP vaccines recorded higher immunization coverage compared with non-NIP vaccines (87.9100%– vs 0%-74.8%). Among the non-NIP vaccines, varicella vaccine (VarV) recorded the highest coverage of 85.4%, which was introduced in 1998; while 7-valent pneumococcal conjugate vaccine(PCV7) recorded the lowest coverage of 0% for primary series, which was introduced recently. Lower coverage rate of non-NIP vaccines was significantly associated with more siblings in household, shorter duration of living in the surveyed areas, lower family income, mother with a job, mother with poor awareness of vaccination, and mother with lower education level. We found the immunization coverage rate of non-NIP vaccines was significant lower than that of NIP vaccines. Expansion of NIP to include non-NIP vaccines can provide better protection against the vaccine preventable diseases through increased immunization coverage. PMID:25760670

Comparative assessment of immunization coverage of migrant children between national immunization program vaccines and non-national immunization program vaccines in East China.

PubMed

Hu, Yu; Luo, Shuying; Tang, Xuewen; Lou, Linqiao; Chen, Yaping; Guo, Jing

2015-01-01

This study aimed to describe the disparities in immunization coverage between National Immunization Program (NIP) vaccines and non-NIP vaccines in Yiwu and to identify potential determinants. A face-to-face interview-based questionnaire survey among 423 migrant children born from 1 June 2010 to 31 May 2013 was conducted. Immunization coverage was estimated according to the vaccines scheduled at different age, the birth cohorts, and socio- demographic characteristics. Single-level logistic regression analysis was applied to identify the determinants of coverage of non-NIP vaccines. We found that NIP vaccines recorded higher immunization coverage compared with non-NIP vaccines (87.9100%- vs 0%-74.8%). Among the non-NIP vaccines, varicella vaccine (VarV) recorded the highest coverage of 85.4%, which was introduced in 1998; while 7-valent pneumococcal conjugate vaccine(PCV7) recorded the lowest coverage of 0% for primary series, which was introduced recently. Lower coverage rate of non-NIP vaccines was significantly associated with more siblings in household, shorter duration of living in the surveyed areas, lower family income, mother with a job, mother with poor awareness of vaccination, and mother with lower education level. We found the immunization coverage rate of non-NIP vaccines was significant lower than that of NIP vaccines. Expansion of NIP to include non-NIP vaccines can provide better protection against the vaccine preventable diseases through increased immunization coverage.

12 CFR 1005.3 - Coverage.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Banking BUREAU OF CONSUMER FINANCIAL PROTECTION ELECTRONIC FUND TRANSFERS (REGULATION E) § 1005.3 Coverage... Consumer Financial Protection Act of 2010, Title X of the Dodd-Frank Wall Street Reform and Consumer Protection Act, Public Law 111-203, 124 Stat. 1376. (b) Electronic fund transfer—(1) Definition. The term...

Trends in, and projections of, indicators of universal health coverage in Bangladesh, 1995-2030: a Bayesian analysis of population-based household data.

PubMed

Rahman, Md Shafiur; Rahman, Md Mizanur; Gilmour, Stuart; Swe, Khin Thet; Krull Abe, Sarah; Shibuya, Kenji

2018-01-01

Many countries are implementing health system reforms to achieve universal health coverage (UHC) by 2030. To understand the progress towards UHC in Bangladesh, we estimated trends in indicators of the health service and of financial risk protection. We also estimated the probability of Bangladesh's achieving of UHC targets of 80% essential health-service coverage and 100% financial risk protection by 2030. We estimated the coverage of UHC indicators-13 prevention indicators and four treatment indicators-from 19 nationally representative population-based household surveys done in Bangladesh from Jan 1, 1991, to Dec 31, 2014. We used a Bayesian regression model to estimate the trend and to predict the coverage of UHC indicators along with the probabilities of achieving UHC targets of 80% coverage of health services and 100% coverage of financial risk protection from catastrophic and impoverishing health payments by 2030. We used the concentration index and relative index of inequality to assess wealth-based inequality in UHC indicators. If the current trends remain unchanged, we estimated that coverage of childhood vaccinations, improved water, oral rehydration treatment, satisfaction with family planning, and non-use of tobacco will achieve the 80% target by 2030. However, coverage of four antenatal care visits, facility-based delivery, skilled birth attendance, postnatal checkups, care seeking for pneumonia, exclusive breastfeeding, non-overweight, and adequate sanitation were not projected to achieve the target. Quintile-specific projections showed wide wealth-based inequality in access to antenatal care, postnatal care, delivery care, adequate sanitation, and care seeking for pneumonia, and this inequality was projected to continue for all indicators. The incidence of catastrophic health expenditure and impoverishment were projected to increase from 17% and 4%, respectively, in 2015, to 20% and 9%, respectively, by 2030. Inequality analysis suggested that wealthiest households would disproportionately face more financial catastrophe than the most disadvantaged households. Despite progress, Bangladesh will not achieve the 2030 UHC targets unless the country scales up interventions related to maternal and child health services, and reforms health financing systems to avoid high dependency on out-of-pocket payments. The introduction of a national health insurance system, increased public funding for health care, and expansion of community-based clinics in rural areas could help to move the country towards UHC. Japan Ministry of Health, Labour, and Welfare. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

The effect of delivery mechanisms on the uptake of bed net re-impregnation in Kilifi District, Kenya.

PubMed

Snow, R W; McCabe, E; Mbogo, C N; Molyneux, C S; Some, E S; Mung'ala, V O; Nevill, C G

1999-03-01

The results of recently completed trials in Africa of insecticide-treated bed nets (ITBN) offer new possibilities for malaria control. These experimental trials aimed for high ITBN coverage combined with high re-treatment rates. Whilst necessary to understand protective efficacy, the approaches used to deliver the intervention provide few indications of what coverage of net re-treatment would be under operational conditions. Varied delivery and financing strategies have been proposed for the sustainable delivery of ITBNs and re-treatment programmes. Following the completion of a randomized, controlled trial on the Kenyan coast, a series of suitable delivery strategies were used to continue net re-treatment in the area. The trial adopted a bi-annual, house-to-house re-treatment schedule free of charge using research project staff and resulted in over 95% coverage of nets issued to children. During the year following the trial, sentinel dipping stations were situated throughout the community and household members informed of their position and opening times. This free re-treatment service achieved between 61-67% coverage of nets used by children for three years. In 1997 a social marketing approach, that introduced cost-retrieval, was used to deliver the net re-treatment services. The immediate result of this transition was that significantly fewer of the mothers who had used the previous re-treatment services adopted this revised approach and coverage declined to 7%. The future of new delivery services and their financing are discussed in the context of their likely impact upon previously defined protective efficacy and cost-effectiveness estimates.

I get height with a little help from my friends: herd protection from sanitation on child growth in rural Ecuador

PubMed Central

Fuller, James A; Villamor, Eduardo; Cevallos, William; Trostle, James; Eisenberg, Joseph NS

2016-01-01

Abstract Background: Infectious disease interventions, such as vaccines and bed nets, have the potential to provide herd protection to non-recipients. Similarly, improved sanitation in one household may provide community-wide benefits if it reduces contamination in the shared environment. Sanitation at the household level is an important predictor of child growth, but less is known about the effect of sanitation coverage in the community. Methods: From 2008 to 2013, we took repeated anthropometric measurements on 1314 children under 5 years of age in 24 rural Ecuadorian villages. Using mixed effects regression, we estimated the association between sanitation coverage in surrounding households and child growth. Results: Sanitation coverage in the surrounding households was strongly associated with child height, as those with 100% coverage in their surroundings had a 67% lower prevalence of stunting [prevalence ratio (PR) 0.32, 95% CI 0.15-0.69] compared with those with 0% coverage. Children from households with improved sanitation had a lower prevalence of stunting (PR 0.86, 95% CI 0.64-1.15). When analysing height as a continuous outcome, the protective effect of sanitation coverage is manifested primarily among girls during the second year of life, the time at which growth faltering is most likely to occur. Conclusions: Our study highlights that a household’s sanitation practices can provide herd protection to the overall community. Studies which fail to account for the positive externalities that sanitation provides will underestimate the overall protective effect. Future studies could seek to identify a threshold of sanitation coverage, similar to a herd immunity threshold, to provide coverage and compliance targets. PMID:26936912

Conservation planning for biodiversity and wilderness: a real-world example.

PubMed

Ceauşu, Silvia; Gomes, Inês; Pereira, Henrique Miguel

2015-05-01

Several of the most important conservation prioritization approaches select markedly different areas at global and regional scales. They are designed to maximize a certain biodiversity dimension such as coverage of species in the case of hotspots and complementarity, or composite properties of ecosystems in the case of wilderness. Most comparisons between approaches have ignored the multidimensionality of biodiversity. We analyze here the results of two species-based methodologies-hotspots and complementarity-and an ecosystem-based methodology-wilderness-at local scale. As zoning of protected areas can increase the effectiveness of conservation, we use the data employed for the management plan of the Peneda-Gerês National Park in Portugal. We compare the approaches against four criteria: species representativeness, wilderness coverage, coverage of important areas for megafauna, and for regulating ecosystem services. Our results suggest that species- and ecosystem-based approaches select significantly different areas at local scale. Our results also show that no approach covers well all biodiversity dimensions. Species-based approaches cover species distribution better, while the ecosystem-based approach favors wilderness, areas important for megafauna, and for ecosystem services. Management actions addressing different dimensions of biodiversity have a potential for contradictory effects, social conflict, and ecosystem services trade-offs, especially in the context of current European biodiversity policies. However, biodiversity is multidimensional, and management and zoning at local level should reflect this aspect. The consideration of both species- and ecosystem-based approaches at local scale is necessary to achieve a wider range of conservation goals.

Conservation Planning for Biodiversity and Wilderness: A Real-World Example

NASA Astrophysics Data System (ADS)

Ceauşu, Silvia; Gomes, Inês; Pereira, Henrique Miguel

2015-05-01

Several of the most important conservation prioritization approaches select markedly different areas at global and regional scales. They are designed to maximize a certain biodiversity dimension such as coverage of species in the case of hotspots and complementarity, or composite properties of ecosystems in the case of wilderness. Most comparisons between approaches have ignored the multidimensionality of biodiversity. We analyze here the results of two species-based methodologies—hotspots and complementarity—and an ecosystem-based methodology—wilderness—at local scale. As zoning of protected areas can increase the effectiveness of conservation, we use the data employed for the management plan of the Peneda-Gerês National Park in Portugal. We compare the approaches against four criteria: species representativeness, wilderness coverage, coverage of important areas for megafauna, and for regulating ecosystem services. Our results suggest that species- and ecosystem-based approaches select significantly different areas at local scale. Our results also show that no approach covers well all biodiversity dimensions. Species-based approaches cover species distribution better, while the ecosystem-based approach favors wilderness, areas important for megafauna, and for ecosystem services. Management actions addressing different dimensions of biodiversity have a potential for contradictory effects, social conflict, and ecosystem services trade-offs, especially in the context of current European biodiversity policies. However, biodiversity is multidimensional, and management and zoning at local level should reflect this aspect. The consideration of both species- and ecosystem-based approaches at local scale is necessary to achieve a wider range of conservation goals.

Acoustic telemetry and network analysis reveal the space use of multiple reef predators and enhance marine protected area design

PubMed Central

Lea, James S. E.; Humphries, Nicolas E.; von Brandis, Rainer G.; Clarke, Christopher R.; Sims, David W.

2016-01-01

Marine protected areas (MPAs) are commonly employed to protect ecosystems from threats like overfishing. Ideally, MPA design should incorporate movement data from multiple target species to ensure sufficient habitat is protected. We used long-term acoustic telemetry and network analysis to determine the fine-scale space use of five shark and one turtle species at a remote atoll in the Seychelles, Indian Ocean, and evaluate the efficacy of a proposed MPA. Results revealed strong, species-specific habitat use in both sharks and turtles, with corresponding variation in MPA use. Defining the MPA's boundary from the edge of the reef flat at low tide instead of the beach at high tide (the current best in Seychelles) significantly increased the MPA's coverage of predator movements by an average of 34%. Informed by these results, the larger MPA was adopted by the Seychelles government, demonstrating how telemetry data can improve shark spatial conservation by affecting policy directly. PMID:27412274

Is It More Important to Address the Issue of Patient Mobility or to Guarantee Universal Health Coverage in Europe?: Comment on "Regional Incentives and Patient Cross-Border Mobility: Evidence From the Italian Experience".

PubMed

Legido-Quigley, Helena

2015-09-02

This paper discusses whether European institutions should devote so much attention and funding to cross-border healthcare or they should instead prioritise guaranteeing universal health coverage (UHC), "addressing inequalities" and tackling the effects of austerity measures. The paper argues through providing the evidence in both areas of research, that the priority at European level from a public health and social justice perspective should be to guarantee UHC for all the population living in Europe and prioritise protective action for those who are most in need. © 2016 by Kerman University of Medical Sciences.

Validity of smoke alarm self-report measures and reasons for over-reporting.

PubMed

Stepnitz, Rebecca; Shields, Wendy; McDonald, Eileen; Gielen, Andrea

2012-10-01

Many residential fire deaths occur in homes with no or non-functioning smoke alarms (SAs). Self-reported SA coverage is high, but studies have found varying validity for self-report measures. The authors aim to: (1) determine over-reporting of coverage, (2) describe socio-demographic correlates of over-reporting and (3) report reasons for over-reporting. The authors surveyed 603 households in a large, urban area about fire safety behaviours and then tested all SAs in the home. 23 participants who over-reported their SA coverage were telephoned and asked about why they had misreported. Full coverage was reported in 70% of households but observed in only 41%, with a low positive predictive value (54.2%) for the self-report measure. Most over-reporters assumed alarms were working because they were mounted or did not think a working alarm in a basement or attic was needed to be fully protected. If alarms cannot be tested, researchers or those counselling residents on fire safety should carefully probe self-reported coverage. Our findings support efforts to equip more homes with hard-wired or 10 year lithium battery alarms to reduce the need for user maintenance.

Clothing Protection from Ultraviolet Radiation: A New Method for Assessment.

PubMed

Gage, Ryan; Leung, William; Stanley, James; Reeder, Anthony; Barr, Michelle; Chambers, Tim; Smith, Moira; Signal, Louise

2017-11-01

Clothing modifies ultraviolet radiation (UVR) exposure from the sun and has an impact on skin cancer risk and the endogenous synthesis of vitamin D. There is no standardized method available for assessing body surface area (BSA) covered by clothing, which limits generalizability between study findings. We calculated the body cover provided by 38 clothing items using diagrams of BSA, adjusting the values to account for differences in BSA by age. Diagrams displaying each clothing item were developed and incorporated into a coverage assessment procedure (CAP). Five assessors used the CAP and Lund & Browder chart, an existing method for estimating BSA, to calculate the clothing coverage of an image sample of 100 schoolchildren. Values of clothing coverage, inter-rater reliability and assessment time were compared between CAP and Lund & Browder methods. Both methods had excellent inter-rater reliability (>0.90) and returned comparable results, although the CAP method was significantly faster in determining a person's clothing coverage. On balance, the CAP method appears to be a feasible method for calculating clothing coverage. Its use could improve comparability between sun-safety studies and aid in quantifying the health effects of UVR exposure. © 2017 The American Society of Photobiology.

Personal Protection of Permethrin-Treated Clothing against Aedes aegypti, the Vector of Dengue and Zika Virus, in the Laboratory

PubMed Central

Orsborne, James; DeRaedt Banks, Sarah; Hendy, Adam; Gezan, Salvador A.; Kaur, Harparkash; Wilder-Smith, Annelies; Lindsay, Steve W.; Logan, James G.

2016-01-01

Background The dengue and Zika viruses are primarily transmitted by Aedes aegypti mosquitoes, which are most active during day light hours and feed both in and outside of the household. Personal protection technologies such as insecticide-treated clothing could provide individual protection. Here we assessed the efficacy of permethrin-treated clothing on personal protection in the laboratory. Methods The effect of washing on treated clothing, skin coverage and protection against resistant and susceptible Ae. aegypti was assessed using modified WHO arm-in-cage assays. Coverage was further assessed using free-flight room tests to investigate the protective efficacy of unwashed factory-dipped permethrin-treated clothing. Clothing was worn as full coverage (long sleeves and trousers) and partial coverage (short sleeves and shorts). Residual permethrin on the skin and its effect on mosquitoes was measured using modified WHO cone assays and quantified using high-pressure liquid chromatography (HPLC) analysis. Results In the arm-in-cage assays, unwashed clothing reduced landing by 58.9% (95% CI 49.2–66.9) and biting by 28.5% (95% CI 22.5–34.0), but reduced to 18.5% (95% CI 14.7–22.3) and 11.1% (95% CI 8.5–13.8) respectively after 10 washes. Landing and biting for resistant and susceptible strains was not significantly different (p<0.05). In free-flight room tests, full coverage treated clothing reduced landing by 24.3% (95% CI 17.4–31.7) and biting by 91% (95% CI 82.2–95.9) with partial coverage reducing landing and biting by 26.4% (95% CI 20.3–31.2) and 49.3% (95% CI 42.1–59.1) respectively with coverage type having no significant difference on landing (p<0.05). Residual permethrin was present on the skin in low amounts (0.0041mg/cm2), but still produced a KD of >80% one hour after wearing treated clothing. Conclusion Whilst partially covering the body with permethrin-treated clothing provided some protection against biting, wearing treated clothing with long sleeves and trousers provided the highest form of protection. Washing treated clothing dramatically reduced protection provided. Permethrin-treated clothing could provide protection to individuals from Ae. aegypti that show permethrin resistance. Additionally, it could continue to provide protection even after the clothing has been worn. Field trials are urgently needed to determine whether clothing can protect against dengue and Zika. PMID:27187593

Personal Protection of Permethrin-Treated Clothing against Aedes aegypti, the Vector of Dengue and Zika Virus, in the Laboratory.

PubMed

Orsborne, James; DeRaedt Banks, Sarah; Hendy, Adam; Gezan, Salvador A; Kaur, Harparkash; Wilder-Smith, Annelies; Lindsay, Steve W; Logan, James G

2016-01-01

The dengue and Zika viruses are primarily transmitted by Aedes aegypti mosquitoes, which are most active during day light hours and feed both in and outside of the household. Personal protection technologies such as insecticide-treated clothing could provide individual protection. Here we assessed the efficacy of permethrin-treated clothing on personal protection in the laboratory. The effect of washing on treated clothing, skin coverage and protection against resistant and susceptible Ae. aegypti was assessed using modified WHO arm-in-cage assays. Coverage was further assessed using free-flight room tests to investigate the protective efficacy of unwashed factory-dipped permethrin-treated clothing. Clothing was worn as full coverage (long sleeves and trousers) and partial coverage (short sleeves and shorts). Residual permethrin on the skin and its effect on mosquitoes was measured using modified WHO cone assays and quantified using high-pressure liquid chromatography (HPLC) analysis. In the arm-in-cage assays, unwashed clothing reduced landing by 58.9% (95% CI 49.2-66.9) and biting by 28.5% (95% CI 22.5-34.0), but reduced to 18.5% (95% CI 14.7-22.3) and 11.1% (95% CI 8.5-13.8) respectively after 10 washes. Landing and biting for resistant and susceptible strains was not significantly different (p<0.05). In free-flight room tests, full coverage treated clothing reduced landing by 24.3% (95% CI 17.4-31.7) and biting by 91% (95% CI 82.2-95.9) with partial coverage reducing landing and biting by 26.4% (95% CI 20.3-31.2) and 49.3% (95% CI 42.1-59.1) respectively with coverage type having no significant difference on landing (p<0.05). Residual permethrin was present on the skin in low amounts (0.0041mg/cm2), but still produced a KD of >80% one hour after wearing treated clothing. Whilst partially covering the body with permethrin-treated clothing provided some protection against biting, wearing treated clothing with long sleeves and trousers provided the highest form of protection. Washing treated clothing dramatically reduced protection provided. Permethrin-treated clothing could provide protection to individuals from Ae. aegypti that show permethrin resistance. Additionally, it could continue to provide protection even after the clothing has been worn. Field trials are urgently needed to determine whether clothing can protect against dengue and Zika.

Clinical evaluation of coverage of open wounds: Polyglycolic acid sheet with fibrin glue spray vs split thickness skin

PubMed Central

Mochizuki, Yumi; Tomioka, Hirofumi; Tushima, Fumihiko; Shimamoto, Hiroaki; Hirai, Hideaki; Oikawa, Yuu; Harada, Hiroyuki

2016-01-01

Purpose: This study aimed to evaluate the coverage of oral wounds using either a polyglycolic acid (PGA) sheet or split-thickness skin grafting (STSG). Materials and Methods: A total of 119 cases of wound coverage using a PGA sheet and fibrin glue spray as well as 132 cases of wound coverage cases using STSG were reviewed retrospectively. The site of the excision area, perioperative conditions, and postoperative functional problems were evaluated. Results: The PGA group had significantly shorter operation time, earlier start of oral intake, and shorter hospitalization than the STSG group. If the PGA sheet over the wound with exposed bone could be protected by a surgical sprint, oral food intake could be started on the day after surgery at the earliest. When the size of the wound in the buccal excisional area was classified into two groups (<6 or ≥6 cm2), mouth opening in the STSG group was significantly larger at 3 months postoperatively. When the size of the wound in the tongue and floor of mouth was classified into two groups (<12 or ≥12 cm2), the STSG group had a significantly higher score in postoperative speech intelligibility. Conclusion: Selection of a PGA sheet or STSG based on the consideration of defect size, tumor location, patients’ local and general condition and tolerance for surgery could reduce the patients’ postsurgical dysfunctional problems. PMID:28299263

Pathways from marine protected area design and management to ecological success

PubMed Central

2015-01-01

Using an international dataset compiled from 121 sites in 87 marine protected areas (MPAs) globally (Edgar et al., 2014), I assessed how various configurations of design and management conditions affected MPA ecological performance, measured in terms of fish species richness and biomass. The set-theoretic approach used Boolean algebra to identify pathways that combined up to five ‘NEOLI’ (No-take, Enforced, Old, Large, Isolated) conditions and that were sufficient for achieving positive, and negative, ecological outcomes. Ecological isolation was overwhelming the most important condition affecting ecological outcomes but Old and Large were also conditions important for achieving high levels of biomass among large fishes (jacks, groupers, sharks). Solution coverage was uniformly low (<0.35) for all models of positive ecological performance suggesting the presence of numerous other conditions and pathways to ecological success that did not involve the NEOLI conditions. Solution coverage was higher (>0.50) for negative results (i.e., the absence of high biomass) among the large commercially-exploited fishes, implying asymmetries in how MPAs may rebuild populations on the one hand and, on the other, protect against further decline. The results revealed complex interactions involving MPA design, implementation, and management conditions that affect MPA ecological performance. In general terms, the presence of no-take regulations and effective enforcement were insufficient to ensure MPA effectiveness on their own. Given the central role of ecological isolation in securing ecological benefits from MPAs, site selection in the design phase appears critical for success. PMID:26644975

Seagrass mapping in Greek territorial waters using Landsat-8 satellite images

NASA Astrophysics Data System (ADS)

Topouzelis, Konstantinos; Makri, Despina; Stoupas, Nikolaos; Papakonstantinou, Apostolos; Katsanevakis, Stelios

2018-05-01

Seagrass meadows are among the most valuable coastal ecosystems on earth due to their structural and functional roles in the coastal environment. This study demonstrates remote sensing's capacity to produce seagrass distribution maps on a regional scale. The seagrass coverage maps provided here describe and quantify for the first time the extent and the spatial distribution of seagrass meadows in Greek waters. This information is needed for identifying priority conservation sites and to help coastal ecosystem managers and stakeholders to develop conservation strategies and design a resilient network of protected marine areas. The results were based on an object-based image analysis of 50 Landsat-8 satellite images. The time window of image acquisition was between June 2013 and July 2015. In total, the seagrass coverage in Greek waters was estimated at 2619 km2. The largest coverages of individual seagrass meadows were found around Lemnos Island (124 km2), Corfu Island (46 km2), and East Peloponnese (47 km2). The accuracy assessment of the detected areas was based on 62 Natura 2000 sites, for which habitat maps were available. The mean total accuracy for all 62 sites was estimated at 76.3%.

24 CFR 203.205 - Plan coverage.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Plan coverage. 203.205 Section 203... Protection Plans (plan) § 203.205 Plan coverage. (a) Plan coverage must take effect at closing or settlement following the initial sale of the property to the homeowner. (b) During the first year of coverage, a Plan...

29 CFR 801.3 - Coverage.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 3 2013-07-01 2013-07-01 false Coverage. 801.3 Section 801.3 Labor Regulations Relating to... POLYGRAPH PROTECTION ACT OF 1988 General § 801.3 Coverage. (a) The coverage of the Act extends to “any... coverage to be coextensive with the full scope of the Congressional power to regulate commerce. See, for...

29 CFR 801.3 - Coverage.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 3 2014-07-01 2014-07-01 false Coverage. 801.3 Section 801.3 Labor Regulations Relating to... POLYGRAPH PROTECTION ACT OF 1988 General § 801.3 Coverage. (a) The coverage of the Act extends to “any... coverage to be coextensive with the full scope of the Congressional power to regulate commerce. See, for...

29 CFR 801.3 - Coverage.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 3 2011-07-01 2011-07-01 false Coverage. 801.3 Section 801.3 Labor Regulations Relating to... POLYGRAPH PROTECTION ACT OF 1988 General § 801.3 Coverage. (a) The coverage of the Act extends to “any... coverage to be coextensive with the full scope of the Congressional power to regulate commerce. See, for...

40 CFR Appendix L to Subpart G of... - Substitutes Listed in the January 27, 2003, Final Rule, Effective March 28, 2003

Code of Federal Regulations, 2011 CFR

2011-07-01

... duplicating or displacing OSHA coverage related to the use of personal protective equipment (e.g., respiratory... duplicating or displacing OSHA coverage related to the use of personal protective equipment (e.g., respiratory....162. 2—Per OSHA requirements, protective gear (SCBA) should be available in the event personnel should...

40 CFR Appendix L to Subpart G of... - Substitutes Listed in the January 27, 2003, Final Rule, Effective March 28, 2003

Code of Federal Regulations, 2010 CFR

2010-07-01

... duplicating or displacing OSHA coverage related to the use of personal protective equipment (e.g., respiratory... duplicating or displacing OSHA coverage related to the use of personal protective equipment (e.g., respiratory....162. 2—Per OSHA requirements, protective gear (SCBA) should be available in the event personnel should...

Effects of the Affordable Care Act's Dependent Coverage Mandate on Private Health Insurance Coverage in Urban and Rural Areas.

PubMed

Look, Kevin A; Kim, Nam Hyo; Arora, Prachi

2017-01-01

To evaluate the impact of the Affordable Care Act's (ACA) dependent coverage mandate on insurance coverage among young adults in metropolitan and nonmetropolitan areas. A cross-sectional analysis was conducted using data from 2006-2009 and 2011 waves of the Medical Expenditure Panel Survey. A difference-in-difference analysis was used to compare changes in full-year private health insurance coverage among young adults aged 19-25 years with an older cohort aged 27-34 years. Separate regressions were estimated for individuals in metropolitan and nonmetropolitan areas and were tested for a differential impact by area of residence. Full-year private health insurance coverage significantly increased by 9.2 percentage points for young adults compared to the older cohort after the ACA mandate (P = .00). When stratifying the regression model by residence area, insurance coverage among young adults significantly increased by 9.0 percentage points in metropolitan areas (P = .00) and 10.1 percentage points in nonmetropolitan areas (P = .03). These changes were not significantly different from each other (P = .82), which suggests the ACA mandate's effects were not statistically different by area of residence. Although young adults in metropolitan and nonmetropolitan areas experienced increased access to private health insurance following the ACA's dependent coverage mandate, it did not appear to directly impact rural-urban disparities in health insurance coverage. Despite residents in both areas gaining insurance coverage, over one-third of young adults still lacked access to full-year health insurance coverage. © 2016 National Rural Health Association.

Evaluation of a Shoulder Fragmentation Protection Brassard Design

DTIC Science & Technology

2008-03-01

compatibility assessments. There were slight advantages of the shoulder caps over the brassard with regards to chaffing and thermal comfort during the fire...and movement task. Even though there were significant differences between the shoulder caps and brassard with respect to chaffing and thermal comfort , the...the brassard’s increased coverage design. The shoulder caps were preferred in areas such as thermal comfort and ease of attachment and removing

The patient protection and affordable care act: how will it affect private health insurance for cancer patients?

PubMed

Schwartz, Karyn; Claxton, Gary

2010-01-01

The Patient Protection and Affordable Care Act will make health coverage more available and affordable while also strengthening regulations on the scope of private health insurance coverage. Most of the law's key provisions take effect in 2014, at which time health insurers will be barred from charging more or denying coverage for individuals with a pre-existing condition. Also in 2014, qualifying individuals will receive subsidies to purchase private insurance through newly created health insurance exchanges. New rules related to caps on benefits and stronger rights to appeal insurance company decisions take effect in 2010. In 2014, all insurance policies sold to individuals and small groups will have to cover an essential benefits package defined by the federal government. Although many Patient Protection and Affordable Care Act provisions do not apply to all types of private coverage, overall the law will provide more protections to cancer patients and survivors in the private health insurance marketplace.

When is protection from impact needed for the face as well as the eyes in occupational environments?

PubMed

Dain, Stephen J; Huang, Rose; Tiao, Aimee; Chou, B Ralph

2018-05-01

The most commonly identified reason for requiring or using occupational eye and face protection is for protection against flying objects. Standards vary on what risk may require protection of the eyes alone and what requires protection for the whole face. Information on the minimum energy transfer for face damage to occur is not well-established. The heads of pigs were used as the common model for human skin. A 6 mm steel ball projected at velocities between 45 and 135 m/s was directed at the face area. Examples of impacts were filmed with a high-speed camera and the resulting damage was rated visually on a scale from 1 (no visible damage) to 5 (penetrated the skin and embedded in the flesh). The results for the cheek area indicate that 85 m/s is the velocity above which damage is more likely to occur unless the skin near the lip is included. For damage to the lip area to be avoided, the velocity needs to be 60 m/s or less. The present data support a maximum impact velocity of 85 m/s, provided the thinner and more vulnerable skin of the lids and orbital adnexa is protected. If the coverage area does not extend to the orbital adnexa, then the absolute upper limit for the velocity is 60 m/s. At this stage, eye-only protection, as represented by the lowest level of impact test in the standards in the form of a drop ball test, is not in question. © 2017 Optometry Australia.

42 CFR 416.44 - Condition for coverage-Environment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false Condition for coverage-Environment. 416.44 Section... constructed, equipped, and maintained to protect the health and safety of patients. (a) Standard: Physical... Health Care Centers of the 2000 edition of the Life Safety Code of the National Fire Protection...

42 CFR 416.44 - Condition for coverage-Environment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Condition for coverage-Environment. 416.44 Section... constructed, equipped, and maintained to protect the health and safety of patients. (a) Standard: Physical... Health Care Centers of the 2000 edition of the Life Safety Code of the National Fire Protection...

Final Environmental Assessment for Wide Area Coverage Construct Land Mobile Network Communications Infrastructure Malmstrom Air Force Base, Montana

DTIC Science & Technology

2008-02-01

FINAL ENVIRONMENTAL ASSESSMENT February 2008 Malmstrom ® AFB WIDE AREA COVERAGE CONSTRUCT LAND MOBILE NETWORK COMMUNICATIONS INFRASTRUCTURE...Wide Area Coverage Construct Land Mobile Network Communications Infrastructure Malmstrom Air Force Base, Montana 5a. CONTRACT NUMBER 5b. GRANT...SIGNIFICANT IMPACT WIDE AREA COVERAGE CONSTRUCT LAND MOBILE NETWORK COMMUNICATIONS INFRASTRUCTURE MALMSTROM AIR FORCE BASE, MONTANA The

Combating child homicide: preventive policing for the new millennium.

PubMed

Boudreaux, Monique C; Lord, Wayne D

2005-04-01

High-profile media coverage of crimes against children has heightened public awareness of critical child safety needs and issues. However, numerous research studies in the area of child homicide have illustrated the importance of the power of science to correct false perceptions and misinformation, improving how to best serve and protect our children. Age-based analyses of childhood crime patterns have vastly improved how law enforcement and social service practitioners identify, investigate, and resolve child victimization cases. Future protective efforts must involve multiagency and multidisciplinary collaboration. Law enforcement, social service clinicians, educators, and academicians should jointly develop and implement pragmatic and effective prevention, detection, and resolution programs and policies.

The End of the HIPAA Privacy Rule? Currents in Contemporary Bioethics.

PubMed

Rothstein, Mark A

2016-06-01

The HIPAA Privacy Rule is notoriously weak because of its incomplete coverage, numerous exclusions and exemptions, and limited rights for individuals. The three areas in which it provides the most protection are fundraising, marketing, and research. Provisions of the 21st Century Cures Act, pending in Congress, and the Notice of Proposed Rulemaking to amend the federal research regulations (Common Rule), awaiting final regulatory action, would weaken the privacy protections for research. If these measures are adopted, the HIPAA Privacy Rule would have so little value that it might not be worth the aggravation and burden. © 2016 American Society of Law, Medicine & Ethics.

[Gaps in effective coverage by socioeconomic status and poverty condition].

PubMed

Gutiérrez, Juan Pablo

2013-01-01

To analyze, in the context of increased health protection in Mexico, the gaps by socioeconomic status and poverty condition on effective coverage of selected preventive interventions. Data from the National Health & Nutrition Survey 2012 and 2006, using previously defined indicators of effective coverage and stratifying them by socioeconomic (SE) status and multidimensional poverty condition. For vaccination interventions, immunological equity has been maintained in Mexico. For indicators related to preventive interventions provided at the clinical setting, effective coverage is lower among those in the lowest SE quintile and among people living in multidimensional poverty. Comparing 2006 and 2012, there is no evidence on gap reduction. While health protection has significantly increased in Mexico, thus reducing SE gaps, those gaps are still important in magnitude for effective coverage of preventive interventions.

40 CFR 51.356 - Vehicle coverage.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 2 2012-07-01 2012-07-01 false Vehicle coverage. 51.356 Section 51.356....356 Vehicle coverage. The performance standard for enhanced I/M programs assumes coverage of all 1968 and later model year light duty vehicles and light duty trucks up to 8,500 pounds GVWR, and includes...

40 CFR 51.356 - Vehicle coverage.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 2 2013-07-01 2013-07-01 false Vehicle coverage. 51.356 Section 51.356....356 Vehicle coverage. The performance standard for enhanced I/M programs assumes coverage of all 1968 and later model year light duty vehicles and light duty trucks up to 8,500 pounds GVWR, and includes...

40 CFR 51.356 - Vehicle coverage.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 2 2011-07-01 2011-07-01 false Vehicle coverage. 51.356 Section 51.356....356 Vehicle coverage. The performance standard for enhanced I/M programs assumes coverage of all 1968 and later model year light duty vehicles and light duty trucks up to 8,500 pounds GVWR, and includes...

40 CFR 51.356 - Vehicle coverage.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 2 2014-07-01 2014-07-01 false Vehicle coverage. 51.356 Section 51.356....356 Vehicle coverage. The performance standard for enhanced I/M programs assumes coverage of all 1968 and later model year light duty vehicles and light duty trucks up to 8,500 pounds GVWR, and includes...

40 CFR 51.356 - Vehicle coverage.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false Vehicle coverage. 51.356 Section 51.356....356 Vehicle coverage. The performance standard for enhanced I/M programs assumes coverage of all 1968 and later model year light duty vehicles and light duty trucks up to 8,500 pounds GVWR, and includes...

29 CFR 801.3 - Coverage.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false Coverage. 801.3 Section 801.3 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR OTHER LAWS APPLICATION OF THE EMPLOYEE POLYGRAPH PROTECTION ACT OF 1988 General § 801.3 Coverage. (a) The coverage of the Act extends to “any...

Health-financing reforms in southeast Asia: challenges in achieving universal coverage.

PubMed

Tangcharoensathien, Viroj; Patcharanarumol, Walaiporn; Ir, Por; Aljunid, Syed Mohamed; Mukti, Ali Ghufron; Akkhavong, Kongsap; Banzon, Eduardo; Huong, Dang Boi; Thabrany, Hasbullah; Mills, Anne

2011-03-05

In this sixth paper of the Series, we review health-financing reforms in seven countries in southeast Asia that have sought to reduce dependence on out-of-pocket payments, increase pooled health finance, and expand service use as steps towards universal coverage. Laos and Cambodia, both resource-poor countries, have mostly relied on donor-supported health equity funds to reach the poor, and reliable funding and appropriate identification of the eligible poor are two major challenges for nationwide expansion. For Thailand, the Philippines, Indonesia, and Vietnam, social health insurance financed by payroll tax is commonly used for formal sector employees (excluding Malaysia), with varying outcomes in terms of financial protection. Alternative payment methods have different implications for provider behaviour and financial protection. Two alternative approaches for financial protection of the non-poor outside the formal sector have emerged-contributory arrangements and tax-financed schemes-with different abilities to achieve high population coverage rapidly. Fiscal space and mobilisation of payroll contributions are both important in accelerating financial protection. Expanding coverage of good-quality services and ensuring adequate human resources are also important to achieve universal coverage. As health-financing reform is complex, institutional capacity to generate evidence and inform policy is essential and should be strengthened. Copyright © 2011 Elsevier Ltd. All rights reserved.

Quench protection challenges in long nb3sn accelerator magnets

NASA Astrophysics Data System (ADS)

Salmi, Tiina-Mari; Ambrosio, G.; Caspi, S.; Chlachidze, Guram; Dhallé, Marc; Felice, Helene; Ferracin, Paolo; Marchevsky, M.; Sabbi, G. L.; ten Kate, H. H. J.

2012-06-01

The quench protection of the several meter long, large aperture high-field Nb3Sn quadrupoles that the LARP collaboration is developing for the LHC interaction region upgrade, requires efficient protection heaters to quickly generate large resistive segments across the windings. To support the protection design, experiments in the recently tested LARP R&D magnets are aimed to characterize the coil response to different protection schemes. In particular, the delay to quench and the final hotspot temperatures are evaluated after firing the heaters at different powering regimes and coverage. Also, the contribution of external energy extraction is investigated. Based on the performed studies and computer simulations, it seems that if the same protection efficiency per unit length that is measured in a 1 m long model magnet can be scaled to a 3.6 m long magnet, and the heater coverage can be improved, about 1 MJ/m of stored energy can be absorbed in the magnet after a quench. However, significant technology developments are needed to scale the protection heater efficiency to longer magnets and to increase the coverage.

Modelling the implications of moving towards universal coverage in Tanzania.

PubMed

Borghi, Josephine; Mtei, Gemini; Ally, Mariam

2012-03-01

A model was developed to assess the impact of possible moves towards universal coverage in Tanzania over a 15-year time frame. Three scenarios were considered: maintaining the current situation ('the status quo'); expanded health insurance coverage (the estimated maximum achievable coverage in the absence of premium subsidies, coverage restricted to those who can pay); universal coverage to all (government revenues used to pay the premiums for the poor). The model estimated the costs of delivering public health services and all health services to the population as a proportion of Gross Domestic Product (GDP), and forecast revenue from user fees and insurance premiums. Under the status quo, financial protection is provided to 10% of the population through health insurance schemes, with the remaining population benefiting from subsidized user charges in public facilities. Seventy-six per cent of the population would benefit from financial protection through health insurance under the expanded coverage scenario, and 100% of the population would receive such protection through a mix of insurance cover and government funding under the universal coverage scenario. The expanded and universal coverage scenarios have a significant effect on utilization levels, especially for public outpatient care. Universal coverage would require an initial doubling in the proportion of GDP going to the public health system. Government health expenditure would increase to 18% of total government expenditure. The results are sensitive to the cost of health system strengthening, the level of real GDP growth, provider reimbursement rates and administrative costs. Promoting greater cross-subsidization between insurance schemes would provide sufficient resources to finance universal coverage. Alternately, greater tax funding for health could be generated through an increase in the rate of Value-Added Tax (VAT) or expanding the income tax base. The feasibility and sustainability of efforts to promote universal coverage will depend on the ability of the system to contain costs.

Patient Protection and Affordable Care Act Medicaid expansion and gains in health insurance coverage and access among cancer survivors.

PubMed

Nikpay, Sayeh S; Tebbs, Margaret G; Castellanos, Emily H

2018-04-17

The Patient Protection and Affordable Care Act extends Medicaid coverage to millions of low-income adults, including many survivors of cancer who were unable to purchase affordable health insurance coverage in the individual health insurance market. Using data from the 2011 to 2015 Behavioral Risk Factor Surveillance System, the authors compared changes in coverage and health care access measures for low-income cancer survivors in states that did and did not expand Medicaid. The study population of 17,381 individuals included adults aged 18 to 64 years, and was predominantly female, white, and unmarried. The authors found a relative reduction in the uninsured rate of 11.7 percentage points and a relative increase in the probability of having a personal physician of 5.8 percentage points. Stratifying by whether states expanded Medicaid by 2015, the authors found that relative gains in coverage and access were larger among those individuals residing in states with expanded Medicaid compared with those residing in nonexpansion states. The results of the current study suggest that the Patient Protection and Affordable Care Act Medicaid expansion has improved coverage and access for cancer survivors. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

Integration of TerraSAR-X, RapidEye and airborne lidar for remote sensing of intertidal bedforms on the upper flats of Norderney (German Wadden Sea)

NASA Astrophysics Data System (ADS)

Adolph, Winny; Jung, Richard; Schmidt, Alena; Ehlers, Manfred; Heipke, Christian; Bartholomä, Alexander; Farke, Hubert

2017-04-01

The Wadden Sea is a large coastal transition area adjoining the southern North Sea uniting ecological key functions with an important role in coastal protection. The region is strictly protected by EU directives and national law and is a UNESCO World Heritage Site, requiring frequent quality assessments and regular monitoring. In 2014 an intertidal bedform area characterised by alternating crests and water-covered troughs on the tidal flats of the island of Norderney (German Wadden Sea sector) was chosen to test different remote sensing methods for habitat mapping: airborne lidar, satellite-based radar (TerraSAR-X) and electro-optical sensors (RapidEye). The results revealed that, although sensitive to different surface qualities, all sensors were able to image the bedforms. A digital terrain model generated from the lidar data shows crests and slopes of the bedforms with high geometric accuracy in the centimetre range, but high costs limit the operation area. TerraSAR-X data enabled identifying the positions of the bedforms reflecting the residual water in the troughs also with a high resolution of up to 1.1 m, but with larger footprints and much higher temporal availability. RapidEye data are sensitive to differences in sediment moisture employed to identify crest areas, slopes and troughs, with high spatial coverage but the lowest resolution (6.5 m). Monitoring concepts may differ in their remote sensing requirements regarding areal coverage, spatial and temporal resolution, sensitivity and geometric accuracy. Also financial budgets limit the selection of sensors. Thus, combining differing assets into an integrated concept of remote sensing contributes to solving these issues.

Arbitrary mangrove-to-water ratios imposed on shrimp farmers in Vietnam contradict with the aims of sustainable forest management.

PubMed

Baumgartner, Urs; Kell, Shelagh; Nguyen, Tuan Hoang

2016-01-01

Worldwide, an estimated 35 % of mangrove forests have been lost between 1980 and 2005-among other reasons due to expansion of aquaculture production systems. In Vietnam, where the total mangrove area decreased from 269,150 ha in 1980 to 157,500 ha in 2000, regulation of such systems in the form of 'mangrove-to-water surface ratio' has had limited success to halt these losses. In this study, a survey of 40 Vietnamese households was conducted in mangrove production forests in Rach Goc commune, Ngoc Hien district, Ca Mau province to understand whether fixed limits on minimal mangrove coverage influence farmers' decisions on mangrove protection. Results of the survey suggest that rural households greatly depend on the incomes generated from shrimp (and crab) farming but that they do not have a share in economic incentives from timber harvests due to lack of full ownership. A strong relationship between mangrove coverage and per pond area income was also revealed. Because farmers are not aware of applicable laws in terms of mangrove-to-water ratios, mangrove coverage tends to shift in favour of higher pond areas. Overall, the findings indicate that regulations in the form of universal mangrove-to-water ratios do not consider the realities of local households, nor are they economically or environmentally useful-rather, they appear to be arbitrary limitations that are not respected by affected communities. The findings question the efficiency of efforts put into stricter enforcement.

Group health plans and health insurance issuers relating to coverage of preventive services under the Patient Protection and Affordable Care Act. Final rules.

PubMed

2012-02-15

These regulations finalize, without change, interim final regulations authorizing the exemption of group health plans and group health insurance coverage sponsored by certain religious employers from having to cover certain preventive health services under provisions of the Patient Protection and Affordable Care Act.

Where have all the people gone? Enhancing global conservation using night lights and social media.

PubMed

Levin, Noam; Kark, Salit; Crandall, David

2015-12-01

Conservation prioritization at large scales is complex, combining biological, environmental, and social factors. While conservation scientists now more often aim to incorporate human-related factors, a critical yet unquantified challenge remains: to identify which areas people use for recreation outside urban centers. To address this gap in applied ecology and conservation, we developed a novel approach for quantifying human presence beyond populated areas by combining social media "big data" and remote sensing tools. We used data from the Flickr photo-sharing website as a surrogate for identifying spatial variation in visitation globally, and complemented this estimate with spatially explicit information on stable night lights between 2004 and 2012, used as a proxy for identifying urban and industrial centers. Natural and seminatural areas attracting visitors were defined as areas both highly photographed and non-lit. The number of Flickr photographers within protected areas was found to be a reliable surrogate for estimating visitor numbers as confirmed by local authority censuses (r = 0.8). Half of all visitors' photos taken in protected areas originated from under 1% of all protected areas on Earth (250 of -27 000). The most photographed protected areas globally included Yosemite and Yellowstone National Parks (USA), and the Lake and Peak Districts (UK). Factors explaining the spatial variation in protected areas Flickr photo coverage included their type (e.g., UNESCO World Heritage sites have higher visitation) and accessibility to roads and trails. Using this approach, we identified photography hotspots, which draw many visitors and are also unlit (i.e., are located outside urban centers), but currently remain largely unprotected, such as Brazil's Pantanal and Bolivia's Salar de Uyuni. The integrated big data approach developed here demonstrates the benefits of combining remote sensing sources and novel geo-tagged and crowd-sourced information from social media in future efforts to identify spatial conservation gaps and pressures in real time, and their spatial and temporal variation globally.

Kestrel: force protection and Intelligence, Surveillance, and Reconnaissance (ISR) persistent surveillance on aerostats

NASA Astrophysics Data System (ADS)

Luber, David R.; Marion, John E.; Fields, David

2012-05-01

Logos Technologies has developed and fielded the Kestrel system, an aerostat-based, wide area persistent surveillance system dedicated to force protection and ISR mission execution operating over forward operating bases. Its development included novel imaging and stabilization capability for day/night operations on military aerostat systems. The Kestrel system's contribution is a substantial enhancement to aerostat-based, force protection systems which to date have relied on narrow field of view ball gimbal sensors to identify targets of interest. This inefficient mechanism to conduct wide area field of view surveillance is greatly enhanced by Kestrel's ability to maintain a constant motion imagery stare of the entire forward operating base (FOB) area. The Kestrel airborne sensor enables 360° coverage out to extended ranges which covers a city sized area at moderate resolution, while cueing a narrow field of view sensor to provide high resolution imagery of targets of interest. The ground station exploitation system enables operators to autonomously monitor multiple regions of interest in real time, and allows for backtracking through the recorded imagery, while continuing to monitor ongoing activity. Backtracking capability allows operators to detect threat networks, their CONOPS, and locations of interest. Kestrel's unique advancement has already been utilized successfully in OEF operations.

Racial and Ethnic Disparities in Services and the Patient Protection and Affordable Care Act

PubMed Central

Abdus, Salam; Mistry, Kamila B.

2015-01-01

Objectives. We examined prereform patterns in insurance coverage, access to care, and preventive services use by race/ethnicity in adults targeted by the coverage expansions of the Patient Protection and Affordable Care Act (ACA). Methods. We used pre-ACA household data from the Medical Expenditure Panel Survey to identify groups targeted by the coverage provisions of the Act (Medicaid expansions and subsidized Marketplace coverage). We examined racial/ethnic differences in coverage, access to care, and preventive service use, across and within ACA relevant subgroups from 2005 to 2010. The study took place at the Agency for Healthcare Research and Quality in Rockville, Maryland. Results. Minorities were disproportionately represented among those targeted by the coverage provisions of the ACA. Targeted groups had lower rates of coverage, access to care, and preventive services use, and racial/ethnic disparities were, in some cases, widest within these targeted groups. Conclusions. Our findings highlighted the opportunity of the ACA to not only to improve coverage, access, and use for all racial/ethnic groups, but also to narrow racial/ethnic disparities in these outcomes. Our results might have particular importance for states that are deciding whether to implement the ACA Medicaid expansions. PMID:26447920

Racial and Ethnic Disparities in Services and the Patient Protection and Affordable Care Act.

PubMed

Abdus, Salam; Mistry, Kamila B; Selden, Thomas M

2015-11-01

We examined prereform patterns in insurance coverage, access to care, and preventive services use by race/ethnicity in adults targeted by the coverage expansions of the Patient Protection and Affordable Care Act (ACA). We used pre-ACA household data from the Medical Expenditure Panel Survey to identify groups targeted by the coverage provisions of the Act (Medicaid expansions and subsidized Marketplace coverage). We examined racial/ethnic differences in coverage, access to care, and preventive service use, across and within ACA relevant subgroups from 2005 to 2010. The study took place at the Agency for Healthcare Research and Quality in Rockville, Maryland. Minorities were disproportionately represented among those targeted by the coverage provisions of the ACA. Targeted groups had lower rates of coverage, access to care, and preventive services use, and racial/ethnic disparities were, in some cases, widest within these targeted groups. Our findings highlighted the opportunity of the ACA to not only to improve coverage, access, and use for all racial/ethnic groups, but also to narrow racial/ethnic disparities in these outcomes. Our results might have particular importance for states that are deciding whether to implement the ACA Medicaid expansions.

Mangroves as a protection from storm surges in a changing climate.

PubMed

Blankespoor, Brian; Dasgupta, Susmita; Lange, Glenn-Marie

2017-05-01

Adaptation to climate change includes addressing sea-level rise (SLR) and increased storm surges in many coastal areas. Mangroves can substantially reduce vulnerability of the adjacent coastal land from inundation but SLR poses a threat to the future of mangroves. This paper quantifies coastal protection services of mangroves for 42 developing countries in the current climate, and a future climate change scenario with a 1-m SLR and 10  % intensification of storms. Findings demonstrate that while SLR and increased storm intensity would increase storm surge areas, the greatest impact is from the expected loss of mangroves. Under current climate and mangrove coverage, 3.5 million people and GDP worth roughly US $400 million are at risk. In the future climate change scenario, vulnerable population and GDP at risk would increase by 103 and 233  %. The greatest risk is in East Asia, especially in Indonesia and the Philippines as well as Myanmar.

Field efficacy of pyrethroid treated plastic sheeting (durable lining) in combination with long lasting insecticidal nets against malaria vectors

PubMed Central

2010-01-01

Background Insecticide treated plastic sheeting (ITPS), sometimes known as durable lining, has potential as a long-lasting insecticidal surface for malaria vector control when used as lining for interior walls and ceilings inside the home. Against a backdrop of increasing long lasting net (LN) coverage, we examined the effect of combining permethrin-treated plastic sheeting (ITPS) with LNs in Burkina Faso. Methods A verandah trap experimental hut trial of ITPS with or without Olyset LN was conducted in the Vallée du Kou near Bobo-Dioulasso, where the two molecular forms of Anopheles gambiae s.s., S (frequency 65%) and M (frequency 35%), occur. The S form is mostly pyrethroid resistant (Fkdr = 92%) owing to the kdr mechanism, and the M form is mostly kdr susceptible (Fkdr = 7%). The treatment arms included ITPS, Olyset, ITPS plus Olyset, ITPS plus untreated net (with or without holes), and untreated control. Results ITPS was significantly inferior to Olyset LN in terms of mortality (37% vs 63%), blood feeding inhibition (20% vs 81%) and deterrence (0 vs 42%) effects, and hence altogether inferior as a means of personal protection (16% vs 89%). The addition of ITPS to Olyset did not improve mortality (62%), blood feeding inhibition (75%), deterrence (50%) or personal protection (88%) over that of Olyset used alone. Use of untreated nets - both holed and intact - with ITPS provided greater protection from blood-feeding. The intact net/ITPS combination killed more mosquitoes than ITPS on its own. Conclusions Although ITPS has a potential role for community control of malaria, at low coverage it is unlikely to be as good as Olyset LNs for household protection. The combination of pyrethroid IRS and pyrethroid LN - as practiced in some countries - is unlikely to be additive except, perhaps, at high levels of IRS coverage. A combination of LN and ITPS treated with an alternative insecticide is likely to be more effective, particularly in areas of pyrethroid resistance. PMID:20682050

Field efficacy of pyrethroid treated plastic sheeting (durable lining) in combination with long lasting insecticidal nets against malaria vectors.

PubMed

Chandre, Fabrice; Dabire, Roch K; Hougard, Jean-Marc; Djogbenou, Luc S; Irish, Seth R; Rowland, Mark; N'guessan, Raphael

2010-08-03

Insecticide treated plastic sheeting (ITPS), sometimes known as durable lining, has potential as a long-lasting insecticidal surface for malaria vector control when used as lining for interior walls and ceilings inside the home. Against a backdrop of increasing long lasting net (LN) coverage, we examined the effect of combining permethrin-treated plastic sheeting (ITPS) with LNs in Burkina Faso. A verandah trap experimental hut trial of ITPS with or without Olyset LN was conducted in the Vallée du Kou near Bobo-Dioulasso, where the two molecular forms of Anopheles gambiae s.s., S (frequency 65%) and M (frequency 35%), occur. The S form is mostly pyrethroid resistant (Fkdr = 92%) owing to the kdr mechanism, and the M form is mostly kdr susceptible (Fkdr = 7%). The treatment arms included ITPS, Olyset, ITPS plus Olyset, ITPS plus untreated net (with or without holes), and untreated control. ITPS was significantly inferior to Olyset LN in terms of mortality (37% vs 63%), blood feeding inhibition (20% vs 81%) and deterrence (0 vs 42%) effects, and hence altogether inferior as a means of personal protection (16% vs 89%). The addition of ITPS to Olyset did not improve mortality (62%), blood feeding inhibition (75%), deterrence (50%) or personal protection (88%) over that of Olyset used alone. Use of untreated nets - both holed and intact - with ITPS provided greater protection from blood-feeding. The intact net/ITPS combination killed more mosquitoes than ITPS on its own. Although ITPS has a potential role for community control of malaria, at low coverage it is unlikely to be as good as Olyset LNs for household protection. The combination of pyrethroid IRS and pyrethroid LN - as practiced in some countries - is unlikely to be additive except, perhaps, at high levels of IRS coverage. A combination of LN and ITPS treated with an alternative insecticide is likely to be more effective, particularly in areas of pyrethroid resistance.

Medicare prescription drug plan coverage of pharmacotherapies for opioid and alcohol dependence in WA.

PubMed

Kennedy, Jae; Dipzinski, Aaron; Roll, John; Coyne, Joseph; Blodgett, Elizabeth

2011-04-01

Pharmacotherapeutic treatments for drug addiction offer new options, but only if they are affordable for patients. The objective of this study is to assess the current availability and cost of five common antiaddiction medications in the largest federal medication insurance program in the US, Medicare Part D. In early 2010, we collected coverage and cost data from 41 Medicare Part D prescription drug plans (PDPs) and 45 Medicare Advantage Plans (MAPs) in Washington State. The great majority of Medicare plans (82-100%) covered common pharmacotherapeutic treatments for drug addiction. These Medicare plans typically placed patent protected medications on their highest formulary tiers, leading to relatively high patient co-payments during the initial Part D coverage period. For example, median monthly co-payments for buprenorphine (Suboxone®) were about $46 for PDPs, and about $56 for MAPs. While Medicare prescription plans usually cover pharmacotherapeutic treatments for drug addiction, high co-payments can limit access. For example, beneficiaries without supplemental coverage who use Vivitrol® would exceed their initial coverage cap in 7-8 months, reaching the "doughnut hole" in their Part D coverage and becoming responsible for the full cost of the medication (over $900 per month). The 2010 Patient Protection and Affordable Care Act will gradually eliminate this coverage gap, and loss of patent protection for other antiaddiction medications (Suboxone® and Campral®) should also drive down patient costs, improving access and compliance. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

7 CFR 1735.11 - Area coverage.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 11 2013-01-01 2013-01-01 false Area coverage. 1735.11 Section 1735.11 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE... Policies § 1735.11 Area coverage. Borrowers must make adequate telephone service available to the widest...

Social health insurance coverage and financial protection among rural-to-urban internal migrants in China: evidence from a nationally representative cross-sectional study

PubMed Central

Chen, Wen; Zhang, Qi; Renzaho, Andre M N; Zhou, Fangjing; Zhang, Hui; Ling, Li

2017-01-01

Introduction Migrants are a vulnerable population and could experience various challenges and barriers to accessing health insurance. Health insurance coverage protects migrants from financial loss related to illness and death. We assessed social health insurance (SHI) coverage and its financial protection effect among rural-to-urban internal migrants (IMs) in China. Methods Data from the ‘2014 National Internal Migrant Dynamic Monitoring Survey’ were used. We categorised 170 904 rural-to-urban IMs according to their SHI status, namely uninsured by SHI, insured by the rural SHI scheme (new rural cooperative medical scheme (NCMS)) or the urban SHI schemes (urban employee-based basic medical insurance (UEBMI)/urban resident-based basic medical insurance (URBMI)), and doubly insured (enrolled in both rural and urban schemes). Financial protection was defined as ‘the percentage of out-of-pocket (OOP) payments for the latest inpatient service during the past 12 months in the total household expenditure’. Results The uninsured rate of SHI and the NCMS, UEBMI/URBMI and double insurance coverage in rural-to-urban IMs was 17.3% (95% CI 16.9% to 17.7%), 66.6% (66.0% to 67.1%), 22.6% (22.2% to 23.0%) and 5.5% (5.3% to 5.7%), respectively. On average, financial protection indicator among uninsured, only NCMS insured, only URBMI/UEBMI insured and doubly insured participants was 13.3%, 9.2%, 6.2% and 5.8%, respectively (p=0.004). After controlling for confounding factors and adjusting the protection effect of private health insurance, compared with no SHI, the UEBMI/URBMI, the NCMS and double insurance could reduce the average percentage share of OOP payments by 33.9% (95% CI 25.5% to 41.4%), 14.1% (6.6% to 20.9%) and 26.8% (11.0% to 39.7%), respectively. Conclusion Although rural-to-urban IMs face barriers to accessing SHI schemes, our findings confirm the positive financial protection effect of SHI. Improving availability and portability of health insurance would promote financial protection for IMs, and further facilitate achieving universal health coverage in China and other countries that face migration-related obstacles to achieve universal coverage. PMID:29082027

Jeffrey Baldwin: A Thematic Analysis of Media Coverage and Implications for Social Work Practice

ERIC Educational Resources Information Center

Choate, Peter W.

2017-01-01

Jeffery Baldwin died in 2002 in the care of his maternal grandparents. The case received intense media attention at various times over an almost eight-year period. Along with other public documents, the media coverage permits an analysis of the practice errors by Child Protection Services that are related to the failure to protect Jeffrey. Nine…

7 CFR 1710.103 - Area coverage.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 11 2013-01-01 2013-01-01 false Area coverage. 1710.103 Section 1710.103 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE... Basic Policies § 1710.103 Area coverage. (a) Borrowers shall make a diligent effort to extend electric...

Proposed regulations could limit access to affordable health coverage for workers' children and family members.

PubMed

Jacobs, Ken; Graham-Squire, Dave; Roby, Dylan H; Kominski, Gerald F; Kinane, Christina M; Needleman, Jack; Watson, Greg; Gans, Daphna

2011-12-01

Key Findings. The Patient Protection and Affordable Care Act (ACA) is designed to offer premium subsidies to help eligible individuals and their families purchase insurance coverage when affordable job-based coverage is not available. However, the law is unclear on how this affordability protection is applied in those instances where self-only coverage offered by an employer is affordable but family coverage is not. Regulations recently proposed by the Department of the Treasury would make family members ineligible for subsidized coverage in the exchange if an employee is offered affordable self-only coverage by an employer, even if family coverage is unaffordable. This could have significant financial consequences for low- and moderate-income families that fall in this gap. Using an alternative interpretation of the law could allow the entire family to enter the exchange when family coverage is unaffordable, which would broaden access to coverage. However, this option has been cited as cost prohibitive. In this brief we consider a middle ground alternative that would base eligibility for the individual worker on the cost of self-only coverage, but would use the additional cost to the employee for family coverage as the basis for determining affordability and eligibility for subsidies for the remaining family members. We find that: Under the middle ground alternative scenario an additional 144,000 Californians would qualify for and use premium subsidies in the California Health Benefit Exchange, half of whom are children. Less than 1 percent of those with employer-based coverage would move to subsidized coverage in the California Health Benefit Exchange as a result of having unaffordable coverage on the job.

Large expansion of oil industry in the Ecuadorian Amazon: biodiversity vulnerability and conservation alternatives.

PubMed

Lessmann, Janeth; Fajardo, Javier; Muñoz, Jesús; Bonaccorso, Elisa

2016-07-01

Ecuador will experience a significant expansion of the oil industry in its Amazonian region, one of the most biodiverse areas of the world. In view of the changes that are about to come, we explore the conflicts between oil extraction interests and biodiversity protection and apply systematic conservation planning to identify priority areas that should be protected in different oil exploitation scenarios. First, we quantified the current extent of oil blocks and protected zones and their overlap with two biodiversity indicators: 25 ecosystems and 745 species (whose distributions were estimated via species distribution models). With the new scheme of oil exploitation, oil blocks cover 68% (68,196 km(2)) of the Ecuadorian Amazon; half of it occupied by new blocks open for bids in the southern Amazon. This region is especially vulnerable to biodiversity losses, because peaks of species diversity, 19 ecosystems, and a third of its protected zones coincide spatially with oil blocks. Under these circumstances, we used Marxan software to identify priority areas for conservation outside oil blocks, but their coverage was insufficient to completely represent biodiversity. Instead, priority areas that include southern oil blocks provide a higher representation of biodiversity indicators. Therefore, preserving the southern Amazon becomes essential to improve the protection of Amazonian biodiversity in Ecuador, and avoiding oil exploitation in these areas (33% of the extent of southern oil blocks) should be considered a conservation alternative. Also, it is highly recommended to improve current oil exploitation technology to reduce environmental impacts in the region, especially within five oil blocks that we identified as most valuable for the conservation of biodiversity. The application of these and other recommendations depends heavily on the Ecuadorian government, which needs to find a better balance between the use of the Amazon resources and biodiversity conservation.

77 FR 64380 - Proposed Collection; Comment Request for Form 13441 and 13441-EZ

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-19

... Form 13441, Health Coverage Tax Credit Registration Form, and Form 13441-EZ. DATES: Written [email protected] . SUPPLEMENTARY INFORMATION: Title: Health Coverage Tax Credit Registration Form. OMB Number: 1545-1842. Form Number: 13441 and 13441-EZ. Abstract: Coverage Tax Credit Registration Form will be...

12 CFR 1024.5 - Coverage of RESPA.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 8 2012-01-01 2012-01-01 false Coverage of RESPA. 1024.5 Section 1024.5 Banks and Banking BUREAU OF CONSUMER FINANCIAL PROTECTION REAL ESTATE SETTLEMENT PROCEDURES ACT (REGULATION X) § 1024.5 Coverage of RESPA. (a) Applicability. RESPA and this part apply to all federally related...

Spatial and environmental connectivity analysis in a cholera vaccine trial.

PubMed

Emch, Michael; Ali, Mohammad; Root, Elisabeth D; Yunus, Mohammad

2009-02-01

This paper develops theory and methods for vaccine trials that utilize spatial and environmental information. Satellite imagery is used to identify whether households are connected to one another via water bodies in a study area in rural Bangladesh. Then relationships between neighborhood-level cholera vaccine coverage and placebo incidence and neighborhood-level spatial variables are measured. The study hypothesis is that unvaccinated people who are environmentally connected to people who have been vaccinated will be at lower risk compared to unvaccinated people who are environmentally connected to people who have not been vaccinated. We use four datasets including: a cholera vaccine trial database, a longitudinal demographic database of the rural population from which the vaccine trial participants were selected, a household-level geographic information system (GIS) database of the same study area, and high resolution Quickbird satellite imagery. An environmental connectivity metric was constructed by integrating the satellite imagery with the vaccine and demographic databases linked with GIS. The results show that there is a relationship between neighborhood rates of cholera vaccination and placebo incidence. Thus, people are indirectly protected when more people in their environmentally connected neighborhood are vaccinated. This result is similar to our previous work that used a simpler Euclidean distance neighborhood to measure neighborhood vaccine coverage [Ali, M., Emch, M., von Seidlein, L., Yunus, M., Sack, D. A., Holmgren, J., et al. (2005). Herd immunity conferred by killed oral cholera vaccines in Bangladesh. Lancet, 366(9479), 44-49]. Our new method of measuring environmental connectivity is more precise since it takes into account the transmission mode of cholera and therefore this study validates our assertion that the oral cholera vaccine provides indirect protection in addition to direct protection.

The quest for universal health coverage: achieving social protection for all in Mexico.

PubMed

Knaul, Felicia Marie; González-Pier, Eduardo; Gómez-Dantés, Octavio; García-Junco, David; Arreola-Ornelas, Héctor; Barraza-Lloréns, Mariana; Sandoval, Rosa; Caballero, Francisco; Hernández-Avila, Mauricio; Juan, Mercedes; Kershenobich, David; Nigenda, Gustavo; Ruelas, Enrique; Sepúlveda, Jaime; Tapia, Roberto; Soberón, Guillermo; Chertorivski, Salomón; Frenk, Julio

2012-10-06

Mexico is reaching universal health coverage in 2012. A national health insurance programme called Seguro Popular, introduced in 2003, is providing access to a package of comprehensive health services with financial protection for more than 50 million Mexicans previously excluded from insurance. Universal coverage in Mexico is synonymous with social protection of health. This report analyses the road to universal coverage along three dimensions of protection: against health risks, for patients through quality assurance of health care, and against the financial consequences of disease and injury. We present a conceptual discussion of the transition from labour-based social security to social protection of health, which implies access to effective health care as a universal right based on citizenship, the ethical basis of the Mexican reform. We discuss the conditions that prompted the reform, as well as its design and inception, and we describe the 9-year, evidence-driven implementation process, including updates and improvements to the original programme. The core of the report concentrates on the effects and impacts of the reform, based on analysis of all published and publically available scientific literature and new data. Evidence indicates that Seguro Popular is improving access to health services and reducing the prevalence of catastrophic and impoverishing health expenditures, especially for the poor. Recent studies also show improvement in effective coverage. This research then addresses persistent challenges, including the need to translate financial resources into more effective, equitable and responsive health services. A next generation of reforms will be required and these include systemic measures to complete the reorganisation of the health system by functions. The paper concludes with a discussion of the implications of the Mexican quest to achieve universal health coverage and its relevance for other low-income and middle-income countries. Copyright © 2012 Elsevier Ltd. All rights reserved.

Medicare Prescription Drug Coverage

MedlinePlus

Part D is the name of Medicare's prescription drug coverage. It's insurance that helps people pay for prescription drugs. It is available to everyone who has Medicare. It provides protection if you ...

A randomized clinical study comparing the plaque inhibition effect of a SnF2/SHMP dentifrice (blend-a-med EXPERT GUMS PROTECTION) and a chlorhexidine digluconate dentifrice (Lacalut Aktiv).

PubMed

Bellamy, P G; Khera, N; Day, T N; Mussett, A J; Barker, M L

2009-01-01

To compare the plaque inhibition benefits of a control 0.454% stannous fluoride/sodium hexametaphosphate/sodium fluoride dentifrice (SnF2/SHMP with 1450 ppm F) to a chlorhexidine digluconate (0.05%), aluminum lactate (0.8%), and aluminum fluoride (AlF3/Chx with 1400 ppm F) dentifrice. Twenty-nine subjects were randomized to a two-period, two-treatment, double-blind crossover sequence using blend-a-med EXPERT GUMS PROTECTION toothpaste (SnF2/SHMP) and Lacalut Aktiv toothpaste (AlF3/Chx). Each treatment was used along with a standard manual toothbrush (Oral-B P35 Indicator) for 17 days. Digital plaque image analysis (DPIA) was used at the end of each period for three consecutive days to evaluate plaque levels; a) overnight (A.M. pre-brush); b) following 40 seconds of brushing with the test product (A.M. post-brush); and c) mid-afternoon (P.M.). Images were analyzed using an objective computer algorithm to calculate the total area of visible plaque. A four-day washout period was instituted for the crossover phase. Twenty-seven subjects completed the study. The SnF2/SHMP dentifrice provided a statistically significant lower level of plaque area coverage compared to the AlF3/Chx dentifrice at all time points. For the SnF2/SHMP dentifrice, plaque coverage was 19.4% lower (p = 0.0043) at the A.M. pre-brush, 25.6% lower (p = 0.0014) at the A.M. post-brush, and 19.8% lower (p = 0.0057) at the P.M. measure relative to the AlF3/Chx dentifrice. The blend-a-med EXPERT GUMS PROTECTION toothpaste inhibits plaque regrowth, both overnight and during the day, to a significantly greater degree than Lacalut Aktiv. Additionally, immediately after brushing with blend-a-med EXPERT GUMS PROTECTION, subjects had significantly less plaque than after brushing with Lacalut Aktiv.

Changes in Coverage of Sun Protection in the News: Threats and Opportunities from Emerging Issues

ERIC Educational Resources Information Center

Scully, Maree; Makin, Jennifer; Maloney, Sarah; Wakefield, Melanie

2014-01-01

This study aimed to determine whether there have been shifts in news coverage of sun protection issues over a 12-year period in the context of an evolving skin cancer prevention agenda. A content analysis was performed on all relevant articles (N = 552) published in the two metropolitan daily newspapers in Melbourne, Australia, from 2001 to 2012.…

Determining the pneumococcal conjugate vaccine coverage required for indirect protection against vaccine-type pneumococcal carriage in low and middle-income countries: a protocol for a prospective observational study.

PubMed

Chan, Jocelyn; Nguyen, Cattram D; Lai, Jana Y R; Dunne, Eileen M; Andrews, Ross; Blyth, Christopher C; Datta, Siddhartha; Fox, Kim; Ford, Rebecca; Hinds, Jason; La Vincente, Sophie; Lehmann, Deborah; Lim, Ruth; Mungun, Tuya; Newton, Paul N; Phetsouvanh, Rattanaphone; Pomat, Willam S; Xeuatvongsa, Anonh; von Mollendorf, Claire; Dance, David A B; Satzke, Catherine; Muholland, Kim; Russell, Fiona M

2018-05-18

Pneumococcal conjugate vaccines (PCVs) prevent disease through both direct protection of vaccinated individuals and indirect protection of unvaccinated individuals by reducing nasopharyngeal (NP) carriage and transmission of vaccine-type (VT) pneumococci. While the indirect effects of PCV vaccination are well described, the PCV coverage required to achieve the indirect effects is unknown. We will investigate the relationship between PCV coverage and VT carriage among undervaccinated children using hospital-based NP pneumococcal carriage surveillance at three sites in Asia and the Pacific. We are recruiting cases, defined as children aged 2-59 months admitted to participating hospitals with acute respiratory infection in Lao People's Democratic Republic, Mongolia and Papua New Guinea. Thirteen-valent PCV status is obtained from written records. NP swabs are collected according to standard methods, screened using lytA qPCR and serotyped by microarray. Village-level vaccination coverage, for the resident communities of the recruited cases, is determined using administrative data or community survey. Our analysis will investigate the relationship between VT carriage among undervaccinated cases (indirect effects) and vaccine coverage using generalised estimating equations. Ethical approval has been obtained from the relevant ethics committees at participating sites. The results are intended for publication in open-access peer-reviewed journals and will demonstrate methods suitable for low- and middle-income countries to monitor vaccine impact and inform vaccine policy makers about the PCV coverage required to achieve indirect protection. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A Novel Deployment Scheme Based on Three-Dimensional Coverage Model for Wireless Sensor Networks

PubMed Central

Xiao, Fu; Yang, Yang; Wang, Ruchuan; Sun, Lijuan

2014-01-01

Coverage pattern and deployment strategy are directly related to the optimum allocation of limited resources for wireless sensor networks, such as energy of nodes, communication bandwidth, and computing power, and quality improvement is largely determined by these for wireless sensor networks. A three-dimensional coverage pattern and deployment scheme are proposed in this paper. Firstly, by analyzing the regular polyhedron models in three-dimensional scene, a coverage pattern based on cuboids is proposed, and then relationship between coverage and sensor nodes' radius is deduced; also the minimum number of sensor nodes to maintain network area's full coverage is calculated. At last, sensor nodes are deployed according to the coverage pattern after the monitor area is subdivided into finite 3D grid. Experimental results show that, compared with traditional random method, sensor nodes number is reduced effectively while coverage rate of monitor area is ensured using our coverage pattern and deterministic deployment scheme. PMID:25045747

Estimation of measles vaccination coverage using the Lot Quality Assurance Sampling (LQAS) method--Tamilnadu, India, 2002-2003.

PubMed

Sivasankaran, Saravanan; Manickam, P; Ramakrishnan, R; Hutin, Y; Gupte, M D

2006-04-28

As part of the global strategic plan to reduce the number of measles deaths in India, the state of Tamilnadu aims at > or =95% measles vaccination coverage. A study was conducted to measure overall coverage levels for the Poondi Primary Health Center (PPHC), a rural health-care facility in Tiruvallur District, and to determine whether any of the PPHC's six health subcenters had coverage levels <95%. The Lot Quality Assurance Sampling (LQAS) method was used to identify health subcenters in the PPHC area with measles vaccination coverage levels <95% among children aged 12-23 months. Lemeshow and Taber sampling plans were used to determine that the measles vaccination status of 73 children aged 12--23 months had to be assessed in each health subcenter coverage area, with a 5% level of significance and a decision value of two. If more than two children were unvaccinated, the null hypothesis (i.e., that coverage in the health subcenter was low [<95%]) was not rejected. If the number of unvaccinated children was two or fewer, the null hypothesis was rejected, and coverage in the subcenter was considered to be good (i.e., > or =95%). All data were pooled in a stratified sample to estimate overall total coverage in the PPHC area. For two (33.3%) of the six health subcenters, more than two children were unvaccinated (i.e., coverage was <95%). Combining results from all six health subcenters generated a coverage estimate of 97.7% (95% confidence interval = 95.7-98.8) on the basis of 428 (97.7%) of 438 children identified as vaccinated. LQAS techniques proved useful in identifying small health areas with lower vaccination coverage, which helps to target interventions. Monthly review of vaccination coverage by subcenter and village is recommended to identify pockets of unvaccinated children and to maintain uniform high coverage in the PPHC area.

The ethics of the affordability of health insurance.

PubMed

Saloner, Brendan; Daniels, Norman

2011-10-01

In this essay we argue that the concept of affordable health insurance is rooted in a social obligation to protect fair equality of opportunity. Specifically, health insurance plays a limited but significant role in protecting opportunity in two ways: it helps keep people functioning normally and it protects their financial security. Together these benefits enable household members to exercise reasonable choices about their plans of life. To achieve truly affordable coverage, society must be able to contain the overall cost of health care, and health insurance must be progressively financed, meaning that those who are best able to pay for coverage should pay the largest share. While the recently passed Patient Protection and Affordable Care Act (ACA) falls short on both of these counts, we argue that it makes important contributions toward household affordability through the use of subsidies and regulations. The main shortcoming of the ACA is an insufficient protection against burdensome cost sharing, which we illustrate using several hypothetical scenarios. We conclude with recommendations about how to make opportunity-enhancing expansions to the current coverage subsidies.

Estimates of the Public Health Impact of a Pediatric Vaccination Program Using an Intranasal Tetravalent Live-Attenuated Influenza Vaccine in Belgium.

PubMed

Gerlier, Laetitia; Lamotte, Mark; Dos Santos Mendes, Sofia; Damm, Oliver; Schwehm, Markus; Eichner, Martin

2016-08-01

Our objectives were to estimate the public health outcomes of vaccinating Belgian children using an intranasal tetravalent live-attenuated influenza vaccine (QLAIV) combined with current coverage of high-risk/elderly individuals using the trivalent inactivated vaccine. We used a deterministic, age-structured, dynamic model to simulate seasonal influenza transmission in the Belgian population under the current coverage or after extending vaccination with QLAIV to healthy children aged 2-17 years. Differential equations describe demographic changes, exposure to infectious individuals, infection recovery, and immunity dynamics. The basic reproduction number (R 0) was calibrated to the observed number of influenza doctor visits/year. Vaccine efficacy was 80 % (live-attenuated) and 59-68 % (inactivated). The 10-year incidence of symptomatic influenza was calculated with different coverage scenarios (add-on to current coverage). Model calibration yielded R 0 = 1.1. QLAIV coverage of 75 % of those aged 2-17 years averted 374,000 symptomatic cases/year (57 % of the current number), 244,000 of which were among adults (indirect effect). Vaccinating 75 % of those aged 2-11 years and 50 % of those aged 12-17 years averted 333,200 cases/year (213,000 adult cases/year). Vaccinating only healthy children aged 2-5 years generated direct protection but limited indirect protection, even with 90 % coverage (40,800 averted adult cases/year; -8.4 %). Targeting all children averted twice as many high-risk cases as targeting high-risk children only (8485 vs. 4965/year with 75 % coverage). Sensitivity analyses showed the robustness of results. The model highlights the direct and indirect protection benefits when vaccinating healthy children with QLAIV in Belgium. Policies targeting only high-risk individuals or the youngest provide limited herd protection, as school-age children are important influenza vectors in the community.

Human papillomavirus vaccine delivery strategies that achieved high coverage in low- and middle-income countries.

PubMed

LaMontagne, D Scott; Barge, Sandhya; Le, Nga Thi; Mugisha, Emmanuel; Penny, Mary E; Gandhi, Sanjay; Janmohamed, Amynah; Kumakech, Edward; Mosqueira, N Rocio; Nguyen, Nghi Quy; Paul, Proma; Tang, Yuxiao; Minh, Tran Hung; Uttekar, Bella Patel; Jumaan, Aisha O

2011-11-01

To assess human papillomavirus (HPV) vaccination coverage after demonstration projects conducted in India, Peru, Uganda and Viet Nam by PATH and national governments and to explore the reasons for vaccine acceptance or refusal. Vaccines were delivered through schools or health centres or in combination with other health interventions, and either monthly or through campaigns at fixed time points. Using a two-stage cluster sample design, the authors selected households in demonstration project areas and interviewed over 7000 parents or guardians of adolescent girls to assess coverage and acceptability. They defined full vaccination as the receipt of all three vaccine doses and used an open-ended question to explore acceptability. Vaccination coverage in school-based programmes was 82.6% (95% confidence interval, CI: 79.3-85.6) in Peru, 88.9% (95% CI: 84.7-92.4) in 2009 in Uganda and 96.1% (95% CI: 93.0-97.8) in 2009 in Viet Nam. In India, a campaign approach achieved 77.2% (95% CI: 72.4-81.6) to 87.8% (95% CI: 84.3-91.3) coverage, whereas monthly delivery achieved 68.4% (95% CI: 63.4-73.4) to 83.3% (95% CI: 79.3-87.3) coverage. More than two thirds of respondents gave as reasons for accepting the HPV vaccine that: (i) it protects against cervical cancer; (ii) it prevents disease, or (iii) vaccines are good. Refusal was more often driven by programmatic considerations (e.g. school absenteeism) than by opposition to the vaccine. High coverage with HPV vaccine among young adolescent girls was achieved through various delivery strategies in the developing countries studied. Reinforcing positive motivators for vaccine acceptance is likely to facilitate uptake.

Human papillomavirus vaccine delivery strategies that achieved high coverage in low- and middle-income countries

PubMed Central

Barge, Sandhya; Le, Nga Thi; Mugisha, Emmanuel; Penny, Mary E; Gandhi, Sanjay; Janmohamed, Amynah; Kumakech, Edward; Mosqueira, N Rocio; Nguyen, Nghi Quy; Paul, Proma; Tang, Yuxiao; Minh, Tran Hung; Uttekar, Bella Patel; Jumaan, Aisha O

2011-01-01

Abstract Objective To assess human papillomavirus (HPV) vaccination coverage after demonstration projects conducted in India, Peru, Uganda and Viet Nam by PATH and national governments and to explore the reasons for vaccine acceptance or refusal. Methods Vaccines were delivered through schools or health centres or in combination with other health interventions, and either monthly or through campaigns at fixed time points. Using a two-stage cluster sample design, the authors selected households in demonstration project areas and interviewed over 7000 parents or guardians of adolescent girls to assess coverage and acceptability. They defined full vaccination as the receipt of all three vaccine doses and used an open-ended question to explore acceptability. Findings Vaccination coverage in school-based programmes was 82.6% (95% confidence interval, CI: 79.3–85.6) in Peru, 88.9% (95% CI: 84.7–92.4) in 2009 in Uganda and 96.1% (95% CI: 93.0–97.8) in 2009 in Viet Nam. In India, a campaign approach achieved 77.2% (95% CI: 72.4–81.6) to 87.8% (95% CI: 84.3–91.3) coverage, whereas monthly delivery achieved 68.4% (95% CI: 63.4–73.4) to 83.3% (95% CI: 79.3–87.3) coverage. More than two thirds of respondents gave as reasons for accepting the HPV vaccine that: (i) it protects against cervical cancer; (ii) it prevents disease, or (iii) vaccines are good. Refusal was more often driven by programmatic considerations (e.g. school absenteeism) than by opposition to the vaccine. Conclusion High coverage with HPV vaccine among young adolescent girls was achieved through various delivery strategies in the developing countries studied. Reinforcing positive motivators for vaccine acceptance is likely to facilitate uptake. PMID:22084528

Clinical and post mortem analysis of combat neck injury used to inform a novel coverage of armour tool.

PubMed

Breeze, J; Fryer, R; Hare, J; Delaney, R; Hunt, N C; Lewis, E A; Clasper, J C

2015-04-01

There is a requirement in the Ministry of Defence for an objective method of comparing the area of coverage of different body armour designs for future applications. Existing comparisons derived from surface wound mapping are limited in that they can only demonstrate the skin entry wound location. The Coverage of Armour Tool (COAT) is a novel three-dimensional model capable of comparing the coverage provided by body armour designs, but limited information exists as to which anatomical structures require inclusion. The aim of this study was to assess the utility of COAT, in the assessment of neck protection, using clinically relevant injury data. Hospital notes and post mortem records of all UK soldiers injured by an explosive fragment to the neck between 01 Jan 2006 and 31 December 2012 from Iraq and Afghanistan were analysed to determine which anatomical structures were responsible for death or functional disability at one year post injury. Using COAT a comparison of three ballistic neck collar designs was undertaken with reference to the percentage of these anatomical structures left exposed. 13/81 (16%) survivors demonstrated complications at one year, most commonly upper limb weakness from brachial plexus injury or a weak voice from laryngeal trauma. In 14/94 (15%) soldiers the neck wound was believed to have been the sole cause of death, primarily from carotid artery damage, spinal cord transection or rupture of the larynx. COAT objectively demonstrated that despite the larger OSPREY collar having almost double the surface area than the two-piece prototype collar, the percentage area of vulnerable cervical structures left exposed only reduced from 16.3% to 14.4%. COAT demonstrated its ability to objectively quantify the potential effectiveness of different body armour designs in providing coverage of vulnerable anatomical structures from different shot line orientations. To improve its utility, it is recommended that COAT be further developed to enable weapon and tissue specific information to be modelled, and that clinically significant injuries to other body regions are also incorporated. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Consumer rights and protections

MedlinePlus

... Turn down an offer of job-based coverage Insurance companies can't limit yearly or lifetime coverage of essential benefits. Under this right, insurance companies can't set a limit on the money ...

Update on Vaccine-Derived Polioviruses - Worldwide, January 2015-May 2016.

PubMed

Jorba, Jaume; Diop, Ousmane M; Iber, Jane; Sutter, Roland W; Wassilak, Steven G; Burns, Cara C

2016-08-05

In 1988, the World Health Assembly resolved to eradicate poliomyelitis worldwide (1). One of the main tools used in polio eradication efforts has been the live, attenuated, oral poliovirus vaccine (OPV) (2), an inexpensive vaccine easily administered by trained volunteers. OPV might require several doses to induce immunity, but provides long-term protection against paralytic disease. Through effective use of OPV, the Global Polio Eradication Initiative (GPEI) has brought wild polioviruses to the threshold of eradication (1). However, OPV use, particularly in areas with low routine vaccination coverage, is associated with the emergence of genetically divergent vaccine-derived polioviruses (VDPVs) whose genetic drift from the parental OPV strains indicates prolonged replication or circulation (3). VDPVs can emerge among immunologically normal vaccine recipients and their contacts as well as among persons with primary immunodeficiencies (PIDs). Immunodeficiency-associated VDPVs (iVDPVs) can replicate for years in some persons with PIDs. In addition, circulating vaccine-derived polioviruses (cVDPVs) (3) can emerge in areas with low OPV coverage and can cause outbreaks of paralytic polio. This report updates previous summaries regarding VDPVs (4).

Minimizing shrinkage of interdental papilla height when treating multiple Miller Class III gingival recession defects.

PubMed

Mahn, Douglas H

2015-04-01

Miller Class III and IV gingival recession defects have interdental bone and soft-tissue loss that limit root coverage. Given the importance of the interdental papilla, protecting the integrity of this structure would seem prudent. Tunnel techniques have been successfully used to protect the interdental papilla. This article discusses the results of two cases in which multiple Miller Class III gingival recession defects were treated using tunnel-grafting techniques and an acellular dermal matrix. In both cases, root coverage was achieved while protecting the interdental papilla height.

Sensor-driven area coverage for an autonomous fixed-wing unmanned aerial vehicle.

PubMed

Paull, Liam; Thibault, Carl; Nagaty, Amr; Seto, Mae; Li, Howard

2014-09-01

Area coverage with an onboard sensor is an important task for an unmanned aerial vehicle (UAV) with many applications. Autonomous fixed-wing UAVs are more appropriate for larger scale area surveying since they can cover ground more quickly. However, their non-holonomic dynamics and susceptibility to disturbances make sensor coverage a challenging task. Most previous approaches to area coverage planning are offline and assume that the UAV can follow the planned trajectory exactly. In this paper, this restriction is removed as the aircraft maintains a coverage map based on its actual pose trajectory and makes control decisions based on that map. The aircraft is able to plan paths in situ based on sensor data and an accurate model of the on-board camera used for coverage. An information theoretic approach is used that selects desired headings that maximize the expected information gain over the coverage map. In addition, the branch entropy concept previously developed for autonomous underwater vehicles is extended to UAVs and ensures that the vehicle is able to achieve its global coverage mission. The coverage map over the workspace uses the projective camera model and compares the expected area of the target on the ground and the actual area covered on the ground by each pixel in the image. The camera is mounted on a two-axis gimbal and can either be stabilized or optimized for maximal coverage. Hardware-in-the-loop simulation results and real hardware implementation on a fixed-wing UAV show the effectiveness of the approach. By including the already developed automatic takeoff and landing capabilities, we now have a fully automated and robust platform for performing aerial imagery surveys.

78 FR 7348 - Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-01

... se and those that may apply for recognition are neither group health insurance coverage nor.... 156.602) c. Requirements for Recognition as Minimum Essential Coverage for Coverage Not Otherwise... recognition that they meet the standards under section 5000A(d)(2)(B) of the Code. We also received...

78 FR 70961 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Notice to...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-27

... for OMB Review; Comment Request; Notice to Employees of Coverage Options Under Fair Labor Standards... Employees of Coverage Options Under Fair Labor Standards Act Section 18B,'' to the Office of Management and... and a related model notice of healthcare coverage options available under the Patient Protection and...

Tetanus toxoid vaccination coverage and differential between urban and rural areas of Bangladesh.

PubMed

Rahman, Mosiur

2009-04-01

Government commitment and support from a range of partnerships have led to a massive increase in tetanus toxoid immunization coverage among women of childbearing age, ensuring that both mothers and babies are protected against tetanus infection in Bangladesh. In order to control and eliminate the vaccine preventable diseases it is important to know the vaccination coverage. The major objective of this study is to determine the complete vaccination rate and the predictors that influence vaccination of mothers during pregnancy and to see whether there is any gap lies between the women of urban and rural areas regarding the tetanus toxoid injection receiving. This study utilizes the data extracted from Bangladesh Demographic and Health Survey 2004 (BDHS).To meets the objectives this study considers bivariate and multivariate analysis. The study represents that 88 per cent urban mothers and 84 per cent rural mothers receive tetanus toxoid injection during their pregnancy period. Logistic regression model is adjusted by wealth index, mother's age at last birth, education, husband's occupation, ever using contraception, fertility preference, wanted last child, having permission to go to hospital/health center, telling about pregnancy complications and mass media exposure for receiving TT injection. All these explanatory variables come out to be as significant determinants of receiving TT injection for all mothers as well as for rural mothers in Bangladesh. On the other hand ever using contraception, wanted last child, telling about pregnancy complications, mass media exposure and wealth index are the significant determinants of receiving TT injection for mothers of urban area.

Sanitation and water supply coverage thresholds associated with active trachoma: Modeling cross-sectional data from 13 countries

PubMed Central

Boisson, Sophie; Willis, Rebecca; Bakhtiari, Ana; al-Khatib, Tawfik; Amer, Khaled; Batcho, Wilfrid; Courtright, Paul; Dejene, Michael; Goepogui, Andre; Kalua, Khumbo; Kebede, Biruck; Macleod, Colin K.; Madeleine, Kouakou IIunga Marie; Mbofana, Mariamo Saide Abdala; Mpyet, Caleb; Ndjemba, Jean; Olobio, Nicholas; Pavluck, Alexandre L.; Sokana, Oliver; Southisombath, Khamphoua; Taleo, Fasihah

2018-01-01

Background Facial cleanliness and sanitation are postulated to reduce trachoma transmission, but there are no previous data on community-level herd protection thresholds. We characterize associations between active trachoma, access to improved sanitation facilities, and access to improved water sources for the purpose of face washing, with the aim of estimating community-level or herd protection thresholds. Methods and findings We used cluster-sampled Global Trachoma Mapping Project data on 884,850 children aged 1–9 years from 354,990 households in 13 countries. We employed multivariable mixed-effects modified Poisson regression models to assess the relationships between water and sanitation coverage and trachomatous inflammation—follicular (TF). We observed lower TF prevalence among those with household-level access to improved sanitation (prevalence ratio, PR = 0.87; 95%CI: 0.83–0.91), and household-level access to an improved washing water source in the residence/yard (PR = 0.81; 95%CI: 0.75–0.88). Controlling for household-level water and latrine access, we found evidence of community-level protection against TF for children living in communities with high sanitation coverage (PR80–90% = 0.87; 95%CI: 0.73–1.02; PR90–100% = 0.76; 95%CI: 0.67–0.85). Community sanitation coverage levels greater than 80% were associated with herd protection against TF (PR = 0.77; 95%CI: 0.62–0.97)—that is, lower TF in individuals whose households lacked individual sanitation but who lived in communities with high sanitation coverage. For community-level water coverage, there was no apparent threshold, although we observed lower TF among several of the higher deciles of community-level water coverage. Conclusions Our study provides insights into the community water and sanitation coverage levels that might be required to best control trachoma. Our results suggest access to adequate water and sanitation can be important components in working towards the 2020 target of eliminating trachoma as a public health problem. PMID:29357365

Progress Toward Universal Health Coverage: A Comparative Analysis in 5 South Asian Countries.

PubMed

Rahman, Md Mizanur; Karan, Anup; Rahman, Md Shafiur; Parsons, Alexander; Abe, Sarah Krull; Bilano, Ver; Awan, Rabia; Gilmour, Stuart; Shibuya, Kenji

2017-09-01

Achieving universal health coverage is one of the key targets in the newly adopted Sustainable Development Goals of the United Nations. To investigate progress toward universal health coverage in 5 South Asian countries and assess inequalities in health services and financial risk protection indicators. In a population-based study, nationally representative household (335 373 households) survey data from Afghanistan (2014 and 2015), Bangladesh (2010 and 2014), India (2012 and 2014), Nepal (2014 and 2015), and Pakistan (2014) were used to calculate relative indices of health coverage, financial risk protection, and inequality in coverage among wealth quintiles. The study was conducted from June 2012 to February 2016. Three dimensions of universal health coverage were assessed: access to basic services, financial risk protection, and equity. Composite and indicator-specific coverage rates, stratified by wealth quintiles, were then estimated. Slope and relative index of inequality were used to assess inequalities in service and financial indicators. Access to basic care varied substantially across all South Asian countries, with mean rates of overall prevention coverage and treatment coverage of 53.0% (95% CI, 42.2%-63.6%) and 51.2% (95% CI, 45.2%-57.1%) in Afghanistan, 76.5% (95% CI, 61.0%-89.0%) and 44.8% (95% CI, 37.1%-52.5%) in Bangladesh, 74.2% (95% CI, 57.0%-88.1%) and 83.5% (95% CI, 54.4%-99.1%) in India, 76.8% (95% CI, 66.5%-85.7%) and 57.8% (95% CI, 50.1%-65.4%) in Nepal, and 69.8% (95% CI, 58.3%-80.2%) and 50.4% (95% CI, 37.1%-63.6%) in Pakistan. Financial risk protection was generally low, with 15.3% (95% CI, 14.7%-16.0%) of respondents in Afghanistan, 15.8% (95% CI, 14.9%-16.8%) in Bangladesh, 17.9% (95% CI, 17.7%-18.2%) in India, 11.8% (95% CI, 11.8%-11.9%) in Nepal, and 4.4% (95% CI, 4.0%-4.9%) in Pakistan reporting incurred catastrophic payments due to health care costs. Access to at least 4 antenatal care visits, institutional delivery, and presence of skilled attendant during delivery were at least 3 times higher among the wealthiest mothers in Afghanistan, Bangladesh, Nepal, and Pakistan compared with the rates among poor mothers. Access to institutional delivery was 60 to 65 percentage points higher among wealthy than poor mothers in Afghanistan, Bangladesh, Nepal, and Pakistan compared with 21 percentage points higher in India. Coverage was least equitable among the countries for adequate sanitation, institutional delivery, and the presence of skilled birth attendants. Health coverage and financial risk protection was low, and inequality in access to health care remains a serious issue for these South Asian countries. Greater progress is needed to improve treatment and preventive services and financial security.

Is EU/EEA population protected from polio?

PubMed Central

Nijsten, DRE; Carrillo-Santisteve, P; Miglietta, A; Ruitenberg, J; Lopalco, PL

2015-01-01

The WHO European Region has been declared polio-free since 2002. By 2010, inactivated polio vaccine (IPV) was the only polio vaccine in use in the EU/EEA for the primary vaccination of children. A systematic review of the literature on polio seroprevalence studies, complemented by the analysis of available vaccine coverage data, has been carried out with the aim of assessing the level of protection against polio in the European population. A total of 52 studies, with data from 14 out of the 31 EU/EEA countries, were included in the analysis. This systematic review shows that, overall, seroprevalence for PV1 and PV3 is high in most countries, although seroimmunity gaps have been detected in several birth cohorts. In particular, relatively low immunity status was found in some countries for individuals born in the 60's and 70's. Discrepancies between reported vaccination coverage and immunity levels have been also highlighted. Countries should make sure that their population is being vaccinated for polio to reduce the risk of local poliovirus transmission in case of importation. Moreover, assessing immunity status should be priority for those traveling to areas where wild polioviruses are still circulating. PMID:25898095

Paying for individual health insurance through tax-sheltered cafeteria plans.

PubMed

Hall, Mark A; Monahan, Amy B

2010-01-01

When employees without group health insurance buy individual coverage, they do so using after-tax income--costing them from 20% to 50% more than others pay for equivalent coverage. Prior to the passage of the Patient Protection and Affordable Care Act (PPACA), several states promoted a potential solution that would allow employees to buy individual insurance through tax-sheltered payroll deduction. This technical but creative approach would allow insurers to combine what is known as "list-billing" with a Section 125 "cafeteria plan." However, these state-level reform attempts have failed to gain significant traction because state small-group reform laws and federal restrictions on medical underwriting cloud the legality of tax-sheltered list-billing. Several authorities have taken the position that insurance paid for through a cafeteria plan must meet the nondiscrimination requirements of the Health Insurance Portability and Accountability Act with respect to eligibility, premiums, and benefits. The recently enacted Patient Protection and Affordable Care Act addresses some of the legal uncertainty in this area, but much remains. For health reform to have its greatest effect, federal regulators must clarify whether individual health insurance can be purchased on a pre-tax basis through a cafeteria plan.

Is EU/EEA population protected from polio?

PubMed

Nijsten, Dre; Carrillo-Santisteve, P; Miglietta, A; Ruitenberg, J; Lopalco, P L

2015-01-01

The WHO European Region has been declared polio-free since 2002. By 2010, inactivated polio vaccine (IPV) was the only polio vaccine in use in the EU/EEA for the primary vaccination of children. A systematic review of the literature on polio seroprevalence studies, complemented by the analysis of available vaccine coverage data, has been carried out with the aim of assessing the level of protection against polio in the European population. A total of 52 studies, with data from 14 out of the 31 EU/EEA countries, were included in the analysis. This systematic review shows that, overall, seroprevalence for PV1 and PV3 is high in most countries, although seroimmunity gaps have been detected in several birth cohorts. In particular, relatively low immunity status was found in some countries for individuals born in the 60's and 70's. Discrepancies between reported vaccination coverage and immunity levels have been also highlighted. Countries should make sure that their population is being vaccinated for polio to reduce the risk of local poliovirus transmission in case of importation. Moreover, assessing immunity status should be priority for those traveling to areas where wild polioviruses are still circulating.

Health Care: Information on Coverage Choices for Servicemembers, Former Servicemembers, and Dependents

DTIC Science & Technology

2014-12-01

drugs, rehabilitative and habilitative services and devices, laboratory services, preventive services and chronic disease management , and pediatric ...the Patient Protection and Affordable Care Act (PPACA) is based on age, income, or other factors. The Centers for Medicare & Medicaid Services (CMS...Services MEC minimum essential coverage PPACA Patient Protection and Affordable Care Act VA Department of Veterans Affairs This is a work of the U.S

A parametric study of rate of advance and area coverage rate performance of synthetic aperture radar.

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

Raynal, Ann Marie; William H. Hensley, Jr.; Burns, Bryan L.

2014-11-01

The linear ground distance per unit time and ground area covered per unit time of producing synthetic aperture radar (SAR) imagery, termed rate of advance (ROA) and area coverage rate (ACR), are important metrics for platform and radar performance in surveillance applications. These metrics depend on many parameters of a SAR system such as wavelength, aircraft velocity, resolution, antenna beamwidth, imaging mode, and geometry. Often the effects of these parameters on rate of advance and area coverage rate are non-linear. This report addresses the impact of different parameter spaces as they relate to rate of advance and area coverage ratemore » performance.« less

How the affordable care act and mental health parity and addiction equity act greatly expand coverage of behavioral health care.

PubMed

Beronio, Kirsten; Glied, Sherry; Frank, Richard

2014-10-01

The Patient Protection and Affordable Care Act (ACA) will expand coverage of mental health and substance use disorder benefits and federal parity protections to over 60 million Americans. The key to this expansion is the essential health benefit provision in the ACA that requires coverage of mental health and substance use disorder services at parity with general medical benefits. Other ACA provisions that should improve access to treatment include requirements on network adequacy, dependent coverage up to age 26, preventive services, and prohibitions on annual and lifetime limits and preexisting exclusions. The ACA offers states flexibility in expanding Medicaid (primarily to childless adults, not generally eligible previously) to cover supportive services needed by those with significant behavioral health conditions in addition to basic benefits at parity. Through these various new requirements, the ACA in conjunction with Mental Health Parity and Addiction Equity Act (MHPAEA) will expand coverage of behavioral health care by historic proportions.

Mapping wildfire vulnerability in Mediterranean Europe. Testing a stepwise approach for operational purposes.

PubMed

Oliveira, Sandra; Félix, Fernando; Nunes, Adélia; Lourenço, Luciano; Laneve, Giovanni; Sebastián-López, Ana

2018-01-15

Vulnerability assessment is a vital component of wildfire management. This research focused on the development of a framework to measure and map vulnerability levels in several areas within Mediterranean Europe, where wildfires are a major concern. The framework followed a stepwise approach to evaluate its main components, expressed by exposure, sensitivity and coping capacity. Data on population density, fuel types, protected areas location, roads infrastructure and surveillance activities, among others, were integrated to create composite indices, representing each component and articulated in multiple dimensions. Maps were created for several test areas, in northwest Portugal, southwest Sardinia in Italy and northeast Corsica in France, with the contribution of local participants from civil protection institutions and forest services. Results showed the influence of fuel sensitivity levels, population distribution and protected areas coverage for the overall vulnerability classes. Reasonable levels of accuracy were found on the maps provided through the validation procedure, with an overall match above 72% for the several sites. The systematic and flexible approach applied allowed for adjustments to local circumstances with regards to data availability and fire management procedures, without compromising its consistency and with substantial operational capabilities. The results obtained and the positive feedback of end-users encourage its further application, as a means to improve wildfire management strategies at multiple levels with the latest scientific outputs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Clustered lot quality assurance sampling: a pragmatic tool for timely assessment of vaccination coverage.

PubMed

Greenland, K; Rondy, M; Chevez, A; Sadozai, N; Gasasira, A; Abanida, E A; Pate, M A; Ronveaux, O; Okayasu, H; Pedalino, B; Pezzoli, L

2011-07-01

To evaluate oral poliovirus vaccine (OPV) coverage of the November 2009 round in five Northern Nigeria states with ongoing wild poliovirus transmission using clustered lot quality assurance sampling (CLQAS). We selected four local government areas in each pre-selected state and sampled six clusters of 10 children in each Local Government Area, defined as the lot area. We used three decision thresholds to classify OPV coverage: 75-90%, 55-70% and 35-50%. A full lot was completed, but we also assessed in retrospect the potential time-saving benefits of stopping sampling when a lot had been classified. We accepted two local government areas (LGAs) with vaccination coverage above 75%. Of the remaining 18 rejected LGAs, 11 also failed to reach 70% coverage, of which four also failed to reach 50%. The average time taken to complete a lot was 10 h. By stopping sampling when a decision was reached, we could have classified lots in 5.3, 7.7 and 7.3 h on average at the 90%, 70% and 50% coverage targets, respectively. Clustered lot quality assurance sampling was feasible and useful to estimate OPV coverage in Northern Nigeria. The multi-threshold approach provided useful information on the variation of IPD vaccination coverage. CLQAS is a very timely tool, allowing corrective actions to be directly taken in insufficiently covered areas. © 2011 Blackwell Publishing Ltd.

Degradation and resilience in Louisiana salt marshes after the BP–Deepwater Horizon oil spill

PubMed Central

Silliman, Brian R.; van de Koppel, Johan; McCoy, Michael W.; Diller, Jessica; Kasozi, Gabriel N.; Earl, Kamala; Adams, Peter N.; Zimmerman, Andrew R.

2012-01-01

More than 2 y have passed since the BP–Deepwater Horizon oil spill in the Gulf of Mexico, yet we still have little understanding of its ecological impacts. Examining effects of this oil spill will generate much-needed insight into how shoreline habitats and the valuable ecological services they provide (e.g., shoreline protection) are affected by and recover from large-scale disturbance. Here we report on not only rapid salt-marsh recovery (high resilience) but also permanent marsh area loss after the BP–Deepwater Horizon oil spill. Field observations, experimental manipulations, and wave-propagation modeling reveal that (i) oil coverage was primarily concentrated on the seaward edge of marshes; (ii) there were thresholds of oil coverage that were associated with severity of salt-marsh damage, with heavy oiling leading to plant mortality; (iii) oil-driven plant death on the edges of these marshes more than doubled rates of shoreline erosion, further driving marsh platform loss that is likely to be permanent; and (iv) after 18 mo, marsh grasses have largely recovered into previously oiled, noneroded areas, and the elevated shoreline retreat rates observed at oiled sites have decreased to levels at reference marsh sites. This paper highlights that heavy oil coverage on the shorelines of Louisiana marshes, already experiencing elevated retreat because of intense human activities, induced a geomorphic feedback that amplified this erosion and thereby set limits to the recovery of otherwise resilient vegetation. It thus warns of the enhanced vulnerability of already degraded marshes to heavy oil coverage and provides a clear example of how multiple human-induced stressors can interact to hasten ecosystem decline. PMID:22733752

Achieving universal health coverage through voluntary insurance: what can we learn from the experience of Lao PDR?

PubMed Central

2013-01-01

Background The Government of Lao Peoples’ Democratic Republic (Lao PDR) has embarked on a path to achieve universal health coverage (UHC) through implementation of four risk-protection schemes. One of these schemes is community-based health insurance (CBHI) – a voluntary scheme that targets roughly half the population. However, after 12 years of implementation, coverage through CBHI remains very low. Increasing coverage of the scheme would require expansion to households in both villages where CBHI is currently operating, and new geographic areas. In this study we explore the prospects of both types of expansion by examining household and district level data. Methods Using a household survey based on a case-comparison design of 3000 households, we examine the determinants of enrolment at the household level in areas where the scheme is currently operating. We model the determinants of enrolment using a probit model and predicted probabilities. Findings from focus group discussions are used to explain the quantitative findings. To examine the prospects for geographic scale-up, we use secondary data to compare characteristics of districts with and without insurance, using a combination of univariate and multivariate analyses. The multivariate analysis is a probit model, which models the factors associated with roll-out of CBHI to the districts. Results The household findings show that enrolment is concentrated among the better off and that adverse selection is present in the scheme. The district level findings show that to date, the scheme has been implemented in the most affluent areas, in closest proximity to the district hospitals, and in areas where quality of care is relatively good. Conclusions The household-level findings indicate that the scheme suffers from poor risk-pooling, which threatens financial sustainability. The district-level findings call into question whether or not the Government of Laos can successfully expand to more remote, less affluent districts, with lower population density. We discuss the policy implications of the findings and specifically address whether CBHI can serve as a foundation for a national scheme, while exploring alternative approaches to reaching the informal sector in Laos and other countries attempting to achieve UHC. PMID:24344925

Trends in news coverage about skin cancer prevention, 1993-2006: increasingly mixed messages for the public.

PubMed

Scully, Maree; Wakefield, Melanie; Dixon, Helen

2008-10-01

To provide a comprehensive overview of trends in news coverage about sun protection issues in an Australian setting over a 14-year period. A content analysis was performed on all relevant articles (N=547) published in two major daily newspapers, The Age and the Herald Sun, from 1993 to 2006. Articles were coded for article type, prominence, theme, spokesperson, topic slant and opinion slant. The most frequent themes were the health effects of ultraviolet (UV) radiation exposure (24% of articles), education/prevention (14%) and product issues (12%). Themes that became more dominant over time were vitamin D issues, solaria issues and fake tans. Sixty per cent of articles included a pro-sun protection spokesperson and 12% an anti-sun protection spokesperson, with the profile of anti-sun protection spokespeople increasing over time. Half the articles reported on topics positive for sun protection, whereas 18% reported on negative topics; however, this difference narrowed considerably from 2001 onwards. In opinionated articles, the opinions expressed by authors were mainly positive (57%) rather than negative (7%) for sun protection. The findings suggest that the mix of sun protection issues covered and views of sun protection have changed over time, resulting in greater coverage of controversies and issues not necessarily positive for sun protection objectives. These findings imply that evaluation of paid skin cancer prevention public education campaigns may need to take account of the changing news media environment in which they take place.

Analysis of aeromedical retrieval coverage using elliptical isochrones: An evaluation of helicopter fleet size configurations in Scotland.

PubMed

Dodds, Naomi; Emerson, Philip; Phillips, Stephanie; Green, David R; Jansen, Jan O

2017-03-01

Trauma systems in remote and rural regions often rely on helicopter emergency medical services to facilitate access to definitive care. The siting of such resources is key, but often relies on simplistic modeling of coverage, using circular isochrones. Scotland is in the process of implementing a national trauma network, and there have been calls for an expansion of aeromedical retrieval capacity. The aim of this study was to analyze population and area coverage of the current retrieval service configuration, with three aircraft, and a configuration with an additional helicopter, in the North East of Scotland, using a novel methodology. Both overall coverage and coverage by physician-staffed aircraft, with enhanced clinical capability, were analyzed. This was a geographical analysis based on calculation of elliptical isochrones, which consider the "open-jaw" configuration of many retrieval flights. Helicopters are not always based at hospitals. We modeled coverage based on different outbound and inbound flights. Areally referenced population data were obtained from the Scottish Government. The current helicopter network configuration provides 94.2% population coverage and 59.0% area coverage. The addition of a fourth helicopter would marginally increase population coverage to 94.4% and area coverage to 59.1%. However, when considering only physician-manned aircraft, the current configuration provides only 71.7% population coverage and 29.4% area coverage, which would be increased to 91.1% and 51.2%, respectively, with a second aircraft. Scotland's current helicopter network configuration provides good population coverage for retrievals to major trauma centers, which would only be increased minimally by the addition of a fourth aircraft in the North East. The coverage provided by the single physician-staffed aircraft is more limited, however, and would be increased considerably by a second physician-staffed aircraft in the North East. Elliptical isochrones provide a useful means of modeling "open-jaw" retrieval missions and provide a more realistic estimate of coverage. Epidemiological study, level IV; therapeutic study, level IV.

Delaunay Triangulation as a New Coverage Measurement Method in Wireless Sensor Network

PubMed Central

Chizari, Hassan; Hosseini, Majid; Poston, Timothy; Razak, Shukor Abd; Abdullah, Abdul Hanan

2011-01-01

Sensing and communication coverage are among the most important trade-offs in Wireless Sensor Network (WSN) design. A minimum bound of sensing coverage is vital in scheduling, target tracking and redeployment phases, as well as providing communication coverage. Some methods measure the coverage as a percentage value, but detailed information has been missing. Two scenarios with equal coverage percentage may not have the same Quality of Coverage (QoC). In this paper, we propose a new coverage measurement method using Delaunay Triangulation (DT). This can provide the value for all coverage measurement tools. Moreover, it categorizes sensors as ‘fat’, ‘healthy’ or ‘thin’ to show the dense, optimal and scattered areas. It can also yield the largest empty area of sensors in the field. Simulation results show that the proposed DT method can achieve accurate coverage information, and provides many tools to compare QoC between different scenarios. PMID:22163792

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

Mackay, Alexander; Fryar, Scotty; Doane, Alan

The Savannah River Site (SRS) is a 310-square-mile United States Department of Energy (US DOE) nuclear facility located along the Savannah River near Aiken, South Carolina that contains six primary stream/river systems. The Lower Three Runs Stream (LTR) is one of the primary streams within the site that is located in the southeast portion of the Savannah River Site. It is a large blackwater stream system that originates in the northeast portion of SRS and follows a southerly direction before it enters the Savannah River. During reactor operations, secondary reactor cooling water, storm sewer discharges, and miscellaneous wastewater was dischargedmore » and contaminated a 20 mile stretch of Lower Three Runs Stream that narrows and provides a limited buffer of US DOE property along the stream and flood-plain. Based on data collected during the years 2009 and 2010 under American Recovery and Re-investment Act funding, the stream was determined to be contaminated with cesium-137 at levels that exceeded acceptable risk based limits. In agreement with the Environmental Protection Agency and the South Carolina Department of Health and Environmental Control, three areas were identified for remediation [1] (SRNS April 2012). A comprehensive safety preparation strategy was developed for safe execution of the LTR remediation project. Contract incentives for safety encouraged the contractor to perform a complete evaluation of the work and develop an implementation plan to perform the work. The safety coverage was controlled to ensure all work was observed and assessed by one person per work area within the project. This was necessary due to the distances between the fence work and three transects being worked, approximately 20 miles. Contractor Management field observations were performed along with DOE assessments to ensure contractor focus on safe performance of the work. Dedicated ambulance coverage for remote worker work activities was provided. This effort was augmented with access to medical evacuation services. The areas where the work was performed were remote and difficult to get emergency vehicles to in a timely manner in case of an accident. Satellite phones were utilized due to intermittent phone coverage. High visibility vests were utilized to enable any hunters in the area to see the workers; due to the limited buffer areas along the stream route. An innovative approach to providing the necessary protection for workers during periods of extreme heat and humidity was also employed, which included the use of 'heat islands' with fans and crew trailers and ice vests for workers. (authors)« less

[Classification of Priority Area for Soil Environmental Protection Around Water Sources: Method Proposed and Case Demonstration].

PubMed

Li, Lei; Wang, Tie-yu; Wang, Xiaojun; Xiao, Rong-bo; Li, Qi-feng; Peng, Chi; Han, Cun-liang

2016-04-15

Based on comprehensive consideration of soil environmental quality, pollution status of river, environmental vulnerability and the stress of pollution sources, a technical method was established for classification of priority area of soil environmental protection around the river-style water sources. Shunde channel as an important drinking water sources of Foshan City, Guangdong province, was studied as a case, of which the classification evaluation system was set up. In detail, several evaluation factors were selected according to the local conditions of nature, society and economy, including the pollution degree of heavy metals in soil and sediment, soil characteristics, groundwater sensitivity, vegetation coverage, the type and location of pollution sources. Data information was mainly obtained by means of field survey, sampling analysis, and remote sensing interpretation. Afterwards, Analytical Hierarchy Process (AHP) was adopted to decide the weight of each factor. The basic spatial data layers were set up respectively and overlaid based on the weighted summation assessment model in Geographical Information System (GIS), resulting in a classification map of soil environmental protection level in priority area of Shunde channel. Accordingly, the area was classified to three levels named as polluted zone, risky zone and safe zone, which respectively accounted for 6.37%, 60.90% and 32.73% of the whole study area. Polluted zone and risky zone were mainly distributed in Lecong, Longjiang and Leliu towns, with pollutants mainly resulted from the long-term development of aquaculture and the industries containing furniture, plastic constructional materials and textile and clothing. In accordance with the main pollution sources of soil, targeted and differentiated strategies were put forward. The newly established evaluation method could be referenced for the protection and sustainable utilization of soil environment around the water sources.

Can private management compensate the ineffective marine reserves in China?

PubMed

Huang, Hui; Wen, Colin Kuo-Chang; Li, Xiubao; Tao, Yuan; Lian, Jainshen; Yang, Jianhui; Cherh, Kah-Leng

2017-02-01

Marine reserves (MRs) have emerged as a preferred method to protect coral reefs from overfishing and human disturbance. However, due to ineffective enforcement by governments, many MRs have been reduced to mere "paper parks" which fail to achieve conservation goals. This is especially true in countries such as China where compliance is low and resources dedicated to enforcement may be scarce. Privately managed marine reserves (PMMRs) may be effective in areas where government enforcement is lacking. To determine if PMMRs are a viable alternative strategy to protect coral reefs, we surveyed and compared fish assemblages and coral coverage in national MRs in Sanya, China to areas of reef privately leased to and managed by dive operators and hospitality industries. We found higher fish abundances and fish sizes in PMMR sites than in MR sites. However, while PMMRs are protected from fishing, other human impacts such as marine debris and illegal coral collection were evident in most tourist sites. Despite protection, long-term monitoring data of PMMRs revealed that in recent years, fish abundances have slightly recovered but species richness has not, indicating the need for a more comprehensive coral reef management plan. We strongly recommend coupling PMMRs with expertise supported regulations as an alternative coral reef management strategy in China.

Annual Cycles of Multiyear Sea Ice Coverage of the Arctic Ocean: 1999-2003

NASA Technical Reports Server (NTRS)

Kwok, R.

2004-01-01

For the years 1999-2003, we estimate the time-varying perennial ice zone (PIZ) coverage and construct the annual cycles of multiyear (MY, including second year) ice coverage of the Arctic Ocean using QuikSCAT backscatter, MY fractions from RADARSAT, and the record of ice export from satellite passive microwave observations. An area balance approach extends the winter MY coverage from QuikSCAT to the remainder of the year. From these estimates, the coverage of MY ice at the beginning of each year is 3774 x 10(exp 3) sq km (2000), 3896 x 10(exp 3) sq km (2001), 4475 x 10(exp 3) sq km (2002), and 4122 x 10(exp 3) sq km (2003). Uncertainties in coverage are approx.150 x 10(exp 3) sq km. In the mean, on 1 January, MY ice covers approx.60% of the Arctic Ocean. Ice export reduces this coverage to approx.55% by 1 May. From the multiple annual cycles, the area of first-year (FY) ice that survives the intervening summers are 1192 x 10(exp 3) sq km (2000), 1509 x 10(exp 3) sq km (2001), and 582 x 10(exp 3) sq km (2002). In order for the MY coverage to remain constant from year to year, these replenishment areas must balance the overall area export and melt during the summer. The effect of the record minimum in Arctic sea ice area during the summer of 2002 is seen in the lowest area of surviving FY ice of the three summers. In addition to the spatial coverage, the location of the PIZ is important. One consequence of the unusual location of the PIZ at the end of the summer of 2002 is the preconditioning for enhanced export of MY ice into the Barents and Kara seas. Differences between the minimums in summer sea ice coverage from our estimates and passive microwave observations are discussed.

Unintended Sunburn: A Potential Target for Sun Protection Messages.

PubMed

McLeod, Geraldine F H; Reeder, Anthony I; Gray, Andrew R; McGee, Rob

2017-01-01

New Zealand (NZ) has the highest melanoma incidence rate in the world. Primary prevention efforts focus on reducing sunburn incidence and increasing sun protective practices in the population. However, sunburn from excessive ultraviolet radiation (UVR) remains common. To reduce sunburn incidence, it is important to examine those individuals who experience unintended sunburn. This study aims to use data from the NZ Triennial Sun Protection Survey to describe respondents who were not intending to tan but were sunburnt after outdoor UVR exposure. Information on sociodemographics, concurrent weather conditions, sun protection attitudes and knowledge, and outdoor behaviour was also collected. The results showed 13.5% of respondents' experienced unintended sunburn during the survey weekend but had not attempted to obtain a tan that summer. Respondents who reported unintended sunburn were more likely than others to have been near water and in unshaded areas, used sunscreen, had higher SunSmart knowledge scores, had lower positive attitudes towards tanning, and were outdoors for a longer duration with less body coverage. As sunburn was unintended these respondents' outdoor sun protective behaviours may be amenable to change. Future public health initiatives should focus on increasing sun protection (clothing and shade) and reducing potential barriers to sun protection.

Unintended Sunburn: A Potential Target for Sun Protection Messages

PubMed Central

McGee, Rob

2017-01-01

New Zealand (NZ) has the highest melanoma incidence rate in the world. Primary prevention efforts focus on reducing sunburn incidence and increasing sun protective practices in the population. However, sunburn from excessive ultraviolet radiation (UVR) remains common. To reduce sunburn incidence, it is important to examine those individuals who experience unintended sunburn. This study aims to use data from the NZ Triennial Sun Protection Survey to describe respondents who were not intending to tan but were sunburnt after outdoor UVR exposure. Information on sociodemographics, concurrent weather conditions, sun protection attitudes and knowledge, and outdoor behaviour was also collected. The results showed 13.5% of respondents' experienced unintended sunburn during the survey weekend but had not attempted to obtain a tan that summer. Respondents who reported unintended sunburn were more likely than others to have been near water and in unshaded areas, used sunscreen, had higher SunSmart knowledge scores, had lower positive attitudes towards tanning, and were outdoors for a longer duration with less body coverage. As sunburn was unintended these respondents' outdoor sun protective behaviours may be amenable to change. Future public health initiatives should focus on increasing sun protection (clothing and shade) and reducing potential barriers to sun protection. PMID:28473925

Longitudinal Patterns of Health Insurance Coverage Among a National Sample of Children in the Child Welfare System

PubMed Central

Raghavan, Ramesh; Aarons, Gregory A.; Roesch, Scott C.; Leslie, Laurel K.

2008-01-01

Objectives. We sought to describe health insurance coverage over time among a national sample of children who came into contact with child welfare or child protective services agencies. Methods. We used data from 4 waves of the National Survey of Child and Adolescent Well-Being to examine insurance coverage among 2501 youths. Longitudinal insurance trajectories were identified using latent class analyses, a technique used to classify individuals into groupings of observed variables, and survey-weighted logistic regression was used to identify variables associated with class membership. Results. We identified 2 latent insurance classes—1 contained children who gained health insurance, and the other contained children who stably maintained coverage over time. History of sexual abuse, and race/ethnicity other than White, Black, and Hispanic, were associated with membership in the “gainer” class. Foster care placement and poorer health status were associated with membership in the “maintainer” class. Caregiver characteristics were not associated with class membership. Conclusions. The majority of children in child welfare had stable health insurance coverage over time. Given this vulnerable population’s dependence upon Medicaid, protection of existing entitlements to Medicaid is essential to preserve their stable insurance coverage. PMID:18235059

Increased Transparency and Consumer Protections for 2016 Marketplace Plans.

PubMed

Brooks-LaSure, Chiquita

2015-12-01

The open enrollment period that ends in December 2015 for coverage begin­ning January 2016 marks the third year of the health care exchanges or marketplaces and of coverage through new qualified health plans. This issue brief investigates several key changes to the qualified health plans, with a focus on increased transparency and consumer protections. A new out-of-pocket costs calculator, requirements regarding provider networks, and prescription drug cost-sharing requirements should serve to better inform and improve consumer selection. In addition, several policy changes will help individuals with more severe health needs. These include: improved prescription drug coverage for HIV/ AIDS and other conditions, allowing prescription drugs that are obtained through the "exceptions" process to count toward the out-of-pocket spending cap, more comprehensive and consistent habilitative coverage, and an individual out-of-pocket spending cap within the family out-of-pocket maximum.

Evaluating the Effectiveness of Natura 2000 Network for Wolf Conservation: A Case-Study in Greece

NASA Astrophysics Data System (ADS)

Votsi, Nefta-Eleftheria P.; Zomeni, Maria S.; Pantis, J. D.

2016-02-01

The wolf ( Canis lupus) is used as a case study to rate Natura 2000 sites in Greece based on preferred wolf habitat characteristics and test whether the network is suitable for their conservation. Road density, agricultural area, site area, connectivity, food availability (i.e., presence of natural prey), and elevation in 237 sites are combined in a logistic regression model. The occurrence of the wolf's natural prey was the most prevalent factor determining wolf presence, followed by agricultural cover. Considering the current status of these features at N2K site level, most sites currently hosting wolves (85.7 %) have good or excellent prospects for the long-term presence of the wolf. On the contrary, 11 sites which now have wolves are predicted to be ineffective in keeping them in the future due to the absence of wild ungulates and their high agricultural coverage. Four sites with no wolf presence currently have excellent prospects to host wolves in the future. Roadless sites are a priority for protection and retaining their current condition is strongly suggested. The proposed approach aims to detect gaps in protection for the wolf and identify priority sites in need of mitigation actions. It can also assist the assessment of conservation policies in Greece and elsewhere toward accomplishing set goals in protected areas. By focusing on wolf protection, we hope to increase agencies' attention to deal with conservation effectiveness, especially in cases like Greece, where a number of sites are insufficiently known and protected and management measures are not properly implemented.

Community based rehabilitation: Does it really improve the level of productivity among persons with physical disabilities?

PubMed

Moniruzzaman; Saha, Palash Chandra; Habib, Md Monjurul

2015-01-01

The Community Based Rehabilitation (CBR) is a common approach to work with disable people to improve their quality of life by improving the level of productivity and integrating them into society. But the effectiveness of CBR varies by country to country. The aim of the study was to find out whether CBR programs really improved the level of productivity among persons with physical disabilities. A cross-sectional study was conducted among equal number of respondents (n=51) from each CBR coverage and non-coverage areas from two different upazilla (sub-districts) located 40 km away from the capital city of Bangladesh. Respondents were selected purposively and data were collected by face to face interviews. Willer's (1994) version of the Community Integration Questionnaire (CIQ) was used to measure the level of productivity among adult with physical disabilities. The mean score of total productivity integration in CBR coverage and non-coverage areas were 4.3 ± 2.4 and 4.5 ± 2.2 respectively. This difference was statistically non-significant (p=0.602).The levels of productivity integration between CBR coverage and non-coverage areas varied only 2-4% (p=0.793). The mean score of productivity integration and levels of productivity were not different significantly in CBR coverage and non-coverage areas.

Prediction of Low Community Sanitation Coverage Using Environmental and Sociodemographic Factors in Amhara Region, Ethiopia

PubMed Central

Oswald, William E.; Stewart, Aisha E. P.; Flanders, W. Dana; Kramer, Michael R.; Endeshaw, Tekola; Zerihun, Mulat; Melaku, Birhanu; Sata, Eshetu; Gessesse, Demelash; Teferi, Tesfaye; Tadesse, Zerihun; Guadie, Birhan; King, Jonathan D.; Emerson, Paul M.; Callahan, Elizabeth K.; Moe, Christine L.; Clasen, Thomas F.

2016-01-01

This study developed and validated a model for predicting the probability that communities in Amhara Region, Ethiopia, have low sanitation coverage, based on environmental and sociodemographic conditions. Community sanitation coverage was measured between 2011 and 2014 through trachoma control program evaluation surveys. Information on environmental and sociodemographic conditions was obtained from available data sources and linked with community data using a geographic information system. Logistic regression was used to identify predictors of low community sanitation coverage (< 20% versus ≥ 20%). The selected model was geographically and temporally validated. Model-predicted probabilities of low community sanitation coverage were mapped. Among 1,502 communities, 344 (22.90%) had coverage below 20%. The selected model included measures for high topsoil gravel content, an indicator for low-lying land, population density, altitude, and rainfall and had reasonable predictive discrimination (area under the curve = 0.75, 95% confidence interval = 0.72, 0.78). Measures of soil stability were strongly associated with low community sanitation coverage, controlling for community wealth, and other factors. A model using available environmental and sociodemographic data predicted low community sanitation coverage for areas across Amhara Region with fair discrimination. This approach could assist sanitation programs and trachoma control programs, scaling up or in hyperendemic areas, to target vulnerable areas with additional activities or alternate technologies. PMID:27430547

Insecticide-treated nets provide protection against malaria to children in an area of insecticide resistance in Southern Benin.

PubMed

Bradley, John; Ogouyèmi-Hounto, Aurore; Cornélie, Sylvie; Fassinou, Jacob; de Tove, Yolande Sissinto Savi; Adéothy, Adicath Adéola; Tokponnon, Filémon T; Makoutode, Patrick; Adechoubou, Alioun; Legba, Thibaut; Houansou, Telesphore; Kinde-Gazard, Dorothée; Akogbeto, Martin C; Massougbodji, Achille; Knox, Tessa Bellamy; Donnelly, Martin; Kleinschmidt, Immo

2017-05-26

Malaria control is heavily reliant on insecticides, especially pyrethroids. Resistance of mosquitoes to insecticides may threaten the effectiveness of insecticide-based vector control and lead to a resurgence of malaria in Africa. In 21 villages in Southern Benin with high levels of insecticide resistance, the resistance status of local vectors was measured at the same time as the prevalence of malaria infection in resident children. Children who used LLINs had lower levels of malaria infection [odds ratio = 0.76 (95% CI 0.59, 0.98, p = 0.033)]. There was no evidence that the effectiveness of nets was different in high and low resistance locations (p = 0.513). There was no association between village level resistance and village level malaria prevalence (p = 0.999). LLINs continue to offer individual protection against malaria infection in an area of high resistance. Insecticide resistance is not a reason to stop efforts to increase coverage of LLINs in Africa.

Protective coating and hyperthermal atomic oxygen texturing of optical fibers used for blood glucose monitoring

NASA Technical Reports Server (NTRS)

Banks, Bruce A. (Inventor)

2008-01-01

Disclosed is a method of producing cones and pillars on polymethylmethacralate (PMMA) optical fibers for glucose monitoring. The method, in one embodiment, consists of using electron beam evaporation to deposit a non-contiguous thin film of aluminum on the distal ends of the PMMA fibers. The partial coverage of aluminum on the fibers is randomly, but rather uniformly distributed across the end of the optical fibers. After the aluminum deposition, the ends of the fibers are then exposed to hyperthermal atomic oxygen, which oxidizes the areas that are not protected by aluminum. The resulting PMMA fibers have a greatly increased surface area and the cones or pillars are sufficiently close together that the cellular components in blood are excluded from passing into the valleys between the cones and pillars. The optical fibers are then coated with appropriated surface chemistry so that they can optically sense the glucose level in the blood sample than that with conventional glucose monitoring.

Environmental variables associated with vacationers' sun protection at warm weather resorts in North America.

PubMed

Andersen, Peter A; Buller, David B; Walkosz, Barbara J; Scott, Michael D; Beck, Larry; Liu, Xia; Abbott, Allison; Eye, Rachel

2016-04-01

Vacationing at sunny, warm weather locations is a risk factor for excessive solar ultraviolet (UV) radiation exposure and skin cancer. This study examined the association of environmental variables related to UV levels with vacationers' sun protection. Vacationers at 41 summer resorts in 17 states and 1 Canadian Province were interviewed (n=3531) and observed (N=4347) during 2012 and 2013. Clothing coverage, sunglasses, and shade use were observed. Use of sunscreen and sunburns were self-reported. Environmental information was recorded by research staff or acquired from ground stations and the weather service. Temperature was positively associated with sun protection behaviors; however clothing coverage was negatively associated with temperature. Cloud cover was negatively associated with sun protection, with the exception of clothing coverage which was positively associated with it. Elevation showed a mixed pattern of associations with vacationer's sun protection. Latitude of a resort was negatively associated with most sun protection behaviors, such that sun protection increased at more southerly resorts. Similarly, the farther south a vacationer traveled to the resort, the less sun protection they employed. The UV index showed a weak, positive relationship with some sun protection behaviors even when controlling for temperature. Vacationers appeared aware that UV is higher at southern latitudes and may learn UV is intense when living in southern regions. However, many used temperature, an unreliable cue, to judge UV intensity and seemed to adjust clothing for warmth not UV protection. Efforts are needed to help individuals make more accurate sun safety decisions. Copyright © 2016. Published by Elsevier Inc.

Use of commercially available foam pipe insulation as a protective device for wounds over the elbow joint area in five dogs.

PubMed

Pavletic, Michael M

2011-11-01

4 large-breed dogs were referred because of nonhealing skin wounds involving the elbow joint area of several weeks to months in duration. One additional large-breed dog was evaluated because of a draining abscess with overlying skin necrosis. Previous attempts at closing each wound over the elbow joint area had been unsuccessful. At the time of hospital admission, open wounds had variable degrees of bacterial contamination and infection. Open wounds over the elbow joint area were closed by use of bipedicle advancement flaps or direct suture apposition of opposing sides of the wound. Lengths of pipe insulation were applied to the forelimb in a fashion to prevent contact pressure to the olecranon for a prolonged period (4 to 13 weeks) after surgery. All wounds healed completely. Release incisions (donor areas) healed by second intention within 3 weeks after surgery. One dog developed periostitis of the olecranon, which responded to antimicrobial administration. A second dog developed a skin bacterial infection below the surgical area that was markedly resistant to antimicrobials. The layered application of commercially available foam pipe insulation provided a simple and economical protective device after closure of problematic skin wounds involving the elbow joint area. Prolonged protection of the olecranon area helped to assure healing was complete and skin coverage was sufficiently stable to reduce the risk of reinjury after removal of the device. Each patient was able to use the involved forelimb during the treatment period. Paired bipedicle advancement flaps (release incisions) were particularly useful for closing small to moderate defects overlying the olecranon in which simple apposition was not feasible.

Role of Remote Sensing and Geographyc Information System Mapping for Protected Areas Land Rice Field Subak, Buffer Zones, and Area Conversion (Case Studies In Gianyar Regency, Bali Province)

NASA Astrophysics Data System (ADS)

Lanya, Indayati; Netera Subadiyasa, N.

2016-11-01

Conversion of rice fields in Bali 2579 ha/year, Law Number 41 of 2009 [1] and five of Government Regulation (GR), mandates the Local Government (LG) has a Regional Regulation (RR) or Rule Regent/Mayor, on the protection of agricultural land sustainable food (PALSF). Yet none provincial government of Bali has PALSF; although Subak as world cultural heritage. Similarly, Gianyar regency development strategy directed to integrate agriculture with tourism. Landsat 8 images, Word View Coverage 2015 Gianyar district and ArcGIS 10.3 software used for of rice field mapping and zoning of land protection Subak. Ten thematic maps (watersheds, land use, irrigation, relief/slope, rainfall, spatial planning, land suitability, productivity, the distance from downtown) as a variable parameter, weighted and balanced numerically. Numerical classification agricultura land using for the overlay menu and reselek. The total value of >125 as rice need to be protected, 100-125 value for buffer zone, and the value of <100 rice fields can be converted to 40 next year. For the 20 next year, the total value of> 100, 50-100 and <50 respectively to rice fields that need to be protected, wetland buffer, and rice fields can be converted. Region Subak sustainable of rice field protection, buffer and can be converted in a row for the next 20 years is 10973 ha, 3855 ha and 311 ha. For the next 40 years Subak conserved of rice field (8019 ha), buffer (5855 ha), and can be converted (3124 ha). Subak land pattern of spread can be converted to an supply of land for non-agricultural development of the region downstream to the access road Ida Bagus Matera (Jln. Province / national) in the coastal areas of Gianyar.

Use of Lot Quality Assurance Sampling (LQAS) to estimate vaccination coverage helps guide future vaccination efforts.

PubMed

Alberti, K P; Guthmann, J P; Fermon, F; Nargaye, K D; Grais, R F

2008-03-01

Inadequate evaluation of vaccine coverage after mass vaccination campaigns, such as used in national measles control programmes, can lead to inappropriate public health responses. Overestimation of vaccination coverage may leave populations at risk, whilst underestimation can lead to unnecessary catch-up campaigns. The problem is more complex in large urban areas where vaccination coverage may be heterogeneous and the programme may have to be fine-tuned at the level of geographic subunits. Lack of accurate population figures in many contexts further complicates accurate vaccination coverage estimates. During the evaluation of a mass vaccination campaign carried out in N'Djamena, the capital of Chad, Lot Quality Assurance Sampling was used to estimate vaccination coverage. Using this method, vaccination coverage could be evaluated within smaller geographic areas of the city as well as for the entire city. Despite the lack of accurate population data by neighbourhood, the results of the survey showed heterogeneity of vaccination coverage within the city. These differences would not have been identified using a more traditional method. The results can be used to target areas of low vaccination coverage during follow-up vaccination activities.

[Micro-community characteristics of vegetations in blowouts and depositional areas of Hulunbuir grassland, Inner Mongolia].

PubMed

Man, Liang; Hasi, Eerdun; Zhang, Ping; Yan, Xu; Xia, Xian-Dong

2008-10-01

By using traditional sampling methods, the micro-communities of vegetations in fixed, semi-bare, and bare blowouts of Hulunbuir grassland were investigated, and the investigation data were statistical analyzed. The results showed that the vegetation coverage decreased in the order of fixed blowout, semi-bare blowout, and bare blowout, and was lower than that of the primary vegetation Form. Stipa grandis. Potentilla acaulis and Kengia squarrosa were the dominant species in fixed blowout, with the coverage being 5%; while P. acaulis and Carex sp. were the dominant species in semi-bare blowout, with the coverage being 2%. The dominant species in depositional areas of semi-bare blowout were P. acaulis, K. squarrosa, Agropyron cristatum, and Thymus mongolicus, and the coverage was 4%. The dominant species on the southwest slope of bare blowout was Agriophyllum pungens. The middle depositional area of bare blowout was also occupied by A. pungens (coverage 4.7%), and the edge of it was dominated by A. cristatum (coverage 2.7%), Carex sp. (coverage 2.6%), and T. mongolicus (coverage 1.7%) from the edge of the depositional area to primary grassland. The mean species importance value in fixed, semi-bare, and bare blowouts was 12.64%, 13.38%, and 20.08%, while that in the depositional area of semi-bare blowout and in the middle and edge of bare blowout was 12.55%, 40.18%, and 11.15%, respectively.

Effectiveness of government strategies for financial protection against costs of hospitalization Care in India.

PubMed

Ranjan, Alok; Dixit, Priyanka; Mukhopadhyay, Indranil; Thiagarajan, Sundararaman

2018-04-16

In the past decade, India has seen the introduction of many 'publicly funded health insurance' schemes (PFHIs) that claim to cover approximately 300 million people and are essentially forms of purchasing care from both public and private providers to reduce out-of-pocket expenditure (OOPE) for hospitalization. Data from a recent government-organized nationwide household survey, The National Sample Survey 71st Round, were used to analyse the effectiveness and equity of tax-funded public health services and PFHIs as distinct but overlapping approaches to financial protection for hospitalization across different socio-economic categories. Cross-tabulation analysis, multivariate logistic regression and propensity score matching were the main analytical methods used. Government hospitals provide access to 45.6% of all hospitalization needs. Although poorer quintiles use public hospitals more often, even in the poorest quintile, as many as 37.2% are utilizing private hospitals. The average OOPE that a household experiences for hospitalization in public hospitals is approximately only one-fifth of the OOPE for hospitalization in the private sector. PFHI schemes cover 12.8% of the population, and coverage is higher in upper quintiles and in urban areas. Hospitalization rates increase with PFHI coverage, and this occurs with both public and private providers. Propensity score matching shows that PFHI contributes to a marginal reduction (1%) in 'catastrophic health expenditure incidence at the 25% threshold' (CHE-25) for the bottom three quintiles. The reported coverage of PFHIs was greater in the upper income quintiles. Utilization of public services was greater in the poorer income quintiles and more marginalized social groups. Periodic surveys are essential to guide policy choices regarding the appropriate mix of strategies for financial protection in pluralistic systems. There is a need for caution regarding any shift in the role of governments from providing services to purchasing care, given the contexts and limitations of currently available PFHIs. Even with tax-funded public services, although the average OOPE is lower than the care purchased through PFHIs, there is still a modest level of CHE and impoverishment due to health care costs that persist. Both strategies need to be synergized for more effective financial protection.

Molecular effective coverage surface area of optical clearing agents for predicting optical clearing potential

NASA Astrophysics Data System (ADS)

Feng, Wei; Ma, Ning; Zhu, Dan

2015-03-01

The improvement of methods for optical clearing agent prediction exerts an important impact on tissue optical clearing technique. The molecular dynamic simulation is one of the most convincing and simplest approaches to predict the optical clearing potential of agents by analyzing the hydrogen bonds, hydrogen bridges and hydrogen bridges type forming between agents and collagen. However, the above analysis methods still suffer from some problem such as analysis of cyclic molecule by reason of molecular conformation. In this study, a molecular effective coverage surface area based on the molecular dynamic simulation was proposed to predict the potential of optical clearing agents. Several typical cyclic molecules, fructose, glucose and chain molecules, sorbitol, xylitol were analyzed by calculating their molecular effective coverage surface area, hydrogen bonds, hydrogen bridges and hydrogen bridges type, respectively. In order to verify this analysis methods, in vitro skin samples optical clearing efficacy were measured after 25 min immersing in the solutions, fructose, glucose, sorbitol and xylitol at concentration of 3.5 M using 1951 USAF resolution test target. The experimental results show accordance with prediction of molecular effective coverage surface area. Further to compare molecular effective coverage surface area with other parameters, it can show that molecular effective coverage surface area has a better performance in predicting OCP of agents.

Characterizing the influence of transportation infrastructure on Emergency Medical Services (EMS) in urban area-A case study of Seoul, South Korea.

PubMed

Cho, Jungwoo; You, Myoungsoon; Yoon, Yoonjin

2017-01-01

In highly urbanized area where traffic condition fluctuates constantly, transportation infrastructure is one of the major contributing factors to Emergency Medical Service (EMS) availability and patient outcome. In this paper, we assess the impact of traffic fluctuation to the EMS first response availability in urban area, by evaluating the k-minute coverage under 21 traffic scenarios. The set of traffic scenarios represents the time-of-day and day-of-week effects, and is generated by combining road link speed information from multiple historical speed databases. In addition to the k-minute area coverage calculation, the k-minute population coverage is also evaluated for every 100m by 100m grid that partitions the case study area of Seoul, South Korea. In the baseline case of traveling at the speed limit, both the area and population coverage reached nearly 100% when compared to the five-minute travel time national target. Employing the proposed LoST (Loss of Serviceability due to Traffic) index, which measures coverage reduction in percentage compared to the baseline case, we find that the citywide average LoST for area and population coverage are similar at 34.2% and 33.8%. However, district-wise analysis reveals that such reduction varies significantly by district, and the magnitude of area and population coverage reduction is not always proportional. We conclude that the effect of traffic variation is significant to successful urban EMS first response performance, and regional variation is evident among local districts. Complexity in the urban environment requires a more adaptive approach in public health resource management and EMS performance target determination.

Predicting Optimal Dihydroartemisinin-Piperaquine Regimens to Prevent Malaria During Pregnancy for Human Immunodeficiency Virus-Infected Women Receiving Efavirenz.

PubMed

Wallender, Erika; Vucicevic, Katarina; Jagannathan, Prasanna; Huang, Liusheng; Natureeba, Paul; Kakuru, Abel; Muhindo, Mary; Nakalembe, Mirium; Havlir, Diane; Kamya, Moses; Aweeka, Francesca; Dorsey, Grant; Rosenthal, Philip J; Savic, Radojka M

2018-03-05

A monthly treatment course of dihydroartemisinin-piperaquine (DHA-PQ) effectively prevents malaria during pregnancy. However, a drug-drug interaction pharmacokinetic (PK) study found that pregnant human immunodeficiency virus (HIV)-infected women receiving efavirenz-based antiretroviral therapy (ART) had markedly reduced piperaquine (PQ) exposure. This suggests the need for alternative DHA-PQ chemoprevention regimens in this population. Eighty-three HIV-infected pregnant women who received monthly DHA-PQ and efavirenz contributed longitudinal PK and corrected QT interval (QTc) (n = 25) data. Population PK and PK-QTc models for PQ were developed to consider the benefits (protective PQ coverage) and risks (QTc prolongation) of alternative DHA-PQ chemoprevention regimens. Protective PQ coverage was defined as maintaining a concentration >10 ng/mL for >95% of the chemoprevention period. PQ clearance was 4540 L/day. With monthly DHA-PQ (2880 mg PQ), <1% of women achieved defined protective PQ coverage. Weekly (960 mg PQ) or low-dose daily (320 or 160 mg PQ) regimens achieved protective PQ coverage for 34% and >96% of women, respectively. All regimens were safe, with ≤2% of women predicted to have ≥30 msec QTc increase. For HIV-infected pregnant women receiving efavirenz, low daily DHA-PQ dosing was predicted to improve protection against parasitemia and reduce risk of toxicity compared to monthly dosing. NCT02282293. © The Author(s) 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

78 FR 39493 - Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-01

...This final rule implements certain functions of the Affordable Insurance Exchanges (``Exchanges''). These specific statutory functions include determining eligibility for and granting certificates of exemption from the individual shared responsibility payment described in section 5000A of the Internal Revenue Code. Additionally, this final rule implements the responsibilities of the Secretary of Health and Human Services, in coordination with the Secretary of the Treasury, to designate other health benefits coverage as minimum essential coverage by providing that certain coverage be designated as minimum essential coverage. It also outlines substantive and procedural requirements that other types of individual coverage must fulfill in order to be certified as minimum essential coverage.

State budget transfers to Health Insurance to expand coverage to people outside formal sector work in Latin America.

PubMed

Mathauer, Inke; Behrendt, Thorsten

2017-02-16

Contributory social health insurance for formal sector employees only has proven challenging for moving towards universal health coverage (UHC). This is because the informally employed and the poor usually remain excluded. One way to expand UHC is to fully or partially subsidize health insurance contributions for excluded population groups through government budget transfers. This paper analyses the institutional design features of such government subsidization arrangements in Latin America and assesses their performance with respect to UHC progress. The aim is to identify UHC conducive institutional design features of such arrangements. A literature search provided the information to analyse institutional design features, with a focus on the following aspects: eligibility/enrolment rules, financing and pooling arrangements, and purchasing and benefit package design. Based on secondary data analysis, UHC progress is assessed in terms of improved population coverage, financial protection and access to needed health care services. Such government subsidization arrangements currently exist in eight countries of Latin America (Bolivia, Chile, Colombia, Costa Rica, Dominican Republic, Mexico, Peru, Uruguay). Institutional design features and UHC related performance vary significantly. Notably, countries with a universalist approach or indirect targeting have higher population coverage rates. Separate pools for the subsidized maintain inequitable access. The relatively large scopes of the benefit packages had a positive impact on financial protection and access to care. In the long term, merging different schemes into one integrated health financing system without opt-out options for the better-off is desirable, while equally expanding eligibility to cover those so far excluded. In the short and medium term, the harmonization of benefit packages could be a priority. UHC progress also depends on substantial supply side investments to ensure the availability of quality services, particularly in rural areas. Future research should generate more evidence on the implementation process and impact of subsidization arrangements on UHC progress.

Temporal trends in coverage of historical cardiac arrests using a volunteer-based network of automated external defibrillators accessible to laypersons and emergency dispatch centers.

PubMed

Hansen, Carolina Malta; Lippert, Freddy Knudsen; Wissenberg, Mads; Weeke, Peter; Zinckernagel, Line; Ruwald, Martin H; Karlsson, Lena; Gislason, Gunnar Hilmar; Nielsen, Søren Loumann; Køber, Lars; Torp-Pedersen, Christian; Folke, Fredrik

2014-11-18

Although increased dissemination of automated external defibrillators (AEDs) has been associated with more frequent AED use, the trade-off between the number of deployed AEDs and coverage of cardiac arrests remains unclear. We investigated how volunteer-based AED dissemination affected public cardiac arrest coverage in high- and low-risk areas. All public cardiac arrests (1994-2011) and all registered AEDs (2007-2011) in Copenhagen, Denmark, were identified and geocoded. AED coverage of cardiac arrests was defined as historical arrests ≤100 m from an AED. High-risk areas were defined as those with ≥1 arrest every 2 years and accounted for 1.0% of the total city area. Of 1864 cardiac arrests, 18.0% (n=335) occurred in high-risk areas throughout the study period. From 2007 to 2011, the number of AEDs and the corresponding coverage of cardiac arrests increased from 36 to 552 and from 2.7% to 32.6%, respectively. The corresponding increase for high-risk areas was from 1 to 30 AEDs and coverage from 5.7% to 51.3%, respectively. Since the establishment of the AED network (2007-2011), few arrests (n=55) have occurred ≤100 m from an AED with only 14.5% (n=8) being defibrillated before the arrival of emergency medical services. Despite the lack of a coordinated public access defibrillation program, the number of AEDs increased 15-fold with a corresponding increase in cardiac arrest coverage from 2.7% to 32.6% over a 5-year period. The highest increase in coverage was observed in high-risk areas (from 5.7% to 51.3%). AED networks can be used as useful tools to optimize AED placement in community settings. © 2014 American Heart Association, Inc.

Evaluation of primary immunization coverage of infants under universal immunization programme in an urban area of bangalore city using cluster sampling and lot quality assurance sampling techniques.

PubMed

K, Punith; K, Lalitha; G, Suman; Bs, Pradeep; Kumar K, Jayanth

2008-07-01

Is LQAS technique better than cluster sampling technique in terms of resources to evaluate the immunization coverage in an urban area? To assess and compare the lot quality assurance sampling against cluster sampling in the evaluation of primary immunization coverage. Population-based cross-sectional study. Areas under Mathikere Urban Health Center. Children aged 12 months to 23 months. 220 in cluster sampling, 76 in lot quality assurance sampling. Percentages and Proportions, Chi square Test. (1) Using cluster sampling, the percentage of completely immunized, partially immunized and unimmunized children were 84.09%, 14.09% and 1.82%, respectively. With lot quality assurance sampling, it was 92.11%, 6.58% and 1.31%, respectively. (2) Immunization coverage levels as evaluated by cluster sampling technique were not statistically different from the coverage value as obtained by lot quality assurance sampling techniques. Considering the time and resources required, it was found that lot quality assurance sampling is a better technique in evaluating the primary immunization coverage in urban area.

Measuring HPV vaccination coverage in Australia: comparing two alternative population-based denominators.

PubMed

Barbaro, Bianca; Brotherton, Julia M L

2015-08-01

To compare the use of two alternative population-based denominators in calculating HPV vaccine coverage in Australia by age groups, jurisdiction and remoteness areas. Data from the National HPV Vaccination Program Register (NHVPR) were analysed at Local Government Area (LGA) level, by state/territory and by the Australian Standard Geographical Classification Remoteness Structure. The proportion of females vaccinated was calculated using both the ABS ERP and Medicare enrolments as the denominator. HPV vaccine coverage estimates were slightly higher using Medicare enrolments than using the ABS estimated resident population nationally (70.8% compared with 70.4% for 12 to 17-year-old females, and 33.3% compared with 31.9% for 18 to 26-year-old females, respectively.) The greatest differences in coverage were found in the remote areas of Australia. There is minimal difference between coverage estimates made using the two denominators except in Remote and Very Remote areas where small residential populations make interpretation more difficult. Adoption of Medicare enrolments for the denominator in the ongoing program would make minimal, if any, difference to routine coverage estimates. © 2015 Public Health Association of Australia.

Motion Trajectories for Wide-area Surveying with a Rover-based Distributed Spectrometer

NASA Technical Reports Server (NTRS)

Tunstel, Edward; Anderson, Gary; Wilson, Edmond

2006-01-01

A mobile ground survey application that employs remote sensing as a primary means of area coverage is highlighted. It is distinguished from mobile robotic area coverage problems that employ contact or proximity-based sensing. The focus is on a specific concept for performing mobile surveys in search of biogenic gases on planetary surfaces using a distributed spectrometer -- a rover-based instrument designed for wide measurement coverage of promising search areas. Navigation algorithms for executing circular and spiral survey trajectories are presented for widearea distributed spectroscopy and evaluated based on area covered and distance traveled.

GPS Eye-in-the-Sky Software Takes Closer Look Below

NASA Technical Reports Server (NTRS)

2006-01-01

At NASA, GPS is a vital resource for scientific research aimed at understanding and protecting Earth. The Agency employs the band of GPS satellites for such functions as mapping Earth s ionosphere and developing earthquake-prediction tools. Extending this worldly wisdom beyond Earth, NASA researchers are even discussing the possibility of developing global positioning satellites around Mars, in anticipation of future manned missions. Despite all of its terrestrial accomplishments, traditional GPS still has its limitations. The Space Agency is working to address these with many new advances, including a "Global Differential GPS" technology that instantaneously provides a position to within 4 inches horizontally and 8 inches vertically, anywhere on Earth. According to NASA's Jet Propulsion Laboratory, no other related system provides the same combination of accuracy and coverage. Furthermore, traditional GPS cannot communicate beyond latitudes of 75deg. That means that most of Greenland and Antarctica cannot receive GPS signals. The Global Differential GPS technology approaches this area of the world using several different GPS signals. These signals overlap to compensate for the gaps in coverage. Now, scientists working in the extreme northernmost and southernmost areas of the world can have access to the same GPS technology that other scientists around the world rely on.

Cluster-sample surveys and lot quality assurance sampling to evaluate yellow fever immunisation coverage following a national campaign, Bolivia, 2007.

PubMed

Pezzoli, Lorenzo; Pineda, Silvia; Halkyer, Percy; Crespo, Gladys; Andrews, Nick; Ronveaux, Olivier

2009-03-01

To estimate the yellow fever (YF) vaccine coverage for the endemic and non-endemic areas of Bolivia and to determine whether selected districts had acceptable levels of coverage (>70%). We conducted two surveys of 600 individuals (25 x 12 clusters) to estimate coverage in the endemic and non-endemic areas. We assessed 11 districts using lot quality assurance sampling (LQAS). The lot (district) sample was 35 individuals with six as decision value (alpha error 6% if true coverage 70%; beta error 6% if true coverage 90%). To increase feasibility, we divided the lots into five clusters of seven individuals; to investigate the effect of clustering, we calculated alpha and beta by conducting simulations where each cluster's true coverage was sampled from a normal distribution with a mean of 70% or 90% and standard deviations of 5% or 10%. Estimated coverage was 84.3% (95% CI: 78.9-89.7) in endemic areas, 86.8% (82.5-91.0) in non-endemic and 86.0% (82.8-89.1) nationally. LQAS showed that four lots had unacceptable coverage levels. In six lots, results were inconsistent with the estimated administrative coverage. The simulations suggested that the effect of clustering the lots is unlikely to have significantly increased the risk of making incorrect accept/reject decisions. Estimated YF coverage was high. Discrepancies between administrative coverage and LQAS results may be due to incorrect population data. Even allowing for clustering in LQAS, the statistical errors would remain low. Catch-up campaigns are recommended in districts with unacceptable coverage.

Availability, usage and expected contribution of potential nursery habitats for the California halibut

NASA Astrophysics Data System (ADS)

Fodrie, F. Joel; Mendoza, Guillermo

2006-06-01

Coastal ecosystems have been identified as important nursery habitats for many of the world's fishery species. Beyond this, there remain many questions about what exactly constitutes high-value, even critical, habitat for juvenile fish. A first step in investigating nursery habitat value should be to catalogue the spatial coverage (availability) of all potential nursery habitats as well as the distribution (usage) of juvenile fish within those habitats. We conducted two years of fall surveys in the nearshore areas of San Diego County, CA, examining the spatial distribution of 0-group California halibut, Paralichthys californicus. The database generated by 527 otter trawls and block-net seine collections was used to produce a series of models employing regression trees to study the abiotic factors (water column and bottom features) that affect juvenile distributions. Along the exposed coast, highest 0-group densities (0.002-0.008 individuals/m 2 (indiv/m 2)) occurred where temperatures exceeded 21.5 °C (2003), and at depths between 3.3 and 5.2 m (2004). Within protected embayments, densities were higher at depths less than 1.5 m (0.054-0.430 indiv/m 2) and, in 2004, inside channeled marsh estuaries (0.156 indiv/m 2). The spatial coverage of potential nursery habitats was calculated using a Geographic Information System (GIS) database, and the total number of resident 0-group halibut within each site was estimated (habitat area × juvenile halibut density) as a proxy for expected contribution of halibut advancing to the adult stock from each nursery. Although 85% of the potential nursery habitat area occurred along the exposed coastline, 69% (2003) to 58% (2004) of 0-group halibut resided in protected embayments. Embayment contribution is much greater in the southern half of the study region, largely due to Mission and San Diego bays. We conclude that all nursery habitat types demonstrate the potential to contribute significantly to stock fitness, and that in general, shallow and better-protected habitats are highly utilized nurseries for 0-group halibut and deserve special attention in management or conservation efforts.

Training and education in religion/spirituality within APA-accredited clinical psychology programs: 8 years later.

PubMed

Schafer, Rachel M; Handal, Paul J; Brawer, Peter A; Ubinger, Megan

2011-06-01

This study was a follow up investigation of Brawer et al.'s (Prof Psychol Res Pr 33(2):203-206, 2002) survey of education and training of clinical psychologists in religion/spirituality. Directors of clinical training were surveyed to determine whether changes had occurred in the coverage of religion and spirituality through course work, research, supervision, and in the systematic coverage of the content area. Results indicated an increased coverage in the areas of supervision, dedicated courses, inclusion as part of another course, and research. There was no increase in systematic coverage, but significantly more programs provided at least some coverage. The current study also assesses other areas of incorporation as well as directors' opinions regarding the importance of religion/spirituality in the field of psychology.

Characteristics of the Japanese sea cucumber Apostichopus japonicus's population in the Sea of Japan (Kievka Bay)

NASA Astrophysics Data System (ADS)

Gavrilova, G. S.; Sukhin, I. Yu.

2011-06-01

In Kievka Bay of the Sea of Japan, the population of the Japanese sea cucumber Apostichopus japonicus inhabits the areas of coarse sediments and complex bottom topography. These distributional patterns are closely related to the species' ecology, i.e., to the demand for protection against the wave turbulence. The aggregationing coverage of the sea cucumber population is about 80 hectares, where ˜200 thousand animals were accounted for in the last years. The aggregation's area varies during the year, which is closely related to the species' biological peculiarities, such as their behavioral patterns and the redistribution of their food resources. A significant increase of the juvenile population occurred after the farm-reared sea cucumber spat were released in 2003.

Barrier Coverage for 3D Camera Sensor Networks

PubMed Central

Wu, Chengdong; Zhang, Yunzhou; Jia, Zixi; Ji, Peng; Chu, Hao

2017-01-01

Barrier coverage, an important research area with respect to camera sensor networks, consists of a number of camera sensors to detect intruders that pass through the barrier area. Existing works on barrier coverage such as local face-view barrier coverage and full-view barrier coverage typically assume that each intruder is considered as a point. However, the crucial feature (e.g., size) of the intruder should be taken into account in the real-world applications. In this paper, we propose a realistic resolution criterion based on a three-dimensional (3D) sensing model of a camera sensor for capturing the intruder’s face. Based on the new resolution criterion, we study the barrier coverage of a feasible deployment strategy in camera sensor networks. Performance results demonstrate that our barrier coverage with more practical considerations is capable of providing a desirable surveillance level. Moreover, compared with local face-view barrier coverage and full-view barrier coverage, our barrier coverage is more reasonable and closer to reality. To the best of our knowledge, our work is the first to propose barrier coverage for 3D camera sensor networks. PMID:28771167

Barrier Coverage for 3D Camera Sensor Networks.

PubMed

Si, Pengju; Wu, Chengdong; Zhang, Yunzhou; Jia, Zixi; Ji, Peng; Chu, Hao

2017-08-03

Barrier coverage, an important research area with respect to camera sensor networks, consists of a number of camera sensors to detect intruders that pass through the barrier area. Existing works on barrier coverage such as local face-view barrier coverage and full-view barrier coverage typically assume that each intruder is considered as a point. However, the crucial feature (e.g., size) of the intruder should be taken into account in the real-world applications. In this paper, we propose a realistic resolution criterion based on a three-dimensional (3D) sensing model of a camera sensor for capturing the intruder's face. Based on the new resolution criterion, we study the barrier coverage of a feasible deployment strategy in camera sensor networks. Performance results demonstrate that our barrier coverage with more practical considerations is capable of providing a desirable surveillance level. Moreover, compared with local face-view barrier coverage and full-view barrier coverage, our barrier coverage is more reasonable and closer to reality. To the best of our knowledge, our work is the first to propose barrier coverage for 3D camera sensor networks.

Using lot quality assurance sampling to improve immunization coverage in Bangladesh.

PubMed Central

Tawfik, Y.; Hoque, S.; Siddiqi, M.

2001-01-01

OBJECTIVE: To determine areas of low vaccination coverage in five cities in Bangladesh (Chittagong, Dhaka, Khulna, Rajshahi, and Syedpur). METHODS: Six studies using lot quality assurance sampling were conducted between 1995 and 1997 by Basic Support for Institutionalizing Child Survival and the Bangladesh National Expanded Programme on Immunization. FINDINGS: BCG vaccination coverage was acceptable in all lots studied; however, the proportion of lots rejected because coverage of measles vaccination was low ranged from 0% of lots in Syedpur to 12% in Chittagong and 20% in Dhaka's zones 7 and 8. The proportion of lots rejected because an inadequate number of children in the sample had been fully vaccinated varied from 11% in Syedpur to 30% in Dhaka. Additionally, analysis of aggregated, weighted immunization coverage showed that there was a high BCG vaccination coverage (the first administered vaccine) and a low measles vaccination coverage (the last administered vaccine) indicating a high drop-out rate, ranging from 14% in Syedpur to 36% in Dhaka's zone 8. CONCLUSION: In Bangladesh, where resources are limited, results from surveys using lot quality assurance sampling enabled managers of the National Expanded Programme on Immunization to identify areas with poor vaccination coverage. Those areas were targeted to receive focused interventions to improve coverage. Since this sampling method requires only a small sample size and was easy for staff to use, it is feasible for routine monitoring of vaccination coverage. PMID:11436470

LEVEL III ECOREGION:ECOREGIONS FOR THE MAIA STUDY REGION

EPA Science Inventory

This data set is a geographic information system (GIS) coverage of aquatic ecoregions for the US Environmental Protection Agency (EPA) Mid-Atlantic Integrated Assessment (MAIA) Project. This coverage was produced from the USEPA Omernik Level III Ecoregions of the Conterminous U...

75 FR 33670 - Proposed Collection; Comment Request for Form 2032

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-14

... 2032, Contract Coverage Under Title II of the Social Security Act. DATES: Written comments should [email protected] . SUPPLEMENTARY INFORMATION: Title: Contract Coverage Under Title II of the Social... abroad by foreign affiliates of American employers are exempt from [[Page 33671

45 CFR 148.101 - Basis and purpose.

Code of Federal Regulations, 2010 CFR

2010-10-01

... FOR THE INDIVIDUAL HEALTH INSURANCE MARKET General Provisions § 148.101 Basis and purpose. This part... individual health insurance coverage for certain eligible individuals who previously had group coverage, and... and protects all individuals and family members who have, or seek, individual health insurance...

Monitoring intervention coverage in the context of universal health coverage.

PubMed

Boerma, Ties; AbouZahr, Carla; Evans, David; Evans, Tim

2014-09-01

Monitoring universal health coverage (UHC) focuses on information on health intervention coverage and financial protection. This paper addresses monitoring intervention coverage, related to the full spectrum of UHC, including health promotion and disease prevention, treatment, rehabilitation, and palliation. A comprehensive core set of indicators most relevant to the country situation should be monitored on a regular basis as part of health progress and systems performance assessment for all countries. UHC monitoring should be embedded in a broad results framework for the country health system, but focus on indicators related to the coverage of interventions that most directly reflect the results of UHC investments and strategies in each country. A set of tracer coverage indicators can be selected, divided into two groups-promotion/prevention, and treatment/care-as illustrated in this paper. Disaggregation of the indicators by the main equity stratifiers is critical to monitor progress in all population groups. Targets need to be set in accordance with baselines, historical rate of progress, and measurement considerations. Critical measurement gaps also exist, especially for treatment indicators, covering issues such as mental health, injuries, chronic conditions, surgical interventions, rehabilitation, and palliation. Consequently, further research and proxy indicators need to be used in the interim. Ideally, indicators should include a quality of intervention dimension. For some interventions, use of a single indicator is feasible, such as management of hypertension; but in many areas additional indicators are needed to capture quality of service provision. The monitoring of UHC has significant implications for health information systems. Major data gaps will need to be filled. At a minimum, countries will need to administer regular household health surveys with biological and clinical data collection. Countries will also need to improve the production of reliable, comprehensive, and timely health facility data. Please see later in the article for the Editors' Summary.

Monitoring Intervention Coverage in the Context of Universal Health Coverage

PubMed Central

Boerma, Ties; AbouZahr, Carla; Evans, David; Evans, Tim

2014-01-01

Monitoring universal health coverage (UHC) focuses on information on health intervention coverage and financial protection. This paper addresses monitoring intervention coverage, related to the full spectrum of UHC, including health promotion and disease prevention, treatment, rehabilitation, and palliation. A comprehensive core set of indicators most relevant to the country situation should be monitored on a regular basis as part of health progress and systems performance assessment for all countries. UHC monitoring should be embedded in a broad results framework for the country health system, but focus on indicators related to the coverage of interventions that most directly reflect the results of UHC investments and strategies in each country. A set of tracer coverage indicators can be selected, divided into two groups—promotion/prevention, and treatment/care—as illustrated in this paper. Disaggregation of the indicators by the main equity stratifiers is critical to monitor progress in all population groups. Targets need to be set in accordance with baselines, historical rate of progress, and measurement considerations. Critical measurement gaps also exist, especially for treatment indicators, covering issues such as mental health, injuries, chronic conditions, surgical interventions, rehabilitation, and palliation. Consequently, further research and proxy indicators need to be used in the interim. Ideally, indicators should include a quality of intervention dimension. For some interventions, use of a single indicator is feasible, such as management of hypertension; but in many areas additional indicators are needed to capture quality of service provision. The monitoring of UHC has significant implications for health information systems. Major data gaps will need to be filled. At a minimum, countries will need to administer regular household health surveys with biological and clinical data collection. Countries will also need to improve the production of reliable, comprehensive, and timely health facility data. Please see later in the article for the Editors' Summary PMID:25243586

Health workers' attitudes, perceptions and knowledge of influenza immunization in Lima, Peru: A mixed methods study.

PubMed

Bazán, Magdalena; Villacorta, Erika; Barbagelatta, Gisella; Jimenez, M Michelle; Goya, Cecilia; Bartolini, Rosario M; Penny, Mary E

2017-05-19

Vaccination against seasonal influenza in health workers is recommended but coverage is variable. This study aimed to determine coverage of influenza vaccination among health workers in Lima, Peru in 2010; explore barriers and enabling elements for vaccination; and suggest strategies to improve coverage. Qualitative interviews informed the development of a survey instrument that consisted of open and close-ended questions. Sub-analyses were done by occupational group and results were calculated as percentages for each possible response with confidence intervals of 95%. Coverage of the influenza vaccination was 77.2%. Vaccinated staff were less likely to have permanent contracts (p=0.0150) and vaccination coverage was lower in physicians (p=0.0001). Over 90% cited protection of themselves, families and patients as reasons for vaccination and 48% mentioned peer encouragement. Fear of adverse events (47%) and organizational barriers (>30%) were reasons for non-vaccination. To improve coverage, highest priority was given to strategies providing more information. Key factors in driving health worker vaccination include desire for protection and peer encouragement. Perceptual barriers based on a misunderstanding of the epidemiology of influenza and vaccination could be overcome by targeted education and information. Organizational barriers require attention to how vaccination is implemented within health facilities. Copyright © 2017 Elsevier Ltd. All rights reserved.

7 CFR 1740.8 - Scoring criteria for the grant competition.

Code of Federal Regulations, 2010 CFR

2010-01-01

... might be the case for some western states and for most translators, there may be only one county within... transmitter and translator must have a core coverage area consisting of one or more counties. (ii) In the case of translators, where a coverage contour area does not exist, the applicant shall define a coverage...

Conserving Biogeography: Habitat Loss and Vicariant Patterns in Endemic Squamates of the Cerrado Hotspot

PubMed Central

de Mello, Pietro L. H.; Machado, Ricardo B.; Nogueira, Cristiano de C.

2015-01-01

Little is known about the threat levels and impacts of habitat loss over the Cerrado Squamate fauna. The region is under severe habitat loss due to mechanized agriculture, accelerated by changes in the Brazilian National Forest Code. The Squamate fauna of the Cerrado is rich in endemics and is intrinsically associated with its surrounding microhabitats, which make up a mosaic of phitophysiognomies throughout the region. Herein we evaluate current conservation status of Squamate biogeographic patterns in the Brazilian Cerrado, the single savanna among global biodiversity hotspots. To do so, we first updated point locality data on 49 endemic Squamates pertaining to seven non-random clusters of species ranges in the Cerrado. Each cluster was assumed to be representative of different biogeographic regions, holding its own set of species, herein mapped according to their extent of occurrence (EOO). We then contrasted these data in four different scenarios, according to the presence or absence of habitat loss and the presence or absence of the current protected area (PA) cover. We searched for non-random patterns of habitat loss and PA coverage among these biogeographic regions throughout the Cerrado. Finally, with the species EOO as biodiversity layers, we used Zonation to discuss contemporary PA distribution, as well as to highlight current priority areas for conservation within the Cerrado. We ran Zonation under all four conservation scenarios mentioned above. We observed that habitat loss and PA coverage significantly differed between biogeographic regions. The southernmost biogeographic region is the least protected and the most impacted, with priority areas highly scattered in small, disjunct fragments. The northernmost biogeographic region (Tocantins-Serra Geral) is the most protected and least impacted, showing extensive priority areas in all Zonation scenarios. Therefore, current and past deforestation trends are severely threatening biogeographic patterns in the Cerrado. Moreover, PA distribution is spatially biased, and does not represent biogeographic divisions of the Cerrado. Consequently, we show that biogeographic patterns and processes are being erased at an accelerated pace, reinforcing the urgent need to create new reserves and to avoid the loss of the last remaining fragments of once continuous biogeographic regions. These actions are fundamental and urgent for conserving biogeographic and evolutionary information in this highly imperiled savanna hotspot. PMID:26252746

Developing a National Tiger Action Plan for the Union of Myanmar

NASA Astrophysics Data System (ADS)

Lynam, Antony J.; Khaing, Saw Tun; Zaw, Khin Maung

2006-01-01

A century ago, tigers were considered pests in Myanmar. Hunters claimed thousands, yet populations persisted. In the past century, because of habitat loss and prey depletion, coupled with the recent demand for traditional medicines, tiger populations have been reduced to a few hundred individuals. As a first step toward long-term planning for tigers, and to guide efforts to increase protected area coverage, the Myanmar government in 1998 initiated a project to develop a revised National Tiger Action Plan. Extensive surveys confirmed tigers in only 4 of 17 survey locations. Significant populations are thought to persist in the far North and far South of the country, where large, intact forests offer the potential for tiger recovery. With partnerships and collaborations, tiger populations can be protected in the short term (<5 years) by expanding protected areas and corridors, mobilizing enforcement staff to reduce poaching of tigers and prey, and amending existing wildlife legislation in accordance with international laws. Over the long term (5-20 years), recovery of Myanmar’s tiger populations will depend on increasing support from local people, zoning tiger areas to reduce habitat loss and disturbance, and maintaining connectivity of existing national and transboundary forests. This article reviews the development of a new National Tiger Action Plan for the Union of Myanmar and discusses a blueprint for conservation measures aimed at saving tigers from extinction.

Developing a national tiger action plan for The Union of Myanmar.

PubMed

Lynam, Antony J; Khaing, Saw Tun; Zaw, Khin Maung

2006-01-01

A century ago, tigers were considered pests in Myanmar. Hunters claimed thousands, yet populations persisted. In the past century, because of habitat loss and prey depletion, coupled with the recent demand for traditional medicines, tiger populations have been reduced to a few hundred individuals. As a first step toward long-term planning for tigers, and to guide efforts to increase protected area coverage, the Myanmar government in 1998 initiated a project to develop a revised National Tiger Action Plan. Extensive surveys confirmed tigers in only 4 of 17 survey locations. Significant populations are thought to persist in the far North and far South of the country, where large, intact forests offer the potential for tiger recovery. With partnerships and collaborations, tiger populations can be protected in the short term (<5 years) by expanding protected areas and corridors, mobilizing enforcement staff to reduce poaching of tigers and prey, and amending existing wildlife legislation in accordance with international laws. Over the long term (5-20 years), recovery of Myanmar's tiger populations will depend on increasing support from local people, zoning tiger areas to reduce habitat loss and disturbance, and maintaining connectivity of existing national and transboundary forests. This article reviews the development of a new National Tiger Action Plan for the Union of Myanmar and discusses a blueprint for conservation measures aimed at saving tigers from extinction.

Erosion Control and Recultivation Measures at a Headrace Channel of a Hydroelectric Power Plant using Different Combined Soil Bioengineering Techniques

NASA Astrophysics Data System (ADS)

Obriejetan, M.; Florineth, F.; Rauch, H. P.

2012-04-01

As a consequence of land use change resulting in an increased number of slope protection constructions and with respect to effects associated with climate change like extremes in temperatures and temperature variations or increased frequency of heavy precipitation, adaptation strategies for sustainable erosion protection systems are needed which meet ecological compatibility and economical requirements. Therefore a wide range of different technical solutions respectively geotextiles and geotextile-related products (blankets, nettings, grids etc.) are available on the market differing considerably in function, material, durability and pricing. Manufacturers usually provide product-specific information pertaining to application field, functional range or (technical) installation features whereas vegetational aspects are frequently neglected while vegetation can contribute substantially to increased near-surface erosion protection respectively slope stability. Though, the success of sustainable erosion control is directly dependent on several vegetational aspects. Adequate development of a functional vegetation layer in combination with geotextiles is closely associated to application aspects such as seeding technique, sowing date and intensity, seed-soil contact or maintenance measures as well as to qualitative aspects like seed quality, germination rates, area of origin, production method or certification. As a general guideline, erosion control within an initial phase is directly related to restoration techniques whereas vegetation specifics with regard to species richness or species composition play a key role in medium to long-term development and slope protection. In this context one of the fundamental objectives of our study is the identification and subsequently the determination of the main interaction processes between technical and biological components of combined slope protection systems. The influence of different geotextile characteristics on specific vegetation properties are studied by setting up comparative test plots at a field study site located at a headrace channel of a hydroelectric power plant. Different vegetational parameters such as basal coverage, species richness, species composition, abundance/dominance values by using a refined Braun-Blanquet cover estimation scale were collected as well as local environmental properties. Results during the first vegetation period show distinct effects of geotextiles especially on overall vegetation coverage and grasses-herbs-ratio. Geotextile supported plots show 20% higher overall coverage but lower amount of herbs after three months of vegetation growth compared to control plots without installation of auxiliary materials. Furthermore coir blankets reveal higher penetration resistance for seed leaves of herbal plants compared to coir nettings. Hence technical erosion protection products, biological components and it's combination have to be closely coordinated in order to achieve specified revegetation objectives and meet long-term functionality.

From the parents' perspective: a user-satisfaction survey of immunization services in Guatemala.

PubMed

Barrera, Lissette; Trumbo, Silas Pierson; Bravo-Alcántara, Pamela; Velandia-González, Martha; Danovaro-Holliday, M Carolina

2014-03-06

Immunization coverage levels in Guatemala have increased over the last two decades, but national targets of ≥95% have yet to be reached. To determine factors related to undervaccination, Guatemala's National Immunization Program conducted a user-satisfaction survey of parents and guardians of children aged 0-5 years. Variables evaluated included parental immunization attitudes, preferences, and practices; the impact of immunization campaigns and marketing strategies; and factors inhibiting immunization. Based on administrative coverage levels and socio-demographic indicators in Guatemala's 22 geographical departments, five were designated as low-coverage and five as high-coverage areas. Overall, 1194 parents and guardians of children aged 0-5 years were interviewed in these 10 departments. We compared indicators between low- and high-coverage areas and identified risk factors associated with undervaccination. Of the 1593 children studied, 29 (1.8%) were determined to be unvaccinated, 458 (28.8%) undervaccinated, and 1106 (69.4%) fully vaccinated. In low-coverage areas, children of less educated (no education: RR=1.49, p=0.01; primary or less: 1.39, p=0.009), older (aged>39 years: RR=1.31, p=0.05), and single (RR=1.32, p=0.03) parents were more likely to have incomplete vaccination schedules. Similarly, factors associated with undervaccination in high-coverage areas included the caregiver's lack of education (none: RR=1.72, p=0.0007; primary or less: RR=1.30, p=0.05) and single marital status (RR=1.36, p=0.03), as well as the child's birth order (second: RR=1.68, p=0.003). Although users generally approved of immunization services, problems in service quality were identified. According to participants, topics such as the risk of adverse events (47.4%) and next vaccination appointments (32.3%) were inconsistently communicated to parents. Additionally, 179 (15.0%) participants reported the inability to vaccinate their child on at least one occasion. Compared to high-coverage areas, participants in low-coverage areas reported poorer service, longer wait times, and greater distances to health centers. In high-coverage areas, participants reported less knowledge about the availability of services. Generally, immunization barriers in Guatemala are related to problems in accessing and attaining high-quality immunization services rather than to a population that does not adequately value vaccination. We provide recommendations to aid the country in maintaining its achievements and addressing new challenges.

29 CFR 500.121 - Coverage and level of insurance required.

Code of Federal Regulations, 2010 CFR

2010-07-01

... REGULATIONS MIGRANT AND SEASONAL AGRICULTURAL WORKER PROTECTION Motor Vehicle Safety and Insurance for Transportation of Migrant and Seasonal Agricultural Workers, Housing Safety and Health for Migrant Workers... workers' compensation coverage is provided. (c) The insurance to be obtained under paragraph (a) of this...

23 CFR 646.109 - Types of coverage.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Types of coverage. 646.109 Section 646.109 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS RAILROADS... for prevention of accidents or protection of property, the cost of whose services is borne...

State trends in premiums and deductibles, 2003-2011: eroding protection and rising costs underscore need for action.

PubMed

Schoen, Cathy; Lippa, Jacob; Collins, Sara; Radley, David

2012-12-01

Rapidly rising health insurance premiums and higher cost-sharing continue to strain the budgets of U.S. working families and employers. Analysis of state trends in private employer-based health insurance from 2003 to 2011 reveals that premiums for family coverage increased 62 percent across states--rising far faster than income for middle- and low-income families. At the same time, deductibles more than doubled in large and small firms. Workers are thus paying more but getting less-protective benefits. If trends continue at their historical rate, the average premium for family coverage will reach nearly $25,000 by 2020. The Affordable Care Act's reforms should begin to moderate costs while improving coverage. But with private insurance costs projected to increase faster than incomes over the next decade, further efforts are needed. If annual premium growth slowed by one percentage point, by 2020 employers and families would save $2,029 annually for family coverage.

The impact of indoor tanning legislation: newspaper coverage of the risks of indoor tanning before and after the California indoor tanning ban for minors.

PubMed

Mayer, Jonathan E; Swetter, Susan M; Guild, Samantha; Geller, Alan C

2015-03-01

On June 1, 2011, the California Senate passed a bill banning minors from indoor tanning. We aimed to determine whether the bill's passage was associated with longer-term media coverage regarding skin protection and the risks associated with indoor tanning. Articles from 31 English-language California newspapers between June 2010-May 2011 (PRE) and June 2011-May 2012 (POST) were searched using terms related to skin protection. Ninety articles were found for in-depth coding and analysis. There were more skin protection articles in the POST period than in the PRE period (57 vs 33; p < .05). In addition, there were more POST articles mentioning the risks of indoor tanning (33 vs 10; p < .001), and a POST article was more likely to mention the risks (58 vs 30%; p < .05). The higher number of POST articles mentioning the risks persisted throughout all quarters. Therefore, the California indoor tanning ban was associated with increased longer-term news coverage of skin protection and the risks associated with indoor tanning. This finding has potential influence on the many states that are considering comparable legislation.

Improving Health Care Coverage, Equity, And Financial Protection Through A Hybrid System: Malaysia's Experience.

PubMed

Rannan-Eliya, Ravindra P; Anuranga, Chamara; Manual, Adilius; Sararaks, Sondi; Jailani, Anis S; Hamid, Abdul J; Razif, Izzanie M; Tan, Ee H; Darzi, Ara

2016-05-01

Malaysia has made substantial progress in providing access to health care for its citizens and has been more successful than many other countries that are better known as models of universal health coverage. Malaysia's health care coverage and outcomes are now approaching levels achieved by member nations of the Organization for Economic Cooperation and Development. Malaysia's results are achieved through a mix of public services (funded by general revenues) and parallel private services (predominantly financed by out-of-pocket spending). We examined the distributional aspects of health financing and delivery and assessed financial protection in Malaysia's hybrid system. We found that this system has been effective for many decades in equalizing health care use and providing protection from financial risk, despite modest government spending. Our results also indicate that a high out-of-pocket share of total financing is not a consistent proxy for financial protection; greater attention is needed to the absolute level of out-of-pocket spending. Malaysia's hybrid health system presents continuing unresolved policy challenges, but the country's experience nonetheless provides lessons for other emerging economies that want to expand access to health care despite limited fiscal resources. Project HOPE—The People-to-People Health Foundation, Inc.

Analysis of Your Professional Liability Insurance Policy

PubMed Central

Sadusk, Joseph F.; Hassard, Howard; Waterson, Rollen

1958-01-01

The most important lessons for the physician to learn in regard to his professional liability insurance coverage are the following: 1. The physician should carefully read his professional liability policy and should secure the educated aid of his attorney and his insurance broker, if they are conversant with this field. 2. He should particularly read the definition of coverage and carefully survey the exclusion clauses which may deny him coverage under certain circumstances. 3. If the physician is in partnership or in a group, he should be certain that he has contingent partnership coverage. 4. The physician should accept coverage only from an insurance carrier of sufficient size and stability that he can be sure his coverage will be guaranteed for “latent liability” claims as the years go along—certainly for his lifetime. 5. The insurance carrier offering the professional liability policy should be prepared to offer coverages up to at least $100,000/$300,000. 6. The physician should be assured that the insurance carrier has claims-handling personnel and legal counsel who are experienced and expert in the professional liability field and who are locally available for service. 7. The physician is best protected by a local or state group program, next best by a national group program, and last, by individual coverage. 8. The physician should look with suspicion on a cancellation clause in which his policy may be summarily cancelled on brief notice. 9. The physician should not buy professional liability insurance on the basis of price alone; adequacy of coverage and service and a good insurance company for his protection should be the deciding factors. PMID:13489519

5 CFR 551.215 - Fire protection activities and 7(k) coverage for FLSA pay and exemption determinations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... similar employees involved in fire protection research or in the design and development of fire protection... Protection and Prevention series, including any qualified firefighter who is assigned to perform support... considerations; (ii) Employees in positions properly classified in other series, such as Forestry Technician, for...

5 CFR 551.215 - Fire protection activities and 7(k) coverage for FLSA pay and exemption determinations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... similar employees involved in fire protection research or in the design and development of fire protection... Protection and Prevention series, including any qualified firefighter who is assigned to perform support... considerations; (ii) Employees in positions properly classified in other series, such as Forestry Technician, for...

5 CFR 551.215 - Fire protection activities and 7(k) coverage for FLSA pay and exemption determinations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... similar employees involved in fire protection research or in the design and development of fire protection... Protection and Prevention series, including any qualified firefighter who is assigned to perform support... considerations; (ii) Employees in positions properly classified in other series, such as Forestry Technician, for...

Evaluation of Primary Immunization Coverage of Infants Under Universal Immunization Programme in an Urban Area of Bangalore City Using Cluster Sampling and Lot Quality Assurance Sampling Techniques

PubMed Central

K, Punith; K, Lalitha; G, Suman; BS, Pradeep; Kumar K, Jayanth

2008-01-01

Research Question: Is LQAS technique better than cluster sampling technique in terms of resources to evaluate the immunization coverage in an urban area? Objective: To assess and compare the lot quality assurance sampling against cluster sampling in the evaluation of primary immunization coverage. Study Design: Population-based cross-sectional study. Study Setting: Areas under Mathikere Urban Health Center. Study Subjects: Children aged 12 months to 23 months. Sample Size: 220 in cluster sampling, 76 in lot quality assurance sampling. Statistical Analysis: Percentages and Proportions, Chi square Test. Results: (1) Using cluster sampling, the percentage of completely immunized, partially immunized and unimmunized children were 84.09%, 14.09% and 1.82%, respectively. With lot quality assurance sampling, it was 92.11%, 6.58% and 1.31%, respectively. (2) Immunization coverage levels as evaluated by cluster sampling technique were not statistically different from the coverage value as obtained by lot quality assurance sampling techniques. Considering the time and resources required, it was found that lot quality assurance sampling is a better technique in evaluating the primary immunization coverage in urban area. PMID:19876474

NV/YMP radiological control manual, Revision 2

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

Gile, A.L.

The Nevada Test Site (NTS) and the adjacent Yucca Mountain Project (YMP) are located in Nye County, Nevada. The NTS has been the primary location for testing nuclear explosives in the continental US since 1951. Current activities include operating low-level radioactive and mixed waste disposal facilities for US defense-generated waste, assembly/disassembly of special experiments, surface cleanup and site characterization of contaminated land areas, and non-nuclear test operations such as controlled spills of hazardous materials at the hazardous Materials (HAZMAT) Spill Center (HSC). Currently, the major potential for occupational radiation exposure is associated with the burial of low-level nuclear waste andmore » the handling of radioactive sources. Planned future remediation of contaminated land areas may also result in radiological exposures. The NV/YMP Radiological Control Manual, Revision 2, represents DOE-accepted guidelines and best practices for implementing Nevada Test Site and Yucca Mountain Project Radiation Protection Programs in accordance with the requirements of Title 10 Code of Federal Regulations Part 835, Occupational Radiation Protection. These programs provide protection for approximately 3,000 employees and visitors annually and include coverage for the on-site activities for both personnel and the environment. The personnel protection effort includes a DOE Laboratory Accreditation Program accredited dosimetry and personnel bioassay programs including in-vivo counting, routine workplace air sampling, personnel monitoring, and programmatic and job-specific As Low as Reasonably Achievable considerations.« less

42 CFR 416.44 - Condition for coverage-Environment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 3 2011-10-01 2011-10-01 false Condition for coverage-Environment. 416.44 Section... for coverage—Environment. The ASC must have a safe and sanitary environment, properly constructed, equipped, and maintained to protect the health and safety of patients. (a) Standard: Physical environment...

41 CFR 60-300.4 - Coverage and waivers.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 41 Public Contracts and Property Management 1 2013-07-01 2013-07-01 false Coverage and waivers. 60-300.4 Section 60-300.4 Public Contracts and Property Management Other Provisions Relating to Public... DISABLED VETERANS, RECENTLY SEPARATED VETERANS, OTHER PROTECTED VETERANS, AND ARMED FORCES SERVICE MEDAL...

41 CFR 60-300.4 - Coverage and waivers.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 41 Public Contracts and Property Management 1 2012-07-01 2009-07-01 true Coverage and waivers. 60-300.4 Section 60-300.4 Public Contracts and Property Management Other Provisions Relating to Public... DISABLED VETERANS, RECENTLY SEPARATED VETERANS, OTHER PROTECTED VETERANS, AND ARMED FORCES SERVICE MEDAL...

42 CFR 416.44 - Condition for coverage-Environment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Condition for coverage-Environment. 416.44 Section... for coverage—Environment. The ASC must have a safe and sanitary environment, properly constructed, equipped, and maintained to protect the health and safety of patients. (a) Standard: Physical environment...

76 FR 77051 - Proposed Collection; Comment Request for Form 13704

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-09

... 13704, Health Coverage Tax Credit Registration Update Form. DATES: Written comments should be [email protected] . SUPPLEMENTARY INFORMATION: Title: Health Coverage Tax Credit Registration Update Form... taxpayers determine if they are eligible for the credit and understand what they need to do to continue to...

Amendment to the interim final rules for group health plans and health insurance coverage relating to status as a grandfathered health plan under the Patient Protection and Affordable Care Act. Amendment to interim final rules with request for comments.

PubMed

2010-11-17

This document contains an amendment to interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding status as a grandfathered health plan; the amendment permits certain changes in policies, certificates, or contracts of insurance without loss of grandfathered status.

Women's Awareness of Their Contraceptive Benefits Under the Patient Protection and Affordable Care Act.

PubMed

Chuang, Cynthia H; Mitchell, Julie L; Velott, Diana L; Legro, Richard S; Lehman, Erik B; Confer, Lindsay; Weisman, Carol S

2015-11-01

The Patient Protection and Affordable Care Act mandates that there be no out-of-pocket cost for Food and Drug Administration-approved contraceptive methods. Among 987 privately insured reproductive aged Pennsylvania women, fewer than 5% were aware that their insurance covered tubal sterilization, and only 11% were aware that they had full coverage for an intrauterine device. For the Affordable Care Act contraceptive coverage mandate to affect effective contraception use and reduce unintended pregnancies, public awareness of the expanded benefits is essential.

Women’s Awareness of Their Contraceptive Benefits Under the Patient Protection and Affordable Care Act

PubMed Central

Mitchell, Julie L.; Velott, Diana L.; Legro, Richard S.; Lehman, Erik B.; Confer, Lindsay; Weisman, Carol S.

2015-01-01

The Patient Protection and Affordable Care Act mandates that there be no out-of-pocket cost for Food and Drug Administration–approved contraceptive methods. Among 987 privately insured reproductive aged Pennsylvania women, fewer than 5% were aware that their insurance covered tubal sterilization, and only 11% were aware that they had full coverage for an intrauterine device. For the Affordable Care Act contraceptive coverage mandate to affect effective contraception use and reduce unintended pregnancies, public awareness of the expanded benefits is essential. PMID:26447910

Implications of China’s future bride shortage for the geographical distribution and social protection needs of never-married men

PubMed Central

Gupta, Monica Das; Ebenstein, Avraham; Sharygin, Ethan

2014-01-01

Because sex ratios at birth have risen sharply in China in recent decades, an increasing proportion of men will be unable to find a bride, and will face old age without the support of a wife and children. We project the proportions of never-married men and their geographical distribution in China in the coming decades. Our projections assume that two tendencies in current marriage patterns will persist: that women will continue to migrate to wealthier areas, and to prefer men with better prospects. We find that, by 2030, more than 20 per cent of men in China aged 30–39 will never have married, and that the proportion will be especially high among poor men in low-income provinces that are least able to provide social protection programmes. The projected geographic concentration of bachelors could be socially disruptive, and the results suggest a need to expand the coverage and central financing of social protection programmes. PMID:23227821

Implications of China's future bride shortage for the geographical distribution and social protection needs of never-married men.

PubMed

Sharygin, Ethan; Ebenstein, Avraham; Das Gupta, Monica

2013-01-01

Because sex ratios at birth have risen sharply in China in recent decades, an increasing proportion of men will be unable to find a bride, and will face old age without the support of a wife and children. We project the proportions of never-married men and their geographical distribution in China in the coming decades. Our projections assume that two tendencies in current marriage patterns will persist: that women will continue to migrate to wealthier areas and to prefer men with better prospects. We find that, by 2030, more than 20 per cent of men in China aged 30-39 will never have married, and that the proportion will be especially high among poor men in low-income provinces that are least able to provide social protection programmes. The projected geographic concentration of bachelors could be socially disruptive, and the results suggest a need to expand the coverage and central financing of social protection programmes.

Environmental variables associated with vacationers' sun protection at warm weather resorts in North America

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

Andersen, Peter A., E-mail: westone47@gmail.com; Buller, David B.; Walkosz, Barbara J.

Background: Vacationing at sunny, warm weather locations is a risk factor for excessive solar ultraviolet (UV) radiation exposure and skin cancer. Objectives: This study examined the association of environmental variables related to UV levels with vacationers' sun protection. Methods: Vacationers at 41 summer resorts in 17 states and 1 Canadian Province were interviewed (n=3531) and observed (N=4347) during 2012 and 2013. Clothing coverage, sunglasses, and shade use were observed. Use of sunscreen and sunburns were self-reported. Environmental information was recorded by research staff or acquired from ground stations and the weather service. Results: Temperature was positively associated with sun protectionmore » behaviors; however clothing coverage was negatively associated with temperature. Cloud cover was negatively associated with sun protection, with the exception of clothing coverage which was positively associated with it. Elevation showed a mixed pattern of associations with vacationer's sun protection. Latitude of a resort was negatively associated with most sun protection behaviors, such that sun protection increased at more southerly resorts. Similarly, the farther south a vacationer traveled to the resort, the less sun protection they employed. The UV index showed a weak, positive relationship with some sun protection behaviors even when controlling for temperature. Conclusions: Vacationers appeared aware that UV is higher at southern latitudes and may learn UV is intense when living in southern regions. However, many used temperature, an unreliable cue, to judge UV intensity and seemed to adjust clothing for warmth not UV protection. Efforts are needed to help individuals make more accurate sun safety decisions. - Highlights: • Vacationers poorly monitor and protect against environmental ultraviolet radiation (UVR). • On cloudy days vacationers fail to protect against UVR. • Temperature is erroneously used by vacationers as a marker for UVR. • Clothing is used primarily by vacationers for warmth, not UVR protection. • The farther south a vacationer travels, the more likely they are to sunburn.« less

Serologic assessment of yellow fever immunity in the rural population of a yellow fever-endemic area in Central Brazil.

PubMed

Machado, Vanessa Wolff; Vasconcelos, Pedro Fernando da Costa; Silva, Eliana Vieira Pinto; Santos, João Barberino

2013-01-01

The yellow fever epidemic that occurred in 1972/73 in Central Brazil surprised the majority of the population unprotected. A clinical-epidemiological survey conducted at that time in the rural area of 19 municipalities found that the highest (13.8%) number of disease cases were present in the municipality of Luziânia, State of Goiás. Thirty-eight years later, a new seroepidemiological survey was conducted with the aim of assessing the degree of immune protection of the rural population of Luziânia, following the continuous attempts of public health services to obtain vaccination coverage in the region. A total of 383 volunteers, aged between 5 and 89 years and with predominant rural labor activities (75.5%), were interviewed. The presence of antibodies against the yellow fever was also investigated in these individuals, by using plaque reduction neutralization test, and correlated to information regarding residency, occupation, epidemiological data and immunity against the yellow fever virus. We found a high (97.6%) frequency of protective titers (>1:10) of neutralizing antibodies against the yellow fever virus; the frequency of titers of 1:640 or higher was 23.2%, indicating wide immune protection against the disease in the study population. The presence of protective immunity was correlated to increasing age. This study reinforces the importance of surveys to address the immune state of a population at risk for yellow fever infection and to the surveillance of actions to control the disease in endemic areas.

Mathematical evaluation of community level impact of combining bed nets and indoor residual spraying upon malaria transmission in areas where the main vectors are Anopheles arabiensis mosquitoes.

PubMed

Okumu, Fredros O; Kiware, Samson S; Moore, Sarah J; Killeen, Gerry F

2013-01-16

Indoor residual insecticide spraying (IRS) and long-lasting insecticide treated nets (LLINs) are commonly used together even though evidence that such combinations confer greater protection against malaria than either method alone is inconsistent. A deterministic model of mosquito life cycle processes was adapted to allow parameterization with results from experimental hut trials of various combinations of untreated nets or LLINs (Olyset, PermaNet 2.0, Icon Life nets) with IRS (pirimiphos methyl, lambda cyhalothrin, DDT), in a setting where vector populations are dominated by Anopheles arabiensis, so that community level impact upon malaria transmission at high coverage could be predicted. Intact untreated nets alone provide equivalent personal protection to all three LLINs. Relative to IRS plus untreated nets, community level protection is slightly higher when Olyset or PermaNet 2.0 nets are added onto IRS with pirimiphos methyl or lambda cyhalothrin but not DDT, and when Icon Life nets supplement any of the IRS insecticides. Adding IRS onto any net modestly enhances communal protection when pirimiphos methyl is sprayed, while spraying lambda cyhalothrin enhances protection for untreated nets but not LLINs. Addition of DDT reduces communal protection when added to LLINs. Where transmission is mediated primarily by An. arabiensis, adding IRS to high LLIN coverage provides only modest incremental benefit (e.g. when an organophosphate like pirimiphos methyl is used), but can be redundant (e.g. when a pyrethroid like lambda cyhalothin is used) or even regressive (e.g. when DDT is used for the IRS). Relative to IRS plus untreated nets, supplementing IRS with LLINs will only modestly improve community protection. Beyond the physical protection that intact nets provide, additional protection against transmission by An. arabiensis conferred by insecticides will be remarkably small, regardless of whether they are delivered as LLINs or IRS. The insecticidal action of LLINs and IRS probably already approaches their absolute limit of potential impact upon this persistent vector so personal protection of nets should be enhanced by improving the physical integrity and durability. Combining LLINs and non-pyrethroid IRS in residual transmission systems may nevertheless be justified as a means to manage insecticide resistance and prevent potential rebound of not only An. arabiensis, but also more potent, vulnerable and historically important species such as Anopheles gambiae and Anopheles funestus.

Setting a national minimum standard for health benefits: how do state benefit mandates compare with benefits in large-group plans?

PubMed

Frey, Allison; Mika, Stephanie; Nuzum, Rachel; Schoen, Cathy

2009-06-01

Many proposed health insurance reforms would establish a federal minimum benefit standard--a baseline set of benefits to ensure that people have adequate coverage and financial protection when they purchase insurance. Currently, benefit mandates are set at the state level; these vary greatly across states and generally target specific areas rather than set an overall standard for what qualifies as health insurance. This issue brief considers what a broad federal minimum standard might look like by comparing existing state benefit mandates with the services and providers covered under the Federal Employees Health Benefits Program (FEHBP) Blue Cross and Blue Shield standard benefit package, an example of minimum creditable coverage that reflects current standard practice among employer-sponsored health plans. With few exceptions, benefits in the FEHBP standard option either meet or exceed those that state mandates require-indicating that a broad-based national benefit standard would include most existing state benefit mandates.

Gaps in universal health coverage in Malawi: A qualitative study in rural communities

PubMed Central

2014-01-01

Background In sub-Saharan Africa, universal health coverage (UHC) reforms have often adopted a technocratic top-down approach, with little attention being paid to the rural communities’ perspective in identifying context specific gaps to inform the design of such reforms. This approach might shape reforms that are not sufficiently responsive to local needs. Our study explored how rural communities experience and define gaps in universal health coverage in Malawi, a country which endorses free access to an Essential Health Package (EHP) as a means towards universal health coverage. Methods We conducted a qualitative cross-sectional study in six rural communities in Malawi. Data was collected from 12 Focus Group Discussions with community residents and triangulated with 8 key informant interviews with health care providers. All respondents were selected through stratified purposive sampling. The material was tape-recorded, fully transcribed, and coded by three independent researchers. Results The results showed that the EHP has created a universal sense of entitlements to free health care at the point of use. However, respondents reported uneven distribution of health facilities and poor implementation of public-private service level agreements, which have led to geographical inequities in population coverage and financial protection. Most respondents reported affordability of medical costs at private facilities and transport costs as the main barriers to universal financial protection. From the perspective of rural Malawians, gaps in financial protection are mainly triggered by supply-side access-related barriers in the public health sector such as: shortages of medicines, emergency services, shortage of health personnel and facilities, poor health workers’ attitudes, distance and transportation difficulties, and perceived poor quality of health services. Conclusions Moving towards UHC in Malawi, therefore, implies the introduction of appropriate interventions to fill the financial protection gaps in the private sector and the access-related gaps in the public sector and/or an effective public-private partnership that completely integrates both sectors. Current universal health coverage reforms need to address context specific gaps and be carefully crafted to avoid creating a sense of universal entitlements in principle, which may not be effectively received by beneficiaries due to contextual and operational bottlenecks. PMID:24884788

Social protection in Brazil: what has changed in social assistance after the 1988 Constitution.

PubMed

Vaitsman, Jeni; de Andrade, Gabriela Rieveres Borges; Farias, Luis Otávio

2009-01-01

This paper discusses the changes in the social assistance component of social protection in the two decades that followed the 1988 Constitution. It discusses the transformations of social protection and social assistance in the past decades and the processes that in the 1990 s advanced the reform of social assistance policies in Brazil without, however, producing great changes in how services were delivered. By 2000 there had been a great expansion of resources as well as benefits and services coverage in social assistance. This paper argues that conditional cash transfer programs, though created and spread in an international context of restrictive policies, when integrated into Brazil s public and universal system of social assistance, substantively widened the scope of social protection. Some effects of the expansion in the Brazilian social protection system are identified: less income inequality; creation of an institutional capacity in the area of social assistance; the social, political and symbolic meaning of the inclusion of a large segment of the population in a public system of social assistance by means of a provision structure that does not belong to traditional devices of philanthropy and clientelism.

40 CFR 144.41 - Minor modifications of permits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Minor modifications of permits. 144.41 Section 144.41 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS... responsibility, coverage, and liability between the current and new permittees has been submitted to the Director...

12 CFR 1005.3 - Coverage.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Banking BUREAU OF CONSUMER FINANCIAL PROTECTION ELECTRONIC FUND TRANSFERS (REGULATION E) General § 1005.3... Consumer Financial Protection Act of 2010, Title X of the Dodd-Frank Wall Street Reform and Consumer Protection Act, Public Law 111-203, 124 Stat. 1376. (b) Electronic fund transfer. (1) Definition. The term...

76 FR 46621 - Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-03

...This document contains amendments to the interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding preventive health services.

41 CFR 60-250.4 - Coverage and waivers.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 41 Public Contracts and Property Management 1 2013-07-01 2013-07-01 false Coverage and waivers. 60-250.4 Section 60-250.4 Public Contracts and Property Management Other Provisions Relating to Public... SPECIAL DISABLED VETERANS, VETERANS OF THE VIETNAM ERA, RECENTLY SEPARATED VETERANS, AND OTHER PROTECTED...

41 CFR 60-250.4 - Coverage and waivers.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 41 Public Contracts and Property Management 1 2012-07-01 2009-07-01 true Coverage and waivers. 60-250.4 Section 60-250.4 Public Contracts and Property Management Other Provisions Relating to Public... SPECIAL DISABLED VETERANS, VETERANS OF THE VIETNAM ERA, RECENTLY SEPARATED VETERANS, AND OTHER PROTECTED...

29 CFR 778.2 - Coverage and exemptions not discussed.

Code of Federal Regulations, 2010 CFR

2010-07-01

... within the general coverage of the wage and hours provisions are wholly or partially excluded from the protection of the Act's minimum-wage and overtime-pay requirements. Some of these exemptions are self... Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR STATEMENTS...

Developing a Communication Strategy for Protecting Children. Report on Problem Definition Analysis Presented to: The Stuart Foundations.

ERIC Educational Resources Information Center

Brandon, Richard N.; Gordon, Andrew; Gordon, Margaret T.; Messerschmidt, David; Mitchell, Lorelei

The Human Services Policy Center of Washington undertook a study of communication strategies for protecting children because of the perception among many leading child protection professionals that a distorted pattern of media coverage is driving child protection policies toward responding to the small proportion of atypical cases which the media…

The areal extent of brown shrimp habitat suitability in Mobile Bay, Alabama, USA: Targeting vegetated habitat restoration

USGS Publications Warehouse

Smith, L.M.; Nestlerode, J.A.; Harwell, L.C.; Bourgeois, P.

2010-01-01

The availability of wetlands and shallow water habitats significantly influences Gulf of Mexico (GOM) penaeid shrimp fishery productivity. However, the GOM region has the highest rate of wetland loss in the USA. Protection and management of these vital GOM habitats are critical to sustainable shrimp fisheries. Brown shrimp (Farfantepenaeus aztecus) are a major component of GOM fisheries. We present an approach for estimating the areal extent of suitable habitat for post-larval and juvenile brown shrimp in Mobile Bay, Alabama, using an existing habitat suitability index model for the northern GOM calculated from probabilistic survey of water quality and sediment data, land cover data, and submerged aquatic vegetation coverages. This estuarine scale approach is intended to support targeted protection and restoration of these habitats. These analyses indicate that approximately 60% of the area of Mobile Bay is categorized as suitable to near optimal for post-larval and juvenile shrimp and 38% of the area is marginally to minimally suitable. We identify potential units within Mobile Bay for targeted restoration to improve habitat suitability. ?? 2010 Springer Science+Business Media B.V.

The biogeography of globally threatened seabirds and island conservation opportunities.

PubMed

Spatz, Dena R; Newton, Kelly M; Heinz, Reina; Tershy, Bernie; Holmes, Nick D; Butchart, Stuart H M; Croll, Donald A

2014-10-01

Seabirds are the most threatened group of marine animals; 29% of species are at some risk of extinction. Significant threats to seabirds occur on islands where they breed, but in many cases, effective island conservation can mitigate these threats. To guide island-based seabird conservation actions, we identified all islands with extant or extirpated populations of the 98 globally threatened seabird species, as recognized on the International Union for Conservation of Nature Red List, and quantified the presence of threatening invasive species, protected areas, and human populations. We matched these results with island attributes to highlight feasible island conservation opportunities. We identified 1362 threatened breeding seabird populations on 968 islands. On 803 (83%) of these islands, we identified threatening invasive species (20%), incomplete protected area coverage (23%), or both (40%). Most islands with threatened seabirds are amenable to island-wide conservation action because they are small (57% were <1 km(2) ), uninhabited (74%), and occur in high- or middle-income countries (96%). Collectively these attributes make islands with threatened seabirds a rare opportunity for effective conservation at scale. © 2014 Society for Conservation Biology.

Undocumented and uninsured: aftereffects of the Patient Protection and Affordable Care Act.

PubMed

Agabin, Nataly; Coffin, Janis

2015-01-01

Although with the implementation of the Patient Protection and Affordable Care Act millions of previously uninsured American residents will gain access to healthcare coverage, millions more will remain uninsured due to the lack of mandatory state Medicaid expansion as well as mandates that forbid undocumented immigrants and legal residents of less than five years from purchasing insurance through the newly available market exchange. With limited options for healthcare coverage due to employment and lack of citizen status, undocumented immigrants rely heavily on funds provided by both Emergency Medicaid and Disproportionate Share Hospital programs. Through reevaluation of current funding, mandates forbidding access to market exchanges, and plans to further enable access to affordable health coverage, states have the unique opportunity to both aid their residents and relieve the financial burden on healthcare facilities and Emergency Medicaid funds.

Health Care Reform and Young Adults' Access to Sexual Health Care: An Exploration of Potential Confidentiality Implications of the Affordable Care Act

PubMed Central

Garcia, Carolyn M.; Long, Sharon K.; Lechner, Kate E.; Lust, Katherine; Eisenberg, Marla E.

2012-01-01

One provision of the 2010 Affordable Care Act is extension of dependent coverage for young adults aged up to 26 years on their parent’s private insurance plan. This change, meant to increase insurance coverage for young adults, might yield unintended consequences. Confidentiality concerns may be triggered by coverage through parental insurance, particularly regarding sexual health. The existing literature and our original research suggest that actual or perceived limits to confidentiality could influence the decisions of young adults about whether, and where, to seek care for sexual health issues. Further research is needed on the scope and outcomes of these concerns. Possible remedial actions include enhanced policies to protect confidentiality in billing and mechanisms to communicate confidentiality protections to young adults. PMID:22897544

Health insurance exchanges under the Patient Protection and Affordable Care Act: regulatory and design challenges.

PubMed

Hoffmann, Stephanie M

2012-12-01

Under the Patient Protection and Affordable Care Act, all states are required to establish health insurance exchanges, marketplaces where individuals and small businesses can purchase health care coverage. In establishing these exchanges, states must address a range of regulatory and design issues to ensure that their exchanges are sustainable and meet the needs of their populations. The issues include the degree of federal involvement in the management of the exchanges, the overall structure and governance of the exchanges, the requirements for insurance plans to be offered on the exchanges, and the design of the exchanges themselves. Each of these issues will play a crucial role in determining the quality of coverage offered to consumers and how effectively they can access that coverage. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

5 CFR 551.215 - Fire protection activities and 7(k) coverage for FLSA pay and exemption determinations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Protection and Prevention series, including any qualified firefighter who is assigned to perform support... considerations; (ii) Employees in positions properly classified in other series, such as Forestry Technician, for whom fire protection functions constitute substantially full-time assignments throughout the year, or...

5 CFR 551.215 - Fire protection activities and 7(k) coverage for FLSA pay and exemption determinations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Protection and Prevention series, including any qualified firefighter who is assigned to perform support... considerations; (ii) Employees in positions properly classified in other series, such as Forestry Technician, for whom fire protection functions constitute substantially full-time assignments throughout the year, or...

29 CFR 2.15 - Protection of witnesses.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Protection of witnesses. 2.15 Section 2.15 Labor Office of the Secretary of Labor GENERAL REGULATIONS Audiovisual Coverage of Administrative Hearings § 2.15 Protection of witnesses. A witness has the right, prior to or during his testimony, to exclude audiovisual...

Socioeconomic inequalities are still a barrier to full child vaccine coverage in the Brazilian Amazon: a cross-sectional study in Assis Brasil, Acre, Brazil.

PubMed

Branco, Fernando Luiz Cunha Castelo; Pereira, Thasciany Moraes; Delfino, Breno Matos; Braña, Athos Muniz; Oliart-Guzmán, Humberto; Mantovani, Saulo Augusto Silva; Martins, Antonio Camargo; Oliveira, Cristieli Sérgio de Menezes; Ramalho, Alanderson Alves; Codeço, Claudia Torres; da Silva-Nunes, Mônica

2014-11-27

Vaccines are very important to reduce morbidity and mortality by preventable infectious diseases, especially during childhood. Optimal coverage is not always achieved, for several reasons. Here we assessed vaccine coverage for the first 12 months of age in children between 12 and 59 months old, residing in the urban area of a small Amazonian city, and factors associated with incomplete vaccination. A census was performed in the urban area of Assis Brasil, in the Brazilian Amazon, in January 2010, with mothers of 282 children aged 12 to 59 months old, using structured interviews and data from vaccination cards. Mixed logistic regression was used to determine factors associated with incomplete vaccination schemes. Only 82.6% of all children had a completed the basic vaccine scheme for the first year of life. Vaccine coverage ranged from 52.7% coverage (oral rotavirus vaccine) to 99.7% coverage (for Bacille Calmette-Guérin). The major deficiencies occurred in doses administered after the first six months of life. Incomplete vaccination was associated with not having enough income to buy a house (aOR = 2.12, 95% CI 1.06-4.21), low maternal schooling (aOR = 2.60, 95% CI 1.28 - 5.29) , and time of residence of the child in the urban area of the city (aOR = 0.73, 95% CI 0.55 - 0.95). This study showed that vaccine coverage in the first twelve months of life in Assis Brasil is similar to other areas in the Amazon and it is below the coverage postulated by the Brazilian Ministry of Health. Low vaccine coverage was associated with socioeconomic inequities that still prevail in the Brazilian Amazon. Short and long-term strategies must be taken to update child vaccines and increase vaccine coverage in the Amazon.

Quantifying the relative irreplaceability of important bird and biodiversity areas.

PubMed

Di Marco, Moreno; Brooks, Thomas; Cuttelod, Annabelle; Fishpool, Lincoln D C; Rondinini, Carlo; Smith, Robert J; Bennun, Leon; Butchart, Stuart H M; Ferrier, Simon; Foppen, Ruud P B; Joppa, Lucas; Juffe-Bignoli, Diego; Knight, Andrew T; Lamoreux, John F; Langhammer, Penny F; May, Ian; Possingham, Hugh P; Visconti, Piero; Watson, James E M; Woodley, Stephen

2016-04-01

World governments have committed to increase the global protected areas coverage by 2020, but the effectiveness of this commitment for protecting biodiversity depends on where new protected areas are located. Threshold- and complementarity-based approaches have been independently used to identify important sites for biodiversity. We brought together these approaches by performing a complementarity-based analysis of irreplaceability in important bird and biodiversity areas (IBAs), which are sites identified using a threshold-based approach. We determined whether irreplaceability values are higher inside than outside IBAs and whether any observed difference depends on known characteristics of the IBAs. We focused on 3 regions with comprehensive IBA inventories and bird distribution atlases: Australia, southern Africa, and Europe. Irreplaceability values were significantly higher inside than outside IBAs, although differences were much smaller in Europe than elsewhere. Higher irreplaceability values in IBAs were associated with the presence and number of restricted-range species; number of criteria under which the site was identified; and mean geographic range size of the species for which the site was identified (trigger species). In addition, IBAs were characterized by higher irreplaceability values when using proportional species representation targets, rather than fixed targets. There were broadly comparable results when measuring irreplaceability for trigger species and when considering all bird species, which indicates a good surrogacy effect of the former. Recently, the International Union for Conservation of Nature has convened a consultation to consolidate global standards for the identification of key biodiversity areas (KBAs), building from existing approaches such as IBAs. Our results informed this consultation, and in particular a proposed irreplaceability criterion that will allow the new KBA standard to draw on the strengths of both threshold- and complementarity-based approaches. © 2015 Society for Conservation Biology.

46 CFR 154.1155 - Hand hose line: Coverage.

Code of Federal Regulations, 2010 CFR

2010-10-01

... STANDARDS FOR SELF-PROPELLED VESSELS CARRYING BULK LIQUEFIED GASES Design, Construction and Equipment Firefighting System: Dry Chemical § 154.1155 Hand hose line: Coverage. The coverage for the area for a hand...

Differential impacts of public health insurance expansions at the local level.

PubMed

Baughman, Reagan

2007-03-01

Dramatic expansions in public health insurance eligibility for U.S. children have only modestly reduced the aggregate number of uninsured at the national level. This paper shows that Medicaid and SCHIP expansions had different impacts on child health insurance coverage patterns based upon local labor market characteristics. Metropolitan areas with high levels of unemployment were most likely to have seen improvements in overall insurance coverage for children between 1990 and 2001. Areas with greater fractions of employment in services, retail or wholesale trade were more likely to have experienced increases in public coverage but not overall coverage rates.

Monitoring progress towards universal health coverage at country and global levels.

PubMed

Boerma, Ties; Eozenou, Patrick; Evans, David; Evans, Tim; Kieny, Marie-Paule; Wagstaff, Adam

2014-09-01

Universal health coverage (UHC) has been defined as the desired outcome of health system performance whereby all people who need health services (promotion, prevention, treatment, rehabilitation, and palliation) receive them, without undue financial hardship. UHC has two interrelated components: the full spectrum of good-quality, essential health services according to need, and protection from financial hardship, including possible impoverishment, due to out-of-pocket payments for health services. Both components should benefit the entire population. This paper summarizes the findings from 13 country case studies and five technical reviews, which were conducted as part of the development of a global framework for monitoring progress towards UHC. The case studies show the relevance and feasibility of focusing UHC monitoring on two discrete components of health system performance: levels of coverage with health services and financial protection, with a focus on equity. These components link directly to the definition of UHC and measure the direct results of strategies and policies for UHC. The studies also show how UHC monitoring can be fully embedded in often existing, regular overall monitoring of health sector progress and performance. Several methodological and practical issues related to the monitoring of coverage of essential health services, financial protection, and equity, are highlighted. Addressing the gaps in the availability and quality of data required for monitoring progress towards UHC is critical in most countries.

Monitoring Progress towards Universal Health Coverage at Country and Global Levels

PubMed Central

Boerma, Ties; Eozenou, Patrick; Evans, David; Evans, Tim; Kieny, Marie-Paule; Wagstaff, Adam

2014-01-01

Universal health coverage (UHC) has been defined as the desired outcome of health system performance whereby all people who need health services (promotion, prevention, treatment, rehabilitation, and palliation) receive them, without undue financial hardship. UHC has two interrelated components: the full spectrum of good-quality, essential health services according to need, and protection from financial hardship, including possible impoverishment, due to out-of-pocket payments for health services. Both components should benefit the entire population. This paper summarizes the findings from 13 country case studies and five technical reviews, which were conducted as part of the development of a global framework for monitoring progress towards UHC. The case studies show the relevance and feasibility of focusing UHC monitoring on two discrete components of health system performance: levels of coverage with health services and financial protection, with a focus on equity. These components link directly to the definition of UHC and measure the direct results of strategies and policies for UHC. The studies also show how UHC monitoring can be fully embedded in often existing, regular overall monitoring of health sector progress and performance. Several methodological and practical issues related to the monitoring of coverage of essential health services, financial protection, and equity, are highlighted. Addressing the gaps in the availability and quality of data required for monitoring progress towards UHC is critical in most countries. PMID:25243899

Automated recognition and tracking of aerosol threat plumes with an IR camera pod

NASA Astrophysics Data System (ADS)

Fauth, Ryan; Powell, Christopher; Gruber, Thomas; Clapp, Dan

2012-06-01

Protection of fixed sites from chemical, biological, or radiological aerosol plume attacks depends on early warning so that there is time to take mitigating actions. Early warning requires continuous, autonomous, and rapid coverage of large surrounding areas; however, this must be done at an affordable cost. Once a potential threat plume is detected though, a different type of sensor (e.g., a more expensive, slower sensor) may be cued for identification purposes, but the problem is to quickly identify all of the potential threats around the fixed site of interest. To address this problem of low cost, persistent, wide area surveillance, an IR camera pod and multi-image stitching and processing algorithms have been developed for automatic recognition and tracking of aerosol plumes. A rugged, modular, static pod design, which accommodates as many as four micro-bolometer IR cameras for 45deg to 180deg of azimuth coverage, is presented. Various OpenCV1 based image-processing algorithms, including stitching of multiple adjacent FOVs, recognition of aerosol plume objects, and the tracking of aerosol plumes, are presented using process block diagrams and sample field test results, including chemical and biological simulant plumes. Methods for dealing with the background removal, brightness equalization between images, and focus quality for optimal plume tracking are also discussed.

78 FR 2200 - Establishment of VOR Federal Airway V-629; Las Vegas, NV

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-10

... existing routes structure for aircraft navigating in an area of marginal radar coverage. This action... navigating in an area of marginal radar coverage. VOR Federal airways are published in paragraph 6010(a) of...

Simplified Models of Vector Control Impact upon Malaria Transmission by Zoophagic Mosquitoes

PubMed Central

Kiware, Samson S.; Chitnis, Nakul; Moore, Sarah J.; Devine, Gregor J.; Majambere, Silas; Merrill, Stephen; Killeen, Gerry F.

2012-01-01

Background High coverage of personal protection measures that kill mosquitoes dramatically reduce malaria transmission where vector populations depend upon human blood. However, most primary malaria vectors outside of sub-Saharan Africa can be classified as “very zoophagic,” meaning they feed occasionally (<10% of blood meals) upon humans, so personal protection interventions have negligible impact upon their survival. Methods and Findings We extended a published malaria transmission model to examine the relationship between transmission, control, and the baseline proportion of bloodmeals obtained from humans (human blood index). The lower limit of the human blood index enables derivation of simplified models for zoophagic vectors that (1) Rely on only three field-measurable parameters. (2) Predict immediate and delayed (with and without assuming reduced human infectivity, respectively) impacts of personal protection measures upon transmission. (3) Illustrate how appreciable indirect communal-level protection for non-users can be accrued through direct personal protection of users. (4) Suggest the coverage and efficacy thresholds required to attain epidemiological impact. The findings suggest that immediate, indirect, community-wide protection of users and non-users alike may linearly relate to the efficacy of a user’s direct personal protection, regardless of whether that is achieved by killing or repelling mosquitoes. High protective coverage and efficacy (≥80%) are important to achieve epidemiologically meaningful impact. Non-users are indirectly protected because the two most common species of human malaria are strict anthroponoses. Therefore, the small proportion of mosquitoes that are killed or diverted while attacking humans can represent a large proportion of those actually transmitting malaria. Conclusions Simplified models of malaria transmission by very zoophagic vectors may be used by control practitioners to predict intervention impact interventions using three field-measurable parameters; the proportion of human exposure to mosquitoes occurring when an intervention can be practically used, its protective efficacy when used, and the proportion of people using it. PMID:22701527

77 FR 70643 - Patient Protection and Affordable Care Act; Standards Related to Essential Health Benefits...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-26

... coverage \\1\\ in the individual and small group markets, Medicaid benchmark and benchmark-equivalent plans...) Act extends the coverage of the EHB package to issuers of non-grandfathered individual and small group... small group markets, and not to Medicaid benchmark or benchmark-equivalent plans. EHB applicability to...

78 FR 13575 - Coverage of Certain Preventive Services Under the Affordable Care Act; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-28

... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 54 [REG-120391-10] RIN 1545-BJ60 Coverage of Certain Preventive Services Under the Affordable Care Act; Correction AGENCY: Internal Revenue... Protection and Affordable Care Act, as amended, and incorporated into the Employee Retirement Income Security...

42 CFR 416.50 - Condition for coverage-Patient rights.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Coverage § 416.50 Condition for coverage—Patient rights. The ASC must inform the patient or the patient's representative or surrogate of the patient's rights and must protect and promote the exercise of these rights, as... with verbal and written notice of the patient's rights in a language and manner that ensures the...

42 CFR 416.50 - Condition for coverage-Patient rights.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Coverage § 416.50 Condition for coverage—Patient rights. The ASC must inform the patient or the patient's representative or surrogate of the patient's rights and must protect and promote the exercise of these rights, as... with verbal and written notice of the patient's rights in a language and manner that ensures the...

Effects of NCMS on access to care and financial protection in China.

PubMed

Hou, Zhiyuan; Van de Poel, Ellen; Van Doorslaer, Eddy; Yu, Baorong; Meng, Qingyue

2014-08-01

The introduction of the New Cooperative Medical Scheme (NCMS) in rural China has been the most rapid and dramatic extension of health insurance coverage in the developing world in this millennium. The literature to date has mainly used the uneven rollout of NCMS across counties as a way of identifying its effects on access to care and financial protection. This study exploits the cross-county variation in NCMS generosity in 2006 and 2008 in the Ningxia and Shandong provinces to estimate the effect of coverage generosity on utilization and financial protection. Our results confirm earlier findings of NCMS being effective in increasing access to care but not in increasing financial protection. In addition, we find NCMS enrollees to be sensitive to the price incentives set in the NCMS design when choosing their provider and providers to respond by increasing prices and/or providing more expensive care. Copyright © 2013 John Wiley & Sons, Ltd.

40 CFR Appendix J to Subpart G of... - Substitutes listed in the January 29, 2002 Final Rule, effective April 1, 2002

Code of Federal Regulations, 2011 CFR

2011-07-01

... destroyed. 5—EPA has no intention of duplicating or displacing OSHA coverage related to the use of personal protective equipment (e.g., respiratory protection), fire protection, hazard communication, worker training..., subpart L, Sections 1910.160 and 1910.162. 2—Per OSHA requirements, protective gear (SCBA) should be...

40 CFR Appendix J to Subpart G of... - Substitutes listed in the January 29, 2002 Final Rule, effective April 1, 2002

Code of Federal Regulations, 2010 CFR

2010-07-01

... destroyed. 5—EPA has no intention of duplicating or displacing OSHA coverage related to the use of personal protective equipment (e.g., respiratory protection), fire protection, hazard communication, worker training..., subpart L, Sections 1910.160 and 1910.162. 2—Per OSHA requirements, protective gear (SCBA) should be...

Maternal and neonatal tetanus elimination: from protecting women and newborns to protecting all.

PubMed

Khan, Rownak; Vandelaer, Jos; Yakubu, Ahmadu; Raza, Azhar Abid; Zulu, Flint

2015-01-01

A total of 35 of the 59 countries that had not eliminated maternal and neonatal tetanus (MNT) as a public health problem in 1999 have since achieved the MNT-elimination goal. Neonatal tetanus deaths have decreased globally from 200,000 in 2000 to 49,000 in 2013. This is the result of increased immunization coverage with tetanus toxoid-containing vaccines among pregnant women, improved access to skilled birth attendance during delivery, and targeted campaigns with these vaccines for women of reproductive age in high-risk areas. In the process, inequities have been reduced, private-public partnerships fostered, and innovations triggered. However, lack of funding, poor accessibility to some areas, suboptimal surveillance, and a perceived low priority for the disease are among the main obstacles. To ensure MNT elimination is sustained, countries must build and maintain strong routine programs that reach people with vaccination and with clean deliveries. This should also be an opportunity to shift programs into preventing tetanus among all people. Regular assessments, and where needed appropriate action, are key to prevent increases in MNT incidence over time, especially in areas that are at higher risk. The main objective of the paper is to provide a detailed update on the progress toward MNT elimination between 1999 and 2014. It elaborates on the challenges and opportunities, and discusses how MNT elimination can be sustained and to shift the program to protect wider populations against tetanus.

Environmental Gap Analysis to Prioritize Conservation Efforts in Eastern Africa

PubMed Central

van Breugel, Paulo; Kindt, Roeland; Lillesø, Jens-Peter Barnekow; van Breugel, Michiel

2015-01-01

Countries in eastern Africa have set aside significant proportions of their land for protection. But are these areas representative of the diverse range of species and habitats found in the region? And do conservation efforts include areas where the state of biodiversity is likely to deteriorate without further interventions? Various studies have addressed these questions at global and continental scales. However, meaningful conservation decisions are required at finer geographical scales. To operate more effectively at the national level, finer scale baseline data on species and on higher levels of biological organization such as the eco-regions are required, among other factors. Here we adopted a recently developed high-resolution potential natural vegetation (PNV) map for eastern Africa as a baseline to more effectively identify conservation priorities. We examined how well different potential natural vegetations (PNVs) are represented in the protected area (PA) network of eastern Africa and used a multivariate environmental similarity index to evaluate biases in PA versus PNV coverage. We additionally overlaid data of anthropogenic factors that potentially influence the natural vegetation to assess the level of threat to different PNVs. Our results indicate substantial differences in the conservation status of PNVs. In addition, particular PNVs in which biodiversity protection and ecological functions are at risk due to human influences are revealed. The data and approach presented here provide a step forward in developing more transparent and better informed translation from global priorities to regional or national implementation in eastern Africa, and are valid for other geographic regions. PMID:25855968

Vegetation Coverage and Impervious Surface Area Estimated Based on the Estarfm Model and Remote Sensing Monitoring

NASA Astrophysics Data System (ADS)

Hu, Rongming; Wang, Shu; Guo, Jiao; Guo, Liankun

2018-04-01

Impervious surface area and vegetation coverage are important biophysical indicators of urban surface features which can be derived from medium-resolution images. However, remote sensing data obtained by a single sensor are easily affected by many factors such as weather conditions, and the spatial and temporal resolution can not meet the needs for soil erosion estimation. Therefore, the integrated multi-source remote sensing data are needed to carry out high spatio-temporal resolution vegetation coverage estimation. Two spatial and temporal vegetation coverage data and impervious data were obtained from MODIS and Landsat 8 remote sensing images. Based on the Enhanced Spatial and Temporal Adaptive Reflectance Fusion Model (ESTARFM), the vegetation coverage data of two scales were fused and the data of vegetation coverage fusion (ESTARFM FVC) and impervious layer with high spatiotemporal resolution (30 m, 8 day) were obtained. On this basis, the spatial variability of the seepage-free surface and the vegetation cover landscape in the study area was measured by means of statistics and spatial autocorrelation analysis. The results showed that: 1) ESTARFM FVC and impermeable surface have higher accuracy and can characterize the characteristics of the biophysical components covered by the earth's surface; 2) The average impervious surface proportion and the spatial configuration of each area are different, which are affected by natural conditions and urbanization. In the urban area of Xi'an, which has typical characteristics of spontaneous urbanization, landscapes are fragmented and have less spatial dependence.

Change-Based Satellite Monitoring Using Broad Coverage and Targetable Sensing

NASA Technical Reports Server (NTRS)

Chien, Steve A.; Tran, Daniel Q.; Doubleday, Joshua R.; Doggett, Thomas

2013-01-01

A generic software framework analyzes data from broad coverage sweeps or general larger areas of interest. Change detection methods are used to extract subsets of directed swath areas that intersect areas of change. These areas are prioritized and allocated to targetable assets. This method is deployed in an automatic fashion, and has operated without human monitoring or intervention for sustained periods of time (months).

Coverage for Gender-Affirming Care: Making Health Insurance Work for Transgender Americans.

PubMed

Padula, William V; Baker, Kellan

2017-08-01

Many transgender Americans continue to remain uninsured or are underinsured because of payers' refusal to cover medically necessary, gender-affirming healthcare services-such as hormone therapy, mental health counseling, and reconstructive surgeries. Coverage refusal results in higher costs and poor health outcomes among transgender people who cannot access gender-affirming care. Research into the value of health insurance coverage for gender-affirming care for transgender individuals shows that the health benefits far outweigh the costs of insuring transition procedures. Although the Affordable Care Act explicitly protects health insurance for transgender individuals, these laws are being threatened; therefore, this article reviews their importance to transgender-inclusive healthcare coverage.

Sub-national variation in measles vaccine coverage and outbreak risk: a case study from a 2010 outbreak in Malawi.

PubMed

Kundrick, Avery; Huang, Zhuojie; Carran, Spencer; Kagoli, Matthew; Grais, Rebecca Freeman; Hurtado, Northan; Ferrari, Matthew

2018-06-15

Despite progress towards increasing global vaccination coverage, measles continues to be one of the leading, preventable causes of death among children worldwide. Whether and how to target sub-national areas for vaccination campaigns continues to remain a question. We analyzed three metrics for prioritizing target areas: vaccination coverage, susceptible birth cohort, and the effective reproductive ratio (R E ) in the context of the 2010 measles epidemic in Malawi. Using case-based surveillance data from the 2010 measles outbreak in Malawi, we estimated vaccination coverage from the proportion of cases reporting with a history of prior vaccination at the district and health facility catchment scale. Health facility catchments were defined as the set of locations closer to a given health facility than to any other. We combined these estimates with regional birth rates to estimate the size of the annual susceptible birth cohort. We also estimated the effective reproductive ratio, R E , at the health facility polygon scale based on the observed rate of exponential increase of the epidemic. We combined these estimates to identify spatial regions that would be of high priority for supplemental vaccination activities. The estimated vaccination coverage across all districts was 84%, but ranged from 61 to 99%. We found that 8 districts and 354 health facility catchments had estimated vaccination coverage below 80%. Areas that had highest birth cohort size were frequently large urban centers that had high vaccination coverage. The estimated R E ranged between 1 and 2.56. The ranking of districts and health facility catchments as priority areas varied depending on the measure used. Each metric for prioritization may result in discrete target areas for vaccination campaigns; thus, there are tradeoffs to choosing one metric over another. However, in some cases, certain areas may be prioritized by all three metrics. These areas should be treated with particular concern. Furthermore, the spatial scale at which each metric is calculated impacts the resulting prioritization and should also be considered when prioritizing areas for vaccination campaigns. These methods may be used to allocate effort for prophylactic campaigns or to prioritize response for outbreak response vaccination.

Surveillance of mother-to-child HIV transmission: socioeconomic and health care coverage indicators.

PubMed

Barcellos, Christovam; Acosta, Lisiane Morelia Weide; Lisboa, Eugenio; Bastos, Francisco Inácio

2009-12-01

To identify clustering areas of infants exposed to HIV during pregnancy and their association with indicators of primary care coverage and socioeconomic condition. Ecological study where the unit of analysis was primary care coverage areas in the city of Porto Alegre, Southern Brazil, in 2003. Geographical Information System and spatial analysis tools were used to describe indicators of primary care coverage areas and socioeconomic condition, and estimate the prevalence of liveborn infants exposed to HIV during pregnancy and delivery. Data was obtained from Brazilian national databases. The association between different indicators was assessed using Spearman's nonparametric test. There was found an association between HIV infection and high birth rates (r=0.22, p<0.01) and lack of prenatal care (r=0.15, p<0.05). The highest HIV infection rates were seen in areas with poor socioeconomic conditions and difficult access to health services (r=0.28, p<0.01). The association found between higher rate of prenatal care among HIV-infected women and adequate immunization coverage (r=0.35, p<0.01) indicates that early detection of HIV infection is effective in those areas with better primary care services. Urban poverty is a strong determinant of mother-to-child HIV transmission but this trend can be fought with health surveillance at the primary care level.

Effects of land use and climate change on ecosystem services in Central Asia's arid regions: A case study in Altay Prefecture, China.

PubMed

Fu, Qi; Li, Bo; Hou, Ying; Bi, Xu; Zhang, Xinshi

2017-12-31

The sustainable use of ecosystem services (ES) can contribute to enhancing human well-being. Understanding the effects of land use and climate change on ES can provide scientific and targeted guidance for the sustainable use of ES. The objective of this study was to reveal the way in which land use and climate change influence the spatial and temporal variations of ES in the mountain-oasis-desert system (MODS). In this study, we assessed water yield, soil conservation, crop production, and sand fixation in 1990, 2000, and 2010 in Altay Prefecture, which is representative of the MODS, based on widely used biophysical models. Moreover, we analyzed the effects of different land use and climate change conditions on ES. The results show that the area of forest and bare land decreased in Altay Prefecture. In contrast, the area of grassland with low coverage and cropland increased. The climate of this area presented an overall warming-wetting trend, with warming-drying and cooling-wetting phenomena in some areas. Soil conservation in the mountain zone, water yield in the oasis zone, and sand fixation in the desert zone all decreased under the influence of land use change alone. The warming-drying trend led to decreased water yield in the oasis zone and increased wind erosion in the desert zone. Based on the results, we recommend that local governments achieve sustainable use of ES by planting grasslands with high coverage in the oasis zone, increasing investment in agricultural science and technology, and establishing protected areas in the mountain and desert zones. The methodology in our study can also be applied to other regions with a MODS structure. Copyright © 2017 Elsevier B.V. All rights reserved.

Can Households Cope with Health Shocks in Vietnam?

PubMed

Mitra, Sophie; Palmer, Michael; Mont, Daniel; Groce, Nora

2016-07-01

This paper investigates the economic impact of health shocks on working-age adults in Vietnam during 2004-2008, using a fixed effects specification. Health shocks cover disability and morbidity and are measured by 'days unable to carry out regular activity', 'days in bed due to illness/injury', and 'hospitalization'. Overall, Vietnamese households are able to smooth total non-health expenditures in the short run in the face of a significant rise in out-of-pocket health expenditures. However, this is accomplished through vulnerability-enhancing mechanisms, especially in rural areas, including increased loans and asset sales and decreased education expenditures. Female-headed and rural households are found to be the least able to protect consumption. Results highlight the need to extend and deepen social protection and universal health coverage. © 2015 The Authors. Health Economics published by John Wiley & Sons Ltd. © 2015 The Authors. Health Economics published by John Wiley & Sons Ltd.

The Patient Protection and Affordable Care Act of 2010: impact on otolaryngology practice and research.

PubMed

Sun, Gordon H; Davis, Matthew M

2012-05-01

The Patient Protection and Affordable Care Act (PPACA) was signed into law by President Barack Obama on March 23, 2010. Since its passage, the PPACA has led to increased health insurance coverage for millions more Americans, and it includes provisions leading to new avenues for clinical and health services research funding. The legislation also favors development of the primary care specialties and general surgery, increased training of midlevel health care providers, and medical training and service in underserved areas of the United States. However, the PPACA does not effectively engage otolaryngologists in quality improvement, despite modifications to the Physician Quality Reporting System. The legislation also levies a tax on cosmetic procedures, affecting both clinicians and patients. This article reviews the sections of the PPACA that are most pertinent to otolaryngologists and explains how these components of the bill will affect otolaryngologic practice and research over the coming decade.

Can Households Cope with Health Shocks in Vietnam?

PubMed Central

Mitra, Sophie; Palmer, Michael; Mont, Daniel

2015-01-01

Abstract This paper investigates the economic impact of health shocks on working‐age adults in Vietnam during 2004–2008, using a fixed effects specification. Health shocks cover disability and morbidity and are measured by ‘days unable to carry out regular activity’, ‘days in bed due to illness/injury’, and ‘hospitalization’. Overall, Vietnamese households are able to smooth total non‐health expenditures in the short run in the face of a significant rise in out‐of‐pocket health expenditures. However, this is accomplished through vulnerability‐enhancing mechanisms, especially in rural areas, including increased loans and asset sales and decreased education expenditures. Female‐headed and rural households are found to be the least able to protect consumption. Results highlight the need to extend and deepen social protection and universal health coverage. © 2015 The Authors. Health Economics published by John Wiley & Sons Ltd. PMID:26017577

78 FR 33233 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-04

... would affect the ability of employers to offer stand-alone pediatric dental coverage in the FF- SHOP... Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans; Small... rule. SUMMARY: This final rule implements provisions of the Patient Protection and Affordable Care Act...

Patient Protection and Affordable Care Act; establishment of the Multi-State Plan Program for the Affordable Insurance Exchanges. Final rule.

PubMed

2014-02-24

The U.S. Office of Personnel Management (OPM) is issuing a final rule implementing modifications to the Multi-State Plan (MSP) Program based on the experience of the Program to date. OPM established the MSP Program pursuant to the Affordable Care Act. This rule clarifies the approach used to enforce the applicable standards of the Affordable Care Act with respect to health insurance issuers that contract with OPM to offer MSP options; amends MSP standards related to coverage area, benefits, and certain contracting provisions under section 1334 of the Affordable Care Act; and makes non-substantive technical changes.

A Two-Phase Coverage-Enhancing Algorithm for Hybrid Wireless Sensor Networks.

PubMed

Zhang, Qingguo; Fok, Mable P

2017-01-09

Providing field coverage is a key task in many sensor network applications. In certain scenarios, the sensor field may have coverage holes due to random initial deployment of sensors; thus, the desired level of coverage cannot be achieved. A hybrid wireless sensor network is a cost-effective solution to this problem, which is achieved by repositioning a portion of the mobile sensors in the network to meet the network coverage requirement. This paper investigates how to redeploy mobile sensor nodes to improve network coverage in hybrid wireless sensor networks. We propose a two-phase coverage-enhancing algorithm for hybrid wireless sensor networks. In phase one, we use a differential evolution algorithm to compute the candidate's target positions in the mobile sensor nodes that could potentially improve coverage. In the second phase, we use an optimization scheme on the candidate's target positions calculated from phase one to reduce the accumulated potential moving distance of mobile sensors, such that the exact mobile sensor nodes that need to be moved as well as their final target positions can be determined. Experimental results show that the proposed algorithm provided significant improvement in terms of area coverage rate, average moving distance, area coverage-distance rate and the number of moved mobile sensors, when compare with other approaches.

[Social protection in Latin America and the Caribbean: changes, contradictions, and limits].

PubMed

Viana, Ana Luiza d'Avila; Fonseca, Ana Maria Medeiros da; Silva, Hudson Pacifico da

2017-07-27

Recent studies suggest that governments in the majority of Latin American and Caribbean countries were able to expand social investments and introduce innovations in social protection policies in the last two decades with positive results in the actions' coverage and impact. However, the restrictions imposed by the current fiscal crisis and the rise of governments more ideologically aligned with the neoliberal discourse in various countries in the region point to a new retreat of the state from the social area, thereby compromising recent advances. The article aims to discuss the changes, contradictions, and limits of recent social protection standards in Latin America and the Caribbean. The discussion includes three items: a description of the history of social protection in the region, seeking to identify its principal historical periods and characteristics (benefits, target public, and financing); the social protection models that have been implemented in the region; and the specific case of health. We argue that although countries have adopted different solutions in the field of social protection, the policies' hybrid nature (with extensive private sector participation in the financing, supply, and management of services) and the prevalence of segmented models (with differential access according to individuals' social status) have been predominant traits in social protection in Latin America and the Caribbean, thus limiting the possibilities for greater equity and social justice.

Household coverage of Swaziland's national community health worker programme: a cross-sectional population-based study.

PubMed

Geldsetzer, Pascal; Vaikath, Maria; De Neve, Jan-Walter; Bossert, Thomas J; Sibandze, Sibusiso; Bärnighausen, Till

2017-08-01

To ascertain household coverage achieved by Swaziland's national community health worker (CHW) programme and differences in household coverage across clients' sociodemographic characteristics. Household survey from June to September 2015 in two of Swaziland's four administrative regions using two-stage cluster random sampling. Interviewers administered a questionnaire to all household members in 1542 households across 85 census enumeration areas. While the CHW programme aims to cover all households in the country, only 44.5% (95% confidence interval: 38.0% to 51.1%) reported that they had ever been visited by a CHW. In both uni- and multivariable regressions, coverage was negatively associated with household wealth (OR for most vs. least wealthy quartile: 0.30 [0.16 to 0.58], P < 0.001) and education (OR for >secondary schooling vs. no schooling: 0.65 [0.47 to 0.90], P = 0.009), and positively associated with residing in a rural area (OR: 2.95 [1.77 to 4.91], P < 0.001). Coverage varied widely between census enumeration areas. Swaziland's national CHW programme is falling far short of its coverage goal. To improve coverage, the programme would likely need to recruit additional CHWs and/or assign more households to each CHW. Alternatively, changing the programme's ambitious coverage goal to visiting only certain types of households would likely reduce existing arbitrary differences in coverage between households and communities. This study highlights the need to evaluate and reform large long-standing CHW programmes in sub-Saharan Africa. © 2017 John Wiley & Sons Ltd.

Complementary satellite sound broadcasting systems: A NASA assessment for the Voice of America

NASA Technical Reports Server (NTRS)

Stevens, Grady H.; Spence, Rodney L.

1988-01-01

Satellite concepts are examined which offer potentially significant sound broadcast coverage of audio as a complement to VOA's existing and planned terrestrial sound broadcasting system. HF bands are emphasized but additional discussion is included for systems using higher frequencies. Low altitude satellites, shuttle altitude (275 km) and sun synchronous (about 1600 to 1800 km), would not be practical for international broadcasting since many satellites would be required for reliable and widespread coverage. Two concepts are discussed which would offer significant and practical broadcast coverage at HF. One, an 8-hr posigrade equatorial orbit, would offer about 1 hr of widespread, twice daily, coverage to three areas of the globe. The time of coverage is even greater when confined to densely populated areas only (2 to 3 hrs). Another orbit, the Apogee at Constant Time/Equatorial (ACE), provides the same coverage, but only once daily to each area. The latter orbit is highly elliptical, allowing insertion of a greater payload (more broadcast channels) with the existing launch capability. The ACE and 8-hr orbit concepts led to systems of about equal costs, with the ACE being slightly better.

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

PubMed

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

2016-06-01

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

Health Insurance Coverage and Its Impact on Medical Cost: Observations from the Floating Population in China

PubMed Central

Zhao, Yinjun; Kang, Bowei; Liu, Yawen; Li, Yichong; Shi, Guoqing; Shen, Tao; Jiang, Yong; Zhang, Mei; Zhou, Maigeng; Wang, Limin

2014-01-01

Background China has the world's largest floating (migrant) population, which has characteristics largely different from the rest of the population. Our goal is to study health insurance coverage and its impact on medical cost for this population. Methods A telephone survey was conducted in 2012. 644 subjects were surveyed. Univariate and multivariate analysis were conducted on insurance coverage and medical cost. Results 82.2% of the surveyed subjects were covered by basic insurance at hometowns with hukou or at residences. Subjects' characteristics including age, education, occupation, and presence of chronic diseases were associated with insurance coverage. After controlling for confounders, insurance coverage was not significantly associated with gross or out-of-pocket medical cost. Conclusion For the floating population, health insurance coverage needs to be improved. Policy interventions are needed so that health insurance can have a more effective protective effect on cost. PMID:25386914

Coverage of Certain Preventive Services Under the Affordable Care Act. Final rules.

PubMed

2015-07-14

This document contains final regulations regarding coverage of certain preventive services under section 2713 of the Public Health Service Act (PHS Act), added by the Patient Protection and Affordable Care Act, as amended, and incorporated into the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code. Section 2713 of the PHS Act requires coverage without cost sharing of certain preventive health services by non-grandfathered group health plans and health insurance coverage. These regulations finalize provisions from three rulemaking actions: Interim final regulations issued in July 2010 related to coverage of preventive services, interim final regulations issued in August 2014 related to the process an eligible organization uses to provide notice of its religious objection to the coverage of contraceptive services, and proposed regulations issued in August 2014 related to the definition of "eligible organization,'' which would expand the set of entities that may avail themselves of an accommodation with respect to the coverage of contraceptive services.

40 CFR 144.34 - Emergency permits.

Code of Federal Regulations, 2010 CFR

2010-07-01

....34 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) UNDERGROUND INJECTION CONTROL PROGRAM Authorization by Permit § 144.34 Emergency permits. (a) Coverage... unless a temporary emergency permit is granted; or (2) A substantial and irretrievable loss of oil or gas...

Origins, design and implementation of the China GAVI project.

PubMed

Liang, Xiaofeng; Cui, Fuqiang; Hadler, Stephen; Wang, Xiaojun; Luo, Huiming; Chen, Yuansheng; Kane, Mark; Shapiro, Craig; Yang, Weizhong; Wang, Yu

2013-12-27

China received GAVI support for hepatitis B vaccination in 2001 because of high disease burden and strong government will to protect infants at risk. The China/GAVI project, implemented since 2002, was funded 50% by GAVI and 50% by the Government of China. The purpose of the project was to increase coverage of hepatitis B vaccine through a pro-poor approach targeting all counties of the 12 Western provinces and poverty counties of the 10 Central provinces, to accelerate integration of hepatitis B vaccine into routine immunization, and assure immunization injection safety. The mechanism of internal coordination among multiple government entities and international cooperation was established and comprehensive strategies were used to improve vaccine coverage and injection safety. After 8 years of implementation, 193,000 health care workers in 118,316 health care facilities participated in the project, mostly at the township hospitals level (55,051) and in community centres (104,547). Through the China GAVI project, the 85% HepB3 coverage goal was reached in 98% of GAVI China project counties, the 75% timely birth dose (TBD) coverage goal was reached in 80% of GAVI project counties, and AD syringes were introduced into 100% of GAVI-supported areas. Additionally, the GAVI project was instrumental in convincing the Chinese Government to sustainably introduce and fully fund HepB vaccine for all newborns in China. The impact of hepB vaccination on HBsAg prevalence was observed throughout China, as HBsAg prevalence (previously ~10%) is now less than 1% among children under 5 years of age. Copyright © 2012 Elsevier Ltd. All rights reserved.

47 CFR 24.103 - Construction requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... licensees shall construct base stations that provide coverage to a composite area of 750,000 square..., shall construct base stations that provide coverage to a composite area of 1,500,000 square kilometers...) of this section. (b) Regional narrowband PCS licensees shall construct base stations that provide...

Quality of ground water in Idaho

USGS Publications Warehouse

Yee, Johnson J.; Souza, William R.

1987-01-01

The major aquifers in Idaho are categorized under two rock types, sedimentary and volcanic, and are grouped into six hydrologic basins. Areas with adequate, minimally adequate, or deficient data available for groundwater-quality evaluations are described. Wide variations in chemical concentrations in the water occur within individual aquifers, as well as among the aquifers. The existing data base is not sufficient to describe fully the ground-water quality throughout the State; however, it does indicate that the water is generally suitable for most uses. In some aquifers, concentrations of fluoride, cadmium, and iron in the water exceed the U.S. Environmental Protection Agency's drinking-water standards. Dissolved solids, chloride, and sulfate may cause problems in some local areas. Water-quality data are sparse in many areas, and only general statements can be made regarding the areal distribution of chemical constituents. Few data are available to describe temporal variations of water quality in the aquifers. Primary concerns related to special problem areas in Idaho include (1) protection of water quality in the Rathdrum Prairie aquifer, (2) potential degradation of water quality in the Boise-Nampa area, (3) effects of widespread use of drain wells overlying the eastern Snake River Plain basalt aquifer, and (4) disposal of low-level radioactive wastes at the Idaho National Engineering Laboratory. Shortcomings in the ground-water-quality data base are categorized as (1) multiaquifer sample inadequacy, (2) constituent coverage limitations, (3) baseline-data deficiencies, and (4) data-base nonuniformity.

Analysis of Existing International Policy Evidence in Public Health Genomics: Mapping Exercise

PubMed Central

Syurina, Elena V.; in den Bäumen, Tobias Schulte; Feron, Frans J.M.; Brand, Angela

2012-01-01

Background In the last decades we have seen a constant growth in the fields of science related to the use of genome-based health information. However, there is a gap between basic science research and the Public Health everyday practice. For a successful introduction of genome-based technologies policy actions on the international level are needed. This work represents the initial stage of the PHGEN II (Public Health Genomics European Network II) project. In order to prepare a base for bridging genomics and Public Health, an inventory study of the existing legislative base dealing with controversies of genome-based knowledge was conducted. The work results in the mapping of the most and the least legislatively covered areas and some preliminary conclusions about the existing gaps. Design and Methods The collection of the evidence-based policies was done through the PHGEN II project. The mapping covered the meta-level (international, European general guidelines). The expert opinion of the partners of the project was required to reflect on and grade the collected evidence. Results An analysis of the evidence was made by the area of coverage: using the list of important policy areas for successful introduction of genome-based technologies into Public Health and the Public Health Genomics Wheel (originally Public Health Wheel developed by Institute of Medicine). Conclusions Severe inequalities in coverage of important issues of Public Health Genomics were found. The most attention was paid to clinical utility and clinical validity of the screening and the protection of human subjects. Important areas such as trade agreements, Public Health Genomics literacy, insurance issues, behaviour modification in response to genomics results etc. were paid less attention to. For the successful adoption of new technologies on the Public Health level the focus should be not only on the translation to clinical practice, but the translation from bench to Public Health policy and back. Coherent and consistent coverage of all aspects of the translation of genome based information and technologies is of outmost importance. PMID:25170444

Insurance coverage and financial burden for families of children with special health care needs.

PubMed

Chen, Alex Y; Newacheck, Paul W

2006-01-01

To examine the role of insurance coverage in protecting families of children with special health care needs (CSHCN) from the financial burden associated with care. Data from the 2001 National Survey of Children with Special Health Care Needs were analyzed. We built 2 multivariate regression models by using "work loss/cut back" and "experiencing financial problems" as the dependent variables, and insurance status as the primary independent variable of interest while adjusting for income, race/ethnicity, functional limitation/severity, and other sociodemographic predictors. Approximately 29.9% of CSHCN live in families where their condition led parents to report cutting back on work or stopping work completely. Families of 20.9% of CSHCN reported experiencing financial difficulties due to the child's condition. Insurance coverage significantly reduced the likelihood of financial problems for families at every income level. The proportion of families experiencing financial problems was reduced from 35.7% to 23.0% for the poor and 44.9% to 24.5% for low-income families with continuous insurance coverage (P < .01 for both comparisons). Similarly, the proportion of parents having to cut back or stop work was reduced from 42.8% to 35.9% for the poor (P < .05) and 43.5% to 33.9% for low-income families (P < .01). Continuous health insurance coverage provides protection from financial burden and hardship for families of CSHCN in all income groups. This evidence is supportive of policies designed to promote universal coverage for CSHCN. However, many poor and low-income families continue to experience work loss and financial problems despite insurance coverage. Hence, health insurance should not be viewed as a solution in itself, but instead as one element of a comprehensive strategy to provide financial safety for families with CSHCN.

Childhood Cancer Survivor Study participants' perceptions and understanding of the Affordable Care Act.

PubMed

Park, Elyse R; Kirchhoff, Anne C; Perez, Giselle K; Leisenring, Wendy; Weissman, Joel S; Donelan, Karen; Mertens, Ann C; Reschovsky, James D; Armstrong, Gregory T; Robison, Leslie L; Franklin, Mariel; Hyland, Kelly A; Diller, Lisa R; Recklitis, Christopher J; Kuhlthau, Karen A

2015-03-01

The Patient Protection and Affordable Care Act (ACA) established provisions intended to increase access to affordable health insurance and thus increase access to medical care and long-term surveillance for populations with pre-existing conditions. However, childhood cancer survivors' coverage priorities and familiarity with the ACA are unknown. Between May 2011 and April 2012, we surveyed a randomly selected, age-stratified sample of 698 survivors and 210 siblings from the Childhood Cancer Survivor Study. Overall, 89.8% of survivors and 92.1% of siblings were insured. Many features of insurance coverage that survivors considered "very important" are addressed by the ACA, including increased availability of primary care (94.6%), no waiting period before coverage initiation (79.0%), and affordable premiums (88.1%). Survivors were more likely than siblings to deem primary care physician coverage and choice, protections from costs due to pre-existing conditions, and no start-up period as "very important" (P < .05 for all). Only 27.3% of survivors and 26.2% of siblings reported familiarity with the ACA (12.1% of uninsured v 29.0% of insured survivors; odds ratio, 2.86; 95% CI, 1.28 to 6.36). Only 21.3% of survivors and 18.9% of siblings believed the ACA would make it more likely that they would get quality coverage. Survivors' and siblings' concerns about the ACA included increased costs, decreased access to and quality of care, and negative impact on employers and employees. Although survivors' coverage preferences match many ACA provisions, survivors, particularly uninsured survivors, were not familiar with the ACA. Education and assistance, perhaps through cancer survivor navigation, are critically needed to ensure that survivors access coverage and benefits. © 2015 by American Society of Clinical Oncology.

Childhood Cancer Survivor Study Participants' Perceptions and Understanding of the Affordable Care Act

PubMed Central

Park, Elyse R.; Kirchhoff, Anne C.; Perez, Giselle K.; Leisenring, Wendy; Weissman, Joel S.; Donelan, Karen; Mertens, Ann C.; Reschovsky, James D.; Armstrong, Gregory T.; Robison, Leslie L.; Franklin, Mariel; Hyland, Kelly A.; Diller, Lisa R.; Recklitis, Christopher J.; Kuhlthau, Karen A.

2015-01-01

Purpose The Patient Protection and Affordable Care Act (ACA) established provisions intended to increase access to affordable health insurance and thus increase access to medical care and long-term surveillance for populations with pre-existing conditions. However, childhood cancer survivors' coverage priorities and familiarity with the ACA are unknown. Methods Between May 2011 and April 2012, we surveyed a randomly selected, age-stratified sample of 698 survivors and 210 siblings from the Childhood Cancer Survivor Study. Results Overall, 89.8% of survivors and 92.1% of siblings were insured. Many features of insurance coverage that survivors considered “very important” are addressed by the ACA, including increased availability of primary care (94.6%), no waiting period before coverage initiation (79.0%), and affordable premiums (88.1%). Survivors were more likely than siblings to deem primary care physician coverage and choice, protections from costs due to pre-existing conditions, and no start-up period as “very important” (P < .05 for all). Only 27.3% of survivors and 26.2% of siblings reported familiarity with the ACA (12.1% of uninsured v 29.0% of insured survivors; odds ratio, 2.86; 95% CI, 1.28 to 6.36). Only 21.3% of survivors and 18.9% of siblings believed the ACA would make it more likely that they would get quality coverage. Survivors' and siblings' concerns about the ACA included increased costs, decreased access to and quality of care, and negative impact on employers and employees. Conclusion Although survivors' coverage preferences match many ACA provisions, survivors, particularly uninsured survivors, were not familiar with the ACA. Education and assistance, perhaps through cancer survivor navigation, are critically needed to ensure that survivors access coverage and benefits. PMID:25646189

Minimum essential coverage and other rules regarding the shared responsibility payment for individuals. Final regulations.

PubMed

2014-11-26

This document contains final regulations relating to the requirement to maintain minimum essential coverage enacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended by the TRICARE Affirmation Act and Public Law 111-173 (collectively, the Affordable Care Act). These final regulations provide individual taxpayers with guidance under section 5000A of the Internal Revenue Code on the requirement to maintain minimum essential coverage and rules governing certain types of exemptions from that requirement.

A Commercial Architecture for Satellite Imagery

DTIC Science & Technology

2006-09-01

incorporates image detection from the visible and near - infrared wavelengths, 3) 16 Ball Aerospace...present limited total area coverage since the field of regard is smallest. The opposite is true for resolution and total area coverage near apogee. The...27 B. SENSOR FIELD OF REGARD ...................................................................27 1. Spherical Analysis

Limited Area Coverage/High Resolution Picture Transmission (LAC/HRPT) data vegetative index calculation processor user's manual

NASA Technical Reports Server (NTRS)

Obrien, S. O. (Principal Investigator)

1980-01-01

The program, LACVIN, calculates vegetative indexes numbers on limited area coverage/high resolution picture transmission data for selected IJ grid sections. The IJ grid sections were previously extracted from the full resolution data tapes and stored on disk files.

Mathematical evaluation of community level impact of combining bed nets and indoor residual spraying upon malaria transmission in areas where the main vectors are Anopheles arabiensis mosquitoes

PubMed Central

2013-01-01

Background Indoor residual insecticide spraying (IRS) and long-lasting insecticide treated nets (LLINs) are commonly used together even though evidence that such combinations confer greater protection against malaria than either method alone is inconsistent. Methods A deterministic model of mosquito life cycle processes was adapted to allow parameterization with results from experimental hut trials of various combinations of untreated nets or LLINs (Olyset®, PermaNet 2.0®, Icon Life® nets) with IRS (pirimiphos methyl, lambda cyhalothrin, DDT), in a setting where vector populations are dominated by Anopheles arabiensis, so that community level impact upon malaria transmission at high coverage could be predicted. Results Intact untreated nets alone provide equivalent personal protection to all three LLINs. Relative to IRS plus untreated nets, community level protection is slightly higher when Olyset® or PermaNet 2.0® nets are added onto IRS with pirimiphos methyl or lambda cyhalothrin but not DDT, and when Icon Life® nets supplement any of the IRS insecticides. Adding IRS onto any net modestly enhances communal protection when pirimiphos methyl is sprayed, while spraying lambda cyhalothrin enhances protection for untreated nets but not LLINs. Addition of DDT reduces communal protection when added to LLINs. Conclusions Where transmission is mediated primarily by An. arabiensis, adding IRS to high LLIN coverage provides only modest incremental benefit (e.g. when an organophosphate like pirimiphos methyl is used), but can be redundant (e.g. when a pyrethroid like lambda cyhalothin is used) or even regressive (e.g. when DDT is used for the IRS). Relative to IRS plus untreated nets, supplementing IRS with LLINs will only modestly improve community protection. Beyond the physical protection that intact nets provide, additional protection against transmission by An. arabiensis conferred by insecticides will be remarkably small, regardless of whether they are delivered as LLINs or IRS. The insecticidal action of LLINs and IRS probably already approaches their absolute limit of potential impact upon this persistent vector so personal protection of nets should be enhanced by improving the physical integrity and durability. Combining LLINs and non-pyrethroid IRS in residual transmission systems may nevertheless be justified as a means to manage insecticide resistance and prevent potential rebound of not only An. arabiensis, but also more potent, vulnerable and historically important species such as Anopheles gambiae and Anopheles funestus. PMID:23324456

Analysis on Temporal-Spatial Changes of Vegetation Cverrge in Farming-Pastoral Ecotone of Inner Mongolia

NASA Astrophysics Data System (ADS)

Yan, X.; Li, J.; Yang, Z.

2018-04-01

Chen Barag Banner is located in the typical farming-pastoral ecotone of Inner Mongolia, and it is also the core area of Hulunbuir steppe. Typical agricultural and pastoral staggered production mode so that the vegetation growth of the region not only determines the local ecological environment, and animal husbandry production, but also have a significant impact on the whole Hulunbuir ecological security and economic development. Therefore, it is necessary to monitor the change of vegetation in this area. Based on 17 MODIS Normalized Difference Vegetation Index (NDVI) images, the authors reconstructed the dynamic change characteristics of Fraction vegetation coverage (FVC) in Chen Barag Banner from 2000 to 2016. In this paper, first at all, Pixel Decomposition Models was introduced to inversion FVC, and the time series of vegetation coverage was reconstructed. Then we analyzed the temporal-spatial changes of FVC by employing transition matrix. Finally, through image analyzing and processing, the results showed that the vegetation coverage in the study area was influenced by effectors including climate, topography and human actives. In the past 17 years, the overall effect of vegetation coverage showed a downward trend of fluctuation. The average vegetation coverage decreased from 58.81 % in 2000 to 48.14 % in 2016, and the area of vegetation cover degradation accounts for 40.09 % of the total change area. Therefore, the overall degradation trend was obvious.

Child morbidity and mortality associated with alternative policy responses to the economic crisis in Brazil: A nationwide microsimulation study.

PubMed

Rasella, Davide; Basu, Sanjay; Hone, Thomas; Paes-Sousa, Romulo; Ocké-Reis, Carlos Octávio; Millett, Christopher

2018-05-01

Since 2015, a major economic crisis in Brazil has led to increasing poverty and the implementation of long-term fiscal austerity measures that will substantially reduce expenditure on social welfare programmes as a percentage of the country's GDP over the next 20 years. The Bolsa Família Programme (BFP)-one of the largest conditional cash transfer programmes in the world-and the nationwide primary healthcare strategy (Estratégia Saúde da Família [ESF]) are affected by fiscal austerity, despite being among the policy interventions with the strongest estimated impact on child mortality in the country. We investigated how reduced coverage of the BFP and ESF-compared to an alternative scenario where the level of social protection under these programmes is maintained-may affect the under-five mortality rate (U5MR) and socioeconomic inequalities in child health in the country until 2030, the end date of the Sustainable Development Goals. We developed and validated a microsimulation model, creating a synthetic cohort of all 5,507 Brazilian municipalities for the period 2017-2030. This model was based on the longitudinal dataset and effect estimates from a previously published study that evaluated the effects of poverty, the BFP, and the ESF on child health. We forecast the economic crisis and the effect of reductions in BFP and ESF coverage due to current fiscal austerity on the U5MR, and compared this scenario with a scenario where these programmes maintain the levels of social protection by increasing or decreasing with the size of Brazil's vulnerable populations (policy response scenarios). We used fixed effects multivariate regression models including BFP and ESF coverage and accounting for secular trends, demographic and socioeconomic changes, and programme duration effects. With the maintenance of the levels of social protection provided by the BFP and ESF, in the most likely economic crisis scenario the U5MR is expected to be 8.57% (95% CI: 6.88%-10.24%) lower in 2030 than under fiscal austerity-a cumulative 19,732 (95% CI: 10,207-29,285) averted under-five deaths between 2017 and 2030. U5MRs from diarrhoea, malnutrition, and lower respiratory tract infections are projected to be 39.3% (95% CI: 36.9%-41.8%), 35.8% (95% CI: 31.5%-39.9%), and 8.5% (95% CI: 4.1%-12.0%) lower, respectively, in 2030 under the maintenance of BFP and ESF coverage, with 123,549 fewer under-five hospitalisations from all causes over the study period. Reduced coverage of the BFP and ESF will also disproportionately affect U5MR in the most vulnerable areas, with the U5MR in the poorest quintile of municipalities expected to be 11.0% (95% CI: 8.0%-13.8%) lower in 2030 under the maintenance of BFP and ESF levels of social protection than under fiscal austerity, compared to no difference in the richest quintile. Declines in health inequalities over the last decade will also stop under a fiscal austerity scenario: the U5MR concentration index is expected to remain stable over the period 2017-2030, compared to a 13.3% (95% CI: 5.6%-21.8%) reduction under the maintenance of BFP and ESF levels of protection. Limitations of our analysis are the ecological nature of the study, uncertainty around future macroeconomic scenarios, and potential changes in other factors affecting child health. A wide range of sensitivity analyses were conducted to minimise these limitations. The implementation of fiscal austerity measures in Brazil can be responsible for substantively higher childhood morbidity and mortality than expected under maintenance of social protection-threatening attainment of Sustainable Development Goals for child health and reducing inequality.

Protected areas: mixed success in conserving East Africa's evergreen forests.

PubMed

Pfeifer, Marion; Burgess, Neil D; Swetnam, Ruth D; Platts, Philip J; Willcock, Simon; Marchant, Robert

2012-01-01

In East Africa, human population growth and demands for natural resources cause forest loss contributing to increased carbon emissions and reduced biodiversity. Protected Areas (PAs) are intended to conserve habitats and species. Variability in PA effectiveness and 'leakage' (here defined as displacement of deforestation) may lead to different trends in forest loss within, and adjacent to, existing PAs. Here, we quantify spatial variation in trends of evergreen forest coverage in East Africa between 2001 and 2009, and test for correlations with forest accessibility and environmental drivers. We investigate PA effectiveness at local, landscape and national scales, comparing rates of deforestation within park boundaries with those detected in park buffer zones and in unprotected land more generally. Background forest loss (BFL) was estimated at -9.3% (17,167 km(2)), but varied between countries (range: -0.9% to -85.7%; note: no BFL in South Sudan). We document high variability in PA effectiveness within and between PA categories. The most successful PAs were National Parks, although only 26 out of 48 parks increased or maintained their forest area (i.e. Effective parks). Forest Reserves (Ineffective parks, i.e. parks that lose forest from within boundaries: 204 out of 337), Nature Reserves (six out of 12) and Game Parks (24 out of 26) were more likely to lose forest cover. Forest loss in buffer zones around PAs exceeded background forest loss, in some areas indicating leakage driven by Effective National Parks. Human pressure, forest accessibility, protection status, distance to fires and long-term annual rainfall were highly significant drivers of forest loss in East Africa. Some of these factors can be addressed by adjusting park management. However, addressing close links between livelihoods, natural capital and poverty remains a fundamental challenge in East Africa's forest conservation efforts.

Reported community-level indoor residual spray coverage from two-stage cluster surveys in sub-Saharan Africa.

PubMed

Larsen, David A; Borrill, Lauren; Patel, Ryan; Fregosi, Lauren

2017-06-13

Malaria is an important cause of morbidity and mortality in malaria-endemic areas. Indoor residual spray is an effective intervention to control malaria, but high community-level coverage is needed to maximize its impact. Using thirty-four two-stage cluster surveys (e.g., demographic and health surveys) and lot quality assurance sampling, indoor residual spray was estimated at the community level (i.e. enumeration-area) across sub-Saharan Africa since 2010. For communities receiving indoor residual spray a logistic regression predicted whether community-level coverage exceeded 50% or not. Household-level coverage was equitable both in terms of wealth and urban/rural, with poorer and rural houses more likely to be sprayed than richer and urban houses. Coverage of indoor residual spray at the community level is poor across the continent, with 54% of communities receiving the intervention not reaching 50% coverage. Having >50% coverage at the community-level was not associated with increasing the number of houses sprayed in the country. Implementation and monitoring of indoor residual coverage at small geographical scales need to improve greatly to receive maximum benefit of the intervention.

Comprehensive smoke-free laws--50 largest U.S. cities, 2000 and 2012.

PubMed

2012-11-16

Secondhand smoke (SHS) exposure causes heart disease and lung cancer in nonsmoking adults and several health conditions in children. Only completely eliminating smoking in indoor spaces fully protects nonsmokers from SHS. State and local laws can provide this protection in enclosed workplaces and public places by completely eliminating smoking in these settings. CDC considers a smoke-free law to be comprehensive if it prohibits smoking in all indoor areas of private workplaces, restaurants, and bars, with no exceptions. In response to growing evidence on the health effects of SHS, communities and states have increasingly adopted comprehensive smoke-free (CSF) laws in recent years. To assess trends in protecting the population from SHS exposure, CDC and the American Nonsmokers' Rights Foundation (ANRF) compared coverage by local or state CSF laws in the 50 largest U.S. cities as of December 31, 2000, and October 5, 2012. The analysis focused on smoking restrictions in the 50 largest cities because these cities represent an important indicator of nationwide trends in local and state policy and because they are home to an estimated 47 million persons, or nearly 15% of the U.S. population. The analysis found that the number of these cities covered by local and/or state CSF laws increased from one city (2%) in 2000 to 30 cities (60%) in 2012. A total of 20 cities (40%) were not covered by a CSF law at either the local or state level in 2012, although 14 of these cities had 100% smoke-free provisions in place at the local or state level in at least one of the three settings considered. The results of this analysis indicate that substantial progress has been achieved during 2000-2012 in implementing CSF laws in the 50 largest U.S. cities. However, gaps in coverage, especially in the southern United States and in states with laws that preempt local smoking restrictions, are contributing to disparities in SHS protections.

Coverage gap in maternal and child health services in India: assessing trends and regional deprivation during 1992-2006.

PubMed

Kumar, Chandan; Singh, Prashant Kumar; Rai, Rajesh Kumar

2013-12-01

Increasing the coverage of key maternal, newborn and child health interventions is essential, if India has to attain Millennium Development Goals 4 and 5. This study assesses the coverage gap in maternal and child health services across states in India during 1992-2006 emphasizing the rural-urban disparities. Additionally, association between the coverage gap and under-5 mortality rate across states are illustrated. The three waves of National Family Health Survey (NFHS) conducted during 1992-1993 (NFHS-1), 1998-1999 (NFHS-2) and 2005-2006 (NFHS-3) were used to construct a composite index of coverage gap in four areas of health-care interventions: family planning, maternal and newborn care, immunization and treatment of sick children. The central, eastern and northeastern regions of India reported a higher coverage gap in maternal and child health care services during 1992-2006, while the rural-urban difference in the coverage gap has increased in Gujarat, Haryana, Rajasthan and Kerala over the period. The analysis also shows a significant positive relationship between the coverage gap index and under-five mortality rate across states. Region or area-specific focus in order to increase the coverage of maternal and child health care services in India should be the priority of the policy-makers and programme executors.

A Two-Phase Coverage-Enhancing Algorithm for Hybrid Wireless Sensor Networks

PubMed Central

Zhang, Qingguo; Fok, Mable P.

2017-01-01

Providing field coverage is a key task in many sensor network applications. In certain scenarios, the sensor field may have coverage holes due to random initial deployment of sensors; thus, the desired level of coverage cannot be achieved. A hybrid wireless sensor network is a cost-effective solution to this problem, which is achieved by repositioning a portion of the mobile sensors in the network to meet the network coverage requirement. This paper investigates how to redeploy mobile sensor nodes to improve network coverage in hybrid wireless sensor networks. We propose a two-phase coverage-enhancing algorithm for hybrid wireless sensor networks. In phase one, we use a differential evolution algorithm to compute the candidate’s target positions in the mobile sensor nodes that could potentially improve coverage. In the second phase, we use an optimization scheme on the candidate’s target positions calculated from phase one to reduce the accumulated potential moving distance of mobile sensors, such that the exact mobile sensor nodes that need to be moved as well as their final target positions can be determined. Experimental results show that the proposed algorithm provided significant improvement in terms of area coverage rate, average moving distance, area coverage–distance rate and the number of moved mobile sensors, when compare with other approaches. PMID:28075365

Long-Term Protection against Diphtheria in the Netherlands after 50 Years of Vaccination: Results from a Seroepidemiological Study

PubMed Central

Swart, E. M.; van Gageldonk, P. G. M.; de Melker, H. E.; van der Klis, F. R.; Berbers, G. A. M.; Mollema, L.

2016-01-01

Background and Aims To evaluate the National Immunisation Programme (NIP) a population-based cross-sectional seroepidemiological study was performed in the Netherlands. We assessed diphtheria antitoxin levels in the general Dutch population and in low vaccination coverage (LVC) areas where a relatively high proportion of orthodox Protestants live who decline vaccination based on religious grounds. Results were compared with a nationwide seroepidemiological study performed 11 years earlier. Methods In 2006/2007 a national serum bank was established. Blood samples were tested for diphtheria antitoxin IgG concentrations using a multiplex immunoassay for 6383 participants from the national sample (NS) and 1518 participants from LVC municipalities. A cut-off above 0.01 international units per ml (IU/ml) was used as minimum protective level. Results In the NS 91% of the population had antibody levels above 0.01 IU/ml compared to 88% in the 1995/1996 serosurvey (p<0.05). On average, 82% (vs. 78% in the 1995/1996 serosurvey, p<0.05) of individuals from the NS born before introduction of diphtheria vaccination in the NIP and 46% (vs. 37% in the 1995/1996 serosurvey, p = 0.11) of orthodox Protestants living in LVC areas had antibody levels above 0.01 IU/ml. Linear regression analysis among fully immunized individuals (six vaccinations) without evidence of revaccination indicated a continuous decline in antibodies in both serosurveys, but geometric mean antibodies remained well above 0.01 IU/ml in all age groups. Conclusions The NIP provides long-term protection against diphtheria, although antibody levels decline after vaccination. As a result of natural waning immunity, a substantial proportion of individuals born before introduction of diphtheria vaccination in the NIP lack adequate levels of diphtheria antibodies. Susceptibility due to lack of vaccination is highest among strictly orthodox Protestants. The potential risk of spread of diphtheria within the geographically clustered orthodox Protestant community after introduction in the Netherlands has not disappeared, despite national long-term high vaccination coverage. PMID:26863307

Identifying Priority Areas for Conservation: A Global Assessment for Forest-Dependent Birds

PubMed Central

Buchanan, Graeme M.; Donald, Paul F.; Butchart, Stuart H. M.

2011-01-01

Limited resources are available to address the world's growing environmental problems, requiring conservationists to identify priority sites for action. Using new distribution maps for all of the world's forest-dependent birds (60.6% of all bird species), we quantify the contribution of remaining forest to conserving global avian biodiversity. For each of the world's partly or wholly forested 5-km cells, we estimated an impact score of its contribution to the distribution of all the forest bird species estimated to occur within it, and so is proportional to the impact on the conservation status of the world's forest-dependent birds were the forest it contains lost. The distribution of scores was highly skewed, a very small proportion of cells having scores several orders of magnitude above the global mean. Ecoregions containing the highest values of this score included relatively species-poor islands such as Hawaii and Palau, the relatively species-rich islands of Indonesia and the Philippines, and the megadiverse Atlantic Forests and northern Andes of South America. Ecoregions with high impact scores and high deforestation rates (2000–2005) included montane forests in Cameroon and the Eastern Arc of Tanzania, although deforestation data were not available for all ecoregions. Ecoregions with high impact scores, high rates of recent deforestation and low coverage by the protected area network included Indonesia's Seram rain forests and the moist forests of Trinidad and Tobago. Key sites in these ecoregions represent some of the most urgent priorities for expansion of the global protected areas network to meet Convention on Biological Diversity targets to increase the proportion of land formally protected to 17% by 2020. Areas with high impact scores, rapid deforestation, low protection and high carbon storage values may represent significant opportunities for both biodiversity conservation and climate change mitigation, for example through Reducing Emissions from Deforestation and Forest Degradation (REDD+) initiatives. PMID:22205998

Synergies and trade-offs in achieving global biodiversity targets.

PubMed

Di Marco, Moreno; Butchart, Stuart H M; Visconti, Piero; Buchanan, Graeme M; Ficetola, Gentile F; Rondinini, Carlo

2016-02-01

After their failure to achieve a significant reduction in the global rate of biodiversity loss by 2010, world governments adopted 20 new ambitious Aichi biodiversity targets to be met by 2020. Efforts to achieve one particular target can contribute to achieving others, but different targets may sometimes require conflicting solutions. Consequently, lack of strategic thinking might result, once again, in a failure to achieve global commitments to biodiversity conservation. We illustrate this dilemma by focusing on Aichi Target 11. This target requires an expansion of terrestrial protected area coverage, which could also contribute to reducing the loss of natural habitats (Target 5), reducing human-induced species decline and extinction (Target 12), and maintaining global carbon stocks (Target 15). We considered the potential impact of expanding protected areas to mitigate global deforestation and the consequences for the distribution of suitable habitat for >10,000 species of forest vertebrates (amphibians, birds, and mammals). We first identified places where deforestation might have the highest impact on remaining forests and then identified places where deforestation might have the highest impact on forest vertebrates (considering aggregate suitable habitat for species). Expanding protected areas toward locations with the highest deforestation rates (Target 5) or the highest potential loss of aggregate species' suitable habitat (Target 12) resulted in partially different protected area network configurations (overlapping with each other by about 73%). Moreover, the latter approach contributed to safeguarding about 30% more global carbon stocks than the former. Further investigation of synergies and trade-offs between targets would shed light on these and other complex interactions, such as the interaction between reducing overexploitation of natural resources (Targets 6, 7), controlling invasive alien species (Target 9), and preventing extinctions of native species (Target 12). Synergies between targets must be identified and secured soon and trade-offs must be minimized before the options for co-benefits are reduced by human pressures. © 2015 Society for Conservation Biology.

Further observations on comparison of immunization coverage by lot quality assurance sampling and 30 cluster sampling.

PubMed

Singh, J; Jain, D C; Sharma, R S; Verghese, T

1996-06-01

Lot Quality Assurance Sampling (LQAS) and standard EPI methodology (30 cluster sampling) were used to evaluate immunization coverage in a Primary Health Center (PHC) where coverage levels were reported to be more than 85%. Of 27 sub-centers (lots) evaluated by LQAS, only 2 were accepted for child coverage, whereas none was accepted for tetanus toxoid (TT) coverage in mothers. LQAS data were combined to obtain an estimate of coverage in the entire population; 41% (95% CI 36-46) infants were immunized appropriately for their ages, while 42% (95% CI 37-47) of their mothers had received a second/ booster dose of TT. TT coverage in 149 contemporary mothers sampled in EPI survey was also 42% (95% CI 31-52). Although results by the two sampling methods were consistent with each other, a big gap was evident between reported coverage (in children as well as mothers) and survey results. LQAS was found to be operationally feasible, but it cost 40% more and required 2.5 times more time than the EPI survey. LQAS therefore, is not a good substitute for current EPI methodology to evaluate immunization coverage in a large administrative area. However, LQAS has potential as method to monitor health programs on a routine basis in small population sub-units, especially in areas with high and heterogeneously distributed immunization coverage.

National- and state-level impact and cost-effectiveness of nonavalent HPV vaccination in the United States.

PubMed

Durham, David P; Ndeffo-Mbah, Martial L; Skrip, Laura A; Jones, Forrest K; Bauch, Chris T; Galvani, Alison P

2016-05-03

Every year in the United States more than 12,000 women are diagnosed with cervical cancer, a disease principally caused by human papillomavirus (HPV). Bivalent and quadrivalent HPV vaccines protect against 66% of HPV-associated cervical cancers, and a new nonavalent vaccine protects against an additional 15% of cervical cancers. However, vaccination policy varies across states, and migration between states interdependently dilutes state-specific vaccination policies. To quantify the economic and epidemiological impacts of switching to the nonavalent vaccine both for individual states and for the nation as a whole, we developed a model of HPV transmission and cervical cancer incidence that incorporates state-specific demographic dynamics, sexual behavior, and migratory patterns. At the national level, the nonavalent vaccine was shown to be cost-effective compared with the bivalent and quadrivalent vaccines at any coverage despite the greater per-dose cost of the new vaccine. Furthermore, the nonavalent vaccine remains cost-effective with up to an additional 40% coverage of the adolescent population, representing 80% of girls and 62% of boys. We find that expansion of coverage would have the greatest health impact in states with the lowest coverage because of the decreasing marginal returns of herd immunity. Our results show that if policies promoting nonavalent vaccine implementation and expansion of coverage are coordinated across multiple states, all states benefit both in health and in economic terms.

Design and Implementation of Secure Area Expansion Scheme for Public Wireless LAN Services

NASA Astrophysics Data System (ADS)

Watanabe, Ryu; Tanaka, Toshiaki

Recently, wireless LAN (WLAN) technology has become a major wireless communication method. The communication bandwidth is increasing and speeds have attained rates exceeding 100 Mbps. Therefore, WLAN technology is regarded as one of the promising communication methods for future networks. In addition, public WLAN connection services can be used in many locations. However, the number of the access points (AP) is insufficient for seamless communication and it cannot be said that users can use the service ubiquitously. An ad-hoc network style connection can be used to expand the coverage area of a public WLAN service. By relaying the user messages among the user nodes, a node can obtain an Internet connection via an AP, even though the node is located outside the AP's direct wireless connection area. Such a coverage area extending technology has many advantages thanks to the feature that no additional infrastructure is required. Therefore, there is a strong demand for this technology as it allows the cost-effective construction of future networks. When a secure ad-hoc routing protocol is used for message exchange in the WLAN service, the message routes are protected from malicious behavior such as route forging and can be maintained appropriately. To do this, however, a new node that wants to join the WLAN service has to obtain information such as the public key certificate and IP address in order to start secure ad-hoc routing. In other words, an initial setup is required for every network node to join the WLAN service properly. Ordinarily, such information should be assigned from the AP. However, new nodes cannot always contact an AP directly. Therefore, there are problems about information delivery in the initial setup of a network node. These problems originate in the multi hop connection based on the ad-hoc routing protocols. In order to realize an expanded area WLAN service, in this paper, the authors propose a secure public key certificate and address provision scheme during the initial setup phase on mobile nodes for the service. The proposed scheme also considers the protection of user privacy. Accordingly, none of the user nodes has to reveal their unique and persistent information to other nodes. Instead of using such information, temporary values are sent by an AP to mobile nodes and used for secure ad-hoc routing operations. Therefore, our proposed scheme prevents tracking by malicious parties by avoiding the use of unique information. Moreover, a test bed was also implemented based on the proposal and an evaluation was carried out in order to confirm performance. In addition, the authors describe a countermeasure against denial of service (DoS) attacks based on the approach to privacy protection described in our proposal.

Surface Plasmon Resonance Study of the Binding of PEO-PPO-PEO Triblock Copolymer and PEO Homopolymer to Supported Lipid Bilayers.

PubMed

Kim, Mihee; Vala, Milan; Ertsgaard, Christopher T; Oh, Sang-Hyun; Lodge, Timothy P; Bates, Frank S; Hackel, Benjamin J

2018-06-12

Poloxamer 188 (P188), a poly(ethylene oxide)- b-poly(propylene oxide)- b-poly(ethylene oxide) triblock copolymer, protects cell membranes against various external stresses, whereas poly(ethylene oxide) (PEO; 8600 g/mol) homopolymer lacks protection efficacy. As part of a comprehensive effort to elucidate the protection mechanism, we used surface plasmon resonance (SPR) to obtain direct evidence of binding of the polymers onto supported lipid bilayers. Binding kinetics and coverage of P188 and PEO were examined and compared. Most notably, PEO exhibited membrane association comparable to that of P188, evidenced by comparable association rate constants and coverage. This result highlights the need for additional mechanistic understanding beyond simple membrane association to explain the differential efficacy of P188 in therapeutic applications.

78 FR 15553 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-11

... at a single level of coverage but would have the option of doing so. For plan years beginning on or... exercise this option, but would instead assist employers in choosing a single QHP to offer their qualified... a SHOP (Sec. 155.705) Facilitating employee choice at a single level of coverage selected by the...

Medicare essential: an option to promote better care and curb spending growth.

PubMed

Davis, Karen; Schoen, Cathy; Guterman, Stuart

2013-05-01

Medicare's core benefit design reflects private insurance as of 1965, with separate coverage for hospital and physician services (and now prescription drugs) and no protection against catastrophic costs. Modernizing Medicare's benefit design to offer comprehensive benefits, financial protection, and incentives to choose high-value care could improve coverage and lower beneficiary costs. We describe a new option we call Medicare Essential, which would combine Medicare's hospital, physician, and prescription drug coverage into an integrated benefit with an annual limit on out-of-pocket expenses for covered benefits. Cost sharing would be reduced for enrollees who seek care from high-quality low-cost providers. Out-of-pocket savings from lower premiums and health care costs for a Medicare Essential enrollee could be $173 per month, compared to what an enrollee would pay with traditional Medicare, prescription drug and private supplemental coverage. Financed by a budget-neutral premium, we estimate that this new plan choice could reduce total health spending relative to current projections by $180 billion and reduce employer retiree spending by $90 billion during 2014-23. Given its potential, such an alternative should be a part of the debate over the future of Medicare.

Sessile and mobile components of a benthic ecosystem display mixed trends within a temperate marine reserve.

PubMed

Howarth, Leigh M; Pickup, Sarah E; Evans, Lowri E; Cross, Tim J; Hawkins, Julie P; Roberts, Callum M; Stewart, Bryce D

2015-06-01

Despite recent efforts to increase the global coverage of marine protected areas (MPAs), studies investigating the effectiveness of marine protected areas within temperate waters remain scarce. Furthermore, out of the few studies published on MPAs in temperate waters, the majority focus on specific ecological or fishery components rather than investigating the ecosystem as a whole. This study therefore investigated the dynamics of both benthic communities and fish populations within a recently established, fully protected marine reserve in Lamlash Bay, Isle of Arran, United Kingdom, over a four year period. A combination of photo and diver surveys revealed live maerl (Phymatolithon calcareum), macroalgae, sponges, hydroids, feather stars and eyelash worms (Myxicola infundibulum) to be significantly more abundant within the marine reserve than on surrounding fishing grounds. Likewise, the overall composition of epifaunal communities in and outside the reserve was significantly different. Both results are consistent with the hypothesis that protecting areas from fishing can encourage seafloor habitats to recover. In addition, the greater abundance of complex habitats within the reserve appeared to providing nursery habitat for juvenile cod (Gadus morhua) and scallops (Pecten maximus and Aequipecten opercularis). In contrast, there was little difference in the abundance of mobile benthic fauna, such as crabs and starfish, between the reserve and outside. Similarly, the use of baited underwater video cameras revealed no difference in the abundance and size of fish between the reserve and outside. Limited recovery of these ecosystem components may be due to the relatively small size (2.67 km(2)) and young age of the reserve (<5 years), both of which might have limited the extent of any benefits afforded to mobile fauna and fish communities. Overall, this study provides evidence that fully protected marine reserves can encourage seafloor habitats to recover, which in turn, can create a number of benefits that flow back to other species, including those of commercial importance. Copyright © 2015 Elsevier Ltd. All rights reserved.

The good news about smoking: how do U.S. newspapers cover tobacco issues?

PubMed

Clegg Smith, Katherine; Wakefield, Melanie; Edsall, Elizabeth

2006-07-01

Media advocacy, or advocacy seeking media attention, can shape the policy environment, but the relationship between the nature of news media coverage of public health topics and policy outcomes has received insufficient research attention. We present the first large-scale study of news coverage of tobacco to focus on the potential impact for policy outcomes. Through our analysis of 9859 tobacco-focused news articles from ioo leading US daily newspapers between 2001 and 2003 we examined whether tobacco issues are newsworthy, and if so, whether coverage is favorable to policy progress. We found strong evidence for news-worthiness, and a tendency for coverage to highlight policy approaches to tackling tobacco. Coverage emphasized successes rather than setbacks, and newspaper editors lent support to tobacco control positions. There were, however, areas that did not garner sufficient attention to sustain a meaningful policy message. Our analysis of coverage of controversial issues also revealed areas where tobacco control efforts seem to pushing against ideological boundaries.

Critical Infrastructure Protection II, The International Federation for Information Processing, Volume 290.

NASA Astrophysics Data System (ADS)

Papa, Mauricio; Shenoi, Sujeet

The information infrastructure -- comprising computers, embedded devices, networks and software systems -- is vital to day-to-day operations in every sector: information and telecommunications, banking and finance, energy, chemicals and hazardous materials, agriculture, food, water, public health, emergency services, transportation, postal and shipping, government and defense. Global business and industry, governments, indeed society itself, cannot function effectively if major components of the critical information infrastructure are degraded, disabled or destroyed. Critical Infrastructure Protection II describes original research results and innovative applications in the interdisciplinary field of critical infrastructure protection. Also, it highlights the importance of weaving science, technology and policy in crafting sophisticated, yet practical, solutions that will help secure information, computer and network assets in the various critical infrastructure sectors. Areas of coverage include: - Themes and Issues - Infrastructure Security - Control Systems Security - Security Strategies - Infrastructure Interdependencies - Infrastructure Modeling and Simulation This book is the second volume in the annual series produced by the International Federation for Information Processing (IFIP) Working Group 11.10 on Critical Infrastructure Protection, an international community of scientists, engineers, practitioners and policy makers dedicated to advancing research, development and implementation efforts focused on infrastructure protection. The book contains a selection of twenty edited papers from the Second Annual IFIP WG 11.10 International Conference on Critical Infrastructure Protection held at George Mason University, Arlington, Virginia, USA in the spring of 2008.

A generalized land-use scenario generator: a case study for the Congo basin.

NASA Astrophysics Data System (ADS)

Caporaso, Luca; Tompkins, Adrian Mark; Biondi, Riccardo; Bell, Jean Pierre

2014-05-01

The impact of deforestation on climate is often studied using highly idealized "instant deforestation" experiments due to the lack of generalized deforestation scenario generators coupled to climate model land-surface schemes. A new deforestation scenario generator has been therefore developed to fulfill this role known as the deforestation ScenArio GEnerator, or FOREST-SAGE. The model produces distributed maps of deforestation rates that account for local factors such as proximity to transport networks, distance weighted population density, forest fragmentation and presence of protected areas and logging concessions. The integrated deforestation risk is scaled to give the deforestation rate as specified by macro-region scenarios such as "business as usual" or "increased protection legislation" which are a function of future time. FOREST-SAGE was initialized and validated using the MODerate Resolution Imaging Spectroradiometer Vegetation Continuous Field data. Despite the high cloud coverage of Congo Basin over the year, we were able to validate the results with high confidence from 2001 to 2010 in a large forested area. Furthermore a set of scenarios has been used to provide a range of possible pathways for the evolution of land-use change over the Congo Basin for the period 2010-2030.

Coastal Seabed Mapping with Hyperspectral and Lidar data

NASA Astrophysics Data System (ADS)

Taramelli, A.; Valentini, E.; Filipponi, F.; Cappucci, S.

2017-12-01

A synoptic view of the coastal seascape and its dynamics needs a quantitative ability to dissect different components over the complexity of the seafloor where a mixture of geo - biological facies determines geomorphological features and their coverage. The present study uses an analytical approach that takes advantage of a multidimensional model to integrate different data sources from airborne Hyperspectral and LiDAR remote sensing and in situ measurements to detect antropogenic features and ecological `tipping points' in coastal seafloors. The proposed approach has the ability to generate coastal seabed maps using: 1) a multidimensional dataset to account for radiometric and morphological properties of waters and the seafloor; 2) a field spectral library to assimilate the high environmental variability into the multidimensional model; 3) a final classification scheme to represent the spatial gradients in the seafloor. The spatial pattern of the response to anthropogenic forcing may be indistinguishable from patterns of natural variability. It is argued that this novel approach to define tipping points following anthropogenic impacts could be most valuable in the management of natural resources and the economic development of coastal areas worldwide. Examples are reported from different sites of the Mediterranean Sea, both from Marine Protected and un-Protected Areas.

Asbestos worker protection. Environmental Protection Agency (EPA). Final rule.

PubMed

2000-11-15

In this Final Rule, EPA is amending both the Asbestos Worker Protection Rule (WPR) and the Asbestos-in-Schools Rule. The WPR amendment protects State and local government employees from the health risks of exposure to asbestos to the same extent as private sector workers by adopting for these employees the Asbestos Standards of the Occupational Safety and Health Administration (OSHA). The WPR's coverage is extended to State and local government employees who are performing construction work, custodial work, and automotive brake and clutch repair work. This final rule cross-references the OSHA Asbestos Standards for Construction and for General Industry, so that future amendments to these OSHA standards are directly and equally effective for employees covered by the WPR. EPA also amends the Asbestos-in-Schools Rule to provide coverage under the WPR for employees of public local education agencies who perform operations, maintenance, and repair activities. EPA is issuing this final rule under section 6 of the Toxic Substances Control Act (TSCA).

Lot quality assurance sampling for monitoring coverage and quality of a targeted condom social marketing programme in traditional and non-traditional outlets in India

PubMed Central

Piot, Bram; Navin, Deepa; Krishnan, Nattu; Bhardwaj, Ashish; Sharma, Vivek; Marjara, Pritpal

2010-01-01

Objectives This study reports on the results of a large-scale targeted condom social marketing campaign in and around areas where female sex workers are present. The paper also describes the method that was used for the routine monitoring of condom availability in these sites. Methods The lot quality assurance sampling (LQAS) method was used for the assessment of the geographical coverage and quality of coverage of condoms in target areas in four states and along selected national highways in India, as part of Avahan, the India AIDS initiative. Results A significant general increase in condom availability was observed in the intervention area between 2005 and 2008. High coverage rates were gradually achieved through an extensive network of pharmacies and particularly of non-traditional outlets, whereas traditional outlets were instrumental in providing large volumes of condoms. Conclusion LQAS is seen as a valuable tool for the routine monitoring of the geographical coverage and of the quality of delivery systems of condoms and of health products and services in general. With a relatively small sample size, easy data collection procedures and simple analytical methods, it was possible to inform decision-makers regularly on progress towards coverage targets. PMID:20167732

Lot quality assurance sampling for monitoring coverage and quality of a targeted condom social marketing programme in traditional and non-traditional outlets in India.

PubMed

Piot, Bram; Mukherjee, Amajit; Navin, Deepa; Krishnan, Nattu; Bhardwaj, Ashish; Sharma, Vivek; Marjara, Pritpal

2010-02-01

This study reports on the results of a large-scale targeted condom social marketing campaign in and around areas where female sex workers are present. The paper also describes the method that was used for the routine monitoring of condom availability in these sites. The lot quality assurance sampling (LQAS) method was used for the assessment of the geographical coverage and quality of coverage of condoms in target areas in four states and along selected national highways in India, as part of Avahan, the India AIDS initiative. A significant general increase in condom availability was observed in the intervention area between 2005 and 2008. High coverage rates were gradually achieved through an extensive network of pharmacies and particularly of non-traditional outlets, whereas traditional outlets were instrumental in providing large volumes of condoms. LQAS is seen as a valuable tool for the routine monitoring of the geographical coverage and of the quality of delivery systems of condoms and of health products and services in general. With a relatively small sample size, easy data collection procedures and simple analytical methods, it was possible to inform decision-makers regularly on progress towards coverage targets.

Recent proposals to limit Medigap coverage and modify Medicare cost sharing.

PubMed

Linehan, Kathryn

2012-02-24

As policymakers look for savings from the Medicare program, some have proposed eliminating or discouraging "first-dollar coverage" available through privately purchased Medigap policies. Medigap coverage, which beneficiaries obtain to protect themselves from Medicare's cost-sharing requirements and its lack of a cap on out-of-pocket spending, may discourage the judicious use of medical services by reducing or eliminating beneficiary cost sharing. It is estimated that eliminating such coverage, which has been shown to be associated with higher Medicare spending, and requiring some cost sharing would encourage beneficiaries to reduce their service use and thus reduce pro­gram spending. However, eliminating first-dollar coverage could cause some beneficiaries to incur higher spending or forego necessary services. Some policy proposals to eliminate first-dollar coverage would also modify Medicare's cost sharing and add an out-of-pocket spending cap for fee-for-service Medicare. This paper discusses Medicare's current cost-sharing requirements, Medigap insurance, and proposals to modify Medicare's cost sharing and eliminate first-dollar coverage in Medigap plans. It reviews the evidence on the effects of first-dollar coverage on spending, some objections to eliminating first-dollar coverage, and results of research that has modeled the impact of eliminating first-dollar coverage, modifying Medicare's cost-sharing requirements, and adding an out-of-pocket limit on beneficiaries' spending.

Is essential newborn care provided by institutions and after home births? Analysis of prospective data from community trials in rural South Asia

PubMed Central

2014-01-01

Background Provision of essential newborn care (ENC) can save many newborn lives in poor resource settings but coverage is far from universal and varies by country and place of delivery. Understanding gaps in current coverage and where coverage is good, in different contexts and places of delivery, could make a valuable contribution to the future design of interventions to reduce neonatal mortality. We sought to describe the coverage of essential newborn care practices for births in institutions, at home with a skilled birth attendant, and at home without a skilled birth attendant (SBA) in rural areas of Bangladesh, Nepal, and India. Methods We used data from the control arms of four cluster randomised controlled trials in Bangladesh, Eastern India and from Makwanpur and Dhanusha districts in Nepal, covering periods from 2001 to 2011. We used these data to identify essential newborn care practices as defined by the World Health Organization. Each birth was allocated to one of three delivery types: home birth without an SBA, home birth with an SBA, or institutional delivery. For each study, we calculated the observed proportion of births that received each care practice by delivery type with 95% confidence intervals, adjusted for clustering and, where appropriate, stratification. Results After exclusions, we analysed data for 8939 births from Eastern India, 27 553 births from Bangladesh, 6765 births from Makwanpur and 15 344 births from Dhanusha. Across all study areas, coverage of essential newborn care practices was highest in institutional deliveries, and lowest in home non-SBA deliveries. However, institutional deliveries did not provide universal coverage of the recommended practices, with relatively low coverage (20%-70%) across all study areas for immediate breastfeeding and thermal care. Institutions in Bangladesh had the highest coverage for almost all care practices except thermal care. Across all areas, fewer than 20% of home non-SBA deliveries used a clean delivery kit, the use of plastic gloves was very low and coverage of recommended thermal care was relatively poor. There were large differences between study areas in handwashing, immediate breastfeeding and delayed bathing. Conclusions There remains substantial scope for health facilities to improve thermal care for the newborn and to encourage immediate and exclusive breastfeeding. For unattended home deliveries, increased handwashing, use of clean delivery kits and basic thermal care offer great scope for improvement. PMID:24606612

40 CFR Appendix P to Subpart G of... - Substitutes Listed in the September 27, 2006 Final Rule, Effective November 27, 2006

Code of Federal Regulations, 2012 CFR

2012-07-01

... latest edition of the NFPA 2001 Standard for Clean Agent Fire Extinguishing Systems, for whichever... requirements. 4—The agent should be recovered from the fire protection system in conjunction with testing or... coverage related to the use of personal protective equipment (e.g., respiratory protection), fire...

40 CFR Appendix P to Subpart G of... - Substitutes Listed in the September 27, 2006 Final Rule, Effective November 27, 2006

Code of Federal Regulations, 2013 CFR

2013-07-01

... latest edition of the NFPA 2001 Standard for Clean Agent Fire Extinguishing Systems, for whichever... requirements. 4—The agent should be recovered from the fire protection system in conjunction with testing or... coverage related to the use of personal protective equipment (e.g., respiratory protection), fire...

40 CFR Appendix P to Subpart G of... - Substitutes Listed in the September 27, 2006 Final Rule, Effective November 27, 2006

Code of Federal Regulations, 2014 CFR

2014-07-01

... latest edition of the NFPA 2001 Standard for Clean Agent Fire Extinguishing Systems, for whichever... requirements. 4—The agent should be recovered from the fire protection system in conjunction with testing or... coverage related to the use of personal protective equipment (e.g., respiratory protection), fire...

Extracting fields snow coverage information with HJ-1A/B satellites data

NASA Astrophysics Data System (ADS)

Dong, Wenquan; Meng, Jihua

2015-10-01

The distribution and change of snow coverage are sensitive factors of climate change. In northeast part of China, farmlands are still covered with snow in spring. Since sowing activity can only be done when the snow melted, fields snow coverage monitoring provides reference for the determination of sowing date. Because of the restriction of the sensors and application requirements, current researches on remote sensing of snow focus more on the study of musicale and large scale, rather than the study of small scale, and especially research on snow melting period is rarely reported.HJ-1A/B satellites are parts of little satellite constellation, focusing on environment and disaster monitoring and meteorological forecast. Compared to other data sources, HJ-1A/B satellites both have comparatively higher temporal and spatial resolution and are more conducive to monitor the variations of melting snow coverage at small watershed. This paper was based on HJ-1A/1B data, taking Hongxing farm of Bei'an, Heilongjiang Province, China as the study area. In this paper, we exploited the methods for extraction of snow cover information on farmland in two cases, both HJ-1A/1B CCD with HJ-1B IRS data and just HJ-1A/1B CCD data. The reason we chose the two cases is that, the two optical satellites HJ-1A/B are capable of providing a whole territory coverage period in visible light spectrum in two days, infrared spectrum in four days. So sometimes we can only obtain CCD image. In this case, the method of normalized snow index cannot be used to extract snow coverage information. Using HJ-1A/1B CCD with HJ-1B IRS data, combined with the theory of snow remote sensing monitoring, this paper analyzed spectral response characteristics of HJ-1A/1B satellites data, then the widely used Normalized Difference Snow Index(NDSI) and S3 Index were quoted to the HJ-1A/1B satellites data. The NDSI uses reflectance values of Red and SWIR spectral bands of HJ-1B, and S3 index uses reflectance values of NIR, Red and SWIR spectral bands. With multi-temporal HJ satellite data, the optimal threshold of normalized snow index was determined to divide the farmland into snow covering area, melting snow area and non-snow area. The results are quite similar to each other and of high accuracy, and the melting snow coverage can be well extracted by two types of normalized snow index. When we can only obtain CCD image, we use supervised classification method to extract melting snow coverage. With this method, the accuracy of fields snow coverage extraction is slightly lower than that using normalized snow index methods mentioned above. And in mountain area, the snow coverage area is slightly larger than that is extracted by normalized snow index methods, because the shadows make the color of snow in the valley darker, the supervised classification method divides it into non-snow coverage area, while the normalized snow index method well weakened the effect of shadow. This study shows that extraction accuracy in both cases is assessed, and both of them can meet the needs of practical applications. HJ-1A/1B satellites are conducive to monitor the variations of melting snow coverage over farmland, and they can provide reference for the determination of sowing date.

Advances in soil erosion modelling through remote sensing data availability at European scale

NASA Astrophysics Data System (ADS)

Panagos, Panos; Karydas, Christos; Borrelli, Pasqualle; Ballabio, Cristiano; Meusburger, Katrin

2014-08-01

Under the European Union's Thematic Strategy for Soil Protection, the European Commission's Directorate-General for the Environment (DG Environment) has identified the mitigation of soil losses by erosion as a priority area. Policy makers call for an overall assessment of soil erosion in their geographical area of interest. They have asked that risk areas for soil erosion be mapped under present land use and climate conditions, and that appropriate measures be taken to control erosion within the legal and social context of natural resource management. Remote sensing data help to better assessment of factors that control erosion, such as vegetation coverage, slope length and slope angle. In this context, the data availability of remote sensing data during the past decade facilitates the more precise estimation of soil erosion risk. Following the principles of the Universal Soil Loss Equation (USLE), various options to calculate vegetative cover management (C-factor) have been investigated. The use of the CORINE Land Cover dataset in combination with lookup table values taken from the literature is presented as an option that has the advantage of a coherent input dataset but with the drawback of static input. Recent developments in the Copernicus programme have made detailed datasets available on land cover, leaf area index and base soil characteristics. These dynamic datasets allow for seasonal estimates of vegetation coverage, and their application in the G2 soil erosion model which represents a recent approach to the seasonal monitoring of soil erosion. The use of phenological datasets and the LUCAS land use/cover survey are proposed as auxiliary information in the selection of the best methodology.

47 CFR 22.951 - Minimum coverage requirement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... MOBILE SERVICES Cellular Radiotelephone Service § 22.951 Minimum coverage requirement. Applications for authority to operate a new cellular system in an unserved area, other than those filed by the licensee of an... toward the minimum coverage requirement. Applications for authority to operate a new cellular system in...

[A health promotion campaign to improve flu vaccination adherence among medical residents in an Italian Teaching Hospital].

PubMed

Barbara, Andrea; Poscia, Andrea; De Meo, Concetta; De Waure, Chiara; Anzelmo, Vincenza; Santoro, Paolo Emilio; Maruccia, Antonio; Giubbini, Gabriele; Corsaro, Alice; Berloco, Filippo; Damiani, Gianfranco; Ricciardi, Walter; Laurenti, Patrizia

2017-01-01

In Italy annual flu vaccination for health care workers is recommended but coverage is usually unsatisfying. The compliance is even worse among medical residents (MRs) both in literature, both in our experience: in the flu season 2014/ 15 only 0.6% of MRs enrolled at the Università Cattolica del Sacro Cuore (UCSC) were vaccinated. For this reason, during the influenza season 2015/16, the Institute of Public Health of the UCSC, in collaboration with the Health Management of the "Agostino Gemelli" Teaching Hospital (FPG) and with the directive board of the Medical Specialization Schools (SSM) present at the University has tested several strategies to improve awareness and adherence to flu vaccination campaign by its staff. This study aims to analyze the impact of the strategies used during the 2015/16 campaign on flu vaccination coverage among MRs of an important Italian Teaching Hospital. The study was conducted among MRs enrolled at the UCSC - FPG in 2015/16. The data was collected by the Occupational Medicine which, during the influenza seasons, immunize MRs against influenza free of charge. For each variable - vaccination, area of specialization (surgical, medical, clinical services), typology of SSM - was measured the absolute and percentage frequency. In order to compare the flu vaccination coverage between seasons 2014/15 and 2015/16 and between areas of specialization in 2015/16 chi-square test was used (statistical significance level of 0.05). The data were analyzed using STATA Software. Were included in the analysis 42 SSM with a total of 1041 MRs. During the vaccination campaign 2015/16, flu vaccine was administered to 99 MRs (9.5%), 8.9% more than in the previous season (p<0.001). There is also a significant difference in vaccine coverage between surgical, medical and clinical services areas in 2015/16 (p <0.001). The highest vaccination coverage was recorded among MRs of Hematology and Urology (54.5%). However, no one MRs had undergone flu vaccination in about 40% of SSM. Seasonal flu vaccination among HCWs is important to protect patients as well as them self and their family members. Considering that MRs represent the next generation of HCWs, they should be sensitized about the importance of preventing the spread of influenza in hospital population, becoming an active part of the necessary cultural change. This study highlights a first and promising, although insufficient, increase in flu vaccination coverage among MRs enrolled at the UCSC - FPG after introducing simple strategies to promote vaccination itself and, more generally, positive and proactive behaviors. The study summarizes the results in the short term, but it is well known that cultural changes require time and constancy. Therefore, it will be useful to monitor the improvement over time and extend the assessment to all health care professionals.

The effect of insecticide-treated bed nets on the incidence and prevalence of malaria in children in an area of unstable seasonal transmission in western Myanmar.

PubMed

Smithuis, Frank M; Kyaw, Moe Kyaw; Phe, U Ohn; van der Broek, Ingrid; Katterman, Nina; Rogers, Colin; Almeida, Patrick; Kager, Piet A; Stepniewska, Kasia; Lubell, Yoel; Simpson, Julie A; White, Nicholas J

2013-10-11

Insecticide-treated bed nets (ITN) reduce malaria morbidity and mortality consistently in Africa, but their benefits have been less consistent in Asia. This study's objective was to evaluate the malaria protective efficacy of village-wide usage of ITN in Western Myanmar and estimate the cost-effectiveness of ITN compared with extending early diagnosis and treatment services. A cluster-randomized controlled trial was conducted in Rakhine State to assess the efficacy of ITNs in preventing malaria and anaemia in children and their secondary effects on nutrition and development. The data were aggregated for each village to obtain cluster-level infection rates. In total 8,175 children under 10 years of age were followed up for 10 months, which included the main malaria transmission period. The incidence and prevalence of Plasmodium falciparum and Plasmodium vivax infections, and the biting behaviour of Anopheles mosquitoes in the area were studied concurrently. The trial data along with costs for current recommended treatment practices were modelled to estimate the cost-effectiveness of ITNs compared with, or in addition to extending the coverage of early diagnosis and treatment services. In aggregate, malaria infections, spleen rates, haemoglobin concentrations, and weight for height, did not differ significantly during the study period between villages with and without ITNs, with a weighted mean difference of -2.6 P. falciparum episodes per 1,000 weeks at risk (95% Confidence Interval -7 to 1.8). In areas with a higher incidence of malaria there was some evidence ITN protective efficacy. The economic analysis indicated that, despite the uncertainty and variability in their protective efficacy in the different study sites, ITN could still be cost-effective, but not if they displaced funding for early diagnosis and effective treatment which is substantially more cost-effective. In Western Myanmar deployment of ITNs did not provide consistent protection against malaria in children living in malaria endemic villages. Early diagnosis and effective treatment is a more cost effective malaria control strategy than deployment of ITNs in this area where the main vector bites early in the evening, often before people are protected by an ITN.

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.

Mapping plastic greenhouse with medium spatial resolution satellite data: Development of a new spectral index

NASA Astrophysics Data System (ADS)

Yang, Dedi; Chen, Jin; Zhou, Yuan; Chen, Xiang; Chen, Xuehong; Cao, Xin

2017-06-01

Plastic greenhouses (PGs) are an important agriculture development technique to protect and control the growing environment for food crops. The extensive use of PGs can change the agriculture landscape and affects the local environment. Accurately mapping and estimating the coverage of PGs is a necessity to the strategic planning of modern agriculture. Unfortunately, PG mapping over large areas is methodologically challenging, as the medium spatial resolution satellite imagery (such as Landsat data) used for analysis lacks spatial details and spectral variations. To fill the gap, the paper proposes a new plastic greenhouse index (PGI) based on the spectral, sensitivity, and separability analysis of PGs using medium spatial resolution images. In the context of the Landsat Enhanced Thematic Mapper Plus (ETM+) imagery, the paper examines the effectiveness and capability of the proposed PGI. The results indicate that PGs in Landsat ETM+ image can be successfully detected by the PGI if the PG fraction is greater than 12% in a mixed pixel. A kappa coefficient of 0.83 and overall accuracy of 91.2% were achieved when applying the proposed PGI in the case of Weifang District, Shandong, China. These results show that the proposed index can be applied to identifying transparent PGs in atmospheric corrected Landsat image and has the potential for the digital mapping of plastic greenhouse coverage over a large area.

Ionospheric irregularities and acoustic/gravity wave activity above low-latitude thunderstorms

DOE PAGES

Lay, Erin H.

2017-12-18

Ionospheric irregularities due to plasma bubbles, scintillation, and acoustic/gravity waves are studied in the low-latitude ionosphere in relation to thunderstorm activity. Ionospheric total electron content (TEC) measurements from the Low Latitude Ionospheric Sensor Network (LISN) and lightning measurements from the World-Wide Lightning Location Network (WWLLN) are compared during two summer months and two winter months in 2013. Large amplitude fluctuations in TEC are found to have a strongly-peaked diurnal pattern in the late evening and nighttime summer ionosphere. The maximum magnitude and coverage area of these fluctuations increases as thunderstorm area increases. Summertime mid-amplitude fluctuations do not exhibit the samemore » diurnal variation, but do increase in magnitude and coverage area as thunderstorm area increases. Wintertime ionospheric fluctuations do not appear to be related to thunderstorm activity. Lastly, these findings show that thunderstorms have an observable effect on magnitude and coverage area of ionospheric fluctuations.« less

Ionospheric irregularities and acoustic/gravity wave activity above low-latitude thunderstorms

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

Lay, Erin H.

Ionospheric irregularities due to plasma bubbles, scintillation, and acoustic/gravity waves are studied in the low-latitude ionosphere in relation to thunderstorm activity. Ionospheric total electron content (TEC) measurements from the Low Latitude Ionospheric Sensor Network (LISN) and lightning measurements from the World-Wide Lightning Location Network (WWLLN) are compared during two summer months and two winter months in 2013. Large amplitude fluctuations in TEC are found to have a strongly-peaked diurnal pattern in the late evening and nighttime summer ionosphere. The maximum magnitude and coverage area of these fluctuations increases as thunderstorm area increases. Summertime mid-amplitude fluctuations do not exhibit the samemore » diurnal variation, but do increase in magnitude and coverage area as thunderstorm area increases. Wintertime ionospheric fluctuations do not appear to be related to thunderstorm activity. Lastly, these findings show that thunderstorms have an observable effect on magnitude and coverage area of ionospheric fluctuations.« less

Ionospheric Irregularities and Acoustic/Gravity Wave Activity Above Low-Latitude Thunderstorms

NASA Astrophysics Data System (ADS)

Lay, Erin H.

2018-01-01

Ionospheric irregularities due to plasma bubbles, scintillation, and acoustic/gravity waves are studied in the low-latitude ionosphere in relation to thunderstorm activity. Ionospheric total electron content (TEC) measurements from the Low Latitude Ionospheric Sensor Network and lightning measurements from the World-Wide Lightning Location Network are compared during two summer months and two winter months in 2013. Large amplitude fluctuations in TEC are found to have a strongly peaked diurnal pattern in the late evening and nighttime summer ionosphere. The maximum magnitude and coverage area of these fluctuations increases as thunderstorm area increases. Summertime midamplitude fluctuations do not exhibit the same diurnal variation but do increase in magnitude and coverage area as thunderstorm area increases. Wintertime ionospheric fluctuations do not appear to be related to thunderstorm activity. These findings show that thunderstorms have an observable effect on magnitude and coverage area of ionospheric fluctuations.

Large conservation gains possible for global biodiversity facets.

PubMed

Pollock, Laura J; Thuiller, Wilfried; Jetz, Walter

2017-06-01

Different facets of biodiversity other than species numbers are increasingly appreciated as critical for maintaining the function of ecosystems and their services to humans. While new international policy and assessment processes such as the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) recognize the importance of an increasingly global, quantitative and comprehensive approach to biodiversity protection, most insights are still focused on a single facet of biodiversity-species. Here we broaden the focus and provide an evaluation of how much of the world's species, functional and phylogenetic diversity of birds and mammals is currently protected and the scope for improvement. We show that the large existing gaps in the coverage for each facet of diversity could be remedied by a slight expansion of protected areas: an additional 5% of the land has the potential to more than triple the protected range of species or phylogenetic or functional units. Further, the same areas are often priorities for multiple diversity facets and for both taxa. However, we find that the choice of conservation strategy has a fundamental effect on outcomes. It is more difficult (that is, requires more land) to maximize basic representation of the global biodiversity pool than to maximize local diversity. Overall, species and phylogenetic priorities are more similar to each other than they are to functional priorities, and priorities for the different bird biodiversity facets are more similar than those of mammals. Our work shows that large gains in biodiversity protection are possible, while also highlighting the need to explicitly link desired conservation objectives and biodiversity metrics. We provide a framework and quantitative tools to advance these goals for multi-faceted biodiversity conservation.

Large conservation gains possible for global biodiversity facets

NASA Astrophysics Data System (ADS)

Pollock, Laura J.; Thuiller, Wilfried; Jetz, Walter

2017-06-01

Different facets of biodiversity other than species numbers are increasingly appreciated as critical for maintaining the function of ecosystems and their services to humans. While new international policy and assessment processes such as the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) recognize the importance of an increasingly global, quantitative and comprehensive approach to biodiversity protection, most insights are still focused on a single facet of biodiversity—species. Here we broaden the focus and provide an evaluation of how much of the world’s species, functional and phylogenetic diversity of birds and mammals is currently protected and the scope for improvement. We show that the large existing gaps in the coverage for each facet of diversity could be remedied by a slight expansion of protected areas: an additional 5% of the land has the potential to more than triple the protected range of species or phylogenetic or functional units. Further, the same areas are often priorities for multiple diversity facets and for both taxa. However, we find that the choice of conservation strategy has a fundamental effect on outcomes. It is more difficult (that is, requires more land) to maximize basic representation of the global biodiversity pool than to maximize local diversity. Overall, species and phylogenetic priorities are more similar to each other than they are to functional priorities, and priorities for the different bird biodiversity facets are more similar than those of mammals. Our work shows that large gains in biodiversity protection are possible, while also highlighting the need to explicitly link desired conservation objectives and biodiversity metrics. We provide a framework and quantitative tools to advance these goals for multi-faceted biodiversity conservation.

Protecting patients, protecting healthcare workers: a review of the role of influenza vaccination

PubMed Central

Music, T

2012-01-01

MUSIC T. (2012) A review of the role the role of influenza vaccination in protecting patients, protecting healthcare workers the role of influenza vaccination. International Nursing Review59, 161–167 Aim: Many health authorities recommend routine influenza vaccination for healthcare workers (HCWs), and during the 2009 A (H1N1) pandemic, the World Health Organization (WHO) recommended immunization of all HCWs worldwide. As this remains an important area of policy debate, this paper examines the case for vaccination, the role of local guidelines, barriers to immunization and initiatives to increase uptake. Background: Seasonal influenza is a major threat to public health, causing up to 1 million deaths annually. Extensive evidence supports the vaccination of priority groups, including HCWs. Immunization protects HCWs themselves, and their vulnerable patients from nosocomial influenza infections. In addition, influenza can disrupt health services and impact healthcare organizations financially. Immunization can reduce staff absences, offer cost savings and provide economic benefits. Methods: This paper reviews official immunization recommendations and HCW vaccination studies, including a recent International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) survey of 26 countries from each region of the world. Results: HCW immunization is widely recommended and supported by the WHO. In the IFPMA study, 88% of countries recommended HCW vaccination, and 61% supported this financially (with no correlation to country development status). Overall, coverage can be improved, and research shows that uptake may be impacted by lack of conveniently available vaccines and misconceptions regarding vaccine safety/efficacy and influenza risk. Conclusions: Many countries recommend HCW vaccination against influenza. In recent years, there has been an increased uptake rate among HCWs in some countries, but not in others. Several initiatives can increase coverage, including education, easy access to free vaccines and the use of formal declination forms. The case for HCW vaccination is clear, and in an effort to further accelerate uptake as a patient safety measure, an increasing number of healthcare organizations, particularly in the USA, are implementing mandatory immunization policies, similar to other obligatory hygiene measures. However, it would be desirable if similar high vaccination uptake rates could be achieved through voluntary procedures. PMID:22591085

Promoting universal financial protection: evidence from seven low- and middle-income countries on factors facilitating or hindering progress

PubMed Central

2013-01-01

Although universal health coverage (UHC) is a global health policy priority, there remains limited evidence on UHC reforms in low- and middle-income countries (LMICs). This paper provides an overview of key insights from case studies in this thematic series, undertaken in seven LMICs (Costa Rica, Georgia, India, Malawi, Nigeria, Tanzania, and Thailand) at very different stages in the transition to UHC. These studies highlight the importance of increasing pre-payment funding through tax funding and sometimes mandatory insurance contributions when trying to improve financial protection by reducing out-of-pocket payments. Increased tax funding is particularly important if efforts are being made to extend financial protection to those outside formal-sector employment, raising questions about the value of pursuing contributory insurance schemes for this group. The prioritisation of insurance scheme coverage for civil servants in the first instance in some LMICs also raises questions about the most appropriate use of limited government funds. The diverse reforms in these countries provide some insights into experiences with policies targeted at the poor compared with universalist reform approaches. Countries that have made the greatest progress to UHC, such as Costa Rica and Thailand, made an explicit commitment to ensuring financial protection and access to needed care for the entire population as soon as possible, while this was not necessarily the case in countries adopting targeted reforms. There also tends to be less fragmentation in funding pools in countries adopting a universalist rather than targeting approach. Apart from limiting cross-subsidies, fragmentation of pools has contributed to differential benefit packages, leading to inequities in access to needed care and financial protection across population groups; once such differentials are entrenched, they are difficult to overcome. Capacity constraints, particularly in purchasing organisations, are a pervasive problem in LMICs. The case studies also highlighted the critical role of high-level political leadership in pursuing UHC policies and citizen support in sustaining these policies. This series demonstrates the value of promoting greater sharing of experiences on UHC reforms across LMICs. It also identifies key areas of future research on health care financing in LMICs that would support progress towards UHC. PMID:24228762

Promoting universal financial protection: evidence from seven low- and middle-income countries on factors facilitating or hindering progress.

PubMed

McIntyre, Di; Ranson, Michael K; Aulakh, Bhupinder K; Honda, Ayako

2013-09-24

Although universal health coverage (UHC) is a global health policy priority, there remains limited evidence on UHC reforms in low- and middle-income countries (LMICs). This paper provides an overview of key insights from case studies in this thematic series, undertaken in seven LMICs (Costa Rica, Georgia, India, Malawi, Nigeria, Tanzania, and Thailand) at very different stages in the transition to UHC.These studies highlight the importance of increasing pre-payment funding through tax funding and sometimes mandatory insurance contributions when trying to improve financial protection by reducing out-of-pocket payments. Increased tax funding is particularly important if efforts are being made to extend financial protection to those outside formal-sector employment, raising questions about the value of pursuing contributory insurance schemes for this group. The prioritisation of insurance scheme coverage for civil servants in the first instance in some LMICs also raises questions about the most appropriate use of limited government funds.The diverse reforms in these countries provide some insights into experiences with policies targeted at the poor compared with universalist reform approaches. Countries that have made the greatest progress to UHC, such as Costa Rica and Thailand, made an explicit commitment to ensuring financial protection and access to needed care for the entire population as soon as possible, while this was not necessarily the case in countries adopting targeted reforms. There also tends to be less fragmentation in funding pools in countries adopting a universalist rather than targeting approach. Apart from limiting cross-subsidies, fragmentation of pools has contributed to differential benefit packages, leading to inequities in access to needed care and financial protection across population groups; once such differentials are entrenched, they are difficult to overcome. Capacity constraints, particularly in purchasing organisations, are a pervasive problem in LMICs. The case studies also highlighted the critical role of high-level political leadership in pursuing UHC policies and citizen support in sustaining these policies.This series demonstrates the value of promoting greater sharing of experiences on UHC reforms across LMICs. It also identifies key areas of future research on health care financing in LMICs that would support progress towards UHC.

Developing a mathematical model for the evaluation of the potential impact of a partially efficacious vaccine on the transmission dynamics of Schistosoma mansoni in human communities.

PubMed

Stylianou, Andria; Hadjichrysanthou, Christoforos; Truscott, James E; Anderson, Roy M

2017-06-17

There is currently no vaccine available to protect humans against infection with the schistosome digenean parasites, although candidate formulations for Schistosoma mansoni are under trial in animal models, including rodents and primates. Current strategies for the control of infection are based on mass drug administration (MDA) targeted at school-aged children of age 5 to 14 years. This approach is unlikely to eliminate exposure to infection except in settings with very low levels of transmission. A deterministic mathematical model for the transmission dynamics of the parasite is described and employed to investigate community level outcomes. The model is defined to encompass two different delivery strategies for the vaccination of the population, namely, infant (cohort) and mass vaccination. However, in this paper the focus is on vaccination delivered in a cohort immunisation programme where infants are immunised within the first year of life before acquiring infection. An analysis of the parasite's transmission dynamics following the administration of a partially protective vaccine is presented. The vaccine acts on parasite mortality, fecundity or/and establishment. A vaccine with an efficacy of over 60% can interrupt transmission in low and moderate transmission settings. In higher transmission intensity areas, greater efficacy or higher infant vaccination coverage is required. Candidate vaccines that act either on parasite mortality, fecundity or establishment within the human host, can be similarly effective. In all cases, however, the duration of protection is important. The community level impact of vaccines with all modes of action, declines if vaccine protection is of a very short duration. However, durations of protection of 5-10 years or more are sufficient, with high coverage and efficacy levels, to halt transmission. The time taken to break transmission may be 18 years or more after the start of the cohort vaccination, depending on the intensity of the transmission in a defined location. The analyses provide support for the proposition that even a partially efficacious vaccine could be of great value in reducing the burden of schistosome infections in endemic regions and hopefully could provide a template for the elimination of parasite transmission.

7 CFR 1740.8 - Scoring criteria for the grant competition.

Code of Federal Regulations, 2013 CFR

2013-01-01

... follows: (1) The rural population of a core coverage area must be calculated. The rural population of a county is calculated by subtracting the county's urban population(s) from the total county population. If the core coverage area consists of multiple counties, the rural population is the sum of all included...

7 CFR 1740.8 - Scoring criteria for the grant competition.

Code of Federal Regulations, 2014 CFR

2014-01-01

... follows: (1) The rural population of a core coverage area must be calculated. The rural population of a county is calculated by subtracting the county's urban population(s) from the total county population. If the core coverage area consists of multiple counties, the rural population is the sum of all included...

7 CFR 1740.8 - Scoring criteria for the grant competition.

Code of Federal Regulations, 2012 CFR

2012-01-01

... follows: (1) The rural population of a core coverage area must be calculated. The rural population of a county is calculated by subtracting the county's urban population(s) from the total county population. If the core coverage area consists of multiple counties, the rural population is the sum of all included...

7 CFR 1740.8 - Scoring criteria for the grant competition.

Code of Federal Regulations, 2011 CFR

2011-01-01

... follows: (1) The rural population of a core coverage area must be calculated. The rural population of a county is calculated by subtracting the county's urban population(s) from the total county population. If the core coverage area consists of multiple counties, the rural population is the sum of all included...

22 CFR 126.5 - Canadian exemptions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... such persons publicly available through the Internet Web site of the Directorate of Defense Trade... coverage area on the surface of the earth less than 200 nautical miles in diameter, where “coverage area” is defined as that area on the surface of the earth that is illuminated by the main beam width of the...

Population-based HPV vaccination programmes are safe and effective: 2017 update and the impetus for achieving better global coverage.

PubMed

Brotherton, Julia M L; Bloem, Paul N

2018-02-01

Persistent oncogenic human papillomavirus (HPV) is the cause of cervical cancer, as well as cancers of the anus, penis, vulva, vagina and oropharynx. There is good evidence that prophylactic HPV vaccines are immunogenic and effective against targeted-type HPV infections and type-specific genital lesions, including high-grade cervical intraepithelial neoplasia (CIN), when administered prior to HPV infection. There is good evidence that HPV vaccines are safe in population usage, with the most frequent adverse event being injection-site reactions. There is evidence to support some cross-protection against non-targeted types occurring following the administration of HPV vaccines. There is limited evidence suggesting that HPV vaccines may be beneficial in preventing future disease in women treated for high-grade CIN. This chapter focuses on the accumulated evidence regarding the global use of the three licensed HPV vaccines including safety, immunogenicity, duration of protection, effectiveness, coverage to date and barriers to higher coverage. Copyright © 2018 Elsevier Ltd. All rights reserved.

Successful respiratory immunization with dry powder live-attenuated measles virus vaccine in rhesus macaques

PubMed Central

Lin, Wen-Hsuan; Griffin, Diane E.; Rota, Paul A.; Papania, Mark; Cape, Stephen P.; Bennett, David; Quinn, Brian; Sievers, Robert E.; Shermer, Charles; Powell, Kenneth; Adams, Robert J.; Godin, Steven; Winston, Scott

2011-01-01

Measles remains an important cause of childhood mortality worldwide. Sustained high vaccination coverage is the key to preventing measles deaths. Because measles vaccine is delivered by injection, hurdles to high coverage include the need for trained medical personnel and a cold chain, waste of vaccine in multidose vials and risks associated with needle use and disposal. Respiratory vaccine delivery could lower these barriers and facilitate sustained high coverage. We developed a novel single unit dose, dry powder live-attenuated measles vaccine (MVDP) for respiratory delivery without reconstitution. We tested the immunogenicity and protective efficacy in rhesus macaques of one dose of MVDP delivered either with a mask or directly intranasal with two dry powder inhalers, PuffHaler and BD Solovent. MVDP induced robust measles virus (MeV)-specific humoral and T-cell responses, without adverse effects, which completely protected the macaques from infection with wild-type MeV more than one year later. Respiratory delivery of MVDP was safe and effective and could aid in measles control. PMID:21282608

Successful respiratory immunization with dry powder live-attenuated measles virus vaccine in rhesus macaques.

PubMed

Lin, Wen-Hsuan; Griffin, Diane E; Rota, Paul A; Papania, Mark; Cape, Stephen P; Bennett, David; Quinn, Brian; Sievers, Robert E; Shermer, Charles; Powell, Kenneth; Adams, Robert J; Godin, Steven; Winston, Scott

2011-02-15

Measles remains an important cause of childhood mortality worldwide. Sustained high vaccination coverage is the key to preventing measles deaths. Because measles vaccine is delivered by injection, hurdles to high coverage include the need for trained medical personnel and a cold chain, waste of vaccine in multidose vials and risks associated with needle use and disposal. Respiratory vaccine delivery could lower these barriers and facilitate sustained high coverage. We developed a novel single unit dose, dry powder live-attenuated measles vaccine (MVDP) for respiratory delivery without reconstitution. We tested the immunogenicity and protective efficacy in rhesus macaques of one dose of MVDP delivered either with a mask or directly intranasal with two dry powder inhalers, PuffHaler and BD Solovent. MVDP induced robust measles virus (MeV)-specific humoral and T-cell responses, without adverse effects, which completely protected the macaques from infection with wild-type MeV more than one year later. Respiratory delivery of MVDP was safe and effective and could aid in measles control.

26 CFR 1.36B-0 - Table of contents.

Code of Federal Regulations, 2013 CFR

2013-04-01

... health plan. (d) Family and family size. (e) Household income. (1) In general. (2) Modified adjusted... credit payment. (k) Exchange. (l) Self-only coverage. (m) Family coverage. (n) Rating area. (o) Effective...) Applicable benchmark plan. (1) In general. (2) Family coverage. (3) Silver level plan not covering a taxpayer...

26 CFR 1.36B-0 - Table of contents.

Code of Federal Regulations, 2014 CFR

2014-04-01

... health plan. (d) Family and family size. (e) Household income. (1) In general. (2) Modified adjusted... credit payment. (k) Exchange. (l) Self-only coverage. (m) Family coverage. (n) Rating area. (o) Effective...) Applicable benchmark plan. (1) In general. (2) Family coverage. (3) Silver level plan not covering a taxpayer...

Tanning, Skin Cancer Risk, and Prevention: A Content Analysis of Eight Popular Magazines that Target Female Readers, 1997–2006

PubMed Central

Cho, Hyunyi; Hall, Jennifer G.; Kosmoski, Carin; Fox, Rebekah L.; Mastin, Teresa

2008-01-01

The majority of tanning bed users in the U.S. are women. Previous health communication research frequently focused on the risk of skin cancer, but few studies assessed the mediated communication environment that may surround women’s beliefs and behaviors relevant to tanning. A content analysis of articles in eight magazines targeting girls, young women, older women, and women who are interested in fitness during the ten-year period of 1997–2006 was conducted. The amount of coverage of tanning bed use consequences was less than 50% of the coverage of tanning benefits. About 40% of the tanning benefits coverage touted looking healthy. The coverage of prevention methods focused on sunscreen use (55%), while the more important methods (e.g., protective clothing use) were rarely featured. Longitudinally, the coverage of the risk and prevention relevant issues increased between 1997 and 2006. The data indicate that the coverage of tanning benefits also increased during the same period. PMID:20228954

Shared responsibility payment for not maintaining minimum essential coverage. Final regulations.

PubMed

2013-08-30

This document contains final regulations on the requirement to maintain minimum essential coverage enacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended by the TRICARE Affirmation Act and Public Law 111-173. These final regulations provide guidance to individual taxpayers on the liability under section 5000A of the Internal Revenue Code for the shared responsibility payment for not maintaining minimum essential coverage and largely finalize the rules in the notice of proposed rulemaking published in the Federal Register on February 1, 2013.

Self-assembly and nanosphere lithography for large-area plasmonic patterns on graphene.

PubMed

Lotito, Valeria; Zambelli, Tomaso

2015-06-01

Plasmonic structures on graphene can tailor its optical properties, which is essential for sensing and optoelectronic applications, e.g. for the enhancement of photoresponsivity of graphene photodetectors. Control over their structural and, hence, spectral properties can be attained by using electron beam lithography, which is not a viable solution for the definition of patterns over large areas. For the fabrication of large-area plasmonic nanostructures, we propose to use self-assembled monolayers of nanospheres as a mask for metal evaporation and etching processes. An optimized approach based on self-assembly at air/water interface with a properly designed apparatus allows the attainment of monolayers of hexagonally closely packed patterns with high long-range order and large area coverage; special strategies are devised in order to protect graphene against damage resulting from surface treatment and further processing steps such as reactive ion etching, which could potentially impair graphene properties. Therefore we demonstrate that nanosphere lithography is a cost-effective solution to create plasmonic patterns on graphene. Copyright © 2014 Elsevier Inc. All rights reserved.

Designing and Testing Broadly-Protective Filoviral Vaccines Optimized for Cytotoxic T-Lymphocyte Epitope Coverage

PubMed Central

Fenimore, Paul W.; Foley, Brian T.; Bakken, Russell R.; Thurmond, James R.; Yusim, Karina; Yoon, Hyejin; Parker, Michael; Hart, Mary Kate; Dye, John M.; Korber, Bette; Kuiken, Carla

2012-01-01

We report the rational design and in vivo testing of mosaic proteins for a polyvalent pan-filoviral vaccine using a computational strategy designed for the Human Immunodeficiency Virus type 1 (HIV-1) but also appropriate for Hepatitis C virus (HCV) and potentially other diverse viruses. Mosaics are sets of artificial recombinant proteins that are based on natural proteins. The recombinants are computationally selected using a genetic algorithm to optimize the coverage of potential cytotoxic T lymphocyte (CTL) epitopes. Because evolutionary history differs markedly between HIV-1 and filoviruses, we devised an adapted computational technique that is effective for sparsely sampled taxa; our first significant result is that the mosaic technique is effective in creating high-quality mosaic filovirus proteins. The resulting coverage of potential epitopes across filovirus species is superior to coverage by any natural variants, including current vaccine strains with demonstrated cross-reactivity. The mosaic cocktails are also robust: mosaics substantially outperformed natural strains when computationally tested against poorly sampled species and more variable genes. Furthermore, in a computational comparison of cross-reactive potential a design constructed prior to the Bundibugyo outbreak performed nearly as well against all species as an updated design that included Bundibugyo. These points suggest that the mosaic designs would be more resilient than natural-variant vaccines against future Ebola outbreaks dominated by novel viral variants. We demonstrate in vivo immunogenicity and protection against a heterologous challenge in a mouse model. This design work delineates the likely requirements and limitations on broadly-protective filoviral CTL vaccines. PMID:23056184

Three-Dimensional Analysis of Deep Space Network Antenna Coverage

NASA Technical Reports Server (NTRS)

Kegege, Obadiah; Fuentes, Michael; Meyer, Nicholas; Sil, Amy

2012-01-01

There is a need to understand NASA s Deep Space Network (DSN) coverage gaps and any limitations to provide redundant communication coverage for future deep space missions, especially for manned missions to Moon and Mars. The DSN antennas are required to provide continuous communication coverage for deep space flights, interplanetary missions, and deep space scientific observations. The DSN consists of ground antennas located at three sites: Goldstone in USA, Canberra in Australia, and Madrid in Spain. These locations are not separated by the exactly 120 degrees and some DSN antennas are located in the bowl-shaped mountainous terrain to shield against radiofrequency interference resulting in a coverage gap in the southern hemisphere for the current DSN architecture. To analyze the extent of this gap and other coverage limitations, simulations of the DSN architecture were performed. In addition to the physical properties of the DSN assets, the simulation incorporated communication forward link calculations and azimuth/elevation masks that constrain the effects of terrain for each DSN antenna. Analysis of the simulation data was performed to create coverage profiles with the receiver settings at a deep space altitudes ranging from 2 million to 10 million km and a spherical grid resolution of 0.25 degrees with respect to longitude and latitude. With the results of these simulations, two- and three-dimensional representations of the area without communication coverage and area with coverage were developed, showing the size and shape of the communication coverage gap projected in space. Also, the significance of this communication coverage gap is analyzed from the simulation data.

[Attitudes and practices towards seasonal influenza vaccination amongst French hospital staff].

PubMed

Maurette, Max; Pinzelli, Pierre; Yordanov Sandev, Aleksandar; Nock, Francis

2017-04-27

This survey intends to describe the attitudes towards vaccination amongst the hospital staff in the region of Castres, in the south-west of France, and their influenza vaccination coverage. A questionnaire was attached to all pay slips in March 2014 and 471 questionnaires were completed (return rate: 22.4%). Seasonal influenza vaccination coverage rate was similar to that reported in other French surveys. Paramedical personnel were less commonly immunized against influenza compared to medical personnel and age was the major factor associated with vaccination. Three quarters of the non-immunized hospital personnel did not wish to be vaccinated against influenza. Nearly 50% of respondents believed that healthcare personnel do not have to be role models regarding vaccination. The arguments considered most compelling in favour of vaccination are protection of the family, then patient protection and finally protection of other staff members. A demand for accurate scientific information was expressed by respondents, preferably delivered at their workplace.

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.

Thermal infrared panoramic imaging sensor

NASA Astrophysics Data System (ADS)

Gutin, Mikhail; Tsui, Eddy K.; Gutin, Olga; Wang, Xu-Ming; Gutin, Alexey

2006-05-01

Panoramic cameras offer true real-time, 360-degree coverage of the surrounding area, valuable for a variety of defense and security applications, including force protection, asset protection, asset control, security including port security, perimeter security, video surveillance, border control, airport security, coastguard operations, search and rescue, intrusion detection, and many others. Automatic detection, location, and tracking of targets outside protected area ensures maximum protection and at the same time reduces the workload on personnel, increases reliability and confidence of target detection, and enables both man-in-the-loop and fully automated system operation. Thermal imaging provides the benefits of all-weather, 24-hour day/night operation with no downtime. In addition, thermal signatures of different target types facilitate better classification, beyond the limits set by camera's spatial resolution. The useful range of catadioptric panoramic cameras is affected by their limited resolution. In many existing systems the resolution is optics-limited. Reflectors customarily used in catadioptric imagers introduce aberrations that may become significant at large camera apertures, such as required in low-light and thermal imaging. Advantages of panoramic imagers with high image resolution include increased area coverage with fewer cameras, instantaneous full horizon detection, location and tracking of multiple targets simultaneously, extended range, and others. The Automatic Panoramic Thermal Integrated Sensor (APTIS), being jointly developed by Applied Science Innovative, Inc. (ASI) and the Armament Research, Development and Engineering Center (ARDEC) combines the strengths of improved, high-resolution panoramic optics with thermal imaging in the 8 - 14 micron spectral range, leveraged by intelligent video processing for automated detection, location, and tracking of moving targets. The work in progress supports the Future Combat Systems (FCS) and the Intelligent Munitions Systems (IMS). The APTIS is anticipated to operate as an intelligent node in a wireless network of multifunctional nodes that work together to serve in a wide range of applications of homeland security, as well as serve the Army in tasks of improved situational awareness (SA) in defense and offensive operations, and as a sensor node in tactical Intelligence Surveillance Reconnaissance (ISR). The novel ViperView TM high-resolution panoramic thermal imager is the heart of the APTIS system. It features an aberration-corrected omnidirectional imager with small optics designed to match the resolution of a 640x480 pixels IR camera with improved image quality for longer range target detection, classification, and tracking. The same approach is applicable to panoramic cameras working in the visible spectral range. Other components of the ATPIS system include network communications, advanced power management, and wakeup capability. Recent developments include image processing, optical design being expanded into the visible spectral range, and wireless communications design. This paper describes the development status of the APTIS system.

76 FR 41993 - Customs and Border Protection Officer Retirement

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-18

... Border Protection Officers Sec. 831.1601 Applicability and purpose. 831.1602 Definitions. 831.1603... position is a prerequisite. Sec. 831.1603 Conditions for coverage in primary positions. (a) An employee's... determination under Sec. Sec. 831.1603(a) and 831.1604(a) must be based solely on the official position...

75 FR 60643 - Customs and Border Protection Officer Retirement

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-01

... Border Protection Officers Sec. 831.1601 Applicability and purpose. 831.1602 Definitions. 831.1603... prerequisite. Sec. 831.1603 Conditions for coverage in primary positions. (a) An employee's service in a.... Sec. 831.1603(a) and 831.1604(a) must be based solely on the official position description of the...

The Relationship of HIPAA to Special Education

ERIC Educational Resources Information Center

Benitz, Catherine, Comp.

2006-01-01

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) includes important, but limited, protections for millions of working Americans and their families around the ability to obtain and keep health coverage. Among its specific protections, HIPAA: (1) Limits the use of preexisting condition exclusions; (2) Prohibits group health…

Mapping AIS coverage for trusted surveillance

NASA Astrophysics Data System (ADS)

Lapinski, Anna-Liesa S.; Isenor, Anthony W.

2010-10-01

Automatic Identification System (AIS) is an unattended vessel reporting system developed for collision avoidance. Shipboard AIS equipment automatically broadcasts vessel positional data at regular intervals. The real-time position and identity data from a vessel is received by other vessels in the area thereby assisting with local navigation. As well, AIS broadcasts are beneficial to those concerned with coastal and harbour security. Land-based AIS receiving stations can also collect the AIS broadcasts. However, reception at the land station is dependent upon the ship's position relative to the receiving station. For AIS to be used as a trusted surveillance system, the characteristics of the AIS coverage area in the vicinity of the station (or stations) should be understood. This paper presents some results of a method being investigated at DRDC Atlantic, Canada) to map the AIS coverage characteristics of a dynamic AIS reception network. The method is shown to clearly distinguish AIS reception edges from those edges caused by vessel traffic patterns. The method can also be used to identify temporal changes in the coverage area, an important characteristic for local maritime security surveillance activities. Future research using the coverage estimate technique is also proposed to support surveillance activities.

Role of shell diffusion area in incubating eggs at simulated high altitude.

PubMed

Weiss, H S

1978-10-01

Embryonic development is inhibited when eggs are incubated at 9,100 m (0.3 atm) despite a normoxic environment. The problem apparently relates to respiratory gas exchange occurring by diffusion through gas-filled pores in the shell. Gaseous flux is therefore inversely proportional to ambient pressure and is affected by the physical characteristics of the ambient gas (Chapman-Enskog equation). Excess loss of H2O and CO2 occurs in eggs incubating at altitude and could be detrimental. Such increased loss should be correctable by decreasing diffusion area. This was tested by progressively increasing coverage of the shell with paraffin and incubating at simulated 0.3 ATA (225 Torr) in 100% O2. Uncoated eggs failed to hatch, but numbers of chicks increased with increased coverage. Maximum hatch was an extrapolated 90% of controls at 69% shell coverage. With further coverage, hatch size decreased. Egg weight loss, and estimate of H2O diffusion, was around three times controls in uncoated eggs but decreased linearly with paraffin coverage, reaching near normal at maximum hatch. Reduction of diffusion area to 0.3 normal at maximum hatch generally balanced the increased flux predicted for 0.3 ATA.

Effects of nozzle type and spray angle on spray deposition in ivy pot plants.

PubMed

Foqué, Dieter; Nuyttens, David

2011-02-01

Fewer plant protection products are now authorised for use in ornamental growings. Frequent spraying with the same product or a suboptimal technique can lead to resistance in pests and diseases. Better application techniques could improve the sustainable use of the plant protection products still available. Spray boom systems--instead of the still predominantly used spray guns--might improve crop protection management in greenhouses considerably. The effect of nozzle type, spray pressure and spray angle on spray deposition and coverage in ivy pot plants was studied, with a focus on crop penetration and spraying the bottom side of the leaves in this dense crop. The experiments showed a significant and important effect of collector position on deposition and coverage in the plant. Although spray deposition and coverage on the bottom side of the leaves are generally low, they could be improved 3.0-4.9-fold using the appropriate application technique. When using a spray boom in a dense crop, the nozzle choice, spray pressure and spray angle should be well considered. The hollow-cone, the air-inclusion flat-fan and the standard flat-fan nozzle with an inclined spray angle performed best because of the effect of swirling droplets, droplets with a high momentum and droplet direction respectively. Copyright © 2010 Society of Chemical Industry.

The risk of incomplete personal protection coverage in vector-borne disease.

PubMed

Miller, Ezer; Dushoff, Jonathan; Huppert, Amit

2016-02-01

Personal protection (PP) techniques, such as insecticide-treated nets, repellents and medications, include some of the most important and commonest ways used today to protect individuals from vector-borne infectious diseases. In this study, we explore the possibility that a PP intervention with partial coverage may have the counterintuitive effect of increasing disease burden at the population level, by increasing the biting intensity on the unprotected portion of the population. To this end, we have developed a dynamic model which incorporates parameters that describe the potential effects of PP on vector searching and biting behaviour and calculated its basic reproductive rate, R0. R0 is a well-established threshold of disease risk; the higher R0 is above unity, the stronger the disease onset intensity. When R0 is below unity, the disease is typically unable to persist. The model analysis revealed that partial coverage with popular PP techniques can realistically lead to a substantial increase in the reproductive number. An increase in R0 implies an increase in disease burden and difficulties in eradication efforts within certain parameter regimes. Our findings therefore stress the importance of studying vector behavioural patterns in response to PP interventions for future mitigation of vector-borne diseases. © 2016 The Author(s).

47 CFR 90.685 - Authorization, construction and implementation of EA licenses.

Code of Federal Regulations, 2014 CFR

2014-10-01

... into operation a sufficient number of base stations to provide coverage to at least one-third of the population of its EA-based service area. Further, each EA licensee must provide coverage to at least two-thirds of the population of the EA-based service area within five years of the grant of their initial...

47 CFR 90.685 - Authorization, construction and implementation of EA licenses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... into operation a sufficient number of base stations to provide coverage to at least one-third of the population of its EA-based service area. Further, each EA licensee must provide coverage to at least two-thirds of the population of the EA-based service area within five years of the grant of their initial...

47 CFR 90.685 - Authorization, construction and implementation of EA licenses.

Code of Federal Regulations, 2011 CFR

2011-10-01

... into operation a sufficient number of base stations to provide coverage to at least one-third of the population of its EA-based service area. Further, each EA licensee must provide coverage to at least two-thirds of the population of the EA-based service area within five years of the grant of their initial...

47 CFR 90.685 - Authorization, construction and implementation of EA licenses.

Code of Federal Regulations, 2012 CFR

2012-10-01

... into operation a sufficient number of base stations to provide coverage to at least one-third of the population of its EA-based service area. Further, each EA licensee must provide coverage to at least two-thirds of the population of the EA-based service area within five years of the grant of their initial...

47 CFR 90.685 - Authorization, construction and implementation of EA licenses.

Code of Federal Regulations, 2013 CFR

2013-10-01

... into operation a sufficient number of base stations to provide coverage to at least one-third of the population of its EA-based service area. Further, each EA licensee must provide coverage to at least two-thirds of the population of the EA-based service area within five years of the grant of their initial...

Risk in daily newspaper coverage of red tide blooms in Southwest Florida.

PubMed

Li, Zongchao; Garrison, Bruce; Ullmann, Steven G; Kirkpatrick, Barbara; Fleming, Lora E; Hoagland, Porter

This study investigated newspaper coverage of Florida red tide blooms in four metropolitan areas of Southwest Florida during a 25-year period, 1987-2012. We focused on how journalists framed red tide stories with respect to environmental risk, health risk, and economic risk. We determined risk to be a key factor in this news coverage, being an aspect of coverage of red tide itself in terms of environmental risk, tourism risk, and public health risk. The study found that red tide news coverage is most often framed as an environmental story.

Assessment of Routine Immunization Coverage in Nyala Locality, Reasons behind Incomplete Immunization in South Darfur State, Sudan

PubMed Central

Ismail, Ismail Tibin Adam; El-Tayeb, Elsadeg Mahgoob; Omer, Mohammed Diaaeldin F.A.; Eltahir, Yassir Mohammed; El-Sayed, El-Tayeb Ahmed; Deribe, Kebede

2014-01-01

Little is known about the coverage of routine immunization service in South Darfur state, Sudan. Therefore, this study was conducted to determine the vaccination rate and barriers for vaccination. A cross-sectional community-based study was undertaken in Nyala locality, south Darfur, Sudan, including urban, rural and Internal Displaced Peoples (IDPs) population in proportional representation. Survey data were collected by a questionnaire which was applied face to face to parents of 213 children 12-23 months. The collected data was then analyzed with SPSS software package. Results showed that vaccination coverage as revealed by showed vaccination card alone was 63.4% while it was increased to 82.2% when both history and cards were used. Some (5.6%) of children were completely non-vaccinated. The factors contributing to the low vaccination coverage were found to be knowledge problems of mothers (51%), access problems (15%) and attitude problems (34%). Children whose mother attended antenatal care and those from urban areas were more likely to complete their immunization schedule. In conclusion, the vaccination coverage in the studied area was low compared to the national coverage. Efforts to increase vaccination converge and completion of the scheduled plan should focus on addressing concerns of caregivers particularly side effects and strengthening the Expanded Programmer on Immunization services in rural areas. PMID:25729558

Assessment of Routine Immunization Coverage in Nyala Locality, Reasons behind Incomplete Immunization in South Darfur State, Sudan.

PubMed

Ismail, Ismail Tibin Adam; El-Tayeb, Elsadeg Mahgoob; Omer, Mohammed Diaaeldin F A; Eltahir, Yassir Mohammed; El-Sayed, El-Tayeb Ahmed; Deribe, Kebede

2014-02-25

Little is known about the coverage of routine immunization service in South Darfur state, Sudan. Therefore, this study was conducted to determine the vaccination rate and barriers for vaccination. A cross-sectional community-based study was undertaken in Nyala locality, south Darfur, Sudan, including urban, rural and Internal Displaced Peoples (IDPs) population in proportional representation. Survey data were collected by a questionnaire which was applied face to face to parents of 213 children 12-23 months. The collected data was then analyzed with SPSS software package. Results showed that vaccination coverage as revealed by showed vaccination card alone was 63.4% while it was increased to 82.2% when both history and cards were used. Some (5.6%) of children were completely non-vaccinated. The factors contributing to the low vaccination coverage were found to be knowledge problems of mothers (51%), access problems (15%) and attitude problems (34%). Children whose mother attended antenatal care and those from urban areas were more likely to complete their immunization schedule. In conclusion, the vaccination coverage in the studied area was low compared to the national coverage. Efforts to increase vaccination converge and completion of the scheduled plan should focus on addressing concerns of caregivers particularly side effects and strengthening the Expanded Programmer on Immunization services in rural areas.

Drug release through liposome pores.

PubMed

Dan, Nily

2015-02-01

Electrical, ultrasound and other types of external fields are known to induce the formation of pores in cellular and model membranes. This paper examines drug release through field induced liposome pores using Monte Carlo simulations. We find that drug release rates vary as a function of pore size and spacing, as well as the overall fraction of surface area covered by pores: The rate of release from liposomes is found to increase rapidly with pore surface coverage, approaching that of the fully ruptured liposome at fractional pore areas. For a given pore surface coverage, the pore size affects the release rate in the limit of low coverage, but not when the pores cover a relatively high fraction of the liposome surface area. On the other hand, for a given pore size and surface coverage, the distribution of pores significantly affects the release in the limit of high surface coverage: The rate of release from a liposome covered with a regularly spaced array of pores is, in this limit, higher than the release rate from (most) systems where the pores are distributed randomly on the liposome surface. In contrast, there is little effect of the pore distribution on release when the pore surface coverage is low. The simulation results are in good agreement with the predictions of detailed diffusion models. Copyright © 2014 Elsevier B.V. All rights reserved.

An adjusted bed net coverage indicator with estimations for 23 African countries

PubMed Central

2013-01-01

Background Many studies have assessed the level of bed net coverage in populations at risk of malaria infection. These revealed large variations in bed net use across countries, regions and social strata. Such studies are often aimed at identifying populations with low access to bed nets that should be prioritized in future interventions. However, often spatial differences in malaria endemicity are not taken into account. By ignoring variability in malaria endemicity, these studies prioritize populations with little access to bed nets, even if these happen to live in low endemicity areas. Conversely, populations living in regions with high malaria endemicity will receive a lower priority once a seizable proportion is protected by bed nets. Adequately assigning priorities requires accounting for both the current level of bed net coverage and the local malaria endemicity. Indeed, as shown here for 23 African countries, there is no correlation between the level of bed net coverage and the level of malaria endemicity in a region. Therefore, the need for future interventions can not be assessed based on current bed net coverage alone. This paper proposes the Adjusted Bed net Coverage (ABC) statistic as a measure taking into account both local malaria endemicity and the level of bed net coverage. The measure allows setting priorities for future interventions taking into account both local malaria endemicity and bed net coverage. Methods A mathematical formulation of the ABC as a weighted difference of bed net coverage and malaria endemicity is presented. The formulation is parameterized based on a model of malaria epidemiology (Smith et al. Trends Parasitol 25:511-516, 2009). By parameterizing the ABC based on this model, the ABC as used in this paper is proxy for the steady-state malaria burden given the current level of bed net coverage. Data on the bed net coverage in under five year olds and malaria endemicity in 23 Sub-Saharan countries is used to show that the ABC prioritizes different populations than the level of bed net coverage by itself. Data from the following countries was used: Angola, Burkina Faso, Burundi, Cameroon, Congo Democratic Republic, Ethiopia, Ghana, Guinea, Kenya, Liberia, Madagascar, Malawi, Mali, Mozambique, Namibia, Nigeria, Rwanda, Senegal, Sierra Leone, Tanzania, Uganda, Zambia and Zimbabwe. The priority order given by the ABC and the bed net coverage are compared at the countries’ level, the first level administrative divisions and for five different wealth quintiles. Results Both at national level and at the level of the administrative divisions the ABC suggests a different priority order for selecting countries and divisions for future interventions. When taking into account malaria endemicity, measures assessing equality in access to bed nets across wealth quintiles, such as slopes of inequality, are prone to change. This suggests that when assessing inequality in access to bed nets one should take into account the local malaria endemicity for populations from different wealth quintiles. Conclusion Accounting for malaria endemicity highlights different countries, regions and socio-economic strata for future intervention than the bed net coverage by itself. Therefore, care should be taken to factor out any effects of local malaria endemicity in assessing bed net coverage and in prioritizing populations for further scale-up of bed net coverage. The ABC is proposed as a simple means to do this that is derived from an existing model of malaria epidemiology. PMID:24359227

Node Scheduling Strategies for Achieving Full-View Area Coverage in Camera Sensor Networks.

PubMed

Wu, Peng-Fei; Xiao, Fu; Sha, Chao; Huang, Hai-Ping; Wang, Ru-Chuan; Xiong, Nai-Xue

2017-06-06

Unlike conventional scalar sensors, camera sensors at different positions can capture a variety of views of an object. Based on this intrinsic property, a novel model called full-view coverage was proposed. We study the problem that how to select the minimum number of sensors to guarantee the full-view coverage for the given region of interest (ROI). To tackle this issue, we derive the constraint condition of the sensor positions for full-view neighborhood coverage with the minimum number of nodes around the point. Next, we prove that the full-view area coverage can be approximately guaranteed, as long as the regular hexagons decided by the virtual grid are seamlessly stitched. Then we present two solutions for camera sensor networks in two different deployment strategies. By computing the theoretically optimal length of the virtual grids, we put forward the deployment pattern algorithm (DPA) in the deterministic implementation. To reduce the redundancy in random deployment, we come up with a local neighboring-optimal selection algorithm (LNSA) for achieving the full-view coverage. Finally, extensive simulation results show the feasibility of our proposed solutions.

Node Scheduling Strategies for Achieving Full-View Area Coverage in Camera Sensor Networks

PubMed Central

Wu, Peng-Fei; Xiao, Fu; Sha, Chao; Huang, Hai-Ping; Wang, Ru-Chuan; Xiong, Nai-Xue

2017-01-01

Unlike conventional scalar sensors, camera sensors at different positions can capture a variety of views of an object. Based on this intrinsic property, a novel model called full-view coverage was proposed. We study the problem that how to select the minimum number of sensors to guarantee the full-view coverage for the given region of interest (ROI). To tackle this issue, we derive the constraint condition of the sensor positions for full-view neighborhood coverage with the minimum number of nodes around the point. Next, we prove that the full-view area coverage can be approximately guaranteed, as long as the regular hexagons decided by the virtual grid are seamlessly stitched. Then we present two solutions for camera sensor networks in two different deployment strategies. By computing the theoretically optimal length of the virtual grids, we put forward the deployment pattern algorithm (DPA) in the deterministic implementation. To reduce the redundancy in random deployment, we come up with a local neighboring-optimal selection algorithm (LNSA) for achieving the full-view coverage. Finally, extensive simulation results show the feasibility of our proposed solutions. PMID:28587304

Vaccinating Girls and Boys with Different Human Papillomavirus Vaccines: Can It Optimise Population-Level Effectiveness?

PubMed Central

Drolet, Mélanie; Boily, Marie-Claude; Van de Velde, Nicolas; Franco, Eduardo L.; Brisson, Marc

2013-01-01

Background Decision-makers may consider vaccinating girls and boys with different HPV vaccines to benefit from their respective strengths; the quadrivalent (HPV4) prevents anogenital warts (AGW) whilst the bivalent (HPV2) may confer greater cross-protection. We compared, to a girls-only vaccination program with HPV4, the impact of vaccinating: 1) both genders with HPV4, and 2) boys with HPV4 and girls with HPV2. Methods We used an individual-based transmission-dynamic model of heterosexual HPV infection and diseases. Our base-case scenario assumed lifelong efficacy of 100% against vaccine types, and 46,29,8,18,6% and 77,43,79,8,0% efficacy against HPV-31,-33,-45,-52,-58 for HPV4 and HPV2, respectively. Results Assuming 70% vaccination coverage and lifelong cross-protection, vaccinating boys has little additional benefit on AGW prevention, irrespective of the vaccine used for girls. Furthermore, using HPV4 for boys and HPV2 for girls produces greater incremental reductions in SCC incidence than using HPV4 for both genders (12 vs 7 percentage points). At 50% vaccination coverage, vaccinating boys produces incremental reductions in AGW of 17 percentage points if both genders are vaccinated with HPV4, but increases female incidence by 16 percentage points if girls are switched to HPV2 (heterosexual male incidence is incrementally reduced by 24 percentage points in both scenarios). Higher incremental reductions in SCC incidence are predicted when vaccinating boys with HPV4 and girls with HPV2 versus vaccinating both genders with HPV4 (16 vs 12 percentage points). Results are sensitive to vaccination coverage and the relative duration of protection of the vaccines. Conclusion Vaccinating girls with HPV2 and boys with HPV4 can optimize SCC prevention if HPV2 has higher/longer cross-protection, but can increase AGW incidence if vaccination coverage is low among boys. PMID:23840589

Vaccinating Girls and Boys with Different Human Papillomavirus Vaccines: Can It Optimise Population-Level Effectiveness?

PubMed

Drolet, Mélanie; Boily, Marie-Claude; Van de Velde, Nicolas; Franco, Eduardo L; Brisson, Marc

2013-01-01

Decision-makers may consider vaccinating girls and boys with different HPV vaccines to benefit from their respective strengths; the quadrivalent (HPV4) prevents anogenital warts (AGW) whilst the bivalent (HPV2) may confer greater cross-protection. We compared, to a girls-only vaccination program with HPV4, the impact of vaccinating: 1) both genders with HPV4, and 2) boys with HPV4 and girls with HPV2. We used an individual-based transmission-dynamic model of heterosexual HPV infection and diseases. Our base-case scenario assumed lifelong efficacy of 100% against vaccine types, and 46,29,8,18,6% and 77,43,79,8,0% efficacy against HPV-31,-33,-45,-52,-58 for HPV4 and HPV2, respectively. Assuming 70% vaccination coverage and lifelong cross-protection, vaccinating boys has little additional benefit on AGW prevention, irrespective of the vaccine used for girls. Furthermore, using HPV4 for boys and HPV2 for girls produces greater incremental reductions in SCC incidence than using HPV4 for both genders (12 vs 7 percentage points). At 50% vaccination coverage, vaccinating boys produces incremental reductions in AGW of 17 percentage points if both genders are vaccinated with HPV4, but increases female incidence by 16 percentage points if girls are switched to HPV2 (heterosexual male incidence is incrementally reduced by 24 percentage points in both scenarios). Higher incremental reductions in SCC incidence are predicted when vaccinating boys with HPV4 and girls with HPV2 versus vaccinating both genders with HPV4 (16 vs 12 percentage points). Results are sensitive to vaccination coverage and the relative duration of protection of the vaccines. Vaccinating girls with HPV2 and boys with HPV4 can optimize SCC prevention if HPV2 has higher/longer cross-protection, but can increase AGW incidence if vaccination coverage is low among boys.

Coverage with Tetanus, Diphtheria, and Acellular Pertussis Vaccine and Influenza Vaccine Among Pregnant Women - Minnesota, March 2013-December 2014.

PubMed

Barber, Alexandra; Muscoplat, Miriam Halstead; Fedorowicz, Anna

2017-01-20

Pertussis and influenza infections can result in severe disease in infants. The diphtheria, tetanus, acellular pertussis (DTaP) vaccine is recommended for infants beginning at age 2 months, and influenza vaccine is recommended for infants aged ≥6 months. Vaccination of pregnant women induces the production of antibodies that are transferred across the placenta to the fetus and provide passive protection until infants are old enough to receive DTaP and influenza vaccines (1-3). To protect young infants before they are age-eligible for vaccination, the Advisory Committee on Immunization Practices (ACIP) has recommended since 2004 that all women who are or will be pregnant during influenza season receive inactivated influenza vaccine (1), and since 2013 that all pregnant women receive the tetanus, diphtheria, acellular pertussis (Tdap) vaccine (3). Tdap and influenza vaccination coverage was assessed among pregnant women in Minnesota. Vital records data containing maternal demographic characteristics, prenatal care data, and delivery payment methods were matched with vaccination data from the Minnesota Immunization Information Connection (MIIC) to assess vaccination coverage. MIIC stores vaccination records for Minnesota residents. Overall, coverage with Tdap vaccine was 58.2% and with influenza vaccine was 45.9%. Coverage was higher for each vaccine among women who received adequate prenatal care compared with those who received inadequate or intermediate care, based on the initiation of prenatal care and the number of recommended prenatal visits attended. Coverage also varied based on mother's race, country of birth or region, and other demographic characteristics. Further study is needed to better understand the maternal vaccination disparities found in this study and to inform future public health initiatives.

Expansion of Coverage under the Patient Protection and Affordable Care Act and Primary Care Utilization

PubMed Central

Hofer, Adam N; Abraham, Jean Marie; Moscovice, Ira

2011-01-01

Context: Provisions of the Patient Protection and Affordable Care Act of 2010 (PPACA) expand Medicaid to all individuals in families earning less than 133 percent of the federal poverty level (FPL) and make available subsidies to uninsured lower-income Americans (133 to 400 percent of FPL) without access to employer-based coverage to purchase insurance in new exchanges. Since primary care physicians typically serve as the point of entry into the health care delivery system, an adequate supply of them is critical to meeting the anticipated increase in demand for medical care resulting from the expansion of coverage. This article provides state-level estimates of the anticipated increases in primary care utilization given the PPACA's provisions for expanded coverage. Methods: Using the Medical Expenditure Panel Survey, this article estimates a multivariate regression model of annual primary care utilization. Using the model estimates and state-level information regarding the number of uninsured, it predicts, by state, the change in primary care visits expected from the expanded coverage. Finally, the article predicts the number of primary care physicians needed to accommodate this change in utilization. Findings: This expanded coverage is predicted to increase by 2019 the number of annual primary care visits between 15.07 million and 24.26 million. Assuming stable levels of physicians’ productivity, between 4,307 and 6,940 additional primary care physicians would be needed to accommodate this increase. Conclusions: The PPACA's health insurance expansion parameters are expected to significantly increase the use of primary care. Two strategies that policymakers may consider are creating stronger financial incentives to attract medical school students to primary care and changing the delivery of care in ways that lead to operational improvements, higher throughput, and better quality of care. PMID:21418313

"Perspectives on financing population-based health care towards Universal Health Coverage among employed individuals in Ghanzi district, Botswana: A qualitative study".

PubMed

Mbogo, Barnabas Africanus; McGill, Deborah

2016-08-19

Globally, about 150 million people experience catastrophic healthcare expenditure services annually. Among low and middle income countries, out-of-pocket expenditure pushes about 100 million people into poverty annually. In Botswana, 83 % of the general population and 58 % of employed individuals do not have medical aid coverage. Moreover, inequity allocation of financial resources between health services suggests marginalization of population-based health care services (i.e. diseases prevention and health promotion). The purpose of the study is to explore perspectives on employed individuals regarding financing population based health care interventions towards Universal Health Coverage (UHC) in order to make recommendations to the Ministry of Health on health financing options to cover population-based health services. A qualitative design grounded in interpretivist epistemology through social constructivism lens was critical for exploring perspectives of employed individuals. Through purposive and snowballing sampling techniques, a total of 15 respondents including 8 males and 7 females were recruited and interviewed using a semi-structured format. Their age ranged from 23 to 59 years with a median of 36 years. Data was analyzed using Thematic Content Analysis technique. Use of social constructivism lens enabled to classify emerging themes into population coverage, health services coverage and financial protection issues. Despite broad understanding of health coverage schemes among participants, knowledge appears insignificant in increasing enrolment. Participants indicated limited understanding of UHC concepts, however showed willingness to embrace UHC upon brief description. Main thematic issues raised include: exclusion of population-based health services from coverage scheme; disparity in financial protection and health services coverage among enrollees; inability to sustain contracted employees; and systematic exclusion of unemployed individuals and informal sector employees. Increasing enrolment in health coverage schemes requires targeted campaign for information dissemination through use of myriads mass media including: social networks, TV, Radio and others. Moreover, re-designing health insurance schemes is critical in order to include population-based interventions; expand uptake of unemployed and informal sector employees; flexibility in monthly premiums payment plan and use of technology to increase access to payment points. Further study need to evaluate the content of health financing policy in Botswana measured against the World Health Organization Universal Health Coverage conceptual requirements for Low and Middle Income Countries.

75 FR 70114 - Amendment to the Interim Final Rules for Group Health Plans and Health Insurance Coverage...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-17

...This document contains an amendment to interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding status as a grandfathered health plan; the amendment permits certain changes in policies, certificates, or contracts of insurance without loss of grandfathered status.

Strengthening institutional and organizational capacity for social health protection of the informal sector in lesser-developed countries: a study of policy barriers and opportunities in Cambodia.

PubMed

Annear, Peter Leslie; Ahmed, Shakil; Ros, Chhun Eang; Ir, Por

2013-11-01

Reaching out to the poor and the informal sector is a major challenge for achieving universal coverage in lesser-developed countries. In Cambodia, extensive coverage by health equity funds for the poor has created the opportunity to consolidate various non-government health financing schemes under the government's proposed social health protection structure. This paper identifies the main policy and operational challenges to strengthening existing arrangements for the poor and the informal sector, and considers policy options to address these barriers. Conducted in conjunction with the Cambodian Ministry of Health in 2011-12, the study reviewed policy documents and collected qualitative data through 18 semi-structured key informant interviews with government, non-government and donor officials. Data were analysed using the Organizational Assessment for Improving and Strengthening Health Financing conceptual framework. We found that a significant shortfall related to institutional, organisational and health financing issues resulted in fragmentation and constrained the implementation of social health protection schemes, including health equity funds, community-based health insurance, vouchers and others. Key documents proposed the establishment of a national structure for the unification of the informal-sector schemes but left unresolved issues related to structure, institutional capacity and the third-party status of the national agency. This study adds to the evidence base on appropriate and effective institutional and organizational arrangements for social health protection in the informal sector in developing countries. Among the key lessons are: the need to expand the fiscal space for health care; a commitment to equity; specific measures to protect the poor; building national capacity for administration of universal coverage; and working within the specific national context. Copyright © 2013 Elsevier Ltd. All rights reserved.

Optimization of Archeological Anomalies using GIS method for Magnetic and Resistivity Study at Sungai Batu, Lembah Bujang, Kedah (Malaysia)

NASA Astrophysics Data System (ADS)

Yusoh, R.; Saad, R.; Saidin, M.; Anda, S. T.; Muhammad, S. B.; Ashraf, M. I. M.; Hazreek, Z. A. M.

2018-04-01

Magnetic and resistivity method has become a reliable option in archeological exploration. The use of both method has become popular these day. However, both method gives different type of sensing in detecting anomalies and direct interpret from the anomalies will result large coverage area for excavation. Therefore, to overcome this issue, both anomalies can be extracted using ArcGIS software to reduce excavated coverage area. The case study located at Sungai Batu, Lembah Bujang near SB2ZZ lot expected buried clay brick monument which will be a perfect case to apply this technique. Magnetic and resistivity method was implemented at the study area where the anomalies coverage area for magnetic and resistivity is 531.5 m2 and 636 m2 respectively which total area of both anomalies was 764 m2. By applying combine technique, the anomalies area reduce to 403.7 m2 which reduce the suspected anomalies by 47.16 %. The unsuspected clay brick monument area was increase from 15.86% to 55.54% which improve the cost and labor work for excavation.

Topoclimatological and snowhydrological survey of Switzerland

NASA Technical Reports Server (NTRS)

Winiger, M. (Principal Investigator)

1980-01-01

The author has identified the following significant results. Low temperature zones depend on the topography and the terrain coverage type (besides the meteorological situation). The usual pattern of cold zones at the bottom of the valleys, warmer belts along the valley slopes, and cold mountain tops is modified by the terrain coverage type. Rural and forested areas normally have different surface temperatures, but along a vertical profile the temperature decrease (or increase) is often of the same order of magnitude. Because there is also a close correlation between the topography and terrain coverage (high percentage of forested areas at the valley slopes up to the timber line, much less along the valley floors), the surface temperature of the warm slope zone is increased compared to a valley profile with uniform coverage.

Monitoring health interventions – who's afraid of LQAS?

PubMed Central

Pezzoli, Lorenzo; Kim, Sung Hye

2013-01-01

Lot quality assurance sampling (LQAS) is used to evaluate health services. Subunits of a population (lots) are accepted or rejected according to the number of failures in a random sample (N) of a given lot. If failures are greater than decision value (d), we reject the lot and recommend corrective actions in the lot (i.e. intervention area); if they are equal to or less than d, we accept it. We used LQAS to monitor coverage during the last 3 days of a meningitis vaccination campaign in Niger. We selected one health area (lot) per day reporting the lowest administrative coverage in the previous 2 days. In the sampling plan we considered: N to be small enough to allow us to evaluate one lot per day, deciding to sample 16 individuals from the selected villages of each health area, using probability proportionate to population size; thresholds and d to vary according to administrative coverage reported; α ≤5% (meaning that, if we would have conducted the survey 100 times, we would have accepted the lot up to five times when real coverage was at an unacceptable level) and β ≤20% (meaning that we would have rejected the lot up to 20 times, when real coverage was equal or above the satisfactory level). We classified all three lots as with the acceptable coverage. LQAS appeared to be a rapid, simple, and statistically sound method for in-process coverage assessment. We encourage colleagues in the field to consider using LQAS in complement with other monitoring techniques such as house-to-house monitoring. PMID:24206650

Monitoring health interventions--who's afraid of LQAS?

PubMed

Pezzoli, Lorenzo; Kim, Sung Hye

2013-11-08

Lot quality assurance sampling (LQAS) is used to evaluate health services. Subunits of a population (lots) are accepted or rejected according to the number of failures in a random sample (N) of a given lot. If failures are greater than decision value (d), we reject the lot and recommend corrective actions in the lot (i.e. intervention area); if they are equal to or less than d, we accept it. We used LQAS to monitor coverage during the last 3 days of a meningitis vaccination campaign in Niger. We selected one health area (lot) per day reporting the lowest administrative coverage in the previous 2 days. In the sampling plan we considered: N to be small enough to allow us to evaluate one lot per day, deciding to sample 16 individuals from the selected villages of each health area, using probability proportionate to population size; thresholds and d to vary according to administrative coverage reported; α ≤5% (meaning that, if we would have conducted the survey 100 times, we would have accepted the lot up to five times when real coverage was at an unacceptable level) and β ≤20% (meaning that we would have rejected the lot up to 20 times, when real coverage was equal or above the satisfactory level). We classified all three lots as with the acceptable coverage. LQAS appeared to be a rapid, simple, and statistically sound method for in-process coverage assessment. We encourage colleagues in the field to consider using LQAS in complement with other monitoring techniques such as house-to-house monitoring.

Strategies for Coordination of a Serosurvey in Parallel with an Immunization Coverage Survey

PubMed Central

Travassos, Mark A.; Beyene, Berhane; Adam, Zenaw; Campbell, James D.; Mulholland, Nigisti; Diarra, Seydou S.; Kassa, Tassew; Oot, Lisa; Sequeira, Jenny; Reymann, Mardi; Blackwelder, William C.; Pasetti, Marcela F.; Sow, Samba O.; Steinglass, Robert; Kebede, Amha; Levine, Myron M.

2015-01-01

A community-based immunization coverage survey is the standard way to estimate effective vaccination delivery to a target population in a region. Accompanying serosurveys can provide objective measures of protective immunity against vaccine-preventable diseases but pose considerable challenges with respect to specimen collection and preservation and community compliance. We performed serosurveys coupled to immunization coverage surveys in three administrative districts (woredas) in rural Ethiopia. Critical to the success of this effort were serosurvey equipment and supplies, team composition, and tight coordination with the coverage survey. Application of these techniques to future studies may foster more widespread use of serosurveys to derive more objective assessments of vaccine-derived seroprotection and monitor and compare the performance of immunization services in different districts of a country. PMID:26055737

A GPS coverage model

NASA Technical Reports Server (NTRS)

Skidmore, Trent A.

1994-01-01

The results of several case studies using the Global Positioning System coverage model developed at Ohio University are summarized. Presented are results pertaining to outage area, outage dynamics, and availability. Input parameters to the model include the satellite orbit data, service area of interest, geometry requirements, and horizon and antenna mask angles. It is shown for precision-landing Category 1 requirements that the planned GPS 21 Primary Satellite Constellation produces significant outage area and unavailability. It is also shown that a decrease in the user equivalent range error dramatically decreases outage area and improves the service availability.

An Investigation of Three Extremity Armor Systems: Determination of Physiological, Biomechanical, and Physical Performance Effects and Quantification of Body Area Coverage

DTIC Science & Technology

2012-03-19

THREE EXTREMITY ARMOR SYSTEMS: DETERMINATION OF PHYSIOLOGICAL, BIOMECHANICAL, AND PHYSICAL PERFORMANCE EFFECTS AND QUANTIFICATION OF BODY AREA...PHYSICAL PERFORMANCE EFFECTS AND QUANTIFICATION OF BODY AREA COVERAGE 5a. CONTRACT NUMBER MIPR #M9545006MPR6CC7 5b. GRANT NUMBER 5c. PROGRAM ELEMENT...WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER NATICK/TR-12/014 9

Dynamic Assessment on the Landscape Patterns and Spatio-temporal Change in the mainstream of Tarim River

NASA Astrophysics Data System (ADS)

Zhang, Hui; Xue, Lianqing; Yang, Changbing; Chen, Xinfang; Zhang, Luochen; Wei, Guanghui

2018-01-01

The Tarim River (TR), as the longest inland river at an arid area in China, is a typical regions of vegetation variation research and plays a crucial role in the sustainable development of regional ecological environment. In this paper, the newest dataset of MODND1M NDVI, at a resolution of 500m, were applied to calculate vegetation index in growing season during the period 2000-2015. Using a vegetation coverage index, a trend line analysis, and the local spatial autocorrelation analysis, this paper investigated the landscape patterns and spatio-temporal variation of vegetation coverage at regional and pixel scales over mainstream of the Tarim River, Xinjiang. The results showed that (1) The bare land area on both sides of Tarim River appeared to have a fluctuated downward trend and there were two obvious valley values in 2005 and 2012. (2) Spatially, the vegetation coverage improved areas is mostly distributed in upstream and the degraded areas is mainly distributed in the left bank of midstream and the end of Tarim River during 2000-2005. (3) The local spatial auto-correlation analysis revealed that vegetation coverage was spatially positive autocorrelated and spatial concentrated. The high-high self-related areas are mainly distributed in upstream, where vegetation cover are relatively good, and the low-low self-related areas are mostly with lower vegetation cover in the lower reaches of Tarim River.

Towards universal health coverage: an evaluation of Rwanda Mutuelles in its first eight years.

PubMed

Lu, Chunling; Chin, Brian; Lewandowski, Jiwon Lee; Basinga, Paulin; Hirschhorn, Lisa R; Hill, Kenneth; Murray, Megan; Binagwaho, Agnes

2012-01-01

Mutuelles is a community-based health insurance program, established since 1999 by the Government of Rwanda as a key component of the national health strategy on providing universal health care. The objective of the study was to evaluate the impact of Mutuelles on achieving universal coverage of medical services and financial risk protection in its first eight years of implementation. We conducted a quantitative impact evaluation of Mutuelles between 2000 and 2008 using nationally-representative surveys. At the national and provincial levels, we traced the evolution of Mutuelles coverage and its impact on child and maternal care coverage from 2000 to 2008, as well as household catastrophic health payments from 2000 to 2006. At the individual level, we investigated the impact of Mutuelles' coverage on enrollees' medical care utilization using logistic regression. We focused on three target populations: the general population, under-five children, and women with delivery. At the household level, we used logistic regression to study the relationship between Mutuelles coverage and the probability of incurring catastrophic health spending. The main limitation was that due to insufficient data, we are not able to study the impact of Mutuelles on health outcomes, such as child and maternal mortalities, directly. The findings show that Mutuelles improved medical care utilization and protected households from catastrophic health spending. Among Mutuelles enrollees, those in the poorest expenditure quintile had a significantly lower rate of utilization and higher rate of catastrophic health spending. The findings are robust to various estimation methods and datasets. Rwanda's experience suggests that community-based health insurance schemes can be effective tools for achieving universal health coverage even in the poorest settings. We suggest a future study on how eliminating Mutuelles copayments for the poorest will improve their healthcare utilization, lower their catastrophic health spending, and affect the finances of health care providers.

Towards Universal Health Coverage: An Evaluation of Rwanda Mutuelles in Its First Eight Years

PubMed Central

Lu, Chunling; Chin, Brian; Lewandowski, Jiwon Lee; Basinga, Paulin; Hirschhorn, Lisa R.; Hill, Kenneth; Murray, Megan; Binagwaho, Agnes

2012-01-01

Background Mutuelles is a community-based health insurance program, established since 1999 by the Government of Rwanda as a key component of the national health strategy on providing universal health care. The objective of the study was to evaluate the impact of Mutuelles on achieving universal coverage of medical services and financial risk protection in its first eight years of implementation. Methods and Findings We conducted a quantitative impact evaluation of Mutuelles between 2000 and 2008 using nationally-representative surveys. At the national and provincial levels, we traced the evolution of Mutuelles coverage and its impact on child and maternal care coverage from 2000 to 2008, as well as household catastrophic health payments from 2000 to 2006. At the individual level, we investigated the impact of Mutuelles' coverage on enrollees' medical care utilization using logistic regression. We focused on three target populations: the general population, under-five children, and women with delivery. At the household level, we used logistic regression to study the relationship between Mutuelles coverage and the probability of incurring catastrophic health spending. The main limitation was that due to insufficient data, we are not able to study the impact of Mutuelles on health outcomes, such as child and maternal mortalities, directly. The findings show that Mutuelles improved medical care utilization and protected households from catastrophic health spending. Among Mutuelles enrollees, those in the poorest expenditure quintile had a significantly lower rate of utilization and higher rate of catastrophic health spending. The findings are robust to various estimation methods and datasets. Conclusions Rwanda's experience suggests that community-based health insurance schemes can be effective tools for achieving universal health coverage even in the poorest settings. We suggest a future study on how eliminating Mutuelles copayments for the poorest will improve their healthcare utilization, lower their catastrophic health spending, and affect the finances of health care providers. PMID:22723985

High and equitable mass vitamin A supplementation coverage in Sierra Leone: a post-event coverage survey.

PubMed

Hodges, Mary H; Sesay, Fatmata F; Kamara, Habib I; Turay, Mohamed; Koroma, Aminata S; Blankenship, Jessica L; Katcher, Heather I

2013-08-01

In Sierra Leone, children ages 6-59 months receive twice-yearly vitamin A supplementation (VAS) through Maternal and Child Health Week (MCHW) events. VAS coverage in 2011 was calculated using government tally sheets of vitamin A capsule distribution and outdated population projections from the 2004 census. We conducted a national post-event coverage (PEC) survey to validate coverage and inform strategies to reach universal coverage of VAS in Sierra Leone. Immediately following the November 2011 MCHW event, we conducted a national PEC survey by interviewing caregivers with children ages 6-59 months using a randomized 30X30 cluster design (N = 900). We also interviewed one health worker and one community health worker in each cluster to determine their knowledge about VAS (N = 60). VAS coverage was 91.8% among children ages 6-59 months, which was lower than the 105.1% reported through tally sheets. Coverage was high and equitable among all districts and between age groups (98.5% for infants ages 6-11 months and 90.5% for children ages 12-59 months). Major reasons for not receiving VAS were that the child was out of the area (42.4%), the household was not visited by community health workers (28.0%), and the caretaker was not aware of the event (11.9%). Twice-yearly delivery of VAS through MCHW events achieved consistently high and equitable coverage in Sierra Leone. Universal coverage may be achieved through continued focus on communication and targeted outreach to hard-to-reach areas during the MCHWs.

The geography of hotspots of rarity-weighted richness of birds and their coverage by Natura 2000

PubMed Central

de Albuquerque, Fábio Suzart; Gregory, Andrew

2017-01-01

A major challenge for biogeographers and conservation planners is to identify where to best locate or distribute high-priority areas for conservation and to explore whether these areas are well represented by conservation actions such as protected areas (PAs). We aimed to identify high-priority areas for conservation, expressed as hotpots of rarity-weighted richness (HRR)–sites that efficiently represent species–for birds across EU countries, and to explore whether HRR are well represented by the Natura 2000 network. Natura 2000 is an evolving network of PAs that seeks to conserve biodiversity through the persistence of the most patrimonial species and habitats across Europe. This network includes Sites of Community Importance (SCI) and Special Areas of Conservation (SAC), where the latter regulated the designation of Special Protected Areas (SPA). Distribution maps for 416 bird species and complementarity-based approaches were used to map geographical patterns of rarity-weighted richness (RWR) and HRR for birds. We used species accumulation index to evaluate whether RWR was efficient surrogates to identify HRRs for birds. The results of our analysis support the proposition that prioritizing sites in order of RWR is a reliable way to identify sites that efficiently represent birds. HRRs were concentrated in the Mediterranean Basin and alpine and boreal biogeographical regions of northern Europe. The cells with high RWR values did not correspond to cells where Natura 2000 was present. We suggest that patterns of RWR could become a focus for conservation biogeography. Our analysis demonstrates that identifying HRR is a robust approach for prioritizing management actions, and reveals the need for more conservation actions, especially on HRR. PMID:28379991

The geography of hotspots of rarity-weighted richness of birds and their coverage by Natura 2000.

PubMed

Albuquerque, Fábio Suzart de; Gregory, Andrew

2017-01-01

A major challenge for biogeographers and conservation planners is to identify where to best locate or distribute high-priority areas for conservation and to explore whether these areas are well represented by conservation actions such as protected areas (PAs). We aimed to identify high-priority areas for conservation, expressed as hotpots of rarity-weighted richness (HRR)-sites that efficiently represent species-for birds across EU countries, and to explore whether HRR are well represented by the Natura 2000 network. Natura 2000 is an evolving network of PAs that seeks to conserve biodiversity through the persistence of the most patrimonial species and habitats across Europe. This network includes Sites of Community Importance (SCI) and Special Areas of Conservation (SAC), where the latter regulated the designation of Special Protected Areas (SPA). Distribution maps for 416 bird species and complementarity-based approaches were used to map geographical patterns of rarity-weighted richness (RWR) and HRR for birds. We used species accumulation index to evaluate whether RWR was efficient surrogates to identify HRRs for birds. The results of our analysis support the proposition that prioritizing sites in order of RWR is a reliable way to identify sites that efficiently represent birds. HRRs were concentrated in the Mediterranean Basin and alpine and boreal biogeographical regions of northern Europe. The cells with high RWR values did not correspond to cells where Natura 2000 was present. We suggest that patterns of RWR could become a focus for conservation biogeography. Our analysis demonstrates that identifying HRR is a robust approach for prioritizing management actions, and reveals the need for more conservation actions, especially on HRR.

Balancing ballistic protection against physiological strain: evidence from laboratory and field trials.

PubMed

Taylor, Nigel A S; Burdon, Catriona A; van den Heuvel, Anne M J; Fogarty, Alison L; Notley, Sean R; Hunt, Andrew P; Billing, Daniel C; Drain, Jace R; Silk, Aaron J; Patterson, Mark J; Peoples, Gregory E

2016-02-01

This project was based on the premise that decisions concerning the ballistic protection provided to defence personnel should derive from an evaluation of the balance between protection level and its impact on physiological function, mobility, and operational capability. Civilians and soldiers participated in laboratory- and field-based studies in which ensembles providing five levels of ballistic protection were evaluated, each with progressive increases in protection, mass (3.4-11.0 kg), and surface-area coverage (0.25-0.52 m(2)). Physiological trials were conducted on volunteers (N = 8) in a laboratory, under hot-dry conditions simulating an urban patrol: walking at 4 km·h(-1) (90 min) and 6 km·h(-1) (30 min or to fatigue). Field-based trials were used to evaluate tactical battlefield movements (mobility) of soldiers (N = 31) under tropical conditions, and across functional tests of power, speed, agility, endurance, and balance. Finally, trials were conducted at a jungle training centre, with soldiers (N = 32) patrolling under tropical conditions (averaging 5 h). In the laboratory, work tolerance was reduced as protection increased, with deep-body temperature climbing relentlessly. However, the protective ensembles could be grouped into two equally stressful categories, each providing a different level of ballistic protection. This outcome was supported during the mobility trials, with the greatest performance decrement evident during fire and movement simulations, as the ensemble mass was increased (-2.12%·kg(-1)). The jungle patrol trials similarly supported this outcome. Therefore, although ballistic protection does increase physiological strain, this research has provided a basis on which to determine how that strain can be balanced against the mission-specific level of required personal protection.

Estimation of the fractional coverage of rainfall in climate models

NASA Technical Reports Server (NTRS)

Eltahir, E. A. B.; Bras, R. L.

1993-01-01

The fraction of the grid cell area covered by rainfall, mu, is an essential parameter in descriptions of land surface hydrology in climate models. A simple procedure is presented for estimating this fraction, based on extensive observations of storm areas and rainfall volumes. Storm area and rainfall volume are often linearly related; this relation can be used to compute the storm area from the volume of rainfall simulated by a climate model. A formula is developed for computing mu, which describes the dependence of the fractional coverage of rainfall on the season of the year, the geographical region, rainfall volume, and the spatial and temporal resolution of the model. The new formula is applied in computing mu over the Amazon region. Significant temporal variability in the fractional coverage of rainfall is demonstrated. The implications of this variability for the modeling of land surface hydrology in climate models are discussed.

A Study to Find Out the Full Immunization Coverage of 12 to 23-month old Children and Areas of Under-Performance using LQAS Technique in a Rural Area of Tripura.

PubMed

Datta, Anjan; Baidya, Subrata; Datta, Srabani; Mog, Chanda; Das, Shampa

2017-02-01

It is very important to analyze the factors which acts as obstacle in achieving 100% immunization among children. Lot Quality Assurance Sampling (LQAS) is one of the effective method to assess such barriers. To assess the full immunization coverage among 12 to 23-month old children of rural field practice area under Department of Community Medicine, Agartala Government Medical College and identify the factors for failure of full immunization. A community based cross-sectional study was conducted from November 2013 to October 2014 on children aged 12 to 23 months old of area under Mohanpur Community health centre. Using LQAS technique 330 samples were selected with multi-stage sampling, each sub-centre being one lot and two calculated to be the decision value. Data was collected using pre-designed pre-tested questionnaire during home visit and verifying immunization card and analysed by computer software SPSS version 21.0. The full immunization coverage among 12 to 23 months old children of Mohanpur area was found as 91.67%. Out of all the 22 sub-centres, 36.36% was found under performing as per pre-fixed criteria and the main reasons for failure of full immunization in those areas are unawareness of need of subsequent doses of vaccines and illness of the children. LQAS is an effective method to identify areas of under-performance even though overall full immunization coverage is high.

Reduction of racial/ethnic disparities in vaccination coverage, 1995-2011.

PubMed

Walker, Allison T; Smith, Philip J; Kolasa, Maureen

2014-04-18

The Presidential Childhood Immunization Initiative was developed in 1993 to address major gaps in childhood vaccination coverage in the United States. Eliminating the cost of vaccines as a barrier to vaccination was one strategy of the Childhood Immunization Initiative; it led to Congressional legislation that authorized creation of the Vaccines for Children program (VFC) in 1994. CDC analyzed National Immunization Survey data for 1995-2011 to evaluate trends in disparities in vaccination coverage rates between non-Hispanic white children and children of other racial/ethnic groups. VFC has been effective in ireducing disparities in vaccination coverage among U.S. children. CDC's Office of Minority Health and Health Equity selected the intervention analysis and discussion that follows to provide an example of a program that has been effective in reducing childhood vaccination coverage-related disparities in the United States. At its inception in 1994, VFC was implemented in 78 Immunization Action Plan areas that covered the entire United States; within each area, concerted efforts were made to improve childhood vaccination coverage. The findings in this report demonstrate that there have been no racial/ethnic disparities in vaccine coverage for measles-mumps-rubella and poliovirus in the United States since 2005. Disparities in coverage for the diphtheria-tetanus-pertussis/diphtheria-tetanus-acellular pertussis vaccine were absent, declining, or inconsistent during this period, depending on the racial/ethnic group examined. The results in this report highlight the effectiveness of VFC.

Child morbidity and mortality associated with alternative policy responses to the economic crisis in Brazil: A nationwide microsimulation study

PubMed Central

Paes-Sousa, Romulo; Ocké-Reis, Carlos Octávio; Millett, Christopher

2018-01-01

Background Since 2015, a major economic crisis in Brazil has led to increasing poverty and the implementation of long-term fiscal austerity measures that will substantially reduce expenditure on social welfare programmes as a percentage of the country’s GDP over the next 20 years. The Bolsa Família Programme (BFP)—one of the largest conditional cash transfer programmes in the world—and the nationwide primary healthcare strategy (Estratégia Saúde da Família [ESF]) are affected by fiscal austerity, despite being among the policy interventions with the strongest estimated impact on child mortality in the country. We investigated how reduced coverage of the BFP and ESF—compared to an alternative scenario where the level of social protection under these programmes is maintained—may affect the under-five mortality rate (U5MR) and socioeconomic inequalities in child health in the country until 2030, the end date of the Sustainable Development Goals. Methods and findings We developed and validated a microsimulation model, creating a synthetic cohort of all 5,507 Brazilian municipalities for the period 2017–2030. This model was based on the longitudinal dataset and effect estimates from a previously published study that evaluated the effects of poverty, the BFP, and the ESF on child health. We forecast the economic crisis and the effect of reductions in BFP and ESF coverage due to current fiscal austerity on the U5MR, and compared this scenario with a scenario where these programmes maintain the levels of social protection by increasing or decreasing with the size of Brazil’s vulnerable populations (policy response scenarios). We used fixed effects multivariate regression models including BFP and ESF coverage and accounting for secular trends, demographic and socioeconomic changes, and programme duration effects. With the maintenance of the levels of social protection provided by the BFP and ESF, in the most likely economic crisis scenario the U5MR is expected to be 8.57% (95% CI: 6.88%–10.24%) lower in 2030 than under fiscal austerity—a cumulative 19,732 (95% CI: 10,207–29,285) averted under-five deaths between 2017 and 2030. U5MRs from diarrhoea, malnutrition, and lower respiratory tract infections are projected to be 39.3% (95% CI: 36.9%–41.8%), 35.8% (95% CI: 31.5%–39.9%), and 8.5% (95% CI: 4.1%–12.0%) lower, respectively, in 2030 under the maintenance of BFP and ESF coverage, with 123,549 fewer under-five hospitalisations from all causes over the study period. Reduced coverage of the BFP and ESF will also disproportionately affect U5MR in the most vulnerable areas, with the U5MR in the poorest quintile of municipalities expected to be 11.0% (95% CI: 8.0%–13.8%) lower in 2030 under the maintenance of BFP and ESF levels of social protection than under fiscal austerity, compared to no difference in the richest quintile. Declines in health inequalities over the last decade will also stop under a fiscal austerity scenario: the U5MR concentration index is expected to remain stable over the period 2017–2030, compared to a 13.3% (95% CI: 5.6%–21.8%) reduction under the maintenance of BFP and ESF levels of protection. Limitations of our analysis are the ecological nature of the study, uncertainty around future macroeconomic scenarios, and potential changes in other factors affecting child health. A wide range of sensitivity analyses were conducted to minimise these limitations. Conclusions The implementation of fiscal austerity measures in Brazil can be responsible for substantively higher childhood morbidity and mortality than expected under maintenance of social protection—threatening attainment of Sustainable Development Goals for child health and reducing inequality. PMID:29787574

Bringing stillbirths out of the shadows in Latin America.

PubMed

de Jesús, Guilherme; Flenady, Vicki

2018-06-07

In the BJOG stillbirth themed issue, Pingray et al (BJOG, 2018) report on stillbirth rates across countries in Latin America, and examined its relationship with socioeconomic and health coverage. Although pooled estimated stillbirth rate (SBR) for Latin America is considerably lower than worldwide estimate (8.1 vs 18.4 per 1.000 births), the authors found a wide variation in country-level stillbirth rates with indicators of socioeconomic and health coverage being key drivers. Gross domestic product (GDP) per capita and women's schooling have a strong inverse relationship with stillbirths. Birth at a health facility, urban population and fertility rate were also important factors. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Weighing conservation objectives: maximum expected coverage versus endangered species protection

Treesearch

Jeffrey L. Arthur; Jeffrey D. Camm; Robert G. Haight; Claire A. Montgomery; Stephen Polasky

2004-01-01

Decision makers involved in land acquisition and protection often have multiple conservation objectives and are uncertain about the occurrence of species or other features in candidate sites. Model informing decisions on selection of sites for reserves need to provide information about cost-efficient trade-offs between objectives and account for incidence uncertainty...

44 CFR 61.12 - Rates based on a flood protection system involving Federal funds.

Code of Federal Regulations, 2013 CFR

2013-10-01

... EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program INSURANCE COVERAGE AND RATES § 61.12 Rates based on a flood protection system involving... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Rates based on a flood...

44 CFR 61.12 - Rates based on a flood protection system involving Federal funds.

Code of Federal Regulations, 2010 CFR

2010-10-01

... EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program INSURANCE COVERAGE AND RATES § 61.12 Rates based on a flood protection system involving... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Rates based on a flood...

44 CFR 61.12 - Rates based on a flood protection system involving Federal funds.

Code of Federal Regulations, 2014 CFR

2014-10-01

... EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program INSURANCE COVERAGE AND RATES § 61.12 Rates based on a flood protection system involving... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Rates based on a flood...

44 CFR 61.12 - Rates based on a flood protection system involving Federal funds.

Code of Federal Regulations, 2011 CFR

2011-10-01

... EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program INSURANCE COVERAGE AND RATES § 61.12 Rates based on a flood protection system involving... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Rates based on a flood...

44 CFR 61.12 - Rates based on a flood protection system involving Federal funds.

Code of Federal Regulations, 2012 CFR

2012-10-01

... EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program INSURANCE COVERAGE AND RATES § 61.12 Rates based on a flood protection system involving... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Rates based on a flood...

The sand-deposition impact of artificial gravel beds on the protection of the Mogao Grottoes

PubMed Central

Li, Guo Shuai; Qu, Jian Jun; Li, Xu Zhi; Wang, Wan Fu

2014-01-01

Gravel beds can prevent sand-dust emission and weaken sand-dust flux. We used wind-tunnel experiments and field observations on artificial gravel beds above the Mogao Grottoes to quantify their impact. In the report, we identified a significant correlation between gravel roughness and its ability to trap wind-transported sand. The optimal combinations of gravel diameter and coverage were determined. The greatest roughness is achieved when small gravel coverage is 75%, medium 40% and large 45%. We found that initial wind speed and gravel coverage are the key factors controlling the amount of sand trapped by the gravel beds. PMID:24614183

Photocatalytic Nanocomposites for the Protection of European Architectural Heritage.

PubMed

Gherardi, Francesca; Roveri, Marco; Goidanich, Sara; Toniolo, Lucia

2018-01-03

In the field of stone protection, the introduction of inorganic nanoparticles, such as TiO₂, ZnO, and Ag in polymeric blends can enhance the protective action of pristine treatments, as well as confer additional properties (photocatalytic, antifouling, and antibacterial). In the framework of the "Nano-Cathedral" European project, nanostructured photocatalytic protective treatments were formulated by using different TiO₂ nanoparticles, solvents, and silane/siloxane systems in the blends. The results about the characterization and application of two promising nano-TiO₂ based products applied on Apuan marble and Ajarte limestone are here reported, aiming at investigating the complex system "treatment/stone-substrate". The nanocomposites show better performances when compared to a commercial reference siloxane based protective treatment, resulting in different performances once applied on different carbonatic substrates, with very low and high open porosity, confirming the necessity of correlating precisely the characteristics of the stone material to those of the protective formulations. In particular, the TiO₂ photocatalytic behavior is strictly linked to the amount of available nanoparticles and to the active surface area. The alkyl silane oligomers of the water-based formulation have a good penetration into the microstructure of Ajarte limestone, whereas the solvent-based and small size monomeric formulation shows better results for Apuan marble, granting a good coverage of the pores. The encouraging results obtained so far in lab will be confirmed by monitoring tests aiming at assessing the effectiveness of the treatments applied in pilot sites of historical Gothic Cathedrals.

Photocatalytic Nanocomposites for the Protection of European Architectural Heritage

PubMed Central

Roveri, Marco; Goidanich, Sara; Toniolo, Lucia

2018-01-01

In the field of stone protection, the introduction of inorganic nanoparticles, such as TiO2, ZnO, and Ag in polymeric blends can enhance the protective action of pristine treatments, as well as confer additional properties (photocatalytic, antifouling, and antibacterial). In the framework of the “Nano-Cathedral” European project, nanostructured photocatalytic protective treatments were formulated by using different TiO2 nanoparticles, solvents, and silane/siloxane systems in the blends. The results about the characterization and application of two promising nano-TiO2 based products applied on Apuan marble and Ajarte limestone are here reported, aiming at investigating the complex system “treatment/stone-substrate”. The nanocomposites show better performances when compared to a commercial reference siloxane based protective treatment, resulting in different performances once applied on different carbonatic substrates, with very low and high open porosity, confirming the necessity of correlating precisely the characteristics of the stone material to those of the protective formulations. In particular, the TiO2 photocatalytic behavior is strictly linked to the amount of available nanoparticles and to the active surface area. The alkyl silane oligomers of the water-based formulation have a good penetration into the microstructure of Ajarte limestone, whereas the solvent-based and small size monomeric formulation shows better results for Apuan marble, granting a good coverage of the pores. The encouraging results obtained so far in lab will be confirmed by monitoring tests aiming at assessing the effectiveness of the treatments applied in pilot sites of historical Gothic Cathedrals. PMID:29301338

Coverage Root after Removing Peripheral Ossifying Fibroma: 5-Year Follow-Up Case Report

PubMed Central

Okajima, Luciana S.; Nunes, Marcelo P.; Montalli, Victor A. M.

2016-01-01

When lesions in soft tissue reach the gingival margin, they can produce aesthetic defects during its permanence and after its removal. Periodontal plastic surgery allows the correction of the gingival contour using different techniques. This paper is a case report of a peripheral ossifying fibroma removal in the interproximal area of teeth 21 and 22 in addition to root coverage of the affected area through two surgical phases: keratinized gingival tissue augmentation surgery with free gingival graft concurrent with removal of the lesion and, in a second stage, root coverage by performing coronally advanced flap technique with a follow-up of five years. The initial results achieved, which were root coverage of 100% after 6 months, promoted an adequate gingival contour and prevented the development of a mucogingival defect or a root exposure with its functional and aesthetic consequences. After five years, the results showed long term success of the techniques, where the margin remained stable with complete root coverage and tissues were stable and harmonic in color. PMID:27891263

Coverage Root after Removing Peripheral Ossifying Fibroma: 5-Year Follow-Up Case Report.

PubMed

Henriques, Paulo S G; Okajima, Luciana S; Nunes, Marcelo P; Montalli, Victor A M

2016-01-01

When lesions in soft tissue reach the gingival margin, they can produce aesthetic defects during its permanence and after its removal. Periodontal plastic surgery allows the correction of the gingival contour using different techniques. This paper is a case report of a peripheral ossifying fibroma removal in the interproximal area of teeth 21 and 22 in addition to root coverage of the affected area through two surgical phases: keratinized gingival tissue augmentation surgery with free gingival graft concurrent with removal of the lesion and, in a second stage, root coverage by performing coronally advanced flap technique with a follow-up of five years. The initial results achieved, which were root coverage of 100% after 6 months, promoted an adequate gingival contour and prevented the development of a mucogingival defect or a root exposure with its functional and aesthetic consequences. After five years, the results showed long term success of the techniques, where the margin remained stable with complete root coverage and tissues were stable and harmonic in color.

The economic status of older people's households in urban and rural settings in Peru, Mexico and China: a 10/66 INDEP study cross-sectional survey.

PubMed

Prince, Martin J; Lloyd-Sherlock, Peter; Guerra, Mariella; Huang, Yueqin; Sosa, Ana Luisa; Uwakwe, Richard; Acosta, Isaac; Liu, Zhaorui; Gallardo, Sara; Guerchet, Maelenn; Mayston, Rosie; de Oca, Veronica Montes; Wang, Hong; Ezeah, Peter

2016-01-01

Few data are available from middle income countries regarding economic circumstances of households in which older people live. Many such settings have experienced rapid demographic, social and economic change, alongside increasing pension coverage. Population-based household surveys in rural and urban catchment areas in Peru, Mexico and China. Participating households were selected from all households with older residents. Descriptive analyses were weighted back for sampling fractions and non-response. Household income and consumption were estimated from a household key informant interview. 877 Household interviews (3177 residents). Response rate 68 %. Household income and consumption correlated plausibly with other economic wellbeing indicators. Household Incomes varied considerably within and between sites. While multigenerational households were the norm, older resident's incomes accounted for a high proportion of household income, and older people were particularly likely to pool income. Differences in the coverage and value of pensions were a major source of variation in household income among sites. There was a small, consistent inverse association between household pension income and labour force participation of younger adult co-residents. The effect of pension income on older adults' labour force participation was less clear-cut. Historical linkage of social protection to formal employment may have contributed to profound late-life socioeconomic inequalities. Strategies to formalise the informal economy, alongside increases in the coverage and value of non-contributory pensions and transfers would help to address this problem.

Large area x-ray detectors for cargo radiography

NASA Astrophysics Data System (ADS)

Bueno, C.; Albagli, D.; Bendahan, J.; Castleberry, D.; Gordon, C.; Hopkins, F.; Ross, W.

2007-04-01

Large area x-ray detectors based on phosphors coupled to flat panel amorphous silicon diode technology offer significant advances for cargo radiologic imaging. Flat panel area detectors provide large object coverage offering high throughput inspections to meet the high flow rate of container commerce. These detectors provide excellent spatial resolution when needed, and enhanced SNR through low noise electronics. If the resolution is reduced through pixel binning, further advances in SNR are achievable. Extended exposure imaging and frame averaging enables improved x-ray penetration of ultra-thick objects, or "select-your-own" contrast sensitivity at a rate many times faster than LDAs. The areal coverage of flat panel technology provides inherent volumetric imaging with the appropriate scanning methods. Flat panel area detectors have flexible designs in terms of electronic control, scintillator selection, pixel pitch, and frame rates. Their cost is becoming more competitive as production ramps up for the healthcare, nondestructive testing (NDT), and homeland protection industries. Typically used medical and industrial polycrystalline phosphor materials such as Gd2O2S:Tb (GOS) can be applied to megavolt applications if the phosphor layer is sufficiently thick to enhance x-ray absorption, and if a metal radiator is used to augment the quantum detection efficiency and reduce x-ray scatter. Phosphor layers ranging from 0.2-mm to 1-mm can be "sandwiched" between amorphous silicon flat panel diode arrays and metal radiators. Metal plates consisting of W, Pb or Cu, with thicknesses ranging from 0.25-mm to well over 1-mm can be used by covering the entire area of the phosphor plate. In some combinations of high density metal and phosphor layers, the metal plate provides an intensification of 25% in signal due to electron emission from the plate and subsequent excitation within the phosphor material. This further improves the SNR of the system.

Assessing different measures of population-level vaccine protection using a case-control study.

PubMed

Ali, Mohammad; You, Young Ae; Kanungo, Suman; Manna, Byomkesh; Deen, Jacqueline L; Lopez, Anna Lena; Wierzba, Thomas F; Bhattacharya, Sujit K; Sur, Dipika; Clemens, John D

2015-11-27

Case-control studies have not been examined for their utility in assessing population-level vaccine protection in individually randomized trials. We used the data of a randomized, placebo-controlled trial of a cholera vaccine to compare the results of case-control analyses with those of cohort analyses. Cases of cholera were selected from the trial population followed for three years following dosing. For each case, we selected 4 age-matched controls who had not developed cholera. For each case and control, GIS was used to calculate vaccine coverage of individuals in a surrounding "virtual" cluster. Specific selection strategies were used to evaluate the vaccine protective effects. 66,900 out of 108,389 individuals received two doses of the assigned regimen. For direct protection among subjects in low vaccine coverage clusters, we observed 78% (95% CI: 47-91%) protection in a cohort analysis and 84% (95% CI: 60-94%) in case-control analysis after adjusting for confounding factors. Using our GIS-based approach, estimated indirect protection was 52% (95% CI: 10-74%) in cohort and 76% (95% CI: 47-89%) in case control analysis. Estimates of total and overall effectiveness were similar for cohort and case-control analyses. The findings show that case-control analyses of individually randomized vaccine trials may be used to evaluate direct as well as population-level vaccine protection. Copyright © 2015. Published by Elsevier Ltd.

A Multi-Scale Approach to Investigating the Red-Crowned Crane–Habitat Relationship in the Yellow River Delta Nature Reserve, China: Implications for Conservation

PubMed Central

Cao, Mingchang; Xu, Haigen; Le, Zhifang; Zhu, Mingchang; Cao, Yun

2015-01-01

The red-crowned crane (Grus japonensis (Statius Müller, 1776)) is a rare and endangered species that lives in wetlands. In this study, we used variance partitioning and hierarchical partitioning methods to explore the red-crowned crane–habitat relationship at multiple scales in the Yellow River Delta Nature Reserve (YRDNR). In addition, we used habitat modeling to identify the cranes’ habitat distribution pattern and protection gaps in the YRDNR. The variance partitioning results showed that habitat variables accounted for a substantially larger total and pure variation in crane occupancy than the variation accounted for by spatial variables at the first level. Landscape factors had the largest total (45.13%) and independent effects (17.42%) at the second level. The hierarchical partitioning results showed that the percentage of seepweed tidal flats were the main limiting factor at the landscape scale. Vegetation coverage contributed the greatest independent explanatory power at the plot scale, and patch area was the predominant factor at the patch scale. Our habitat modeling results showed that crane suitable habitat covered more than 26% of the reserve area and that there remained a large protection gap with an area of 20,455 ha, which accounted for 69.51% of the total suitable habitat of cranes. Our study indicates that landscape and plot factors make a relatively large contribution to crane occupancy and that the focus of conservation effects should be directed toward landscape- and plot-level factors by enhancing the protection of seepweed tidal flats, tamarisk-seepweed tidal flats, reed marshes and other natural wetlands. We propose that efforts should be made to strengthen wetland restoration, adjust functional zoning maps, and improve the management of human disturbance in the YRDNR. PMID:26065417

Risk in daily newspaper coverage of red tide blooms in Southwest Florida

PubMed Central

Li, Zongchao; Garrison, Bruce; Ullmann, Steven G.; Kirkpatrick, Barbara; Fleming, Lora E.; Hoagland, Porter

2016-01-01

This study investigated newspaper coverage of Florida red tide blooms in four metropolitan areas of Southwest Florida during a 25-year period, 1987-2012. We focused on how journalists framed red tide stories with respect to environmental risk, health risk, and economic risk. We determined risk to be a key factor in this news coverage, being an aspect of coverage of red tide itself in terms of environmental risk, tourism risk, and public health risk. The study found that red tide news coverage is most often framed as an environmental story. PMID:27087790

The Area Coverage of Geophysical Fields as a Function of Sensor Field-of View

NASA Technical Reports Server (NTRS)

Key, Jeffrey R.

1994-01-01

In many remote sensing studies of geophysical fields such as clouds, land cover, or sea ice characteristics, the fractional area coverage of the field in an image is estimated as the proportion of pixels that have the characteristic of interest (i.e., are part of the field) as determined by some thresholding operation. The effect of sensor field-of-view on this estimate is examined by modeling the unknown distribution of subpixel area fraction with the beta distribution, whose two parameters depend upon the true fractional area coverage, the pixel size, and the spatial structure of the geophysical field. Since it is often not possible to relate digital number, reflectance, or temperature to subpixel area fraction, the statistical models described are used to determine the effect of pixel size and thresholding operations on the estimate of area fraction for hypothetical geophysical fields. Examples are given for simulated cumuliform clouds and linear openings in sea ice, whose spatial structures are described by an exponential autocovariance function. It is shown that the rate and direction of change in total area fraction with changing pixel size depends on the true area fraction, the spatial structure, and the thresholding operation used.

Information Operations: A Research Aid Includes Coverage of: Information Warfare, Information Assurance, and Infrastructure Protection.

DTIC Science & Technology

1997-09-01

Policy Implications Stephen D. Biddle, IDA Papaer P-3123 Institute for Defense Analysis (IDA), Strategy Forces and Research Division 1801 N...IDA INSTITUTE FOR DEFENSE ANALYSES Information Operations: A Research Aid Includes Coverage of: Information Warfare, Information Assurance...Gray, Principal Investigator [pBC Q^^E^ nsSSPECTBD 8’ 19980303 031 This work was conducted under IDA’S central research program. The publication of

Why the affordable care act needs a better name: 'Americare'.

PubMed

Sage, William M

2010-08-01

The culmination of a century's effort to enact universal coverage in the United States is a law with an uninspiring title, the Patient Protection and Affordable Care Act, and an even more awkward acronym, PPACA. The Obama administration has decided to call the legislation the Affordable Care Act, but the expansion of health coverage that the law sets in motion has no name, and therefore no identity. It badly needs one.

A novel habitat-based approach to predict impacts of marine protected areas on fishers.

PubMed

Teixeira, João B; Moura, Rodrigo L; Mills, Morena; Klein, Carissa; Brown, Christopher J; Adams, Vanessa M; Grantham, Hedley; Watts, Matthew; Faria, Deborah; Amado-Filho, Gilberto M; Bastos, Alex C; Lourival, Reinaldo; Possingham, Hugh P

2017-06-24

While marine protected areas (MPAs) can simultaneously contribute to biodiversity conservation and fisheries management, the global network is biased towards particular ecosystem types, as it was largely established in an ad hoc fashion. The optimization of trade-offs between biodiversity benefits and socio-economic values increases implementation success and minimizes enforcement costs in the long run, but is often neglected in marine spatial planning (MSP). Although the acquisition of spatially explicit socioeconomic data is often perceived as a costly/secondary step in MSP, it is critical to account for lost opportunities by people whose activities will be restricted, especially fishers. Here we present an easily-reproducible habitat-based approach to estimate the spatial distribution of opportunity cost to fishers in data poor regions, assuming that the most accessible areas have higher values and their designation as no-take zones represents increased loss of fishing opportunities. Our method requires only habitat and bathymetric maps, a list of target species, the location of ports, and the relative importance for each port and/or vessel/gear type. The potential distribution of fishing resources is estimated from bathymetric ranges and benthic habitat distribution, while the relative importance of the different resources is estimated for each port, considering total catches (kg), revenues and/or stakeholder perception. Finally, the model can combine different cost layers to produce a comprehensive cost layer, and also allows for the evaluation of tradeoffs. The development of FishCake was based on data from a contentious conservation-planning arena (Abrolhos Bank, Brazil) in which attempts to expand MPA coverage failed due to fishers' resistance. The opportunity cost approach that we introduce herein allows for the incorporation of economic interests of different stakeholders and evaluation of tradeoffs among different stakeholder groups. The novel approach can be directly used to support conservation planning, in Abrolhos and elsewhere, and is expected to facilitate community consultation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Global biodiversity: indicators of recent declines

USGS Publications Warehouse

Butchart, Stuart H.M.; Walpole, Matt; Collen, Ben; Van Strien, Arco; Scharlemann, Jorn P.W.; Almond, Rosamunde E.A.; Baillie, Jonathan E.M.; Bomhard, Bastian; Brown, Claire; Bruno, John; Carpenter, Kent E.; Carr, Genevieve M.; Chanson, Janice; Chenery, Anna M.; Csirke, Jorge; Davidson, Nick C.; Dentener, Frank; Foster, Matt; Galli, Alessandro; Galloway, James N.; Genovesi, Piero; Gregory, Richard D.; Hockings, Marc; Kapos, Valerie; Lamarque, Jean-Francois; Leverington, Fiona; Loh, Jonathan; McGeoch, Melodie A.; McRae, Louise; Minasyan, Anahit; Morcillo, Monica Hernandez; Oldfield, Thomasina E.E.; Pauly, Daniel; Quader, Suhel; Revenga, Carmen; Sauer, John R.; Skolnik, Benjamin; Spear, Dian; Stanwell-Smith, Damon; Stuart, Simon N.; Symes, Andy; Tierney, Megan; Tyrrell, Tristan D.; Vie, Jean-Christophe; Watson, Reg

2011-01-01

In 2002, world leaders committed, through the Convention on Biological Diversity, to achieve a significant reduction in the rate of biodiversity loss by 2010. We compiled 31 indicators to report on progress toward this target. Most indicators of the state of biodiversity (covering species' population trends, extinction risk, habitat extent and condition, and community composition) showed declines, with no significant recent reductions in rate, whereas indicators of pressures on biodiversity (including resource consumption, invasive alien species, nitrogen pollution, overexploitation, and climate change impacts) showed increases. Despite some local successes and increasing responses (including extent and biodiversity coverage of protected areas, sustainable forest management, policy responses to invasive alien species, and biodiversity-related aid), the rate of biodiversity loss does not appear to be slowing.

The ABCs of HIPCs (health insurance purchasing cooperatives).

PubMed

Wicks, E K; Curtis, R E; Haugh, K

1993-01-01

HIPCs, or health care purchasing cooperatives, are attracting widespread interest as a key element of the managed competition approach to health reform. HIPCs perform several useful roles for individuals and small employers unable to obtain health insurance coverage in the current system by spreading risk more evenly and purchasing coverage in a given region or market area. While HIPCs are generally associated with managed competition, they are also compatible with reform strategies that require employers to pay for coverage or those that provide incentives for expanded coverage.

Uninsured veterans who will need to obtain insurance coverage under the patient protection and affordable care act.

PubMed

Tsai, Jack; Rosenheck, Robert

2014-03-01

We examined the number and clinical needs of uninsured veterans, including those who will be eligible for the Medicaid expansion and health insurance exchanges in 2014. We analyzed weighted data for 8710 veterans from the 2010 National Survey of Veterans, classifying it by veterans' age, income, household size, and insurance status. Of 22 million veterans, about 7%, or more than 1.5 million, were uninsured and will need to obtain coverage by enrolling in US Department of Veterans Affairs (VA) care or the Medicaid expansion or by participating in the health insurance exchanges. Of those uninsured, 55%, or more than 800 000, are likely eligible for the Medicaid expansion if states implement it. Compared with veterans with any health coverage, those who were uninsured were younger and more likely to be single, Black, and low income and to have been deployed to Iraq and Afghanistan. The Patient Protection and Affordable Care Act is likely to have a considerable impact on uninsured veterans, which may have implications for the VA, the Medicaid expansion, and the health insurance exchanges.

ACA dependent coverage provision reduced high out-of-pocket health care spending for young adults.

PubMed

Busch, Susan H; Golberstein, Ezra; Meara, Ellen

2014-08-01

Since September 2010 the Affordable Care Act (ACA) has required that insurers allow children to remain as dependents on their parents' private insurance plans until age twenty-six. Studies have shown that this provision increased coverage rates among young adults. In this article we analyze whether the provision also protected young adults from large and uncertain out-of-pocket expenses. We found that the policy was associated with a statistically significant reduction in the share of young adults facing annual out-of-pocket expenditures greater than $1,500 (decreasing from 4.2 percent to 2.9 percent), compared to an increase in the proportion of their slightly older peers facing such expenditures (increasing from 4.4 percent to 5.4 percent), a net difference of -2.4 percentage points, or 57 percent. We conclude that the dependent coverage provision in the ACA provides financial protection for young adults at a time when they often face high debt burden but low wages. Project HOPE—The People-to-People Health Foundation, Inc.

Mapping of the Seagrass Cover Along the Mediterranean Coast of Turkey Using Landsat 8 Oli Images

NASA Astrophysics Data System (ADS)

Bakirman, T.; Gumusay, M. U.; Tuney, I.

2016-06-01

Benthic habitat is defined as ecological environment where marine animals, plants and other organisms live in. Benthic habitat mapping is defined as plotting the distribution and extent of habitats to create a map with complete coverage of the seabed showing distinct boundaries separating adjacent habitats or the use of spatially continuous environmental data sets to represent and predict biological patterns on the seafloor. Seagrass is an essential endemic marine species that prevents coast erosion and regulates carbon dioxide absorption in both undersea and atmosphere. Fishing, mining, pollution and other human activities cause serious damage to seabed ecosystems and reduce benthic biodiversity. According to the latest studies, only 5-10% of the seafloor is mapped, therefore it is not possible to manage resources effectively, protect ecologically important areas. In this study, it is aimed to map seagrass cover using Landsat 8 OLI images in the northern part of Mediterranean coast of Turkey. After pre-processing (e.g. radiometric, atmospheric, water depth correction) of Landsat images, coverage maps are produced with supervised classification using in-situ data which are underwater photos and videos. Result maps and accuracy assessment are presented and discussed.

Broad Area Wireless Networking Via High Altitude Platforms

DTIC Science & Technology

2013-06-01

35  Figure 12.  Sprint WiMAX handset. From [24...altitude of 21K meters , a payload capacity of 100 kg, and 1000 watts of onboard power for payload requirements. They also developed a series of...providing 24-hour coverage. The balloons are launched with a recoverable payload and operated at an altitude of 24K–30K meters to provide a coverage area

Temporal dynamic of reef benthic communities in two marine protected areas in the Caribbean

NASA Astrophysics Data System (ADS)

Perera-Valderrama, Susana; Hernández-Arana, Héctor; Ruiz-Zárate, Miguel-Ángel; Alcolado, Pedro M.; Caballero-Aragón, Hansel; González-Cano, Jaime; Vega-Zepeda, Alejandro; Victoria-Salazar, Isael; Cobián-Rojas, Dorka; González-Méndez, Juliett; Hernández-González, Zaimiuri; de la Guardia-Llansó, Elena

2017-10-01

This study assessed the coral reef condition of two marine protected areas in the Caribbean: Guanahacabibes National Park, Cuba, and Costa Occidental de Isla Mujeres-Punta Cancun-Punta Nizuc National Park, Mexico, in a two-year period. The analyzed indicators for corals were live coral cover, diameter and height of the colonies, ancient and recent mortalities and abundance of recruits, which were evaluated in quadrats of 1 m2. In addition, it was estimated the coverage by morphofunctional groups of macroalgae in 25 × 25 cm quadrats and the density of the Diadema antillarum urchin in 1 m2 quadrats. The results showed differences between countries at broad spatial scales (hundreds of kilometers). Reefs of both MPAs seem to be in different stages of changes, which have been associated with deterioration of Caribbean reefs, toward the dominance of more resistant, non-tridimensional coral species, causing a decrease of the reef complexity that may leads to the reefs to collapse. At scales of kilometers (within MPAs), a similar pattern was found in reefs of GNP-Cuba and different trends were observed in reefs of CNP-Mexico. The observed differences between CNP-Mexico sites appear to be associated with the current tourism use patterns.

Insurance Enrollment at a Student-Run Free Clinic After the Patient Protection and Affordable Care Act.

PubMed

McGeehan, Megan; DeMaria, Rebecca; Charney, Pamela; Batavia, Ashita S

2017-08-01

The Patient Protection and Affordable Care Act (ACA) aims to increase insurance coverage through government subsidies. Medical student-run free clinics (SRFC) are an important entry point into the healthcare system for the uninsured. SRFCs do not have a standardized approach for navigating the complexities of enrollment. The Weill Cornell Community Clinic (WCCC) developed a unique enrollment model that may inform other SRFCs. Our objective is to describe enrollment processes at SRFCs throughout New York City, and to evaluate enrollment outcomes and persistent barriers to coverage at WCCC. We surveyed SRFC leadership throughout NYC to understand enrollment processes. We evaluated enrollment outcomes at WCCC through chart review and structured phone interviews. Subjects included WCCC patients seen in clinic between October 1, 2013 and September 30, 2015 (N = 140). Demographic information, method of insurance enrollment, and qualitative description of enrollment barriers were collected. SRFCs in New York City have diverse enrollment processes. 48% (N = 42) of WCCC patients obtained health insurance. Immigration status was a barrier to coverage in 21% of patients. Failure to gain coverage was predicted by larger household size (p = 0.02). Gender and employment status were not associated with remaining uninsured. The main barriers to enrollment were inability to afford premiums and lack of interest. Insurance enrollment processes at SRFCs in New York City are mostly ad hoc and outcomes are rarely tracked. Following implementation of the ACA, WCCC stands out for its structured approach, with approximately half of eligible WCCC patients gaining coverage during the study period.

Risk in Daily Newspaper Coverage of Red Tide Blooms in Southwest Florida

ERIC Educational Resources Information Center

Li, Zongchao; Garrison, Bruce; Ullmann, Steven G.; Kirkpatrick, Barbara; Fleming, Lora E.; Hoagland, Porter

2015-01-01

This study investigated newspaper coverage of Florida red tide blooms in four metropolitan areas of Southwest Florida during a 25-year period, 1987-2012. We focused on how journalists framed red tide stories with respect to environmental risk, health risk, and economic risk. We determined risk to be a key factor in this news coverage, being an…

Variation of Vegetation Ecological Water Consumption and Its Response to Vegetation Coverage Changes in the Rocky Desertification Areas in South China

PubMed Central

Zhou, Jinxing; Guo, Hongyan; Cui, Ming; Liu, Yuguo; Ning, Like; Tang, Fukai

2016-01-01

Over the past several decades, rocky desertification has led to severe ecological problems in karst areas in South China. After a rocky desertification treatment project was completed, the vegetation coverage changed greatly and, consequently, increased the ecology water consumption (approximately equal to the actual evapotranspiration) of the regional vegetation. Thus, it intensified the regional water stresses. This study explored the changes in the actual evapotranspiration (ETa) response to the vegetation coverage changes in the rocky desertification areas in South China based on the precipitation (P), potential evapotranspiration (ETp) and NDVI (the normalized difference vegetation index) datasets. The revised Bagrov model was used to simulate the actual evapotranspiration changes with the supposed increasing NDVI. The results indicated that the average NDVI value was lower when the rocky desertification was more severe. The ETa, evapotranspiration efficiency (ETa/ETp) and potential humidity (P/ETp) generally increased with the increasing NDVI. The sensitivity of the ETa response to vegetation coverage changes varied due to different precipitation conditions and different rocky desertification severities. The ETa was more sensitive under drought conditions. When a drought occurred, the ETa exhibited an average increase of 40~60 mm with the NDVI increasing of 0.1 in the rocky desertification areas. Among the 5 different severity categories of rocky desertification, the ETa values’ responses to NDVI changes were less sensitive in the severe rocky desertification areas but more sensitive in the extremely and potential rocky desertification areas. For example, with the NDVI increasing of 0.025, 0.05, 0.075, and 0.1, the corresponding ETa changes increased by an average of 2.64 mm, 10.62 mm, 19.19 mm, and 27.58 mm, respectively, in severe rocky desertification areas but by 4.94 mm, 14.99 mm, 26.80, and 37.13 mm, respectively, in extremely severe rocky desertification areas. Understanding the vegetation ecological water consumption response to the vegetation coverage changes is essential for the vegetation restoration and water stresses mitigation in rocky desertification areas. PMID:27798642

Variation of Vegetation Ecological Water Consumption and Its Response to Vegetation Coverage Changes in the Rocky Desertification Areas in South China.

PubMed

Wan, Long; Tong, Jing; Zhou, Jinxing; Guo, Hongyan; Cui, Ming; Liu, Yuguo; Ning, Like; Tang, Fukai

2016-01-01

Over the past several decades, rocky desertification has led to severe ecological problems in karst areas in South China. After a rocky desertification treatment project was completed, the vegetation coverage changed greatly and, consequently, increased the ecology water consumption (approximately equal to the actual evapotranspiration) of the regional vegetation. Thus, it intensified the regional water stresses. This study explored the changes in the actual evapotranspiration (ETa) response to the vegetation coverage changes in the rocky desertification areas in South China based on the precipitation (P), potential evapotranspiration (ETp) and NDVI (the normalized difference vegetation index) datasets. The revised Bagrov model was used to simulate the actual evapotranspiration changes with the supposed increasing NDVI. The results indicated that the average NDVI value was lower when the rocky desertification was more severe. The ETa, evapotranspiration efficiency (ETa/ETp) and potential humidity (P/ETp) generally increased with the increasing NDVI. The sensitivity of the ETa response to vegetation coverage changes varied due to different precipitation conditions and different rocky desertification severities. The ETa was more sensitive under drought conditions. When a drought occurred, the ETa exhibited an average increase of 40~60 mm with the NDVI increasing of 0.1 in the rocky desertification areas. Among the 5 different severity categories of rocky desertification, the ETa values' responses to NDVI changes were less sensitive in the severe rocky desertification areas but more sensitive in the extremely and potential rocky desertification areas. For example, with the NDVI increasing of 0.025, 0.05, 0.075, and 0.1, the corresponding ETa changes increased by an average of 2.64 mm, 10.62 mm, 19.19 mm, and 27.58 mm, respectively, in severe rocky desertification areas but by 4.94 mm, 14.99 mm, 26.80, and 37.13 mm, respectively, in extremely severe rocky desertification areas. Understanding the vegetation ecological water consumption response to the vegetation coverage changes is essential for the vegetation restoration and water stresses mitigation in rocky desertification areas.

Vaccination Coverage Cluster Surveys in Middle Dreib – Akkar, Lebanon: Comparison of Vaccination Coverage in Children Aged 12-59 Months Pre- and Post-Vaccination Campaign

PubMed Central

Assaad, Ramia; Rebeschini, Arianna; Hamadeh, Randa

2016-01-01

Introduction With the high proportion of refugee population throughout Lebanon and continuous population movement, it is sensible to believe that, in particular vulnerable areas, vaccination coverage may not be at an optimal level. Therefore, we assessed the vaccination coverage in children under 5 in a district of the Akkar governorate before and after a vaccination campaign. During the vaccination campaign, conducted in August 2015, 2,509 children were vaccinated. Materials and Methods We conducted a pre- and post-vaccination campaign coverage surveys adapting the WHO EPI cluster survey to the Lebanese MoPH vaccination calendar. Percentages of coverage for each dose of each vaccine were calculated for both surveys. Factors associated with complete vaccination were explored. Results Comparing the pre- with the post-campaign surveys, coverage for polio vaccine increased from 51.9% to 84.3%, for Pentavalent from 49.0% to 71.9%, for MMR from 36.2% to 61.0%, while the percentage of children with fully updated vaccination calendar increased from 32.9% to 53.8%. While Lebanese children were found to be better covered for some antigens compared to Syrians at the first survey, this difference disappeared at the post-campaign survey. Awareness and logistic obstacles were the primary reported causes of not complete vaccination in both surveys. Discussion Vaccination campaigns remain a quick and effective approach to increase vaccination coverage in crisis-affected areas. However, campaigns cannot be considered as a replacement of routine vaccination services to maintain a good level of coverage. PMID:27992470

Evaluation of a wildfire smoke forecasting system as a tool for public health protection.

PubMed

Yao, Jiayun; Brauer, Michael; Henderson, Sarah B

2013-10-01

Exposure to wildfire smoke has been associated with cardiopulmonary health impacts. Climate change will increase the severity and frequency of smoke events, suggesting a need for enhanced public health protection. Forecasts of smoke exposure can facilitate public health responses. We evaluated the utility of a wildfire smoke forecasting system (BlueSky) for public health protection by comparing its forecasts with observations and assessing their associations with population-level indicators of respiratory health in British Columbia, Canada. We compared BlueSky PM2.5 forecasts with PM2.5 measurements from air quality monitors, and BlueSky smoke plume forecasts with plume tracings from National Oceanic and Atmospheric Administration Hazard Mapping System remote sensing data. Daily counts of the asthma drug salbutamol sulfate dispensations and asthma-related physician visits were aggregated for each geographic local health area (LHA). Daily continuous measures of PM2.5 and binary measures of smoke plume presence, either forecasted or observed, were assigned to each LHA. Poisson regression was used to estimate the association between exposure measures and health indicators. We found modest agreement between forecasts and observations, which was improved during intense fire periods. A 30-μg/m3 increase in BlueSky PM2.5 was associated with an 8% increase in salbutamol dispensations and a 5% increase in asthma-related physician visits. BlueSky plume coverage was associated with 5% and 6% increases in the two health indicators, respectively. The effects were similar for observed smoke, and generally stronger in very smoky areas. BlueSky forecasts showed modest agreement with retrospective measures of smoke and were predictive of respiratory health indicators, suggesting they can provide useful information for public health protection.

The economics of social marketing: the case of mosquito nets in Tanzania.

PubMed

Kikumbih, Nassor; Hanson, Kara; Mills, Anne; Mponda, Hadji; Schellenberg, Joanna Armstrong

2005-01-01

There is a growing appreciation of the role of the private sector in expanding the use of key health interventions. At the policy level, this has raised questions about how public sector resources can best be used to encourage the private sector in order to achieve public health impact. Social marketing has increasingly been used to distribute public health products in developing countries. The Kilombero and Ulanga Insecticide-Treated Net Project (KINET) project used a social marketing approach in two districts of Tanzania to stimulate the development of the market for insecticide-treated mosquito nets (ITNs) for malaria control. Using evidence from household surveys, focus group discussions and a costing study in the intervention area and a control area, this paper examines two issues: (1) How does social marketing affect the market for ITNs, where this is described in terms of price and coverage levels; and (2) What does the added cost of social marketing "buy" in terms of coverage and equity, compared with an unassisted commercial sector model? It appears that supply improved in both areas, although there was a greater increase in supply in the intervention area. However, the main impact of social marketing on the market for nets was to shift demand in the intervention district, leading to a higher coverage market outcome. While social marketing was more costly per net distributed than the unassisted commercial sector, higher overall levels of coverage were achieved in the social marketing area together with higher coverage of the lowest socioeconomic group, of pregnant women and children under 5 years, and of those living on the periphery of their villages. These findings are interpreted in the context of Tanzania's national plan for scaling up ITNs.

Hydrological Responses of Weather Conditions and Crop Change of Agricultural Area in the Rincon Valley, New Mexico

NASA Astrophysics Data System (ADS)

Ahn, S.; Sheng, Z.; Abudu, S.

2017-12-01

Hydrologic cycle of agricultural area has been changing due to the impacts of climate and land use changes (crop coverage changes) in an arid region of Rincon Valley, New Mexico. This study is to evaluate the impacts of weather condition and crop coverage change on hydrologic behavior of agricultural area in Rincon Valley (2,466km2) for agricultural watershed management using a watershed-scale hydrologic model, SWAT (Soil and Water Assessment Tool). The SWAT model was developed to incorporate irrigation of different crops using auto irrigation function. For the weather condition and crop coverage change evaluation, three spatial crop coverages including a normal (2008), wet (2009), and dry (2011) years were prepared using USDA crop data layer (CDL) for fourteen different crops. The SWAT model was calibrated for the period of 2001-2003 and validated for the period of 2004-2006 using daily-observed streamflow data. Scenario analysis was performed for wet and dry years based on the unique combinations of crop coverages and releases from Caballo Reservoir. The SWAT model simulated the present vertical water budget and horizontal water transfer considering irrigation practices in the Rincon Valley. Simulation results indicated the temporal and spatial variability for irrigation and non-irrigation seasons of hydrologic cycle in agricultural area in terms of surface runoff, evapotranspiration, infiltration, percolation, baseflow, soil moisture, and groundwater recharge. The water supply of the dry year could not fully cover whole irrigation period due to dry weather conditions, resulting in reduction of crop acreage. For extreme weather conditions, the temporal variation of water budget became robust, which requires careful irrigation management of the agricultural area. The results could provide guidelines for farmers to decide crop patterns in response to different weather conditions and water availability.

[Species composition and spatial structure of plants in urban parks of Beijing].

PubMed

Zhao, Juan-Juan; Ouyang, Zhi-Yun; Zheng, Hua; Xu, Wei-Hua; Wang, Xiao-Ke

2009-02-01

By the method of stratified random sampling, the species composition and spatial structure of the plants in 53 parks in Beijing urban area were investigated, aimed to provide basic information for the protection of plant diversity in the parks and the management of the parks. A total of 492 plant species belong to 96 families and 283 genera were recorded. Based on the data of 21 investigation items about the trees, shrubs, and grasses in the study area and related statistical analyses, the plant structural patterns commonly seen in the green space of the parks of Beijing urban area were introduced. Among the plants in the parks, native species occupied 53.86% of the total. The chorological composition of the genera embraced broad kinds of geographical elements in China, and the predominance of dominant plants was remarkable. In most green patches of the parks, herbaceous species were more abundant and had higher coverage, shrubs had relatively low coverage and were less beneath tree canopy, and trees and shrubs had lower species richness and density. The canopy breadth and the diameter of breast height of trees as well as the breadth of shrubs and the heights of trees and shrubs were basically at the second grade, but the canopy structure of the trees were better, with good conditions of sunlight and growth. The crown missing of the shrubs was relatively low. It was suggested from correlation analyses and document survey of Beijing parks construction history that park landscape design, alien species introduction; and cultivation management were the main factors affecting the species composition and spatial structure of the plants in Beijing urban parks.

A Study to Find Out the Full Immunization Coverage of 12 to 23-month old Children and Areas of Under-Performance using LQAS Technique in a Rural Area of Tripura

PubMed Central

Baidya, Subrata; Datta, Srabani; Mog, Chanda; Das, Shampa

2017-01-01

Introduction It is very important to analyze the factors which acts as obstacle in achieving 100% immunization among children. Lot Quality Assurance Sampling (LQAS) is one of the effective method to assess such barriers. Aim To assess the full immunization coverage among 12 to 23-month old children of rural field practice area under Department of Community Medicine, Agartala Government Medical College and identify the factors for failure of full immunization. Materials and Methods A community based cross-sectional study was conducted from November 2013 to October 2014 on children aged 12 to 23 months old of area under Mohanpur Community health centre. Using LQAS technique 330 samples were selected with multi-stage sampling, each sub-centre being one lot and two calculated to be the decision value. Data was collected using pre-designed pre-tested questionnaire during home visit and verifying immunization card and analysed by computer software SPSS version 21.0. Results The full immunization coverage among 12 to 23 months old children of Mohanpur area was found as 91.67%. Out of all the 22 sub-centres, 36.36% was found under performing as per pre-fixed criteria and the main reasons for failure of full immunization in those areas are unawareness of need of subsequent doses of vaccines and illness of the children. Conclusion LQAS is an effective method to identify areas of under-performance even though overall full immunization coverage is high. PMID:28384892

Trends in access to health services and financial protection in China between 2003 and 2011: a cross-sectional study.

PubMed

Meng, Qun; Xu, Ling; Zhang, Yaoguang; Qian, Juncheng; Cai, Min; Xin, Ying; Gao, Jun; Xu, Ke; Boerma, J Ties; Barber, Sarah L

2012-03-03

In the past decade, the Government of China initiated health-care reforms to achieve universal access to health care by 2020. We assessed trends in health-care access and financial protection between 2003, and 2011, nationwide. We used data from the 2003, 2008, and 2011 National Health Services Survey (NHSS), which used multistage stratified cluster sampling to select 94 of 2859 counties from China's 31 provinces and municipalities. The 2011 survey was done with a subset of the NHSS sampling frame to monitor key indicators after the national health-care reforms were announced in 2009. Three sets of indicators were chosen to measure trends in access to coverage, health-care activities, and financial protection. Data were disaggregated by urban or rural residence and by three geographical regions: east, central, and west, and by household income. We examined change in equity across and within regions. The number of households interviewed was 57,023 in 2003, 56,456 in 2008, and 18,822 in 2011. Response rates were 98·3%, 95·0%, and 95·5%, respectively. The number of individuals interviewed was 193,689 in 2003, 177,501 in 2008, and 59,835 in 2011. Between 2003 and 2011, insurance coverage increased from 29·7% (57,526 of 193,689) to 95·7% (57,262 of 59,835, p<0·0001). The average share of inpatient costs reimbursed from insurance increased from 14·4 (13·7-15·1) in 2003 to 46·9 (44·7-49·1) in 2011 (p<0·0001). Hospital delivery rates averaged 95·8% (1219 of 1272) in 2011. Hospital admissions increased 2·5 times to 8·8% (5288 of 59,835, p<0·0001) in 2011 from 3·6% (6981 of 193,689) in 2003. 12·9% of households (2425 of 18,800) had catastrophic health expenses in 2011. Caesarean section rates increased from 19·2% (736 of 3835) to 36·3% (443 of 1221, p<0·0001) between 2003 and 2011. Remarkable increases in insurance coverage and inpatient reimbursement were accompanied by increased use and coverage of health care. Important advances have been made in achieving equal access to services and insurance coverage across and within regions. However, these increases have not been accompanied by reductions in catastrophic health expenses. With the achievement of basic health-services coverage, future challenges include stronger risk protection, and greater efficiency and quality of care. None. Copyright © 2012 Elsevier Ltd. All rights reserved.

Protecting patients, protecting healthcare workers: a review of the role of influenza vaccination.

PubMed

Music, T

2012-06-01

Many health authorities recommend routine influenza vaccination for healthcare workers (HCWs), and during the 2009 A (H1N1) pandemic, the World Health Organization (WHO) recommended immunization of all HCWs worldwide. As this remains an important area of policy debate, this paper examines the case for vaccination, the role of local guidelines, barriers to immunization and initiatives to increase uptake. Seasonal influenza is a major threat to public health, causing up to 1 million deaths annually. Extensive evidence supports the vaccination of priority groups, including HCWs. Immunization protects HCWs themselves, and their vulnerable patients from nosocomial influenza infections. In addition, influenza can disrupt health services and impact healthcare organizations financially. Immunization can reduce staff absences, offer cost savings and provide economic benefits. This paper reviews official immunization recommendations and HCW vaccination studies, including a recent International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) survey of 26 countries from each region of the world. HCW immunization is widely recommended and supported by the WHO. In the IFPMA study, 88% of countries recommended HCW vaccination, and 61% supported this financially (with no correlation to country development status). Overall, coverage can be improved, and research shows that uptake may be impacted by lack of conveniently available vaccines and misconceptions regarding vaccine safety/efficacy and influenza risk. Many countries recommend HCW vaccination against influenza. In recent years, there has been an increased uptake rate among HCWs in some countries, but not in others. Several initiatives can increase coverage, including education, easy access to free vaccines and the use of formal declination forms. The case for HCW vaccination is clear, and in an effort to further accelerate uptake as a patient safety measure, an increasing number of healthcare organizations, particularly in the USA, are implementing mandatory immunization policies, similar to other obligatory hygiene measures. However, it would be desirable if similar high vaccination uptake rates could be achieved through voluntary procedures. © 2011 The Author. International Nursing Review © 2011 International Council of Nurses.

Digital geologic map database of the Nevada Test Site area, Nevada

USGS Publications Warehouse

Wahl, R.R.; Sawyer, D.A.; Minor, S.A.; Carr, M.D.; Cole, J.C.; Swadley, W.C.; Laczniak, R.J.; Warren, R.G.; Green, K.S.; Engle, C.M.

1997-01-01

Forty years of geologic investigations at the Nevada Test Site (NTS) have been digitized. These data include all geologic information that: (1) has been collected, and (2) can be represented on a map within the map borders at the map scale is included in the map digital coverages. The following coverages are included with this dataset: Coverage Type Description geolpoly Polygon Geologic outcrops geolflts line Fault traces geolatts Point Bedding attitudes, etc. geolcald line Caldera boundaries geollins line Interpreted lineaments geolmeta line Metamorphic gradients The above coverages are attributed with numeric values and interpreted information. The entity files documented below show the data associated with each coverage.

Protected Areas: Mixed Success in Conserving East Africa’s Evergreen Forests

PubMed Central

Pfeifer, Marion; Burgess, Neil D.; Swetnam, Ruth D.; Platts, Philip J.; Willcock, Simon; Marchant, Robert

2012-01-01

In East Africa, human population growth and demands for natural resources cause forest loss contributing to increased carbon emissions and reduced biodiversity. Protected Areas (PAs) are intended to conserve habitats and species. Variability in PA effectiveness and ‘leakage’ (here defined as displacement of deforestation) may lead to different trends in forest loss within, and adjacent to, existing PAs. Here, we quantify spatial variation in trends of evergreen forest coverage in East Africa between 2001 and 2009, and test for correlations with forest accessibility and environmental drivers. We investigate PA effectiveness at local, landscape and national scales, comparing rates of deforestation within park boundaries with those detected in park buffer zones and in unprotected land more generally. Background forest loss (BFL) was estimated at −9.3% (17,167 km2), but varied between countries (range: −0.9% to −85.7%; note: no BFL in South Sudan). We document high variability in PA effectiveness within and between PA categories. The most successful PAs were National Parks, although only 26 out of 48 parks increased or maintained their forest area (i.e. Effective parks). Forest Reserves (Ineffective parks, i.e. parks that lose forest from within boundaries: 204 out of 337), Nature Reserves (six out of 12) and Game Parks (24 out of 26) were more likely to lose forest cover. Forest loss in buffer zones around PAs exceeded background forest loss, in some areas indicating leakage driven by Effective National Parks. Human pressure, forest accessibility, protection status, distance to fires and long-term annual rainfall were highly significant drivers of forest loss in East Africa. Some of these factors can be addressed by adjusting park management. However, addressing close links between livelihoods, natural capital and poverty remains a fundamental challenge in East Africa’s forest conservation efforts. PMID:22768074

Spatial relationship between climatic diversity and biodiversity conservation value.

PubMed

Wang, Junjun; Wu, Ruidong; He, Daming; Yang, Feiling; Hu, Peijun; Lin, Shiwei; Wu, Wei; Diao, Yixin; Guo, Yang

2018-06-04

Capturing the full range of climatic diversity in a reserve network is expected to improve the resilience of biodiversity to climate change. Therefore, a study on systematic conservation planning for climatic diversity that explicitly or implicitly hypothesizes that regions with higher climatic diversity will support greater biodiversity is needed. However, little is known about the extent and generality of this hypothesis. This study utilized the case of Yunnan, southwest China, to quantitatively classify climatic units and modeled 4 climatic diversity indicators, including the variety of climatic units (VCU), rarity of climatic units (RCU), endemism of climatic units (ECU) and a composite index of climatic units (CICD). We used 5 reliable priority conservation area (PCA) schemes to represent the areas with high biodiversity conservation value. We then investigated the spatial relationships between the 4 climatic diversity indicators and the 5 PCA schemes and assessed the representation of climatic diversity within the existing nature reserves. The CICD exhibited the best performance for indicating high conservation value areas, followed by the ECU and RCU. However, contrary to conventional knowledge, VCU did not show a positive association with biodiversity conservation value. The rarer or more endemic climatic units tended to have higher reserve coverage than the more common units. However, only 28 units covering 10.5% of the land in Yunnan had more than 17% of their areas protected. In addition to climatic factors, topography and human disturbances also significantly affected the relationship between climatic diversity and biodiversity conservation value. This analysis suggests that climatic diversity can be an effective surrogate for establishing a more robust reserve network under climate change in Yunnan. Our study improves the understanding of the relationship between climatic diversity and biodiversity and helps build an evidence-based foundation for systematic conservation planning that targets climatic diversity in response to climate change. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

76 FR 52475 - Summary of Benefits and Coverage and Uniform Glossary-Templates, Instructions, and Related...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-22

...The Departments of the Health and Human Services, Labor, and the Treasury (the Departments) are simultaneously publishing in the Federal Register this document and proposed regulations (2011 proposed regulations) under the Patient Protection and Affordable Care Act to implement the disclosure for group health plans and health insurance issuers of the summary of benefits and coverage (SBC) and the uniform glossary. This document proposes a template for an SBC; instructions, sample language, and a guide for coverage examples calculations to be used in completing the template; and a uniform glossary that would satisfy the disclosure requirements under section 2715 of the Public Health Service (PHS) Act. Comments are invited on these materials.

Informality and the expansion of social protection programs: evidence from Mexico.

PubMed

Azuara, Oliver; Marinescu, Ioana

2013-09-01

Many countries are moving from employer-based to universal health coverage, which can generate crowd out. In Mexico, Seguro Popular provides public health coverage to the uninsured. Using the gradual roll-out of the system at the municipality level, we estimate that Seguro Popular had no effect on informality in the overall population. Informality did increase by 1.7% for less educated workers, but the wage gains for workers who switch between the formal and the informal sector were not significantly affected. This suggests that marginal workers do not choose between formal and informal jobs on the basis of health insurance coverage. Copyright © 2013 Elsevier B.V. All rights reserved.

Watchdog activity monitor (WAM) for use wth high coverage processor self-test

NASA Technical Reports Server (NTRS)

Tulpule, Bhalchandra R. (Inventor); Crosset, III, Richard W. (Inventor); Versailles, Richard E. (Inventor)

1988-01-01

A high fault coverage, instruction modeled self-test for a signal processor in a user environment is disclosed. The self-test executes a sequence of sub-tests and issues a state transition signal upon the execution of each sub-test. The self-test may be combined with a watchdog activity monitor (WAM) which provides a test-failure signal in the presence of a counted number of state transitions not agreeing with an expected number. An independent measure of time may be provided in the WAM to increase fault coverage by checking the processor's clock. Additionally, redundant processor systems are protected from inadvertent unsevering of a severed processor using a unique unsever arming technique and apparatus.

Cost and coverage: implications of the McCain plan to restructure health insurance.

PubMed

Buchmueller, Thomas; Glied, Sherry A; Royalty, Anne; Swartz, Katherine

2008-01-01

Senator John McCain's (R-AZ) health plan would eliminate the current tax exclusion of employer payments for health coverage, replace the exclusion with a refundable tax credit for those who purchase coverage, and encourage Americans to move to a national market for nongroup insurance. Middle-range estimates suggest that initially this change will have little impact on the number of uninsured people, although within five years this number will likely grow as the value of the tax credit falls relative to rising health care costs. Moving toward a relatively unregulated nongroup market will tend to raise costs, reduce the generosity of benefits, and leave people with fewer consumer protections.

The relationship between medical care costs and personal bankruptcy.

PubMed

Brotman, Billie Ann

2006-01-01

The number of personal bankruptcy filings has broken records over the last few years. Filings for nonbusiness bankruptcy protection totaled 1,650,279 in 2003, an increase of 9.6 percent between the years 2002 and 2003. This article examines the relationship in the United States between personal bankruptcy filings, and medical care costs and coverage. There seems to be a positive, statistically significant relationship between medical care costs and nonbusiness bankruptcy numbers; however, medical care coverage has limited or no explanatory value as a factor explaining total nonbusiness bankruptcy filings. The regression models suggest a weak or no relationship between the number of nonbusiness bankruptcy filings and health insurance coverage.

Use of mobile phones for improving vaccination coverage among children living in rural hard-to-reach areas and urban streets of Bangladesh.

PubMed

Uddin, Md Jasim; Shamsuzzaman, Md; Horng, Lily; Labrique, Alain; Vasudevan, Lavanya; Zeller, Kelsey; Chowdhury, Mridul; Larson, Charles P; Bishai, David; Alam, Nurul

2016-01-04

In Bangladesh, full vaccination rates among children living in rural hard-to-reach areas and urban streets are low. We conducted a quasi-experimental pre-post study of a 12-month mobile phone intervention to improve vaccination among 0-11 months old children in rural hard-to-reach and urban street dweller areas. Software named "mTika" was employed within the existing public health system to electronically register each child's birth and remind mothers about upcoming vaccination dates with text messages. Android smart phones with mTika were provided to all health assistants/vaccinators and supervisors in intervention areas, while mothers used plain cell phones already owned by themselves or their families. Pre and post-intervention vaccination coverage was surveyed in intervention and control areas. Among children over 298 days old, full vaccination coverage actually decreased in control areas--rural baseline 65.9% to endline 55.2% and urban baseline 44.5% to endline 33.9%--while increasing in intervention areas from rural baseline 58.9% to endline 76*8%, difference +18.8% (95% CI 5.7-31.9) and urban baseline 40.7% to endline 57.1%, difference +16.5% (95% CI 3.9-29.0). Difference-in-difference (DID) estimates were +29.5% for rural intervention versus control areas and +27.1% for urban areas for full vaccination in children over 298 days old, and logistic regression adjusting for maternal education, mobile phone ownership, and sex of child showed intervention effect odds ratio (OR) of 3.8 (95% CI 1.5-9.2) in rural areas and 3.0 (95% CI 1.4-6.4) in urban areas. Among all age groups, intervention effects on age-appropriate vaccination coverage were positive: DIDs +13.1-30.5% and ORs 2.5-4.6 (p<0.001 in all comparisons). Qualitative data showed the intervention was well-accepted. Our study demonstrated that a mobile phone intervention can improve vaccination coverage in rural hard-to-reach and urban street dweller communities in Bangladesh. This small-scale successful demonstration should serve as an example to other low-income countries with high mobile phone usage. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Effects of climate and land use change on the changes of vegetation coverage in farming-pastoral ecotone of Northern China].

PubMed

Liu, Jun-Hui; Gao, Ji-Xi

2008-09-01

Based on the remote sensing images and the meteorological data in 1986 and 2000, and by using the model of extracting vegetation coverage, the spatiotemporal changes of vegetation coverage in the farming-pastoral ecotone of Northern China in 1986-2000 were studied, with the effects of climate and land use change on the changes analyzed. The results showed that in this ecotone, the area with lower vegetation coverage was increasing, while that with higher vegetation coverage was in adverse. The regions with increasing vegetation coverage were mainly in the east of northeast section, the west of north section, and the west of northwest section of the ecotone, while the vegetation coverage in the other sections was obviously degraded. The vegetation coverage were positively correlated with precipitation and aridity index, but negatively correlated with temperature. The change direction and extent of the vegetation coverage varied with land use types.

The effect of insecticide-treated bed nets on the incidence and prevalence of malaria in children in an area of unstable seasonal transmission in western Myanmar

PubMed Central

2013-01-01

Background Insecticide-treated bed nets (ITN) reduce malaria morbidity and mortality consistently in Africa, but their benefits have been less consistent in Asia. This study’s objective was to evaluate the malaria protective efficacy of village-wide usage of ITN in Western Myanmar and estimate the cost-effectiveness of ITN compared with extending early diagnosis and treatment services. Methods A cluster-randomized controlled trial was conducted in Rakhine State to assess the efficacy of ITNs in preventing malaria and anaemia in children and their secondary effects on nutrition and development. The data were aggregated for each village to obtain cluster-level infection rates. In total 8,175 children under 10 years of age were followed up for 10 months, which included the main malaria transmission period. The incidence and prevalence of Plasmodium falciparum and Plasmodium vivax infections, and the biting behaviour of Anopheles mosquitoes in the area were studied concurrently. The trial data along with costs for current recommended treatment practices were modelled to estimate the cost-effectiveness of ITNs compared with, or in addition to extending the coverage of early diagnosis and treatment services. Results In aggregate, malaria infections, spleen rates, haemoglobin concentrations, and weight for height, did not differ significantly during the study period between villages with and without ITNs, with a weighted mean difference of −2.6 P. falciparum episodes per 1,000 weeks at risk (95% Confidence Interval −7 to 1.8). In areas with a higher incidence of malaria there was some evidence ITN protective efficacy. The economic analysis indicated that, despite the uncertainty and variability in their protective efficacy in the different study sites, ITN could still be cost-effective, but not if they displaced funding for early diagnosis and effective treatment which is substantially more cost-effective. Conclusion In Western Myanmar deployment of ITNs did not provide consistent protection against malaria in children living in malaria endemic villages. Early diagnosis and effective treatment is a more cost effective malaria control strategy than deployment of ITNs in this area where the main vector bites early in the evening, often before people are protected by an ITN. PMID:24119916

77 FR 54859 - Proposed Establishment of VOR Federal Airway V-629; Las Vegas, NV

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-06

... of marginal radar coverage. This would enhance the efficiency of the National Airspace System (NAS... aircraft navigating in an area of marginal radar coverage. VOR Federal airways are published in paragraph...

Evaluation of immunization coverage by lot quality assurance sampling compared with 30-cluster sampling in a primary health centre in India.

PubMed

Singh, J; Jain, D C; Sharma, R S; Verghese, T

1996-01-01

The immunization coverage of infants, children and women residing in a primary health centre (PHC) area in Rajasthan was evaluated both by lot quality assurance sampling (LQAS) and by the 30-cluster sampling method recommended by WHO's Expanded Programme on Immunization (EPI). The LQAS survey was used to classify 27 mutually exclusive subunits of the population, defined as residents in health subcentre areas, on the basis of acceptable or unacceptable levels of immunization coverage among infants and their mothers. The LQAS results from the 27 subcentres were also combined to obtain an overall estimate of coverage for the entire population of the primary health centre, and these results were compared with the EPI cluster survey results. The LQAS survey did not identify any subcentre with a level of immunization among infants high enough to be classified as acceptable; only three subcentres were classified as having acceptable levels of tetanus toxoid (TT) coverage among women. The estimated overall coverage in the PHC population from the combined LQAS results showed that a quarter of the infants were immunized appropriately for their ages and that 46% of their mothers had been adequately immunized with TT. Although the age groups and the periods of time during which the children were immunized differed for the LQAS and EPI survey populations, the characteristics of the mothers were largely similar. About 57% (95% CI, 46-67) of them were found to be fully immunized with TT by 30-cluster sampling, compared with 46% (95% CI, 41-51) by stratified random sampling. The difference was not statistically significant. The field work to collect LQAS data took about three times longer, and cost 60% more than the EPI survey. The apparently homogeneous and low level of immunization coverage in the 27 subcentres makes this an impractical situation in which to apply LQAS, and the results obtained were therefore not particularly useful. However, if LQAS had been applied by local staff in an area with overall high coverage and population subunits with heterogeneous coverage, the method would have been less costly and should have produced useful results.