State Action 5: Role-Based, Timely Access to Information for Authorized Stakeholders. State Actions to Change the Culture around Data--from Building to Using Data

ERIC Educational Resources Information Center

Data Quality Campaign, 2010

2010-01-01

Data are only useful if people are able to access, understand and use them. Without access to the right information, stakeholders are forced to make decisions based on anecdote, experience or instinct. For information to be useful, it must be timely, readily available, and easy to understand. This brief highlights the importance of implementing…

A dynamic access control method based on QoS requirement

NASA Astrophysics Data System (ADS)

Li, Chunquan; Wang, Yanwei; Yang, Baoye; Hu, Chunyang

2013-03-01

A dynamic access control method is put forward to ensure the security of the sharing service in Cloud Manufacturing, according to the application characteristics of cloud manufacturing collaborative task. The role-based access control (RBAC) model is extended according to the characteristics of cloud manufacturing in this method. The constraints are considered, which are from QoS requirement of the task context to access control, based on the traditional static authorization. The fuzzy policy rules are established about the weighted interval value of permissions. The access control authorities of executable service by users are dynamically adjusted through the fuzzy reasoning based on the QoS requirement of task. The main elements of the model are described. The fuzzy reasoning algorithm of weighted interval value based QoS requirement is studied. An effective method is provided to resolve the access control of cloud manufacturing.

Access Control in Location-Based Services

NASA Astrophysics Data System (ADS)

Ardagna, Claudio A.; Cremonini, Marco; de Capitani di Vimercati, Sabrina; Samarati, Pierangela

Recent enhancements in location technologies reliability and precision are fostering the development of a new wave of applications that make use of the location information of users. Such applications introduces new aspects of access control which should be addressed. On the one side, precise location information may play an important role and can be used to develop Location-based Access Control (LBAC) systems that integrate traditional access control mechanisms with conditions based on the physical position of users. On the other side, location information of users can be considered sensitive and access control solutions should be developed to protect it against unauthorized accesses and disclosures. In this chapter, we address these two aspects related to the use and protection of location information, discussing existing solutions, open issues, and some research directions.

The Paperless Solution

NASA Technical Reports Server (NTRS)

2001-01-01

REI Systems, Inc. developed a software solution that uses the Internet to eliminate the paperwork typically required to document and manage complex business processes. The data management solution, called Electronic Handbooks (EHBs), is presently used for the entire SBIR program processes at NASA. The EHB-based system is ideal for programs and projects whose users are geographically distributed and are involved in complex management processes and procedures. EHBs provide flexible access control and increased communications while maintaining security for systems of all sizes. Through Internet Protocol- based access, user authentication and user-based access restrictions, role-based access control, and encryption/decryption, EHBs provide the level of security required for confidential data transfer. EHBs contain electronic forms and menus, which can be used in real time to execute the described processes. EHBs use standard word processors that generate ASCII HTML code to set up electronic forms that are viewed within a web browser. EHBs require no end-user software distribution, significantly reducing operating costs. Each interactive handbook simulates a hard-copy version containing chapters with descriptions of participants' roles in the online process.

Obesity and government.

PubMed

Kahan, Scott; Zvenyach, Tracy

2016-10-01

Despite much effort, obesity prevalence and disease severity continues to worsen. The purpose of this review is to describe the leading government supported food and nutrition interventions and policies to prevent and address obesity in the USA. The review also summarizes obesity interventions and policies that the government plays a role in, but further development is warranted. The government's role in obesity has largely focused on interventions and policies such as national surveillance, obesity education and awareness, grant-based food subsidy programs, zoning for food access, school-based nutrition programs, dietary guidelines, nutrition labeling, and food marketing and pricing policies. The government has played a lesser role in obesity interventions and policies that provide access to evidence-based obesity care to people affected by the disease. Given the magnitude of the obesity epidemic, the government should explore multiple evidence-based interventions and policies across prevention and clinical care.

A model of roles and responsibilities in oral health promotion based on perspectives of a community-based initiative for pre-school children in the U.K.

PubMed

Henderson, E; Rubin, G

2014-03-01

(i) To explore dental, school and family perspectives of an oral health promotion (OHP) initiative to improve access for pre-school children in deprived communities; (ii) to develop a model of roles and responsibilities for OHP in community settings. Semi-structured focus groups (n = 6) with dental practice staff (n = 24), and semi-structured interviews with school staff (n = 9) and parents and children (n = 4) who were involved in an OHP initiative for pre-school children. Framework analysis was applied to identify themes. Themes were used to develop a model of roles and responsibilities for OHP, based on the WHO Planning and evaluating health promotion model. Respondents subscribed to a community-based approach to improving access to dental services for pre-school children in deprived areas, with an emphasis on shared responsibility and communication. In addition to macro-level actions in directing health policy and services, commissioners were held responsible for investing in micro-level actions, such as funding OHP training and involving parents, and meso-level actions such as reducing barriers to access. The model we have developed builds on WHO recommendations on health promotion to identify the key roles and responsibilities that should be incorporated into further initiatives in OHP.

Task Delegation Based Access Control Models for Workflow Systems

NASA Astrophysics Data System (ADS)

Gaaloul, Khaled; Charoy, François

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

76 FR 54190 - Proposed Privacy Act System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-31

... decentralized, with each mission area and agency managing its respective FOIA programs. At the end of each year...-know basis. Role-based access controls are used, and FX is only accessible via the Internet using USDA...

An end-to-end secure patient information access card system.

PubMed

Alkhateeb, A; Singer, H; Yakami, M; Takahashi, T

2000-03-01

The rapid development of the Internet and the increasing interest in Internet-based solutions has promoted the idea of creating Internet-based health information applications. This will force a change in the role of IC cards in healthcare card systems from a data carrier to an access key medium. At the Medical Informatics Department of Kyoto University Hospital we are developing a smart card patient information project where patient databases are accessed via the Internet. Strong end-to-end data encryption is performed via Secure Socket Layers, transparent to transmit patient information. The smart card is playing the crucial role of access key to the database: user authentication is performed internally without ever revealing the actual key. For easy acceptance by healthcare professionals, the user interface is integrated as a plug-in for two familiar Web browsers, Netscape Navigator and MS Internet Explorer.

The role of gender in housing for individuals with severe mental illness: a qualitative study of the Canadian service context

PubMed Central

Kidd, Sean A; Virdee, Gursharan; Krupa, Terry; Burnham, Darrell; Hemingway, Dawn; Margolin, Indrani; Patterson, Michelle; Zabkiewicz, Denise

2013-01-01

Objective This study was undertaken to examine the role of gender as it relates to access to housing among individuals with severe mental illness (SMI) in Canada. Design An exploratory, qualitative approach was used to assess the perspectives of Canadian housing experts. The focus of inquiry was on the role of gender and associated intersections (eg, ethnicity) in pathways to housing access and housing needs for individuals with SMI. Setting A purposeful sampling strategy was undertaken to access respondents across all Canadian geographic regions, with diversity across settings (urban and rural) and service sectors (hospital based and community based). Participants –29 individuals (6 men and 23 women) considered to be experts in a housing service context as it pertains to SMI were recruited. On average, participants had worked for 15 years in services that specialised in the support and delivery of housing services to people with SMI. Measures Semistructured interviews with participants focused on the role gender plays in access to housing in their specific context. Barriers and facilitators were examined as were intersections with other relevant factors, such as ethnicity, poverty and parenthood. Quantitative ratings of housing accessibility as a function of gender were also collected. Results Participants across geographic contexts described a lack of shelter facilities for women, leading to a reliance on exploitative circumstances. Other findings included a compounding of discrimination for ethnic minority women, the unique resource problems faced in rural contexts, and the difficulties that attend access to shelter and housing for parents with SMI. Conclusions These findings suggest that, along with a generally poor availability of housing stock for individuals with SMI, access problems are compounded by a lack of attention to the unique needs and illness trajectories that attend gender. PMID:23794544

The need for the use of XACML access control policy in a distributed EHR and some performance considerations.

PubMed

Sucurovic, Snezana; Milutinovic, Veljko

2008-01-01

The Internet based distributed large scale information systems implements attribute based access control (ABAC) rather than Role Based Access Control (RBAC). The reason is that the Internet is identity less and that ABAC scales better. EXtensible Access Control Markup Language is standardized language for writing access control policies, access control requests and access control responses in ABAC. XACML can provide decentralized administration and credentials distribution. In year 2002 version of CEN ENV 13 606 attributes have been attached to EHCR components and in such a system ABAC and XACML have been easy to implement. This paper presents writing XACML policies in the case when attributes are in hierarchical structure. It is presented two possible solutions to write XACML policy in that case and that the solution when set functions are used is more compact and provides 10% better performances.

Perspectives on Networking.

ERIC Educational Resources Information Center

Levy, Sue

1992-01-01

Presents a library automation vendor's perspective on networking based on activities at Ameritech Information Systems. Topics discussed include the information explosion; information technology; user expectations and needs; remote access; the library of the future; systems integration; ownership versus access; copyright laws; and the role of the…

A security architecture for interconnecting health information systems.

PubMed

Gritzalis, Dimitris; Lambrinoudakis, Costas

2004-03-31

Several hereditary and other chronic diseases necessitate continuous and complicated health care procedures, typically offered in different, often distant, health care units. Inevitably, the medical records of patients suffering from such diseases become complex, grow in size very fast and are scattered all over the units involved in the care process, hindering communication of information between health care professionals. Web-based electronic medical records have been recently proposed as the solution to the above problem, facilitating the interconnection of the health care units in the sense that health care professionals can now access the complete medical record of the patient, even if it is distributed in several remote units. However, by allowing users to access information from virtually anywhere, the universe of ineligible people who may attempt to harm the system is dramatically expanded, thus severely complicating the design and implementation of a secure environment. This paper presents a security architecture that has been mainly designed for providing authentication and authorization services in web-based distributed systems. The architecture has been based on a role-based access scheme and on the implementation of an intelligent security agent per site (i.e. health care unit). This intelligent security agent: (a). authenticates the users, local or remote, that can access the local resources; (b). assigns, through temporary certificates, access privileges to the authenticated users in accordance to their role; and (c). communicates to other sites (through the respective security agents) information about the local users that may need to access information stored in other sites, as well as about local resources that can be accessed remotely.

On the Design of a Comprehensive Authorisation Framework for Service Oriented Architecture (SOA)

DTIC Science & Technology

2013-07-01

Authentication Server AZM Authorisation Manager AZS Authorisation Server BP Business Process BPAA Business Process Authorisation Architecture BPAD Business...Internet Protocol Security JAAS Java Authentication and Authorisation Service MAC Mandatory Access Control RBAC Role Based Access Control RCA Regional...the authentication process, make authorisation decisions using application specific access control functions that results in the practice of

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

PubMed

Gope, Prosanta; Amin, Ruhul

2016-11-01

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

Impact of Health on Education Access and Achievement. Policy Brief Number 3

ERIC Educational Resources Information Center

Pridmore, P.

2008-01-01

Access to education is recognized as a basic human right and yet projections based on current trends show that more than 50 countries will not achieve universal primary education by 2015. This briefing paper looks at the role of malnutrition and diseases in the failure of countries to meet EFA targets. It is based on the CREATE Pathways to Access…

The role of NASA's Water Resources applications area in improving access to water quality-related information and water resources management

NASA Astrophysics Data System (ADS)

Lee, C. M.

2016-02-01

The NASA Applied Sciences Program plays a unique role in facilitating access to remote sensing-based water information derived from US federal assets towards the goal of improving science and evidence-based decision-making in water resources management. The Water Resources Application Area within NASA Applied Sciences works specifically to develop and improve water data products to support improved management of water resources, with partners who are faced with real-world constraints and conditions including cost and regulatory standards. This poster will highlight the efforts and collaborations enabled by this program that have resulted in integration of remote sensing-based information for water quality modeling and monitoring within an operational context.

The role of NASA's Water Resources applications area in improving access to water quality-related information and water resources management

NASA Astrophysics Data System (ADS)

Lee, C. M.

2016-12-01

The NASA Applied Sciences Program plays a unique role in facilitating access to remote sensing-based water information derived from US federal assets towards the goal of improving science and evidence-based decision-making in water resources management. The Water Resources Application Area within NASA Applied Sciences works specifically to develop and improve water data products to support improved management of water resources, with partners who are faced with real-world constraints and conditions including cost and regulatory standards. This poster will highlight the efforts and collaborations enabled by this program that have resulted in integration of remote sensing-based information for water quality modeling and monitoring within an operational context.

An Analysis of Website Accessibility in Higher Education in Indonesia Based on WCAG 2.0 Guidelines

NASA Astrophysics Data System (ADS)

Arasid, W.; Abdullah, A. G.; Wahyudin, D.; Abdullah, C. U.; Widiaty, I.; Zakaria, D.; Amelia, N.; Juhana, A.

2018-02-01

Website accessibility is a simple way to access a website by everyone so that information on the website can be easily understood. This study aims to improve the accessibility of universities’ website to analyze website accessibility problems based on WCAG 2.0 guidelines. This study analyzed 13 universities’ websites in West Java, Indonesia by using TAW as an evaluation tool. The evaluation results were presented in a graph showing the error rate of each university’s website. The same errors that occurred in almost all websites were: non-text content, info and relationships, page title, link purpose, language of page, on input, labels and instructions, parsing, and name, role, value criteria. This study was expected to provide information to the university and to perform as guidelines for website accessibility improvements.

A federated capability-based access control mechanism for internet of things (IoTs)

NASA Astrophysics Data System (ADS)

Xu, Ronghua; Chen, Yu; Blasch, Erik; Chen, Genshe

2018-05-01

The prevalence of Internet of Things (IoTs) allows heterogeneous embedded smart devices to collaboratively provide intelligent services with or without human intervention. While leveraging the large-scale IoT-based applications like Smart Gird and Smart Cities, IoT also incurs more concerns on privacy and security. Among the top security challenges that IoTs face is that access authorization is critical in resource and information protection over IoTs. Traditional access control approaches, like Access Control Lists (ACL), Role-based Access Control (RBAC) and Attribute-based Access Control (ABAC), are not able to provide a scalable, manageable and efficient mechanisms to meet requirement of IoT systems. The extraordinary large number of nodes, heterogeneity as well as dynamicity, necessitate more fine-grained, lightweight mechanisms for IoT devices. In this paper, a federated capability-based access control (FedCAC) framework is proposed to enable an effective access control processes to devices, services and information in large scale IoT systems. The federated capability delegation mechanism, based on a propagation tree, is illustrated for access permission propagation. An identity-based capability token management strategy is presented, which involves registering, propagation and revocation of the access authorization. Through delegating centralized authorization decision-making policy to local domain delegator, the access authorization process is locally conducted on the service provider that integrates situational awareness (SAW) and customized contextual conditions. Implemented and tested on both resources-constrained devices, like smart sensors and Raspberry PI, and non-resource-constrained devices, like laptops and smart phones, our experimental results demonstrate the feasibility of the proposed FedCAC approach to offer a scalable, lightweight and fine-grained access control solution to IoT systems connected to a system network.

Proximity-based access control for context-sensitive information provision in SOA-based systems

NASA Astrophysics Data System (ADS)

Rajappan, Gowri; Wang, Xiaofei; Grant, Robert; Paulini, Matthew

2014-06-01

Service Oriented Architecture (SOA) has enabled open-architecture integration of applications within an enterprise. For net-centric Command and Control (C2), this elucidates information sharing between applications and users, a critical requirement for mission success. The Information Technology (IT) access control schemes, which arbitrate who gets access to what information, do not yet have the contextual knowledge to dynamically allow this information sharing to happen dynamically. The access control might prevent legitimate users from accessing information relevant to the current mission context, since this context may be very different from the context for which the access privileges were configured. We evaluate a pair of data relevance measures - proximity and risk - and use these as the basis of dynamic access control. Proximity is a measure of the strength of connection between the user and the resource. However, proximity is not sufficient, since some data might have a negative impact, if leaked, which far outweighs importance to the subject's mission. For this, we use a risk measure to quantify the downside of data compromise. Given these contextual measures of proximity and risk, we investigate extending Attribute-Based Access Control (ABAC), which is used by the Department of Defense, and Role-Based Access Control (RBAC), which is widely used in the civilian market, so that these standards-based access control models are given contextual knowledge to enable dynamic information sharing. Furthermore, we consider the use of such a contextual access control scheme in a SOA-based environment, in particular for net-centric C2.

Social Role Discovery in Human Events (Open Access)

DTIC Science & Technology

2013-10-03

to all people in the videos. We also present a novel YouTube social roles dataset with ground truth role annota- tions, and introduce annotations on a... nursing home [13], making role identifi- cation a difficult human task. Ideally, we would like to auto- matically discover such interaction-based role...34# $% &’$( ! Figure 2. Sample frames from different events in the YouTube Social

Specialty Care Access in the Safety Net-the Role of Public Hospitals and Health Systems.

PubMed

Makaroun, Lena K; Bowman, Chelsea; Duan, Kevin; Handley, Nathan; Wheeler, Daniel J; Pierluissi, Edgar; Chen, Alice Hm

2017-01-01

Access to specialty care in the United States safety net, already strained, is fac-ing increasing pressure with an influx of patients following the passage of the Affordable Care Act (ACA). We surveyed 18 public hospitals and health systems across the country to describe the current state of specialty care delivery in safety-net systems. We elicited information regarding challenges, provider models, metrics of access and productivity, and strategies for improving access. Based on our findings, we propose a framework for assessing and improving specialty care access with a focus on population health planning.

The Role of Automatic Indexing in Access Control: A Modular View

ERIC Educational Resources Information Center

Hartson, H. Rex

1974-01-01

A model which relates the access control and indexing functions. The model is based on concept protection which allows a practically unbounded number of levels (subsets) of protection without requiring a fixed hierarchy among the levels. This protection is offered independently for each of the user operations allowed. (Author)

Windows on the brain: the emerging role of atlases and databases in neuroscience

NASA Technical Reports Server (NTRS)

Van Essen, David C.; VanEssen, D. C. (Principal Investigator)

2002-01-01

Brain atlases and associated databases have great potential as gateways for navigating, accessing, and visualizing a wide range of neuroscientific data. Recent progress towards realizing this potential includes the establishment of probabilistic atlases, surface-based atlases and associated databases, combined with improvements in visualization capabilities and internet access.

Promoting Access: The Role of Organization and Awareness Factors. Elementary Subjects Center Series No. 1.

ERIC Educational Resources Information Center

Prawat, Richard S.

This review presents a framework that accommodates static and dynamic approaches to comprehension of students' transfer of knowledge and skill. The review focuses on three sets of variables considered fundamental to students' ability to access intellectual resources in potentially relevant situations: knowledge bases, strategies, and dispositions.…

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

PubMed

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

2013-09-01

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

Cloud-assisted mobile-access of health data with privacy and auditability.

PubMed

Tong, Yue; Sun, Jinyuan; Chow, Sherman S M; Li, Pan

2014-03-01

Motivated by the privacy issues, curbing the adoption of electronic healthcare systems and the wild success of cloud service models, we propose to build privacy into mobile healthcare systems with the help of the private cloud. Our system offers salient features including efficient key management, privacy-preserving data storage, and retrieval, especially for retrieval at emergencies, and auditability for misusing health data. Specifically, we propose to integrate key management from pseudorandom number generator for unlinkability, a secure indexing method for privacy-preserving keyword search which hides both search and access patterns based on redundancy, and integrate the concept of attribute-based encryption with threshold signing for providing role-based access control with auditability to prevent potential misbehavior, in both normal and emergency cases.

Attitude and confidence of undergraduate medical programme educators to practice and teach evidence-based healthcare: a cross-sectional survey.

PubMed

Young, Taryn; Esterhuizen, Tonya M; Volmink, Jimmy; Clarke, Mike

2016-06-01

Medical student educators play critical roles in evidence-based healthcare (EBHC) teaching and learning and as role models practicing EBHC. This study assessed their confidence to practice and teach EBHC, their attitude to EBHC and barriers to practicing and teaching EBHC. We conducted a cross-sectional online survey of educators of undergraduate medical students at a South African academic institution. STATA 12 was used for quantitative data analysis. Responses to open-ended questions were coded, and further interpretation done using thematic content analysis. Forty two (19%) educators from various departments responded to the invitation sent to everyone formally involved in teaching undergraduate medical students. They had high levels of knowledge and understanding of EBHC. Many had received training in teaching and learning approaches, although EBHC training received was mainly on enabling competencies. Limitations to practicing EBHC included lack of time, clinical workload, limited access to Internet and resources, knowledge and skills. One quarter of the respondents indicated that they teach EBHC. Perceived barriers to teaching EBHC reported related to students (e.g. lack of interest), context (e.g. access to databases) and educators (e.g. competing priorities). Respondents' suggestions for support included reliable Internet access, easy point-of-care access to databases and resources, increasing awareness of EBHC, building capacity to practice and facilitate learning of EBHC and a supportive community of practice. Educators play a critical role in facilitating EBHC learning not just in the classroom, but also in practice. Without adequate support, training and development, they are ill equipped to be the role models future healthcare professionals need.

HIV-infected women’s perspectives on the use of the Internet for social support: A potential role for online group-based interventions

PubMed Central

Blackstock, Oni J.; Shah, Pooja A.; Haughton, Lorlette J.; Horvath, Keith J.; Cunningham, Chinazo O.

2015-01-01

While the development and implementation of HIV-related online interventions has expanded, few have been tailored for women or have leveraged Web 2.0’s capabilities to provide social support. We conducted semi-structured interviews with 27 women with HIV at an urban community health center to understand their perspectives on the potential role of the Internet and the use of an online group format to provide social support. Data were analyzed using the constant comparative method. We identified six themes: a need for groups and increased sense of connectedness, convenience and accessibility, trust as a precondition for participating, online groups as a potential facilitator or barrier to expression, limited digital access and literacy, and privacy concerns. Overall, women were highly supportive of online group-based interventions but acknowledged the need for increased digital access and Internet navigation training. Hybrid (in-person and online) interventions may be most useful for women with HIV. PMID:25749532

The Use of Proxy Caches for File Access in a Multi-Tier Grid Environment

NASA Astrophysics Data System (ADS)

Brun, R.; Duellmann, D.; Ganis, G.; Hanushevsky, A.; Janyst, L.; Peters, A. J.; Rademakers, F.; Sindrilaru, E.

2011-12-01

The use of proxy caches has been extensively studied in the HEP environment for efficient access of database data and showed significant performance with only very moderate operational effort at higher grid tiers (T2, T3). In this contribution we propose to apply the same concept to the area of file access and analyse the possible performance gains, operational impact on site services and applicability to different HEP use cases. Base on a proof-of-concept studies with a modified XROOT proxy server we review the cache efficiency and overheads for access patterns of typical ROOT based analysis programs. We conclude with a discussion of the potential role of this new component at the different tiers of a distributed computing grid.

The Use of Proxy Caches for File Access in a Multi-Tier Grid Environment

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

Brun, R.; Dullmann, D.; Ganis, G.

2012-04-19

The use of proxy caches has been extensively studied in the HEP environment for efficient access of database data and showed significant performance with only very moderate operational effort at higher grid tiers (T2, T3). In this contribution we propose to apply the same concept to the area of file access and analyze the possible performance gains, operational impact on site services and applicability to different HEP use cases. Base on a proof-of-concept studies with a modified XROOT proxy server we review the cache efficiency and overheads for access patterns of typical ROOT based analysis programs. We conclude with amore » discussion of the potential role of this new component at the different tiers of a distributed computing grid.« less

An Intelligent Information Access System Assisting a Case Based Learning Methodology Evaluated in Higher Education with Medical Students

ERIC Educational Resources Information Center

Aparicio, Fernando; De Buenaga, Manuel; Rubio, Margarita; Hernando, Asuncion

2012-01-01

In recent years there has been a shift in educational methodologies toward a student-centered approach, one which increasingly emphasizes the integration of computer tools and intelligent systems adopting different roles. In this paper we describe in detail the development of an Intelligent Information Access system used as the basis for producing…

Education, Work, and Employment. Volume I--Education, Training and Access to the Labour Market.

ERIC Educational Resources Information Center

Hallak, Jacques; And Others

This volume contains four studies covering various approaches and having different scopes for studying the problem of access to jobs and the role of education and training as criteria for recruitment. The first study, on the metropolitan area of Panama, covers all sectors of activity. It is based on a questionnaire administered to 80 companies to…

The Role of Women's Colleges and Universities in Providing Access to Postsecondary Education

ERIC Educational Resources Information Center

Renn, Kristen A.

2017-01-01

Based on a qualitative, comparative, multiple case study of the contributions and status of 21st century women's colleges and universities, this article analyzes the topic of women's access to postsecondary education in ten nations. Despite decreasing numbers of women-only institutions in some regions (e.g., North America), the sector is growing…

The Impact of Role Models on Health Outcomes for Lesbian, Gay, Bisexual and Transgender Youth

PubMed Central

Bird, Jason D. P.; Kuhns, Lisa; Garofalo, Robert

2011-01-01

Purpose There is little research on the impact of role models on health outcomes for Lesbian, Gay, Bisexual, and Transgender (LGBT) youth. This exploratory study describes the presence and availability of LGBT affirming role models and examines the relationship between the accessibility of role models and health outcomes among a community-based sample of LGBT youth. Methods A convenience sample of 496 ethnically-diverse, 16–24 year old LGBT youth was recruited to complete a computer-assisted interview using standardized instruments validated with adolescents. The prevalence and characteristics of role models was described. Differences in subgroup distribution were assessed using Pearson Chi-square (p<0.05). Differences in health outcomes for those with and without role models and the nature of those role models were determined using analysis of co-variance (ANCOVA) models, with post hoc Bonferroni tests to probe significant global findings. Results Sixty-percent of the participants reported having a role model, with younger participants significantly more likely to report having a role model. A majority of the participants reported having inaccessible role models, especially among younger participants. The presence and accessibility of a role model did not have a significant relationship to binge drinking, drug use, or STI diagnoses; however, participants with inaccessible role models showed increased psychological distress versus those with accessible or no role models. Conclusions Inaccessible role models may not be sufficient for protecting youth from negative outcomes and formal mechanisms for connecting LGBT youth with caring adults who can serve as role models, such as mentoring programs, are critical. PMID:22443838

Approach to spatial information security based on digital certificate

NASA Astrophysics Data System (ADS)

Cong, Shengri; Zhang, Kai; Chen, Baowen

2005-11-01

With the development of the online applications of geographic information systems (GIS) and the spatial information services, the spatial information security becomes more important. This work introduced digital certificates and authorization schemes into GIS to protect the crucial spatial information combining the techniques of the role-based access control (RBAC), the public key infrastructure (PKI) and the privilege management infrastructure (PMI). We investigated the spatial information granularity suited for sensitivity marking and digital certificate model that fits the need of GIS security based on the semantics analysis of spatial information. It implements a secure, flexible, fine-grained data access based on public technologies in GIS in the world.

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

PubMed

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

2013-01-01

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

Attitude and confidence of undergraduate medical programme educators to practice and teach evidence-based healthcare: a cross-sectional survey

PubMed Central

Young, Taryn; Esterhuizen, Tonya M.; Volmink, Jimmy; Clarke, Mike

2016-01-01

ABSTRACT Aim: Medical student educators play critical roles in evidence-based healthcare (EBHC) teaching and learning and as role models practicing EBHC. This study assessed their confidence to practice and teach EBHC, their attitude to EBHC and barriers to practicing and teaching EBHC. Methods: We conducted a cross-sectional online survey of educators of undergraduate medical students at a South African academic institution. STATA 12 was used for quantitative data analysis. Responses to open-ended questions were coded, and further interpretation done using thematic content analysis. Results: Forty two (19%) educators from various departments responded to the invitation sent to everyone formally involved in teaching undergraduate medical students. They had high levels of knowledge and understanding of EBHC. Many had received training in teaching and learning approaches, although EBHC training received was mainly on enabling competencies. Limitations to practicing EBHC included lack of time, clinical workload, limited access to Internet and resources, knowledge and skills. One quarter of the respondents indicated that they teach EBHC. Perceived barriers to teaching EBHC reported related to students (e.g. lack of interest), context (e.g. access to databases) and educators (e.g. competing priorities). Respondents’ suggestions for support included reliable Internet access, easy point-of-care access to databases and resources, increasing awareness of EBHC, building capacity to practice and facilitate learning of EBHC and a supportive community of practice. Conclusion: Educators play a critical role in facilitating EBHC learning not just in the classroom, but also in practice. Without adequate support, training and development, they are ill equipped to be the role models future healthcare professionals need. PMID:26626283

Access Control Management for SCADA Systems

NASA Astrophysics Data System (ADS)

Hong, Seng-Phil; Ahn, Gail-Joon; Xu, Wenjuan

The information technology revolution has transformed all aspects of our society including critical infrastructures and led a significant shift from their old and disparate business models based on proprietary and legacy environments to more open and consolidated ones. Supervisory Control and Data Acquisition (SCADA) systems have been widely used not only for industrial processes but also for some experimental facilities. Due to the nature of open environments, managing SCADA systems should meet various security requirements since system administrators need to deal with a large number of entities and functions involved in critical infrastructures. In this paper, we identify necessary access control requirements in SCADA systems and articulate access control policies for the simulated SCADA systems. We also attempt to analyze and realize those requirements and policies in the context of role-based access control that is suitable for simplifying administrative tasks in large scale enterprises.

The Role of Community Health Centers in Reducing Racial Disparities in Spatial Access to Primary Care.

PubMed

Seymour, Jane W; Polsky, Daniel E; Brown, Elizabeth J; Barbu, Corentin M; Grande, David

2017-07-01

Racial minorities are more likely to live in primary care shortage areas. We sought to understand community health centers' (CHCs) role in reducing disparities. We surveyed all primary care practices in an urban area, identified low access areas, and examined how CHCs influence spatial accessibility. Census tracts with higher rates of public insurance (≥40% vs <10%, odds ratio [OR] = 31.06, P < .001; 30-39% vs 10%, OR = 7.84, P = 0.001) were more likely to be near a CHC and those with moderate rates of uninsurance (10%-19% vs <10%, OR = 0.42, P = .045) were less likely. Racial composition was not associated with proximity. Tracts close to a CHC were less likely (OR = 0.11, P < .0001) to be in a low access area. This association did not differ based on racial composition. Although CHCs were more likely to be in areas with a greater fraction of racial minorities, location was more strongly influenced by public insurance rates. CHCs reduced the likelihood of being in low access areas but the effect did not vary by tract racial composition.

Academic Patents and Access to Medicines in Developing Countries

PubMed Central

2009-01-01

There is a widespread and growing concern that patents hinder access to life-saving drugs in developing countries. Recent student movements and legislative initiatives emphasize the potential role that research universities in developed countries could have in ameliorating this “access gap.” These efforts are based on the assumption that universities own patents on a substantial number of drugs and that patents on these drugs are currently filed in developing countries. I provide empirical evidence regarding these issues and explore the feasibility and desirability of proposals to change university patenting and licensing practices to promote access to medicines in the developing world. PMID:19008514

Trustworthy data collection from implantable medical devices via high-speed security implementation based on IEEE 1363.

PubMed

Hu, Fei; Hao, Qi; Lukowiak, Marcin; Sun, Qingquan; Wilhelm, Kyle; Radziszowski, Stanisław; Wu, Yao

2010-11-01

Implantable medical devices (IMDs) have played an important role in many medical fields. Any failure in IMDs operations could cause serious consequences and it is important to protect the IMDs access from unauthenticated access. This study investigates secure IMD data collection within a telehealthcare [mobile health (m-health)] network. We use medical sensors carried by patients to securely access IMD data and perform secure sensor-to-sensor communications between patients to relay the IMD data to a remote doctor's server. To meet the requirements on low computational complexity, we choose N-th degree truncated polynomial ring (NTRU)-based encryption/decryption to secure IMD-sensor and sensor-sensor communications. An extended matryoshkas model is developed to estimate direct/indirect trust relationship among sensors. An NTRU hardware implementation in very large integrated circuit hardware description language is studied based on industry Standard IEEE 1363 to increase the speed of key generation. The performance analysis results demonstrate the security robustness of the proposed IMD data access trust model.

Role-Based And Adaptive User Interface Designs In A Teledermatology Consult System: A Way To Secure And A Way To Enhance

PubMed Central

Lin, Yi-Jung; Speedie, Stuart

2003-01-01

User interface design is one of the most important parts of developing applications. Nowadays, a quality user interface must not only accommodate interaction between machines and users, but also needs to recognize the differences and provide functionalities for users from role-to-role or even individual-to-individual. With the web-based application of our Teledermatology consult system, the development environment provides us highly useful opportunities to create dynamic user interfaces, which lets us to gain greater access control and has the potential to increase efficiency of the system. We will describe the two models of user interfaces in our system: Role-based and Adaptive. PMID:14728419

Authoring Tools

NASA Astrophysics Data System (ADS)

Treviranus, Jutta

Authoring tools that are accessible and that enable authors to produce accessible Web content play a critical role in web accessibility. Widespread use of authoring tools that comply to the W3C Authoring Tool Accessibility Guidelines (ATAG) would ensure that even authors who are neither knowledgeable about nor particularly motivated to produce accessible content do so by default. The principles and techniques of ATAG are discussed. Some examples of accessible authoring tools are described including authoring tool content management components such as TinyMCE. Considerations for creating an accessible collaborative environment are also covered. As part of providing accessible content, the debate between system-based personal optimization and one universally accessible site configuration is presented. The issues and potential solutions to address the accessibility crisis presented by the advent of rich internet applications are outlined. This challenge must be met to ensure that a large segment of the population is able to participate in the move toward the web as a two-way communication mechanism.

Culture, category salience, and inductive reasoning.

PubMed

Choi, I; Nisbett, R E; Smith, E E

1997-12-01

The role of category salience in category-based induction was demonstrated in two ways: (i) temporarily increasing category salience facilitated category-based induction, and (ii) this effect was moderated by cultural differences that we predicted would be related to chronic category salience. Subjects for whom categories were presumed to be more accessible (Americans) were not as much influenced by manipulations to increase category salience as subjects who were presumed to have lower chronic accessibility of categories (Koreans). However, as anticipated, this pattern was reversed for inferences about behavioral properties of social categories. Due to the 'interdependent' nature of their culture, Koreans presumably have relatively higher chronic accessibility for social categories than do relatively 'independent' Americans, and hence were not influenced as much by increasing category salience.

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

PubMed

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

2011-01-01

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

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

PubMed Central

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

2011-01-01

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

User Access Management Based on Network Pricing for Social Network Applications

PubMed Central

Ma, Xingmin; Gu, Qing

2018-01-01

Social applications play a very important role in people’s lives, as users communicate with each other through social networks on a daily basis. This presents a challenge: How does one receive high-quality service from social networks at a low cost? Users can access different kinds of wireless networks from various locations. This paper proposes a user access management strategy based on network pricing such that networks can increase its income and improve service quality. Firstly, network price is treated as an optimizing access parameter, and an unascertained membership algorithm is used to make pricing decisions. Secondly, network price is adjusted dynamically in real time according to network load. Finally, selecting a network is managed and controlled in terms of the market economy. Simulation results show that the proposed scheme can effectively balance network load, reduce network congestion, improve the user's quality of service (QoS) requirements, and increase the network’s income. PMID:29495252

Automated Computer Access Request System

NASA Technical Reports Server (NTRS)

Snook, Bryan E.

2010-01-01

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

Reducing the distance: equity issues in distance learning in public education

NASA Astrophysics Data System (ADS)

Campbell, Patricia B.; Storo, Jennifer

1996-12-01

Distance learning and educational equity both began with an emphasis on access, on providing underserved students with an increased access to education. Today definitions of equity have gone beyond simple access to include equal or equivalent treatment and outcomes while definitions of underserved students have expanded to include girls, children of color, children with limited English proficiency and children with disabilities. At the same time the definition of distance learning has expanded to include new technologies, new audiences and new roles. Based on these new definitions and roles, the article raises a number of equity challenges for distance learning educators centering around who is taught, what is taught and how the teaching is done. To answer these challenges, a series of recommendations are suggested that educators can implement to make distance learning a leader in increasing educational equity for all students. The time to act is now.

The Effect of the Home Environment on Physical Activity and Dietary Intake in Preschool Children

PubMed Central

Østbye, Truls; Malhotra, Rahul; Stroo, Marissa; Lovelady, Cheryl; Brouwer, Rebecca; Zucker, Nancy; Fuemmeler, Bernard

2013-01-01

Background The effects of the home environment on child health behaviors related to obesity are unclear. Purpose To examine the role of the home physical activity (PA) and food environment on corresponding outcomes in young children, and assess maternal education/work status as a moderator. Methods Overweight or obese mothers reported on the home PA and food environment (accessibility, role modeling and parental policies). Outcomes included child moderate-vigorous PA (MVPA) and sedentary time derived from accelerometer data and two dietary factors (“junk” and healthy food intake scores) based on factor analysis of mother-reported food intake. Linear regression models assessed the net effect (controlling for child demographics, study arm, supplemental timepoint, maternal education/work status, child body mass index and accelerometer wear-time (for PA outcomes)) of the home environment on the outcomes and moderation by maternal education/work status. Data was collected in North Carolina from 2007–2011. Results Parental policies supporting PA increased MVPA time, and limiting access to unhealthy foods increased the healthy food intake score. Role modeling of healthy eating behaviors increased the healthy food intake score among children of mothers with no college education. Among children of mothers with no college education and not working, limiting access to unhealthy foods and role modeling reduced “junk” food intake scores while parental policies supporting family meals increased “junk” food intake scores. Conclusions To promote MVPA, parental policies supporting child PA are warranted. Limited access to unhealthy foods and role modeling of healthy eating may improve the quality of the child’s food intake. PMID:23736357

The effect of the home environment on physical activity and dietary intake in preschool children.

PubMed

Østbye, T; Malhotra, R; Stroo, M; Lovelady, C; Brouwer, R; Zucker, N; Fuemmeler, B

2013-10-01

The effects of the home environment on child health behaviors related to obesity are unclear. To examine the role of the home physical activity (PA) and food environment on corresponding outcomes in young children, and assess maternal education/work status as a moderator. Overweight or obese mothers reported on the home PA and food environment (accessibility, role modeling and parental policies). Outcomes included child moderate-vigorous PA (MVPA) and sedentary time derived from accelerometer data and two dietary factors ('junk' and healthy food intake scores) based on factor analysis of mother-reported food intake. Linear regression models assessed the net effect (controlling for child demographics, study arm, supplemental time point, maternal education/work status, child body mass index and accelerometer wear time (for PA outcomes)) of the home environment on the outcomes and moderation by maternal education/work status. Data were collected in North Carolina from 2007 to 2011. Parental policies supporting PA increased MVPA time, and limiting access to unhealthy foods increased the healthy food intake score. Role modeling of healthy eating behaviors increased the healthy food intake score among children of mothers with no college education. Among children of mothers with no college education and not working, limiting access to unhealthy foods and role modeling reduced 'junk' food intake scores whereas parental policies supporting family meals increased 'junk' food intake scores. To promote MVPA, parental policies supporting child PA are warranted. Limited access to unhealthy foods and role modeling of healthy eating may improve the quality of the child's food intake.

Securely and Flexibly Sharing a Biomedical Data Management System

PubMed Central

Wang, Fusheng; Hussels, Phillip; Liu, Peiya

2011-01-01

Biomedical database systems need not only to address the issues of managing complex data, but also to provide data security and access control to the system. These include not only system level security, but also instance level access control such as access of documents, schemas, or aggregation of information. The latter is becoming more important as multiple users can share a single scientific data management system to conduct their research, while data have to be protected before they are published or IP-protected. This problem is challenging as users’ needs for data security vary dramatically from one application to another, in terms of who to share with, what resources to be shared, and at what access level. We develop a comprehensive data access framework for a biomedical data management system SciPort. SciPort provides fine-grained multi-level space based access control of resources at not only object level (documents and schemas), but also space level (resources set aggregated in a hierarchy way). Furthermore, to simplify the management of users and privileges, customizable role-based user model is developed. The access control is implemented efficiently by integrating access privileges into the backend XML database, thus efficient queries are supported. The secure access approach we take makes it possible for multiple users to share the same biomedical data management system with flexible access management and high data security. PMID:21625285

Secure access control and large scale robust representation for online multimedia event detection.

PubMed

Liu, Changyu; Lu, Bin; Li, Huiling

2014-01-01

We developed an online multimedia event detection (MED) system. However, there are a secure access control issue and a large scale robust representation issue when we want to integrate traditional event detection algorithms into the online environment. For the first issue, we proposed a tree proxy-based and service-oriented access control (TPSAC) model based on the traditional role based access control model. Verification experiments were conducted on the CloudSim simulation platform, and the results showed that the TPSAC model is suitable for the access control of dynamic online environments. For the second issue, inspired by the object-bank scene descriptor, we proposed a 1000-object-bank (1000OBK) event descriptor. Feature vectors of the 1000OBK were extracted from response pyramids of 1000 generic object detectors which were trained on standard annotated image datasets, such as the ImageNet dataset. A spatial bag of words tiling approach was then adopted to encode these feature vectors for bridging the gap between the objects and events. Furthermore, we performed experiments in the context of event classification on the challenging TRECVID MED 2012 dataset, and the results showed that the robust 1000OBK event descriptor outperforms the state-of-the-art approaches.

Rational Inhibitors of DNA Base Excision Repair (BER) Enzymes: New Tools for Elucidating the Role of the BER in Cancer Chemotherapy

DTIC Science & Technology

2005-05-01

Revised Manuscript Received March 3, 2005 ABSTRACT: Base flipping is a highly conserved strategy used by enzymes to gain catalytic access to DNA bases that...73.13. Jencks, W. P. (1985) A primer for the bema hapothle-an between uracil and other normal DNA bases at this inter- empirical-approach to the

Medication management for community palliative care patients and the role of a specialist palliative care pharmacist: A qualitative exploration of consumer and health care professional perspectives.

PubMed

Kuruvilla, Lisha; Weeks, Greg; Eastman, Peter; George, Johnson

2018-05-01

Pharmacists have a key role to play in optimisation of medication regimens and promotion of medication safety. The role of specialist pharmacists as part of the multidisciplinary palliative care team, especially in the primary care setting, is not widely recognised. To explore the perspectives of stakeholders about the gaps in the current model of community palliative care services in relation to medication management and to assess their opinions pertaining to the role of a specialist palliative care pharmacist in addressing some of those gaps. Qualitative study utilising three focus groups involving 20 stakeholders. Thematic analysis was carried out using a framework approach and interpreted in the context of the Chronic Care Model for improving primary care for patients with chronic illness. Setting was a large regional Australian palliative care service. Participants included palliative care consumers and clinicians specifically patients, caregivers, physicians, nurses and pharmacists. Five major themes emerged from the focus groups: access to resources, medicines and information; shared care; challenges of polypharmacy; informal caregiver needs and potential roles of a palliative care pharmacist. Gaps in access to medicines/resources, training for generalist practitioners, communication between treating teams and lack of support for patients and carers were cited as factors adversely impacting medication management in community-based palliative care. While community-based palliative care is an essential aspect of meeting the health care demands of an ageing society, the current model has several gaps and limitations. An appropriately qualified and skilled pharmacist within the palliative care team may help to address some of the gaps in relation to medication access and appropriateness.

From Web accessibility to Web adaptability.

PubMed

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

2009-07-01

This article asserts that current approaches to enhance the accessibility of Web resources fail to provide a solid foundation for the development of a robust and future-proofed framework. In particular, they fail to take advantage of new technologies and technological practices. The article introduces a framework for Web adaptability, which encourages the development of Web-based services that can be resilient to the diversity of uses of such services, the target audience, available resources, technical innovations, organisational policies and relevant definitions of 'accessibility'. The article refers to a series of author-focussed approaches to accessibility through which the authors and others have struggled to find ways to promote accessibility for people with disabilities. These approaches depend upon the resource author's determination of the anticipated users' needs and their provision. Through approaches labelled as 1.0, 2.0 and 3.0, the authors have widened their focus to account for contexts and individual differences in target audiences. Now, the authors want to recognise the role of users in determining their engagement with resources (including services). To distinguish this new approach, the term 'adaptability' has been used to replace 'accessibility'; new definitions of accessibility have been adopted, and the authors have reviewed their previous work to clarify how it is relevant to the new approach. Accessibility 1.0 is here characterised as a technical approach in which authors are told how to construct resources for a broadly defined audience. This is known as universal design. Accessibility 2.0 was introduced to point to the need to account for the context in which resources would be used, to help overcome inadequacies identified in the purely technical approach. Accessibility 3.0 moved the focus on users from a homogenised universal definition to recognition of the idiosyncratic needs and preferences of individuals and to cater for them. All of these approaches placed responsibility within the authoring/publishing domain without recognising the role the user might want to play, or the roles that other users in social networks, or even Web services might play. Adaptability shifts the emphasis and calls for greater freedom for the users to facilitate individual accessibility in the open Web environment.

Silencing of a Germin-Like Protein Gene (CchGLP) in Geminivirus-Resistant Pepper (Capsicum chinense Jacq.) BG-3821 Increases Susceptibility to Single and Mixed Infections by Geminiviruses PHYVV and PepGMV

PubMed Central

Mejía-Teniente, Laura; Joaquin-Ramos, Ahuizolt de Jesús; Torres-Pacheco, Irineo; Rivera-Bustamante, Rafael F.; Guevara-Olvera, Lorenzo; Rico-García, Enrique; Guevara-Gonzalez, Ramon G.

2015-01-01

Germin-like proteins (GLPs) are encoded by a family of genes found in all plants, and in terms of function, the GLPs are implicated in the response of plants to biotic and abiotic stresses. CchGLP is a gene encoding a GLP identified in a geminivirus-resistant Capsicum chinense Jacq accession named BG-3821, and it is important in geminivirus resistance when transferred to susceptible tobacco in transgenic experiments. To characterize the role of this GLP in geminivirus resistance in the original accession from which this gene was identified, this work aimed at demonstrating the possible role of CchGLP in resistance to geminiviruses in Capsicum chinense Jacq. BG-3821. Virus-induced gene silencing studies using a geminiviral vector based in PHYVV component A, displaying that silencing of CchGLP in accession BG-3821, increased susceptibility to geminivirus single and mixed infections. These results suggested that CchGLP is an important factor for geminivirus resistance in C. chinense BG-3821 accession. PMID:26610554

Silencing of a Germin-Like Protein Gene (CchGLP) in Geminivirus-Resistant Pepper (Capsicum chinense Jacq.) BG-3821 Increases Susceptibility to Single and Mixed Infections by Geminiviruses PHYVV and PepGMV.

PubMed

Mejía-Teniente, Laura; Joaquin-Ramos, Ahuizolt de Jesús; Torres-Pacheco, Irineo; Rivera-Bustamante, Rafael F; Guevara-Olvera, Lorenzo; Rico-García, Enrique; Guevara-Gonzalez, Ramon G

2015-11-25

Germin-like proteins (GLPs) are encoded by a family of genes found in all plants, and in terms of function, the GLPs are implicated in the response of plants to biotic and abiotic stresses. CchGLP is a gene encoding a GLP identified in a geminivirus-resistant Capsicum chinense Jacq accession named BG-3821, and it is important in geminivirus resistance when transferred to susceptible tobacco in transgenic experiments. To characterize the role of this GLP in geminivirus resistance in the original accession from which this gene was identified, this work aimed at demonstrating the possible role of CchGLP in resistance to geminiviruses in Capsicum chinense Jacq. BG-3821. Virus-induced gene silencing studies using a geminiviral vector based in PHYVV component A, displaying that silencing of CchGLP in accession BG-3821, increased susceptibility to geminivirus single and mixed infections. These results suggested that CchGLP is an important factor for geminivirus resistance in C. chinense BG-3821 accession.

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

PubMed Central

2011-01-01

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

Efficient Access Control in Multimedia Social Networks

NASA Astrophysics Data System (ADS)

Sachan, Amit; Emmanuel, Sabu

Multimedia social networks (MMSNs) have provided a convenient way to share multimedia contents such as images, videos, blogs, etc. Contents shared by a person can be easily accessed by anybody else over the Internet. However, due to various privacy, security, and legal concerns people often want to selectively share the contents only with their friends, family, colleagues, etc. Access control mechanisms play an important role in this situation. With access control mechanisms one can decide the persons who can access a shared content and who cannot. But continuously growing content uploads and accesses, fine grained access control requirements (e.g. different access control parameters for different parts in a picture), and specific access control requirements for multimedia contents can make the time complexity of access control to be very large. So, it is important to study an efficient access control mechanism suitable for MMSNs. In this chapter we present an efficient bit-vector transform based access control mechanism for MMSNs. The proposed approach is also compatible with other requirements of MMSNs, such as access rights modification, content deletion, etc. Mathematical analysis and experimental results show the effectiveness and efficiency of our proposed approach.

A Districtwide Study of Automaticity When Included in Concept-Based Elementary School Mathematics Instruction

ERIC Educational Resources Information Center

McGee, Daniel; Richardson, Patrick; Brewer, Meredith; Gonulates, Funda; Hodgson, Theodore; Weinel, Rebecca

2017-01-01

While conceptual understanding of properties, operations, and the base-ten number system is certainly associated with the ability to access math facts fluently, the role of math fact memorization to promote conceptual understanding remains contested. In order to gain insight into this question, this study looks at the results when one of three…

Data Manipulation in an XML-Based Digital Image Library

ERIC Educational Resources Information Center

Chang, Naicheng

2005-01-01

Purpose: To help to clarify the role of XML tools and standards in supporting transition and migration towards a fully XML-based environment for managing access to information. Design/methodology/approach: The Ching Digital Image Library, built on a three-tier architecture, is used as a source of examples to illustrate a number of methods of data…

The Role of School Based Health Centers (SBHCs) in Improving Health Equity and Reducing Health Disparities. Position Statement

ERIC Educational Resources Information Center

Blacksin, Beth; Gall, Gail; Feldman, Elizabeth; Miller, Elizabeth

2010-01-01

Health inequities exist largely among socially disadvantaged people who are denied the highest attainable standard of health available to many Americans. Access to culturally competent, high quality, first-contact primary care through school-based health centers is an effective way to reduce health inequities and, therefore, improve health…

Health Professionals' Attitudes towards Evidence-Based Medicine and the Role of the Information Professional in Exploitation of the Research Evidence.

ERIC Educational Resources Information Center

Lewis, Ruth A.; Rolinson, Janet; Urquhart, Christine J.

1998-01-01

A survey of 182 doctors, nurses, and allied professionals examined health professionals' awareness of evidence-based medicine (EBM). Results show most health professionals wanted workplace access to resources, that doctors preferred to do their own searching, and that health professionals doubted librarians could find relevant articles, suggesting…

Meeting the Curricular Challenges of Inclusive Assessment: The Role of Alignment, Opportunity to Learn, and Student Engagement

ERIC Educational Resources Information Center

Kurz, Alexander; Talapatra, Devadrita; Roach, Andrew T.

2012-01-01

Inclusive test-based accountability systems are intended to focus attention on the teaching and learning of important knowledge and skills for students with disabilities. Test score inferences to this end are often based on unverified assumptions of curricular alignment, access, and engagement. Focusing on students with disabilities, we discuss…

The rural community care gerontologic nurse entrepreneur: role development strategies.

PubMed

Caffrey, Rosalie A

2005-10-01

Rural elderly individuals are an underserved population with limited access to health care. There is an increasing need for independent community care nurses to provide assistance to home-based elderly individuals with chronic illnesses to prevent unnecessary medical and placement decisions and, thus, allow them to maintain independence and quality of life. This article describes the rural setting and why community care nurses are needed, and explores strategies for implementing the role of the independent nurse entrepreneur in caring for community-based elderly individuals in rural settings.

Decomposing Educational Inequalities in Child Mortality: A Temporal Trend Analysis of Access to Water and Sanitation in Peru

PubMed Central

Bohra, Tasneem; Benmarhnia, Tarik; McKinnon, Britt; Kaufman, Jay S.

2017-01-01

Previous studies of inequality in health and mortality have largely focused on income-based inequality. Maternal education plays an important role in determining access to water and sanitation, and inequalities in child mortality arising due to differential access, especially in low- and middle-income countries such as Peru. This article aims to explain education-related inequalities in child mortality in Peru using a regression-based decomposition of the concentration index of child mortality. The analysis combines a concentration index created along a cumulative distribution of the Demographic and Health Surveys sample ranked according to maternal education, and decomposition measures the contribution of water and sanitation to educational inequalities in child mortality. We observed a large education-related inequality in child mortality and access to water and sanitation. There is a need for programs and policies in child health to focus on ensuring equity and to consider the educational stratification of the population to target the most disadvantaged segments of the population. PMID:27821698

An approach to access control in electronic health record.

PubMed

Sucurovic, Snezana

2010-08-01

OASIS is a non-for-profit consortium that drives the development convergence and adoption of open standards for the global information society. It involves more than 600 organizations and individuals as well as IT leaders Sun, Microsoft, IBM and Oracle. One of its standards is XACML which appeared a few years ago and now there are about 150,000 hits on Google. XACML (eXtensible Access Control Markup Language) is not technology related. Sun published in 2004 open source Sun XACML which is in compliance with XACML 1.0. specification and now works to make it comply with XACML 2.0. The heart of XACML are attributes values of defined type and name that is to be attached to a subject, a resource, an action and an environment in which a subject request action on resource. In that way XACML is to replace Role Based Access Control which dominated for years. The paper examines performances in CEN 13 606 and ISO 22 600 based healthcare system which uses XACML for access control.

Secure Access Control and Large Scale Robust Representation for Online Multimedia Event Detection

PubMed Central

Liu, Changyu; Li, Huiling

2014-01-01

We developed an online multimedia event detection (MED) system. However, there are a secure access control issue and a large scale robust representation issue when we want to integrate traditional event detection algorithms into the online environment. For the first issue, we proposed a tree proxy-based and service-oriented access control (TPSAC) model based on the traditional role based access control model. Verification experiments were conducted on the CloudSim simulation platform, and the results showed that the TPSAC model is suitable for the access control of dynamic online environments. For the second issue, inspired by the object-bank scene descriptor, we proposed a 1000-object-bank (1000OBK) event descriptor. Feature vectors of the 1000OBK were extracted from response pyramids of 1000 generic object detectors which were trained on standard annotated image datasets, such as the ImageNet dataset. A spatial bag of words tiling approach was then adopted to encode these feature vectors for bridging the gap between the objects and events. Furthermore, we performed experiments in the context of event classification on the challenging TRECVID MED 2012 dataset, and the results showed that the robust 1000OBK event descriptor outperforms the state-of-the-art approaches. PMID:25147840

Memory-efficient table look-up optimized algorithm for context-based adaptive variable length decoding in H.264/advanced video coding

NASA Astrophysics Data System (ADS)

Wang, Jianhua; Cheng, Lianglun; Wang, Tao; Peng, Xiaodong

2016-03-01

Table look-up operation plays a very important role during the decoding processing of context-based adaptive variable length decoding (CAVLD) in H.264/advanced video coding (AVC). However, frequent table look-up operation can result in big table memory access, and then lead to high table power consumption. Aiming to solve the problem of big table memory access of current methods, and then reduce high power consumption, a memory-efficient table look-up optimized algorithm is presented for CAVLD. The contribution of this paper lies that index search technology is introduced to reduce big memory access for table look-up, and then reduce high table power consumption. Specifically, in our schemes, we use index search technology to reduce memory access by reducing the searching and matching operations for code_word on the basis of taking advantage of the internal relationship among length of zero in code_prefix, value of code_suffix and code_lengh, thus saving the power consumption of table look-up. The experimental results show that our proposed table look-up algorithm based on index search can lower about 60% memory access consumption compared with table look-up by sequential search scheme, and then save much power consumption for CAVLD in H.264/AVC.

Current State of Value-Based Purchasing Programs.

PubMed

Chee, Tingyin T; Ryan, Andrew M; Wasfy, Jason H; Borden, William B

2016-05-31

The US healthcare system is rapidly moving toward rewarding value. Recent legislation, such as the Affordable Care Act and the Medicare Access and CHIP Reauthorization Act, solidified the role of value-based payment in Medicare. Many private insurers are following Medicare's lead. Much of the policy attention has been on programs such as accountable care organizations and bundled payments; yet, value-based purchasing (VBP) or pay-for-performance, defined as providers being paid fee-for-service with payment adjustments up or down based on value metrics, remains a core element of value payment in Medicare Access and CHIP Reauthorization Act and will likely remain so for the foreseeable future. This review article summarizes the current state of VBP programs and provides analysis of the strengths, weaknesses, and opportunities for the future. Multiple inpatient and outpatient VBP programs have been implemented and evaluated; the impact of those programs has been marginal. Opportunities to enhance the performance of VBP programs include improving the quality measurement science, strengthening both the size and design of incentives, reducing health disparities, establishing broad outcome measurement, choosing appropriate comparison targets, and determining the optimal role of VBP relative to alternative payment models. VBP programs will play a significant role in healthcare delivery for years to come, and they serve as an opportunity for providers to build the infrastructure needed for value-oriented care. © 2016 American Heart Association, Inc.

The Role of Non-Governmental Organisations and Faith-Based Organisations in Achieving Education for All: The Case of Sierra Leone

ERIC Educational Resources Information Center

Nishimuko, Mikako

2009-01-01

Sierra Leone, one of the world's poorest countries, experienced a civil war from 1991 to 2002. The government's capacity to provide educational services remains weak, and still over 30% of children in the country are hard to reach and do not have access to primary education. This paper discusses the role of non-governmental organisations (NGOs)…

Do no harm: the role of community pharmacists in regulating public access to prescription drugs in Saudi Arabia.

PubMed

Bahnassi, Anas

2016-04-01

Pharmacists have a crucial role to ensure regulated public access to prescription drugs. The study aimed to investigate the views of community pharmacists practising in Saudi Arabia on their role in the unauthorised supply of prescription drugs, consider the possible contributory factors and report pharmacists' suggested strategies to regulate supply. One hundred community pharmacists were invited to participate in an interview-based survey, including questions on demographic characteristics, and the unauthorised supply of prescription drugs. Descriptive statistics were conducted, and associations between categorical responses tested; a P value of ≤0.05 was considered significant. Responses to open questions were analysed thematically. In Saudi Arabia, there is widespread unregulated supply of prescription drugs; pharmacists are under pressure from patients to provide prescription drugs for a wide range of clinical conditions. There are safety and appropriateness concerns when drugs are provided based on patient demand rather than clinical need. Pharmacists do not maintain patient records with information on drugs supplied and associated actions. While most pharmacists supply prescription drugs without the necessary prescriber authorisation, they also this may jeopardise patients safety. While we have many concerns about this practice its present form, we believe pharmacists should have certain prescribing privileges within their areas of competence. A legal framework is needed to guarantee proper pharmacists' training, support, mentorship and access to the tools required to provide safe pharmacy practice. © 2015 Royal Pharmaceutical Society.

Paying more for faster care? Individuals' attitude toward price-based priority access in health care.

PubMed

Benning, Tim M; Dellaert, Benedict G C

2013-05-01

Increased competition in the health care sector has led hospitals and other health care institutions to experiment with new access allocation policies that move away from traditional expert based allocation of care to price-based priority access (i.e., the option to pay more for faster care). To date, little is known about individuals' attitude toward price-based priority access and the evaluation process underlying this attitude. This paper addresses the role of individuals' evaluations of collective health outcomes as an important driver of their attitude toward (price-based) allocation policies in health care. The authors investigate how individuals evaluate price-based priority access by means of scenario-based survey data collected in a representative sample from the Dutch population (N = 1464). They find that (a) offering individuals the opportunity to pay for faster care negatively affects their evaluations of both the total and distributional collective health outcome achieved, (b) however, when health care supply is not restricted (i.e., when treatment can be offered outside versus within the regular working hours of the hospital) offering price-based priority access affects total collective health outcome evaluations positively instead of negatively, but it does not change distributional collective health outcome evaluations. Furthermore, (c) the type of health care treatment (i.e., life saving liver transplantation treatment vs. life improving cosmetic ear correction treatment - priced at the same level to the individual) moderates the effect of collective health outcome evaluations on individuals' attitude toward allocation policies. For policy makers and hospital managers the results presented in this article are helpful because they provide a better understanding of what drives individuals' preferences for health care allocation policies. In particular, the results show that policies based on the "paying more for faster care" principle are more attractive to the general public when treatment takes place outside the regular working hours of a hospital. Copyright © 2013 Elsevier Ltd. All rights reserved.

The secure authorization model for healthcare information system.

PubMed

Hsu, Wen-Shin; Pan, Jiann-I

2013-10-01

Exploring healthcare system for assisting medical services or transmitting patients' personal health information in web application has been widely investigated. Information and communication technologies have been applied to the medical services and healthcare area for a number of years to resolve problems in medical management. In the healthcare system, not all users are allowed to access all the information. Several authorization models for restricting users to access specific information at specific permissions have been proposed. However, as the number of users and the amount of information grows, the difficulties for administrating user authorization will increase. The critical problem limits the widespread usage of the healthcare system. This paper proposes an approach for role-based and extends it to deal with the information for authorizations in the healthcare system. We propose the role-based authorization model which supports authorizations for different kinds of objects, and a new authorization domain. Based on this model, we discuss the issues and requirements of security in the healthcare systems. The security issues for services shared between different healthcare industries will also be discussed.

Towards universal access to skilled birth attendance: the process of transforming the role of traditional birth attendants in Rural China.

PubMed

Jiang, Hong; Qian, Xu; Chen, Lili; Li, Jian; Escobar, Erin; Story, Mary; Tang, Shenglan

2016-03-21

Institution-based childbirth, with the ultimate goal of universal access to skilled birth attendance (SBA), has been selected as a key strategy to reduce the maternal mortality rate in many developing countries. However, the question of how to engage traditional birth attendants (TBAs) in the advocacy campaign for SBA poses a number of challenges. This paper aims to demonstrate how TBAs in rural regions of China have been integrated into the health system under a policy of institutional delivery. Research was conducted through literature and document reviews and individual in-depth interviews with stakeholders of the safe motherhood program in rural Guangxi Zhuang Autonomous Region, China. A total of 33 individual interviews were conducted with regional and local politicians, policy makers, health managers, health providers, civil society members, village cadres for women affairs, former TBAs, village maternal health workers, mothers and their mother-in-laws. Since 1998, TBA's traditional role of providing in-home care during childbirth has been restructured and their social role has been strengthened in rural Guangxi. TBAs were redesigned to function as the linkage between women and the health system. A new policy in 1999 shifted the role of TBAs to village maternal health workers whose responsibilities were mainly to promote perinatal care and institution-based delivery of pregnant women. This successful transformation involved engaging with government and other actors, training TBAs for their new role, and providing incentives and sanctions for human resources management. The China experience of transforming the role of TBAs in Guangxi rural area is an example of successfully engaging TBAs in promoting institution-based childbirth.

Design of Accelerator Online Simulator Server Using Structured Data

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

Shen, Guobao; /Brookhaven; Chu, Chungming

2012-07-06

Model based control plays an important role for a modern accelerator during beam commissioning, beam study, and even daily operation. With a realistic model, beam behaviour can be predicted and therefore effectively controlled. The approach used by most current high level application environments is to use a built-in simulation engine and feed a realistic model into that simulation engine. Instead of this traditional monolithic structure, a new approach using a client-server architecture is under development. An on-line simulator server is accessed via network accessible structured data. With this approach, a user can easily access multiple simulation codes. This paper describesmore » the design, implementation, and current status of PVData, which defines the structured data, and PVAccess, which provides network access to the structured data.« less

Fundus Photography in the 21st Century--A Review of Recent Technological Advances and Their Implications for Worldwide Healthcare.

PubMed

Panwar, Nishtha; Huang, Philemon; Lee, Jiaying; Keane, Pearse A; Chuan, Tjin Swee; Richhariya, Ashutosh; Teoh, Stephen; Lim, Tock Han; Agrawal, Rupesh

2016-03-01

The introduction of fundus photography has impacted retinal imaging and retinal screening programs significantly. Fundus cameras play a vital role in addressing the cause of preventive blindness. More attention is being turned to developing countries, where infrastructure and access to healthcare are limited. One of the major limitations for tele-ophthalmology is restricted access to the office-based fundus camera. Recent advances in access to telecommunications coupled with introduction of portable cameras and smartphone-based fundus imaging systems have resulted in an exponential surge in available technologies for portable fundus photography. Retinal cameras in the near future would have to cater to these needs by featuring a low-cost, portable design with automated controls and digitalized images with Web-based transfer. In this review, we aim to highlight the advances of fundus photography for retinal screening as well as discuss the advantages, disadvantages, and implications of the various technologies that are currently available.

Fundus Photography in the 21st Century—A Review of Recent Technological Advances and Their Implications for Worldwide Healthcare

PubMed Central

Panwar, Nishtha; Huang, Philemon; Lee, Jiaying; Keane, Pearse A.; Chuan, Tjin Swee; Richhariya, Ashutosh; Teoh, Stephen; Lim, Tock Han

2016-01-01

Abstract Background: The introduction of fundus photography has impacted retinal imaging and retinal screening programs significantly. Literature Review: Fundus cameras play a vital role in addressing the cause of preventive blindness. More attention is being turned to developing countries, where infrastructure and access to healthcare are limited. One of the major limitations for tele-ophthalmology is restricted access to the office-based fundus camera. Results: Recent advances in access to telecommunications coupled with introduction of portable cameras and smartphone-based fundus imaging systems have resulted in an exponential surge in available technologies for portable fundus photography. Retinal cameras in the near future would have to cater to these needs by featuring a low-cost, portable design with automated controls and digitalized images with Web-based transfer. Conclusions: In this review, we aim to highlight the advances of fundus photography for retinal screening as well as discuss the advantages, disadvantages, and implications of the various technologies that are currently available. PMID:26308281

"This Is My Family outside of My Family": Care-Based Relating in a Model Early College High School

ERIC Educational Resources Information Center

Ari, Omer; Fisher-Ari, Teresa R.; Killacky, Jim; Angel, Roma

2017-01-01

Early college (EC) is a novel educational model in the US that combines high school and college in an effort to increase underrepresented students' access to higher education by providing engaging, hands-on instruction in a supportive learning environment. For this phenomenological inquiry, we sought to understand the role of care-based relating…

Role Socialization: Designing a Web-Based Program to Orient New School Nurses

ERIC Educational Resources Information Center

Campbell, Tia B.

2009-01-01

Traditional orientation programs for school nurses may not meet the needs of nurses new to the specialty. In this era where technology is a major aspect of our daily lives, the Internet offers new school nurses an avenue where information can be accessed at anytime and from anyplace. This article explores a Web-based orientation program that has…

Mixed multi-scalar methods to assess wood biomass availability on family forests in Virginia's Southside

Treesearch

M. D. Brinckman; J. F. Munsell

2009-01-01

Interest in wood-based bio-energy production systems is increasing. Multiscalar, mixed-method approaches focusing on both biophysical and social aspects of procurable feedstock are needed. Family forests will likely play an important role in supplying forest-based biomass. However, access depends in large part on the management trends among family forest owners. This...

The influence of training and experience on memory strategy.

PubMed

Patrick, John; Morgan, Phillip L; Smy, Victoria; Tiley, Leyanne; Seeby, Helen; Patrick, Tanya; Evans, Jonathan

2015-07-01

This paper investigates whether, and if so how much, prior training and experience overwrite the influence of the constraints of the task environment on strategy deployment. This evidence is relevant to the theory of soft constraints that focuses on the role of constraints in the task environment (Gray, Simms, Fu, & Schoelles, Psychological Review, 113: 461-482, 2006). The theory explains how an increase in the cost of accessing information induces a more memory-based strategy involving more encoding and planning. Experiments 1 and 3 adopt a traditional training and transfer design using the Blocks World Task in which participants were exposed to training trials involving a 2.5-s delay in accessing goal-state information before encountering transfer trials in which there was no access delay. The effect of prior training was assessed by the degree of memory-based strategy adopted in the transfer trials. Training with an access delay had a substantial carry-over effect and increased the subsequent degree of memory-based strategy adopted in the transfer environment. However, such effects do not necessarily occur if goal-state access cost in training is less costly than in transfer trials (Experiment 2). Experiment 4 used a fine-grained intra-trial design to examine the effect of experiencing access cost on one, two, or three occasions within the same trial and found that such experience on two consecutive occasions was sufficient to induce a more memory-based strategy. This paper establishes some effects of training that are relevant to the soft constraints theory and also discusses practical implications.

Access management research and awareness program : phase IV final report

DOT National Transportation Integrated Search

1999-11-01

Access management involves balancing the dual roles that roadways must play - through travel and access to property and economic activity. When these roles are not in proper balance, the result is a roadway system that functions sub-optimally. The Io...

PCASSO: a design for secure communication of personal health information via the internet.

PubMed

Baker, D B; Masys, D R

1999-05-01

The Internet holds both promise and peril for the communications of person-identifiable health information. Because of technical features designed to promote accessibility and interoperability rather than security, Internet addressing conventions and transport protocols are vulnerable to compromise by malicious persons and programs. In addition, most commonly used personal computer (PC) operating systems currently lack the hardware-based system software protection and process isolation that are essential for ensuring the integrity of trusted applications. Security approaches designed for electronic commerce, that trade known security weaknesses for limited financial liability, are not sufficient for personal health data, where the personal damage caused by unintentional disclosure may be far more serious. To overcome these obstacles, we are developing and evaluating an Internet-based communications system called PCASSO (Patient-centered access to secure systems online) that applies state of the art security to health information. PCASSO includes role-based access control, multi-level security, strong device and user authentication, session-specific encryption and audit trails. Unlike Internet-based electronic commerce 'solutions,' PCASSO secures data end-to-end: in the server; in the data repository; across the network; and on the client. PCASSO is designed to give patients as well as providers access to personal health records via the Internet.

In-home firearm access among US adolescents and the role of religious subculture: Results from a nationally representative study.

PubMed

Stroope, Samuel; Tom, Joshua C

2017-09-01

Religious participation is linked to numerous positive safety outcomes for adolescents. Scant attention, however, has been paid to associations between religious participation and safety risks among adolescents. Using data from Add Health (N = 18,449), a nationally representative school-based sample of US adolescents, this study examines the relationship between adolescents' religious affiliation and easy access to firearms at home. Regression analyses adjust for complex sampling design and compare easy firearm access at home among conservative Protestant adolescents to adolescent firearm access in other religious traditions. Conservative Protestant adolescents have a substantially greater likelihood of easy access to a gun at home compared to adolescents of all other major religious traditions in the United States. Recognizing differences in adolescent firearm access between subcultural groups can help public health interventions more effectively identify and address the needs of vulnerable populations. The paper's conclusion considers suggestions for effective policy and programmatic initiatives. Copyright © 2017 Elsevier Inc. All rights reserved.

Potential access to primary health care: what does the National Program for Access and Quality Improvement data show?

PubMed Central

Uchôa, Severina Alice da Costa; Arcêncio, Ricardo Alexandre; Fronteira, Inês Santos Estevinho; Coêlho, Ardigleusa Alves; Martiniano, Claudia Santos; Brandão, Isabel Cristina Araújo; Yamamura, Mellina; Maroto, Renata Melo

2016-01-01

Objective: to analyze the influence of contextual indicators on the performance of municipalities regarding potential access to primary health care in Brazil and to discuss the contribution from nurses working on this access. Method: a multicenter descriptive study based on secondary data from External Evaluation of the National Program for Access and Quality Improvement in Primary Care, with the participation of 17,202 primary care teams. The chi-square test of proportions was used to verify differences between the municipalities stratified based on size of the coverage area, supply, coordination, and integration; when necessary, the chi-square test with Yates correction or Fisher's exact test were employed. For the population variable, the Kruskal-Wallis test was used. Results: the majority of participants were nurses (n=15.876; 92,3%). Statistically significant differences were observed between the municipalities in terms of territory (p=0.0000), availability (p=0.0000), coordination of care (p=0.0000), integration (p=0.0000) and supply (p=0.0000), verifying that the municipalities that make up area 6 tend to have better performance in these dimensions. Conclusion: areas 4,5 and 6 performed better in every analyzed dimension, and the nurse had a leading role in the potential to access primary health care in Brazil. PMID:26959332

[Stranger isolated minors and the french health care system: qualitative study].

PubMed

Guégan, Marion; Rivollier, Elisabeth

2017-01-01

While waiting for health insurance coverage, unaccompanied foreign minors (UFM) can attend PASS healthcare access clinics in French hospitals. The aim of this study was to identify UFM's representations and perceptions of the French health care system. This qualitative study was based on a series of individual, semi-structured interviews of UFMs attending a PASS clinic. The methodology was approved by the French data protection authority and an ethics committee. A total of 21 UFMs were interviewed. Participants expressed their satisfaction with health care, although the health care system was perceived as a complex system. The prescription is essential, as it enables the patient to obtain medications, the ultimate goal of health care access. Not all participants knew about the existence of national health insurance. They were unable to distinguish between PASS clinics and the hospital in general and the screening role of PASS clinics was often poorly understood. The general practitioner was not always identified and his role was poorly understood. Educators were perceived as playing a decisive role in health care access. Heath is essential for all UFMs. None of them referred to mental health issues. UFMs need better information about the health care system and their rights. The educators' health care support training, their knowledge of the rights of UFMs and the role of healthcare professionals need to be improved. Screening of mental illness needs to be developed.

Access to health care for undocumented migrant children and pregnant women: the paradox between values and attitudes of health care professionals.

PubMed

Ruiz-Casares, Mónica; Rousseau, Cécile; Laurin-Lamothe, Audrey; Rummens, Joanna Anneke; Zelkowitz, Phyllis; Crépeau, François; Steinmetz, Nicolas

2013-02-01

Access to health care for undocumented migrant children and pregnant women confronts human rights and professional values with political and institutional regulations that limit services. In order to understand how health care professionals deal with these diverging mandates, we assessed their attitudes toward providing care to this population. Clinicians, administrators, and support staff (n = 1,048) in hospitals and primary care centers of a large multiethnic city responded to an online survey about attitudes toward access to health care services. Analysis examined the role of personal and institutional correlates of these attitudes. Foreign-born respondents and those in primary care centers were more likely to assess the present access to care as a serious problem, and to endorse broad or full access to services, primarily based on human rights reasons. Clinicians were more likely than support staff to endorse full or broad access to health care services. Respondents who approved of restricted or no access also endorsed health as a basic human right (61.1%) and child development as a priority (68.6%). A wide gap separates attitudes toward entitlement to health care and the endorsement of principles stemming from human rights and the best interest of the child. Case-based discussions with professionals facing value dilemmas and training on children's rights are needed to promote equitable practices and advocacy against regulations limiting services.

The Role of Genome Accessibility in Transcription Factor Binding in Bacteria.

PubMed

Gomes, Antonio L C; Wang, Harris H

2016-04-01

ChIP-seq enables genome-scale identification of regulatory regions that govern gene expression. However, the biological insights generated from ChIP-seq analysis have been limited to predictions of binding sites and cooperative interactions. Furthermore, ChIP-seq data often poorly correlate with in vitro measurements or predicted motifs, highlighting that binding affinity alone is insufficient to explain transcription factor (TF)-binding in vivo. One possibility is that binding sites are not equally accessible across the genome. A more comprehensive biophysical representation of TF-binding is required to improve our ability to understand, predict, and alter gene expression. Here, we show that genome accessibility is a key parameter that impacts TF-binding in bacteria. We developed a thermodynamic model that parameterizes ChIP-seq coverage in terms of genome accessibility and binding affinity. The role of genome accessibility is validated using a large-scale ChIP-seq dataset of the M. tuberculosis regulatory network. We find that accounting for genome accessibility led to a model that explains 63% of the ChIP-seq profile variance, while a model based in motif score alone explains only 35% of the variance. Moreover, our framework enables de novo ChIP-seq peak prediction and is useful for inferring TF-binding peaks in new experimental conditions by reducing the need for additional experiments. We observe that the genome is more accessible in intergenic regions, and that increased accessibility is positively correlated with gene expression and anti-correlated with distance to the origin of replication. Our biophysically motivated model provides a more comprehensive description of TF-binding in vivo from first principles towards a better representation of gene regulation in silico, with promising applications in systems biology.

Simulating the Historical Process To Create Laboratory Exercises That Teach Research Methods.

ERIC Educational Resources Information Center

Alcock, James

1994-01-01

Explains how controlling student access to data can be used as a strategy enabling students to take the role of a research geologist. Students develop models based on limited data and conduct field tests by comparing their predictions with the additional data. (DDR)

75 FR 8043 - National Institute of Standards and Technology

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-23

... the National Institute of Standards and Technology (``NIST''), U.S. Department of Commerce, is... and commonwealths, to NIST's interest in the invention embodied in U.S. Patent No. 6,088,679 (Application No. 08/ 980,908), titled ``Workflow Management Employing Role-based Access Control,'' NIST Docket...

Toward edge minability for role mining in bipartite networks

NASA Astrophysics Data System (ADS)

Dong, Lijun; Wang, Yi; Liu, Ran; Pi, Benjie; Wu, Liuyi

2016-11-01

Bipartite network models have been extensively used in information security to automatically generate role-based access control (RBAC) from dataset. This process is called role mining. However, not all the topologies of bipartite networks are suitable for role mining; some edges may even reduce the quality of role mining. This causes unnecessary time consumption as role mining is NP-hard. Therefore, to promote the quality of role mining results, the capability that an edge composes roles with other edges, called the minability of edge, needs to be identified. We tackle the problem from an angle of edge importance in complex networks; that is an edge easily covered by roles is considered to be more important. Based on this idea, the k-shell decomposition of complex networks is extended to reveal the different minability of edges. By this way, a bipartite network can be quickly purified by excluding the low-minability edges from role mining, and thus the quality of role mining can be effectively improved. Extensive experiments via the real-world datasets are conducted to confirm the above claims.

Perceived rules and accessibility: measurement and mediating role in the association between parental education and vegetable and soft drink intake.

PubMed

Gebremariam, Mekdes K; Lien, Nanna; Torheim, Liv Elin; Andersen, Lene F; Melbye, Elisabeth L; Glavin, Kari; Hausken, Solveig E S; Sleddens, Ester F C; Bjelland, Mona

2016-08-17

The existence of socioeconomic differences in dietary behaviors is well documented. However, studies exploring the mechanisms behind these differences among adolescents using comprehensive and reliable measures of mediators are lacking. The aims of this study were (a) to assess the psychometric properties of new scales assessing the perceived rules and accessibility related to the consumption of vegetables and soft drinks and (b) to explore their mediating role in the association between parental education and the corresponding dietary behaviors. A cross-sectional survey including 440 adolescents from three counties in Norway (mean age 14.3 years (SD = 0.6)) was conducted using a web-based questionnaire. Principal component analysis, test-retest and internal reliability analysis were conducted. The mediating role of perceived accessibility and perceived rules in the association between parental education and the dietary behaviors was explored using linear regression analyses. Factor analyses confirmed two separate subscales, named "accessibility" and "rules", both for vegetables and soft drinks (factor loadings >0.60). The scales had good internal consistency reliability (0.70-0.87). The test-retest reliability of the scales was moderate to good (0.44-0.62). Parental education was inversely related to the consumption of soft drinks and positively related to the consumption of vegetables. Perceived accessibility and perceived rules related to soft drink consumption were found to mediate the association between parental education and soft drink consumption (47.5 and 8.5 % of total effect mediated). Accessibility of vegetables was found to mediate the association between parental education and the consumption of vegetables (51 % of total effect mediated). The new scales developed in this study are comprehensive and have adequate validity and reliability; they are therefore considered appropriate for use among 13-15 year-olds. Parents, in particular those with a low educational background, should be encouraged to increase the accessibility of vegetables and to decrease the accessibility of soft drinks, in particular during dinner. Enforcing parental rules limiting soft drink intake in families with low parental education also appears relevant.

Community access to health information in Ireland.

PubMed

Macdougall, J

1999-06-01

This paper is based on a research project conducted on consumer health information (CHI) in the Republic of Ireland, the results of which were published in a report entitled Well Read: Developing Consumer Health Information in Ireland. The paper describes the research methodology and the Irish experience in relation to CHI followed by a discussion of access problems, illustrated with examples from the special needs and primary care sectors. The role of information providers in relation to primary healthcare and libraries is examined briefly, and finally the main research conclusions and recommendations are highlighted.

Survey of Condition Indicators for Condition Monitoring Systems (Open Access)

DTIC Science & Technology

2014-09-29

Hinesburg, Vermont, 05461, USA jz@renewablenrgsystems.com ABSTRACT Currently, the wind energy industry is swiftly changing its maintenance strategy...from schedule based maintenance to predictive based maintenance . Condition monitoring systems (CMS) play an important role in the predictive... maintenance cycle. As condition monitoring systems are being adopted by more and more OEM and O&M service providers from the wind energy industry, it is

Decomposing Educational Inequalities in Child Mortality: A Temporal Trend Analysis of Access to Water and Sanitation in Peru.

PubMed

Bohra, Tasneem; Benmarhnia, Tarik; McKinnon, Britt; Kaufman, Jay S

2017-01-11

Previous studies of inequality in health and mortality have largely focused on income-based inequality. Maternal education plays an important role in determining access to water and sanitation, and inequalities in child mortality arising due to differential access, especially in low- and middle-income countries such as Peru. This article aims to explain education-related inequalities in child mortality in Peru using a regression-based decomposition of the concentration index of child mortality. The analysis combines a concentration index created along a cumulative distribution of the Demographic and Health Surveys sample ranked according to maternal education, and decomposition measures the contribution of water and sanitation to educational inequalities in child mortality. We observed a large education-related inequality in child mortality and access to water and sanitation. There is a need for programs and policies in child health to focus on ensuring equity and to consider the educational stratification of the population to target the most disadvantaged segments of the population. © The American Society of Tropical Medicine and Hygiene.

Homeless but connected: the role of heterogeneous social network ties and social networking technology in the mental health outcomes of street-living adolescents.

PubMed

Rice, Eric; Kurzban, Seth; Ray, Diana

2012-12-01

Although social integration tends to have positive effects on the mental health of housed adolescents, the role of homeless adolescents' social networks is more ambiguous. Social network data were collected from 136 homeless adolescents in Hollywood, California to examine how network ties are associated with symptoms of anxiety and depression. Face-to-face relationships with street-based peers were a risk factor for both anxiety and depression, while contacting home-based friends through social networking technology was found to be protective for depression. Community-based and public agencies serving homeless adolescents should consider facilitating the maintenance of these protective relationships by providing internet access.

Enhancing access and retention in substance abuse treatment: the role of Medicaid payment acceptance and cultural competence.

PubMed

Guerrero, Erick G

2013-10-01

Health insurance coverage and quality of care are common factors believed to improve access for and retention of racial and ethnic minority groups in health care. However, there is little evidence that acceptance of public insurance and provision of culturally responsive care decrease wait time and retention of minority populations in community-based substance abuse treatment. We analyzed client and program data collected in 2010-2011 from publicly funded treatment programs in Los Angeles County, CA. An analytical sample of 13,328 primarily African American and Latino clients nested within 104 treatment programs located in minority communities was analyzed using multilevel negative binomial regressions on count measures of days to initiate and days spent in treatment. Programs that accepted public insurance (p<.001) and in which staff reported personal involvement (p<.01) and linkages and resources with minority communities (p<.001) were negatively associated with client wait time. Similarly, programs with culturally responsive policies and assessment and treatment practices (p<.05) were positively associated with retention in treatment, after controlling for individual and program characteristics. These preliminary findings provide an evidentiary base for the role of community-based financial and cultural practices in improving accessibility and treatment adherence in a population at high risk of treatment dropout. Implications related to health care reform legislation, which seeks to expand public insurance and enhance culturally competent care, are discussed. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Ontology Research and Development. Part 1-A Review of Ontology Generation.

ERIC Educational Resources Information Center

Ding, Ying; Foo, Schubert

2002-01-01

Discusses the role of ontology in knowledge representation, including enabling content-based access, interoperability, communications, and new levels of service on the Semantic Web; reviews current ontology generation studies and projects as well as problems facing such research; and discusses ontology mapping, information extraction, natural…

The Librarian and the Library User: What the Future Holds.

ERIC Educational Resources Information Center

Electronic Library, 1997

1997-01-01

Discusses the role of information professionals in the future, based on a session at the Online Information 96 conference in London (England). Topics include equipment and software needs; technological advances; a trend toward distance education; how library users are adapting to change; interlibrary loans; online public access catalogs; and…

Paraprofessionals in Rural Development. Concept Paper.

ERIC Educational Resources Information Center

Colle, Royal D.; And Others

To establish a better knowledge base concerning the role of developing nation paraprofessionals in facilitating rural poor access to public services and in order to identify problems that arise in developing these patterns of service, an extensive literature search and compilation and analysis of over 50 health projects and 30 agricultural…

Adaptation to climate variability: The role of the USDA Southern Plains Climate Hub

USDA-ARS?s Scientific Manuscript database

The Southern Plains USDA Climate Hub was established in 2014 in El Reno, Oklahoma to develop and deliver science-based, information and technologies to agricultural and natural resource land managers that enable climate-informed decision-making, and to provide access to assistance to implement those...

77 FR 8825 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-15

... LEAD BY EXAMPLE using the application just as we expect those ``in the field'' to do. The information... access and visibility of this information. DMHRSi uses role-based security so a user sees only the... hosted in a secure facility managed by the Defense Information Systems Agency. For JMIS military and...

Can Universities Survive the 21st Century?

ERIC Educational Resources Information Center

Summerlee, Alastair J. S.; Murray, Jacqueline

2008-01-01

Universities worldwide are facing a number of contradictory and competing pressures that range from under-funding to the very nature of universities and their roles in society. Pressures of the information explosion, the democratization of information through access to the Internet, and the advent of the knowledge-based economies have changed the…

Addressing Energy Poverty through Smarter Technology

ERIC Educational Resources Information Center

Oldfield, Eddie

2011-01-01

Energy poverty is a key detriment to labor productivity, economic growth, and social well-being. This article presents a qualitative review of literature on the potential role of intelligent communication technology, web-based standards, and smart grid technology to alleviate energy costs and improve access to clean distributed energy in developed…

Evolving provider payment models and patient access to innovative medical technology.

PubMed

Long, Genia; Mortimer, Richard; Sanzenbacher, Geoffrey

2014-12-01

Abstract Objective: To investigate the evolving use and expected impact of pay-for-performance (P4P) and risk-based provider reimbursement on patient access to innovative medical technology. Structured interviews with leading private payers representing over 110 million commercially-insured lives exploring current and planned use of P4P provider payment models, evidence requirements for technology assessment and new technology coverage, and the evolving relationship between the two topics. Respondents reported rapid increases in the use of P4P and risk-sharing programs, with roughly half of commercial lives affected 3 years ago, just under two-thirds today, and an expected three-quarters in 3 years. All reported well-established systems for evaluating new technology coverage. Five of nine reported becoming more selective in the past 3 years in approving new technologies; four anticipated that in the next 3 years there will be a higher evidence requirement for new technology access. Similarly, four expected it will become more difficult for clinically appropriate but costly technologies to gain coverage. All reported planning to rely more on these types of provider payment incentives to control costs, but didn't see them as a substitute for payer technology reviews and coverage limitations; they each have a role to play. Interviews limited to nine leading payers with models in place; self-reported data. Likely implications include a more uncertain payment environment for providers, and indirectly for innovative medical technology and future investment, greater reliance on quality and financial metrics, and increased evidence requirements for favorable coverage and utilization decisions. Increasing provider financial risk may challenge the traditional technology adoption paradigm, where payers assumed a 'gatekeeping' role and providers a countervailing patient advocacy role with regard to access to new technology. Increased provider financial risk may result in an additional hurdle to the adoption of new technology, rather than substitution of provider- for payer-based gatekeeping.

The Role of the Access Services Manager in the Virtual Library

ERIC Educational Resources Information Center

Jetton, Lora Lennertz; Bailey, Alberta S.

2010-01-01

This article updates a previous article published in 1992 that described the role of the access services manager in policy formation. Since that time, the access services department and mission has matured and evolved to a prominent position within the library organization. Technological changes and innovation in the marketplace of wired and…

Advanced Practice Nursing: A Strategy for Achieving Universal Health Coverage and Universal Access to Health

PubMed Central

Bryant-Lukosius, Denise; Valaitis, Ruta; Martin-Misener, Ruth; Donald, Faith; Peña, Laura Morán; Brousseau, Linda

2017-01-01

ABSTRACT Objective: to examine advanced practice nursing (APN) roles internationally to inform role development in Latin America and the Caribbean to support universal health coverage and universal access to health. Method: we examined literature related to APN roles, their global deployment, and APN effectiveness in relation to universal health coverage and access to health. Results: given evidence of their effectiveness in many countries, APN roles are ideally suited as part of a primary health care workforce strategy in Latin America to enhance universal health coverage and access to health. Brazil, Chile, Colombia, and Mexico are well positioned to build this workforce. Role implementation barriers include lack of role clarity, legislation/regulation, education, funding, and physician resistance. Strong nursing leadership to align APN roles with policy priorities, and to work in partnership with primary care providers and policy makers is needed for successful role implementation. Conclusions: given the diversity of contexts across nations, it is important to systematically assess country and population health needs to introduce the most appropriate complement and mix of APN roles and inform implementation. Successful APN role introduction in Latin America and the Caribbean could provide a roadmap for similar roles in other low/middle income countries. PMID:28146177

Applying the Earth System Grid Security System in a Heterogeneous Environment of Data Access Services

NASA Astrophysics Data System (ADS)

Kershaw, Philip; Lawrence, Bryan; Lowe, Dominic; Norton, Peter; Pascoe, Stephen

2010-05-01

CEDA (Centre for Environmental Data Archival) based at STFC Rutherford Appleton Laboratory is host to the BADC (British Atmospheric Data Centre) and NEODC (NERC Earth Observation Data Centre) with data holdings of over half a Petabyte. In the coming months this figure is set to increase by over one Petabyte through the BADC's role as one of three data centres to host the CMIP5 (Coupled Model Intercomparison Project Phase 5) core archive of climate model data. Quite apart from the problem of managing the storage of such large volumes there is the challenge of collating the data together from the modelling centres around the world and enabling access to these data for the user community. An infrastructure to support this is being developed under the US Earth System Grid (ESG) and related projects bringing together participating organisations together in a federation. The ESG architecture defines Gateways, the web interfaces that enable users to access data and data serving applications organised into Data Nodes. The BADC has been working in collaboration with US Earth System Grid team and other partners to develop a security system to restrict access to data. This provides single sign-on via both OpenID and PKI based means and uses role based authorisation facilitated by SAML and OpenID based interfaces for attribute retrieval. This presentation will provide an overview of the access control architecture and look at how this has been implemented for CEDA. CEDA has developed an expertise in data access and information services over several years through a number of projects to develop and enhance these capabilities. Participation in CMIP5 comes at a time when a number of other software development activities are coming to fruition. New services are in the process of being deployed alongside services making up the system for ESG. The security system must apply access control across this heterogeneous environment of different data services and technologies. One strand of the development efforts within CEDA has been the NDG (NERC Datagrid) Security system. This system has been extended to interoperate with ESG, greatly assisted by the standards based approach adopted for the ESG security architecture. Drawing from experience from previous projects the decision was taken to refactor the NDG Security software into a component based architecture to enable a separation of concerns between access control and the functionality of a given application being protected. Such an approach is only possible through a generic interface. At CEDA, this has been realised in the Python programming language using the WSGI (Web Server Gateway Interface) specification. A parallel Java filter based implementation is also under development with our US partners for use with the THREDDS Data Server. Using such technologies applications and middleware can be assembled into custom configurations to meet different requirements. In the case of access control, NDG Security middleware can be layered over the top of existing applications without the need to modify them. A RESTful approach to the application of authorisation policy has been key in this approach. We explore the practical implementation of such a scheme alongside the application of the ESG security architecture to CEDA's OGC web services implementation COWS.

Active RNAP pre-initiation sites are highly mutated by cytidine deaminases in yeast, with AID targeting small RNA genes

PubMed Central

Taylor, Benjamin JM; Wu, Yee Ling; Rada, Cristina

2014-01-01

Cytidine deaminases are single stranded DNA mutators diversifying antibodies and restricting viral infection. Improper access to the genome leads to translocations and mutations in B cells and contributes to the mutation landscape in cancer, such as kataegis. It remains unclear how deaminases access double stranded genomes and whether off-target mutations favor certain loci, although transcription and opportunistic access during DNA repair are thought to play a role. In yeast, AID and the catalytic domain of APOBEC3G preferentially mutate transcriptionally active genes within narrow regions, 110 base pairs in width, fixed at RNA polymerase initiation sites. Unlike APOBEC3G, AID shows enhanced mutational preference for small RNA genes (tRNAs, snoRNAs and snRNAs) suggesting a putative role for RNA in its recruitment. We uncover the high affinity of the deaminases for the single stranded DNA exposed by initiating RNA polymerases (a DNA configuration reproduced at stalled polymerases) without a requirement for specific cofactors. DOI: http://dx.doi.org/10.7554/eLife.03553.001 PMID:25237741

The Impact of Community Based Health Insurance in Enhancing Better Accessibility and Lowering the Chance of Having Financial Catastrophe Due to Health Service Utilization: A Case Study of Savannakhet Province, Laos.

PubMed

Bodhisane, Somdeth; Pongpanich, Sathirakorn

2017-07-01

The Lao population mostly relies on out-of-pocket expenditures for health care services. This study aims to determine the role of community-based health insurance in making health care services accessible and in preventing financial catastrophe resulting from personal payment for inpatient services. A cross-sectional study design was applied. Data collection involved 126 insured and 126 uninsured households in identical study sites. Two logistic regression models were used to predict and compare the probability of hospitalization and financial catastrophe that occurred in both insured and uninsured households within the previous year. The findings show that insurance status does not significantly improve accessibility and financial protection against catastrophic expenditure. The reason is relatively simple, as catastrophic health expenditure refers to a total out-of-pocket payment equal to or more than 40% of household income minus subsistence. When household income declines as a result of inability to work due to illness, the 40% threshold is quickly reached. Despite this, results suggest that insured households are not significantly better off under community-based health insurance. However, compared to uninsured households, insured households do have better accessibility and a lower probability of reaching the financial catastrophe threshold.

Strategic purchasing reform in Estonia: Reducing inequalities in access while improving care concentration and quality.

PubMed

Habicht, Triin; Habicht, Jarno; van Ginneken, Ewout

2015-08-01

As of 2014, the Estonian Health Insurance Fund has adopted new purchasing procedures and criteria, which it now has started to implement in specialist care. Main changes include (1) redefined access criteria based on population need rather than historical supply, which aim to achieve more equal access of providers and specialties; (2) stricter definition and use of optimal workload criteria to increase the concentration of specialist care (3) better consideration of patient movement; and (4) an increased emphasis on quality to foster quality improvement. The new criteria were first used in the contract cycle that started in 2014 and resulted in fewer contracted providers for a similar volume of care compared to the previous contract cycle. This implies that provision of specialized care has become concentrated at fewer providers. It is too early to draw firm conclusions on the impact on care quality or on actors, but the process has sparked debate on the role of selective contracting and the role of public and private providers in Estonian health care. Lastly, the Estonian experience may hold important lessons for other countries looking to overcome inequalities in access while concentrating care and improving care quality. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

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

PubMed Central

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

2004-01-01

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

Doing Your Science While You're in Orbit

NASA Astrophysics Data System (ADS)

Green, Mark L.; Miller, Stephen D.; Vazhkudai, Sudharshan S.; Trater, James R.

2010-11-01

Large-scale neutron facilities such as the Spallation Neutron Source (SNS) located at Oak Ridge National Laboratory need easy-to-use access to Department of Energy Leadership Computing Facilities and experiment repository data. The Orbiter thick- and thin-client and its supporting Service Oriented Architecture (SOA) based services (available at https://orbiter.sns.gov) consist of standards-based components that are reusable and extensible for accessing high performance computing, data and computational grid infrastructure, and cluster-based resources easily from a user configurable interface. The primary Orbiter system goals consist of (1) developing infrastructure for the creation and automation of virtual instrumentation experiment optimization, (2) developing user interfaces for thin- and thick-client access, (3) provide a prototype incorporating major instrument simulation packages, and (4) facilitate neutron science community access and collaboration. The secure Orbiter SOA authentication and authorization is achieved through the developed Virtual File System (VFS) services, which use Role-Based Access Control (RBAC) for data repository file access, thin-and thick-client functionality and application access, and computational job workflow management. The VFS Relational Database Management System (RDMS) consists of approximately 45 database tables describing 498 user accounts with 495 groups over 432,000 directories with 904,077 repository files. Over 59 million NeXus file metadata records are associated to the 12,800 unique NeXus file field/class names generated from the 52,824 repository NeXus files. Services that enable (a) summary dashboards of data repository status with Quality of Service (QoS) metrics, (b) data repository NeXus file field/class name full text search capabilities within a Google like interface, (c) fully functional RBAC browser for the read-only data repository and shared areas, (d) user/group defined and shared metadata for data repository files, (e) user, group, repository, and web 2.0 based global positioning with additional service capabilities are currently available. The SNS based Orbiter SOA integration progress with the Distributed Data Analysis for Neutron Scattering Experiments (DANSE) software development project is summarized with an emphasis on DANSE Central Services and the Virtual Neutron Facility (VNF). Additionally, the DANSE utilization of the Orbiter SOA authentication, authorization, and data transfer services best practice implementations are presented.

Nativity status and access to care in Canada and the U.S.: factoring in the roles of race/ethnicity and socioeconomic status.

PubMed

Lebrun, Lydie A; Shi, Leiyu

2011-08-01

We conducted cross-country comparisons of Canada and the U.S., and assessed the extent to which access to care varies by nativity status overall, as well as in conjunction with race/ethnicity and socioeconomic status. Data came from the Joint Canada-U.S. Survey of Health (n=6,620 non-elderly adults). Access measures included having a regular medical doctor, consultation with a health professional in the past year, dentist visit in the past year, Pap test in the past three years, and any unmet health care needs in the past year. Logistic regression was employed to estimate the relative odds of access to care, adjusting for potential confounders. Disparities in access to care based on nativity status overall, as well as nativity-by-race joint effects, were found in both countries. There was also a dose-response effect of education on access to care among the native-born but not among the foreign-born; there were few nativity-by-income joint effects.

Ethical Considerations for the Participation of Children of Minor Parents in Clinical Trials.

PubMed

Ott, Mary A; Crawley, Francis P; Sáez-Llorens, Xavier; Owusu-Agyei, Seth; Neubauer, David; Dubin, Gary; Poplazarova, Tatjana; Begg, Norman; Rosenthal, Susan L

2018-06-01

Children of minor parents are under-represented in clinical trials. This is largely because of the ethical, legal, and regulatory complexities in the enrolment, consent, and appropriate access of children of minor parents to clinical research. Using a case-based approach, we examine appropriate access of children of minor parents in an international vaccine trial. We first consider the scientific justification for inclusion of children of minor parents in a vaccine trial. Laws and regulations governing consent generally do not address the issue of minor parents. In their absence, local community and cultural contexts may influence consent processes. Rights of the minor parent include dignity in their role as a parent and respect for their decision-making capacity in that role. Rights of the child include the right to have decisions made in their best interest and the right to the highest attainable standard of health. Children of minor parents may have vulnerabilities related to the age of their parent, such as increased rates of poverty, that have implications for consent. Neuroscience research suggests that, by age 12-14 years, minors have adult-level capacity to make research decisions in situations with low emotion and low distraction. We conclude with a set of recommendations based on these findings to facilitate appropriate access and equity related to the participation of children of minor parents in clinical research.

The experiences of working carers of older people regarding access to a web-based family care support network offered by a municipality.

PubMed

Andersson, Stefan; Erlingsson, Christen; Magnusson, Lennart; Hanson, Elizabeth

2017-09-01

Policy makers in Sweden and other European Member States pay increasing attention as to how best support working carers; carers juggling providing unpaid family care for older family members while performing paid work. Exploring perceived benefits and challenges with web-based information and communication technologies as a means of supporting working carers' in their caregiving role, this paper draws on findings from a qualitative study. The study aimed to describe working carers' experiences of having access to the web-based family care support network 'A good place' (AGP) provided by the municipality to support those caring for an older family member. Content analysis of interviews with nine working carers revealed three themes: A support hub, connections to peers, personnel and knowledge; Experiencing ICT support as relevant in changing life circumstances; and Upholding one's personal firewall. Findings indicate that the web-based family care support network AGP is an accessible, complementary means of support. Utilising support while balancing caregiving, work obligations and responsibilities was made easier with access to AGP; enabling working carers to access information, psychosocial support and learning opportunities. In particular, it provided channels for carers to share experiences with others, to be informed, and to gain insights into medical and care issues. This reinforced working carers' sense of competence, helping them meet caregiving demands and see positive aspects in their situation. Carers' low levels of digital skills and anxieties about using computer-based support were barriers to utilising web-based support and could lead to deprioritising of this support. However, to help carers overcome these barriers and to better match web-based support to working carers' preferences and situations, web-based support must be introduced in a timely manner and must more accurately meet each working carer's unique caregiving needs. © 2016 Nordic College of Caring Science.

Patients' experiences of an open access follow up arrangement in managing inflammatory bowel disease

PubMed Central

Rogers, A; Kennedy, A; Nelson, E; Robinson, A

2004-01-01

Background: Improving access is a key policy issue in improving quality of care and extending patient choice and participation. People's experience of changing from fixed outpatient appointments to more flexible direct access arrangements for chronic disease has been underexplored. Objectives: To examine patients' views on using an open system of access compared with fixed outpatient appointments as part of a guided self-management intervention for inflammatory bowel disease (IBD). Design: Embedded qualitative study undertaken alongside a randomised controlled trial. Semi-structured interviews were undertaken to obtain an in depth understanding of patients' experience of the change in access arrangements. Participants: A purposive sample (n = 30) was drawn from the intervention group (n = 700) according to a range of responses to the trial baseline and follow up quantitative measures. Results: 28 interviews were included in the analysis. Compared with the previous system of fixed appointments, preference for the new open access system was based on enhanced personal control in contacting services and the view that it fitted better with everyday routine management and the requirement for urgent medical contact when symptoms fail to respond to medication. Preference for retaining fixed appointments was based on a sense of security from gaining access which did not require the individual to initiate the request for medical help. Conclusions: Open access may fit better with patients' self-management of their condition and everyday routines, roles and responsibilities. Ensuring that outpatient organisational arrangements and personnel are responsive to patient initiated requests for appointments is likely to impact on the acceptability of this type of access arrangement. Some people may continue to prefer the fixed appointment system which should be retained if patient choice is to be respected. PMID:15465941

Partnering for Health

ERIC Educational Resources Information Center

Ammerman, Adrienne

2011-01-01

A little-known health care safety net plays a big role for young people across the U.S. More than 1,900 school-based health centers (SBHCs) provide access to care--primary health, mental health and counseling, family outreach, and chronic illness management--to nearly 1.7 million children and adolescents. SBHCs are partnerships between schools and…

Mathematics Education in Secondary Schools and Two-Year Colleges. A Sourcebook.

ERIC Educational Resources Information Center

Campbell, Paul J.; Grinstein, Louise S.

The changing role of mathematics in society may require a different mathematics curriculum in the schools. Curriculum builders work constructing pieces of the new mathematics curriculum. To last, this new curriculum must be based on a foundation of experience and research. This book provides access to that foundation for secondary schools and…

The Critical Role of Catholic Higher Education in Sustaining Catholic Elementary Schools

ERIC Educational Resources Information Center

Belfiore, Phillip J.

2017-01-01

Declining enrollment and increased school closings or consolidations in Pre-K-12 Catholic education, especially in the Northeast, reduce the accessibility and options families have for faith-based education. Catholic colleges and universities, especially schools of education, can take an active lead in confronting some of the challenges faced by…

Schools as Racial Spaces: Understanding and Resisting Structural Racism

ERIC Educational Resources Information Center

Blaisdell, Benjamin

2016-01-01

Analyzing schools as racial spaces can help researchers examine the role of teachers in the perpetuation of structural racism in schools. Based on ethnographic and autoethnographic work, this article offers examples of schools as racial spaces, spaces where whiteness controlled access. It also highlights four teachers who pursued racial equity in…

Emancipatory Research: Support for Women's Access to Power. Draft.

ERIC Educational Resources Information Center

Brunner, C. Cryss

This paper presents findings of a critical ethnography that examined the relationship between gender and the definition of power, and its use in the politicized role of the superintendent. Based on Stewart Clegg's (1988) conceptualization of power relationships as "circuits of power," the ethnography was conducted in a larger metropolitan area…

The Role of IT Literacy in Defining Digital Divide Policy Needs

ERIC Educational Resources Information Center

Ferro, Enrico; Helbig, Natalie C.; Gil-Garcia, J. Ramon

2011-01-01

This article expands our current understanding of the digital divide by examining differences in individuals' IT skills acquisition. In the last two decades scholars have gradually refined the conceptualization of the digital divide, moving from a dichotomous model mainly based on access, to a multidimensional model accounting for differences in…

Creating Inclusive Campus Communities: The Vital Role of Peer Mentorship in Inclusive Higher Education

ERIC Educational Resources Information Center

Lewis, Catherine

2017-01-01

Across the country, colleges are opening their doors to students with intellectual and developmental disabilities. At University of Rochester (UR), we coordinate one such initiative called "Transition Opportunities at University of Rochester (TOUR)." Inclusive higher education at UR is based on the philosophy that ACCESS + SUPPORT =…

Online Help to End-Users in a Networked Environment.

ERIC Educational Resources Information Center

Meyer, Paul

1991-01-01

Discusses the need for online help for end-users based on experiences with an online public access catalog (OPAC) at the University of Cape Town libraries. The concept of end users is examined, the role of search intermediaries in information systems is explained, and online help and systems design is discussed. (LRW)

Online Information Services for Secondary School Students. Second Edition.

ERIC Educational Resources Information Center

Aversa, Elizabeth Smith; And Others

This guide addresses the role of online searching in school library media centers. The first section reviews the literature in the area and presents guidelines for planning and implementing online access for students based on the experiences reported. This section lists 44 references. The second section summarizes the results of a 1986 survey of…

Automating individualized coaching and authentic role-play practice for brief intervention training.

PubMed

Hayes-Roth, B; Saker, R; Amano, K

2010-01-01

Brief intervention helps to reduce alcohol abuse, but there is a need for accessible, cost-effective training of clinicians. This study evaluated STAR Workshop , a web-based training system that automates efficacious techniques for individualized coaching and authentic role-play practice. We compared STAR Workshop to a web-based, self-guided e-book and a no-treatment control, for training the Engage for Change (E4C) brief intervention protocol. Subjects were medical and nursing students. Brief written skill probes tested subjects' performance of individual protocol steps, in different clinical scenarios, at three test times: pre-training, post-training, and post-delay (two weeks). Subjects also did live phone interviews with a standardized patient, post-delay. STAR subjects performed significantly better than both other groups. They showed significantly greater improvement from pre-training probes to post-training and post-delay probes. They scored significantly higher on post-delay phone interviews. STAR Workshop appears to be an accessible, cost-effective approach for training students to use the E4C protocol for brief intervention in alcohol abuse. It may also be useful for training other clinical interviewing protocols.

RBAC Driven Least Privilege Architecture For Control Systems

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

Hull, Julie; Markham, Mark

The concept of role based access control (RBAC) within the IT environment has been studied by researchers and was supported by NIST (circa 1992). This earlier work highlighted the benefits of RBAC which include reduced administrative workload and policies which are easier to analyze and apply. The goals of this research were to expand the application of RBAC in the following ways. Apply RBAC to the control systems environment: The typical RBAC model within the IT environment is used to control a user’s access to files. Within the control system environment files are replaced with measurement (e.g., temperature) and controlmore » (e.g. valve) points organized as a hierarchy of control assets (e.g. a boiler, compressor, refinery unit). Control points have parameters (e.g., high alarm limit, set point, etc.) associated with them. The RBAC model is extended to support access to points and their parameters based upon roles while at the same time allowing permissions for the points to be defined at the asset level or point level directly. In addition, centralized policy administration with distributed access enforcement mechanisms was developed to support the distributed architecture of distributed control systems and SCADA; Extend the RBAC model to include access control for software and devices: The established RBAC approach is to assign users to roles. This work extends that notion by first breaking the control system down into three layers 1) users, 2) software and 3) devices. An RBAC model is then created for each of these three layers. The result is that RBAC can be used to define machine-to-machine policy enforced via the IP security (IPsec) protocol. This highlights the potential to use RBAC for machine-to-machine connectivity within the internet of things; and Enable dynamic policy based upon the operating mode of the system: The IT environment is generally static with respect to policy. However, large cyber physical systems such as industrial controls have various operating modes (start-up, normal operation, emergency, shut-down and maintenance are typical). The policy enforcement architecture must be able to support changes in access permissions as the mode of the control system changes. For example an operator’s role may not allow the operator to shut down a pump during “normal operation” but that same operator role may be given permission to shut down the pump if the refinery transitions to “emergency” mode. The effectiveness of the approach was validated by applying it to the Experion Process Knowledge System. This is a large commercial industrial control system often used to control oil refineries and other assets within the oil and gas sector. As a by-product, other industries using Experion (Pharmaceuticals, Specialty Chemicals, etc.) also benefit from increased security. Policies representative of those that would be used within an oil refinery were created and validated against the RBAC model as implemented in the underlying SQL database. The administration of policy is simplified which in turn makes it practical for security administrators to specify policies which enforce least privilege. The result is a qualitative reduction in risk. The benefits of the enhanced RBAC model are clear and as a result. Honeywell is incorporating portions of the RBAC research into the 2014 release of Experion.« less

Uses of cancer registries for public health and clinical research in Europe: Results of the European Network of Cancer Registries survey among 161 population-based cancer registries during 2010-2012.

PubMed

Siesling, S; Louwman, W J; Kwast, A; van den Hurk, C; O'Callaghan, M; Rosso, S; Zanetti, R; Storm, H; Comber, H; Steliarova-Foucher, E; Coebergh, J W

2015-06-01

To provide insight into cancer registration coverage, data access and use in Europe. This contributes to data and infrastructure harmonisation and will foster a more prominent role of cancer registries (CRs) within public health, clinical policy and cancer research, whether within or outside the European Research Area. During 2010-12 an extensive survey of cancer registration practices and data use was conducted among 161 population-based CRs across Europe. Responding registries (66%) operated in 33 countries, including 23 with national coverage. Population-based oncological surveillance started during the 1940-50s in the northwest of Europe and from the 1970s to 1990s in other regions. The European Union (EU) protection regulations affected data access, especially in Germany and France, but less in the Netherlands or Belgium. Regular reports were produced by CRs on incidence rates (95%), survival (60%) and stage for selected tumours (80%). Evaluation of cancer control and quality of care remained modest except in a few dedicated CRs. Variables evaluated were support of clinical audits, monitoring adherence to clinical guidelines, improvement of cancer care and evaluation of mass cancer screening. Evaluation of diagnostic imaging tools was only occasional. Most population-based CRs are well equipped for strengthening cancer surveillance across Europe. Data quality and intensity of use depend on the role the cancer registry plays in the politico, oncomedical and public health setting within the country. Standard registration methodology could therefore not be translated to equivalent advances in cancer prevention and mass screening, quality of care, translational research of prognosis and survivorship across Europe. Further European collaboration remains essential to ensure access to data and comparability of the results. Copyright © 2014 Elsevier Ltd. All rights reserved.

An Accessible Proteogenomics Informatics Resource for Cancer Researchers.

PubMed

Chambers, Matthew C; Jagtap, Pratik D; Johnson, James E; McGowan, Thomas; Kumar, Praveen; Onsongo, Getiria; Guerrero, Candace R; Barsnes, Harald; Vaudel, Marc; Martens, Lennart; Grüning, Björn; Cooke, Ira R; Heydarian, Mohammad; Reddy, Karen L; Griffin, Timothy J

2017-11-01

Proteogenomics has emerged as a valuable approach in cancer research, which integrates genomic and transcriptomic data with mass spectrometry-based proteomics data to directly identify expressed, variant protein sequences that may have functional roles in cancer. This approach is computationally intensive, requiring integration of disparate software tools into sophisticated workflows, challenging its adoption by nonexpert, bench scientists. To address this need, we have developed an extensible, Galaxy-based resource aimed at providing more researchers access to, and training in, proteogenomic informatics. Our resource brings together software from several leading research groups to address two foundational aspects of proteogenomics: (i) generation of customized, annotated protein sequence databases from RNA-Seq data; and (ii) accurate matching of tandem mass spectrometry data to putative variants, followed by filtering to confirm their novelty. Directions for accessing software tools and workflows, along with instructional documentation, can be found at z.umn.edu/canresgithub. Cancer Res; 77(21); e43-46. ©2017 AACR . ©2017 American Association for Cancer Research.

Open hydrology courseware using the United States Geological Survey’s National Water Census Data Portal

USGS Publications Warehouse

Nelson, Jake; Ames, Daniel P.; Blodgett, David L.

2018-01-01

The U.S. Geological Survey (USGS) is the primary U.S. Government agency for water data collection and dissemination. In this role, the USGS has recently created and deployed a National Water Census Data Portal (NWC-DP) which provides access to streamflow, evapotransporation, precipitation, aquatic biology and other data at the national level. Recognizing the value of these data sets for hydrologic science education, this paper presents an effort to bridge the gap between pencil–and-paper-based hydrology curriculum and the USGS NWC-DP resource. Specifically, we have developed an R package, National Water Census Education (NWCEd), and five associated laboratory exercises that integrate R- and web-services-based access to the NWC-DP data sets. Using custom functions built into the NWCEd, students are able to access unprecedented amounts of hydrologic data from the NWC-DP, which can be applied to current hydrology curriculum and analyzed using NWCEd and a number of other open-source R tools.

Homeless but Connected: The Role of Heterogeneous Social Network Ties and Social Networking Technology in the Mental Health Outcomes of Street-Living Youth

PubMed Central

Rice, Eric; Ray, Diana; Kurzban, Seth

2013-01-01

Although social integration tends to have positive effects on the mental health of housed adolescents, the role of homeless adolescents’ social networks is more ambiguous. Social network data were collected from 136 homeless adolescents in Hollywood, California to examine how network ties are associated with symptoms of anxiety and depression. Face-to-face relationships with street-based peers were a risk factor for both anxiety and depression, while contacting home-based friends through social networking technology was found to be protective for depression. Community-based and public agencies serving homeless adolescents should consider facilitating the maintenance of these protective relationships by providing internet access. PMID:22075769

First-line managers' descriptions and reflections regarding their staff's access to empowering structures.

PubMed

Skytt, Bernice; Hagerman, Heidi; Strömberg, Annika; Engström, Maria

2015-11-01

To elucidate first-line managers' descriptions and reflections regarding their staff's access to empowering structures using Kanter's theory of structural empowerment. Good structural conditions within workplaces are essential to employees' wellbeing, and their ability to access empowerment structures is largely dependent on the management. Twenty-eight first-line managers in elderly care were interviewed. Deductive qualitative content analysis was used to analyse data. Managers perceived that staff had varying degrees of access to the empowering structures described in Kanter's theory - and that they possessed formal power in their roles as contact persons and representatives. The descriptions mostly started from the managers' own actions, although some started from the needs of staff members. All managers described their staff's access to the empowering structures in Kanter's theory as important, yet it seemed as though this was not always reflected on and discussed as a strategic issue. Managers could make use of performance and appraisal dialogues to keep up to date on staff's access to empowering structures. Recurrent discussions in the management group based on such current information could promote staff's access to power through empowering structures and make job definitions a strategic issue in the organisation. © 2014 John Wiley & Sons Ltd.

Impact of Socioeconomic Inequality on Access, Adherence, and Outcomes of Antiretroviral Treatment Services for People Living with HIV/AIDS in Vietnam.

PubMed

Tran, Bach Xuan; Hwang, Jongnam; Nguyen, Long Hoang; Nguyen, Anh Tuan; Latkin, Noah Reed Knowlton; Tran, Ngoc Kim; Minh Thuc, Vu Thi; Nguyen, Huong Lan Thi; Phan, Huong Thu Thi; Le, Huong Thi; Tran, Tho Dinh; Latkin, Carl A

2016-01-01

Ensuring an equal benefit across different patient groups is necessary while scaling up free-of-charge antiretroviral treatment (ART) services. This study aimed to measure the disparity in access, adherence, and outcomes of ART in Vietnam and the effects of socioeconomic status (SES) characteristics on the levels of inequality. A cross-sectional study was conducted in 1133 PLWH in Vietnam. ART access, adherence, and treatment outcomes were self-reported using a structured questionnaire. Wealth-related inequality was calculated using a concentration index, and a decomposition analysis was used to determine the contribution of each SES variable to inequality in access, adherence, and outcomes of ART. Based on SES, minor inequality was found in ART access and adherence while there was considerable inequality in ART outcomes. Poor people were more likely to start treatment early, while rich people had better adherence and overall treatment outcomes. Decomposition revealed that occupation and education played important roles in inequality in ART access, adherence, and treatment outcomes. The findings suggested that health services should be integrated into the ART regimen. Furthermore, occupational orientation and training courses should be provided to reduce inequality in ART access, adherence, and treatment outcomes.

Exploring the leadership role of the clinical nurse specialist on an inpatient palliative care consulting team.

PubMed

Stilos, Kalli; Daines, Pat

2013-03-01

Demand for palliative care services in Canada will increase owing to an aging population and the evolving role of palliative care in non-malignant illness. Increasing healthcare demands continue to shape the clinical nurse specialist (CNS) role, especially in the area of palliative care. Clinical nurse specialists bring specialized knowledge, skills and leadership to the clinical setting to enhance patient and family care. This paper highlights the clinical leadership role of the CNS as triage leader for a hospital-based palliative care consulting team. Changes to the team's referral and triage processes are emphasized as key improvements to team efficiency and timely access to care for patients and families.

Community health workers in Lesotho: Experiences of health promotion activities.

PubMed

Seutloali, Thato; Napoles, Lizeka; Bam, Nomonde

2018-02-27

Lesotho adopted primary health care in 1979, and community health workers (CHWs) were included in the programme to focus on health promotion, particularly to reach people in underserved rural areas. Although the CHW programme has been successful, the heavy burden of disease because of HIV and/or AIDS and tuberculosis shifted resources from health promotion to home-based care. The study explored the lived experience of CHWs in conducting health promotion activities in Lesotho. The study was conducted in four health centres in Berea district, Lesotho. A qualitative study was conducted using an interviewer guide translated from English into Sesotho for four CHW focus group discussions, four individual interviews of key informants and four semi-structured interviews with the health centre nurses. The roles of CHWs in health promotion ranged from offering basic first aid and home-based care to increasing access to health care services by taking patients to the facilities and promoting behaviour change through health education. Their perceived successes included increased access to health care services and reduced mortality rates. CHW challenges involved their demotivation to carry out their work because of lack of or inconsistent financial incentives and supplies, work overload which compromises quality of their work and limited community involvement. This study concludes that CHWs are beneficial to health promotion and its various activities. They had a clear understanding of their roles and responsibilities, although they did not fully comprehend that what they were describing was, in fact, health promotion. When it came to advocacy, CHWs did not fully understand it, nor did they consider it as part of their roles, although they acknowledged its importance. Their role of increasing access to health care services by accompanying patients to the facilities has increased considerably because of changes in disease burden. This is affecting their ability to practise other health promotion activities which focus on disease prevention.

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

PubMed

Hawthorne, Timothy L; Kwan, Mei-Po

2012-01-01

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

The Nutrition Educator's Role in Access to Food.

ERIC Educational Resources Information Center

Eide, Wenche Barth

1982-01-01

Urges that nutrition educators have a crucial role to play in educating people to influence the economic processes of food production and marketing. Examines the relationship between food patterns, cultural values, and access to food. (SK)

An exploration of deaf women's access to mental health nurse education in the United Kingdom.

PubMed

Sharples, Naomi

2013-09-01

Historically deaf people have been denied access to professional nurse education due to a range of language, communication and ideological barriers. The following study was set in the North of England and draws upon the Western experience and knowledge base of deaf people's experience of access to professional education. The aim of this study was to understand the experiences of the first British Sign Language using deaf qualified nurses before they entered the Pre-registration Diploma in Nursing Programme, during the programme and after the programme as they progressed into professional nursing roles. The purpose of the study was to gather the nurses' thoughts and feelings about their experiences and to analyse these using thematic analysis within a narrative interpretive tradition against a backdrop of Jurgen Habermas' critical theory and Paulo Freire's critical pedagogy. By drawing out significant themes to structure a deeper understanding of the nurses' unique positions, they offer a model for inclusive education practice that would support deaf people and people from minority groups into nursing and other health care professions. The signed narratives were video recorded and interpreted into written English transcripts which were then analysed to discover the underlying themes using Boyatzis' (1998) thematic analysis. The findings are set against an historical and contemporary setting of deaf people in Western society, their experiences of education, health and employment. These unique findings illustrate the significance of an accessible language environment for the nurses, the role of the organisation in ensuring access for the nurses and the impact of barriers to education and the clinical environment. The implications for education and practice supports the need to analyse the workforce required in deaf services, to scrutinize the access provided, to develop cultural competence skills, enhance the use of additional support mechanisms, generate accessible communities of practice and to draw upon the deaf nurses' own ideas and perspectives to develop accessible provision. Copyright © 2012 Elsevier Ltd. All rights reserved.

Land Development and Subdivision Regulations that Support Access Management

DOT National Transportation Integrated Search

1993-01-01

This report examines the role of the comprehensive plan in developing an access : management program, aspects of current regulatory practice that contribute to : access problems, and regulatory techniques that support access management : principles. ...

The Role of Remote Sensing in Assessing Forest Biomass in Appalachian South Carolina

NASA Technical Reports Server (NTRS)

Shain, W.; Nix, L.

1982-01-01

Information is presented on the use of color infrared aerial photographs and ground sampling methods to quantify standing forest biomass in Appalachian South Carolina. Local tree biomass equations are given and subsequent evaluation of stand density and size classes using remote sensing methods is presented. Methods of terrain analysis, environmental hazard rating, and subsequent determination of accessibility of forest biomass are discussed. Computer-based statistical analyses are used to expand individual cover-type specific ground sample data to area-wide cover type inventory figures based on aerial photographic interpretation and area measurement. Forest biomass data are presented for the study area in terms of discriminant size classes, merchantability limits, accessibility (as related to terrain and yield/harvest constraints), and potential environmental impact of harvest.

Health services research in urology.

PubMed

Yu, Hua-Yin; Ulmer, William; Kowalczyk, Keith J; Hu, Jim C

2011-06-01

Health services research (HSR) is increasingly important given the focus on patient-centered, cost-effective, high-quality health care. We examine how HSR affects contemporary evidence-based urologic practice and its role in shaping future urologic research and care. PubMed, urologic texts, and lay literature were reviewed for terms pertaining to HSR/outcomes research and urologic disease processes. HSR is a broad discipline that focuses on access, cost, and outcomes of Health care. Its use has been applied to a myriad of urologic conditions to identify deficiencies in access, to evaluate cost-effectiveness of therapies, and to evaluate structural, process, and outcome quality measures. HSR utilizes an evidence-based approach to identify the most effective ways to organize/manage, finance, and deliver high-quality urologic care and to tailor care optimized to individuals.

Free Open Access Medical Education (FOAM) Resources in a Team-Based Learning Educational Series.

PubMed

Fallon, Timothy; Strout, Tania D

2018-01-01

Although Free Open Access Medical Education (FOAM) has become popular within emergency medicine, concerns exist regarding its role in resident education. We sought to develop an educational intervention whereby residents could review FOAM resources while maintaining faculty oversight. We created a novel curriculum pairing FOAM from the Academic Life in Emergence Medicine (ALiEM) Approved Instructional Resources (Air) series with a team-based learning (TBL) format. Residents have an opportunity to engage with FOAM in a structured setting with faculty input on possible practice changes. This series has been well-received by residents and appears to have increased engagement with core content material. Qualitative feedback from residents on this series has been positive and we believe this is the first described use of TBL in emergency medicine.

Significance of mental health legislation for successful primary care for mental health and community mental health services: A review.

PubMed

Ayano, Getinet

2018-03-29

 Mental health legislation (MHL) is required to ensure a regulatory framework for mental health services and other providers of treatment and care, and to ensure that the public and people with a mental illness are afforded protection from the often-devastating consequences of mental illness.  To provide an overview of evidence on the significance of MHL for successful primary care for mental health and community mental health servicesMethod: A qualitative review of the literature on the significance of MHL for successful primary care for mental health and community mental health services was conducted.  In many countries, especially in those who have no MHL, people do not have access to basic mental health care and treatment they require. One of the major aims of MHL is that all people with mental disorders should be provided with treatment based on the integration of mental health care services into the primary healthcare (PHC). In addition, MHL plays a crucial role in community integration of persons with mental disorders, the provision of care of high quality, the improvement of access to care at community level. Community-based mental health care further improves access to mental healthcare within the city, to have better health and mental health outcomes, and better quality of life, increase acceptability, reduce associated social stigma and human rights abuse, prevent chronicity and physical health comorbidity will likely to be detected early and managed.  Mental health legislation plays a crucial role in community integration of persons with mental disorders, integration of mental health at primary health care, the provision of care of high quality and the improvement of access to care at community level. It is vital and essential to have MHL for every country.

Facilitating and supporting HIV+ parenthood: Lessons for developing the advocate role of voluntary HIV support services workers.

PubMed

Cane, Tam Pheona Chipawe

2018-06-01

Increasingly as people living with HIV (PLWHIV) aim to become parents, they engage with HIV voluntary services for support through either fertility or adoption services. Yet, little is known about the role of HIV support services workers in facilitating access to fertility treatment or child adoption. The purpose of this study was to explore the role of HIV support workers based in HIV voluntary organisations who have a key role helping PLWHIV in navigating relevant fertility and adoption processes. This was an exploratory qualitative study which involved interviewing six HIV support workers, from across the UK. Interviews were conducted using face to face interviews, recorded and transcribed. Findings revealed that HIV services support workers provide practical support in advocating service provision, and emotional and social support along the journey. They also face challenges in their role from health care professionals including information sharing and gatekeeping. The role of HIV support workers is important in facilitating access to resources and complex systems. HIV support workers should be recognised and as they are often a trusted professional to address stigma, discrimination and barriers to services. The study contributes to research seeking to understand the emerging needs and support requirements for people living with HIV seeking fertility and adoption. Further work in this area is warranted. Copyright © 2018 Elsevier B.V. All rights reserved.

Socializing in an open drug scene: the relationship between access to private space and drug-related street disorder.

PubMed

Debeck, Kora; Wood, Evan; Qi, Jiezhi; Fu, Eric; McArthur, Doug; Montaner, Julio; Kerr, Thomas

2012-01-01

Limited attention has been given to the potential role that the structure of housing available to people who are entrenched in street-based drug scenes may play in influencing the amount of time injection drug users (IDU) spend on public streets. We sought to examine the relationship between time spent socializing in Vancouver's drug scene and access to private space. Using multivariate logistic regression we evaluated factors associated with socializing (three+ hours each day) in Vancouver's open drug scene among a prospective cohort of IDU. We also assessed attitudes towards relocating socializing activities if greater access to private indoor space was provided. Among our sample of 1114 IDU, 43% fit our criteria for socializing in the open drug scene. In multivariate analysis, having limited access to private space was independently associated with socializing (adjusted odds ratio: 1.80, 95% confidence interval: 1.28-2.55). In further analysis, 65% of 'socializers' reported positive attitudes towards relocating socializing if they had greater access to private space. These findings suggest that providing IDU with greater access to private indoor space may reduce one component of drug-related street disorder. Low-threshold supportive housing based on the 'housing first' model that include safeguards to manage behaviors associated with illicit drug use appear to offer important opportunities to create the types of private spaces that could support a reduction in street disorder. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Socializing in an Open Drug Scene: The relationship Between Access to Private Space and Drug-Related Street Disorder

PubMed Central

DeBeck, Kora; Wood, Evan; Qi, Jiezhi; Fu, Eric; McArthur, Doug; Montaner, Julio; Kerr, Thomas

2011-01-01

Background Limited attention has been given to the potential role that the structure of housing available to people who are entrenched in street-based drug scenes may play in influencing the amount of time injection drug users (IDU) spend on public streets. We sought to examine the relationship between time spent socializing in Vancouver's drug scene and access to private space. Methods Using multivariate logistic regression we evaluated factors associated with socializing (three+ hours each day) in Vancouver's open drug scene among a prospective cohort of IDU. We also assessed attitudes towards relocating socializing activities if greater access to private indoor space was provided. Results Among our sample of 1114 IDU, 43% fit our criteria for socializing in the open drug scene. In multivariate analysis, having limited access to private space was independently associated with socializing (adjusted odds ratio: 1.80, 95% confidence interval: 1.28 – 2.55). In further analysis, 65% of ‘socializers’ reported positive attitudes towards relocating socializing if they had greater access to private space. Conclusion These findings suggest that providing IDU with greater access to private indoor space may reduce one component of drug-related street disorder. Low-threshold supportive housing based on the ‘housing first’ model that include safeguards to manage behaviors associated with illicit drug use appear to offer important opportunities to create the types of private spaces that could support a reduction in street disorder. PMID:21764528

Geographical accessibility to community pharmacies by the elderly in metropolitan Lisbon.

PubMed

Padeiro, Miguel

2018-07-01

In ageing societies, community pharmacies play an important role in delivering medicines, responsible advising, and other targeted services. Elderly people are among their main consumers, as they use more prescription drugs, need more specific health care, and experience more mobility issues than other age groups. This makes geographical accessibility a relevant concern for them. To measure geographical pedestrian accessibility to community pharmacies by elderly people in the Lisbon Metropolitan Area (LMA). The number of elderly people living within a 10- and 15-min walk was estimated based on the exploitation of population census data, the address-based location of 801 community pharmacies, and a Google Maps Application Programming Interface (API) method for calculating distances between pharmacies and the centroids of census statistical subsections. Results were compared to figures attained via traditional methods. In the LMA, 61.2% of the elderly live less than a 10 min walk from the nearest pharmacy and 76.9% live less than 15 min away. This opposes the common view that pharmacies are highly accessible in urban areas. In addition, results show a high spatial variability of proximity to pharmacies. Despite the illusion of good coverage suggested at the metropolitan scale, accessibility measures demonstrate the existence of pharmaceutical deprivation areas for the elderly. The findings indicate the need for more accuracy in both access measurements and redistribution policies. Measurement methods and population targets should be reconsidered. Copyright © 2017 Elsevier Inc. All rights reserved.

"God Has My Back": The Role of Faith-Based Institutions in Preparing African-American Students for College Success

ERIC Educational Resources Information Center

Placenti, Phillip M.

2012-01-01

African-American students are less likely to attend and successfully complete college than their Asian and White peers. Possible explanations for this disparity include racial and ethnic segregation, socioeconomic challenges, persistent shortages of qualified teachers, and scant access to college-preparatory curricula. In the context of such…

ICT and Web Technology Based Innovations in Education Sector

ERIC Educational Resources Information Center

Sangeeta Namdev, Dhamdhere

2012-01-01

ICT made real magic and drastic changes in all service sectors along with higher education and library practices and services. The academic environment is changing from formal education to distance and online learning mode because of ICT. Web technology and mobile technology has made great impact on education sector. The role of Open Access,…

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

ERIC Educational Resources Information Center

Whitfield, Petronilla

2016-01-01

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

How Are Teacher-Librarians Finding Resources for Coursework?: Distance Learners and the Role of University Library Services

ERIC Educational Resources Information Center

de Jong, Cees-Jan; Branch, Jennifer L.

2005-01-01

Providing distance learners access to library services does not automatically translate into usage of those resources. The literature on information-seeking behaviour of distance learners has indicated that they prefer to use local resources, as well as Web-based resources. This study investigates perspectives on library services and available…

Foundation degree students as work-based learners: the mentor's role.

PubMed

Wareing, Mark

Healthcare assistants and support workers are beginning to access higher education programmes to expand their roles and practice. One example has been the development of the foundation degree (FD) - a 2-year diploma level course delivered via work-based learning. These undergraduate workplace learners require the support of mentors and assessors. It is proposed that traditional notions of mentorship are insufficiently attuned to the needs of work-based learners who need to prepare more for performance, rather than for practice. This argument rests on the observation that FD students are already immersed in practice and possess a wealth of experience to link to the underpinning knowledge gained from higher education. Evidence from a small piece of interpretive research is used to inform this discussion and highlight the unique needs of work-based learners within the clinical setting.

Access and acceptability of community-based services for older Greek migrants in Australia: user and provider perspectives.

PubMed

Hurley, Catherine; Panagiotopoulos, Georgia; Tsianikas, Michael; Newman, Lareen; Walker, Ruth

2013-03-01

In most developed nations, ageing migrants represent a growing proportion of the older population. Policies that emphasise care in the community depend on older migrants having access to formal services along with informal support, yet little is known about how older migrants experience community-based formal services. By examining the views of both Greek elders in Australia and those of formal service providers, this research fills an important gap in the literature around access to and acceptability of formal community-based services for older migrants. A research team including two Greek background researchers used existing social groups and a snowball sampling method to conduct face-to-face interviews and focus groups with seventy older Greeks in Adelaide, Australia. In addition, 22 community-based service providers were interviewed over the telephone. Results from users and providers showed that while many older Greeks experience service access issues, they also relied heavily on family for support and assistance at home. Reliance on family was both in preference to formal services or where formal services were used, to locate, negotiate and monitor such services. Common barriers identified by both groups included cost, transport and availability, but additional challenges were posed by language, literacy and cultural attitudes. Demographic changes including greater employment mobility and female workforce participation among adult children will have implications for both formal and informal care providers. Formal service providers need to ensure that services are promoted and delivered to take account of the important role of family in informal support while also addressing the access challenges posed by language and literacy. Research conducted by researchers from the same cultural background in the respondent's native language can further advance knowledge in this area. © 2012 Blackwell Publishing Ltd.

Virtual reality: emerging role of simulation training in vascular access.

PubMed

Davidson, Ingemar J A; Lok, Charmaine; Dolmatch, Bart; Gallieni, Maurizio; Nolen, Billy; Pittiruti, Mauro; Ross, John; Slakey, Douglas

2012-11-01

Evolving new technologies in vascular access mandate increased attention to patient safety; an often overlooked yet valuable training tool is simulation. For the end-stage renal disease patient, simulation tools are effective for all aspects of creating access for peritoneal dialysis and hemodialysis. Based on aviation principles, known as crew resource management, we place equal emphasis on team training as individual training to improve interactions between team members and systems, cumulating in improved safety. Simulation allows for environmental control and standardized procedures, letting the trainee practice and correct mistakes without harm to patients, compared with traditional patient-based training. Vascular access simulators range from suture devices, to pressurized tunneled conduits for needle cannulation, to computer-based interventional simulators. Simulation training includes simulated case learning, root cause analysis of adverse outcomes, and continual update and refinement of concepts. Implementation of effective human to complex systems interaction in end-stage renal disease patients involves a change in institutional culture. Three concepts discussed in this article are as follows: (1) the need for user-friendly systems and technology to enhance performance, (2) the necessity for members to both train and work together as a team, and (3) the team assigned to use the system must test and practice it to a proficient level before safely using the system on patients. Copyright © 2012 Elsevier Inc. All rights reserved.

Predictors of nonfunctional arteriovenous access at hemodialysis initiation and timing of access creation: A registry-based study

PubMed Central

Metzger, Marie; Labeeuw, Michel; Ayav, Carole; Jacquelinet, Christian; Massy, Ziad A.; Stengel, Bénédicte

2017-01-01

Determinants of nonfunctional arteriovenous (AV) access, including timing of AV access creation, have not been sufficiently described. We studied 29 945 patients who had predialysis AV access placement and were included in the French REIN registry from 2005 through 2013. AV access was considered nonfunctional when dialysis began with a catheter. We estimated crude and adjusted odds ratio (OR) with 95% confidence intervals (CI) of nonfunctional versus functional AV access associated with case-mix, facility characteristics, and timing of AV access creation. Analyses were stratified by dialysis start condition (planned or as an emergency) and comorbidity profile. Overall, 18% patients had nonfunctional AV access at hemodialysis initiation. In the group with planned dialysis start, female gender (OR 1.43, 95% CI 1.32–1.56), diabetes (OR 1.28, 95% CI 1.15–1.44), and a higher number of cardiovascular comorbidities (OR 1.27, 95% CI 1.09–1.49, and 1.31, 1.05–1.64, for 3 and >3 cardiovascular comorbidities versus none, respectively) were independent predictors of nonfunctional AV access. A higher percentage of AV access creation at the region level was associated with a lower rate of nonfunctional AV access (OR 0.98, 95% CI 0.98–0.99 per 1% increase). The odds of nonfunctional AV access decreased as time from creation to hemodialysis initiation increased up to 3 months in nondiabetic patients with fewer than 2 cardiovascular comorbidities and 6 months in patients with diabetes or 2 or more such comorbidities. In conclusion, both patient characteristics and clinical practices may play a role in successful AV access use at hemodialysis initiation. Adjusting the timing of AV access creation to patients’ comorbidity profiles may improve functional AV access rates. PMID:28749967

Predictors of nonfunctional arteriovenous access at hemodialysis initiation and timing of access creation: A registry-based study.

PubMed

Alencar de Pinho, Natalia; Coscas, Raphael; Metzger, Marie; Labeeuw, Michel; Ayav, Carole; Jacquelinet, Christian; Massy, Ziad A; Stengel, Bénédicte

2017-01-01

Determinants of nonfunctional arteriovenous (AV) access, including timing of AV access creation, have not been sufficiently described. We studied 29 945 patients who had predialysis AV access placement and were included in the French REIN registry from 2005 through 2013. AV access was considered nonfunctional when dialysis began with a catheter. We estimated crude and adjusted odds ratio (OR) with 95% confidence intervals (CI) of nonfunctional versus functional AV access associated with case-mix, facility characteristics, and timing of AV access creation. Analyses were stratified by dialysis start condition (planned or as an emergency) and comorbidity profile. Overall, 18% patients had nonfunctional AV access at hemodialysis initiation. In the group with planned dialysis start, female gender (OR 1.43, 95% CI 1.32-1.56), diabetes (OR 1.28, 95% CI 1.15-1.44), and a higher number of cardiovascular comorbidities (OR 1.27, 95% CI 1.09-1.49, and 1.31, 1.05-1.64, for 3 and >3 cardiovascular comorbidities versus none, respectively) were independent predictors of nonfunctional AV access. A higher percentage of AV access creation at the region level was associated with a lower rate of nonfunctional AV access (OR 0.98, 95% CI 0.98-0.99 per 1% increase). The odds of nonfunctional AV access decreased as time from creation to hemodialysis initiation increased up to 3 months in nondiabetic patients with fewer than 2 cardiovascular comorbidities and 6 months in patients with diabetes or 2 or more such comorbidities. In conclusion, both patient characteristics and clinical practices may play a role in successful AV access use at hemodialysis initiation. Adjusting the timing of AV access creation to patients' comorbidity profiles may improve functional AV access rates.

The role of transportation to access maternal care services for women in rural Bangladesh and Burkina Faso: A mixed methods study.

PubMed

Alam, Nazmul; Chowdhury, Mahbub Elahi; Kouanda, Seni; Seppey, Mathieu; Alam, Anadil; Savadogo, Justin Ragnessi; Sia, Drissa; Fournier, Pierre

2016-11-01

To understand the role of transportation in accessing health care during pregnancy, delivery, and the postpartum period among women in rural Bangladesh and Burkina Faso. An exploratory mixed methods study was conducted in Mymensingh district in Bangladesh and Kaya district in Burkina Faso. We recruited 300 women from Bangladesh and 340 from Burkina Faso with a delivery outcome within one year of interview. Key informant interviews were conducted with 19 participants and 12 focus group discussions took place with attendees in selected community clinics. Of the interviewees, 45.7% in Bangladesh and 73.2% in Burkina Faso reported having had health complications during their last pregnancy, delivery, or postpartum period. Of all women, 42.7% in Bangladesh and 67.4% in Burkina Faso sought facility care for their complications. Facility-based delivery was much higher in Burkina Faso (87.7%) than Bangladesh (38.2%). Literacy, transport availability, transportation costs, and travel time were associated with care seeking behavior. Lack of reliable transportation was reported as a significant barrier to accessing care during pregnancy, delivery, and postpartum by women in Bangladesh and Burkina Faso. Effort should be made to improve access to emergency obstetric care, and transport intervention should be strengthened. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Status and determinants of small farming households' food security and role of market access in enhancing food security in rural Pakistan

PubMed Central

Ying, Liu; Bashir, Muhammad Khalid; Abid, Muhammad; Zulfiqar, Farhad

2017-01-01

In most of the developing countries, lack of resources and little market accessibility are among the major factors that affect small farming household food security. This study aims to investigate the status of small farming households’ food security, and its determinants including the role of market accessibility factors in enhancing food security at household level. In addition, this study also determines the households’ perception about different kinds of livelihoods risks. This study is based on a household survey of 576 households conducted through face-to-face interviews using structured interviews in Punjab, Pakistan. Food security status is calculated using dietary intake method. The study findings show that one-fourth of the households are food insecure. The study findings reveal that farm households perceive increase in food prices, crop diseases, lack of irrigation water and increase in health expenses as major livelihood risks. Further, the results of logistic regression show that family size, monthly income, food prices, health expenses and debt are main factors influencing the food security status of rural households. Furthermore, the market accessibility factors (road distance and transportation cost) do significantly affect the small farming household food security. The results suggest that local food security can be enhanced by creating off-farm employment opportunities, improved transportation facilities and road infrastructure. PMID:29077719

Status and determinants of small farming households' food security and role of market access in enhancing food security in rural Pakistan.

PubMed

Ahmed, Umar Ijaz; Ying, Liu; Bashir, Muhammad Khalid; Abid, Muhammad; Zulfiqar, Farhad

2017-01-01

In most of the developing countries, lack of resources and little market accessibility are among the major factors that affect small farming household food security. This study aims to investigate the status of small farming households' food security, and its determinants including the role of market accessibility factors in enhancing food security at household level. In addition, this study also determines the households' perception about different kinds of livelihoods risks. This study is based on a household survey of 576 households conducted through face-to-face interviews using structured interviews in Punjab, Pakistan. Food security status is calculated using dietary intake method. The study findings show that one-fourth of the households are food insecure. The study findings reveal that farm households perceive increase in food prices, crop diseases, lack of irrigation water and increase in health expenses as major livelihood risks. Further, the results of logistic regression show that family size, monthly income, food prices, health expenses and debt are main factors influencing the food security status of rural households. Furthermore, the market accessibility factors (road distance and transportation cost) do significantly affect the small farming household food security. The results suggest that local food security can be enhanced by creating off-farm employment opportunities, improved transportation facilities and road infrastructure.

Anatomical features of skull base and oral cavity: a pilot study to determine the accessibility of the sella by transoral robotic-assisted surgery.

PubMed

Amelot, Aymeric; Trunet, Stephanie; Degos, Vincent; André, Olivier; Dionnet, Aurore; Cornu, Philippe; Hans, Stéphane; Chauvet, Dorian

2015-10-01

The role of transoral robotic surgery (TORS) in the skull base emerges and represents the natural progression toward miniinvasive resections in confined spaces. The accessibility of the sella via TORS has been recently described on fresh human cadavers. An anatomic study is mandatory to know if this approach would be feasible in the majority of patients regardless of their oral morphological features. From 30 skull base CT scans from patients who were asked to open their mouth as wide as they can, we measured specific dimensions of the oral cavity and the skull base, such as length of the palate, mouth opening and distance from the sella to the palate. All data were acquired on a sagittal midline plane and on a 25° rotation plane, which simulated the axis of the robotic instruments. Looking at the projection of the dental palatine line on the sella, we studied possible predictive factors of sellar accessibility and tried to bring objective data for surgical feasibility. We also proposed an angle α to study the working angle at the skull base. We observed that the maximal mouth opening was a good predictive factor of sellar accessibility by TORS (p < 0.05). The mouth aperture threshold value for a good sensitivity, over 80 %, was comparable to the mean value of mouth opening in our series, 38.9 and 39.4 mm respectively. Moreover, we showed a statistically significant increase of the working angle α at the skull base comparing the lateral access to the midline one (p < 0.05). This seemed to quantitatively demonstrate that the robotic arms placed at the labial commissure of the mouth can reach the sella. From these anatomical features and previous cadaveric dissections, we assume that TORS may be feasible on a majority of patients to remove pituitary adenomas.

An opportunity: improving client services during disaster relief.

PubMed

Helferich, Omar Keith; Griggs, John E

2006-11-01

Access to current, accurate, and relevant information is mandatory for effective disaster response. In-field observations, reviews of after-action reports, and basic research indicate that this most basic of requirements is not being met. Participating disaster recovery parties, in particular environmental health agencies, lack clarity about their exact roles and lack the most basic of technological solutions that could support any given role definition. There is a need, from both cost and training perspectives, for a single, integrated solution covering risk-based routine inspections, abnormalities, and major incidents.

Transforming home health nursing with telehealth technology.

PubMed

Farrar, Francisca Cisneros

2015-06-01

Telehealth technology is an evidence-based delivery model tool that can be integrated into the plan of care for mental health patients. Telehealth technology empowers access to health care, can help decrease or prevent hospital readmissions, assist home health nurses provide shared decision making, and focuses on collaborative care. Telehealth and the recovery model have transformed the role of the home health nurse. Nurses need to be proactive and respond to rapidly emerging technologies that are transforming their role in home care. Copyright © 2015 Elsevier Inc. All rights reserved.

Beyond procedure's content: the role of accessibility experiences and personal uncertainty in procedural justice judgements.

PubMed

Greifeneder, Rainer; Müller, Patrick; Stahlberg, Dagmar; Van den Bos, Kees; Bless, Herbert

2011-01-01

Procedural justice concerns play a critical role in economic settings, politics, and other domains of human life. Despite the vast evidence corroborating their relevance, considerably less is known about how procedural justice judgments are formed. Whereas earlier theorizing focused on the systematic integration of content information, the present contribution provides a new perspective on the formation of justice judgments by examining the influence of accessibility experiences. Specifically, we hypothesize that procedural justice judgments may be formed based on the ease or difficulty with which justice-relevant information comes to mind. Three experiments corroborate this prediction in that procedures were evaluated less positively when the retrieval of associated unfair aspects was easy compared to difficult. Presumably this is because when it feels easy (difficult) to retrieve unfair aspects, these are perceived as frequent (infrequent), and hence the procedure as unjust (just). In addition to demonstrating that ease-of-retrieval may influence justice judgments, the studies further revealed that reliance on accessibility experiences is high in conditions of personal certainty. We suggest that this is because personal uncertainty fosters systematic processing of content information, whereas personal certainty may invite less taxing judgmental strategies such as reliance on ease-of-retrieval.

On Searching Available Channels with Asynchronous MAC-Layer Spectrum Sensing

NASA Astrophysics Data System (ADS)

Jiang, Chunxiao; Ma, Xin; Chen, Canfeng; Ma, Jian; Ren, Yong

Dynamic spectrum access has become a focal issue recently, in which identifying the available spectrum plays a rather important role. Lots of work has been done concerning secondary user (SU) synchronously accessing primary user's (PU's) network. However, on one hand, SU may have no idea about PU's communication protocols; on the other, it is possible that communications among PU are not based on synchronous scheme at all. In order to address such problems, this paper advances a strategy for SU to search available spectrums with asynchronous MAC-layer sensing. With this method, SUs need not know the communication mechanisms in PU's network when dynamically accessing. We will focus on four aspects: 1) strategy for searching available channels; 2) vacating strategy when PUs come back; 3) estimation of channel parameters; 4) impact of SUs' interference on PU's data rate. The simulations show that our search strategy not only can achieve nearly 50% less interference probability than equal allocation of total search time, but also well adapts to time-varying channels. Moreover, access by our strategies can attain 150% more access time than random access. The moment matching estimator shows good performance in estimating and tracing time-varying channels.

Identity and Access Management and Security in Higher Education.

ERIC Educational Resources Information Center

Bruhn, Mark; Gettes, Michael; West, Ann

2003-01-01

Discusses the drivers for an identity management system (IdM), components of this system, and its role within a school security strategy, focusing on: basic access management; requirements for access management; middleware support for an access management system; IdM implementation considerations (e.g., access eligibilities, authentication…

Evaluating a community-partnered cancer clinical trials pilot intervention with African American communities.

PubMed

Green, Melissa A; Michaels, Margo; Blakeney, Natasha; Odulana, Adebowale A; Isler, Malika Roman; Richmond, Alan; Long, Debra G; Robinson, William S; Taylor, Yhenneko J; Corbie-Smith, Giselle

2015-03-01

Cancer clinical trial (CCT) accrual and retention rates remain disproportionately low among African Americans. Awarenesss and access to trials are crucial facilitators of trial participation. Strategies developed within a community-based participatory framework (CBPR) are potential solutions to increase awareness and access to CCTs. In this study, we describe the pilot phase of three innovative community-centered modules to improve basic CCT knowledge, awareness of locations to access CCT information, and opportunities to participate in CCTs. Four community organizations completed Community Bridges to CCT training-of-the-trainer and recruited adult African American volunteers to participate in one of three CCT education modules: a workshop about CCTs, a role play describing one person's experience with CCTs, or a call and response session reviewing myths and facts about CCTs. Pre- and post-test surveys were collected and analyzed using McNemar agreement statistic to evaluate changes in knowledge and attitudes regarding trials. Trainers enrolled 125 participants in the call and response (n = 22), role play (n = 60), and workshop (n = 43) modules. Module participants were mostly African American, female, and with a mean age of 53 years. Comparison of pre- and post-test responses demonstrates favorable changes in awareness of CCTs and where to access CCTs across the sample. Analysis by module type indicates significant increases for participants in the call and response (p < 0.01) and role play modules (p < 0.001), but not the workshop module. Despite measures taken to increase the participation and retention rate of African Americans in clinical trials, little advancement has been made. Developing tailored community education modules on CCTs within the CBPR framework is a promising innovation to increase knowledge about CCTs and favorable attitudes about participation that are known precursors to trial enrollment.

'Beyond the willing & the waiting' - The role of peer-based approaches in hepatitis C diagnosis & treatment.

PubMed

Henderson, Charles; Madden, Annie; Kelsall, Jenny

2017-12-01

This commentary seeks to examine the role, value and importance of peer-based programmatic approaches for ensuring the effective roll-out of the new hepatitis C (HCV) treatments among those most affected - that is, people who inject drugs (PWID). The authors examine recent approaches to HCV treatment in Australia including the provision of universal access to the new DAA regimens regardless of acquisition, genotype or severity of disease. These approaches are contextualised within wider global strategies to support HCV elimination as a public health threat by 2030 (WHO, 2016). Despite the unprecedented opportunity presented by the availability of the new treatments, the fact remains that those most affected by hepatitis C are still largely hidden and disconnected from the health system and are likely to stay that way without targeted education and support. There is a need to for greater investment in new and innovative HCV+ PWID peer education approaches for HCV diagnosis and treatment that add value to existing models of care to improve pathways and support people across their entire treatment journey. Key components include expanding existing peer-based programmes and developing new innovative peer initiatives, supporting the development of the PWID peer workforce, developing new, targeted peer education resources and promoting linkages and partnerships between peer based and HCV treatment service providers in primary and community settings. Our approach to HCV elimination needs to take account of people's broader lives, their vulnerabilities, their life journeys and their potential points of connection, engagement and access. Peer-based organisations and networks provide that unique point of engagement and access for those HCV+ PWID for whom the health system is an unfamiliar even forbidding place or for whom hepatitis C can be but one of many overwhelming issues in the lives. Copyright © 2017 Elsevier B.V. All rights reserved.

An Optimal Mobile Service for Telecare Data Synchronization using a Role-based Access Control Model and Mobile Peer-to-Peer Technology.

PubMed

Ke, Chih-Kun; Lin, Zheng-Hua

2015-09-01

The progress of information and communication technologies (ICT) has promoted the development of healthcare which has enabled the exchange of resources and services between organizations. Organizations want to integrate mobile devices into their hospital information systems (HIS) due to the convenience to employees who are then able to perform specific healthcare processes from any location. The collection and merage of healthcare data from discrete mobile devices are worth exploring possible ways for further use, especially in remote districts without public data network (PDN) to connect the HIS. In this study, we propose an optimal mobile service which automatically synchronizes the telecare file resources among discrete mobile devices. The proposed service enforces some technical methods. The role-based access control model defines the telecare file resources accessing mechanism; the symmetric data encryption method protects telecare file resources transmitted over a mobile peer-to-peer network. The multi-criteria decision analysis method, ELECTRE (Elimination Et Choice Translating Reality), evaluates multiple criteria of the candidates' mobile devices to determine a ranking order. This optimizes the synchronization of telecare file resources among discrete mobile devices. A prototype system is implemented to examine the proposed mobile service. The results of the experiment show that the proposed mobile service can automatically and effectively synchronize telecare file resources among discrete mobile devices. The contribution of this experiment is to provide an optimal mobile service that enhances the security of telecare file resource synchronization and strengthens an organization's mobility.

PAs in orthopedics in the VHA's community-based outpatient clinics.

PubMed

Reed, Daniel O; Hooker, Roderick S

2017-04-01

In the Veterans Health Administration (VHA) system, most orthopedic care takes place in the VA medical centers (VAMCs). Because most patients receiving orthopedic care were referred by adult medicine providers, more widely deploying physician assistants (PAs) in orthopedic medicine might help offset this workload. An orthopedic medicine demonstration project recruited, trained, and positioned PAs in community-based outpatient clinics (CBOCs) to improve access to care. The project involved surgeons at the Houston VAMC instructing five newly employed PAs in a wide range of orthopedic evaluation and management strategies before their assignment to a CBOC. An administrative assessment compared encounter data pre- and postproject (2012 and 2014) to determine if this strategy modified orthopedic workload and improved patient access to care. By 2014, orthopedic patient visit volume had increased 31%-10% at the VAMC and 21% at the five CBOCs. Overall, the five deployed PAs managed 28% of all orthopedic encounters spread over 1 year and only 3.2% of visits required VAMC referral for further evaluation or treatment. During the project, the total volume of patient visits increased throughout the Houston VAMC region but access to care for this specialty service also increased, with more veteran musculoskeletal care being met at the five CBOCs, off-loading visit demand centrally. The adaptability and flexibility of new roles has been identified as one of the defining characteristics of PAs. That the VHA can take advantage of this role malleability suggests that employing PAs is useful in meeting medical service needs of veterans.

[Strategic measures for patient safety in the National Health System: on-line training resources and access to scientific knowledge].

PubMed

Novillo-Ortíz, D; Agra, Y; Fernández-Maíllo, M M; del Peso, P; Terol, E

2008-12-01

Patient safety (PS) is a priority strategy included in the Quality Plan for the Spanish National Health System and its first objective is to promote PS culture among professionals and patients. The Internet is playing a key role in the access to clinical evidence and in the training of health professionals. A multidisciplinary working group was created, who defined the criteria to help improve clinical practice in the field of patient safety, by making available and using web-based patient safety training resources and information. Taking advantage of the possibilities offered by the Internet in terms of training, two online self-training tutorials were developed on risk management, patient safety and adverse event prevention. A Newsletter was also launched, together with two specific patient safety Supplements. Moreover, to extend the reach of the PS Strategy, a patient safety web page and weblog were created, in addition to a collaborative (internal) working group tool. Excelenciaclinica.net was also developed; a meta-search engine specialized in evidence-based information for health professionals, to make it easier to access reliable and valuable information. Health professionals were also allowed to consult, free of charge, reliable health information resources, such as the GuiaSalud platform, the Cochrane Library Plus and the resources of the Joanna Briggs Institute. The involvement of health professionals in these measures and the role that these measures may be expected to play in the development of a premium-quality health service.

Strategies to promote practice nurse capacity to deliver evidence-based care: An example from sexual healthcare.

PubMed

Dadich, Ann; Abbott, Penny; Hosseinzadeh, Hassan

2015-01-01

Evidence-based practice is pivotal to effective patient care. However, its translation into practice remains limited. Given the central role of primary care in many healthcare systems, it is important to identify strategies that bolster clinician-capacity to promote evidence-based care. The purpose of this paper is to identify strategies to increase Practice Nurse capacity to promote evidence-based sexual healthcare within general practice. A survey of 217 Practice Nurses in an Australian state and ten respondent-interviews regarding two resources to promote evidence-based sexual healthcare - namely, a clinical aide and online training. The perceived impact of both resources was determined by views on relevance and design - particularly for the clinical aide. Resource-use was influenced by role and responsibilities within the workplace, accessibility, and support from patients and colleagues. This is the first Australian study to reveal strategies to promote evidence-based sexual healthcare among Practice Nurses. The findings provide a platform for future research on knowledge translation processes, particularly among clinicians who might be disengaged from sexual healthcare. Given the benefits of evidence-based practices, it is important that managers recognize their role, and the role of their services, in promoting these. Without explicit support for evidence-based care and recognition of the Practice Nurse role in such care, knowledge translation is likely to be limited. Knowledge translation among Practice Nurses can be facilitated by: resources-deemed informative, relevant, and user-friendly, as well as support from patients, colleagues, and their workplace.

The Role of the Health Information Manager in a Research-Based Information Technology Project.

PubMed

Freyne, Alice

2009-06-01

Information technology advances in healthcare provide many and varied opportunities for the Health Information Manager. Here is one example involving a Melbourne-based research project and an innovative approach to patient information delivery. The research project area of study is multimedia content delivery in the following applications: as an adjunct to the surgical informed consent process, patient information or instruction presentation and clinical education. The objective is to develop evidence-based, effective and accessible information and knowledge resources for patients and health care providers.

[Access control management in electronic health records: a systematic literature review].

PubMed

Carrión Señor, Inmaculada; Fernández Alemán, José Luis; Toval, Ambrosio

2012-01-01

This study presents the results of a systematic literature review of aspects related to access control in electronic health records systems, wireless security and privacy and security training for users. Information sources consisted of original articles found in Medline, ACM Digital Library, Wiley InterScience, IEEE Digital Library, Science@Direct, MetaPress, ERIC, CINAHL and Trip Database, published between January 2006 and January 2011. A total of 1,208 articles were extracted using a predefined search string and were reviewed by the authors. The final selection consisted of 24 articles. Of the selected articles, 21 dealt with access policies in electronic health records systems. Eleven articles discussed whether access to electronic health records should be granted by patients or by health organizations. Wireless environments were only considered in three articles. Finally, only four articles explicitly mentioned that technical training of staff and/or patients is required. Role-based access control is the preferred mechanism to deploy access policy by the designers of electronic health records. In most systems, access control is managed by users and health professionals, which promotes patients' right to control personal information. Finally, the security of wireless environments is not usually considered. However, one line of research is eHealth in mobile environments, called mHealth. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

Impact of Socioeconomic Inequality on Access, Adherence, and Outcomes of Antiretroviral Treatment Services for People Living with HIV/AIDS in Vietnam

PubMed Central

Nguyen, Long Hoang; Nguyen, Anh Tuan; Latkin, Noah Reed Knowlton; Tran, Ngoc Kim; Minh Thuc, Vu Thi; Nguyen, Huong Lan Thi; Phan, Huong Thu Thi; Le, Huong Thi; Tran, Tho Dinh; Latkin, Carl A.

2016-01-01

Background Ensuring an equal benefit across different patient groups is necessary while scaling up free-of-charge antiretroviral treatment (ART) services. This study aimed to measure the disparity in access, adherence, and outcomes of ART in Vietnam and the effects of socioeconomic status (SES) characteristics on the levels of inequality. Methods A cross-sectional study was conducted in 1133 PLWH in Vietnam. ART access, adherence, and treatment outcomes were self-reported using a structured questionnaire. Wealth-related inequality was calculated using a concentration index, and a decomposition analysis was used to determine the contribution of each SES variable to inequality in access, adherence, and outcomes of ART. Results Based on SES, minor inequality was found in ART access and adherence while there was considerable inequality in ART outcomes. Poor people were more likely to start treatment early, while rich people had better adherence and overall treatment outcomes. Decomposition revealed that occupation and education played important roles in inequality in ART access, adherence, and treatment outcomes Conclusion The findings suggested that health services should be integrated into the ART regimen. Furthermore, occupational orientation and training courses should be provided to reduce inequality in ART access, adherence, and treatment outcomes. PMID:28005937

Profiling of the Terpene Metabolome in Carrot Fruits of Wild ( Daucus carota L. ssp. carota) Accessions and Characterization of a Geraniol Synthase.

PubMed

Yahyaa, Mosaab; Ibdah, Muhammad; Marzouk, Sally; Ibdah, Mwafaq

2018-03-14

Fruits from wild carrot ( Daucus carota L. ssp. carota) have been used for medicinal purposes since ancient times. The oil of its seeds, with their abundant monoterpenes and sesquiterpenes, has drawn attention in recent years because of its potential pharmaceutical application. A combined chemical, biochemical, and molecular study was conducted to evaluate the differential accumulation of terpene volatiles in carrot fruits of wild accessions. This work reports a similarity-based cloning strategy identification and functional characterization of one carrot monoterpene terpene synthase, WtDcTPS1. Recombinant WtDcTPS1 protein produces mainly geraniol, the predominant monoterpene in carrot seeds of wild accession 23727. The results suggest a role for the WtDcTPS1 gene in the biosynthesis of carrot fruit aroma and flavor compounds.

AFLP-based genetic diversity assessment of commercially important tea germplasm in India.

PubMed

Sharma, R K; Negi, M S; Sharma, S; Bhardwaj, P; Kumar, R; Bhattachrya, E; Tripathi, S B; Vijayan, D; Baruah, A R; Das, S C; Bera, B; Rajkumar, R; Thomas, J; Sud, R K; Muraleedharan, N; Hazarika, M; Lakshmikumaran, M; Raina, S N; Ahuja, P S

2010-08-01

India has a large repository of important tea accessions and, therefore, plays a major role in improving production and quality of tea across the world. Using seven AFLP primer combinations, we analyzed 123 commercially important tea accessions representing major populations in India. The overall genetic similarity recorded was 51%. No significant differences were recorded in average genetic similarity among tea populations cultivated in various geographic regions (northwest 0.60, northeast and south both 0.59). UPGMA cluster analysis grouped the tea accessions according to geographic locations, with a bias toward China or Assam/Cambod types. Cluster analysis results were congruent with principal component analysis. Further, analysis of molecular variance detected a high level of genetic variation (85%) within and limited genetic variation (15%) among the populations, suggesting their origin from a similar genetic pool.

Fine-grained policy control in U.S. Army Research Laboratory (ARL) multimodal signatures database

NASA Astrophysics Data System (ADS)

Bennett, Kelly; Grueneberg, Keith; Wood, David; Calo, Seraphin

2014-06-01

The U.S. Army Research Laboratory (ARL) Multimodal Signatures Database (MMSDB) consists of a number of colocated relational databases representing a collection of data from various sensors. Role-based access to this data is granted to external organizations such as DoD contractors and other government agencies through a client Web portal. In the current MMSDB system, access control is only at the database and firewall level. In order to offer finer grained security, changes to existing user profile schemas and authentication mechanisms are usually needed. In this paper, we describe a software middleware architecture and implementation that allows fine-grained access control to the MMSDB at a dataset, table, and row level. Result sets from MMSDB queries issued in the client portal are filtered with the use of a policy enforcement proxy, with minimal changes to the existing client software and database. Before resulting data is returned to the client, policies are evaluated to determine if the user or role is authorized to access the data. Policies can be authored to filter data at the row, table or column level of a result set. The system uses various technologies developed in the International Technology Alliance in Network and Information Science (ITA) for policy-controlled information sharing and dissemination1. Use of the Policy Management Library provides a mechanism for the management and evaluation of policies to support finer grained access to the data in the MMSDB system. The GaianDB is a policy-enabled, federated database that acts as a proxy between the client application and the MMSDB system.

Brokering the Evidence-Practice Gap: A Strategy for Moving Evidence Into Clinical Practice.

PubMed

Segre, Lisa S; Trusty, Stephanie; Gullickson, Renee; Chuffo Davila, Rebecca; O'Hara, Michael W

2018-05-08

Moving novel, evidence-based interventions into broad community use is challenging. This column describes how a midlevel public health administrator acted in the role of broker to link university-based researchers with maternal health clinical staff to successfully implement an innovative, evidence-based maternal depression treatment. Program evaluation assessed adoption, implementation, reach, and effectiveness. In reflecting on this partnership, the broker provided critical elements of access, credibility, and accountability. A partnership between service providers and research teams provides one strategy to disseminate evidence-based practices among those served by public-health programs.

The College Choice Process: A Qualitative Review of the Role of Parents in Freshman, First Generation Scholarship Recipients' Access to Higher Education

ERIC Educational Resources Information Center

Hebert, Ronald Dudley, Jr.

2017-01-01

This dissertation explores the role of parents in freshman, first generation scholarship recipients' access to higher education. Three overarching goals guide the research: To gain knowledge and a better understanding of the college choice process of freshman, first generation scholarship recipients; to better understand the role of parents in the…

Design and implementation of embedded un-interruptible power supply system (EUPSS) for web-based mobile application

NASA Astrophysics Data System (ADS)

Zhang, De-gan; Zhang, Xiao-dan

2012-11-01

With the growth of the amount of information manipulated by embedded application systems, which are embedded into devices and offer access to the devices on the internet, the requirements of saving the information systemically is necessary so as to fulfil access from the client and the local processing more efficiently. For supporting mobile applications, a design and implementation solution of embedded un-interruptible power supply (UPS) system (in brief, EUPSS) is brought forward for long-distance monitoring and controlling of UPS based on Web. The implementation of system is based on ATmega161, RTL8019AS and Arm chips with TCP/IP protocol suite for communication. In the embedded UPS system, an embedded file system is designed and implemented which saves the data and index information on a serial EEPROM chip in a structured way and communicates with a microcontroller unit through I2C bus. By embedding the file system into UPS system or other information appliances, users can access and manipulate local data on the web client side. Embedded file system on chips will play a major role in the growth of IP networking. Based on our experiment tests, the mobile users can easily monitor and control UPS in different places of long-distance. The performance of EUPSS has satisfied the requirements of all kinds of Web-based mobile applications.

Modeling Social Capital as Dynamic Networks to Promote Access to Oral Healthcare

PubMed Central

Northridge, Mary E.; Kunzel, Carol; Zhang, Qiuyi; Kum, Susan S.; Gilbert, Jessica L.; Jin, Zhu; Metcalf, Sara S.

2016-01-01

Social capital, as comprised of human connections in social networks and their associated benefits, is closely related to the health of individuals, communities, and societies at large. For disadvantaged population groups such as older adults and racial/ethnic minorities, social capital may play a particularly critical role in mitigating the negative effects and reinforcing the positive effects on health. In this project, we model social capital as both cause and effect by simulating dynamic networks. Informed in part by a community-based health promotion program, an agent-based model is contextualized in a GIS environment to explore the complexity of social disparities in oral and general health as experienced at the individual, interpersonal, and community scales. This study provides the foundation for future work investigating how health and healthcare accessibility may be influenced by social networks. PMID:27668298

Modeling Social Capital as Dynamic Networks to Promote Access to Oral Healthcare.

PubMed

Wang, Hua; Northridge, Mary E; Kunzel, Carol; Zhang, Qiuyi; Kum, Susan S; Gilbert, Jessica L; Jin, Zhu; Metcalf, Sara S

2016-01-01

Social capital, as comprised of human connections in social networks and their associated benefits, is closely related to the health of individuals, communities, and societies at large. For disadvantaged population groups such as older adults and racial/ethnic minorities, social capital may play a particularly critical role in mitigating the negative effects and reinforcing the positive effects on health. In this project, we model social capital as both cause and effect by simulating dynamic networks. Informed in part by a community-based health promotion program, an agent-based model is contextualized in a GIS environment to explore the complexity of social disparities in oral and general health as experienced at the individual, interpersonal, and community scales. This study provides the foundation for future work investigating how health and healthcare accessibility may be influenced by social networks.

A Further Evaluation of Bridge Roles: Regional and National Organizations for Dissemination of Computer-Oriented Curriculum Materials for Higher Education.

ERIC Educational Resources Information Center

Dank, Joseph R.

Several things must be done before a critical mass of computer-based materials can form a library. Existing materials must be upgraded, and made accessible, flexible and customized for individual users. Their mobility must be increased by reconciling inter-system differences and by providing necessary skills, resources and reward structures.…

Opportunities in the Affordable Care Act to Advance Long-Term Services and Supports: The Role of Rehabilitation Counseling

ERIC Educational Resources Information Center

Caldwell, Joe; Alston, Reginald J.

2012-01-01

The Affordable Care Act includes many new provisions for long-term services and supports (LTSS). Among these are several new options, improvements, and incentives within Medicaid to balance service systems and expand access to home and community-based services. This article discusses some of the major provisions, implementations, and implications…

Language and Content "Integration": The Affordances of Additional Languages as a Tool within a Single Curriculum Space

ERIC Educational Resources Information Center

Cross, Russell

2016-01-01

"Language across the curriculum" has been pivotal in establishing a knowledge base on the role of language for accessing opportunities afforded by the curriculum. Yet, the ubiquity of language "within" all facets of human activity--not least of all the more abstract domains of thinking and relating with others--can easily…

The Role of Student Learning Outcomes for Institutional Accountability and Transparency. Pathways to College Network Brief

ERIC Educational Resources Information Center

Pathways to College Network, 2012

2012-01-01

The national focus on college completion has prompted a number of ambitious education goals, numerous research- and practice-based initiatives, and a spotlight on the need to continually improve higher education access and success. This national dialogue has raised not only public and political will for postsecondary completion, but also a number…

Training in Parent Consultation Skills for Primary Care Practitioners in Early Intervention in the Pre-School Context.

ERIC Educational Resources Information Center

Crisante, Lea

2003-01-01

Describes the implementation of a brief behavioral intervention, based on the Triple P-Positive Parenting Program, by 13 pre-school practitioners with 39 parents. The results point to the role of primary care practitioners in providing services in settings that are easily accessed by parents, thus increasing the availability of support to parents…

Inside the Digital Wild West: How School Leaders Both Access and Avoid Social Media

ERIC Educational Resources Information Center

Corrigan, Laurie; Robertson, Lorayne

2015-01-01

This study examines the roles of Canadian school leaders in response to the rising phenomenon of student use of social media which impacts school climate and safety. The use of social media has resulted in more online text and image-based communication to multiple users and less face-to-face communication with single users. Adolescent…

Learning to Work during Work Placement: Negotiating Access to Work and Participation through "Origination" and Establishing a "Legitimate Presence"

ERIC Educational Resources Information Center

Pang, Priscilla

2015-01-01

Research on work-based learning has produced much insight into how newcomers to work roles acquire the skills and knowledge required in their work. Overwhelmingly, studies have shown that learning takes place through participation in work activities which provides opportunities for learning. But participation can be problematic when workers and…

A registry-based randomized trial comparing radial and femoral approaches in women undergoing percutaneous coronary intervention: the SAFE-PCI for Women (Study of Access Site for Enhancement of PCI for Women) trial.

PubMed

Rao, Sunil V; Hess, Connie N; Barham, Britt; Aberle, Laura H; Anstrom, Kevin J; Patel, Tejan B; Jorgensen, Jesse P; Mazzaferri, Ernest L; Jolly, Sanjit S; Jacobs, Alice; Newby, L Kristin; Gibson, C Michael; Kong, David F; Mehran, Roxana; Waksman, Ron; Gilchrist, Ian C; McCourt, Brian J; Messenger, John C; Peterson, Eric D; Harrington, Robert A; Krucoff, Mitchell W

2014-08-01

This study sought to determine the effect of radial access on outcomes in women undergoing percutaneous coronary intervention (PCI) using a registry-based randomized trial. Women are at increased risk of bleeding and vascular complications after PCI. The role of radial access in women is unclear. Women undergoing cardiac catheterization or PCI were randomized to radial or femoral arterial access. Data from the CathPCI Registry and trial-specific data were merged into a final study database. The primary efficacy endpoint was Bleeding Academic Research Consortium type 2, 3, or 5 bleeding or vascular complications requiring intervention. The primary feasibility endpoint was access site crossover. The primary analysis cohort was the subgroup undergoing PCI; sensitivity analyses were conducted in the total randomized population. The trial was stopped early for a lower than expected event rate. A total of 1,787 women (691 undergoing PCI) were randomized at 60 sites. There was no significant difference in the primary efficacy endpoint between radial or femoral access among women undergoing PCI (radial 1.2% vs. 2.9% femoral, odds ratio [OR]: 0.39; 95% confidence interval [CI]: 0.12 to 1.27); among women undergoing cardiac catheterization or PCI, radial access significantly reduced bleeding and vascular complications (0.6% vs. 1.7%; OR: 0.32; 95% CI: 0.12 to 0.90). Access site crossover was significantly higher among women assigned to radial access (PCI cohort: 6.1% vs. 1.7%; OR: 3.65; 95% CI: 1.45 to 9.17); total randomized cohort: (6.7% vs. 1.9%; OR: 3.70; 95% CI: 2.14 to 6.40). More women preferred radial access. In this pragmatic trial, which was terminated early, the radial approach did not significantly reduce bleeding or vascular complications in women undergoing PCI. Access site crossover occurred more often in women assigned to radial access. (SAFE-PCI for Women; NCT01406236). Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Early intensive behavioral intervention: Emergence of a consumer-driven service model

PubMed Central

Jacobson, John W.

2000-01-01

Parents are becoming influential stimulators and shapers of public policy in regard to educational services for their children. Increasingly, this advocacy has created a controversy about the role of applied behavior analysis as a foundation for early intensive behavioral intervention in autism. Uncertainties exist in policy regarding the role of behavior analysis in early intervention and the capacity of behavior analysis to field a trained work force. Based on contacts with parents of children with autism and information available in a variety of forms on the Internet, there is a rising demand for fundamentally better early intervention services that are available and accessible, provide active intervention, and are based on principles of behavior analysis. Contemporary movements in special and early education, however, appear to be nonconducive to scientifically based treatments, and school districts seem hostile to an increasing role for behavior analysis and to the establishment of services that are responsive to changing parental priorities for the education of their children with autism and related disorders. PMID:22478344

Central venous access in children: indications, devices, and risks.

PubMed

Ares, Guillermo; Hunter, Catherine J

2017-06-01

Central venous catheters (CVCs) have a prominent role in the diagnostic and therapy of neonates and children. Herein, we describe the multiple indications for CVC use and the different devices available for central venous access. Given the prevalent use of CVCs, healthcare systems are focused on reducing complications from their use, particularly central line-associated bloodstream infections (CLABSIs). The most up-to-date information available sheds light on best practices and future areas of investigation. Large systematic reviews of randomized trials suggest that ultrasound guidance for placement of CVCs in children is safer than using blind technique, at least for internal jugular vein access. Appropriate catheter tip placement is associated with decreased complications. Furthermore, the prophylactic use of ethanol lock between cycles of parenteral nutrition administration has reduced the rates of CLABSI. A recent randomized trial in pediatric CVCs showed a benefit with antibiotic-coated CVCs. Based on the available evidence, multiple techniques for CVC placement are still valid, including the landmark technique based on practitioner experience, but ultrasound guidance has been shown to decrease complications from line placement. Adherence to CVC care protocols is essential in reducing infectious complications.

A ROle-Oriented Filtering (ROOF) approach for collaborative recommendation

NASA Astrophysics Data System (ADS)

Ghani, Imran; Jeong, Seung Ryul

2016-09-01

In collaborative filtering (CF) recommender systems, existing techniques frequently focus on determining similarities among users' historical interests. This generally refers to situations in which each user normally plays a single role and his/her taste remains consistent over the long term. However, we note that existing techniques have not been significantly employed in a role-oriented context. This is especially so in situations where users may change their roles over time or play multiple roles simultaneously, while still expecting to access relevant information resources accordingly. Such systems include enterprise architecture management systems, e-commerce sites or journal management systems. In scenarios involving existing techniques, each user needs to build up very different profiles (preferences and interests) based on multiple roles which change over time. Should this not occur to a satisfactory degree, their previous information will either be lost or not utilised at all. To limit the occurrence of such issues, we propose a ROle-Oriented Filtering (ROOF) approach focusing on the manner in which multiple user profiles are obtained and maintained over time. We conducted a number of experiments using an enterprise architecture management scenario. In so doing, we observed that the ROOF approach performs better in comparison with other existing collaborative filtering-based techniques.

Arteriovenous Vascular Access Selection and Evaluation

PubMed Central

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

2016-01-01

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

The Quality of Open-Access Video-Based Orthopaedic Instructional Content for the Shoulder Physical Exam is Inconsistent.

PubMed

Urch, Ekaterina; Taylor, Samuel A; Cody, Elizabeth; Fabricant, Peter D; Burket, Jayme C; O'Brien, Stephen J; Dines, David M; Dines, Joshua S

2016-10-01

The internet has an increasing role in both patient and physician education. While several recent studies critically appraised the quality and accuracy of web-based written information available to patients, no studies have evaluated such parameters for open-access video content designed for provider use. The primary goal of the study was to determine the accuracy of internet-based instructional videos featuring the shoulder physical examination. An assessment of quality and accuracy of said video content was performed using the basic shoulder examination as a surrogate for the "best-case scenario" due to its widely accepted components that are stable over time. Three search terms ("shoulder," "examination," and "shoulder exam") were entered into the four online video resources most commonly accessed by orthopaedic surgery residents (VuMedi, G9MD, Orthobullets, and YouTube). Videos were captured and independently reviewed by three orthopaedic surgeons. Quality and accuracy were assessed in accordance with previously published standards. Of the 39 video tutorials reviewed, 61% were rated as fair or poor. Specific maneuvers such as the Hawkins test, O'Brien sign, and Neer impingement test were accurately demonstrated in 50, 36, and 27% of videos, respectively. Inter-rater reliability was excellent (mean kappa 0.80, range 0.79-0.81). Our results suggest that information presented in open-access video tutorials featuring the physical examination of the shoulder is inconsistent. Trainee exposure to such potentially inaccurate information may have a significant impact on trainee education.

Intraspecific plant-soil feedback and intraspecific overyielding in Arabidopsis thaliana.

PubMed

Bukowski, Alexandra R; Petermann, Jana S

2014-06-01

Understanding the mechanisms of community coexistence and ecosystem functioning may help to counteract the current biodiversity loss and its potentially harmful consequences. In recent years, plant-soil feedback that can, for example, be caused by below-ground microorganisms has been suggested to play a role in maintaining plant coexistence and to be a potential driver of the positive relationship between plant diversity and ecosystem functioning. Most of the studies addressing these topics have focused on the species level. However, in addition to interspecific interactions, intraspecific interactions might be important for the structure of natural communities. Here, we examine intraspecific coexistence and intraspecific diversity effects using 10 natural accessions of the model species Arabidopsis thaliana (L.) Heynh. We assessed morphological intraspecific diversity by measuring several above- and below-ground traits. We performed a plant-soil feedback experiment that was based on these trait differences between the accessions in order to determine whether A. thaliana experiences feedback at intraspecific level as a result of trait differences. We also experimentally tested the diversity-productivity relationship at intraspecific level. We found strong differences in above- and below-ground traits between the A. thaliana accessions. Overall, plant-soil feedback occurred at intraspecific level. However, accessions differed in the direction and strength of this feedback: Some accessions grew better on their own soils, some on soils from other accessions. Furthermore, we found positive diversity effects within A. thaliana: Accession mixtures produced a higher total above-ground biomass than accession monocultures. Differences between accessions in their feedback response could not be explained by morphological traits. Therefore, we suggest that they might have been caused by accession-specific accumulated soil communities, by root exudates, or by accession-specific resource use based on genetic differences that are not expressed in morphological traits. Synthesis. Our results provide some of the first evidence for intraspecific plant-soil feedback and intraspecific overyielding. These findings may have wider implications for the maintenance of variation within species and the importance of this variation for ecosystem functioning. Our results highlight the need for an increased focus on intraspecific processes in plant diversity research to fully understand the mechanisms of coexistence and ecosystem functioning.

Intraspecific plant–soil feedback and intraspecific overyielding in Arabidopsis thaliana

PubMed Central

Bukowski, Alexandra R; Petermann, Jana S

2014-01-01

Understanding the mechanisms of community coexistence and ecosystem functioning may help to counteract the current biodiversity loss and its potentially harmful consequences. In recent years, plant–soil feedback that can, for example, be caused by below-ground microorganisms has been suggested to play a role in maintaining plant coexistence and to be a potential driver of the positive relationship between plant diversity and ecosystem functioning. Most of the studies addressing these topics have focused on the species level. However, in addition to interspecific interactions, intraspecific interactions might be important for the structure of natural communities. Here, we examine intraspecific coexistence and intraspecific diversity effects using 10 natural accessions of the model species Arabidopsis thaliana (L.) Heynh. We assessed morphological intraspecific diversity by measuring several above- and below-ground traits. We performed a plant–soil feedback experiment that was based on these trait differences between the accessions in order to determine whether A. thaliana experiences feedback at intraspecific level as a result of trait differences. We also experimentally tested the diversity–productivity relationship at intraspecific level. We found strong differences in above- and below-ground traits between the A. thaliana accessions. Overall, plant–soil feedback occurred at intraspecific level. However, accessions differed in the direction and strength of this feedback: Some accessions grew better on their own soils, some on soils from other accessions. Furthermore, we found positive diversity effects within A. thaliana: Accession mixtures produced a higher total above-ground biomass than accession monocultures. Differences between accessions in their feedback response could not be explained by morphological traits. Therefore, we suggest that they might have been caused by accession-specific accumulated soil communities, by root exudates, or by accession-specific resource use based on genetic differences that are not expressed in morphological traits. Synthesis. Our results provide some of the first evidence for intraspecific plant–soil feedback and intraspecific overyielding. These findings may have wider implications for the maintenance of variation within species and the importance of this variation for ecosystem functioning. Our results highlight the need for an increased focus on intraspecific processes in plant diversity research to fully understand the mechanisms of coexistence and ecosystem functioning. PMID:25360284

Reticulate evolution and incomplete lineage sorting among the ponderosa pines.

PubMed

Willyard, Ann; Cronn, Richard; Liston, Aaron

2009-08-01

Interspecific gene flow via hybridization may play a major role in evolution by creating reticulate rather than hierarchical lineages in plant species. Occasional diploid pine hybrids indicate the potential for introgression, but reticulation is hard to detect because ancestral polymorphism is still shared across many groups of pine species. Nucleotide sequences for 53 accessions from 17 species in subsection Ponderosae (Pinus) provide evidence for reticulate evolution. Two discordant patterns among independent low-copy nuclear gene trees and a chloroplast haplotype are better explained by introgression than incomplete lineage sorting or other causes of incongruence. Conflicting resolution of three monophyletic Pinus coulteri accessions is best explained by ancient introgression followed by a genetic bottleneck. More recent hybridization transferred a chloroplast from P. jeffreyi to a sympatric P. washoensis individual. We conclude that incomplete lineage sorting could account for other examples of non-monophyly, and caution against any analysis based on single-accession or single-locus sampling in Pinus.

The impact of blended learning on student performance in a cardiovascular pharmacotherapy course.

PubMed

McLaughlin, Jacqueline E; Gharkholonarehe, Nastaran; Khanova, Julia; Deyo, Zach M; Rodgers, Jo E

2015-03-25

To examine student engagement with, perception of, and performance resulting from blended learning for venous thromboembolism in a required cardiovascular pharmacotherapy course for second-year students. In 2013, key foundational content was packaged into an interactive online module for students to access prior to coming to class; class time was dedicated to active-learning exercises. Students who accessed all online module segments participated in more in class clicker questions (p=0.043) and performed better on the examination (p=0.023). There was no difference in clicker participation or examination performance based on time of module access (prior to or after class). The majority of participants agreed or strongly agreed that foundational content learned prior to class, applied activities during class, and content-related questions in the online module greatly enhanced learning. This study highlights the importance of integrating online modules with classroom learning and the role of blended learning in improving academic performance.

Influence of the membrane lipophilic environment on the structure and on the substrate access/egress routes of the human aromatase enzyme. A computational study.

PubMed

Sgrignani, Jacopo; Magistrato, Alessandra

2012-06-25

Human aromatase (HA), an enzyme located on the membrane of the endoplasmatic reticulum, is of crucial biological importance in the biosynthesis of estrogens. High levels of estrogens are related with important pathologies, conferring to HA a key role as a pharmacological target. In this study we provide, for the first time, an atomistic model of HA embedded on a membrane model to understand the influence of the membrane lipophilic environment on the structural and dynamical properties of HA and on the access/egress pathways of the substrate (androstenedione, ASD) and of the oxygen molecule (involved in the enzymatic process) into/from the HA active site. To this end we used several computational techniques such as force field-based molecular dynamics (MD) simulations, Random Expulsion MD, Steered MD, and Implicit Ligand Sampling. Our results show that the membrane anchoring does not markedly affect the structural properties and the flexibility of the protein, but they clearly point out that the membrane has a marked effect on the access/egress routes of the reactants, stabilizing the formation of different channels for both ASD and O(2) with respect to those observed in pure water solution. Due to the importance of HA in medicine and since access/egress channels may influence its substrate selectivity, a detailed understanding of the role of the membrane in shaping these channels may be of valuable help in drug design.

Prioritizing health disparities in medical education to improve care

PubMed Central

Awosogba, Temitope; Betancourt, Joseph R.; Conyers, F. Garrett; Estapé, Estela S.; Francois, Fritz; Gard, Sabrina J.; Kaufman, Arthur; Lunn, Mitchell R.; Nivet, Marc A.; Oppenheim, Joel D.; Pomeroy, Claire; Yeung, Howa

2015-01-01

Despite yearly advances in life-saving and preventive medicine, as well as strategic approaches by governmental and social agencies and groups, significant disparities remain in health, health quality, and access to health care within the United States. The determinants of these disparities include baseline health status, race and ethnicity, culture, gender identity and expression, socioeconomic status, region or geography, sexual orientation, and age. In order to renew the commitment of the medical community to address health disparities, particularly at the medical school level, we must remind ourselves of the roles of doctors and medical schools as the gatekeepers and the value setters for medicine. Within those roles are responsibilities toward the social mission of working to eliminate health disparities. This effort will require partnerships with communities as well as with academic centers to actively develop and to implement diversity and inclusion strategies. Besides improving the diversity of trainees in the pipeline, access to health care can be improved, and awareness can be raised regarding population-based health inequalities. PMID:23659676

Authentication Architecture for Region-Wide e-Health System with Smartcards and a PKI

NASA Astrophysics Data System (ADS)

Zúquete, André; Gomes, Helder; Cunha, João Paulo Silva

This paper describes the design and implementation of an e-Health authentication architecture using smartcards and a PKI. This architecture was developed to authenticate e-Health Professionals accessing the RTS (Rede Telemática da Saúde), a regional platform for sharing clinical data among a set of affiliated health institutions. The architecture had to accommodate specific RTS requirements, namely the security of Professionals' credentials, the mobility of Professionals, and the scalability to accommodate new health institutions. The adopted solution uses short-lived certificates and cross-certification agreements between RTS and e-Health institutions for authenticating Professionals accessing the RTS. These certificates carry as well the Professional's role at their home institution for role-based authorization. Trust agreements between e-Health institutions and RTS are necessary in order to make the certificates recognized by the RTS. As a proof of concept, a prototype was implemented with Windows technology. The presented authentication architecture is intended to be applied to other medical telematic systems.

Installing computers in older adults' homes and teaching them to access a patient education web site: a systematic approach.

PubMed

Dauz, Emily; Moore, Jan; Smith, Carol E; Puno, Florence; Schaag, Helen

2004-01-01

This article describes the experiences of nurses who, as part of a large clinical trial, brought the Internet into older adults' homes by installing a computer, if needed, and connecting to a patient education Web site. Most of these patients had not previously used the Internet and were taught even basic computer skills when necessary. Because of increasing use of the Internet in patient education, assessment, and home monitoring, nurses in various roles currently connect with patients to monitor their progress, teach about medications, and answer questions about appointments and treatments. Thus, nurses find themselves playing the role of technology managers for patients with home-based Internet connections. This article provides step-by-step procedures for computer installation and training in the form of protocols, checklists, and patient user guides. By following these procedures, nurses can install computers, arrange Internet access, teach and connect to their patients, and prepare themselves to install future generations of technological devices.

Shared Medical Imaging Repositories.

PubMed

Lebre, Rui; Bastião, Luís; Costa, Carlos

2018-01-01

This article describes the implementation of a solution for the integration of ownership concept and access control over medical imaging resources, making possible the centralization of multiple instances of repositories. The proposed architecture allows the association of permissions to repository resources and delegation of rights to third entities. It includes a programmatic interface for management of proposed services, made available through web services, with the ability to create, read, update and remove all components resulting from the architecture. The resulting work is a role-based access control mechanism that was integrated with Dicoogle Open-Source Project. The solution has several application scenarios like, for instance, collaborative platforms for research and tele-radiology services deployed at Cloud.

Framework and prototype for a secure XML-based electronic health records system.

PubMed

Steele, Robert; Gardner, William; Chandra, Darius; Dillon, Tharam S

2007-01-01

Security of personal medical information has always been a challenge for the advancement of Electronic Health Records (EHRs) initiatives. eXtensible Markup Language (XML), is rapidly becoming the key standard for data representation and transportation. The widespread use of XML and the prospect of its use in the Electronic Health (e-health) domain highlights the need for flexible access control models for XML data and documents. This paper presents a declarative access control model for XML data repositories that utilises an expressive XML role control model. The operational semantics of this model are illustrated by Xplorer, a user interface generation engine which supports search-browse-navigate activities on XML repositories.

BUILD: A community development simulation game, appendix A

NASA Technical Reports Server (NTRS)

Orlando, J. A.; Pennington, A. J.

1973-01-01

The computer based urban decision-making game BUILD is described. BUILD is aimed at: (1) allowing maximum expression of value positions by participants through resolution of intense, task-oriented conflicts: (2) heuristically gathering information on both the technical and social functioning of the city through feedback from participants: (3) providing community participants with access to technical expertise in urban decision making, and to expose professionals to the value positions of the community: and (4) laying the groundwork for eventual development of an actual policy making tool. A brief description of the roles, sample input/output formats, an initial scenario, and information on accessing the game through a time-sharing system are included.

Role of Al2O3 thin layer on improving the resistive switching properties of Ta5Si3-based conductive bridge random accesses memory device

NASA Astrophysics Data System (ADS)

Kumar, Dayanand; Aluguri, Rakesh; Chand, Umesh; Tseng, Tseung-Yuen

2018-04-01

Ta5Si3-based conductive bridge random access memory (CBRAM) devices have been investigated to improve their resistive switching characteristics for their application in future nonvolatile memory technology. Changes in the switching characteristics by the addition of a thin Al2O3 layer of different thicknesses at the bottom electrode interface of a Ta5Si3-based CBRAM devices have been studied. The double-layer device with a 1 nm Al2O3 layer has shown improved resistive switching characteristics over the single layer one with a high on/off resistance ratio of 102, high endurance of more than 104 cycles, and good retention for more than 105 s at the temperature of 130 °C. The higher thermal conductivity of Al2O3 over Ta5Si3 has been attributed to the enhanced switching properties of the double-layer devices.

Animacy-Based Accessibility and Competition in Relative Clause Production in Hindi and Malayalam.

PubMed

Perera, C K; Srivastava, A K

2016-08-01

Two studies investigated interaction of animacy-based accessibility and competition processes with language specific constraints in shaping production preferences. Relative clause elicitation tasks (Gennari et al. in Cogn Psychol 65:141-176, 2012) were performed by two groups with 40 participants in each. Significantly more passives were produced with animate question/focus and assigned subject function to them in Malayalam, while the difference was insignificant in Hindi with animacy not equating with grammatical function assignment. Both languages produced active objects with OSV order significantly more with animate question/focus. This indicates animacy effect on word order. Animacy also influenced the expression of the agent phase in both languages as a tendency was found to omit the agent by-phase or to delay its appearance, when the two animate nouns entering into the structure are highly similar. The results point to language specific constraints in relative clause production and variability in the role of animacy-based retrieval order across languages.

The influence of gender roles on health seeking behaviour during pregnancy in Turkey.

PubMed

Ay, Pinar; Hayran, Osman; Topuzoglu, Ahmet; Hidiroglu, Seyhan; Coskun, Anahit; Save, Dilsad; Nalbant, Hacer; Ozdemir, Erhan; Eker, Levent

2009-08-01

To explore the impact of gender roles in relation to health seeking behaviour during pregnancy and childbirth. The study was conducted in neighbourhoods with low antenatal care rates in three provinces of Turkey. The study population consisted of pregnant women who never got or discontinued antenatal care and their peers, families and community leaders. Sixteen focus group discussions and 125 in-depth interviews were conducted with a total of 239 participants. Pregnancy and childbirth are interwoven strongly with gender roles. Since the patriarchal system acknowledges women through the means of childbirth, women are expected to have many children. Hence women experience pregnancy as a burden and are not motivated to seek antenatal care. During pregnancy, only 'serious' conditions are considered as legitimate reasons for accessing care. However, the decision regarding whether a pregnant woman is seriously sick or not belongs to the responsibilities of elder women, which delays service use. Providing information regarding the value of antenatal care also to elder women is essential in increasing the demand to the services. Incorporating gender perspectives into daily health practice and maintaining access to high quality reproductive care services are vital in reducing the gender based barriers to care.

Implementing Role-Changing Versus Time-Changing Innovations in Health Care: Differences in Helpfulness of Staff Improvement Teams, Management, and Network for Learning.

PubMed

Nembhard, Ingrid M; Morrow, Christopher T; Bradley, Elizabeth H

2015-12-01

Health care organizations often fail in their effort to implement care-improving innovations. This article differentiates role-changing innovations, altering what workers do, from time-changing innovations, altering when tasks are performed or for how long. We examine our hypothesis that the degree to which access to groups that can alter organizational learning--staff, management, and external network--facilitates implementation depends on innovation type. Our longitudinal study using ordinal logistic regression and survey data on 517 hospitals' implementation of evidence-based practices for treating heart attack confirmed our thesis for factors granting access to each group: improvement team's representativeness (of affected staff), senior management engagement, and network membership. Although team representativeness and network membership were positively associated with implementing role-changing practices, senior management engagement was not. In contrast, senior management engagement was positively associated with implementing time-changing practices, whereas team representativeness was not, and network membership was not unless there was limited management engagement. These findings advance implementation science by explaining mixed results across past studies: Nature of change for workers alters potential facilitators' effects on implementation. © The Author(s) 2015.

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

Kinzey, Bruce R.; Smalley, Edward; Haefer, R.

This document presents the results of a voluntary web-based inventory survey of public street and area lighting across the U.S. undertaken during the latter half of 2013.This survey attempts to access information about the national inventory in a “bottoms-up” manner, going directly to owners and operators. Adding to previous “top down” estimates, it is intended to improve understanding of the role of public outdoor lighting in national energy use.

Dissection of a Truth Regime: The Narrowing Effects on the Public Good of Neoliberal Discourse in the Virginia Performance-Based Funding Policy

ERIC Educational Resources Information Center

Letizia, Angelo J.

2016-01-01

A major role of all public higher education institutions is to foster the public good. In democratic societies, the public good emphasizes the more collective activities and benefits and how resources are accessible to all in a society. Institutions of higher education create new knowledge, promote cultural tolerance, increase civic activity, and…

The Role of Student Financial Aid in Expanding Opportunities for Higher Education in Ohio. Report of the Financial Aid Study Committee.

ERIC Educational Resources Information Center

Ohio Board of Regents, Columbus.

The Financial Aid Study Committee of the Ohio Board of Regents was impaneled in October 1987 to determine if the state's major financial aid investments, principally the Ohio Instructional Grant Program, are an adequate resource in addressing state access objectives. Significant changes in the Ohio economic base have given rise to renewed emphasis…

Negotiating Livelihoods beyond Beijing: The Burden of Women Food Vendors in the Informal Economy of Limbe, Cameroon

ERIC Educational Resources Information Center

Fonchingong, Charles C.

2005-01-01

As a response to the trappings of globalisation and the commoditisation of the sphere of production, women continue to play a crucial role in securing livelihoods by guaranteeing access to food in rural, peri-urban, and urban areas. Based on a survey of food vendors, this paper evaluates women's input through informal earnings, the coping…

Classroom-Based Inequalities and Achievement Gaps in First Grade: The Role of Classroom Context and Access to Qualified and Effective Teachers

ERIC Educational Resources Information Center

Palardy, Gregory J.

2015-01-01

Background: An enduring question about achievement gaps is, which aspects of schools contribute most? At the early grade levels, when children spend the vast majority of their school day in a single classroom with a single teacher, school inequities that correlate with achievement gaps likely originate within the classroom. This study examined the…

Fluorine-directed 1,2-trans glycosylation of rare sugars.

PubMed

Aiguabella, Nuria; Holland, Mareike C; Gilmour, Ryan

2016-06-28

To reconcile the urgent need to access well defined β-configured 2,6-di-deoxypyranose analogues for chemical biology, with the intrinsic α-selectivity of the native system, the directing role of fluorine at C2 has been explored. Localised partial charge inversion (C-H(δ+)→ C-F(δ-)) elicits a reversal of the substrate-based α-stereoselectivity, irrespective of the protecting group electronics.

Universities as Hubs for Next-Generation Networks: A Model for Universities to Spur 21st Century Internet Access and Innovation in Their Communities

ERIC Educational Resources Information Center

Lennett, Benjamin; Morris, Sarah J.; Byrum, Greta

2012-01-01

Based on a request for information (RFI) submitted to The University Community Next Generation Innovation Project (Gig.U), the paper describes a model for universities to develop next generation broadband infrastructure in their communities. In the our view universities can play a critical role in spurring next generation networks into their…

An emergency department-based mental health nurse practitioner outpatient service: part 2, staff evaluation.

PubMed

Wand, Timothy; White, Kathryn; Patching, Joanna; Dixon, Judith; Green, Timothy

2011-12-01

The nurse practitioner role incorporates enhancing access to health-care services, particularly for populations that are underserved. This entails working collaboratively with colleagues across multidisciplinary teams and emphasizing a nursing model of practice within the nurse practitioner role. In Australia, the added value associated with establishing mental health nurse practitioner (MHNP) positions based in the emergency department (ED) is emerging. This paper presents qualitative findings from a study using a mixed-method design to evaluate an ED-based MHNP outpatient service in Sydney, Australia. One component of the evaluation involved semistructured interviews conducted with a random selection of study participants and a stratified sample of ED staff. This is the second of a two-part paper that presents an analysis of the qualitative data derived from the staff interviews (n = 20). Emergency staff were very supportive of the outpatient service, and perceived that it enhanced overall service provision and improved outcomes for patients. Moreover, staff expressed interest in receiving more formal feedback on the outcomes of the service. Staff also felt that service provision would be enhanced through additional mental health liaison nurses working in the department, especially after hours. An ED-based MHNP outpatient service expedites access to follow up to individuals with a broad range of problems, and supports ED staff in the provision of safe, effective, and more holistic care. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

Helpful advice and hidden expertize: pharmacy users' experiences of community pharmacy accessibility.

PubMed

Lindsey, Laura; Husband, Andy; Steed, Liz; Walton, Robert; Todd, Adam

2017-09-01

In recent years community pharmacies have emerged as strategically important settings to deliver services aimed at promoting public health. In order to develop evidence-based approaches to public health interventions that exploit the unique accessibility of community pharmacies, it is important to determine how people experience care in this context. This study, therefore, aimed to describe how care is perceived and experienced in community pharmacies with particular focus on community pharmacy access. In-depth semi-structured interviews were used to explore the perceptions and experiences' of people using community pharmacies. A total of 30 participants were interviewed. Themes specifically emerged in relation to community pharmacy access; these fell into four main categories: relationships; time; lack of awareness; and empowerment. The experience of developing a trusting relationship with the pharmacist is an important consideration in the context of community pharmacy accessibility. This could be an important consideration when a person uses a community pharmacy to access a public health service. There is also a perceived lack of awareness among the general public about the extended role of community pharmacy; this is a potential barrier toward people using them. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

State policy and teen childbearing: a review of research studies.

PubMed

Beltz, Martha A; Sacks, Vanessa H; Moore, Kristin A; Terzian, Mary

2015-02-01

Teen childbearing is affected by many individual, family, and community factors; however, another potential influence is state policy. Rigorous studies of the relationship between state policy and teen birth rates are few in number but represent a body of knowledge that can inform policy and practice. This article reviews research assessing associations between state-level policies and teen birth rates, focusing on five policy areas: access to family planning, education, sex education, public assistance, and access to abortion services. Overall, several studies have found that measures related to access to and use of family planning services and contraceptives are related to lower state-level teen birth rates. These include adolescent enrollment in clinics, minors' access to contraception, conscience laws, family planning expenditures, and Medicaid waivers. Other studies, although largely cross-sectional analyses, have concluded that policies and practices to expand or improve public education are also associated with lower teen birth rates. These include expenditures on education, teacher-to-student ratios, and graduation requirements. However, the evidence regarding the role of public assistance, abortion access, and sex education policies in reducing teen birth rates is mixed and inconclusive. These conclusions must be viewed as tentative because of the limited number of rigorous studies that examine the relationship between state policy and teen birth rates over time. Many specific policies have only been analyzed by a single study, and few findings are based on recent data. As such, more research is needed to strengthen our understanding of the role of state policies in teen birth rates. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

An on-demand provision model for geospatial multisource information with active self-adaption services

NASA Astrophysics Data System (ADS)

Fan, Hong; Li, Huan

2015-12-01

Location-related data are playing an increasingly irreplaceable role in business, government and scientific research. At the same time, the amount and types of data are rapidly increasing. It is a challenge how to quickly find required information from this rapidly growing volume of data, as well as how to efficiently provide different levels of geospatial data to users. This paper puts forward a data-oriented access model for geographic information science data. First, we analyze the features of GIS data including traditional types such as vector and raster data and new types such as Volunteered Geographic Information (VGI). Taking into account these analyses, a classification scheme for geographic data is proposed and TRAFIE is introduced to describe the establishment of a multi-level model for geographic data. Based on this model, a multi-level, scalable access system for geospatial information is put forward. Users can select different levels of data according to their concrete application needs. Pull-based and push-based data access mechanisms based on this model are presented. A Service Oriented Architecture (SOA) was chosen for the data processing. The model of this study has been described by providing decision-making process of government departments with a simulation of fire disaster data collection. The use case shows this data model and the data provision system is flexible and has good adaptability.

Creating Accessibility to Education: The Role of School Staff's Discretionary Practices

ERIC Educational Resources Information Center

Barberis, Eduardo; Buchowicz, Izabela

2015-01-01

This article explores the role of school staff in the accessibility of education with a focus on professional discretion and its relation with institutions and contexts. Drawing on the street-level bureaucracy approach it looks into different types of discretionary practices and asks how their legitimacy influences their success. The analysis is…

Science Teacher Candidates' Perceptions about Roles and Nature of Scientific Models

ERIC Educational Resources Information Center

Yenilmez Turkoglu, Ayse; Oztekin, Ceren

2016-01-01

Background: Scientific models have important roles in science and science education. For scientists, they provide a means for generating new knowledge or function as an accessible summary of scientific studies. In science education, on the other hand, they are accessible representations of abstract concepts, and are also organizational frameworks…

Mortality salience and the spreading activation of worldview-relevant constructs: exploring the cognitive architecture of terror management.

PubMed

Arndt, Jamie; Greenberg, Jeff; Cook, Alison

2002-09-01

Seven experiments assessed the hypothesis derived from terror management theory that reminding people of their mortality would increase accessibility of constructs central to their worldview. Experiment 1 found that mortality primes, relative to control primes, increased accessibility of nationalistic constructs for men but not for women. Experiment 2 replicated this finding and also found that mortality salience increased romantic accessibility for women but not for men. Four subsequent experiments supported the role of unconscious death-related ideation in producing these effects. A final experiment demonstrated that situational primes can increase the accessibility of nationalistic constructs for women after mortality salience. The roles of situational cues and individual differences in the effects of exposure to death-related stimuli on worldview-relevant construct accessibility are discussed.

Experiment Software and Projects on the Web with VISPA

NASA Astrophysics Data System (ADS)

Erdmann, M.; Fischer, B.; Fischer, R.; Geiser, E.; Glaser, C.; Müller, G.; Rieger, M.; Urban, M.; von Cube, R. F.; Welling, C.

2017-10-01

The Visual Physics Analysis (VISPA) project defines a toolbox for accessing software via the web. It is based on latest web technologies and provides a powerful extension mechanism that enables to interface a wide range of applications. Beyond basic applications such as a code editor, a file browser, or a terminal, it meets the demands of sophisticated experiment-specific use cases that focus on physics data analyses and typically require a high degree of interactivity. As an example, we developed a data inspector that is capable of browsing interactively through event content of several data formats, e.g., MiniAOD which is utilized by the CMS collaboration. The VISPA extension mechanism can also be used to embed external web-based applications that benefit from dynamic allocation of user-defined computing resources via SSH. For example, by wrapping the JSROOT project, ROOT files located on any remote machine can be inspected directly through a VISPA server instance. We introduced domains that combine groups of users and role-based permissions. Thereby, tailored projects are enabled, e.g. for teaching where access to student’s homework is restricted to a team of tutors, or for experiment-specific data that may only be accessible for members of the collaboration. We present the extension mechanism including corresponding applications and give an outlook onto the new permission system.

Ethics, economics, and public financing of health care.

PubMed

Hurley, J

2001-08-01

There is a wide variety of ethical arguments for public financing of health care that share a common structure built on a series of four logically related propositions regarding: (1) the ultimate purpose of a human life or human society; (2) the role of health and its distribution in society in advancing this ultimate purpose; (3) the role of access to or utilisation of health care in maintaining or improving the desired level and distribution of health among members of society, and (4) the role of public financing in ensuring the ethically justified access to and utilisation of health care by members of society. This paper argues that economics has much to contribute to the development of the ethical foundations for publicly financed health care. It focuses in particular on recent economic work to clarify the concepts of access and need and their role in analyses of the just distribution of health care resources, and on the importance of economic analysis of health care and health care insurance markets in demonstrating why public financing is necessary to achieve broad access to and utilisation of health care services.

A Conceptual Model of the Cognitive Processing of Environmental Distance Information

NASA Astrophysics Data System (ADS)

Montello, Daniel R.

I review theories and research on the cognitive processing of environmental distance information by humans, particularly that acquired via direct experience in the environment. The cognitive processes I consider for acquiring and thinking about environmental distance information include working-memory, nonmediated, hybrid, and simple-retrieval processes. Based on my review of the research literature, and additional considerations about the sources of distance information and the situations in which it is used, I propose an integrative conceptual model to explain the cognitive processing of distance information that takes account of the plurality of possible processes and information sources, and describes conditions under which particular processes and sources are likely to operate. The mechanism of summing vista distances is identified as widely important in situations with good visual access to the environment. Heuristics based on time, effort, or other information are likely to play their most important role when sensory access is restricted.

Enhancing palliative care delivery in a regional community in Australia.

PubMed

Phillips, Jane L; Davidson, Patricia M; Jackson, Debra; Kristjanson, Linda; Bennett, Margaret L; Daly, John

2006-08-01

Although access to palliative care is a fundamental right for people in Australia and is endorsed by government policy, there is often limited access to specialist palliative care services in regional, rural and remote areas. This article appraises the evidence pertaining to palliative care service delivery to inform a sustainable model of palliative care that meets the needs of a regional population on the mid-north coast of New South Wales. Expert consultation and an eclectic literature review were undertaken to develop a model of palliative care service delivery appropriate to the needs of the target population and resources of the local community. On the basis of this review, a local palliative care system that is based on a population-based approach to service planning and delivery, with formalized integrated network agreements and role delineation between specialist and generalist providers, has the greatest potential to meet the palliative care needs of this regional coastal community.

Ends versus means: the role of markets in expanding access to contraceptives.

PubMed

Hanson, K; Kumaranayake, L; Thomas, I

2001-06-01

Achieving and sustaining universal access to contraceptives are key policy goals of interventions supplying contraceptive commodities. Donor support for contraceptive supplies is substantial and many public and national programmes rely on donated and subsidized supplies of contraceptives. Sustainability of programme benefits is a concern to both national governments and donor agencies. At the same time, market-based provision of contraceptives has become a major source of contraceptives for individuals in a number of countries. While the goals or 'ends' of policy are to increase and sustain universal access to contraceptives, there is debate about the role of markets and their negative impacts on equity and universality. There is also concern that while public programmes supplying free contraceptives may, in the medium-term, achieve high coverage, they may hamper the achievement of long-term sustainability and the development of commercial markets. This paper focuses on the tension between the public health and market paradigms, and uses economic analysis as a framework in order to examine the relative roles or 'means' for subsidized public and commercial private sector supply of contraceptives. The review of the theory and evidence focuses on the trade-offs between public sector and market provision of contraceptives, examining the role for the public sector given the potential for market failures, the impact of public provision on the development of markets, and the role of price in demand. However, because of the potential conflict between these policy objectives, we argue that strategies to deliver contraceptives should be based on the specific characteristics of the context. In particular four variables (contraceptive prevalence rates, HIV prevalence, income level of country, size and geographic spread of private sector development) are important in characterizing this context, and these are highlighted in a matrix of programme priorities. Public choices need to take into account the ways in which they will affect the potential for development of sustainable private sources of supply. Undertaking a 'market assessment' should be a key stage in the analysis of policy options. Such an assessment should address demand factors, health priorities, actual and potential sources of supply and the relationships between public and private supply. Clearly the development of markets for contraceptives is not an end in itself, but may prove an important means of improving the health of women and men.

Improving access to care through the patient-centered medical home.

PubMed

North, Stephen W; McElligot, James; Douglas, Gaye; Martin, Amanda

2014-02-01

School-based health centers (SBHCs) serve an essential role in providing access to high-quality, comprehensive care to underserved children and adolescents in more than 2,000 schools across the United States. SBHCs are an essential component of the health care safety net, and their role in the patient-centered medical home (PCMH) continues to evolve as both collaborating partners and, when fully functioning, independent PCMHs. The American Academy of Pediatrics (AAP) supports the use of SBHCs, citing the proven benefits and exciting potential as justification, but also offers caution and recommends a focus on communication within the community. Traditional "brick and mortar" SBHCs are more likely to be located in urban communities (54.2% urban versus 18.0% rural) and be in schools with more students, allowing for a greater return on investment. Current SBHCs are located in schools with an average population of 997 students. The need for a large school population to help an SBHC approach financial viability excludes children in rural communities who are more likely to attend a school with fewer than 500 students, be poor, and have difficulty accessing health care.2 The expansion of telehealth technologies allows the creation of solutions to decrease geographic barriers that have limited the growth of SBHCs in rural communities. Telehealth school-based health centers (tSBHCs) that exclusively provide services through telemedicine are operating and developing in communities where geographic barriers and financial challenges have prevented the establishment of brick and mortar SBHCs. TSBHCs are beginning to increase the number and variety of services they provide through the use of telehealth to include behavioral health, nutrition services, and pediatric specialists. Understanding the role of tSBHCs in the growth of the PCMH model is critical for using these tools to continue to improve child and adolescent health. Copyright 2014, SLACK Incorporated.

Surgical simulators in urological training--views of UK Training Programme Directors.

PubMed

Forster, James A; Browning, Anthony J; Paul, Alan B; Biyani, C Shekhar

2012-09-01

What's known on the subject? and What does the study add? The role of surgical simulators is currently being debated in urological and other surgical specialties. Simulators are not presently implemented in the UK urology training curriculum. The availability of simulators and the opinions of Training Programme Directors' (TPD) on their role have not been described. In the present questionnaire-based survey, the trainees of most, but not all, UK TPDs had access to laparoscopic simulators, and that all responding TPDs thought that simulators improved laparoscopic training. We hope that the present study will be a positive step towards making an agreement to formally introduce simulators into the UK urology training curriculum. To discuss the current situation on the use of simulators in surgical training. To determine the views of UK Urology Training Programme Directors (TPDs) on the availability and use of simulators in Urology at present, and to discuss the role that simulators may have in future training. An online-questionnaire survey was distributed to all UK Urology TPDs. In all, 16 of 21 TPDs responded. All 16 thought that laparoscopic simulators improved the quality of laparoscopic training. The trainees of 13 TPDs had access to a laparoscopic simulator (either in their own hospital or another hospital in the deanery). Most TPDs thought that trainees should use simulators in their free time, in quiet time during work hours, or in teaching sessions (rather than incorporated into the weekly timetable). We feel that the current apprentice-style method of training in urological surgery is out-dated. We think that all TPDs and trainees should have access to a simulator, and that a formal competency based simulation training programme should be incorporated into the urology training curriculum, with trainees reaching a minimum proficiency on a simulator before undertaking surgical procedures. © 2012 THE AUTHORS. BJU INTERNATIONAL © 2012 BJU INTERNATIONAL.

The Literacy Divide: Health Literacy and the Use of an Internet-Based Patient Portal in an Integrated Health System—Results from the Diabetes Study of Northern California (DISTANCE)

PubMed Central

SARKAR, URMIMALA; KARTER, ANDREW J.; LIU, JENNIFER Y.; ADLER, NANCY E.; NGUYEN, ROBERT; LÓPEZ, ANDREA; SCHILLINGER, DEAN

2010-01-01

Internet-based patient portals are intended to improve access and quality, and will play an increasingly important role in health care, especially for diabetes and other chronic diseases. Diabetes patients with limited health literacy have worse health outcomes, and limited health literacy may be a barrier to effectively utilizing internet-based health access services. We investigated use of an internet-based patient portal among a well characterized population of adults with diabetes. We estimated health literacy using three validated self-report items. We explored the independent association between health literacy and use of the internet-based patient portal, adjusted for age, gender, race/ethnicity, educational attainment, and income. Among 14,102 participants (28% non-Hispanic White, 14% Latino, 21% African-American, 9% Asian, 12% Filipino, and 17% multiracial or other ethnicity), 6099 (62%) reported some limitation in health literacy, and 5671 (40%) respondents completed registration for the patient portal registration. In adjusted analyses, those with limited health literacy had higher odds of never signing on to the patient portal (OR 1.7, 1.4 to 1.9) compared with those who did not report any health literacy limitation. Even among those with internet access, the relationship between health literacy and patient portal use persisted (OR 1.4, 95% CI 1.2 to 1.8). Diabetes patients reporting limited health literacy were less likely to both access and navigate an internet-based patient portal than those with adequate health literacy. Although the internet has potential to greatly expand the capacity and reach of health care systems, current use patterns suggest that, in the absence of participatory design efforts involving those with limited health literacy, those most at risk for poor diabetes health outcomes will fall further behind if health systems increasingly rely on internet-based services. PMID:20845203

Towards a theoretical model on medicines as a health need.

PubMed

Vargas-Peláez, Claudia Marcela; Soares, Luciano; Rover, Marina Raijche Mattozo; Blatt, Carine Raquel; Mantel-Teeuwisse, Aukje; Rossi Buenaventura, Francisco Augusto; Restrepo, Luis Guillermo; Latorre, María Cristina; López, José Julián; Bürgin, María Teresa; Silva, Consuelo; Leite, Silvana Nair; Mareni Rocha, Farias

2017-04-01

Medicines are considered one of the main tools of western medicine to resolve health problems. Currently, medicines represent an important share of the countries' healthcare budget. In the Latin America region, access to essential medicines is still a challenge, although countries have established some measures in the last years in order to guarantee equitable access to medicines. A theoretical model is proposed for analysing the social, political, and economic factors that modulate the role of medicines as a health need and their influence on the accessibility and access to medicines. The model was built based on a narrative review about health needs, and followed the conceptual modelling methodology for theory-building. The theoretical model considers elements (stakeholders, policies) that modulate the perception towards medicines as a health need from two perspectives - health and market - at three levels: international, national and local levels. The perception towards medicines as a health need is described according to Bradshaw's categories: felt need, normative need, comparative need and expressed need. When those different categories applied to medicines coincide, the patients get access to the medicines they perceive as a need, but when the categories do not coincide, barriers to access to medicines are created. Our theoretical model, which holds a broader view about the access to medicines, emphasises how power structures, interests, interdependencies, values and principles of the stakeholders could influence the perception towards medicines as a health need and the access to medicines in Latin American countries. Copyright © 2017 Elsevier Ltd. All rights reserved.

Model of load distribution for earth observation satellite

NASA Astrophysics Data System (ADS)

Tu, Shumin; Du, Min; Li, Wei

2017-03-01

For the system of multiple types of EOS (Earth Observing Satellites), it is a vital issue to assure that each type of payloads carried by the group of EOS can be used efficiently and reasonably for in astronautics fields. Currently, most of researches on configuration of satellite and payloads focus on the scheduling for launched satellites. However, the assignments of payloads for un-launched satellites are bit researched, which are the same crucial as the scheduling of tasks. Moreover, the current models of satellite resources scheduling lack of more general characteristics. Referring the idea about roles-based access control (RBAC) of information system, this paper brings forward a model based on role-mining of RBAC to improve the generality and foresight of the method of assignments of satellite-payload. By this way, the assignment of satellite-payload can be mapped onto the problem of role-mining. A novel method will be introduced, based on the idea of biclique-combination in graph theory and evolutionary algorithm in intelligence computing, to address the role-mining problem of satellite-payload assignments. The simulation experiments are performed to verify the novel method. Finally, the work of this paper is concluded.

A Shift in the Role of Glutamatergic Signaling in the Nucleus Accumbens Core with the Development of an Addicted Phenotype

PubMed Central

Doyle, Susan E.; Ramôa, Carolina; Garber, Garrett; Newman, Joshua; Toor, Shaun; Lynch, Wendy J.

2014-01-01

Background While dopamine signaling in the nucleus accumbens (NAc) plays a well-established role in motivating cocaine use in early “non-addicted” stages, recent evidence suggests that other signaling pathways may be critical once addiction has developed. Given the importance of glutamatergic signaling in the NAc for drug-seeking and relapse, here we examined its role in motivating cocaine self-administration under conditions known to produce either a “non-addicted” or an “addicted” phenotype. Methods Following acquisition, male and female Sprague Dawley rats were given either short access (3 fixed-ratio 1 sessions, 20 infusions/day) or extended 24-hr access (10 days; 4 trials/hr; up to 96 infusions/day) to cocaine. Following a 14-day abstinence period, motivation for cocaine was assessed under a progressive-ratio schedule, and once stable, the effects of intra-NAc infusions of the glutamate AMPA/KA receptor antagonist CNQX (0.0, 0.01, 0.03, 0.1 μg/side) were determined. As an additional measure for the development of an addicted phenotype, separate groups of rats were screened under an extinction/cue-induced reinstatement procedure following abstinence from short versus extended access self-administration. Results Motivation for cocaine and levels of extinction and reinstatement responding were markedly higher following extended versus short access self-administration confirming the development of an addicted phenotype in the extended access group. CNQX dose-dependently reduced motivation for cocaine in the extended access group, but was without effect in the short access group. Conclusions These results suggest that the role of glutamatergic signaling in the NAc, though not essential for motivating cocaine use in “non-addicted” stages, becomes critical once addiction has developed. PMID:24629536

Global access to surgical care: a modelling study.

PubMed

Alkire, Blake C; Raykar, Nakul P; Shrime, Mark G; Weiser, Thomas G; Bickler, Stephen W; Rose, John A; Nutt, Cameron T; Greenberg, Sarah L M; Kotagal, Meera; Riesel, Johanna N; Esquivel, Micaela; Uribe-Leitz, Tarsicio; Molina, George; Roy, Nobhojit; Meara, John G; Farmer, Paul E

2015-06-01

More than 2 billion people are unable to receive surgical care based on operating theatre density alone. The vision of the Lancet Commission on Global Surgery is universal access to safe, affordable surgical and anaesthesia care when needed. We aimed to estimate the number of individuals worldwide without access to surgical services as defined by the Commission's vision. We modelled access to surgical services in 196 countries with respect to four dimensions: timeliness, surgical capacity, safety, and affordability. We built a chance tree for each country to model the probability of surgical access with respect to each dimension, and from this we constructed a statistical model to estimate the proportion of the population in each country that does not have access to surgical services. We accounted for uncertainty with one-way sensitivity analyses, multiple imputation for missing data, and probabilistic sensitivity analysis. At least 4·8 billion people (95% posterior credible interval 4·6-5·0 [67%, 64-70]) of the world's population do not have access to surgery. The proportion of the population without access varied widely when stratified by epidemiological region: greater than 95% of the population in south Asia and central, eastern, and western sub-Saharan Africa do not have access to care, whereas less than 5% of the population in Australasia, high-income North America, and western Europe lack access. Most of the world's population does not have access to surgical care, and access is inequitably distributed. The near absence of access in many low-income and middle-income countries represents a crisis, and as the global health community continues to support the advancement of universal health coverage, increasing access to surgical services will play a central role in ensuring health care for all. None. Copyright © 2015 Alkire et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd.. All rights reserved.

Influence of peer support on HIV/STI prevention and safety amongst international migrant sex workers: A qualitative study at the Mexico-Guatemala border

PubMed Central

Brouwer, Kimberly C.; Rocha-Jimenez, Teresita; Fernandez-Casanueva, Carmen; Morales-Miranda, Sonia; Goldenberg, Shira M.

2018-01-01

Background Migrant women engaged in precarious employment, such as sex work, frequently face pronounced social isolation alongside other barriers to health and human rights. Although peer support has been identified as a critical HIV and violence prevention intervention for sex workers, little is known about access to peer support or its role in shaping health and social outcomes for migrant sex workers. This article analyses the role of peer support in shaping vulnerability and resilience related to HIV/STI prevention and violence among international migrant sex workers at the Mexico-Guatemala border. Methods This qualitative study is based on 31 semi-structured interviews conducted with international migrant sex workers in the Mexico-Guatemala border communities of Tapachula, Mexico and Tecún Umán and Quetzaltenango, Guatemala. Results Peer support was found to be critical for reducing social isolation; improving access to HIV/STI knowledge, prevention and resources; and mitigating workplace violence, particularly at the initial stages of migration and sex work. Peer support was especially critical for countering social isolation, and peers represented a valuable source of HIV/STI prevention knowledge and resources (e.g., condoms), as well as essential safety supports in the workplace. However, challenges to accessing peer support were noted, including difficulties establishing long-lasting relationships and other forms of social participation due to frequent mobility, as well as tensions among peers within some work environments. Variations in access to peer support related to country of work, work environment, sex work and migration stage, and sex work experience were also identified. Conclusions Results indicate that peer-led and community empowerment interventions represent a promising strategy for promoting the health, safety and human rights of migrant sex workers. Tailored community empowerment interventions addressing the unique migration-related contexts and challenges faced by migrant sex workers should be a focus of future community-based research, alongside promotion of broader structural changes. PMID:29304164

Influence of peer support on HIV/STI prevention and safety amongst international migrant sex workers: A qualitative study at the Mexico-Guatemala border.

PubMed

Febres-Cordero, Belen; Brouwer, Kimberly C; Rocha-Jimenez, Teresita; Fernandez-Casanueva, Carmen; Morales-Miranda, Sonia; Goldenberg, Shira M

2018-01-01

Migrant women engaged in precarious employment, such as sex work, frequently face pronounced social isolation alongside other barriers to health and human rights. Although peer support has been identified as a critical HIV and violence prevention intervention for sex workers, little is known about access to peer support or its role in shaping health and social outcomes for migrant sex workers. This article analyses the role of peer support in shaping vulnerability and resilience related to HIV/STI prevention and violence among international migrant sex workers at the Mexico-Guatemala border. This qualitative study is based on 31 semi-structured interviews conducted with international migrant sex workers in the Mexico-Guatemala border communities of Tapachula, Mexico and Tecún Umán and Quetzaltenango, Guatemala. Peer support was found to be critical for reducing social isolation; improving access to HIV/STI knowledge, prevention and resources; and mitigating workplace violence, particularly at the initial stages of migration and sex work. Peer support was especially critical for countering social isolation, and peers represented a valuable source of HIV/STI prevention knowledge and resources (e.g., condoms), as well as essential safety supports in the workplace. However, challenges to accessing peer support were noted, including difficulties establishing long-lasting relationships and other forms of social participation due to frequent mobility, as well as tensions among peers within some work environments. Variations in access to peer support related to country of work, work environment, sex work and migration stage, and sex work experience were also identified. Results indicate that peer-led and community empowerment interventions represent a promising strategy for promoting the health, safety and human rights of migrant sex workers. Tailored community empowerment interventions addressing the unique migration-related contexts and challenges faced by migrant sex workers should be a focus of future community-based research, alongside promotion of broader structural changes.

Security and privacy in electronic health records: a systematic literature review.

PubMed

Fernández-Alemán, José Luis; Señor, Inmaculada Carrión; Lozoya, Pedro Ángel Oliver; Toval, Ambrosio

2013-06-01

To report the results of a systematic literature review concerning the security and privacy of electronic health record (EHR) systems. Original articles written in English found in MEDLINE, ACM Digital Library, Wiley InterScience, IEEE Digital Library, Science@Direct, MetaPress, ERIC, CINAHL and Trip Database. Only those articles dealing with the security and privacy of EHR systems. The extraction of 775 articles using a predefined search string, the outcome of which was reviewed by three authors and checked by a fourth. A total of 49 articles were selected, of which 26 used standards or regulations related to the privacy and security of EHR data. The most widely used regulations are the Health Insurance Portability and Accountability Act (HIPAA) and the European Data Protection Directive 95/46/EC. We found 23 articles that used symmetric key and/or asymmetric key schemes and 13 articles that employed the pseudo anonymity technique in EHR systems. A total of 11 articles propose the use of a digital signature scheme based on PKI (Public Key Infrastructure) and 13 articles propose a login/password (seven of them combined with a digital certificate or PIN) for authentication. The preferred access control model appears to be Role-Based Access Control (RBAC), since it is used in 27 studies. Ten of these studies discuss who should define the EHR systems' roles. Eleven studies discuss who should provide access to EHR data: patients or health entities. Sixteen of the articles reviewed indicate that it is necessary to override defined access policies in the case of an emergency. In 25 articles an audit-log of the system is produced. Only four studies mention that system users and/or health staff should be trained in security and privacy. Recent years have witnessed the design of standards and the promulgation of directives concerning security and privacy in EHR systems. However, more work should be done to adopt these regulations and to deploy secure EHR systems. Copyright © 2013 Elsevier Inc. All rights reserved.

The role of the premotor cortex and the primary motor cortex in action verb comprehension: evidence from Granger causality analysis.

PubMed

Yang, Jie; Shu, Hua

2012-08-01

Although numerous studies find the premotor cortex and the primary motor cortex are involved in action language comprehension, so far the nature of these motor effects is still in controversy. Some researchers suggest that the motor effects reflect that the premotor cortex and the primary motor cortex make functional contributions to the semantic access of action verbs, while other authors argue that the motor effects are caused by comprehension. In the current study, we used Granger causality analysis to investigate the roles of the premotor cortex and the primary motor cortex in processing of manual-action verbs. Regions of interest were selected in the primary motor cortex (M1) and the premotor cortex based on a hand motion task, and in the left posterior middle temporal gyrus (lexical semantic area) based on the reading task effect. We found that (1) the left posterior middle temporal gyrus had a causal influence on the left M1; and (2) the left posterior middle temporal gyrus and the left premotor cortex had bidirectional causal relations. These results suggest that the premotor cortex and the primary motor cortex play different roles in manual verb comprehension. The premotor cortex may be involved in motor simulation that contributes to action language processing, while the primary motor cortex may be engaged in a processing stage influenced by the meaning access of manual-action verbs. Further investigation combining effective connectivity analysis and technique with high temporal resolution is necessary for better clarification of the roles of the premotor cortex and the primary motor cortex in action language comprehension. Copyright © 2012 Elsevier Inc. All rights reserved.

Group Membership Based Authorization to CADC Resources

NASA Astrophysics Data System (ADS)

Damian, A.; Dowler, P.; Gaudet, S.; Hill, N.

2012-09-01

The Group Membership Service (GMS), implemented at the Canadian Astronomy Data Centre (CADC), is a prototype of what could eventually be an IVOA standard for a distributed and interoperable group membership protocol. Group membership is the core authorization concept that enables teamwork and collaboration amongst astronomers accessing distributed resources and services. The service integrates and complements other access control related IVOA standards such as single-sign-on (SSO) using X.509 proxy certificates and the Credential Delegation Protocol (CDP). The GMS has been used at CADC for several years now, initially as a subsystem and then as a stand-alone Web service. It is part of the authorization mechanism for controlling the access to restricted Web resources as well as the VOSpace service hosted by the CADC. We present the role that GMS plays within the access control system at the CADC, including the functionality of the service and how the different CADC services make use of it to assert user authorization to resources. We also describe the main advantages and challenges of using the service as well as future work to increase its robustness and functionality.

Are community-based pharmacists underused in the care of persons living with HIV? A need for structural and policy changes.

PubMed

Kibicho, Jennifer; Pinkerton, Steven D; Owczarzak, Jill; Mkandawire-Valhmu, Lucy; Kako, Peninnah M

2015-01-01

To describe community pharmacists' perceptions on their current role in direct patient care services, an expanded role for pharmacists in providing patient care services, and changes needed to optimally use pharmacists' expertise to provide high-quality direct patient care services to people living with human immunodeficiency virus (HIV) infections. Cross-sectional study. Four Midwestern cities in the United States in August through October 2009. 28 community-based pharmacists practicing in 17 pharmacies. Interviews. Opinions of participants about roles of specialty and nonspecialty pharmacists in caring for patients living with HIV infections. Pharmacists noted that although challenges in our health care system characterized by inaccessible health professionals presented opportunities for a greater pharmacist role, there were missed opportunities for greater level of patient care services in many community-based nonspecialty settings. Many pharmacists in semispecialty and nonspecialty pharmacies expressed a desire for an expanded role in patient care congruent with their pharmacy education and training. Structural-level policy changes needed to transform community-based pharmacy settings to patient-centered medical homes include recognizing pharmacists as important players in the multidisciplinary health care team, extending the health information exchange highway to include pharmacist-generated electronic therapeutic records, and realigning financial incentives. Comprehensive policy initiatives are needed to optimize the use of highly trained pharmacists in enhancing the quality of health care to an ever-growing number of Americans with chronic conditions who access care in community-based pharmacy settings.

The Role of Open Access and Open Educational Resources: A Distance Learning Perspective

ERIC Educational Resources Information Center

Hatzipanagos, Stylianos; Gregson, Jon

2015-01-01

The paper explores the role of Open Access (in licensing, publishing and sharing research data) and Open Educational Resources within Distance Education, with a focus on the context of the University of London International Programmes. We report on a case study where data were gathered from librarians and programme directors relating to existing…

(Re)Examining the Role of Family and Community in College Access and Choice: A Metasynthesis

ERIC Educational Resources Information Center

Mwangi, Chrystal A. George

2015-01-01

Using meta-synthesis, this study analyzes higher education literature to provide a comprehensive understanding of the role of nonparent family and community (NPFC) members such as siblings, extended family, fictive kin, and peers in college access and choice. Findings revealed the diverse familial and community networks of today's college going…

The Role of Boards in College Access Programs: Creating and Maintaining Quality

ERIC Educational Resources Information Center

Center for Higher Education Policy Analysis, University of Southern California, 2006

2006-01-01

Access programs are facing increased scrutiny. Not all programs are equally effective. In an environment in which resources are short, funders increasingly require criteria that enable them to make informed decisions about program quality. As elaborated in this report , one role of a high performance board is to help develop benchmarks of…

The Role of E-Vocabularies in the Description and Retrieval of Digital Educational Resources

ERIC Educational Resources Information Center

Fernández-Pampillón, Ana M.

2017-01-01

Vocabularies are linguistic resources that make it possible to access knowledge through words. They can constitute a mechanism to identify, describe, explore, and access all the digital resources with informational content pertaining to a specific knowledge domain. In this regard, they play a key role as systems for the representation and…

Telescience testbedding for life science missions on the Space Station

NASA Technical Reports Server (NTRS)

Rasmussen, D.; Mian, A.; Bosley, J.

1988-01-01

'Telescience', defined as the ability of distributed system users to perform remote operations associated with NASA Space Station life science operations, has been explored by a developmental testbed project allowing rapid prototyping to evaluate the functional requirements of telescience implementation in three areas: (1) research planning and design, (2) remote operation of facilities, and (3) remote access to data bases for analysis. Attention is given to the role of expert systems in telescience, its use in realistic simulation of Space Shuttle payload remote monitoring, and remote interaction with life science data bases.

Iridium-Catalyzed Asymmetric Hydrogenation of Ketones with Accessible and Modular Ferrocene-Based Amino-phosphine Acid (f-Ampha) Ligands.

PubMed

Yu, Jianfei; Long, Jiao; Yang, Yuhong; Wu, Weilong; Xue, Peng; Chung, Lung Wa; Dong, Xiu-Qin; Zhang, Xumu

2017-02-03

A series of tridentate ferrocene-based amino-phosphine acid (f-Ampha) ligands have been successfully developed. The f-Ampha ligands are extremely air stable and exhibited excellent performance in the Ir-catalyzed asymmetric hydrogenation of ketones (full conversions, up to >99% ee, and 500 000 TON). DFT calculations were performed to elucidate the reaction mechanism and the importance of the -COOH group. Control experiments also revealed that the -COOH group played a key role in this reaction.

"People don't understand what goes on in here": A consensual qualitative research analysis of inmate-caregiver perspectives on prison-based end-of-life care.

PubMed

Depner, Rachel M; Grant, Pei C; Byrwa, David J; Breier, Jennifer M; Lodi-Smith, Jennifer; Luczkiewicz, Debra L; Kerr, Christopher W

2018-05-01

The age demographic of the incarcerated is quickly shifting from young to old. Correctional facilities are responsible for navigating inmate access to healthcare; currently, there is no standardization for access to end-of-life care. There is growing research support for prison-based end-of-life care programs that incorporate inmate peer caregivers as a way to meet the needs of the elderly and dying who are incarcerated. This project aims to (a) describe a prison-based end-of-life program utilizing inmate peer caregivers, (b) identify inmate-caregiver motivations for participation, and (c) analyze the role of building trust and meaningful relationships within the correctional end-of-life care setting. A total of 22 semi-structured interviews were conducted with inmate-caregivers. Data were analyzed using Consensual Qualitative Research methodology. All inmate-caregivers currently participating in the end-of-life peer care program at Briarcliff Correctional Facility were given the opportunity to participate. All participants were male, over the age of 18, and also incarcerated at Briarcliff Correctional Facility, a maximum security, state-level correctional facility. In total, five over-arching and distinct domains emerged; this manuscript focuses on the following three: (a) program description, (b) motivation, and (c) connections with others. Findings suggest that inmate-caregivers believe they provide a unique and necessary adaptation to prison-based end-of-life care resulting in multilevel benefits. These additional perceived benefits go beyond a marginalized group gaining access to patient-centered end-of-life care and include potential inmate-caregiver rehabilitation, correctional medical staff feeling supported, and correctional facilities meeting end-of-life care mandates. Additional research is imperative to work toward greater standardization of and access to end-of-life care for the incarcerated.

Kindergarten/Elementary School Teachers and Web-based Oral Health-Related Resources: An Exploration.

PubMed

Inglehart, Marita Rohr; Zuzo, Gabrielle A; Wilson, Joshua J

The percentage of U.S. children with poor oral health continues to be high. Kindergarten/elementary school educators could play an important role in teaching students about oral health promotion. The objectives were to assess which oral health-related web-based resources teachers consider most helpful and how teachers' attitudes, knowledge, and behavioural intentions concerning oral health-related teaching change between before and after having access to a resource website. Web-based survey data were collected from 95 kindergarten/elementary school educators before and after they accessed a website with oral health-related information for teachers (web-link: http://media.dent.umich.edu/teachoralhealth/index.html). Most teachers accessed lesson plans about 'Teeth and smiling' (90%) and 'Taking care of your teeth' (88%) and the fewest accessed information about 'Nutrition and health' (42%) and 'Information for parents' (39%). On average, all materials were perceived as useful (5-point scale with 5 = 'very useful', range = 3.80 to 4.04). Responses to the question on how important dental health is for a child's ability to learn improved significantly from before to after the educational intervention (5-point scale with 5 = 'very important', 3.78 vs 4.44). Knowledge increased and behavioural intentions improved as well. The percentage of teachers who reported that they had included oral health-related material in the past was 47% and the percentage who intended to include it in the future was 65% (p < 0.001). Providing kindergarten/elementary school educators with web-based resource materials improves their attitudes, increases their knowledge and leads to positive behavioural intentions concerning educating their students about oral health.

Role of the chromatin landscape and sequence in determining cell type-specific genomic glucocorticoid receptor binding and gene regulation

PubMed Central

Huska, Matthew R.; Jurk, Marcel; Schöpflin, Robert; Starick, Stephan R.; Schwahn, Kevin; Cooper, Samantha B.; Yamamoto, Keith R.; Thomas-Chollier, Morgane; Vingron, Martin

2017-01-01

Abstract The genomic loci bound by the glucocorticoid receptor (GR), a hormone-activated transcription factor, show little overlap between cell types. To study the role of chromatin and sequence in specifying where GR binds, we used Bayesian modeling within the universe of accessible chromatin. Taken together, our results uncovered that although GR preferentially binds accessible chromatin, its binding is biased against accessible chromatin located at promoter regions. This bias can only be explained partially by the presence of fewer GR recognition sequences, arguing for the existence of additional mechanisms that interfere with GR binding at promoters. Therefore, we tested the role of H3K9ac, the chromatin feature with the strongest negative association with GR binding, but found that this correlation does not reflect a causative link. Finally, we find a higher percentage of promoter–proximal GR binding for genes regulated by GR across cell types than for cell type-specific target genes. Given that GR almost exclusively binds accessible chromatin, we propose that cell type-specific regulation by GR preferentially occurs via distal enhancers, whose chromatin accessibility is typically cell type-specific, whereas ubiquitous target gene regulation is more likely to result from binding to promoter regions, which are often accessible regardless of cell type examined. PMID:27903902

Leveraging the Affordances of YouTube: The Role of Pedagogical Knowledge and Mental Models of Technology Functions for Lesson Planning with Technology

ERIC Educational Resources Information Center

Krauskopf, Karsten; Zahn, Carmen; Hesse, Friedrich W.

2012-01-01

Web-based digital video tools enable learners to access video sources in constructive ways. To leverage these affordances teachers need to integrate their knowledge of a technology with their professional knowledge about teaching. We suggest that this is a cognitive process, which is strongly connected to a teacher's mental model of the tool's…

Diversity evaluation based on morphological, physiological and isozyme variation in genetic resources of garlic (Allium sativum L.) collected worldwide.

PubMed

Hirata, Sho; Abdelrahman, Mostafa; Yamauchi, Naoki; Shigyo, Masayoshi

2016-11-26

The aim of this study was to obtain primary information about the global diversity of garlic (Allium sativum L.) by evaluating morphological, physiological and isozyme variation. A total of 107 garlic accessions collected worldwide were grown in Yamaguchi, Japan. Five morphological traits (bulb weight, bulb diameter, number of cloves per bulb, number of bulbils and scape length) and one physiological trait (bolting period) of the collected garlic showed wide variation. Meanwhile, a total of 140 garlic accessions, including the 107 mentioned above, were characterized by leucine aminopeptidase (LAP) and phosphoglucoisomerase (PGI) isozyme analyses; they clearly showed polymorphisms in putative isozyme loci (Lap-1, Lap-2 and Pgi-1). Allelic frequencies were estimated in each group of accessions categorized by their geographical origin, and the observed (H o ) and expected (H e ) heterozygosities were calculated. The allelic frequencies differed between groups. A principal component analysis based on morpho-physiological data indicated a grouping of the garlic accessions into Central Asian and Northern Mediterranean groups as well as others. We discuss the roles of artificial and natural selection that may have caused differentiation in these traits, on the assumption that ancestral domesticated garlic populations have adapted in various regions using standing variation or mutations that accumulated during expansion, and have evolved along with human-preferred traits over a long history of cultivation.

SiteDB: Marshalling people and resources available to CMS

NASA Astrophysics Data System (ADS)

Metson, S.; Bonacorsi, D.; Dias Ferreira, M.; Egeland, R.

2010-04-01

In a collaboration the size of CMS (approx. 3000 users, and almost 100 computing centres of varying size) communication and accurate information about the sites it has access to is vital in co-ordinating the multitude of computing tasks required for smooth running. SiteDB is a tool developed by CMS to track sites available to the collaboration, the allocation to CMS of resources available at those sites and the associations between CMS members and the sites (as either a manager/operator of the site or a member of a group associated to the site). It is used to track the roles a person has for an associated site or group. SiteDB eases the coordination load for the operations teams by providing a consistent interface to manage communication with the people working at a site, by identifying who is responsible for a given task or service at a site and by offering a uniform interface to information on CMS contacts and sites. SiteDB provides api's and reports for other CMS tools to use to access the information it contains, for instance enabling CRAB to use "user friendly" names when black/white listing CE's, providing role based authentication and authorisation for other web based services and populating various troubleshooting squads in external ticketing systems in use daily by CMS Computing operations.

Data storage technology comparisons

NASA Technical Reports Server (NTRS)

Katti, Romney R.

1990-01-01

The role of data storage and data storage technology is an integral, though conceptually often underestimated, portion of data processing technology. Data storage is important in the mass storage mode in which generated data is buffered for later use. But data storage technology is also important in the data flow mode when data are manipulated and hence required to flow between databases, datasets and processors. This latter mode is commonly associated with memory hierarchies which support computation. VLSI devices can reasonably be defined as electronic circuit devices such as channel and control electronics as well as highly integrated, solid-state devices that are fabricated using thin film deposition technology. VLSI devices in both capacities play an important role in data storage technology. In addition to random access memories (RAM), read-only memories (ROM), and other silicon-based variations such as PROM's, EPROM's, and EEPROM's, integrated devices find their way into a variety of memory technologies which offer significant performance advantages. These memory technologies include magnetic tape, magnetic disk, magneto-optic disk, and vertical Bloch line memory. In this paper, some comparison between selected technologies will be made to demonstrate why more than one memory technology exists today, based for example on access time and storage density at the active bit and system levels.

Globalising Accessibility: Drawing on the Experiences of Developed Countries to Enable the Participation of Disabled People in Zambia

ERIC Educational Resources Information Center

Banda-Chalwe, Martha; Nitz, Jennifer C.; de Jonge, Desleigh

2012-01-01

This paper explores the accessibility situation in a developing country such as Zambia. The global view of accessibility for disabled people is provided to examine the accessibility situation in developed and developing countries, highlighting the role of the environment in achieving rights for disabled people. Recognition of disability rights…

Beginning the socialization to a new workforce model: dental students' preliminary knowledge of and attitudes about the role of the dental therapist.

PubMed

Blue, Christine; Phillips, Robert; Born, David; Lopez, Naty

2011-11-01

The purpose of the study reported here was to assess first- and second-year dental students' knowledge of and attitudes about the role of the dental therapist in the oral health care delivery system. The results of this study are informing the continued development and implementation of a new dental workforce training model at the University of Minnesota. Dental students at the university (Classes of 2012 and 2013) were surveyed in 2009, with follow-up surveys planned for the subsequent five years. Multiple-choice questions and statements to be ranked using a Likert scale were used to determine what the students knew and thought about dental therapists' scope of practice, care delivery, work quality, cost-effectiveness, and role in reducing disparities in oral health care access. The results suggest that the students had generally neutral or uncertain attitudes about dental therapy, based on minimal knowledge about the role of dental therapists. In addition, we found little difference in attitudes between the two classes, the only exception being that the first-year students less often perceived the therapists as a solution to access problems. These baseline data are guiding the intraprofessional training of dental, dental hygiene, and dental therapy students toward the goal of positive socialization to a new workforce model and affirmation of the dental therapist as a member of the oral health care team.

Stigma as experienced by women accessing prevention of parent to child transmission of HIV services in Karnataka, India

PubMed Central

Rahangdale, Lisa; Banandur, Pradeep; Sreenivas, Amita; Turan, Janet; Washington, Reynold; Cohen, Craig R.

2010-01-01

In Karnataka, India only one-third of HIV-infected pregnant women received antiretroviral prophylaxis at delivery in 2007 through the state government’s prevention of parent-to-child HIV transmission (PPTCT) program. The current qualitative study explored the role of HIV-associated stigma as a barrier to accessing PPTCT services in the rural northern Karnataka district of Bagalkot using in depth interviews and focus group discussions with HIV-infected women who had participated in the PPTCT program, male and female family members, and HIV service providers. Participants discussed personal experiences, community perceptions of HIV, and decision-making related to accessing PPTCT services. They described stigma towards HIV-infected individuals from multiple sources: healthcare workers, community members, family and self. Stigma-related behaviors were based on fears of HIV transmission through personal contact and moral judgment. Experience and/or fears of discrimination led pregnant women to avoid using PPTCT interventions. Government, cultural and historical factors are described as the roots of much the stigma-related behavior in this setting. Based on these formative data, PPTCT program planners should consider further research and interventions aimed at diminishing institutional and interpersonal HIV-associated stigma experienced by pregnant women. PMID:20635247

Access to Aid-in-Dying in the United States: Shifting the Debate From Rights to Justice.

PubMed

Buchbinder, Mara

2018-06-01

Much of the literature on aid-in-dying (AID) has drawn heavily on rights-based ethical and legal frameworks that emphasize patients' rights of self-determination in end-of-life decision-making. Less attention has focused on how terminally ill people actually experience such putative rights once they are legally authorized. This analytic essay draws on findings from the Vermont Study on Aid-in-Dying, an ethnographic study of the implementation of AID in Vermont (2015-2017). First, I show that terminally ill people can face a range of barriers to accessing AID in permissive jurisdictions, and that access to AID is mediated by various inequalities endemic to US health care, as well as some that are unique to AID. I then build on these findings to examine the utility of the concept of justice for public health scholarship on AID. By integrating empirical, ethical, and policy analysis, I reframe rights-based frameworks that emphasize the role of individual choice and decision-making at the end of life. In doing so, I draw attention to health care justice as a neglected issue in public health perspectives on AID.

Prescribing Clinicians’ Perspectives on Evidence-Based Psychotherapy for Posttraumatic Stress Disorder

PubMed Central

Barnett, Erin R.; Bernardy, Nancy C.; Jenkyn, Aaron B.; Parker, Louise E.; Lund, Brian C.; Alexander, Bruce; Friedman, Matthew J.

2014-01-01

Evidence-based psychotherapies (EBP) for Posttraumatic Stress Disorder are not utilized to their full extent within the Department of Veterans Affairs (VA). VA provides care to many persons with PTSD and has been in the forefront of clinical practice guidelines and EBP training and dissemination. Yet VA continues to find EBP implementation difficult. Veterans with PTSD often initially present to prescribing clinicians, who then help make care decisions. It is therefore critical that these clinicians correctly screen and triage appropriate mental health care. The purpose of this study was to assess VA prescribing clinicians’ knowledge, perceptions, and referral behaviors related to EBPs for PTSD and to identify facilitators and barriers to implementing EBPs within VA. We conducted qualitative interviews with 26 VA prescribing clinicians. Limited access to EBPs was the most commonly noted barrier. The clinicians we interviewed also held specific beliefs and behaviors that may delay or deter EBPs. Strategies to improve utilization also emerged. Findings suggest the need for increased access to EBPs, training to optimize the role of prescribing clinicians in helping Veterans with PTSD make appropriate care decisions, and specific organizational changes to facilitate access and effective referral systems for EBPs. PMID:25431445

Assessing the role of access and price on the consumption of fruits and vegetables across New York City using agent-based modeling.

PubMed

Li, Yan; Zhang, Donglan; Thapa, Janani R; Madondo, Kumbirai; Yi, Stella; Fisher, Elisa; Griffin, Kerry; Liu, Bian; Wang, Youfa; Pagán, José A

2018-01-01

Most residents in New York City (NYC) do not consume sufficient fruits and vegetables every day. Difficulties with access and high prices of fruits and vegetables in some neighborhoods contribute to different consumption patterns across NYC neighborhoods. We developed an agent-based model (ABM) to predict dietary behaviors of individuals at the borough and neighborhood levels. Model parameters were estimated from the 2014 NYC Community Health Survey, United States Census data, and the literature. We simulated six hypothetical interventions designed to improve access and reduce the price of fruits and vegetables. We found that all interventions would lead to increases in fruit and vegetable consumption but the results vary substantially across boroughs and neighborhoods. For example, a 10% increase in the number of fruit/vegetable vendors combined with a 10% decrease in the prices of fruits and vegetables would lead to a median increase of 2.28% (range: 0.65%-4.92%) in the consumption of fruits and vegetables, depending on neighborhood. We also found that the impact of increasing the number of vendors on fruit/vegetable consumption is more pronounced in unhealthier local food environments while the impact of reducing prices on fruits/vegetable consumption is more pronounced in neighborhoods with low levels of education. An agent-based model of dietary behaviors that takes into account neighborhood context has the potential to inform how fruit/vegetable access and pricing strategies may specifically work in tandem to increase the consumption of fruits and vegetables at the local level. Copyright © 2017 Elsevier Inc. All rights reserved.

Cancer Caregiver: Perceived Benefits of Technology.

PubMed

Lapid, Maria I; Atherton, Pamela J; Clark, Matthew M; Kung, Simon; Sloan, Jeff A; Rummans, Teresa A

2015-11-01

The burden associated with caregiving has been well documented. Caregivers have multiple responsibilities, and technology may be accessible as a potential burden-alleviating resource. We surveyed cancer caregivers regarding current technology use and willingness to use technology for easing burden or distress. Because age has been associated with technology use, responses were compared between geriatric (≥65 years old) and nongeriatric (18-64 years old) caregivers. We had 112 respondents. Based on nonmissing responses, 66% (n=71) were women, 95% (n=106) were white, and 84% (n=91) had post-high school education. Almost all caregivers reported having Internet (105 [94%]) and e-mail (102 [91%]) access. Nongeriatric caregivers indicated more willingness to access Internet-based tools that help caregivers (54 [93%] versus 41 [76%]; p=0.04) and were more frequent users of social media (37 [64%] versus 16 [30%]; p=0.01), smartphones (33 [57%] versus 16 [30%]; p=0.01), and other mobile wireless devices (42 [72%] versus 19 [35%]; p<0.001) than geriatric caregivers. They also more frequently expected technologies to improve their own quality of life (p=0.009), increase their feelings of being effective as a caregiver (p=0.02), and save time (p=0.003). Regardless of age, a majority of caregivers (67 [62%]) endorsed the potential benefit of caregiving technologies in preventing burnout. Most caregivers have high access to and use of technology. Geriatric and nongeriatric caregivers were receptive to technology-based tools to help with their caregiving roles. Although nongeriatric caregivers expected to derive more benefit from such tools, both groups believed that caregiving technologies could reduce burden.

Cognitive and psychological science insights to improve climate change data visualization

NASA Astrophysics Data System (ADS)

Harold, Jordan; Lorenzoni, Irene; Shipley, Thomas F.; Coventry, Kenny R.

2016-12-01

Visualization of climate data plays an integral role in the communication of climate change findings to both expert and non-expert audiences. The cognitive and psychological sciences can provide valuable insights into how to improve visualization of climate data based on knowledge of how the human brain processes visual and linguistic information. We review four key research areas to demonstrate their potential to make data more accessible to diverse audiences: directing visual attention, visual complexity, making inferences from visuals, and the mapping between visuals and language. We present evidence-informed guidelines to help climate scientists increase the accessibility of graphics to non-experts, and illustrate how the guidelines can work in practice in the context of Intergovernmental Panel on Climate Change graphics.

The PO.DAAC Portal and its use of the Drupal Framework

NASA Astrophysics Data System (ADS)

Alarcon, C.; Huang, T.; Bingham, A.; Cosic, S.

2011-12-01

The Physical Oceanography Distributed Active Archive Center portal (http://podaac.jpl.nasa.gov) is the primary interface for discovering and accessing oceanographic datasets collected from the vantage point of space. In addition, it provides information about NASA's satellite missions and operational activities at the data center. Recently the portal underwent a major redesign and deployment utilizing the Drupal framework. The Drupal framework was chosen as the platform for the portal due to its flexibility, open source community, and modular infrastructure. The portal features efficient content addition and management, mailing lists, forums, role based access control, and a faceted dataset browse capability. The dataset browsing was built as a custom Drupal module and integrates with a SOLR search engine.

Can NGOs regulate medicines markets? Social enterprise in wholesaling, and access to essential medicines.

PubMed

Mackintosh, Maureen; Chaudhuri, Sudip; Mujinja, Phares Gm

2011-02-28

Citizens of high income countries rely on highly regulated medicines markets. However low income countries' impoverished populations generally struggle for access to essential medicines through out-of-pocket purchase on poorly regulated markets; results include ill health, drug resistance and further impoverishment. While the role of health facilities owned by non-governmental organisations (NGOs) in low income countries is well documented, national and international wholesaling of essential medicines by NGOs is largely unstudied. This article describes and assesses the activity of NGOs and social enterprise in essential medicines wholesaling. The article is based on a set of interviews conducted in 2006-8 with trading NGOs and social enterprises operating in Europe, India and Tanzania. The analysis applies socio-legal and economic perspectives on social enterprise and market regulation. Trading NGOs can resist the perverse incentives inherent in medicines wholesaling and improve access to essential medicines; they can also, in definable circumstances, exercise a broader regulatory influence over their markets by influencing the behaviour of competitors. We explore reasons for success and failure of social enterprise in essential medicines wholesaling, including commercial manufacturers' market response; social enterprise traders' own market strategies; and patterns of market advantage, market segmentation and subsidy generated by donors. We conclude that, in the absence of effective governmental activity and regulation, social enterprise wholesaling can improve access to good quality essential medicines. This role should be valued and where appropriate supported in international health policy design. NGO regulatory impact can complement but should not replace state action.

Can NGOs regulate medicines markets? Social enterprise in wholesaling, and access to essential medicines

PubMed Central

2011-01-01

Background Citizens of high income countries rely on highly regulated medicines markets. However low income countries' impoverished populations generally struggle for access to essential medicines through out-of-pocket purchase on poorly regulated markets; results include ill health, drug resistance and further impoverishment. While the role of health facilities owned by non-governmental organisations (NGOs) in low income countries is well documented, national and international wholesaling of essential medicines by NGOs is largely unstudied. This article describes and assesses the activity of NGOs and social enterprise in essential medicines wholesaling. Methods The article is based on a set of interviews conducted in 2006-8 with trading NGOs and social enterprises operating in Europe, India and Tanzania. The analysis applies socio-legal and economic perspectives on social enterprise and market regulation. Results Trading NGOs can resist the perverse incentives inherent in medicines wholesaling and improve access to essential medicines; they can also, in definable circumstances, exercise a broader regulatory influence over their markets by influencing the behaviour of competitors. We explore reasons for success and failure of social enterprise in essential medicines wholesaling, including commercial manufacturers' market response; social enterprise traders' own market strategies; and patterns of market advantage, market segmentation and subsidy generated by donors. Conclusions We conclude that, in the absence of effective governmental activity and regulation, social enterprise wholesaling can improve access to good quality essential medicines. This role should be valued and where appropriate supported in international health policy design. NGO regulatory impact can complement but should not replace state action. PMID:21356076

Optimizing Telehealth Strategies for Subspecialty Care: Recommendations from Rural Pediatricians

PubMed Central

Demirci, Jill R.; Bogen, Debra L.; Mehrotra, Ateev; Miller, Elizabeth

2015-01-01

Abstract Background: Telehealth offers strategies to improve access to subspecialty care for children in rural communities. Rural pediatrician experiences and preferences regarding the use of these telehealth strategies for children's subspecialty care needs are not known. We elicited rural pediatrician experiences and preferences regarding different pediatric subspecialty telehealth strategies. Materials and Methods: Seventeen semistructured telephone interviews were conducted with rural pediatricians from 17 states within the United States. Interviewees were recruited by e-mails to a pediatric rural health listserv and to rural pediatricians identified through snowball sampling. Themes were identified through thematic analysis of interview transcripts. Institutional Review Board approval was obtained. Results: Rural pediatricians identified several telehealth strategies to improve access to subspecialty care, including physician access hotlines, remote electronic medical record access, electronic messaging systems, live video telemedicine, and telehealth triage systems. Rural pediatricians provided recommendations for optimizing the utility of each of these strategies based on their experiences with different systems. Rural pediatricians preferred specific telehealth strategies for specific clinical contexts, resulting in a proposed framework describing the complementary role of different telehealth strategies for pediatric subspecialty care. Finally, rural pediatricians identified additional benefits associated with the use of telehealth strategies and described a desire for telehealth systems that enhanced (rather than replaced) personal relationships between rural pediatricians and subspecialists. Conclusions: Rural pediatricians described complementary roles for different subspecialty care telehealth strategies. Additionally, rural pediatricians provided recommendations for optimizing individual telehealth strategies. Input from rural pediatricians will be crucial for optimizing specific telehealth strategies and designing effective telehealth systems. PMID:25919585

Expanding the Role of Nurse Practitioners: Effects on Rural Access to Care for Injured Workers

ERIC Educational Resources Information Center

Sears, Jeanne M.; Wickizer, Thomas M.; Franklin, Gary M.; Cheadle, Allen D.; Berkowitz, Bobbie

2008-01-01

Context: A 3-year pilot program to expand the role of nurse practitioners (NPs) in the Washington State workers' compensation system was implemented in 2004 (SHB 1691), amid concern about disparities in access to health care for injured workers in rural areas. SHB 1691 authorized NPs to independently perform most functions of an attending…

The Role of Student Loans in College Access. Research Report.

ERIC Educational Resources Information Center

Baum, Sandy

This paper discusses the role of student loans in college access. Borrowing to pay for education is a sound decision for most students, and student loans are a vital part of college financing policy. There has been a considerable increase in student borrowing, and much of this results from the introduction of the Stafford Loan in 1993. Borrowing…

Predictors of Safety Training Transfer Support as In-Role Behavior of Occupational Health and Safety Professionals

ERIC Educational Resources Information Center

Freitas, Ana Cristina; Silva, Sílvia Agostinho; Santos, Catarina Marques

2017-01-01

Purpose: The purpose of this study is to identify individual and contextual influences on in-house safety trainers' role orientation toward the transfer of training (TT). Design/methodology/approach: The authors tested a model where felt-responsibility for TT mediates the influence of job resources (i.e. autonomy, access to resources, access to…

Leadership for Transformative Change: Lessons from Technology-Mediated Reform in Broad-Access Colleges. CCRC Working Paper No. 8

ERIC Educational Resources Information Center

Klempin, Serena; Karp, Melinda Mechur

2015-01-01

Community colleges and broad-access four-year institutions have a crucial role to play in increasing educational equity in the United States. In order to fulfill this role, however, institutions must engage in organizational change to address their low completion rates. Drawing on qualitative case studies of six colleges, this study explores the…

Community Engagement in a complex intervention to improve access to primary mental health care for hard-to-reach groups.

PubMed

Lamb, Jonathan; Dowrick, Christopher; Burroughs, Heather; Beatty, Susan; Edwards, Suzanne; Bristow, Kate; Clarke, Pam; Hammond, Jonathan; Waheed, Waquas; Gabbay, Mark; Gask, Linda

2015-12-01

Despite the availability of effective evidence-based treatments for depression and anxiety, many 'harder-to-reach' social and patient groups experience difficulties accessing treatment. We developed a complex intervention, the AMP (Improving Access to Mental Health in Primary Care) programme, which combined community engagement (CE), tailored (individual and group) psychosocial interventions and primary care involvement. To develop and evaluate a model for community engagement component of the complex intervention. This paper focuses on the development of relationships between stakeholders, their engagement with the issue of access to mental health and with the programme through the CE model. Our evaluation draws on process data, qualitative interviews and focus groups, brought together through framework analysis to evaluate the issues and challenges encountered. A case study of the South Asian community project carried out in Longsight in Greater Manchester, United Kingdom. Complex problems require multiple local stakeholders to work in concert. Assets based approaches implicitly make demands on scarce time and resources. Community development approaches have many benefits, but perceptions of open-ended investment are a barrier. The time-limited nature of a CE intervention provides an impetus to 'do it now', allowing stakeholders to negotiate their investment over time and accommodating their wider commitments. Both tangible outcomes and recognition of process benefits were vital in maintaining involvement. CE interventions can play a key role in improving accessibility and acceptability by engaging patients, the public and practitioners in research and in the local service ecology. © 2014 John Wiley & Sons Ltd.

Ethics, economics, and public financing of health care

PubMed Central

Hurley, J.

2001-01-01

There is a wide variety of ethical arguments for public financing of health care that share a common structure built on a series of four logically related propositions regarding: (1) the ultimate purpose of a human life or human society; (2) the role of health and its distribution in society in advancing this ultimate purpose; (3) the role of access to or utilisation of health care in maintaining or improving the desired level and distribution of health among members of society, and (4) the role of public financing in ensuring the ethically justified access to and utilisation of health care by members of society. This paper argues that economics has much to contribute to the development of the ethical foundations for publicly financed health care. It focuses in particular on recent economic work to clarify the concepts of access and need and their role in analyses of the just distribution of health care resources, and on the importance of economic analysis of health care and health care insurance markets in demonstrating why public financing is necessary to achieve broad access to and utilisation of health care services. Key Words: Ethics • economics • health care financing PMID:11479353

Values, inter-attitudinal structure, and attitude change: value accessibility can increase a related attitude's resistance to change.

PubMed

Blankenship, Kevin L; Wegener, Duane T; Murray, Renee A

2015-12-01

Accessibility is one of the most basic structural properties of an attitude and an important factor to consider in attitude strength. Despite its importance, relatively little work has examined the role of attitude accessibility in an inter-attitudinal context, particularly as it relates to the strength of related attitudes in the network. The present research examines accessibility as a property of one attitude (toward an abstract goal or end-state, that is, a value) that might influence the strength of a different but related attitude (toward a social policy conceptually related to the value). In Study 1, a highly accessible evaluative component of a value increased resistance to change of attitudes and behavioral intentions toward a social policy related to that value. Similarly, a manipulation of value accessibility (Studies 2 and 3) led to increased resistance of attitudes and behavioral intentions toward a social policy related to that value. Implications for the role of accessibility in inter-attitudinal strength are discussed. © 2015 by the Society for Personality and Social Psychology, Inc.

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

ERIC Educational Resources Information Center

Grandbois, Jennifer; Beheshti, Jamshid

2014-01-01

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

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

PubMed

Gathoni, Nasra

2012-01-01

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

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

PubMed Central

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

2013-01-01

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

Virtual Observatory Interfaces to the Chandra Data Archive

NASA Astrophysics Data System (ADS)

Tibbetts, M.; Harbo, P.; Van Stone, D.; Zografou, P.

2014-05-01

The Chandra Data Archive (CDA) plays a central role in the operation of the Chandra X-ray Center (CXC) by providing access to Chandra data. Proprietary interfaces have been the backbone of the CDA throughout the Chandra mission. While these interfaces continue to provide the depth and breadth of mission specific access Chandra users expect, the CXC has been adding Virtual Observatory (VO) interfaces to the Chandra proposal catalog and observation catalog. VO interfaces provide standards-based access to Chandra data through simple positional queries or more complex queries using the Astronomical Data Query Language. Recent development at the CDA has generalized our existing VO services to create a suite of services that can be configured to provide VO interfaces to any dataset. This approach uses a thin web service layer for the individual VO interfaces, a middle-tier query component which is shared among the VO interfaces for parsing, scheduling, and executing queries, and existing web services for file and data access. The CXC VO services provide Simple Cone Search (SCS), Simple Image Access (SIA), and Table Access Protocol (TAP) implementations for both the Chandra proposal and observation catalogs within the existing archive architecture. Our work with the Chandra proposal and observation catalogs, as well as additional datasets beyond the CDA, illustrates how we can provide configurable VO services to extend core archive functionality.

Developing accessible cyberinfrastructure-enabled knowledge communities in the national disability community: theory, practice, and policy.

PubMed

Myhill, William N; Cogburn, Derrick L; Samant, Deepti; Addom, Benjamin Kwasi; Blanck, Peter

2008-01-01

Since publication of the Atkins Commission report in 2003, the national scientific community has placed significant emphasis on developing cyberinfrastructure-enabled knowledge communities, which are designed to facilitate enhanced efficiency and collaboration in geographically distributed networks of researchers. This article suggests that the new cyberinfrastructure movement may not fully benefit those participants with disabilities, unless closer attention is paid to legal mandates and universal design principles. Many technology-enhanced learning communities provide geographically distributed collaboration opportunities that expand the inclusion of diverse peoples and help close the digital divide. However, to date, most collaboratory efforts have not emphasized the need for access among people with disabilities nor meeting minimum standards for technological accessibility. To address these concerns, this article reports on two pilot collaboratory studies that explore the role advanced information, communication, and collaboration technologies play in enhancing geographically distributed collaboration among specific research and applied networks within the national disability community. Universal design principles inform the design of the collaboratory and its use and our efforts to ensure access for all. Data for this article come from Web-based surveys, interviews, observations, computer logs, and detailed, mixed-methods accessibility testing. Emerging results suggest that with deliberate and systematic efforts, cyberinfrastructure can be more accessible and generate benefits among persons with disabilities. The authors provide lessons learned and recommendations for future research, policy, law, and practice.

The use of online information resources by nurses.

PubMed

Wozar, Jody A; Worona, Paul C

2003-04-01

Based on the results of an informal needs assessment, the Usage of Online Information Resources by Nurses Project was designed to provide clinical nurses with accurate medical information at the point of care by introducing them to existing online library resources through instructional classes. Actual usage of the resources was then monitored for a set period of time. A two-hour hands-on class was developed for interested nurses. Participants were instructed in the content and use of several different online resources. A special Web page was designed for this project serving as an access point to the resources. Using a password system and WebTrends trade mark software, individual participant's usage of the resources was monitored for a thirty-day period following the class. At the end of the thirty days, usage results were tabulated, and participants were sent general evaluation forms. Eight participants accessed the project page thirty-nine times in a thirty-day period. The most accessed resource was Primary Care Online (PCO), accessed thirty-three times. PCO was followed by MD Consult (17), Ovid (8), NLM resources (5), and electronic journals (1). The individual with the highest usage accessed the project page thirteen times. Practicing clinical nurses will use online medical information resources if they are first introduced to them and taught how to access and use them. Health sciences librarians can play an important role in providing instruction to this often overlooked population.

Wheelchair users, access and exclusion in South African higher education.

PubMed

Chiwandire, Desire; Vincent, Louise

2017-01-01

South Africa's Constitution guarantees everyone, including persons with disabilities, the right to education. A variety of laws are in place obliging higher education institutions to provide appropriate physical access to education sites for all. In practice, however, many buildings remain inaccessible to people with physical disabilities. To describe what measures South African universities are taking to make their built environments more accessible to students with diverse types of disabilities, and to assess the adequacy of such measures. We conducted semi-structured in-depth face-to-face interviews with disability unit staff members (DUSMs) based at 10 different public universities in South Africa. Challenges with promoting higher education accessibility for wheelchair users include the preservation and heritage justification for failing to modify older buildings, ad hoc approaches to creating accessible environments and failure to address access to toilets, libraries and transport facilities for wheelchair users. South African universities are still not places where all students are equally able to integrate socially. DUSMs know what ought to be done to make campuses more accessible and welcoming to students with disabilities and should be empowered to play a leading role in sensitising non-disabled members of universities, to create greater awareness of, and appreciation for, the multiple ways in which wheelchair user students continue to be excluded from full participation in university life. South African universities need to adopt a systemic approach to inclusion, which fosters an understanding of inclusion as a fundamental right rather than as a luxury.

Qualitative analysis of a nurse's responses to stroke caregivers on a web-based supportive intervention.

PubMed

Pierce, Linda L; Steiner, Victoria; de Dios, Ann Margaret Vergel; Vollmer, Megan; Govoni, Amy L; Thompson, Teresa L Cervantez

2015-04-01

Approximately 800 000 people experience a stroke every year; most are cared for by unpaid family members in home settings. Web-based interventions provide 24/7 access to education/support services and have been explored in the literature with family caregivers dealing with chronic conditions. Current research into nurses' web-based interactions with caregivers in these interventions is lacking. The aim of this qualitative secondary data analysis was to examine a nurse specialist's responses and advice that she gave in a web-based supportive intervention for stroke family caregivers used in a randomized controlled trial for 1 year. Using a qualitative research design, caregivers were recruited from rehabilitation facilities in Ohio and Michigan (n = 36). They accessed the intervention's email forum and discussion group facilitated by the nurse. These email message data were examined using rigorous content analysis. The caregivers were primarily white women caring for a spouse, with an average age of 54 years. From the 2148 email messages between the nurse and caregivers, five themes emerged and were drawn to Friedemann's Framework. These themes included: getting to know the situation (Friedemann's coherence and individuation), validating emotions (individuation), promoting self-care (individuation), assisting in role adaptation (system maintenance and individuation), and providing healthcare information (system maintenance and individuation). These caregivers of stroke survivors were asking for advice, seeking support, and looking for information from an advanced practice nurse. Nurses, and others, in supportive roles can use these findings to promote informed care and directed interventions for caregivers dealing with stroke and its outcomes.

Scholarly Electronic Full-Text Publications via the Internet: Issues and Impacts

NASA Technical Reports Server (NTRS)

Kosmin, Linda J.

1999-01-01

On-line access to complete texts of scholarly journal articles, conference papers, and books is facilitated by rapidly developing World-wide Web Internet access and capabilities. Meanwhile, print publications continue to be produced and read in spite of the proliferation of many networked electronic publications. The purpose of this presentation is to highlight fundamental issues impacting stakeholder groups, as the trend continues towards migration from paper to affordable ubiquitous networked full-text publications. Librarians, publishers, authors and end-users have various viewpoints, interests, and concerns. There are many issues challenging all stakeholder groups. For instance, all share concerns about administering copyright compliance and enforcing fair use. Uncontrollable electronic downstreaming could result in infringed copyright, while limiting a publisher's entitled revenue stream. Moreover, metered fee-based access may hamper scholarly information research. And, self-authoring on the Internet without peer filtering could lead to information clutter. Many related issues challenge librarians in particular. Among these are rising journal subscription prices, regardless if offered in print or electronic. Some electronic offerings are independent of print, others supplement or duplicate print; several publishers presently require subscribing to print in order to access electronic. Furthermore, numbers of publications are n'ow being marketed via the Internet directly to end-users, which can be viewed as encouraging users to bypass the traditional library. A key issue challenging publishers today is the rapidly expanding electronic user base that is demanding delivery of added-value full-text to desktop computers. Also of growing concern appears to be the decline in print sales to libraries, thereby reducing traditional revenue stream potential. Nowadays, publishers are more hesitant about investing in the production of publications geared toward small niche subjects, since these tend to require higher pricing and carry limited sales potential. Both electronic and print publications necessitate similar editorial, production, operating, and marketing dollars. Tradeoffs owing to delivery format difference do not necessarily mean less dollars need to be spent. Authors wishing to publish books are facing a decline in the role of scholarly monographs in electronic media. However, they are witnessing increased roles of electronic preprints and electronic journal articles. Moreover, the Internet fosters self-publishing without peer monitoring or formal review. Issues challenging end-users include electronic barriers to peer-reviewed formal published works (i.e., fee-based subscriptions to journal literature vs. traditional free-library concept). This often means password only access or IP address controlled site-licensed access. Also, in an uncontrolled Internet environment, sometimes there is a blurring of publication authorship/ownership, as various pieces of publications are cut/pasted into/re-posted on various, disconnected Web searchable home pages.

Sociocultural variables in youth access to tobacco: replication 5 years later.

PubMed

Landrine, H; Klonoff, E A; Campbell, R; Reina-Patton, A

2000-05-01

A prior study presented the only systematic investigation of the role of sociocultural variables in youth access to tobacco. White, black, and Latino girls and boys attempted to purchase cigarettes in the same 72 stores at the same time of day. Results revealed significantly greater sales to girls than to boys and to minorities than to whites. Before concluding that sociocultural variables must be addressed in merchant intervention programs designed to reduce youth access to tobacco, this study must be replicated, particularly in light of the significant decreases in youth access in the past 5 years. This article presents that replication. The stores used in the prior study were selected, and 12 white, black, and Latino girls and boys attempted to purchase cigarettes in those stores at the same time of day. Results Youths' access rate in 1999 (12.7%) was significantly lower than in the prior (1993-1995) study (41%). No effect for minors' gender was found, but the ethnicity effect again emerged: Black and Latino youth were 2.5 times more likely to be sold cigarettes than their white counterparts. Multiple sociocultural variables affect youth access to tobacco when access rates are high, but only youth ethnicity plays a role when access rates are low. Merchant interventions designed to reduce youth access to tobacco must address ethnic issues.

Evidence for morphological composition in compound words using MEG.

PubMed

Brooks, Teon L; Cid de Garcia, Daniela

2015-01-01

Psycholinguistic and electrophysiological studies of lexical processing show convergent evidence for morpheme-based lexical access for morphologically complex words that involves early decomposition into their constituent morphemes followed by some combinatorial operation. Considering that both semantically transparent (e.g., sailboat) and semantically opaque (e.g., bootleg) compounds undergo morphological decomposition during the earlier stages of lexical processing, subsequent combinatorial operations should account for the difference in the contribution of the constituent morphemes to the meaning of these different word types. In this study we use magnetoencephalography (MEG) to pinpoint the neural bases of this combinatorial stage in English compound word recognition. MEG data were acquired while participants performed a word naming task in which three word types, transparent compounds (e.g., roadside), opaque compounds (e.g., butterfly), and morphologically simple words (e.g., brothel) were contrasted in a partial-repetition priming paradigm where the word of interest was primed by one of its constituent morphemes. Analysis of onset latency revealed shorter latencies to name compound words than simplex words when primed, further supporting a stage of morphological decomposition in lexical access. An analysis of the associated MEG activity uncovered a region of interest implicated in morphological composition, the Left Anterior Temporal Lobe (LATL). Only transparent compounds showed increased activity in this area from 250 to 470 ms. Previous studies using sentences and phrases have highlighted the role of LATL in performing computations for basic combinatorial operations. Results are in tune with decomposition models for morpheme accessibility early in processing and suggest that semantics play a role in combining the meanings of morphemes when their composition is transparent to the overall word meaning.

Overcoming access barriers to health services through membership-based microfinance organizations: a review of evidence from South Asia

PubMed Central

Saha, Somen; Annear, Peter Leslie

2015-01-01

It is a challenge for the poor to overcome the barriers to accessing health services. Membership-based microfinance with associated health programmes can improve health outcomes for the poor. This study reviewed the evidence published between 1993 and 2013 on the role of membership-based microfinance with associated health programmes in improving health outcomes for the poor in South Asia. A total of 661 papers were identified and 26 selected for inclusion, based on the relevance and rigour of the research methods. Of these 26, five were evidence reviews. Of the remaining 21 papers, 12 were from India, seven from Bangladesh, and one each from Sri Lanka and Indonesia. Three papers addressed more than one theme. Five key themes emerged from the review: (i) the impact of microfinance programmes on the social and economic situation of the poor; (ii) the impact of microfinance programmes on community health; (iii) the impact of integrated microfinance health programmes on raising client awareness; (iv) the impact of integrated microfinance health programmes on financing health care; and (v) the impact of integrated microfinance health programmes on affordable health-care products and services. The review provides new evidence on the pathways through which microfinance helps to improve population health and value for money for such programmes. Among countries with large populations in the informal sector, there is a strong case for policy-makers to support these groups in providing access to life-saving health care among the poor. PMID:25685728

Postglacial migration supplements climate in determining plant species ranges in Europe

PubMed Central

Normand, Signe; Ricklefs, Robert E.; Skov, Flemming; Bladt, Jesper; Tackenberg, Oliver; Svenning, Jens-Christian

2011-01-01

The influence of dispersal limitation on species ranges remains controversial. Considering the dramatic impacts of the last glaciation in Europe, species might not have tracked climate changes through time and, as a consequence, their present-day ranges might be in disequilibrium with current climate. For 1016 European plant species, we assessed the relative importance of current climate and limited postglacial migration in determining species ranges using regression modelling and explanatory variables representing climate, and a novel species-specific hind-casting-based measure of accessibility to postglacial colonization. Climate was important for all species, while postglacial colonization also constrained the ranges of more than 50 per cent of the species. On average, climate explained five times more variation in species ranges than accessibility, but accessibility was the strongest determinant for one-sixth of the species. Accessibility was particularly important for species with limited long-distance dispersal ability, with southern glacial ranges, seed plants compared with ferns, and small-range species in southern Europe. In addition, accessibility explained one-third of the variation in species' disequilibrium with climate as measured by the realized/potential range size ratio computed with niche modelling. In conclusion, we show that although climate is the dominant broad-scale determinant of European plant species ranges, constrained dispersal plays an important supplementary role. PMID:21543356

Exploring the use of nonmedical sources of prescription drugs among immigrant Latinos in the rural Southeastern USA.

PubMed

Vissman, Aaron T; Bloom, Fred R; Leichliter, Jami S; Bachmann, Laura H; Montaño, Jaime; Topmiller, Michael; Rhodes, Scott D

2011-01-01

Little is known about access to medicine among immigrant Latinos in the United States (US). This study explored access to, and use of, prescription drugs obtained from nonmedical sources among recently arrived, Spanish-speaking immigrant Latinos in rural North Carolina (NC). Our community-based participatory research partnership collected, analyzed, and interpreted data from individual in-depth interviews with Latino community members and rural health service providers. A purposive sample of 30 community members, including traditional healers, religious leaders, transgender Latinos, heterosexual Latino men and women, and Latino gay men, were interviewed to gain emic ("insider") perspectives on use of nonmedical sources of prescription drugs. Six local Latino health service providers also were interviewed to gain etic ("outsider") perspectives on use. Participants described the roles of tiendas (grocers), family, and social networks in accessing treatment advice and prescription drugs. They described health care expectations among immigrants and contingencies for accessing prescription drugs in the US. Prescription medicines (eg, antibiotics, hormones, Viagra, analgesics), injection equipment (eg, syringes), and medical advice were identified as readily available from nonmedical sources. Increased access to formalized health care and effective health education initiatives are needed to meet the challenges facing immigrant Latinos. © 2010 National Rural Health Association.

Joint Battlespace Infosphere: Information Management Within a C2 Enterprise

DTIC Science & Technology

2005-06-01

using. In version 1.2, we support both MySQL and Oracle as underlying implementations where the XML metadata schema is mapped into relational tables in...Identity Servers, Role-Based Access Control, and Policy Representation – Databases: Oracle , MySQL , TigerLogic, Berkeley XML DB 15 Instrumentation Services...converted to SQL for execution. Invocations are then forwarded to the appropriate underlying IOR core components that have the responsibility of issuing

Continued Funding for Prime Development

DTIC Science & Technology

2012-04-18

Portal The PrIMe Portal is based on the Drupal open-source software. During the past year we upgraded it to version 6. There are currently over 350...Primekinetics.org ( Drupal Data warehouse \\, WebDAV Access Layer - L qeirch Re~~ est Role validation/Authorization Authentication Module I ~ Module...PHP language with the help of CMF Drupal -6. The standard modules of the Drupal core set are developed by third parties and obtained from the

E-Learning in a Low-Status Female Profession: The Role of Motivation, Anxiety and Social Support in the Learning Divide

ERIC Educational Resources Information Center

Vandenbroeck, M.; Verschelden, G.; Boonaert, T.

2008-01-01

The literature seems to suggest that women may be at risk from being excluded from adult education programmes, which use e-learning, especially when they have low economic status. Based on a survey of 551 women, family day care providers, we conclude that there is a persistent divide in PC access and use, as well as in perceived PC skills…

Role of Military in Post-Conflict Sri Lanka

DTIC Science & Technology

2012-03-01

state of Tamil Eelam based on the rights of self- determination .”30 They protested restricted citizenship and franchise rights for South Indian Tamils...Lankan terrorist organizations from August 1983 for several reasons,38 beginning with New Delhi’s objection to Sri Lanka’s pro -Western policy after 1977...nonTaxnom. (accessed August 15, 2011) 35 Government of Sri Lanka, “The Parliament of Sri Lanka, 1978 Constitution,” http://www.priu.gov.lk/ Cons

Trends in hospital librarianship and hospital library services: 1989 to 2006.

PubMed

Thibodeau, Patricia L; Funk, Carla J

2009-10-01

The research studied the status of hospital librarians and library services to better inform the Medical Library Association's advocacy activities. The Vital Pathways Survey Subcommittee of the Task Force on Vital Pathways for Hospital Librarians distributed a web-based survey to hospital librarians and academic health sciences library directors. The survey results were compared to data collected in a 1989 survey of hospital libraries by the American Hospital Association in order to identify any trends in hospital libraries, roles of librarians, and library services. A web-based hospital library report form based on the survey questions was also developed to more quickly identify changes in the status of hospital libraries on an ongoing basis. The greatest change in library services between 1989 and 2005/06 was in the area of access to information, with 40% more of the respondents providing access to commercial online services, 100% more providing access to Internet resources, and 28% more providing training in database searching and use of information resources. Twenty-nine percent (n = 587) of the 2005/06 respondents reported a decrease in staff over the last 5 years. Survey data support reported trends of consolidation of hospitals and hospital libraries and additions of new services. These services have likely required librarians to acquire new skills. It is hoped that future surveys will be undertaken to continue to study these trends.

Trends in hospital librarianship and hospital library services: 1989 to 2006

PubMed Central

Thibodeau, Patricia L.; Funk, Carla J.

2009-01-01

Objective: The research studied the status of hospital librarians and library services to better inform the Medical Library Association's advocacy activities. Methods: The Vital Pathways Survey Subcommittee of the Task Force on Vital Pathways for Hospital Librarians distributed a web-based survey to hospital librarians and academic health sciences library directors. The survey results were compared to data collected in a 1989 survey of hospital libraries by the American Hospital Association in order to identify any trends in hospital libraries, roles of librarians, and library services. A web-based hospital library report form based on the survey questions was also developed to more quickly identify changes in the status of hospital libraries on an ongoing basis. Results: The greatest change in library services between 1989 and 2005/06 was in the area of access to information, with 40% more of the respondents providing access to commercial online services, 100% more providing access to Internet resources, and 28% more providing training in database searching and use of information resources. Twenty-nine percent (n = 587) of the 2005/06 respondents reported a decrease in staff over the last 5 years. Conclusions: Survey data support reported trends of consolidation of hospitals and hospital libraries and additions of new services. These services have likely required librarians to acquire new skills. It is hoped that future surveys will be undertaken to continue to study these trends. PMID:19851491

End-user searching: impetus for an expanding information management and technology role for the hospital librarian.

PubMed Central

Klein, M S; Ross, F

1997-01-01

Using the results of the 1993 Medical Library Association (MLA) Hospital Libraries Section survey of hospital-based end-user search services, this article describes how end-user search services can become an impetus for an expanded information management and technology role for the hospital librarian. An end-user services implementation plan is presented that focuses on software, hardware, finances, policies, staff allocations and responsibilities, educational program design, and program evaluation. Possibilities for extending end-user search services into information technology and informatics, specialized end-user search systems, and Internet access are described. Future opportunities are identified for expanding the hospital librarian's role in the face of changing health care management, advances in information technology, and increasing end-user expectations. PMID:9285126

Harmonizing the Interests of Free Speech, Obscenity, and Child Pornography in Cyberspace: The New Roles of Parents, Technology, and Legislation for Internet Safety

PubMed Central

Olagunju, Amos O.

2009-01-01

Inadvertent access to website addresses and spam e-mails continue to make pornography rampant on the Internet in schools, homes, and libraries. Collectively, parents, teachers, and members of the community must become more aware of the risks and consequences of open access to the Internet, and the distinction between censorship and Internet access filtering. Parental involvement is crucial for raising children with healthy Internet habits to access social and educational materials. Although generations have coped with different times and trials, technology is ushering in new trials. Parents and communities cannot ignore the present and future technology ingrained into the lives of children. This paper contends that parents armed with legislation and technological security devices for access to the Internet ought to strengthen the character of online Internet safety. The discussion is focused on the roles that parents, communities, technology, and laws should play in order to protect children from obscene and pornographic threats from cyberspace. It is argued that the roles of education and technology should outweigh the legislative interventions of governments. A critique of significant litigations and laws on obscenity and pornography is presented. The paper offers a variety of security tools and techniques for protecting children from Internet access to obscene and pornographic materials. The impacts of pornographic materials on the welfare of children, adolescents, women, and families are discussed. PMID:19936562

Role of the chromatin landscape and sequence in determining cell type-specific genomic glucocorticoid receptor binding and gene regulation.

PubMed

Love, Michael I; Huska, Matthew R; Jurk, Marcel; Schöpflin, Robert; Starick, Stephan R; Schwahn, Kevin; Cooper, Samantha B; Yamamoto, Keith R; Thomas-Chollier, Morgane; Vingron, Martin; Meijsing, Sebastiaan H

2017-02-28

The genomic loci bound by the glucocorticoid receptor (GR), a hormone-activated transcription factor, show little overlap between cell types. To study the role of chromatin and sequence in specifying where GR binds, we used Bayesian modeling within the universe of accessible chromatin. Taken together, our results uncovered that although GR preferentially binds accessible chromatin, its binding is biased against accessible chromatin located at promoter regions. This bias can only be explained partially by the presence of fewer GR recognition sequences, arguing for the existence of additional mechanisms that interfere with GR binding at promoters. Therefore, we tested the role of H3K9ac, the chromatin feature with the strongest negative association with GR binding, but found that this correlation does not reflect a causative link. Finally, we find a higher percentage of promoter-proximal GR binding for genes regulated by GR across cell types than for cell type-specific target genes. Given that GR almost exclusively binds accessible chromatin, we propose that cell type-specific regulation by GR preferentially occurs via distal enhancers, whose chromatin accessibility is typically cell type-specific, whereas ubiquitous target gene regulation is more likely to result from binding to promoter regions, which are often accessible regardless of cell type examined. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

Harmonizing the interests of free speech, obscenity, and child pornography in cyberspace: the new roles of parents, technology, and legislation for internet safety.

PubMed

Olagunju, Amos O

2009-11-18

Inadvertent access to website addresses and spam e-mails continue to make pornography rampant on the Internet in schools, homes, and libraries. Collectively, parents, teachers, and members of the community must become more aware of the risks and consequences of open access to the Internet, and the distinction between censorship and Internet access filtering. Parental involvement is crucial for raising children with healthy Internet habits to access social and educational materials. Although generations have coped with different times and trials, technology is ushering in new trials. Parents and communities cannot ignore the present and future technology ingrained into the lives of children. This paper contends that parents armed with legislation and technological security devices for access to the Internet ought to strengthen the character of online Internet safety. The discussion is focused on the roles that parents, communities, technology, and laws should play in order to protect children from obscene and pornographic threats from cyberspace. It is argued that the roles of education and technology should outweigh the legislative interventions of governments. A critique of significant litigations and laws on obscenity and pornography is presented. The paper offers a variety of security tools and techniques for protecting children from Internet access to obscene and pornographic materials. The impacts of pornographic materials on the welfare of children, adolescents, women, and families are discussed.

Incorporating digital health literacy into adult ESL education on the US-Mexico border.

PubMed

Mein, Erika; Fuentes, Brenda; Soto Más, Francisco; Muro, Andrés

2012-12-01

The increasing digitization of information and communication has undoubtedly impacted the ways in which people in the United States access and interpret health information. Although the traditional emphasis of health literacy research has been the comprehension of health-related texts such as patient information forms, prescriptions, and medicine labels, the increased use of electronic means to locate health information requires more critical engagement with texts beyond basic comprehension. In accessing electronic health information, patients need to be able to navigate the vast amount of online health information and to interpret and synthesize health information across multiple sources (i.e. websites) while also evaluating the credibility of these sources. Recent health literacy research has examined the increased role of the media literacy in influencing health behaviors (Bergsma & Carney, 2008) and the role of increased access to computers (Salovey et al., 2009), but little (if any) research to date has provided recommendations for best practices related to meeting the health literacy demands required by digitization. This article attempts to fill this gap by exploring the use of the internet as a key source of health information and by looking at best practices in teaching digital health literacy. It describes the development of a digital literacy component within a community-based health literacy/ESL curriculum funded by the National Institutes of Health and implemented on the US-Mexico border.

Incorporating digital health literacy into adult ESL education on the US-Mexico border

PubMed Central

Mein, Erika; Fuentes, Brenda; Soto Más, Francisco; Muro, Andrés

2013-01-01

The increasing digitization of information and communication has undoubtedly impacted the ways in which people in the United States access and interpret health information. Although the traditional emphasis of health literacy research has been the comprehension of health-related texts such as patient information forms, prescriptions, and medicine labels, the increased use of electronic means to locate health information requires more critical engagement with texts beyond basic comprehension. In accessing electronic health information, patients need to be able to navigate the vast amount of online health information and to interpret and synthesize health information across multiple sources (i.e. websites) while also evaluating the credibility of these sources. Recent health literacy research has examined the increased role of the media literacy in influencing health behaviors (Bergsma & Carney, 2008) and the role of increased access to computers (Salovey et al., 2009), but little (if any) research to date has provided recommendations for best practices related to meeting the health literacy demands required by digitization. This article attempts to fill this gap by exploring the use of the internet as a key source of health information and by looking at best practices in teaching digital health literacy. It describes the development of a digital literacy component within a community-based health literacy/ESL curriculum funded by the National Institutes of Health and implemented on the US-Mexico border. PMID:23730533

Adolescent and Young Adult Cancer Survivorship Educational Programming: A Qualitative Evaluation

PubMed Central

Fair, Kayla; Hong, Yan Alicia; Kellstedt, Debra; Ory, Marcia G

2017-01-01

Background This program evaluation considers the need for increased professional and patient education for adolescent and young adult (AYA) cancer survivorship. Due to the high incidence of late effects of cancer treatment among AYA cancer survivors, knowledge sharing and communications are needed throughout the transition from cancer care into community care. AYA survivors are likely to need developmentally appropriate psychosocial care as well as extensive follow-on surveillance by physicians who are educated and aware of the likely chronic conditions and late effects that may occur in these patients. Objective The objective of this study was to evaluate the outcomes of the After Cancer Care Ends, Survivorship Starts for Adolescent and Young Adults (ACCESS AYA) programming. The intent of the ACCESS AYA program was to build health literacy around AYA survivorship issues and to stimulate improved communications between survivors and health care providers. This paper addresses the central research question of “How did the ACCESS AYA program increase health literacy, communications, and understanding among AYA survivors and providers?” Methods The primarily qualitative evaluation included a brief introductory survey of participant awareness and effectiveness of the ACCESS AYA project serving as a recruitment tool. Survey respondents were invited to participate in in-depth interviews based on interview guides tailored to the different stakeholder groups. The evaluation used the Atlas Ti qualitative database and software for coding and key word analyses. Interrater reliability analyses were assessed using Cohen kappa analysis with Stata 12.1 (StataCorp LLC) software. Results The key themes, which included survivor wellbeing, health care professional education, cancer advocates role and education, hospital and community-based resources, and the role of societal support, are presented in a concept map. The interrater reliability scores (ranging from 1 to minus 1) were .893 for first cycle coding and .784 for the second cycle. In the brief quantitative survey based on a scale of 1 to 5 with 5 as high, the 22 respondents rated their level of awareness of the project with a mean 3.2 (CI 3.02-3.45) and project effectiveness with a mean of 4 (CI 3.72-4.27). Conclusions This study contributes to understanding of the ACCESS AYA survivor community in central Texas and the health care professionals and advocates who aid them in their efforts to a new normal life and wellbeing in their survivorship. The results of the evaluation highlight the need to continue to build both survivor and professional resources to address the unique impact of cancer on AYA cancer survivors. PMID:28410172

Eyes on the prize: reflections on the impact of the evolving digital ecology on the librarian as expert intermediary and knowledge coach, 1969-2009.

PubMed

Homan, J Michael

2010-01-01

The 2009 Janet Doe Lecture reflects on the continuing value and increasing return on investment of librarian-mediated services in the constantly evolving digital ecology and complex knowledge environment of the health sciences. The interrelationship of knowledge, decision making based on knowledge, technology used to access and retrieve knowledge, and the important linkage roles of expert librarian intermediaries is examined. Professional experiences from 1969 to 2009, occurring during a time of unprecedented changes in the digital ecology of librarianship, are the base on which the evolving role and value of librarians as knowledge coaches and expert intermediaries are examined. Librarian-mediated services linking knowledge and critical decision making in health care have become more valuable than ever as technology continues to reshape an increasingly complex knowledge environment.

The evolving identity, capacity, and capability of the future surgeon.

PubMed

Himidan, Sharifa; Kim, Peter

2015-06-01

Technology has transformed surgery more within the last 30 years than the previous 2000 years of human history combined. These innovations have changed not only how the surgeon practices but have also altered the very essence of what it is to be a surgeon in the modern era. Beyond the industrial revolution, today's information revolution allows patients access to an abundance of easily accessible, unfiltered information which they can use to evaluate their surgical treatment, and truly participate in their personal care. We are entering yet another revolution specifically affecting surgeons, where the traditional surgical tools of our craft are becoming "smart." Intelligence in surgical tools and connectivity based on sensory data, processing, and analysis are enabling and enhancing a surgeon's capacity and capability. Given the tempo of change, within one generation the traditional role and identity of a surgeon will be fully transformed. In this article, the impact of the information revolution, technological advances combined with smart connectivity on the changing role of surgery will be considered. Copyright © 2015 Elsevier Inc. All rights reserved.

Visual Access in Interpreter-Mediated Learning Situations for Deaf and Hard-of-Hearing High School Students Where an Artifact Is in Use

PubMed Central

Thomassen, Gøril

2016-01-01

This article highlights interpreter-mediated learning situations for deaf high school students where such mediated artifacts as technical machines, models, and computer graphics are used by the teacher to illustrate his or her teaching. In these situations, the teacher’s situated gestures and utterances, and the artifacts will contribute independent pieces of information. However, the deaf student can only have his or her visual attention focused on one source at a time. The problem to be addressed is how the interpreter coordinates the mediation when it comes to deaf students’ visual orientation. The presented discourse analysis is based on authentic video recordings from inclusive learning situations in Norway. The theoretical framework consists of concepts of role, footing, and face-work (Goffman, E. (1959). The presentation of self in everyday life. London, UK: Penguin Books). The findings point out dialogical impediments to visual access in interpreter-mediated learning situations, and the article discusses the roles and responsibilities of teachers and educational interpreters. PMID:26681267

Prioritizing health disparities in medical education to improve care.

PubMed

Awosogba, Temitope; Betancourt, Joseph R; Conyers, F Garrett; Estapé, Estela S; Francois, Fritz; Gard, Sabrina J; Kaufman, Arthur; Lunn, Mitchell R; Nivet, Marc A; Oppenheim, Joel D; Pomeroy, Claire; Yeung, Howa

2013-05-01

Despite yearly advances in life-saving and preventive medicine, as well as strategic approaches by governmental and social agencies and groups, significant disparities remain in health, health quality, and access to health care within the United States. The determinants of these disparities include baseline health status, race and ethnicity, culture, gender identity and expression, socioeconomic status, region or geography, sexual orientation, and age. In order to renew the commitment of the medical community to address health disparities, particularly at the medical school level, we must remind ourselves of the roles of doctors and medical schools as the gatekeepers and the value setters for medicine. Within those roles are responsibilities toward the social mission of working to eliminate health disparities. This effort will require partnerships with communities as well as with academic centers to actively develop and to implement diversity and inclusion strategies. Besides improving the diversity of trainees in the pipeline, access to health care can be improved, and awareness can be raised regarding population-based health inequalities. © 2013 New York Academy of Sciences.

Accessibility and socio-economic development of human settlements.

PubMed

Hasan, Samiul; Wang, Xiaoming; Khoo, Yong Bing; Foliente, Greg

2017-01-01

Access to facilities, services and socio-economic opportunities plays a critical role in the growth and decline of cities and human settlements. Previous attempts to explain changes in socio-economic indicators by differences in accessibility have not been convincing as countries with highly developed transport infrastructure have only seen marginal benefits of infrastructure improvements. Australia offers an ideal case for investigating the effects of accessibility on development since it is seen as home to some of the most liveable cities in the world while, at the same time, it also has some of the most isolated settlements. We investigate herein the connectivity and accessibility of all 1814 human settlements (population centers exceeding 200 persons) in Australia, and how they relate to the socio-economic characteristics of, and opportunities in, each population center. Assuming population as a proxy indicator of available opportunities, we present a simple ranking metric for a settlement using the number of population and the distance required to access all other settlements (and the corresponding opportunities therein). We find a strikingly unequal distribution of access to opportunities in Australia, with a marked prominence of opportunities in capital cities in four of the eight states. The two largest cities of Sydney and Melbourne have a dominant position across all socio-economic indicators, compared to all the other cities. In general, we observe across all the settlements that a decrease in access to opportunities is associated with relatively greater socio-economic disadvantage including increased median age and unemployment rate and decreased median household income. Our methodology can be used to better understand the potential benefits of improved accessibility based on infrastructure development, especially for remote areas and for cities and towns with many socio-economically disadvantaged population.

Accessibility and socio-economic development of human settlements

PubMed Central

Wang, Xiaoming; Khoo, Yong Bing; Foliente, Greg

2017-01-01

Access to facilities, services and socio-economic opportunities plays a critical role in the growth and decline of cities and human settlements. Previous attempts to explain changes in socio-economic indicators by differences in accessibility have not been convincing as countries with highly developed transport infrastructure have only seen marginal benefits of infrastructure improvements. Australia offers an ideal case for investigating the effects of accessibility on development since it is seen as home to some of the most liveable cities in the world while, at the same time, it also has some of the most isolated settlements. We investigate herein the connectivity and accessibility of all 1814 human settlements (population centers exceeding 200 persons) in Australia, and how they relate to the socio-economic characteristics of, and opportunities in, each population center. Assuming population as a proxy indicator of available opportunities, we present a simple ranking metric for a settlement using the number of population and the distance required to access all other settlements (and the corresponding opportunities therein). We find a strikingly unequal distribution of access to opportunities in Australia, with a marked prominence of opportunities in capital cities in four of the eight states. The two largest cities of Sydney and Melbourne have a dominant position across all socio-economic indicators, compared to all the other cities. In general, we observe across all the settlements that a decrease in access to opportunities is associated with relatively greater socio-economic disadvantage including increased median age and unemployment rate and decreased median household income. Our methodology can be used to better understand the potential benefits of improved accessibility based on infrastructure development, especially for remote areas and for cities and towns with many socio-economically disadvantaged population. PMID:28636630

Negotiating Access to Health Information to Promote Students' Health

ERIC Educational Resources Information Center

Radis, Molly E.; Updegrove, Stephen C.; Somsel, Anne; Crowley, Angela A.

2016-01-01

Access to student health information, such as immunizations, screenings, and care plans for chronic conditions, is essential for school nurses to fulfill their role in promoting students' health. School nurses typically encounter barriers to accessing health records and spend many hours attempting to retrieve health information. As a result,…

Librarians and Libraries Supporting Open Access Publishing

ERIC Educational Resources Information Center

Richard, Jennifer; Koufogiannakis, Denise; Ryan, Pam

2009-01-01

As new models of scholarly communication emerge, librarians and libraries have responded by developing and supporting new methods of storing and providing access to information and by creating new publishing support services. This article will examine the roles of libraries and librarians in developing and supporting open access publishing…

Open Access and Civic Scientific Information Literacy

ERIC Educational Resources Information Center

Zuccala, Alesia

2010-01-01

Introduction: We examine how residents and citizens of The Netherlands perceive open access to acquire preliminary insight into the role it might play in cultivating civic scientific literacy. Open access refers to scientific or scholarly research literature available on the Web to scholars and the general public in free online journals and…

Trust-based Access Control in Virtual Learning Community

NASA Astrophysics Data System (ADS)

Wang, Shujuan; Liu, Qingtang

The virtual learning community is an important application pattern of E-Learning. It emphasizes the cooperation of the members in the community, the members would like to share their learning resources, to exchange their experience and complete the study task together. This instructional mode has already been proved as an effective way to improve the quality and efficiency of instruction. At the present time, the virtual learning communities are mostly designed using static access control policy by which the access permission rights are authorized by the super administrator, the super administrator assigns different rights to different roles, but the virtual and social characteristics of virtual learning community make information sharing and collaboration a complex problem, the community realizes its instructional goal only if the members in it believe that others will offer the knowledge they owned and believe the knowledge others offered is well-meaning and worthy. This paper tries to constitute an effective trust mechanism, which could promise favorable interaction and lasting knowledge sharing.

The Impact of Blended Learning on Student Performance in a Cardiovascular Pharmacotherapy Course

PubMed Central

McLaughlin, Jacqueline E.; Gharkholonarehe, Nastaran; Khanova, Julia; Deyo, Zach M.

2015-01-01

Objective. To examine student engagement with, perception of, and performance resulting from blended learning for venous thromboembolism in a required cardiovascular pharmacotherapy course for second-year students. Design. In 2013, key foundational content was packaged into an interactive online module for students to access prior to coming to class; class time was dedicated to active-learning exercises. Assessment. Students who accessed all online module segments participated in more in class clicker questions (p=0.043) and performed better on the examination (p=0.023). There was no difference in clicker participation or examination performance based on time of module access (prior to or after class). The majority of participants agreed or strongly agreed that foundational content learned prior to class, applied activities during class, and content-related questions in the online module greatly enhanced learning. Conclusion. This study highlights the importance of integrating online modules with classroom learning and the role of blended learning in improving academic performance. PMID:25861105

Role of Protein and Amino Acids in Infant and Young Child Nutrition: Considerations for the Development and Delivery of High Quality Complementary Food Supplements.

PubMed

Ghosh, Shibani; Kurpad, Anura; Tano-Debrah, Kwaku; Otoo, Gloria E; Aaron, Grant A; Toride, Yasuhiko; Uauy, Ricardo

2015-01-01

Prevention of malnutrition in infants and children is multifaceted and requires the following: access to and intake of nutritious food starting at birth with exclusive breastfeeding for the first 6 mo of life, continued breastfeeding in combination with complementary foods from 6-24 mo of age, access to clean drinking water and sanitation, and access to preventive and curative health care (including prenatal). Nutrient-dense complementary foods can improve nutritional status and have long-term benefits; however, in a review of plant-based complementary foods in developing countries, most of them failed to meet many micronutrient requirements. There is need to provide other cost-effective alternatives to increase the quality of the diet during the complementary feeding stage of the lifecycle. This paper provides an overview of the development, testing, efficacy and effectiveness of the delivery of KOKO Plus on the growth and nutritional status of infants 6-24 mo of age.

Who's in the Queue? A Demographic Analysis of Public Access Computer Users and Uses in U.S. Public Libraries. Research Brief Number 4

ERIC Educational Resources Information Center

Manjarrez, Carlos A.; Schoembs, Kyle

2011-01-01

Over the past decade, policy discussions about public access computing in libraries have focused on the role that these institutions play in bridging the digital divide. In these discussions, public access computing services are generally targeted at individuals who either cannot afford a computer and Internet access, or have never received formal…

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

ERIC Educational Resources Information Center

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

2015-01-01

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

Access control mechanism of wireless gateway based on open flow

NASA Astrophysics Data System (ADS)

Peng, Rong; Ding, Lei

2017-08-01

In order to realize the access control of wireless gateway and improve the access control of wireless gateway devices, an access control mechanism of SDN architecture which is based on Open vSwitch is proposed. The mechanism utilizes the features of the controller--centralized control and programmable. Controller send access control flow table based on the business logic. Open vSwitch helps achieve a specific access control strategy based on the flow table.

Scalable principles of community-based high-value care for seriously ill individuals: Diamonds in the rough.

PubMed

Parikh, Ravi B; Bowman, Brynn; Dahlin, Constance; Twohig, Jeanne S; Meier, Diane E

2017-03-01

Early, integrated palliative care has been shown to improve quality of life and reduce utilization in both inpatient and outpatient settings. As health systems shift to risk-based payment structures, palliative care will play an increasing role in improving value of care outside of the hospital. Based on successful models of community-based palliative care, we identify six principles - interdisciplinary team-based care; 24/7 access and responsiveness; concurrent palliative care with disease-directed treatment; targeting services to high-risk patients; integrated medical and social supports; and caregiver support - that are widely implemented because of their impact on improving value for seriously ill individuals. Copyright © 2016 Elsevier Inc. All rights reserved.

Are community-based pharmacists underused in the care of persons living with HIV? A need for structural and policy changes

PubMed Central

Kibicho, Jennifer; Pinkerton, Steven D.; Owczarzak, Jill; Mkandawire–Valhmu, Lucy; Kako, Peninnah M.

2016-01-01

Objectives To describe community pharmacists' perceptions on their current role in direct patient care services, an expanded role for pharmacists in providing patient care services, and changes needed to optimally use pharmacists' expertise to provide high-quality direct patient care services to people living with human immunodeficiency virus (HIV) infections. Design Cross-sectional study. Setting Four Midwestern cities in the United States in August through October 2009. Participants 28 community-based pharmacists practicing in 17 pharmacies. Interventions Interviews. Main Outcome Measures Opinions of participants about roles of specialty and nonspecialty pharmacists in caring for patients living with human immunodeficiency virus infections. Results Pharmacists noted that although challenges in our health care system characterized by inaccessible health professionals presented opportunities for a greater pharmacist role, there were missed opportunities for greater level of patient care services in many community-based nonspecialty settings. Many pharmacists in semispecialty and nonspecialty pharmacies expressed a desire for an expanded role in patient care congruent with their pharmacy education and training. Conclusion Structural-level policy changes needed to transform community-based pharmacy settings to patient-centered medical homes include recognizing pharmacists as important players in the multidisciplinary health care team, extending the health information exchange highway to include pharmacist-generated electronic therapeutic records, and realigning financial incentives. Comprehensive policy initiatives are needed to optimize the use of highly trained pharmacists in enhancing the quality of health care to an ever-growing number of Americans with chronic conditions who access care in community-based pharmacy settings. PMID:25575148

The role of community pharmacy-based vaccination in the USA: current practice and future directions

PubMed Central

Bach, Albert T; Goad, Jeffery A

2015-01-01

Community pharmacy-based provision of immunizations in the USA has become commonplace in the last few decades, with success in increasing rates of immunizations. Community pharmacy-based vaccination services are provided by pharmacists educated in the practice of immunization delivery and provide a convenient and accessible option for receiving immunizations. The pharmacist’s role in immunization practice has been described as serving in the roles of educator, facilitator, and immunizer. With a majority of pharmacist-provided vaccinations occurring in the community pharmacy setting, there are many examples of community pharmacists serving in these immunization roles with successful outcomes. Different community pharmacies employ a number of different models and workflow practices that usually consist of a year-round in-house service staffed by their own immunizing pharmacist. Challenges that currently exist in this setting are variability in scopes of immunization practice for pharmacists across states, inconsistent reimbursement mechanisms, and barriers in technology. Many of these challenges can be alleviated by continual education; working with legislators, state boards of pharmacy, stakeholders, and payers to standardize laws; and reimbursement design. Other challenges that may need to be addressed are improvements in communication and continuity of care between community pharmacists and the patient centered medical home. PMID:29354521

Vascular access type, health-related quality of life, and depression in hemodialysis patients: a preliminary report.

PubMed

Afsar, Baris; Elsurer, Rengin; Covic, Adrian; Kanbay, Mehmet

2012-01-01

Arteriovenous fistulas (AVF) are the vascular access of choice for hemodialysis (HD) compared with arteriovenous grafts (AVG) and central venous catheters (CVC). In spite of increasing recognition of importance of a patient's perception of health-related quality of life (HRQOL) and depression, few studies have assessed the association of vascular access type with HRQOL and depression. The purpose of our study was to examine HRQOL and depression among patients with different vascular access. Severity of symptoms of depression and HRQOL were assessed by Beck Depression Inventory (BDI) and Short Form-36 (SF-36), respectively. Vascular access was reported as one of three options; AVF, AVG, and CVC. In total, 136 patients were included; 104 had AVF, 15 had AVG, and 17 had CVC. BDI and HRQOL parameters differed among patients with different vascular access types. In post hoc analysis, BDI and HRQOL subscales were not different between patients with AVF and AVG. Patients with CVC had lower physical functioning (P:.001), role-physical limitation (P:.015), general health perception (P:.017), vitality (P:.010), social functioning (P:.004), role-emotional (P:.008), mental health (P:.001), physical component summary score (P:.017), and mental component summary score (P:.006) when compared to patients with AVF. Patients with CVC had lower physical functioning (P:.044), role-emotional (P:.044) and mental health scores (P:.04) when compared to patients with AVG. Having a CVC may negatively influence HRQOL in HD patients. Vascular access type does not seem to be related to depressed mood in HD.

MedBlock: Efficient and Secure Medical Data Sharing Via Blockchain.

PubMed

Fan, Kai; Wang, Shangyang; Ren, Yanhui; Li, Hui; Yang, Yintang

2018-06-21

With the development of electronic information technology, electronic medical records (EMRs) have been a common way to store the patients' data in hospitals. They are stored in different hospitals' databases, even for the same patient. Therefore, it is difficult to construct a summarized EMR for one patient from multiple hospital databases due to the security and privacy concerns. Meanwhile, current EMRs systems lack a standard data management and sharing policy, making it difficult for pharmaceutical scientists to develop precise medicines based on data obtained under different policies. To solve the above problems, we proposed a blockchain-based information management system, MedBlock, to handle patients' information. In this scheme, the distributed ledger of MedBlock allows the efficient EMRs access and EMRs retrieval. The improved consensus mechanism achieves consensus of EMRs without large energy consumption and network congestion. In addition, MedBlock also exhibits high information security combining the customized access control protocols and symmetric cryptography. MedBlock can play an important role in the sensitive medical information sharing.

Primary care physicians' knowledge of and confidence in their referrals for special education services in 3- to 5-year-old children.

PubMed

Hastings, Elizabeth A; Lumeng, Julie C; Clark, Sarah J

2014-02-01

Children 3 to 5 years old with developmental delays are eligible for special education services. To assess primary care physicians' (PCPs) knowledge, attitudes, and practices regarding their referrals to the special education system on behalf of children 3 to 5 years old. Mail survey of 400 office-based general pediatricians and 414 family physicians in Michigan, fielded in fall 2012 and winter 2013, with a response rate of 44%. The 4-page survey included knowledge questions about special education eligibility, PCPs' role in accessing school-based services, and self-confidence in ability to help patients access these services. PCPs neither fully understood requirements for special education services nor were they very confident in identifying 3- to 5-year-old children eligible for special education services. PCPs recognize interacting with special education as a relative weakness, and they may be accepting of interventions to improve their knowledge and skills.

Stigma as a barrier to treatment for child acute malnutrition in Marsabit County, Kenya.

PubMed

Bliss, Jessica Robin; Njenga, Martin; Stoltzfus, Rebecca Joyce; Pelletier, David Louis

2016-01-01

Acute malnutrition affects millions of children each year, yet global coverage of life-saving treatment through the community-based management of acute malnutrition (CMAM) is estimated to be below 15%. We investigated the potential role of stigma as a barrier to accessing CMAM. We surveyed caregivers bringing children to rural health facilities in Marsabit County, Kenya, divided into three strata based on the mid-upper arm circumference of the child: normal status (n = 327), moderate acute malnutrition (MAM, n = 241) and severe acute malnutrition (SAM, n = 143). We used multilevel mixed effects logistic regression to estimate the odds of reporting shame as a barrier to accessing health care. We found that the most common barriers to accessing child health care were those known to be universally problematic: women's time and labour constraints. These constituted the top five most frequently reported barriers regardless of child acute malnutrition status. In contrast, the odds of reporting shame as a barrier were 3.64 (confidence interval: 1.66-8.03, P < 0.05) times higher in caregivers of MAM and SAM children relative to those of normal children. We conclude that stigma is an under-recognized barrier to accessing CMAM and may constrain programme coverage. In light of the large gap in coverage of CMAM, there is an urgent need to understand the sources of acute malnutrition-associated stigma and adopt effective means of de-stigmatization. © 2015 John Wiley & Sons Ltd.

HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT FOR THE ADOPTION OF INNOVATIVE MEDICAL DEVICES WITHIN FRENCH HOSPITALS: OPPORTUNITIES AND CHALLENGES FOR INDUSTRY.

PubMed

Dutot, Camille; Mercier, Grégoire; Borget, Isabelle; de Sauvebeuf, Côme; Martelli, Nicolas

2017-01-01

Within French university hospitals, some internal committees are in charge of conducting hospital-based health technology assessment (Hb-HTA) to support managerial decisions regarding the adoption of innovations. For manufacturers, hospitals are usually the entry point for new and innovative medical devices, which cannot be accessed without the Hb-HTA committees' approval. Thus, the main objective of this pilot survey was to explore manufacturers' insights into Hb-HTA processes. A two-step pilot survey was conducted in 2014. First, semi-structured phone interviews were carried out to capture manufacturers' feedback on the Hb-HTA procedure. Second, a prospective and iterative questionnaire designed to explore manufacturers' market access strategies was administered. Eight manufacturers from the medical device industry completed the retrospective phone interviews, and five of them participated in the prospective survey. According to the overall feedback, the Hb-HTA process timeline and transparency are major issues, and the expectations of internal committees, especially in terms of clinical evidence, remain difficult to understand. However, despite this and due to the complexity of reimbursement processes at the national level, manufacturers are increasingly considering hospital adoption through Hb-HTA submission as a viable market access and coverage opportunity. Our study reaffirms the primary role of hospitals in the diffusion of innovative medical devices. However, to ensure efficient and broad access to innovation, cooperation between local and national HTA bodies is critical and should be promoted.

Boys Go Fishing, Girls Work at Home: Gender Roles, Poverty and Unequal School Access among Semi-Nomadic Fishing Communities in South Western Madagascar

ERIC Educational Resources Information Center

Nascimento Moreira, Catarina; Rabenevanana, Man Wai; Picard, David

2017-01-01

Drawing from data gathered in South Western Madagascar in 2011, the work explores the combination of poverty and traditional gender roles as a critical factor in determining unequal school access among young people from semi-nomadic fishing communities. It demonstrates that from the age of early puberty, most boys go fishing with their fathers and…

Despite Increased Insurance Coverage, Nonwhite Sexual Minorities Still Experience Disparities In Access To Care.

PubMed

Hsieh, Ning; Ruther, Matt

2017-10-01

Previous studies suggest that members of sexual minority groups have poorer access to health services than heterosexuals. However, few studies have examined how sexual orientation interacts with gender and race to affect health care experience. Moreover, little is known about the role in health care disparities played by economic strains such as unemployment and poverty, which may result from prejudice and discrimination based on sexual orientation. Using data for 2013-15 from the National Health Interview Survey, we found that most members of sexual minority groups no longer have higher uninsurance rates than heterosexuals, but many continue to experience poorer access to high-quality care. Gay nonwhite men, bisexual white women, and bisexual and lesbian nonwhite women are disadvantaged in multiple aspects of access, compared to straight white men. Only some of these disparities are attributable to economic factors, which implies that noneconomic barriers to care are substantial. Our results suggest that the intersection of multiple social identities can reveal important gaps in health care experience. Making culturally sensitive services available may be key to closing the gaps. Project HOPE—The People-to-People Health Foundation, Inc.

Food mirages: geographic and economic barriers to healthful food access in Portland, Oregon.

PubMed

Breyer, Betsy; Voss-Andreae, Adriana

2013-11-01

This paper investigated the role of grocery store prices in structuring food access for low-income households in Portland, Oregon. We conducted a detailed healthful foods market basket survey and developed an index of store cost based on the USDA Thrifty Food Plan. Using this index, we estimated the difference in street-network distance between the nearest low-cost grocery store and the nearest grocery store irrespective of cost. Spatial regression of this metric in relation to income, poverty, and gentrification at the census tract scale lead to a new theory regarding food access in the urban landscape. Food deserts are sparse in Portland, but food mirages are abundant, particularly in gentrifying areas where poverty remains high. In a food mirage, grocery stores are plentiful but prices are beyond the means of low-income households, making them functionally equivalent to food deserts in that a long journey to obtain affordable, nutritious food is required in either case. Results suggested that evaluation of food environments should, at a minimum, consider both proximity and price in assessing healthy food access for low-income households. © 2013 Elsevier Ltd. All rights reserved.

USDOT ATTRI program : international innovation coordination plan : final report.

DOT National Transportation Integrated Search

2016-12-01

Transportation plays a critical role in enhancing access to education, jobs, healthcare, recreation, leisure, and other activities. The United States Department of Transportations (USDOTs) Accessible Transportation Technology Research Initiativ...

Social Justice Debate and College Access in Latin America: Merit or Need? The Role of Educational Institutions and States in Broadening Access to Higher Education in the Region

ERIC Educational Resources Information Center

Villalobos, Cristóbal; Treviño, Ernesto; Wyman, Ignacio; Scheele, Judith

2017-01-01

During the first decade of the 21st century, Latin America experienced an intense economic growth that increased access in the school system. In this context, the paper analyzes four different programs from Bolivia (Intercultural Community Indigenous Universities), Brazil (Quotas´ Law), Chile (Follow up and Effective Access to Higher Education…

Mobile devices and weak ties: a study of vision impairments and workplace access in Bangalore.

PubMed

Pal, Joyojeet; Lakshmanan, Meera

2015-07-01

To explore ways in which social and economic interactions are changed by access to mobile telephony. This is a mixed-methods study of mobile phone use among 52 urban professionals with vision impairments in Bangalore, India. Interviews and survey results indicated that mobile devices, specifically those with adaptive technology software, play a vital role as multi-purpose devices that enable people with disabilities to navigate economically and socially in an environment where accessibility remains a significant challenge. We found that mobile devices play a central role in enabling and sustaining weak ties, but also that these weak ties have important gender-specific implications. We found that women have less access to weak ties than men, which impacts women's access to assistive technology (AT). This has potential implications for women's sense of safety and independence, both of which are strongly related to AT access. Implications for Rehabilitation Adaptive technologies increase individuals' ability to keep in contact with casual connections or weak ties through phone calls or social media. Men tend to have stronger access to weak ties than women in India due to cultural impediments to independent access to public spaces. Weak ties are an important source of assistive technology (AT) due to the high rate of resale of used AT, typically through informal networks.

The Role of Health Kiosks in 2009: Literature and Informant Review

PubMed Central

Jones, Ray

2009-01-01

Kiosks can provide patients with access to health systems in public locations, but with increasing home Internet access their usefulness is questioned. A literature and informant review identified kiosks used for taking medical histories, health promotion, self assessment, consumer feedback, patient registration, patient access to records, and remote consultations. Sited correctly with good interfaces, kiosks can be used by all demographics but many ‘projects’ have failed to become routine practice. A role remains for: (a) integrated kiosks as part of patient ‘flow’, (b) opportunistic kiosks to catch people’s attention. Both require clear ‘ownership’ to succeed. PMID:19578463

Water reclamation, reuse and public health.

PubMed

Rose, J B

2007-01-01

The number of people who have limited access to high-quality water has increased, and while this is a growing global crisis, water issues, problems and solutions are often seen as localised. Water reuse and reclamation will play a significant role in achieving sustainability and public health protection in the future. The wastewater and reuse community should be responsible for monitoring sewage impacts and improvements as demonstrated through pathogen reduction with appropriate treatment. Viruses, Cryptosporidium and Giardia can all be reduced during treatment anywhere from 99% to 99.9999%, achieving drinking water quality, if so desired. Recommendations to achieve better access to scientific information for decision making include: 1) developing a global data base for biological contaminant loading from wastewater and 2) defining the public health protection via reuse and reclamation.

Access to Health Care: Does Neighborhood Residential Instability Matter?

ERIC Educational Resources Information Center

Kirby, James B.; Kaneda, Toshiko

2006-01-01

Many Americans do not have access to adequate medical care. Previous research on this problem focuses primarily on individual-level determinants of access such as income and insurance coverage. The role of community-level factors in helping or hindering individuals in obtaining needed medical care, however, has not received much attention. We…

Globalizing Higher Education Access in South-West Nigeria

ERIC Educational Resources Information Center

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

2013-01-01

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

Women's Declining Employment with Access to Higher Education: Issues and Challenges

ERIC Educational Resources Information Center

Sangar, Sunita

2014-01-01

Access to higher education opened up avenues for more women workforce in decent employment contributing to the national economy. Government policies/schemes played a significant role in improving this significant indicator of women empowerment. This access also had an impact on their enrolment and choice of subjects but was accompanied by several…

Child Health and Access to Medical Care

ERIC Educational Resources Information Center

Leininger, Lindsey; Levy, Helen

2015-01-01

It might seem strange to ask whether increasing access to medical care can improve children's health. Yet Lindsey Leininger and Helen Levy begin by pointing out that access to care plays a smaller role than we might think, and that many other factors, such as those discussed elsewhere in this issue, strongly influence children's health.…

Access to healthcare insurance and healthcare services among syringe exchange program clients in Massachusetts: qualitative findings from health navigators with the iDU ("I do") Care Collaborative.

PubMed

Stopka, Thomas J; Hutcheson, Marguerite; Donahue, Ashley

2017-05-18

Little is known about access to health insurance among people who inject drugs (PWID) who attend syringe exchange programs (SEPs). The goal of the current study was to assess perceptions of SEP staff, including health navigators and program managers, on access to health insurance and healthcare access among SEP clients following implementation of state and federal policies to enhance universal healthcare access in Massachusetts. Between December 2014 and January 2015, we conducted in-depth interviews (n = 14) with SEP staff, including both program managers and health navigators, to assess knowledge, attitudes, and beliefs related to health insurance enrollment and access to enhanced referrals among SEP clients. We developed a preliminary coding scheme from the interview guide and used a grounded theory approach to guide inclusion of subsequent thematic codes that emanated from the data. We analyzed the coded data thematically in an iterative fashion using a consensus-based approach. We identified five primary themes that emerged from the qualitative interviews, including high levels of health insurance enrollment among SEP clients; barriers to enrolling in health insurance; highly needed referrals to services, including improved access to substance use disorder treatment and hepatitis C virus treatment; barriers to referring clients to these highly needed services; and recommendations for policy change. While barriers to enrollment and highly needed referrals remain, access to and enrollment in healthcare insurance plans among PWID at SEPs in Massachusetts are high. With the uncertain stability of the Affordable Care Act following the US presidential election of 2016, our findings summarize the opportunities and challenges that are connected to health insurance and healthcare access in Massachusetts. SEPs can play an important role in facilitating access to health insurance and enhancing access to preventive health and primary care.

Collaborative remembering revisited: Study context access modulates collaborative inhibition and later benefits for individual memory.

PubMed

Abel, Magdalena; Bäuml, Karl-Heinz T

2017-11-01

Collaborating groups typically show reduced recall relative to nominal groups, i.e., to the cumulated non-redundant recall of the same number of people remembering in isolation-a finding termed collaborative inhibition. Motivated by the results of several previous studies, this study examined in two experiments whether access to study context at test influences the effects of collaboration. In both experiments, subjects collaborated in triads or recalled previously studied material in isolation. Experiment 1 applied short versus prolonged retention intervals to vary access to study context at test, whereas Experiment 2 used the list-method directed forgetting task and applied remember versus forget instructions to modulate context access. In both experiments, collaborative inhibition was present when access to study context at test was intact (i.e., after the short delay and the remember instruction) but was eliminated when the access was impaired (i.e., after the prolonged delay and the forget instruction). Also, post-collaborative gains for individual recall were greater when context access was impaired and collaborative inhibition was eliminated. The findings demonstrate a critical role of access to study context at test for collaborative inhibition, indicating that impaired context access may reflect a general boundary condition for the recall impairment. The possible role of context reactivation processes for beneficial effects of social recall is discussed.

Investigating the validity and usability of an interactive computer programme for assessing competence in telephone-based mental health triage.

PubMed

Sands, Natisha; Elsom, Stephen; Keppich-Arnold, Sandra; Henderson, Kathryn; King, Peter; Bourke-Finn, Karen; Brunning, Debra

2016-02-01

Telephone-based mental health triage services are frontline health-care providers that operate 24/7 to facilitate access to psychiatric assessment and intervention for people requiring assistance with a mental health problem. The mental health triage clinical role is complex, and the populations triage serves are typically high risk; yet to date, no evidence-based methods have been available to assess clinician competence to practice telephone-based mental health triage. The present study reports the findings of a study that investigated the validity and usability of the Mental Health Triage Competency Assessment Tool, an evidence-based, interactive computer programme designed to assist clinicians in developing and assessing competence to practice telephone-based mental health triage. © 2015 Australian College of Mental Health Nurses Inc.

Climate Change Impact on the Southeastern Europe Security Environment and the Increasing Role of the Bulgarian Army as the World Warms

DTIC Science & Technology

2016-06-10

expected risks posed by climate change will reshape the Bulgarian Army structure and capabilities if the Army is to develop the proficiency to face...thousands of local timber based manufacturers and small scaled industries, and a few big and international oriented pulp, paper and board producers...prevention, social timber supply, etc.55 54 Union of Concerned Scientists, “Climate Hot Map,” accessed 20

Ombudsmen in health care: case study of a municipal health ombudsman

PubMed Central

da Silva, Rita de Cássia Costa; Pedroso, Marcelo Caldeira; Zucchi, Paola

2014-01-01

OBJECTIVE To analyze the role of a Municipal Health Ombudsman and its contribution to the public health management from the perspective of the public health system users and the municipal health counselors. METHODS Qualitative research approach using the case study, descriptive and transversal methods. The unit of analysis was a Municipal Health Ombudsman, in the state of Minas Gerais, Southeastern Brazil, between May and August 2010. The study was observational in nature and data were collected through interviews with two groups of stakeholders: users and municipal health counselors. We interviewed 44 Brazilian Unified Health System users who had made direct use of the Municipal Health Ombudsman and all 20 municipal health counselors. The data obtained were analyzed based on three issues: (1) nature of the data obtained; (2) discussion of subsidies to qualify the ombudsman’s functioning as a management tool; (3) proposals for actions to improve democratic management in the area of public health. RESULTS The complaints to the ombudsman denoted difficulties in access to health care services running the risk of their being perceived as shortcuts to gaining accessibility, disregarding the principle of social justice. The role of the ombudsman has the citizens’ approval. Users reported the following main functions of the ombudsman: to support the resolution of health problems, to listen and to clarify issues regarding Brazilian Unified Health System operations and procedures. Information was emphasized by health counselors as an instrument of power and access to the rights of Brazilian Unified Health System users. They highlighted that the ombudsman has the role of ensuring justice to foster an effective health policy, besides playing an important mediating role between the board of the municipal health system, its managers and citizens. Furthermore, the ombudsman was shown to have an execution role that transcends its regular functions. CONCLUSIONS The study found that the ombudsman is a key management tool in monitoring the health care system. Therefore, the establishment of the ombudsman is an advance in the field of democratic management. Nevertheless, there are challenges to be overcome in order to improve ombudsman contribution to the execution of health policies and representing citizens in ensuring their rights to health care. PMID:24789646

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

PubMed

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

2015-01-01

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

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

PubMed Central

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

2015-01-01

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

The relationship between sociability and productivity.

PubMed

Karimi, Saeed; Mohammadinia, Leila; Mofid, Maryam; Javadi, Marziye; Torabi, Reza

2014-01-01

When productivity is in the same way with culture and organized socialization, it is the gem of organization that can ensure stableness and survival of the organizations and be the mechanism for taking the competitive advantage. In contrast, the attention to socialization and the effect of that on productivity is less than its effect on public culture and organization culture. Hence this article evaluates the relationship between these variables in two groups of employees in selected hospitals in Isfahan. This study is descriptive - correlation. The subject society who was studied was employees (nurses and staffs) of Kashany educational public hospital, Isabn Maryam public hospital, charitable Hojatie hospital and private Sadi hospitals in Isfahan province. For determination of socialization, the Biligard questionnaire and for productivity of employees the productivity questionnaire based on Goldesmit model were used that the justifiability and stability of them are confirmed by experts. The number of subject under study is calculated based on 250 persons-formula sampling. There is a direct and significant correlation between socialization and productivity. On the other hand, the factors such age, sex, organizational position, history and the kind of employment, had no role excluding Sadi hospital. Although the productivity of the employees affects the accessibility of the hospital to its effective goals, the effective factors that play a role in increasing or decreasing the accessibility cannot be ignored.

Trends in academic health sciences libraries and their emergence as the "knowledge nexus" for their academic health centers.

PubMed

Kronenfeld, Michael R

2005-01-01

The objective of this study was to identify trends in academic health sciences libraries (AHSLs) as they adapt to the shift from a print knowledgebase to an increasingly digital knowledgebase. This research was funded by the 2003 David A. Kronick Traveling Fellowship. The author spent a day and a half interviewing professional staff at each library. The questionnaire used was sent to the directors of each library in advance of the visit, and the directors picked the staff to be interviewed and set up the schedule. Seven significant trends were identified. These trends are part of the shift of AHSLs from being facility and print oriented with a primary focus on their role as repositories of a print-based knowledgebase to a new focus on their role as the center or "nexus" for the organization, access, and use of an increasingly digital-based knowledgebase. This paper calls for a national effort to develop a new model or structure for health sciences libraries to more effectively respond to the challenges of access and use of a digital knowledgebase, much the same way the National Library of Medicine did in the 1960s and 1970s in developing and implementing the National Network of Libraries of Medicine. The paper then concludes with some examples or ideas for research to assist in this process.

Trends in academic health sciences libraries and their emergence as the “knowledge nexus” for their academic health centers*

PubMed Central

Kronenfeld, Michael R.

2005-01-01

Objectives: The objective of this study was to identify trends in academic health sciences libraries (AHSLs) as they adapt to the shift from a print knowledgebase to an increasingly digital knowledgebase. This research was funded by the 2003 David A. Kronick Traveling Fellowship. Methods: The author spent a day and a half interviewing professional staff at each library. The questionnaire used was sent to the directors of each library in advance of the visit, and the directors picked the staff to be interviewed and set up the schedule. Results: Seven significant trends were identified. These trends are part of the shift of AHSLs from being facility and print oriented with a primary focus on their role as repositories of a print-based knowledgebase to a new focus on their role as the center or “nexus” for the organization, access, and use of an increasingly digital-based knowledgebase. Conclusion: This paper calls for a national effort to develop a new model or structure for health sciences libraries to more effectively respond to the challenges of access and use of a digital knowledgebase, much the same way the National Library of Medicine did in the 1960s and 1970s in developing and implementing the National Network of Libraries of Medicine. The paper then concludes with some examples or ideas for research to assist in this process. PMID:15685271

Computer security: a necessary element of integrated information systems.

PubMed Central

Butzen, F; Furler, F

1986-01-01

The Matheson Report sees the medical library as playing a key role in a network of interlocking information bases that will extend from central repositories of medical information to each physician's personal records. It appears, however, that the role of security in this vision has not been fully delineated. This paper discusses problems in maintaining the security of confidential medical information, the state of the applicable law, and techniques for security (with special emphasis on the UNIX operating system). It is argued that the absence of security threatens any plan to build an information network, as there will be resistance to any system that may give intruders access to confidential data. PMID:3742113

An Information Architect's View of Earth Observations for Disaster Risk Management

NASA Astrophysics Data System (ADS)

Moe, K.; Evans, J. D.; Cappelaere, P. G.; Frye, S. W.; Mandl, D.; Dobbs, K. E.

2014-12-01

Satellite observations play a significant role in supporting disaster response and risk management, however data complexity is a barrier to broader use especially by the public. In December 2013 the Committee on Earth Observation Satellites Working Group on Information Systems and Services documented a high-level reference model for the use of Earth observation satellites and associated products to support disaster risk management within the Global Earth Observation System of Systems context. The enterprise architecture identified the important role of user access to all key functions supporting situational awareness and decision-making. This paper focuses on the need to develop actionable information products from these Earth observations to simplify the discovery, access and use of tailored products. To this end, our team has developed an Open GeoSocial API proof-of-concept for GEOSS. We envision public access to mobile apps available on smart phones using common browsers where users can set up a profile and specify a region of interest for monitoring events such as floods and landslides. Information about susceptibility and weather forecasts about flood risks can be accessed. Users can generate geo-located information and photos of local events, and these can be shared on social media. The information architecture can address usability challenges to transform sensor data into actionable information, based on the terminology of the emergency management community responsible for informing the public. This paper describes the approach to collecting relevant material from the disasters and risk management community to address the end user needs for information. The resulting information architecture addresses the structural design of the shared information in the disasters and risk management enterprise. Key challenges are organizing and labeling information to support both online user communities and machine-to-machine processing for automated product generation.

Assessing the role of syringe dispensing machines and mobile van outlets in reaching hard-to-reach and high-risk groups of injecting drug users (IDUs): a review

PubMed Central

Islam, Md Mofizul; Conigrave, Katherine M

2007-01-01

Reaching hard-to-reach and high-risk injecting drug users (IDUs) is one of the most important challenges for contemporary needle syringe programs (NSPs). The aim of this review is to examine, based upon the available international experience, the effectiveness of syringe vending machines and mobile van/bus based NSPs in making services more accessible to these hard-to-reach and high-risk groups of IDUs. A literature search revealed 40 papers/reports, of which 18 were on dispensing machines (including vending and exchange machines) and 22 on mobile vans. The findings demonstrate that syringe dispensing machines and mobile vans are promising modalities of NSPs, which can make services more accessible to the target group and in particular to the harder-to-reach and higher-risk groups of IDUs. Their anonymous and confidential approaches make services attractive, accessible and acceptable to these groups. These two outlets were found to be complementary to each other and to other modes of NSPs. Services through dispensing machines and mobile vans in strategically important sites are crucial elements in continuing efforts in reducing the spread of HIV and other blood borne viruses among IDUs. PMID:17958894

Toward a social capital based framework for understanding the water-health nexus.

PubMed

Bisung, Elijah; Elliott, Susan J

2014-05-01

In recent years, there has been considerable interest in social capital theory in both research and policy arenas. Social capital has been associated with many aspects of improvements in health, environment and development. This paper assesses the theoretical support for a social capital based analysis of environment and health issues with a focus on the water-health nexus in low and middle income countries. We review conceptualisation of social capital by Pierre Bourdieu in relation to his concepts of "fields" and "habitus" as well as other conceptualisations of social capital by James Coleman and Robert Putnam. We integrate these authors' ideas with ecosocial analysis of social and geographical patterns of access to safe water, adequate sanitation and hygiene and the resulting health impacts. Further, we develop a conceptual framework for linking social capital and health through the water-health nexus. The framework focuses on the role of social capital in improving water-related knowledge, attitudes and practices as well as facilitating collective action towards improving access to water and sanitation. The proposed framework will facilitate critical engagement with the pathways through which social processes and interactions influence health within the context of access to water, sanitation and hygiene in low and middle income countries. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Arabidopsis Information Resource: Making and Mining the ‘Gold Standard’ Annotated Reference Plant Genome

PubMed Central

Berardini, Tanya Z.; Reiser, Leonore; Li, Donghui; Mezheritsky, Yarik; Muller, Robert; Strait, Emily; Huala, Eva

2015-01-01

The Arabidopsis Information Resource (TAIR) is a continuously updated, online database of genetic and molecular biology data for the model plant Arabidopsis thaliana that provides a global research community with centralized access to data for over 30,000 Arabidopsis genes. TAIR’s biocurators systematically extract, organize, and interconnect experimental data from the literature along with computational predictions, community submissions, and high throughput datasets to present a high quality and comprehensive picture of Arabidopsis gene function. TAIR provides tools for data visualization and analysis, and enables ordering of seed and DNA stocks, protein chips and other experimental resources. TAIR actively engages with its users who contribute expertise and data that augments the work of the curatorial staff. TAIR’s focus in an extensive and evolving ecosystem of online resources for plant biology is on the critically important role of extracting experimentally-based research findings from the literature and making that information computationally accessible. In response to the loss of government grant funding, the TAIR team founded a nonprofit entity, Phoenix Bioinformatics, with the aim of developing sustainable funding models for biological databases, using TAIR as a test case. Phoenix has successfully transitioned TAIR to subscription-based funding while still keeping its data relatively open and accessible. PMID:26201819

A Probabilistic Model of Social Working Memory for Information Retrieval in Social Interactions.

PubMed

Li, Liyuan; Xu, Qianli; Gan, Tian; Tan, Cheston; Lim, Joo-Hwee

2018-05-01

Social working memory (SWM) plays an important role in navigating social interactions. Inspired by studies in psychology, neuroscience, cognitive science, and machine learning, we propose a probabilistic model of SWM to mimic human social intelligence for personal information retrieval (IR) in social interactions. First, we establish a semantic hierarchy as social long-term memory to encode personal information. Next, we propose a semantic Bayesian network as the SWM, which integrates the cognitive functions of accessibility and self-regulation. One subgraphical model implements the accessibility function to learn the social consensus about IR-based on social information concept, clustering, social context, and similarity between persons. Beyond accessibility, one more layer is added to simulate the function of self-regulation to perform the personal adaptation to the consensus based on human personality. Two learning algorithms are proposed to train the probabilistic SWM model on a raw dataset of high uncertainty and incompleteness. One is an efficient learning algorithm of Newton's method, and the other is a genetic algorithm. Systematic evaluations show that the proposed SWM model is able to learn human social intelligence effectively and outperforms the baseline Bayesian cognitive model. Toward real-world applications, we implement our model on Google Glass as a wearable assistant for social interaction.

Self-organizing feature maps for dynamic control of radio resources in CDMA microcellular networks

NASA Astrophysics Data System (ADS)

Hortos, William S.

1998-03-01

The application of artificial neural networks to the channel assignment problem for cellular code-division multiple access (CDMA) cellular networks has previously been investigated. CDMA takes advantage of voice activity and spatial isolation because its capacity is only interference limited, unlike time-division multiple access (TDMA) and frequency-division multiple access (FDMA) where capacities are bandwidth-limited. Any reduction in interference in CDMA translates linearly into increased capacity. To satisfy the high demands for new services and improved connectivity for mobile communications, microcellular and picocellular systems are being introduced. For these systems, there is a need to develop robust and efficient management procedures for the allocation of power and spectrum to maximize radio capacity. Topology-conserving mappings play an important role in the biological processing of sensory inputs. The same principles underlying Kohonen's self-organizing feature maps (SOFMs) are applied to the adaptive control of radio resources to minimize interference, hence, maximize capacity in direct-sequence (DS) CDMA networks. The approach based on SOFMs is applied to some published examples of both theoretical and empirical models of DS/CDMA microcellular networks in metropolitan areas. The results of the approach for these examples are informally compared to the performance of algorithms, based on Hopfield- Tank neural networks and on genetic algorithms, for the channel assignment problem.

Computational Models of the Representation of Bangla Compound Words in the Mental Lexicon.

PubMed

Dasgupta, Tirthankar; Sinha, Manjira; Basu, Anupam

2016-08-01

In this paper we aim to model the organization and processing of Bangla compound words in the mental lexicon. Our objective is to determine whether the mental lexicon access a Bangla compound word as a whole or decomposes the whole word into its constituent morphemes and then recognize them accordingly. To address this issue, we adopted two different strategies. First, we conduct a cross-modal priming experiment over a number of native speakers. Analysis of reaction time (RT) and error rates indicates that in general, Bangla compound words are accessed via partial decomposition process. That is some word follows full-listing mode of representation and some words follow the decomposition route of representation. Next, based on the collected RT data we have developed a computational model that can explain the processing phenomena of the access and representation of Bangla compound words. In order to achieve this, we first explored the individual roles of head word position, morphological complexity, orthographic transparency and semantic compositionality between the constituents and the whole compound word. Accordingly, we have developed a complexity based model by combining these features together. To a large extent we have successfully explained the possible processing phenomena of most of the Bangla compound words. Our proposed model shows an accuracy of around 83 %.

Wheelchair users, access and exclusion in South African higher education

PubMed Central

2017-01-01

Background South Africa’s Constitution guarantees everyone, including persons with disabilities, the right to education. A variety of laws are in place obliging higher education institutions to provide appropriate physical access to education sites for all. In practice, however, many buildings remain inaccessible to people with physical disabilities. Objectives To describe what measures South African universities are taking to make their built environments more accessible to students with diverse types of disabilities, and to assess the adequacy of such measures. Method We conducted semi-structured in-depth face-to-face interviews with disability unit staff members (DUSMs) based at 10 different public universities in South Africa. Results Challenges with promoting higher education accessibility for wheelchair users include the preservation and heritage justification for failing to modify older buildings, ad hoc approaches to creating accessible environments and failure to address access to toilets, libraries and transport facilities for wheelchair users. Conclusion South African universities are still not places where all students are equally able to integrate socially. DUSMs know what ought to be done to make campuses more accessible and welcoming to students with disabilities and should be empowered to play a leading role in sensitising non-disabled members of universities, to create greater awareness of, and appreciation for, the multiple ways in which wheelchair user students continue to be excluded from full participation in university life. South African universities need to adopt a systemic approach to inclusion, which fosters an understanding of inclusion as a fundamental right rather than as a luxury. PMID:28936420

Design of Medians for Principal Arterials

DOT National Transportation Integrated Search

2001-08-01

Public highways and streets have dual but competing roles: to provide property access and to move through traffic. Highway functional classification systems recognize the competition between access and flow, generally specifying that principal arteri...

A new role for primary care teams in the United States after “Obamacare:” Track and improve health insurance coverage rates

PubMed Central

DeVoe, Jennifer; Angier, Heather; Hoopes, Megan; Gold, Rachel

2017-01-01

Maintaining continuous health insurance coverage is important. With recent expansions in access to coverage in the United States after “Obamacare,” primary care teams have a new role in helping to track and improve coverage rates and to provide outreach to patients. We describe efforts to longitudinally track health insurance rates using data from the electronic health record (EHR) of a primary care network and to use these data to support practice-based insurance outreach and assistance. Although we highlight a few examples from one network, we believe there is great potential for doing this type of work in a broad range of family medicine and community health clinics that provide continuity of care. By partnering with researchers through practice-based research networks and other similar collaboratives, primary care practices can greatly expand the use of EHR data and EHR-based tools targeting improvements in health insurance and quality health care. PMID:28966926

Patient empowerment by the means of citizen-managed Electronic Health Records: web 2.0 health digital identity scenarios.

PubMed

Falcão-Reis, Filipa; Correia, Manuel E

2010-01-01

With the advent of more sophisticated and comprehensive healthcare information systems, system builders are becoming more interested in patient interaction and what he can do to help to improve his own health care. Information systems play nowadays a crucial and fundamental role in hospital work-flows, thus providing great opportunities to introduce and improve upon "patient empowerment" processes for the personalization and management of Electronic Health Records (EHRs). In this paper, we present a patient's privacy generic control mechanisms scenarios based on the Extended OpenID (eOID), a user centric digital identity provider previously developed by our group, which leverages a secured OpenID 2.0 infrastructure with the recently released Portuguese Citizen Card (CC) for secure authentication in a distributed health information environment. eOID also takes advantage of Oauth assertion based mechanisms to implement patient controlled secure qualified role based access to his EHR, by third parties.

Over-the-counter but out of reach: a pharmacy-based survey of OTC syringe sales in Tijuana, Mexico.

PubMed

Pollini, Robin A; Gallardo, Manuel; Ruiz, Serena; Case, Patricia; Zaller, Nickolas; Lozada, Remedios

2014-05-01

Sterile syringe access is critical to HIV prevention efforts targeting injection drug users (IDUs) but some pharmacies do not sell syringes over-the-counter (OTC) even where such sales are legal. We conducted a pharmacy survey in Tijuana, Mexico (where OTC sales are legal) to characterize attitudes toward syringe sales and to explore support for expanding pharmacy-based HIV prevention efforts. Of 203 respondents, 28% supported OTC syringe sales to IDUs and 74% said their pharmacy required a prescription for at least some syringe sales. Support for OTC syringe sales was independently associated with selling OTC syringes, understanding the role of sterile syringes in HIV prevention, and recognizing pharmacies as an important health resource for IDUs. Most respondents supported an expanded role for pharmacies in HIV prevention, exclusive of OTC syringe sales. Our study provides information for developing interventions to promote OTC syringe sales and expanding pharmacy-based distribution of HIV-related information and resources.

Walkability for Different Urban Granularities

NASA Astrophysics Data System (ADS)

Hollenstein, D.; Bleisch, S.

2016-06-01

The positive effects of low-intensity physical activity are widely acknowledged and in this context walking is often promoted as an active form of transport. Under the concept of walkability the role of the built environment in encouraging walking is investigated. For that purpose, walkability is quantified area-wise by measuring a varying set of built environment attributes. In purely GIS-based approaches to studying walkability, indices are generally built using existing and easily accessible data. These include street network design, population density, land use mix, and access to destinations. Access to destinations is usually estimated using either a fixed radius, or distances in the street network. In this paper, two approaches to approximate a footpath network are presented. The two footpath networks were built making different assumptions regarding the walkability of different street types with respect to more or less restrictive safety preferences. Information on sidewalk presence, pedestrian crossings, and traffic restrictions were used to build both networks. The first network comprises car traffic free areas only. The second network includes streets with low speed limits that have no sidewalks. Both networks are compared to the more commonly used street network in an access-to-distance analysis. The results suggest that for the generally highly walkable study area, access to destination mostly depends on destination density within the defined walkable distance. However, on single street segments access to destinations is diminished when only car traffic free spaces are assumed to be walkable.

Developing a Family-Based HIV Prevention Intervention in Rural Kenya: Challenges in Conducting Community-Based Participatory Research

PubMed Central

Puffer, Eve S.; Pian, Jessica; Sikkema, Kathleen J.; Ogwang-Odhiambo, Rose A.; Broverman, Sherryl A.

2013-01-01

Community-based participatory research (CBPR) introduces new ethical challenges for HIV prevention studies in low-resource international settings. We describe a CBPR study in rural Kenya to develop and pilot a family-based HIV prevention and mental health promotion intervention. Academic partners (APs) worked with a community advisory committee (CAC) during formative research, intervention development, and a pilot trial. Ethical challenges emerged related to: negotiating power imbalances between APs and the CAC; CAC members’ shifting roles as part of the CAC and wider community; and anticipated challenges in decision making about sustainability. Factors contributing to ethical dilemmas included low access to education, scarcity of financial resources, and the shortage of HIV-related services despite high prevalence. PMID:23651936

ProbOnto: ontology and knowledge base of probability distributions.

PubMed

Swat, Maciej J; Grenon, Pierre; Wimalaratne, Sarala

2016-09-01

Probability distributions play a central role in mathematical and statistical modelling. The encoding, annotation and exchange of such models could be greatly simplified by a resource providing a common reference for the definition of probability distributions. Although some resources exist, no suitably detailed and complex ontology exists nor any database allowing programmatic access. ProbOnto, is an ontology-based knowledge base of probability distributions, featuring more than 80 uni- and multivariate distributions with their defining functions, characteristics, relationships and re-parameterization formulas. It can be used for model annotation and facilitates the encoding of distribution-based models, related functions and quantities. http://probonto.org mjswat@ebi.ac.uk Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press.

Evaluating a hybrid web-based basic genetics course for health professionals.

PubMed

Wallen, Gwenyth R; Cusack, Georgie; Parada, Suzan; Miller-Davis, Claiborne; Cartledge, Tannia; Yates, Jan

2011-08-01

Health professionals, particularly nurses, continue to struggle with the expanding role of genetics information in the care of their patients. This paper describes an evaluation study of the effectiveness of a hybrid basic genetics course for healthcare professionals combining web-based learning with traditional face-to-face instructional techniques. A multidisciplinary group from the National Institutes of Health (NIH) created "Basic Genetics Education for Healthcare Providers" (BGEHCP). This program combined 7 web-based self-education modules with monthly traditional face-to-face lectures by genetics experts. The course was pilot tested by 186 healthcare providers from various disciplines with 69% (n=129) of the class registrants enrolling in a pre-post evaluation trial. Outcome measures included critical thinking knowledge items and a Web-based Learning Environment Inventory (WEBLEI). Results indicated a significant (p<0.001) change in knowledge scores. WEBLEI scores indicated program effectiveness particularly in the area of convenience, access and the course structure and design. Although significant increases in overall knowledge scores were achieved, scores in content areas surrounding genetic risk identification and ethical issues regarding genetic testing reflected continued gaps in knowledge. Web-based genetics education may help overcome genetics knowledge deficits by providing access for health professionals with diverse schedules in a variety of national and international settings. Published by Elsevier Ltd.

A viewpoint-based case-based reasoning approach utilising an enterprise architecture ontology for experience management

NASA Astrophysics Data System (ADS)

Martin, Andreas; Emmenegger, Sandro; Hinkelmann, Knut; Thönssen, Barbara

2017-04-01

The accessibility of project knowledge obtained from experiences is an important and crucial issue in enterprises. This information need about project knowledge can be different from one person to another depending on the different roles he or she has. Therefore, a new ontology-based case-based reasoning (OBCBR) approach that utilises an enterprise ontology is introduced in this article to improve the accessibility of this project knowledge. Utilising an enterprise ontology improves the case-based reasoning (CBR) system through the systematic inclusion of enterprise-specific knowledge. This enterprise-specific knowledge is captured using the overall structure given by the enterprise ontology named ArchiMEO, which is a partial ontological realisation of the enterprise architecture framework (EAF) ArchiMate. This ontological representation, containing historical cases and specific enterprise domain knowledge, is applied in a new OBCBR approach. To support the different information needs of different stakeholders, this OBCBR approach has been built in such a way that different views, viewpoints, concerns and stakeholders can be considered. This is realised using a case viewpoint model derived from the ISO/IEC/IEEE 42010 standard. The introduced approach was implemented as a demonstrator and evaluated using an application case that has been elicited from a business partner in the Swiss research project.

Church and spirituality in the lives of the African American community.

PubMed

Giger, Joyce Newman; Appel, Susan J; Davidhizar, Ruth; Davis, Claudia

2008-10-01

The African American church is held in the highest esteem by most African Americans. Although the influence of the African American church has been underestimated by physicians and nurses, it could be pivotal in optimizing health status among African Americans. Because of this influence, health care practitioners, including nurses, are now recognizing the important role that the African American church plays in improving the health status of individuals in the African American community. This article illuminates the health and health care concerns of the African American community by considering the traditional lack of equal access for this population and the role that the church can play in not only offering church-based health care services but also improving the health status of church congregations. Future roles of the African American church for improved health status are also suggested.

Reframing the concept of alternative livelihoods

PubMed Central

Wright, Juliet H.; Hill, Nicholas A. O.; Roe, Dilys; Rowcliffe, J. Marcus; Kümpel, Noëlle F.; Day, Mike; Booker, Francesca; Milner‐Gulland, E. J.

2015-01-01

Abstract Alternative livelihood project (ALP) is a widely used term for interventions that aim to reduce the prevalence of activities deemed to be environmentally damaging by substituting them with lower impact livelihood activities that provide at least equivalent benefits. ALPs are widely implemented in conservation, but in 2012, an International Union for Conservation of Nature resolution called for a critical review of such projects based on concern that their effectiveness was unproven. We focused on the conceptual design of ALPs by considering their underlying assumptions. We placed ALPs within a broad category of livelihood‐focused interventions to better understand their role in conservation and their intended impacts. We dissected 3 flawed assumptions about ALPs based on the notions of substitution, the homogenous community, and impact scalability. Interventions based on flawed assumptions about people's needs, aspirations, and the factors that influence livelihood choice are unlikely to achieve conservation objectives. We therefore recommend use of a sustainable livelihoods approach to understand the role and function of environmentally damaging behaviors within livelihood strategies; differentiate between households in a community that have the greatest environmental impact and those most vulnerable to resource access restrictions to improve intervention targeting; and learn more about the social–ecological system within which household livelihood strategies are embedded. Rather than using livelihood‐focused interventions as a direct behavior‐change tool, it may be more appropriate to focus on either enhancing the existing livelihood strategies of those most vulnerable to conservation‐imposed resource access restrictions or on use of livelihood‐focused interventions that establish a clear link to conservation as a means of building good community relations. However, we recommend that the term ALP be replaced by the broader term livelihood‐focused intervention. This avoids the implicit assumption that alternatives can fully substitute for natural resource‐based livelihood activities. PMID:26310510

HEDD: Human Enhancer Disease Database

PubMed Central

Wang, Zhen; Zhang, Quanwei; Zhang, Wen; Lin, Jhih-Rong; Cai, Ying; Mitra, Joydeep

2018-01-01

Abstract Enhancers, as specialized genomic cis-regulatory elements, activate transcription of their target genes and play an important role in pathogenesis of many human complex diseases. Despite recent systematic identification of them in the human genome, currently there is an urgent need for comprehensive annotation databases of human enhancers with a focus on their disease connections. In response, we built the Human Enhancer Disease Database (HEDD) to facilitate studies of enhancers and their potential roles in human complex diseases. HEDD currently provides comprehensive genomic information for ∼2.8 million human enhancers identified by ENCODE, FANTOM5 and RoadMap with disease association scores based on enhancer–gene and gene–disease connections. It also provides Web-based analytical tools to visualize enhancer networks and score enhancers given a set of selected genes in a specific gene network. HEDD is freely accessible at http://zdzlab.einstein.yu.edu/1/hedd.php. PMID:29077884

Eyes on the prize: reflections on the impact of the evolving digital ecology on the librarian as expert intermediary and knowledge coach, 1969–2009*

PubMed Central

Homan, J. Michael

2010-01-01

Objective: The 2009 Janet Doe Lecture reflects on the continuing value and increasing return on investment of librarian-mediated services in the constantly evolving digital ecology and complex knowledge environment of the health sciences. Setting: The interrelationship of knowledge, decision making based on knowledge, technology used to access and retrieve knowledge, and the important linkage roles of expert librarian intermediaries is examined. Methodology: Professional experiences from 1969 to 2009, occurring during a time of unprecedented changes in the digital ecology of librarianship, are the base on which the evolving role and value of librarians as knowledge coaches and expert intermediaries are examined. Conclusion: Librarian-mediated services linking knowledge and critical decision making in health care have become more valuable than ever as technology continues to reshape an increasingly complex knowledge environment. PMID:20098655

Education as a springboard for transformational leadership development: listening to the voices of nurses.

PubMed

Galuska, Lee A

2014-02-01

Nurses must assume a transformational leadership role in increasing the quality, safety, access, and value in the health care system. To lead effectively in this transformation process, nurses must be prepared for leadership roles. A strong leadership knowledge based acquired through education provides the springboard for nursing leadership competency development. This metasynthesis of 27 studies provided a broad understanding of the contribution and effectiveness of education for leadership competency from the perspective of nurses who have experienced it. Four overarching themes emerged: evidence-based relevant content, optimized learning strategies, benefits to the learner and others, and tensions and threats to the application of learning. This study affirms the value of a strong educational foundation for nursing leadership. With the support of a firm, yet flexible, educational platform, nurses will be positioned to more effectively lead and partner in health care transformation.

Promoting Science-based Governance through Monitoring Changes to Agencies' Public Presentation

NASA Astrophysics Data System (ADS)

Rinberg, A.; Bergman, A.

2017-12-01

As the scientific basis for the missions of agencies like the Environmental Protection Agency have come under attack this year, political appointees and career staff alike have made changes to public-facing agency web content and resources. These changes have resulted in scientific information and findings being removed from the government's web presence and have reduced access to resources that inform the public about important topics like climate change and clean water. But these removals also obscure the work that the the federal government has done and the role it is legally required to play, which is often based squarely on key scientific findings. By monitoring changes to federal agency websites and ensuring that the public continues to be informed about the government's role in using science to improve the public's well-being, we can help retain the integrity of these important agencies and bolster their public support.

Primary care physician management, referral, and relations with specialists concerning patients at risk for cancer due to family history.

PubMed

Wood, M E; Flynn, B S; Stockdale, A

2013-01-01

Risk stratification based on family history is a feature of screening guidelines for a number of cancers and referral guidelines for genetic counseling/testing for cancer risk. Our aim was to describe primary care physician perceptions of their role in managing cancer risk based on family history. Structured interviews were conducted by a medical anthropologist with primary care physicians in 3 settings in 2 north-eastern states. Transcripts were systematically analyzed by a research team to identify major themes expressed by participants. Forty interviews were conducted from May 2003 through May 2006. Physicians provided a diversity of views on roles in management of cancer risk based on family history, management practices and patient responses to risk information. They also provided a wide range of perspectives on criteria used for referral to specialists, types of specialists referred to and expected management roles for referred patients. Some primary care physicians appeared to make effective use of family history information for cancer risk management, but many in this sample did not. Increased focus on efficient assessment tools based on recognized guidelines, accessible guides to management options, and patient education and decision aids may be useful directions to facilitate broader use of family history information for cancer risk management. Copyright © 2013 S. Karger AG, Basel.

Student Technology Use in a Self-Access Center

ERIC Educational Resources Information Center

Castellano, Joachim; Mynard, Jo; Rubesch, Troy

2011-01-01

Technology has played an increasingly vital role in self-access learning over the past twenty years or so, yet little research has been conducted into learners' actual use of the technology both for self-directed learning and as part of everyday life. This paper describes an ongoing action research project at a self-access learning center (SALC)…

Speed of Lexical Access to Arabic and English Letters

ERIC Educational Resources Information Center

Alasali, Hesham H.; Aljomaa, Suliman S.

2015-01-01

To examining the role of cultural differences in speed of lexical access, we employed two types of Posner (1967) name matching task: Arabic and English types. We have conducted an experiment on 30 native Arabic speakers from King Saud University. The results showed that the lexical access to physically identical letters is faster than lexical…

NASA's Earth Science Gateway: A Platform for Interoperable Services in Support of the GEOSS Architecture

NASA Astrophysics Data System (ADS)

Alameh, N.; Bambacus, M.; Cole, M.

2006-12-01

Nasa's Earth Science as well as interdisciplinary research and applications activities require access to earth observations, analytical models and specialized tools and services, from diverse distributed sources. Interoperability and open standards for geospatial data access and processing greatly facilitate such access among the information and processing compo¬nents related to space¬craft, airborne, and in situ sensors; predictive models; and decision support tools. To support this mission, NASA's Geosciences Interoperability Office (GIO) has been developing the Earth Science Gateway (ESG; online at http://esg.gsfc.nasa.gov) by adapting and deploying a standards-based commercial product. Thanks to extensive use of open standards, ESG can tap into a wide array of online data services, serve a variety of audiences and purposes, and adapt to technology and business changes. Most importantly, the use of open standards allow ESG to function as a platform within a larger context of distributed geoscience processing, such as the Global Earth Observing System of Systems (GEOSS). ESG shares the goals of GEOSS to ensure that observations and products shared by users will be accessible, comparable, and understandable by relying on common standards and adaptation to user needs. By maximizing interoperability, modularity, extensibility and scalability, ESG's architecture fully supports the stated goals of GEOSS. As such, ESG's role extends beyond that of a gateway to NASA science data to become a shared platform that can be leveraged by GEOSS via: A modular and extensible architecture Consensus and community-based standards (e.g. ISO and OGC standards) A variety of clients and visualization techniques, including WorldWind and Google Earth A variety of services (including catalogs) with standard interfaces Data integration and interoperability Mechanisms for user involvement and collaboration Mechanisms for supporting interdisciplinary and domain-specific applications ESG has played a key role in recent GEOSS Service Network (GSN) demos and workshops, acting not only as a service and data catalog and discovery client, but also as a portrayal and visualization client to distributed data.

Faith-based organizations and the Affordable Care Act: Reducing Latino mental health care disparities.

PubMed

Villatoro, Alice P; Dixon, Elizabeth; Mays, Vickie M

2016-02-01

The Patient Protection and Affordable Care Act (ACA; 2010) is expected to increase access to mental health care through provisions aimed at increasing health coverage among the nation's uninsured, including 10.2 million eligible Latino adults. The ACA will increase health coverage by expanding Medicaid eligibility to individuals living below 138% of the federal poverty level, subsidizing the purchase of private insurance among individuals not eligible for Medicaid, and requiring employers with 50 or more employees to offer health insurance. An anticipated result of this landmark legislation is improvement in the screening, diagnosis, and treatment of mental disorders in racial/ethnic minorities, particularly for Latinos, who traditionally have had less access to these services. However, these efforts alone may not sufficiently ameliorate mental health care disparities for Latinos. Faith-based organizations (FBOs) could play an integral role in the mental health care of Latinos by increasing help seeking, providing religion-based mental health services, and delivering supportive services that address common access barriers among Latinos. Thus, in determining ways to eliminate Latino mental health care disparities under the ACA, examining pathways into care through the faith-based sector offers unique opportunities to address some of the cultural barriers confronted by this population. We examine how partnerships between FBOs and primary care patient-centered health homes may help reduce the gap of unmet mental health needs among Latinos in this era of health reform. We also describe the challenges FBOs and primary care providers need to overcome to be partners in integrated care efforts. (c) 2016 APA, all rights reserved).

Faith-Based Organizations and the Affordable Care Act: Reducing Latino Mental Healthcare Disparities

PubMed Central

Villatoro, Alice P.; Dixon, Elizabeth; Mays, Vickie M.

2014-01-01

The Patient Protection and Affordable Care Act (ACA) is expected to increase access to mental healthcare through provisions aimed at increasing health coverage among the nation's uninsured, including 10.2 million eligible Latino non-elderly adults. The ACA will increase health coverage by expanding Medicaid eligibility to individuals living below 138% of the federal poverty level, subsidizing the purchase of private insurance among individuals not eligible for Medicaid, and requiring employers with 50 or more employees to offer health insurance. An anticipated result of this landmark legislation is improvement in the screening, diagnosis, and treatment of mental disorders in racial/ethnic minorities, particularly for Latinos, who traditionally have had less access to these services. However, these efforts alone may not sufficiently ameliorate mental healthcare disparities for Latinos. Faith-based organizations (FBOs) could play an integral role in the mental healthcare of Latinos by increasing help-seeking, providing religion-based mental health services, and delivering supportive services that address common access barriers among Latinos. Thus, in determining ways to eliminate Latino mental healthcare disparities under the ACA, examining pathways into care through the faith-based sector offers unique opportunities to address some of the cultural barriers confronted by this population. We examine how partnerships between FBOs and primary care patient-centered medical homes (PCMH) may help reduce the gap of unmet mental health needs among Latinos in this era of health reform. We also describe the challenges FBOs and PCMH providers need to overcome in order to be partners in integrated care efforts. PMID:26845492

Genome-wide sequence variations between wild and cultivated tomato species revisited by whole genome sequence mapping.

PubMed

Sahu, Kamlesh Kumar; Chattopadhyay, Debasis

2017-06-02

Cultivated tomato (Solanum lycopersicum L.) is the second most important vegetable crop after potato and a member of thirteen interfertile species of Solanum genus. Domestication and continuous selection for desirable traits made cultivated tomato species susceptible to many stresses as compared to the wild species. In this study, we analyzed and compared the genomes of wild and cultivated tomato accessions to identify the genomic regions that encountered changes during domestication. Analysis was based on SNP and InDel mining of twentynine accessions of twelve wild tomato species and forty accessions of cultivated tomato. Percentage of common SNPs among the accessions within a species corresponded with the reproductive behavior of the species. SNP profiles of the wild tomato species within a phylogenetic subsection varied with their geographical distribution. Interestingly, the ratio of genic SNP to total SNPs increased with phylogenetic distance of the wild tomato species from the domesticated species, suggesting that variations in gene-coding region play a major role in speciation. We retrieved 2439 physical positions in 1594 genes including 32 resistance related genes where all the wild accessions possessed a common wild variant allele different from all the cultivated accessions studied. Tajima's D analysis predicted a very strong purifying selection associated with domestication in nearly 1% of its genome, half of which is contributed by chromosome 11. This genomic region with a low Tajima's D value hosts a variety of genes associated with important agronomic trait such as, fruit size, tiller number and wax deposition. Our analysis revealed a broad-spectrum genetic base in wild tomato species and erosion of that in cultivated tomato due to recurrent selection for agronomically important traits. Identification of the common wild variant alleles and the genomic regions undergoing purifying selection during cultivation would facilitate future breeding program by introgression from wild species.

Older family carers in rural areas: experiences from using caregiver support services based on Information and Communication Technology (ICT).

PubMed

Blusi, Madeleine; Asplund, Kenneth; Jong, Mats

2013-09-01

The aim of this intervention study was to illuminate the meaning of ICT-based caregiver support as experienced by older family carers living in vast rural areas, caring for a spouse at home. In order to access, the support service participants were provided with a computer and high speed Internet in their homes. Semi structured webcam-interviews were carried out with 31 family carers. A strategy for webcam interviewing was developed to ensure quality and create a comfortable interview situation for the family carers. Interviews were analysed using content analyses, resulting in the themes: Adopting new technology with help from others and Regaining social inclusion . The results indicate that ICT-based support can be valuable for older family carers in rural areas as it contributes to improve quality in daily life in a number of ways. In order to fully experience the benefits, family carers need to be frequent users of the provided support. Adequate training and encouragement from others were essential in motivating family carers to use the support service. Access to Internet and webcamera contributed to reducing loneliness and isolation, strengthening relationships with relatives living far away and enabled access to services no longer available in the area. Use of the ICT-service had a positive influence on the relationship between the older carer and adult grandchildren. It also contributed to carer competence and promote feelings of regaining independence and a societal role.

The role of mothers-in-law in antenatal care decision-making in Nepal: a qualitative study.

PubMed

Simkhada, Bibha; Porter, Maureen A; van Teijlingen, Edwin R

2010-07-01

Antenatal care (ANC) has been recognised as a way to improve health outcomes for pregnant women and their babies. However, only 29% of pregnant women receive the recommended four antenatal visits in Nepal but reasons for such low utilisation are poorly understood. As in many countries of South Asia, mothers-in-law play a crucial role in the decisions around accessing health care facilities and providers. This paper aims to explore the mother-in-law's role in (a) her daughter-in-law's ANC uptake; and (b) the decision-making process about using ANC services in Nepal. In-depth interviews were conducted with 30 purposively selected antenatal or postnatal mothers (half users, half non-users of ANC), 10 husbands and 10 mothers-in-law in two different (urban and rural) communities. Our findings suggest that mothers-in-law sometime have a positive influence, for example when encouraging women to seek ANC, but more often it is negative. Like many rural women of their generation, all mothers-in-law in this study were illiterate and most had not used ANC themselves. The main factors leading mothers-in-law not to support/encourage ANC check ups were expectations regarding pregnant women fulfilling their household duties, perceptions that ANC was not beneficial based largely on their own past experiences, the scarcity of resources under their control and power relations between mothers-in-law and daughters-in-law. Individual knowledge and social class of the mothers-in-law of users and non-users differed significantly, which is likely to have had an effect on their perceptions of the benefits of ANC. Mothers-in-law have a strong influence on the uptake of ANC in Nepal. Understanding their role is important if we are to design and target effective community-based health promotion interventions. Health promotion and educational interventions to improve the use of ANC should target women, husbands and family members, particularly mothers-in-law where they control access to family resources.

Exploring the contribution of the Clinical Librarian to facilitating evidence-based nursing.

PubMed

Tod, Angela M; Bond, Beverly; Leonard, Niamh; Gilsenan, Irene J; Palfreyman, Simon

2007-04-01

To examine the potential role of the Clinical Librarian in facilitating evidence-based practice of nurses in acute hospital settings and develop a model for the role. There is a growing policy and professional expectation that nurses will seek out and apply evidence in their clinical practice. Studies have demonstrated that nurses experience barriers in working with an evidence-based approach. The role of Clinical Librarian has been used in other countries and within medicine to overcome some of the barriers to evidence-based practice. There are limitations in the previous work in terms of rigour of evaluation, scope of the Clinical Librarian role and application to nursing in a UK setting. A qualitative consultation of 72 nurses in acute care settings. Six consultation group interviews of between 4-19 participants. Written records were recorded by the scribe. Content analysis was undertaken to identify the range and frequency of comments. Clinical questions currently go unanswered because of barriers of time, skills deficits and access to resources. Literature searching, skills training and evidence dissemination were the main areas of work the staff requested that a Clinical Librarian should undertake. It was anticipated that the Clinical Librarian could interact and work productively with nursing staff with a limited but regular presence on the ward. Interim communication could be via e-mail, phone and written suggestions and requests for work. It was seen to be vital that the Clinical Librarian worked in partnership with staff to build evidence-based practice capacity and ensure clinical relevance of the work. This study has generated the first model for the Clinical Librarian role with an emphasis on nursing. It is derived from the views of clinical nurses. Recommendations are made for the implementation and evaluation of such a role. The Clinical Librarian could be an invaluable support to promoting evidence-based nursing.

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

PubMed

McCann, Terence V; Lubman, Dan I

2012-08-01

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

Patient choice, Internet based information sources, and perceptions of health care: Evidence from Sweden using survey data from 2010 and 2013.

PubMed

Wahlstedt, Emma; Ekman, Björn

2016-08-01

Several countries have increased patients' abilities to choose their health care providers, frequently under the assumption that patients are themselves the best agents to make such decisions. In parallel, national and regional health authorities have enhanced access to Internet based information sources (IBIS) to assist patients in making an informed choice. Relatively little, however, is known about the effect that the use of such sources has on key outcomes, including patients' perceptions of care. The aim of this study is to analyze the role of the Internet for patients' confidence in the provider and perceived access to care in the context of choice based reforms in Sweden. The study uses a regional, population health survey from the southern part of Sweden. Non-parametric chi-square tests are used to assess the nature of Internet users, including their gender, age and socioeconomic status. Logistic regression models are specified to analyze the role of IBIS on patient perceptions of care while controlling for other factors. Actual use of Internet based information sources for health care was relatively low in 2010 and only somewhat higher in 2013. The characteristics of IBIS users varied significantly across different population groups, such that they were younger, more educated, female, and also considered themselves to be in better health compared with those who reported not using this source of health care information. Finally, the average IBIS user was less likely to report having a high level of satisfaction with respect to their primary care use; OR 0.69 [95 % CI: 0.54-0,87] and OR 0.52 [95 % CI: 0,41-0,66], for confidence in provider and perceived access to care, respectively, in 2013. Despite health agencies' attempts to make information on health care providers available on the Internet, this source of health care information is not used to any large extent in the current sample. The fact that some people use this source of information more compared with others suggests the need to consider alternative ways of informing the general public about choice options. The use of Internet based sources may also be linked with the experience of actually using health services, which suggests a need to further analyze this complex consumer behavior process.

Retrieval activates related words more than presentation.

PubMed

Hausman, Hannah; Rhodes, Matthew G

2018-03-23

Retrieving information enhances learning more than restudying. One explanation of this effect is based on the role of mediators (e.g., sand-castle can be mediated by beach). Retrieval is hypothesised to activate mediators more than restudying, but existing tests of this hypothesis have had mixed results [Carpenter, S. K. (2011). Semantic information activated during retrieval contributes to later retention: Support for the mediator effectiveness hypothesis of the testing effect. Journal of Experimental Psychology: Learning, Memory, and Cognition, 37(6), 1547-1552. doi: 10.1037/a0024140 ; Lehman, M., & Karpicke, J. D. (2016). Elaborative retrieval: Do semantic mediators improve memory? Journal of Experimental Psychology: Learning, Memory, and Cognition, 42(10), 1573-1591. doi: 10.1037/xlm0000267 ]. The present experiments explored an explanation of the conflicting results, testing whether mediator activation during a retrieval attempt depends on the accessibility of the target information. A target was considered less versus more accessible when fewer versus more cues were given during retrieval practice (Experiments 1 and 2), when the target had been studied once versus three times initially (Experiment 3), or when the target could not be recalled versus could be recalled during retrieval practice (Experiments 1-3). A mini meta-analysis of all three experiments revealed a small effect such that retrieval activated mediators more than presentation, but mediator activation was not reliably related to target accessibility. Thus, retrieval may enhance learning by activating mediators, in part, but these results suggest the role of other processes, too.

Barriers for integrating personalized medicine into clinical practice: a qualitative analysis.

PubMed

Najafzadeh, Mehdi; Davis, Jennifer C; Joshi, Pamela; Marra, Carlo

2013-04-01

Personalized medicine-tailoring interventions based on individual's genetic information-will likely change routine clinical practice in the future. Yet, how practitioners plan to apply genetic information to inform medical decision making remains unclear. We aimed to investigate physician's perception about the future role of personalized medicine, and to identify the factors that influence their decision in using genetic testing in their practice. We conducted three semi-structured focus groups in three health regions (Fraser, Vancouver coastal, and Interior) in British Columbia, Canada. In the focus groups, participants discussed four topics on personalized medicine: (i) physicians' general understanding, (ii) advantages and disadvantages, (iii) potential impact and role in future clinical practice, and (iv) perceived barriers to integrating personalized medicine into clinical practice. Approximately 36% (n = 9) of physicians self-reported that they were not familiar with the concept of personalized medicine. After introducing the concept, the majority of physicians (68%, n = 19 of 28) were interested in incorporating personalized medicine in their practice, provided they have access to the necessary knowledge and tools. Participants mostly believed that genetic developments will directly affect their practice in the future. The key concerns highlighted were physician's access to clinical guidelines and training opportunities for the use of genetic testing and data interpretation. Despite the challenges that personalized medicine can create, in general, physicians in the focus groups expressed strong interest in using genetic information in their practice if they have access to the necessary knowledge and tools. Copyright © 2013 Wiley Periodicals, Inc.

New Educational Environments Aimed at Developing Intercultural Understanding while Reinforcing the Use of English in Experience-Based Learning (Nuevos entornos educativos destinados a desarrollar la comprensión intercultural y a reforzar el uso del inglés mediante el aprendizaje basado en experiencias)

ERIC Educational Resources Information Center

Bruguier, Leonard R.; Greathouse Amador, Louise M.

2012-01-01

New learning environments with communication and information tools are increasingly accessible with technology playing a crucial role in expanding and reconceptualizing student learning experiences. This paper reviews the outcome of an innovative course offered by four universities in three countries: Canada, the United States, and Mexico. Course…

The snake on the caduceus: dimensions of medical and psychiatric responsibility in the Third Reich.

PubMed

Hunter, E

1993-03-01

The literature on the activities of medical professionals during the tumultuous years of the Third Reich has, over the last decade, increased substantially. However, many questions remain unanswered and the subject is likely to receive further attention following recent access to previously restricted archival material in Eastern Europe. In this paper, based on the English language literature, the author explores the role of medicine, and in particular psychiatry, in defining the bio-medical vision that was central to Nazi ideology.

Lung cancer treatment rates and the role of the lung cancer nurse specialist: a qualitative study

PubMed Central

Redman, Judy; McDonnell, Ann; Borthwick, Diana; White, John

2015-01-01

Objectives This qualitative study examines how the Lung Cancer Nurse Specialist (LCNS) role operates and why they may be able to increase access to treatment. Setting 4 Hospital NHS Foundation Trusts in England. Design A multiple case study design using semistructured interviews, observation and Framework Analysis techniques. Participants Four LCNSs, comprised the ‘cases’. Twenty four clinicians who worked with the LCNS participated in individual interviews. Six LCNSs took part in a group interview and 60 lung cancer multidisciplinary team (MDT) members and co-ordinators were observed in the MDT meeting. Results The LCNS is crucial within the MDT and can act as a catalyst to patient access to treatment. The study identified the clinical activity (assessment, managing symptoms, psychological support and information provision) and role characteristics that can facilitate treatment access. These characteristics are the LCNS's presence across the patient pathway, acting as the ‘hub’ of the MDT, maintaining a holistic patient focus and working to an advanced level of practice. The findings indicate how factors may have a cumulative impact on treatment access. Conclusions If UK patient with lung cancer survival rates are to improve in line with comparable countries, we need to employ every advantage. This study demonstrates how the LCNS role may open doors to positive patient outcomes, including treatment. Further research is required to explore patients’ experiences, decision-making and attitudes to treatment. PMID:26685023

WE-F-211-01: The Evolving Landscape of Scientific Publishing.

PubMed

Armato, S; Hendee, W; Marshall, C; Curran, B

2012-06-01

The dissemination of scientific advances has changed little since the first peer-reviewed journal was published in 1665 - that is, until this past decade. The print journal, delivered by mail and stored on office shelves and in library reading rooms around the world, has been transformed by immediate, on-demand access to scientific discovery in electronic form. At the same time, the producers and consumers of that scientific content have greatly increased in number, and the balance between supply and demand has required innovations in the world of scientific publishing. In light of technological advances and societal expectations, the dissemination of scientific knowledge has assumed a new form, one that is dynamic and rapidly changing. The academic medical physicist must understand this evolution to ensure that appropriate decisions are made with regard to journal submission strategies and that relevant information on new findings is obtained in a timely manner. Medical Physics is adapting to these changes in substantive ways. This new scientific publishing landscape has implications for subscription models, targeted access through semantic enrichment, user interactivity with content, customized content delivery, and advertising opportunities. Many organizations, including the AAPM, depend on scientific publishing as a significant source of revenue, but web-based delivery raises the expectation that access should be free and threatens this model. The purpose of this symposium is to explore the factors that have contributed to the current state of scientific publishing, to anticipate future directions in this arena, and to convey how medical physicists may benefit from the expanded opportunities, both as authors and as readers. 1. To appreciate the importance of scientific and clinical practice communication for the advancement of the medical physics field 2. To understand the roles of the Editorial Board and the Journal Business Management Committee in the promotion and advancement of Medical Physics 3. To explore technology-driven content delivery mechanisms and their role in facilitating content access and driving content usage 4. To understand the potential benefits and pitfalls of various economic and editorial models of scientific publications and the recent shifts away from the traditional role of libraries. © 2012 American Association of Physicists in Medicine.

Collaborative funding to facilitate airport ground access.

DOT National Transportation Integrated Search

2012-06-01

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

"Community ambassadors" for South Asian elder immigrants: late-life acculturation and the roles of community health workers.

PubMed

Blair, Thomas R W

2012-11-01

Elder immigrants face multiple barriers to accessing health care and other basic services. The Community Ambassador Program for Seniors (CAPS), based in Fremont, California, trains volunteer "ambassadors" from several ethnic and faith communities to perform information and referral services for elders, particularly immigrants. The purpose of this study is to examine the roles of ambassadors in ecologic context as community health workers (CHWs) for clients undergoing late-life acculturation. Ambassadors from three different communities, all of South Asian heritage, were interviewed using a semi-structured guide. 20 out of 23 ambassadors from these communities participated, from December 2008 to December 2009. Data collection and analysis followed grounded theory methodology. Results are presented as an integrated explanatory model, with three major components: (1) acculturative stress, particularly within elders' families; (2) polygonal relationships, a construct that includes elders, their caregivers, CHWs, and service providers, and builds on the notion of a "geriatric triad" (Adelman, Greene, & Charon, 1987); and (3) role hybridity, a novel explanation for CHWs' social niche. Ambassadors mediated elder clients' acculturation both inside and outside elders' families. As such, ambassadors worked in polygonal relationships with elder clients and elders' children, rather than simply working in dyads with elder clients themselves. In the CAPS context, this polygonal framework integrates intra-familial and extra-familial acculturative dynamics into a single relational model. Within these relationships, CHWs exhibited hybridity of social roles, integrating familial and professional attributes, but fully achieving neither familial nor professional status. Practical implications, including importance of outreach to elders' children, accessibility of social programs, and the consequences of role hybridity as a property of CHW identity and function, are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Cost-effectiveness analyses and their role in improving healthcare strategies.

PubMed

Rodriguez, Maria I; Caughey, Aaron B

2013-12-01

In this era of healthcare reform, attention is focused on increasing the quality of care and access to services, while simultaneously reducing the cost. Economic evaluations can play an important role in translating research to evidence-based practice and policy. Cost-effectiveness analysis (CEA) and its utility for clinical and policy decision making among U.S. obstetricians and gynecologists is reviewed. Three case examples demonstrating the value of this methodology in decision making are considered. A discussion of the methodologic principles of CEA, the advantages, and the limitations of the methodology are presented. CEA can play an important role in evidence-based decision making, with value for clinicians and policy makers alike. These studies are of particular interest in the field of obstetrics and gynecology, in which uncertainty from epidemiologic or clinical trials exists, or multiple perspectives need to be considered (maternal, neonatal, and societal). As with all research, it is essential that economic evaluations are conducted according to established methodologic standards. Interpretation and application of results should occur with a clear understanding of both the value and the limitations of economic evaluations.

The Climate-G Portal: a Grid Enabled Scientifc Gateway for Climate Change

NASA Astrophysics Data System (ADS)

Fiore, Sandro; Negro, Alessandro; Aloisio, Giovanni

2010-05-01

Grid portals are web gateways aiming at concealing the underlying infrastructure through a pervasive, transparent, user-friendly, ubiquitous and seamless access to heterogeneous and geographical spread resources (i.e. storage, computational facilities, services, sensors, network, databases). Definitively they provide an enhanced problem-solving environment able to deal with modern, large scale scientific and engineering problems. Scientific gateways are able to introduce a revolution in the way scientists and researchers organize and carry out their activities. Access to distributed resources, complex workflow capabilities, and community-oriented functionalities are just some of the features that can be provided by such a web-based environment. In the context of the EGEE NA4 Earth Science Cluster, Climate-G is a distributed testbed focusing on climate change research topics. The Euro-Mediterranean Center for Climate Change (CMCC) is actively participating in the testbed providing the scientific gateway (Climate-G Portal) to access to the entire infrastructure. The Climate-G Portal has to face important and critical challenges as well as has to satisfy and address key requirements. In the following, the most relevant ones are presented and discussed. Transparency: the portal has to provide a transparent access to the underlying infrastructure preventing users from dealing with low level details and the complexity of a distributed grid environment. Security: users must be authenticated and authorized on the portal to access and exploit portal functionalities. A wide set of roles is needed to clearly assign the proper one to each user. The access to the computational grid must be completely secured, since the target infrastructure to run jobs is a production grid environment. A security infrastructure (based on X509v3 digital certificates) is strongly needed. Pervasivity and ubiquity: the access to the system must be pervasive and ubiquitous. This is easily true due to the nature of the needed web approach. Usability and simplicity: the portal has to provide simple, high level and user friendly interfaces to ease the access and exploitation of the entire system. Coexistence of general purpose and domain oriented services: along with general purpose services (file transfer, job submission, etc.), the portal has to provide domain based services and functionalities. Subsetting of data, visualization of 2D maps around a virtual globe, delivery of maps through OGC compliant interfaces (i.e. Web Map Service - WMS) are just some examples. Since april 2009, about 70 users (85% coming from the climate change community) got access to the portal. A key challenge of this work is the idea to provide users with an integrated working environment, that is a place where scientists can find huge amount of data, complete metadata support, a wide set of data access services, data visualization and analysis tools, easy access to the underlying grid infrastructure and advanced monitoring interfaces.

A Framework for Context Sensitive Risk-Based Access Control in Medical Information Systems

PubMed Central

Choi, Donghee; Kim, Dohoon; Park, Seog

2015-01-01

Since the access control environment has changed and the threat of insider information leakage has come to the fore, studies on risk-based access control models that decide access permissions dynamically have been conducted vigorously. Medical information systems should protect sensitive data such as medical information from insider threat and enable dynamic access control depending on the context such as life-threatening emergencies. In this paper, we suggest an approach and framework for context sensitive risk-based access control suitable for medical information systems. This approach categorizes context information, estimating and applying risk through context- and treatment-based permission profiling and specifications by expanding the eXtensible Access Control Markup Language (XACML) to apply risk. The proposed framework supports quick responses to medical situations and prevents unnecessary insider data access through dynamic access authorization decisions in accordance with the severity of the context and treatment. PMID:26075013

Access to Elementary Education in India: Politics, Policies and Progress. CREATE Pathways to Access. Research Monograph No. 44

ERIC Educational Resources Information Center

Little, Angela W.

2010-01-01

This monograph examines progress in, and policies for, access to elementary education over the past 60 years, the role played by political factors in the process of policy formulation and implementation and the drivers and inhibitors of the implementation of reforms in elementary education in recent years in India. Drawing on interviews and…

Z. Smith Reynolds Library: Its Role in Wake Forest University's Access 2000 Project.

ERIC Educational Resources Information Center

Smith, Susan

1996-01-01

Describes the Access 2000 project at Wake Forest University (North Carolina) where students should have access to computers by the year 2000. Highlights include its history and goals; and the library's part in training faculty, staff, and students to use the new technology that includes an IBM ThinkPad laptop computer for each incoming first-year…

Inner-city asthma: the role of the community.

PubMed

Persky, Victoria; Turyk, Mary; Piorkowski, Julie; Coover, Lenore; Knight, John; Wagner, Cynthia; Hernandez, Eva; Eldeirawi, Kamal; Fitzpatrick, Anne

2007-11-01

Asthma morbidity and mortality are disproportionately high in low-income minority populations. Variations in environmental exposures, stress, and access to appropriate health care all contribute to these disparities. The complex nature of asthma with strong contributions from environmental, psychosocial, and biological factors suggest that community-based approaches focused on the unique needs of high-risk populations may be effective. The few previous randomized trials suggest that case management with professionals and/or community health educators may reduce asthma morbidity. Health-educator programs should be lodged in stable infrastructures with training and funding for community health workers to obtain long-term sustainability. Factors not amenable to individual intervention, however, such as poor condition of homes, outdoor pollution, and lack of access to appropriate care, will require collaborative efforts of community groups, academic professionals, public agencies, and health-care providers.

Architecture and implementation for a system enabling smartphones to access smart card based healthcare records.

PubMed

Karampelas, Vasilios; Pallikarakis, Nicholas; Mantas, John

2013-01-01

The healthcare researchers', academics' and practitioners' interest concerning the development of Healthcare Information Systems has been on a steady rise for the last decades. Fueling this steady rise has been the healthcare professional need of quality information, in every healthcare provision incident, whenever and wherever this incident may take place. In order to address this need a truly mobile health care system is required, one that will be able to provide a healthcare provider with accurate patient-related information regardless of the time and place that healthcare is provided. In order to fulfill this role the present study proposes the architecture for a Healthcare Smartcard system, which provides authenticated healthcare professionals with remote mobile access to a Patient's Healthcare Record, through their Smartphone. Furthermore the research proceeds to develop a working prototype system.

Solar Week: Learning from Experience

NASA Astrophysics Data System (ADS)

Alexander, D.; Hauck, K.

2003-12-01

Solar Week is a week-long set of games and activities allowing students to interact directly with solar science and solar scientists. Solar Week was developed as a spin-off of the highly successful Yohkoh Public Outreach Project (YPOP). While YPOP provided access to solar images, movies and activities, the main goal of Solar Week was to enhance the participation of women, who are under-represented in the physical sciences. Solar Week achieves this by providing young women, primarily in grades 6-8, with access to role models in the sciences. The scientists participating in Solar Week are women from a variety of backgrounds and with a variety of scientific expertise. In this paper, our aim is to provide some insight into developing activity-based space science for the web and to discuss the lessons-learned from tailoring to a specific group of participants.

The North Country on the Job Network: a unique role for occupational health nurses in a community coalition.

PubMed

Kennedy, Margaret Q; Badger, Elizabeth; Pompeii, Lisa; Lipscomb, Hester J

2003-05-01

1. Through a community based program, nurses were hired by a rural medical center to facilitate care for injured workers in the community. This placed the nurses outside the industrial and insurance arenas. 2. Rapid access to care and expedited return to work were made possible largely through improved communication, facilitated by the nurse case coordinators, among all involved parties (i.e., workers, employers, health care providers, insurance carriers). 3. The program provides access to occupational health nurses, or case managers, to a large number of rural workers--many of whom work for small employers and would not have these services otherwise. 4. The simple administrative model has resulted in increased numbers of workers returning to work with decreasing numbers of transitional or modified duty days.

Online shopping interface components: relative importance as peripheral and central cues.

PubMed

Warden, Clyde A; Wu, Wann-Yih; Tsai, Dungchun

2006-06-01

The Elaboration Likelihood Model (ELM) uses central (more thoughtful) and peripheral (less thoughtful) routes of persuasion to maximize communication effectiveness. This research implements ELM to investigate the relative importance of different aspects of the user experience in online shopping. Of all the issues surrounding online shopping, convenience, access to information, and trust were found to be the most important. These were implemented in an online conjoint shopping task. Respondents were found to use the central route of the ELM on marketing messages that involved issues of minimizing travel, information access, and assurances of system security. Users employed the peripheral ELM route when considering usability, price comparison, and personal information protection. A descriptive model of Web-based marketing components, their roles in the central and peripheral routes, and their relative importance to online consumer segments was developed.

Sub-specialization in plastic surgery in Sub-saharan Africa: capacities, gaps and opportunities

PubMed Central

Ibrahim, Abdulrasheed

2014-01-01

The skill set of a plastic surgeon, which addresses a broad range of soft tissue conditions that are prevalent in sub-Saharan Africa, remains relevant in the unmet need for surgical care. Recently, there has being a major paradigm shift from discipline-based to disease-based care, resulting in an emerging component of patient-centered care; adequate access to subspecialty care in plastic and reconstructive surgery. Given the need for an evolution in sub-specialization, this article focuses on the benefits and future role of differentiation of plastic surgeons into sub-specialty training pathways in sub-Saharan Africa. PMID:25584125

ARM/GCSS/SPARC TWP-ICE CRM Intercomparison Study

NASA Technical Reports Server (NTRS)

Fridlind, Ann; Ackerman, Andrew; Petch, Jon; Field, Paul; Hill, Adrian; McFarquhar, Greg; Xie, Shaocheng; Zhang, Minghua

2010-01-01

Specifications are provided for running a cloud-resolving model (CRM) and submitting results in a standardized format for inclusion in a n intercomparison study and archiving for public access. The simulated case study is based on measurements obtained during the 2006 Tropical Warm Pool - International Cloud Experiment (TWP-ICE) led by the U. S. department of Energy Atmospheric Radiation Measurement (ARM) program. The modeling intercomparison study is based on objectives developed in concert with the Stratospheric Processes And their Role in Climate (SPARC) program and the GEWEX cloud system study (GCSS) program. The Global Energy and Water Cycle Experiment (GEWEX) is a core project of the World Climate Research PRogramme (WCRP).

Efficient Authorization of Rich Presence Using Secure and Composed Web Services

NASA Astrophysics Data System (ADS)

Li, Li; Chou, Wu

This paper presents an extended Role-Based Access Control (RBAC) model for efficient authorization of rich presence using secure web services composed with an abstract presence data model. Following the information symmetry principle, the standard RBAC model is extended to support context sensitive social relations and cascaded authority. In conjunction with the extended RBAC model, we introduce an extensible presence architecture prototype using WS-Security and WS-Eventing to secure rich presence information exchanges based on PKI certificates. Applications and performance measurements of our presence system are presented to show that the proposed RBAC framework for presence and collaboration is well suited for real-time communication and collaboration.

Readily Accessible and Highly Efficient Ferrocene-Based Amino-Phosphine-Alcohol (f-Amphol) Ligands for Iridium-Catalyzed Asymmetric Hydrogenation of Simple Ketones.

PubMed

Yu, Jianfei; Duan, Meng; Wu, Weilong; Qi, Xiaotian; Xue, Peng; Lan, Yu; Dong, Xiu-Qin; Zhang, Xumu

2017-01-18

We have successfully developed a series of novel and modular ferrorence-based amino-phosphine-alcohol (f-Amphol) ligands, and applied them to iridium-catalyzed asymmetric hydrogenation of various simple ketones to afford the corresponding chiral alcohols with excellent enantioselectivities and conversions (98-99.9 % ee, >99 % conversion, turnover number up to 200 000). Control experiments and density functional theory (DFT) calculations have shown that the hydroxyl group of our f-Amphol ligands played a key role in this asymmetric hydrogenation. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Online activities to optimize in person learning

NASA Astrophysics Data System (ADS)

Stelzer, Tim

Students' unprecedented access to content on the web is providing a unique opportunity to transform the role lectures in education, moving the focus from content delivery to helping students synthesize the content into knowledge. We have introduced a variety of activities to facilitate this transformation at the University of Illinois, including web-based preflight assessments of student understanding before lecture, peer instruction (clickers) to assess and facilitate student understanding during lecture, and web-based multimedia pre-lectures designed to provide students with content before lecture. In this talk I will discuss the pedagogical motivation for introducing these activities, and the impact they have had at the University of Illinois. .

Nursing care of children in general practice settings: roles and responsibilities.

PubMed

Walsh, Anne; Barnes, Margaret; Mitchell, Amy E

2015-11-01

To examine roles and responsibilities of Practice Nurses in the area of child health and development and in advising parents about child health issues. As the focus of Australia's health care system shifts further towards the primary health care sector, governmental initiatives require that Practice Nurses are knowledgeable, confident and competent in providing care in the area of child health and development. Little is known about roles and responsibilities of Practice Nurses in this area. Cross-sectional survey design. Practice Nurses completed a national online survey examining the roles and responsibilities in child health and development, professional development needs and role satisfaction. Data were collected from June 2010-April 2011. Respondents (N = 159) reported having a significant role in well and sick child care and were interested in extending their role. Frequent activities included immunization, phone triage/advice, child health/development advice, wound care and Healthy Kids Checks. However, few had paediatric/child nursing backgrounds or postgraduate qualifications in paediatric nursing and they reported limited preparation for the role. Practice Nurses reported difficulties with keeping up-to-date with child health information and advising parents confidently. Satisfaction was relatively low regarding opportunities and encouragement to undertake professional development and expand scope of practice. Practice Nurses are largely unprepared to meet the demands of their child health role and need support to develop and maintain the skills and knowledge base necessary for high-quality, evidence-based practice. Both financial and time support is needed to enable Practice Nurses to access child health professional development. © 2015 John Wiley & Sons Ltd.

Who's Got the Booze? The Role of Access to Alcohol in the Relations Between Social Status and Individual Use.

PubMed

Deutsch, Arielle R; Steinley, Douglas; Sher, Kenneth J; Slutske, Wendy S

2017-09-01

The findings of previous research that examined relationships between popularity and alcohol use in adolescents have been mixed, and few hypotheses have proposed mechanisms for this relationship. The current study expands on previous literature (a) by examining a possible mechanism that can explain the relation between popularity and alcohol use (home access to alcohol) and (b) by using another sociometric measure ("betweenness"), beyond popularity, that may relate more to home alcohol access. Using network-level data from adolescents in 9th-11th grades in eight schools within two in-home waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we examined two sociometric measures of social status: popularity (number of schoolmates who nominated participants as a friend) and betweenness (level of ties participants have to multiple social subgroups within a network). Betweenness, but not popularity, related to later alcohol use. Having home access to alcohol positively related to later alcohol use, and having friends with home access to alcohol negatively related to later alcohol use. Alcohol access was also related to later sociometric status. Friends' alcohol access negatively related to later betweenness, and personal alcohol access moderated other pathways predicting betweenness. Betweenness appears to play a unique role in the association between social status and alcohol use in adolescent social networks. This is potentially tied to specific ways in which adolescents may be able to access alcohol (through home or through friends with access at home). More research is necessary to examine the ways in which multiple sociometric statuses relate to the contexts in which adolescents access and use alcohol.

The intersection of class origin and immigration background in structuring social capital: the role of transnational ties.

PubMed

Andersson, Anton; Edling, Christofer; Rydgren, Jens

2018-03-01

The study investigates inequalities in access to social capital based on social class origin and immigration background and examines the role of transnational ties in explaining these differences. Social capital is measured with a position generator methodology that separates between national and transnational contacts in a sample of young adults in Sweden with three parental backgrounds: at least one parent born in Iran or Yugoslavia, or two Sweden-born parents. The results show that having socioeconomically advantaged parents is associated with higher levels of social capital. Children of immigrants are found to have a greater access to social capital compared to individuals with native background, and the study shows that this is related to transnational contacts, parents' education and social class in their country of origin. Children of immigrants tend to have more contacts abroad, while there is little difference in the amount of contacts living in Sweden across the three groups. It is concluded that knowledge about immigration group resources help us predict its member's social capital, but that the analysis also needs to consider how social class trajectories and migration jointly structure national and transnational contacts. © London School of Economics and Political Science 2017.

Energy services in the information age: The convergence of energy, communications, and information technologies

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

Centolella, P.A.

1998-07-01

Most of the economic efficiency benefits of electric restructuring--consumer choice based on price and risk preferences, efficient capacity utilization, capacity expansion that reflects marketability, and innovative products--depend upon consumer access to information and opportunities to respond to time- and location-specific prices and customized products. Information and communications technologies from back-room data management centers to intelligent consumer gateways will play an essential role in marketing energy services in a retail access environment. This paper describes the role of information and communications technology in electric industry restructuring and retailing of energy services. It includes a survey of economic analyses on the likelymore » variability in competitive generation prices and consumer responses if such prices are effectively communicated. The paper describes the potential benefits and cost savings associated with flexible consumer responses to price variability. It identifies consumer loads and preferences. Finally, the paper describes the building blocks of information systems being developed to facilitate price-responsive energy management and provide a range of other energy services. Intelligent gateways, analytical tools for facility load prediction and optimizing energy management responses, and electronic commerce applications are discussed.« less

Civil Society, Political Mobilization, and the Impact of HIV Scale-up on Health Systems in Brazil

PubMed Central

Parker, Richard G.

2011-01-01

This article examines the role of civil society in shaping HIV and AIDS policies and programs in Brazil. It focuses on the historical context of the re-democratization of Brazilian society during the 1980s, when the initial response to the epidemic took shape, and emphasizes the role of social movements linked to the progressive Catholic Church, the sanitary reform movement in public health, and the emerging gay rights movement in the early response to the epidemic in Brazil. It highlights the broad-based civil society coalition that took shape over the course of the 1990s, and the political alliances that were built up shortly after the 1996 International AIDS Conference in Vancouver, Canada, in order to pass legislation guaranteeing the right to antiretroviral treatment access. It emphasizes the continued importance of civil society organizations – in particular, AIDS-related NGOS – and leading AIDS activists in exerting continued pressure in order to guarantee the sustainability of treatment access, and the impact that action focused on HIV and AIDS has had on the Brazilian public health system more broadly, particularly through strengthening health infrastructures and providing a model for health-related social mobilization more broadly. PMID:19858939

Visual Access in Interpreter-Mediated Learning Situations for Deaf and Hard-of-Hearing High School Students Where an Artifact Is in Use.

PubMed

Berge, Sigrid Slettebakk; Thomassen, Gøril

2016-04-01

This article highlights interpreter-mediated learning situations for deaf high school students where such mediated artifacts as technical machines, models, and computer graphics are used by the teacher to illustrate his or her teaching. In these situations, the teacher's situated gestures and utterances, and the artifacts will contribute independent pieces of information. However, the deaf student can only have his or her visual attention focused on one source at a time. The problem to be addressed is how the interpreter coordinates the mediation when it comes to deaf students' visual orientation. The presented discourse analysis is based on authentic video recordings from inclusive learning situations in Norway. The theoretical framework consists of concepts of role, footing, and face-work (Goffman, E. (1959). The presentation of self in everyday life. London, UK: Penguin Books). The findings point out dialogical impediments to visual access in interpreter-mediated learning situations, and the article discusses the roles and responsibilities of teachers and educational interpreters. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Where, When, and How mmWave is Used in 5G and Beyond

NASA Astrophysics Data System (ADS)

Sakaguchi, Kei; Haustein, Thomas; Barbarossa, Sergio; Strinati, Emilio Calvanese; Clemente, Antonio; Destino, Giuseppe; Pärssinen, Aarno; Kim, Ilgyu; Chung, Heesang; Kim, Junhyeong; Keusgen, Wilhelm; Weiler, Richard J.; Takinami, Koji; Ceci, Elena; Sadri, Ali; Xian, Liang; Maltsev, Alexander; Tran, Gia Khanh; Ogawa, Hiroaki; Mahler, Kim; Heath, Robert W., Jr.

Wireless engineers and business planners commonly raise the question on where, when, and how millimeter-wave (mmWave) will be used in 5G and beyond. Since the next generation network is not just a new radio access standard, but instead an integration of networks for vertical markets with diverse applications, answers to the question depend on scenarios and use cases to be deployed. This paper gives four 5G mmWave deployment examples and describes in chronological order the scenarios and use cases of their probable deployment, including expected system architectures and hardware prototypes. The paper starts with 28 GHz outdoor backhauling for fixed wireless access and moving hotspots, which will be demonstrated at the PyeongChang winter Olympic games in 2018. The second deployment example is a 60 GHz unlicensed indoor access system at the Tokyo-Narita airport, which is combined with Mobile Edge Computing (MEC) to enable ultra-high speed content download with low latency. The third example is mmWave mesh network to be used as a micro Radio Access Network ({\\mu}-RAN), for cost-effective backhauling of small-cell Base Stations (BSs) in dense urban scenarios. The last example is mmWave based Vehicular-to-Vehicular (V2V) and Vehicular-to-Everything (V2X) communications system, which enables automated driving by exchanging High Definition (HD) dynamic map information between cars and Roadside Units (RSUs). For 5G and beyond, mmWave and MEC will play important roles for a diverse set of applications that require both ultra-high data rate and low latency communications.

Adolescent and Young Adult Cancer Survivorship Educational Programming: A Qualitative Evaluation.

PubMed

Vollmer Dahlke, Deborah; Fair, Kayla; Hong, Yan Alicia; Kellstedt, Debra; Ory, Marcia G

2017-02-10

This program evaluation considers the need for increased professional and patient education for adolescent and young adult (AYA) cancer survivorship. Due to the high incidence of late effects of cancer treatment among AYA cancer survivors, knowledge sharing and communications are needed throughout the transition from cancer care into community care. AYA survivors are likely to need developmentally appropriate psychosocial care as well as extensive follow-on surveillance by physicians who are educated and aware of the likely chronic conditions and late effects that may occur in these patients. The objective of this study was to evaluate the outcomes of the After Cancer Care Ends, Survivorship Starts for Adolescent and Young Adults (ACCESS AYA) programming. The intent of the ACCESS AYA program was to build health literacy around AYA survivorship issues and to stimulate improved communications between survivors and health care providers. This paper addresses the central research question of "How did the ACCESS AYA program increase health literacy, communications, and understanding among AYA survivors and providers?" The primarily qualitative evaluation included a brief introductory survey of participant awareness and effectiveness of the ACCESS AYA project serving as a recruitment tool. Survey respondents were invited to participate in in-depth interviews based on interview guides tailored to the different stakeholder groups. The evaluation used the Atlas Ti qualitative database and software for coding and key word analyses. Interrater reliability analyses were assessed using Cohen kappa analysis with Stata 12.1 (StataCorp LLC) software. The key themes, which included survivor wellbeing, health care professional education, cancer advocates role and education, hospital and community-based resources, and the role of societal support, are presented in a concept map. The interrater reliability scores (ranging from 1 to minus 1) were .893 for first cycle coding and .784 for the second cycle. In the brief quantitative survey based on a scale of 1 to 5 with 5 as high, the 22 respondents rated their level of awareness of the project with a mean 3.2 (CI 3.02-3.45) and project effectiveness with a mean of 4 (CI 3.72-4.27). This study contributes to understanding of the ACCESS AYA survivor community in central Texas and the health care professionals and advocates who aid them in their efforts to a new normal life and wellbeing in their survivorship. The results of the evaluation highlight the need to continue to build both survivor and professional resources to address the unique impact of cancer on AYA cancer survivors. ©Deborah Vollmer Dahlke, Kayla Fair, Yan Alicia Hong, Debra Kellstedt, Marcia G Ory. Originally published in JMIR Cancer (http://cancer.jmir.org), 10.02.2017.

Using a NIATx based local learning collaborative for performance improvement

PubMed Central

Roosa, Mathew; Scripa, Joseph S.; Zastowny, Thomas R.; Ford, James H.

2012-01-01

Local governments play an important role in improving substance abuse and mental health services. The structure of the local learning collaborative requires careful attention to old relationships and challenges local governmental leaders to help move participants from a competitive to collaborative environment. This study describes one county’s experience applying the NIATx process improvement model via a local learning collaborative. Local substance abuse and mental health agencies participated in two local learning collaboratives designed to improve client retention in substance abuse treatment and client access to mental health services. Results of changes implemented at the provider level on access and retention are outlined. The process of implementing evidence-based practices by using the Plan-Do-Study-Act rapid-cycle change is a powerful combination for change at the local level. Key lessons include: creating a clear plan and shared vision, recognizing that one size does not fit all, using data can help fuel participant engagement, a long collaborative may benefit from breaking it into smaller segments, and paying providers to offset costs of participation enhances their engagement. The experience gained in Onondaga County, New York, offers insights that serve as a foundation for using the local learning collaborative in other community-based organizations. PMID:21371751

The CDC Hemophilia B mutation project mutation list: a new online resource.

PubMed

Li, Tengguo; Miller, Connie H; Payne, Amanda B; Craig Hooper, W

2013-11-01

Hemophilia B (HB) is caused by mutations in the human gene F9. The mutation type plays a pivotal role in genetic counseling and prediction of inhibitor development. To help the HB community understand the molecular etiology of HB, we have developed a listing of all F9 mutations that are reported to cause HB based on the literature and existing databases. The Centers for Disease Control and Prevention (CDC) Hemophilia B Mutation Project (CHBMP) mutation list is compiled in an easily accessible format of Microsoft Excel and contains 1083 unique mutations that are reported to cause HB. Each mutation is identified using Human Genome Variation Society (HGVS) nomenclature standards. The mutation types and the predicted changes in amino acids, if applicable, are also provided. Related information including the location of mutation, severity of HB, the presence of inhibitor, and original publication reference are listed as well. Therefore, our mutation list provides an easily accessible resource for genetic counselors and HB researchers to predict inhibitors. The CHBMP mutation list is freely accessible at http://www.cdc.gov/hemophiliamutations.

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

PubMed

Pergament, Deborah; Ilijic, Katie

2014-12-15

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

Paying for reproductive health services in Bangladesh: intersections between cost, quality and culture.

PubMed

Schuler, Sidney Ruth; Bates, Lisa M; Islam, Md Khairul

2002-09-01

In 1997 a consortium of non-governmental organizations (NGOs) in Bangladesh began to implement health sector reform measures intended to expand access to and improve the quality of family planning and other basic health services. The new service delivery model entails higher costs for clients and requires that they take greater initiative. Clients have to travel further to get certain services, and they have to pay more for them than they did under the previous door-to-door family planning model. This paper is based on findings from a qualitative study looking at client and community reactions to the programme changes. It examines a number of barriers to access and constraints to cost recovery, including gender, class and ideas about entitlements, the role of government and obligations among people. The NGOs want to maximize cost recovery while making the basic services they offer accessible to most people. The findings suggest that this requires more than the establishment of an appropriate pricing structure. Attitudes related to charging and paying for services must also change, along with the institutional policies and practices that support them.

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

PubMed Central

Pergament, Deborah; Ilijic, Katie

2014-01-01

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

Complementary concept for an image archive and communication system in a cardiological department based on CD-medical, an online archive, and networking facilities

NASA Astrophysics Data System (ADS)

Oswald, Helmut; Mueller-Jones, Kay; Builtjes, Jan; Fleck, Eckart

1998-07-01

The developments in information technologies -- computer hardware, networking and storage media -- has led to expectations that these advances make it possible to replace 35 mm film completely by digital techniques in the catheter laboratory. Besides the role of an archival medium, cine film is used as the major image review and exchange medium in cardiology. None of the today technologies can fulfill completely the requirements to replace cine film. One of the major drawbacks of cine film is the single access in time and location. For the four catheter laboratories in our institutions we have designed a complementary concept combining the CD-R, also called CD-medical, as a single patient storage and exchange medium, and a digital archive for on-line access and image review of selected frames or short sequences on adequate medical workstations. The image data from various modalities as well as all digital documents regarding to a patient are part of an electronic patient record. The access, the processing and the display of documents is supported by an integrated medical application.

Genotypic diversity and environmental stability of starch physicochemical properties in the USDA rice mini-core collection.

PubMed

Li, Kehu; Bao, Jinsong; Corke, Harold; Sun, Mei

2017-04-15

The USDA rice mini-core collection consists of 217 accessions representative of a world-wide germplam bank. We investigated its genotypic diversity in starch physicochemical properties and the effects of genotype, environment and G×E interaction in this study. High genotypic diversity was found in all 18 measured starch quality traits in the mini-core rice in two location-years in China. Genotype, environment and G×E effects on these traits were analysed using 115 common accessions successfully produced in both environments. Thermal properties (T o , T p and T c ) were very stable whereas most other traits differed significantly between environments. However, when these accessions were divided into five subgroups based on amylose content, environment was found to have differential effects. G×E interaction also played a significant role in determining the starch traits. These findings will provide guidance for selection from the diverse genotypes in the USDA mini-core collection for cultivation and for developing cultivars with desired cooking and eating quality. Copyright © 2016 Elsevier Ltd. All rights reserved.

Strategic partnerships between academic dental institutions and communities: addressing disparities in oral health care.

PubMed

Johnson, Bradford R; Loomer, Peter M; Siegel, Sharon C; Pilcher, Elizabeth S; Leigh, Janet E; Gillespie, M Jane; Simmons, Raymond K; Turner, Sharon P

2007-10-01

A landmark report from the U.S. surgeon general identified disparities in oral health care as an urgent and high-priority problem. A parallel development in the dental education community is the growing consensus that significant curriculum reform is long overdue. The authors performed a literature review and conducted a series of structured interviews with key institutional and community stakeholders from seven geographical regions of the United States. They investigated a wide range of partnerships between community-based dental clinics and academic dental institutions. On the basis of their interviews and literature review, the authors identified common themes and made recommendations to the dental community to improve access to care while enhancing the dental curriculum. Reducing disparities in access to oral health care and the need for reform of the dental curriculum may be addressed, in part, by a common solution: strategic partnerships between academic dental institutions and communities. Practice Implications. Organized dentistry and individual practitioners, along with other major stakeholders, can play a significant role in supporting reform of the dental curriculum and improving access to care.

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

PubMed

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

2015-08-01

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

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

PubMed Central

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

2015-01-01

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

The web-surfing bariatic patient: the role of the internet in the decision-making process.

PubMed

Paolino, Luca; Genser, Laurent; Fritsch, Sylvie; De' Angelis, Nicola; Azoulay, Daniel; Lazzati, Andrea

2015-04-01

Health-related information on the Internet is constantly increasing, but its quality and accountability are difficult to assess. Patients browse the Net to get more information, but the impact of the Internet on their decisions about surgical techniques, referral centers, or surgeon choice are still not clear. This study aimed to describe the role of the Internet in the decision-making process of obese patients seeking bariatric surgery. Two hundred and twelve candidates for bariatric surgery were asked to answer a questionnaire evaluating their access to the Internet, the usefulness and trustworthiness of Internet-retrieved information, the verification of the information, and the role of the information in the decision-making process. Two hundred and twelve patients answered the questionnaire. Of these, 95.1% had access to the Internet and 77.8% reported having researched about bariatric surgery. Their main interests were the surgical techniques (81.4%) and other patients' experiences (72.3%). The favorite Web sites were those affiliated to public hospitals or edited by other patients. The accountability of the e-information was mainly evaluated by discussion with the general practitioner (GP) (83.0%) or family members and friends (46.8%). One patient in four decided to undergo bariatric surgery mainly based on e-information, while discussion about treatment options with the GP and the hospital reputation were taken into account in 77.8 and 51.7% of cases, respectively. Most patients seeking bariatric surgery search for health information online. E-information seems to have an important role in the decision-making process of patients who are candidates for bariatric surgery.

EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis.

PubMed

van Eijk-Hustings, Yvonne; van Tubergen, Astrid; Boström, Carina; Braychenko, Elena; Buss, Beate; Felix, José; Firth, Jill; Hammond, Alison; Harston, Benny; Hernandez, Cristina; Huzjak, Masa; Korandová, Jana; Kukkurainen, Marja Leena; Landewé, Robert; Mezieres, Maryse; Milincovic, Marijana; Moretti, Antonella; Oliver, Susan; Primdahl, Jette; Scholte-Voshaar, Marieke; de la Torre-Aboki, Jenny; Waite-Jones, Jennifer; Westhovens, Rene; Zangi, Heidi Andersen; Heiberg, Turid; Hill, Jackie

2012-01-01

The authors aim to develop European League Against Rheumatism recommendations for the role of the nurse in the management of patients with chronic inflammatory arthritis, to identify a research agenda and to determine an educational agenda. A task force made up of a multidisciplinary expert panel including nurses, rheumatologists, occupational therapist, physiotherapist, psychologist, epidemiologist and patient representatives, representing 14 European countries, carried out the development of the recommendations, following the European League Against Rheumatism standardised operating procedures. The task force met twice. In the first meeting, the aims of the task force were defined, and eight research questions were developed. This was followed by a comprehensive, systematic literature search. In the second meeting, the results from the literature review were presented to the task force that subsequently formulated the recommendations, research agenda and educational agenda. In total, 10 recommendations were formulated. Seven recommendations covered the contribution of nurses to care and management: education, satisfaction with care, access to care, disease management, psychosocial support, self-management and efficiency of care. Three recommendations focused on professional support for nurses: availability of guidelines or protocols, access to education and encouragement to undertake extended roles. The strength of the recommendations varied from A to C, dependent on the category of evidence (1A-3), and a high level of agreement was achieved. Additionally, the task force agreed upon 10 topics for future research and an educational agenda. 10 recommendations for the role of the nurse in the management of chronic inflammatory arthritis were developed using a combination of evidence-based and expert consensus approach.

Potential roles for transposable elements in creating imprinted expression.

PubMed

Anderson, Sarah N; Springer, Nathan M

2018-04-01

Changes in gene expression can have profound effects on phenotype. Nature has provided many complex patterns of gene regulation such as imprinting. Imprinted genes exhibit differences in the expression of the maternal and paternal alleles, even though they reside in the same nucleus with access to the same trans-acting factors. Significant attention has been focused on the potential reasons that imprinted expression could be beneficial and stabilized by selection. However, less attention has focused on understanding how imprinted expression might arise or decay. We discuss the evidence for frequent turnover of imprinted expression based on evolutionary analyses in plants and the potential role for transposable elements (TEs) in creating imprinted expression patterns. Copyright © 2018 Elsevier Ltd. All rights reserved.

Advancing the Practice of CRCs: Why Professional Development Matters.

PubMed

Behar-Horenstein, Linda S; Prikhidko, Alena; Kolb, H Robert

2018-01-01

Clinical research coordinators (CRCs) assume critical responsibilities central to the success of the research team. The complexity of their role requires essential professional qualifications. One barrier to professionalization, however, has been the inconsistent, or absent, competency-based training. This study explored participants' perceptions of training experiences designed to prepare them for the national certification exam. Focus group methodology was used to document their experiences. The findings showed that sustainable mentoring relationships developed, participant confidence levels increased, and anxiety about performance capacity diminished. Cognitive reframing of the work environment and CRC roles was facilitated by training that fostered sharing and social reinforcement of professional and personal identities. Findings from this study suggest that access to meaningful training and quality instruction supports the professionalization of CRCs.

Roles of chemical signals in regulation of the adaptive responses to iron deficiency.

PubMed

Liu, Xing Xing; He, Xiao Lin; Jin, Chong Wei

2016-05-03

Iron is an essential micronutrient for plants but is not readily accessible in most calcareous soils. Although the adaptive responses of plants to iron deficiency have been well documented, the signals involved in the regulatory cascade leading to their activation are not well understood to date. Recent studies revealed that chemical compounds, including sucrose, auxin, ethylene and nitric oxide, positively regulated the Fe-deficiency-induced Fe uptake processes in a cooperative manner. Nevertheless, cytokinins, jasmonate and abscisic acid were shown to act as negative signals in transmitting the iron deficiency information. The present mini review is to briefly address the roles of chemical signals in regulation of the adaptive responses to iron deficiency based on the literatures published in recent years.

The role of the helicopter in transportation. [technology assessment for use in civil aviation

NASA Technical Reports Server (NTRS)

Dajani, J. S.; Warner, D.; Epstein, D.; Obrien, J.

1976-01-01

A general overview is presented of the role that the helicopter plays in the current aviation scene with special emphasis on its use in the airport access function. Technological problems of present-day aircraft are discussed along with some plausible solutions. The economic and regulatory aspects of commercial helicopter operations are presented. Finally six commercial operations utilizing helicopters are reviewed and conditions that enhance the success of the helicopter in the airport access function are proposed.

Simulation-based assessment in anesthesiology: requirements for practical implementation.

PubMed

Boulet, John R; Murray, David J

2010-04-01

Simulations have taken a central role in the education and assessment of medical students, residents, and practicing physicians. The introduction of simulation-based assessments in anesthesiology, especially those used to establish various competencies, has demanded fairly rigorous studies concerning the psychometric properties of the scores. Most important, major efforts have been directed at identifying, and addressing, potential threats to the validity of simulation-based assessment scores. As a result, organizations that wish to incorporate simulation-based assessments into their evaluation practices can access information regarding effective test development practices, the selection of appropriate metrics, the minimization of measurement errors, and test score validation processes. The purpose of this article is to provide a broad overview of the use of simulation for measuring physician skills and competencies. For simulations used in anesthesiology, studies that describe advances in scenario development, the development of scoring rubrics, and the validation of assessment results are synthesized. Based on the summary of relevant research, psychometric requirements for practical implementation of simulation-based assessments in anesthesiology are forwarded. As technology expands, and simulation-based education and evaluation takes on a larger role in patient safety initiatives, the groundbreaking work conducted to date can serve as a model for those individuals and organizations that are responsible for developing, scoring, or validating simulation-based education and assessment programs in anesthesiology.

Dynamic virtual machine allocation policy in cloud computing complying with service level agreement using CloudSim

NASA Astrophysics Data System (ADS)

Aneri, Parikh; Sumathy, S.

2017-11-01

Cloud computing provides services over the internet and provides application resources and data to the users based on their demand. Base of the Cloud Computing is consumer provider model. Cloud provider provides resources which consumer can access using cloud computing model in order to build their application based on their demand. Cloud data center is a bulk of resources on shared pool architecture for cloud user to access. Virtualization is the heart of the Cloud computing model, it provides virtual machine as per application specific configuration and those applications are free to choose their own configuration. On one hand, there is huge number of resources and on other hand it has to serve huge number of requests effectively. Therefore, resource allocation policy and scheduling policy play very important role in allocation and managing resources in this cloud computing model. This paper proposes the load balancing policy using Hungarian algorithm. Hungarian Algorithm provides dynamic load balancing policy with a monitor component. Monitor component helps to increase cloud resource utilization by managing the Hungarian algorithm by monitoring its state and altering its state based on artificial intelligent. CloudSim used in this proposal is an extensible toolkit and it simulates cloud computing environment.

Internetworking satellite and local exchange networks for personal communications applications

NASA Technical Reports Server (NTRS)

Wolff, Richard S.; Pinck, Deborah

1993-01-01

The demand for personal communications services has shown unprecedented growth, and the next decade and beyond promise an era in which the needs for ubiquitous, transparent and personalized access to information will continue to expand in both scale and scope. The exchange of personalized information is growing from two-way voice to include data communications, electronic messaging and information services, image transfer, video, and interactive multimedia. The emergence of new land-based and satellite-based wireless networks illustrates the expanding scale and trend toward globalization and the need to establish new local exchange and exchange access services to meet the communications needs of people on the move. An important issue is to identify the roles that satellite networking can play in meeting these new communications needs. The unique capabilities of satellites, in providing coverage to large geographic areas, reaching widely dispersed users, for position location determination, and in offering broadcast and multicast services, can complement and extend the capabilities of terrestrial networks. As an initial step in exploring the opportunities afforded by the merger of satellite-based and land-based networks, several experiments utilizing the NASA ACTS satellite and the public switched local exchange network were undertaken to demonstrate the use of satellites in the delivery of personal communications services.

Why do patients seek primary medical care in emergency departments? An ethnographic exploration of access to general practice

PubMed Central

Brangan, Emer; Wye, Lesley; Checkland, Kath; Lasserson, Daniel; Morris, Richard; Tammes, Peter; Purdy, Sarah

2017-01-01

Objectives To describe how processes of primary care access influence decisions to seek help at the emergency department (ED). Design Ethnographic case study combining non-participant observation, informal and formal interviewing. Setting Six general practitioner (GP) practices located in three commissioning organisations in England. Participants and methods Reception areas at each practice were observed over the course of a working week (73 hours in total). Practice documents were collected and clinical and non-clinical staff were interviewed (n=19). Patients with recent ED use, or a carer if aged 16 and under, were interviewed (n=29). Results Past experience of accessing GP care recursively informed patient decisions about where to seek urgent care, and difficulties with access were implicit in patient accounts of ED use. GP practices had complicated, changeable systems for appointments. This made navigating appointment booking difficult for patients and reception staff, and engendered a mistrust of the system. Increasingly, the telephone was the instrument of demand management, but there were unintended consequences for access. Some patient groups, such as those with English as an additional language, were particularly disadvantaged, and the varying patient and staff semantic of words like ‘urgent’ and ‘emergency’ was exacerbated during telephone interactions. Poor integration between in-hours and out-of-hours care and patient perceptions of the quality of care accessible at their GP practice also informed ED use. Conclusions This study provides important insight into the implicit role of primary care access on the use of ED. Discourses around ‘inappropriate’ patient demand neglect to recognise that decisions about where to seek urgent care are based on experiential knowledge. Simply speeding up access to primary care or increasing its volume is unlikely to alleviate rising ED use. Systems for accessing care need to be transparent, perceptibly fair and appropriate to the needs of diverse patient groups. PMID:28473509

Direct access midwifery booking for prenatal care and its role in Down syndrome screening.

PubMed

Nawaz, Tariq S; Tringham, Gillian M; Holding, Stephen; McFarlane, Jane; Lindow, Stephen W

2011-10-01

To compare the uptake of Down syndrome screening by women following referral by direct access and general practitioner (GP) modes. The method of referral by either GP or direct access, for women who booked into prenatal care in Hull and East Yorkshire in 2010, was analysed using data collected from the Protos database at the Women and Children's Hospital, Hull. Subsequently, the uptake of first and second trimester screening for Down syndrome was reviewed by combining the Protos database to the screening data collected by the Clinical Biochemistry Laboratory at Hull Royal Infirmary, Hull. Women booked into prenatal care significantly earlier when referred by GP in comparison to direct access with a significant difference in screening uptake of 49.5 and 42.7%, respectively. The ratio of uptake between first and second trimester screening was not significantly different. Further research on the new direct access method of referral is required, as it may have a role in the uptake of prenatal screening for Down syndrome. More time is needed to show a definitive effect. Copyright © 2011 John Wiley & Sons, Ltd.

Rural Veteran Access to Healthcare Services: Investigating the Role of Information and Communication Technologies in Overcoming Spatial Barriers

PubMed Central

Schooley, Benjamin L; Horan, Thomas A; Lee, Pamela W; West, Priscilla A

2010-01-01

This multimethod pilot study examined patient and practitioner perspectives on the influence of spatial barriers to healthcare access and the role of health information technology in overcoming these barriers. The study included a survey administered to patients attending a Department of Veterans Affairs (VA) health visit, and a focus group with VA care providers. Descriptive results and focus group findings are presented. Spatial distance is a significant factor for many rural veterans when seeking healthcare. For this sample of rural veterans, a range of telephone, computer, and Internet technologies may become more important for accessing care as Internet access becomes more ubiquitous and as younger veterans begin using the VA health system. The focus group highlighted the negative impact of distance, economic considerations, geographic barriers, and specific medical conditions on access to care. Lack of adequate technology infrastructure was seen as an obstacle to utilization. This study discusses the need to consider distance, travel modes, age, and information technology infrastructure and adoption when designing health information technology to care for rural patients. PMID:20697468

Managing the effect of TRIPS on availability of priority vaccines.

PubMed Central

Milstien, Julie; Kaddar, Miloud

2006-01-01

The stated purpose of intellectual property protection is to stimulate innovation. The Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) requires all Members of the World Trade Organization (WTO) to enact national laws conferring minimum standards of intellectual property protection by certain deadlines. Critics of the Agreement fear that such action is inconsistent with ensuring access to medicines in the developing world. A WHO convened meeting on intellectual property rights and vaccines in developing countries, on which this paper is based, found no evidence that TRIPS has stimulated innovation in developing market vaccine development (where markets are weak) or that protection of intellectual property rights has had a negative effect on access to vaccines. However, access to future vaccines in the developing world could be threatened by compliance with TRIPS. The management of such threats requires adherence of all countries to the Doha Declaration on TRIPS, and the protections guaranteed by the Agreement itself, vigilance on TRIPS-plus elements of free trade agreements, developing frameworks for licensing and technology transfer, and promoting innovative vaccine development in developing countries. The role of international organizations in defining best practices, dissemination of information, and monitoring TRIPS impact will be crucial to ensuring optimal access to priority new vaccines for the developing world. PMID:16710544

Dynamic access control model for privacy preserving personalized healthcare in cloud environment.

PubMed

Son, Jiseong; Kim, Jeong-Dong; Na, Hong-Seok; Baik, Doo-Kwon

2015-01-01

When sharing and storing healthcare data in a cloud environment, access control is a central issue for preserving data privacy as a patient's personal health data may be accessed without permission from many stakeholders. Specifically, dynamic authorization for the access of data is required because personal health data is stored in cloud storage via wearable devices. Therefore, we propose a dynamic access control model for preserving the privacy of personal healthcare data in a cloud environment. The proposed model considers context information for dynamic access. According to the proposed model, access control can be dynamically determined by changing the context information; this means that even for a subject with the same role in the cloud, access permission is defined differently depending on the context information and access condition. Furthermore, we experiment the ability of the proposed model to provide correct responses by representing a dynamic access decision with real-life personalized healthcare system scenarios.

American Muslim Perceptions of Healing: Key Agents in Healing, and Their Roles

PubMed Central

Padela, Aasim I.; Killawi, Amal; Forman, Jane; DeMonner, Sonya; Heisler, Michele

2015-01-01

American Muslims represent a growing and diverse community. Efforts at promoting cultural competence, enhancing cross-cultural communication skills, and improving community health must account for the religio-cultural frame through which American Muslims view healing. Using a community-based participatory research model, we conducted 13 focus groups at area mosques in southeast Michigan to explore American Muslim views on healing and to identify the primary agents, and their roles, within the healing process. Participants shared a God-centric view of healing. Healing was accessed through direct means such as supplication and recitation of the Qur'an, or indirectly through human agents including imams, health care practitioners, family, friends, and community. Human agents served integral roles, influencing spiritual, psychological, and physical health. Additional research into how religiosity, health care systems, and community factors influence health-care-seeking behaviors is warranted. PMID:22393065

The role of organizational context and individual nurse characteristics in explaining variation in use of information technologies in evidence based practice

PubMed Central

2012-01-01

Background There is growing awareness of the role of information technology in evidence-based practice. The purpose of this study was to investigate the role of organizational context and nurse characteristics in explaining variation in nurses’ use of personal digital assistants (PDAs) and mobile Tablet PCs for accessing evidence-based information. The Promoting Action on Research Implementation in Health Services (PARIHS) model provided the framework for studying the impact of providing nurses with PDA-supported, evidence-based practice resources, and for studying the organizational, technological, and human resource variables that impact nurses’ use patterns. Methods A survey design was used, involving baseline and follow-up questionnaires. The setting included 24 organizations representing three sectors: hospitals, long-term care (LTC) facilities, and community organizations (home care and public health). The sample consisted of 710 participants (response rate 58%) at Time 1, and 469 for whom both Time 1 and Time 2 follow-up data were obtained (response rate 66%). A hierarchical regression model (HLM) was used to evaluate the effect of predictors from all levels simultaneously. Results The Chi square result indicated PDA users reported using their device more frequently than Tablet PC users (p = 0.001). Frequency of device use was explained by ‘breadth of device functions’ and PDA versus Tablet PC. Frequency of Best Practice Guideline use was explained by ‘willingness to implement research,’ ‘structural and electronic resources,’ ‘organizational slack time,’ ‘breadth of device functions’ (positive effects), and ‘slack staff’ (negative effect). Frequency of Nursing Plus database use was explained by ‘culture,’ ‘structural and electronic resources,’ and ‘breadth of device functions’ (positive effects), and ‘slack staff’ (negative). ‘Organizational culture’ (positive), ‘breadth of device functions’ (positive), and ‘slack staff ‘(negative) were associated with frequency of Lexi/PEPID drug dictionary use. Conclusion Access to PDAs and Tablet PCs supported nurses’ self-reported use of information resources. Several of the organizational context variables and one individual nurse variable explained variation in the frequency of information resource use. PMID:23276201

Psychological and biological responses to race-based social stress as pathways to disparities in educational outcomes.

PubMed

Levy, Dorainne J; Heissel, Jennifer A; Richeson, Jennifer A; Adam, Emma K

2016-09-01

We present the race-based disparities in stress and sleep in context model (RDSSC), which argues that racial/ethnic disparities in educational achievement and attainment are partially explained by the effects of race-based stressors, such as stereotype threat and perceived discrimination, on psychological and biological responses to stress, which, in turn, impact cognitive functioning and academic performance. Whereas the roles of psychological coping responses, such as devaluation and disidentification, have been theorized in previous work, the present model integrates the roles of biological stress responses, such as changes in stress hormones and sleep hours and quality, to this rich literature. We situate our model of the impact of race-based stress in the broader contexts of other stressors [e.g., stressors associated with socioeconomic status (SES)], developmental histories of stress, and individual and group differences in access to resources, opportunity and employment structures. Considering both psychological and biological responses to race-based stressors, in social contexts, will yield a more comprehensive understanding of the emergence of academic disparities between Whites and racial/ethnic minorities. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Is Team-Based Primary Care Associated with Less Access Problems and Self-Reported Unmet Need in Canada?

PubMed

Zygmunt, Austin; Asada, Yukiko; Burge, Frederick

2017-10-01

As in many jurisdictions, the delivery of primary care in Canada is being transformed from solo practice to team-based care. In Canada, team-based primary care involves general practitioners working with nurses or other health care providers, and it is expected to improve equity in access to care. This study examined whether team-based care is associated with fewer access problems and less unmet need and whether socioeconomic gradients in access problems and unmet need are smaller in team-based care than in non-team-based care. Data came from the 2008 Canadian Survey of Experiences with Primary Health Care (sample size: 10,858). We measured primary care type as team-based or non-team-based and socioeconomic status by income and education. We created four access problem variables and four unmet need variables (overall and three specific components). For each, we ran separate logistic regression models to examine their associations with primary care type. We examined socioeconomic gradients in access problems and unmet need stratified by primary care type. Primary care type had no statistically significant, independent associations with access problems or unmet need. Among those with non-team-based care, a statistically significant education gradient for overall access problems existed, whereas among those with team-based care, no statistically significant socioeconomic gradients existed.

Information Access in Rural Areas of the United States: The Public Library's Role in the Digital Divide and the Implications of Differing State Funding Models

ERIC Educational Resources Information Center

Thiele, Jennifer

2016-01-01

In the United States, individual states have different means of determining and distributing funding. This influences library service and access to information particularly as it pertains to critical Internet access. Funding and service trends have changed, especially as it relates to public libraries, with some modifications working to their…

The Impact of Language on Educational Access in South Africa. CREATE Pathways to Access. Research Monograph No. 24

ERIC Educational Resources Information Center

Lafon, Michel

2009-01-01

The role of Medium of Instruction or Language of Learning and Teaching has not received sufficient attention as a factor denying meaningful access to education in South Africa. Yet the majority of under-performing learners are also children who learn in a language that is not their mother-tongue. This research aims to assess how recent language…

Access to Contraception in the Context of Zika: Health System Challenges and Responses

PubMed Central

Darney, Blair G.; Aiken, Abigail R.A.; Küng, Stephanie

2017-01-01

Women in areas of the Americas with endemic Aedes mosquito populations are at risk for exposure to Zika virus, which can cause fetal brain abnormalities and associated congenital microcephaly. Individual health care providers may encounter health systems barriers to providing evidence-based care. We focus on Mexico and the U.S. state of Texas to highlight the role of health system factors in contraceptive access in the context of Zika, and highlight efforts in Puerto Rico as an example of efforts to improve access to contraception. In Mexico, states with the highest unmet need for contraception are low-lying, coastal states. The government recently announced an investment to combat Zika, but made no mention of family planning initiatives to assist women in preventing pregnancy. In Texas, the Department of State Health Services (DSHS) has issued recommendations to help women and men avoid mosquito-bites; the issue of whether women should plan or avoid pregnancy is not addressed. Puerto Rico has the largest number of confirmed cases of Zika virus in the US states and territories. Recently, the CDC Foundation launched the Zika Contraception Access Network (Z-CAN), which provides contraceptives at no cost to participating clinics in Puerto Rico. The Zika virus highlights weaknesses in health systems that make it difficult for women to use contraception if they want to delay births. Women across the globe, with or without Zika, need access to contraception to prevent unintended pregnancy, and providers require functioning health systems that offer the support to ensure access is a reality. PMID:28277362

National Health Service Principles as Experienced by Vulnerable London Migrants in "Austerity Britain": A Qualitative Study of Rights, Entitlements, and Civil-Society Advocacy

PubMed Central

Rafighi, Elham; Poduval, Shoba; Legido-Quigley, Helena; Howard, Natasha

2016-01-01

Background: Recent British National Health Service (NHS) reforms, in response to austerity and alleged ‘health tourism,’ could impose additional barriers to healthcare access for non-European Economic Area (EEA) migrants. This study explores policy reform challenges and implications, using excerpts from the perspectives of non-EEA migrants and health advocates in London. Methods: A qualitative study design was selected. Data were collected through document review and 22 in-depth interviews with non-EEA migrants and civil-society organisation representatives. Data were analysed thematically using the NHS principles. Results: The experiences of those ‘vulnerable migrants’ (ie, defined as adult non-EEA asylum-seekers, refugees, undocumented, low-skilled, and trafficked migrants susceptible to marginalised healthcare access) able to access health services were positive, with healthcare professionals generally demonstrating caring attitudes. However, general confusion existed about entitlements due to recent NHS changes, controversy over ‘health tourism,’ and challenges registering for health services or accessing secondary facilities. Factors requiring greater clarity or improvement included accessibility, communication, and clarity on general practitioner (GP) responsibilities and migrant entitlements. Conclusion: Legislation to restrict access to healthcare based on immigration status could further compromise the health of vulnerable individuals in Britain. This study highlights current challenges in health services policy and practice and the role of non-governmental organizations (NGOs) in healthcare advocacy (eg, helping the voices of the most vulnerable reach policy-makers). Thus, it contributes to broadening national discussions and enabling more nuanced interpretation of ongoing global debates on immigration and health. PMID:27694650

National Health Service Principles as Experienced by Vulnerable London Migrants in "Austerity Britain": A Qualitative Study of Rights, Entitlements, and Civil-Society Advocacy.

PubMed

Rafighi, Elham; Poduval, Shoba; Legido-Quigley, Helena; Howard, Natasha

2016-05-08

Recent British National Health Service (NHS) reforms, in response to austerity and alleged 'health tourism,' could impose additional barriers to healthcare access for non-European Economic Area (EEA) migrants. This study explores policy reform challenges and implications, using excerpts from the perspectives of non-EEA migrants and health advocates in London. A qualitative study design was selected. Data were collected through document review and 22 in-depth interviews with non-EEA migrants and civil-society organisation representatives. Data were analysed thematically using the NHS principles. The experiences of those 'vulnerable migrants' (ie, defined as adult non-EEA asylum-seekers, refugees, undocumented, low-skilled, and trafficked migrants susceptible to marginalised healthcare access) able to access health services were positive, with healthcare professionals generally demonstrating caring attitudes. However, general confusion existed about entitlements due to recent NHS changes, controversy over 'health tourism,' and challenges registering for health services or accessing secondary facilities. Factors requiring greater clarity or improvement included accessibility, communication, and clarity on general practitioner (GP) responsibilities and migrant entitlements. Legislation to restrict access to healthcare based on immigration status could further compromise the health of vulnerable individuals in Britain. This study highlights current challenges in health services policy and practice and the role of non-governmental organizations (NGOs) in healthcare advocacy (eg, helping the voices of the most vulnerable reach policy-makers). Thus, it contributes to broadening national discussions and enabling more nuanced interpretation of ongoing global debates on immigration and health. © 2016 by Kerman University of Medical Sciences

IATUL Conference 1985.

ERIC Educational Resources Information Center

Information Services and Use, 1985

1985-01-01

Summarizes presentations at conference on theme "The future of information resources for science and technology and role of libraries": industrial and commercial use of national, regional, and university resources; balance between public- and private-sector resources; local access in national and regional context; access to information…

Conservation, Preservation, and Digitization.

ERIC Educational Resources Information Center

Lynch, Clifford A.; Brownrigg, Edwin B.

1986-01-01

Digital technologies should be considered a method of preservation for library materials. Current conservation strategies of restoration, deacidification, and microfilming are expensive, and they limit access. Digitization offers improved access while preserving materials and reflects a change in the library role from depository of printed…

[Financing healthcare in low-income countries: recurring questions, new challenges].

PubMed

Audibert, M; Mathonnat, J; de Roodenbeke, E

2004-01-01

Healthcare financing policies in low-income countries have gone through three successive phases. In the first phase the dominant approach was based on free access to healthcare and focused first on development of vertical programs and then on the necessity of providing primary care to all. While maintaining the emphasis on accessibility to primary care, the second policy phase introduced user fees and attempted to integrate healthcare programs into district-based healthcare structures. The third phase has been strongly influenced by the relationship between healthcare and development and the Millenium Objectives and places strong emphasis on necessity of developing insurance schemes. Recent studies on the relationship between healthcare spending and health status indicate that the efficiency and effectiveness of healthcare spending plays a more determinant role than the amount. At the same time an effort is being made to develop synergy between the different players in the health care systems and to clarify the role of each player by hinging financing decisions on operating criteria such as "public welfare", externalities, catastrophic costs, and equity. Although many countries have made significant progress, there are still several lagging areas, i.e., coverage for the poorest segment of the population (despite the rhetoric), follow-up of financing, and governance. Increasing external aid already initiated by several states may have a non-negligible impact on the macroeconomic balance. Since these changes could lead to adverse effects on health, there is a need to implement careful non-dogmatic policies.

Insights into the Affordable Medicines Facility-malaria in Ghana: the role of caregivers and licensed chemical sellers in four regions.

PubMed

Adjei, Andrew A; Winch, Peter; Laar, Amos; Sullivan, David J; Sakyi, Kwame S; Stephens, Judith K; Adjei, George O; Boateng, Isaac A; Aubyn, Vivian N Ama; Kubio, Chrysantus; Tuakli, Julliette; Vanotoo, Linda; Bortei, Bernard B; Amo-Addae, Maame; Sorvor, Felix; Coleman, Nathaniel; Dalglish, Sarah; Owusu, Richmond; Gebreyesus, Tsega; Essuman, Edward; Greene, Rebecca; Ankomah, Ezekiel; Houston, Kiely; Bart-Plange, Constance; Salamat, Samuel; Addison, Ebenezer A; Quakyi, Isabella A

2016-05-10

The Affordable Medicine Facility-malaria (AMFm) was an innovative global financing mechanism for the provision of quality-assured artemisinin-based combination therapy (ACT) across both the private and public health sectors in eight countries in sub-Saharan Africa. This study evaluated the effectiveness of AMFm subsidies in increasing access to ACT in Ghana and documented malaria management practices at the household and community levels during the implementation of the AMFm. This study, conducted in four regions in Ghana between January, 2011 to December, 2012, employed cross-sectional mixed-methods design that included qualitative and quantitative elements, specifically household surveys, focus group discussions (FGD) and in-depth interviews. The study indicated high ACT availability, adequate provider knowledge and reasonably low quality-assured ACT use in the study areas, all of which are a reflection of a high market share of ACT in these hard-to-reach areas of the country. Adequate recognition of childhood malaria symptoms by licensed chemical seller (LCS) attendants was observed. A preference by caregivers for LCS over health facilities for seeking treatment solutions to childhood malaria was found. Artemisinin-based combination therapy with the AMFm logo was accessible and affordable for most people seeking treatment from health facilities and LCS shops in rural areas. Caregivers and LCS were seen to play key roles in the health of the community especially with children under 5 years of age.

The role of the bilingual/bicultural worker in dementia education, support and care.

PubMed

Boughtwood, Desiree; Shanley, Christopher; Adams, Jon; Santalucia, Yvonne; Kyriazopoulos, Helena; Rowland, Jeffrey; Pond, Dimity

2013-01-01

Members of minority populations often have difficulty knowing about and accessing dementia services. One of the strategies used to promote access is the employment of bilingual/bicultural workers (sometimes referred to as multicultural, link or outreach workers). This study involved interviews with 24 bilingual/bicultural workers in south western Sydney, Australia to gain a better understanding of their role within the dementia field. Seven themes emerged: importance of working with family; process of building trust when moving between two cultures; importance of understanding the culture; self-care and culture; flexibility of their role; linking community members; and linking communities to mainstream services. Bilingual/bicultural workers play a significant and complex role in supporting individuals and families within their community who are affected by dementia. The significance of their role needs to be more clearly acknowledged in the development of policy, further research and service provision within the dementia field.

Features and selection of vascular access devices.

PubMed

Sansivero, Gail Egan

2010-05-01

To review venous anatomy and physiology, discuss assessment parameters before vascular access device (VAD) placement, and review VAD options. Journal articles, personal experience. A number of VAD options are available in clinical practice. Access planning should include comprehensive assessment, with attention to patient participation in the planning and selection process. Careful consideration should be given to long-term access needs and preservation of access sites. Oncology nurses are uniquely suited to perform a key role in VAD planning and placement. With knowledge of infusion therapy, anatomy and physiology, device options, and community resources, nurses can be key leaders in preserving vascular access and improving the safety and comfort of infusion therapy. Copyright 2010 Elsevier Inc. All rights reserved.

The new ALICE DQM client: a web access to ROOT-based objects

NASA Astrophysics Data System (ADS)

von Haller, B.; Carena, F.; Carena, W.; Chapeland, S.; Chibante Barroso, V.; Costa, F.; Delort, C.; Dénes, E.; Diviá, R.; Fuchs, U.; Niedziela, J.; Simonetti, G.; Soós, C.; Telesca, A.; Vande Vyvre, P.; Wegrzynek, A.

2015-12-01

A Large Ion Collider Experiment (ALICE) is the heavy-ion detector designed to study the physics of strongly interacting matter and the quark-gluon plasma at the CERN Large Hadron Collider (LHC). The online Data Quality Monitoring (DQM) plays an essential role in the experiment operation by providing shifters with immediate feedback on the data being recorded in order to quickly identify and overcome problems. An immediate access to the DQM results is needed not only by shifters in the control room but also by detector experts worldwide. As a consequence, a new web application has been developed to dynamically display and manipulate the ROOT-based objects produced by the DQM system in a flexible and user friendly interface. The architecture and design of the tool, its main features and the technologies that were used, both on the server and the client side, are described. In particular, we detail how we took advantage of the most recent ROOT JavaScript I/O and web server library to give interactive access to ROOT objects stored in a database. We describe as well the use of modern web techniques and packages such as AJAX, DHTMLX and jQuery, which has been instrumental in the successful implementation of a reactive and efficient application. We finally present the resulting application and how code quality was ensured. We conclude with a roadmap for future technical and functional developments.

Computational Modeling of Morphological Effects in Bangla Visual Word Recognition.

PubMed

Dasgupta, Tirthankar; Sinha, Manjira; Basu, Anupam

2015-10-01

In this paper we aim to model the organization and processing of Bangla polymorphemic words in the mental lexicon. Our objective is to determine whether the mental lexicon accesses a polymorphemic word as a whole or decomposes the word into its constituent morphemes and then recognize them accordingly. To address this issue, we adopted two different strategies. First, we conduct a masked priming experiment over native speakers. Analysis of reaction time (RT) and error rates indicates that in general, morphologically derived words are accessed via decomposition process. Next, based on the collected RT data we have developed a computational model that can explain the processing phenomena of the access and representation of Bangla derivationally suffixed words. In order to do so, we first explored the individual roles of different linguistic features of a Bangla morphologically complex word and observed that processing of Bangla morphologically complex words depends upon several factors like, the base and surface word frequency, suffix type/token ratio, suffix family size and suffix productivity. Accordingly, we have proposed different feature models. Finally, we combine these feature models together and came up with a new model that takes the advantage of the individual feature models and successfully explain the processing phenomena of most of the Bangla morphologically derived words. Our proposed model shows an accuracy of around 80% which outperforms the other related frequency models.

The making of a nurse manager: the role of experiential learning in leadership development.

PubMed

Cathcart, Eloise Balasco; Greenspan, Miriam; Quin, Matthew

2010-05-01

To articulate the experientially acquired knowledge, skill and ethics embedded in nurse manager practice and describe the ways in which they were developed. The role of the nurse manager is usually described in lists of competencies, talents and traits which fail to capture the experience-based judgment and practical knowledge in this pivotal organizational role. Using Benner's methodology of practice articulation, 32 nurse managers wrote and interpreted first person narratives of their practice. The experience level of the group ranged from new nurse managers to those with more than 10 years' role tenure. The seminars were facilitated by a seasoned nurse executive and nurse manager with expertise in narrative interpretation. Interpretation of the paradigm case of one nurse manager suggests that complex leadership challenges can be a source of significant experiential learning for the individual and for the group. CONCLUSIONS; Articulating and reflecting on experiential learning elucidates the skilled knowledge and judgment embedded in nurse manager practice which cannot be accessed in any other way. Articulating the practical knowledge which is necessary for effective nurse manager practice can hasten the development of role incumbents.

Survey of Australian practitioners' provision of healthy lifestyle advice to clients who are obese.

PubMed

Ashby, Samantha; James, Carole; Plotnikoff, Ronald; Collins, Clare; Guest, Maya; Kable, Ashley; Snodgrass, Suzanne

2012-06-01

Obesity is a global issue, with healthcare practitioners increasingly involved in clinical interactions with people who are overweight or obese. These interactions are opportunities to provide evidence-based healthy lifestyle advice, and impact on public health. This study used a cross-sectional survey of Australian healthcare practitioners to investigate what influenced the provision of healthy lifestyle advice to obese and overweight clients. A modified theory of planned behavior was used to explore knowledge translation processes. Knowledge translation was linked to three factors: (i) a healthcare practitioner's education and confidence in the currency of their knowledge; (ii) personal characteristics - whether they accepted that providing this advice was within their domain of practice; and (iii) the existence of organizational support structures, such as access to education, and best practice guidelines. To fulfill the potential role healthcare practitioners can play in the provision of evidence-based health promotion advice requires organizations to provide access to practice guidelines and to instill a belief in their workforce that this is a shared professional domain. © 2012 Blackwell Publishing Asia Pty Ltd.

Moving to evidence-based practice in long-term care: the role of a Best Practise Resource Centre in two long-term care settings.

PubMed

Brazil, Kevin; Royle, Joan A; Montemuro, Maureen; Blythe, Jennifer; Church, Anne

2004-03-01

In this article, the authors provide an overview on the development of a Long-Term Care Best Practise Resource Centre. The results of both a feasibility study and the outcomes of a 1-year demonstration project are presented. The demonstration project involved a hospital as the information service provider and two demonstration sites, a home care service agency and a nursing home that used the services of the Centre. The goals of the Centre were threefold: provide access to literature for staff in long-term care (LTC) settings; improve the information management skills of health care providers; and support research and the integration of best practices in LTC organizations. The results of the pilot study contributed to the development of a collaborative information access system for LTC clinicians and managers that provides timely, up-to-date information contributing to improving the quality of care for adults receiving LTC. Based on this demonstration project, strategies for successful innovation in LTC are identified.

Are dispensaries indispensable? Patient experiences of access to cannabis from medical cannabis dispensaries in Canada.

PubMed

Capler, Rielle; Walsh, Zach; Crosby, Kim; Belle-Isle, Lynne; Holtzman, Susan; Lucas, Philippe; Callaway, Robert

2017-09-01

In 2001, Canada established a federal program for cannabis for therapeutic purposes (CTP). Medical cannabis dispensaries (dispensaries) are widely accessed as a source of CTP despite storefront sales of cannabis being illegal. The discrepancy between legal status and social practice has fuelled active debate regarding the role of dispensaries. The present study aims to inform this debate by analysing CTP user experiences with different CTP sources, and comparing dispensary users to those accessing CTP from other sources. We compared sociodemographic characteristics, health related factors and patterns of cannabis use of 445 respondents, 215 who accessed CTP from dispensaries with 230 who accessed other sources. We compared patients' ratings of CTP sources (dispensaries, Health Canada's supplier, self-production, other producer, friend or acquaintance, street dealer) for quality and availability of product, safety and efficiency of access, cost, and feeling respected while accessing. Patients using dispensaries were older, more likely to have arthritis and HIV/AIDS, and less likely to have mental health conditions than those not using dispensaries. Those accessing dispensaries used larger quantities of cannabis, placed greater value on access to specific strains, and were more likely to have legal authorization for CTP. Dispensaries were rated equally to or more favourably than other sources of CTP for quality, safety, availability, efficiency and feeling respected, and less favourably than self-production and other producer for cost. Given the high endorsement of dispensaries by patients, future regulations should consider including dispensaries as a source of CTP and address known barriers to access such as cost and health care provider support. Further research should assess the impact of the addition of licensed producers on the role and perceived value of dispensaries within the Canadian medical cannabis system. Copyright © 2017 Elsevier B.V. All rights reserved.

Disparities in access to care and satisfaction among U.S. children: the roles of race/ethnicity and poverty status.

PubMed

Shi, Leiyu; Stevens, Gregory D

2005-01-01

The study assessed the progress made toward reducing racial and ethnic disparities in access to health care among U.S. children between 1996 and 2000. Data are from the Household Component of the 1996 and 2000 Medical Expenditure Panel Survey. Bivariate associations of combinations of race/ethnicity and poverty status groups were examined with four measures of access to health care and a single measure of satisfaction. Logistic regression was used to examine the association of race/ethnicity with access, controlling for sociodemographic factors associated with access to care. To highlight the role of income, we present models with and without controlling for poverty status. Racial and ethnic minority children experience significant deficits in accessing medical care compared with whites. Asians, Hispanics, and blacks were less likely than whites to have a usual source of care, health professional or doctor visit, and dental visit in the past year. Asians were more likely than whites to be dissatisfied with the quality of medical care in 2000 (but not 1996), while blacks and Hispanics were more likely than whites to be dissatisfied with the quality of medical care in 1996 (but not in 2000). Both before and after controlling for health insurance coverage, poverty status, health status, and several other factors associated with access to care, these disparities in access to care persisted between 1996 and 2000. Continued monitoring of racial and ethnic differences is necessary in light of the persistence of racial/ethnic and socioeconomic disparities in access to care. Given national goals to achieve equity in health care and eliminate racial/ ethnic disparities in health, greater attention needs to be paid to the interplay of race/ethnicity factors and poverty status in influencing access.

Blood Flow in Idealized Vascular Access for Hemodialysis: A Review of Computational Studies.

PubMed

Ene-Iordache, Bogdan; Remuzzi, Andrea

2017-09-01

Although our understanding of the failure mechanism of vascular access for hemodialysis has increased substantially, this knowledge has not translated into successful therapies. Despite advances in technology, it is recognized that vascular access is difficult to maintain, due to complications such as intimal hyperplasia. Computational studies have been used to estimate hemodynamic changes induced by vascular access creation. Due to the heterogeneity of patient-specific geometries, and difficulties with obtaining reliable models of access vessels, idealized models were often employed. In this review we analyze the knowledge gained with the use of computational such simplified models. A review of the literature was conducted, considering studies employing a computational fluid dynamics approach to gain insights into the flow field phenotype that develops in idealized models of vascular access. Several important discoveries have originated from idealized model studies, including the detrimental role of disturbed flow and turbulent flow, and the beneficial role of spiral flow in intimal hyperplasia. The general flow phenotype was consistent among studies, but findings were not treated homogeneously since they paralleled achievements in cardiovascular biomechanics which spanned over the last two decades. Computational studies in idealized models are important for studying local blood flow features and evaluating new concepts that may improve the patency of vascular access for hemodialysis. For future studies we strongly recommend numerical modelling targeted at accurately characterizing turbulent flows and multidirectional wall shear disturbances.

Identifying the core competencies of mental health telephone triage.

PubMed

Sands, Natisha; Elsom, Stephen; Gerdtz, Marie; Henderson, Kathryn; Keppich-Arnold, Sandra; Droste, Nicolas; Prematunga, Roshani K; Wereta, Zewdu W

2013-11-01

The primary aim of this study was to identify the core competencies of mental health telephone triage, including key role tasks, skills, knowledge and responsibilities, in which clinicians are required to be competent to perform safe and effective triage. Recent global trends indicate an increased reliance on telephone-based health services to facilitate access to health care across large populations. The trend towards telephone-based health services has also extended to mental health settings, evidenced by the growing number of mental health telephone triage services providing 24-hour access to specialist mental health assessment and treatment. Mental health telephone triage services are critical to the early identification of mental health problems and the provision of timely, appropriate interventions. In spite of the rapid growth in mental health telephone triage and the important role these services play in the assessment and management of mental illness and related risks, there has been very little research investigating this area of practice. An observational design was employed to address the research aims. Structured observations (using dual wireless headphones) were undertaken on 197 occasions of mental health telephone triage over a three-month period from January to March 2011. The research identified seven core areas of mental health telephone triage practice in which clinicians are required to be competent in to perform effective mental health telephone triage, including opening the call; performing mental status examination; risk assessment; planning and action; termination of call; referral and reporting; and documentation. The findings of this research contribute to the evidence base for mental health telephone triage by articulating the core competencies for practice. The mental health telephone triage competencies identified in this research may be used to define an evidence-based framework for mental health telephone triage practice that aims to improve the quality, consistency and accuracy of telephone-based mental health triage assessment. © 2012 Blackwell Publishing Ltd.

What's in Your Techno-Future? Vendors Share Their Views.

ERIC Educational Resources Information Center

Gerber, Carole

1995-01-01

Examines vendors' views on the future of CD-ROM technology. Topics include the library role, single point access, costs, tape backup, user-friendly library automation systems and databases, improved quality, the growth of Internet access, and perspectives on technology in schools. (AEF)

Florida: Library Networking and Technology Development.

ERIC Educational Resources Information Center

Wilkins, Barratt, Ed.

1996-01-01

Explains the development of library networks in Florida and the role of the state library. Topics include regional multitype library consortia; a statewide bibliographic database; interlibrary loan; Internet access in public libraries; government information, including remote public access; automation projects; telecommunications; and free-nets.…

Informatics in radiology: A prototype Web-based reporting system for onsite-offsite clinician communication.

PubMed

Arnold, Corey W; Bui, Alex A T; Morioka, Craig; El-Saden, Suzie; Kangarloo, Hooshang

2007-01-01

The communication of imaging findings to a referring physician is an important role of the radiologist. However, communication between onsite and offsite physicians is a time-consuming process that can obstruct work flow and frequently involves no exchange of visual information, which is especially problematic given the importance of radiologic images for diagnosis and treatment. A prototype World Wide Web-based image documentation and reporting system was developed for use in supporting a "communication loop" that is based on the concept of a classic "wet-read" system. The proposed system represents an attempt to address many of the problems seen in current communication work flows by implementing a well-documented and easily accessible communication loop that is adaptable to different types of imaging study evaluation. Images are displayed in a native (DICOM) Digital Imaging and Communications in Medicine format with a Java applet, which allows accurate presentation along with use of various image manipulation tools. The Web-based infrastructure consists of a server that stores imaging studies and reports, with Web browsers that download and install necessary client software on demand. Application logic consists of a set of PHP (hypertext preprocessor) modules that are accessible with an application programming interface. The system may be adapted to any clinician-specialist communication loop, and, because it integrates radiologic standards with Web-based technologies, can more effectively communicate and document imaging data. RSNA, 2007

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.

HIV vaccines advocacy: the role of UNAIDS. Research and accessibility.

PubMed

Piot, P

1996-01-01

This article presents an interview with Dr. Peter Piot, executive director of the Joint UN Program on HIV/AIDS (UNAIDS) on the role of UNAIDS in the advocacy of HIV vaccines. Piot stressed that an efficient HIV vaccine, truly protective against HIV infection, could make all the difference in the campaign against AIDS. To this effect, the role of the UNAIDS is to carry out advocacy in favor of research as well as to collaborate with the diverse private initiatives that already exist. Commenting on the issue of guaranteed accessibility of HIV vaccine for developing countries, Piot states that it is possible to sell the product through seeking the support of donor organizations. When vaccine trials in a country are supported, it will also be made sure that the basic guarantees exist for making that product accessible to the population. Moreover, considering the impact of the pandemic on the business and economic community, Piot emphasized that alliance between the public and private sector is necessary in the struggle against AIDS. In general, the role of UNAIDS in the evaluation of a preventive vaccine for HIV is centered around communication, impact on community, and impact on prevention programs.

Current State of Value-Based Purchasing Programs

PubMed Central

Chee, Tingyin T.; Ryan, Andrew M.; Wasfy, Jason H.; Borden, William B.

2016-01-01

The United States healthcare system is rapidly moving toward rewarding value. Recent legislation, such as the Affordable Care Act and the Medicare Access and CHIP Reauthorization Act (MACRA), solidified the role of value-based payment in Medicare. Many private insurers are following Medicare’s lead. Much of the policy attention has been on programs such as accountable care organizations and bundled payments; yet, value-based purchasing (VBP) or pay-for-performance, defined as providers being paid fee-for-service with payment adjustments up or down based on value metrics, remains a core element of value payment in MACRA and will likely remain so for the foreseeable future. This review article summarizes the current state of VBP programs and provides analysis of the strengths, weaknesses, and opportunities for the future. Multiple inpatient and outpatient VBP programs have been implemented and evaluated, with the impact of those programs being marginal. Opportunities to enhance the performance of VBP programs include improving the quality measurement science, strengthening both the size and design of incentives, reducing health disparities, establishing broad outcome measurement, choosing appropriate comparison targets, and determining the optimal role of VBP relative to alternative payment models. VBP programs will play a significant role in healthcare delivery for years to come, and they serve as an opportunity for providers to build the infrastructure needed for value-oriented care. PMID:27245648

An overview of the outcomes and impact of specialist and advanced nursing and midwifery practice, on quality of care, cost and access to services: A narrative review.

PubMed

Casey, Mary; O'Connor, Laserina; Cashin, Andrew; Smith, Rita; O'Brien, Denise; Nicholson, Emma; O'Leary, Denise; Fealy, Gerard; McNamara, Martin; Glasgow, Mary Ellen; Stokes, Diarmuid; Egan, Claire

2017-09-01

This paper presents the results of a systematic rapid review and narrative synthesis of the literature of the outcomes and impact of specialist and advanced nursing and midwifery practice regarding quality of care, cost and access to services. A rapid review was undertaken of the relevant national and international literature, regulatory and policy documents relating to the establishment and definition of nurses' and midwives' specialist and advanced practice roles. A search of the Cumulative Index to the Nursing and Allied Health Literature (CINAHL), PubMed (MEDLINE) was undertaken from 2012 to 2015. The study also included primary data collection on the perceived impact of specialist and advanced practice nursing and midwifery roles and enablers and barriers to these roles using semi-structured interviews. These are not included in this paper. To facilitate a systematic approach to searching the literature, the PICO framework, was adapted. The database search yielded 437 articles relevant to the analysis of specialist and advanced practice in relation to quality care, cost and access to services with additional articles added in a manual review of reference lists. In the final review a total of 86 articles were included as they fulfilled the eligibility criteria. The evidence presented in the 86 articles indicates that nursing and midwifery practitioners continue to be under-utilised despite the evidence that greater reliance on advanced nurse practitioners could improve accessibility of primary care services while also saving on cost. Results point to continued difficulties associated with accurate measurement of the impact of these roles on patient outcomes. This review demonstrates that there is a need for robust measurement of the impact of these roles on patient outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

The role of literal meaning in figurative language comprehension: evidence from masked priming ERP

PubMed Central

Weiland, Hanna; Bambini, Valentina; Schumacher, Petra B.

2014-01-01

The role of literal meaning during the construction of meaning that goes beyond pure literal composition was investigated by combining cross-modal masked priming and ERPs. This experimental design was chosen to compare two conflicting theoretical positions on this topic. The indirect access account claims that literal aspects are processed first, and additional meaning components are computed only if no satisfactory interpretation is reached. In contrast, the direct access approach argues that figurative aspects can be accessed immediately. We presented metaphors (These lawyers are hyenas, Experiment 1a and 1b) and producer-for-product metonymies (The boy read Böll, Experiment 2a and 2b) with and without a prime word that was semantically relevant to the literal meaning of the target word (furry and talented, respectively). In the presentation without priming, metaphors revealed a biphasic N400-Late Positivity pattern, while metonymies showed an N400 only. We interpret the findings within a two-phase language architecture where contextual expectations guide initial access (N400) and precede pragmatic adjustment resulting in reconceptualization (Late Positivity). With masked priming, the N400-difference was reduced for metaphors and vanished for metonymies. This speaks against the direct access view that predicts a facilitating effect for the literal condition only and hence would predict the N400-difference to increase. The results are more consistent with indirect access accounts that argue for facilitation effects for both conditions and consequently for consistent or even smaller N400-amplitude differences. This combined masked priming ERP paradigm therefore yields new insights into the role of literal meaning in the online composition of figurative language. PMID:25136309

A review of the health and economic implications of patent protection, with a specific focus on Thailand.

PubMed

Yamabhai, Inthira; Smith, Richard D

2012-08-01

Although it has been two decades since the Thai Patent Act was amended to comply with the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), there has been little emphasis given to assessing the implications of this amendment. The purpose of this review is to summarize the health and economic impact of patent protection, with a focus on the experience of Thailand. A review of national and international empirical evidence on the health and economic implications of patents from 1980 to 2009 was undertaken. The findings illustrate the role of patent protection in four areas: price, present access, future access, and international trade and investment. Forty-three empirical studies were found, three of which were from Thai databases. Patenting does increase price, although the size of effect differs according to the methodology and country. Although weakening patent rights could increase present access, evidence suggests that strengthening patenting may benefit future access; although this is based on complex assumptions and estimations. Moreover, while patent protection appears to have a positive impact on trade flow, the implication for foreign direct investment (FDI) is equivocal. Empirical studies in Thailand, and other similar countries, are rare, compromising the robustness and generalizability of conclusions. However, evidence does suggest that patenting presents a significant inter-temporal challenge in balancing aspects of current versus future access to technologies. This underlines the urgent need to prioritize health research resources to assess the wider implications of patent protection.

Distributed policy based access to networked heterogeneous ISR data sources

NASA Astrophysics Data System (ADS)

Bent, G.; Vyvyan, D.; Wood, David; Zerfos, Petros; Calo, Seraphin

2010-04-01

Within a coalition environment, ad hoc Communities of Interest (CoI's) come together, perhaps for only a short time, with different sensors, sensor platforms, data fusion elements, and networks to conduct a task (or set of tasks) with different coalition members taking different roles. In such a coalition, each organization will have its own inherent restrictions on how it will interact with the others. These are usually stated as a set of policies, including security and privacy policies. The capability that we want to enable for a coalition operation is to provide access to information from any coalition partner in conformance with the policies of all. One of the challenges in supporting such ad-hoc coalition operations is that of providing efficient access to distributed sources of data, where the applications requiring the data do not have knowledge of the location of the data within the network. To address this challenge the International Technology Alliance (ITA) program has been developing the concept of a Dynamic Distributed Federated Database (DDFD), also know as a Gaian Database. This type of database provides a means for accessing data across a network of distributed heterogeneous data sources where access to the information is controlled by a mixture of local and global policies. We describe how a network of disparate ISR elements can be expressed as a DDFD and how this approach enables sensor and other information sources to be discovered autonomously or semi-autonomously and/or combined, fused formally defined local and global policies.

Cognitive-communication disorder following right hemisphere stroke: exploring rehabilitation access and outcomes.

PubMed

Hewetson, Ronelle; Cornwell, Petrea; Shum, David

2017-07-01

Rehabilitation positively influences return to activities and social roles in people with aphasia. The cognitive-communication disorder (CCD) found following a right hemisphere stroke has been less extensively researched with rehabilitation access and outcomes yet to be determined. To document rehabilitation access and outcomes for people with CCD post-stroke; and compare outcomes based on presence (viz CCD; aphasia) or absence of communication impairment. A retrospective chart audit was completed for patients with first onset unilateral stroke, with a hospital length of stay (LOS) of at least two days and a communication assessment by a speech pathologist. Data extracted included presence and severity of communication impairment, access to and LOS in a rehabilitation unit, and functional outcome measures recorded at rehabilitation discharge. The majority of the 115 patients who met inclusion criteria were living independently (n = 112, 97.4%) at the time of stroke. CCD (66%) was diagnosed with similar frequency to aphasia (68%). The presence of communication impairment did not result in significant differences in rehabilitation LOS and discharge destination when compared to hemispheric strokes without communication impairment. Severity of CCD was an independent predictor of functional gain by rehabilitation discharge. People with CCD require comparable access to rehabilitation as people with aphasia, and severity of CCD should be considered in determining rehabilitation LOS. A large number of people are discharged with ongoing CCD which warrants exploration of potential participation restrictions created by the communication impairment.

Investigation of the Food Choice, Promoters and Barriers to Food Access Issues, and Food Insecurity Among Low-Income, Free-Living Minnesotan Seniors.

PubMed

Oemichen, Megan; Smith, Chery

2016-06-01

Investigate food choice, food access, and food insecurity among seniors. Eight focus groups were conducted in 2 counties with high and low Supplemental Nutrition Assistance Program (SNAP) participation rates. A total of 62 seniors (aged ≥ 60 years) were recruited and each attended 1 focus group at a community center. The sample was 79% female and most were Caucasian (91%), similar to state demographics. The focus group themes of how seniors make food choices and access food, and food insecurity perceptions among this population were identified based on discussion commonalities. For quantitative data, P < .05 was significant. Five themes emerged: (1) former experiences affecting eating behaviors; (2) financial and food security driving use of food assistance programs; (3) food access strategies: restaurants, retail markets, and alternative sources; (4) physical changes associated with aging influencing food access and intake; and (5) social influences that play a role in decision making. Both SNAP and congregate dining offer food assistance to seniors, but SNAP use was considered unacceptable by some seniors living in county 1 because of the negative stigma attached to the program or because they lacked program knowledge about income criteria. More effort needs to be made to educate seniors about SNAP. It is important to gain insight into how food insecurity affects their food choices. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Availability and accessibility of evidence-based information resources provided by medical libraries in Australia.

PubMed

Ritchie, A; Sowter, B

2000-01-01

This article reports on the results of an exploratory survey of the availability and accessibility of evidence-based information resources provided by medical libraries in Australia. Although barriers impede access to evidence-based information for hospital clinicians, the survey revealed that Medline and Cinahl are available in over 90% of facilities. In most cases they are widely accessible via internal networks and the Internet. The Cochrane Library is available in 69% of cases. The Internet is widely accessible and most libraries provide access to some full-text, electronic journals. Strategies for overcoming restrictions and integrating information resources with clinical workflow are being pursued. State, regional and national public and private consortia are developing agreements utilising on-line technology. These could produce cost savings and more equitable access to a greater range of evidence-based resources.

Dynamic partitioning as a way to exploit new computing paradigms: the cloud use case.

NASA Astrophysics Data System (ADS)

Ciaschini, Vincenzo; Dal Pra, Stefano; dell'Agnello, Luca

2015-12-01

The WLCG community and many groups in the HEP community have based their computing strategy on the Grid paradigm, which proved successful and still ensures its goals. However, Grid technology has not spread much over other communities; in the commercial world, the cloud paradigm is the emerging way to provide computing services. WLCG experiments aim to achieve integration of their existing current computing model with cloud deployments and take advantage of the so-called opportunistic resources (including HPC facilities) which are usually not Grid compliant. One missing feature in the most common cloud frameworks, is the concept of job scheduler, which plays a key role in a traditional computing centre, by enabling a fairshare based access at the resources to the experiments in a scenario where demand greatly outstrips availability. At CNAF we are investigating the possibility to access the Tier-1 computing resources as an OpenStack based cloud service. The system, exploiting the dynamic partitioning mechanism already being used to enable Multicore computing, allowed us to avoid a static splitting of the computing resources in the Tier-1 farm, while permitting a share friendly approach. The hosts in a dynamically partitioned farm may be moved to or from the partition, according to suitable policies for request and release of computing resources. Nodes being requested in the partition switch their role and become available to play a different one. In the cloud use case hosts may switch from acting as Worker Node in the Batch system farm to cloud compute node member, made available to tenants. In this paper we describe the dynamic partitioning concept, its implementation and integration with our current batch system, LSF.