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.

45 CFR 98.31 - Parental access.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Parental Rights and Responsibilities § 98.31 Parental access. The... assistance is provided afford parents unlimited access to their children, and to the providers caring for...

45 CFR 98.31 - Parental access.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Welfare Department of Health and Human Services GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Parental Rights and Responsibilities § 98.31 Parental access. The... assistance is provided afford parents unlimited access to their children, and to the providers caring for...

45 CFR 98.31 - Parental access.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Parental Rights and Responsibilities § 98.31 Parental access. The... assistance is provided afford parents unlimited access to their children, and to the providers caring for...

45 CFR 98.31 - Parental access.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Parental Rights and Responsibilities § 98.31 Parental access. The... assistance is provided afford parents unlimited access to their children, and to the providers caring for...

45 CFR 98.31 - Parental access.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Parental Rights and Responsibilities § 98.31 Parental access. The... assistance is provided afford parents unlimited access to their children, and to the providers caring for...

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

PubMed

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

2015-09-02

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

A Model for Trust-based Access Control and Delegation in Mobile Clouds (Post Print)

DTIC Science & Technology

2013-10-01

the access-granter knowing the identity of access requester beforehand and authenticating the requester, can no longer be applied. Mobile Wallet Cloud...TktC) for a reservation and con- tacts the user’s mobile wallet provider (MobWC) to purchase the ticket from TktC. For accessing different services...receiving regular services. For example, the human user in our scenario can be an elite member with the mobile wallet service provider that

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

PubMed

Naughton, Doreen K

2014-06-01

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

28 CFR 115.182 - Access to emergency medical services.

Code of Federal Regulations, 2013 CFR

2013-07-01

... medical services. (a) Detainee victims of sexual abuse in lockups shall receive timely, unimpeded access to emergency medical treatment. (b) Treatment services shall be provided to the victim without... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Access to emergency medical services. 115...

28 CFR 115.182 - Access to emergency medical services.

Code of Federal Regulations, 2014 CFR

2014-07-01

... medical services. (a) Detainee victims of sexual abuse in lockups shall receive timely, unimpeded access to emergency medical treatment. (b) Treatment services shall be provided to the victim without... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Access to emergency medical services. 115...

28 CFR 115.182 - Access to emergency medical services.

Code of Federal Regulations, 2012 CFR

2012-07-01

... medical services. (a) Detainee victims of sexual abuse in lockups shall receive timely, unimpeded access to emergency medical treatment. (b) Treatment services shall be provided to the victim without... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Access to emergency medical services. 115...

Patients’ Online Access to Their Primary Care Electronic Health Records and Linked Online Services: Implications for Research and Practice

PubMed Central

Mold, Freda; de Lusignan, Simon

2015-01-01

Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems. PMID:26690225

Patients' Online Access to Their Primary Care Electronic Health Records and Linked Online Services: Implications for Research and Practice.

PubMed

Mold, Freda; de Lusignan, Simon

2015-12-04

Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems.

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.

A DTN-Based Multiple Access Fast Forward Service for the NASA Space Network

NASA Technical Reports Server (NTRS)

Israel, David; Davis, Faith; Marquart. Jane

2011-01-01

The NASA Space Network provides a demand access return link service capable of providing users a space link "on demand". An equivalent service in the forward link direction is not possible due to Tracking and Data Relay Spacecraft (TDRS) constraints. A Disruption Tolerant Networking (DTN)-based Multiple Access Fast Forward (MAFF) service has been proposed to provide a forward link to a user as soon as possible. Previous concept studies have identified a basic architecture and implementation approach. This paper reviews the user scenarios and benefits of an MAFF service and proposes an implementation approach based on the use of DTN protocols.

Practical Strategies for Making Online Library Services and Instruction Accessible to All Patrons

ERIC Educational Resources Information Center

Wray, Christina C.

2013-01-01

Providing accessible library services and instruction to distance users with disabilities can seem daunting. This article, which grew out of a webinar presented by the author to the Health Science Special Interest Group of ACRL, provides practical strategies to help content creators utilize built-in accessibility features and provides a resources…

A framework for improving access and customer service times in health care: application and analysis at the UCLA Medical Center.

PubMed

Duda, Catherine; Rajaram, Kumar; Barz, Christiane; Rosenthal, J Thomas

2013-01-01

There has been an increasing emphasis on health care efficiency and costs and on improving quality in health care settings such as hospitals or clinics. However, there has not been sufficient work on methods of improving access and customer service times in health care settings. The study develops a framework for improving access and customer service time for health care settings. In the framework, the operational concept of the bottleneck is synthesized with queuing theory to improve access and reduce customer service times without reduction in clinical quality. The framework is applied at the Ronald Reagan UCLA Medical Center to determine the drivers for access and customer service times and then provides guidelines on how to improve these drivers. Validation using simulation techniques shows significant potential for reducing customer service times and increasing access at this institution. Finally, the study provides several practice implications that could be used to improve access and customer service times without reduction in clinical quality across a range of health care settings from large hospitals to small community clinics.

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.

Collaboration Between Medical Providers and Dental Hygienists in Pediatric Health Care.

PubMed

Braun, Patricia A; Cusick, Allison

2016-06-01

Basic preventive oral services for children can be provided within the medical home through the collaborative care of medical providers and dental hygienists to expand access for vulnerable populations. Because dental caries is a largely preventable disease, it is untenable that it remains the most common chronic disease of childhood. Leveraging the multiple visits children have with medical providers has potential to expand access to early preventive oral services. Developing interprofessional relationships between dental providers, including dental hygienists, and medical providers is a strategic approach to symbiotically expand access to dental care. Alternative care delivery models that provide dental services in the medical home expand access to these services for vulnerable populations. The purpose of this article is to explore 4 innovative care models aimed to expand access to dental care. Current activities in Colorado and around the nation are described regarding the provision of basic preventive oral health services (eg, fluoride varnish) by medical providers with referral to a dentist (expanded coordinated care), the colocation of dental hygiene services into the medical home (colocated care), the integration of a dental hygienist into the medical care team (integrated care), and the expansion of the dental home into the community setting through telehealth-enabled teams (virtual dental home). Gaps in evidence regarding the impacts of these models are elucidated. Bringing preventive and restorative dental services to the patient both in the medical home and in the community has potential to reduce long-standing barriers to receive these services, improve oral health outcomes of vulnerable patients, and decrease oral health disparities. Copyright © 2016 Elsevier Inc. All rights reserved.

OASIS: A Data Fusion System Optimized for Access to Distributed Archives

NASA Astrophysics Data System (ADS)

Berriman, G. B.; Kong, M.; Good, J. C.

2002-05-01

The On-Line Archive Science Information Services (OASIS) is accessible as a java applet through the NASA/IPAC Infrared Science Archive home page. It uses Geographical Information System (GIS) technology to provide data fusion and interaction services for astronomers. These services include the ability to process and display arbitrarily large image files, and user-controlled contouring, overlay regeneration and multi-table/image interactions. OASIS has been optimized for access to distributed archives and data sets. Its second release (June 2002) provides a mechanism that enables access to OASIS from "third-party" services and data providers. That is, any data provider who creates a query form to an archive containing a collection of data (images, catalogs, spectra) can direct the result files from the query into OASIS. Similarly, data providers who serve links to datasets or remote services on a web page can access all of these data with one instance of OASIS. In this was any data or service provider is given access to the full suite of capabilites of OASIS. We illustrate the "third-party" access feature with two examples: queries to the high-energy image datasets accessible from GSFC SkyView, and links to data that are returned from a target-based query to the NASA Extragalactic Database (NED). The second release of OASIS also includes a file-transfer manager that reports the status of multiple data downloads from remote sources to the client machine. It is a prototype for a request management system that will ultimately control and manage compute-intensive jobs submitted through OASIS to computing grids, such as request for large scale image mosaics and bulk statistical analysis.

28 CFR 115.353 - Resident access to outside support services and legal representation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... provide residents with access to outside victim advocates for emotional support services related to sexual abuse, by providing, posting, or otherwise making accessible mailing addresses and telephone numbers... reports of abuse will be forwarded to authorities in accordance with mandatory reporting laws. (c) The...

28 CFR 115.353 - Resident access to outside support services and legal representation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... provide residents with access to outside victim advocates for emotional support services related to sexual abuse, by providing, posting, or otherwise making accessible mailing addresses and telephone numbers... reports of abuse will be forwarded to authorities in accordance with mandatory reporting laws. (c) The...

28 CFR 115.353 - Resident access to outside support services and legal representation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... provide residents with access to outside victim advocates for emotional support services related to sexual abuse, by providing, posting, or otherwise making accessible mailing addresses and telephone numbers... reports of abuse will be forwarded to authorities in accordance with mandatory reporting laws. (c) The...

Accessing the SEED genome databases via Web services API: tools for programmers.

PubMed

Disz, Terry; Akhter, Sajia; Cuevas, Daniel; Olson, Robert; Overbeek, Ross; Vonstein, Veronika; Stevens, Rick; Edwards, Robert A

2010-06-14

The SEED integrates many publicly available genome sequences into a single resource. The database contains accurate and up-to-date annotations based on the subsystems concept that leverages clustering between genomes and other clues to accurately and efficiently annotate microbial genomes. The backend is used as the foundation for many genome annotation tools, such as the Rapid Annotation using Subsystems Technology (RAST) server for whole genome annotation, the metagenomics RAST server for random community genome annotations, and the annotation clearinghouse for exchanging annotations from different resources. In addition to a web user interface, the SEED also provides Web services based API for programmatic access to the data in the SEED, allowing the development of third-party tools and mash-ups. The currently exposed Web services encompass over forty different methods for accessing data related to microbial genome annotations. The Web services provide comprehensive access to the database back end, allowing any programmer access to the most consistent and accurate genome annotations available. The Web services are deployed using a platform independent service-oriented approach that allows the user to choose the most suitable programming platform for their application. Example code demonstrate that Web services can be used to access the SEED using common bioinformatics programming languages such as Perl, Python, and Java. We present a novel approach to access the SEED database. Using Web services, a robust API for access to genomics data is provided, without requiring large volume downloads all at once. The API ensures timely access to the most current datasets available, including the new genomes as soon as they come online.

Interoperable Data Access Services for NOAA IOOS

NASA Astrophysics Data System (ADS)

de La Beaujardiere, J.

2008-12-01

The Integrated Ocean Observing System (IOOS) is intended to enhance our ability to collect, deliver, and use ocean information. The goal is to support research and decision-making by providing data on our open oceans, coastal waters, and Great Lakes in the formats, rates, and scales required by scientists, managers, businesses, governments, and the public. The US National Oceanic and Atmospheric Administration (NOAA) is the lead agency for IOOS. NOAA's IOOS office supports the development of regional coastal observing capability and promotes data management efforts to increase data accessibility. Geospatial web services have been established at NOAA data providers including the National Data Buoy Center (NDBC), the Center for Operational Oceanographic Products and Services (CO-OPS), and CoastWatch, and at regional data provider sites. Services established include Open-source Project for a Network Data Access Protocol (OpenDAP), Open Geospatial Consortium (OGC) Sensor Observation Service (SOS), and OGC Web Coverage Service (WCS). These services provide integrated access to data holdings that have been aggregated at each center from multiple sources. We wish to collaborate with other groups to improve our service offerings to maximize interoperability and enhance cross-provider data integration, and to share common service components such as registries, catalogs, data conversion, and gateways. This paper will discuss the current status of NOAA's IOOS efforts and possible next steps.

A mobile school-based HCT service - is it youth friendly?

PubMed

Lawrence, Estelle; Struthers, Patricia; Van Hove, Geert

2016-12-01

Despite an increase in HIV Counselling and Testing (HCT), few young people have been tested. It has been suggested that they do not test because formal health services (where HCT is provided) are often not youth friendly. The World Health Organisation describes a youth-friendly health service (YFHS) as one which is accessible, equitable, acceptable, appropriate, and effective. A mobile school-based model has been implemented by a non-governmental organisation in Cape Town in an attempt to make HCT more youth friendly and accessible to young people. The objective of this study was to explore whether this mobile school-based HCT service is youth friendly. The study was descriptive, using three qualitative data collection methods: observation of the HCT site at two secondary schools; interviews with six service providers; and direct observation of 21 HCT counselling sessions. The mobile school-based HCT service fulfilled some of the criteria for being a YFHS. The service was equitable in that all students, irrespective of race, gender, age, or socio-economic status, were free to use the service. It was accessible in terms of location and cost, but students were not well informed to make decisions about using the service. The service was acceptable in that confidentiality was guaranteed and the service providers were friendly and non-judgemental, but it was not considered acceptable in that there was limited privacy. The service was appropriate in that HCT is recommended as an intervention for decreasing the transmission of HIV, based on evidence and expert opinion; however, in this case, HCT was provided as a stand-alone service rather than part of a full package of services. Moreover, studies have suggested that young people want to know their HIV status. The service was ineffective in that it identified students who are HIV positive; however, these students were not assisted to access care. Providing HCT in the school setting may make HCT more accessible for students, but it needs to be provided in an equitable, accessible, acceptable, and effective way.

A mobile school-based HCT service – is it youth friendly?

PubMed Central

Lawrence, Estelle; Struthers, Patricia; Van Hove, Geert

2016-01-01

Abstract Background: Despite an increase in HIV Counselling and Testing (HCT), few young people have been tested. It has been suggested that they do not test because formal health services (where HCT is provided) are often not youth friendly. The World Health Organisation describes a youth-friendly health service (YFHS) as one which is accessible, equitable, acceptable, appropriate, and effective. A mobile school-based model has been implemented by a non-governmental organisation in Cape Town in an attempt to make HCT more youth friendly and accessible to young people. The objective of this study was to explore whether this mobile school-based HCT service is youth friendly. Methods: The study was descriptive, using three qualitative data collection methods: observation of the HCT site at two secondary schools; interviews with six service providers; and direct observation of 21 HCT counselling sessions. Key Results: The mobile school-based HCT service fulfilled some of the criteria for being a YFHS. The service was equitable in that all students, irrespective of race, gender, age, or socio-economic status, were free to use the service. It was accessible in terms of location and cost, but students were not well informed to make decisions about using the service. The service was acceptable in that confidentiality was guaranteed and the service providers were friendly and non-judgemental, but it was not considered acceptable in that there was limited privacy. The service was appropriate in that HCT is recommended as an intervention for decreasing the transmission of HIV, based on evidence and expert opinion; however, in this case, HCT was provided as a stand-alone service rather than part of a full package of services. Moreover, studies have suggested that young people want to know their HIV status. The service was ineffective in that it identified students who are HIV positive; however, these students were not assisted to access care. Conclusion: Providing HCT in the school setting may make HCT more accessible for students, but it needs to be provided in an equitable, accessible, acceptable, and effective way. PMID:27576352

Accessing maternal and child health services in Melbourne, Australia: Reflections from refugee families and service providers

PubMed Central

2012-01-01

Background Often new arrivals from refugee backgrounds have experienced poor health and limited access to healthcare services. The maternal and child health (MCH) service in Victoria, Australia, is a joint local and state government operated, cost-free service available to all mothers of children aged 0–6 years. Although well-child healthcare visits are useful in identifying health issues early, there has been limited investigation in the use of these services for families from refugee backgrounds. This study aims to explore experiences of using MCH services, from the perspective of families from refugee backgrounds and service providers. Methods We used a qualitative study design informed by the socioecological model of health and a cultural competence approach. Two geographical areas of Melbourne were selected to invite participants. Seven focus groups were conducted with 87 mothers from Karen, Iraqi, Assyrian Chaldean, Lebanese, South Sudanese and Bhutanese backgrounds, who had lived an average of 4.7 years in Australia (range one month-18 years). Participants had a total of 249 children, of these 150 were born in Australia. Four focus groups and five interviews were conducted with MCH nurses, other healthcare providers and bicultural workers. Results Four themes were identified: facilitating access to MCH services; promoting continued engagement with the MCH service; language challenges; and what is working well and could be done better. Several processes were identified that facilitated initial access to the MCH service but there were implications for continued use of the service. The MCH service was not formally notified of new parents arriving with young children. Pre-arranged group appointments by MCH nurses for parents who attended playgroups worked well to increase ongoing service engagement. Barriers for parents in using MCH services included access to transportation, lack of confidence in speaking English and making phone bookings. Service users and providers reported that continuity of nurse and interpreter is preferred for increasing client-provider trust and ongoing engagement. Conclusions Although participants who had children born in Melbourne had good initial access to, and experience of, using MCH services, significant barriers remain. A systems-oriented, culturally competent approach to service provision would improve the service utilisation experience for parents and providers, including formalising links and notifications between settlement services and MCH services. PMID:22587587

Accessing maternal and child health services in Melbourne, Australia: reflections from refugee families and service providers.

PubMed

Riggs, Elisha; Davis, Elise; Gibbs, Lisa; Block, Karen; Szwarc, Jo; Casey, Sue; Duell-Piening, Philippa; Waters, Elizabeth

2012-05-15

Often new arrivals from refugee backgrounds have experienced poor health and limited access to healthcare services. The maternal and child health (MCH) service in Victoria, Australia, is a joint local and state government operated, cost-free service available to all mothers of children aged 0-6 years. Although well-child healthcare visits are useful in identifying health issues early, there has been limited investigation in the use of these services for families from refugee backgrounds. This study aims to explore experiences of using MCH services, from the perspective of families from refugee backgrounds and service providers. We used a qualitative study design informed by the socioecological model of health and a cultural competence approach. Two geographical areas of Melbourne were selected to invite participants. Seven focus groups were conducted with 87 mothers from Karen, Iraqi, Assyrian Chaldean, Lebanese, South Sudanese and Bhutanese backgrounds, who had lived an average of 4.7 years in Australia (range one month-18 years). Participants had a total of 249 children, of these 150 were born in Australia. Four focus groups and five interviews were conducted with MCH nurses, other healthcare providers and bicultural workers. Four themes were identified: facilitating access to MCH services; promoting continued engagement with the MCH service; language challenges; and what is working well and could be done better. Several processes were identified that facilitated initial access to the MCH service but there were implications for continued use of the service. The MCH service was not formally notified of new parents arriving with young children. Pre-arranged group appointments by MCH nurses for parents who attended playgroups worked well to increase ongoing service engagement. Barriers for parents in using MCH services included access to transportation, lack of confidence in speaking English and making phone bookings. Service users and providers reported that continuity of nurse and interpreter is preferred for increasing client-provider trust and ongoing engagement. Although participants who had children born in Melbourne had good initial access to, and experience of, using MCH services, significant barriers remain. A systems-oriented, culturally competent approach to service provision would improve the service utilisation experience for parents and providers, including formalising links and notifications between settlement services and MCH services.

78 FR 30226 - Accessibility Requirements for Internet Browsers

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-22

... products and services with peripheral devices or specialized customer premise equipment commonly used by... the telephone or services that such manufacturer or provider offers is accessible to and usable by... requires certain Internet browsers used for advanced communications services to be accessible to people...

Investing in People: Access to Higher Education. Report to the Governor and 2003 Legislature.

ERIC Educational Resources Information Center

Minnesota Higher Education Services Office, St. Paul.

This report highlights services and programs of the Minnesota Higher Education Services Office that provide access to postsecondary education, noting efforts to provide services efficiently through increased use of technology and collaborations. After an introduction which discusses the Office's functions, nine sections examine: (1) "Student…

47 CFR 51.903 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... equivalent of the incumbent local exchange carrier access service provided by a non-incumbent local exchange... or other customer provided by an incumbent local exchange carrier or any functional equivalent of the incumbent local exchange carrier access service provided by a non-incumbent local exchange carrier...

47 CFR 51.903 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... equivalent of the incumbent local exchange carrier access service provided by a non-incumbent local exchange... or other customer provided by an incumbent local exchange carrier or any functional equivalent of the incumbent local exchange carrier access service provided by a non-incumbent local exchange carrier...

47 CFR 51.903 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... equivalent of the incumbent local exchange carrier access service provided by a non-incumbent local exchange... or other customer provided by an incumbent local exchange carrier or any functional equivalent of the incumbent local exchange carrier access service provided by a non-incumbent local exchange carrier...

How far will they go? Assessing the travel distance of current and former drug users to access harm reduction services.

PubMed

Allen, Sean; Ruiz, Monica; O'Rourke, Allison

2015-03-01

Prior research has explored spatial access to syringe exchange programs (SEPs) among people who inject drugs (PWID), but little is known about service utilization by former PWID who continue to access services (e.g., HIV screenings and referrals for social services) at harm reduction providers. The purpose of this research is to examine differences in access to SEPs between current and former PWID seeking services at a mobile SEP in Washington, DC. A geometric point distance estimation technique was applied to data collected as part of a PWID population estimation study that took place in Washington, DC, in March and April 2014. We calculated the walking distance from the centroid point of home residence zip code to the mobile exchange site where PWID presented for services. An independent samples t-test was used to examine differences in walking distance measures between current and former PWID. Differences in mean walking distance were statistically significant with current and former PWID having mean walking distances of 2.75 and 1.80 miles, respectively. The results of this study suggest that former PWID who are engaging with SEPs primarily for non-needle exchange services (e.g., medical or social services) may have decreased access to SEPs than their counterparts who are active injectors. This research provides support for expanding SEP operations such that both active and former PWID have increased access to harm reduction providers and associated health and social services. Increasing service accessibility may help resolve unmet needs among current and former PWID.

Service composition towards increasing end-user accessibility.

PubMed

Kaklanis, Nikolaos; Votis, Konstantinos; Tzovaras, Dimitrios

2015-01-01

This paper presents the Cloud4all Service Synthesizer Tool, a framework that enables efficient orchestration of accessibility services, as well as their combination into complex forms, providing more advanced functionalities towards increasing the accessibility of end-users with various types of functional limitations. The supported services are described formally within an ontology, enabling, thus, semantic service composition. The proposed service composition approach is based on semantic matching between services specifications on the one hand and user needs/preferences and current context of use on the other hand. The use of automatic composition of accessibility services can significantly enhance end-users' accessibility, especially in cases where assistive solutions are not available in their device.

Accessing Electronic Journals.

ERIC Educational Resources Information Center

McKay, Sharon Cline

1999-01-01

Discusses issues librarians need to consider when providing access to electronic journals. Topics include gateways; index and abstract services; validation and pay-per-view; title selection; integration with OPACs (online public access catalogs)or Web sites; paper availability; ownership versus access; usage restrictions; and services offered…

News from ESO Archive Services: Next Generation Request Handler and Data Access Delegation

NASA Astrophysics Data System (ADS)

Fourniol, N.; Lockhart, J.; Suchar, D.; Tacconi-Garman, L. E.; Moins, C.; Bierwirth, T.; Eglitis, P.; Vuong, M.; Micol, A.; Delmotte, N.; Vera, I.; Dobrzycki, A.; Forchì, V.; Lange, U.; Sogni, F.

2012-09-01

We present the new ESO Archive services which improve the electronic data access via the Download Manager and also provide PIs with the option to delegate data access to their collaborators via the Data Access Control.

Development of Virtual Resource Based IoT Proxy for Bridging Heterogeneous Web Services in IoT Networks.

PubMed

Jin, Wenquan; Kim, DoHyeun

2018-05-26

The Internet of Things is comprised of heterogeneous devices, applications, and platforms using multiple communication technologies to connect the Internet for providing seamless services ubiquitously. With the requirement of developing Internet of Things products, many protocols, program libraries, frameworks, and standard specifications have been proposed. Therefore, providing a consistent interface to access services from those environments is difficult. Moreover, bridging the existing web services to sensor and actuator networks is also important for providing Internet of Things services in various industry domains. In this paper, an Internet of Things proxy is proposed that is based on virtual resources to bridge heterogeneous web services from the Internet to the Internet of Things network. The proxy enables clients to have transparent access to Internet of Things devices and web services in the network. The proxy is comprised of server and client to forward messages for different communication environments using the virtual resources which include the server for the message sender and the client for the message receiver. We design the proxy for the Open Connectivity Foundation network where the virtual resources are discovered by the clients as Open Connectivity Foundation resources. The virtual resources represent the resources which expose services in the Internet by web service providers. Although the services are provided by web service providers from the Internet, the client can access services using the consistent communication protocol in the Open Connectivity Foundation network. For discovering the resources to access services, the client also uses the consistent discovery interface to discover the Open Connectivity Foundation devices and virtual resources.

Access to dental care among 15–64 year old people

PubMed Central

Eslamipour, Faezeh; Heydari, Kamal; Ghaiour, Marzieh; Salehi, Hoda

2018-01-01

INTRODUCTION: The current study aims to study people's access to oral and dental health-care services and their satisfaction with the services provided to them. MATERIALS AND METHODS: A descriptive study with multi-stage sampling was conducted on 1360 people aged 16–64 years residing in Isfahan city, Iran. The required data were collected by a questionnaire which comprised of three main parts: demographic characteristics, patients’ access to oral and dental health-care services and its barriers and participants’ satisfaction with access to services. Data were analyzed by SPSS statistical software. RESULTS: The results showed 40% of participants reported an average level for oral health, and 82% of them did not have any problems regarding access to dental care facilities. The main causes of their dissatisfaction were high cost of services (60%) and insufficient health insurance coverage (40%). About 73% reported that they had to spend 30 min or less to access to a dental health-care facility. In addition, 50% of participants were satisfied with the provided services. The main reported reasons for referring to dentists were oral and dental problems (69%) and regular check-ups (15%). There was no significant relationship between participants’ gender, education level, insurance coverage, and access to dental health-care centers (P > 0.05). CONCLUSION: Most participants were satisfied with access to dental healthcare, but they were dissatisfied with the costs and inadequate insurance coverage. About half of the participants were satisfied with the services provided to them, and the highest level of satisfaction was reported for easy access to health-care centers. PMID:29693027

Young people with depression and their experience accessing an enhanced primary care service for youth with emerging mental health problems: a qualitative study

PubMed Central

2012-01-01

Background 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. Method 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. Results 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. Conclusions 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. PMID:22853550

SPACEHAB missions as pathfinders for ISS services development

NASA Astrophysics Data System (ADS)

Hamill, Doris; Jackson, Kenneth; Mirra, Carlo

2003-01-01

SPACEHAB, Inc. has established a commercial business model for providing access to space. The model, based on private initiative and investment, has offered "turn key" access to space including both launch and integration and operations services. Some features of this business model should be applied directly to providing service in the ISS era: offering packaged service at a fixed price; customer focus; private investment as the basis for offering services; and efficient and continually improving customer service. But International Space Station (ISS) will pose challenges that have not been pioneered in the STS era: a new base of customers must be developed; on-orbit hardware will be more difficult to modify; access to ISS is controlled by government space agencies. These problems will tax the ingenuity of those who wish to provide services in space on a commercial business model.

An economic analysis on optical Ethernet in the access network

NASA Astrophysics Data System (ADS)

Kim, Sung Hwi; Nam, Dohyun; Yoo, Gunil; Kim, WoonHa

2004-04-01

Nowadays, Broadband service subscribers have increased exponentially and have almost saturated in Korea. Several types of solutions for broadband service applied to the field. Among several types of broadband services, most of subscribers provided xDSL service like ADSL or VDSL. Usually, they who live in an apartment provided Internet service by Ntopia network as FTTC structure that is a dormant network in economical view at KT. Under competitive telecom environment for new services like video, we faced with needing to expand or rebuild portions of our access networks, are looking for ways to provide any service that competitors might offer presently or in the near future. In order to look for new business model like FTTH service, we consider deploying optical access network. In spite of numerous benefits of PON until now, we cannot believe that PON is the best solution in Korea. Because we already deployed optical access network of ring type feeder cable and have densely population of subscribers that mainly distributed inside 6km from central office. So we try to utilize an existing Ntopia network for FTTH service under optical access environment. Despite of such situations, we try to deploy PON solution in the field as FTTC or FTTH architecture. Therefore we analyze PON structure in comparison with AON structure in order to look for optimized structure in Korea. At first, we describe the existing optical access networks and network architecture briefly. Secondly we investigate the cost of building optical access networks by modeling cost functions on AON and PON structure which based on Ethernet protocol, and analyze two different network architectures according to different deployment scenarios: Urban, small town, rural. Finally we suggest the economic and best solution with PON structure to optimize to optical access environment of KT.

47 CFR 51.217 - Nondiscriminatory access: Telephone numbers, operator services, directory assistance services...

Code of Federal Regulations, 2011 CFR

2011-10-01

... to have access to its directory assistance services, including directory assistance databases, so... provider, including transfer of the LECs' directory assistance databases in readily accessible magnetic.... Updates to the directory assistance database shall be made in the same format as the initial transfer...

Context-aware access control for pervasive access to process-based healthcare systems.

PubMed

Koufi, Vassiliki; Vassilacopoulos, George

2008-01-01

Healthcare is an increasingly collaborative enterprise involving a broad range of healthcare services provided by many individuals and organizations. Grid technology has been widely recognized as a means for integrating disparate computing resources in the healthcare field. Moreover, Grid portal applications can be developed on a wireless and mobile infrastructure to execute healthcare processes which, in turn, can provide remote access to Grid database services. Such an environment provides ubiquitous and pervasive access to integrated healthcare services at the point of care, thus improving healthcare quality. In such environments, the ability to provide an effective access control mechanism that meets the requirement of the least privilege principle is essential. Adherence to the least privilege principle requires continuous adjustments of user permissions in order to adapt to the current situation. This paper presents a context-aware access control mechanism for HDGPortal, a Grid portal application which provides access to workflow-based healthcare processes using wireless Personal Digital Assistants. The proposed mechanism builds upon and enhances security mechanisms provided by the Grid Security Infrastructure. It provides tight, just-in-time permissions so that authorized users get access to specific objects according to the current context. These permissions are subject to continuous adjustments triggered by the changing context. Thus, the risk of compromising information integrity during task executions is reduced.

Electronic Collection Management and Electronic Information Services

DTIC Science & Technology

2003-04-01

compilation report, use: ADA415655 The component part is provided here to allow users access to individually authored sections f proceedings, annals...providers or as brokers between the user and the primary service provider. There has also been a significant reorientation from concept of "ownership...access. It will also look at the major trends in electronic user services including electronic information delivery and electronic reference. Finally, it

BioPortal: enhanced functionality via new Web services from the National Center for Biomedical Ontology to access and use ontologies in software applications.

PubMed

Whetzel, Patricia L; Noy, Natalya F; Shah, Nigam H; Alexander, Paul R; Nyulas, Csongor; Tudorache, Tania; Musen, Mark A

2011-07-01

The National Center for Biomedical Ontology (NCBO) is one of the National Centers for Biomedical Computing funded under the NIH Roadmap Initiative. Contributing to the national computing infrastructure, NCBO has developed BioPortal, a web portal that provides access to a library of biomedical ontologies and terminologies (http://bioportal.bioontology.org) via the NCBO Web services. BioPortal enables community participation in the evaluation and evolution of ontology content by providing features to add mappings between terms, to add comments linked to specific ontology terms and to provide ontology reviews. The NCBO Web services (http://www.bioontology.org/wiki/index.php/NCBO_REST_services) enable this functionality and provide a uniform mechanism to access ontologies from a variety of knowledge representation formats, such as Web Ontology Language (OWL) and Open Biological and Biomedical Ontologies (OBO) format. The Web services provide multi-layered access to the ontology content, from getting all terms in an ontology to retrieving metadata about a term. Users can easily incorporate the NCBO Web services into software applications to generate semantically aware applications and to facilitate structured data collection.

Mental health service utilization of Somali adolescents: religion, community, and school as gateways to healing.

PubMed

Ellis, B Heidi; Lincoln, Alisa K; Charney, Meredith E; Ford-Paz, Rebecca; Benson, Molly; Strunin, Lee

2010-11-01

This mixed-method study examines the utility of the Gateway Provider Model (GPM) in understanding service utilization and pathways to help for Somali refugee adolescents. Somali adolescents living in the Northeastern United States, and their caregivers, were interviewed. Results revealed low rates of use of mental health services. However other sources of help, such as religious and school personnel, were accessed more frequently. The GPM provides a helpful model for understanding refugee youth access to services, and an elaborated model is presented showing how existing pathways to help could be built upon to improve refugee youth access to services.

System services and architecture of the TMI satellite mobile data system

NASA Technical Reports Server (NTRS)

Gokhale, D.; Agarwal, A.; Guibord, A.

1993-01-01

The North American Mobile Satellite Service (MSS) system being developed by AMSC/TMI and scheduled to go into service in early 1995 will include the provision for real time packet switched services (mobile data service - MDS) and circuit switched services (mobile telephony service - MTS). These services will utilize geostationary satellites which provide access to mobile terminals (MT's) through L-band beams. The MDS system utilizes a star topology with a centralized data hub (DH) and will support a large number of mobile terminals. The DH, which accesses the satellite via a single Ku band beam, is responsible for satellite resource management, for providing mobile users with access to public and private data networks, and for comprehensive network management of the system. This paper describes the various MDS services available for the users, the ground segment elements involved in the provisioning of these services, and a summary description of the channel types, protocol architecture, and network management capabilities provided within the system.

Migrant beer promoters' experiences accessing reproductive health care in Cambodia, Laos, Thailand, and Vietnam: lessons for planners and providers.

PubMed

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

2015-03-01

Migrant beer promoters in Cambodia, Laos, Thailand, and Vietnam were surveyed to determine their experiences in accessing reproductive health care services in the cities of Phnom Penh, Vientiane, Bangkok, and Hanoi. A total of 7 health care institutions were chosen as popular with migrant beer promoters. Staff at these institutions provided information on the institution, and 390 beer promoters were surveyed about their experiences while accessing services. There were discrepancies between findings from the staff interviews and the experiences of the beer promoters. In general, the migrant women were satisfied with the cost, location, friendliness of the health care providers, and knowledge and skills of the providers. They were less positive about confidentiality and waiting times, though many still agreed that these were not an issue. Health care planners and providers should take note of the issues affecting access to reproductive health care services for migrant women when they design and implement services. © 2012 APJPH.

Pilot evaluation of a web-based intervention targeting sexual health service access.

PubMed

Brown, K E; Newby, K; Caley, M; Danahay, A; Kehal, I

2016-04-01

Sexual health service access is fundamental to good sexual health, yet interventions designed to address this have rarely been implemented or evaluated. In this article, pilot evaluation findings for a targeted public health behavior change intervention, delivered via a website and web-app, aiming to increase uptake of sexual health services among 13-19-year olds are reported. A pre-post questionnaire-based design was used. Matched baseline and follow-up data were identified from 148 respondents aged 13-18 years. Outcome measures were self-reported service access, self-reported intention to access services and beliefs about services and service access identified through needs analysis. Objective service access data provided by local sexual health services were also analyzed. Analysis suggests the intervention had a significant positive effect on psychological barriers to and antecedents of service access among females. Males, who reported greater confidence in service access compared with females, significantly increased service access by time 2 follow-up. Available objective service access data support the assertion that the intervention may have led to increases in service access. There is real promise for this novel digital intervention. Further evaluation is planned as the model is licensed to and rolled out by other local authorities in the United Kingdom. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

47 CFR 54.601 - Eligibility.

Code of Federal Regulations, 2011 CFR

2011-10-01

...). (2) Internet access and limited toll-free access to internet. (i) For purposes of this subpart, eligible Internet access is an information service that enables rural health care providers to post their...) Internet access shall be eligible for universal service support under § 54.621(a). (iii) Limited toll-free...

76 FR 26341 - Medicaid Program; Methods for Assuring Access to Covered Medicaid Services

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-06

... Medicare & Medicaid Services 42 CFR Part 447 Medicare Program; Methods for Assuring Access to Covered... Services 42 CFR Part 447 [CMS 2328-P] RIN 0938-AQ54 Medicaid Program; Methods for Assuring Access to... design the procedures for enrolling providers of such care, and to set the methods for establishing...

Utilizing Syllabi to Support Access Services and Beyond: A Case Study

ERIC Educational Resources Information Center

Parrott, Justin; Lindsay, Beth Daniel

2017-01-01

New York University Abu Dhabi (NYUAD) Library receives copies of all course syllabi to provide a number of services to faculty and students related to acquisitions, access, collection development, subject liaison, and library instruction. Access services and acquisitions staff, as well as subject liaison librarians, work together using specific…

A Systematic Scheme for Multiple Access in Ethernet Passive Optical Access Networks

NASA Astrophysics Data System (ADS)

Ma, Maode; Zhu, Yongqing; Hiang Cheng, Tee

2005-11-01

While backbone networks have experienced substantial changes in the last decade, access networks have not changed much. Recently, passive optical networks (PONs) seem to be ready for commercial deployment as access networks, due to the maturity of a number of enabling technologies. Among the PON technologies, Ethernet PON (EPON) standardized by the IEEE 802.3ah Ethernet in the First Mile (EFM) Task Force is the most attractive one because of its high speed, low cost, familiarity, interoperability, and low overhead. In this paper, we consider the issue of upstream channel sharing in the EPONs. We propose a novel multiple-access control scheme to provide bandwidth-guaranteed service for high-demand customers, while providing best effort service to low-demand customers according to the service level agreement (SLA). The analytical and simulation results prove that the proposed scheme performs best in what it is designed to do compared to another well-known scheme that has not considered providing differentiated services. With business customers preferring premium services with guaranteed bandwidth and residential users preferring low-cost best effort services, our scheme could benefit both groups of subscribers, as well as the operators.

Survey of Federal, National, and International standards applicable to the NASA applications data services

NASA Technical Reports Server (NTRS)

Kuch, T.; Sakamoto, R.

1981-01-01

An applications data service (ADS) was developed to meet the challenges in the data access and integration. The ADS provides a common service to locate and access applications data electronically and integrate the cross correlative data sets required by multiple users. Its catalog and network services increase data visibility as well as provide the data in a more rapid manner and a usable form.

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

ERIC Educational Resources Information Center

Gerhardt, Lillian N.

1981-01-01

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

Gaining Access to the Internet.

ERIC Educational Resources Information Center

Notess, Greg R.

1992-01-01

Discusses Internet services and protocols (i.e., electronic mail, file transfer, and remote login) and provides instructions for retrieving guides and directories of the Internet. Services providing access to the Internet are described, including bulletin board systems, regional networks, nationwide connections, and library organizations; and a…

Adverse or acceptable: negotiating access to a post-apartheid health care contract.

PubMed

Harris, Bronwyn; Eyles, John; Penn-Kekana, Loveday; Thomas, Liz; Goudge, Jane

2014-05-15

As in many fragile and post-conflict countries, South Africa's social contract has formally changed from authoritarianism to democracy, yet access to services, including health care, remains inequitable and contested. We examine access barriers to quality health services and draw on social contract theory to explore ways in which a post-apartheid health care contract is narrated, practiced and negotiated by patients and providers. We consider implications for conceptualizing and promoting more inclusive, equitable health services in a post-conflict setting. Using in-depth interviews with 45 patients and 67 providers, and field observations from twelve health facilities in one rural and two urban sub-districts, we explore access narratives of those seeking and delivering - negotiating - maternal health, tuberculosis and antiretroviral services in South Africa. Although South Africa's right to access to health care is constitutionally guaranteed, in practice, a post-apartheid health care contract is not automatically or unconditionally inclusive. Access barriers, including poverty, an under-resourced, hierarchical health system, the nature of illness and treatment, and negative attitudes and actions, create conditions for insecure or adverse incorporation into this contract, or even exclusion (sometimes temporary) from health care services. Such barriers are exacerbated by differences in the expectations that patients and providers have of each other and the contract, leading to differing, potentially conflicting, identities of inclusion and exclusion: defaulting versus suffering patients, uncaring versus overstretched providers. Conversely, caring, respectful communication, individual acts of kindness, and institutional flexibility and leadership may mitigate key access barriers and limit threats to the contract, fostering more positive forms of inclusion and facilitating easier access to health care. Building health in fragile and post-conflict societies requires the negotiation of a new social contract. Surfacing and engaging with differences in patient and provider expectations of this contract may contribute to more acceptable, accessible health care services. Additionally, the health system is well positioned to highlight and connect the political economy, institutions and social relationships that create and sustain identities of exclusion and inclusion - (re)politicise suffering - and co-ordinate and lead intersectoral action for overcoming affordability and availability barriers to inclusive and equitable health care services.

75 FR 69150 - Self-Regulatory Organizations; The Depository Trust Company; Order Approving Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-10

... Process in Providing Trustee Access to the Security Position Report Service November 4, 2010. I.... The current review process to approve a trustee's access to the SPR service for a security is done... a trustee's access to DTC's SPR service for an issue with an automated approval process, DTC will be...

The Impacts of Using a Collaborative Evaluation Approach in Higher Education: A Case Study of Local YMCAs Providing College Access Services

ERIC Educational Resources Information Center

Campbell, Johnavae E.

2013-01-01

This dissertation offers a case study of the YMCA of the USA's pilot Higher Education Service Project (YHESP) with 61 local YMCAs on how the collaborative evaluation approach functioned to facilitate an organizational culture around evaluation and reinvention strategies of YMCAs as college access service providers. Multiple data collection sources…

Equity of access to reproductive health services among youths in resource-limited suburban communities of Mandalay City, Myanmar

PubMed Central

2012-01-01

Background Inequity of accessibility to and utilization of reproductive health (RH) services among youths is a global concern, especially in resource-limited areas. The level of inequity also varies by cultural and socio-economic contexts. To tailor RH services to the needs of youths, relevant solutions are required. This study aimed to assess baseline information on access to and utilization of RH services and unmet needs among youths living in resource-limited, suburban communities of Mandalay City, Myanmar. Methods A community-based, cross-sectional study was conducted in all resource-limited, suburban communities of Mandalay City, Myanmar. A total of 444 randomly selected youths aged between 15 and 24 years were interviewed for three main outcomes, namely accessibility to and utilization of RH services and youth's unmet needs for these services. Factors associated with these outcomes were determined using multivariate logistic regression. Results Although geographical accessibility was high (79.3%), financial accessibility was low (19.1%) resulting in a low overall accessibility (34.5%) to RH services. Two-thirds of youths used some kind of RH services at least once in the past. Levels of unmet needs for sexual RH information, family planning, maternal care and HIV testing were 62.6%, 31.9%, 38.7% and 56.2%, respectively. Youths living in the south or south-western suburbs, having a deceased parent, never being married or never exposed to mass media were less likely to access RH services. Being a young adult, current student, working as a waste recycler, having ever experienced a sexual relationship, ever being married, ever exposed to mass media, having a high knowledge of RH services and providers or a high level of accessibility to RH services significantly increased the likelihood of utilization of those services. In addition to youths’ socio-demographic characteristics, exposure to mass media, norm of peer exposure and knowledge on types of providers and services significantly influenced the unmet needs of youths towards RH services. Conclusion Despite the availability of RH services, youth’s accessibility to and utilization of those services were unsatisfactory. The levels of youths’ unmet RH needs were alarmingly high. PMID:23241510

42 CFR 422.112 - Access to services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Access to services. (a) Rules for coordinated care plans. An MA organization that offers an MA... organization ensures that all covered services, including supplemental services contracted for by (or on behalf... organization must meet the following requirements: (1) Provider network. (i) Maintain and monitor a network of...

42 CFR 422.112 - Access to services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Access to services. (a) Rules for coordinated care plans. An MA organization that offers an MA... organization ensures that all covered services, including supplemental services contracted for by (or on behalf... organization must meet the following requirements: (1) Provider network. (i) Maintain and monitor a network of...

42 CFR 422.112 - Access to services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Access to services. (a) Rules for coordinated care plans. An MA organization that offers an MA... organization ensures that all covered services, including supplemental services contracted for by (or on behalf... organization must meet the following requirements: (1) Provider network. (i) Maintain and monitor a network of...

Improving sexual health services in the city: can the NHS learn from clients and the service industry

PubMed Central

Patel, Hitesh; Baeza, Juan; Patel, Mitesh; Greene, Linda; Theobald, Nick

2007-01-01

Abstract Objective  Genitourinary service providers are struggling to meet patient demand and have introduced changes in access structure to cope. In this study, we explored the perspectives of clients and providers upon the different models of access introduced and whether these maintained service quality using the SERQUAL model. Methods  Primary data were collected in May 2005 at two genitourinary medicine clinics, two Accident and Emergency Departments and from members of a university ‘gay’ society all of which were located in London. Forty‐four high‐risk clients and 11 health service providers underwent semi‐structured face‐to‐face interviews. Results  Both the walk‐in and appointment‐based access systems were appreciated by clients. Clients said that the most important issue was that they were not turned away when they presented. Health‐care providers had a variety of opinions about the two systems as they had different impacts on morale, training and service provision. Conclusions  Service quality can be maintained by using both walk‐in and appointment‐based systems. This is because our data, in line with Parasuraman's model of service quality, showed that ‘access’ is but one determinant of quality. Having different modes of access facilitates patient choice, which is paramount in a modern health‐care system. However, to provide a good service it is important to maintain a motivated staff, who can be affected by their working environment. PMID:17524007

Intelligent Urban Public Transportation for Accessibility Dedicated to People with Disabilities

PubMed Central

Zhou, Haiying; Hou, Kun-Mean; Zuo, Decheng; Li, Jian

2012-01-01

The traditional urban public transport system generally cannot provide an effective access service for people with disabilities, especially for disabled, wheelchair and blind (DWB) passengers. In this paper, based on advanced information & communication technologies (ICT) and green technologies (GT) concepts, a dedicated public urban transportation service access system named Mobi+ has been introduced, which facilitates the mobility of DWB passengers. The Mobi+ project consists of three subsystems: a wireless communication subsystem, which provides the data exchange and network connection services between buses and stations in the complex urban environments; the bus subsystem, which provides the DWB class detection & bus arrival notification services; and the station subsystem, which implements the urban environmental surveillance & bus auxiliary access services. The Mobi+ card that supports multi-microcontroller multi-transceiver adopts the fault-tolerant component-based hardware architecture, in which the dedicated embedded system software, i.e., operating system micro-kernel and wireless protocol, has been integrated. The dedicated Mobi+ embedded system provides the fault-tolerant resource awareness communication and scheduling mechanism to ensure the reliability in data exchange and service provision. At present, the Mobi+ system has been implemented on the buses and stations of line ‘2’ in the city of Clermont-Ferrand (France). The experiential results show that, on one hand the Mobi+ prototype system reaches the design expectations and provides an effective urban bus access service for people with disabilities; on the other hand the Mobi+ system is easily to deploy in the buses and at bus stations thanks to its low energy consumption and small form factor. PMID:23112622

Intelligent urban public transportation for accessibility dedicated to people with disabilities.

PubMed

Zhou, Haiying; Hou, Kun-Mean; Zuo, Decheng; Li, Jian

2012-01-01

The traditional urban public transport system generally cannot provide an effective access service for people with disabilities, especially for disabled, wheelchair and blind (DWB) passengers. In this paper, based on advanced information & communication technologies (ICT) and green technologies (GT) concepts, a dedicated public urban transportation service access system named Mobi+ has been introduced, which facilitates the mobility of DWB passengers. The Mobi+ project consists of three subsystems: a wireless communication subsystem, which provides the data exchange and network connection services between buses and stations in the complex urban environments; the bus subsystem, which provides the DWB class detection & bus arrival notification services; and the station subsystem, which implements the urban environmental surveillance & bus auxiliary access services. The Mobi+ card that supports multi-microcontroller multi-transceiver adopts the fault-tolerant component-based hardware architecture, in which the dedicated embedded system software, i.e., operating system micro-kernel and wireless protocol, has been integrated. The dedicated Mobi+ embedded system provides the fault-tolerant resource awareness communication and scheduling mechanism to ensure the reliability in data exchange and service provision. At present, the Mobi+ system has been implemented on the buses and stations of line '2' in the city of Clermont-Ferrand (France). The experiential results show that, on one hand the Mobi+ prototype system reaches the design expectations and provides an effective urban bus access service for people with disabilities; on the other hand the Mobi+ system is easily to deploy in the buses and at bus stations thanks to its low energy consumption and small form factor.

Interorganizational collaboration for health care between nongovernmental organizations (NGOs) in Pakistan.

PubMed

Gulzar, Laila; Henry, Beverly

2005-11-01

The complexity and cost of health systems requires innovative forms of organization to provide accessible health services of an acceptable quality and at an acceptable cost. Interorganizational collaboration (IoC) is an innovation to increase the availability of organizational resources, improve service effectiveness, and improve access to health care. In Pakistan, a weak health system and little collaboration limit access, especially of women and children, to health services. Many nongovernmental organizations (NGOs) provide primary health care to the very poor, and some appear to collaborate to varying degrees; however, this has not been systematically analyzed. The purpose of this qualitative research, the first scientific study of collaboration between NGOs providing health services in Pakistan, was to describe collaboration between three pairs of NGOs providing community-based health services to women in Karachi. A long-term goal is to build a basis for future research linking IoC to access to health care and health outcomes. Findings indicated that collaboration was strongest when there was willingness to cooperate, a need for expertise and funds, and adaptive efficiency. In Pakistan's complex social environment, collaboration tended to be stronger when there was fairly high organizational formalization. Broader IoC appears to be positively associated with women's access to health care. Recommendations are made for future research, education, and management.

Enhancing UCSF Chimera through web services

PubMed Central

Huang, Conrad C.; Meng, Elaine C.; Morris, John H.; Pettersen, Eric F.; Ferrin, Thomas E.

2014-01-01

Integrating access to web services with desktop applications allows for an expanded set of application features, including performing computationally intensive tasks and convenient searches of databases. We describe how we have enhanced UCSF Chimera (http://www.rbvi.ucsf.edu/chimera/), a program for the interactive visualization and analysis of molecular structures and related data, through the addition of several web services (http://www.rbvi.ucsf.edu/chimera/docs/webservices.html). By streamlining access to web services, including the entire job submission, monitoring and retrieval process, Chimera makes it simpler for users to focus on their science projects rather than data manipulation. Chimera uses Opal, a toolkit for wrapping scientific applications as web services, to provide scalable and transparent access to several popular software packages. We illustrate Chimera's use of web services with an example workflow that interleaves use of these services with interactive manipulation of molecular sequences and structures, and we provide an example Python program to demonstrate how easily Opal-based web services can be accessed from within an application. Web server availability: http://webservices.rbvi.ucsf.edu/opal2/dashboard?command=serviceList. PMID:24861624

KSC-02pd0392

NASA Image and Video Library

2002-04-03

KENNEDY SPACE CENTER, FLA. -- With the Rotating Service Structure rolled back, Space Shuttle Atlantis stands ready for launch on mission STS-110. The Orbiter Access Arm extends from the Fixed Service Structure (FSS) to the crew compartment hatch, through which the STS-110 crew will enter Atlantis. Above the golden external tank is the vent hood (known as the "beanie cap") at the end of the gaseous oxygen vent arm. Vapors are created as the liquid oxygen in the external tank boil off. The hood vents the gaseous oxygen vapors away from the Space Shuttle vehicle. The RSS provides protected access to the orbiter for changeout and servicing of payloads at the pad. The structure has access platforms at five levels to provide access to the payload bay. The FSS provides access to the orbiter and the RSS. Mission STS-110 is scheduled to launch April 4 on its 11-day mission to the International Space Station

Provider Perspectives on School-Based Mental Health for Urban Minority Youth: Access and Services

ERIC Educational Resources Information Center

Gamble, Brandon E.; Lambros, Katina M.

2014-01-01

This article provides results from a qualitative study on the efforts of school-based mental health providers (SBMHPs) who serve students in urban, suburban, and ethnically diverse settings to help families access quality mental health services. School-based mental health plays a key role in the provision of direct and indirect intervention…

Provider perceptions of stigma and discrimination experienced by adolescents and young adults with pHiV while accessing sexual and reproductive health care.

PubMed

Fair, Cynthia D; Berk, Meredith

2018-02-01

Historically, children with perinatally-acquired HIV (PHIV) were viewed as the "innocent victims" as their HIV infection was not acquired through sexual/drug related means. Today, adolescents with PHIV are surviving into young adulthood and are engaging in developmentally expected behaviors such as establishing intimate, sexual relationships. Like other youth, those living with PHIV often need to access sexual and reproductive health (SRH) services. Previous research has documented stigma and discrimination experienced by adult women living with HIV as they try to access SRH care. However, little is known about the experiences of stigma and discrimination encountered by the maturing adolescents and young adults (AYA) with PHIV when accessing services. HIV health care providers (HHCPs) who frequently care for this population are in a unique position to learn about and understand the stigma and discrimination experienced by their patients in formal service settings. HHCPs (n = 57, 28 medical and 29 social service providers) were recruited using snowball sampling, and completed an online survey based on patient-shared experiences of stigma and discrimination when accessing SRH-related health care and social services. Thirty-eight percent (22/57) of providers reported that their patients with PHIV had shared encounters of stigma or discrimination when accessing SRH services. Coded open-ended provider comments indicated that AYA patients experienced challenges with providers who were unfamiliar with PHIV and expressed surprise that someone with PHIV was still alive. Analyses also revealed prejudicial attitudes towards women with HIV. Patients reported being counseled to terminate their pregnancy and lectured about their "poor choices." As AYA with PHIV transition out of pediatric and adolescent care, it is important for providers to simultaneously help them navigate care in other health settings, as well as educate adult health care providers about possible misconceptions of caring for individuals with PHIV.

Users' views of prison health services: a qualitative study.

PubMed

Condon, Louise; Hek, Gill; Harris, Francesca; Powell, Jane; Kemple, Terry; Price, Sally

2007-05-01

This paper is a report of a study of the views of prisoners about health services provided in prisons. Prison provides an opportunity for a 'hard to reach' group to access health services, primarily those provided by nurses. Prisoners typically have high health and social needs, but the views and experiences of prisoners about health services in prison have not been widely researched. Semi-structured interviews were carried out with 111 prisoners in purposively selected 12 prisons in England in 2005. Interviews covered both prisoners' views of health services and their own ways of caring for their health in prison. Interviews were analysed to develop a conceptual framework and identify dominant themes. Prisoners considered health services part of a personal prison journey, which began at imprisonment and ended on release. For those who did not access health services outside prison, imprisonment improved access to both mental and physical health services. Prisoners identified accessing services, including those provided by nurses, confidentiality, being seen as a 'legitimate' patient and living with a chronic condition as problems within the prison healthcare system. At all points along the prison healthcare journey, the prison regime could conflict with optimal health care. Lack of autonomy is a major obstacle to ensuring that prisoners' health needs are fully met. Their views should be considered when planning, organizing and delivering prison health services. Further research is needed to examine how nurses can ensure a smooth journey through health care for prisoners.

A qualitative study of health system barriers to accessibility and utilization of maternal and newborn healthcare services in Ghana after user-fee abolition.

PubMed

Ganle, John Kuumuori; Parker, Michael; Fitzpatrick, Raymond; Otupiri, Easmon

2014-12-21

To reduce financial barriers to access, and improve access to and use of skilled maternal and newborn healthcare services, the government of Ghana, in 2003, implemented a new maternal healthcare policy that provided free maternity care services in all public and mission healthcare facilities. Although supervised delivery in Ghana has increased from 47% in 2003 to 55% in 2010, strikingly high maternal mortality ratio and low percentage of skilled attendance are still recorded in many parts of the country. To explore health system factors that inhibit women's access to and use of skilled maternal and newborn healthcare services in Ghana despite these services being provided free. We conducted qualitative research with 185 expectant and lactating mothers and 20 healthcare providers in six communities in Ghana between November 2011 and May 2012. We used Attride-Stirling's thematic network analysis framework to analyze and present our data. We found that in addition to limited and unequal distribution of skilled maternity care services, women's experiences of intimidation in healthcare facilities, unfriendly healthcare providers, cultural insensitivity, long waiting time before care is received, limited birthing choices, poor care quality, lack of privacy at healthcare facilities, and difficulties relating to arranging suitable transportation were important health system barriers to increased and equitable access and use of services in Ghana. Our findings highlight how a focus on patient-side factors can conceal the fact that many health systems and maternity healthcare facilities in low-income settings such as Ghana are still chronically under-resourced and incapable of effectively providing an acceptable minimum quality of care in the event of serious obstetric complications. Efforts to encourage continued use of maternity care services, especially skilled assistance at delivery, should focus on addressing those negative attributes of the healthcare system that discourage access and use.

Variation in geographic access to chemotherapy by definitions of providers and service locations: a population-based observational study.

PubMed

Schroeder, Mary C; Chapman, Cole G; Nattinger, Matthew C; Halfdanarson, Thorvardur R; Abu-Hejleh, Taher; Tien, Yu-Yu; Brooks, John M

2016-07-18

An aging population, with its associated rise in cancer incidence and strain on the oncology workforce, will continue to motivate patients, healthcare providers and policy makers to better understand the existing and growing challenges of access to chemotherapy. Administrative data, and SEER-Medicare data in particular, have been used to assess patterns of healthcare utilization because of its rich information regarding patients, their treatments, and their providers. To create measures of geographic access to chemotherapy, patients and oncologists must first be identified. Others have noted that identifying chemotherapy providers from Medicare claims is not always straightforward, as providers may report multiple or incorrect specialties and/or practice in multiple locations. Although previous studies have found that specialty codes alone fail to identify all oncologists, none have assessed whether various methods of identifying chemotherapy providers and their locations affect estimates of geographic access to care. SEER-Medicare data was used to identify patients, physicians, and chemotherapy use in this population-based observational study. We compared two measures of geographic access to chemotherapy, local area density and distance to nearest provider, across two definitions of chemotherapy provider (identified by specialty codes or billing codes) and two definitions of chemotherapy service location (where chemotherapy services were proven to be or possibly available) using descriptive statistics. Access measures were mapped for three representative registries. In our sample, 57.2 % of physicians who submitted chemotherapy claims reported a specialty of hematology/oncology or medical oncology. These physicians were associated with 91.0 % of the chemotherapy claims. When providers were identified through billing codes instead of specialty codes, an additional 50.0 % of beneficiaries (from 23.8 % to 35.7 %) resided in the same ZIP code as a chemotherapy provider. Beneficiaries were also 1.3 times closer to a provider, in terms of driving time. Our access measures did not differ significantly across definitions of service location. Measures of geographic access to care were sensitive to definitions of chemotherapy providers; far more providers were identified through billing codes than specialty codes. They were not sensitive to definitions of service locations, as providers, regardless of how they are identified, generally provided chemotherapy at each of their practice locations.

Providing School Students, Staff, and Parents with Access to Vendors of Goods and Services. A Model Policy and Rules, with Comments.

ERIC Educational Resources Information Center

Iowa State Dept. of Public Instruction, Des Moines.

This model policy is designed to help local school officials provide vendors with the greatest reasonable opportunity to compete for access to the school community, while protecting the school's need for reasonable control of that access, so that students, parents, and staff can obtain the best goods and services at the best price. It is offered…

Capabilities in Context: Evaluating the Net-Centric Enterprise

DTIC Science & Technology

2009-03-01

with an intuitive keyword search using the enterprise’s federated search capability. Service accessibility. Testers will ensure that local service has...search using the enterprise’s federated search capability. Data accessibility. Testers will ensure that Feder- ated Search results provide active link...user may request access to the data, and be available within ‘‘2 clicks’’ from the active link provided by Federated Search . Data understandability

Web service activities at the IRIS DMC to support federated and multidisciplinary access

NASA Astrophysics Data System (ADS)

Trabant, Chad; Ahern, Timothy K.

2013-04-01

At the IRIS Data Management Center (DMC) we have developed a suite of web service interfaces to access our large archive of, primarily seismological, time series data and related metadata. The goals of these web services include providing: a) next-generation and easily used access interfaces for our current users, b) access to data holdings in a form usable for non-seismologists, c) programmatic access to facilitate integration into data processing workflows and d) a foundation for participation in federated data discovery and access systems. To support our current users, our services provide access to the raw time series data and metadata or conversions of the raw data to commonly used formats. Our services also support simple, on-the-fly signal processing options that are common first steps in many workflows. Additionally, high-level data products derived from raw data are available via service interfaces. To support data access by researchers unfamiliar with seismic data we offer conversion of the data to broadly usable formats (e.g. ASCII text) and data processing to convert the data to Earth units. By their very nature, web services are programmatic interfaces. Combined with ubiquitous support for web technologies in programming & scripting languages and support in many computing environments, web services are very well suited for integrating data access into data processing workflows. As programmatic interfaces that can return data in both discipline-specific and broadly usable formats, our services are also well suited for participation in federated and brokered systems either specific to seismology or multidisciplinary. Working within the International Federation of Digital Seismograph Networks, the DMC collaborated on the specification of standardized web service interfaces for use at any seismological data center. These data access interfaces, when supported by multiple data centers, will form a foundation on which to build discovery and access mechanisms for data sets spanning multiple centers. To promote the adoption of these standardized services the DMC has developed portable implementations of the software needed to host these interfaces, minimizing the work required at each data center. Within the COOPEUS project framework, the DMC is working with EU partners to install web services implementations at multiple data centers in Europe.

76 FR 33686 - Proposed Extension of Part 4 of the Commission's Rules Regarding Outage Reporting to...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-09

... broadband ISPs, a term which includes broadband Internet access service providers and broadband backbone... Internet consumers and businesses that purchase Internet access through less traditional access arrangements (e.g., prepaid Internet access cards). 23. Some broadband ISPs provide Internet access directly...

The Education Value of Cloud Computing

ERIC Educational Resources Information Center

Katzan, Harry, Jr.

2010-01-01

Cloud computing is a technique for supplying computer facilities and providing access to software via the Internet. Cloud computing represents a contextual shift in how computers are provisioned and accessed. One of the defining characteristics of cloud software service is the transfer of control from the client domain to the service provider.…

34 CFR 364.37 - What access to records must be provided?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true What access to records must be provided? 364.37 Section 364.37 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE INDEPENDENT LIVING SERVICES...

75 FR 37971 - Providing Stability and Security for Medicare Reimbursements

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-30

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

A team approach to improving colorectal cancer services using administrative health data.

PubMed

Porter, Geoffrey; Urquhart, Robin; Bu, Jingyu; Kendell, Cynthia; Macintyre, Maureen; Dewar, Ron; Kephart, George; Asada, Yukiko; Grunfeld, Eva

2012-01-31

Colorectal cancer (CRC) is the third most commonly diagnosed cancer in Canada and accounts for 11.9% of all cancer-related mortality. Fortunately, previous studies have provided evidence of improved outcomes from access to timely and appropriate health services along the disease trajectory in CRC. As a result, the CIHR/CCNS Team in Access to Colorectal Cancer Services in Nova Scotia (Team ACCESS) was created to build colorectal cancer (CRC) research capacity in Nova Scotia (NS) and to study access to and quality of CRC services along the entire continuum of cancer care. The objectives of this paper are to: 1) provide a detailed description of the methodologies employed across the various studies being conducted by Team ACCESS; 2) demonstrate how administrative health data can be used to evaluate access and quality in CRC services; and 3) provide an example of an interdisciplinary team approach to addressing health service delivery issues. All patients diagnosed with CRC in NS between 2001 and 2005 were identified through the Nova Scotia Cancer Registry (NSCR) and staged using the Collaborative Stage Data Collection System. Using administrative databases that were linked at the patient level, Team ACCESS created a retrospective longitudinal cohort with comprehensive demographic, clinical, and healthcare utilization data. These data were used to examine access to and quality of CRC services in NS, as well as factors affecting access to and quality of care, at various transition points along the continuum of care. Team ACCESS has also implemented integrated knowledge translation strategies targeting policy- and decision- makers. The development of Team ACCESS represents a unique approach to CRC research. We anticipate that the skills, tools, and knowledge generated from our work will also advance the study of other cancer disease sites in NS. Given the increasing prevalence of cancer, and with national and provincial funding agencies promoting collaborative research through increased funding for research team development, the work carried out by Team ACCESS is important in the Canadian context and exemplifies how a team approach is essential to comprehensively addressing issues surrounding not only cancer, but other chronic diseases in Canada.

Accessibility and spatial distribution of general practice services in an Australian city by levels of social disadvantage.

PubMed

Hyndman, J C; Holman, C D

2001-12-01

The accessibility and spatial distribution of health services provided by the main source of primary medical care in Australia--the general practice surgery--was investigated by level of social disadvantage of local catchment areas. All 459 general practice surgeries in Perth, an Australian city of 1.2 million residents, were surveyed with a 94% response. Amount of service provision was measured using weekly doctor-hours, available from consulting rooms during opening hours, and associated nurse-hours of service. Access factors were defined as the distance to the nearest surgery, provision of Sunday and evening services, ease of making a same day appointment, bulk-billing, and whether the surgery offered a choice of gender of doctor. There were relatively more surgeries in disadvantaged areas and doctor-hours of service provision were also greater (41.0 h/1,000 most disadvantaged vs. 37.9 h/1000 least disadvantaged). Bulk-billing care, at no direct cost to the patient, was more likely to be provided in most disadvantaged areas compared with least disadvantaged areas (61 vs. 38%). However, populations living in the most disadvantaged areas were less likely to be able to see the local GP at short notice (91 vs. 95%), to have access to a local female GP (56 vs. 62%) or a local service in the evenings (42 vs. 51%). While the overall picture of accessibility was favourable, there was considerable variation in the type of services provided to different socioeconomic groups. Health care planners should investigate the reasons for these differences and advise Government to ensure that access factors affecting publicly funded services are equitably distributed.

Bibliotherapy for mental health service users Part 2: a survey of psychiatric libraries in the UK.

PubMed

Fanner, Deborah; Urqhuart, Christine

2009-06-01

UK health policy advocates a patient-centred approach to patient care. Library services could serve the rehabilitation needs of mental health service users through bibliotherapy (the use of written, audio or e-learning materials to provide therapeutic support). Part 2 of this two-part paper assesses the views of psychiatric libraries in the UK on providing access to service users and possible services provided. An e-mail questionnaire survey of psychiatric library members of the psychiatric lending co-operative scheme (n = 100) obtained a response rate of 55%, mostly from libraries based in hospitals. At present, libraries funded by the health service provide minimal facilities for service users. Librarians are uncertain about the benefits and practicalities of providing access to service users. In order to implement change, information providers across the National Health Service (NHS) will need to work collaboratively to overcome attitudinal and institutional barriers, including the key issue of funding.

What systems participants know about access and service entry and why managers should listen.

PubMed

Duncombe, Rohena

2017-08-01

Objective The present study looked at the views of people directly involved in the entry process for community health counselling using the frame of the health access literature. The concurrence of system participants' views with the access literature highlights access issues, particularly for people who are vulnerable or disadvantaged. The paper privileges the voices of the system participants, inviting local health services to consider using participatory design to improve access at the entry point. Methods People involved in the entry process for community health counselling explored the question, 'What, for you, are the features of a good intake system?' They also commented on themes identified during pilot interviews. These were thematically analysed for each participant group by the researcher to develop a voice for each stakeholder group. Results People accessing the service could be vulnerable and the entry process failed to take that into account. People directly involved in the counselling service entry system, system participants, consisted of: professionals referring in, people seeking services and reception staff taking first enquiries. They shared substantially the same concerns as each other. The responses from these system participants are consistent with the international literature on access and entry into health services. Conclusion Participatory service design could improve primary healthcare service entry at the local level. Canvassing the experiences of system participants is important for delivering services to those who have the least access and, in that way, could contribute to health equity. What is known about the topic? People with the highest health needs receive the fewest services. Health inequality is increasing. What does this paper add? System participants can provide advice consistent with the academic research literature that is useful for improving service entry at the local level. What are the implications for practitioners? Participatory design can inform policy makers and service providers. Entry systems could acknowledge the potential vulnerability or disadvantage of people approaching the service.

Migrating To The Cloud: Preparing The USMC CDET For MCEITS

DTIC Science & Technology

2016-03-01

Service SAAR System Authorization Access Request SaaS Software as a... Service (IaaS), Platform as a Service (PaaS), Software as a Service ( SaaS ), and Data as a Service (DaaS) (Takai, 2012). A closer examination of each...8 3. Software as a Service NIST described SaaS as a model of cloud computing where the service provider offers its customers fee-based access

Challenges Women with Disability Face in Accessing and Using Maternal Healthcare Services in Ghana: A Qualitative Study.

PubMed

Ganle, John Kuumuori; Otupiri, Easmon; Obeng, Bernard; Edusie, Anthony Kwaku; Ankomah, Augustine; Adanu, Richard

2016-01-01

While a number of studies have examined the factors affecting accessibility to and utilisation of healthcare services by persons with disability in general, there is little evidence about disabled women's access to maternal health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and the challenges they face in accessing skilled maternal health services. The objective of this paper is to explore the challenges women with disabilities encounter in accessing and using institutional maternal healthcare services in Ghana. A qualitative study was conducted in 27 rural and urban communities in the Bosomtwe and Central Gonja districts of Ghana with a total of 72 purposively sampled women with different physical, visual, and hearing impairments who were either lactating or pregnant at the time of this research. Semi-structured in-depth interviews were used to gather data. Attride-Stirling's thematic network framework was used to analyse the data. Findings suggest that although women with disability do want to receive institutional maternal healthcare, their disability often made it difficult for such women to travel to access skilled care, as well as gain access to unfriendly physical health infrastructure. Other related access challenges include: healthcare providers' insensitivity and lack of knowledge about the maternity care needs of women with disability, negative attitudes of service providers, the perception from able-bodied persons that women with disability should be asexual, and health information that lacks specificity in terms of addressing the special maternity care needs of women with disability. Maternal healthcare services that are designed to address the needs of able-bodied women might lack the flexibility and responsiveness to meet the special maternity care needs of women with disability. More disability-related cultural competence and patient-centred training for healthcare providers as well as the provision of disability-friendly transport and healthcare facilities and services are needed.

'It's risky to walk in the city with syringes': understanding access to HIV/AIDS services for injecting drug users in the former Soviet Union countries of Ukraine and Kyrgyzstan

PubMed Central

2011-01-01

Background Despite massive scale up of funds from global health initiatives including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and other donors, the ambitious target agreed by G8 leaders in 2005 in Gleneagles to achieve universal access to HIV/AIDS treatment by 2010 has not been reached. Significant barriers to access remain in former Soviet Union (FSU) countries, a region now recognised as a priority area by policymakers. There have been few empirical studies of access to HIV/AIDS services in FSU countries, resulting in limited understanding and implementation of accessible HIV/AIDS interventions. This paper explores the multiple access barriers to HIV/AIDS services experienced by a key risk group-injecting drug users (IDUs). Methods Semi-structured interviews were conducted in two FSU countries-Ukraine and Kyrgyzstan-with clients receiving Global Fund-supported services (Ukraine n = 118, Kyrgyzstan n = 84), service providers (Ukraine n = 138, Kyrgyzstan n = 58) and a purposive sample of national and subnational stakeholders (Ukraine n = 135, Kyrgyzstan n = 86). Systematic thematic analysis of these qualitative data was conducted by country teams, and a comparative synthesis of findings undertaken by the authors. Results Stigmatisation of HIV/AIDS and drug use was an important barrier to IDUs accessing HIV/AIDS services in both countries. Other connected barriers included: criminalisation of drug use; discriminatory practices among government service providers; limited knowledge of HIV/AIDS, services and entitlements; shortages of commodities and human resources; and organisational, economic and geographical barriers. Conclusions Approaches to thinking about universal access frequently assume increased availability of services means increased accessibility of services. Our study demonstrates that while there is greater availability of HIV/AIDS services in Ukraine and Kyrgyzstan, this does not equate with greater accessibility because of multiple, complex, and interrelated barriers to HIV/AIDS service utilisation at the service delivery level. Factors external to, as well as within, the health sector are key to understanding the access deficit in the FSU where low or concentrated HIV/AIDS epidemics are prevalent. Funders of HIV/AIDS programmes need to consider how best to tackle key structural and systemic drivers of access including prohibitionist legislation on drugs use, limited transparency and low staff salaries within the health sector. PMID:21752236

Investigation of Service Quality of Measurement Reference Points for the Internet Services on Mobile Networks

NASA Astrophysics Data System (ADS)

Lipenbergs, E.; Bobrovs, Vj.; Ivanovs, G.

2016-10-01

To ensure that end-users and consumers have access to comprehensive, comparable and user-friendly information regarding the Internet access service quality, it is necessary to implement and regularly renew a set of legislative regulatory acts and to provide monitoring of the quality of Internet access services regarding the current European Regulatory Framework. The actual situation regarding the quality of service monitoring solutions in different European countries depends on national regulatory initiatives and public awareness. The service monitoring solutions are implemented using different measurement methodologies and tools. The paper investigates the practical implementations for developing a harmonising approach to quality monitoring in order to obtain objective information on the quality of Internet access services on mobile networks.

Organizing uninsured safety-net access to specialist physician services.

PubMed

Hall, Mark A

2013-05-01

Arranging referrals for specialist services is often the greatest difficulty that safety-net access programs face in attempting to provide fairly comprehensive services for the uninsured. When office-based community specialists are asked to care for uninsured patients, they cite the following barriers: difficulty determining which patients merit charity care, having to arrange for services patients need from other providers, and concerns about liability for providing inadequate care. Solutions to these barriers to specialist access can be found in the same institutional arrangements that support primary care and hospital services for the uninsured. These safety-net organization structures can be extended to include specialist physician care by funding community health centers to contract for specialist referrals, using free-standing referral programs to subsidize community specialists who accept uninsured patients at discounted rates, and encouraging hospitals through tax exemption or disproportionate share funding to require specialists on their medical staffs to accept an allocation of uninsured office-based referrals.

The Hawke's Bay Condom Card Scheme: a qualitative study of the views of service providers on increased, discreet access for youth to free condoms.

PubMed

Ryder, Hollie; Aspden, Trudi; Sheridan, Janie

2015-12-01

The incidence of sexually transmitted infections and unplanned pregnancies in adolescence is of concern. The Hawke's Bay District Health Board, New Zealand, set up a pilot condom card scheme ('the Scheme') to allow 13- to 24-year-olds, deemed suitable for the Scheme, to access free condoms from pharmacies on presentation of a Condom Card. Our study explored the views of service providers of a pilot Condom Card Scheme. Qualitative interviews were conducted with 17 service providers (nurses, pharmacists, pharmacy staff) between February and April 2013. Our findings showed that the Scheme was viewed positively by service providers, who indicated almost universal support for the Scheme to continue. However, participants noted a perceived lack of advertising, low number of sites for collection of condoms, lack of flexibility of the Scheme's criteria relating to who could access the scheme and issues with some pharmacy service providers, all of which led to a number of recommendations for improving the Scheme. The views of service providers indicate broad support for the continuation of the Scheme. Canvassing young people's suggestions for improving the Scheme is also essential. © 2015 Royal Pharmaceutical Society.

A multi-service data management platform for scientific oceanographic products

NASA Astrophysics Data System (ADS)

D'Anca, Alessandro; Conte, Laura; Nassisi, Paola; Palazzo, Cosimo; Lecci, Rita; Cretì, Sergio; Mancini, Marco; Nuzzo, Alessandra; Mirto, Maria; Mannarini, Gianandrea; Coppini, Giovanni; Fiore, Sandro; Aloisio, Giovanni

2017-02-01

An efficient, secure and interoperable data platform solution has been developed in the TESSA project to provide fast navigation and access to the data stored in the data archive, as well as a standard-based metadata management support. The platform mainly targets scientific users and the situational sea awareness high-level services such as the decision support systems (DSS). These datasets are accessible through the following three main components: the Data Access Service (DAS), the Metadata Service and the Complex Data Analysis Module (CDAM). The DAS allows access to data stored in the archive by providing interfaces for different protocols and services for downloading, variables selection, data subsetting or map generation. Metadata Service is the heart of the information system of the TESSA products and completes the overall infrastructure for data and metadata management. This component enables data search and discovery and addresses interoperability by exploiting widely adopted standards for geospatial data. Finally, the CDAM represents the back-end of the TESSA DSS by performing on-demand complex data analysis tasks.

GIS Services, Visualization Products, and Interoperability at the National Oceanic and Atmospheric Administration (NOAA) National Climatic Data Center (NCDC)

NASA Astrophysics Data System (ADS)

Baldwin, R.; Ansari, S.; Reid, G.; Lott, N.; Del Greco, S.

2007-12-01

The main goal in developing and deploying Geographic Information System (GIS) services at NOAA's National Climatic Data Center (NCDC) is to provide users with simple access to data archives while integrating new and informative climate products. Several systems at NCDC provide a variety of climatic data in GIS formats and/or map viewers. The Online GIS Map Services provide users with data discovery options which flow into detailed product selection maps, which may be queried using standard "region finder" tools or gazetteer (geographical dictionary search) functions. Each tabbed selection offers steps to help users progress through the systems. A series of additional base map layers or data types have been added to provide companion information. New map services include: Severe Weather Data Inventory, Local Climatological Data, Divisional Data, Global Summary of the Day, and Normals/Extremes products. THREDDS Data Server technology is utilized to provide access to gridded multidimensional datasets such as Model, Satellite and Radar. This access allows users to download data as a gridded NetCDF file, which is readable by ArcGIS. In addition, users may subset the data for a specific geographic region, time period, height range or variable prior to download. The NCDC Weather Radar Toolkit (WRT) is a client tool which accesses Weather Surveillance Radar 1988 Doppler (WSR-88D) data locally or remotely from the NCDC archive, NOAA FTP server or any URL or THREDDS Data Server. The WRT Viewer provides tools for custom data overlays, Web Map Service backgrounds, animations and basic filtering. The export of images and movies is provided in multiple formats. The WRT Data Exporter allows for data export in both vector polygon (Shapefile, Well-Known Text) and raster (GeoTIFF, ESRI Grid, VTK, NetCDF, GrADS) formats. As more users become accustom to GIS, questions of better, cheaper, faster access soon follow. Expanding use and availability can best be accomplished through standards which promote interoperability. Our GIS related products provide Open Geospatial Consortium (OGC) compliant Web Map Services (WMS), Web Feature Services (WFS), Web Coverage Services (WCS) and Federal Geographic Data Committee (FGDC) metadata as a complement to the map viewers. KML/KMZ data files (soon to be compliant OGC specifications) also provide access.

Mobile and Accessible Learning for MOOCs

ERIC Educational Resources Information Center

Sharples, Mike; Kloos, Carlos Delgado; Dimitriadis, Yannis; Garlatti, Serge; Specht, Marcus

2015-01-01

Many modern web-based systems provide a "responsive" design that allows material and services to be accessed on mobile and desktop devices, with the aim of providing "ubiquitous access." Besides offering access to learning materials such as podcasts and videos across multiple locations, mobile, wearable and ubiquitous…

47 CFR 54.615 - Obtaining services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... provided under § 54.621, that the requester cannot obtain toll-free access to an Internet service provider... thing of value; (6) If the service or services are being purchased as part of an aggregated purchase...

Using a service sector segmented approach to identify community stakeholders who can improve access to suicide prevention services for veterans.

PubMed

Matthieu, Monica M; Gardiner, Giovanina; Ziegemeier, Ellen; Buxton, Miranda

2014-04-01

Veterans in need of social services may access many different community agencies within the public and private sectors. Each of these settings has the potential to be a pipeline for attaining needed health, mental health, and benefits services; however, many service providers lack information on how to conceptualize where Veterans go for services within their local community. This article describes a conceptual framework for outreach that uses a service sector segmented approach. This framework was developed to aid recruitment of a provider-based sample of stakeholders (N = 70) for a study on improving access to the Department of Veterans Affairs and community-based suicide prevention services. Results indicate that although there are statistically significant differences in the percent of Veterans served by the different service sectors (F(9, 55) = 2.71, p = 0.04), exposure to suicidal Veterans and providers' referral behavior is consistent across the sectors. Challenges to using this framework include isolating the appropriate sectors for targeted outreach efforts. The service sector segmented approach holds promise for identifying and referring at-risk Veterans in need of services. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Limited accessibility to HIV services for persons with disabilities living with HIV in Ghana, Uganda and Zambia.

PubMed

Tun, Waimar; Okal, Jerry; Schenk, Katie; Esantsi, Selina; Mutale, Felix; Kyeremaa, Rita Kusi; Ngirabakunzi, Edson; Asiah, Hilary; McClain-Nhlapo, Charlotte; Moono, Grimond

2016-01-01

Knowledge about experiences in accessing HIV services among persons with disabilities who are living with HIV in sub-Saharan Africa is limited. Although HIV transmission among persons with disabilities in Africa is increasingly acknowledged, there is a need to bring to life the experiences and voices from persons with disabilities living with HIV to raise awareness of programme implementers and policy makers about their barriers in accessing HIV services. This paper explores how the barriers faced by persons with disabilities living with HIV impede their ability to access HIV-related services and manage their disease. We conducted focus group discussions with 76 persons (41 females; 35 males) with physical, visual and/or hearing impairments who were living with HIV in Ghana, Uganda and Zambia (2012-2013). We explored challenges and facilitators at different levels (individual, psychosocial and structural) of access to HIV services. Transcripts were analyzed using a framework analysis approach. Persons with disabilities living with HIV encountered a wide variety of challenges in accessing HIV services. Delays in testing for HIV were common, with most waiting until they were sick to be tested. Reasons for delayed testing included challenges in getting to the health facilities, lack of information about HIV and testing, and HIV- and disability-related stigma. Barriers to HIV-related services, including care and treatment, at health facilities included lack of disability-friendly educational materials and sign interpreters, stigmatizing treatment by providers and other patients, lack of skills to provide tailored services to persons with disabilities living with HIV and physically inaccessible infrastructure, all of which make it extremely difficult for persons with disabilities to initiate and adhere to HIV treatment. Accessibility challenges were greater for women than men due to gender-related roles. Challenges were similar across the three countries. Favourable experiences in accessing HIV services were reported in Uganda and Zambia, where disability-tailored services were offered by non-governmental organizations and government facilities (Uganda only). Persons with disabilities living with HIV encounter many challenges in accessing HIV testing and continued care and treatment services. Changes are needed at every level to ensure accessibility of HIV services for persons with disabilities.

Adverse or acceptable: negotiating access to a post-apartheid health care contract

PubMed Central

2014-01-01

Background As in many fragile and post-conflict countries, South Africa’s social contract has formally changed from authoritarianism to democracy, yet access to services, including health care, remains inequitable and contested. We examine access barriers to quality health services and draw on social contract theory to explore ways in which a post-apartheid health care contract is narrated, practiced and negotiated by patients and providers. We consider implications for conceptualizing and promoting more inclusive, equitable health services in a post-conflict setting. Methods Using in-depth interviews with 45 patients and 67 providers, and field observations from twelve health facilities in one rural and two urban sub-districts, we explore access narratives of those seeking and delivering – negotiating - maternal health, tuberculosis and antiretroviral services in South Africa. Results Although South Africa’s right to access to health care is constitutionally guaranteed, in practice, a post-apartheid health care contract is not automatically or unconditionally inclusive. Access barriers, including poverty, an under-resourced, hierarchical health system, the nature of illness and treatment, and negative attitudes and actions, create conditions for insecure or adverse incorporation into this contract, or even exclusion (sometimes temporary) from health care services. Such barriers are exacerbated by differences in the expectations that patients and providers have of each other and the contract, leading to differing, potentially conflicting, identities of inclusion and exclusion: defaulting versus suffering patients, uncaring versus overstretched providers. Conversely, caring, respectful communication, individual acts of kindness, and institutional flexibility and leadership may mitigate key access barriers and limit threats to the contract, fostering more positive forms of inclusion and facilitating easier access to health care. Conclusions Building health in fragile and post-conflict societies requires the negotiation of a new social contract. Surfacing and engaging with differences in patient and provider expectations of this contract may contribute to more acceptable, accessible health care services. Additionally, the health system is well positioned to highlight and connect the political economy, institutions and social relationships that create and sustain identities of exclusion and inclusion – (re)politicise suffering - and co-ordinate and lead intersectoral action for overcoming affordability and availability barriers to inclusive and equitable health care services. PMID:24885882

Women's access needs in maternity care in rural Tasmania, Australia: a mixed methods study.

PubMed

Hoang, Ha; Le, Quynh; Terry, Daniel

2014-03-01

This study investigates (i) maternity care access issues in rural Tasmania, (ii) rural women's challenges in accessing maternity services and (iii) rural women's access needs in maternity services. A mixed-method approach using a survey and semi-structured interviews was conducted. The survey explored women's views of rural maternity services from antenatal to postnatal care, while interviews reinforced the survey results and provided insights into the access issues and needs of women in maternity care. The survey was completed by n=210 women, with a response rate of 35%, with n=22 follow-up interviews being conducted. The survey indicated the majority of rural women believed antenatal education and check-ups and postnatal check-ups should be provided locally. The majority of women surveyed also believed in the importance of having a maternity unit in the local hospital, which was further iterated and clarified within the interviews. Three main themes emerged from the interview data, namely (i) lack of access to maternity services, (ii) difficulties in accessing maternity services, and (iii) rural women's access needs. The study suggested that women's access needs are not fully met in some rural areas of Tasmania. Rural women face many challenges when accessing maternity services, including financial burden and risk of labouring en route. The study supports the claim that the closure of rural maternity units shifts cost and risk from the health care system to rural women and their families. Copyright © 2013 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Improving Access To, Quality, and the Effectiveness of Digital Tutoring in K-12 Education

ERIC Educational Resources Information Center

Burch, Patricia; Good, Annalee; Heinrich, Carolyn

2016-01-01

There is considerable variation in how providers of digital education describe what they do, their services, how students access services, and what is delivered, complicating efforts to accurately assess its impact. We examine program characteristics of digital tutoring providers using rich, longitudinal observational and interview data and then…

Enhanced primary mental healthcare for Indigenous Australians: service implementation strategies and perspectives of providers.

PubMed

Reifels, Lennart; Nicholas, Angela; Fletcher, Justine; Bassilios, Bridget; King, Kylie; Ewen, Shaun; Pirkis, Jane

2018-01-01

Improving access to culturally appropriate mental healthcare has been recognised as a key strategy to address the often greater burden of mental health issues experienced by Indigenous populations. We present data from the evaluation of a national attempt at improving access to culturally appropriate mental healthcare for Indigenous Australians through a mainstream primary mental healthcare program, the Access to Allied Psychological Services program, whilst specifically focusing on the implementation strategies and perspectives of service providers. We conducted semi-structured interviews with 31 service providers (primary care agency staff, referrers, and mental health professionals) that were analysed thematically and descriptively. Agency-level implementation strategies to enhance service access and cultural appropriateness included: the conduct of local service needs assessments; Indigenous stakeholder consultation and partnership development; establishment of clinical governance frameworks; workforce recruitment, clinical/cultural training and supervision; stakeholder and referrer education; and service co-location at Indigenous health organisations. Dedicated provider-level strategies to ensure the cultural appropriateness of services were primarily aimed at the context and process of delivery (involving, flexible referral pathways, suitable locations, adaptation of client engagement and service feedback processes) and, to a lesser extent, the nature and content of interventions (provision of culturally adapted therapy). This study offers insights into key factors underpinning the successful national service implementation approach. Study findings highlight that concerted national attempts to enhance mainstream primary mental healthcare for Indigenous people are critically dependent on effective local agency- and provider-level strategies to optimise the integration, adaptation and broader utility of these services within local Indigenous community and healthcare service contexts. Despite the explicit provider focus, this study was limited by a lack of Indigenous stakeholder perspectives. Key study findings are of direct relevance to inform the future implementation and delivery of culturally appropriate primary mental healthcare programs for Indigenous populations in Australia and internationally.

42 CFR 422.112 - Access to services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... services. (a) Rules for coordinated care plans. An MA organization that offers an MA coordinated care plan may specify the networks of providers from whom enrollees may obtain services if the MA organization... Medicare enrollee, are available and accessible under the plan. To accomplish this, the MA organization...

45 CFR 98.43 - Equal access.

Code of Federal Regulations, 2012 CFR

2012-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Lead Agency and Provider Requirements § 98.43 Equal access. (a) The Lead Agency shall certify that the payment rates for the provision of child care services under this part are...

45 CFR 98.43 - Equal access.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Department of Health and Human Services GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Lead Agency and Provider Requirements § 98.43 Equal access. (a) The Lead Agency shall certify that the payment rates for the provision of child care services under this part are...

45 CFR 98.43 - Equal access.

Code of Federal Regulations, 2011 CFR

2011-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Lead Agency and Provider Requirements § 98.43 Equal access. (a) The Lead Agency shall certify that the payment rates for the provision of child care services under this part are...

45 CFR 98.43 - Equal access.

Code of Federal Regulations, 2013 CFR

2013-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Lead Agency and Provider Requirements § 98.43 Equal access. (a) The Lead Agency shall certify that the payment rates for the provision of child care services under this part are...

45 CFR 98.43 - Equal access.

Code of Federal Regulations, 2010 CFR

2010-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Lead Agency and Provider Requirements § 98.43 Equal access. (a) The Lead Agency shall certify that the payment rates for the provision of child care services under this part are...

Improving access to primary mental health care for Australian children.

PubMed

Bassilios, Bridget; Nicholas, Angela; Reifels, Lennart; King, Kylie; Spittal, Matthew J; Fletcher, Justine; Pirkis, Jane

2016-11-01

This study examines the uptake by children aged predominantly 0-11 years of an Australian primary mental health service - the Access to Allied Psychological Services programme - which began in 2001. In particular, it considers access to, and use of, the child component of Access to Allied Psychological Services, the Child Mental Health Service, introduced in 2010. Using routinely collected programme data from a national minimum dataset and regional population data, we conducted descriptive and regression analysis to examine programme uptake, predictors of service reach and consumer- and treatment-based characteristics of service. Between 2003 and 2013, 18,631 referrals for children were made and 75,178 sessions were scheduled via Access to Allied Psychological Services, over 50% of which were via the Child Mental Health Service in its first 3 years of operation. The rate of referrals for children to the Child Mental Health Service was associated with the rate of Access to Allied Psychological Services referrals for consumers aged 12+ years. The Child Mental Health Service has increased services provided within the Access to Allied Psychological Services programme for children with emotional and behavioural issues and their families, and is potentially filling a service gap in the area of prevention and early intervention for children who have significant levels of need but are unable to access other mental health services. Our findings are policy-relevant for other developed countries with a similar primary mental health care system that are considering means of improving service access by children. © The Royal Australian and New Zealand College of Psychiatrists 2016.

Land-mobile satellite communication system

NASA Technical Reports Server (NTRS)

Yan, Tsun-Yee (Inventor); Rafferty, William (Inventor); Dessouky, Khaled I. (Inventor); Wang, Charles C. (Inventor); Cheng, Unjeng (Inventor)

1993-01-01

A satellite communications system includes an orbiting communications satellite for relaying communications to and from a plurality of ground stations, and a network management center for making connections via the satellite between the ground stations in response to connection requests received via the satellite from the ground stations, the network management center being configured to provide both open-end service and closed-end service. The network management center of one embodiment is configured to provides both types of service according to a predefined channel access protocol that enables the ground stations to request the type of service desired. The channel access protocol may be configured to adaptively allocate channels to open-end service and closed-end service according to changes in the traffic pattern and include a free-access tree algorithm that coordinates collision resolution among the ground stations.

Financing mental health services for adolescents: a background paper.

PubMed

Kapphahn, Cynthia; Morreale, Madlyn; Rickert, Vaughn I; Walker, Leslie

2006-09-01

Good mental health provides an essential foundation for normal growth and development through adolescence and into adulthood. Many adolescents, however, experience mental health problems that significantly impede the attainment of their full potential. The majority of these adolescents do not receive needed mental health services, in part because of financial obstacles to care. This article reviews the magnitude and impact of mental health problems during adolescence and highlights the importance of insurance coverage in assuring access to mental health services for adolescents. Significant limitations in private health insurance coverage of mental health services are outlined. Recent federal and state efforts to move toward parity in private insurance coverage between mental and physical health services are discussed, including an explanation of the role of Medicaid and the State Children's Health Insurance Program (SCHIP) in providing access to mental health services for adolescents. Finally, other elements that would facilitate financial access to essential mental health services for adolescents are presented.

NNDC Data Services

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

Tuli, J.K.; Sonzogni,A.

The National Nuclear Data Center has provided remote access to some of its resources since 1986. The major databases and other resources available currently through NNDC Web site are summarized. The National Nuclear Data Center (NNDC) has provided remote access to the nuclear physics databases it maintains and to other resources since 1986. With considerable innovation access is now mostly through the Web. The NNDC Web pages have been modernized to provide a consistent state-of-the-art style. The improved database services and other resources available from the NNOC site at www.nndc.bnl.govwill be described.

Using Virtual Observatory Services in Sky View

NASA Technical Reports Server (NTRS)

McGlynn, Thomas A.

2007-01-01

For over a decade Skyview has provided astronomers and the public with easy access to survey and imaging data from all wavelength regimes. SkyView has pioneered many of the concepts that underlie the Virtual Observatory. Recently SkyView has been released as a distributable package which uses VO protocols to access image and catalog services. This chapter describes how to use the Skyview as a local service and how to customize it to access additional VO services and local data.

Measuring school health center impact on access to and quality of primary care.

PubMed

Gibson, Erica J; Santelli, John S; Minguez, Mara; Lord, Alyssa; Schuyler, Ashley C

2013-12-01

School health centers (SHC) that provide comprehensive health care may improve access and quality of care for students; however, published impact data are limited. We evaluated access and quality of health services at an urban high school with a SHC compared with a school without a SHC, using a quasiexperimental research design. Data were collected at the beginning of the school year, using a paper and pencil classroom questionnaire (n = 2,076 students). We measured SHC impact in several ways including grade by school interaction terms. Students at the SHC school were more likely to report having a regular healthcare provider, awareness of confidential services, support for health services in their school, and willingness to utilize those services. Students in the SHC school reported higher quality of care as measured by: respect for their health concerns, adequate time with the healthcare provider, understandable provider communications, and greater provider discussion at their last visit on topics such as sexual activity, birth control, emotions, future plans, diet, and exercise. Users of the SHC were also more likely to report higher quality of care, compared with either nonusers or students in the comparison school. Access to comprehensive health services via a SHC led to improved access to health care and improved quality of care. Impact was measureable on a school-wide basis but was greater among SHC users. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Inequities in access to HIV prevention services for transgender men: results of a global survey of men who have sex with men.

PubMed

Scheim, Ayden I; Santos, Glenn-Milo; Arreola, Sonya; Makofane, Keletso; Do, Tri D; Hebert, Patrick; Thomann, Matthew; Ayala, George

2016-01-01

Free or low-cost HIV testing, condoms, and lubricants are foundational HIV prevention strategies, yet are often inaccessible for men who have sex with men (MSM). In the global context of stigma and poor healthcare access, transgender (trans) MSM may face additional barriers to HIV prevention services. Drawing on data from a global survey of MSM, we aimed to describe perceived access to prevention services among trans MSM, examine associations between stigma and access, and compare access between trans MSM and cisgender (non-transgender) MSM. The 2014 Global Men's Health and Rights online survey was open to MSM (inclusive of trans MSM) from any country and available in seven languages. Baseline data (n=3857) were collected from July to October 2014. Among trans MSM, correlations were calculated between perceived service accessibility and anti-transgender violence, healthcare provider stigma, and discrimination. Using a nested matched-pair study design, trans MSM were matched 4:1 to cisgender MSM on age group, region, and HIV status, and conditional logistic regression models compared perceived access to prevention services by transgender status. About 3.4% of respondents were trans men, of whom 69 were included in the present analysis. The average trans MSM participant was 26 to 35 years old (56.5%); lived in western Europe, North America, or Oceania (75.4%); and reported being HIV-negative (98.6%). HIV testing, condoms, and lubricants were accessible for 43.5, 53.6, and 26.1% of trans MSM, respectively. Ever having been arrested or convicted due to being trans and higher exposure to healthcare provider stigma in the past six months were associated with less access to some prevention services. Compared to matched cisgender controls, trans MSM reported significantly lower odds of perceived access to HIV testing (OR=0.57, 95% CI=0.33, 0.98) and condom-compatible lubricants (OR=0.54, 95% CI=0.30, 0.98). This first look at access to HIV prevention services for trans MSM globally found that most reported inadequate access to basic prevention services and that they were less likely than cisgender MSM to have access to HIV testing and lubricants. Results indicate the need to enhance access to basic HIV prevention services for trans MSM, including MSM-specific services.

A national survey of UK health libraries investigating the cost of interlibrary loan services and assessing the accessibility to key orthopaedic journals.

PubMed

Tahim, Arpan; Stokes, Oliver; Vedi, Vikas

2012-06-01

 NHS Library Services are utilised by NHS staff and junior trainees to locate scientific papers that provide them with the evidence base required for modern medical practice. The cost of accessing articles can be considerable particularly for junior trainees.  This survey looks at variations in cost of journal article loans and investigates access to particular orthopaedic journals across the country.  A national survey of UK Health Libraries was performed. Access to and costs of journals and interlibrary loan services were assessed. Availability of five wide-reaching orthopaedic journals was investigated.  Seven hundred and ten libraries were identified. One hundred and ten libraries completed the questionnaire (16.7%). Of these, 96.2% reported free access to scientific journals for users. 99.1% of libraries used interlibrary loan services with 38.2% passing costs on to the user at an average of £2.99 per article. 72.7% of libraries supported orthopaedic services. Journal of Bone and Joint Surgery (British) had greatest onsite availability.  The study demonstrates fluctuations in cost of access to interlibrary loan services and variation in access to important orthopaedic journals. It provides a reflection of current policy of charging for the acquisition of medical evidence by libraries in the UK. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

Early Experiences with Mobile Electronic Health Records Application in a Tertiary Hospital in Korea

PubMed Central

Park, Minah; Hong, Eunseok; Kim, Sunhyu; Ahn, Ryeok; Hong, Jungseok; Song, Seungyeol; Kim, Tak; Kim, Jeongkeun; Yeo, Seongwoon

2015-01-01

Objectives Recent advances in mobile technology have opened up possibilities to provide strongly integrated mobile-based services in healthcare and telemedicine. Although the number of mobile Electronic Health Record (EHR) applications is large and growing, there is a paucity of evidence demonstrating the usage patterns of these mobile applications by healthcare providers. This study aimed to illustrate the deployment process for an integrated mobile EHR application and to analyze usage patterns after provision of the mobile EHR service. Methods We developed an integrated mobile application that aimed to enhance the mobility of healthcare providers by improving access to patient- and hospital-related information during their daily medical activities. The study included mobile EHR users who accessed patient healthcare records between May 2013 and May 2014. We performed a data analysis using a web server log file analyzer from the integrated EHR system. Cluster analysis was applied to longitudinal user data based on their application usage pattern. Results The mobile EHR service named M-UMIS has been in service since May 2013. Every healthcare provider in the hospital could access the mobile EHR service and view the medical charts of their patients. The frequency of using services and network packet transmission on the M-UMIS increased gradually during the study period. The most frequently accessed service in the menu was the patient list. Conclusions A better understanding regarding the adoption of mobile EHR applications by healthcare providers in patient-centered care provides useful information to guide the design and implementation of future applications. PMID:26618036

Enhancing UCSF Chimera through web services.

PubMed

Huang, Conrad C; Meng, Elaine C; Morris, John H; Pettersen, Eric F; Ferrin, Thomas E

2014-07-01

Integrating access to web services with desktop applications allows for an expanded set of application features, including performing computationally intensive tasks and convenient searches of databases. We describe how we have enhanced UCSF Chimera (http://www.rbvi.ucsf.edu/chimera/), a program for the interactive visualization and analysis of molecular structures and related data, through the addition of several web services (http://www.rbvi.ucsf.edu/chimera/docs/webservices.html). By streamlining access to web services, including the entire job submission, monitoring and retrieval process, Chimera makes it simpler for users to focus on their science projects rather than data manipulation. Chimera uses Opal, a toolkit for wrapping scientific applications as web services, to provide scalable and transparent access to several popular software packages. We illustrate Chimera's use of web services with an example workflow that interleaves use of these services with interactive manipulation of molecular sequences and structures, and we provide an example Python program to demonstrate how easily Opal-based web services can be accessed from within an application. Web server availability: http://webservices.rbvi.ucsf.edu/opal2/dashboard?command=serviceList. © The Author(s) 2014. Published by Oxford University Press on behalf of Nucleic Acids Research.

Changes in perceptions of quality of, and access to, services among clients of a fractional franchise network in Nepal.

PubMed

Agha, Sohail; Gage, Anastasia; Balal, Asma

2007-05-01

With declining levels of international donor funding for financing reproductive health programmes, developing country governments and international donors are looking towards private sector strategies to expand the supply of quality reproductive health services. One of the challenges of a health franchise is to improve the quality of services provided by independent private practitioners. Private providers are more likely to abide by the quality standards set by a franchiser if they see a financial benefit resulting from franchise participation. This study was conducted to measure whether (a) there were improvements in perceived quality of care and perceived access to health facilities once these facilities became part of a franchise and (b) improvements in perceived quality and perceived access were associated with increased client loyalty to franchised clinics. Franchisees were given basic reproductive health training for seven days and services marketing training for two days. Exit interviews were conducted with male and female clients at health facilities. A pre-test measurement was taken in April 2001, prior to the start of project activities. A post-test measurement was taken in February/March 2002, about 9 months after the pre-test. Multilevel regression analysis, which takes the hierarchical structure of the data into account, was used for the analysis. After taking provider-level variation into account and controlling for client characteristics, the analyses showed significant improvements in perceived quality of care and perceived access to services. Private provider participation in a franchise network helps improve client perceptions of quality of, and access to, services. Improvements in client perceptions of quality and access contribute to increased client loyalty to franchised clinics. Once increased client loyalty translates into higher client volumes, providers are likely to see the benefits of franchise participation. In turn, this should lead to increased provider willingness to remain part of the franchise and to abide by the standards of quality set by the franchiser.

Provider and service-user perspectives of volunteer health-worker service provision in Ayeyarwady Region, Myanmar: a qualitative study.

PubMed

Watt, Nicola; Yupar, Aye; Sender, Paul; Campbell, Fiona; Legido-Quigley, Helena; Howard, Natasha

2016-12-09

To explore perspectives and reported experiences of service users, community providers and policymakers related to volunteer health-worker services provision in a rural area of Myanmar. A qualitative interview study was conducted in rural communities with 54 service users and 17 community providers in Ayeyarwady Region, Myanmar, and with 14 national managers and policymakers in Yangon Myanmar. Topics included reasons for seeking health services, views and experiences, and comparison with experiences of other services. Data were analysed thematically using deductive and inductive coding. Accessibility and affordability were important to all participants. Service users described the particular relevance of trust, familiarity and acceptability in choosing a provider. Perceived quality and effectiveness were necessary for trust to develop. Perceived value of volunteers was a cross-cutting dimension, which was interpreted differently by different participants. Results suggest that volunteers are appropriate and valued, and support 'availability', 'accessibility' and 'acceptability' as dimensions of health services access in this setting. However, social complexities should be considered to ensure effective service delivery. Further research into trust-building, developing quality perceptions and resulting service-user choices would be useful to inform effective policy and planning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

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

PubMed

Boissonnault, William G; Lovely, Karen

2016-11-01

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

Reaching the unreachable: barriers of the poorest to accessing NGO healthcare services in Bangladesh.

PubMed

Ahmed, Nizam U; Alam, Mohammed M; Sultana, Fadia; Sayeed, Shahana N; Pressman, Aliza M; Powers, Mary Beth

2006-12-01

The NGO Service Delivery Program (NSDP), a USAID-funded programme, is the largest NGO programme in Bangladesh. Its strategic flagship activity is the essential services package through which healthcare services are administered by NGOs in Bangladesh. The overall goal of the NSDP is to increase access to essential healthcare services by communities, especially the poor. Recognizing that the poorest in the community often have no access to essential healthcare services due to various barriers, a study was conducted to identify what the real barriers to access by the poor are. This included investigations to further understand the perceptions of the poor of real or imagined barriers to accessing healthcare; ways for healthcare centres to maximize services to the poor; how healthcare providers can maximize service-use; inter-personal communication between healthcare providers and those seeking healthcare among the poor; and ways to improve the capacity of service providers to reach the poorest segment of the community. The study, carried out in two phases, included 24 static and satellite clinics within the catchment areas of eight NGOs under the NSDP in Bangladesh, during June-September 2003. Participatory urban and rural appraisal techniques, focus-group discussions, and in-depth interviews were employed as research methods in the study. The target populations in the study included males and females, service-users and non-users, and special groups, such as fishermen, sex workers, potters, Bedes (river gypsies), and lower-caste people-all combined representing a heterogeneous community. The following four major categories of barriers emerged as roadblocks to accessing quality healthcare for the poor: (a) low income to be able to afford healthcare, (b) lack of awareness of the kind of healthcare services available, (c) deficiencies and inconsistencies in the quality of services, and (d) lack of close proximity to the healthcare facility. Those interviewed perceived their access problems to be: (a) a limited range of NGO services available as they felt what are available do not meet their demands; (b) a high service-charge for the healthcare services they sought; (c) higher prices of drugs at the facility compared to the market place; (d) a belief that the NGO clinics are primarily to serve the rich people, (e) lack of experienced doctors at the centres; and (f) the perception that the facility and its services were more oriented to women and children, but not to males. Others responded that they should be allowed to get treatment with credit and, if needed, payment should be waived for some due to their poverty level. While the results of the study revealed many perceptions of barriers to healthcare services by the poor, the feedback provided by the study indicates how important it is to learn from the poorest segment of society. This will assist healthcare providers and the healthcare system itself to become more sensitized to the needs and problems faced by this segment of the society and to make recommendations to remove barriers and improvement of access. Treatment with credit and waived payment for the poorest were also recommended as affordable alternative private healthcare services for the poor.

An Introduction to Services Accessible on the Internet.

ERIC Educational Resources Information Center

Giguere, Marlene

1992-01-01

Provides an overview of the INTERNET and INTERNET services of interest to libraries, including electronic mail, bulletin boards, electronic publishing, online public access catalogs and databases, and downloaded texts and software. (16 references) (MES)

Essays on the Impacts of Geography and Institutions on Access to Energy and Public Infrastructure Services

NASA Astrophysics Data System (ADS)

Archibong, Belinda

While previous literature has emphasized the importance of energy and public infrastructure services for economic development, questions surrounding the implications of unequal spatial distribution in access to these resources remain, particularly in the developing country context. This dissertation provides evidence on the nature, origins and implications of this distribution uniting three strands of research from the development and political economy, regional science and energy economics fields. The dissertation unites three papers on the nature of spatial inequality of access to energy and infrastructure with further implications for conflict risk , the historical institutional and biogeographical determinants of current distribution of access to energy and public infrastructure services and the response of households to fuel price changes over time. Chapter 2 uses a novel survey dataset to provide evidence for spatial clustering of public infrastructure non-functionality at schools by geopolitical zone in Nigeria with further implications for armed conflict risk in the region. Chapter 3 investigates the drivers of the results in chapter 2, exploiting variation in the spatial distribution of precolonial institutions and geography in the region, to provide evidence for the long-term impacts of these factors on current heterogeneity of access to public services. Chapter 4 addresses the policy implications of energy access, providing the first multi-year evidence on firewood demand elasticities in India, using the spatial variation in prices for estimation.

"On the Sidelines": Access to Autism-Related Services in the West Bank

ERIC Educational Resources Information Center

Dababnah, Sarah; Bulson, Kathleen

2015-01-01

We examined access to autism-related services among Palestinians (N = 24) raising children with autism spectrum disorder (ASD) in the West Bank. Using qualitative methods, we identified five primary interview themes. Poor screening, diagnostic, and psychoeducational practices were prevalent, as parents reported service providers minimized parental…

47 CFR 64.402 - Policies and procedures for the provision of priority access service by commercial mobile radio...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 3 2011-10-01 2011-10-01 false Policies and procedures for the provision of... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) MISCELLANEOUS... National Security and Emergency Preparedness personnel shall provide priority access service in accordance...

Public and Private Adoption: A Comparison of Service and Accessibility.

ERIC Educational Resources Information Center

Daly, Kerry J.; Sobol, Michael P.

1994-01-01

Used data from national survey of public and private adoption service providers in Canada to examine similarities and differences with respect to clients served, issues associated with adoption accessibility, and nature of postadoption services. Found high degree of homogeneity that cut across public and private division, with typical adoptive…

Improving the Accessibility and Efficiency of Point-of-Care Diagnostics Services in Low- and Middle-Income Countries: Lean and Agile Supply Chain Management.

PubMed

Kuupiel, Desmond; Bawontuo, Vitalis; Mashamba-Thompson, Tivani P

2017-11-29

Access to point-of-care (POC) diagnostics services is essential for ensuring rapid disease diagnosis, management, control, and surveillance. POC testing services can improve access to healthcare especially where healthcare infrastructure is weak and access to quality and timely medical care is a challenge. Improving the accessibility and efficiency of POC diagnostics services, particularly in resource-limited settings, may be a promising route to improving healthcare outcomes. In this review, the accessibility of POC testing is defined as the distance/proximity to the nearest healthcare facility for POC diagnostics service. This review provides an overview of the impact of POC diagnostics on healthcare outcomes in low- and middle-income countries (LMICs) and factors contributing to the accessibility of POC testing services in LMICs, focusing on characteristics of the supply chain management and quality systems management, characteristics of the geographical location, health infrastructure, and an enabling policy framework for POC diagnostics services. Barriers and challenges related to the accessibility of POC diagnostics in LMICs were also discussed. Bearing in mind the reported barriers and challenges as well as the disease epidemiology in LMICs, we propose a lean and agile supply chain management framework for improving the accessibility and efficiency of POC diagnostics services in these settings.

Improving the Accessibility and Efficiency of Point-of-Care Diagnostics Services in Low- and Middle-Income Countries: Lean and Agile Supply Chain Management

PubMed Central

Kuupiel, Desmond; Bawontuo, Vitalis

2017-01-01

Access to point-of-care (POC) diagnostics services is essential for ensuring rapid disease diagnosis, management, control, and surveillance. POC testing services can improve access to healthcare especially where healthcare infrastructure is weak and access to quality and timely medical care is a challenge. Improving the accessibility and efficiency of POC diagnostics services, particularly in resource-limited settings, may be a promising route to improving healthcare outcomes. In this review, the accessibility of POC testing is defined as the distance/proximity to the nearest healthcare facility for POC diagnostics service. This review provides an overview of the impact of POC diagnostics on healthcare outcomes in low- and middle-income countries (LMICs) and factors contributing to the accessibility of POC testing services in LMICs, focusing on characteristics of the supply chain management and quality systems management, characteristics of the geographical location, health infrastructure, and an enabling policy framework for POC diagnostics services. Barriers and challenges related to the accessibility of POC diagnostics in LMICs were also discussed. Bearing in mind the reported barriers and challenges as well as the disease epidemiology in LMICs, we propose a lean and agile supply chain management framework for improving the accessibility and efficiency of POC diagnostics services in these settings. PMID:29186013

GSFC network operations with Tracking and Data Relay Satellites

NASA Astrophysics Data System (ADS)

Spearing, R.; Perreten, D. E.

The Tracking and Data Relay Satellite System (TDRSS) Network (TN) has been developed to provide services to all NASA User spacecraft in near-earth orbits. Three inter-relating entities will provide these services. The TN has been transformed from a network continuously changing to meet User specific requirements to a network which is flexible to meet future needs without significant changes in operational concepts. Attention is given to the evolution of the TN network, the TN capabilities-space segment, forward link services, tracking services, return link services, the three basic capabilities, single access services, multiple access services, simulation services, the White Sands Ground Terminal, the NASA communications network, and the network control center.

GSFC network operations with Tracking and Data Relay Satellites

NASA Technical Reports Server (NTRS)

Spearing, R.; Perreten, D. E.

1984-01-01

The Tracking and Data Relay Satellite System (TDRSS) Network (TN) has been developed to provide services to all NASA User spacecraft in near-earth orbits. Three inter-relating entities will provide these services. The TN has been transformed from a network continuously changing to meet User specific requirements to a network which is flexible to meet future needs without significant changes in operational concepts. Attention is given to the evolution of the TN network, the TN capabilities-space segment, forward link services, tracking services, return link services, the three basic capabilities, single access services, multiple access services, simulation services, the White Sands Ground Terminal, the NASA communications network, and the network control center.

A systematic analysis of the needs of people with HIV in Australia: stakeholder views of the key elements for a healthy life.

PubMed

Dodson, Sarity; Batterham, Roy; McDonald, Karalyn; Elliott, Julian H; Osborne, Richard H

2016-07-04

Background: The HealthMap project is developing an intervention to reduce cardiovascular risk in people living with HIV. As part of the formative stages of the intervention design, we sought to understand the needs of people with HIV (PWHIV). Methods: Two concept-mapping workshops with PWHIV (n=10), and one with HIV care providers (n=6) were conducted. The workshop findings were consolidated into a questionnaire administered to PWHIV (n=300) and HIV care providers (n=107). Participants were asked to rate the importance of each of 81 presented needs and the degree to which it was currently being met. Results: Workshops provided insights into what PWHIV perceive they need, to live with and manage their condition, and its impact on their life; these included: (1) clinical science research and development; (2) information and support; (3) personal situation; (4) healthcare quality; (5) access to services; (6) access to services specific to ageing; and (7) social justice. Questionnaire results revealed that PWHIV considered information and support, and research and development most important. For providers, healthcare quality, clients' personal situation, and social justice were most important. In terms of unmet needs, PWHIV and providers both highlighted issues in the areas of social justice, and access to aged care services. Conclusions: PWHIV and HIV providers continue to report unmet needs in the areas of social justice and emerging concerns about access to aged care services. Services must continue to address these issues of access and equity.

No longer 'flying blind': how access has changed emergency mental health care in rural and remote emergency departments, a qualitative study.

PubMed

Saurman, Emily; Kirby, Sue E; Lyle, David

2015-04-14

Mental health presentations are considered to be a difficult aspect of emergency care. Although emergency department (ED) staff is qualified to provide emergency mental health care, for some, such presentations pose a challenge to their training, confidence, and time. Providing access to relevant and responsive specialist mental health care can influence care and management for these patients. The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) is a telepsychiatry program that was established to improve access to specialist emergency mental health care across rural and remote western NSW, Australia. This study uses interviews with ED providers to understand their experience of managing emergency mental health patients and their use of MHEC-RAP. The lens of access was applied to assess program impact and inform continuing program development. With MHEC-RAP, these ED providers are no longer 'flying blind'. They are also more confident to manage and care for emergency mental health patients locally. For these providers, access to specialists who are able to conduct assessments and provide relevant and responsive advice for emergency mental health presentations was valued. Assessing the fit between the consumer and service as a requirement for the development, evaluation, and ongoing management of the service should result in decisions about design and delivery that achieve improved access to care and meet the needs of their consumers. The experience of these providers prior to MHEC-RAP is consistent with that reported in other rural and remote populations suggesting that MHEC-RAP could address limitations in access to specialist care and change the provision of emergency mental health care elsewhere. MHEC-RAP has not only provided access to specialist mental health care for local ED providers, but it has changed their practice and perspective. MHEC-RAP could be adapted for implementation elsewhere. Provider experience confirms that the program is accessible and offers insights to those considering how to establish an emergency telepyschiatry service in other settings.

Availability of school health services for young children.

PubMed

Heneghan, A M; Malakoff, M E

1997-10-01

A survey to assess availability of school health services was distributed to 221 directors of Schools of the 21st Century, an educational model that provides integrated services to children and families. Of this distribution, 126 (57%) surveys were returned; 88% of respondents reported they provided some type of school health services for their students; 75% of schools had access to school nursing services, yet only 33% had a school nurse on-site; 50% had less than daily access to a school nurse. Despite a high reported prevalence of physical and mental health problems, other services such as acute care, nutrition counseling, dental screenings, or mental health services were provided less frequently. Barriers perceived as problematic for schools providing health services included inadequate funding, limited parental awareness, and opposition by school or community members. Respondents believed transportation, limited financial resources, and inadequate health insurance were barriers to care for children and families. Among this sample of schools, school health services varied in availability and comprehensiveness. Educators, health providers, and parents must work together to provide improved school health services for children.

Differences in Experiences of Discrimination in Accessing Social Services Among Transgender/Gender Nonconforming Individuals by (Dis)Ability.

PubMed

Kattari, Shanna K; Walls, N Eugene; Speer, Stephanie Rachel

2017-01-01

Transgender and gender nonconforming (GNC) individuals frequently experience discrimination and potentially a lack of respect from service providers, suggesting they have decreased access to professionals with cultural competency. Similarly, people with disabilities experience higher levels of discrimination in social services than their nondisabled counterparts. From an intersectional perspective, this study examines rates of discrimination in accessing social services faced by transgender and GNC people, comparing across ability. Data indicate that although transgender and GNC individuals of all abilities experience gender-based discrimination when accessing social services, those with disabilities experience higher levels of antitransgender discrimination in mental health centers, rape crisis centers, and domestic violence shelters.

Unifying Access to National Hydrologic Data Repositories via Web Services

NASA Astrophysics Data System (ADS)

Valentine, D. W.; Jennings, B.; Zaslavsky, I.; Maidment, D. R.

2006-12-01

The CUAHSI hydrologic information system (HIS) is designed to be a live, multiscale web portal system for accessing, querying, visualizing, and publishing distributed hydrologic observation data and models for any location or region in the United States. The HIS design follows the principles of open service oriented architecture, i.e. system components are represented as web services with well defined standard service APIs. WaterOneFlow web services are the main component of the design. The currently available services have been completely re-written compared to the previous version, and provide programmatic access to USGS NWIS. (steam flow, groundwater and water quality repositories), DAYMET daily observations, NASA MODIS, and Unidata NAM streams, with several additional web service wrappers being added (EPA STORET, NCDC and others.). Different repositories of hydrologic data use different vocabularies, and support different types of query access. Resolving semantic and structural heterogeneities across different hydrologic observation archives and distilling a generic set of service signatures is one of the main scalability challenges in this project, and a requirement in our web service design. To accomplish the uniformity of the web services API, data repositories are modeled following the CUAHSI Observation Data Model. The web service responses are document-based, and use an XML schema to express the semantics in a standard format. Access to station metadata is provided via web service methods, GetSites, GetSiteInfo and GetVariableInfo. The methdods form the foundation of CUAHSI HIS discovery interface and may execute over locally-stored metadata or request the information from remote repositories directly. Observation values are retrieved via a generic GetValues method which is executed against national data repositories. The service is implemented in ASP.Net, and other providers are implementing WaterOneFlow services in java. Reference implementation of WaterOneFlow web services is available. More information about the ongoing development of CUAHSI HIS is available from http://www.cuahsi.org/his/.

Characteristics of clients who access mobile compared to clinic HIV counselling and testing services: a matched study from Cape Town, South Africa.

PubMed

Meehan, Sue-Ann; Naidoo, Pren; Claassens, Mareli M; Lombard, Carl; Beyers, Nulda

2014-12-20

Studies within sub-Saharan African countries have shown that mobile services increase uptake of HIV counselling and testing (HCT) services when compared to clinics and are able to access different populations, but these have included provider-initiated HCT in clinics. This study aimed to compare the characteristics of clients who self-initiated HCT at either a mobile or a clinic service in terms of demographic and socio-economic variables, also comparing reasons for accessing a particular health service provider. This study took place in eight areas around Cape Town. A matched design was used with one mobile HCT service matched with one or more clinics (offering routine HCT services) within each of the eight areas. Adult clients who self-referred for an HIV test within a specified time period at either a mobile or clinic service were invited to participate in the study. Data were collected between February and April 2011 using a questionnaire. Summary statistics were calculated for each service type within a matched pair and differences of outcomes from pairs were used to calculate effect sizes and 95% confidence intervals. 1063 participants enrolled in the study with 511 from mobile and 552 from clinic HCT services. The proportion of males accessing mobile HCT significantly exceeded that of clinic HCT (p < 0.001). The mean age of participants attending mobile HCT was higher than clinic participants (p = 0.023). No significant difference was found for socio-economic variables between participants, with the exception of access to own piped water (p = 0.029). Participants who accessed mobile HCT were significantly more likely to report that they were just passing, deemed an "opportunistic" visit (p = 0.014). Participants who accessed clinics were significantly more likely to report the service being close to home or work (p = 0.035). An HCT strategy incorporating a mobile HCT service, has a definite role to play in reaching those population groups who do not typically access HCT services at a clinic, especially males and those who take advantage of the opportunity to test. Mobile HCT services can complement clinic services.

Index of Access: a new innovative and dynamic tool for rural health service and workforce planning.

PubMed

McGrail, Matthew R; Russell, Deborah J; Humphreys, John S

2017-10-01

Objective Improving access to primary health care (PHC) remains a key issue for rural residents and health service planners. This study aims to show that how access to PHC services is measured has important implications for rural health service and workforce planning. Methods A more sophisticated tool to measure access to PHC services is proposed, which can help health service planners overcome the shortcomings of existing measures and long-standing access barriers to PHC. Critically, the proposed Index of Access captures key components of access and uses a floating catchment approach to better define service areas and population accessibility levels. Moreover, as demonstrated through a case study, the Index of Access enables modelling of the effects of workforce supply variations. Results Hypothetical increases in supply are modelled for a range of regional centres, medium and small rural towns, with resulting changes of access scores valuable to informing health service and workforce planning decisions. Conclusions The availability and application of a specific 'fit-for-purpose' access measure enables a more accurate empirical basis for service planning and allocation of health resources. This measure has great potential for improved identification of PHC access inequities and guiding redistribution of PHC services to correct such inequities. What is known about the topic? Resource allocation and health service planning decisions for rural and remote health settings are currently based on either simple measures of access (e.g. provider-to-population ratios) or proxy measures of access (e.g. standard geographical classifications). Both approaches have substantial limitations for informing rural health service planning and decision making. What does this paper add? The adoption of a new improved tool to measure access to PHC services, the Index of Access, is proposed to assist health service and workforce planning. Its usefulness for health service planning is demonstrated using a case study to hypothetically model changes in rural PHC workforce supply. What are the implications for practitioners? The Index of Access has significant potential for identifying how rural and remote primary health care access inequities can be addressed. This critically important information can assist health service planners, for example those working in primary health networks, to determine where and how much redistribution of PHC services is needed to correct existing inequities.

Cultural barriers in access to healthcare services for people with disability in Iran: A qualitative study.

PubMed

Soltani, Shahin; Takian, Amirhossein; Akbari Sari, Ali; Majdzadeh, Reza; Kamali, Mohammad

2017-01-01

Background: People with disability experience various problems to access to healthcare services. This study aimed to identify cultural barriers in access to healthcare services for people with disability in Iran. Methods: We conducted a qualitative study using content analysis to identify the cultural barriers. We used semi-structured interviews to collect data. Participants were selected through purposeful sampling with maximum variation. 50 individual interviews were conducted with three groups of people with disability, healthcare services providers and policy makers, September to May 2015, at different locations in Tehran, Iran. Results: We identified a number of different cultural barriers in access to health services for people with disability in Iran. These related to health service providers, namely reluctance to provide health services and disrespect; related to People with disability, namely denial of disability, disproportionate expectation, shame and insufficient sociocultural supports; and related to policy makers, namely lack of concern, little attention to the culture of disability and discrimination. We categorized misconception as a barrier that was observed at all levels of the society. Conclusion: Disability is a reality that some human being may experience and live with it. The negative attitude towards people with disability has a close relationship with the cultural norms of a society. The culture of disability in different dimensions should be a priority for all policy makers. Removing cultural barriers in access to healthcare for people with a disability needs collective efforts and collaborations among all stakeholders.

Logical optical line terminal technologies towards flexible and highly reliable metro- and access-integrated networks

NASA Astrophysics Data System (ADS)

Okamoto, Satoru; Sato, Takehiro; Yamanaka, Naoaki

2017-01-01

In this paper, flexible and highly reliable metro and access integrated networks with network virtualization and software defined networking technologies will be presented. Logical optical line terminal (L-OLT) technologies and active optical distribution networks (ODNs) are the key to introduce flexibility and high reliability into the metro and access integrated networks. In the Elastic Lambda Aggregation Network (EλAN) project which was started in 2012, a concept of the programmable optical line terminal (P-OLT) has been proposed. A role of the P-OLT is providing multiple network services that have different protocols and quality of service requirements by single OLT box. Accommodated services will be Internet access, mobile front-haul/back-haul, data-center access, and leased line. L-OLTs are configured within the P-OLT box to support the functions required for each network service. Multiple P-OLTs and programmable optical network units (P-ONUs) are connected by the active ODN. Optical access paths which have flexible capacity are set on the ODN to provide network services from L-OLT to logical ONUs (L-ONUs). The L-OLT to L-ONU path on the active ODN provides a logical connection. Therefore, introducing virtualization technologies becomes possible. One example is moving an L-OLT from one P-OLT to another P-OLT like a virtual machine. This movement is called L-OLT migration. The L-OLT migration provides flexible and reliable network functions such as energy saving by aggregating L-OLTs to a limited number of P-OLTs, and network wide optical access path restoration. Other L-OLT virtualization technologies and experimental results will be also discussed in the paper.

Equity in access to maternal and child health services in five developing countries: what works.

PubMed

Talukder, M D Noorunnabi; Rob, Ubaidur

2010-01-01

People living in rural areas are yet to have equitable access to maternal and child health services in many developing countries. This article examines selected health service delivery models that improved access to services in five developing countries. The article is based on the review of background papers on Bangladesh, Pakistan, Cambodia, Ghana, and Tanzania, prepared as part of a multi-country study on health systems and maternal and child health. Findings suggest that equity in access to health services largely depends on a system that ensures a combination of facility-based service delivery and outreach services with a functioning referral network. A key factor is the availability of health workforce at the community level. Community-based deployment of service providers or recruitment and training of community health workers is critical in enhancing service coverage and linking local populations to a health facility. Incentive is necessary to keep community health workers' interest in providing services. However, health workforce alone cannot ensure good health outcomes. They must be embedded in a functioning service delivery network to transform structural inputs into outcomes. Moreover, local-level health systems should have the ability to allocate resources in strategic ways addressing the pressing health needs of the people.

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

PubMed

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

2017-01-18

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

Partisan Activism and Access to Welfare in Lebanon

PubMed Central

2014-01-01

How do welfare regimes function when state institutions are weak and ethnic or sectarian groups control access to basic services? This paper explores how people gain access to basic services in Lebanon, where sectarian political parties from all major religious communities are key providers of social assistance and services. Based on analyses of an original national survey (n= 1,911) as well as in-depth interviews with providers and other elites (n= 175) and beneficiaries of social programs (n= 135), I make two main empirical claims in the paper. First, political activism and a demonstrated commitment to a party are associated with access to social assistance; and second, higher levels of political activism may facilitate access to higher levels or quantities of aid, including food baskets and financial assistance for medical and educational costs. These arguments highlight how politics can mediate access to social assistance in direct ways and add new dimensions to scholarly debates about clientelism by focusing on contexts with politicized religious identities and by problematizing the actual goods and services exchanged. PMID:24904187

Utilization of mobile phones for accessing menstrual regulation services among low-income women in Bangladesh: a qualitative analysis.

PubMed

Messinger, Chelsea Jordan; Mahmud, Ilias; Kanan, Sushama; Jahangir, Yamin Tauseef; Sarker, Malabika; Rashid, Sabina Faiz

2017-01-14

As many as one-third of all pregnancies in Bangladesh are unplanned, with nearly one-half of these pregnancies ending in either menstrual regulation (MR) or illegal clandestine abortion. Although MR is provided free of charge, or at a nominal cost, through the public sector and various non-profits organizations, many women face barriers in accessing safe, affordable MR and post-MR care. Mobile health (mHealth) services present a promising platform for increasing access to MR among low-income women at risk for clandestine abortion. We sought to investigate the knowledge, attitudes and practices regarding mHealth of both MR clients and formal and informal sexual and reproductive healthcare providers in urban and rural low-income settlements in Bangladesh. A total of 58 interviews were conducted with MR clients, formal MR providers, and informal MR providers in four low-income settlements in the Dhaka and Sylhet districts of Bangladesh. Interview data was coded and qualitatively analysed for themes using standard qualitative research practices. Our findings suggest that low-income MR clients in Bangladesh have an inadequate understanding of how to use their mobile phones to obtain health service information or counselling related to MR, and correspondingly low levels of formal or informal mHealth service utilization. Few were aware of any formal mHealth services in place in their communities, despite the fact that providers stated that hotlines were available. Overall, MR clients expressed positive opinions of mHealth services as a means of improving women's access to affordable and timely MR. Formal and informal MR providers believed that mobile phones had benefits with respect to information dissemination and making appointments, but emphasized the necessity of in-person consultations for effective sexual and reproductive healthcare. We report low utilization yet high acceptability of mHealth services among low-income MR clients in Bangladesh. Expanding formal and informal mHealth services targeted towards MR - and increasing publicity of these services in low-income communities - may help increase timely access to accurate MR information and formal providers among women at risk for clandestine abortion. While expanding formal and informal mHealth services for SRHR in Bangladesh may be useful in disseminating information about MR and connecting women with formal providers, in-person visits remain necessary for adequate treatment.

12 CFR 7.5004 - Sale of excess electronic capacity and by-products.

Code of Federal Regulations, 2010 CFR

2010-01-01

... bank's needs for banking purposes include: (1) Data processing services; (2) Production and distribution of non-financial software; (3) Providing periodic back-up call answering services; (4) Providing full Internet access; (5) Providing electronic security system support services; (6) Providing long...

Your Family and Managed Care: A Guide for Families of Children with Mental, Emotional or Behavioral Disorders.

ERIC Educational Resources Information Center

Bazelon Center for Mental Health Law, Washington, DC.

Designed for parents of children with mental, emotional, or behavior disorders, this booklet provides information on accessing mental health services through health maintenance organizations. The first part of the guide provides information on how managed care can improve children's access to behavioral health services through expanded service…

Sorting Out the Web: Approaches to Subject Access. Contemporary Studies in Information Management, Policies, and Services.

ERIC Educational Resources Information Center

Schwartz, Candy

This book examines what has been done in providing subject access to networked resources. The first chapter provides a historical overview of information services, developments in information technology, end users, and the Internet, as well as a discussion of the library response to these developments. The second chapter discusses metadata,…

Faculty-Librarian Collaboration for Library Services in the Online Classroom: Student Evaluation Results and Recommended Practices for Implementation

ERIC Educational Resources Information Center

Figa, Elizabeth; Bone, Tonda; Macpherson, Janet R.

2009-01-01

Student success is influenced by their ability to access, evaluate, and use resources. Traditionally, academic librarianship has provided students with these information literacy skills. The increase in distance learning options has created the need for libraries to provide both reference services equitable to those available onsite and access to…

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

PubMed

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

2017-08-01

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

A Previsit Screening Checklist Improves Teamwork and Access to Preventive Services in a Medical Home Serving Low-Income Adolescent and Young Adult Patients.

PubMed

Allende-Richter, Sophie H; Johnson, Sydney T; Maloyan, Mariam; Glidden, Patricia; Rice, Kerrilynn; Epee-Bounya, Alexandra

2018-06-01

Publicly insured adolescents and young adults experience significant obstacles in accessing primary care services. As a result, they often present to their medical appointments with multiple unmet needs, adding time and complexity to the visit. The goal of this project was to optimize team work and access to primary care services among publicly insured adolescents and young adults attending an urban primary care clinic, using a previsit screening checklist to identify patient needs and delegate tasks within a care team to coordinate access to health services at the time of the visit. We conducted an interventional quality improvement initiative in a PDSA (Plan-Do-Study-Act) cycle format; 291 patients, 13 to 25 years old were included in the study over an 8-months period. The majority of patients were receptive to the previsit screening checklist; 85% of services requested were provided; nonclinician staff felt more involved in patient care; and providers' satisfaction increased.

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

PubMed Central

2014-01-01

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

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

PubMed

Arnold, Shaye Beverly

2014-10-01

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

Productivity and quality improvements in health care through airboss mobile messaging services.

PubMed

Shah, P J; Martinez, R; Cooney, E

1997-01-01

The US health care industry is in the midst of revolutionary changes. Under tremendous pressures from third-party payers and managed care programs to control costs while providing high quality medical services, health care entities are now looking at information technologies to help them achieve their goals. These goals typically include improved productivity, efficiency and decision-making capabilities among staff members. Moreover, hospitals and other health care facilities that provide a broad and integrated range of inpatient and outpatient care, wellness and home care services are in the best position to offer comprehensive packages to managed care and private insurers. Many health care providers and administrators are considered mobile employees. This mobility can range from intra-building and intra-campus to multi-site and metropolitan areas. This group often relies on a variety of information technologies such as personal computers, communicating laptops, pagers, cellular phones, wireline phones, cordless phones and fax machines to stay in touch and handle information needs. These health care professionals require mobile information access and messaging tools to improve communications, control accessibility and enhance decision-making capabilities. AirBoss mobile messaging services could address the health care industry's need for improved messaging capabilities for its mobile employees. The AirBoss family of services supports integrated voice services, data messaging, mobile facsimile and customized information delivery. This paper describes overview of the current mobile data networking capability, the AirBoss architecture, the health care-related applications it addresses and long-term benefits. In addition, a prototype application for mobile home health care workers is illustrated. This prototype application provides integrated e-mail, information services, web access, real-time access and update of patient records from wireline or wireless networks, and cross media delivery and notification. It provides seamless wide area access to patient data in a secure environment, thus providing a continuity of care from the hospital to home.

Patients' online access to their electronic health records and linked online services: a systematic review in primary care.

PubMed

Mold, Freda; de Lusignan, Simon; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Arvanitis, Theodoros N; Ellis, Beverley

2015-03-01

Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider. To assess the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care. A systematic review was conducted that focused on all studies about online record access and transactional services in primary care. Data sources included MEDLINE, Embase, CINAHL, Cochrane Library, EPOC, DARE, King's Fund, Nuffield Health, PsycINFO, OpenGrey (1999-2012). The literature was independently screened against detailed inclusion and exclusion criteria; independent dual data extraction was conducted, the risk of bias (RoB) assessed, and a narrative synthesis of the evidence conducted. A total of 176 studies were identified, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved self-care, and better communication and engagement with clinicians. Safety improvements were patient-led through identifying medication errors and facilitating more use of preventive services. Provision of online record access and services resulted in a moderate increase of e-mail, no change on telephone contact, but there were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy. While the RoB scores suggest many of the studies were of low quality, patients using online services reported increased convenience and satisfaction. These services positively impacted on patient safety, although there were variations of record access and use by specific ethnic and socioeconomic groups. Professional concerns about privacy were unrealised and those about workload were only partly so. © British Journal of General Practice 2015.

Patients’ online access to their electronic health records and linked online services: a systematic review in primary care

PubMed Central

Mold, Freda; de Lusignan, Simon; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Arvanitis, Theodoros N; Ellis, Beverley

2015-01-01

Background Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider. Aim To assess the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care. Design and setting A systematic review was conducted that focused on all studies about online record access and transactional services in primary care. Method Data sources included MEDLINE, Embase, CINAHL, Cochrane Library, EPOC, DARE, King’s Fund, Nuffield Health, PsycINFO, OpenGrey (1999–2012). The literature was independently screened against detailed inclusion and exclusion criteria; independent dual data extraction was conducted, the risk of bias (RoB) assessed, and a narrative synthesis of the evidence conducted. Results A total of 176 studies were identified, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved self-care, and better communication and engagement with clinicians. Safety improvements were patient-led through identifying medication errors and facilitating more use of preventive services. Provision of online record access and services resulted in a moderate increase of e-mail, no change on telephone contact, but there were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy. Conclusion While the RoB scores suggest many of the studies were of low quality, patients using online services reported increased convenience and satisfaction. These services positively impacted on patient safety, although there were variations of record access and use by specific ethnic and socioeconomic groups. Professional concerns about privacy were unrealised and those about workload were only partly so. PMID:25733435

EntrezAJAX: direct web browser access to the Entrez Programming Utilities.

PubMed

Loman, Nicholas J; Pallen, Mark J

2010-06-21

Web applications for biology and medicine often need to integrate data from Entrez services provided by the National Center for Biotechnology Information. However, direct access to Entrez from a web browser is not possible due to 'same-origin' security restrictions. The use of "Asynchronous JavaScript and XML" (AJAX) to create rich, interactive web applications is now commonplace. The ability to access Entrez via AJAX would be advantageous in the creation of integrated biomedical web resources. We describe EntrezAJAX, which provides access to Entrez eUtils and is able to circumvent same-origin browser restrictions. EntrezAJAX is easily implemented by JavaScript developers and provides identical functionality as Entrez eUtils as well as enhanced functionality to ease development. We provide easy-to-understand developer examples written in JavaScript to illustrate potential uses of this service. For the purposes of speed, reliability and scalability, EntrezAJAX has been deployed on Google App Engine, a freely available cloud service. The EntrezAJAX webpage is located at http://entrezajax.appspot.com/

Integrated AUTODIN System Architecture Report. Part 1.

DTIC Science & Technology

1977-12-01

necessary standards; (2) identify the roles and relationships of components of the Integrated AUTODIN System; (3) establish an Inter -Service/Agency ANPE...provide a network access element now designated the Inter -Service/Agency AMPE (I-S/A AMPE). The AUTODIN I ASCs will be phased out by "phasing in...further access area needs provided by an Inter -Service/Agency AMPE, which can serve all DoD users in an area and interface either AUTODIN I or AUTODIN

High School Students' Self-Reported Use of School Clinics and Nurses.

PubMed

Harper, Christopher R; Liddon, Nicole; Dunville, Richard; Habel, Melissa A

2016-10-01

Access to school health clinics and nurses has been linked with improved student achievement and health. Unfortunately, no studies have examined how many students report using school clinics or nurses and for which services. This study addressed this gap with data from a nationally representative sample of 15- to 25-year-olds. Respondents who reported being in high school were provided a list of services and asked whether they had gone to a school nurse or clinic for any of the listed services. Nearly 90% reported having access to a school clinic or nurse. Among students with access, 65.6% reported using at least one service. Non-White students and younger students were more likely to report having access to a clinic or nurse. These results show many students have access to clinics or nurses and are using these services, although not uniformly for all services. © The Author(s) 2016.

Patient, Program, and System Barriers and Facilitators to Detoxification Services in the U.S. Veterans Health Administration: A Qualitative Study of Provider Perspectives.

PubMed

Schultz, Nicole R; Martinez, Rociel; Cucciare, Michael A; Timko, Christine

2016-08-23

Because substance use disorder (SUD) treatment is expanding, and detoxification (detox) is often the entry point to SUD treatment, it is critical to provide ready access to detox services. The purpose of the current study was to examine patient, program, and system barriers or facilitators to detox access within an integrated health care system with variable rates of detox utilization across facilities. Inpatient and outpatient providers from 31 different U.S. Veterans Health Administration detox programs were interviewed. Qualitative analyses identified six facilitators and 11 barriers to detox access. Facilitators included program staff and program characteristics such as encouragement and immediate access, as well as systemic cooperation and patient circumstances. Barriers to detox included programmatic and systemic problems, including lack of available detox services, program rules or admission requirements, funding shortages, stigma related to a SUD diagnosis or receiving detox services, and a deficiency of education and training. Other major barriers pertained to patients' lack of motivation and competing responsibilities. To improve detox access, health care settings should consider enhancing supportive relationships by emphasizing outreach, engagement, and rapport-building with patients, improving systemic communication and teamwork, educating patients on available detox services and the detox process, and addressing patient centered barriers such as resistance to detox or competing responsibilities. In addition, programs should consider open-door and immediate-admission policies. These approaches may improve detox access, which is important for increasing the likelihood of transitioning patients to SUD treatment, thus improving outcomes and reducing utilization of high-cost services.

Benefits of cloud computing for PACS and archiving.

PubMed

Koch, Patrick

2012-01-01

The goal of cloud-based services is to provide easy, scalable access to computing resources and IT services. The healthcare industry requires a private cloud that adheres to government mandates designed to ensure privacy and security of patient data while enabling access by authorized users. Cloud-based computing in the imaging market has evolved from a service that provided cost effective disaster recovery for archived data to fully featured PACS and vendor neutral archiving services that can address the needs of healthcare providers of all sizes. Healthcare providers worldwide are now using the cloud to distribute images to remote radiologists while supporting advanced reading tools, deliver radiology reports and imaging studies to referring physicians, and provide redundant data storage. Vendor managed cloud services eliminate large capital investments in equipment and maintenance, as well as staffing for the data center--creating a reduction in total cost of ownership for the healthcare provider.

Gender, sexuality and the discursive representation of access and equity in health services literature: implications for LGBT communities

PubMed Central

2011-01-01

Background This article considers how health services access and equity documents represent the problem of access to health services and what the effects of that representation might be for lesbian, gay, bisexual and transgender (LGBT) communities. We conducted a critical discourse analysis on selected access and equity documents using a gender-based diversity framework as determined by two objectives: 1) to identify dominant and counter discourses in health services access and equity literature; and 2) to develop understanding of how particular discourses impact the inclusion, or not, of LGBT communities in health services access and equity frameworks.The analysis was conducted in response to public health and clinical research that has documented barriers to health services access for LGBT communities including institutionalized heterosexism, biphobia, and transphobia, invisibility and lack of health provider knowledge and comfort. The analysis was also conducted as the first step of exploring LGBT access issues in home care services for LGBT populations in Ontario, Canada. Methods A critical discourse analysis of selected health services access and equity documents, using a gender-based diversity framework, was conducted to offer insight into dominant and counter discourses underlying health services access and equity initiatives. Results A continuum of five discourses that characterize the health services access and equity literature were identified including two dominant discourses: 1) multicultural discourse, and 2) diversity discourse; and three counter discourses: 3) social determinants of health (SDOH) discourse; 4) anti-oppression (AOP) discourse; and 5) citizen/social rights discourse. Conclusions The analysis offers a continuum of dominant and counter discourses on health services access and equity as determined from a gender-based diversity perspective. The continuum of discourses offers a framework to identify and redress organizational assumptions about, and ideological commitments to, sexual and gender diversity and health services access and equity. Thus, the continuum of discourses may serve as an important element of a health care organization's access and equity framework for the evaluation of access to good quality care for diverse LGBT populations. More specfically, the analysis offers four important points of consideration in relation to the development of a health services access and equity framework. PMID:21957894

Gender, sexuality and the discursive representation of access and equity in health services literature: implications for LGBT communities.

PubMed

Daley, Andrea E; Macdonnell, Judith A

2011-09-29

This article considers how health services access and equity documents represent the problem of access to health services and what the effects of that representation might be for lesbian, gay, bisexual and transgender (LGBT) communities. We conducted a critical discourse analysis on selected access and equity documents using a gender-based diversity framework as determined by two objectives: 1) to identify dominant and counter discourses in health services access and equity literature; and 2) to develop understanding of how particular discourses impact the inclusion, or not, of LGBT communities in health services access and equity frameworks.The analysis was conducted in response to public health and clinical research that has documented barriers to health services access for LGBT communities including institutionalized heterosexism, biphobia, and transphobia, invisibility and lack of health provider knowledge and comfort. The analysis was also conducted as the first step of exploring LGBT access issues in home care services for LGBT populations in Ontario, Canada. A critical discourse analysis of selected health services access and equity documents, using a gender-based diversity framework, was conducted to offer insight into dominant and counter discourses underlying health services access and equity initiatives. A continuum of five discourses that characterize the health services access and equity literature were identified including two dominant discourses: 1) multicultural discourse, and 2) diversity discourse; and three counter discourses: 3) social determinants of health (SDOH) discourse; 4) anti-oppression (AOP) discourse; and 5) citizen/social rights discourse. The analysis offers a continuum of dominant and counter discourses on health services access and equity as determined from a gender-based diversity perspective. The continuum of discourses offers a framework to identify and redress organizational assumptions about, and ideological commitments to, sexual and gender diversity and health services access and equity. Thus, the continuum of discourses may serve as an important element of a health care organization's access and equity framework for the evaluation of access to good quality care for diverse LGBT populations. More specfically, the analysis offers four important points of consideration in relation to the development of a health services access and equity framework.

Fixed Route Accessible Bus Service in Connecticut : A Case Study

DOT National Transportation Integrated Search

1981-07-01

U.S. Department of Transportation regulations implementing Section 504 of the Rehabilitation Act of 1973, require transit agencies to provide wheelchair accessibility on fixed-route bus service. The study is part of the series which included studies ...

Access to general practice for Pacific peoples: a place for cultural competency.

PubMed

Ludeke, Melissa; Puni, Ronald; Cook, Lynley; Pasene, Maria; Abel, Gillian; Sopoaga, Faafetai

2012-06-01

Access to primary health care services has been identified as a problem for Pacific peoples. Although cost is the most frequently cited barrier to Pacific service utilisation, some research has indicated that access may also be influenced by features of mainstream primary care services. This study aimed to identify features of mainstream general practice services that act as barriers to accessing these services for Pacific peoples in order to explore strategies that providers could adopt to enable their practices to be more welcoming, accessible and appropriate for Pacific peoples. Pacific participants were recruited through Pacific networks known to Pegasus Health and via 'snowball' sampling. In total, 20 participants participated in one of three focus groups. A semi-structured interview explored the participants' views and experiences of mainstream general practice care. Thematic analysis was utilised to interpret the data. The analysis revealed five themes highlighting non-financial features of mainstream general practice services that may influence the availability and acceptability of these services to Pacific peoples: language and communication; rushed consultations; appointment availability; reception; and Pacific presence. The findings indicate that all personnel within the primary care setting have the ability to directly engage in the improvement of the health status of Pacific peoples in New Zealand by developing cultural competency and incorporating flexibility and diversity into the care and service they provide.

Quantified Trust Levels for Authentication

NASA Astrophysics Data System (ADS)

Thomas, Ivonne; Menzel, Michael; Meinel, Christoph

Service-oriented Architectures (SOAs) facilitate applications to integrate seamlessly services from collaborating business partners regardless of organizational borders. In order to secure access to these services, mechanisms for authentication and authorisation must be deployed that control the access based on identity-related information. To enable a business partners’ users to access the provided services, an identity federation is often established that enables the brokering of identity information across organisational borders. The establishment of such a federation requires complex agreements and contracts that define common policies, obligations and procedures. Generally, this includes obligations on the authentication process as well.

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

PubMed

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

2016-08-17

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

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

ERIC Educational Resources Information Center

Burns, C. Sean

2013-01-01

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

A Privacy Access Control Framework for Web Services Collaboration with Role Mechanisms

NASA Astrophysics Data System (ADS)

Liu, Linyuan; Huang, Zhiqiu; Zhu, Haibin

With the popularity of Internet technology, web services are becoming the most promising paradigm for distributed computing. This increased use of web services has meant that more and more personal information of consumers is being shared with web service providers, leading to the need to guarantee the privacy of consumers. This paper proposes a role-based privacy access control framework for Web services collaboration, it utilizes roles to specify the privacy privileges of services, and considers the impact on the reputation degree of the historic experience of services in playing roles. Comparing to the traditional privacy access control approaches, this framework can make the fine-grained authorization decision, thus efficiently protecting consumers' privacy.

Access to safe legal abortion in Malaysia: women's insights and health sector response.

PubMed

Low, Wah-Yun; Tong, Wen-Ting; Wong, Yut-Lin; Jegasothy, Ravindran; Choong, Sim-Poey

2015-01-01

Malaysia has an abortion law, which permits termination of pregnancy to save a woman's life and to preserve her physical and mental health (Penal Code Section 312, amended in 1989). However, lack of clear interpretation and understanding of the law results in women facing difficulties in accessing abortion information and services. Some health care providers were unaware of the legalities of abortion in Malaysia and influenced by their personal beliefs with regard to provision of abortion services. Accessibility to safer abortion techniques is also an issue. The development of the 2012 Guidelines on Termination of Pregnancy and Guidelines for Management of Sexual and Reproductive Health among Adolescents in Health Clinics by the Ministry of Health, Malaysia, is a step forward toward increasing women's accessibility to safe abortion services in Malaysia. This article provides an account of women's accessibility to abortion in Malaysia and the health sector response in addressing the barriers. © 2014 APJPH.

Exploring the effectiveness of the output-based aid voucher program to increase uptake of gender-based violence recovery services in Kenya: A qualitative evaluation

PubMed Central

2012-01-01

Background Few studies in Africa have explored in detail the ability of output-based aid (OBA) voucher programs to increase access to gender-based violence recovery (GBVR) services. Methods A qualitative study was conducted in 2010 and involved: (i) in-depth interviews (IDIs) with health managers, service providers, voucher management agency (VMA) managers and (ii) focus group discussions (FGDs) with voucher users, voucher non-users, voucher distributors and opinion leaders drawn from five program sites in Kenya. Results The findings showed promising prospects for the uptake of OBA GBVR services among target population. However, a number of factors affect the uptake of the services. These include lack of general awareness of the GBVR services vouchers, lack of understanding of the benefit package, immediate financial needs of survivors, as well as stigma and cultural beliefs that undermine reporting of cases or seeking essential medical services. Moreover, accreditation of only hospitals to offer GBVR services undermines access to the services in rural areas. Poor responsiveness from law enforcement agencies and fear of reprisal from perpetrators also undermine treatment options and access to medical services. Low provider knowledge on GBVR services and lack of supplies also affect effective provision and management of GBVR services. Conclusions The above findings suggest that there is a need to build the capacity of health care providers and police officers, strengthen the community strategy component of the OBA program to promote the GBVR services voucher, and conduct widespread community education programs aimed at prevention, ensuring survivors know how and where to access services and addressing stigma and cultural barriers. PMID:22691436

Qualitative investigation of barriers to accessing care by people who inject drugs in Saskatoon, Canada: perspectives of service providers

PubMed Central

2013-01-01

Background People who inject drugs (PWID) often encounter barriers when attempting to access health care and social services. In our previous study conducted to identify barriers to accessing care from the perspective of PWIDs in Saskatoon, Canada: poverty, lack of personal support, discrimination, and poor knowledge and coordination of service providers among other key barriers were identified. The purpose of the present investigation was to explore what service providers perceive to be the greatest barriers for PWIDs to receive optimal care. This study is an exploratory investigation with a purpose to enrich the literature and to guide community action. Methods Data were collected through focus groups with service providers in Saskatoon. Four focus groups were held with a total of 27 service providers. Data were transcribed and qualitative analysis was performed. As a result, concepts were identified and combined into major themes. Results Four barriers to care were identified by service providers: inefficient use of resources, stigma and discrimination, inadequate education and the unique and demanding nature of PWIDs. Participants also identified many successful services. Conclusion The results from this investigation suggest poor utilization of resources, lack of continuing education of health care providers on addictions and coping skills with such demanding population, and social stigma and disparity. We recommend improvements in resource utilization through, for example, case management. In addition, sensitivity training and more comprehensive service centers designed to meet PWID’s complex needs may improve care. However, community-wide commitment to addressing injection drug issues will also be required for lasting solutions. PMID:24079946

Obstacles to preventive care for individuals with disability: Implications for nurse practitioners.

PubMed

Marrocco, Anna; Krouse, Helene J

2017-05-01

Individuals with disabilities have been identified as a population with a significantly lower usage of preventive services. Nurse practitioners (NPs) provide a key access point in the healthcare delivery system for preventive services for vulnerable populations such as those with disabilities. It is essential to understand existing barriers that prohibit access to effective preventive care for this vulnerable population. Systematic search and review of Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, PubMed, Google Scholar, and government reports and World Health Organizations reports. Twenty-six articles were included in the review. This literature review confirmed previous notions that people with disabilities are receiving much fewer preventive services than the general population. The studies reviewed identified four major barriers that contributed to the lack of preventive care. These barriers included physical environment and system, transportation, provider knowledge and attitude, and financial. Recognition of the obstacles that this subpopulation faces in accessing preventive care services is the first step to effectively remedying this problem. Preventive services have been identified as one of the cornerstones to improving health and quality of life. By understanding the circumstances that restrict those with disabilities from accessing preventive services, NPs can provide meaningful and effective solutions. ©2017 American Association of Nurse Practitioners.

Limited accessibility to HIV services for persons with disabilities living with HIV in Ghana, Uganda and Zambia

PubMed Central

Tun, Waimar; Okal, Jerry; Schenk, Katie; Esantsi, Selina; Mutale, Felix; Kyeremaa, Rita Kusi; Ngirabakunzi, Edson; Asiah, Hilary; McClain-Nhlapo, Charlotte; Moono, Grimond

2016-01-01

Introduction Knowledge about experiences in accessing HIV services among persons with disabilities who are living with HIV in sub-Saharan Africa is limited. Although HIV transmission among persons with disabilities in Africa is increasingly acknowledged, there is a need to bring to life the experiences and voices from persons with disabilities living with HIV to raise awareness of programme implementers and policy makers about their barriers in accessing HIV services. This paper explores how the barriers faced by persons with disabilities living with HIV impede their ability to access HIV-related services and manage their disease. Methods We conducted focus group discussions with 76 persons (41 females; 35 males) with physical, visual and/or hearing impairments who were living with HIV in Ghana, Uganda and Zambia (2012–2013). We explored challenges and facilitators at different levels (individual, psychosocial and structural) of access to HIV services. Transcripts were analyzed using a framework analysis approach. Results Persons with disabilities living with HIV encountered a wide variety of challenges in accessing HIV services. Delays in testing for HIV were common, with most waiting until they were sick to be tested. Reasons for delayed testing included challenges in getting to the health facilities, lack of information about HIV and testing, and HIV- and disability-related stigma. Barriers to HIV-related services, including care and treatment, at health facilities included lack of disability-friendly educational materials and sign interpreters, stigmatizing treatment by providers and other patients, lack of skills to provide tailored services to persons with disabilities living with HIV and physically inaccessible infrastructure, all of which make it extremely difficult for persons with disabilities to initiate and adhere to HIV treatment. Accessibility challenges were greater for women than men due to gender-related roles. Challenges were similar across the three countries. Favourable experiences in accessing HIV services were reported in Uganda and Zambia, where disability-tailored services were offered by non-governmental organizations and government facilities (Uganda only). Conclusions Persons with disabilities living with HIV encounter many challenges in accessing HIV testing and continued care and treatment services. Changes are needed at every level to ensure accessibility of HIV services for persons with disabilities. PMID:27443266

Carer and service providers' experiences of individual funding models for children with a disability in rural and remote areas.

PubMed

Dew, Angela; Bulkeley, Kim; Veitch, Craig; Bundy, Anita; Lincoln, Michelle; Brentnall, Jennie; Gallego, Gisselle; Griffiths, Scott

2013-07-01

There is a global movement for people with a disability towards person-centred practices with opportunities for self-determination and choice. Person-centred approaches may involve individual funding (IF) for the purchase of required support. A shift to a person-centred model and IF should allow people with a disability and their carers greater choice in therapy access. However, individuals who live in rural and remote areas have less choice and access to therapy services than their metropolitan counterparts. Drawing on data from a larger study into therapy service delivery in a rural and remote area of New South Wales, Australia, this study describes some benefits and barriers to using IF to access therapy services in rural areas. Ten carers and 60 service providers participated in audio-recorded focus groups and individual interviews during which IF was discussed. Transcribed data were analysed using thematic analysis and constant comparison. Greater access to and choice of therapy providers were identified as benefits of IF. Four barriers were identified: (i) lack of information and advice; (ii) limited local service options and capacity; (iii) higher costs and fewer services and (iv) complexity of self-managing packages. A range of strategies is required to address the barriers to using IF in rural and remote areas. Carers indicated a need for: accessible information; a local contact person for support and guidance; adequate financial compensation to offset additional travel expenses and coordinated eligibility and accountability systems. Service providers required: coordinated cross-sector approaches; local workforce planning to address therapist shortages; certainty around service viability and growth; clear policies and procedures around implementation of IF. This study highlights the need for further discussion and research about how to overcome the barriers to the optimal use of an IF model for those living in rural and remote areas. © 2013 John Wiley & Sons Ltd.

Implementation of Section 255 of the Telecommunications Act of 1996: access to telecommunications services, telecommunications equipment, and customer premises equipment by persons with disabilities--FCC. Notice of proposed rulemaking.

PubMed

1998-05-22

This Notice of Proposed Rulemaking (NPRM) is an important step in the Commission's effort to increase the accessibility of telecommunications services and equipment to Americans with disabilities. The NPRM proposes a framework for implementing section 255 of the Communications Act of 1934 (Act), which requires telecommunications equipment manufacturers and service providers to ensure that their equipment and services are accessible to persons with disabilities, to the extent it is readily achievable to do so. In addition, if accessibility is not readily achievable, section 255 requires manufacturers and service providers to ensure compatibility with existing peripheral devices or specialized customer premises equipment commonly used by individuals with disabilities to achieve access, to the extent it is readily achievable to do so. The NPRM first explores the Commission's legal authority to establish rules implementing section 255. The NPRM then seeks comment on the interpretation of specific statutory terms that are relevant to the proceeding. Finally, the NPRM seeks comment on proposals to implement and enforce the requirement that telecommunications equipment and services be made accessible to the extent readily achievable. The actions proposed in the NPRM are needed to ensure that people with disabilities are not left behind in the telecommunications revolution and consequently isolated from contemporary life.

Establishing pathways for access to pharmacist-provided patient care.

PubMed

Schommer, Jon C; Doucette, William R; Planas, Lourdes G

2015-01-01

To describe the pathways being established for access to pharmacist-provided patient care and supply recommendations for the next steps in this process. A series of reports published by the American Pharmacists Association regarding pharmacist-provided patient care services. Community pharmacies and integrated health organizations have emerged as the two predominant pathways for patient access to pharmacist-provided patient care. We view these two pathways as complementary in helping cover patients' entire medication therapy needs as they traverse acute and chronic health care services. However, gaps in access to pharmacist-provided care remain, especially during transitions in care. In further establishing pathways for access to pharmacist-provided patient care, we propose that the application of collaboration theory will help close gaps that currently exist between health care organizations. Such an approach carries risk and will require trust among participating organizations. This approach is also likely to require updating and contemporizing pharmacy practice acts and other statutes to allow pharmacists to practice at maximum capacity within new models of care. To perform their new roles and create sustainable business models to support these new functions, pharmacists will need to be paid for their services. To this end, changes will need to be made to payment and documentation systems, incentives, and contracting approaches to develop proper reimbursement and accounting for pharmacists' new roles.

20 CFR 652.207 - How does a State meet the requirement for universal access to services provided under the Act?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How does a State meet the requirement for universal access to services provided under the Act? 652.207 Section 652.207 Employees' Benefits EMPLOYMENT... exercising this discretion, a State must meet the Act's requirements. (b) These requirements are: (1) Labor...

Privacy & Security Notice | Argonne National Laboratory

Science.gov Websites

server logs: The Internet Protocol (IP) address of the domain from which you access the Internet (i.e service to authorized users, to access, obtain, alter, damage, or destroy information, or otherwise to . 123.456.789.012) whether yours individually or provided as a proxy by your Internet Service Provider (ISP), The

Immigrant women's experiences of maternity-care services in Canada: a systematic review using a narrative synthesis.

PubMed

Higginbottom, Gina M A; Morgan, Myfanwy; Alexandre, Mirande; Chiu, Yvonne; Forgeron, Joan; Kocay, Deb; Barolia, Rubina

2015-02-11

Canada's diverse society and its statutory commitment to multiculturalism means that a synthesis of knowledge related to the healthcare experiences of immigrants is essential to realise the health potential for future Canadians. Although concerns about the maternity experiences of immigrants in Canada are relatively new, recent national guidelines explicitly call for the tailoring of services to user needs. We therefore assessed the experiences of immigrant women accessing maternity-care services in Canada. In particular, we investigated the experiences of immigrant women in Canada in accessing and navigating maternity and related healthcare services from conception to 6 months postpartum in Canada. Our focus was on (a) the accessibility and acceptability of maternity-care services for immigrant women and (b) the effects of the perceptions and experiences of these women on their birth and postnatal outcomes. We conducted a systematic review using a systematic search and narrative synthesis of peer-reviewed and non-peer-reviewed reports of empirical research, with the aim of providing stakeholders with perspectives on maternity-care services as experienced by immigrant women. We partnered with key stakeholders ('integrated knowledge users') to ensure the relevancy of topics and to tailor recommendations for effective translation into future policy, practice and programming. Two search phases and a three-stage selection process for published and grey literature were conducted prior to appraisal of literature quality and narrative synthesis of the findings. Our knowledge synthesis of maternity care among immigrants to Canada provided a coherent evidence base for (a) eliciting a better understanding of the factors that generate disparities in accessibility, acceptability and outcomes during maternity care; and (b) improving culturally based competency in maternity care. Our synthesis also identified pertinent issues in multiple sectors that should be addressed to configure maternity services and programs appropriately. Although immigrant women in Canada are generally given the opportunity to obtain necessary services, they face many barriers in accessing and utilising these services. These barriers include lack of information about or awareness of the services, insufficient supports to access these services and discordant expectations between the women and their service providers. PROSPERO registration number: CRD42012002185 .

Opportunities and limitations for using new media and mobile phones to expand access to sexual and reproductive health information and services for adolescent girls and young women in six Nigerian states.

PubMed

Akinfaderin-Agarau, Fadekem; Chirtau, Manre; Ekponimo, Sylvia; Power, Samantha

2012-06-01

Reproductive health problems are a challenge affecting young people in Nigeria. Education as a Vaccine (EVA) implements the My Question and Answer Service, using mobile phones to provide sexual and reproductive health (SRH) information and services. Use of the service by adolescent girls and young women is low. Focus group discussions were held with 726 females to assess their access to mobile phones, as well as the barriers and limitations to the use of their phones to seek SRH information and services. Results demonstrate high mobile phone access but limited use of phones to access SRH information and services. Barriers to use of these services include cost of service for young female clients, request for socio-demographic information that could break anonymity, poor marketing and publicity, socio-cultural beliefs and expectations of young girls, individual personality and beliefs, as well as infrastructural/network quality. It is therefore recommended that these barriers be adequately addressed to increase the potential use of mobile phone for providing adolescent and young girls with SRH information and services. In addition, further initiatives and research are needed to explore the potentials of social media in meeting this need.

Onsite Provision of Specialized Contraceptive Services: Does Title X Funding Enhance Access?

PubMed Central

Riedel, Julie Cross; Menz, Mary; Darney, Philip D.; Brindis, Claire D.

2014-01-01

Abstract Background: This article presents the extent to which providers enrolled in California's Family Planning, Access, Care, and Treatment (Family PACT) program offer contraceptive methods onsite, thus eliminating one important access barrier. Family PACT has a diverse provider network, including public-sector providers receiving Title X funding, public-sector providers not receiving Title X funding, and private-sector providers. We explored whether Title X funding enhances providers' ability to offer contraceptive methods that require specialized skills onsite. Methods: Data were derived from 1,072 survey responses to a 2010 provider-capacity survey matched by unique identifier to administrative claims data. Results: A significantly greater proportion of Title X–funded providers compared to non–Title X public and private providers offered onsite services for the following studied methods: intrauterine contraceptives (90% Title X, 51% public non–Title X, 38% private); contraceptive implants (58% Title X, 19% public non–Title X, 7% private); vasectomy (8% Title X, 4% public non–Title X, 1% private); and fertility-awareness methods (69% Title X, 55% public non–Title X, 49% private) (all p<0.0001). The association between onsite provision and Title X funding remained after stratifying individually by clinic specialty, facility capacity to provide reproductive health services (based on staffing), and rural/urban location. Conclusions: Extra funding for publicly funded family-planning programs, through mechanisms such as Title X, appears to be associated with increased onsite access to a wide range of contraceptive services, including those that require special skills and training. PMID:24405313

Onsite provision of specialized contraceptive services: does Title X funding enhance access?

PubMed

Thiel de Bocanegra, Heike; Cross Riedel, Julie; Menz, Mary; Darney, Philip D; Brindis, Claire D

2014-05-01

This article presents the extent to which providers enrolled in California's Family Planning, Access, Care, and Treatment (Family PACT) program offer contraceptive methods onsite, thus eliminating one important access barrier. Family PACT has a diverse provider network, including public-sector providers receiving Title X funding, public-sector providers not receiving Title X funding, and private-sector providers. We explored whether Title X funding enhances providers' ability to offer contraceptive methods that require specialized skills onsite. Data were derived from 1,072 survey responses to a 2010 provider-capacity survey matched by unique identifier to administrative claims data. A significantly greater proportion of Title X-funded providers compared to non-Title X public and private providers offered onsite services for the following studied methods: intrauterine contraceptives (90% Title X, 51% public non-Title X, 38% private); contraceptive implants (58% Title X, 19% public non-Title X, 7% private); vasectomy (8% Title X, 4% public non-Title X, 1% private); and fertility-awareness methods (69% Title X, 55% public non-Title X, 49% private) (all p<0.0001). The association between onsite provision and Title X funding remained after stratifying individually by clinic specialty, facility capacity to provide reproductive health services (based on staffing), and rural/urban location. Extra funding for publicly funded family-planning programs, through mechanisms such as Title X, appears to be associated with increased onsite access to a wide range of contraceptive services, including those that require special skills and training.

Making Spatial Statistics Service Accessible On Cloud Platform

NASA Astrophysics Data System (ADS)

Mu, X.; Wu, J.; Li, T.; Zhong, Y.; Gao, X.

2014-04-01

Web service can bring together applications running on diverse platforms, users can access and share various data, information and models more effectively and conveniently from certain web service platform. Cloud computing emerges as a paradigm of Internet computing in which dynamical, scalable and often virtualized resources are provided as services. With the rampant growth of massive data and restriction of net, traditional web services platforms have some prominent problems existing in development such as calculation efficiency, maintenance cost and data security. In this paper, we offer a spatial statistics service based on Microsoft cloud. An experiment was carried out to evaluate the availability and efficiency of this service. The results show that this spatial statistics service is accessible for the public conveniently with high processing efficiency.

Improving data discoverability, accessibility, and interoperability with the Esri ArcGIS Platform at the NASA Atmospheric Science Data Center (ASDC).

NASA Astrophysics Data System (ADS)

Tisdale, M.

2017-12-01

NASA's Atmospheric Science Data Center (ASDC) is operationally using the Esri ArcGIS Platform to improve data discoverability, accessibility and interoperability to meet the diversifying user requirements from government, private, public and academic communities. The ASDC is actively working to provide their mission essential datasets as ArcGIS Image Services, Open Geospatial Consortium (OGC) Web Mapping Services (WMS), and OGC Web Coverage Services (WCS) while leveraging the ArcGIS multidimensional mosaic dataset structure. Science teams at ASDC are utilizing these services through the development of applications using the Web AppBuilder for ArcGIS and the ArcGIS API for Javascript. These services provide greater exposure of ASDC data holdings to the GIS community and allow for broader sharing and distribution to various end users. These capabilities provide interactive visualization tools and improved geospatial analytical tools for a mission critical understanding in the areas of the earth's radiation budget, clouds, aerosols, and tropospheric chemistry. The presentation will cover how the ASDC is developing geospatial web services and applications to improve data discoverability, accessibility, and interoperability.

Overview of harm reduction in prisons in seven European countries.

PubMed

Sander, Gen; Scandurra, Alessio; Kamenska, Anhelita; MacNamara, Catherine; Kalpaki, Christina; Bessa, Cristina Fernandez; Laso, Gemma Nicolás; Parisi, Grazia; Varley, Lorraine; Wolny, Marcin; Moudatsou, Maria; Pontes, Nuno Henrique; Mannix-McNamara, Patricia; Libianchi, Sandro; Antypas, Tzanetos

2016-10-07

While the last decade has seen a growth of support for harm reduction around the world, the availability and accessibility of quality harm reduction services in prison settings is uneven and continues to be inadequate compared to the progress achieved in the broader community. This article provides a brief overview of harm reduction in prisons in Catalonia (Spain), Greece, Ireland, Italy, Latvia, Poland, and Portugal. While each country provides a wide range of harm reduction services in the broader community, the majority fail to provide these same services or the same quality of these services, in prison settings, in clear violation of international human rights law and minimum standards on the treatment of prisoners. Where harm reduction services have been available and easily accessible in prison settings for some time, better health outcomes have been observed, including significantly reduced rates of HIV and HCV incidence. While the provision of harm reduction in each of these countries' prisons varies considerably, certain key themes and lessons can be distilled, including around features of an enabling environment for harm reduction, resource allocation, collection of disaggregated data, and accessibility of services.

Secret Shoppers Find Access To Providers And Network Accuracy Lacking For Those In Marketplace And Commercial Plans.

PubMed

Haeder, Simon F; Weimer, David L; Mukamel, Dana B

2016-07-01

The adequacy of provider networks for plans sold through insurance Marketplaces established under the Affordable Care Act has received much scrutiny recently. Various studies have established that networks are generally narrow. To learn more about network adequacy and access to care, we investigated two questions. First, no matter the nominal size of a network, can patients gain access to primary care services from providers of their choice in a timely manner? Second, how does access compare to plans sold outside insurance Marketplaces? We conducted a "secret shopper" survey of 743 primary care providers from five of California's nineteen insurance Marketplace pricing regions in the summer of 2015. Our findings indicate that obtaining access to primary care providers was generally equally challenging both inside and outside insurance Marketplaces. In less than 30 percent of cases were consumers able to schedule an appointment with an initially selected physician provider. Information about provider networks was often inaccurate. Problems accessing services for patients with acute conditions were particularly troubling. Effectively addressing issues of network adequacy requires more accurate provider information. Project HOPE—The People-to-People Health Foundation, Inc.

Access Control of Web- and Java-Based Applications

NASA Technical Reports Server (NTRS)

Tso, Kam S.; Pajevski, Michael J.

2013-01-01

Cybersecurity has become a great concern as threats of service interruption, unauthorized access, stealing and altering of information, and spreading of viruses have become more prevalent and serious. Application layer access control of applications is a critical component in the overall security solution that also includes encryption, firewalls, virtual private networks, antivirus, and intrusion detection. An access control solution, based on an open-source access manager augmented with custom software components, was developed to provide protection to both Web-based and Javabased client and server applications. The DISA Security Service (DISA-SS) provides common access control capabilities for AMMOS software applications through a set of application programming interfaces (APIs) and network- accessible security services for authentication, single sign-on, authorization checking, and authorization policy management. The OpenAM access management technology designed for Web applications can be extended to meet the needs of Java thick clients and stand alone servers that are commonly used in the JPL AMMOS environment. The DISA-SS reusable components have greatly reduced the effort for each AMMOS subsystem to develop its own access control strategy. The novelty of this work is that it leverages an open-source access management product that was designed for Webbased applications to provide access control for Java thick clients and Java standalone servers. Thick clients and standalone servers are still commonly used in businesses and government, especially for applications that require rich graphical user interfaces and high-performance visualization that cannot be met by thin clients running on Web browsers

Making the Net More Intelligent.

ERIC Educational Resources Information Center

Somers, Doug

1998-01-01

Discusses how service providers can address the challenge of costs and the need for attractive services valuable to business customers. Focuses on Internet service control; applying intelligent networking features to the internet working services dilemma; and providing access control over network-based applications for Internet virtual private…

Northern California Earthquake Data Center: Data Sets and Data Services

NASA Astrophysics Data System (ADS)

Neuhauser, D. S.; Allen, R. M.; Zuzlewski, S.

2015-12-01

The Northern California Earthquake Data Center (NCEDC) provides a permanent archive and real-time data distribution services for a unique and comprehensive data set of seismological and geophysical data sets encompassing northern and central California. We provide access to over 85 terabytes of continuous and event-based time series data from broadband, short-period, strong motion, and strain sensors as well as continuous and campaign GPS data at both standard and high sample rates. The Northen California Seismic System (NCSS), operated by UC Berkeley and USGS Menlo Park, has recorded over 900,000 events from 1984 to the present, and the NCEDC serves catalog, parametric information, moment tensors and first motion mechanisms, and time series data for these events. We also serve event catalogs, parametric information, and event waveforms for DOE enhanced geothermal system monitoring in northern California and Nevada. The NCEDC provides a several ways for users to access these data. The most recent development are web services, which provide interactive, command-line, or program-based workflow access to data. Web services use well-established server and client protocols and RESTful software architecture that allow users to easily submit queries and receive the requested data in real-time rather than through batch or email-based requests. Data are returned to the user in the appropriate format such as XML, RESP, simple text, or MiniSEED depending on the service and selected output format. The NCEDC supports all FDSN-defined web services as well as a number of IRIS-defined and NCEDC-defined services. We also continue to support older email-based and browser-based access to data. NCEDC data and web services can be found at http://www.ncedc.org and http://service.ncedc.org.

Equity in Access to Health Promotion and Risk Reduction Services: Implications for Elder Health.

ERIC Educational Resources Information Center

Smith, Nancy H.; Howze, Elizabeth Harper

Although there is a national emphasis on health promotion and preventive practices, questions remain regarding the equity of access to these services by low income and minority groups, and the implications of inequities for elder health. Data from a systematic survey of 500 public and private providers of health promotion services in northern…

Digital Library Services: Perceptions and Expectations of User Communities and Librarians in a New Zealand Academic Library.

ERIC Educational Resources Information Center

Xia, Wei

2003-01-01

Provides an overview of research conducted at Victoria University of Wellington regarding differing perceptions and expectations of user communities and librarians related to the usability of digital services. Considers access to services, currency of information on the Web site, the online public access catalog, databases, electronic journals,…

75 FR 60158 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing of a Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-29

... Process in Providing Trustee Access to the Security Position Report Service September 24, 2010. Pursuant...'') service with an automated approval process. II. Self-Regulatory Organization's Statement of the Purpose of... approve a Trustee's access to the SPR service for a security is done manually, and the process is...

A Pacific population's access to and use of health services in Dunedin.

PubMed

Sopoaga, Faafetai; Parkin, Lianne; Gray, Andrew

2012-10-26

Pacific peoples in New Zealand (mostly of Samoan, Tongan, or Cook Islands origin) have poor health compared to the total New Zealand population. Understanding their access to and use of health services is important in resolving this. A survey of Pacific peoples in Dunedin obtained information about their access to and use of health services. 372 questionnaires were analysed. Approximately one-quarter did not have a regular doctor or health service. At least 50% used hospital emergency services for non-urgent illnesses. Nearly two-thirds used a "walk-in" primary care service. A significant proportion of Pacific peoples did not have a regular GP or health service in Dunedin. It was surprising students were more likely to be in this category because student health services should be more affordable. A "walk-in" primary care facility has a role in the delivery of primary care services. Pacific organisations can assist primary care providers to encourage access to and the appropriate use of health services.

Improving regional and rural cancer services in Western Australia.

PubMed

Platt, Violet; O'Connor, Kathleen; Coleman, Rhonda

2015-02-01

This paper examines health reform which has been designed to improve cancer services across Western Australia. Western Australia is a large state divided into nine regions each with differing demographics. The diversity of the state and the distribution of the population over a large area of land create significant challenge in ensuring equality in service delivery. A comparison was conducted looking at cancer services in Western Australia pre-2005 and service delivery in 2014. A review of the partnership initiatives and programs provides a clear discussion on the need for coordination of care between service providers. The approach undertaken in Western Australia has seen an increase in the delivery of cancer services closer to the patient's home as well as greater involvement of primary care professionals in cancer care. This work has resulted in demonstrated improvements in patient care and support. Services for cancer patients need to be accessible closer to home with distance being an appreciable barrier to treatment access.A statewide approach needs to be developed to ensure all people have equitable access to service delivery. © 2015 National Rural Health Alliance Inc.

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

PubMed

Miller, N A

1992-05-01

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

"Be kind to young people so they feel at home": a qualitative study of adolescents' and service providers' perceptions of youth-friendly sexual and reproductive health services in Vanuatu.

PubMed

Kennedy, Elissa C; Bulu, Siula; Harris, Jennifer; Humphreys, David; Malverus, Jayline; Gray, Natalie J

2013-10-31

Sexual activity during adolescence is common in Vanuatu, however many adolescents lack access to sexual and reproductive health (SRH) services and subsequently suffer a disproportionate burden of poor SRH. There is limited peer-reviewed research describing adolescents' SRH service delivery preferences in Vanuatu to inform policy and programs. The aim of this qualitative study was to explore the barriers preventing adolescents from accessing SRH services in Vanuatu and the features of a youth-friendly health service as defined by adolescents. Sixty-six focus group discussions were conducted with 341 male and female adolescents aged 15-19 years in rural and urban communities. Additionally, 12 semi-structured interviews were undertaken with policymakers and service providers. Data were analysed using thematic analysis. Socio-cultural norms and taboos regarding adolescent sexual behaviour were the most significant factors preventing adolescents from accessing services. These contributed to adolescents' own fear and shame, judgmental attitudes of service providers, and disapproval from parents and community gate-keepers. Lack of confidentiality and privacy, costs, and adolescents' lack of SRH knowledge were also important barriers. Adolescents and service providers identified opportunities to make existing services more youth-friendly. The most important feature of a youth-friendly health service described by adolescents was a friendly service provider. Free or affordable services, reliable commodity supply, confidentiality and privacy were also key features. The need to address socio-cultural norms and community knowledge and attitudes was also highlighted. There are significant demand and supply-side barriers contributing to low utilisation of SRH services by adolescents in Vanuatu. However, there are many opportunities to make existing SRH services more youth-friendly, such as improving service provider training. Investment is also required in strategies that aim to create a more supportive environment for adolescent SRH.

Programmatic access to data and information at the IRIS DMC via web services

NASA Astrophysics Data System (ADS)

Weertman, B. R.; Trabant, C.; Karstens, R.; Suleiman, Y. Y.; Ahern, T. K.; Casey, R.; Benson, R. B.

2011-12-01

The IRIS Data Management Center (DMC) has developed a suite of web services that provide access to the DMC's time series holdings, their related metadata and earthquake catalogs. In addition, services are available to perform simple, on-demand time series processing at the DMC prior to being shipped to the user. The primary goal is to provide programmatic access to data and processing services in a manner usable by and useful to the research community. The web services are relatively simple to understand and use and will form the foundation on which future DMC access tools will be built. Based on standard Web technologies they can be accessed programmatically with a wide range of programming languages (e.g. Perl, Python, Java), command line utilities such as wget and curl or with any web browser. We anticipate these services being used for everything from simple command line access, used in shell scripts and higher programming languages to being integrated within complex data processing software. In addition to improving access to our data by the seismological community the web services will also make our data more accessible to other disciplines. The web services available from the DMC include ws-bulkdataselect for the retrieval of large volumes of miniSEED data, ws-timeseries for the retrieval of individual segments of time series data in a variety of formats (miniSEED, SAC, ASCII, audio WAVE, and PNG plots) with optional signal processing, ws-station for station metadata in StationXML format, ws-resp for the retrieval of instrument response in RESP format, ws-sacpz for the retrieval of sensor response in the SAC poles and zeros convention and ws-event for the retrieval of earthquake catalogs. To make the services even easier to use, the DMC is developing a library that allows Java programmers to seamlessly retrieve and integrate DMC information into their own programs. The library will handle all aspects of dealing with the services and will parse the returned data. By using this library a developer will not need to learn the details of the service interfaces or understand the data formats returned. This library will be used to build the software bridge needed to request data and information from within MATLAB°. We also provide several client scripts written in Perl for the retrieval of waveform data, metadata and earthquake catalogs using command line programs. For more information on the DMC's web services please visit http://www.iris.edu/ws/

Study of multi-LLID technology to support multi-services carring in EPONS

NASA Astrophysics Data System (ADS)

Li, Wang; Yi, Benshun; Cheng, Chuanqing

2006-09-01

The Ethernet Passive Optical Network (EPON) has recently attracted more and more research attentions since it could be a perfect candidate for next generation access networks. EPON utilizes pon structure to carry ethernet data, having the both advantages of pon and ethernet devices. From traditional view, EPON is considered to only be a Ethernet services access platform and wake in supporting multi-services especially real-time service. It is obvious that if epon designed only to aim to carrying data service, it is difficult for epon devices to fulfill service provider's command of taking EPON as a integrated service access platform. So discussing the multi-services carrying technology in EPONs is a significative task. This paper deploy a novel method of multi-llid to support multi-services carrying in EPONs.

The Design of Passive Optical Networking+Ethernet over Coaxial Cable Access Networking and Video-on-Demand Services Carrying

NASA Astrophysics Data System (ADS)

Ji, Wei

2013-07-01

Video on demand is a very attractive service used for entertainment, education, and other purposes. The design of passive optical networking+Ethernet over coaxial cable accessing and a home gateway system is proposed. The network integrates the passive optical networking and Ethernet over coaxial cable to provide high dedicated bandwidth for the metropolitan video-on-demand services. Using digital video broadcasting, IP television protocol, unicasting, and broadcasting mechanisms maximizes the system throughput. The home gateway finishes radio frequency signal receiving and provides three kinds of interfaces for high-definition video, voice, and data, which achieves triple-play and wire/wireless access synchronously.

Inequality in access to cultural ecosystem services from protected areas in the Chilean biodiversity hotspot.

PubMed

Martinez-Harms, Maria Jose; Bryan, Brett A; Wood, Spencer A; Fisher, David M; Law, Elizabeth; Rhodes, Jonathan R; Dobbs, Cynnamon; Biggs, Duan; Wilson, Kerrie A

2018-09-15

Experiences with nature through visits to protected areas provide important cultural ecosystem services that have the potential to strengthen pro-environmental attitudes and behavior. Understanding accessibility to protected areas and likely preferences for enjoying the benefits of nature visits are key factors in identifying ways to reduce inequality in access and inform the planning and management for future protected areas. We develop, at a regional scale, a novel social media database of visits to public protected areas in part of the Chilean biodiversity hotspot using geotagged photographs and assess the inequality of access using the home locations of the visitors and socio-economic data. We find that 20% of the population of the region make 87% of the visits to protected areas. The larger, more biodiverse protected areas were the most visited and provided most cultural ecosystem services. Wealthier people tend to travel further to visit protected areas while people with lower incomes tend to visit protected areas that are closer to home. By providing information on the current spatial flows of people to protected areas, we demonstrate the need to expand the protected area network, especially in lower income areas, to reduce inequality in access to the benefits from cultural ecosystem services provided by nature to people. Copyright © 2018 Elsevier B.V. All rights reserved.

The Virtual Space Physics Observatory: Quick Access to Data and Tools

NASA Technical Reports Server (NTRS)

Cornwell, Carl; Roberts, D. Aaron; McGuire, Robert E.

2006-01-01

The Virtual Space Physics Observatory (VSPO; see http://vspo.gsfc.nasa.gov) has grown to provide a way to find and access about 375 data products and services from over 100 spacecraft/observatories in space and solar physics. The datasets are mainly chosen to be the most requested, and include most of the publicly available data products from operating NASA Heliophysics spacecraft as well as from solar observatories measuring across the frequency spectrum. Service links include a "quick orbits" page that uses SSCWeb Web Services to provide a rapid answer to questions such as "What spacecraft were in orbit in July 1992?" and "Where were Geotail, Cluster, and Polar on 2 June 2001?" These queries are linked back to the data search page. The VSPO interface provides many ways of looking for data based on terms used in a registry of resources using the SPASE Data Model that will be the standard for Heliophysics Virtual Observatories. VSPO itself is accessible via an API that allows other applications to use it as a Web Service; this has been implemented in one instance using the ViSBARD visualization program. The VSPO will become part of the Space Physics Data Facility, and will continue to expand its access to data. A challenge for all VOs will be to provide uniform access to data at the variable level, and we will be addressing this question in a number of ways.

A Bookmarking Service for Organizing and Sharing URLs

NASA Technical Reports Server (NTRS)

Keller, Richard M.; Wolfe, Shawn R.; Chen, James R.; Mathe, Nathalie; Rabinowitz, Joshua L.

1997-01-01

Web browser bookmarking facilities predominate as the method of choice for managing URLs. In this paper, we describe some deficiencies of current bookmarking schemes, and examine an alternative to current approaches. We present WebTagger(TM), an implemented prototype of a personal bookmarking service that provides both individuals and groups with a customizable means of organizing and accessing Web-based information resources. In addition, the service enables users to supply feedback on the utility of these resources relative to their information needs, and provides dynamically-updated ranking of resources based on incremental user feedback. Individuals may access the service from anywhere on the Internet, and require no special software. This service greatly simplifies the process of sharing URLs within groups, in comparison with manual methods involving email. The underlying bookmark organization scheme is more natural and flexible than current hierarchical schemes supported by the major Web browsers, and enables rapid access to stored bookmarks.

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

PubMed Central

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

2017-01-01

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

Multi-service terminal adapter based on IP technology applications in rural area

NASA Astrophysics Data System (ADS)

Gao, Li; Li, Xiaobo; Yan, Juntao; Ren, Xupeng

Take advantage of ample modern existing telecom network resources to rural areas may achieve it's information society gradually. This includes the establishment of integrated rural information service platform, modern remote education center and electronic administration management platform for rural areas. The geographical and economic constraints must be overcome for structuring the rural service support system, in order to provide technical support, information products and information services to modern rural information service system. It is important that development an access platform based IP technology, which supports multi-service access in order to implement a variety of types of mobile terminal equipment adapter access and to reduce restrictions on mobile terminal equipment.

Adolescents and access to health care.

PubMed Central

Klein, J. D.; Slap, G. B.; Elster, A. B.; Cohn, S. E.

1993-01-01

The developmental characteristics and health behaviors of adolescents make the availability of certain services--including reproductive health services, diagnosis and treatment of sexually transmitted disease, mental health and substance abuse counseling and treatment--critically important. Furthermore, to serve adolescents appropriately, services must be available in a wide range of health care settings, including community-based adolescent health, family planning and public health clinics, school-based and school-linked health clinics, physicians' offices, HMOs, and hospitals. National, authoritative content standards (for example, the American Medical Association's Guidelines for Adolescent Preventive Services (GAPS), a multispecialty, interdisciplinary guideline for a package of clinical preventive services for adolescents may increase the possibility that insurers will cover adolescent preventive services, and that these services will become part of health professionals' curricula and thus part of routine practice. However, additional and specific guidelines mandating specific services that must be available to adolescents in clinical settings (whether in schools or in communities) are also needed. Although local government, parents, providers, and schools must assume responsibility for ensuring that health services are available and accessible to adolescents, federal and state financing mandates are also needed to assist communities and providers in achieving these goals. The limitations in what even comprehensive programs currently are able to provide, and the dismally low rates of preventive service delivery to adolescents, suggests that adolescents require multiple points of access to comprehensive, coordinated services, and that preventive health interventions must be actively and increasingly integrated across health care, school, and community settings. Unless access issues are dealt with in a rational, coordinated fashion, America's adolescents will not have access to appropriate health services. Current efforts to minimize current health care expenditures through managed care programs inevitably conflict with efforts to deliver comprehensive preventive services to all adolescents. Use of multiple sites may not represent inadequate access to care. However, as managed care reimbursement continues to expand, school-based clinics and free-standing adolescent health programs increasingly report decreases in reimbursement without a change in demand for services. The Office of Technology Assessment study called for explicit funding and expansion of services for America's youth; since then, a federal Office of Adolescent Health has been authorized, and, by the time this reaches print, should have received appropriations and been staffed. Dryfoos has called for expansion to nearly 5000 comprehensive programs in the coming years.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:8148842

Travellers accessing addiction services in Ireland (2007 to 2010): analysis of routine surveillance data.

PubMed

Carew, Anne Marie; Cafferty, Siobhán; Long, Jean; Bellerose, Delphine; Lyons, Suzi

2013-01-01

By accessing addiction treatment services recorded in routine national drug treatment data, the characteristics of Irish Travellers were analyzed to understand their needs and develop policies to tackle issues faced by this community. The number of Traveller cases accessing services increased by 163% between 2007 and 2010. Alcohol and opiates were the most common problem substances reported. Traveller women reported high rates of problem opiate use and risky injecting behaviors, contrary to the perception that problem substance use is a predominantly male issue. This presents a challenge to services to provide targeted, effective services to Travellers with problem substance use.

Design guidelines for raised and traversable medians in urban areas.

DOT National Transportation Integrated Search

1983-01-01

Major urban and suburban streets must provide a high level of service for through traffic as well as access to abutting properties. To an extent, the provisions of traffic service and the accommodation of access needs are conflicting functions that a...

Passive Infrared (PIR)-Based Indoor Position Tracking for Smart Homes Using Accessibility Maps and A-Star Algorithm.

PubMed

Yang, Dan; Xu, Bin; Rao, Kaiyou; Sheng, Weihua

2018-01-24

Indoor occupants' positions are significant for smart home service systems, which usually consist of robot service(s), appliance control and other intelligent applications. In this paper, an innovative localization method is proposed for tracking humans' position in indoor environments based on passive infrared (PIR) sensors using an accessibility map and an A-star algorithm, aiming at providing intelligent services. First the accessibility map reflecting the visiting habits of the occupants is established through the integral training with indoor environments and other prior knowledge. Then the PIR sensors, which placement depends on the training results in the accessibility map, get the rough location information. For more precise positioning, the A-start algorithm is used to refine the localization, fused with the accessibility map and the PIR sensor data. Experiments were conducted in a mock apartment testbed. The ground truth data was obtained from an Opti-track system. The results demonstrate that the proposed method is able to track persons in a smart home environment and provide a solution for home robot localization.

Passive Infrared (PIR)-Based Indoor Position Tracking for Smart Homes Using Accessibility Maps and A-Star Algorithm

PubMed Central

Yang, Dan; Xu, Bin; Rao, Kaiyou; Sheng, Weihua

2018-01-01

Indoor occupants’ positions are significant for smart home service systems, which usually consist of robot service(s), appliance control and other intelligent applications. In this paper, an innovative localization method is proposed for tracking humans’ position in indoor environments based on passive infrared (PIR) sensors using an accessibility map and an A-star algorithm, aiming at providing intelligent services. First the accessibility map reflecting the visiting habits of the occupants is established through the integral training with indoor environments and other prior knowledge. Then the PIR sensors, which placement depends on the training results in the accessibility map, get the rough location information. For more precise positioning, the A-start algorithm is used to refine the localization, fused with the accessibility map and the PIR sensor data. Experiments were conducted in a mock apartment testbed. The ground truth data was obtained from an Opti-track system. The results demonstrate that the proposed method is able to track persons in a smart home environment and provide a solution for home robot localization. PMID:29364188

‘Doing the hard yards’: carer and provider focus group perspectives of accessing Aboriginal childhood disability services

PubMed Central

2013-01-01

Background Despite a high prevalence of disability, Aboriginal Australians access disability services in Australia less than non-Aboriginal Australians with a disability. The needs of Aboriginal children with disability are particularly poorly understood. They can endure long delays in treatment which can impact adversely on development. This study sought to ascertain the factors involved in accessing services and support for Aboriginal children with a disability. Methods Using the focus group method, two community forums, one for health and service providers and one for carers of Aboriginal children with a disability, were held at an Aboriginal Community Controlled Health Service (ACCHS) in the Sydney, metropolitan area of New South Wales, Australia. Framework analysis was applied to qualitative data to elucidate key issues relevant to the dimensions of access framework. Independent coding consistency checks were performed and consensus of analysis verified by the entire research team, several of whom represented the local Aboriginal community. Results Seventeen health and social service providers representing local area government and non-government-funded health and social service organisations and five carers participated in two separate forums between September and October 2011. Lack of awareness of services and inadequate availability were prominent concerns in both groups despite geographic proximity to a major metropolitan area with significant health infrastructure. Carers noted racism, insufficient or non-existent services, and the need for an enhanced role of ACCHSs and AHWs in disability support services. Providers highlighted logistical barriers and cultural and historical issues that impacted on the effectiveness of mainstream services for Aboriginal people. Conclusions Despite dedicated disability services in an urban community, geographic proximity does not mitigate lack of awareness and availability of support. This paper has enumerated a number of considerations to address provision of disability services in an urban Australian Aboriginal community including building expertise and specialist capacity within Aboriginal Health Worker positions and services. Increasing awareness of services, facilitating linkages and referrals, eliminating complexities to accessing support, and working with families and Aboriginal community organisations within a framework of resilience and empowerment to ensure a relevant and acceptable model are necessary steps to improving support and care for Aboriginal children with a disability. PMID:23958272

Accessing Suomi NPP OMPS Products through the GES DISC Online Data Services

NASA Technical Reports Server (NTRS)

Johnson, J.; Wei, J.; Gerasimov, I.; Vollmer, Bruce E.

2017-01-01

This presentation will provide an overview of the OMPS products available at the GES DISC archive, as well as demonstrate the various data services provided by the GES DISC. Since the TOMS, SBUV, and EOS Aura (OMI, MLS, HIRDLS) data products are also available from the GES DISC archive, these can be easily accessed and compared with the OMPS data.

Tackling child health inequalities due to deprivation: using health equity audit to improve and monitor access to a community paediatric service.

PubMed

Maharaj, V; Rahman, F; Adamson, L

2014-03-01

Deprived children constitute a large population with high levels of ill health, and difficulty with access to healthcare contributes to their poor health outcomes. There is debate on how best to engage deprived families and the literature on differential access to paediatric care based on deprivation is limited. To demonstrate that community paediatrics can contribute to reduction of health inequalities by providing services that are accessible to and preferentially used by children whose health is likely to be affected by deprivation. To provide a template for others to improve and monitor equity in their services. Long-term service reconfiguration and health equity audit. We used routinely collected activity data and the Indices of Multiple Deprivation to construct equity profiles of the children using our service, and compared these with the profile of the population aged 0-16 years in the geographical area covered by the service. The new patient contact rate for the most deprived children in the population was more than three times that of the least deprived [odds ratio (OR) 3.29, 95% confidence interval (CI) 2.76-3.93]. Deprived children were more than twice as likely to require multi-agency meetings as part of their medical care (OR 2.28, 95% CI 1.94-2.69). Seventy per cent (3693/5312) of our total contacts were with children in the two most deprived quintiles. There was a marked socio-economic gradient in all types of contact. The model of care used by our community paediatric service successfully engages deprived families, thereby reducing health inequalities due to poor access. Key features are multi-agency working, removing barriers to access, raising staff awareness and use of health equity audit. Our findings provide support for tackling health inequalities via health services that are available to all, but capable of responding proportionately according to level of need, a model recently described as proportionate universalism. © 2012 John Wiley & Sons Ltd.

Providing primary health care through integrated microfinance and health services in Latin America.

PubMed

Geissler, Kimberley H; Leatherman, Sheila

2015-05-01

The simultaneous burdens of communicable and chronic non-communicable diseases cause significant morbidity and mortality in middle-income countries. The poor are at particular risk, with lower access to health care and higher rates of avoidable mortality. Integrating health-related services with microfinance has been shown to improve health knowledge, behaviors, and access to appropriate health care. However, limited evidence is available on effects of fully integrating clinical health service delivery alongside microfinance services through large scale and sustained long-term programs. Using a conceptual model of health services access, we examine supply- and demand-side factors in a microfinance client population receiving integrated services. We conduct a case study using data from 2010 to 2012 of the design of a universal screening program and primary care services provided in conjunction with microfinance loans by Pro Mujer, a women's development organization in Latin America. The program operates in Argentina, Bolivia, Mexico, Nicaragua, and Peru. We analyze descriptive reports and administrative data for measures related to improving access to primary health services and management of chronic diseases. We find provision of preventive care is substantial, with an average of 13% of Pro Mujer clients being screened for cervical cancer each year, 21% receiving breast exams, 16% having a blood glucose measurement, 39% receiving a blood pressure measurement, and 46% having their body mass index calculated. This population, with more than half of those screened being overweight or obese and 9% of those screened having elevated glucose measures, has major risk factors for diabetes, high blood pressure, and cardiovascular disease without intervention. The components of the Pro Mujer health program address four dimensions of healthcare access: geographic accessibility, availability, affordability, and acceptability. Significant progress has been made to meet basic health needs, but challenges remain to ensure that health care provided is of reliable quality to predictably improve health outcomes over time. Copyright © 2015 Elsevier Ltd. All rights reserved.

SIDECACHE: Information access, management and dissemination framework for web services.

PubMed

Doderer, Mark S; Burkhardt, Cory; Robbins, Kay A

2011-06-14

Many bioinformatics algorithms and data sets are deployed using web services so that the results can be explored via the Internet and easily integrated into other tools and services. These services often include data from other sites that is accessed either dynamically or through file downloads. Developers of these services face several problems because of the dynamic nature of the information from the upstream services. Many publicly available repositories of bioinformatics data frequently update their information. When such an update occurs, the developers of the downstream service may also need to update. For file downloads, this process is typically performed manually followed by web service restart. Requests for information obtained by dynamic access of upstream sources is sometimes subject to rate restrictions. SideCache provides a framework for deploying web services that integrate information extracted from other databases and from web sources that are periodically updated. This situation occurs frequently in biotechnology where new information is being continuously generated and the latest information is important. SideCache provides several types of services including proxy access and rate control, local caching, and automatic web service updating. We have used the SideCache framework to automate the deployment and updating of a number of bioinformatics web services and tools that extract information from remote primary sources such as NCBI, NCIBI, and Ensembl. The SideCache framework also has been used to share research results through the use of a SideCache derived web service.

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.

The Demonstrator for the European Plate Observing System (EPOS)

NASA Astrophysics Data System (ADS)

Hoffmann, T. L.; Euteneuer, F.; Ulbricht, D.; Lauterjung, J.; Bailo, D.; Jeffery, K. G.

2014-12-01

An important outcome of the 4-year Preparatory Phase of the ESFRI project European Plate Observing System (EPOS) was the development and first implementation of the EPOS Demonstrator by the project's ICT Working Group 7. The Demonstrator implements the vertical integration of the three-layer architectural scheme for EPOS, connecting the Integrated Core Services (ICS), Thematic Core Services (TCS) and the National Research Infrastructures (NRI). The demonstrator provides a single GUI with central key discovery and query functionalities, based on already existing services by the seismic, geologic and geodetic communities. More specifically the seismic services of the Demonstrator utilize webservices and APIs for data and discovery of raw seismic data (FDSN webservices by the EIDA Network), events (Geoportal by EMSC) and analytical data products (e.g., hazard maps by EFEHR via OGC WMS). For geologic services, the EPOS Demonstrator accesses OneGeology Europe which serves the community with geologic maps and point information via OGC webservices. The Demonstrator also provides access to raw geodetic data via a newly developed universal tool called GSAC. The Demonstrator itself resembles the future Integrated Core Service (ICS) and provides direct access to the end user. Its core functionality lies in a metadata catalogue, which serves as the central information hub and stores information about all RIs, related persons, projects, financial background and technical access information. The database schema of the catalogue is based on CERIF, which has been slightly adapted. Currently, the portal provides basic query functions as well as cross domain search. [www.epos.cineca.it

42 CFR 417.106 - Quality assurance program; Availability, accessibility, and continuity of basic and supplemental...

Code of Federal Regulations, 2012 CFR

2012-10-01

... emergency care service, if the number of providers of that basic health service who will provide the service... includes general practice, family practice, general internal medicine, general pediatrics, and general... after-hours services. (Medically necessary emergency services must be available 24 hours a day, 7 days a...

42 CFR 417.106 - Quality assurance program; Availability, accessibility, and continuity of basic and supplemental...

Code of Federal Regulations, 2014 CFR

2014-10-01

... emergency care service, if the number of providers of that basic health service who will provide the service... includes general practice, family practice, general internal medicine, general pediatrics, and general... after-hours services. (Medically necessary emergency services must be available 24 hours a day, 7 days a...

42 CFR 417.106 - Quality assurance program; Availability, accessibility, and continuity of basic and supplemental...

Code of Federal Regulations, 2013 CFR

2013-10-01

... emergency care service, if the number of providers of that basic health service who will provide the service... includes general practice, family practice, general internal medicine, general pediatrics, and general... after-hours services. (Medically necessary emergency services must be available 24 hours a day, 7 days a...

Evaluating the impact of a maternal health voucher programme on service use before and after the introduction of free maternity services in Kenya: a quasi-experimental study.

PubMed

Dennis, Mardieh L; Abuya, Timothy; Campbell, Oona Maeve Renee; Benova, Lenka; Baschieri, Angela; Quartagno, Matteo; Bellows, Benjamin

2018-01-01

From 2006 to 2016, the Government of Kenya implemented a reproductive health voucher programme in select counties, providing poor women subsidised access to public and private sector care. In June 2013, the government introduced a policy calling for free maternity services to be provided in all public facilities. The concurrent implementation of these interventions presents an opportunity to provide new insights into how users adapt to a changing health financing and service provision landscape. We used data from three cross-sectional surveys to assess changes over time in use of 4+ antenatal care visits, facility delivery, postnatal care and maternal healthcare across the continuum among a sample of predominantly poor women in six counties. We conducted a difference-in-differences analysis to estimate the impact of the voucher programme on these outcomes, and whether programme impact changed after free maternity services were introduced. Between the preintervention/roll-out phase and full implementation, the voucher programme was associated with a 5.5% greater absolute increase in use of facility delivery and substantial increases in use of the private sector for all services. After free maternity services were introduced, the voucher programme was associated with a 5.7% higher absolute increase in use of the recommended package of maternal health services; however, disparities in access to facility births between voucher and comparison counties declined. Increased use of private sector services by women in voucher counties accounts for their greater access to care across the continuum. Our findings show that the voucher programme is associated with a modest increase in women's use of the full continuum of maternal health services at the recommended timings after free maternity services were introduced. The greater use of private sector services in voucher counties also suggests that there is need to expand women's access to acceptable and affordable providers.

The cost of accessing infant HIV medications and health services in Uganda.

PubMed

Bergmann, Julie N; Wanyenze, Rhoda K; Stockman, Jamila K

2017-11-01

Patient costs are a critical barrier to the elimination of mother to child HIV transmission. Despite the Ugandan government providing free public HIV services, infant antiretroviral (ARV) prophylaxis coverage remains low (25%). To understand costs mothers incur in accessing ARV prophylaxis for their infants, we conducted a mixed methods study to quantify and identify their direct costs. We used cross-sectional survey data and focus group discussions from 49 HIV-positive mothers in Uganda. Means and standard deviations were calculated for the direct costs (e.g., transportation, caretaker, services/medications) involved in accessing infant HIV services. The direct cost of attending HIV clinic visits averaged $3.71 (SD = $3.52). Focus group discussions identified two costs hindering access to infant HIV services: transportation costs and informal service charges. All participants reported significant costs associated with accessing infant HIV services - the equivalent of 2-3 days' income. To address transportation costs, community and home care models should be explored. Additionally, stricter policies and oversight should be implemented to prevent informal HIV service charges.

Secondary stroke prevention services in Canada: a cross-sectional survey and geospatial analysis of resources, capacity and geographic access

PubMed Central

Jewett, Lauren; Harroud, Adil; Hill, Michael D.; Côté, Robert; Wein, Theodore; Smith, Eric E.; Gubitz, Gord; Demchuk, Andrew M.; Sahlas, Demetrios J.; Gladstone, David J.; Lindsay, M. Patrice

2018-01-01

Background: Rapid assessment and management of transient ischemic attacks and nondisabling strokes by specialized stroke prevention services reduces the risk of recurrent stroke and improves outcomes. In Canada, with its vast geography and with 16.8% of the population living in rural areas, access to these services is challenging, and considerable variation in access to care exists. The purpose of this multiphase study was to identify sites across Canada providing stroke prevention services, evaluate resource capacity and determine geographic access for Canadians. Methods: We developed a Stroke Prevention Services Resource Inventory that contained 22 questions on the organization and delivery of stroke prevention services and quality monitoring. The inventory ran from November 2015 to January 2016 and was administered online. We conducted a geospatial analysis to estimate access by drive times. Considerations were made for hours of operation and access within and across provincial borders. Results: A total of 123 stroke prevention sites were identified, of which 119 (96.7%) completed the inventory. Most (95) are designated stroke prevention or rapid assessment clinics. Of the 119 sites, 68 operate full time, and 39 operate less than 2.5 days per week. A total of 87.3% of the Canadian population has access to a stroke prevention service within a 1-hour drive; however, only 69.2% has access to a service that operates 5-7 days a week. Allowing provincial border crossing improves access (< 6-h drive) for those who are beyond a 6-hour drive within their home province (3.4%). Interpretation: Most Canadians have reasonable geographic access to stroke prevention services. Allowing patients to cross borders improves the existing access for many, particularly some remote communities along the Ontario-Quebec and British Columbia-Alberta borders. PMID:29472251

Challenges in immunisation service delivery for refugees in Australia: A health system perspective.

PubMed

Mahimbo, A; Seale, H; Smith, M; Heywood, A

2017-09-12

Refugees are at risk of being under-immunised in their countries of origin, in transit and post-resettlement in Australia. Whilst studies have focused on identifying barriers to accessibility of health services among refugees, few focus on providers' perspectives on immunisation service delivery to this group. Health service providers are well placed to provide insights into the pragmatic challenges associated with refugee health service delivery, which can be useful in identifying strategies aimed at improving immunisation coverage among this group. A qualitative study involving 30 semi-structured interviews was undertaken with key stakeholders in immunisation service delivery across all States and Territories in Australia between December 2014 and December 2015. Thematic analysis was undertaken. Variability in accessing program funding and vaccines, lack of a national policy for catch-up vaccination, unclear roles and responsibilities for catch-up, a lack of a central immunisation register and insufficient training among general practitioners were seen as the main challenges impacting on immunisation service delivery for refugees. This study provides insight into the challenges that impact on effective immunisation service delivery for refugees. Deliberate strategies such as national funding for relevant vaccines, improved data collection nationally and increased guidance for general practitioners on catch-up immunisation for refugees would help to ensure equitable access across all age groups. Copyright © 2017 Elsevier Ltd. All rights reserved.

Challenges Women with Disability Face in Accessing and Using Maternal Healthcare Services in Ghana: A Qualitative Study

PubMed Central

Ganle, John Kuumuori; Otupiri, Easmon; Obeng, Bernard; Edusie, Anthony Kwaku; Ankomah, Augustine; Adanu, Richard

2016-01-01

Background While a number of studies have examined the factors affecting accessibility to and utilisation of healthcare services by persons with disability in general, there is little evidence about disabled women's access to maternal health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and the challenges they face in accessing skilled maternal health services. The objective of this paper is to explore the challenges women with disabilities encounter in accessing and using institutional maternal healthcare services in Ghana. Methods and Findings A qualitative study was conducted in 27 rural and urban communities in the Bosomtwe and Central Gonja districts of Ghana with a total of 72 purposively sampled women with different physical, visual, and hearing impairments who were either lactating or pregnant at the time of this research. Semi-structured in-depth interviews were used to gather data. Attride-Stirling’s thematic network framework was used to analyse the data. Findings suggest that although women with disability do want to receive institutional maternal healthcare, their disability often made it difficult for such women to travel to access skilled care, as well as gain access to unfriendly physical health infrastructure. Other related access challenges include: healthcare providers’ insensitivity and lack of knowledge about the maternity care needs of women with disability, negative attitudes of service providers, the perception from able-bodied persons that women with disability should be asexual, and health information that lacks specificity in terms of addressing the special maternity care needs of women with disability. Conclusions Maternal healthcare services that are designed to address the needs of able-bodied women might lack the flexibility and responsiveness to meet the special maternity care needs of women with disability. More disability-related cultural competence and patient-centred training for healthcare providers as well as the provision of disability-friendly transport and healthcare facilities and services are needed. PMID:27347880

AAC services for multilingual populations: South African service provider perspectives.

PubMed

Tönsing, Kerstin M; van Niekerk, Karin; Schlünz, Georg I; Wilken, Ilana

In South Africa, many persons in need of augmentative and alternative communication (AAC) come from multilingual backgrounds. There is as yet a limited evidence base (locally and internationally) for the provision of AAC services to multilingual populations. The perspectives of service providers can assist in gaining an understanding of current practices and the factors that influence these. The study aimed to obtain the perspectives of AAC service providers about practices in providing AAC systems and AAC intervention to clients from multilingual backgrounds. Fifteen AAC service providers were purposefully chosen to participate in one of three focus groups - two face-to-face and one online focus group. Data from the face-to-face focus groups was transcribed verbatim. Thematic analysis was used to identify themes and subthemes in the data. Four overarching themes were identified, namely (a) current practices, (b) factors influencing current practices, (c) service provides' orientation towards different language options in AAC intervention, and (d) needs and desired developments regarding AAC technology. This paper reports on the first three themes. Service providers reported their practices to range from a focus on L1 exclusively, L2 exclusively, to a multilingual (sequential or simultaneous) approach. The South African language context, family language preferences and choices, service provider skill and knowledge, as well as AAC technology were identified as factors influencing their practices. Although many viewed access to multiple languages through AAC as positive, they also expressed concerns and reservations about providing multilingual AAC services. Although service providers in general saw the need to give clients from multilingual backgrounds access to multiple languages using AAC, this did not always translate into multilingual AAC practices. Both extrinsic factors (e.g. the lack of appropriate AAC devices, software and apps giving access to non-English languages) and intrinsic factors (service providers' language competency and their beliefs about the cognitive demands of multilingual AAC systems) influenced their practices and choices. Appropriate AAC service delivery to multilingual populations in South Africa would require not only appropriate AAC technology developments, but also research evidence to establish the efficacy of multilingual AAC interventions for clients with a variety of characteristics. Copyright © 2018 Elsevier Inc. All rights reserved.

Availability of essential health services in post-conflict Liberia.

PubMed

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

2010-07-01

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

48 CFR 1837.203-70 - Providing contractors access to sensitive information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... developed at private expense or that the Government has generated that qualifies for an exception to the... require access to sensitive information in the Government's possession, which may be entitled to... because the service provider has access to other companies' sensitive information, and shall establish...

48 CFR 1837.203-70 - Providing contractors access to sensitive information.

Code of Federal Regulations, 2011 CFR

2011-10-01

... developed at private expense or that the Government has generated that qualifies for an exception to the... require access to sensitive information in the Government's possession, which may be entitled to... because the service provider has access to other companies' sensitive information, and shall establish...

Consumers’ experiences of back pain in rural Western Australia: access to information and services, and self-management behaviours

PubMed Central

2012-01-01

Background Coordinated, interdisciplinary services, supported by self-management underpin effective management for chronic low back pain (CLBP). However, a combination of system, provider and consumer-based barriers exist which limit the implementation of such models into practice, particularly in rural areas where unique access issues exist. In order to improve health service delivery for consumers with CLBP, policymakers and service providers require a more in depth understanding of these issues. The objective of this qualitative study was to explore barriers experienced by consumers in rural settings in Western Australia (WA) to accessing information and services and implementing effective self-management behaviours for CLBP. Methods Fourteen consumers with a history of CLBP from three rural sites in WA participated. Maximum variation sampling was employed to ensure a range of experiences were captured. An interviewer, blinded to quantitative pain history data, conducted semi-structured telephone interviews using a standardised schedule to explore individuals’ access to information and services for CLBP, and self-management behaviours. Interviews were digitally recorded and transcribed verbatim. Inductive analysis techniques were used to derive and refine key themes. Results Five key themes were identified that affected individuals’ experiences of managing CLBP in a rural setting, including: 1) poor access to information and services in rural settings; 2) inadequate knowledge and skills among local practitioners; 3) feelings of isolation and frustration; 4) psychological burden associated with CLBP; and 5) competing lifestyle demands hindering effective self-management for CLBP. Conclusions Consumers in rural WA experienced difficulties in knowing where to access relevant information for CLBP and expressed frustration with the lack of service delivery options to access interdisciplinary and specialist services for CLBP. Competing lifestyle demands such as work and family commitments were cited as key barriers to adopting regular self-management practices. Consumer expectations for improved health service coordination and a workforce skilled in pain management are relevant to future service planning, particularly in the contexts of workforce capacity, community health services, and enablers to effective service delivery in primary care. PMID:23057669

78 FR 67053 - Special Access for Price Cap Local Exchange Carriers; AT&T Corporation Petition for Rulemaking To...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-08

... Commission's rules; Accounting authorization holders in the maritime and maritime mobile-satellite radio... services, international service providers, satellite service providers, or entities that hold... Provider (1) indicate whether the connected Location is a building, cell site, or other man-made structure...

Facilitators and Barriers to Dental Care Among Mexican Migrant Women and Their Families in North San Diego County.

PubMed

Velez, Diane; Palomo-Zerfas, Ana; Nunez-Alvarez, Arcela; Ayala, Guadalupe X; Finlayson, Tracy L

2017-10-01

To qualitatively examine facilitators and barriers to dental care access and quality services among Mexican migrant women and their families living in North San Diego County, California. Six focus groups were conducted, with 52 participants. Three focus groups were with community residents (average group size of 10), and three were with community health workers/leaders (called Lideres; average group size of 7). The behavioral model for vulnerable populations theoretical framework guided qualitative data analyses. Predisposing factors to dental care access varied and included immigration status, language, and dental care experiences. Barriers to accessing quality dental services included high cost, lack of insurance coverage, dissatisfaction with providers, long wait times and discrimination. Participants expressed a desire for health policy changes, including affordable coverage for immigrants and their families. This study provided insights into how dental care providers, community health centers, and policymakers can improve dental care access and services to migrant populations.

47 CFR 8.9 - Other laws and considerations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.9 Other laws and... Internet access service may have to address the needs of emergency communications or law enforcement... provider of broadband Internet access service to address copyright infringement or other unlawful activity. ...

47 CFR 8.9 - Other laws and considerations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.9 Other laws and... Internet access service may have to address the needs of emergency communications or law enforcement... provider of broadband Internet access service to address copyright infringement or other unlawful activity. ...

47 CFR 8.9 - Other laws and considerations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.9 Other laws and... Internet access service may have to address the needs of emergency communications or law enforcement... provider of broadband Internet access service to address copyright infringement or other unlawful activity. ...

76 FR 50481 - Proposed Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-15

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Proposed... children. Respondents: State Child Access and Visitation Programs and State and/or local service providers... burden respondents respondent response hours State and Local Child Access Program 350 1 15 5,250 Survey...

47 CFR 8.9 - Other Laws and Considerations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.9 Other Laws and... Internet access service may have to address the needs of emergency communications or law enforcement... provider of broadband Internet access service to address copyright infringement or other unlawful activity. ...

Atmospheric Composition Data and Information Services Center (ACDISC)

NASA Technical Reports Server (NTRS)

Kempler, S.

2005-01-01

NASA's GSFC Earth Sciences (GES) Data and Information and Data Services Center (DISC) manages the archive, distribution and data access for atmospheric composition data from AURA'S OMI, MLS, and hopefully one day, HIRDLS instruments, as well as heritage datasets from TOMS, UARS, MODIS, and AIRS. This data is currently archived in the GES Distributed Active Archive Center (DAAC). The GES DISC has begun the development of a community driven data management system that's sole purpose is to manage and provide value added services to NASA's Atmospheric Composition (AC) Data. This system, called the Atmospheric Composition Data and Information Services Center (ACDISC) will provide access all AC datasets from the above mentioned instruments, as well as AC datasets residing at remote archive sites (e.g, LaRC DAAC) The goals of the ACDISC are to: 1) Provide a data center for Atmospheric Scientists, guided by Atmospheric Scientists; 2) Be absolutely responsive to the data and data service needs of the Atmospheric Composition (AC) community; 3) Provide services (i.e., expertise) that will facilitate the effortless access to and usage of AC data; 4) Collaborate with AC scientists to facilitate the use of data from multiple sensors for long term atmospheric research. The ACDISC is an AC specific, user driven, multi-sensor, on-line, easy access archive and distribution system employing data analysis and visualization, data mining, and other user requested techniques that facilitate science data usage. The purpose of this presentation is to provide the evolution path that the GES DISC in order to better serve AC data, and also to receive continued community feedback and further foster collaboration with AC data users and providers.

Evaluation of the first pharmacist-administered vaccinations in Western Australia: a mixed-methods study

PubMed Central

Hattingh, H Laetitia; Sim, T Fei; Parsons, R; Czarniak, P; Vickery, A; Ayadurai, S

2016-01-01

Objectives This study evaluated the uptake of Western Australian (WA) pharmacist vaccination services, the profiles of consumers being vaccinated and the facilitators and challenges experienced by pharmacy staff in the preparation, implementation and delivery of services. Design Mixed-methods methodology with both quantitative and qualitative data through surveys, pharmacy computer records and immuniser pharmacist interviews. Setting Community pharmacies in WA that provided pharmacist vaccination services between March and October 2015. Participants Immuniser pharmacists from 86 pharmacies completed baseline surveys and 78 completed exit surveys; computer records from 57 pharmacies; 25 immuniser pharmacists were interviewed. Main outcome measures Pharmacy and immuniser pharmacist profiles; pharmacist vaccination services provided and consumer profiles who accessed services. Results 15 621 influenza vaccinations were administered by immuniser pharmacists at 76 WA community pharmacies between March and October 2015. There were no major adverse events, and <1% of consumers experienced minor events which were appropriately managed. Between 12% and 17% of consumers were eligible to receive free influenza vaccinations under the National Immunisation Program but chose to have it at a pharmacy. A high percentage of vaccinations was delivered in rural and regional areas indicating that provision of pharmacist vaccination services facilitated access for rural and remote consumers. Immuniser pharmacists reported feeling confident in providing vaccination services and were of the opinion that services should be expanded to other vaccinations. Pharmacists also reported significant professional satisfaction in providing the service. All participating pharmacies intended to continue providing influenza vaccinations in 2016. Conclusions This initial evaluation of WA pharmacist vaccination services showed that vaccine delivery was safe. Convenience and accessibility were important aspects in usage of services. There is scope to expand pharmacist vaccination services to other vaccines and younger children; however, government funding to pharmacists needs to be considered. PMID:27650763

"I just answer 'yes' to everything they say": access to health care for deaf people in Worcester, South Africa and the politics of exclusion.

PubMed

Kritzinger, Janis; Schneider, Marguerite; Swartz, Leslie; Braathen, Stine Hellum

2014-03-01

To explore whether there are other factors besides communication difficulties that hamper access to health care services for deaf patients. Qualitative methodology using semi-structured interviews with 16 deaf participants from the National Institute for the Deaf in Worcester and 3 Key informants from the Worcester area, South Africa. Communication difficulties were found to be a prominent barrier in accessing health care services. In addition to this interpersonal factors including lack of independent thought, overprotectedness, non-questioning attitude, and lack of familial communication interact with communication difficulties in a way that further hampers access to health care services. These interpersonal factors play a unique role in how open and accepting health services feel to deaf patients. Health care services need to take cognizance of the fact that providing sign language interpreters in the health care setting will not necessarily make access more equitable for deaf patients, as they have additional barriers besides communication to overcome before successfully accessing health care services. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

EntrezAJAX: direct web browser access to the Entrez Programming Utilities

PubMed Central

2010-01-01

Web applications for biology and medicine often need to integrate data from Entrez services provided by the National Center for Biotechnology Information. However, direct access to Entrez from a web browser is not possible due to 'same-origin' security restrictions. The use of "Asynchronous JavaScript and XML" (AJAX) to create rich, interactive web applications is now commonplace. The ability to access Entrez via AJAX would be advantageous in the creation of integrated biomedical web resources. We describe EntrezAJAX, which provides access to Entrez eUtils and is able to circumvent same-origin browser restrictions. EntrezAJAX is easily implemented by JavaScript developers and provides identical functionality as Entrez eUtils as well as enhanced functionality to ease development. We provide easy-to-understand developer examples written in JavaScript to illustrate potential uses of this service. For the purposes of speed, reliability and scalability, EntrezAJAX has been deployed on Google App Engine, a freely available cloud service. The EntrezAJAX webpage is located at http://entrezajax.appspot.com/ PMID:20565938

The gap between coverage and care-what can Canadian paediatricians do about access to health services for refugee claimant children?

PubMed

Rink, N; Muttalib, F; Morantz, G; Chase, L; Cleveland, J; Rousseau, C; Li, P

2017-11-01

In June 2012, the government of Canada severely restricted the scope of the Interim Federal Health Program that had hitherto provided coverage for the health care needs of refugee claimants. The Quebec government decided to supplement coverage via the provincial health program. Despite this, we hypothesized that refugee claimant children in Montreal would continue to experience significant difficulties in accessing basic health care. (1) Report the narrative experiences of refugee claimant families who were denied health care services in Montreal following June 2012, (2) describe the predominant barriers to accessing health care services and understanding their impact using thematic analysis and (3) derive concrete recommendations for child health care providers to improve access to care for refugee claimant children. Eleven parents recruited from two sites in Montreal participated in semi-structured interviews designed to elicit a narrative account of their experiences seeking health care. Interviews were recorded, transcribed, coded using NVivo software and subjected to thematic analysis. Thematic analysis of the data revealed five themes concerning barriers to health care access: lack of continuous health coverage, health care administrators/providers' lack of understanding of Interim Federal Health Program coverage, refusal of services or fees charged, refugee claimants' lack of understanding about health care rights and services and language barriers, and four themes concerning the impact of denial of care episodes: potential for adverse health outcomes, psychological distress, financial burden and social stigma. We propose eight action points for advocacy by Canadian paediatricians to improve access to health care for refugee claimant children in their communities and institutions.

Using Open and Interoperable Ways to Publish and Access LANCE AIRS Near-Real Time Data

NASA Technical Reports Server (NTRS)

Zhao, Peisheng; Lynnes, Christopher; Vollmer, Bruce; Savtchenko, Andrey; Theobald, Michael; Yang, Wenli

2011-01-01

The Atmospheric Infrared Sounder (AIRS) Near-Real Time (NRT) data from the Land Atmosphere Near real-time Capability for EOS (LANCE) element at the Goddard Earth Sciences Data and Information Services Center (GES DISC) provides information on the global and regional atmospheric state, with very low temporal latency, to support climate research and improve weather forecasting. An open and interoperable platform is useful to facilitate access to, and integration of, LANCE AIRS NRT data. As Web services technology has matured in recent years, a new scalable Service-Oriented Architecture (SOA) is emerging as the basic platform for distributed computing and large networks of interoperable applications. Following the provide-register-discover-consume SOA paradigm, this presentation discusses how to use open-source geospatial software components to build Web services for publishing and accessing AIRS NRT data, explore the metadata relevant to registering and discovering data and services in the catalogue systems, and implement a Web portal to facilitate users' consumption of the data and services.

Across the health-social care divide: elderly people as active users of health care and social care.

PubMed

Roberts, K

2001-03-01

Several ways in which elderly people may assume an active role when using welfare services are discussed here. Selected findings are presented from a study that explored the experience and behaviour of elderly people on discharge from inpatient care with regard to criteria indicating user influence or control (namely participation, representation, access, choice, information and redress). Data were collected via semistructured interviews with service users (n = 30) soon after their return home from hospital. A number of differences were revealed between health care and social care in relation to users being provided with opportunities to assume an active role and in being willing and able to assume an active role. These differences were manifest in elderly service users accessing services, seeking information, exercising choice and acting independently of service providers. It appeared paradoxical that contact points were more easily defined with regard to health care yet users were more likely to exercise choice and act independently in securing social care. It is suggested that social care needs and appropriate service delivery are more easily recognised than making the link between perceived health care needs and appropriate services. In addition, it appeared that informal and private providers are more widely available and accessible for social care. If comprehensive continuing care is to be provided, incorporating both health and social care elements, greater uniformity appears to be required across the welfare sector. Lessons for social care provision from the delivery of health care suggest the clear definition of contact points to facilitate service use. Making health care more accessible, however, does not appear to be easily attainable due to the monopoly provision of health care and the lack of direct purchasing power by potential users.

Templet Web: the use of volunteer computing approach in PaaS-style cloud

NASA Astrophysics Data System (ADS)

Vostokin, Sergei; Artamonov, Yuriy; Tsarev, Daniil

2018-03-01

This article presents the Templet Web cloud service. The service is designed for high-performance scientific computing automation. The use of high-performance technology is specifically required by new fields of computational science such as data mining, artificial intelligence, machine learning, and others. Cloud technologies provide a significant cost reduction for high-performance scientific applications. The main objectives to achieve this cost reduction in the Templet Web service design are: (a) the implementation of "on-demand" access; (b) source code deployment management; (c) high-performance computing programs development automation. The distinctive feature of the service is the approach mainly used in the field of volunteer computing, when a person who has access to a computer system delegates his access rights to the requesting user. We developed an access procedure, algorithms, and software for utilization of free computational resources of the academic cluster system in line with the methods of volunteer computing. The Templet Web service has been in operation for five years. It has been successfully used for conducting laboratory workshops and solving research problems, some of which are considered in this article. The article also provides an overview of research directions related to service development.

12 CFR 1016.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2013 CFR

2013-01-01

... encrypted form, as long as you do not provide the recipient with a means to decode the number or code. (2... reporting agency, an account number or similar form of access number or access code for a consumer's credit... similar form of access number or access code: (1) To your agent or service provider solely in order to...

12 CFR 1016.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2014 CFR

2014-01-01

... encrypted form, as long as you do not provide the recipient with a means to decode the number or code. (2... reporting agency, an account number or similar form of access number or access code for a consumer's credit... similar form of access number or access code: (1) To your agent or service provider solely in order to...

12 CFR 216.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2012 CFR

2012-01-01

... code in an encrypted form, as long as you do not provide the recipient with a means to decode the... than to a consumer reporting agency, an account number or similar form of access number or access code... account number or similar form of access number or access code: (1) To your agent or service provider...

16 CFR 313.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2013 CFR

2013-01-01

... encrypted form, as long as you do not provide the recipient with a means to decode the number or code. (2... consumer reporting agency, an account number or similar form of access number or access code for a consumer... similar form of access number or access code: (1) To your agent or service provider solely in order to...

16 CFR 313.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2011 CFR

2011-01-01

... encrypted form, as long as you do not provide the recipient with a means to decode the number or code. (2... consumer reporting agency, an account number or similar form of access number or access code for a consumer... similar form of access number or access code: (1) To your agent or service provider solely in order to...

12 CFR 216.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2014 CFR

2014-01-01

... code in an encrypted form, as long as you do not provide the recipient with a means to decode the... than to a consumer reporting agency, an account number or similar form of access number or access code... account number or similar form of access number or access code: (1) To your agent or service provider...

16 CFR 313.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2012 CFR

2012-01-01

... encrypted form, as long as you do not provide the recipient with a means to decode the number or code. (2... consumer reporting agency, an account number or similar form of access number or access code for a consumer... similar form of access number or access code: (1) To your agent or service provider solely in order to...

12 CFR 216.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2013 CFR

2013-01-01

... code in an encrypted form, as long as you do not provide the recipient with a means to decode the... than to a consumer reporting agency, an account number or similar form of access number or access code... account number or similar form of access number or access code: (1) To your agent or service provider...

12 CFR 1016.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2012 CFR

2012-01-01

... encrypted form, as long as you do not provide the recipient with a means to decode the number or code. (2... reporting agency, an account number or similar form of access number or access code for a consumer's credit... similar form of access number or access code: (1) To your agent or service provider solely in order to...

12 CFR 332.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2013 CFR

2013-01-01

... encrypted form, as long as you do not provide the recipient with a means to decode the number or code. (2... consumer reporting agency, an account number or similar form of access number or access code for a consumer... similar form of access number or access code: (1) To your agent or service provider solely in order to...

12 CFR 332.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2011 CFR

2011-01-01

... encrypted form, as long as you do not provide the recipient with a means to decode the number or code. (2... consumer reporting agency, an account number or similar form of access number or access code for a consumer... similar form of access number or access code: (1) To your agent or service provider solely in order to...

12 CFR 332.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2014 CFR

2014-01-01

... encrypted form, as long as you do not provide the recipient with a means to decode the number or code. (2... consumer reporting agency, an account number or similar form of access number or access code for a consumer... similar form of access number or access code: (1) To your agent or service provider solely in order to...

12 CFR 216.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2011 CFR

2011-01-01

... code in an encrypted form, as long as you do not provide the recipient with a means to decode the... than to a consumer reporting agency, an account number or similar form of access number or access code... account number or similar form of access number or access code: (1) To your agent or service provider...

12 CFR 332.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2012 CFR

2012-01-01

... encrypted form, as long as you do not provide the recipient with a means to decode the number or code. (2... consumer reporting agency, an account number or similar form of access number or access code for a consumer... similar form of access number or access code: (1) To your agent or service provider solely in order to...

16 CFR 313.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2014 CFR

2014-01-01

... encrypted form, as long as you do not provide the recipient with a means to decode the number or code. (2... consumer reporting agency, an account number or similar form of access number or access code for a consumer... similar form of access number or access code: (1) To your agent or service provider solely in order to...

Llnking the EarthScope Data Virtual Catalog to the GEON Portal

NASA Astrophysics Data System (ADS)

Lin, K.; Memon, A.; Baru, C.

2008-12-01

The EarthScope Data Portal provides a unified, single-point of access to EarthScope data and products from USArray, Plate Boundary Observatory (PBO), and San Andreas Fault Observatory at Depth (SAFOD) experiments. The portal features basic search and data access capabilities to allow users to discover and access EarthScope data using spatial, temporal, and other metadata-based (data type, station specific) search conditions. The portal search module is the user interface implementation of the EarthScope Data Search Web Service. This Web Service acts as a virtual catalog that in turn invokes Web services developed by IRIS (Incorporated Research Institutions for Seismology), UNAVCO (University NAVSTAR Consortium), and GFZ (German Research Center for Geosciences) to search for EarthScope data in the archives at each of these locations. These Web Services provide information about all resources (data) that match the specified search conditions. In this presentation we will describe how the EarthScope Data Search Web service can be integrated into the GEONsearch application in the GEON Portal (see http://portal.geongrid.org). Thus, a search request issued at the GEON Portal will also search the EarthScope virtual catalog thereby providing users seamless access to data in GEON as well as the Earthscope via a common user interface.

Defense Message System Way Ahead: Conclusions and Recommendations from the Industry Advisory Panel

DTIC Science & Technology

2000-03-01

access terminals • Increasing requirement for authentication and data security for conducting business • Mergers and acquisitions in Internet space...market, used to carry PKI certificates for all types of security services including access control, confidentiality, integrity, and non-repudiation...Wireless access widespread § Unified messaging pervasive § Security /privacy dependent on service provider Long-term § Highly reliable systems

Analysis of the Security and Privacy Requirements of Cloud-Based Electronic Health Records Systems

PubMed Central

Fernández, Gonzalo; López-Coronado, Miguel

2013-01-01

Background The Cloud Computing paradigm offers eHealth systems the opportunity to enhance the features and functionality that they offer. However, moving patients’ medical information to the Cloud implies several risks in terms of the security and privacy of sensitive health records. In this paper, the risks of hosting Electronic Health Records (EHRs) on the servers of third-party Cloud service providers are reviewed. To protect the confidentiality of patient information and facilitate the process, some suggestions for health care providers are made. Moreover, security issues that Cloud service providers should address in their platforms are considered. Objective To show that, before moving patient health records to the Cloud, security and privacy concerns must be considered by both health care providers and Cloud service providers. Security requirements of a generic Cloud service provider are analyzed. Methods To study the latest in Cloud-based computing solutions, bibliographic material was obtained mainly from Medline sources. Furthermore, direct contact was made with several Cloud service providers. Results Some of the security issues that should be considered by both Cloud service providers and their health care customers are role-based access, network security mechanisms, data encryption, digital signatures, and access monitoring. Furthermore, to guarantee the safety of the information and comply with privacy policies, the Cloud service provider must be compliant with various certifications and third-party requirements, such as SAS70 Type II, PCI DSS Level 1, ISO 27001, and the US Federal Information Security Management Act (FISMA). Conclusions Storing sensitive information such as EHRs in the Cloud means that precautions must be taken to ensure the safety and confidentiality of the data. A relationship built on trust with the Cloud service provider is essential to ensure a transparent process. Cloud service providers must make certain that all security mechanisms are in place to avoid unauthorized access and data breaches. Patients must be kept informed about how their data are being managed. PMID:23965254

Analysis of the security and privacy requirements of cloud-based electronic health records systems.

PubMed

Rodrigues, Joel J P C; de la Torre, Isabel; Fernández, Gonzalo; López-Coronado, Miguel

2013-08-21

The Cloud Computing paradigm offers eHealth systems the opportunity to enhance the features and functionality that they offer. However, moving patients' medical information to the Cloud implies several risks in terms of the security and privacy of sensitive health records. In this paper, the risks of hosting Electronic Health Records (EHRs) on the servers of third-party Cloud service providers are reviewed. To protect the confidentiality of patient information and facilitate the process, some suggestions for health care providers are made. Moreover, security issues that Cloud service providers should address in their platforms are considered. To show that, before moving patient health records to the Cloud, security and privacy concerns must be considered by both health care providers and Cloud service providers. Security requirements of a generic Cloud service provider are analyzed. To study the latest in Cloud-based computing solutions, bibliographic material was obtained mainly from Medline sources. Furthermore, direct contact was made with several Cloud service providers. Some of the security issues that should be considered by both Cloud service providers and their health care customers are role-based access, network security mechanisms, data encryption, digital signatures, and access monitoring. Furthermore, to guarantee the safety of the information and comply with privacy policies, the Cloud service provider must be compliant with various certifications and third-party requirements, such as SAS70 Type II, PCI DSS Level 1, ISO 27001, and the US Federal Information Security Management Act (FISMA). Storing sensitive information such as EHRs in the Cloud means that precautions must be taken to ensure the safety and confidentiality of the data. A relationship built on trust with the Cloud service provider is essential to ensure a transparent process. Cloud service providers must make certain that all security mechanisms are in place to avoid unauthorized access and data breaches. Patients must be kept informed about how their data are being managed.

Common Data Servers as a Foundation for Specialized Services

NASA Astrophysics Data System (ADS)

Burger, E. F.; Schweitzer, R.; O'Brien, K.; Manke, A. B.; Smith, K. M.

2017-12-01

NOAA's Pacific Marine Environmental Laboratory (PMEL) hosts a broad range of research efforts that span many scientific and environmental research disciplines. Many of these research projects have their own data streams that are as diverse as the research. Data are collected using various platforms, including innovative new platforms such as Saildrones and autonomous profilers. With its requirements for public access to federally funded research results and data, the 2013 White House Office of Science and Technology memo on Public Access to Research Results (PARR) changed the data landscape for Federal agencies. In 2015, with support from the PMEL Director, the PMEL Science Data Integration Group (SDIG) initiated a multi-year effort to formulate and implement an integrated data-management strategy for PMEL research efforts. The PMEL integrated data management strategy will provide data access, visualization and some archive services to PMEL data and use existing and proven frameworks for this capability. In addition to these foundational data services, these data access and visualization frameworks are also leveraged to provide enhanced services to scientists. One enhanced service developed is a data management "dashboard". This application provides scientists with a snapshot of their data assets, access to these data, a map view of data locations, and information on the archival status. Ideally, information on the dashboard continually updates to accurately reflect the project's data asset status. This poster explains how frameworks such as ERDDAP and LAS were used as a foundation for the development of custom services, as well as an explanation of the PMEL data management dashboard functionality. We will also highlight accomplishments of the PMEL Integrated data management strategy implementation.

Contract management in USA hospitals: service duplication and access within local markets.

PubMed

Carey, Kathleen; Dor, Avi

2008-08-01

This paper examines the extent to which hospitals that are under external contract management engage in service duplication, as well as the degree to which the various services they offer contribute to or detract from community access. The study incorporates all USA hospitals using data from the American Hospital Association Annual Survey Database, supplemented by county level measures obtained from the area resource file (ARF). Using data on the 3794 hospitals classified as acute care facilities in 2002, we performed a set of logistic regressions that analyzed whether a hospital offered each of 74 distinct services. For each service (regression), key independent variables measured the number of other hospitals in the local market area that also offered the service. Local area market definitions are the areas circumscribed by the hospital within distances of 10 and 20 miles. Results suggest that contract-managed (CM) hospitals display a more competitive pattern (service duplication) than hospitals in general, but CM hospitals that are the sole provider of services locally are less likely to offer services than traditionally managed sole hospital providers. Contract management does not appear to offer any particular advantages in improving access to hospital services.

Using EMBL-EBI services via Web interface and programmatically via Web Services

PubMed Central

Lopez, Rodrigo; Cowley, Andrew; Li, Weizhong; McWilliam, Hamish

2015-01-01

The European Bioinformatics Institute (EMBL-EBI) provides access to a wide range of databases and analysis tools that are of key importance in bioinformatics. As well as providing Web interfaces to these resources, Web Services are available using SOAP and REST protocols that enable programmatic access to our resources and allow their integration into other applications and analytical workflows. This unit describes the various options available to a typical researcher or bioinformatician who wishes to use our resources via Web interface or programmatically via a range of programming languages. PMID:25501941

Providing Multi-Page Data Extraction Services with XWRAPComposer

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

Liu, Ling; Zhang, Jianjun; Han, Wei

2008-04-30

Dynamic Web data sources – sometimes known collectively as the Deep Web – increase the utility of the Web by providing intuitive access to data repositories anywhere that Web access is available. Deep Web services provide access to real-time information, like entertainment event listings, or present a Web interface to large databases or other data repositories. Recent studies suggest that the size and growth rate of the dynamic Web greatly exceed that of the static Web, yet dynamic content is often ignored by existing search engine indexers owing to the technical challenges that arise when attempting to search the Deepmore » Web. To address these challenges, we present DYNABOT, a service-centric crawler for discovering and clustering Deep Web sources offering dynamic content. DYNABOT has three unique characteristics. First, DYNABOT utilizes a service class model of the Web implemented through the construction of service class descriptions (SCDs). Second, DYNABOT employs a modular, self-tuning system architecture for focused crawling of the Deep Web using service class descriptions. Third, DYNABOT incorporates methods and algorithms for efficient probing of the Deep Web and for discovering and clustering Deep Web sources and services through SCD-based service matching analysis. Our experimental results demonstrate the effectiveness of the service class discovery, probing, and matching algorithms and suggest techniques for efficiently managing service discovery in the face of the immense scale of the Deep Web.« less

47 CFR 54.706 - Contributions.

Code of Federal Regulations, 2011 CFR

2011-10-01

...; (12) Telex; (13) Telegraph; (14) Video services; (15) Satellite service; (16) Resale of interstate services; (17) Payphone services; and (18) Interconnected VoIP services. (19) Prepaid calling card... telecommunications services. (d) Entities providing open video systems (OVS), cable leased access, or direct...

47 CFR 54.706 - Contributions.

Code of Federal Regulations, 2012 CFR

2012-10-01

...; (12) Telex; (13) Telegraph; (14) Video services; (15) Satellite service; (16) Resale of interstate services; (17) Payphone services; and (18) Interconnected VoIP services. (19) Prepaid calling card... telecommunications services. (d) Entities providing open video systems (OVS), cable leased access, or direct...

47 CFR 54.706 - Contributions.

Code of Federal Regulations, 2014 CFR

2014-10-01

...; (12) Telex; (13) Telegraph; (14) Video services; (15) Satellite service; (16) Resale of interstate services; (17) Payphone services; and (18) Interconnected VoIP services. (19) Prepaid calling card... telecommunications services. (d) Entities providing open video systems (OVS), cable leased access, or direct...

47 CFR 54.706 - Contributions.

Code of Federal Regulations, 2013 CFR

2013-10-01

...; (12) Telex; (13) Telegraph; (14) Video services; (15) Satellite service; (16) Resale of interstate services; (17) Payphone services; and (18) Interconnected VoIP services. (19) Prepaid calling card... telecommunications services. (d) Entities providing open video systems (OVS), cable leased access, or direct...

47 CFR 54.706 - Contributions.

Code of Federal Regulations, 2010 CFR

2010-10-01

...; (12) Telex; (13) Telegraph; (14) Video services; (15) Satellite service; (16) Resale of interstate services; (17) Payphone services; and (18) Interconnected VoIP services. (19) Prepaid calling card... telecommunications services. (d) Entities providing open video systems (OVS), cable leased access, or direct...

47 CFR 79.2 - Accessibility of programming providing emergency information.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) BROADCAST RADIO SERVICES ACCESSIBILITY OF VIDEO PROGRAMMING Video Programming Owners, Providers, and... of programming providing emergency information. (1) Video programming distributors must make... or by using a method of visual presentation, as described in § 79.1. (2) Video programming...

Healthcare provider perspectives on barriers to HIV-care access and utilisation among Latinos living with HIV in the US-Mexico border.

PubMed

Servin, Argentina E; Muñoz, Fátima A; Zúñiga, María Luisa

2014-01-01

Latinos living with HIV residing in the US-Mexico border region frequently seek care on both sides of the border. Given this fact, a border health perspective to understanding barriers to care is imperative to improve patient health outcomes. This qualitative study describes and compares experiences and perceptions of Mexican and US HIV care providers regarding barriers to HIV care access for Latino patients living in the US-Mexico border region. In 2010, we conducted in-depth qualitative interviews with HIV care providers in Tijuana (n = 10) and San Diego (n = 9). We identified important similarities and differences between Mexican and US healthcare provider perspectives on HIV care access and barriers to service utilisation. Similarities included the fact that HIV-positive Latino patients struggle with access to ART medication, mental health illness, substance abuse and HIV-related stigma. Differences included Mexican provider perceptions of medication shortages and US providers feeling that insurance gaps influenced medication access. Differences and similarities have important implications for cross-border efforts to coordinate health services for patients who seek care in both countries.

Improving maternal healthcare utilisation in sub-Saharan Africa through micro-finance.

PubMed

Abekah-Nkrumah, Gordon; Abor, Patience Aseweh; Abor, Joshua; Adjasi, Charles K D

2011-01-01

This paper aims to examine links between women's access to micro-finance and how they use maternal healthcare services in sub-Saharan Africa (SSA). The authors use theoretical and empirical literature to propose a framework to sustain and improve women's access to maternal healthcare services through micro-financing. It is found that improved access to micro-finance by women, combined with education may enhance maternal health service uptake. The paper does not consider empirical data in the analysis. The authors advocate empirically testing the framework proposed in other SSA countries. It is important to empower women by facilitating their access to education and micro-finance. This has implications for improving maternal healthcare utilization in SSA. The paper moves beyond poor access to maternal health services in SSA and proposes a framework for providing sustainable solutions.

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

Code of Federal Regulations, 2011 CFR

2011-10-01

... system; and (3) Does not provide access to any digital transmission of multichannel video programming or... COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive... security functions. (a)(1) A multichannel video programming distributor that utilizes navigation devices to...

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

DOT National Transportation Integrated Search

2009-01-01

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

The Access Vermont Initiative: An Investigation of Team Development in Two Vermont Catchment Areas Providing Services to Children with Severe Emotional Disturbances and Their Families.

ERIC Educational Resources Information Center

Fox, Barbara J.; Wright, Leanne M.

This study was designed to document the processes and dynamics of two multidisciplinary teams under the Access Vermont program, which provides services for children and youth with serious emotional disabilities and their families. In both cases, local interagency teams in the largely rural catchment areas developed plans for an initiative focused…

Understanding structural barriers to accessing HIV testing and prevention services among black men who have sex with men (BMSM) in the United States.

PubMed

Levy, Matthew E; Wilton, Leo; Phillips, Gregory; Glick, Sara Nelson; Kuo, Irene; Brewer, Russell A; Elliott, Ayana; Watson, Christopher; Magnus, Manya

2014-05-01

Structural-level factors have contributed to the substantial disproportionate rates of HIV among Black men who have sex with men (BMSM) in the United States. Despite insufficient HIV testing patterns, however, there is a void in research investigating the relationship between structural factors and access to HIV testing and prevention services among BMSM. Building on previous scholarly work and incorporating a dynamic social systems conceptual framework, we conducted a comprehensive review of the literature on structural barriers to HIV testing and prevention services among BMSM across four domains: healthcare, stigma and discrimination, incarceration, and poverty. We found that BMSM experience inadequate access to culturally competent services, stigma and discrimination that impede access to services, a deficiency of services in correctional institutions, and limited services in areas where BMSM live. Structural interventions that eliminate barriers to HIV testing and prevention services and provide BMSM with core skills to navigate complex systems are needed.

Understanding Structural Barriers to Accessing HIV Testing and Prevention Services Among Black Men Who Have Sex with Men (BMSM) in the United States

PubMed Central

Wilton, Leo; Phillips, Gregory; Glick, Sara Nelson; Kuo, Irene; Brewer, Russell A.; Elliott, Ayana; Watson, Christopher; Magnus, Manya

2015-01-01

Structural-level factors have contributed to the substantial disproportionate rates of HIV among Black men who have sex with men (BMSM) in the United States. Despite insufficient HIV testing patterns, however, there is a void in research investigating the relationship between structural factors and access to HIV testing and prevention services among BMSM. Building on previous scholarly work and incorporating a dynamic social systems conceptual framework, we conducted a comprehensive review of the literature on structural barriers to HIV testing and prevention services among BMSM across four domains: healthcare, stigma and discrimination, incarceration, and poverty. We found that BMSM experience inadequate access to culturally competent services, stigma and discrimination that impede access to services, a deficiency of services in correctional institutions, and limited services in areas where BMSM live. Structural interventions that eliminate barriers to HIV testing and prevention services and provide BMSM with core skills to navigate complex systems are needed. PMID:24531769

Improving access to oral health care services among underserved populations in the U.S.: is there a role for mid-level dental providers?

PubMed

Shaefer, H Luke; Miller, Matthew

2011-08-01

Nearly one-third of U.S. citizens lack access to basic preventive and primary oral health care services, which is primarily the result of the high costs of care and the uneven geographic distribution of dental providers. This article examines the case for and against one possible solution to address these barriers to oral health care: the introduction of a mid-level dental provider (MDP) position within the dental field.

Interpersonal relations between health care workers and young clients: barriers to accessing sexual and reproductive health care.

PubMed

Alli, Farzana; Maharaj, Pranitha; Vawda, Mohammed Yacoob

2013-02-01

Interpersonal relations between health care providers and young clients have long being cited as an important element for improving client up take of services, satisfaction and overall health outcomes. In an era of HIV and AIDS this forms a critical determinant to young people accessing sexual and reproductive health care. This study explores to what extent interpersonal relations form a barrier to young peoples access to and satisfaction of health services. The study draws on data from 200 client exit interviews and four in-depth interviews conducted with university students and university health care staff in Kwazulu-Natal, South Africa. While young people are aware of the importance of utilising STI, HIV and family planning services they experienced barriers in their relationship with providers. This served as a deterrent to their use of the health facility. Adequate training in interpersonal relations for youth-friendly service provision is essential in helping overcome communication problems and enabling providers to interact with young clients at a more personal level.

Unifying Water Data Sources: How the CUAHSI Water Data Center is Enabling and Improving Access to a Growing Catalog of over 100 Data Providers

NASA Astrophysics Data System (ADS)

Pollak, J.; Berry, K.; Couch, A.; Arrigo, J.; Hooper, R. P.

2013-12-01

Scientific data about water are collected and distributed by numerous sources which can differ tremendously in scale. As competition for water resources increases, increasing access to and understanding of information about water will be critical. The mission of the new CUAHSI Water Data Center (WDC) is to provide those researchers who collect data a medium to publish their datasets and give those wanting to discover data the proper tools to efficiently find the data that they seek. These tools include standards-based data publication, data discovery tools based upon faceted and telescoping search, and a data analysis tool HydroDesktop that downloads and unifies data in standardized formats. The CUAHSI Hydrologic Information System (HIS) is a community developed and open source system for sharing water data. As a federated, web service oriented system it enables data publication for a diverse user population including scientific investigators (Research Coordination Networks, Critical Zone Observatories), government agencies (USGS, NASA, EPA), and citizen scientists (watershed associations). HydroDesktop is an end user application for data consumption in this system that the WDC supports. This application can be used for finding, downloading, and analyzing data from the HIS. It provides a GIS interface that allows users to incorporate spatial data that are not accessible via HIS, simple analysis tools to facilitate graphing and visualization, tools to export data to common file types, and provides an extensible architecture that developers can build upon. HydroDesktop, however, is just one example of a data access client for HIS. The web service oriented architecture enables data access by an unlimited number of clients provided they can consume the web services used in HIS. One such example developed at the WDC is the 'Faceted Search Client', which capitalizes upon exploratory search concepts to improve accuracy and precision during search. We highlight such features of the CUAHSI-HIS which make it particularly appropriate for providing unified access to several sources of water data. A growing community of researchers and educators are employing these tools for education; including sharing best practices around creating modules, supporting researchers and educators in accessing the services, and cataloging and sharing modules. The CUAHSI WDC is a community governed organization. Our agenda is driven by the community's voice through a Board of Directors and committees that decide strategic direction (new products), tactical decisions (product improvement), and evaluation of usability. By providing the aforementioned services within a community driven framework, we believe the WDC is providing critical services that include improving water data discoverability, accessibility and usability within a sustainable governance structure.

Cloud Computing

DTIC Science & Technology

2009-11-12

Service (IaaS) Software -as-a- Service ( SaaS ) Cloud Computing Types Platform-as-a- Service (PaaS) Based on Type of Capability Based on access Based...Mellon University Software -as-a- Service ( SaaS ) Application-specific capabilities, e.g., service that provides customer management Allows organizations...as a Service ( SaaS ) Model of software deployment in which a provider licenses an application to customers for use as a service on

Handling of the demilitarized zone using service providers in SAP

NASA Astrophysics Data System (ADS)

Iovan, A.; Robu, R.

2016-02-01

External collaboration needs to allow data access from the Internet. In a trusted Internet collaboration scenario where the external user works on the same data like the internal user direct access to the data in the Intranet is required. The paper presents a solution to get access to certain data in the Enterprise Resource Planning system, having the User Interface on a system in the Demilitarized Zone and the database on a system which is located in the trusted area. Using the Service Provider Interface framework, connections between separate systems can be created in different areas of the network. The paper demonstrates how to connect the two systems, one in the Demilitarized Zone and one in the trusted area, using SAP ERP 6.0 with Enhancement Package 7. In order to use the Service Provider Interface SAP Business Suite Foundation component must be installed in both systems. The advantage of using the Service Provider Interface framework is that the external user works on the same data like the internal user (and not on copies). This assures data consistency and less overhead for backup and security systems.

Rationing is a reality in rural physiotherapy: a qualitative exploration of service level decision-making.

PubMed

Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

2015-03-27

Deciding what health services are provided is a key consideration in delivering appropriate and accessible health care for rural and remote populations. Despite residents of rural communities experiencing poorer health outcomes and exhibiting higher health need, workforce shortages and maldistribution mean that rural communities do not have access to the range of services available in metropolitan centres. Where demand exceeds available resources, decisions about resource allocation are required. A qualitative approach enabled the researchers to explore participant perspectives about decisions informing rural physiotherapy service provision. Stakeholder perspectives were obtained through surveys and in-depth interviews. A system theory-case study heuristic provided a framework for exploration across sites within the investigation area: a large area of one Australian state with a mix of rural, regional and remote communities. Thirty-nine surveys were received from participants in eleven communities. Nineteen in-depth interviews were conducted with physiotherapist and key decision-makers. Increasing demand, organisational priorities, fiscal austerity measures and workforce challenges were identified as factors influencing both decision-making and service provision. Rationing of physiotherapy services was common to all sites of this study. Rationing of services, more commonly expressed as service prioritisation, was more evident in responses of public sector physiotherapy participants compared to private physiotherapists. However, private physiotherapists in rural areas reported capacity limits, including expertise, space and affordability that constrained service provision. The imbalance between increasing service demands and limited physiotherapy capacity meant making choices was inevitable. Decreased community access to local physiotherapy services and increased workforce stress, a key determinant of retention, are two results of such choices or decisions. Decreased access was particularly evident for adults and children requiring neurological rehabilitation and for people requiring post-acute physiotherapy. It should not be presumed that rural private physiotherapy providers will cover service gaps that may emerge from changes to public sector service provision. Clinician preference combines with capacity limits and the imperative of financial viability to negate such assumptions. This study provides insight into rural physiotherapy service provision not usually evident and can be used to inform health service planning and decision-making and education of current and future rural physiotherapists.

Apollo: Giving application developers a single point of access to public health models using structured vocabularies and Web services

PubMed Central

Wagner, Michael M.; Levander, John D.; Brown, Shawn; Hogan, William R.; Millett, Nicholas; Hanna, Josh

2013-01-01

This paper describes the Apollo Web Services and Apollo-SV, its related ontology. The Apollo Web Services give an end-user application a single point of access to multiple epidemic simulators. An end user can specify an analytic problem—which we define as a configuration and a query of results—exactly once and submit it to multiple epidemic simulators. The end user represents the analytic problem using a standard syntax and vocabulary, not the native languages of the simulators. We have demonstrated the feasibility of this design by implementing a set of Apollo services that provide access to two epidemic simulators and two visualizer services. PMID:24551417

Apollo: giving application developers a single point of access to public health models using structured vocabularies and Web services.

PubMed

Wagner, Michael M; Levander, John D; Brown, Shawn; Hogan, William R; Millett, Nicholas; Hanna, Josh

2013-01-01

This paper describes the Apollo Web Services and Apollo-SV, its related ontology. The Apollo Web Services give an end-user application a single point of access to multiple epidemic simulators. An end user can specify an analytic problem-which we define as a configuration and a query of results-exactly once and submit it to multiple epidemic simulators. The end user represents the analytic problem using a standard syntax and vocabulary, not the native languages of the simulators. We have demonstrated the feasibility of this design by implementing a set of Apollo services that provide access to two epidemic simulators and two visualizer services.

Spatial Accessibility to Health Care Services: Identifying under-Serviced Neighbourhoods in Canadian Urban Areas.

PubMed

Shah, Tayyab Ikram; Bell, Scott; Wilson, Kathi

2016-01-01

Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC) in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods. This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA) method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population), was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms) used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons). An integrated geocoding approach was used to establish PHC locations. The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs. The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care services at the neighbourhood level. In particular, the results show that the low access neighbourhoods tend to be clustered in the neighbourhoods at the urban periphery and immediately surrounding the downtown area.

headspace - Australia's innovation in youth mental health: who are the clients and why are they presenting?

PubMed

Rickwood, Debra J; Telford, Nic R; Parker, Alexandra G; Tanti, Chris J; McGorry, Patrick D

2014-02-03

To provide the first national profile of the characteristics of young people (aged 12-25 years) accessing headspace centre services - the Australian Government's innovation in youth mental health service delivery - and investigate whether headspace is providing early service access for adolescents and young adults with emerging mental health problems. Census of all young people accessing a headspace centre across the national network of 55 centres comprising a total of 21 274 headspace clients between 1 January and 30 June 2013. Reason for presentation, Kessler Psychological Distress Scale, stage of illness, diagnosis, functioning. Young people were most likely to present with mood and anxiety symptoms and disorders, self-reporting their reason for attendance as problems with how they felt. Client demographic characteristics tended to reflect population-level distributions, although clients from regional areas and of Aboriginal and Torres Strait Islander background were particularly well represented, whereas those who were born outside Australia were underrepresented. headspace centres are providing a point of service access for young Australians with high levels of psychological distress and need for care in the early stages of the development of mental disorder.

Improving access to specialists in remote communities: a cross-sectional study and cost analysis of the use of eConsult in Nunavut.

PubMed

Liddy, Clare; McKellips, Fanny; Armstrong, Catherine Deri; Afkham, Amir; Fraser-Roberts, Leigh; Keely, Erin

2017-01-01

Residents of remote communities face inequities in access to specialists, excessive wait times, and poorly coordinated care. The Champlain BASE TM (Building Access to Specialists through eConsultation) service facilitates asynchronous communication between primary care providers (PCP) and specialists. The service was extended to several PCPs in Nunavut in 2014. To (1) describe the use of eConsult services in Nunavut, and (2) conduct a costing evaluation. A cross-sectional study and cost analysis of all eConsult cases submitted between August 2014 and April 2016. PCPs from Nunavut submitted 165 eConsult cases. The most popular specialties were dermatology (16%), cardiology (8%), endocrinology (7%), otolaryngology (7%), and obstetrics/gynaecology (7%). Specialists provided a response in a median of 0.9 days (IQR=0.3-3.0, range=0.01-15.02). In 35% of cases, PCPs were able to avoid the face-to-face specialist visits they had originally planned for their patients. Total savings associated with eConsult in Nunavut are estimated at $180,552.73 or $1,100.93 per eConsult. The eConsult service provided patients in Nunavut's remote communities with prompt access to specialist advice. The service's chief advantage in Canada's northern communities is its ability to offer electronic access to a breadth of specialties far greater than could be supported locally. Our findings suggest that a territory-wide adoption of eConsult would generate enormous savings.

Health provider perspectives on mental health service provision for Chinese people living in Christchurch, New Zealand

PubMed Central

ZHANG, Qiuhong; GAGE, Jeffrey; BARNETT, Pauline

2013-01-01

Background Migration imposes stress and may contribute to the incidence of mental illness among natives of mainland China living overseas. Both cultural norms and service inadequacies may act as barriers to accessing needed mental health services. Objective Assess New Zealand health providers' perspectives on the utilization of mental health services by immigrants from mainland China. Methods A qualitative study in Christchurch, New Zealand involved in-depth interviews with nine mental health professionals with experience in providing services to Chinese clients. The interviews were transcribed and thematically analysed. Results Four main themes emerged from the interviews: (1) specific mental health concerns of Chinese migrants; (2) subgroups of migrants most likely to manifest mental health problems; (3) barriers to accessing services; and (4) the centrality of social support networks to the mental health of Chinese migrants. Conclusions Qualitative research with health providers in high-income countries who provide mental health services to the growing numbers of migrants from mainland China can identify areas where improved cultural sensitivity could increase both the utilization of mental health services by Chinese immigrants and the effectiveness of these services. PMID:24991180

Spatial accessibility to healthcare services in Shenzhen, China: improving the multi-modal two-step floating catchment area method by estimating travel time via online map APIs.

PubMed

Tao, Zhuolin; Yao, Zaoxing; Kong, Hui; Duan, Fei; Li, Guicai

2018-05-09

Shenzhen has rapidly grown into a megacity in the recent decades. It is a challenging task for the Shenzhen government to provide sufficient healthcare services. The spatial configuration of healthcare services can influence the convenience for the consumers to obtain healthcare services. Spatial accessibility has been widely adopted as a scientific measurement for evaluating the rationality of the spatial configuration of healthcare services. The multi-modal two-step floating catchment area (2SFCA) method is an important advance in the field of healthcare accessibility modelling, which enables the simultaneous assessment of spatial accessibility via multiple transport modes. This study further develops the multi-modal 2SFCA method by introducing online map APIs to improve the estimation of travel time by public transit or by car respectively. As the results show, the distribution of healthcare accessibility by multi-modal 2SFCA shows significant spatial disparity. Moreover, by dividing the multi-modal accessibility into car-mode and transit-mode accessibility, this study discovers that the transit-mode subgroup is disadvantaged in the competition for healthcare services with the car-mode subgroup. The disparity in transit-mode accessibility is the main reason of the uneven pattern of healthcare accessibility in Shenzhen. The findings suggest improving the public transit conditions for accessing healthcare services to reduce the disparity of healthcare accessibility. More healthcare services should be allocated in the eastern and western Shenzhen, especially sub-districts in Dapeng District and western Bao'an District. As these findings cannot be drawn by the traditional single-modal 2SFCA method, the advantage of the multi-modal 2SFCA method is significant to both healthcare studies and healthcare system planning.

HIV-positive mothers in Viet Nam: using their status to build support groups and access essential services.

PubMed

Oosterhoff, Pauline; Anh, Nguyen Thu; Yen, Pham Ngoc; Wright, Pamela; Hardon, Anita

2008-11-01

Various support and self-help groups for people living with HIV and their families have developed in Viet Nam in recent years. This paper reports on a case study of Sunflowers, the first support group for HIV positive mothers in Hanoi, begun in 2004, and a sister group begun in 2005 in Thai Nguyen province. From April 2004 to early 2007, we carried out semi-structured interviews with 275 health care workers and 153 HIV-positive women and members of their families, as well as participant observation of group meetings and activities. Sunflowers have successfully organised themselves to access vital social, medical and economic support and services for themselves, their children and partners. They gained self-confidence, and learned to communicate with their peers and voice their needs to service providers. Based on personal development plans, they have accessed other state services, such as loans, job counselling and legal advice. They have also gained access to school and treatment for their children, who had previously been excluded. Although the women were vulnerable to HIV as wives and mothers, motherhood also provided them with social status and an identity they used to help build organisations and develop strategies to access the essential services that they and their families need.

Nurse-led management of chronic disease in a residential care setting.

PubMed

Neylon, Julie

2015-11-01

Introduction of the advanced nurse practitioner (ANP) role has enabled nurses to develop their clinical knowledge and skills, providing greater service provision and improved access to healthcare services. It can also help with the challenges of providing care to an ageing population in primary care. This article reports on the evaluation of an ANP-led clinic in two residential care homes that provides annual reviews for chronic disease management (CDM). A mixed method approach was used to evaluate the service using clinical data obtained from the electronic patient record system and software and patient satisfaction questionnaires. The number of patients receiving CDM reviews in the homes increased as a result of the clinic. Completed satisfaction questionnaires further demonstrated patients' satisfaction and willingness to engage with the service. The service highlights the ANP's effectiveness in managing residential care home patients with chronic diseases and improving their access to healthcare services.

47 CFR 51.307 - Duty to provide access on an unbundled basis to network elements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... network elements. 51.307 Section 51.307 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED... Carriers § 51.307 Duty to provide access on an unbundled basis to network elements. (a) An incumbent LEC... service, nondiscriminatory access to network elements on an unbundled basis at any technically feasible...

47 CFR 51.307 - Duty to provide access on an unbundled basis to network elements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... network elements. 51.307 Section 51.307 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED... Carriers § 51.307 Duty to provide access on an unbundled basis to network elements. (a) An incumbent LEC... service, nondiscriminatory access to network elements on an unbundled basis at any technically feasible...

76 FR 56712 - CLIA Program and HIPAA Privacy Rule; Patients' Access to Test Reports

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-14

...; Patients' Access to Test Reports AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS; Centers for...) regulations to specify that, upon a patient's request, the laboratory may provide access to completed test... provide for release of test reports to authorized persons and, if applicable, the individuals (or their...

75 FR 29479 - Medicare and Medicaid Programs: Proposed Changes Affecting Hospital and Critical Access Hospital...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-26

... have to include all adverse events that may result from telemedicine services provided by the distant... adverse events that result from the telemedicine services provided by the distant-site physician or... include all adverse events that result from the telemedicine services provided by the distant-site...

Arizona's Application Service Provider.

ERIC Educational Resources Information Center

Jordan, Darla

2002-01-01

Describes the U.S.'s first statewide K-12 application service provider (ASP). The ASP, implemented by the Arizona School Facilities Board, provides access to productivity, communications, and education software programs from any Internet-enabled device, whether in the classroom or home. (EV)

Trans people's experiences with assisted reproduction services: a qualitative study.

PubMed

James-Abra, S; Tarasoff, L A; Green, D; Epstein, R; Anderson, S; Marvel, S; Steele, L S; Ross, L E

2015-06-01

What are the experiences of trans persons (i.e. those whose gender identity does not match the gender assigned to them at birth) who sought or accessed assisted reproduction (AR) services in Ontario, Canada, between 2007 and 2010? The majority of trans persons report negative experiences with AR service providers. Apart from research examining desire to have children among trans people, most of the literature on this topic has debated the ethics of assisting trans persons to become parents. To-date, all of the published research concerning trans persons' experiences with AR services is solely from the perspective of service providers; no studies have examined the experiences of trans people themselves. Secondary qualitative research study of data from nine trans-identified people and their partners (total n = 11) collected as part of a community-based study of access to AR services for sexual and gender minority people between 2010 and 2012. Trans-identified volunteers (and their partners, when applicable) who had used or attempted to access AR services since 2007 from across Ontario, Canada, participated in a 60-90 minute, semi-structured qualitative interview. Qualitative analysis was performed using a descriptive phenomenological approach. Emerging themes were continually checked against the data as part of an iterative process. The data highlight barriers to accessing AR services for trans people. Participant recommendations for improving AR service provision to better meet the needs of this population are presented. These recommendations address the following areas: (i) AR service provider education and training; (ii) service provider and clinic practices and (iii) clinic environment. The majority of study participants were trans people who identified as men and who resided in major urban areas; those living in smaller communities may have different experiences that were not adequately captured in this analysis. While existing literature debates the ethics of assisting trans people to become parents through the use of AR, our study demonstrates that they are already accessing or attempting to access these services. This reality necessitates a shift toward exploring the ways in which AR services can be improved to better meet the needs of this population, from the perspectives of both service users and service providers. This project was supported by the Canadian Institutes of Health Research-Institute of Gender and Health, in partnership with the Assisted Human Reproduction Canada: Catalyst Grant: Psychosocial Issues Associated with Assisted Human Reproduction (FRN-103595). S.M. was supported by a Canada Graduate Scholarship from the Social Science and Humanities Research Council, as well as research funding from Osgoode Hall Law School, York University. S.J.-A. was supported by an Ontario Graduate Scholarship funded by the Province of Ontario and the University of Toronto. N/A. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The Traveler's Guide to E-mail Access.

ERIC Educational Resources Information Center

Clyde, Anne

1999-01-01

Presents options that travelers can use to keep in e-mail contact. Discusses equipment/access issues related to traveling with a laptop; Internet cafes; free e-mail services; accessing home mail via a Web page; and new options e-mail access for travelers. Includes Internet resources on Internet access providers. (AEF)

Early Intervention Services in Youth Mental Health

ERIC Educational Resources Information Center

Wade, Darryl; Johnston, Amy; Campbell, Bronwyn; Littlefield, Lyn

2007-01-01

Mental and substance use disorders are leading contributors to the burden of disease among young people in Australia, but young people experience a range of barriers to accessing appropriate treatment for their mental health concerns. The development of early intervention services that provide accessible and effective mental health care has the…

76 FR 7207 - Notice of Public Information Collection Being Reviewed by the Federal Communications Commission...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-09

... Docket No. 07-52, FCC 10-201, require all providers of broadband Internet access service to publicly... of their broadband Internet access services sufficient for consumers to make informed choices... Network Management Practices, Preserving the Open Internet and Broadband Industry Practices, Report and...

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

ERIC Educational Resources Information Center

Eisenman, Richard L.; And Others

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

Toward a New Model for Promoting Urban Children's Mental Health: Accessible, Effective, and Sustainable School-Based Mental Health Services

ERIC Educational Resources Information Center

Atkins, Marc S.; Graczyk, Patricia A.; Frazier, Stacy L.; Abdul-Adil, Jaleel

2003-01-01

A program of research related to school-based models for urban children's mental health is described, with a particular focus on improving access to services, promoting children's functioning, and providing for program sustainability. The first study in this series responded to the urgent need to engage more families in mental health services, and…

Do health and medical workforce shortages explain the lower rate of rural consumers' complaints to Victoria's Health Services Commissioner?

PubMed

Jones, Judith A; Humphreys, John S; Wilson, Beth

2005-12-01

To identify which explanations account for lower rural rates of complaint about health services--(i) fear of consequences where there is little choice of alternative provider; (ii) a higher complaint threshold for rural consumers; (iii) lack of access to complaint mechanisms; or (iv) reduced access to services about which to complain. Ecological study incorporating consumer complaint, population and workforce distribution data sources. All health care providers practising in Victoria. De-identified records of all closed consumer complaints made to the Health Services Commissioner, Victoria, between March 1988 and April 2001 by Victorian residents (13 856 records). Differences in the percentage of under-representation in complaint rates in total and for each of four categories of health services providers for different size communities. No consistent relationship was observed between community size and either degree of under-representation of complaints against any category of provider, or the proportion of serious or substantial complaints. Rural under-representation was highest (41%) for dentists, the provider category with the lowest proportion working in rural areas (17%), and lowest (18%) for hospitals, with the highest representation in rural areas (28% of beds). More rural complaints were about access issues (10.7% rural and 8.4% metropolitan). Reduced opportunity to use health services due to rural health and medical workforce shortages was the best-supported explanation for the lower rural complaint rate. Workforce shortages impact on the quality of rural health services and on residents' opportunities to improve their health status.

Putting FLEXPART to REST: The Provision of Atmospheric Transport Modeling Services

NASA Astrophysics Data System (ADS)

Morton, Don; Arnold, Dèlia

2015-04-01

We are developing a RESTful set of modeling services for the FLEXPART modeling system. FLEXPART (FLEXible PARTicle dispersion model) is a Lagrangian transport and dispersion model used by a growing international community. It has been used to simulate and forecast the atmospheric transport of wildfire smoke, volcanic ash and radionuclides and may be run in backwards mode to provide information for the determination of emission sources such as nuclear emissions and greenhouse gases. This open source software is distributed in source code form, and has several compiler and library dependencies that users need to address. Although well-documented, getting it compiled, set up, running, and post-processed is often tedious, making it difficult for the inexperienced or casual user. Well-designed modeling services lower the entry barrier for scientists to perform simulations, allowing them to create and execute their models from a variety of devices and programming environments. This world of Service Oriented Architectures (SOA) has progressed to a REpresentational State Transfer (REST) paradigm, in which the pervasive and mature HTTP environment is used as a foundation for providing access to model services. With such an approach, sound software engineering practises are adhered to in order to deploy service modules exhibiting very loose coupling with the clients. In short, services are accessed and controlled through the formation of properly-constructed Uniform Resource Identifiers (URI's), processed in an HTTP environment. In this way, any client or combination of clients - whether a bash script, Python program, web GUI, or even Unix command line - that can interact with an HTTP server, can run the modeling environment. This loose coupling allows for the deployment of a variety of front ends, all accessing a common modeling backend system. Furthermore, it is generally accepted in the cloud computing community that RESTful approaches constitute a sound approach towards successful deployment of services. Through the design of a RESTful, cloud-based modeling system, we provide the ubiquitous access to FLEXPART that allows scientists to focus on modeling processes instead of tedious computational details. In this work, we describe the modeling services environment, and provide examples of access via command-line, Python programs, and web GUI interfaces.

Streamlining On-Demand Access to Joint Polar Satellite System (JPSS) Data Products for Weather Forecasting

NASA Astrophysics Data System (ADS)

Evans, J. D.; Tislin, D.

2017-12-01

Observations from the Joint Polar Satellite System (JPSS) support National Weather Service (NWS) forecasters, whose Advanced Weather Interactive Processing System (AWIPS) Data Delivery (DD) will access JPSS data products on demand from the National Environmental Satellite, Data, and Information Service (NESDIS) Product Distribution and Access (PDA) service. Based on the Open Geospatial Consortium (OGC) Web Coverage Service, this on-demand service promises broad interoperability and frugal use of data networks by serving only the data that a user needs. But the volume, velocity, and variety of JPSS data products impose several challenges to such a service. It must be efficient to handle large volumes of complex, frequently updated data, and to fulfill many concurrent requests. It must offer flexible data handling and delivery, to work with a diverse and changing collection of data, and to tailor its outputs into products that users need, with minimal coordination between provider and user communities. It must support 24x7 operation, with no pauses in incoming data or user demand; and it must scale to rapid changes in data volume, variety, and demand as new satellites launch, more products come online, and users rely increasingly on the service. We are addressing these challenges in order to build an efficient and effective on-demand JPSS data service. For example, on-demand subsetting by many users at once may overload a server's processing capacity or its disk bandwidth - unless alleviated by spatial indexing, geolocation transforms, or pre-tiling and caching. Filtering by variable (/ band / layer) may also alleviate network loads, and provide fine-grained variable selection; to that end we are investigating how best to provide random access into the variety of spatiotemporal JPSS data products. Finally, producing tailored products (derivatives, aggregations) can boost flexibility for end users; but some tailoring operations may impose significant server loads. Operating this service in a cloud computing environment allows cost-effective scaling during the development and early deployment phases - and perhaps beyond. We will discuss how NESDIS and NWS are assessing and addressing these challenges to provide timely and effective access to JPSS data products for weather forecasters throughout the country.

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

DTIC Science & Technology

2008-07-14

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

Evidence of Product Differentiation in the Microfinance Industry

DTIC Science & Technology

2011-05-09

financial services, which include deposits and more importantly credit. Access to credit allows the poor to overcome initial capital barriers when...of microfinance provides financial access to the poorest regions of the world and is seen by many as a means of creating self-sustaining markets. The...that as more for- profit MFI enter the microfinance industry, non-profit MFIs will be crowded out, reducing borrowers‟ access to financial services

E-Service Quality Management

ERIC Educational Resources Information Center

Batagan, Lorena; Pocovnicu, Adrian; Capisizu, Sergiu

2009-01-01

A characteristic of today's society is the increasing use of modern information and communication technologies in all areas. Computer applications, called e-services, are being developed to provide efficient access to services, electronically. Quality management systems are needed to provide a consistent way to select, evaluate, prioritize and…

The INFN-CNAF Tier-1 GEMSS Mass Storage System and database facility activity

NASA Astrophysics Data System (ADS)

Ricci, Pier Paolo; Cavalli, Alessandro; Dell'Agnello, Luca; Favaro, Matteo; Gregori, Daniele; Prosperini, Andrea; Pezzi, Michele; Sapunenko, Vladimir; Zizzi, Giovanni; Vagnoni, Vincenzo

2015-05-01

The consolidation of Mass Storage services at the INFN-CNAF Tier1 Storage department that has occurred during the last 5 years, resulted in a reliable, high performance and moderately easy-to-manage facility that provides data access, archive, backup and database services to several different use cases. At present, the GEMSS Mass Storage System, developed and installed at CNAF and based upon an integration between the IBM GPFS parallel filesystem and the Tivoli Storage Manager (TSM) tape management software, is one of the largest hierarchical storage sites in Europe. It provides storage resources for about 12% of LHC data, as well as for data of other non-LHC experiments. Files are accessed using standard SRM Grid services provided by the Storage Resource Manager (StoRM), also developed at CNAF. Data access is also provided by XRootD and HTTP/WebDaV endpoints. Besides these services, an Oracle database facility is in production characterized by an effective level of parallelism, redundancy and availability. This facility is running databases for storing and accessing relational data objects and for providing database services to the currently active use cases. It takes advantage of several Oracle technologies, like Real Application Cluster (RAC), Automatic Storage Manager (ASM) and Enterprise Manager centralized management tools, together with other technologies for performance optimization, ease of management and downtime reduction. The aim of the present paper is to illustrate the state-of-the-art of the INFN-CNAF Tier1 Storage department infrastructures and software services, and to give a brief outlook to forthcoming projects. A description of the administrative, monitoring and problem-tracking tools that play a primary role in managing the whole storage framework is also given.

The electric industry's gyrations are giving some telecommunications experts that old familiar feeling

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

Graniere, R.J.

1993-06-15

A timeline of the past 20 years would characterize an American telecommunications policy revolution dominated by alternating periods of market structure and access. It also would reveal that this cycle is not a casual phenomenon but the result of procompetitive regulatory and judicial decisions that spawn equal and open access issues whose resolution is, in turn, a source of additional market structure issues. Passage of the Energy Policy Act of 1992 has started a similar cogenerative process in the electricity industry. How can electric utility executives and regulators use the lessons of the telecommunications industry to deal with emerging transmissionmore » issues in the electricity industry They can begin by realizing that multiple forms of mandatory transmission access may be new to electric utilities, but they are second nature to telephone local exchange companies (LECs). For example, LECs have been providing local access services to equipment manufacturers and long-distance companies for over a decade. These firms also are deploying local access services for the enhanced and information-services providers under the rubric of open network architecture (ONA). This full range of access services might soon be commonplace in the electricity industry, too, as exempt wholesale generators (EWGs) enter the wholesale power markets.« less

BioCatalogue: a universal catalogue of web services for the life sciences

PubMed Central

Bhagat, Jiten; Tanoh, Franck; Nzuobontane, Eric; Laurent, Thomas; Orlowski, Jerzy; Roos, Marco; Wolstencroft, Katy; Aleksejevs, Sergejs; Stevens, Robert; Pettifer, Steve; Lopez, Rodrigo; Goble, Carole A.

2010-01-01

The use of Web Services to enable programmatic access to on-line bioinformatics is becoming increasingly important in the Life Sciences. However, their number, distribution and the variable quality of their documentation can make their discovery and subsequent use difficult. A Web Services registry with information on available services will help to bring together service providers and their users. The BioCatalogue (http://www.biocatalogue.org/) provides a common interface for registering, browsing and annotating Web Services to the Life Science community. Services in the BioCatalogue can be described and searched in multiple ways based upon their technical types, bioinformatics categories, user tags, service providers or data inputs and outputs. They are also subject to constant monitoring, allowing the identification of service problems and changes and the filtering-out of unavailable or unreliable resources. The system is accessible via a human-readable ‘Web 2.0’-style interface and a programmatic Web Service interface. The BioCatalogue follows a community approach in which all services can be registered, browsed and incrementally documented with annotations by any member of the scientific community. PMID:20484378

BioCatalogue: a universal catalogue of web services for the life sciences.

PubMed

Bhagat, Jiten; Tanoh, Franck; Nzuobontane, Eric; Laurent, Thomas; Orlowski, Jerzy; Roos, Marco; Wolstencroft, Katy; Aleksejevs, Sergejs; Stevens, Robert; Pettifer, Steve; Lopez, Rodrigo; Goble, Carole A

2010-07-01

The use of Web Services to enable programmatic access to on-line bioinformatics is becoming increasingly important in the Life Sciences. However, their number, distribution and the variable quality of their documentation can make their discovery and subsequent use difficult. A Web Services registry with information on available services will help to bring together service providers and their users. The BioCatalogue (http://www.biocatalogue.org/) provides a common interface for registering, browsing and annotating Web Services to the Life Science community. Services in the BioCatalogue can be described and searched in multiple ways based upon their technical types, bioinformatics categories, user tags, service providers or data inputs and outputs. They are also subject to constant monitoring, allowing the identification of service problems and changes and the filtering-out of unavailable or unreliable resources. The system is accessible via a human-readable 'Web 2.0'-style interface and a programmatic Web Service interface. The BioCatalogue follows a community approach in which all services can be registered, browsed and incrementally documented with annotations by any member of the scientific community.

Finding a Trans-Affirmative Provider: Challenges Faced by Trans and Gender Diverse Psychologists and Psychology Trainees.

PubMed

Dickey, Lore M; Singh, Anneliese A

2017-08-01

This article explores some of the challenges faced by trans and gender diverse (TGD) individuals who not only are attempting to access trans-affirmative care, but who are also members of the very profession from which they are seeking services. The authors explore challenges related to finding supervision, accessing care for assessment services, and finding a provider for personal counseling. With each example, the authors unpack the challenges and also address the implications for training for all involved. Based on these challenges that TGD psychologists and trainees face in attempting to access care, the authors provide recommendations related to trans-affirmative training for psychologists. © 2017 Wiley Periodicals, Inc.

Survey of the capacity for essential surgery and anaesthesia services in Papua New Guinea.

PubMed

Martin, Janet; Tau, Goa; Cherian, Meena Nathan; Vergel de Dios, Jennifer; Mills, David; Fitzpatrick, Jane; Adu-Krow, William; Cheng, Davy

2015-12-16

To assess capacity to provide essential surgical services including emergency, obstetric and anaesthesia care in Papua New Guinea (PNG) in order to support planning for relevant post-2015 sustainable development goals for PNG. Cross-sectional survey. Hospitals and health facilities in PNG. 21 facilities including 3 national/provincial hospitals, 11 district/rural hospitals, and 7 health centres. The WHO Situational Analysis Tool to Assess Emergency and Essential Surgical Care (WHO-SAT) was used to measure each participating facility's capacity to deliver essential surgery and anaesthesia services, including 108 items related to relevant infrastructure, human resources, interventions and equipment. While major surgical procedures were provided at each hospital, fewer than 30% had uninterrupted access to oxygen, and 57% had uninterrupted access to resuscitation bag and mask. Most hospitals reported capacity to provide general anaesthesia, though few hospitals reported having at least one certified surgeon, obstetrician and anaesthesiologist. Access to anaesthetic machines, pulse oximetry and blood bank was severely limited. Many non-hospital health centres providing basic surgical procedures, but almost none had uninterrupted access to electricity, running water, oxygen and basic supplies for resuscitation, airway management and obstetric services. Capacity for essential surgery and anaesthesia services is severely limited in PNG due to shortfalls in physical infrastructure, human resources, and basic equipment and supplies. Achieving post-2015 sustainable development goals, including universal healthcare, will require significant investment in surgery and anaesthesia capacity in PNG. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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.

The effect of access to contraceptive services on injectable use and demand for family planning in Malawi.

PubMed

Skiles, Martha Priedeman; Cunningham, Marc; Inglis, Andrew; Wilkes, Becky; Hatch, Ben; Bock, Ariella; Barden-O'Fallon, Janine

2015-03-01

Previous studies have identified positive relationships between geographic proximity to family planning services and contraceptive use, but have not accounted for the effect of contraceptive supply reliability or the diminishing influence of facility access with increasing distance. Kernel density estimation was used to geographically link Malawi women's use of injectable contraceptives and demand for birth spacing or limiting, as drawn from the 2010 Demographic and Health Survey, with contraceptive logistics data from family planning service delivery points. Linear probability models were run to identify associations between access to injectable services-measured by distance alone and by distance combined with supply reliability-and injectable use and family planning demand among rural and urban populations. Access to services was an important predictor of injectable use. The probability of injectable use among rural women with the most access by both measures was 7‒8 percentage points higher than among rural dwellers with the least access. The probability of wanting to space or limit births among urban women who had access to the most reliable supplies was 18 percentage points higher than among their counterparts with the least access. Product availability in the local service environment plays a critical role in women's demand for and use of contraceptive methods. Use of kernel density estimation in creating facility service environments provides a refined approach to linking women with services and accounts for both distance to facilities and supply reliability. Urban and rural differences should be considered when seeking to improve contraceptive access.

45 CFR 286.10 - What does the term “assistance” mean?

Code of Federal Regulations, 2010 CFR

2010-10-01

...) programs, transitional services, job retention, job advancement, and other employment-related services that do not provide basic income support; and (7) Transportation benefits provided under a Job Access or...

Experiences of Healthcare Professionals to the Introduction in Sweden of a Public eHealth Service: Patients' Online Access to their Electronic Health Records.

PubMed

Ålander, Ture; Scandurra, Isabella

2015-01-01

Patients' increasing demands for medical information, the digitization of health records and the fast spread of Internet access form a basis of introducing new eHealth services. An international trend is to provide access for patients to health information of various kind. In Sweden, access by patients to their proper electronic health record (EHR) has been provided in a pilot county since November 2012. This eHealth service is controversial and criticism has arised from the clinical professions, mainly physicians. Two web surveys were conducted to discover whether the opinions of healthcare professionals differ; between staff that have had experience with patients accessing their own EHR and those who have no such expericence. Experienced nurses found the EHR more important for the patients and a better reform, compared to unexperienced nurses in the rest of the country. Similarly, physicians with their own experience had a more positive attitude compared to non-experienced physicians. The conclusion of this study is that healthcare professionals must be involved in the implementation of public eHealth services such as EHRs and that real experiences of the professionals should be better disseminated to their inexperienced peers.

Availability of essential health services in post-conflict Liberia

PubMed Central

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

2010-01-01

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

Mental health service delivery following health system reform in Colombia.

PubMed

Romero-González, Mauricio; González, Gerardo; Rosenheck, Robert A

2003-12-01

In 1993, Colombia underwent an ambitious and comprehensive process of health system reform based on managed competition and structured pluralism, but did not include coverage for mental health services. In this study, we sought to evaluate the impact of the reform on access to mental health services and whether there were changes in the pattern of mental health service delivery during the period after the reform. Changes in national economic indicators and in measures of mental health and non-mental health service delivery for the years 1987 and 1997 were compared. Data were obtained from the National Administrative Department of Statistics of Colombia (DANE), the Department of National Planning and Ministry of the Treasury of Colombia, and from national official reports of mental health and non-mental health service delivery from the Ministry of Health of Colombia for the same years. While population-adjusted access to mental health outpatient services declined by -2.7% (-11.2% among women and +5.8% among men), access to general medical outpatient services increased dramatically by 46%. In-patient admissions showed smaller differences, with a 7% increase in mental health admissions, as compared to 22.5% increase in general medical admissions. The health reform in Colombia imposed competition across all health institutions with the intention of encouraging efficiency and financial autonomy. However, the challenge of institutional survival appears to have fallen heavily on mental health care institutions that were also expected to participate in managed competition, but that were at a serious disadvantage because their services were excluded from the compulsory standardized package of health benefits. While the Colombian health care reform intended to close the gap between those who had and those who did not have access to health services, it appears to have failed to address access to specialized mental health services, although it does seem to have promoted a change in the pattern of mental health service delivery from a reliance on costly inpatient care to more efficient outpatient services. Health reform in Colombia improved access to health services for the general medical services, but not for specialized mental health services. Although the primary goal of the health reform was to provide universal medical coverage, by not including mental health services in the standardized benefits package, inequities in the delivery of mental health services appear to have been perpetuated or even exacerbated. IMPLICATIONS FOR HEALTH CARE AND POLICY FORMULATION: If health reform in Colombia and elsewhere is to provide universal coverage and adequate access to comprehensive health care, mental health services must be added to the standardized package of health benefits and efforts to develop accessible and effective mental health treatment at the primary care level should continue. Mental health services research in Colombia should focus future studies on the differential impact of health reform on access to mental health services across regions, and between urban and rural areas.

Globus Identity, Access, and Data Management: Platform Services for Collaborative Science

NASA Astrophysics Data System (ADS)

Ananthakrishnan, R.; Foster, I.; Wagner, R.

2016-12-01

Globus is software-as-a-service for research data management, developed at, and operated by, the University of Chicago. Globus, accessible at www.globus.org, provides high speed, secure file transfer; file sharing directly from existing storage systems; and data publication to institutional repositories. 40,000 registered users have used Globus to transfer tens of billions of files totaling hundreds of petabytes between more than 10,000 storage systems within campuses and national laboratories in the US and internationally. Web, command line, and REST interfaces support both interactive use and integration into applications and infrastructures. An important component of the Globus system is its foundational identity and access management (IAM) platform service, Globus Auth. Both Globus research data management and other applications use Globus Auth for brokering authentication and authorization interactions between end-users, identity providers, resource servers (services), and a range of clients, including web, mobile, and desktop applications, and other services. Compliant with important standards such as OAuth, OpenID, and SAML, Globus Auth provides mechanisms required for an extensible, integrated ecosystem of services and clients for the research and education community. It underpins projects such as the US National Science Foundation's XSEDE system, NCAR's Research Data Archive, and the DOE Systems Biology Knowledge Base. Current work is extending Globus services to be compliant with FEDRAMP standards for security assessment, authorization, and monitoring for cloud services. We will present Globus IAM solutions and give examples of Globus use in various projects for federated access to resources. We will also describe how Globus Auth and Globus research data management capabilities enable rapid development and low-cost operations of secure data sharing platforms that leverage Globus services and integrate them with local policy and security.

Outreach services to improve access to health care in South Africa: lessons from three community health worker programmes.

PubMed

Nxumalo, Nonhlanhla; Goudge, Jane; Thomas, Liz

2013-01-24

In South Africa, there are renewed efforts to strengthen primary health care and community health worker (CHW) programmes. This article examines three South African CHW programmes, a small local non-governmental organisation (NGO), a local satellite of a national NGO, and a government-initiated service, that provide a range of services from home-based care, childcare, and health promotion to assist clients in overcoming poverty-related barriers to health care. The comparative case studies, located in Eastern Cape and Gauteng, were investigated using qualitative methods. Thematic analysis was used to identify factors that constrain and enable outreach services to improve access to care. The local satellite (of a national NGO), successful in addressing multi-dimensional barriers to care, provided CHWs with continuous training focused on the social determinants of ill-health, regular context-related supervision, and resources such as travel and cell-phone allowances. These workers engaged with, and linked their clients to, agencies in a wide range of sectors. Relationships with participatory structures at community level stimulated coordinated responses from service providers. In contrast, an absence of these elements curtailed the ability of CHWs in the small NGO and government-initiated service to provide effective outreach services or to improve access to care. Significant investment in resources, training, and support can enable CHWs to address barriers to care by negotiating with poorly functioning government services and community participation structures.

Survey of the capacity for essential surgery and anaesthesia services in Papua New Guinea

PubMed Central

Martin, Janet; Tau, Goa; Cherian, Meena Nathan; Vergel de Dios, Jennifer; Mills, David; Fitzpatrick, Jane; Adu-Krow, William; Cheng, Davy

2015-01-01

Objective To assess capacity to provide essential surgical services including emergency, obstetric and anaesthesia care in Papua New Guinea (PNG) in order to support planning for relevant post-2015 sustainable development goals for PNG. Design Cross-sectional survey. Setting Hospitals and health facilities in PNG. Participants 21 facilities including 3 national/provincial hospitals, 11 district/rural hospitals, and 7 health centres. Outcome measures The WHO Situational Analysis Tool to Assess Emergency and Essential Surgical Care (WHO-SAT) was used to measure each participating facility's capacity to deliver essential surgery and anaesthesia services, including 108 items related to relevant infrastructure, human resources, interventions and equipment. Results While major surgical procedures were provided at each hospital, fewer than 30% had uninterrupted access to oxygen, and 57% had uninterrupted access to resuscitation bag and mask. Most hospitals reported capacity to provide general anaesthesia, though few hospitals reported having at least one certified surgeon, obstetrician and anaesthesiologist. Access to anaesthetic machines, pulse oximetry and blood bank was severely limited. Many non-hospital health centres providing basic surgical procedures, but almost none had uninterrupted access to electricity, running water, oxygen and basic supplies for resuscitation, airway management and obstetric services. Conclusions Capacity for essential surgery and anaesthesia services is severely limited in PNG due to shortfalls in physical infrastructure, human resources, and basic equipment and supplies. Achieving post-2015 sustainable development goals, including universal healthcare, will require significant investment in surgery and anaesthesia capacity in PNG. PMID:26674504

Browsing for the Best Internet Access Provider?

ERIC Educational Resources Information Center

Weil, Marty

1996-01-01

Highlights points to consider when choosing an Internet Service Provider. Serial Line Internet Protocol (SLIP) and Point to Point Protocol (PPP) are compared regarding price, performance, bandwidth, speed, and technical support. Obtaining access via local, national, consumer online, and telephone-company providers is discussed. A pricing chart and…

47 CFR 36.191 - Equal access equipment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... provided by long distance carriers affiliated with the local exchange company is included. (d) Effective... AND RESERVES FOR TELECOMMUNICATIONS COMPANIES 1 Telecommunications Property Equal Access Equipment... excluded. In the case of independent telephone companies, intrastate toll service provided by the...

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

PubMed

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

2017-06-01

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

What is “Support” in Supportive Housing: Client and Service Providers’ Perspectives

PubMed Central

Owczarzak, Jill; Dickson-Gomez, Julia; Convey, Mark; Weeks, Margaret

2014-01-01

Supportive housing programs are proposed as a way of increasing housing access and stability for the chronically homeless, improving access to needed services, and decreasing vulnerability to HIV and other diseases. Little is known about residents’ understandings of and experiences with different models of supportive housing and how they fit within residents’ broader strategies to maintain housing. We conducted semi-structured interviews with 23 residents and 10 service providers from nine different supportive housing programs in Hartford, Connecticut. Data analysis explored residents’ perceptions of and experiences with supportive housing programs in the context of strategies to access resources and receive emotional, financial, and other forms of support. Themes of independence, coercion, and choice pervaded participants’ narratives of their experiences accessing services. Concerns with privacy influenced the types of relationships residents formed with program staff and clients. Findings illustrate the need for more ethnographic studies of how supportive housing services are delivered by community agencies and accessed by clients. PMID:25477620

Optical fiber cable and wiring techniques for fiber to the home (FTTH)

NASA Astrophysics Data System (ADS)

Takai, Hirofumi; Yamauchi, Osamu

2009-08-01

NTT group's new medium-term management strategy calls for 20 million optical subscribers by 2010, and NTT Laboratories is pushing forward to meet this goal. Before that date, an efficient optical access network must be constructed, and afterwards, when the era of mass optical communications finally arrives, the facilities and equipment supporting the network will have to be effectively operated and maintained. At NTT Access Network Service Systems Laboratories, we are developing various technologies to correspond to the massive deployment of optical broadband services. We are also developing various new technologies for efficiently operating optical access network systems that will continue to expand in the future, and to supply our customers with good services. This paper provides an overview of the new optical access network system technologies that are being developed at NTT Access Network Service Systems Laboratories to address these issues.

Enhancing Discovery, Search, and Access of NASA Hydrological Data by Leveraging GEOSS

NASA Technical Reports Server (NTRS)

Teng, William L.

2015-01-01

An ongoing NASA-funded project has removed a longstanding barrier to accessing NASA data (i.e., accessing archived time-step array data as point-time series) for selected variables of the North American and Global Land Data Assimilation Systems (NLDAS and GLDAS, respectively) and other EOSDIS (Earth Observing System Data Information System) data sets (e.g., precipitation, soil moisture). These time series (data rods) are pre-generated. Data rods Web services are accessible through the CUAHSI Hydrologic Information System (HIS) and the Goddard Earth Sciences Data and Information Services Center (GES DISC) but are not easily discoverable by users of other non-NASA data systems. The Global Earth Observation System of Systems (GEOSS) is a logical mechanism for providing access to the data rods. An ongoing GEOSS Water Services project aims to develop a distributed, global registry of water data, map, and modeling services cataloged using the standards and procedures of the Open Geospatial Consortium and the World Meteorological Organization. The ongoing data rods project has demonstrated the feasibility of leveraging the GEOSS infrastructure to help provide access to time series of model grid information or grids of information over a geographical domain for a particular time interval. A recently-begun, related NASA-funded ACCESS-GEOSS project expands on these prior efforts. Current work is focused on both improving the performance of the generation of on-the-fly (OTF) data rods and the Web interfaces from which users can easily discover, search, and access NASA data.

Picture This: Exploring the Lived Experience of High-Functioning Stroke Survivors Using Photovoice.

PubMed

Maratos, Marie; Huynh, Linh; Tan, Julia; Lui, Jordon; Jarus, Tal

2016-07-01

An increasing number of high-functioning stroke survivors are present with minimal functional impairments and are often discharged with reduced access to community reintegration. Our objectives were to explore the lived experience of high-functioning stroke survivors and to identify gaps in community and rehabilitation services. Photovoice was used with five high-functioning stroke survivors to photo-document their experiences. A modified inductive thematic analysis was used, and meanings behind the photographs were elicited through four focus group sessions followed by photography exhibitions. Five themes emerged: lack of understanding and consideration for persons with disability, emotional and behavioral impacts after stroke, self-reliance and dependence on others, importance of appropriate and accessible services, and financial determinants of quality of life. By including service users' voices; investing in adapted, community-based programs; and providing educational programs for creating attitudinal change among service providers, the polarization between who can and cannot access services will be reduced. © The Author(s) 2016.

Provider imposed restrictions to clients’ access to family planning in urban Uttar Pradesh, India: a mixed methods study

PubMed Central

2013-01-01

Background Medical barriers refer to unnecessary policies or procedures imposed by health care providers that are not necessarily medically advised; these restrictions impede clients’ access to family planning (FP). This mixed methods study investigates provider imposed barriers to provision of FP using recent quantitative and qualitative data from urban Uttar Pradesh, India. Methods Baseline quantitative data were collected in six cities in Uttar Pradesh, India from service delivery points (SDP), using facility audits, exit interviews, and provider surveys; for this study, the focus is on the provider surveys. More than 250 providers were surveyed in each city. Providers were asked about the FP methods they provide, and if they restrict clients’ access to each method based on age, parity, partner consent, or marital status. For the qualitative research, we conducted one-on-one interviews with 21 service providers in four of the six cities in Uttar Pradesh. Each interview lasted approximately 45 minutes. Results The quantitative findings show that providers restrict clients’ access to spacing and long-acting and permanent methods of FP based on age, parity, partner consent and marital status. Qualitative findings reinforce that providers, at times, make judgments about their clients’ education, FP needs and ability to understand FP options thereby imposing unnecessary barriers to FP methods. Conclusions Provider restrictions on FP methods are common in these urban Uttar Pradesh sites. This means that women who are young, unmarried, have few or no children, do not have the support of their partner, or are less educated may not be able to access or use FP or their preferred method. These findings highlight the need for in-service training for staff, with a focus on reviewing current guidelines and eligibility criteria for provision of methods. PMID:24365015

77 FR 1482 - Powerex Corp.

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-10

... certain provisions of its filed reciprocity open access transmission tariff (OATT), business practices...)(1)) to provide transmission services that comport with the Commission's open access principles...

Economic models for prevention: making a system work for patients

PubMed Central

2015-01-01

The purpose of this article is to describe alternative means of providing patient centered, preventive based, services using an alternative non-profit, economic model. Hard to reach, vulnerable groups, including children, adults and elders, often have difficulties accessing traditional dental services for a number of reasons, including economic barriers. By partnering with community organizations that serve these groups, collaborative services and new opportunities for access are provided. The concept of a dental home is well accepted as a means of providing care, and, for these groups, provision of such services within community settings provides a sustainable means of delivery. Dental homes provided through community partnerships can deliver evidence based dental care, focused on a preventive model to achieve and maintain oral health. By using a non-profit model, the entire dental team is provided with incentives to deliver measurable quality improvements in care, rather than a more traditional focus on volume of activity alone. Examples are provided that demonstrate how integrated oral health services can deliver improved health outcomes with the potential to reduce total costs while improving quality. PMID:26391814

Access to and use of sexual and reproductive health services provided by midwives among rural immigrant women in Spain: midwives’ perspectives

PubMed Central

Otero-Garcia, Laura; Goicolea, Isabel; Gea-Sánchez, Montserrat; Sanz-Barbero, Belen

2013-01-01

Background There is insufficient information regarding access and participation of immigrant women in Spain in sexual and reproductive health programs. Recent studies show their lower participation rate in gynecological cancer screening programs; however, little is known about the participation in other sexual and reproductive health programs by immigrant women living in rural areas with high population dispersion. Objectives The objective of this study is to explore the perceptions of midwives who provide these services regarding immigrant women's access and participation in sexual and reproductive health programs offered in a rural area. Design A qualitative study was performed, within a larger ethnographic study about rural primary care, with data collection based on in-depth interviews and field notes. Participants were the midwives in primary care serving 13 rural basic health zones (BHZ) of Segovia, a region of Spain with high population dispersion. An interview script was designed to collect information about midwives’ perceptions on immigrant women's access to and use of the healthcare services that they provide. Interviews were recorded and transcribed with participant informed consent. Data were analyzed based on the qualitative content analysis approach and triangulation of results with fieldwork notes. Results Midwives perceive that immigrants in general, and immigrant women in particular, underuse family planning services. This underutilization is associated with cultural differences and gender inequality. They also believe that the number of voluntary pregnancy interruptions among immigrant women is elevated and identify childbearing and childrearing-related tasks and the language barrier as obstacles to immigrant women accessing the available prenatal and postnatal healthcare services. Conclusions Immigrant women's underutilization of midwifery services may be linked to the greater number of unintended pregnancies, pregnancy terminations, and the delay in the first prenatal visit, as discerned by midwives. Future research should involve samples of immigrant women themselves, to provide a deeper understanding of the current knowledge, attitudes, and practices of the immigrant population regarding reproductive and sexual health to provide better health services. PMID:24206651

Adapting the CUAHSI Hydrologic Information System to OGC standards

NASA Astrophysics Data System (ADS)

Valentine, D. W.; Whitenack, T.; Zaslavsky, I.

2010-12-01

The CUAHSI Hydrologic Information System (HIS) provides web and desktop client access to hydrologic observations via water data web services using an XML schema called “WaterML”. The WaterML 1.x specification and the corresponding Water Data Services have been the backbone of the HIS service-oriented architecture (SOA) and have been adopted for serving hydrologic data by several federal agencies and many academic groups. The central discovery service, HIS Central, is based on an metadata catalog that references 4.7 billion observations, organized as 23 million data series from 1.5 million sites from 51 organizations. Observations data are published using HydroServer nodes that have been deployed at 18 organizations. Usage of HIS has increased by 8x from 2008 to 2010, and doubled in usage from 1600 data series a day in 2009 to 3600 data series a day in the first half of 2010. The HIS central metadata catalog currently harvests information from 56 Water Data Services. We collaborate on the catalog updates with two federal partners, USGS and US EPA: their data series are periodically reloaded into the HIS metadata catalog. We are pursuing two main development directions in the HIS project: Cloud-based computing, and further compliance with Open Geospatial Consortium (OGC) standards. The goal of moving to cloud-computing is to provide a scalable collaborative system with a simpler deployment and less dependence of hardware maintenance and staff. This move requires re-architecting the information models underlying the metadata catalog, and Water Data Services to be independent of the underlying relational database model, allowing for implementation on both relational databases, and cloud-based processing systems. Cloud-based HIS central resources can be managed collaboratively; partners share responsibility for their metadata by publishing data series information into the centralized catalog. Publishing data series will use REST-based service interfaces, like OData, as the basis for ingesting data series information into a cloud-hosted catalog. The future HIS services involve providing information via OGC Standards that will allow for observational data access from commercial GIS applications. Use of standards will allow for tools to access observational data from other projects using standards, such as the Ocean Observatories Initiative, and for tools from such projects to be integrated into the HIS toolset. With international collaborators, we have been developing a water information exchange language called “WaterML 2.0” which will be used to deliver observations data over OGC Sensor Observation Services (SOS). A software stack of OGC standard services will provide access to HIS information. In addition to SOS, Web Mapping and Feature Services (WMS, and WFS) will provide access to location information. Catalog Services for the Web (CSW) will provide a catalog for water information that is both centralized, and distributed. We intend the OGC standards supplement the existing HIS service interfaces, rather than replace the present service interfaces. The ultimate goal of this development is expand access to hydrologic observations data, and create an environment where these data can be seamlessly integrated with standards-compliant data resources.

The FUTUREVOLC Supersite's e-Infrastructure - A multidisciplinary data hub and data service for Icelandic Volcanoes

NASA Astrophysics Data System (ADS)

Vogfjörd, Kristín S.; Sigmundsson, Freysteinn; Sverrisson, Sverrir Th.; Sigurdsson, Sigurdur F.; Ófeigsson, Benedikt G.; Arnarsson, Ólafur S.; Kristinsson, Ingvar; Ilyinskaya, Evgenia; Oddsdóttir, Thorarna Ýr; Bergsveinsson, Sölvi Th.; Hjartansson, Kristján R.

2014-05-01

The FUTUREVOLC volanological supersite will establish a data hub and dataservice, where researchers, hazard managers and other stake holders can freely obtain access to multidisciplinary data and products on activity, unrest and eruptions at Icelandic volcanoes. The supersite is firmly founded on close interaction between the main Icelandic volcanological research and monitoring institutions, in coordination with expertise from European researchers participating in FUTUREVOLC. The hub is located at the Icelandic Meteorological Office (IMO), an institution responsible for monitoring and archiving data on all natural hazards in Iceland and, which also has a mandate as the state volcano observatory. This association will ensure a long-term sustainable data service. The data accessible at the hub include in-situ and space-based observations, products and models from all the relevant disciplines contributing to volcanological research and local as well as cross-border hazard management, i.e. Earth sciences, atmospheric science, hydrology, remote sensing and space science. Access to the data will be in compliance with the access policy of the GEO (Group on Earth Observations), providing registered users with easy and timely access to data and products of documented quality. This commitment has already led to the acceptance of FUTUREVOLC as a permanent geohazard supersite by CEOS (Committee on Earth Observation Satellites), which will ensure access to additional satellite data and products on Icelandic volcanoes. To facilitate services to seismological data at the supersite hub, the IMO is reconstructing its existing data base and utilizing the SeisComp3 software to manage waveform and parameter data. The accompanying ArcLink component will be used to provide access to event data and waveforms. Access to GPS data will be provided by the GSAC web service which has been installed at the IMO through collaboration with UNAVCO. If appropriate, the format and data base structure of SeisComp will be used to store other time series data or point observations and either ArcLink or GSAC may be used to service the access to these data. However, the software development required for the overall construction of the FUTUREVOLC data hub and web service will be performed by two Icelandic software companies participating in the project. Once established, the goal is for the FUTUREVOLC data service to become a volcanological data node in EPOS (the European Plate Observing System), providing access to data and services on Icelandic volcanoes. Collaboration between FUTUREVOLC and the e-Infrastructure working group of EPOS (WG7) has already been initiated and the supersite hub will implement a CERIF metadata base (Common European Research Information Format), which has been chosen by EPOS to facilitate discovery and joint analysis of different datasets. Future developments in Nordic collaboration in meteorology may also lead to possible association of High Performance Computing with the data node.

What core primary health care services should be available to Australians living in rural and remote communities?

PubMed

Thomas, Susan L; Wakerman, John; Humphreys, John S

2014-08-21

Australians living in rural and remote areas experience poorer access to primary health care (PHC) and poorer health outcomes compared to metropolitan populations. Current health reform in Australia aims to ensure all Australians, regardless of where they live, have access to essential PHC services. However, at a national level policy makers and health planners lack an evidence-based set of core PHC services to assist in implementing this goal. A Delphi method was used to reach consensus on an evidence-based list of core PHC services to which all Australians should have access and their necessary support functions. Experts in rural and remote and/or Indigenous PHC, including policy-makers, academics, clinicians and consumers, were invited to consider a list of core services derived from the literature. Thirty nine experts agreed to participate. After three survey rounds there was a strong consensus (≥80% agreement) on core PHC services namely; 'care of the sick and injured', 'mental health', 'maternal/child health', 'allied health', 'sexual/reproductive health', 'rehabilitation', 'oral/dental health' and 'public health/illness prevention'; and on the PHC support functions of; 'management/governance/leadership', 'coordination', 'health infrastructure', 'quality systems', 'data systems', 'professional development' and 'community participation'. Themes emerging from qualitative data included challenges in providing equitable PHC in rural and remote areas, the importance of service coordination and diverse strategies to overcome access barriers. This study identifies a basket of PHC services that consumers in rural and remote communities can expect to access. It provides rigorously derived evidence that will contribute to a more systematic approach to PHC service planning and availability and will assist policy makers in the allocation of scarce resources necessary to improve the health outcomes of residents of rural and remote areas.

Paediatric Palliative Care in Resource-Poor Countries

PubMed Central

Boucher, Sue; Daniels, Alex; Nkosi, Busi

2018-01-01

There is a great need for paediatric palliative care (PPC) services globally, but access to services is lacking in many parts of the world, particularly in resource-poor settings. Globally it is estimated that 21.6 million children need access to palliative care, with 8.2 needing specialist services. PC has been identified as important within the global health agenda e.g., within universal health coverage, and a recent Lancet commission report recognised the need for PPC. However, a variety of challenges have been identified to PPC development globally such as: access to treatment, access to medications such as oral morphine, opiophobia, a lack of trained health and social care professionals, a lack of PPC policies and a lack of awareness about PPC. These challenges can be overcome utilising a variety of strategies including advocacy and public awareness, education, access to medications, implementation and research. Examples will be discussed impacting on the provision of PPC in resource-poor settings. High-quality PPC service provision can be provided with resource-poor settings, and there is an urgent need to scale up affordable, accessible, and quality PPC services globally to ensure that all children needing palliative care can access it. PMID:29463065

Spatial access disparities to primary health care in rural and remote Australia.

PubMed

McGrail, Matthew Richard; Humphreys, John Stirling

2015-11-04

Poor spatial access to health care remains a key issue for rural populations worldwide. Whilst geographic information systems (GIS) have enabled the development of more sophisticated access measures, they are yet to be adopted into health policy and workforce planning. This paper provides and tests a new national-level approach to measuring primary health care (PHC) access for rural Australia, suitable for use in macro-level health policy. The new index was constructed using a modified two-step floating catchment area method framework and the smallest available geographic unit. Primary health care spatial access was operationalised using three broad components: availability of PHC (general practitioner) services; proximity of populations to PHC services; and PHC needs of the population. Data used in its measurement were specifically chosen for accuracy, reliability and ongoing availability for small areas. The resultant index reveals spatial disparities of access to PHC across rural Australia. While generally more remote areas experienced poorer access than more populated rural areas, there were numerous exceptions to this generalisation, with some rural areas close to metropolitan areas having very poor access and some increasingly remote areas having relatively good access. This new index provides a geographically-sensitive measure of access, which is readily updateable and enables a fine granulation of access disparities. Such an index can underpin national rural health programmes and policies designed to improve rural workforce recruitment and retention, and, importantly, health service planning and resource allocation decisions designed to improve equity of PHC access.

Demand access communications for TDRSS users

NASA Technical Reports Server (NTRS)

Zillig, David; Weinberg, Aaron; Mcomber, Robert

1994-01-01

The Tracking and Data Relay Satellite System (TDRSS) has long been used to provide reliable low and high-data rate relay services between user spacecraft in Earth orbit and the ground. To date, these TDRSS services have been implemented via prior scheduling based upon estimates of user needs and mission event timelines. While this approach may be necessary for large users that require greater amounts of TDRSS resources, TDRSS can potentially offer the planned community of smaller science missions (e.g., the small explorer missions), and other emerging users, the unique opportunity for services on demand. In particular, innovative application of the existing TDRSS Multiple Access (MA) subsystem, with its phased array antenna, could be used to implement true demand access services without modification to either the TDRSS satellites or the user transponder, thereby introducing operational and performance benefits to both the user community and the Space Network. In this paper, candidate implementations of demand access service via the TDRSS MA subsystem are examined in detail. Both forward and return link services are addressed and a combination of qualitative and quantitative assessments are provided. The paper also identifies further areas for investigation in this ongoing activity that is being conducted by GSFC/Code 531 under the NASA Code O Advanced Systems Program.

Barriers to formal emergency obstetric care services' utilization.

PubMed

Essendi, Hildah; Mills, Samuel; Fotso, Jean-Christophe

2011-06-01

Access to appropriate health care including skilled birth attendance at delivery and timely referrals to emergency obstetric care services can greatly reduce maternal deaths and disabilities, yet women in sub-Saharan Africa continue to face limited access to skilled delivery services. This study relies on qualitative data collected from residents of two slums in Nairobi, Kenya in 2006 to investigate views surrounding barriers to the uptake of formal obstetric services. Data indicate that slum dwellers prefer formal to informal obstetric services. However, their efforts to utilize formal emergency obstetric care services are constrained by various factors including ineffective health decision making at the family level, inadequate transport facilities to formal care facilities and insecurity at night, high cost of health services, and inhospitable formal service providers and poorly equipped health facilities in the slums. As a result, a majority of slum dwellers opt for delivery services offered by traditional birth attendants (TBAs) who lack essential skills and equipment, thereby increasing the risk of death and disability. Based on these findings, we maintain that urban poor women face barriers to access of formal obstetric services at family, community, and health facility levels, and efforts to reduce maternal morbidity and mortality among the urban poor must tackle the barriers, which operate at these different levels to hinder women's access to formal obstetric care services. We recommend continuous community education on symptoms of complications related to pregnancy and timely referral. A focus on training of health personnel on "public relations" could also restore confidence in the health-care system with this populace. Further, we recommend improving the health facilities in the slums, improving the services provided by TBAs through capacity building as well as involving TBAs in referral processes to make access to services timely. Measures can also be put in place to enhance security in the slums at night.

30 CFR 291.113 - What actions may MMS take to remedy denial of open and nondiscriminatory access?

Code of Federal Regulations, 2010 CFR

2010-07-01

... open and nondiscriminatory access? 291.113 Section 291.113 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR APPEALS OPEN AND NONDISCRIMINATORY ACCESS TO OIL AND GAS PIPELINES... grantee or transporter has not provided open access or nondiscriminatory access, then the decision will...

Using EMBL-EBI Services via Web Interface and Programmatically via Web Services.

PubMed

Lopez, Rodrigo; Cowley, Andrew; Li, Weizhong; McWilliam, Hamish

2014-12-12

The European Bioinformatics Institute (EMBL-EBI) provides access to a wide range of databases and analysis tools that are of key importance in bioinformatics. As well as providing Web interfaces to these resources, Web Services are available using SOAP and REST protocols that enable programmatic access to our resources and allow their integration into other applications and analytical workflows. This unit describes the various options available to a typical researcher or bioinformatician who wishes to use our resources via Web interface or programmatically via a range of programming languages. Copyright © 2014 John Wiley & Sons, Inc.

Data Sets and Data Services at the Northern California Earthquake Data Center

NASA Astrophysics Data System (ADS)

Neuhauser, D. S.; Zuzlewski, S.; Allen, R. M.

2014-12-01

The Northern California Earthquake Data Center (NCEDC) houses a unique and comprehensive data archive and provides real-time services for a variety of seismological and geophysical data sets that encompass northern and central California. We have over 80 terabytes of continuous and event-based time series data from broadband, short-period, strong motion, and strain sensors as well as continuous and campaign GPS data at both standard and high sample rates in both raw and RINEX format. The Northen California Seismic System (NCSS), operated by UC Berkeley and USGS Menlo Park, has recorded over 890,000 events from 1984 to the present, and the NCEDC provides catalog, parametric information, moment tensors and first motion mechanisms, and time series data for these events. We also host and provide event catalogs, parametric information, and event waveforms for DOE enhanced geothermal system monitoring in northern California and Nevada. The NCEDC provides a variety of ways for users to access these data. The most recent development are web services, which provide interactive, command-line, or program-based workflow access to data. Web services use well-established server and client protocols and RESTful software architecture that allow users to easily submit queries and receive the requested data in real-time rather than through batch or email-based requests. Data are returned to the user in the appropriate format such as XML, RESP, simple text, or MiniSEED depending on the service and selected output format. The NCEDC supports all FDSN-defined web services as well as a number of IRIS-defined and NCEDC-defined services. We also continue to support older email-based and browser-based access to data. NCEDC data and web services can be found at http://www.ncedc.org and http://service.ncedc.org.

Introducing the PRIDE Archive RESTful web services.

PubMed

Reisinger, Florian; del-Toro, Noemi; Ternent, Tobias; Hermjakob, Henning; Vizcaíno, Juan Antonio

2015-07-01

The PRIDE (PRoteomics IDEntifications) database is one of the world-leading public repositories of mass spectrometry (MS)-based proteomics data and it is a founding member of the ProteomeXchange Consortium of proteomics resources. In the original PRIDE database system, users could access data programmatically by accessing the web services provided by the PRIDE BioMart interface. New REST (REpresentational State Transfer) web services have been developed to serve the most popular functionality provided by BioMart (now discontinued due to data scalability issues) and address the data access requirements of the newly developed PRIDE Archive. Using the API (Application Programming Interface) it is now possible to programmatically query for and retrieve peptide and protein identifications, project and assay metadata and the originally submitted files. Searching and filtering is also possible by metadata information, such as sample details (e.g. species and tissues), instrumentation (mass spectrometer), keywords and other provided annotations. The PRIDE Archive web services were first made available in April 2014. The API has already been adopted by a few applications and standalone tools such as PeptideShaker, PRIDE Inspector, the Unipept web application and the Python-based BioServices package. This application is free and open to all users with no login requirement and can be accessed at http://www.ebi.ac.uk/pride/ws/archive/. © The Author(s) 2015. Published by Oxford University Press on behalf of Nucleic Acids Research.

Comparison of Online Agricultural Information Services.

ERIC Educational Resources Information Center

Reneau, Fred; Patterson, Richard

1984-01-01

Outlines major online agricultural information services--agricultural databases, databases with agricultural services, educational databases in agriculture--noting services provided, access to the database, and costs. Benefits of online agricultural database sources (availability of agricultural marketing, weather, commodity prices, management…

42 CFR 441.555 - Support system.

Code of Federal Regulations, 2014 CFR

2014-10-01

... accessing services, supports, and resources. (xi) Development of risk management agreements. (A) The State... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... attendant providers, available service delivery models and if applicable, financial management entities...

42 CFR 441.555 - Support system.

Code of Federal Regulations, 2013 CFR

2013-10-01

... accessing services, supports, and resources. (xi) Development of risk management agreements. (A) The State... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... attendant providers, available service delivery models and if applicable, financial management entities...

42 CFR 441.555 - Support system.

Code of Federal Regulations, 2012 CFR

2012-10-01

... accessing services, supports, and resources. (xi) Development of risk management agreements. (A) The State... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... attendant providers, available service delivery models and if applicable, financial management entities...

Integration of legal aspects and human rights approach in palliative care delivery-the Nyeri Hospice model.

PubMed

Musyoki, David; Gichohi, Sarafina; Ritho, Johnson; Ali, Zipporah; Kinyanjui, Asaph; Muinga, Esther

2016-01-01

Palliative care is patient and family-centred care that optimises quality of life by anticipating, preventing, and treating suffering. Open Society Foundation public health program (2011) notes that people facing life-threatening illnesses are deeply vulnerable: often in severe physical pain, worried about death, incapacitation, or the fate of their loved ones. Legal issues can increase stress for patients and families and make coping harder, impacting on the quality of care. In the absence of a clear legal provision expressly recognising palliative care in Kenya, providers may face numerous legal and ethical dilemmas that affect the availability, accessibility, and delivery of palliative care services and commodities. In order to ensure positive outcomes from patients, their families, and providers, palliative care services should be prioritised by all and includes advocating for the integration of legal support into those services. Palliative care service providers should be able to identify the various needs of patients and their families including specific issues requiring legal advice and interventions. Access to legal services remains a big challenge in Kenya, with limited availability of specialised legal services for health-related legal issues. An increased awareness of the benefits of legal services in palliative care will drive demand for easily accessible and more affordable direct legal services to address legal issues for a more holistic approach to quality palliative care.

Barriers in access to home care services among ethnic minority and Dutch elderly--a qualitative study.

PubMed

Suurmond, Jeanine; Rosenmöller, Doenja L; El Mesbahi, Hakima; Lamkaddem, Majda; Essink-Bot, Marie-Louise

2016-02-01

Ethnic minority elderly have a high prevalence of functional limitations and chronic conditions compared to Dutch elderly. However, their use of home care services is low compared to Dutch elderly. Explore the barriers to access to home care services for Turkish, Moroccan Surinamese and ethnic Dutch elderly. Qualitative semi-structured group interviews and individual interviews. The Netherlands. Seven group interviews (n=50) followed by individual interviews (n=5) were conducted, in the preferred language of the participants. Results were ordered and reported according to a framework of access to health care services. This framework describes five dimensions of accessibility to generate access to health care services, from the perspective of the users: ability to perceive health needs, ability to seek health care, ability to reach, ability to pay and ability to engage. This study shows that while barriers are common among all groups, several specific barriers in access to home care services exist for ethnic minority elderly. Language and communication barriers as well as limited networks and a preference for informal care seem to mutually enforce each other, resulting in many barriers during the navigation process to home care. In order to provide equal access to home care for all who need it, the language and communication barriers should be tackled by home care services and home care nurses. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effect of public-private partnership in treatment of sexually transmitted infections among female sex workers in Andhra Pradesh, India.

PubMed

Kokku, Suresh Babu; Mahapatra, Bidhubhusan; Tucker, Saroj; Saggurti, Niranjan; Prabhakar, Parimi

2014-02-01

Providing sexually transmitted infection (STI) services to female sex workers (FSWs) in rural and resource constrained settings is a challenge. This paper describes an approach to address this challenge through a partnership with government health facilities, and examines the effect of this partnership on the utilization of STI services by FSWs in Andhra Pradesh, India. Partnerships were formed with 46 government clinics located in rural areas for providing STI treatment to FSWs in 2007. Government health facilities were supported by local and State level non-government organizations (NGOs) through provision of medicines, training of medical staff, outreach in the communities, and other coordination activities. Data from programme monitoring and behaviour tracking survey were used to examine the accessibility and acceptability in utilization of STI services from partnership clinics. The number of FSWs accessing services at the partnership clinics increased from 1627 in 2007 to over 15,000 in 2010. The average number of annual visits by FSWs to these clinics in 2010 was 3.4. In opinion surveys, the majority of FSWs accessing services at the partnership clinics expressed confidence that they would continue to receive effective services from the government facilities even if the programme terminates. The overall attitude of FSWs to visit government clinics was more positive among FSWs from partnership clinic areas compared to those from non-partnership clinic areas. The partnership mechanism between the NGO-supported HIV prevention programme and government clinic facilities appeared to be a promising opportunity to provide timely and accessible STI services for FSWs living in rural and remote areas.

Challenges in Providing End-of-Life Care for People with Intellectual Disability: Health Services Access

ERIC Educational Resources Information Center

Wark, Stuart; Hussain, Rafat; Müller, Arne; Ryan, Peta; Parmenter, Trevor

2017-01-01

Background: Increasing life expectancy for people with intellectual disability is resulting in greater need for end-of-life care services. However, limited knowledge is available regarding what barriers to accessing end-of-life care support are evident, particularly comparatively across rural and metropolitan locations. Methods: Focus group…

Restructuring to Promote Collaboration and Exceed User Needs: The Blackwell Library Access Services Experience

ERIC Educational Resources Information Center

Chakraborty, Mou; English, Michael; Payne, Sharon

2013-01-01

Through vision, leadership, and creativity, Salisbury University's Blackwell Library transformed its access services department structurally and philosophically to better position itself to meet, and strive to exceed, today's user needs and expectations. Restructuring and the introduction of new leadership and new ideas provided the foundation for…

Beyond equality: Providing equitable care for persons with disabilities

PubMed Central

Wakeham, Scott; Heung, Sally; Lee, Janet; Sadowski, Cheryl A.

2017-01-01

Background: Almost 14% of Canadians have a disability, and older adults are most commonly affected. People living with disabilities have challenges accessing health care services, including medications and other services provided in pharmacies. Methods: A literature review was conducted regarding disability and pharmacy services. Resources regarding accessibility were also incorporated. Results: A number of organizations provide guidance on caring for those with disabilities. A primary concern for these vulnerable individuals relates to being invisible or overlooked by the health care system. There are also the stresses of physical, communication and attitudinal barriers. Pharmacists may be unaware of these barriers and may actually be contributing to them. To understand their patients’ accessibility needs, pharmacists can consider physical and nonphysical barriers and engage in education, advocacy and communications training to improve their patient-centred care for individuals with disabilities. Discussion and Conclusion: Pharmacists can improve the care of individuals with disabilities by learning more about accessibility. Within the community pharmacy environment, there are physical and nonphysical interventions that pharmacists can implement to ensure that patient-centred care is prioritized. PMID:29163726

Digital Health Services and Digital Identity in Alberta.

PubMed

McEachern, Aiden; Cholewa, David

2017-01-01

The Government of Alberta continues to improve delivery of healthcare by allowing Albertans to access their health information online. Alberta is the only province in Canada with provincial electronic health records for all its citizens. These records are currently made available to medical practitioners, but Alberta Health believes that providing Albertans access to their health records will transform the delivery of healthcare in Alberta. It is important to have a high level of assurance that the health records are provided to the correct Albertan. Alberta Health requires a way for Albertans to obtain a digital identity with a high level of identity assurance prior to releasing health records via the Personal Health Portal. Service Alberta developed the MyAlberta Digital ID program to provide a digital identity verification service. The Ministry of Health is leveraging MyAlberta Digital ID to enable Albertans to access their personal health records through the Personal Health Portal. The Government of Alberta is advancing its vision of patient-centred healthcare by enabling Albertans to access a trusted source for health information and their electronic health records using a secure digital identity.

The Virtual Solar-Terrestrial Observatory; access to and use of diverse solar and solar- terrestrial data.

NASA Astrophysics Data System (ADS)

Fox, P.; McGuinness, D.; Cinquini, L.; West, P.; Garcia, J.; Zednik, S.; Benedict, J.

2008-05-01

This presentation will demonstrate how users and other data providers can utilize the Virtual Solar-Terrestrial Observatory (VSTO) to find, access and use diverse data holdings from the disciplines of solar, solar-terrestrial and space physics. VSTO provides a web portal, web services and a native applications programming interface for various levels of users. Since these access methods are based on semantic web technologies and refer to the VSTO ontology, users also have the option of taking advantage of value added services when accessing and using the data. We present example of both conventional use of VSTO as well as the advanced semantics use. Finally, we present our future directions for VSTO and semantic data frameworks in general.

The Virtual Solar-Terrestrial Observatory; access to and use of diverse solar and solar-terrestrial data

NASA Astrophysics Data System (ADS)

Fox, P.

2007-05-01

This presentation will demonstrate how users and other data providers can utilize the Virtual Solar-Terrestrial Observatory (VSTO) to find, access and use diverse data holdings from the disciplines of solar, solar-terrestrial and space physics. VSTO provides a web portal, web services and a native applications programming interface for various levels of users. Since these access methods are based on semantic web technologies and refer to the VSTO ontology, users also have the option of taking advantage of value added services when accessing and using the data. We present example of both conventional use of VSTO as well as the advanced semantics use. Finally, we present our future directions for VSTO and semantic data frameworks in general.

Evaluation of the first pharmacist-administered vaccinations in Western Australia: a mixed-methods study.

PubMed

Hattingh, H Laetitia; Sim, T Fei; Parsons, R; Czarniak, P; Vickery, A; Ayadurai, S

2016-09-20

This study evaluated the uptake of Western Australian (WA) pharmacist vaccination services, the profiles of consumers being vaccinated and the facilitators and challenges experienced by pharmacy staff in the preparation, implementation and delivery of services. Mixed-methods methodology with both quantitative and qualitative data through surveys, pharmacy computer records and immuniser pharmacist interviews. Community pharmacies in WA that provided pharmacist vaccination services between March and October 2015. Immuniser pharmacists from 86 pharmacies completed baseline surveys and 78 completed exit surveys; computer records from 57 pharmacies; 25 immuniser pharmacists were interviewed. Pharmacy and immuniser pharmacist profiles; pharmacist vaccination services provided and consumer profiles who accessed services. 15 621 influenza vaccinations were administered by immuniser pharmacists at 76 WA community pharmacies between March and October 2015. There were no major adverse events, and <1% of consumers experienced minor events which were appropriately managed. Between 12% and 17% of consumers were eligible to receive free influenza vaccinations under the National Immunisation Program but chose to have it at a pharmacy. A high percentage of vaccinations was delivered in rural and regional areas indicating that provision of pharmacist vaccination services facilitated access for rural and remote consumers. Immuniser pharmacists reported feeling confident in providing vaccination services and were of the opinion that services should be expanded to other vaccinations. Pharmacists also reported significant professional satisfaction in providing the service. All participating pharmacies intended to continue providing influenza vaccinations in 2016. This initial evaluation of WA pharmacist vaccination services showed that vaccine delivery was safe. Convenience and accessibility were important aspects in usage of services. There is scope to expand pharmacist vaccination services to other vaccines and younger children; however, government funding to pharmacists needs to be considered. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Providing QoS guarantee in 3G wireless networks

NASA Astrophysics Data System (ADS)

Chuah, MooiChoo; Huang, Min; Kumar, Suresh

2001-07-01

The third generation networks and services present opportunities to offer multimedia applications and services that meet end-to-end quality of service requirements. In this article, we present UMTS QoS architecture and its requirements. This includes the definition of QoS parameters, traffic classes, the end-to-end data delivery model, and the mapping of end-to-end services to the services provided by the network elements of the UMTS. End-to-end QoS of a user flow is achieved by the combination of the QoS control over UMTS Domain and the IP core Network. In the Third Generation Wireless network, UMTS bearer service manager is responsible to manage radio and transport resources to QoS-enabled applications. The UMTS bearer service consists of the Radio Access Bearer Service between Mobile Terminal and SGSN and Core Network bearer service between SGSN and GGSN. The Radio Access Bearer Service is further realized by the Radio Bearer Service (mostly air interface) and Iu bearer service. For the 3G air interface, one can provide differentiated QoS via intelligent burst allocation scheme, adaptive spreading factor control and weighted fair queueing scheduling algorithms. Next, we discuss the requirements for the transport technologies in the radio access network to provide differentiated QoS to multiple classes of traffic. We discuss both ATM based and IP based transport solutions. Last but not least, we discuss how QoS mechanism is provided in the core network to ensure e2e quality of service requirements. We discuss how mobile terminals that use RSVP as QoS signaling mechanisms can be are supported in the 3G network which may implement only IETF diffserv mechanism. . We discuss how one can map UMTS QoS classes with IETF diffserv code points. We also discuss 2G/3G handover scenarios and how the 2G/3G QoS parameters can be mapped.

Telemental health technology in deaf and general mental-health services: access and use.

PubMed

Austen, Sally; McGrath, Melissa

2006-01-01

Long-distance travel to provide mental health services for deaf people has implications for efficiency, safety, and equality of service. However, uptake of Telemental Health (TMH) has been slow in both deaf and general mental health services. A quantitative study was used to investigate access to TMH and whether staff confidence, experience, or demographics affect TMH use. It was concluded that staff in neither deaf mental health services nor general mental health services had adequate knowledge of or access to TMH. Staff expressed concerns over TMH's appropriateness in their work. Previous use of videoconferencing was assosciated significantly with confidence, but previous use of videophones was not. Neither staff in deaf services nor deaf staff were more experienced with or more confident about videoconferencing, whereas, within deaf services, deaf staff were significantly more confident about videophone use. Training implications are discussed.

Active offer of health services in French in Ontario: Analysis of reorganization and management strategies of health care organizations.

PubMed

Farmanova, Elina; Bonneville, Luc; Bouchard, Louise

2018-01-01

The availability of health services in French is not only weak but also inexistent in some regions in Canada. As a result, estimated 78% of more than a million of Francophones living in a minority situation in Canada experience difficulties accessing health care in French. To promote the delivery of health services in French, publicly funded organizations are encouraged to take measures to ensure that French-language services are clearly visible, available, easily accessible, and equivalent to the quality of services offered in English. This study examines the reorganization and management strategies taken by health care organizations in Ontario that provide health services in French. Review and analysis of designation plans of a sample of health care organizations. Few health care organizations providing services in French have concrete strategies to guarantee availability, visibility, and accessibility of French-language services. Implementation of the active offer of French-language services is likely to be difficult and slow. The Ontario government must strengthen collaboration with health care organizations, Francophone communities, and other key actors participating in the designation process to help health care organizations build capacities for the effective offer of French-language services. Copyright © 2017 John Wiley & Sons, Ltd.

[Multidimensional assessment of public health care services for adolescents in Chile].

PubMed

Williams, Catalina de T; Poblete, Fernando A; Baldrich, Francisca A

2012-09-01

Adolescents are an especially vulnerable age group in terms of behavioral issues and require skilled teams in health centers. To assess the quality of health services provided to teenage users in Primary Health Care. A study of multiple cases was carried out in two family health centers in Puente Alto, Chile. Health services delivered to adolescents were evaluated from the provider's perspective, through qualitative design of focus groups and interviews to the care teams at each centre. For technical quality, comparing electronic records of two tracer conditions (prenatal care and depression) with technical standards established by Delphi methodology and from teenage users perspective, through a survey of service satisfaction. In both centers, providers perceived a lack of training in adolescent care, a deficient preventive approach and a limited access to care. The technical evaluation showed an inappropriate recording of both tracer conditions. The instrument used to assess user satisfaction survey was reliable and showed that the best perceived issue was medical care and treatment, and the least perceived, was the access to the services. Professionals working in these health care facilities, feel unprepared to provide comprehensive approach to adolescents. The surveyed teenagers complained of limited access to care. Therefore this age group continues to be as a non-priority group for health care.

Abortion law, policy and services in India: a critical review.

PubMed

Hirve, Siddhivinayak S

2004-11-01

Despite 30 years of liberal legislation, the majority of women in India still lack access to safe abortion care. This paper critically reviews the history of abortion law and policy in India since the 1960s and research on abortion service delivery. Amendments in 2002 and 2003 to the 1971 Medical Termination of Pregnancy Act, including devolution of regulation of abortion services to the district level, punitive measures to deter provision of unsafe abortions, rationalisation of physical requirements for facilities to provide early abortion, and approval of medical abortion, have all aimed to expand safe services. Proposed amendments to the MTP Act to prevent sex-selective abortions would have been unethical and violated confidentiality, and were not taken forward. Continuing problems include poor regulation of both public and private sector services, a physician-only policy that excludes mid-level providers and low registration of rural compared to urban clinics; all restrict access. Poor awareness of the law, unnecessary spousal consent requirements, contraceptive targets linked to abortion, and informal and high fees also serve as barriers. Training more providers, simplifying registration procedures, de-linking clinic and provider approval, and linking policy with up-to-date technology, research and good clinical practice are some immediate measures needed to improve women's access to safe abortion care.

Perspectives on providing good access to dental services for elderly people: patient selection, dentists' responsibility and budget management.

PubMed

Grytten, Jostein; Holst, Dorthe

2013-06-01

To suggest a model for organizing and financing dental services for elderly people so that they have good access to services. There are few studies on how dental services for elderly people should be organized and financed. This is surprising if we take into consideration the fact that the proportion of elderly people is growing faster than any other group in the population, and that elderly people have more dental diseases and poorer access to dental services than the rest of the adult population. In several countries, dental services are characterized by private providers who often operate in a market with competition and free price-setting. Private dentists have no community responsibility, and they are free to choose which patients they treat. Literature review and critical reasoning. In order to avoid patient selection, a patient list system for elderly people is recommended, with per capita remuneration for the patients that the dentist is given responsibility for. The patient list system means that the dentist assumes responsibility for a well-defined list of elderly people. Our model will lead to greater security in the dentist/patient relationship, and patients with great treatment needs will be ensured access to dental services. © 2012 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

Cloud computing for context-aware enhanced m-Health services.

PubMed

Fernandez-Llatas, Carlos; Pileggi, Salvatore F; Ibañez, Gema; Valero, Zoe; Sala, Pilar

2015-01-01

m-Health services are increasing its presence in our lives due to the high penetration of new smartphone devices. This new scenario proposes new challenges in terms of information accessibility that require new paradigms which enable the new applications to access the data in a continuous and ubiquitous way, ensuring the privacy required depending on the kind of data accessed. This paper proposes an architecture based on cloud computing paradigms in order to empower new m-Health applications to enrich their results by providing secure access to user data.

Walking the Tightrope.

ERIC Educational Resources Information Center

Weingarten, Fred W.

1994-01-01

Discusses issues relating to the public interest regarding the National Information Infrastructure. Topics addressed include access, including access to the physical infrastructure and resources and access as a service provider; information rights, including privacy, intellectual property, freedom of speech, and government information; public…

Young People’s Preferences for Family Planning Service Providers in Rural Malawi: A Discrete Choice Experiment

PubMed Central

Michaels-Igbokwe, Christine; Terris-Prestholt, Fern; Lagarde, Mylene; Chipeta, Effie; Cairns, John

2015-01-01

Objective To quantify the impact of service provider characteristics on young people’s choice of family planning (FP) service provider in rural Malawi in order to identify strategies for increasing access and uptake of FP among youth. Methods and Findings A discrete choice experiment was developed to assess the relative impact of service characteristics on preferences for FP service providers among young people (aged 15–24). Four alternative providers were included (government facility, private facility, outreach and community based distribution of FP) and described by six attributes (the distance between participants’ home and the service delivery point, frequency of service delivery, waiting time at the facility, service providers’ attitude, availability of FP commodities and price). A random parameters logit model was used to estimate preferences for service providers and the likely uptake of services following the expansion of outreach and community based distribution (CBDA) services. In the choice experiment young people were twice as likely to choose a friendly provider (government service odds ratio [OR] = 2.45, p<0.01; private service OR = 1.99, p<0.01; CBDA OR = 1.88, p<0.01) and more than two to three times more likely to choose a provider with an adequate supply of FP commodities (government service OR = 2.48, p<0.01; private service OR = 2.33, p<0.01; CBDA = 3.85, p<0.01). Uptake of community based services was greater than facility based services across a variety of simulated service scenarios indicating that such services may be an effective means of expanding access for youth in rural areas and an important tool for increasing service uptake among youth. Conclusions Ensuring that services are acceptable to young people may require additional training for service providers in order to ensure that all providers are friendly and non-judgemental when dealing with younger clients and to ensure that supplies are consistently available. PMID:26630492

Healthcare provider perspectives on barriers to HIV-care access and utilisation among Latinos living with HIV in the US-Mexico border

PubMed Central

Servin, Argentina E.; Muñoz, Fátima A.; Zúñiga, María Luisa

2015-01-01

Latinos living with HIV residing in the US-Mexico border region frequently seek care on both sides of the border. Given this fact, a border health perspective to understanding barriers to care is imperative to improve patient health outcomes. This qualitative study describes and compares experiences and perceptions of Mexican and US HIV care providers regarding barriers to HIV care access for Latino patients living in the US-Mexico border region. In 2010, we conducted in-depth qualitative interviews with HIV care providers in Tijuana (n = 10) and San Diego (n = 9). We identified important similarities and differences between Mexican and US healthcare provider perspectives on HIV care access and barriers to service utilisation. Similarities included the fact that HIV-positive Latino patients struggle with access to ART medication, mental health illness, substance abuse and HIV-related stigma. Differences included Mexican provider perceptions of medication shortages and US providers feeling that insurance gaps influenced medication access. Differences and similarities have important implications for cross-border efforts to coordinate health services for patients who seek care in both countries. PMID:24592920

Cyberinfrastructure at IRIS: Challenges and Solutions Providing Integrated Data Access to EarthScope and Other Earth Science Data

NASA Astrophysics Data System (ADS)

Ahern, T. K.; Barga, R.; Casey, R.; Kamb, L.; Parastatidis, S.; Stromme, S.; Weertman, B. T.

2008-12-01

While mature methods of accessing seismic data from the IRIS DMC have existed for decades, the demands for improved interdisciplinary data integration call for new approaches. Talented software teams at the IRIS DMC, UNAVCO and the ICDP in Germany, have been developing web services for all EarthScope data including data from USArray, PBO and SAFOD. These web services are based upon SOAP and WSDL. The EarthScope Data Portal was the first external system to access data holdings from the IRIS DMC using Web Services. EarthScope will also draw more heavily upon products to aid in cross-disciplinary data reuse. A Product Management System called SPADE allows archive of and access to heterogeneous data products, presented as XML documents, at the IRIS DMC. Searchable metadata are extracted from the XML and enable powerful searches for products from EarthScope and other data sources. IRIS is teaming with the External Research Group at Microsoft Research to leverage a powerful Scientific Workflow Engine (Trident) and interact with the web services developed at centers such as IRIS to enable access to data services as well as computational services. We believe that this approach will allow web- based control of workflows and the invocation of computational services that transform data. This capability will greatly improve access to data across scientific disciplines. This presentation will review some of the traditional access tools as well as many of the newer approaches that use web services, scientific workflow to improve interdisciplinary data access.

Vouchers for health: A demand side output-based aid approach to reproductive health services in Kenya.

PubMed

Janisch, C P; Albrecht, M; Wolfschuetz, A; Kundu, F; Klein, S

2010-01-01

Reaching the United Nation's Millennium Development Goals has been a focus for many countries and development partners. In Kenya, as in many other countries with low levels of development, access to and equity of basic quality health services is limited, especially for the very poor. Among poor populations, maternal mortality is high as access to medical care and financial means are lacking. In 2005, the Governments of Kenya and Germany in cooperation with KfW Banking Group made funds available for the Reproductive Health OBA Voucher Programme offering vouchers for Safe Motherhood, Family Planning and Gender Violence Recovery Services. This programme, herein referred to as Vouchers for Health, was launched in June of 2006 in five Kenyan districts with the aim of providing health services for safe deliveries, long-term family planning methods and victims of gender violence. The way that the programme is being implemented in Kenya demonstrates that the voucher-based approach comprises a variety of key structural elements of a national health insurance scheme: accreditation; quality assurance; reimbursement system; claims processing; integrating the private sector; client choice; provider competition; and access to and equity of services provided.

The acceptability to patients of PhysioDirect telephone assessment and advice services; a qualitative interview study.

PubMed

Pearson, Jennifer; Richardson, Jane; Calnan, Michael; Salisbury, Chris; Foster, Nadine E

2016-03-28

In response to long waiting lists and problems with access to primary care physiotherapy, several Primary Care Trusts (PCTs) (now Clinical Commissioning Groups CCGs) developed physiotherapy-led telephone assessment and treatment services. The Medical Research Council (MRC) funded PhysioDirect trial was a randomised control trial (RCT) in four PCTs, with a total of 2252 patients that compared this approach with usual physiotherapy care. This nested qualitative study aimed to explore the acceptability of the PhysioDirect telephone assessment and advice service to patients with musculoskeletal conditions. We conducted 57 semi-structured interviews with adults from 4 PCTs who were referred from general practice to physiotherapy with musculoskeletal conditions and were participating in the PhysioDirect trial. The Framework method was used to analyse the qualitative data. The PhysioDirect service was largely viewed as acceptable although some saw it as a first step to subsequent face-to-face physiotherapy. Most participants found accessing the PhysioDirect service straightforward and smooth, and they valued the faster access to physiotherapy advice offered by the telephone service. Participants generally viewed both the PhysioDirect service and the physiotherapists providing the service as helpful. Participants' preferences and priorities for treatment defined the acceptable features of PhysioDirect but the acceptable features were traded off against less acceptable features. Some participants felt that the PhysioDirect service was impersonal and impaired the development of a good relationship with their physiotherapist, which made the service feel remote and less valuable. The PhysioDirect service was broadly acceptable to participants since it provided faster access to physiotherapy advice for their musculoskeletal conditions. Participants felt that it is best placed as one method of accessing physiotherapy services, in addition to, rather than as a replacement for, more traditional face-to-face physiotherapy assessment and treatment.

Tinnitus referral pathways within the National Health Service in England: a survey of their perceived effectiveness among audiology staff

PubMed Central

2011-01-01

Background In the UK, audiology services deliver the majority of tinnitus patient care, but not all patients experience the same level of service. In 2009, the Department of Health released a Good Practice Guide to inform commissioners about key aspects of a quality tinnitus service in order to promote equity of tinnitus patient care in UK primary care, audiology, and in specialist multi-disciplinary centres. The purpose of the present research was to evaluate utilisation and opinions on pathways for the referral of tinnitus patients to and from English Audiology Departments. Methods We surveyed all audiology staff engaged in providing tinnitus services across England. A 36-item questionnaire was mailed to 351 clinicians in all 163 National Health Service (NHS) Trusts identified as having a tinnitus service. 138 clinicians responded. The results presented here describe experiences and opinions of the current patient pathways to and from the audiology tinnitus service. Results The most common referral pathway was from general practice to a hospital-based Ear, Nose & Throat department and from there to a hospital-based audiology department (64%). Respondents considered the NHS tinnitus referral process to be generally effective (67%), but expressed needs for improving GP referral and patients' access to services. 'Open access' to the audiology clinic was rarely an option for patients (9%), nor was the opportunity to access specialist counselling provided by clinical psychology (35%). To decrease the number of inappropriate referrals, 40% of respondents called for greater awareness by referrers about the audiology tinnitus service. Conclusions Respondents in the present survey were generally satisfied with the tinnitus referral system. However, they highlighted some potential targets for service improvement including 1] faster and more appropriate referral from GPs, to be achieved through education on tinnitus referral criteria, 2] improved access to psychological services through audiologist training, and 3] ongoing support from tinnitus support groups, national charities, or open access to the tinnitus clinic for existing patients. PMID:21733188

Tinnitus referral pathways within the National Health Service in England: a survey of their perceived effectiveness among audiology staff.

PubMed

Gander, Phillip E; Hoare, Derek J; Collins, Luke; Smith, Sandra; Hall, Deborah A

2011-07-06

In the UK, audiology services deliver the majority of tinnitus patient care, but not all patients experience the same level of service. In 2009, the Department of Health released a Good Practice Guide to inform commissioners about key aspects of a quality tinnitus service in order to promote equity of tinnitus patient care in UK primary care, audiology, and in specialist multi-disciplinary centres. The purpose of the present research was to evaluate utilisation and opinions on pathways for the referral of tinnitus patients to and from English Audiology Departments. We surveyed all audiology staff engaged in providing tinnitus services across England. A 36-item questionnaire was mailed to 351 clinicians in all 163 National Health Service (NHS) Trusts identified as having a tinnitus service. 138 clinicians responded. The results presented here describe experiences and opinions of the current patient pathways to and from the audiology tinnitus service. The most common referral pathway was from general practice to a hospital-based Ear, Nose & Throat department and from there to a hospital-based audiology department (64%). Respondents considered the NHS tinnitus referral process to be generally effective (67%), but expressed needs for improving GP referral and patients' access to services. 'Open access' to the audiology clinic was rarely an option for patients (9%), nor was the opportunity to access specialist counselling provided by clinical psychology (35%). To decrease the number of inappropriate referrals, 40% of respondents called for greater awareness by referrers about the audiology tinnitus service. Respondents in the present survey were generally satisfied with the tinnitus referral system. However, they highlighted some potential targets for service improvement including 1] faster and more appropriate referral from GPs, to be achieved through education on tinnitus referral criteria, 2] improved access to psychological services through audiologist training, and 3] ongoing support from tinnitus support groups, national charities, or open access to the tinnitus clinic for existing patients.

GENESI-DR - A single access point to Earth Science data

NASA Astrophysics Data System (ADS)

Cossu, R.; Goncalves, P.; Pacini, F.

2009-04-01

The amount of information being generated about our planet is increasing at an exponential rate, but it must be easily accessible in order to apply it to the global needs relating to the state of the Earth. Currently, information about the state of the Earth, relevant services, analysis results, applications and tools are accessible in a very scattered and uncoordinated way, often through individual initiatives from Earth Observation mission operators, scientific institutes dealing with ground measurements, service companies, data catalogues, etc. A dedicated infrastructure providing transparent access to all this will support Earth Science communities by allowing them to easily and quickly derive objective information and share knowledge based on all environmentally sensitive domains. The use of high-speed networks (GÉANT) and the experimentation of new technologies, like BitTorrent, will also contribute to better services for the Earth Science communities. GENESI-DR (Ground European Network for Earth Science Interoperations - Digital Repositories), an ESA-led, European Commission (EC)-funded two-year project, is taking the lead in providing reliable, easy, long-term access to Earth Science data via the Internet. This project will allow scientists from different Earth Science disciplines located across Europe to locate, access, combine and integrate historical and fresh Earth-related data from space, airborne and in-situ sensors archived in large distributed repositories. GENESI-DR builds a federated collection of heterogeneous digital Earth Science repositories to establish a dedicated infrastructure providing transparent access to all this and allowing Earth Science communities to easily and quickly derive objective information and share knowledge based on all environmentally sensitive domains. The federated digital repositories, seen as services and data providers, will share access to their resources (catalogue functions, data access, processing services etc.) and will adhere to a common set of standards / policies / interfaces. The end-users will be provided with a virtual collection of digital Earth Science data, irrespectively of their location in the various single federated repositories. GENESI-DR objectives have lead to the identification of the basic GENESI-DR infrastructure requirements: • Capability, for Earth Science users, to discover data from different European Earth Science Digital Repositories through the same interface in a transparent and homogeneous way; • Easiness and speed of access to large volumes of coherently maintained distributed data in an effective and timely way; • Capability, for DR owners, to easily make available their data to a significantly increased audience with no need to duplicate them in a different storage system. Data discovery is based on a Central Discovery Service, which allows users and applications to easily query information about data collections and products existing in heterogeneous catalogues, at federated DR sites. This service can be accessed by users via web interface, the GENESI-DR Web Portal, or by external applications via open standardized interfaces exposed by the system. The Central Discovery Service identifies the DRs providing products complying with the user search criteria and returns the corresponding access points to the requester. By taking into consideration different and efficient data transfer technologies such as HTTPS, GridFTP and BitTorrent, the infrastructure provides easiness and speed of access. Conversely, for data publishing GENESI-DR provides several mechanisms to assist DR owners in producing a metadata catalogues. In order to reach its objectives, the GENESI-DR e-Infrastructure will be validated against user needs for accessing and sharing Earth Science data. Initially, four specific applications in the land, atmosphere and marine domains have been selected, including: • Near real time orthorectification for agricultural crops monitoring • Urban area mapping in support of emergency response • Data assimilation in GlobModel, addressing major environmental and health issues in Europe, with a particular focus on air quality • SeaDataNet to aid environmental assessments and to forecast the physical state of the oceans in near real time. Other applications will complement this during the second half of the project. GENESI-DR also aims to develop common approaches to preserve the historical archives and the ability to access the derived user information as both software and hardware transformations occur. Ensuring access to Earth Science data for future generations is of utmost importance because it allows for the continuity of knowledge generation improvement. For instance, scientists accessing today's climate change data in 50 years will be able to better understand and detect trends in global warming and apply this knowledge to ongoing natural phenomena. GENESI-DR will work towards harmonising operations and applying approved standards, policies and interfaces at key Earth Science data repositories. To help with this undertaking, GENESI-DR will establish links with the relevant organisations and programmes such as space agencies, institutional environmental programmes, international Earth Science programmes and standardisation bodies.

A Systematic Review of Asynchronous, Provider-to-Provider, Electronic Consultation Services to Improve Access to Specialty Care Available Worldwide.

PubMed

Liddy, Clare; Moroz, Isabella; Mihan, Ariana; Nawar, Nikhat; Keely, Erin

2018-06-21

Electronic consultation (eConsult) is an asynchronous electronic communication tool allowing primary care providers to obtain a specialist consultant's expert opinion in a timely manner, thereby offering a potential solution to excessive wait times for specialist care, which remain a serious concern in many countries. Our 2014 review of eConsult services demonstrated feasibility and high acceptability among patients and providers. However, gaps remain in knowledge regarding eConsult's impact on system costs and patient outcomes. Following the PRISMA guidelines, we conducted a systematic review in May 2017 of English and French literature on OVID Medline, EMBASE, ERIC, and CINAHL databases, examining all studies on eConsult services published since our previous review. The Quadruple Aim Framework was used to synthesize outcomes. Articles reporting on the impact of eConsult on access, patient safety and satisfaction, utilization rates, clinical workflow, and continuing medical education were analyzed using a narrative synthesis approach. The initial search yielded 1,021 results, 50 of which were included on abstract and received a quality assessment and full text review. Of these, 43 were included in our final analysis. Results demonstrated the worldwide presence of eConsult services in North America and countries beyond, including Brazil, Australia, Spain, and The Netherlands. The breadth of specialty services offered has greatly expanded beyond dermatology and includes cardiology, nephrology, and hematology among others. Overall impact on access measures, acceptability, cost, and provider satisfaction remain positive. There is limited research on population health outcomes of morbidity and mortality. The availability of eConsult services has spread both geographically and in terms of specialty services offered. By allowing for a greater population to be served, access to care is being improved; however, long-term impact should continue to be assessed with a focus on patient safety, morbidity, mortality, and cost effectiveness metrics.

Giving rheumatology patients online home access to their electronic medical record (EMR): advantages, drawbacks and preconditions according to care providers.

PubMed

van der Vaart, Rosalie; Drossaert, Constance H C; Taal, Erik; van de Laar, Mart A F J

2013-09-01

Technology enables patients home access to their electronic medical record (EMR), via a patient portal. This study aims to analyse (dis)advantages, preconditions and suitable content for this service, according to rheumatology health professionals. A two-phase policy Delphi study was conducted. First, interviews were performed with nurses/nurse practitioners (n = 9) and rheumatologists (n = 13). Subsequently, collected responses were quantified, using a questionnaire among the interviewees. The following advantages of patient home access to the EMR were reported: (1) enhancement of patient participation in treatment, (2) increased knowledge and self-management, (3) improved patient-provider interaction, (4) increased patient safety, and (5) better communication with others. Foreseen disadvantages of the service included: (1) problems with interpretation of data, (2) extra workload, (3) a change in consultation content, and (4) disturbing the patient-provider interaction. Also, the following preconditions emerged from the data: (1) optimal security, (2) no extra record, but a patient-accessible section, (3) no access to clinical notes, and (4) a lag time on the release of lab data. Most respondents reported that data on diagnosis, medication, treatment plan and consultations could be released to patients. On releasing more complex data, such as bodily examinations, lab results and radiological images the opinions differed considerably. Providing patients home access to their medical record might be a valuable next step into patient empowerment and in service towards the patient, provided that security is optimal and content and presentation of data are carefully considered.

The experiences of parents of children with mental disability regarding access to mental health care.

PubMed

Coomer, R A

2013-07-01

The aim of this qualitative study was to describe the problems that parents or caregivers of children with mental health disabilities and disorders in Namibia experience when accessing healthcare resources for their children. Data was collected through focus group discussions with the participants and individual interviews with the key informants. Overall, a total of 41 people provided information for this study. Thematic data analysis was used to assess the data. The main barriers experienced by the parents were poor service provision, transport and money, whilst access to education services facilitated access to healthcare services. The challenges go beyond commonly-reported problems such as sub-optimal service provision and include the basic challenge of lack of transportation to reach healthcare services. Many of the barriers identified in this study have been related to general problems with the healthcare system in Namibia. Therefore there is a need to address general concerns about healthcare provision as well as improve specific services for children with mental health disabilities and disorders in Namibia.

Accessing Sexual and Reproductive Health Information and Services: A Mixed Methods Study of Young Women's Needs and Experiences in Soweto, South Africa.

PubMed

Lince-Deroche, Naomi; Hargey, Adila; Holt, Kelsey; Shochet, Tara

2015-03-01

Young women and girls in South Africa are at high risk of unintended pregnancy and HIV. Previous studies have reported barriers to contraceptive and other sexual and reproductive health (SRH) services among young women in this context. We aimed to assess young women's SRH knowledge and experiences and to determine how they get SRH information and services in Soweto, South Africa using quantitative and qualitative methods. Young women, aged 18-24, recruited from primary health clinics and a shopping mall, reported that they have access to SRH information and know where to obtain services. However there are challenges to accessing and utilizing information and services including providers' unsupportive attitudes, uneven power dynamics in relationships and communication issues with parents and community members. There is a need to assist young women in understanding the significance of SRH information. They need access to age-appropriate, youth-friendly services in order to have healthy sexual experiences.

Patients' online access to their electronic health records and linked online services: a systematic interpretative review.

PubMed

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

2014-09-08

To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues. Primary care. A total of 143 studies were included. 17 were experimental in design and subject to risk of bias assessment, which is reported in a separate paper. Detailed inclusion and exclusion criteria have also been published elsewhere in the protocol. Our primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services. No studies reported changes in health outcomes; though eight detected medication errors and seven reported improved uptake of preventative care. Professional concerns over privacy were reported in 14 studies. 18 studies reported concern over potential increased workload; with some showing an increase workload in email or online messaging; telephone contact remaining unchanged, and face-to face contact staying the same or falling. Owing to heterogeneity in reporting overall workload change was hard to predict. 10 studies reported how online access offered convenience, primarily for more advantaged patients, who were largely highly satisfied with the process when clinician responses were prompt. Patient online access and services offer increased convenience and satisfaction. However, professionals were concerned about impact on workload and risk to privacy. Studies correcting medication errors may improve patient safety. There may need to be a redesign of the business process to engage health professionals in online access and of the EHR to make it friendlier and provide equity of access to a wider group of patients. A1 SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42012003091. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Patients’ online access to their electronic health records and linked online services: a systematic interpretative review

PubMed Central

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

2014-01-01

Objectives To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues. Setting Primary care. Participants A total of 143 studies were included. 17 were experimental in design and subject to risk of bias assessment, which is reported in a separate paper. Detailed inclusion and exclusion criteria have also been published elsewhere in the protocol. Primary and secondary outcome measures Our primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services. Results No studies reported changes in health outcomes; though eight detected medication errors and seven reported improved uptake of preventative care. Professional concerns over privacy were reported in 14 studies. 18 studies reported concern over potential increased workload; with some showing an increase workload in email or online messaging; telephone contact remaining unchanged, and face-to face contact staying the same or falling. Owing to heterogeneity in reporting overall workload change was hard to predict. 10 studies reported how online access offered convenience, primarily for more advantaged patients, who were largely highly satisfied with the process when clinician responses were prompt. Conclusions Patient online access and services offer increased convenience and satisfaction. However, professionals were concerned about impact on workload and risk to privacy. Studies correcting medication errors may improve patient safety. There may need to be a redesign of the business process to engage health professionals in online access and of the EHR to make it friendlier and provide equity of access to a wider group of patients. A1. Systematic review registration number PROSPERO CRD42012003091. PMID:25200561

Conscientious objection and compromising the patient: Response to Hughes.

PubMed

Savulescu, Julian; Schuklenk, Udo

2018-06-19

Hughes offers a consequentialist response to our rejection of accommodation of conscientious objection in medicine. We argue here that his compromise proposition has been tried in many jurisdictions and has failed to deliver unimpeded access to care for eligible patients. The compromise position, entailing an accommodation of conscientious objection provided there is unimpeded access, fails to grasp that the objectors are both determined not to provide services they object to as well as to subvert patient access to the objected to services. Unpredictable future developments in drug R&D and resulting treatment and prevention options in medicine make the compromise position unrealistic. © 2018 John Wiley & Sons Ltd.

17 CFR 160.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2011 CFR

2011-04-01

... form of access number or access code, does not include a number or code in an encrypted form, as long... consumer reporting agency, an account number or similar form of access number or access code for a consumer... similar form of access number or access code: (1) To your agent or service provider solely in order to...

12 CFR 716.12 - Limits on sharing of account number information for marketing purposes.

Code of Federal Regulations, 2012 CFR

2012-01-01

... form of access number or access code, does not include a number or code in an encrypted form, as long... consumer reporting agency, an account number or similar form of access number or access code for a consumer... similar form of access number or access code: (1) To your agent or service provider solely in order to...

17 CFR 248.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., or similar form of access number or access code, does not include a number or code in an encrypted... consumer reporting agency, an account number or similar form of access number or access code for a consumer... similar form of access number or access code: (1) To your agent or service provider solely in order to...

12 CFR 716.12 - Limits on sharing of account number information for marketing purposes.

Code of Federal Regulations, 2011 CFR

2011-01-01

... form of access number or access code, does not include a number or code in an encrypted form, as long... consumer reporting agency, an account number or similar form of access number or access code for a consumer... similar form of access number or access code: (1) To your agent or service provider solely in order to...

12 CFR 716.12 - Limits on sharing of account number information for marketing purposes.

Code of Federal Regulations, 2013 CFR

2013-01-01

... form of access number or access code, does not include a number or code in an encrypted form, as long... consumer reporting agency, an account number or similar form of access number or access code for a consumer... similar form of access number or access code: (1) To your agent or service provider solely in order to...

Fixed Access Network Sharing

NASA Astrophysics Data System (ADS)

Cornaglia, Bruno; Young, Gavin; Marchetta, Antonio

2015-12-01

Fixed broadband network deployments are moving inexorably to the use of Next Generation Access (NGA) technologies and architectures. These NGA deployments involve building fiber infrastructure increasingly closer to the customer in order to increase the proportion of fiber on the customer's access connection (Fibre-To-The-Home/Building/Door/Cabinet… i.e. FTTx). This increases the speed of services that can be sold and will be increasingly required to meet the demands of new generations of video services as we evolve from HDTV to "Ultra-HD TV" with 4k and 8k lines of video resolution. However, building fiber access networks is a costly endeavor. It requires significant capital in order to cover any significant geographic coverage. Hence many companies are forming partnerships and joint-ventures in order to share the NGA network construction costs. One form of such a partnership involves two companies agreeing to each build to cover a certain geographic area and then "cross-selling" NGA products to each other in order to access customers within their partner's footprint (NGA coverage area). This is tantamount to a bi-lateral wholesale partnership. The concept of Fixed Access Network Sharing (FANS) is to address the possibility of sharing infrastructure with a high degree of flexibility for all network operators involved. By providing greater configuration control over the NGA network infrastructure, the service provider has a greater ability to define the network and hence to define their product capabilities at the active layer. This gives the service provider partners greater product development autonomy plus the ability to differentiate from each other at the active network layer.

Ecosystem Services Flows: Why Stakeholders' Power Relationships Matter.

PubMed

Felipe-Lucia, María R; Martín-López, Berta; Lavorel, Sandra; Berraquero-Díaz, Luis; Escalera-Reyes, Javier; Comín, Francisco A

2015-01-01

The ecosystem services framework has enabled the broader public to acknowledge the benefits nature provides to different stakeholders. However, not all stakeholders benefit equally from these services. Rather, power relationships are a key factor influencing the access of individuals or groups to ecosystem services. In this paper, we propose an adaptation of the "cascade" framework for ecosystem services to integrate the analysis of ecological interactions among ecosystem services and stakeholders' interactions, reflecting power relationships that mediate ecosystem services flows. We illustrate its application using the floodplain of the River Piedra (Spain) as a case study. First, we used structural equation modelling (SEM) to model the dependence relationships among ecosystem services. Second, we performed semi-structured interviews to identify formal power relationships among stakeholders. Third, we depicted ecosystem services according to stakeholders' ability to use, manage or impair ecosystem services in order to expose how power relationships mediate access to ecosystem services. Our results revealed that the strongest power was held by those stakeholders who managed (although did not use) those keystone ecosystem properties and services that determine the provision of other services (i.e., intermediate regulating and final services). In contrast, non-empowered stakeholders were only able to access the remaining non-excludable and non-rival ecosystem services (i.e., some of the cultural services, freshwater supply, water quality, and biological control). In addition, land stewardship, access rights, and governance appeared as critical factors determining the status of ecosystem services. Finally, we stress the need to analyse the role of stakeholders and their relationships to foster equal access to ecosystem services.

Ecosystem Services Flows: Why Stakeholders’ Power Relationships Matter

PubMed Central

Felipe-Lucia, María R.; Martín-López, Berta; Lavorel, Sandra; Berraquero-Díaz, Luis; Escalera-Reyes, Javier; Comín, Francisco A.

2015-01-01

The ecosystem services framework has enabled the broader public to acknowledge the benefits nature provides to different stakeholders. However, not all stakeholders benefit equally from these services. Rather, power relationships are a key factor influencing the access of individuals or groups to ecosystem services. In this paper, we propose an adaptation of the “cascade” framework for ecosystem services to integrate the analysis of ecological interactions among ecosystem services and stakeholders’ interactions, reflecting power relationships that mediate ecosystem services flows. We illustrate its application using the floodplain of the River Piedra (Spain) as a case study. First, we used structural equation modelling (SEM) to model the dependence relationships among ecosystem services. Second, we performed semi-structured interviews to identify formal power relationships among stakeholders. Third, we depicted ecosystem services according to stakeholders’ ability to use, manage or impair ecosystem services in order to expose how power relationships mediate access to ecosystem services. Our results revealed that the strongest power was held by those stakeholders who managed (although did not use) those keystone ecosystem properties and services that determine the provision of other services (i.e., intermediate regulating and final services). In contrast, non-empowered stakeholders were only able to access the remaining non-excludable and non-rival ecosystem services (i.e., some of the cultural services, freshwater supply, water quality, and biological control). In addition, land stewardship, access rights, and governance appeared as critical factors determining the status of ecosystem services. Finally, we stress the need to analyse the role of stakeholders and their relationships to foster equal access to ecosystem services. PMID:26201000

Spatial Accessibility to Health Care Services: Identifying under-Serviced Neighbourhoods in Canadian Urban Areas

PubMed Central

Shah, Tayyab Ikram; Bell, Scott; Wilson, Kathi

2016-01-01

Background Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC) in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods. Methods This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA) method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population), was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms) used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons). An integrated geocoding approach was used to establish PHC locations. Results The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs. Conclusions The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care services at the neighbourhood level. In particular, the results show that the low access neighbourhoods tend to be clustered in the neighbourhoods at the urban periphery and immediately surrounding the downtown area. PMID:27997577

Facilitators of and barriers to accessing clinical prevention services for the South Asian population in Surrey, British Columbia: a qualitative study.

PubMed

Majid, Sanaa; Douglas, Rachel; Lee, Victoria; Stacy, Elizabeth; Garg, Arun K; Ho, Kendall

2016-01-01

British Columbia falls short in uptake of recommended clinical prevention services, with even lower rates among immigrant populations. This study explored facilitators of and barriers to uptake of clinical prevention services among people from South Asia, who represent 31% of the population in Surrey, British Columbia. We used a qualitative descriptive approach and employed vignettes in a focus group setting to elicit perspectives of South Asian people on accessing clinical prevention services. Participants aged 40 years or more were recruited between October 2014 and February 2015 from health care and community settings such as older-adult housing, day programs and health education events. Letters of introduction to the study were provided in English or Punjabi or both to all potential participants. We conducted qualitative content analysis of the results. Sixty-two South Asian adults (36 women and 26 men) aged 40-87 years participated in 1 of 8 focus groups in health care or community settings. Facilitators of and barriers to accessing clinical prevention services were noted at the patient, primary care provider and health care system levels. Facilitators at the patient level included taking ownership over one's health, health literacy and respecting the provider's advice; barriers included fear of the diagnosis, death and/or procedures, perceived low risk of disease or utility of the intervention, and side effects of procedures. Provider factors centred on a trust-based patient-provider relationship, strong communication and adequate time during visits. Health care system factors included such facilitators as processes to routinely offer prevention services as part of other health care or social services, systems that encourage prevention-oriented family practice and services at low or no cost to the patient. Our findings validate previously identified facilitators of and barriers to accessing preventive care for immigrant populations. However, the results suggest that system-level factors influencing the duration of primary care visits may have a more salient impact on uptake of clinical prevention services in this population.

HIV Testing and HIV/AIDS Treatment Services in Rural Counties in 10 Southern States: Service Provider Perspectives

ERIC Educational Resources Information Center

Sutton, Madeline; Anthony, Monique-Nicole; Vila, Christie; McLellan-Lemal, Eleanor; Weidle, Paul J.

2010-01-01

Context: Forty percent of AIDS cases are reported in the southern United States, the region with the largest proportion of HIV/AIDS cases from rural areas. Data are limited regarding provider perspectives of the accessibility and availability of HIV testing and treatment services in southern rural counties. Purpose: We surveyed providers in the…

Athletic Training Services in Public Secondary Schools: A Benchmark Study

PubMed Central

Pryor, Riana R.; Casa, Douglas J.; Vandermark, Lesley W.; Stearns, Rebecca L.; Attanasio, Sarah M.; Fontaine, Garrett J.; Wafer, Alex M.

2015-01-01

Context: Authors of the most recent study of athletic training (AT) services have suggested that only 42% of secondary schools have access to athletic trainers. However, this study was limited by a small sample size and was conducted more than 10 years ago. Objective: To determine current AT services in public secondary schools. Design: Cross-sectional study. Setting: Public secondary schools in the United States. Patients or Other Participants: A total of 8509 (57%) of 14 951 secondary schools from all 50 states and Washington, DC, responded to the survey. Main Outcome Measure(s): Data on AT services were collected for individual states, National Athletic Trainers' Association districts, and the nation. Results: Of the 8509 schools that responded, 70% (n = 5930) had AT services, including full-time (n = 3145, 37%), part-time (n = 2619, 31%), and per diem (n = 199, 2%) AT services, and 27% (n = 2299) had AT services from a hospital or physical therapy clinic. A total of 4075 of 8509 schools (48%) provided coverage at all sports practices. Eighty-six percent (2 394 284/2 787 595) of athletes had access to AT services. Conclusions: Since the last national survey, access to AT services increased such that 70% of respondent public secondary schools provided athletic trainers at sports games or practices. Approximately one-third of all public secondary schools had full-time athletic trainers. This number must increase further to provide appropriate medical coverage at athletic practices and games for secondary school athletes. PMID:25689559

School Libraries Are Essential: Meeting the Virtual Access and Collaboration Needs of the 21st-Century Learner and Teacher

ERIC Educational Resources Information Center

Darrow, Rob

2009-01-01

School librarians have excelled in providing a physical library space that is welcoming, making sure students have an inviting space to access print and digital materials, and developing collections that provide access for all ages of students. In the physical library space services such as collaborating with teachers and consulting with students…

Evaluating the impact of social franchising on family planning use in Kenya.

PubMed

Chakraborty, Nirali M; Mbondo, Mwende; Wanderi, Joyce

2016-06-18

In Kenya, as in many low-income countries, the private sector is an important component of health service delivery and of providing access to preventive and curative health services. The Tunza Social Franchise Network, operated by Population Services Kenya, is Kenya's largest network of private providers, comprising 329 clinics. Franchised clinics are only one source of family planning (FP), and this study seeks to understand whether access to a franchise increases the overall use or provides another alternative for women who would have found FP services in the public sector. A quasi-experimental study compared 50 catchment areas where there is a Tunza franchise and no other franchised provider with 50 purposively matched control areas within 20 km of each selected Tunza area, with a health facility, but no franchised facility. Data from 5609 women of reproductive age were collected on demographic and socioeconomic status, FP use, and care-seeking behavior. Multivariate logistic regression, with intervention and control respondents matched using coarsened exact matching, was conducted. Overall modern contraceptive use in this population was 53 %, with 24.8 % of women using a long-acting or permanent method (LAPM). There was no significant difference in odds of current or new FP use by group, adjusted for age. However, respondents in Tunza catchment areas are significantly more likely to be LAPM users (adj. OR = 1.49, p = 0.015). Further, women aged 18-24 and 41-49 in Tunza catchment areas have a significantly higher marginal probability of LAPM use than those in control areas. This study indicates that access to a franchise is correlated with access to and increased use of LAPMs, which are more effective, and cost-effective, methods of FP. While franchised facilities may provide additional points of access for FP and other services, the presence of the franchise does not, in and of itself, increase the use of FP in Kenya.

The Philosophy of User Interfaces in HELIO and the Importance of CASSIS

NASA Astrophysics Data System (ADS)

Bonnin, X.; Aboudarham, J.; Renié, C.; Csillaghy, A.; Messerotti, M.; Bentley, R. D.

2012-09-01

HELIO is a European project funded under FP7 (Project No. 238969). One of its goals as a Heliospheric Virtual Observatory is to provide an easy access to many datasets scattered all over the world, in the fields of Solar physics, Heliophysics, and Planetary magnetospheres. The efficiency of such a tool is very much related to the quality of the user interface. HELIO infrastructure is based on a Service Oriented Architecture (SOA), regrouping a network of standalone components, which allows four main types of interfaces: - HELIO Front End (HFE) is a browser-based user interface, which offers a centralized access to the HELIO main functionalities. Especially, it provides the possibility to reach data directly, or to refine selection by determination of observing characteristics, such as which instrument was observing at that time, which instrument was at this location, etc. - Many services/components provide their own standalone graphical user interface. While one can directly access individually each of these interfaces, they can also be connected together. - Most services also provide direct access for any tools through a public interface. A small java library, called Java API, simplifies this access by providing client stubs for services and shields the user from security, discovery and failover issues. - Workflows capabilities are available in HELIO, allowing complex combination of queries over several services. We want the user to be able to navigate easily, at his needs, through the various interfaces, and possibly use a specific one in order to make much-dedicated queries. We will also emphasize the importance of the CASSIS project (Coordination Action for the integration of Solar System Infrastructure and Science) in encouraging the interoperability necessary to undertake scientific studies that span disciplinary boundaries. If related projects follow the guidelines being developed by CASSIS then using external resources with HELIO will be greatly simplified.

IT Challenges for Space Medicine or How do We Protect Medical Information and Still Get Useful Work Done?

NASA Technical Reports Server (NTRS)

Johnson-Throop, Kathy A.

2010-01-01

Space Medicine provides healthcare services of various types for astronauts throughout their lifetime starting from the time they are selected as astronauts. IT challenges include: protection of private medical information, access from locations both inside and outside NASA, nearly 24x7 access, access during disasters, international partner access, data archiving, off-region backup, secure communication of medical data to people outside the NASA system (e.g. expert consultants), efficient movement of medical record information between locations, search and retrieval of relevant information, and providing all of these services/capabilities within a limited budget. In Space Medicine, we have provided for these in various ways: limit the amount of private medical information stored locally, utilize encryption mechanisms that the international partners can also use, utilize 2-factor authentication, virtualize servers, employ concept-based search, and use of standardized terminologies (SNOMED) and messaging (HL7).

Right time, right place: improving access to health service through effective retention and distribution of health workers

PubMed Central

2013-01-01

This editorial introduces the 'Right time, Right place: improving access to health service through effective retention and distribution of health workers’ thematic series. This series draws from studies in a range of countries and provides new insights into what can be done to improve access to health through more effective human resources policies, planning and management. The primary focus is on health workforce distribution and retention. PMID:24274820

Evaluation of introduction scenarios for a broadband access network

NASA Astrophysics Data System (ADS)

Bocker, Geert-Jan; Cuthbert, Laurie; Gobbi, Roberta; Inch, Robert; Sara, Lini

1995-02-01

The provision of broadband services at a reasonable cost to residential and small business customers is one of the major challenges facing operators. The introduction of cost-effective systems considering the existing infrastructure is an important study. Within the RACE project 2024 Broadband Access Facilities, the economic and evolution aspects of different introduction scenarios of a broadband access system suitable for providing these services are investigated. This paper presents the final results of this study.

Tracking health care service use and the experiences of adults with autism spectrum disorder without intellectual disability: A longitudinal study of service rates, barriers and satisfaction.

PubMed

Vogan, Vanessa; Lake, Johanna K; Tint, Ami; Weiss, Jonathan A; Lunsky, Yona

2017-04-01

Adults with Autism Spectrum Disorder (ASD) encounter many difficulties finding and accessing health care services. Despite this, few studies have considered the health service use patterns of adults with ASD without intellectual disability (ID). The current study examines a diverse range of medical and mental health services and supports, as well as adults' personal experiences accessing and using these services, barriers to service use, and reported unmet service needs. Forty adults (ages 18-61 years) with ASD without ID completed surveys every two months about their health service use for a total of 12-18 months. Bivariate analyses were conducted to understand the individual demographic and clinical factors associated with rate of service use, satisfaction with services, and barriers to health care. Results indicated that, beyond a family doctor, the most commonly used services were dentistry, individual counseling, and psychiatry. Individuals who had medical problems experienced significantly more barriers to service use than those who did not, and those who had medical and mental health problems were less satisfied with services. Findings highlight the challenges adults with ASD without ID face accessing appropriate, quality services to meet their needs, particularly those with complex medical and mental health issues. Service providers must strive to provide adequate health care to this population who may become distressed if their needs are left unmet. Copyright © 2016 Elsevier Inc. All rights reserved.

Acceptable Care? Illness Constructions, Healthworlds, and Accessible Chronic Treatment in South Africa

PubMed Central

Harris, Bronwyn; Eyles, John; Moshabela, Mosa

2015-01-01

Achieving equitable access to health care is an important policy goal, with access influenced by affordability, availability, and acceptability of specific services. We explore patient narratives from a 5-year program of research on health care access to examine relationships between social constructions of illness and the acceptability of health services in the context of tuberculosis treatment and antiretroviral therapy in South Africa. Acceptability of services seems particularly important to the meanings patients attach to illness and care, whereas—conversely—these constructions appear to influence what constitutes acceptability and hence affect access to care. We highlight the underestimated role of individually, socially, and politically constructed healthworlds; traditional and biomedical beliefs; and social support networks. Suggested policy implications for improving acceptability and hence overall health care access include abandoning patronizing approaches to care and refocusing from treating “disease” to responding to “illness” by acknowledging and incorporating patients’ healthworlds in patient–provider interactions. PMID:25829509

47 CFR 69.301 - General.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) ACCESS CHARGES... access elements net investment as defined in § 69.2 (z) shall be apportioned among the interexchange category, the billing and collection category and access elements as provided in this subpart. For purposes...

The value of Web-based library services at Cedars-Sinai Health System.

PubMed

Halub, L P

1999-07-01

Cedars-Sinai Medical Library/Information Center has maintained Web-based services since 1995 on the Cedars-Sinai Health System network. In that time, the librarians have found the provision of Web-based services to be a very worthwhile endeavor. Library users value the services that they access from their desktops because the services save time. They also appreciate being able to access services at their convenience, without restriction by the library's hours of operation. The library values its Web site because it brings increased visibility within the health system, and it enables library staff to expand services when budget restrictions have forced reduced hours of operation. In creating and maintaining the information center Web site, the librarians have learned the following lessons: consider the design carefully; offer what services you can, but weigh the advantages of providing the services against the time required to maintain them; make the content as accessible as possible; promote your Web site; and make friends in other departments, especially information services.

The value of Web-based library services at Cedars-Sinai Health System.

PubMed Central

Halub, L P

1999-01-01

Cedars-Sinai Medical Library/Information Center has maintained Web-based services since 1995 on the Cedars-Sinai Health System network. In that time, the librarians have found the provision of Web-based services to be a very worthwhile endeavor. Library users value the services that they access from their desktops because the services save time. They also appreciate being able to access services at their convenience, without restriction by the library's hours of operation. The library values its Web site because it brings increased visibility within the health system, and it enables library staff to expand services when budget restrictions have forced reduced hours of operation. In creating and maintaining the information center Web site, the librarians have learned the following lessons: consider the design carefully; offer what services you can, but weigh the advantages of providing the services against the time required to maintain them; make the content as accessible as possible; promote your Web site; and make friends in other departments, especially information services. PMID:10427423

Customer service: developing a new mindset for today's instant gratification society.

PubMed

Stockburger, W T

1998-01-01

Today's society expects and demands immediate service, results and access to information. Can those of us in leadership positions say that the service we provide is equal to or exceeds what our customers expect? How can we redesign our services so they are better than those we currently provide? Some people look to advances in technology as one means to improve services and access to information, but this should not be the only means. If we are to develop a philosophy of exceptional service, we must develop a vision of those services. We must gain an understanding of our customers, plus a knowledge of products, the availability of resources and any industry constraints. In healthcare, we must look to leadership to achieve our goals. A goal of exceptional customer service must be communicated to all levels of service providers from management. Top-down action by management--leadership by example--is critical. Leadership must gain the trust of both customers and employees by actively listening to both verbal and nonverbal comments at all points of service. Without an understanding of our customers' needs, it won't be possible to deliver services at or above their expectations.

Essential Skills and Knowledge for Troubleshooting E-Resources Access Issues in a Web-Scale Discovery Environment

ERIC Educational Resources Information Center

Carter, Sunshine; Traill, Stacie

2017-01-01

Electronic resource access troubleshooting is familiar work in most libraries. The added complexity introduced when a library implements a web-scale discovery service, however, creates a strong need for well-organized, rigorous training to enable troubleshooting staff to provide the best service possible. This article outlines strategies, tools,…

"Different Strokes for Different Folks": Presenting EAD in Three UK Online Catalogues

ERIC Educational Resources Information Center

Hill, Amanda; Stockting, Bill; Higgins, Sarah

2005-01-01

This article discusses three different online services providing federated access to finding aids relating to archives found in a number of repositories: the Archives Hub, Access to Archives (A2A) and Navigational Aids for the History of Science, Technology and the Environment (NAHSTE). While the scale of the services is very different, a…

Accessing the Health Care Financing System: A Resource Guide for Local Education Agencies. Bulletin No. 91298.

ERIC Educational Resources Information Center

Wisconsin State Dept. of Public Instruction, Madison.

This guide is intended to assist Wisconsin school districts in accessing the health care financing system as a means of supporting specialized services. Topics covered include: determination of a local education agency's potential for third-party covered services; the need to become a certified provider dependent upon the funding source;…

IP access networks with QoS support

NASA Astrophysics Data System (ADS)

Sargento, Susana; Valadas, Rui J. M. T.; Goncalves, Jorge; Sousa, Henrique

2001-07-01

The increasing demand of new services and applications is pushing for drastic changes on the design of access networks targeted mainly for residential and SOHO users. Future access networks will provide full service integration (including multimedia), resource sharing at the packet level and QoS support. It is expected that using IP as the base technology, the ideal plug-and-play scenario, where the management actions of the access network operator are kept to a minimum, will be achieved easily. This paper proposes an architecture for access networks based on layer 2 or layer 3 multiplexers that allows a number of simplifications in the network elements and protocols (e.g. in the routing and addressing functions). We discuss two possible steps in the evolution of access networks towards a more efficient support of IP based services. The first one still provides no QoS support and was designed with the goal of reusing as much as possible current technologies; it is based on tunneling to transport PPP sessions. The second one introduces QoS support through the use of emerging technologies and protocols. We illustrate the different phases of a multimedia Internet access session, when using SIP for session initiation, COPS for the management of QoS policies including the AAA functions and RSVP for resource reservation.

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.

Mapping online transportation service quality and multiclass classification problem solving priorities

NASA Astrophysics Data System (ADS)

Alamsyah, Andry; Rachmadiansyah, Imam

2018-03-01

Online transportation service is known for its accessibility, transparency, and tariff affordability. These points make online transportation have advantages over the existing conventional transportation service. Online transportation service is an example of disruptive technology that change the relationship between customers and companies. In Indonesia, there are high competition among online transportation provider, hence the companies must maintain and monitor their service level. To understand their position, we apply both sentiment analysis and multiclass classification to understand customer opinions. From negative sentiments, we can identify problems and establish problem-solving priorities. As a case study, we use the most popular online transportation provider in Indonesia: Gojek and Grab. Since many customers are actively give compliment and complain about company’s service level on Twitter, therefore we collect 61,721 tweets in Bahasa during one month observations. We apply Naive Bayes and Support Vector Machine methods to see which model perform best for our data. The result reveal Gojek has better service quality with 19.76% positive and 80.23% negative sentiments than Grab with 9.2% positive and 90.8% negative. The Gojek highest problem-solving priority is regarding application problems, while Grab is about unusable promos. The overall result shows general problems of both case study are related to accessibility dimension which indicate lack of capability to provide good digital access to the end users.

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

Access to Recovery and Recidivism among Former Prison Inmates

PubMed Central

Ray, Bradley; Grommon, Eric; Buchanan, Victoria; Brown, Brittany

2015-01-01

Access to Recovery (ATR) is a SAMHSA-funded initiative that offers a mix of clinical and supportive services for substance abuse. ATR clients choose which services will help to overcome barriers in their road to recovery, and a recovery consultant provides vouchers and helps link the client to these community resources. One of ATR's goals was to provide services to those involved in the criminal justice system in the hopes that addressing substance abuse issues could reduce subsequent criminal behaviors. This study examines this goal by looking at recidivism among a sample of clients in one state's ATR program who returned to the community after incarceration. Results suggest there were few differential effects of service selections on subsequent recidivism. However, there are significant differences in recidivism rates among the agencies that provided ATR services. Agencies with more resources and a focus on prisoner reentry had better recidivism outcomes than those that focus only on substance abuse services. PMID:26385191

Providing Access to a Diverse Set of Global Reanalysis Dataset Collections

NASA Astrophysics Data System (ADS)

Schuster, D.; Worley, S. J.

2015-12-01

The National Center for Atmospheric Research (NCAR) Research Data Archive (RDA, http://rda.ucar.edu) provides open access to a variety of global reanalysis dataset collections to support atmospheric and related sciences research worldwide. These include products from the European Centre for Medium-Range Weather Forecasts (ECMWF), Japan Meteorological Agency (JMA), National Centers for Environmental Prediction (NCEP), National Oceanic and Atmospheric Administration (NOAA), and NCAR.All RDA hosted reanalysis collections are freely accessible to registered users through a variety of methods. Standard access methods include traditional browser and scripted HTTP file download. Enhanced downloads are available through the Globus GridFTP "fire and forget" data transfer service, which provides an efficient, reliable, and preferred alternative to traditional HTTP-based methods. For those that favor interoperable access using compatible tools, the Unidata THREDDS Data server provides remote access to complete reanalysis collections by virtual dataset aggregation "files". Finally, users can request data subsets and format conversions to be prepared for them through web interface form requests or web service API batch requests. This approach uses NCAR HPC and central file systems to effectively prepare products from the high-resolution and very large reanalyses archives. The presentation will include a detailed inventory of all RDA reanalysis dataset collection holdings, and highlight access capabilities to these collections through use case examples.

A JEE RESTful service to access Conditions Data in ATLAS

NASA Astrophysics Data System (ADS)

Formica, Andrea; Gallas, E. J.

2015-12-01

Usage of condition data in ATLAS is extensive for offline reconstruction and analysis (e.g. alignment, calibration, data quality). The system is based on the LCG Conditions Database infrastructure, with read and write access via an ad hoc C++ API (COOL), a system which was developed before Run 1 data taking began. The infrastructure dictates that the data is organized into separate schemas (assigned to subsystems/groups storing distinct and independent sets of conditions), making it difficult to access information from several schemas at the same time. We have thus created PL/SQL functions containing queries to provide content extraction at multi-schema level. The PL/SQL API has been exposed to external clients by means of a Java application providing DB access via REST services, deployed inside an application server (JBoss WildFly). The services allow navigation over multiple schemas via simple URLs. The data can be retrieved either in XML or JSON formats, via simple clients (like curl or Web browsers).

Data Integration Using SOAP in the VSO

NASA Astrophysics Data System (ADS)

Tian, K. Q.; Bogart, R. S.; Davey, A.; Dimitoglou, G.; Gurman, J. B.; Hill, F.; Martens, P. C.; Wampler, S.

2003-05-01

The Virtual Solar Observatory (VSO) project has implemented a time interval search for all four participating data archives. The back-end query services are implemented as web services, and are accessible via SOAP. SOAP (Simple Object Access Protocol) defines an RPC (Remote Procedure Call) mechanism that employs HTTP as its transport and encodes the client-server interactions (request and response messages) in XML (eXtensible Markup Language) documents. In addition to its core function of identifying relevant datasets in the local archive, the SOAP server at each data provider acts as a "wrapper" that maps descriptions in an abstract data model to those in the provider-specific data model, and vice versa. It is in this way that VSO integrates heterogeneous data services and allows access to them using a common interface. Our experience with SOAP has been fruitful. It has proven to be a better alternative to traditional web access methods, namely POST and GET, because of its flexibility and interoperability.

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

PubMed

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

2009-12-01

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

Integrated Air Surveillance Concept of Operations

DTIC Science & Technology

2011-11-01

information, intelligence, weather data, and other situational awareness-related information. 4.2.4 Shared Services Automated processing of sensor and...other surveillance information will occur through shared services , accessible through an enterprise network infrastructure, that provide for collecting...also be provided, such as information discovery and translation. The IS architecture effort will identify specific shared services . Shared

Oregon School-Based Health Centers 1996-1997 Services Report.

ERIC Educational Resources Information Center

Alexander, Tammis; Nystrom, Robert J.; Spitz, Lauren

School based health centers (SBHC) are effective providers of health services and education because they are easy for students to access, they take an integrated and developmentally appropriate approach to meeting health needs, and they are prevention-oriented. This report describes the 1996-1997 services provided in 15 of 19 state-supported…

Canadian Practice Guidelines for Comprehensive Community Treatment for Schizophrenia and Schizophrenia Spectrum Disorders.

PubMed

Addington, Donald; Anderson, Elizabeth; Kelly, Martina; Lesage, Alain; Summerville, Chris

2017-09-01

The objective of this review is to identify the features and components of a comprehensive system of services for people living with schizophrenia. A comprehensive system was conceived as one that served the full range of people with schizophrenia and was designed with consideration of the incidence and prevalence of schizophrenia. The system should provide access to the full range of evidence-based services, should be recovery oriented, and should provide patient-centred care. A systematic search was conducted for published guidelines for schizophrenia and schizophrenia spectrum disorders. The guidelines were rated by at least 2 raters, and recommendations adopted were primarily drawn from the National Institute for Clinical Excellence (2014) Guideline on Psychosis and Schizophrenia in adults and the Scottish Intercollegiate Guidelines Network guidelines on management of schizophrenia. The recommendations adapted for Canada cover the range of services required to provide comprehensive services. Comprehensive services for people with schizophrenia can be organized and delivered to improve the quality of life of people with schizophrenia and their carers. The services need to be organized in a system that provides access to those who need them.

Discordant indigenous and provider frames explain challenges in improving access to arthritis care: a qualitative study using constructivist grounded theory.

PubMed

Thurston, Wilfreda E; Coupal, Stephanie; Jones, C Allyson; Crowshoe, Lynden F J; Marshall, Deborah A; Homik, Joanne; Barnabe, Cheryl

2014-06-11

Access to health services is a determinant of population health and is known to be reduced for a variety of specialist services for Indigenous populations in Canada. With arthritis being the most common chronic condition experienced by Indigenous populations and causing high levels of disability, it is critical to resolve access disparities through an understanding of barriers and facilitators to care. The objective of this study was to inform future health services reform by investigating health care access from the perspective of Aboriginal people with arthritis and health professionals. Using constructivist grounded theory methodology we investigated Indigenous peoples' experiences in accessing arthritis care through the reports of 16 patients and 15 healthcare providers in Alberta, Canada. Semi-structured interviews were conducted between July 2012 and February 2013 and transcribed verbatim. The patient and provider data were first analyzed separately by two team members then brought together to form a framework. The framework was refined through further analysis following the multidisciplinary research team's discussions. Once the framework was developed, reports on the patient and provider data were shared with each participant group independently and participants were interviewed to assess validity of the summary. In the resulting theoretical framework Indigenous participants framed their experience with arthritis as 'toughing it out' and spoke of racism encountered in the healthcare setting as a deterrent to pursuing care. Healthcare providers were frustrated by high disease severity and missed appointments, and framed Indigenous patients as lacking 'buy-in'. Constraints imposed by complex healthcare systems contributed to tensions between Indigenous peoples and providers. Low specialist care utilization rates among Indigenous people cannot be attributed to cultural and social preferences. Further, the assumptions made by providers lead to stereotyping and racism and reinforce rejection of healthcare by patients. Examples of 'working around' the system were revealed and showed potential for improved utilization of specialist services. This framework has significant implications for health policy and indicates that culturally safe services are a priority in addressing chronic disease management.

Reactome graph database: Efficient access to complex pathway data

PubMed Central

Korninger, Florian; Viteri, Guilherme; Marin-Garcia, Pablo; Ping, Peipei; Wu, Guanming; Stein, Lincoln; D’Eustachio, Peter

2018-01-01

Reactome is a free, open-source, open-data, curated and peer-reviewed knowledgebase of biomolecular pathways. One of its main priorities is to provide easy and efficient access to its high quality curated data. At present, biological pathway databases typically store their contents in relational databases. This limits access efficiency because there are performance issues associated with queries traversing highly interconnected data. The same data in a graph database can be queried more efficiently. Here we present the rationale behind the adoption of a graph database (Neo4j) as well as the new ContentService (REST API) that provides access to these data. The Neo4j graph database and its query language, Cypher, provide efficient access to the complex Reactome data model, facilitating easy traversal and knowledge discovery. The adoption of this technology greatly improved query efficiency, reducing the average query time by 93%. The web service built on top of the graph database provides programmatic access to Reactome data by object oriented queries, but also supports more complex queries that take advantage of the new underlying graph-based data storage. By adopting graph database technology we are providing a high performance pathway data resource to the community. The Reactome graph database use case shows the power of NoSQL database engines for complex biological data types. PMID:29377902

Reactome graph database: Efficient access to complex pathway data.

PubMed

Fabregat, Antonio; Korninger, Florian; Viteri, Guilherme; Sidiropoulos, Konstantinos; Marin-Garcia, Pablo; Ping, Peipei; Wu, Guanming; Stein, Lincoln; D'Eustachio, Peter; Hermjakob, Henning

2018-01-01

Reactome is a free, open-source, open-data, curated and peer-reviewed knowledgebase of biomolecular pathways. One of its main priorities is to provide easy and efficient access to its high quality curated data. At present, biological pathway databases typically store their contents in relational databases. This limits access efficiency because there are performance issues associated with queries traversing highly interconnected data. The same data in a graph database can be queried more efficiently. Here we present the rationale behind the adoption of a graph database (Neo4j) as well as the new ContentService (REST API) that provides access to these data. The Neo4j graph database and its query language, Cypher, provide efficient access to the complex Reactome data model, facilitating easy traversal and knowledge discovery. The adoption of this technology greatly improved query efficiency, reducing the average query time by 93%. The web service built on top of the graph database provides programmatic access to Reactome data by object oriented queries, but also supports more complex queries that take advantage of the new underlying graph-based data storage. By adopting graph database technology we are providing a high performance pathway data resource to the community. The Reactome graph database use case shows the power of NoSQL database engines for complex biological data types.

Not Near Enough: Racial and Ethnic Disparities in Access to Nearby Behavioral Health Care and Primary Care

PubMed Central

VanderWielen, Lynn M.; Gilchrist, Emma C.; Nowels, Molly A.; Petterson, Stephen M.; Rust, George; Miller, Benjamin F.

2016-01-01

Background Racial, ethnic, and geographical health disparities have been widely documented in the United States. However, little attention has been directed towards disparities associated with integrated behavioral health and primary care services. Methods Access to behavioral health professionals among primary care physicians was examined using multinomial logistic regression analyses with 2010 National Plan and Provider Enumeration System, American Medical Association Physician Masterfile, and American Community Survey data. Results Primary care providers practicing in neighborhoods with higher percentages of African Americans and Hispanics were less likely to have geographically proximate behavioral health professionals. Primary care providers in rural areas were less likely to have geographically proximate behavioral health professionals. Conclusion Neighborhood-level factors are associated with access to nearby behavioral health and primary care. Additional behavioral health professionals are needed in racial/ ethnic minority neighborhoods and rural areas to provide access to behavioral health services, and to progress toward more integrated primary care. PMID:26320931

Assessing seasonality of travel distance to harm reduction service providers among persons who inject drugs.

PubMed

Allen, Sean T; Ruiz, Monica S; Roess, Amira; Jones, Jeff

2015-10-12

Prior research has examined access to syringe exchange program (SEP) services among persons who inject drugs (PWID), but no research has been conducted to evaluate variations in SEP access based on season. This is an important gap in the literature given that seasonal weather patterns and inclement weather may affect SEP service utilization. The purpose of this research is to examine differences in access to SEPs by season among PWID in the District of Columbia (DC). A geometric point distance estimation technique was applied to records from a DC SEP that operated from 1996 to 2011. We calculated the walking distance (via sidewalks) from the centroid point of zip code of home residence to the exchange site where PWID presented for services. Analysis of variance (ANOVA) was used to examine differences in walking distance measures by season. Differences in mean walking distance measures were statistically significant between winter and spring with PWID traveling approximately 2.88 and 2.77 miles, respectively, to access the SEP during these seasons. The results of this study suggest that seasonal differences in SEP accessibility may exist between winter and spring. PWID may benefit from harm reduction providers adapting their SEP operations to provide a greater diversity of exchange locations during seasons in which inclement weather may negatively influence engagement with SEPs. Increasing the number of exchange locations based on season may help resolve unmet needs among injectors.

The Geodetic Seamless Archive Centers Service Layer: A System Architecture for Federating Geodesy Data Repositories

NASA Astrophysics Data System (ADS)

McWhirter, J.; Boler, F. M.; Bock, Y.; Jamason, P.; Squibb, M. B.; Noll, C. E.; Blewitt, G.; Kreemer, C. W.

2010-12-01

Three geodesy Archive Centers, Scripps Orbit and Permanent Array Center (SOPAC), NASA's Crustal Dynamics Data Information System (CDDIS) and UNAVCO are engaged in a joint effort to define and develop a common Web Service Application Programming Interface (API) for accessing geodetic data holdings. This effort is funded by the NASA ROSES ACCESS Program to modernize the original GPS Seamless Archive Centers (GSAC) technology which was developed in the 1990s. A new web service interface, the GSAC-WS, is being developed to provide uniform and expanded mechanisms through which users can access our data repositories. In total, our respective archives hold tens of millions of files and contain a rich collection of site/station metadata. Though we serve similar user communities, we currently provide a range of different access methods, query services and metadata formats. This leads to a lack of consistency in the userís experience and a duplication of engineering efforts. The GSAC-WS API and its reference implementation in an underlying Java-based GSAC Service Layer (GSL) supports metadata and data queries into site/station oriented data archives. The general nature of this API makes it applicable to a broad range of data systems. The overall goals of this project include providing consistent and rich query interfaces for end users and client programs, the development of enabling technology to facilitate third party repositories in developing these web service capabilities and to enable the ability to perform data queries across a collection of federated GSAC-WS enabled repositories. A fundamental challenge faced in this project is to provide a common suite of query services across a heterogeneous collection of data yet enabling each repository to expose their specific metadata holdings. To address this challenge we are developing a "capabilities" based service where a repository can describe its specific query and metadata capabilities. Furthermore, the architecture of the GSL is based on a model-view paradigm that decouples the underlying data model semantics from particular representations of the data model. This will allow for the GSAC-WS enabled repositories to evolve their service offerings to incorporate new metadata definition formats (e.g., ISO-19115, FGDC, JSON, etc.) and new techniques for accessing their holdings. Building on the core GSAC-WS implementations the project is also developing a federated/distributed query service. This service will seamlessly integrate with the GSAC Service Layer and will support data and metadata queries across a collection of federated GSAC repositories.

20 CFR 663.505 - What are eligible providers of training services?

Code of Federal Regulations, 2010 CFR

2010-04-01

...-B funds to provide training services to eligible adult and dislocated worker customers. (b) In order... worker funds to provide training: (i) To individuals using ITA's to access training through the eligible... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are eligible providers of training...

20 CFR 663.505 - What are eligible providers of training services?

Code of Federal Regulations, 2011 CFR

2011-04-01

...-B funds to provide training services to eligible adult and dislocated worker customers. (b) In order... worker funds to provide training: (i) To individuals using ITA's to access training through the eligible... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false What are eligible providers of training...

Geographic Disparities in Access to Agencies Providing Income-Related Social Services.

PubMed

Bauer, Scott R; Monuteaux, Michael C; Fleegler, Eric W

2015-10-01

Geographic location is an important factor in understanding disparities in access to health-care and social services. The objective of this cross-sectional study is to evaluate disparities in the geographic distribution of income-related social service agencies relative to populations in need within Boston. Agency locations were obtained from a comprehensive database of social services in Boston. Geographic information systems mapped the spatial relationship of the agencies to the population using point density estimation and was compared to census population data. A multivariate logistic regression was conducted to evaluate factors associated with categories of income-related agency density. Median agency density within census block groups ranged from 0 to 8 agencies per square mile per 100 population below the federal poverty level (FPL). Thirty percent (n = 31,810) of persons living below the FPL have no access to income-related social services within 0.5 miles, and 77 % of persons living below FPL (n = 83,022) have access to 2 or fewer agencies. 27.0 % of Blacks, 30.1 % of Hispanics, and 41.0 % of non-Hispanic Whites with incomes below FPL have zero access. In conclusion, some neighborhoods in Boston with a high concentration of low-income populations have limited access to income-related social service agencies.

Interfaces to PeptideAtlas: a case study of standard data access systems

PubMed Central

Handcock, Jeremy; Robinson, Thomas; Deutsch, Eric W.; Boyle, John

2012-01-01

Access to public data sets is important to the scientific community as a resource to develop new experiments or validate new data. Projects such as the PeptideAtlas, Ensembl and The Cancer Genome Atlas (TCGA) offer both access to public data and a repository to share their own data. Access to these data sets is often provided through a web page form and a web service API. Access technologies based on web protocols (e.g. http) have been in use for over a decade and are widely adopted across the industry for a variety of functions (e.g. search, commercial transactions, and social media). Each architecture adapts these technologies to provide users with tools to access and share data. Both commonly used web service technologies (e.g. REST and SOAP), and custom-built solutions over HTTP are utilized in providing access to research data. Providing multiple access points ensures that the community can access the data in the simplest and most effective manner for their particular needs. This article examines three common access mechanisms for web accessible data: BioMart, caBIG, and Google Data Sources. These are illustrated by implementing each over the PeptideAtlas repository and reviewed for their suitability based on specific usages common to research. BioMart, Google Data Sources, and caBIG are each suitable for certain uses. The tradeoffs made in the development of the technology are dependent on the uses each was designed for (e.g. security versus speed). This means that an understanding of specific requirements and tradeoffs is necessary before selecting the access technology. PMID:22941959

49 CFR 633.15 - Access to information.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Oversight Services § 633.15 Access to information. A recipient of FTA funds for a major capital project shall provide the...

49 CFR 633.15 - Access to information.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Oversight Services § 633.15 Access to information. A recipient of FTA funds for a major capital project shall provide the...

49 CFR 633.15 - Access to information.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Oversight Services § 633.15 Access to information. A recipient of FTA funds for a major capital project shall provide the...

49 CFR 633.15 - Access to information.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Oversight Services § 633.15 Access to information. A recipient of FTA funds for a major capital project shall provide the...

49 CFR 633.15 - Access to information.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Oversight Services § 633.15 Access to information. A recipient of FTA funds for a major capital project shall provide the...

A telecommunications journey rural health network.

PubMed

Moore, Joe

2012-01-01

Utilizing a multi-gigabit statewide fiber healthcare network, Radiology Consultants of Iowa (RCI) set out to provide instantaneous service to their rural, critical access, hospital partners. RCIs idea was to assemble a collection of technologies and services that would even out workflow, reduce time on the road, and provide superior service. These technologies included PACS, voice recognition enabled dictation, HL7 interface technology, an imaging system for digitizing paper and prior films, and modern communication networks. The Iowa Rural Health Telecommunication Project was undertaken to form a system that all critical access hospitals would participate in, allowing RCI radiologists the efficiency of "any image, anywhere, anytime".

Barriers to Access to Palliative Care

PubMed Central

Hawley, Pippa

2017-01-01

Despite significant advances in understanding the benefits of early integration of palliative care with disease management, many people living with a chronic life-threatening illness either do not receive any palliative care service or receive services only in the last phase of their illness. In this article, I explore some of the reasons for failure to provide palliative care services and recommend some strategies to overcome these barriers, emphasizing the importance of describing palliative care accurately. I provide language which I hope will help health care professionals of all disciplines explain what palliative care has to offer and ensure wider access to palliative care, early in the course of their illness. PMID:28469439

Measures of Success for Earth System Science Education: The DLESE Evaluation Services and the Evaluation Toolkit Collection

NASA Astrophysics Data System (ADS)

McCaffrey, M. S.; Buhr, S. M.; Lynds, S.

2005-12-01

Increased agency emphasis upon the integration of research and education coupled with the ability to provide students with access to digital background materials, learning activities and primary data sources has begun to revolutionize Earth science education in formal and informal settings. The DLESE Evaluation Services team and the related Evaluation Toolkit collection (http://www.dlese.org/cms/evalservices/ ) provides services and tools for education project leads and educators. Through the Evaluation Toolkit, educators may access high-quality digital materials to assess students' cognitive gains, examples of alternative assessments, and case studies and exemplars of authentic research. The DLESE Evaluation Services team provides support for those who are developing evaluation plans on an as-requested basis. In addition, the Toolkit provides authoritative peer reviewed articlesabout evaluation research techniques and strategies of particular importance to geoscience education. This paper will provide an overview of the DLESE Evaluation Toolkit and discuss challenges and best practices for assessing student learning and evaluating Earth system sciences education in a digital world.

47 CFR 9.7 - Access to 911 and E911 service capabilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... service shall make that capability available to a requesting interconnected VoIP provider as set forth in... interconnected VoIP provider. An owner or controller makes a capability available to a CMRS provider if the owner... interconnected VoIP provider only if that capability is necessary to enable the interconnected VoIP provider to...

47 CFR 9.7 - Access to 911 and E911 service capabilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... service shall make that capability available to a requesting interconnected VoIP provider as set forth in... interconnected VoIP provider. An owner or controller makes a capability available to a CMRS provider if the owner... interconnected VoIP provider only if that capability is necessary to enable the interconnected VoIP provider to...

Health Service Accessibility and Risk in Cervical Cancer Prevention: Comparing Rural Versus Nonrural Residence in New Mexico.

PubMed

McDonald, Yolanda J; Goldberg, Daniel W; Scarinci, Isabel C; Castle, Philip E; Cuzick, Jack; Robertson, Michael; Wheeler, Cosette M

2017-09-01

Multiple intrapersonal and structural barriers, including geography, may prevent women from engaging in cervical cancer preventive care such as screening, diagnostic colposcopy, and excisional precancer treatment procedures. Geographic accessibility, stratified by rural and nonrural areas, to necessary services across the cervical cancer continuum of preventive care is largely unknown. Health care facility data for New Mexico (2010-2012) was provided by the New Mexico Human Papillomavirus Pap Registry (NMHPVPR), the first population-based statewide cervical cancer screening registry in the United States. Travel distance and time between the population-weighted census tract centroid to the nearest facility providing screening, diagnostic, and excisional treatment services were examined using proximity analysis by rural and nonrural census tracts. Mann-Whitney test (P < .05) was used to determine if differences were significant and Cohen's r to measure effect. Across all cervical cancer preventive health care services and years, women who resided in rural areas had a significantly greater geographic accessibility burden when compared to nonrural areas (4.4 km vs 2.5 km and 4.9 minutes vs 3.0 minutes for screening; 9.9 km vs 4.2 km and 10.4 minutes vs 4.9 minutes for colposcopy; and 14.8 km vs 6.6 km and 14.4 minutes vs 7.4 minutes for precancer treatment services, all P < .001). Improvements in cervical cancer prevention should address the potential benefits of providing the full spectrum of screening, diagnostic and precancer treatment services within individual facilities. Accessibility, assessments distinguishing rural and nonrural areas are essential when monitoring and recommending changes to service infrastructures (eg, mobile versus brick and mortar). © 2016 National Rural Health Association.

Health Service Accessibility and Risk in Cervical Cancer Prevention: Comparing Rural Versus Nonrural Residence in New Mexico

PubMed Central

McDonald, Yolanda J.; Goldberg, Daniel W.; Scarinci, Isabel C.; Castle, Philip E.; Cuzick, Jack; Robertson, Michael; Wheeler, Cosette M.

2018-01-01

Purpose Multiple intrapersonal and structural barriers, including geography, may prevent women from engaging in cervical cancer preventive care such as screening, diagnostic colposcopy, and excisional precancer treatment procedures. Geographic accessibility, stratified by rural and nonrural areas, to necessary services across the cervical cancer continuum of preventive care is largely unknown. Methods Health care facility data for New Mexico (2010-2012) was provided by the New Mexico Human Papillomavirus Pap Registry (NMHPVPR), the first population-based statewide cervical cancer screening registry in the United States. Travel distance and time between the population-weighted census tract centroid to the nearest facility providing screening, diagnostic, and excisional treatment services were examined using proximity analysis by rural and nonrural census tracts. Mann-Whitney test (P < .05) was used to determine if differences were significant and Cohen's r to measure effect. Findings Across all cervical cancer preventive health care services and years, women who resided in rural areas had a significantly greater geographic accessibility burden when compared to nonrural areas (4.4 km vs 2.5 km and 4.9 minutes vs 3.0 minutes for screening; 9.9 km vs 4.2 km and 10.4 minutes vs 4.9 minutes for colposcopy; and 14.8 km vs 6.6 km and 14.4 minutes vs 7.4 minutes for precancer treatment services, all P < .001). Conclusion Improvements in cervical cancer prevention should address the potential benefits of providing the full spectrum of screening, diagnostic and precancer treatment services within individual facilities. Accessibility, assessments distinguishing rural and nonrural areas are essential when monitoring and recommending changes to service infrastructures (eg, mobile versus brick and mortar). PMID:27557124

Effect of public-private partnership in treatment of sexually transmitted infections among female sex workers in Andhra Pradesh, India

PubMed Central

Kokku, Suresh Babu; Mahapatra, Bidhubhusan; Tucker, Saroj; Saggurti, Niranjan; Prabhakar, Parimi

2014-01-01

Background & objectives: Providing sexually transmitted infection (STI) services to female sex workers (FSWs) in rural and resource constrained settings is a challenge. This paper describes an approach to address this challenge through a partnership with government health facilities, and examines the effect of this partnership on the utilization of STI services by FSWs in Andhra Pradesh, India. Methods: Partnerships were formed with 46 government clinics located in rural areas for providing STI treatment to FSWs in 2007. Government health facilities were supported by local and State level non-government organizations (NGOs) through provision of medicines, training of medical staff, outreach in the communities, and other coordination activities. Data from programme monitoring and behaviour tracking survey were used to examine the accessibility and acceptability in utilization of STI services from partnership clinics. Results: The number of FSWs accessing services at the partnership clinics increased from 1627 in 2007 to over 15,000 in 2010. The average number of annual visits by FSWs to these clinics in 2010 was 3.4. In opinion surveys, the majority of FSWs accessing services at the partnership clinics expressed confidence that they would continue to receive effective services from the government facilities even if the programme terminates. The overall attitude of FSWs to visit government clinics was more positive among FSWs from partnership clinic areas compared to those from non-partnership clinic areas. Interpretation & conclusions: The partnership mechanism between the NGO-supported HIV prevention programme and government clinic facilities appeared to be a promising opportunity to provide timely and accessible STI services for FSWs living in rural and remote areas. PMID:24718405

Crisis of conscience: reconciling religious health care providers' beliefs and patients' rights.

PubMed

White, K A

1999-07-01

In this note, Katherine A. White explores the conflict between religious health care providers who provide care in accordance with their religious beliefs and the patients who want access to medical care that these religious providers find objectionable. Specifically, she examines Roman Catholic health care institutions and HMOs that follow the Ethical and Religious Directives for Catholic Health Care Services and considers other religious providers with similar beliefs. In accordance with the Directives, these institutions maintain policies that restrict access to "sensitive" services like abortion, family planning, HIV counseling, infertility treatment, and termination of life-support. White explains how most state laws protecting providers' right to refuse treatments in conflict with religious principles do not cover this wide range of services. Furthermore, many state and federal laws and some court decisions guarantee patients the right to receive this care. The constitutional complication inherent in this provider-patient conflict emerges in White's analysis of the interaction of the Free Exercise and Establishment Clauses of the First Amendment and patients' right to privacy. White concludes her note by exploring the success of both provider-initiated and legislatively mandated compromise strategies. She first describes the strategies adopted by four different religious HMOs which vary in how they increase or restrict access to sensitive services. She then turns her focus to state and federal "bypass" legislation, ultimately concluding that increased state supervision might help these laws become more viable solutions to provider-patient conflicts.

Cancer support services--are they appropriate and accessible for Indigenous cancer patients in Queensland, Australia?

PubMed

Whop, Lisa J; Garvey, Gail; Lokuge, Kamalini; Mallitt, Kylie A; Valery, Patricia C

2012-01-01

In Queensland, Australia, the incidence of cancer (all cancers combined) is 21% lower for Indigenous people compared with non-Indigenous people but mortality is 36% higher. Support services play an important role in helping cancer patients through their cancer journey. Indigenous cancer patients are likely to face greater unmet supportive care needs and more barriers to accessing cancer care and support. Other barriers include the higher proportion of Indigenous people who live remotely and in regional areas, a known difficulty for access to health services. This study describes the availability of cancer support services in Queensland for Indigenous patients and relevant location. Using a set criteria 121 services were selected from a pre-existing database (n = 344) of cancer services. These services were invited to complete an online questionnaire. ArcGIS (http://www.esri.com/software/arcgis/index.html) was used to map the services' location (using postcode) against Indigenous population by local government area. Services were classified as an 'Indigenous' or 'Indigenous friendly' service using set criteria. Eighty-three services (73.6%) completed the questionnaire. Mapping revealed services are located where there are relatively low percentages of Indigenous people compared with the whole population. No 'Indigenous-specific' services were identified; however, 11 services (13%) were classed 'Indigenous-friendly'. The primary support offered by these services was 'information'. Fewer referrals were received from Indigenous liaison officers compared with other health professionals. Only 8.6% of services reported frequently having contact with an Indigenous organisation; however, 44.6% of services reported that their staff participated in cultural training. Services also identified barriers to access which may exist for Indigenous clientele, including no Indigenous staff and the costs involved in accessing the service, but were unable to address these issues due to restricted staff and funding capacity. Further research into the best models for providing culturally appropriate cancer support services to Indigenous people is essential to ensure Indigenous patients are well supported throughout their cancer journey. Emphasis should be placed on providing support services where a high Indigenous population percentage resides to ensure support is maintained in rural and remote settings. Further efforts should be placed on relationships with Indigenous organisations and mainstream support services and encouraging referral from Indigenous liaison officers.

47 CFR 54.621 - Access to advanced telecommunications and information services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... monthly cost of eligible Internet access shall be eligible for universal support. Health care providers shall certify that the Internet access selected is the most cost-effective method for their health care needs as defined in § 54.615(c)(7), and that purchase of the Internet access is reasonably related to...

47 CFR 54.621 - Access to advanced telecommunications and information services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... monthly cost of eligible Internet access shall be eligible for universal support. Health care providers shall certify that the Internet access selected is the most cost-effective method for their health care needs as defined in § 54.615(c)(7), and that purchase of the Internet access is reasonably related to...

Mental health crisis and respite services: service user and carer aspirations.

PubMed

Lyons, C; Hopley, P; Burton, C R; Horrocks, J

2009-06-01

There is emerging evidence that crisis resolution services can provide alternatives to hospital admission, reducing demand on inpatient beds. Following a public consultation exercise in Lancashire (England), a team of nurses undertook a study, using interactive research methodology, to gain an understanding of how users and carers define a crisis and what range of crisis services, resources and interventions service users and carers thought would help avoid unnecessary hospital admission. Data collection comprised postal questionnaires and 24 group meetings with service users and carers, which were held during 2006. Data were analysed, and seven themes were identified: (1) definitions of a crisis; (2) access to services; (3) interventions; (4) range of services required (before, during and after crisis); (5) place of treatment; (6) recovery and rehabilitation; and (7) community support. We conclude that expressed preferences of service users and carers for pre-emptive services that are delivered flexibly will present a challenge for service commissioners and providers, particularly where stringent access criteria are used. Home-based pre-emptive services that reduce the need for unnecessary hospital treatment may avoid progression to social exclusion of service users.

Paediatric emergency department utilisation: is it necessary an educational intervention?

PubMed

De Tina, Annalisa; Quattrin, Rosanna; Montina, Laura; Brusaferro, Silvio

2014-01-01

Over the past ten years there has been a progressive increase in accesses to services for paediatric emergency room, documented in Italy and abroad. The aim of the study is describe the sociodemographic, cultural, subjective and objective factors for non-urgent access to paediatric emergency service in an Italian region. It was adopted a descriptive survey of a sample of non-urgent accesses to two paediatric emergency room services in an Italian region during the period from February-March 2009, through the administration of questionnaires and the consultation of facilities databases. Half of the accesses to the paediatric emergency room are not urgent and are to be referred to the paediatric primary care. 80% of the users do not call for advice before coming to the emergency room. The convenience of the service, which accounts for more than 50% of the case, and the proximity from home are reasons to go to the emergency room. Approximately half of the accesses to the paediatric emergency department could be managed by primary care services. The convenience of the service, the self-referred and the proximity to home are emerging as the only influential factors reported by literature. In the future it should become crucial providing strategies for education/health information focused on non-urgent paediatric problems and offering people a call center phone service in order to filter and prevent the inappropriate accesses.

Mental Health Nurse Incentive Program: facilitating physical health care for people with mental illness?

PubMed

Happell, Brenda; Platania-Phung, Chris; Scott, David

2013-10-01

People with serious mental illness have increased rates of physical ill-health and reduced contact with primary care services. In Australia, the Mental Health Nurse Incentive Program (MHNIP) was developed to facilitate access to mental health services. However, as a primary care service, the contribution to physical health care is worthy of consideration. Thirty-eight nurses who were part of the MHNIP participated in a national survey of nurses working in mental health about physical health care. The survey invited nurses to report their views on the physical health of consumers and the regularity of physical health care they provide. Physical health-care provision in collaboration with general practitioners (GPs) and other health-care professionals was reported as common. The findings suggest that the MHNIP provides integrated care, where nurses and GPs work in collaboration, allowing enough time to discuss physical health or share physical health activities. Consumers of this service appeared to have good access to physical and mental health services, and nurses had access to primary care professionals to discuss consumers' physical health and develop their clinical skills in the physical domain. The MHNIP has an important role in addressing physical health concerns, in addition to the mental health issues of people accessing this service. © 2012 The Authors; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Managing healthcare information using short message service (SMS) in wireless broadband networks

NASA Astrophysics Data System (ADS)

Documet, Jorge; Tsao, Sinchai; Documet, Luis; Liu, Brent J.; Zhou, Zheng; Joseph, Anika O.

2007-03-01

Due to the ubiquity of cell phones, SMS (Short Message Service) has become an ideal means to wirelessly manage a Healthcare environment and in particular PACS (Picture Archival and Communications System) data. SMS is a flexible and mobile method for real-time access and control of Healthcare information systems such as HIS (Hospital Information System) or PACS. Unlike conventional wireless access methods, SMS' mobility is not limited by the presence of a WiFi network or any other localized signal. It provides a simple, reliable yet flexible method to communicate with an information system. In addition, SMS services are widely available for low costs from cellular phone service providers and allows for more mobility than other services such as wireless internet. This paper aims to describe a use case of SMS as a means of remotely communicating with a PACS server. Remote access to a PACS server and its Query-Retrieve services allows for a more convenient, flexible and streamlined radiology workflow. Wireless access methods such as SMS will increase dedicated PACS workstation availability for more specialized DICOM (Digital Imaging and Communications in Medicine) workflow management. This implementation will address potential security, performance and cost issues of applying SMS as part of a healthcare information management system. This is in an effort to design a wireless communication system with optimal mobility and flexibility at minimum material and time costs.

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

PubMed

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

2013-01-01

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

ATM over hybrid fiber-coaxial cable networks: practical issues in deploying residential ATM services

NASA Astrophysics Data System (ADS)

Laubach, Mark

1996-11-01

Residential broadband access network technology based on asynchronous transfer modem (ATM) will soon reach commercial availability. The capabilities provided by ATM access network promise integrated services bandwidth available in excess of those provided by traditional twisted pair copper wire public telephone networks. ATM to the side of the home placed need quality of service capability closest to the subscriber allowing immediate support for Internet services and traditional voice telephony. Other services such as desktop video teleconferencing and enhanced server-based application support can be added as part of future evolution of the network. Additionally, advanced subscriber home networks can be supported easily. This paper presents an updated summary of the standardization efforts for the ATM over HFC definition work currently taking place in the ATM forum's residential broadband working group and the standards progress in the IEEE 802.14 cable TV media access control and physical protocol working group. This update is fundamental for establishing the foundation for delivering ATM-based integrated services via a cable TV network. An economic model for deploying multi-tiered services is presenting showing that a single-tier service is insufficient for a viable cable operator business. Finally, the use of an ATM based system lends itself well to various deployment scenarios of synchronous optical networks (SONET).

SeaDataNet - Pan-European infrastructure for marine and ocean data management: Unified access to distributed data sets

NASA Astrophysics Data System (ADS)

Schaap, D. M. A.; Maudire, G.

2009-04-01

SeaDataNet is an Integrated research Infrastructure Initiative (I3) in EU FP6 (2006 - 2011) to provide the data management system adapted both to the fragmented observation system and the users need for an integrated access to data, meta-data, products and services. Therefore SeaDataNet insures the long term archiving of the large number of multidisciplinary data (i.e. temperature, salinity current, sea level, chemical, physical and biological properties) collected by many different sensors installed on board of research vessels, satellite and the various platforms of the marine observing system. The SeaDataNet project started in 2006, but builds upon earlier data management infrastructure projects, undertaken over a period of 20 years by an expanding network of oceanographic data centres from the countries around all European seas. Its predecessor project Sea-Search had a strict focus on metadata. SeaDataNet maintains significant interest in the further development of the metadata infrastructure, but its primary objective is the provision of easy data access and generic data products. SeaDataNet is a distributed infrastructure that provides transnational access to marine data, meta-data, products and services through 40 interconnected Trans National Data Access Platforms (TAP) from 35 countries around the Black Sea, Mediterranean, North East Atlantic, North Sea, Baltic and Arctic regions. These include: National Oceanographic Data Centres (NODC's) Satellite Data Centres. Furthermore the SeaDataNet consortium comprises a number of expert modelling centres, SME's experts in IT, and 3 international bodies (ICES, IOC and JRC). Planning: The SeaDataNet project is delivering and operating the infrastructure in 3 versions: Version 0: maintenance and further development of the metadata systems developed by the Sea-Search project plus the development of a new metadata system for indexing and accessing to individual data objects managed by the SeaDataNet data centres. This is known as the Common Data Index (CDI) V0 system Version 1: harmonisation and upgrading of the metadatabases through adoption of the ISO 19115 metadata standard and provision of transparent data access and download services from all partner data centres through upgrading the Common Data Index and deployment of a data object delivery service. Version 2: adding data product services and OGC compliant viewing services and further virtualisation of data access. SeaDataNet Version 0: The SeaDataNet portal has been set up at http://www.seadatanet.org and it provides a platform for all SeaDataNet services and standards as well as background information about the project and its partners. It includes discovery services via the following catalogues: CSR - Cruise Summary Reports of research vessels; EDIOS - Locations and details of monitoring stations and networks / programmes; EDMED - High level inventory of Marine Environmental Data sets collected and managed by research institutes and organisations; EDMERP - Marine Environmental Research Projects ; EDMO - Marine Organisations. These catalogues are interrelated, where possible, to facilitate cross searching and context searching. These catalogues connect to the Common Data Index (CDI). Common Data Index (CDI) The CDI gives detailed insight in available datasets at partners databases and paves the way to direct online data access or direct online requests for data access / data delivery. The CDI V0 metadatabase contains more than 340.000 individual data entries from 36 CDI partners from 29 countries across Europe, covering a broad scope and range of data, held by these organisations. For purposes of standardisation and international exchange the ISO19115 metadata standard has been adopted. The CDI format is defined as a dedicated subset of this standard. A CDI XML format supports the exchange between CDI-partners and the central CDI manager, and ensures interoperability with other systems and networks. CDI XML entries are generated by participating data centres, directly from their databases. CDI-partners can make use of dedicated SeaDataNet Tools to generate CDI XML files automatically. Approach for SeaDataNet V1 and V2: The approach for SeaDataNet V1 and V2, which is in line with the INSPIRE Directive, comprises the following services: Discovery services = Metadata directories Security services = Authentication, Authorization & Accounting (AAA) Delivery services = Data access & downloading of datasets Viewing services = Visualisation of metadata, data and data products Product services = Generic and standard products Monitoring services = Statistics on usage and performance of the system Maintenance services = Updating of metadata by SeaDataNet partners The services will be operated over a distributed network of interconnected Data Centres accessed through a central Portal. In addition to service access the portal will provide information on data management standards, tools and protocols. The architecture has been designed to provide a coherent system based on V1 services, whilst leaving the pathway open for later extension with V2 services. For the implementation, a range of technical components have been defined. Some are already operational with the remainder in the final stages of development and testing. These make use of recent web technologies, and also comprise Java components, to provide multi-platform support and syntactic interoperability. To facilitate sharing of resources and interoperability, SeaDataNet has adopted SOAP Web Service technology. The SeaDataNet architecture and components have been designed to handle all kinds of oceanographic and marine environmental data including both in-situ measurements and remote sensing observations. The V1 technical development is ready and the V1 system is now being implemented and adopted by all participating data centres in SeaDataNet. Interoperability: Interoperability is the key to distributed data management system success and it is achieved in SeaDataNet V1 by: Using common quality control protocols and flag scale Using controlled vocabularies from a single source that have been developed using international content governance Adopting the ISO 19115 metadata standard for all metadata directories Providing XML Validation Services to quality control the metadata maintenance, including field content verification based on Schematron. Providing standard metadata entry tools Using harmonised Data Transport Formats (NetCDF, ODV ASCII and MedAtlas ASCII) for data sets delivery Adopting of OGC standards for mapping and viewing services Using SOAP Web Services in the SeaDataNet architecture SeaDataNet V1 Delivery Services: An important objective of the V1 system is to provide transparent access to the distributed data sets via a unique user interface at the SeaDataNet portal and download service. In the SeaDataNet V1 architecture the Common Data Index (CDI) V1 provides the link between discovery and delivery. The CDI user interface enables users to have a detailed insight of the availability and geographical distribution of marine data, archived at the connected data centres, and it provides the means for downloading data sets in common formats via a transaction mechanism. The SeaDataNet portal provides registered users access to these distributed data sets via the CDI V1 Directory and a shopping basket mechanism. This allows registered users to locate data of interest and submit their data requests. The requests are forwarded automatically from the portal to the relevant SeaDataNet data centres. This process is controlled via the Request Status Manager (RSM) Web Service at the portal and a Download Manager (DM) java software module, implemented at each of the data centres. The RSM also enables registered users to check regularly the status of their requests and download data sets, after access has been granted. Data centres can follow all transactions for their data sets online and can handle requests which require their consent. The actual delivery of data sets is done between the user and the selected data centre. The CDI V1 system is now being populated by all participating data centres in SeaDataNet, thereby phasing out CDI V0. 0.1 SeaDataNet Partners: IFREMER (France), MARIS (Netherlands), HCMR/HNODC (Greece), ULg (Belgium), OGS (Italy), NERC/BODC (UK), BSH/DOD (Germany), SMHI (Sweden), IEO (Spain), RIHMI/WDC (Russia), IOC (International), ENEA (Italy), INGV (Italy), METU (Turkey), CLS (France), AWI (Germany), IMR (Norway), NERI (Denmark), ICES (International), EC-DG JRC (International), MI (Ireland), IHPT (Portugal), RIKZ (Netherlands), RBINS/MUMM (Belgium), VLIZ (Belgium), MRI (Iceland), FIMR (Finland ), IMGW (Poland), MSI (Estonia), IAE/UL (Latvia), CMR (Lithuania), SIO/RAS (Russia), MHI/DMIST (Ukraine), IO/BAS (Bulgaria), NIMRD (Romania), TSU (Georgia), INRH (Morocco), IOF (Croatia), PUT (Albania), NIB (Slovenia), UoM (Malta), OC/UCY (Cyprus), IOLR (Israel), NCSR/NCMS (Lebanon), CNR-ISAC (Italy), ISMAL (Algeria), INSTM (Tunisia)

How NASA's Atmospheric Science Data Center (ASDC) is operationally using the Esri ArcGIS Platform to improve data discoverability, accessibility and interoperability to meet the diversifying government, private, public and academic communities' driven requirements.

NASA Astrophysics Data System (ADS)

Tisdale, M.

2016-12-01

NASA's Atmospheric Science Data Center (ASDC) is operationally using the Esri ArcGIS Platform to improve data discoverability, accessibility and interoperability to meet the diversifying government, private, public and academic communities' driven requirements. The ASDC is actively working to provide their mission essential datasets as ArcGIS Image Services, Open Geospatial Consortium (OGC) Web Mapping Services (WMS), OGC Web Coverage Services (WCS) and leveraging the ArcGIS multidimensional mosaic dataset structure. Science teams and ASDC are utilizing these services, developing applications using the Web AppBuilder for ArcGIS and ArcGIS API for Javascript, and evaluating restructuring their data production and access scripts within the ArcGIS Python Toolbox framework and Geoprocessing service environment. These capabilities yield a greater usage and exposure of ASDC data holdings and provide improved geospatial analytical tools for a mission critical understanding in the areas of the earth's radiation budget, clouds, aerosols, and tropospheric chemistry.

Scaling up delivery of contraceptive implants in sub-Saharan Africa: operational experiences of Marie Stopes International

PubMed Central

Duvall, Susan; Thurston, Sarah; Weinberger, Michelle; Nuccio, Olivia; Fuchs-Montgomery, Nomi

2014-01-01

Contraceptive implants offer promising opportunities for addressing the high and growing unmet need for modern contraceptives in sub-Saharan Africa. Marie Stopes International (MSI) offers implants as one of many family planning options. Between 2008 and 2012, MSI scaled up voluntary access to implants in 15 sub-Saharan African countries, from 80,041 implants in 2008 to 754,329 implants in 2012. This 9-fold increase amounted to more than 1.7 million implants delivered cumulatively over the 5-year period. High levels of client satisfaction were attained alongside service provision scale up by using existing MSI service delivery channels—mobile outreach, social franchising, and clinics—to implement strategies that broadened access for underserved clients and maintained service quality. Use of adaptive and context-specific service delivery models and attention to key operational components, including sufficient numbers of trained providers, strong supply chains, diverse financing mechanisms, and implant removal services, underpinned our service delivery efforts. Accounting for 70% of the implants delivered by MSI in 2012, mobile outreach services through dedicated MSI provider teams played a central role in scale-up efforts, fueled in part by the provision of free or heavily subsidized services. Social franchising also demonstrated promise for future program growth, along with MSI clinics. Continued high growth in implant provision between 2011 and 2012 in all sub-Saharan African countries indicates the region's capacity for further service delivery expansion. Meeting the expected rising demand for implants and ensuring long-term sustainable access to the method, as part of a comprehensive method mix, will require continued use of appropriate service delivery models, effective operations, and ongoing collaboration between the private, public, and nongovernmental sectors. MSI's experience can be instructive for future efforts to ensure contraceptive access and choice in sub-Saharan Africa, especially as the global health community works to achieve its Family Planning 2020 (FP2020) commitments to expand family planning access to 120 million new users. PMID:25276564

Scaling up delivery of contraceptive implants in sub-Saharan Africa: operational experiences of Marie Stopes International.

PubMed

Duvall, Susan; Thurston, Sarah; Weinberger, Michelle; Nuccio, Olivia; Fuchs-Montgomery, Nomi

2014-02-01

Contraceptive implants offer promising opportunities for addressing the high and growing unmet need for modern contraceptives in sub-Saharan Africa. Marie Stopes International (MSI) offers implants as one of many family planning options. Between 2008 and 2012, MSI scaled up voluntary access to implants in 15 sub-Saharan African countries, from 80,041 implants in 2008 to 754,329 implants in 2012. This 9-fold increase amounted to more than 1.7 million implants delivered cumulatively over the 5-year period. High levels of client satisfaction were attained alongside service provision scale up by using existing MSI service delivery channels-mobile outreach, social franchising, and clinics-to implement strategies that broadened access for underserved clients and maintained service quality. Use of adaptive and context-specific service delivery models and attention to key operational components, including sufficient numbers of trained providers, strong supply chains, diverse financing mechanisms, and implant removal services, underpinned our service delivery efforts. Accounting for 70% of the implants delivered by MSI in 2012, mobile outreach services through dedicated MSI provider teams played a central role in scale-up efforts, fueled in part by the provision of free or heavily subsidized services. Social franchising also demonstrated promise for future program growth, along with MSI clinics. Continued high growth in implant provision between 2011 and 2012 in all sub-Saharan African countries indicates the region's capacity for further service delivery expansion. Meeting the expected rising demand for implants and ensuring long-term sustainable access to the method, as part of a comprehensive method mix, will require continued use of appropriate service delivery models, effective operations, and ongoing collaboration between the private, public, and nongovernmental sectors. MSI's experience can be instructive for future efforts to ensure contraceptive access and choice in sub-Saharan Africa, especially as the global health community works to achieve its Family Planning 2020 (FP2020) commitments to expand family planning access to 120 million new users.

'Net Equity: A Report on Income and Internet Access.

ERIC Educational Resources Information Center

Moss, Mitchell; Mitra, Steve

1998-01-01

Examines the structure of the subscriber base formed under the current pricing policies of Internet providers and investigates how access to the Internet varies in communities with different demographic characteristics. Report is based on a survey from a national Internet service provided in 1997. (SLD)

47 CFR 79.2 - Accessibility of programming providing emergency information.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) BROADCAST RADIO SERVICES CLOSED CAPTIONING AND VIDEO DESCRIPTION OF VIDEO PROGRAMMING § 79.2 Accessibility... information. (1) Video programming distributors must make emergency information, as defined in paragraph (a...; (ii) Emergency information that is provided in the video portion of a regularly scheduled newscast, or...

47 CFR 79.2 - Accessibility of programming providing emergency information.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) BROADCAST RADIO SERVICES CLOSED CAPTIONING AND VIDEO DESCRIPTION OF VIDEO PROGRAMMING § 79.2 Accessibility... information. (1) Video programming distributors must make emergency information, as defined in paragraph (a...; (ii) Emergency information that is provided in the video portion of a regularly scheduled newscast, or...

47 CFR 79.2 - Accessibility of programming providing emergency information.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) BROADCAST RADIO SERVICES CLOSED CAPTIONING AND VIDEO DESCRIPTION OF VIDEO PROGRAMMING § 79.2 Accessibility... information. (1) Video programming distributors must make emergency information, as defined in paragraph (a..., as described in § 79.1. (2) Video programming distributors and video programming providers must make...

47 CFR 79.2 - Accessibility of programming providing emergency information.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) BROADCAST RADIO SERVICES CLOSED CAPTIONING AND VIDEO DESCRIPTION OF VIDEO PROGRAMMING § 79.2 Accessibility... information. (1) Video programming distributors must make emergency information, as defined in paragraph (a...; (ii) Emergency information that is provided in the video portion of a regularly scheduled newscast, or...

12 CFR 573.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2014 CFR

2014-01-01

... access number or access code, does not include a number or code in an encrypted form, as long as you do... account number or similar form of access number or access code for a consumer's credit card account... or access code: (1) To your agent or service provider solely in order to perform marketing for your...

12 CFR 573.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2012 CFR

2012-01-01

... access number or access code, does not include a number or code in an encrypted form, as long as you do... reporting agency, an account number or similar form of access number or access code for a consumer's credit... number or access code: (1) To your agent or service provider solely in order to perform marketing for...

12 CFR 573.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2011 CFR

2011-01-01

... access number or access code, does not include a number or code in an encrypted form, as long as you do... reporting agency, an account number or similar form of access number or access code for a consumer's credit... number or access code: (1) To your agent or service provider solely in order to perform marketing for...

12 CFR 40.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2011 CFR

2011-01-01

... similar form of access number or access code, does not include a number or code in an encrypted form, as... reporting agency, an account number or similar form of access number or access code for a consumer's credit... number or access code: (1) To the bank's agent or service provider solely in order to perform marketing...

12 CFR 40.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2014 CFR

2014-01-01

... similar form of access number or access code, does not include a number or code in an encrypted form, as... reporting agency, an account number or similar form of access number or access code for a consumer's credit... number or access code: (1) To the bank's agent or service provider solely in order to perform marketing...

12 CFR 40.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2012 CFR

2012-01-01

... similar form of access number or access code, does not include a number or code in an encrypted form, as... reporting agency, an account number or similar form of access number or access code for a consumer's credit... number or access code: (1) To the bank's agent or service provider solely in order to perform marketing...

12 CFR 40.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2013 CFR

2013-01-01

... similar form of access number or access code, does not include a number or code in an encrypted form, as... reporting agency, an account number or similar form of access number or access code for a consumer's credit... number or access code: (1) To the bank's agent or service provider solely in order to perform marketing...

12 CFR 573.12 - Limits on sharing account number information for marketing purposes.

Code of Federal Regulations, 2013 CFR

2013-01-01

... access number or access code, does not include a number or code in an encrypted form, as long as you do... account number or similar form of access number or access code for a consumer's credit card account... or access code: (1) To your agent or service provider solely in order to perform marketing for your...

Cross-sectional study examining whether the extent of first-contact access to primary care differentially benefits those with certain personalities to receive preventive services

PubMed Central

Pandhi, Nancy; Schumacher, Jessica R; Thorpe, Carolyn T; Smith, Maureen A

2016-01-01

Objective The extent of first-contact access to primary care (ie, easy availability when needed) is associated with receiving recommended preventive services. Whether this access benefits patients at risk of preventive services underutilisation, such as those with certain personality characteristics, is unclear. Setting Secondary analysis of the 2003–2006 round of the Wisconsin Longitudinal Study. Participants 6975 respondents who reported a usual provider whose specialty was internal medicine or family medicine. Those reporting not visiting a medical provider in the past 12 months, and those who were uninsured were excluded. Primary outcome measures Receiving mammography, cholesterol testing and influenza vaccination. Adjusted predicted probabilities (aPP) of receiving these services were analysed stratified by personality characteristics overall, and if significant, then interacted with first-contact access. Results Lower conscientiousness as compared with higher conscientiousness predicted less of all 3 preventive services; mammography (aPP 80%; 95% CI (77% to 83%) vs aPP 85%; (95% CI 82% to 87%)), cholesterol testing (88%; (85% to 90%) vs 93% (91% to 94%), and influenza vaccination (62%; (59% to 64%) vs 66%; (63% to 68%)). Lower agreeableness as compared with higher agreeableness predicted less mammography (77%; (73% to 81%) vs 84%; (82% to 87%)) and less influenza vaccination (59%; (56% to 62%) vs 65%; (63% to 68%)). Lower extraversion predicted less cholesterol testing (88%; (86% to 91%) vs (92%; (90% to 94%)). Lower openness to experience predicted less influenza vaccination (59%; (56% to 63%) vs (68%; (65% to 70%)). For agreeableness, these differences in receiving preventive services did not persist when first-contact access to primary care was present. Conclusions Certain personality characteristics predicted receiving less preventive care services. For those with less agreeableness, improved first-contact access to primary care mitigated this effect. If these results are replicated in other studies, primary care offices seeking to improve population health through receiving preventive services should prioritise increasing their first-contact accessibility. PMID:26951211

The tsunami service bus, an integration platform for heterogeneous sensor systems

NASA Astrophysics Data System (ADS)

Haener, R.; Waechter, J.; Kriegel, U.; Fleischer, J.; Mueller, S.

2009-04-01

1. INTRODUCTION Early warning systems are long living and evolving: New sensor-systems and -types may be developed and deployed, sensors will be replaced or redeployed on other locations and the functionality of analyzing software will be improved. To ensure a continuous operability of those systems their architecture must be evolution-enabled. From a computer science point of view an evolution-enabled architecture must fulfill following criteria: • Encapsulation of and functionality on data in standardized services. Access to proprietary sensor data is only possible via these services. • Loose coupling of system constituents which easily can be achieved by implementing standardized interfaces. • Location transparency of services what means that services can be provided everywhere. • Separation of concerns that means breaking a system into distinct features which overlap in functionality as little as possible. A Service Oriented Architecture (SOA) as e. g. realized in the German Indonesian Tsunami Early Warning System (GITEWS) and the advantages of functional integration on the basis of services described below adopt these criteria best. 2. SENSOR INTEGRATION Integration of data from (distributed) data sources is just a standard task in computer science. From few well known solution patterns, taking into account performance and security requirements of early warning systems only functional integration should be considered. Precondition for this is that systems are realized compliant to SOA patterns. Functionality is realized in form of dedicated components communicating via a service infrastructure. These components provide their functionality in form of services via standardized and published interfaces which could be used to access data maintained in - and functionality provided by dedicated components. Functional integration replaces the tight coupling at data level by a dependency on loosely coupled services. If the interfaces of the service providing components remain unchanged, components can be maintained and evolved independently on each other and service functionality as a whole can be reused. In GITEWS the functional integration pattern was adopted by applying the principles of an Enterprise Service Bus (ESB) as a backbone. Four services provided by the so called Tsunami Service Bus (TSB) which are essential for early warning systems are realized compliant to services specified within the Sensor Web Enablement (SWE) initiative of the Open Geospatial Consortium (OGC). 3. ARCHITECTURE The integration platform was developed to access proprietary, heterogeneous sensor data and to provide them in a uniform manner for further use. Its core, the TSB provides both a messaging-backbone and -interfaces on the basis of a Java Messaging Service (JMS). The logical architecture of GITEWS consists of four independent layers: • A resource layer where physical or virtual sensors as well as data or model storages provide relevant measurement-, event- and analysis-data: Utilizable for the TSB are any kind of data. In addition to sensors databases, model data and processing applications are adopted. SWE specifies encoding both to access and to describe these data in a comprehensive way: 1. Sensor Model Language (SensorML): Standardized description of sensors and sensor data 2. Observations and Measurements (O&M): Model and encoding of sensor measurements • A service layer to collect and conduct data from heterogeneous and proprietary resources and provide them via standardized interfaces: The TSB enables interaction with sensors via the following services: 1. Sensor Observation Service (SOS): Standardized access to sensor data 2. Sensor Planning Service (SPS): Controlling of sensors and sensor networks 3. Sensor Alert Service (SAS): Active sending of data if defined events occur 4. Web Notification Service (WNS): Conduction of asynchronous dialogues between services • An orchestration layer where atomic services are composed and arranged to high level processes like a decision support process: One of the outstanding features of service-oriented architectures is the possibility to compose new services from existing ones, which can be done programmatically or via declaration (workflow or process design). This allows e. g. the definition of new warning processes which could be adapted easily to new requirements. • An access layer which may contain graphical user interfaces for decision support, monitoring- or visualization-systems: To for example visualize time series graphical user interfaces request sensor data simply via the SOS. 4.BENEFIT The integration platform is realized on top of well known and widely used open source software implementing industrial standards. New sensors could be added easily to the infrastructure. Client components don't need to be adjusted if new sensor-types or -individuals are added to the system, because they access the sensors via standardized services. With implementing SWE fully compatible to the OGC specification it is possible to establish the "detection" and integration of sensors via the Web. Thus realizing a system of systems that combines early warning system functionality at different levels of detail (distant early warning systems, monitoring systems and any sensor system) is feasible.

Barriers and facilitators to effective coverage of Intimate Partner Violence services for immigrant women in Spain.

PubMed

Briones-Vozmediano, Erica; La Parra, Daniel; Vives-Cases, Carmen

2015-12-01

To explore service providers' perceptions in order to identify barriers and facilitators to effective coverage of Intimate Partner Violence (IPV) services for immigrant women in Spain, according to the different categories proposed in Tanahashi's model of effective coverage. A qualitative study based on 29 in-depth personal interviews and four group interviews with a total of 43 professionals working in public services (social and health-care services, women's refuges, the police force, the judiciary) and NGOs in Barcelona, Madrid, Valencia and Alicante (Spain) in 2011. Current IPV services in Spain partially fail in their coverage of abused immigrant women due to barriers of (i) availability, such as the inexistence of culturally appropriate services; (ii) accessibility, as having a residence permit is a prerequisite for women's access to different services and rights; (iii) acceptability, such as women's lack of confidence in the effectiveness of services; and (iv) effectiveness, for example, lack of specific training among professionals on the issues of IPV and immigration. However, interviewees also identified facilitators, such as the enabling environment promoted by the Spanish Law on Gender-Based Violence (1/2004), and the impetus it has provided for the development of other specific legislative tools to address IPV in immigrant populations in Spain (availability, accessibility and effectiveness). Whilst not dismissing cultural barriers, aspects related to service structure are identified by providers as the main barriers and facilitators to immigrant women use of IPV services. Despite noteworthy achievements, improvements are still required in terms of mainstreaming assistance tailored to immigrant women's needs in IPV policies and services. © 2014 John Wiley & Sons Ltd.