Accessibility Criteria Research Articles

A randomized controlled trial assessing the use of ultrasound for nurse-performed IV placement in difficult access ED patients

ObjectiveThis study analyzed outcomes associated with nurse-performed ultrasound (US)–guided intravenous (IV) placement compared to standard of care (SOC) palpation IV technique on poor vascular access patients. MethodsThis was a randomized, prospective single-site study. Phase 1 involved education/training of a cohort of nurses to perform US-guided IVs. This consisted of a didactic module and hands-on requirement of 10 proctored functional IVs on live subjects. Phase 2 involved patient enrollment. emergency department patients meeting strict criteria of poor access were randomized to US-guided or SOC palpation arm. A functional IV placed by a study nurse was considered successful. Unsuccessful placement implied the study nurse failed, and a rescue IV was attempted. Time to IV placement was the total time required to obtain a functional IV and, if needed, a rescue IV. ResultsA total of 124 subjects were enrolled; 63 were randomized to the US-guided arm, and 61 were randomized into the SOC arm; 2 patients were excluded, leaving 59 patients. Success rate was 76% for the US-guided arm and 56% for the SOC arm (P=.02). Compared to the SOC arm, the odds ratio for success for the US-guided arm was 2.52 (95% confidence interval, 1.09-5.92). The mean time to IV placement for the US-guided arm was 15.8 and 20.7 minutes for the SOC arm (P=.75). ConclusionIn difficult access patients, nurses were more successful in obtaining IV access using US guidance than palpation SOC technique. Lengthier placement times were observed more frequently when the SOC IV technique was used.

An Exploratory Investigation of E-Rest: Teletherapy for Chronically Aphasic Speakers.

Delivering aphasia therapy via telecommunication may provide a means to deliver intensive therapy in a cost-effective way. Teletherapy, remotely-administered (language) treatment, may support the repetitive drill practices that people with chronic aphasia need to perform when learning to compensate for their lasting language difficulties. The use of teletherapy may allow speech and language pathologists (SLPs) to focus in-person sessions more strongly on the generalisation of therapy effects to daily life. This single subject study is an investigation whether a teletherapy application called e-REST meets the criteria of accessibility, user-friendliness, as well as effectiveness. e-REST, the teletherapy version of the Dutch and adapted Reduced Syntax Therapy, teaches chronically aphasic speakers of Dutch who experience difficulties in sentence production to convey their messages in a kind of telegraphic style. The results obtained suggest that it is reasonable to conduct a larger study into the user-friendliness, accessibility, effectiveness, and cost-effectiveness of e-REST.

Investigación pediátrica española financiada: contribución de Anales de Pediatría a su difusión

ObjectiveTo identify Spanish funded paediatric research published in general paediatric journals included in the Web of Science (WoS) from 2010 to 2014) and those published in the Anales de Pediatría. To examine the relationship between funding and the prestige of the journals. To describe the journal conditions to meet the open access criteria. Material and methodSpanish funded paediatric articles (FA) were identified by using the WoS Funding Agency field, and by reviewing the original documents for the Anales de Pediatria (AP). For the FA published in AP the number and kind of funding agencies were identified. The possible differences in citations between FA and non-funded was assessed for articles published in this journal using the Kruskal-Wallis non-parametric test. For general journals, the patterns of distribution of FA and non-FA were investigated according to the quartile of the journal. The journal's self-archiving conditions were described using Sherpa/romeo database. ResultsFunding was received for 27.5%, being 16.6% for those published in AP. In these, 105 funding agencies were identified, with 80% being national. The FA published in AP did not receive significantly more citations. In general journals, the presence of FA is greater in Q1 and Q2 journals. More than half (56%) of articles were published in subscription journals. All journals that publish FA allow self-archiving in repositories, but with embargos of at least 12 months. ConclusionsThe role of AP in the dissemination of FA is still limited. Embargos in self-archiving permits compliance of Spanish open access mandate, but may hinder compliance in Europe.

Mobilizing Local Authorities Around Public Health Priorities.

Large Analysis and Review of European Housing and Health Status (LARES) was conducted in Europe in 2002 to 2003 to study the relationship between citizens' health and built environments. One of its objectives was to put public health priorities on the agenda of local decision-makers to implement solutions for the community. We adapted the LARES protocol as a pilot project in a small French-Canadian town in Quebec Province in 2012. The distinguishing feature of this project was the collaborative approach taken with local actors, especially the municipality, which was committed a priori to using survey data from an urban planning perspective. The project produced interesting results that were used to motivate actions concerning people living in bad sanitary conditions; to draft the urban plan including the development of parks, green spaces, and bicycle paths; and to allow the municipality to meet eligibility criteria for access to renovation programs. If a partnership with the local actors and their commitment to promote and realize the project were obtained at the beginning, then the survey could be replicated in other communities.

A new approach for automating land partitioning using binary search and Delaunay triangulation

One of the most important, yet time-consuming steps of the land consolidation process, which is related to pooling fragmented lands together, is the production of land partitioning plans. After the land redistribution process is finished, the land partitioning process begins. In that process, the locations of parcels within the blocks are determined. Due to the non-uniform geometric shapes of the blocks, the areas of the parcels cannot be divided directly. The production of an ideal land partitioning plan is not suitable automatically unless a quick, accurate process to divide the lands is secured. In this study, production of a pre-land partitioning plan is realized using both the binary search method and the Delaunay triangulation method, taking into consideration shape, size, value and road access criteria. The result of the experimental study shows that the proposed approach for dividing the parcels makes the process take place more quickly. Thus, a solid base for creating an automatic land partitioning plan—one that is closest to an ideal plan—will be provided with this study.

Finding Appropriate Site for Public Art Center and Eco-Effective Design Potential Analysis among Abandoned Buildings in Khabarovsk City Applying GIS Methodology

Using GIS principles this study attempts to review abandoned buildings situated in Khabarovsk city, analyze them and their surroundings in terms of present condition, accessibility and other criteria to select appropriate site for creating Public Art Center where citizens could develop their art skills and share them with others. Also in this study was collected simple geographical data that could be helpful in analyses of renewable resources potential as in different parts of Khabarovsk and in the whole city. During the study process were reviewed worldwide examples of abandoned buildings regeneration, methods of energy consumption reduction in newly built facilities, principles and objectives in creating public places and methods of analyzing data in GIS program. Also on the base of different kinds of city maps such as land use map, road map and geographical map were prepared attribute tables with various criteria and their characterizations, which are important for studied city spaces analyses. As a result was proposed model that could be created in GIS and was shown the whole process of specific site selection with implementation of various program tools. Furthermore was made model map that shows graphically all project steps and provides easier understanding of whole analyses process.

B and T Cell Epitope-Based Peptides Predicted from Evolutionarily Conserved and Whole Protein Sequences of Ebola Virus as Vaccine Targets.

Ebola virus (EBV) has become a serious threat to public health. Different approaches were applied to predict continuous and discontinuous B cell epitopes as well as T cell epitopes from the sequence-based and available three-dimensional structural analyses of each protein of EBV. Peptides '(79) VPSATKRWGFRSGVPP(94) ' from GP1 and '(515) LHYWTTQDEGAAIGLA(530) ' from GP2 of Ebola were found to be the consensus peptidic sequences predicted as linear B cell epitope of which the latter contains a region (519) TTQDEG(524) that fulfilled all the criteria of accessibility, hydrophilicity, flexibility and beta turn region for becoming an ideal B cell epitope. Different nonamers as T cell epitopes were obtained that interacted with different numbers of MHC class I and class II alleles with a binding affinity of <100 nm. Interestingly, these alleles also bound to the MHC class I alleles mostly prevalent in African and South Asian regions. Of these, 'LANETTQAL' and 'FLYDRLAST' nonamers were predicted to be the most potent T cell epitopes and they, respectively, interacted with eight and twelve class I alleles that covered 63.79% and 54.16% of world population, respectively. These nonamers were found to be the core sequences of 15mer peptides that interacted with the most common class II allele, HLA-DRB1*01:01. They were further validated for their binding to specific class I alleles using docking technique. Thus, these predicted epitopes may be used as vaccine targets against EBV and can be validated in model hosts to verify their efficacy as vaccine.

Accessibility of Turkish university Web sites

In 2010, the author of this paper conducted an evaluation of the accessibility level of the home pages of Turkish Universities (Kurt in Univers Access Inf Soc 10(1):101---110, 2011). That investigation, which utilized a variety of different evaluative techniques, as recommended by the World Wide Web Consortium, found that none of the reviewed home pages met the minimum criteria for Web accessibility. In 2015, the author completed a follow-up audit of the same universities' home pages, using a similar methodological approach. The goal of the audit was to determine whether Web site accessibility had increased or improved during the intervening 5-year period. This paper, which details the results of the second study, demonstrates that in general accessibility levels have actually decreased slightly. Each of the university Web sites reviewed contains at least one of a variety of components that makes it inaccessible to some users. Of these, the most prominent is neglecting to provide equivalent text alternative for content that has been presented in non-text formats, although doing so would be a relatively simple matter.

The value of spatial analysis for tracking supply for family planning: the case of Kinshasa, DRC.

While geographic information systems (GIS) are frequently used to research accessibility issues for healthcare services around the world, sophisticated spatial analysis protocols and outputs often prove inappropriate and unsustainable to support evidence-based programme strategies in resource-constrained environments. This article examines how simple, open-source and interactive GIS tools have been used to locate family planning (FP) services delivery points in Kinshasa (Democratic Republic of Congo) and to identify underserved areas, determining the potential location of new service points, and to support advocacy for FP programmes. Using smartphone-based data collection applications (OpenDataKit), we conducted two surveys of FP facilities supported by partner organizations in 2012 and 2013 and used the results to assess gaps in FP services coverage, using both ratio of facilities per population and distance-based accessibility criteria. The cartographic outputs included both static analysis maps and interactive Google Earth displays, and sought to support advocacy and evidence-based planning for the placement of new service points. These maps, at the scale of Kinshasa or for each of the 35 health zones that cover the city, garnered a wide interest from the operational level of the health zones' Chief Medical Officers, who were consulted to contribute field knowledge on potential new service delivery points, to the FP programmes officers at the Ministry of Health, who could use the map to inform resources allocation decisions throughout the city.

Predicting the success of IVF: external validation of the van Loendersloot's model.

Is the predictive model for IVF success proposed by van Loendersloot et al. valid in a different geographical and cultural context? The model discriminates well but was less accurate than in the original context where it was developed. Several independent groups have developed models that combine different variables with the aim of estimating the chance of pregnancy with IVF but only four of them have been externally validated. One of these four, the van Loendersloot's model, deserves particular attention and further investigation for at least three reasons; (i) the reported area under the receiver operating characteristics curve (c-statistics) in the temporal validation setting was the highest reported to date (0.68), (ii) the perspective of the model is clinically wise since it includes variables obtained from previous failed cycles, if any, so it can be applied to any women entering an IVF cycle, (iii) the model lacks external validation in a geographically different center. Retrospective cohort study of women undergoing oocyte retrieval for IVF between January 2013 and December 2013 at the infertility unit of the Fondazione Ca' Granda, Ospedale Maggiore Policlinico of Milan, Italy. Only the first oocyte retrieval cycle performed during the study period was included in the study. Women with previous IVF cycles were excluded if the last one before the study cycle was in another center. The main outcome was the cumulative live birth rate per oocytes retrieval. Seven hundred seventy-two women were selected. Variables included in the van Loendersloot's model and the relative weights (beta) were used. The variable resulting from this combination (Y) was transformed into a probability. The discriminatory capacity was assessed using the c-statistics. Calibration was made using a logistic regression that included Y as the unique variable and live birth as the outcome. Data are presented using both the original and the calibrated models. Performance was evaluated correlating the mean predicted chances of live births in the five quintiles and the observed rates. Two-hundred-eleven live births (27%) were obtained. The c-statistic was 0.64 (95% CI: 0.61-0.67, P < 0.001). The slope of the linear predictor (calibration slope) expressed as an Odds Ratio was 1.81 (95% CI: 1.46-2.24, P < 0.001), corresponding to a beta of 0.630. The calibration intercept was +0.349 (P = 0.13). While a clear discrepancy exists using the original model, data appear properly distributed with the calibrated model. The Pearson coefficient of the correlation between the mean predicted chances of live births in the five quintiles and the observed rates was 0.99 (P = 0.002). Data were collected retrospectively, thus exposing them to potential inaccuracies. The selection criteria for access to IVF adopted in our center might be too stringent, leading to the exclusion of women with a poor, yet acceptable chance of live birth. Therefore, the validity of the model in women with a very low chance of live birth could not be tested. The van Loendersloot's model can be used in other contexts but it is important that it has local calibration. It may help in counseling couples about their chance of success but it cannot be used to exclude treatments. Further research is needed to improve the discriminatory performance of IVF predictive models. None. Not applicable.

Modelos de atención multidisciplinar en pacientes con artritis psoriásica en España

ObjetiveTo describe (structure, processes) of the multidisciplinary care models in psoriatic arthritis (PsA) in Spain, as well as barriers and facilitators of their implementation. MethodsA qualitative study was performed following structured interviews with 24 professionals (12 rheumatologists, 12 dermatologists who provide multidisciplinary care for patients with PsA). We collected data related to the hospital, department, population and multidisciplinary care model (type, physical and human resources, professional requirements, objectives, referral criteria, agendas, protocols, responsibilities, decision- making, research and education, clinical sessions, development and planning of the model, advantages and disadvantages of the model, barriers and facilitators in the implementation of the model. The models characteristics are described. ResultsWe analyzed 12 multidisciplinary care models in PsA, with at least 1-2 years of experience, and 3 subtypes of models, face-to-face, parallel, and preferential circuit. All are adapted to the hospital and professionals characteristics. A proper implementation planning is essential. The involvement and empathy between professionals and an access and well-defined referral criteria are important facilitators in the implementation of a model. The management of agendas and data collection to measure the multidisciplinary care models health outcomes are the main barriers. ConclusionsThere are different multidisciplinary care models in PsA that can improve patient outcomes, system efficiency and collaboration between specialists.

Models of maritime safety for development of navigation support systems

Navigation support systems are part of modern maritime transportation chain where larger and larger vessels are handled in ports. Support systems for sea navigation must meet certain criteria for access, integrity, accuracy and other factors. Modelling of safety criteria for technical creation of support systems like PNS (Pilot Navigation System) or LDS (Laser Docking System) consists of several stages both conceptual, and real time experimental. Even basic systems must be designed and developed in manner where assumed safety factors are met.

Identifying Older Adults with Serious Illness: A Critical Step toward Improving the Value of Health Care.

To create and test three prospective, increasingly restrictive definitions of serious illness. Health and Retirement Study, 2000-2012. We evaluated subjects' 1-year outcomes from the interview date when they first met each definition: (A) one or more severe medical conditions (Condition) and/or receiving assistance with activities of daily living (Functional Limitation); (B) Condition and/or Functional Limitation and hospital admission in the last 12months and/or residing in a nursing home (Utilization); and (C) Condition and Functional Limitation and Utilization. Definitions are increasingly restrictive, but not mutually exclusive. Of 11,577 eligible subjects, 5,297 met definition A; 3,151 definition B; and 1,447 definition C. One-year outcomes were as follows: hospitalization 33 percent (A), 44 percent (B), 47 percent (C); total average Medicare costs $20,566 (A), $26,349 (B), and $30,828 (C); and mortality 13 percent (A), 19 percent (B), 28 percent (C). In comparison, among those meeting no definition, 12 percent had hospitalizations, total Medicare costs averaged $7,789, and 2 percent died. Prospective identification of older adults with serious illness is feasible using clinically accessible criteria and may be a critical step toward improving health care value. These definitions may aid clinicians and health systems in targeting patients who could benefit from additional services.

Evaluation of Quality Public Transport Criteria in Terms of Passenger Satisfaction

Abstract This article presents a detailed description and explanation of the methodology for evaluation of quality public transport criteria in terms of passenger satisfaction. In 2011-2014 this method was applied in an assessment of passenger satisfaction with the urban public transport system in Ostrava. In order to assess passengers’ satisfaction, traffic survey has been chosen utilizing questionnaire and student inquirers. The results achieved by application of the method have been processed to evaluate time accessibility criteria of a public transport system. Time accessibility criteria group (accessibility of stops, waiting for a connection and transferability in the public transport network) evaluates physical and psychological aspects of the passenger during his arrival at the station, while leaving the station, in the course of waiting for a connection and during the transfer. The time accessibility criteria are considered the most significant criteria that impact a passenger’s decision to utilise public transport options.

Patient Safety Assessment at Primary Health Care Centers in Cairo, Egypt

Background: Patient safety at primary health care centers (PHCC) is rarely assessed, particularly in developing countries. Objectives: This study aimed to assess some items of patient safety program at primary health care centers, Cairo, Egypt. Methods: A cross sectional study was carried out on primary health care centers (PHCC) in Cairo, from January through March 2016 to assess the quality of some patient safety items. Two PHCC were selected randomly from the health affairs directorate of Nasr city, Eastern Cairo (El-Hagana family medicine center and 6th district family medicine center). The data were collected through interviewing and observing technique using structured questionnaire containing the quality items. The used questionnaire and interview checklist were developed and formulated according to the WHO patient safety and OSHA self inspection checklist. Scoring of the studied items are done and compared between the two studied centers using statistical test with p value of significance was set at ≤ 0.05. Results: There were statistically significant differences between the studied family medicine centers with regard to some studied patient safety goals where the higher compliance was achieved in the 6th district center. For the studied quality improvement requirements, however, there was no statistically significant difference between the studied centers for almost all studied items. Comparison of compliance of the studied centers with the criteria of access, there was statistically significant difference regarding most of the studied items of this topic with the highest compliance was observed in6th district center, although no one of the studied centers has met all the studied characteristics of that topic. Assessing the availability and uses of personal protective equipment (PPE), the study findings showed a variation among the studied centers. Only one third of the clinics of El-Hagana center showed a compliance with PPE. Conclusion: Patient safety at primary health care centers has to be reviewed and assessed periodically. There are need to carry national large study to assess quality of patient safety program in PHCC all over the country.

Nature Based Tourism Resources Assessment Using Geographic Information System (GIS): Case Study in Bogor

A natural and socio-cultural resource is the capital in developing tourism in a region. The demand of sustainable tourism has become an important aspect that must be considered by local government. Therefore, nature-based tourism resources assessment is important in order to determine the appropriate region in the planning of a sustainable tourism destination. The aim of this study is to develop a spatial model of natural tourism planning based on criteria of attractiveness and accessibility of object in Bogor. The attractiveness of the object was develop based on the variety of landscape in term of Land cover & physical condition of villages, meanwhile the accessibility was determined based on distance from the sub-district capital. Result showed there were seven typologies of areas, namely (a) high attractiveness and accessibility (b) high attractiveness and medium accessibility, (c) high attractiveness and low accessibility, (d) medium attractiveness and high accessibility, (e) medium attractiveness and accessibility, (f) medium attractiveness and low accessibility (g) low attractiveness and accessibility.

Toward Visual Accessibility in the Built Environment: The ViDeA Project

In the last decades, the general awareness with regard to the topic of universal design (or design for all) has been steadily increasing. As a consequence, more attention is being paid to the requirements of all segments of population (specifically including those with certain perceptual and/or motoric limitations). Nonetheless, additional efforts toward improving pertinent regulations, design practices, and relevant technologies are needed. Specifically, the field of visual accessibility in the built environment has not received the same level of consideration as some other areas of universal design. Given this background, the present contribution reports on the most recent progress made in the course of the ongoing ViDeA research project. This research effort aims primarily at the development of effective means toward supporting the design and implementation of visually accessible solutions in the built environment. Thereby, a central objective is to enhance the mobility of people with sight restriction. Visually impaired people primarily orient themselves based on their residual eyesight. The optimization of lighting solutions represents a highly critical measure toward creating environmental circumstances in which the remaining eyesight can be optimally utilised. The main components of the ViDeA project are as follows: An original set of optometric experiments, the evaluation of a number of use cases and the development of a computational tool for architects and engineers in order to facilitate the evaluation of visual accessibility criteria of projects. The deliverables of the ViDeA project are expected to enhance the quality of visual performance guidelines and augment the capabilities of simulation-based design optimization tools.

The contribution of the geography of disability to the development of ‘accessible tourism’

The article presents an outline of the evolution of the geography of disability (since the 1930s) taking into account significant issues in the creation of theoretical foundations as well as practical action in ‘accessible tourism’. It may be considered a review. Based on an analysis of literature, the first section presents a definition of ‘accessible tourism’ and the development of the geography of disability, the result of which is the geographical model of disability. The second section is a synthetic presentation of the effect of geographical research on the development of theoretical accessible tourism concepts and their implications in practice. The final conclusions highlight the need to identify the level of detail in universal design principles applied to buildings, spaces, services, which are to fulfil the criteria of accessibility for people with various types of disability.

User Satisfaction of Environmental Quality in University Buildings

In this study, user satisfaction with environmental quality in university buildings are investigated. The buildings that were selected for the study are the School Medicine, Veterinary School and Faculty of Agriculture buildings located at Uludag University Gorukle Campus, Bursa, Turkey. A user satisfaction questionnaire developed by the authors was used to evaluate the level of satisfaction of the users in these buildings. The key themes selected were design - planning, physical environmental control, and social environment parameters. Design - planning parameter is evaluated by accessibility and reachability criteria; physical environmental control parameter is evaluated by thermal comfort, audial comfort and visual comfort criteria; and social environment parameter is evaluated by service areas and socializing criteria. The survey form, which is based on a Likert type was applied to 100 users in each building, reaching a total of 300 users. The data collected was analyzed by percentages. According to the research results, the proximity of buildings to the center of the campus, ability to easily access different storeys in buildings, ensuring thermal comfort conditions are created, not using artificial air conditioning, blocking noise from external and internal sources, fulfilling visual comfort conditions, adequate number of wet areas and car parks, establishment of eating, drinking and resting spaces, spaces for social interaction and adequate landscaping and green areas and the ability to effectively use open spaces are among the factors that influence user satisfaction in buildings. Keywords : environmental quality, user satisfaction questionnaire, university buildings

“People of Freedom and Unlimited Movement”: Representations of Roma in Post-Communist Memorial Museums

The “universalization of the Holocaust” and the insistence on Roma rights as an EU accession criteria have changed the memory of the Roma genocide in post-communist countries. This article examines how Roma are represented in post-communist memorial museums which wanted to prove that they correspond with “European memory standards”. The three case studies discussed here are the &lt;em&gt;Museum of the Slovak National Uprising&lt;/em&gt;, the &lt;em&gt;Jasenovac Memorial Museum&lt;/em&gt; and the &lt;em&gt;Holocaust Memorial Center&lt;/em&gt; in Budapest. I argue that today Roma are being represented for the first time, but in a stereotypical way and through less prominent means in exhibitions which lack individualizing elements like testimonies, photographs from their life before the persecution or artifacts. This can only partially be explained by the (relative) unavailability of data that is often deplored by researchers of the Roma genocide.