Tools for supporting solution scattering during the COVID-19 pandemic

During the COVID-19 pandemic, synchrotron beamlines were forced to limit user access. Performing routine measurements became a challenge. At the Life Science X-ray Scattering (LiX) beamline, new instrumentation and mail-in protocols have been developed to remove the access barrier to solution scattering measurements. Our efforts took advantage of existing instrumentation and coincided with the larger effort at NSLS-II to support remote measurements. Given the limited staff–user interaction for mail-in measurements, additional software tools have been developed to ensure data quality, to automate the adjustments in data processing, as users would otherwise rely on the experience of the beamline staff, and produce a summary of the initial assessments of the data. This report describes the details of these developments.

Access Barrier in Rural Older Adults’ Use of Pain Management and Palliative Care Services: A Systematic Review

Background: Pain and symptom management is critical in ensuring quality of life for chronically ill older adults. However, while pain management and palliative care have steadily expanded in recent years, many underserved populations, such as rural older adults, experience barriers in accessing such specialty services, in part due to transportation issues. The purpose of this systematic review is to examine the specific types of transportation-related barriers experienced by rural older adults in accessing pain and palliative care. Methods: Studies were searched through the following 10 databases: Abstracts in Social Gerontology, Academic Search Premier, CINAHL, MEDLINE, PsycINFO, SocINDEX with Full Text, Cochrane Database of Systematic Reviews, Nursing & Allied Health Database, Sociological Abstracts, and PubMED. Studies were chosen for initial review if they were written in English, full text, included older adults in the sample, and examined pain/palliative care/hospice, rural areas, and transportation. A total of 174 abstracts were initially screened, 15 articles received full-text reviews and 8 met the inclusion criteria. Results: Findings of the 8 studies identified transportation-related issues as major access barrier to pain and palliative care among rural older adults: specifically, lack of public transportation; lack of wheelchair accessible vehicles; lack of reliable drivers; high cost of transportation services; poor road conditions; and remoteness to the closest pain and palliative care service providers. Conclusion: Results suggest that rural older adults have unique transportation needs due to the urban-centric location of pain and palliative care services. Implications for practice, policy and research with older adults are discussed.

openPFGE: An open source and low cost pulsed-field gel electrophoresis equipment

DNA electrophoresis is a fundamental technique in molecular biology that allows the separation of DNA molecules up to ~50 Kbp. Pulsed-field gel electrophoresis [PFGE] is a variation of the conventional DNA electrophoresis technique that allows the separation of very large DNA molecules up to ~10 Mbp. PFGE equipment is very expensive and it becomes an access barrier to many laboratories. Also, just a few privative designs of the equipment are available and it becomes difficult for the community to improve or customize their functioning. Here, we provide an open source PFGE equipment capable of the separation of DNA molecules up to, at least, ~2 Mbp and at low cost: USD$850, about 3% of the price of typical commercial equipment.Specifications table

Accessing Barriers and Determinants of Prevention of Mother to Child Transmission (PMTCT) of Human Immune Deficiency Virus (HIV) Services at Public Teaching Hospitals in Enugu State, Nigeria

Introduction: The most effective means of reducing Mother-to-Child transmission of HIV is to provide suppressive HAART. Prevention of Mother to Child Transmission (PMTCT) directly affects the achievement of Sustainable Development goals just. The unmet need for PMTCT services in Nigeria, particularly in Enugu state, is unacceptably high. This study aimed to assess factors associated with access barriers and determinants to PMTCT services in public health facilities in Enugu, Nigeria. Materials and Methods: The study design was a facility-based analytical cross-sectional study. HIV positive nursing mothers who were accessing PMTCT services were studied. Questionnaire was used. Chi-square test and Binary logistic regression was done to for determinants of experience of any access barrier. Level of significance was determined at a p-value of ≤ 0.05. Results: A total of 2275 participants were reported on. A higher proportion of participants were in 30-34 years age group 124 (45.1%), attained secondary education 144(52.4%) and provided for by their husbands 174(63.3%) The major barriers identified were; long waiting time at the facility 184(66.9%), distance of facility 161(58.5%), PMTCT being far away from other units/departments 155(56.4%), Health workers talking to the clients with no respect 151(54.9%), Stigma and discrimination from friends/neighbours 163(59.3%) and from health workers 123(44.7%) as well as being too busy with household chores 130(47.3%). There were statistically significant association between experience of barriers with age in categories (χ2=11.741, p =0.008), religion (χ2=5.381, p =0.020), source of income (χ2= 8.817, p=0.032) and ethnicity (χ2=9.240, p=0.026). Conclusion: Over ninety percent of respondents experienced a form of barrier. The major barriers include; long waiting time, distance to facility, location of PMTCT units, Health workers attitude, Stigma and discrimination from health workers as well as being too busy with household chores. There was no identified predictor of access barrier.

Hambatan Akses ke Puskesmas pada Lansia di Indonesia

The elderly are one of the most vulnerable groups with very high dependency rates. This condition has the potential to cause other problems for the caregiver or his family. The elderly also has the potential to suffer from catastrophic diseases that have costly consequences. This research is a further analysis of Riskesdas 2013 data, that presented in descriptive quantitative. The results showed that elderly people living in urban as well as rural areas have a tendency of moderate access barrier to Puskesmas. There are still 15% of very poor elderly people who have major access barrier to Puskesmas. This study concludes that although elderly access to Puskesmas is quite good, but the access of very poor elderly is still need more attention. The government needs to provide basic health care facilities in more rural areas. The government also needs to realize a National Health Insurance with tax-based funding, to ensure universal coverage regardless of the ability to pay the community. Abstrak Lansia adalah salah satu kelompok rentan yang memiliki angka ketergantungan sangat tinggi. Kondisi ini berpotensi menimbulkan masalah lain bagi yang merawat atau keluarganya. Lansia juga berpotensi menderita penyakit katastropik yang menimbulkan konsekuensi biaya yang mahal. Penelitian ini merupakan analisis lanjut data Riskesdas 2013, yang disajikan secara deskriptif kuantitatif. Hasil penelitian menunjukkan bahwa lansia yang tinggal di perkotaan maupun perdesaan mempunyai kecenderungan hambatan akses sedang untuk ke Puskesmas. Masih ada 15% lansia sangat miskin yang memiliki hambatan besar ke Puskesmas. Penelitian ini menyimpulkan bahwa meski akses lansia ke Puskesmas sudah cukup baik, tetapi akses lansia yang sangat miskin masih perlu mendapat perhatian lebih. Pemerintah perlu menyediakan fasilitas pelayanan kesehatan dasar di wilayah perdesaan yang lebih banyak. Pemerintah juga perlu mewujudkan sebuah Jaminan Kesehatan Nasional dengan pendanaan berbasis pajak, untuk memastikan cakupan secara universal dengan tanpa menghiraukan kemampuan membayar masyarakat.

Improving Pointing in Graphical User Interfaces for People With Motor Impairments Through Ability-Based Design

Pointing to targets in graphical user interfaces remains a frequent and fundamental necessity in modern computing systems. Yet for millions of people with motor impairments, children, and older users, pointing—whether with a mouse cursor, a stylus, or a finger on a touch screen—remains a major access barrier because of the fine-motor skills required. In a series of projects inspired by and contributing to ability-based design, we have reconsidered the nature and assumptions behind pointing, resulting in changes to how mouse cursors work, the types of targets used, the way interfaces are designed and laid out, and even how input devices are used. The results from these explorations show that people with motor difficulties can acquire targets in graphical user interfaces when interfaces are designed to better match the abilities of their users. Ability-based design, as both a design philosophy and a design approach, provides a route to realizing a future in which people can utilize whatever abilities they have to express themselves not only to machines, but to the world.

Passenger Mobility in a Discontinuous Space: Modelling Access/Egress to Maritime Barrier in a Case Study

The present study analyses a transport system in a discontinuous space. Classical specifications of transport models cannot be applied directly when evaluating the influence of territorial discontinuity and related barriers on user behaviour. Adjustments are required for this specific case because studies relative to discontinuous spaces are limited. The influence concerns the different travel components (access, barrier, on board, and egress) and could impact travel choices (departure time, destination, mode, and path). In this paper, the models refer to access and egress components with a focus on the mode of travel choice level. The paper focusses on the influence of discontinuity, introducing some adjustments to the classical demand models used to simulate discontinuity crossing. The main variables influencing the user’s choice, and their relative weight in discontinuous space, are investigated. These elements are fundamental for any planning and design procedures to improve the quality of mobility. In the paper, the case study of the Strait of Messina in southern Italy is analysed. In this case, the barrier is constituted by the sea that physically separates the two shores. In this work, only strait crossings via hydrofoil, from Reggio Calabria to Messina, are considered in random sample interviews.

Timely referral saves the lives of mothers and newborns: Midwifery led continuum of care in marginalized teagarden communities – A qualitative case study in Bangladesh

Background: Prompt and efficient identification, referral of pregnancy related complications and emergencies are key factors to the reduction of maternal and newborn morbidity and mortality. As a response to this critical need, a midwifery led continuum of reproductive health care was introduced in five teagardens in the Sylhet division, Bangladesh during 2016. Within this intervention, professional midwives provided reproductive healthcare to pregnant teagarden women in the community. This study evaluates the effect of the referral of pregnancy related complications. Methods: A qualitative case study design by reviewing records retrospectively was used to explore the effect of deploying midwives on referrals of pregnancy related complications from the selected teagardens to the referral health facilities in Moulvibazar district of the Sylhet division during 2016. In depth analyses was also performed on 15 randomly selected cases to understand the facts behind the referral. Results: Out of a total population of 450 pregnant women identified by the midwives, 72 complicated mothers were referred from the five teagardens to the facilities. 76.4% of mothers were referred to conduct delivery at facilities, and 31.1% of them were referred with the complication of prolonged labour. Other major complications were pre-eclampsia (17.8%), retention of the placenta with post-partum hemorrhage (11.1%) and premature rupture of the membrane (8.9%). About 60% of complicated mothers were referred to the primary health care centre, and among them 14% of mothers were delivered by caesarean section. 94% deliveries resulted in livebirths and only 6% were stillbirths. Conclusions: This study reveals that early detection of pregnancy complications by skilled professionals and timely referral to a facility is beneficial in saving the majority of baby’s as well as mother’s lives in resource-poor teagardens with a considerable access barrier to health facilities.