Essential elements of postabortion care: origins, evolution and future directions

In this comment, we chronicle the development and expansion of a postabortion care model designed to promote interventions that address abortion-related public health concerns even when abortion laws and policies are restrictive. We review years of program experience with the original model, which led to the development of an expanded and updated model, Essential Elements of Postabortion Care (PAC). Implementing the model challenges global public health leaders, donors, technical assistance agencies and ministries of health to work with communities to ensure that all women who want to prevent or space pregnancies can obtain contraceptive services; that all women have access to services to manage complications from abortion, whether induced or spontaneous; and that all women receiving treatment also receive counseling and the reproductive and other health services they need at the treatment visit, as well as follow-up care and contraceptive resupply

Developing front-end Web 2.0 technologies to access services, content and things in the future Internet

The future Internet is expected to be composed of a mesh of interoperable web services accessible from all over the web. This approach has not yet caught on since global user?service interaction is still an open issue. This paper states one vision with regard to next-generation front-end Web 2.0 technology that will enable integrated access to services, contents and things in the future Internet. In this paper, we illustrate how front-ends that wrap traditional services and resources can be tailored to the needs of end users, converting end users into prosumers (creators and consumers of service-based applications). To do this, we propose an architecture that end users without programming skills can use to create front-ends, consult catalogues of resources tailored to their needs, easily integrate and coordinate front-ends and create composite applications to orchestrate services in their back-end. The paper includes a case study illustrating that current user-centred web development tools are at a very early stage of evolution. We provide statistical data on how the proposed architecture improves these tools. This paper is based on research conducted by the Service Front End (SFE) Open Alliance initiative.

Analysis of the essential literature on project management in Spanish

The advancement of science and engineering projects is brewing major changes in the various phases of a project. These changes have produced more rigorous aspects of project management that tracks the research fronts of engineering and project management becomes key. However, research in engineering and project management in Spanish is hindered by access to information to enable the person concerned to ascertain the most recent and current research, limiting the exchange of information and strengthening research networks in this field interest with great implications in business, industry and scientific issues. Therefore, the article aims to present the state of the art of engineering research and project management in Spanish, using the analysis of scientific domains and network analysis of the research literature to identify and analyze relationships between authors and documents that establish the base and research fronts topic under study. The results also provide statistics on the contribution of international research in Spanish and scientific collaboration networks.

An economic analysis of unilateral refusals to license intellectual property

The intellectual property laws in the United States provide the owners of intellectual property with discretion to license the right to use that property or to make or sell products that embody the intellectual property. However, the antitrust laws constrain the use of property, including intellectual property, by a firm with market power and may place limitations on the licensing of intellectual property. This paper focuses on one aspect of antitrust law, the so-called “essential facilities doctrine,” which may impose a duty upon firms controlling an “essential facility” to make that facility available to their rivals. In the intellectual property context, an obligation to make property available is equivalent to a requirement for compulsory licensing. Compulsory licensing may embrace the requirement that the owner of software permit access to the underlying code so that others can develop compatible application programs. Compulsory licensing may undermine incentives for research and development by reducing the value of an innovation to the inventor. This paper shows that compulsory licensing also may reduce economic efficiency in the short run by facilitating the entry of inefficient producers and by promoting licensing arrangements that result in higher prices.

Towards the Consideration of the U.S. Community College Model to Address the Need for Higher Education Reforms in Ghana

ABSTRACT The higher education systems throughout the continent of Africa are undergoing unprecedented challenges and are considered in crisis. African countries, including Ghana, all have in common ties to their colonial legacy whereby they are confronted with weak policies put in place by their colonizers. Having gained their independence, Africans should now take responsibility for the task of reforming their higher education system. To date, nothing substantial has been accomplished, with serious implications for weakening and damaging the structures of the foundation of their educational systems. This qualitative, single case study utilized a postcolonial theory-critical pedagogy framework, providing guidance for coming to grips with the mindset posed by Ghana's colonial heritage in the postcolonial era, especially in terms of its damaging effects on Ghana's higher education system. The study explores alternative pathways for secondary school students to transition to tertiary education--a problematic transition that currently hinders open access to all and equality in educational opportunity, resulting in a tremendous pool of discontinued students. This transitional problem is directly related to Ghana's crisis in higher education with far reaching consequences. The alternative pathway considered in this study is an adaptation of the U.S. community college model or an integration of its applicable aspects into the current structures of the higher education system already in place. In-depth interviews were conducted with 5 Ghanaian professors teaching at community colleges in the United States, 5 Ghanaian professors teaching at universities in Ghana, and 2 educational consultants from the Ghanaian Ministry of Education. Based on their perspectives of the current state of Ghanaian higher education, analyzed in terms of pedagogy, structure/infrastructure, and curriculum, the participants provided their perceptions of salient aspects of the U.S. community college model that would be applicable to Ghana's situation, along with other recommendations. Access to all, including equality of educational opportunity, was considered essential, followed by adaptability, affordability, practicality, and quality of curriculum content and delivery. Canada's successful adaptation of the U.S. model was also discussed. Findings can help guide consideration of alternative pathways to higher education in Ghana and Africa as a whole.

A general proposal to multilingual information access based on syntactic-semantic patterns

In the last few years, there has been a wide development in the research on textual information systems. The goal is to improve these systems in order to allow an easy localization, treatment and access to the information stored in digital format (Digital Databases, Documental Databases, and so on). There are lots of applications focused on information access (for example, Web-search systems like Google or Altavista). However, these applications have problems when they must access to cross-language information, or when they need to show information in a language different from the one of the query. This paper explores the use of syntactic-sematic patterns as a method to access to multilingual information, and revise, in the case of Information Retrieval, where it is possible and useful to employ patterns when it comes to the multilingual and interactive aspects. On the one hand, the multilingual aspects that are going to be studied are the ones related to the access to documents in different languages from the one of the query, as well as the automatic translation of the document, i.e. a machine translation system based on patterns. On the other hand, this paper is going to go deep into the interactive aspects related to the reformulation of a query based on the syntactic-semantic pattern of the request.

The EU essential facilities doctrine. Research Papers in Law, 6/2006

Introduction. The essential facilities doctrine may be seen as the ‘extra weight’ which is put onto the balance, in order to give precedence to the maintenance of competition over the complete contractual freedom of undertakings controlling an important and unique facility. The main purpose of the doctrine is to impose upon such ‘dominant’ undertakings the duty to negotiate and/or give access to the facility, against a reasonable fee, to other undertakings, which cannot pursue their own activity (and therefore will perish) without access to such a facility. This very simple description of the content of the doctrine underlines its limitations: through the imposition of a duty to negotiate or contractual obligations, the rule tends to compensate for the weaknesses of the competitive structure of a market, which are due to the existence of some essential facility. In other words, the doctrine does not by itself provide a definitive solution to the lack of competition, but tends to contractually maintain or even create some competition.1 The doctrine of essential facilities originates in the US antitrust case law of the Circuit and District Courts, but has never been officially acknowledged by the Supreme Court. It has been further developed and hotly debated by scholars in the US, both from a legal and from an economic viewpoint. In the EU, the essential facilities doctrine was openly introduced by the Commission during the early 1990s, but has received only limited and indirect support by the Court of First Instance (the CFI) and the European Court of Justice (the ECJ). It also indirectly inspired the legislation concerning the deregulation of traditional ‘natural’ monopolies. The judicial origin of the doctrine, combined with the hesitant application by the appeal courts, both in the US and the EU, cast uncertainty not only on the precise scope of the doctrine, but also on the issue of its very existence. These questions receive a particular light within the EU context, where the doctrine is called upon to play a different role from its US counterpart. In order to address the above issues, we will first pretend that an EU essential facility doctrine does indeed exist and we shall try to identify the scope and content thereof, through its main applications (Section 1). Subsequently, we will try to answer the question whether such a doctrine should exist at all in the EU (Section 2).

How Do Second-Generation Immigrant Students Access Higher Education? The Importance of Vocational Routes to Higher Education in Switzerland, France, and Germany

We analyse the access to different institutional pathways to higher education for second-generation students, focusing on youths that hold a higher-education entrance certificate. The alternative vocational pathway appears to compensate to some degree, compared to the traditional academic one, for North-African and Southern-European youths in France, those from Turkey in Germany, and to a lesser degree those from Portugal, Turkey, Ex-Yugoslavia, Albania/Kosovo in Switzerland. This is not the case in Switzerland for Western-European, Italian, and Spanish youths who indeed access higher education via the academic pathway more often than Swiss youths. Using youth panel and survey data, multinomial models are applied to analyse these pathway choices.

Referral to rehabilitation following traumatic brain injury: a model for understanding inequities in access

Identifying inequities in access to health care requires critical scrutiny of the patterns and processes of care decisions. This paper describes a conceptual model. derived from social problems theory. which is proposed as a useful framework for explaining patterns of post-acute care referral and in particular, individual variations in referral to rehabilitation after traumatic brain injury (TBI). The model is based on three main components: (1) characteristics of the individual with TBI, (2) activities of health care professionals and the processes of referral. and (3) the contexts of care. The central argument is that access to rehabilitation following TBI is a dynamic phenomenon concerning the interpretations and negotiations of health care professionals. which in turn are shaped by the organisational and broader health care contexts. The model developed in this paper provides opportunity to develop a complex analysis of post-acute care referral based on patient factors, contextual factors and decision-making processes. It is anticipated that this framework will have utility in other areas examining and understanding patterns of access to health care. (C) 2002 Elsevier Science Ltd. All rights reserved.

Quantifying the use of the statin antilipemic drugs: Comparisons and contrasts between Nova Scotia, Canada, and Queensland, Australia

Background: jurisdictions are developing public drug insurance systems to improve access to pharmaceuticals, cost-effective prescribing, and patient health and well-being. We compared 2 Jurisdictions with different pharmaceutical policies to determine prescribing patterns for 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (le, statins). Objective: The aim of this work was to investigate the feasibility of using available prescription admimstrative databases to compare the use of statins in Queensland, Australia, and in Nova Scotia, Canada. Methods: Data from the Nova Scotia Pharmacare Program and the Health Insurance Commission in Australia were used to obtain dispensing data. Utilization was compared for the 5-year period from 1997 through 2001, using the World Health Organization anatomic therapeutic chemical/defined daily dose (DDD) system. Results: In the year 2001, there were 177,000 beneficiaries in the public drug plan in Nova Scotia (62% aged ≥ 65 years old) and 960,000 concession beneficiaries (pensioners and social security recipients, 61% aged ≥ 65 years) in Queensland. These 2 groups were comparable. The overall utilization of statin medications increased steadily in both areas over the study period, from 50 to 205 DDD/1000 beneficiaries per day. Comparison of the 2 growth lines showed no statistically significant differences in overall statin use despite differences in brand availabilities and policies about prescribing. In the year 2001, atorvastatin was the most commonly prescribed statin in both areas, comprising 46% of statin use in Nova Scotia and 51% in Queensland. Mean doses of each statin prescribed were slightly above the DDDs. Expenditure on statins per 1000 beneficiaries and per DDD were similar in each jurisdiction, being slightly higher in Nova Scotia. Conclusions: Despite differences in pharmaceutical reimbursement systems, use of the statins was similar in Nova Scotia and Queensland. The feasibility of the methodology was demonstrated. Future studies, including comparisons of drug utilization for other classes of drugs for which drug policies may be divergent (eg, different pricing structures or prior authorization requirements), or for which less evidence for appropriate use is available, may be useful. © 2005 Excerpta Medica, Inc.

Using machine vision classification to control access of animals to water

Invasive vertebrate pests together with overabundant native species cause significant economic and environmental damage in the Australian rangelands. Access to artificial watering points, created for the pastoral industry, has been a major factor in the spread and survival of these pests. Existing methods of controlling watering points are mechanical and cannot discriminate between target species. This paper describes an intelligent system of controlling watering points based on machine vision technology. Initial test results clearly demonstrate proof of concept for machine vision in this application. These initial experiments were carried out as part of a 3-year project using machine vision software to manage all large vertebrates in the Australian rangelands. Concurrent work is testing the use of automated gates and innovative laneway and enclosure design. The system will have application in any habitat throughout the world where a resource is limited and can be enclosed for the management of livestock or wildlife.

Understanding the yeast host cell response to recombinant membrane protein production

Membrane proteins are drug targets for a wide range of diseases. Having access to appropriate samples for further research underpins the pharmaceutical industry's strategy for developing new drugs. This is typically achieved by synthesizing a protein of interest in host cells that can be cultured on a large scale, allowing the isolation of the pure protein in quantities much higher than those found in the protein's native source. Yeast is a popular host as it is a eukaryote with similar synthetic machinery to that of the native human source cells of many proteins of interest, while also being quick, easy and cheap to grow and process. Even in these cells, the production of human membrane proteins can be plagued by low functional yields; we wish to understand why. We have identified molecular mechanisms and culture parameters underpinning high yields and have consolidated our findings to engineer improved yeast host strains. By relieving the bottlenecks to recombinant membrane protein production in yeast, we aim to contribute to the drug discovery pipeline, while providing insight into translational processes.

Medicines management across the primary-hospital healthcare interface: a study of paediatric patients

A comparison of medicines management documents in use by NHS organisations in the West Midlands confirms that there are important differences between the primary care and hospital sectors in respect to medicines management interface issues. Of these, two aspects important to paediatric patients have been studied. These are the transfer of information as a patient is admitted to hospital, and access to long-term medicines for home-patients. National guidance provided by NICE requires medication reconciliation to be undertaken on admission to hospital for adults. A study of paediatric admissions, reported in this thesis, demonstrates that the clinical importance of this process is at least as important for children as for adults, and challenges current UK guidance. The transfer of essential medication information on hospital admission is central to the medication reconciliation process. Two surveys of PCTs in 2007 and again in 2009 demonstrate that very few PCTs provide guidance to GPs to support this process. Provision of guidance is increasing slowly but remains the exception. The provision of long-term medicines for children at home is hindered by this patient population often needing unlicensed drugs. Further studies demonstrate that primary care processes regularly fail to maintain access to essential drugs and patients and their carers frequently turn to hospitals for help. Surveys of hospital medical staff (single site) and hospital nurses (six UK sites) demonstrates the activity these healthcare workers perform to help children get the medicines they need. A similar survey of why carers turn to a hospital pharmacy department for urgent supplies (usually termed rescue-medicines) adds to the understanding of these problems and supports identifying service changes. A large survey of community pharmacies demonstrates the difficulties they have when dispensing hospital prescriptions and identifies practical solutions. This programme concludes by recommending service changes to support medication management for children.

"Crack down on the celebrity junkies": does media coverage of celebrity drug use pose a risk to young people?

This study analysed news media content to examine the role played by celebrity drug use in young people's perceptions of drug use. We know that young people have access to discourses of drug use through music and other media which may emphasise short term gains (of pleasure or sexual success) over longer term health and social problems. This study goes beyond a simple modelling approach by using Media Framing Analysis (MFA) to take an in-depth look at the messages themselves and how they are 'framed'. New stories about Amy Winehouse's drug use were used and we conducted focus groups with young people asking them questions about drugs, celebrity and the media. Frames identified include: 'troubled genius', 'losing patience' and 'glamorization or gritty realism'. Initially, the press championed Winehouse's musical talent but soon began to tire of her recklessness; the participants tended to be unimpressed with Winehouse's drug use, characterising her as a promising artist who had 'gone off the rails'. Young people were far more critical of Winehouse than might be expected, demonstrating that concerns about the influence of celebrity drug use and its impact on future health risk behaviour among young people may have been over-simplified and exaggerated. This study illustrates the need to understand young people and their frames of reference within popular culture when designing drug awareness information relevant to them. Furthermore, it indicates that critical media skills analysis may contribute to health risk education programmes related to drug use.

Childhood auditory processing disorder as a developmental disorder:the case for a multi-professional approach to diagnosis and management

Auditory processing disorder (APD) is diagnosed when a patient presents with listening difficulties which can not be explained by a peripheral hearing impairment or higher-order cognitive or language problems. This review explores the association between auditory processing disorder (APD) and other specific developmental disorders such as dyslexia and attention-deficit hyperactivity disorder. The diagnosis and aetiology of APD are similar to those of other developmental disorders and it is well established that APD often co-occurs with impairments of language, literacy, and attention. The genetic and neurological causes of APD are poorly understood, but developmental and behavioural genetic research with other disorders suggests that clinicians should expect APD to co-occur with other symptoms frequently. The clinical implications of co-occurring symptoms of other developmental disorders are considered and the review concludes that a multi-professional approach to the diagnosis and management of APD, involving speech and language therapy and psychology as well as audiology, is essential to ensure that children have access to the most appropriate range of support and interventions.