WorldWideScience

Sample records for current disposal practice

  1. Radioactive waste disposal in Slovakia: Current practice and development

    International Nuclear Information System (INIS)

    Salzer, P.; Hanusik, V.; Ehn, L.

    2002-01-01

    The paper describes activities concerning the disposal of radioactive waste in the Slovak Republic. For disposal of the low and intermediate short-lived radioactive waste, the National radioactive waste repository Mochovce (near surface type) was put into operation in 1999. History and approaches to repository development, siting and construction are briefly described. Recent activities regarding the repository are concerning on the safety re-assessment and re-derivation of coherent waste acceptance criteria, studies of repository covering and possible enlargement. In the second part, attention is given to the Slovak deep geological repository development programme, which has been under way since 1996. Most of the results were obtained from the siting part of the programme, where four localities (six sites) were identified as prospective for next investigation. The paper also gives an overview on next two routes of deep repository development programme: studies resulted later in performance assessment and general activities, i.e. design studies, analysis of legislative and infrastructure conditions, planning and evaluation of works. (author)

  2. Current practices for maintaining occupational exposures ALARA at low-level waste disposal sites

    International Nuclear Information System (INIS)

    Hadlock, D.E.; Herrington, W.N.; Hooker, C.D.; Murphy, D.W.; Gilchrist, R.L.

    1983-12-01

    The United States Nuclear Regulatory Commission contracted with Pacific Northwest Laboratory (PNL) to provide technical assistance in establishing operational guidelines, with respect to radiation control programs and methods of minimizing occupational radiation exposure, at Low-Level Waste (LLW) disposal sites. The PNL, through site visits, evaluated operations at LLW disposal sites to determine the adequacy of current practices in maintaining occupational exposures as low as is reasonably achievable (ALARA). The data sought included the specifics of: ALARA programs, training programs, external exposure control, internal exposure control, respiratory protection, surveillance, radioactive waste management, facilities and equipment, and external dose analysis. The results of the study indicated the following: The Radiation Protection and ALARA programs at the three commercial LLW disposal sites were observed to be adequate in scope and content compared to similar programs at other types of nuclear facilities. However, it should be noted that there were many areas that could be improved upon to help ensure the health and safety of occupationally exposed individuals

  3. Current practices for maintaining occupational exposures ALARA at low-level waste disposal sites

    Energy Technology Data Exchange (ETDEWEB)

    Hadlock, D.E.; Herrington, W.N.; Hooker, C.D.; Murphy, D.W.; Gilchrist, R.L.

    1983-12-01

    The United States Nuclear Regulatory Commission contracted with Pacific Northwest Laboratory (PNL) to provide technical assistance in establishing operational guidelines, with respect to radiation control programs and methods of minimizing occupational radiation exposure, at Low-Level Waste (LLW) disposal sites. The PNL, through site visits, evaluated operations at LLW disposal sites to determine the adequacy of current practices in maintaining occupational exposures as low as is reasonably achievable (ALARA). The data sought included the specifics of: ALARA programs, training programs, external exposure control, internal exposure control, respiratory protection, surveillance, radioactive waste management, facilities and equipment, and external dose analysis. The results of the study indicated the following: The Radiation Protection and ALARA programs at the three commercial LLW disposal sites were observed to be adequate in scope and content compared to similar programs at other types of nuclear facilities. However, it should be noted that there were many areas that could be improved upon to help ensure the health and safety of occupationally exposed individuals.

  4. U.S. policy and current practices for blending low-level radioactive waste for disposal

    Energy Technology Data Exchange (ETDEWEB)

    Kessel, David S.; Kim, Chang Lak [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

    2016-09-15

    In the near future, many countries, including the Republic of Korea, will face a significant increase in low level radioactive waste (LLW) from nuclear power plant decommissioning. The purpose of this paper is to look at blending as a method for enhancing disposal options for low-level radioactive waste from the decommissioning of nuclear reactors. The 2007 U.S. Nuclear Regulatory Commission strategic assessment of the status of the U.S. LLW program identified the need to move to a risk-informed and performance-based regulatory approach for managing LLW. The strategic assessment identified blending waste of varying radionuclide concentrations as a potential means of enhancing options for LLW disposal. The NRC's position is that concentration averaging or blending can be performed in a way that does not diminish the overall safety of LLW disposal. The revised regulatory requirements for blending LLW are presented in the revised NRC Branch Technical Position for Concentration Averaging and Encapsulation (CA BTP 2015). The changes to the CA BTP that are the most significant for NPP operation, maintenance and decommissioning are reviewed in this paper and a potential application is identified for decommissioning waste in Korea. By far the largest volume of LLW from NPPs will come from decommissioning rather than operation. The large volumes in decommissioning present an opportunity for significant gains in disposal efficiency from blending and concentration averaging. The application of concentration averaging waste from a reactor bio-shield is also presented.

  5. U.S. policy and current practices for blending low-level radioactive waste for disposal

    International Nuclear Information System (INIS)

    Kessel, David S.; Kim, Chang Lak

    2016-01-01

    In the near future, many countries, including the Republic of Korea, will face a significant increase in low level radioactive waste (LLW) from nuclear power plant decommissioning. The purpose of this paper is to look at blending as a method for enhancing disposal options for low-level radioactive waste from the decommissioning of nuclear reactors. The 2007 U.S. Nuclear Regulatory Commission strategic assessment of the status of the U.S. LLW program identified the need to move to a risk-informed and performance-based regulatory approach for managing LLW. The strategic assessment identified blending waste of varying radionuclide concentrations as a potential means of enhancing options for LLW disposal. The NRC's position is that concentration averaging or blending can be performed in a way that does not diminish the overall safety of LLW disposal. The revised regulatory requirements for blending LLW are presented in the revised NRC Branch Technical Position for Concentration Averaging and Encapsulation (CA BTP 2015). The changes to the CA BTP that are the most significant for NPP operation, maintenance and decommissioning are reviewed in this paper and a potential application is identified for decommissioning waste in Korea. By far the largest volume of LLW from NPPs will come from decommissioning rather than operation. The large volumes in decommissioning present an opportunity for significant gains in disposal efficiency from blending and concentration averaging. The application of concentration averaging waste from a reactor bio-shield is also presented

  6. Disposal - practical problems

    International Nuclear Information System (INIS)

    Hycnar, J.; Pinko, L.

    1995-01-01

    Most Polish power plants have stockyards for storage of fly ash and slag. This paper describes the: methods of fly ash and slag storage used, methods of conveying the waste to the stockpiles (by railway cars, trucks, belt conveyors or hydraulically); construction of wet stockyards and dry stockyards and comparison of the ash dumped, development of methods of ash disposal in mine workings; composition and properties of fly ash and slag from hard coal; and the effects of ash storage yards on the environment (by leaching of trace elements, dust, effect on soils, and noise of machinery). 16 refs., 3 figs., 6 tabs

  7. Management and disposal of alpha-contaminated wastes. A survey of current practices, strategies and R and D activities in some EC countries and the USA

    International Nuclear Information System (INIS)

    Mannone, F.

    1983-01-01

    In view of the rationalization of radwaste treatment, conditioning and storage procedures so far applied at the Ispra Establishment, a survey of alpha-waste management practices and strategies currently in use or under development in some EC countries and in the USA has been carried out. In considering radwastes arising at nuclear research centres and nuclear plants, the most importance has been attached here to their alpha- rather than to their beta- or gamma-contamination degree. Various process technologiques currently practised for pre-treatment, conditioning, storage and/or disposal of alpha-waste at several European nuclear centres and plants, as well as at some US DOE laboratories, have been scrutinized, including also process operations aimed at recovering Pu, both for economical and ecological reasons. The present alpha-waste management and disposal scenario has been completed by the survey of research, development and demonstration work underway in Europe and in the USA in this field. Finally, national organizations, policies and strategies for radwastes management and disposal have been briefly outlined. As main source of information, the proceeding of several technical seminars, symposia, meetings and conferences, individually and jointly organized by the NEA (OECD), IAEA, CEC and published during about the last 20 years have been utilized. This report is intended to give the necessary background for the critical review of waste management practices so far applied at the Ispra Establisment, as well as for their possible modifications according to more up-to-date management schemes

  8. Optimization of uranium mill tailings disposal practices

    International Nuclear Information System (INIS)

    Richardson, Allan C.B.; Rowe, William D.

    1984-01-01

    So far as we have been to discern, no uranium mill tailings pile has yet been properly stabilized for long-term disposal. And although considerable effort is now being directed at developing practical solutions and at establishing standards for permanent disposal, the difficulties in application are diverse. They arise from the variety of environments in which milling is conducted, the significant costs associated with disposing of the large volumes of materials involved, the diverse nature of the hazards to be protected against, and uncertainties in both performance of controls and in how to determine societal responsibilities for management of the long term hazards to human populations from uranium tailings. There are 24 uranium tailings piles in the United States which no longer have responsible owners, and must now be disposed of by the U.S. Government in order to protect public health

  9. Radioactive waste disposal : policies and practices in New Zealand

    International Nuclear Information System (INIS)

    Robertson, M.K.

    1996-01-01

    The management of radioactive waste and its ultimate dispoal have been a significant problem for the nuclear industry. A lot of resources have been devoted to developing management and dispoal systems. As well as being one of the major technical problems, it has been a very significant public relations issue. Public concern about risks associated with disposal of radioactive waste has been on a global scle. It has focused on local issues in some countries, but generl attitudes have been common worldwide. Great differences exist between countries in the scale and aspects of nuclear technoloy in use. In particular the presence or absence of a nuclear power programme, and to a lesser extent of any nuclear reactors, greatly influence the magnitude of the waste disposal problem. Nevertheless, public perceptions of the problem are to some degree independent of these differences. What radioactive wastes are there in New Zealand? Is there a hazard to the New Zealand public or the New Zealand environment from current radioactive waste disposal practices? What policies are in place to control these practices? This report seeks to provide some information on these questions. It also brings together in one document the waste disposal policies followed by the National Radiation Laboratory for different uses of radioactive mateials. Except for some small quantities which are exempt from most controls, radioactive material can be used in New Zealand only under the control of a person holding a licence under the Radiation Protection Act 1965. All requirements of the Radiation Protection Regulations 1982 must also be observed. More detailed safety advice and further mandatory requirements are contained in codes of safe practice. Compliance with one of these is a condition on most licencees. These provisions are administered by the National Radiation Laboratory (NRL) of the Ministry of Health. (author). 7 refs., 2 tabs., 1 fig

  10. Post-disposal safety assessment of toxic and radioactive waste: waste types, disposal practices, disposal criteria, assessment methods and post-disposal impacts

    International Nuclear Information System (INIS)

    Torres, C.; Simon, I.; Little, R.H.; Charles, D.; Grogan, H.A.; Smith, G.M.; Sumerling, T.J.; Watkins, B.M.

    1993-01-01

    The need for safety assessments of waste disposal stems not only from the implementation of regulations requiring the assessment of environmental effects, but also from the more general need to justify decisions on protection requirements. As waste-disposal methods have become more technologically based, through the application of more highly engineered design concepts and through more rigorous and specific limitations on the types and quantities of the waste disposed, it follows that assessment procedures also must become more sophisticated. It is the overall aim of this study to improve the predictive modelling capacity for post-disposal safety assessments of land-based disposal facilities through the development and testing of a comprehensive, yet practicable, assessment framework. This report records all the work which has been undertaken during Phase 1 of the study. Waste types, disposal practices, disposal criteria and assessment methods for both toxic and radioactive waste are reviewed with the purpose of identifying those features relevant to assessment methodology development. Difference and similarities in waste types, disposal practices, criteria and assessment methods between countries, and between toxic and radioactive wastes are highlighted and discussed. Finally, an approach to identify post-disposal impacts, how they arise and their effects on humans and the environment is described

  11. Public practice regarding disposal of unused medicines in Ireland.

    Science.gov (United States)

    Vellinga, Akke; Cormican, Sarah; Driscoll, Jacqueline; Furey, Michelle; O'Sullivan, Mai; Cormican, Martin

    2014-04-15

    Over recent years, a global increase in the use of pharmaceutical products has been observed. EU directives state that "Member states shall ensure that appropriate collection systems are in place for medicinal products that are unused or have expired" (Directive 2001/83/EC and Directive 2004/27/EC). There is no published data on how people in Ireland dispose of unused medicines; therefore the purpose of this study is to establish baseline information on storage and disposal of medicines. Data was collected over two 2-week periods a year apart. People in the streets of Galway and Cork were approached randomly and invited to participate by filling out a questionnaire. The questionnaire was completed by 398 individuals (207 in Galway and 191 in Cork). Unused medicines were kept in the home by 88% of the respondents. The most cited reason for keeping unused medicines was "in case they are needed later" (68%). Of the respondents who had disposed of medicine in the past, 72% had done so inappropriately. Environmentally inappropriate disposal methods were through general waste disposal and via the sewage system. Interestingly, of the people who had received advice on disposal practices from a healthcare professional, 75% disposed of their medicine appropriately. There is little awareness among members of the public regarding appropriate ways to dispose of unused medicines. Our findings suggest that effective communication and established protocols will promote appropriate disposal practices. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Current status of high level radioactive waste disposal in Japan and foreign countries

    International Nuclear Information System (INIS)

    Tanaka, Satoru; Tanabe, Hiromi; Inagaki, Yusuke; Ishida, Hisahiro; Kato, Osamu; Kurata, Mitsuyuki; Yamachika, Hidehiko

    2002-01-01

    At a time point of 2002, there is no country actually disposing high level radioactive wastes into grounds, but in most of countries legislative preparation and practicing agents are carried out and site selection is promoted together with energetic advancement of its R and Ds. As disposal methods of the high level radioactive wastes, various methods such as space disposal, oceanic bottom disposal, ice bed disposal, ground disposal, and so on have been examined. And, a processing technology called partitioning and transmutation technology separating long-lived radionuclides from liquid high level radioactive waste and transmutation into short-lived or harmless radionuclides has also been studied. Here was introduced their wrestling conditions in Japan and main foreign countries, as a special issue of the Current status of high level radioactive waste disposal in Japan and foreign countries'. The high level radioactive wastes (glassification solids or spent nuclear fuels) are wastes always formed by nuclear power generation and establishment of technologies is an important subject for nuclear fuel cycle. (G.K.)

  13. Knowledge and practice of sewage disposal in Abattoir community ...

    African Journals Online (AJOL)

    Knowledge and practice of sewage disposal in Abattoir community of Jos South LGA, Plateau State, Nigeria. ... Conclusion: Despite the commendable findings in this community, the community is still at risk due to the poor practices of a few that were persisting in the community. Both government and community efforts are ...

  14. Current practice in Europe

    DEFF Research Database (Denmark)

    Proclemer, Alessandro; Dagres, Nikolaos; Marinskis, Germanas

    2013-01-01

    The purpose of the EP wire is to examine the clinical practice in the management of sustained ventricular tachycardia (VT), with special focus on diagnostic and therapeutic strategies. Forty-five European centres, all members of the EHRA-EP Research network completed the questions of the survey...

  15. International low level waste disposal practices and facilities

    International Nuclear Information System (INIS)

    Nutt, W.M.

    2011-01-01

    The safe management of nuclear waste arising from nuclear activities is an issue of great importance for the protection of human health and the environment now and in the future. The primary goal of this report is to identify the current situation and practices being utilized across the globe to manage and store low and intermediate level radioactive waste. The countries included in this report were selected based on their nuclear power capabilities and involvement in the nuclear fuel cycle. This report highlights the nuclear waste management laws and regulations, current disposal practices, and future plans for facilities of the selected international nuclear countries. For each country presented, background information and the history of nuclear facilities are also summarized to frame the country's nuclear activities and set stage for the management practices employed. The production of nuclear energy, including all the steps in the nuclear fuel cycle, results in the generation of radioactive waste. However, radioactive waste may also be generated by other activities such as medical, laboratory, research institution, or industrial use of radioisotopes and sealed radiation sources, defense and weapons programs, and processing (mostly large scale) of mineral ores or other materials containing naturally occurring radionuclides. Radioactive waste also arises from intervention activities, which are necessary after accidents or to remediate areas affected by past practices. The radioactive waste generated arises in a wide range of physical, chemical, and radiological forms. It may be solid, liquid, or gaseous. Levels of activity concentration can vary from extremely high, such as levels associated with spent fuel and residues from fuel reprocessing, to very low, for instance those associated with radioisotope applications. Equally broad is the spectrum of half-lives of the radionuclides contained in the waste. These differences result in an equally wide variety of

  16. International low level waste disposal practices and facilities

    Energy Technology Data Exchange (ETDEWEB)

    Nutt, W.M. (Nuclear Engineering Division)

    2011-12-19

    The safe management of nuclear waste arising from nuclear activities is an issue of great importance for the protection of human health and the environment now and in the future. The primary goal of this report is to identify the current situation and practices being utilized across the globe to manage and store low and intermediate level radioactive waste. The countries included in this report were selected based on their nuclear power capabilities and involvement in the nuclear fuel cycle. This report highlights the nuclear waste management laws and regulations, current disposal practices, and future plans for facilities of the selected international nuclear countries. For each country presented, background information and the history of nuclear facilities are also summarized to frame the country's nuclear activities and set stage for the management practices employed. The production of nuclear energy, including all the steps in the nuclear fuel cycle, results in the generation of radioactive waste. However, radioactive waste may also be generated by other activities such as medical, laboratory, research institution, or industrial use of radioisotopes and sealed radiation sources, defense and weapons programs, and processing (mostly large scale) of mineral ores or other materials containing naturally occurring radionuclides. Radioactive waste also arises from intervention activities, which are necessary after accidents or to remediate areas affected by past practices. The radioactive waste generated arises in a wide range of physical, chemical, and radiological forms. It may be solid, liquid, or gaseous. Levels of activity concentration can vary from extremely high, such as levels associated with spent fuel and residues from fuel reprocessing, to very low, for instance those associated with radioisotope applications. Equally broad is the spectrum of half-lives of the radionuclides contained in the waste. These differences result in an equally wide variety of

  17. Current R and D Status on High-Level Radioactive Waste Disposal in Selected Countries

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Youn Myoung; Hwang, Yong Soo

    2008-11-15

    Current R and D status of such countries moving forward as the United States, Sweden, France, Japan and a few other countries for high-level radioactive waste (HLW) disposal in deep geological formation has been reviewed. Even though no HLW repositories have not practically constructed nor operated yet, lots of related R and D are being proceeded in many countries as well as in Korea. Through this brief review further progress is anticipated in this related R and D area in Korea.

  18. Waste management and disposal in Czechoslovakia: Practices and proposals

    International Nuclear Information System (INIS)

    Marek, J.

    1984-01-01

    An overview is presented on the actual practices and planning for the management of radioactive wastes in Czechoslovakia. Types and specific arisings of wastes, applied immobilization processes, and the planning for disposal of reactor wastes are outlined. A comprehensive R and D programme is focussed on the management of reactor wastes, as the spent fuel is returned to the Sovjet Union after a 10 year cooling time. (orig.)

  19. Innovative Disposal Practices at the Nevada Test Site to Meet Its Low-Level Waste Generators' Future Disposal Needs

    International Nuclear Information System (INIS)

    Di Sanza, E.F.; Carilli, J.T.

    2006-01-01

    Waste Acceptance Criteria. The disposal operations previously mentioned take place at the NTS in two disposal facilities. The isolation protection and overall performance of the two LLW disposal facilities at the NTS transcend those of any federal radioactive waste disposal site in the United States. The first of the two disposal sites is the Area 5 Radioactive Waste Management Site (RWMS) which is situated on alluvial fan deposits in the Frenchman Flat basin, approximately 770 feet (235 meters) above the water table. The Area 5 RWMS utilizes a combination of engineered shallow land disposal cells and deep augured shafts for the disposal of a variety of waste streams. Fifteen miles (24 kilometers) north of the Area 5 RWMS is the Area 3 RWMS located approximately 1,600 feet (488 meters) above the water table in Yucca Flat. Disposal activities at the Area 3 RWMS center around the placement of bulk LLW in subsidence craters formed from underground testing of nuclear weapons. Native alluvium soil is used to cover waste placed in the disposal cells at both facilities. In addition, information on the technical attributes, facility performance, updates on waste disposal volumes and capabilities, and current and future disposal site requirements will also be described. (authors)

  20. Current status and new trends in the methodology of safety assessment for near surface disposal facilities

    International Nuclear Information System (INIS)

    Ilie, Petre; Didita, Liana; Danchiv, Alexandru

    2008-01-01

    The main goal of this paper is to present the status of the safety assessment methodology at the end of IAEA CRP 'Application of Safety Assessment Methodology for Near-Surface Radioactive Waste Disposal Facilities (ASAM)', and the new trends outlined at the launch of the follow-up project 'Practical Implementation of Safety Assessment Methodologies in a Context of Safety Case of Near-Surface Facilities (PRISM)'. Over the duration of the ASAM project, the ISAM methodology was confirmed as providing a good framework for conducting safety assessment calculations. In contrast, ASAM project identified the limitations of the ISAM methodology as currently formulated. The major limitations are situated in the area of the use of safety assessment for informing practical decisions about alternative waste and risk management strategies for real disposal sites. As a result of the limitation of the ISAM methodology, the PRISM project is established as an extension of the ISAM and ASAM projects. Based on the outcomes of the ASAM project, the main objective of the PRISM project are: 1 - to develop an overview of what constitutes an adequate safety case and safety assessment with a view to supporting decision making processes; 2 - to provide practical illustrations of how the safety assessment methodology could be used for addressing some specific issues arising from the ASAM project and national cases; 3 - to support harmonization with the IAEA's international safety standards. (authors)

  1. Oil-tanker waste-disposal practices: A review

    International Nuclear Information System (INIS)

    1992-01-01

    In the spring of 1991, the Environmental Protection Agency, Region 10 (EPA), launched an investigation into tanker waste disposal practices for vessels discharging ballast water at the Alyeska Pipeline Services Company's Ballast Water Treatment (BWT) facility and marine terminal in Valdez, Alaska. It had been alleged that the Exxon Shipping Company was transferring 'toxic wastes originating in California' to Valdez. In response, EPA decided to examine all waste streams generated on board and determine what the fate of these wastes were in addition to investigating the Exxon specific charges. An extensive Information Request was generated and sent to the shipping companies that operate vessels transporting Alaska North Slope Crude. Findings included information on cargo and fuel tank washings, cleaning agents, and engine room waste

  2. Phased reversibility under the current French disposal concept

    International Nuclear Information System (INIS)

    Hoorelbeke, J.-M.

    2000-01-01

    The French law of 30 December 1991 and the implementing decrees provide for taking into account the reversibility in the study of geological disposal. This takes place within the framework of a 15 year research program. The research in this field implies both the assessment of technological possibilities for retrieving waste packages safely from the repository and the assessment of the consequence of delaying the closure of the repositories on the long term safety. This research program aims at proposing to the decision makers, by the year 2006, an open range of relevant options with regards to reversibility. (author)

  3. Assessing farmers' practices on disposal of pesticide waste after use

    International Nuclear Information System (INIS)

    Damalas, Christos A.; Telidis, Georgios K.; Thanos, Stavros D.

    2008-01-01

    Common practices of farmers on disposal of pesticide waste after use were surveyed in five regions of the rural area of Pieria in northern Greece using a structured questionnaire administered via personal interviews. Concerning leftover spray solutions, most farmers reported that they normally re-spray the treated field area until the spraying tank is empty (54.9%) or they apply the leftover spray solutions to another crop listed on the product label (30.2%). A minority of the farmers (4.3%) mentioned that they often release the leftover spray solutions near or into irrigation canals and streams. As regards rinsates generated from washing the application equipment, most farmers reported that they release the rinsates over a non-cropped area (45.7%) or they drop the rinsates near or into irrigation canals and streams (40.7%). Moreover, a great proportion of the farmers stated that they dump the empty containers by the field (30.2%) or they throw them near or into irrigation canals and streams (33.3%). Burning the empty containers in open fire (17.9%) or throwing the empty containers in common waste places (11.1%) was also reported. Several farmers stated that they continue to use old pesticides for spraying (35.8%). Training programs which raise awareness of farmers of the potential hazards of pesticide use and particularly of the proper management of waste products, recycling programs and collection systems for unwanted agricultural chemicals to prevent inappropriate waste disposal, as well as improving packaging of pesticides to minimize waste production are essential for promoting safety during all phases of pesticide handling

  4. Perspectives on past and Present Waste Disposal Practices: A community-Based Participatory Research Project in Three Saskatchewan First Nations Communities

    OpenAIRE

    Rebecca Zagozewski; Ian Judd-Henrey; Suzie Nilson; Lalita Bharadwaj

    2011-01-01

    The impact of current and historical waste disposal practices on the environment and human health of Indigenous people in First Nations communities has yet to be adequately addressed. Solid waste disposal has been identified as a major environmental threat to First Nations Communities. A community-based participatory research project (CBPR) was initiated by the Saskatoon Tribal Council Health and Family Services Incorporated to investigate concerns related to waste disposal in three Saskatche...

  5. Perspectives on Past and Present Waste Disposal Practices: A Community-Based Participatory Research Project in Three Saskatchewan First Nations Communities

    OpenAIRE

    Rebecca Zagozewski; Ian Judd-Henrey; Suzie Nilson; Lalita Bharadwaj

    2011-01-01

    The impact of current and historical waste disposal practices on the environment and human health of Indigenous people in First Nations communities has yet to be adequately addressed. Solid waste disposal has been identified as a major environmental threat to First Nations Communities. A community-based participatory research project (CBPR) was initiated by the Saskatoon Tribal Council Health and Family Services Incorporated to investigate concerns related to waste disposal in three Saskatche...

  6. Viral tracer studies indicate contamination of marine waters by sewage disposal practices in key largo, Florida.

    Science.gov (United States)

    Paul, J H; Rose, J B; Brown, J; Shinn, E A; Miller, S; Farrah, S R

    1995-06-01

    Domestic wastewater disposal practices in the Florida Keys are primarily limited to on-site disposal systems such as septic tanks, injection wells, and illegal cesspits. Poorly treated sewage is thus released into the highly porous subsurface Key Largo limestone matrix. To investigate the fate and transport of sewage in the subsurface environment and the potential for contamination of marine surface waters, we employed bacteriophages as tracers in a domestic septic system and a simulated injection well in Key Largo, Florida. Transport of bacteriophage (Phi)HSIC-1 from the septic tank to adjacent surface canal waters and outstanding marine waters occurred in as little as 11 and 23 h, respectively. Transport of the Salmonella phage PRD1 from the simulated injection well to a canal adjacent to the injection site occurred in 11.2 h. Estimated rates of migration of viral tracers ranged from 0.57 to 24.2 m/h, over 500-fold greater than flow rates measured previously by subsurface flow meters in similar environments. These results suggest that current on-site disposal practices can lead to contamination of the subsurface and surface marine waters in the Keys.

  7. Sharps disposal practices among diabetic patients using insulin ...

    African Journals Online (AJOL)

    ... disposal by the dispensing institutions. Patients should also be educated regarding health risks associated with used needles. The South African Metabolic and Endocrine (SEMDSA) Guidelines and the South African Standard Treatment Guidelines (STG) should also give clear guidance on the safe disposal of needles.

  8. Practical and safe implementation of disposal with prefabricated EBS modules

    International Nuclear Information System (INIS)

    Kawamura, Hideki; McKinley, Ian G.; Neall, Fiona B.

    2008-01-01

    The use of prefabricated EBS modules ('PEMs') to minimise the problems involved with handling compacted bentonite and ensuring that it is emplaced to established quality levels has been investigated in various national programmes for disposal of both HLW and SF. To date, however, this has tended to be decoupled from studies of related operational aspects such as assessing / minimising the consequences of use of concrete for support structures, ensuring ease of tele-operated reversal of waste packages during emplacement (e.g. in the event of operational disturbances) / retrieval at a later time, logistical optimisation (especially for programmes with large waste inventories) and cost minimisation. It is clear that specific aspects of operational safety and practicality can be considerably enhanced if designs are modified with a focus on them. It is trickier to provide optimised solutions, which simultaneously address all these critical points. Nevertheless, with a bit of lateral thinking, it appears possible to devise options that may not only ease the operational phase, but may also actually improve post-closure safety case robustness - although improved, more realistic performance assessment codes and databases will be needed to demonstrate this rigorously. To illustrate this approach, an example will be presented based of disposal of vitrified HLW in a fractured hard rock; the general principles involved are, however, also applicable to other higher activity wastes and other host rocks. Key aspects of the design are: Optimisation of PEM design for both short-term and long-term performance; Development of a rail emplacement system which eases remote handled emplacement / recovery; Large diameter, lined emplacement tunnels to ensure operational robustness; Use of multi-package overpacks (e.g. 6 HLW containers in each PEM) and short tunnels to ease emplacement logistics; and Backfilling with a non-swelling sacrificial pH buffer (eases handling and improves

  9. Patients’ Knowledge of and Practices Relating to the Disposal of Used Insulin Needles

    Directory of Open Access Journals (Sweden)

    Kerri T. Musselman, PharmD

    2010-01-01

    Full Text Available Objective: To determine (1 how patients currently dispose of used insulin needles, (2 whether patients were educated about disposal of their used insulin needles, and (3 who educated patients about the disposal of their used insulin needles.Methods: A self-administered questionnaire was designed for this study. The survey assessed patient knowledge about disposal of used insulin needles and the patient-reported source and location of education about disposal techniques. The questionnaire was administered to a convenience sample of patients from four locations in Richmond, Virginia. Any patient who used insulin, was at least 18 years old, and was willing to complete the survey was eligible for inclusion.Results: Fifty responses were received with 40% indicating that education had been received on the disposal of used needles. From that 40%, nurses were identified as the source of education 60% of the time and pharmacists 25% of the time. Approximately 50% of the respondents reported disposing of used needles directly in the trash when at home. While away from home, 22% reported placing used needles in the trash, and 38% took them home for disposal.Conclusion: Patients are not consistently educated regarding the proper disposal of used needles. Health care practitioners should play a larger role in educating patients about the potential risks of inappropriate needle disposal and appropriate disposal methods. Future research is still needed to understand fully the magnitude of the problems associated with inappropriate needle disposal by patients.

  10. Current practices in economic appraisal

    NARCIS (Netherlands)

    Mossink, J.C.M.

    2000-01-01

    By means of economic appraisal, the costs and the benefits of health, environment and safety management can be made clear, both at the national level and at the company level. As such it is a tool in advocating good practices. This paper explores the possibilities of economic appraisal for policy

  11. Perspectives on past and Present Waste Disposal Practices: A community-Based Participatory Research Project in Three Saskatchewan First Nations Communities

    Directory of Open Access Journals (Sweden)

    Rebecca Zagozewski

    2011-01-01

    Full Text Available The impact of current and historical waste disposal practices on the environment and human health of Indigenous people in First Nations communities has yet to be adequately addressed. Solid waste disposal has been identified as a major environmental threat to First Nations Communities. A community-based participatory research project (CBPR was initiated by the Saskatoon Tribal Council Health and Family Services Incorporated to investigate concerns related to waste disposal in three Saskatchewan First Nations Communities. Utilizing a qualitative approach, we aimed to gain an understanding of past and present waste disposal practices and to identify any human and environmental health concerns related to these practices. One to one interviews and sharing circles were conducted with Elders. Elders were asked to share their perspectives on past and present waste disposal practices and to comment on the possible impacts these practices may have on the environment and community health. Historically waste disposal practices were similar among communities. The homeowner generated small volumes of waste, was exclusively responsible for disposal and utilized a backyard pit. Overtime waste disposal evolved to weekly pick-up of un-segregated garbage with waste disposal and open trash burning in a community dump site. Dump site locations and open trash burning were identified as significant health issues related to waste disposal practices in these communities. This research raises issues of inequity in the management of waste in First Nations Communities. It highlights the need for long-term sustainable funding to support community-based waste disposal and management strategies and the development of First Nations centered and delivered educational programs to encourage the adoption and implementation of waste reduction, reutilization and recycling activities in these communities.

  12. Perspectives on past and present waste disposal practices: a community-based participatory research project in three Saskatchewan first nations communities.

    Science.gov (United States)

    Zagozewski, Rebecca; Judd-Henrey, Ian; Nilson, Suzie; Bharadwaj, Lalita

    2011-04-28

    The impact of current and historical waste disposal practices on the environment and human health of Indigenous people in First Nations communities has yet to be adequately addressed. Solid waste disposal has been identified as a major environmental threat to First Nations Communities. A community-based participatory research project (CBPR) was initiated by the Saskatoon Tribal Council Health and Family Services Incorporated to investigate concerns related to waste disposal in three Saskatchewan First Nations Communities. Utilizing a qualitative approach, we aimed to gain an understanding of past and present waste disposal practices and to identify any human and environmental health concerns related to these practices. One to one interviews and sharing circles were conducted with Elders. Elders were asked to share their perspectives on past and present waste disposal practices and to comment on the possible impacts these practices may have on the environment and community health. Historically waste disposal practices were similar among communities. The homeowner generated small volumes of waste, was exclusively responsible for disposal and utilized a backyard pit. Overtime waste disposal evolved to weekly pick-up of un-segregated garbage with waste disposal and open trash burning in a community dump site. Dump site locations and open trash burning were identified as significant health issues related to waste disposal practices in these communities. This research raises issues of inequity in the management of waste in First Nations Communities. It highlights the need for long-term sustainable funding to support community-based waste disposal and management strategies and the development of First Nations centered and delivered educational programs to encourage the adoption and implementation of waste reduction, reutilization and recycling activities in these communities.

  13. A material flow analysis on current electrical and electronic waste disposal from Hong Kong households

    International Nuclear Information System (INIS)

    Lau, Winifred Ka-Yan; Chung, Shan-Shan; Zhang, Chan

    2013-01-01

    Highlights: ► Most household TWARC waste is sold directly to private e-waste collectors in HK. ► The current e-waste recycling network is popular with HK households. ► About 80% of household generated TWARC is exported overseas each year. ► Over 7000 tonnes/yr of household generated TWARC reach landfills. ► It is necessary to upgrade safety and awareness in HK’s e-waste recycling industry. - Abstract: A material flow study on five types of household electrical and electronic equipment, namely television, washing machine, air conditioner, refrigerator and personal computer (TWARC) was conducted to assist the Government of Hong Kong to establish an e-waste take-back system. This study is the first systematic attempt on identifying key TWARC waste disposal outlets and trade practices of key parties involved in Hong Kong. Results from two questionnaire surveys, on local households and private e-waste traders, were used to establish the material flow of household TWARC waste. The study revealed that the majority of obsolete TWARC were sold by households to private e-waste collectors and that the current e-waste collection network is efficient and popular with local households. However, about 65,000 tonnes/yr or 80% of household generated TWARC waste are being exported overseas by private e-waste traders, with some believed to be imported into developing countries where crude recycling methods are practiced. Should Hong Kong establish a formal recycling network with tight regulatory control on imports and exports, the potential risks of current e-waste recycling practices on e-waste recycling workers, local residents and the environment can be greatly reduced

  14. A material flow analysis on current electrical and electronic waste disposal from Hong Kong households

    Energy Technology Data Exchange (ETDEWEB)

    Lau, Winifred Ka-Yan [Department of Biology, Hong Kong Baptist University, Kowloon Tong (Hong Kong); Chung, Shan-Shan, E-mail: sschung@hkbu.edu.hk [Department of Biology, Hong Kong Baptist University, Kowloon Tong (Hong Kong); Zhang, Chan [Department of Biology, Hong Kong Baptist University, Kowloon Tong (Hong Kong)

    2013-03-15

    Highlights: ► Most household TWARC waste is sold directly to private e-waste collectors in HK. ► The current e-waste recycling network is popular with HK households. ► About 80% of household generated TWARC is exported overseas each year. ► Over 7000 tonnes/yr of household generated TWARC reach landfills. ► It is necessary to upgrade safety and awareness in HK’s e-waste recycling industry. - Abstract: A material flow study on five types of household electrical and electronic equipment, namely television, washing machine, air conditioner, refrigerator and personal computer (TWARC) was conducted to assist the Government of Hong Kong to establish an e-waste take-back system. This study is the first systematic attempt on identifying key TWARC waste disposal outlets and trade practices of key parties involved in Hong Kong. Results from two questionnaire surveys, on local households and private e-waste traders, were used to establish the material flow of household TWARC waste. The study revealed that the majority of obsolete TWARC were sold by households to private e-waste collectors and that the current e-waste collection network is efficient and popular with local households. However, about 65,000 tonnes/yr or 80% of household generated TWARC waste are being exported overseas by private e-waste traders, with some believed to be imported into developing countries where crude recycling methods are practiced. Should Hong Kong establish a formal recycling network with tight regulatory control on imports and exports, the potential risks of current e-waste recycling practices on e-waste recycling workers, local residents and the environment can be greatly reduced.

  15. The land disposal of organic materials in radioactive wastes: international practice and regulation

    International Nuclear Information System (INIS)

    Hooper, A.J.

    1988-01-01

    World-wide practice and regulation with regard to organic materials in radioactive wastes for land disposal have been examined with a view to establishing, where possible, their scientific justification and their relevance to disposal of organic-bearing wastes in the UK. (author)

  16. Practical evaluations of low-level waste disposal facilities

    International Nuclear Information System (INIS)

    Rogers, V.C.

    1989-01-01

    In general, there have been about four main tools that have been used to assist in selecting a disposal technology and in evaluating that technology: Legislative direction; Operator selection; Multiattribute utility estimation; and Risk assessment and cost benefit evaluation. The first technique, legislative direction, is an important factor in determining the range of disposal technologies that may be considered. Some host state entities have chosen not to participate in the disposal technology selection, but will let the facility operator propose and defend his preferred facility concept in the license application. Multiattribute utility estimation is a widely used tool for evaluating technologies, particularly in the preliminary stages of selecting a disposal technology when significant technical and institutional information is missing. Many factors, including a range of technical, safety, environmental, societal, political, and economic concerns must be considered in the selection process. Many of these are hard to quantify and not all are of equal importance. Multiattrubute utility estimation allows for these factors to be considered in selecting a technology with incomplete information. This chapter provides description of two analysis techniques: multiattribute utility estimation and cost benefit evaluation. Both can be used to help profile disposal alternatives in relation to specific factors or criteria

  17. The effect of young children's faeces disposal practices on child growth: evidence from 34 countries.

    Science.gov (United States)

    Bauza, Valerie; Guest, Jeremy S

    2017-10-01

    To characterize the relationship between child faeces disposal and child growth in low- and middle-income countries. We analysed caregiver responses and anthropometric data from Demographic and Health Surveys (2005-2014) for 202 614 children under five and 82 949 children under two to examine the association between child faeces disposal and child growth. Child faeces disposal in an improved toilet was associated with reduced stunting for children under five [adjusted prevalence ratio (aPR) = 0.90, 95% confidence interval (CI) 0.89-0.92] and a 0.12 increase in height-for-age z-score (HAZ; 95% CI: 0.10-0.15) among all households. Among households with improved sanitation access, practicing improved child faeces disposal was still associated with a decrease in stunting (aPR = 0.94, 95% CI: 0.91-0.96) and a 0.09 increase in HAZ (95% CI: 0.06-0.13). Improved child faeces disposal was also associated with reductions in underweight and wasting, and an increase in weight-for-age z-score (WAZ), but not an increase in weight-for-height z-score (WHZ). Community coverage level of improved child faeces disposal was also associated with stunting, with 75-100% coverage associated with the greatest reduction in stunting. Child faeces disposal in an unimproved toilet was associated with reductions in underweight and wasting, but not stunting. Improved child faeces disposal practices could achieve greater reductions in child undernutrition than improving toilet access alone. Additionally, the common classification of child faeces disposal as 'safe' regardless of the type of toilet used for disposal may underestimate the benefits of disposal in an improved toilet and overestimate the benefits of disposal in an unimproved toilet. © 2017 John Wiley & Sons Ltd.

  18. Bentonite analogue research related to geological disposal of radioactive waste: current status and future outlook

    Energy Technology Data Exchange (ETDEWEB)

    Reijonen, H.M. [Saanio and Rickkola Oy, Helsinki (Finland); Russel, A.W. [Bedrock Geosciences, Auenstein (Switzerland)

    2015-06-15

    The practice of utilising natural analogues in assessing the long-term behaviour of various components of geological repositories for radioactive waste is already well established in most disposal programmes. Numerous studies on bentonites, focussing on bentonite interaction with other components of the engineered barrier system and a range of host rock environments, are present in the literature. In this article, recent bentonite natural analogue studies are briefly reviewed, and gaps in the current literature identified, with the aim of (1) suggesting where relevant new information could be obtained by data mining published bentonite natural analogue studies with a new focus on current safety case requirements, (2) collecting relevant information by revisiting known bentonite analogue sites and conducting investigations with more appropriate analytical techniques, and (3) identifying novel study sites where, for example, bentonite longevity in very dilute to highly saline groundwater conditions can be studied. It must be noted that the use of natural analogues in safety case development is likely to be site and repository design-specific in nature and thus emphasis is placed on the appropriate use of relevant natural analogue data on bentonite longevity. (authors)

  19. Bentonite analogue research related to geological disposal of radioactive waste: current status and future outlook

    International Nuclear Information System (INIS)

    Reijonen, H.M.; Russel, A.W.

    2015-01-01

    The practice of utilising natural analogues in assessing the long-term behaviour of various components of geological repositories for radioactive waste is already well established in most disposal programmes. Numerous studies on bentonites, focussing on bentonite interaction with other components of the engineered barrier system and a range of host rock environments, are present in the literature. In this article, recent bentonite natural analogue studies are briefly reviewed, and gaps in the current literature identified, with the aim of (1) suggesting where relevant new information could be obtained by data mining published bentonite natural analogue studies with a new focus on current safety case requirements, (2) collecting relevant information by revisiting known bentonite analogue sites and conducting investigations with more appropriate analytical techniques, and (3) identifying novel study sites where, for example, bentonite longevity in very dilute to highly saline groundwater conditions can be studied. It must be noted that the use of natural analogues in safety case development is likely to be site and repository design-specific in nature and thus emphasis is placed on the appropriate use of relevant natural analogue data on bentonite longevity. (authors)

  20. Overview of current chelation practices

    Directory of Open Access Journals (Sweden)

    Y. Aydinok

    2011-12-01

    , should provide long-term survival and quality of life for patients with iron loading anemias. The goal of this review is to summarize current concepts in iron chelation therapies based on the considerable amount of prospective data obtained by clinical studies. 去铁胺 (DFO)是自20世纪80年以来输血引起铁过载的参考标准疗法。 虽然它是一种高效的铁螯合剂,但是去铁胺皮下给药的遵从性问题依旧是主要问题。 口服螯合剂去铁酮(DFP)在北美没有销售许可证,但是,它在1994年获得印度许可,1999年欧洲联盟(EU)批准授予去铁酮销售许可证,特别是当去铁胺不足、无法忍受或无法接受时,去铁酮可用于重型地中海贫血患者。 还可获得关于在6岁至10岁之间的儿童身上使用去铁酮的有限数据,但是没有关于在6岁以下儿童身上使用去铁酮的数据。 随后美国食品和药品管理局(FDA)和欧洲药品管理局(EMA)分别在2005年和2006年批准口服螯合剂去铁酮作为第一疗法来治疗2岁以上输血引起铁过载的患者。 铁螯合的主要目的是将身体铁维持在安全水平,但一旦铁累积起来,铁螯合的目标是把组织铁降低到安全级别,这是一个缓慢的过程。 确定螯合剂的螯合方案、剂量和频率管理的主要依据是身体铁负担、心肌铁的状态和输血铁负载速率。 适当监控螯合对测量特殊方案的反应速率和提供计量调整来加强螯合效果和避免毒效尤其重要。 由于一些因素,诸如:螯合剂的吸收和代谢,螯合方案的效果可能呈现个别变化。 耐受性和遵从性也是影响螯合反应的个别变量。 了解螯合剂的优点和局限性,准确确定铁过载患者的螯合需求以及设计毒效更小但效果更优的个性化螯合方案,可以向铁过载贫血患者提供长期的生存和生活质量。 此次调研的目的是在临床研究获得的相当数

  1. Biomedical waste management in Ayurveda hospitals - current practices & future prospectives.

    Science.gov (United States)

    Rajan, Renju; Robin, Delvin T; M, Vandanarani

    2018-03-16

    Biomedical waste management is an integral part of traditional and contemporary system of health care. The paper focuses on the identification and classification of biomedical wastes in Ayurvedic hospitals, current practices of its management in Ayurveda hospitals and its future prospective. Databases like PubMed (1975-2017 Feb), Scopus (1960-2017), AYUSH Portal, DOAJ, DHARA and Google scholar were searched. We used the medical subject headings 'biomedical waste' and 'health care waste' for identification and classification. The terms 'biomedical waste management', 'health care waste management' alone and combined with 'Ayurveda' or 'Ayurvedic' for current practices and recent advances in the treatment of these wastes were used. We made a humble attempt to categorize the biomedical wastes from Ayurvedic hospitals as the available data about its grouping is very scarce. Proper biomedical waste management is the mainstay of hospital cleanliness, hospital hygiene and maintenance activities. Current disposal techniques adopted for Ayurveda biomedical wastes are - sewage/drains, incineration and land fill. But these methods are having some merits as well as demerits. Our review has identified a number of interesting areas for future research such as the logical application of bioremediation techniques in biomedical waste management and the usage of effective micro-organisms and solar energy in waste disposal. Copyright © 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Published by Elsevier B.V. All rights reserved.

  2. Current status and future plans of R and D on geological disposal of HLW in Japan

    International Nuclear Information System (INIS)

    Sasaki, Noriaki

    1994-01-01

    As to the final disposal of HLW, it is considered highly important to provide a clear distinction between implementation of disposal and the research and development as independent processes, and to increase the transparency of the overall disposal program by defining concrete schedules and the roles and responsibilities of the organizations involved. The Power Reactor and Nuclear Fuel Development Corporation (PNC) has being conducted research and development on the geological disposal of HLW, as the leading organization. The responsibility of PNC is to ensure smooth progress of research and development project and to carry out studies of geological environment. The role of the Japanese government is to take overall responsibilities for appropriate and steady implementations of the program, as well as enacting any laws or policies required. On the other hand, electricity supply utilities are responsible to secure necessary funds for disposal, and in accordance with their role as waste producers, they are expected to cooperate even at the stage of research and development. Fundamental features of research and development of PNC carried out at this stage are as follows; (1) Generic research and development, (2) To establish scientific and technical bases of geological isolation of HLW in Japan, (3) About 15 years program from 1989 with documentation of progress reports, (4) Approach from near-field to far-field. PNC summarized the findings obtained by 1991, and submitted a document (H3 Report) in September 1992 as the first progress report. H3 Report is the first and comprehensive technical report on geological disposal of HLW in Japan, and provides information for the public to find out the current status of the research and development. This paper reviews the conclusions of H3 Report, overall procedures and schedule for implementing geological disposal, and future plans of R and D in PNC. (J.P.N.)

  3. Current safety issues in the development of geological disposal of radioactive waste in France

    International Nuclear Information System (INIS)

    Raimbault, P.

    2002-01-01

    Deep geological disposal of high level and medium level long-lived waste in France is one of the three research paths defined by the law of 30th December 1991 on radioactive waste management. Research should be undertaken on: separation and transmutation of long-lived radionuclides in these waste; reversible or non reversible disposal in deep geological layers supported by investigations in underground laboratories; processes for conditioning and long term surface storage of these waste. In 2006, a global evaluation report on this research should be established by the Government and sent to the French Parliament. On this basis the Parliament should promulgate a law providing new objectives for the research and possibly presenting a framework for a deep disposal process. The French Nuclear Safety Authority has the responsibility to license the underground laboratories foreseen in the second research path and the nuclear facilities involved in the first and third research paths and make sure that existing high level and medium level long-lived waste currently produced are properly managed. It will give its advice on the safety aspects associated to the envisaged future management options. Its main concern is that results obtained in 2006 will be conclusive enough to take decisions for future orientations. Concerning the deep disposal option, under the responsibility of ANDRA (Agence Nationale pour la gestion des Dechets RAdioactifs), the construction of an underground laboratory has been authorized on the Bure site, in eastern France, and the shafts are under construction. The main issue is the level of investigations that may be performed in the host rock in order to support the feasibility study of a disposal concept on this site. Other issues are the elaboration of new safety standards to set a framework for a safety assessment of a disposal concept, the specifications for acceptance of waste packages in a future deep disposal, and relation of safety matters with

  4. Code of practice for the disposal of radioactive waste by the user

    International Nuclear Information System (INIS)

    1985-01-01

    The purpose of the Code is to recommend practices for the Safe disposal of small quantities of radioactive waste so that the exposure of persons to radiation is as low as reasonably achievable and below prescribed limits. The areas covered are: radiological hazard assessments; waste forms; responsibilities of statutory authorities, users and tip and incinerator operators; transport of radioactive waste; mechanisms of disposal, including municipal tips, incineration, sewerage, disposal to the atmosphere and interim storage. Guidelines are given for the packaging and transport of radioactive waste

  5. Disposal practices of unused and expired pharmaceuticals among general public in Kabul

    OpenAIRE

    Bashaar, Mohammadk; Thawani, Vijay; Hassali, Mohamed Azmi; Saleem, Fahad

    2017-01-01

    Abstract Background Most of the medicine users remain unaware about the disposal of unused or expired medicines. The aim of this study was to know the disposal practices of unused and expired medicines among the general public in Kabul. Methods This was a descriptive, cross-sectional survey, conducted through face-to-face interviews using prevalidated structured questionnaire. Returned questionnaires were double-checked for accuracy. Statistical Package for Social Science (SPSS) version 23 wa...

  6. Current waste management practices at PINSTECH

    International Nuclear Information System (INIS)

    Ul Haq, E.; Aslam, M.; Orfi, S.D.

    2002-01-01

    The waste being generated at PINSTECH is of the intermediate and low level Category that is in the form of gas, liquid and solids. It is collected, monitored, segregated, treated, packed and immobilized for its final disposal. Basic concepts of delay decay, disposal and containment of radioactive waste are followed to prevent its direct contact with human and its environment. PINSTECH follows shallow ground disposal in the restricted area. The disposal site has favorable characteristics e.g. sun shine dry climate and high evaporation rate. The gaseous waste is directed towards stack, where it passes through charcoal and HEPA filters and then released to the atmosphere. Post disposal monitoring of the disposal area is performed to check leaching/migration of radionuclides from disposal locations to the surrounding environment. No migration of radioactivity has been detected indicating satisfactory performance of the waste management system. (author)

  7. Current Risk Management Practices in Psychotherapy Supervision.

    Science.gov (United States)

    Mehrtens, Ilayna K; Crapanzano, Kathleen; Tynes, L Lee

    2017-12-01

    Psychotherapy competence is a core skill for psychiatry residents, and psychotherapy supervision is a time-honored approach to teaching this skill. To explore the current supervision practices of psychiatry training programs, a 24-item questionnaire was sent to all program directors of Accreditation Council for Graduate Medical Education (ACGME)-approved adult psychiatry programs. The questionnaire included items regarding adherence to recently proposed therapy supervision practices aimed at reducing potential liability risk. The results suggested that current therapy supervision practices do not include sufficient management of the potential liability involved in therapy supervision. Better protections for patients, residents, supervisors and the institutions would be possible with improved credentialing practices and better documentation of informed consent and supervision policies and procedures. © 2017 American Academy of Psychiatry and the Law.

  8. Current economic trends in equine practice.

    Science.gov (United States)

    Clark, Andrew R

    2009-12-01

    Current economic trends in equine practice are trends of weakness. Most practices, after a decade of double-digit growth, have migrated to survival mode within a few months. Understanding that all regions and disciplines are affected differently, using the Porter five forces model, we can identify changes that must be made in our business models first to survive and then to position ourselves to prosper when the recession ends. If we are to avoid long-term damage to our practices, we must use cost control and work efficiency in addition to price concessions.

  9. KS 2031 Radioactive waste - Disposal by the user - Code of practice

    International Nuclear Information System (INIS)

    Mayaka, Edward E.

    2017-01-01

    Sources of ionizing radiation are widely used in Medicine, Agriculture, Industry, Research and Education, and Security checks. The purpose of this code of practice is to recommend practices which are helpful in achieving the ALARA principle for small quantities of radioactive waste and which will ensure a degree of uniformity in radioactive waste disposal procedures. It has been prepared to supplement the radiation control legislation implemented by the Radiation Protection Board. It is possible to carry out a formal radiological hazard assessment of any proposed radioactive waste disposal activity that provides estimates of the risk to a population that is potentially exposed to ionising radiation as a result of the activity

  10. Principal prerequisites and practice for using deep aquifers for disposal of liquid radioactive wastes

    International Nuclear Information System (INIS)

    Spitsyn, V.I.; Pimenov, M.K.; Balukova, V.D.; Leontichuk, A.S.; Kokorin, I.N.; Yudin, F.P.; Rakov, N.A.

    1977-01-01

    One of the most promising methods of safe disposal of liquid radioactive wastes in the USSR is the creation of storage places in deep aquifers in zones of stagnant regime or the slow exchange of underground water. The results of investigations and disposal practices testify to the safety and efficiency of such a method of final waste disposal which fulfils the main requirements for protecting the environment. Geological formations and stratum-collectors may be studied and selected to secure localization of liquid radioactive wastes injected into them for many tens and even hundreds of thousand years. The main requirements and criteria which must be met by geological structures and stratum-collectors to ensure safe disposal of wastes are formulated. Waste disposal is realized only after a thorough scientific appreciation of health and safety of present and future generations with regard to the regime of disposal and physico-chemical processes depending on the compatibility of the wastes with rocks and stratal waters as well as on the period of time of waste exposure up to the maximum permissible concentrations. Positive and negative factors of the method are analysed. Methods of preparing waste for disposal and chemical methods of restoring the response of the holes, ways of effective remote control of disposal and environment, etc., are briefly discussed. The results of 10-12 years experimental and industrial exploitation of storage places for liquid radioactive wastes of low- and medium-level activity are presented. The results of enlarged field tests on disposal of high-level activity liquid wastes are described. Preliminary prediction calculations are shown to be confirmed with sufficient accuracy by the data on exploitation. (author)

  11. Assessment of knowledge and practices for disposal of unfinished ...

    African Journals Online (AJOL)

    Methods: A cross-sectional survey was conducted in the Municipal involving 409 (186 male and 223 female) conveniently sampled participants visiting major drug ... Results: Household storage was the commonest practice (94.4%) towards unfinished medications while throwing away (3.4%), sharing (1.7%) and selling ...

  12. How Advertising History Helps Explain Current Practices.

    Science.gov (United States)

    Lanfranco, Leonard W.

    Students majoring in advertising can benefit from a study of that field in its historical context because such study helps them to understand current practices and to foresee future developments. One model of teaching advertising history within a required course about advertising and society begins with some basic definitions of the advertising…

  13. Teaching Math Online: Current Practices in Turkey

    Science.gov (United States)

    Akdemir, Omur

    2011-01-01

    Changing nature of student population, developments in technology, and insufficient number of traditional universities have made online courses popular around the globe. This study was designed to investigate the current practices of teaching mathematics online in Turkish Universities through a qualitative inquiry. The snowball sampling method was…

  14. Current status of the Demonstration Test of Underground Cavern-Type Disposal Facilities

    International Nuclear Information System (INIS)

    Akiyama, Yoshihiro; Terada, Kenji; Oda, Nobuaki; Yada, Tsutomu; Nakajima, Takahiro

    2011-01-01

    In Japan, the underground cavern-type disposal facilities for low-level waste (LLW) with relatively high radioactivity, mainly generated from power reactor decommissioning, and for certain transuranic (TRU) waste, mainly from spent fuel reprocessing, are designed to be constructed in a cavern 50-100 m underground and to employ an engineered barrier system (EBS) made of bentonite and cement materials. To advance a disposal feasibility study, the Japanese government commissioned the Demonstration Test of Underground Cavern-Type Disposal Facilities in fiscal year (FY) 2005. Construction of a full-scale mock-up test facility in an actual subsurface environment started in FY 2007. The main test objective is to establish the construction methodology and procedures that ensure the required quality of the EBS on-site. A portion of the facility was constructed by 2010, and the test has demonstrated both the practicability of the construction and the achievement of quality standards: low permeability of less than 5x10 -13 m/s and low-diffusion of less than 1x10 -12 m 2 /s at the completion of construction. This paper covers the test results from the construction of certain parts using bentonite and cement materials. (author)

  15. Patterns and correlates of solid waste disposal practices in Dar es ...

    African Journals Online (AJOL)

    This study examines the patterns and correlations of solid waste disposal practices among households in urbanized and populated Dar es Salaam city in Tanzania. The Tanzanian Household Budget Survey (HBS) data covering many households' characteristics was used. Multinomial Logit (MNL) model was applied to ...

  16. Child feces disposal practices in rural Orissa: a cross sectional study.

    Directory of Open Access Journals (Sweden)

    Fiona Majorin

    Full Text Available BACKGROUND: An estimated 2.5 billion people worldwide lack access to improved sanitation facilities. While large-scale programs in some countries have increased latrine coverage, they sometimes fail to ensure optimal latrine use, including the safe disposal of child feces, a significant source of exposure to fecal pathogens. We undertook a cross-sectional study to explore fecal disposal practices among children in rural Orissa, India in villages where the Government of India's Total Sanitation Campaign had been implemented at least three years prior to the study. METHODS AND FINDINGS: We conducted surveys with heads of 136 households with 145 children under 5 years of age in 20 villages. We describe defecation and feces disposal practices and explore associations between safe disposal and risk factors. Respondents reported that children commonly defecated on the ground, either inside the household (57.5% for pre-ambulatory children or around the compound (55.2% for ambulatory children. Twenty percent of pre-ambulatory children used potties and nappies; the same percentage of ambulatory children defecated in a latrine. While 78.6% of study children came from 106 households with a latrine, less than a quarter (22.8% reported using them for disposal of child feces. Most child feces were deposited with other household waste, both for pre-ambulatory (67.5% and ambulatory (58.1% children. After restricting the analysis to households owning a latrine, the use of a nappy or potty was associated with safe disposal of feces (OR 6.72, 95%CI 1.02-44.38 though due to small sample size the regression could not adjust for confounders. CONCLUSIONS: In the area surveyed, the Total Sanitation Campaign has not led to high levels of safe disposal of child feces. Further research is needed to identify the actual scope of this potential gap in programming, the health risk presented and interventions to minimize any adverse effect.

  17. A review of the justification for exemption orders, and for other low-level radioactive waste disposal practices

    International Nuclear Information System (INIS)

    Sumerling, T.J.; Sweeney, B.J.

    1987-04-01

    The historical background and philosophy underlying the Radioactive Substances Act (RSA) and the system of Authorisation and Exemption is examined and the radiological protection criteria contemporary with the introduction of the RSA and those now current are reviewed. The potential radiological impact (maximum individual doses and collective doses to disposal workers and to members of the public) from ''dustbin limit'' disposals, special precautions burial, disposal of demolition wastes, incineration of H-3 and C-14 and from disposals under each of the current Exemption Orders with waste disposal implications are calculated. (author)

  18. A summary of radiological waste disposal practices in the United States and the United Kingdom - 16379

    International Nuclear Information System (INIS)

    Maranville, Victoria M.; McGrath, Richard

    2009-01-01

    A systematic review of near-surface repositories for radioactive waste in the United States (US) was conducted. The main focus of the review consisted of a literature search of available documents and other published sources on low level radioactive waste (LLRW) disposal practices, remediation of LLRW sites in the US, and public participation for remediation efforts of near-surface radiological waste disposal sites in the US. This review was undertaken to provide background information in support of work by the United Kingdom's (UK) Low Level Waste Repository (LLWR) and to aid in optimizing the future management of this site. The review contained a summary of the US and UK radiological waste classification requirements including a discussion of the waste types, disposal requirements, and the differences between US and UK disposal practices. A regulatory overview and evolution of regulatory requirements in the US is presented. The UK regulatory environment is also discussed and contrasted to the US process. The public participation, as part of the US regulatory process, is provided and the mechanism for stakeholder identification and involvement is detailed. To demonstrate how remediation of radiologically impacted sites is implemented in the US, existing US case studies, in which remediation activities were carried out, were reviewed. The following information was compiled: type of wastes disposed of to US shallow ground facilities [with comparison with UK classifications], facility designs (with special emphasis on those directly comparable to the subsurface conditions in the UK), and deficiencies identified in operation or in demonstrating safe post closure; and processes and difficulties in remedial actions encountered at the selected sites. Stakeholder involvement is discussed within the case studies. Publicly available information related to radiological waste management and disposal practices were reviewed. Two sites are presented in this publication for

  19. Waste reuse and disposal practices in milk production in Paraná

    Directory of Open Access Journals (Sweden)

    Ferenc Istvan Bánkuti

    2012-12-01

    Full Text Available Brazil is among the six largest producers of milk cow in the world. In 2010, Brazilian milk production reached 30.7 billion liters, corresponding to 4.8% of total world production, according to official data from IBGE. As stated by an IPARDES report in 2010, Paraná state has 114,488 milk producers, being responsible for an increased production of 71% between 1997 and 2006. Besides such remarkable figures, there are still important challenges to be surpassed in milk chain, which includes environmental adequation of livestock production. According to a study published by Banco do Brasil Foundation and Interamerican Institute for Agricultural Cooperation – IICA in 2010, social and environmental sustainability are among factors restricting milk chain competitiveness. The aim of this paper is to verify waste reuse and disposal in dairy cattle farming in Paraná. Methodological procedures in this research comprised: (a literature review on milk agribusiness system and environmental adequation; (b formulation of semi-structured questionnaires, including questions about environmental practices in 2011; (c data analysis through descriptive statistics. Random sampling included milk producers in Santa Izabel do Oeste and Marechal Candido Rondon, in southwestern Paraná. Eighty producers were interviewed, equally sampled in both places, resulting in 79 valid interviews. As results, 79.4% of milk producers informed they have day-to-day practices to reuse wastes internally produced in farming. Main practice highlighted was the use of manure waste in agriculture. Only one producer in the sample adopted the use of poultry manure. Considering correct disposal of pesticide packaging, 84.4% of producers are in accordance to legal requirements; 10.1% of total interviewed producers do not follow legal requirement for packaging disposal, and 5% do not use pesticides at all, so not being concerned to that practice. Concerning appropriate disposal of medical

  20. Professional courtesy--current practices and attitudes.

    Science.gov (United States)

    Levy, M A; Arnold, R M; Fine, M J; Kapoor, W N

    1993-11-25

    Physicians have long provided care free of charge or at a reduced rate as a professional courtesy to other physicians and their families. We conducted a stratified national mail survey to assess the extent to which this practice has changed in recent years. Using the American Medical Association's 1991 master list of physicians, we selected a random sample of 4800 practicing physicians from 12 direct-care specialties. These physicians were asked about their current policy and opinions regarding professional courtesy. Of the 2224 respondents, 2127 (96 percent) offered professional courtesy, defined as providing free or discounted health care to physicians and their families. Psychiatrists were less likely to offer professional courtesy than physicians in any of the other specialties (80 percent vs. 91 to 99 percent, P courtesy included billing only the insurance company (75 percent), providing care at no charge (49 percent), and giving a partial discount (23 percent). Twenty-three percent of the respondents reported that they had changed their policy regarding professional courtesy since starting to practice. Among those who had changed their policy, the most common changes were to increase the practice of billing only the insurance company (67 percent) and to provide care at no charge less often (58 percent). The majority of physicians responding to the survey thought that professional courtesy solidified bonds between physicians (79 percent) and was sound business practice (62 percent); 12 percent believed that it was too expensive to offer free or discounted care as a professional courtesy, and 14 percent thought that the practice had negative effects on the physician-patient interaction. Our survey of physicians involved in direct patient care indicates that, with the exception of psychiatrists, almost all American physicians offer free or discounted care as a professional courtesy and support the practice.

  1. Domestic waste disposal practice and perceptions of private sector waste management in urban Accra.

    Science.gov (United States)

    Yoada, Ramatta Massa; Chirawurah, Dennis; Adongo, Philip Baba

    2014-07-08

    Waste poses a threat to public health and the environment if it is not stored, collected, and disposed of properly. The perception of waste as an unwanted material with no intrinsic value has dominated attitudes towards disposal. This study investigates the domestic waste practices, waste disposal, and perceptions about waste and health in an urban community. The study utilised a mixed-method approach. A cross-sectional survey questionnaire and in-depth interview were used to collect data. A total of 364 household heads were interviewed in the survey and six key informants were interviewed with the in-depth interviews. The results of the study revealed that 93.1% of households disposed of food debris as waste and 77.8% disposed of plastic materials as waste. The study also showed that 61.0% of the households disposed of their waste at community bins or had waste picked up at their homes by private contractors. The remaining 39.0% disposed of their waste in gutters, streets, holes and nearby bushes. Of those who paid for the services of private contractors, 62.9% were not satisfied with the services because of their cost and irregular collection. About 83% of the respondents were aware that improper waste management contributes to disease causation; most of the respondents thought that improper waste management could lead to malaria and diarrhoea. There was a general perception that children should be responsible for transporting waste from the households to dumping sites. Proper education of the public, the provision of more communal trash bins, and the collection of waste by private contractors could help prevent exposing the public in municipalities to diseases.

  2. Domestic waste disposal practice and perceptions of private sector waste management in urban Accra

    Science.gov (United States)

    2014-01-01

    Background Waste poses a threat to public health and the environment if it is not stored, collected, and disposed of properly. The perception of waste as an unwanted material with no intrinsic value has dominated attitudes towards disposal. This study investigates the domestic waste practices, waste disposal, and perceptions about waste and health in an urban community. Methods The study utilised a mixed-method approach. A cross-sectional survey questionnaire and in-depth interview were used to collect data. A total of 364 household heads were interviewed in the survey and six key informants were interviewed with the in-depth interviews. Results The results of the study revealed that 93.1% of households disposed of food debris as waste and 77.8% disposed of plastic materials as waste. The study also showed that 61.0% of the households disposed of their waste at community bins or had waste picked up at their homes by private contractors. The remaining 39.0% disposed of their waste in gutters, streets, holes and nearby bushes. Of those who paid for the services of private contractors, 62.9% were not satisfied with the services because of their cost and irregular collection. About 83% of the respondents were aware that improper waste management contributes to disease causation; most of the respondents thought that improper waste management could lead to malaria and diarrhoea. There was a general perception that children should be responsible for transporting waste from the households to dumping sites. Conclusion Proper education of the public, the provision of more communal trash bins, and the collection of waste by private contractors could help prevent exposing the public in municipalities to diseases. PMID:25005728

  3. Siting history and current construction status of disposal facility for low and intermediate level radioactive waste in Korea

    International Nuclear Information System (INIS)

    Sakai, Akihiro; Kikuchi, Saburo; Maruyama, Masakatsu

    2008-01-01

    Korean government decided disposal site for low and intermediate level radioactive waste (LILW), which is located at coastal area near the Wolsong nuclear power plants in Gyeong-Ju city in December. 2005, based on the result of votes of residents in four candidate sites. Since then, Korea Hydro and Nuclear Power Co., Ltd (KHNP), which is the management company of the LILW disposal facility, has carried out the preparation for construction of disposal facility and its licensing process. At the first phase, 100 thousand drums in 200 liter are planned to be disposed of in the rock cavern type disposal facility located at the depth from 80m to 130m below the sea level, and finally 800 thousand drums in 200 liter are planned to be disposed of in the site. This report shows the history of siting for the LILW disposal, the outline of design of disposal facility and current status of its construction, based on the information which was obtained mainly during our visit to the disposal site in Korea. (author)

  4. Radioactive waste sea disposal practices and the need for international regulations

    International Nuclear Information System (INIS)

    Reyners, P.

    1975-01-01

    Radioactive waste is mainly disposed of as liquid releases in coastal waters or as solid wastes dumped in the high seas. The Geneva Convention on the high seas which lays down that Contracting States should not, by unilateral measures, pollute the seas by dumping radioactive wastes, and Article 37 of the Euratom Treaty on the Commission's control over radioactive waste disposal plans by Member States constitute the principal legal basis for such activities at international level. The competent international organisations, IAEA and the OECD Nuclear Energy Agency (NEA), have both made detailed studies on the scientific, technical and legal aspects of sea disposal of radioactive wastes. Following consideration of the possibilities of waste dumping in the Atlantic and the related hazard assessment, at its Member State's request, NEA in 1967 undertook an initial experimental packaged waste disposal operation in the high seas. This operation's technical success encouraged Member States to undertake further operations in subsequent years under NEA international control. At present, in view of the entry into force of the London Convention on prevention of marine pollution by dumping of wastes, it seems desirable that the international character of such operations be preserved and all countries concerned be encouraged to adopt an international code of practice for sea disposal of radioactive wastes [fr

  5. Thai pediatricians' current practice toward childhood asthma.

    Science.gov (United States)

    Kamalaporn, Harutai; Chawalitdamrong, Pongpan; Preutthipan, Aroonwan

    2018-04-01

    Childhood asthma is a substantial health burden in Thailand. Due to a lack of pediatric respiratory specialists (pediatric pulmonologists and allergists; RS), most Thai children are cared for by general pediatricians (pediatric primary care providers (PCP)). We investigated whether current practices of Thai pediatricians complied with asthma guidelines and compared practices (diagnosis and treatments) provided by PCP and RS. A cross-sectional study was conducted using electronic surveys including four case scenarios of different asthma phenotypes distributed to Thai pediatricians. Asthma diagnosis and management were evaluated for compliance with standard guidelines. The practices of PCP and RS were compared. From 800 surveys distributed, there were 405 respondents (51%). Most respondents (81%) were PCP, who preferred to use clinical diagnosis rather than laboratory investigations to diagnose asthma. For acute asthmatic attacks, 58% of the pediatricians prescribed a systemic corticosteroid. For uncontrolled asthma, 89% of the pediatricians prescribed at least one controller. For exercise-induced bronchospasm, 55% of the pediatricians chose an inhaled bronchodilator, while 38% chose a leukotriene receptor antagonist (LTRA). For virus-induced wheeze, 40% of the respondents chose an LTRA, while 15% chose inhaled corticosteroids (ICS). PCP prescribed more oral bronchodilators (31% vs. 18%, p = 0.02), antibiotics (20% vs. 6%, p attack. Most of the Thai pediatricians' practices toward diagnosis and treatment of acute asthmatic attack and uncontrolled asthma conform to the guidelines. PCP prescribed more oral bronchodilators, antibiotics, and antihistamines than RS.

  6. Knowledge, attitude, and practices on usage, disposal, and effect of plastic bags on sheep and goats.

    Science.gov (United States)

    Otsyina, H R; Nguhiu-Mwangi, J; Mogoa, E G M; Mbuthia, P G; Ogara, W O

    2018-02-08

    The objective of this study was to evaluate knowledge, attitudes, and practices of people in the Nairobi and Kajiado Counties, Kenya, on the usage, disposal, and effect of plastic waste on sheep and goats (shoats). A semi-structured questionnaire was used to collect data from 384 respondents in four communities in the two counties. Most of the people irrespective of their age, occupation, and educational status used plastic bags of some type on a daily basis. A high proportion of the respondents (37.0%, 142) used plastic bags because of the low cost. Approximately, 79.1% (304) disposed used plastic bags in open dumps. A total of 147 (38.3%) households kept shoats. Out of these, 38.1% (56) purchased feed and also allowed their animals to roam. Most of them (45.3%, 174) thought that lack of feed for the animals was the main reason why shoats roam and scavenge at refuse dump sites and road sides. A large proportion of the respondents (44.5%, 143) mentioned death of animals as the ultimate consequence of ingestion of waste plastic bags. Though, the respondents were aware that indiscriminate disposal of used plastic bags could result in death of the animals from which they derive their livelihoods, they nevertheless continued with the practice. There is a need for a paradigm shift in the way and manner plastic bags are used and disposed.

  7. Disposal practices of unused and expired pharmaceuticals among general public in Kabul

    Directory of Open Access Journals (Sweden)

    Mohammad Bashaar

    2017-01-01

    Full Text Available Abstract Background Most of the medicine users remain unaware about the disposal of unused or expired medicines. The aim of this study was to know the disposal practices of unused and expired medicines among the general public in Kabul. Methods This was a descriptive, cross-sectional survey, conducted through face-to-face interviews using prevalidated structured questionnaire. Returned questionnaires were double-checked for accuracy. Statistical Package for Social Science (SPSS version 23 was used for statistical analysis. Results Total of 301 valid questionnaires were returned with a response rate of 100% in which 73.4% men and 26.6% women participated. More than half of the respondents were university graduates. Interestingly, 83.4% of the interviewees purchased medicines on the prescription of which 47.2% were university graduates, while 14.6% purchased medicine over the counter. Among the respondents, 46.5/100 purchased antibiotics and the remaining purchased NSAIDs, anti-hypertensive and anti-diabetic medicines. Significantly, 97/100 checked the expiry date of medicine before buying. Majority (95.3% of the respondents’ stored medicines at home. 77.7% of the respondents discarded the expired medicines in household trash. Majority of respondents held government responsible for creation of awareness for proper medicine disposal. Almost entire sample (98% felt that improper disposal of unused and expired medicines can affect the environment and health. Conclusion Gaps exist in practices, therefore robust, safe and cost-effective pharmaceutical waste management program supported with media campaign is needed. Healthcare practitioners and community pharmacists should offer training to educate customers on standard medicine disposal practices.

  8. Disposal practices of unused and expired pharmaceuticals among general public in Kabul.

    Science.gov (United States)

    Bashaar, Mohammad; Thawani, Vijay; Hassali, Mohamed Azmi; Saleem, Fahad

    2017-01-07

    Most of the medicine users remain unaware about the disposal of unused or expired medicines. The aim of this study was to know the disposal practices of unused and expired medicines among the general public in Kabul. This was a descriptive, cross-sectional survey, conducted through face-to-face interviews using prevalidated structured questionnaire. Returned questionnaires were double-checked for accuracy. Statistical Package for Social Science (SPSS) version 23 was used for statistical analysis. Total of 301 valid questionnaires were returned with a response rate of 100% in which 73.4% men and 26.6% women participated. More than half of the respondents were university graduates. Interestingly, 83.4% of the interviewees purchased medicines on the prescription of which 47.2% were university graduates, while 14.6% purchased medicine over the counter. Among the respondents, 46.5/100 purchased antibiotics and the remaining purchased NSAIDs, anti-hypertensive and anti-diabetic medicines. Significantly, 97/100 checked the expiry date of medicine before buying. Majority (95.3%) of the respondents' stored medicines at home. 77.7% of the respondents discarded the expired medicines in household trash. Majority of respondents held government responsible for creation of awareness for proper medicine disposal. Almost entire sample (98%) felt that improper disposal of unused and expired medicines can affect the environment and health. Gaps exist in practices, therefore robust, safe and cost-effective pharmaceutical waste management program supported with media campaign is needed. Healthcare practitioners and community pharmacists should offer training to educate customers on standard medicine disposal practices.

  9. Current status of regional hydrogeological studies and numerical simulations on geological disposal

    International Nuclear Information System (INIS)

    Nakao, Shinsuke; Kikuchi, Tsuneo; Ishido, Tsuneo

    2004-01-01

    Current status of regional hydrogeological studies on geological disposal including hydrogeological modeling using numerical simulators is reviewed in this report. A regional scale and boundary conditions of numerical models are summarized mainly from the results of the RHS (regional hydrogeological study) project conducted by Japan Nuclear Cycle Development Institute (JNC) in the Tono area. We also refer to the current conceptual modes of hydrology and numerical models of unsaturated zone flow at Yucca Mountain, Nevada, which is the arid site proposed for consideration as the United States' first underground high-level radioactive waste repository. Understanding behavior of a freshwater-saltwater transition zone seems to play a key role in the hydrogeological modeling in a coastal region. Technical features of a numerical simulator as a tool for geothermal reservoir modeling is also briefly described. (author)

  10. Knowledge and practices about hospital waste disposal and universal safety precautions in class IV employee.

    Science.gov (United States)

    Megha, Khobragade; Daksha, Pandit

    2013-01-01

    Norms and guidelines are formed for safe disposal of hospital waste but question is whether these guidelines are being followed and if so, to what extent. Hence, this study was conducted with objective to study the knowledge and practices about hospital waste disposal and universal safety precautions in class IV employee and to study its relationship with education, occupation and training. A cross-sectional study was carried out in a teaching hospital in Mumbai using semi-structured questionnaire in which Class IV employee were included. Questionnaire was filled by face to face interview. Data were analyzed using SPSS. 48.7% Class IV employee were not trained. More than 40% were following correct practices about disinfection of infectious waste. None of the respondents were using protective footwear while handling hospital waste. Only 25.5% were vaccinated for hepatitis B. 16% had done HIV testing due to contact with blood, body fluid, needle stick injury. Knowledge and practices about hospital waste disposal and universal precaution were statistically significant in trained respondents. Training of employees should be given top priority; those already in service should be given on the job training at the earliest.

  11. Statutory compliance in assets disposal practices in the public sector: Evidence from Ghana

    Directory of Open Access Journals (Sweden)

    Oswald Atiga

    2015-03-01

    Full Text Available Background: This article examined the unserviceable assets disposal practices of five polytechnics (tertiary educational institutions in Ghana. Objectives: The aim was to determine the extent of statutory compliance, and the degree to which value for money was achieved in actual disposal. Method: A survey was conducted using interviewer-administered questionnaires containing five-point likert scale test items. Descriptive statistics and a one-way analysis of variance (ANOVA were employed to analyse the data. Results: The study results showed that a limited number of polytechnics had internal policies to operationalise statutory procurement legislation. Top management demonstrated very clear understanding of procurement legislation whilst senior-level managers displayed mixed levels of understanding. The section of the legislation dealing with disposals and the procedures pertaining thereto is perceived to be difficult to implement and does not promote value for money. Top management’s interference in auctions was the toughest challenge in the process, whilst public auction was the predominant method used in assets disposal. Research limitations: The research was carried out in only five polytechnics. This study could be replicated in other tertiary institutions or in other sectors outside higher education.

  12. Current practices and options for confinement of uranium mill tailings

    International Nuclear Information System (INIS)

    1981-01-01

    At the United Nations Conference on the Human Environment, which took place in Stockholm from 4 to 6 June 1972, national governments were asked to explore, with the International Atomic Energy Agency and other appropriate international organizations, international co-operation on radioactive waste matters including those of mining and tailings disposal. Since that time the IAEA has been active in the field of uranium and thorium mill tailings management. As part of this activity, the present report describes current practices and options for confinement of uranium mill tailings. It is addressed to technical and administrative personnel who are involved in planning and implementing national and industrial programmes on the management of such tailings. In 1974 and 1975 the IAEA convened meetings of experts to review matters of interest and importance in the management of uranium and thorium mine and mill tailings. These activities led to the publication in 1976 of Management of Wastes from the Mining and Milling of Uranium and Thorium Ores, a Code of Practice and Guide to the Code, IAEA Safety Series No. 44. As a continuation of this activity, the IAEA is here dealing more specifically with the design and siting considerations for the management of uranium mill tailings

  13. Current practice in transvenous lead extraction

    DEFF Research Database (Denmark)

    Bongiorni, Maria Grazia; Blomström-Lundqvist, Carina; Kennergren, Charles

    2012-01-01

    AIM: Current practice with regard to transvenous lead extraction among European implanting centres was analysed by this survey. METHODS AND RESULTS: Among all contacted centres, 164, from 30 countries, declared that they perform transvenous lead extraction and answered 58 questions...... with a compliance rate of 99.9%. Data from the survey show that there seems to be an overall increasing experience of managing various techniques of lead extraction and a widespread involvement of cardiac centres in this treatment. Results and complication rates seem comparable with those of main international...... registries. CONCLUSION: This survey gives an interesting snapshot of lead extraction in Europe today and gives some clues for future research and prospective European registries....

  14. Massive transfusion protocols: current best practice

    Directory of Open Access Journals (Sweden)

    Hsu YM

    2016-03-01

    Full Text Available Yen-Michael S Hsu,1 Thorsten Haas,2 Melissa M Cushing1 1Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA; 2Department of Anesthesia, University Children's Hospital Zurich, Zurich, Switzerland Abstract: Massive transfusion protocols (MTPs are established to provide rapid blood replacement in a setting of severe hemorrhage. Early optimal blood transfusion is essential to sustain organ perfusion and oxygenation. There are many variables to consider when establishing an MTP, and studies have prospectively evaluated different scenarios and patient populations to establish the best practices to attain improved patient outcomes. The establishment and utilization of an optimal MTP is challenging given the ever-changing patient status during resuscitation efforts. Much of the MTP literature comes from the trauma population, due to the fact that massive hemorrhage is the leading cause of preventable trauma-related death. As we come to further understand the positive and negative clinical impacts of transfusion-related factors, massive transfusion practice can be further refined. This article will first discuss specific MTPs targeting different patient populations and current relevant international guidelines. Then, we will examine a wide selection of therapeutic products to support MTPs, including newly available products and the most suitable of the traditional products. Lastly, we will discuss the best design for an MTP, including ratio-based MTPs and MTPs based on the use of point-of-care coagulation diagnostic tools. Keywords: hemorrhage, MTP, antifibrinolytics, coagulopathy, trauma, ratio, logistics, guidelines, hemostatic

  15. Low-level radioactive waste disposal in the United States: An overview of current commercial regulations and concepts

    International Nuclear Information System (INIS)

    Kennedy, W.E. Jr.

    1993-08-01

    Commercial low-level radioactive waste disposal in the United States is regulated by the US Nuclear Regulatory Commission (NRC) under 10 CFR 61 (1991). This regulation was issued in 1981 after a lengthy and thorough development process that considered the radionuclide concentrations and characteristics associated with commercial low-level radioactive waste streams; alternatives for waste classification; alternative technologies for low-level radioactive waste disposal; and data, modeling, and scenario analyses. The development process also included the publication of both draft and final environmental impact statements. The final regulation describes the general provisions; licenses; performance objectives; technical requirements for land disposal; financial assurances; participation by state governments and Indian tribes; and records, reports, tests, and inspections. This paper provides an overview of, and tutorial on, current commercial low-level radioactive waste disposal regulations in the United States

  16. Current obstetrical practice and umbilical cord prolapse.

    Science.gov (United States)

    Usta, I M; Mercer, B M; Sibai, B M

    1999-01-01

    The aim of this study was to assess the contribution of current obstetrical practice to the occurrence and complications of umbilical cord prolapse. Maternal and neonatal charts of 87 pregnancies complicated by true umbilical cord prolapse during a 5-year period were reviewed. Twin gestation and noncephalic presentations were common features (14 and 41%, respectively). Eighty-nine percent (77) of infants were delivered by cesarean section of which 29% were classical and 88% were primary. The mean gestational age at delivery was 34.0 +/- 6.0 weeks, and the mean birth weight was 2318 +/- 1159 g. Obstetrical intervention preceded 41 (47%) cases (the obstetrical intervention group): amniotomy (9), scalp electrode application (4), intrauterine pressure catheter insertion (6), attempted external cephalic version (7), expectant management of preterm premature rupture of membranes (14), manual rotation of the fetal head (1), and amnioreduction (1). There were 11 perinatal deaths. Thirty-three percent of the infants (32) had a 5-min Apgar score < 7 and 34% had a cord pH < 7.20. Neonatal seizures, intracerebral hemorrhage, necrotizing enterocolitis, hyaline membrane disease, persistent fetal circulation, sepsis, assisted ventilation, and perinatal mortality were comparable in the "obstetrical intervention" and "no-intervention" groups. Most of the neonatal complications occurred in infants < 32 weeks' gestation. We conclude that obstetrical intervention contributes to 47% of umbilical cord prolapse cases; however, it does not increase the associated perinatal morbidity and mortality.

  17. Verification and validation for waste disposal models

    International Nuclear Information System (INIS)

    1987-07-01

    A set of evaluation criteria has been developed to assess the suitability of current verification and validation techniques for waste disposal methods. A survey of current practices and techniques was undertaken and evaluated using these criteria with the items most relevant to waste disposal models being identified. Recommendations regarding the most suitable verification and validation practices for nuclear waste disposal modelling software have been made

  18. Lessons to be learned from radioactive waste disposal practices for non-radioactive hazardous waste management

    International Nuclear Information System (INIS)

    Merz, E.R.

    1991-01-01

    The criteria to be set up for any kind of hazardous waste disposal must always be put in perspective: 1. what are the waste characteristics? 2. what time period for safe isolation is of interest? 3. which geological disposal alternatives exist? Different approaches may be used in the short- and long-term perspective. In either case, a general procedure is recommended which involves concentrating, containing and isolating the source of toxicity, both radioactive and chemotoxic substances, as far as practicable. Waste characterization of either chemotoxic or radioactive wastes should be performed applying comparable scientifically based principles. The important question which arises is whether their hazard potential can be quantified on the basis of dose comparison regarding the morbidity effects of radiation and of chemical pollutants. Good control over the consequences of hazardous waste disposal requires threat detailed criteria for tolerable contamination of radioactive as well as chemical pollutants should be established, and that compliance with these criteria can be demonstrated. As yet, there are no well developed principles for assessing the detriment from most types of genotoxic waste other than radioactive material. The time horizon discussed for both categories of waste for their proof of safe isolation differs by a factor of about one hundred. (au)

  19. Disposal of disused sealed sources and approach for safety assessment of near surface disposal facilities (national practice of Ukraine)

    International Nuclear Information System (INIS)

    Alekseeva, Z.; Letuchy, A.; Tkachenko, N.V.

    2003-01-01

    The main sources of wastes are 13 units of nuclear power plants under operation at 4 NPP sites (operational wastes and spent sealed sources), uranium-mining industry, area of Chernobyl exclusion zone contaminated as a result of ChNPP accident, and over 8000 small users of sources of ionising radiation in different fields of scientific, medical and industrial applications. The management of spent sources is carried out basing on the technology from the early sixties. In accordance with this scheme accepted sources are disposed of either in the near surface concrete vaults or in borehole facilities of typical design. Radioisotope devices and gamma units are placed into near surface vaults and sealed sources in capsules into borehole repositories respectively. Isotope content of radwaste in the repositories is multifarious including Co-60, Cs-137, Sr-90, Ir-192, Tl-204, Po-210, Ra-226, Pu-239, Am-241, H-3, Cf-252. A new programme for waste management has been adopted. It envisions the modifying of the 'Radon' facilities for long-term storage safety assessment and relocation of respective types of waste in 'Vector' repositories.Vector Complex will be built in the site which is located within the exclusion zone 10Km SW of the Chernobyl NPP. In Vector Complex two types of disposal facilities are designed to be in operation: 1) Near surface repositories for short lived LLRW and ILRW disposal in reinforced concrete containers. Repositories will be provided with multi layer waterproofing barriers - concrete slab on layer composed of mixture of sand and clay. Every layer of radwaste is supposed to be filled with 1cm clay layer following disposal; 2) Repositories for disposal of bulky radioactive waste without cans into concrete vaults. Approaches to safety assessment are discussed. Safety criteria for waste disposal in near surface repositories are established in Radiation Protection Standards (NRBU-97) and Addendum 'Radiation protection against sources of potential exposure

  20. 21 CFR 225.1 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Current good manufacturing practice. 225.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS General Provisions § 225.1 Current good manufacturing practice. (a) Section 501(a)(2)(B) of the Federal Food, Drug, and Cosmetic Act...

  1. 21 CFR 110.5 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 110.5 Section...) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD General Provisions § 110.5 Current good manufacturing practice. (a) The criteria and...

  2. 21 CFR 1271.150 - Current good tissue practice requirements.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Current good tissue practice requirements. 1271... HUMAN CELLS, TISSUES, AND CELLULAR AND TISSUE-BASED PRODUCTS Current Good Tissue Practice § 1271.150 Current good tissue practice requirements. (a) General. This subpart D and subpart C of this part set...

  3. 21 CFR 226.1 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Current good manufacturing practice. 226.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR TYPE A MEDICATED ARTICLES General Provisions § 226.1 Current good manufacturing practice. (a) The criteria in §§ 226.10 through 226.115, inclusive...

  4. Impact of Construction Waste Disposal Charging Scheme on work practices at construction sites in Hong Kong.

    Science.gov (United States)

    Yu, Ann T W; Poon, C S; Wong, Agnes; Yip, Robin; Jaillon, Lara

    2013-01-01

    Waste management in the building industry in Hong Kong has become an important environmental issue. Particularly, an increasing amount of construction and demolition (C&D) waste is being disposed at landfill sites. In order to reduce waste generation and encourage reuse and recycling, the Hong Kong Government has implemented the Construction Waste Disposal Charging Scheme (CWDCS) to levy charges on C&D waste disposal to landfills. In order to provide information on the changes in reducing waste generation practice among construction participants in various work trades, a study was conducted after 3 years of implementation of the CWDCS via a structured questionnaire survey in the building industry in Hong Kong. The study result has revealed changes with work flows of the major trades as well as differentiating the levels of waste reduced. Three building projects in the public and private sectors were selected as case studies to demonstrate the changes in work flows and the reduction of waste achieved. The research findings reveal that a significant reduction of construction waste was achieved at the first 3 years (2006-2008) of CWDCS implementation. However, the reduction cannot be sustained. The major trades have been influenced to a certain extent by the implementation of the CWDCS. Slight improvement in waste management practices was observed, but reduction of construction waste in the wet-finishing and dry-finishing trades has undergone little improvement. Implementation of the CWDCS has not yet motivated subcontractors to change their methods of construction so as to reduce C&D waste. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Impact of Construction Waste Disposal Charging Scheme on work practices at construction sites in Hong Kong

    International Nuclear Information System (INIS)

    Yu, Ann T.W.; Poon, C.S.; Wong, Agnes; Yip, Robin; Jaillon, Lara

    2013-01-01

    Highlights: ► A significant reduction of construction waste was achieved at the first 3 years of CWDCS implementation. ► However, the reduction cannot be sustained. ► Implementation of the CWDCS has generated positive effects in waste reduction by all main trades. - Abstract: Waste management in the building industry in Hong Kong has become an important environmental issue. Particularly, an increasing amount of construction and demolition (C and D) waste is being disposed at landfill sites. In order to reduce waste generation and encourage reuse and recycling, the Hong Kong Government has implemented the Construction Waste Disposal Charging Scheme (CWDCS) to levy charges on C and D waste disposal to landfills. In order to provide information on the changes in reducing waste generation practice among construction participants in various work trades, a study was conducted after 3 years of implementation of the CWDCS via a structured questionnaire survey in the building industry in Hong Kong. The study result has revealed changes with work flows of the major trades as well as differentiating the levels of waste reduced. Three building projects in the public and private sectors were selected as case studies to demonstrate the changes in work flows and the reduction of waste achieved. The research findings reveal that a significant reduction of construction waste was achieved at the first 3 years (2006–2008) of CWDCS implementation. However, the reduction cannot be sustained. The major trades have been influenced to a certain extent by the implementation of the CWDCS. Slight improvement in waste management practices was observed, but reduction of construction waste in the wet-finishing and dry-finishing trades has undergone little improvement. Implementation of the CWDCS has not yet motivated subcontractors to change their methods of construction so as to reduce C and D waste.

  6. Impact of Construction Waste Disposal Charging Scheme on work practices at construction sites in Hong Kong

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Ann T.W., E-mail: bsannyu@polyu.edu.hk [Department of Building and Real Estate, The Hong Kong Polytechnic University, Hung Hom, Kowloon (Hong Kong); Poon, C.S.; Wong, Agnes; Yip, Robin; Jaillon, Lara [Department of Civil and Structural Engineering, Hong Kong Polytechnic University, Hung Hom, Kowloon (Hong Kong)

    2013-01-15

    Highlights: Black-Right-Pointing-Pointer A significant reduction of construction waste was achieved at the first 3 years of CWDCS implementation. Black-Right-Pointing-Pointer However, the reduction cannot be sustained. Black-Right-Pointing-Pointer Implementation of the CWDCS has generated positive effects in waste reduction by all main trades. - Abstract: Waste management in the building industry in Hong Kong has become an important environmental issue. Particularly, an increasing amount of construction and demolition (C and D) waste is being disposed at landfill sites. In order to reduce waste generation and encourage reuse and recycling, the Hong Kong Government has implemented the Construction Waste Disposal Charging Scheme (CWDCS) to levy charges on C and D waste disposal to landfills. In order to provide information on the changes in reducing waste generation practice among construction participants in various work trades, a study was conducted after 3 years of implementation of the CWDCS via a structured questionnaire survey in the building industry in Hong Kong. The study result has revealed changes with work flows of the major trades as well as differentiating the levels of waste reduced. Three building projects in the public and private sectors were selected as case studies to demonstrate the changes in work flows and the reduction of waste achieved. The research findings reveal that a significant reduction of construction waste was achieved at the first 3 years (2006-2008) of CWDCS implementation. However, the reduction cannot be sustained. The major trades have been influenced to a certain extent by the implementation of the CWDCS. Slight improvement in waste management practices was observed, but reduction of construction waste in the wet-finishing and dry-finishing trades has undergone little improvement. Implementation of the CWDCS has not yet motivated subcontractors to change their methods of construction so as to reduce C and D waste.

  7. Ultimate disposal of radioactive waste in the FRG - current progress of projects and perspectives

    International Nuclear Information System (INIS)

    Roesel, H.

    1989-01-01

    In the Federal Republic of Germany, the state is responsible for providing for the ultimate disposal of radioactive waste, whereas the cost is borne by the waste producing establishments. The Federal Ministry for the Environment, Nature Conservation and Reactor Safety, (BMU), as the competent state authority has delegated its responsibilities in this matter to the Physikalisch-Technische Bundesanstalt (PTB). The PTB is allowed to have work done by third parties. For this purpose, the Deutsche Gesellschaft zum Bau und Betrieb von Endlagern fuer Abfallstoffe mbH (DBE) has been founded, which since 1979 is investigating the Gorleben salt dome for suitability to serve as a repository for all type of solid, radioactive waste. The final decisions on site approval can be taken after completion of the underground exploration work, which according to current schedules is expected to be achieved at the end of the 1990s. The other candidate site, the Konrad mine, has been investigated by the GSF in the years 1976 to 1982, and on August 31, 1982 the PTB has filed an application to institute the plan approval procedure for the Konrad mine to be prepared to serve as a waste repository. The plan is expected to be laid open in the first half of 1989, and hearings possibly be held in the second half. In case of plan approval, the site preparation will probably take 3 years, so that the Konrad mine will be ready to receive radioactive waste by the year 1993. (orig.) [de

  8. Determining ''Best Practicable Environmental Options'' for final waste disposal of radioactive waste

    International Nuclear Information System (INIS)

    Smith, Graham

    1999-01-01

    This presentation discusses some ideas on what the Best Practical Environmental Option (BPEO) process should include. A BPEO study to help develop a radioactive waste management strategy should not only look at post-closure safety of a facility. In the UK there was a 1986 Study of BPEOs for management of low and intermediate level radioactive wastes. This study tried to answer important questions such as (1) What are the practical options, (2) Which wastes should go to shallow burial, (3) Which wastes should go to sea disposal, (4) How does storage compare with disposal and (5) What are the cost and environmental trade-offs. The presentation discusses what was done to answer the questions. The BPEO Study resulted in major improved effort to characterise waste, much greater quantitative understanding of where and when the real costs, and environmental and radiological impacts arise. All options would be useful within a national strategy. But there was clearly a need for resolution of political acceptance problems, integration of policy with other hazardous waste management, and stronger legal framework

  9. Current construction status of Korea Wolsong Nuclear Environment Management Center (low and intermediate level radioactive waste disposal facility)

    International Nuclear Information System (INIS)

    Suzuki, Yasuo

    2010-01-01

    Through the RANDEC delegation tour to Korea in Nov. 2009, we have earned new information on recent development of the radioactive waste management in Korea. In this report, we will introduce such development in Korea, focusing on the current construction status of Korean LILW (low and intermediate level radioactive waste) disposal site, now called, Wolsong Nuclear Environment Management Center. (author)

  10. Current researches on safety assessment of radioactive waste disposal in the United States

    International Nuclear Information System (INIS)

    Tasaka, Hiroshi; Kiyose, Ryohei

    1980-01-01

    Recently, the problem of safe disposal of radioactive waste generated from nuclear fuel cycle becomes more important in Japan. On the other hand, many researches on shallow land burial of low-level wastes and geologic isolation of high-level wastes have been carried out in the United States of America. In this report, the researches on the safety assessment of radioactive waste disposal in the United States of America were briefly introduced with emphasis on the studies on behavior and migration of radionuclide from disposed waste in geosphere. (author)

  11. Minipool Caprylic Acid Fractionation of Plasma Using Disposable Equipment: A Practical Method to Enhance Immunoglobulin Supply in Developing Countries

    Science.gov (United States)

    El-Ekiaby, Magdy; Vargas, Mariángela; Sayed, Makram; Gorgy, George; Goubran, Hadi; Radosevic, Mirjana; Burnouf, Thierry

    2015-01-01

    Background Immunoglobulin G (IgG) is an essential plasma-derived medicine that is lacking in developing countries. IgG shortages leave immunodeficient patients without treatment, exposing them to devastating recurrent infections from local pathogens. A simple and practical method for producing IgG from normal or convalescent plasma collected in developing countries is needed to provide better, faster access to IgG for patients in need. Methodology/Principal Findings IgG was purified from 10 consecutive minipools of 20 plasma donations collected in Egypt using single-use equipment. Plasma donations in their collection bags were subjected to 5%-pH5.5 caprylic acid treatment for 90 min at 31°C, and centrifuged to remove the precipitate. Supernatants were pooled, then dialyzed and concentrated using a commercial disposable hemodialyzer. The final preparation was filtered online by gravity, aseptically dispensed into storage transfusion bags, and frozen at 5 logs reduction of HIV, BVDV, and PRV infectivity in less than 15 min of caprylic acid treatment. Conclusions/Significance 90% pure, virally-inactivated immunoglobulins can be prepared from plasma minipools using simple disposable equipment and bag systems. This easy-to-implement process could be used to produce immunoglobulins from local plasma in developing countries to treat immunodeficient patients. It is also relevant for preparing hyperimmune IgG from convalescent plasma during infectious outbreaks such as the current Ebola virus episode. PMID:25719558

  12. Minipool caprylic acid fractionation of plasma using disposable equipment: a practical method to enhance immunoglobulin supply in developing countries.

    Directory of Open Access Journals (Sweden)

    Magdy El-Ekiaby

    2015-02-01

    Full Text Available Immunoglobulin G (IgG is an essential plasma-derived medicine that is lacking in developing countries. IgG shortages leave immunodeficient patients without treatment, exposing them to devastating recurrent infections from local pathogens. A simple and practical method for producing IgG from normal or convalescent plasma collected in developing countries is needed to provide better, faster access to IgG for patients in need.IgG was purified from 10 consecutive minipools of 20 plasma donations collected in Egypt using single-use equipment. Plasma donations in their collection bags were subjected to 5%-pH5.5 caprylic acid treatment for 90 min at 31°C, and centrifuged to remove the precipitate. Supernatants were pooled, then dialyzed and concentrated using a commercial disposable hemodialyzer. The final preparation was filtered online by gravity, aseptically dispensed into storage transfusion bags, and frozen at 5 logs reduction of HIV, BVDV, and PRV infectivity in less than 15 min of caprylic acid treatment.90% pure, virally-inactivated immunoglobulins can be prepared from plasma minipools using simple disposable equipment and bag systems. This easy-to-implement process could be used to produce immunoglobulins from local plasma in developing countries to treat immunodeficient patients. It is also relevant for preparing hyperimmune IgG from convalescent plasma during infectious outbreaks such as the current Ebola virus episode.

  13. The Evolution of Low-Level Radioactive Waste (LLW) Disposal Practices at the Savannah River Site Coupled with Vigorous Stakeholder Interaction

    International Nuclear Information System (INIS)

    Goldston, W. T.; Wilhite, E. L.; Cook, J. R.; Sauls, V. W.

    2002-01-01

    Low-level radioactive waste (LLW) disposal practices at SRS evolved from trench disposal with little long-term performance basis to disposal in robust concrete vaults, again without modeling long-term performance. Now, based on an assessment of long-term performance of various waste forms and methods of disposal, the LLW disposal program allows for a ''smorgasbord'' of various disposal techniques and waste forms, all modeled to ensure long-term performance is understood. New disposal techniques include components-in-grout, compaction/volume reduction prior to disposal, and trench disposal of extremely low activity waste. Additionally, factoring partition coefficient (Kd) measurements based on waste forms has been factored into performance models. This paper will trace the development of the different disposal methods, and the extensive public communications effort that resulted in endorsement of the changes by the SRS Citizens Advisory Board

  14. Unused Medications Disposal Practice: The case of Patients Visiting University of Gondar Specialized Teaching Hospital, Gondar, Ethiopia

    OpenAIRE

    Tadele Atinafu; Abayneh Takele; Adeladlew Kassie; Adane Yehualaw; Getu Tesfaw; Tesfanesh Desseno; Tadesse Mekonnen; Mulugeta Fentie

    2014-01-01

    Background: The disposal of unwanted medications has been a concern in many countries, as pharmaceutical waste enters the ecosystem, ultimately having an effect on human health and environment. The main objective of this study was to assess unused medications disposal practice of patients Method: Institution based cross sectional study was used. Patients were systematically selected and interviewed using structured questionnaires. The Data was analyzed using SPSS version 20. Result: Out of...

  15. Direct disposal of spent nuclear fuel. The current status of technology January 1987

    International Nuclear Information System (INIS)

    Wheelton, I.S.; Kelly, B.R.; Wood, E.

    1987-02-01

    The Study assesses the degree and status of research and development worldwide on Direct Disposal of Spent Nuclear Fuel. It is limited to technological, radiological and waste management aspects appertaining to Light Water and AGR Reactor Systems and reviews the 'State of the Art' in terms of applicability to the United Kingdom. The report concludes that much technology exists both at National and International level which the UK can apply to the subject of Direct Disposal. (author)

  16. 21 CFR 120.5 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 120.5 Section... Provisions § 120.5 Current good manufacturing practice. Part 110 of this chapter applies in determining whether the facilities, methods, practices, and controls used to process juice are safe, and whether the...

  17. 21 CFR 129.1 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 129.1 Section... Current good manufacturing practice. The applicable criteria in part 110 of this chapter, as well as the..., methods, practices, and controls used in the processing, bottling, holding, and shipping of bottled...

  18. 21 CFR 113.5 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 113.5 Section... CONTAINERS General Provisions § 113.5 Current good manufacturing practice. The criteria in §§ 113.10, 113.40..., methods, practices, and controls used by the commercial processor in the manufacture, processing, or...

  19. Current operating practices of nuclear insurance pools

    International Nuclear Information System (INIS)

    O'Connell, J.M.

    1993-01-01

    This paper discusses the nuclear pooling system and co-operation between the pools, present practice and capacity, with a breakdown of the limits for third party liability and material damage. The author also describes the relationship between the pools and the nuclear operators (the policyholders), and concludes that the nuclear pools have been successful in serving the interests of their member companies, their policyholders and the governments as they have provided a stable insurance market by making available capacity in amounts that had never before been assembled and placed at risk in a single location. 2 tabs

  20. The current regulatory requirements on optimisation and BAT in Sweden in the context of geological disposal

    International Nuclear Information System (INIS)

    Dverstorp, B.

    2010-01-01

    Bjorn Dverstorp, Swedish Radiation Safety authority (SSM) presented 'The current regulatory requirements on optimisation and BAT in Sweden in the context of geological disposal'. In Sweden, a nuclear waste repository will be evaluated according to both to general environmental legislation (the Environmental Code, SFS, 1998:808) and according to more specific requirements in the Act on Nuclear Activities (SFS, 1984:3) and the Radiation Protection Act (SFS, 1988:220). The evaluations according to these laws will be carried out according to two separate, but coordinated, legal-review and decision-making processes. This will be a basis for the siting process. Although the requirements on BAT and siting in the Environmental Code apply to radiological protection, they aim at a broader system optimisation. The more specific requirements on optimisation and BAT of radiological protection of geological disposal systems are given in the regulations associated with the Radiation Protection Act. The Swedish radiation protection regulations (SSM, 2009) comprise three corner stones: a risk target, environmental protection goals and the use of optimisation and BAT. In SSM' s guidance optimisation is defined as a means to reduce risk, guided by the results of risk calculations. In case of a conflict between BAT and optimisation, measures satisfying BAT should have priority. Application of optimisation and BAT on different timescales are described as well as for human intrusion scenarios. B. Dverstorp explained that because of uncertainties in the long term there is a need for additional arguments in the safety case in support of decision making. It is in this context that the requirements on optimisation and BAT should be seen as supplementary to the risk target, in providing evidence that the developer has taken into consideration, as far as reasonably possible, measures and options for reducing future doses and risks. Both principles focus on the proponent's work on developing

  1. Evaluating Current Practices in Shelf Life Estimation.

    Science.gov (United States)

    Capen, Robert; Christopher, David; Forenzo, Patrick; Huynh-Ba, Kim; LeBlond, David; Liu, Oscar; O'Neill, John; Patterson, Nate; Quinlan, Michelle; Rajagopalan, Radhika; Schwenke, James; Stroup, Walter

    2018-02-01

    The current International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) methods for determining the supported shelf life of a drug product, described in ICH guidance documents Q1A and Q1E, are evaluated in this paper. To support this evaluation, an industry data set is used which is comprised of 26 individual stability batches of a common drug product where most batches are measured over a 24 month storage period. Using randomly sampled sets of 3 or 6 batches from the industry data set, the current ICH methods are assessed from three perspectives. First, the distributional properties of the supported shelf lives are summarized and compared to the distributional properties of the true shelf lives associated with the industry data set, assuming the industry data set represents a finite population of drug product batches for discussion purposes. Second, the results of the ICH "poolability" tests for model selection are summarized and the separate shelf life distributions from the possible alternative models are compared. Finally, the ICH methods are evaluated in terms of their ability to manage risk. Shelf life estimates that are too long result in an unacceptable percentage of nonconforming batches at expiry while those that are too short put the manufacturer at risk of possibly having to prematurely discard safe and efficacious drug product. Based on the analysis of the industry data set, the ICH-recommended approach did not produce supported shelf lives that effectively managed risk. Alternative approaches are required.

  2. Current pharmacotherapies for obesity: A practical perspective.

    Science.gov (United States)

    Golden, Angela

    2017-10-01

    To review the currently available pharmacotherapies for obesity management with a particular focus on the United States. Narrative review based on literature searches and the latest prescribing information (up to July 2017). Obesity pharmacotherapies may assist those individuals who have obesity, or overweight with comorbidities, who have failed to maintain weight loss with lifestyle modifications alone (caloric restriction and increased physical activity). Currently approved options in the United States include phentermine for short-term use and five obesity pharmacotherapies that can be used long-term (orlistat, lorcaserin, phentermine-topiramate, naltrexone-bupropion, and liraglutide 3.0 mg). If the use of an obesity pharmacotherapy is indicated, treatment should be selected to provide the most appropriate option for each individual and their circumstances. Variables such as contraindications, individual comorbidities, patient choice, patient readiness to incorporate additional behavioral changes (e.g., alcohol prohibition), and cost should guide choices. Each of the obesity pharmacotherapies has advantages and disadvantages that can help guide treatment choice. Those receiving treatment may also have individual preferences based on factors such as administration route, frequency of dosing, and/or safety profile. In addition, some options may be particularly appropriate for patients with common obesity-related complications such as depression or diabetes. ©2017 American Association of Nurse Practitioners.

  3. Current status of radioactive waste disposal in Japan and foreign countries

    International Nuclear Information System (INIS)

    Yamamoto, Masahumi; Inagaki, Yusuke; Kurata, Mitsuyuki; Tanabe, Hiromi

    2002-01-01

    Various kinds of wastes are generated from operation and decommissioning of nuclear facilities such as a nuclear power plant, a reprocessing plant and so on. These wastes contain radionuclides and are called 'Radioactive Waste'. The radionuclides in the wastes vary considerably in amount from small to large and their half-lives differ in length from short-lived to long-lived. The safety principle for radioactive waste management is to prevent human beings and the environment from receiving radiation exposure over the level which the safety authority in each country approve based on the recommendations by international organizations such as the International Commission on Radiation Protection (ICRP). To assure the conformity to this safety principle, each country has examined the safety measures to dispose of radioactive wastes on the basis of their own condition. For example, high-level radioactive waste (H LW) from reprocessing plant or spent fuel designated as waste and intermediate-and low-level long-lived radioactive wastes, which contain large quantity of long-lived radionuclides, will be disposed of into a deep stable geological formation. The intermediate-and low-level short-lived radioactive wastes, which mainly contain short-lived radionuclides with limited quantity of long-lived radionuclides, have been disposed of in a controlled surface disposal facility or in a rock cavern in the depth of 50-100 m. Clearance level has been considered to be applied for the wastes, which contain very small amount of radionuclides and those wastes bellow clearance level will cause negligible hazards only even without taking any radiation control measures. Such wastes could be reused, recycled or disposed of in the same manner as general wastes from the industries, etc. (author)

  4. Psychological assessment for bariatric surgery: current practices.

    Science.gov (United States)

    Flores, Carolina Aita

    2014-01-01

    The prevalence of obesity on a global scale has alarmed health institutions, the general population and professionals involved in its treatment. Bariatric surgery has emerged as an effective and lasting alternative for weight reduction and improved general health. In this context and as part of a multidisciplinary team, psychologists are responsible for the preoperative psychological assessment of bariatric candidates. To investigate how psychological assessments are occurring, including the identification of utilized resources; factors that are addressed; the duration of the process; existing protocols; and to evaluate the importance of this practice. A systematic review of national and international literature, through PubMed and Scielo's databases, using "psychological assessment", "obesity" and "surgery", as keywords. There is an agreement about the main factors that should be investigated during the preoperative assessment, as well as the main contraindications for the surgical procedure. The importance of the psychological assessment is well established in the field of bariatric surgery. However, this area needs a standard protocol to guide the mental health professionals that deal with bariatric patients.

  5. Footwear in rock climbing: Current practice.

    Science.gov (United States)

    McHenry, R D; Arnold, G P; Wang, W; Abboud, R J

    2015-09-01

    Many rock climbers wear ill-fitting and excessively tight footwear during activity. However, there is insufficient evidence of the extent or harms of this practice. To investigate footwear use in rock climbers with a focus on issues surrounding fit. A cross-sectional study with active rock climbers of over one year of experience completing a survey on their activity and footwear. Additionally, the authors quantified foot and shoe lengths and sizes alongside demographic data. Ill-fitting and excessively tight footwear was found in 55 out of 56 rock climbers. Foot pain during activity was also commonplace in 91% of the climbers. A mean size reduction of almost 4 UK shoe sizes was found between the climbers' street shoe size and that of their climbing footwear using a calibrated foot/shoe ruler. There is an unfortunate association of climbers of higher abilities seeking a tighter shoe fit (pfootwear use amongst rock climbers, further investigation may aim to quantify its impact and seek a solution balancing climbing performance while mitigating foot injury. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Topical steroids in the current clinical practice

    Directory of Open Access Journals (Sweden)

    T. A. Belousova

    2014-01-01

    Full Text Available The article discusses issues related to current criteria for selection of glucocorticosteroids for external use as the basic therapy for a great number of allergic and inflammatory skin diseases. The authors emphasize that non-fluorinated GCSs having the best efficacy-to-safety ratio must be the drugs of first choice. The article provides data on a positive clinical experience of using a non-halogenated glucocorticosteroid for external use - hydrocortisone 17-butyrate (Laticort - for treatment of steroid-sensitive dermatoses in children and adults. The drug has a high anti-inflammatory action and minimum risk of the development of side effects, which is sufficient for using it in sensitive areas of skin (face, neck, folds, genitals both in children and in adults. The availability of three forms of the drug (solution, cream and ointment ensures the expedience and convenience of its application at any stage of the inflammatory process and for any localization.

  7. Disposal of Iodine-129

    International Nuclear Information System (INIS)

    Morgan, M.T.; Moore, J.G.; Devaney, H.E.; Rogers, G.C.; Williams, C.; Newman, E.

    1978-01-01

    One of the problems to be solved in the nuclear waste management field is the disposal of radioactive iodine-129, which is one of the more volatile and long-lived fission products. Studies have shown that fission products can be fixed in concrete for permanent disposal. Current studies have demonstrated that practical cementitious grouts may contain up to 18% iodine as barium iodate. The waste disposal criterion is based on the fact that harmful effects to present or future generations can be avoided by isolation and/or dilution. Long-term isolation is effective in deep, dry repositories; however, since penetration by water is possible, although unlikely, release was calculated based on leach rates into water. Further considerations have indicated that sea disposal on or in the ocean floor may be a more acceptable alternative

  8. 21 CFR 123.5 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 123.5 Section...) FOOD FOR HUMAN CONSUMPTION FISH AND FISHERY PRODUCTS General Provisions § 123.5 Current good manufacturing practice. (a) Part 110 of this chapter applies in determining whether the facilities, methods...

  9. Current practice in paediatric basic life support

    Directory of Open Access Journals (Sweden)

    Heczková Jana

    2017-06-01

    Full Text Available Introduction. Although the incidence of cardiac arrest in children is much lower than in adults, the condition is still considered a major health problem with a very low chance for survival. As in adults, the timely provision of cardiopulmonary resuscitation (CPR in children is crucial. Current guidelines for CPR in children were published along with the guidelines for CPR in adults in 2015. As in previous years, they are based on consensus provided by International Liaison Committee on Resuscitation (ILCOR. Guidelines of particular ILCOR member councils may vary and reflect regional characteristic such as different access to health care, education methods or willingness of population to provide emergency assistance. Moreover, the conditions requiring CPR in children are characterized not only by different incidence, but also by aetiology or techniques used for different age groups. Therefore, emphasis is put on simplicity and feasibility as well as on consistency with adult guidelines to improve retention of the paediatric sequences. Nurses may be first rescuers not only in health care facilities. Better understanding of CPR guidelines might help them to improve their ability to detect conditions requiring CRP and also initiate and provide effective emergency care.

  10. Telehealth: current practices and future directions

    Science.gov (United States)

    David, Yadin B.

    1996-02-01

    When we review the positive impact that the integration of ostensibly independent patient-care services have on the efficient management of quality care, education, and collaborative research, it is not surprising that telehealth deployment is on the rise. The forces that drive this phenomenon include: the need to manage the entire disease episode; the desire for wider geographically-distributed quality health care; the escalation of customer expectations; globalization of healthcare and its support services; an increase in patient and provider convenience; and the acceptance of the present technological community. At the Telehealth Center at the Texas Children's Hospital, current classifications of clinical applications are listed: (1) initial urgent evaluation of patients, (2) triage decisions and pretransfer arrangements, (3) medical and surgical follow-up and medication review, (4) consultation for primary care encounters, (5) real-time subspecialty care consultation and planning, (6) management of chronic diseases and conditions, (7) extended diagnostic work-ups, (8) review of diagnostic images, and (9) preventive medicine and patient education. The delivery of such services is associated with challenges and opportunities. As we move forward from limited data processing to an integrated communication system, from centralized main frame functions to personalized and location-independent workstations, and from hospitals to clinics and homecare, an increase in the minimum features provided by the equipment and the communication systems must accompany the widening variety of clinical applications. Future expansion of telehealth systems stands to revolutionize the delivery of services to the benefits of providers' networks, our economy, and patients through integration.

  11. Environmental stewardship practices of veterinary professionals and educators related to use and disposal of pharmaceuticals and personal care products.

    Science.gov (United States)

    Lam, Jennifer; Chan, Samuel S; Conway, Flaxen D L; Stone, David

    2018-03-01

    OBJECTIVE To document the environmental stewardship practices (decisions and actions regarding use and disposal) of pet and human pharmaceuticals and personal care products (PPCPs) among pet-owning veterinary-care professionals (practicing veterinarians, veterinary students, and veterinary technicians and trainees) and environmental educators. DESIGN Internet-based cross-sectional survey. SAMPLE 191 pet owners (103 veterinary-care professionals and 88 environmental educators). PROCEDURES Study participants were recruited by means of a 2-part internet survey distributed to veterinary-care professional and environmental educator networks of individuals residing in Washington state, Oregon, and southern California. Survey questions addressed motivators for environmental stewardship practices (ie, decisions and actions regarding use and disposal of pet and human PPCPs). RESULTS Data were collected from 191 respondents; the response rate for individuals who self-selected to opt in was 78% (191/246). Of the 191 respondents, 42 (22%) stored pet pharmaceuticals indefinitely. The most common disposal method was the garbage (88/191 [46%]). Veterinary-care professionals counseled clients infrequently regarding environmental stewardship practices for PPCPs. Fifty-five percent (105/191) of all respondents preferred more environmentally friendly and clinically effective PPCPs. CONCLUSIONS AND CLINICAL RELEVANCE Results of the present survey emphasized the urgent need for improved educational resources to minimize environmental contamination from improper disposal of PPCPs. Environmental and economic motivations among pet owners in the veterinary-care and education professions indicate further opportunities for outreach and institutional support.

  12. Unreviewed Disposal Question Evaluation: Impact of New Information since 2008 PA on Current Low-Level Solid Waste Operations

    Energy Technology Data Exchange (ETDEWEB)

    Flach, G.; Smith, F.; Hamm, L.; Butcher, T.

    2014-10-06

    Solid low-level waste disposal operations are controlled in part by an E-Area Low-Level Waste Facility (ELLWF) Performance Assessment (PA) that was completed by the Savannah River National Laboratory (SRNL) in 2008 (WSRC 2008). Since this baseline analysis, new information pertinent to disposal operations has been identified as a natural outcome of ongoing PA maintenance activities and continuous improvement in model simulation techniques (Flach 2013). An Unreviewed Disposal Question (UDQ) Screening (Attachment 1) has been initiated regarding the continued ability of the ELLWF to meet Department of Energy (DOE) Order 435.1 performance objectives in light of new PA items and data identified since completion of the original UDQ Evaluation (UDQE). The present UDQE assesses the ability of Solid Waste (SW) to meet performance objectives by estimating the influence of new information items on a recent sum-of-fractions (SOF) snapshot for each currently active E-Area low-level waste disposal unit. A final SOF, as impacted by this new information, is projected based on the assumptions that the current disposal limits, Waste Information Tracking System (WITS) administrative controls, and waste stream composition remain unchanged through disposal unit operational closure (Year 2025). Revision 1 of this UDQE addresses the following new PA items and data identified since completion of the original UDQE report in 2013: New Kd values for iodine, radium and uranium; Elimination of cellulose degradation product (CDP) factors; Updated radionuclide data; Changes in transport behavior of mobile radionuclides; Potential delay in interim closure beyond 2025; and Component-in-grout (CIG) plume interaction correction. Consideration of new information relative to the 2008 PA baseline generally indicates greater confidence that PA performance objectives will be met than indicated by current SOF metrics. For SLIT9, the previous prohibition of non-crushable containers in revision 0

  13. Aptamer therapeutics: A review of current practice

    International Nuclear Information System (INIS)

    Perkins, A.C.; Missailidis, S.

    2007-01-01

    meet the criteria for robust, generic drug discovery technology and open new horizons for the development of future radiopharmaceuticals. We have shown that aptamers directed against the MUC1 antigen, a tumour marker previously extensively used in tumour imaging and therapy, demonstrated high specificity and uniform penetration in tumour xenografts. The future strategy will be to manipulate the molecular weight of the molecules to achieve an optimum balance between the low immunogenicity and excellent tumour penetration for diagnostic imaging and targeted therapy. In this way, a balance can be achieved between the rapid renal clearance and adequate tumour uptake required for diagnostic imaging and targeted therapy. The current work and future prospects for aptamer therapeutics will be described. (author)

  14. Overview of current and alternative slaughter practices

    Directory of Open Access Journals (Sweden)

    Troeger K.

    2004-01-01

    Full Text Available The conventional cattle slaughtering process includes some critical stages where a dissemination of Specified Risk Material (SRM: brain, spinal cord within or onto the carcass and within the slaughterhouse environment can occur. These processes are captive bolt stunning, removal of the head and first of all carcass splitting (sawing the spine lengthways. Captive bolt (CB stunning results in massive brain tissue damage with bleeding, and in some cases brain tissue also emerges from the CB hole. As the heart is still functioning, there is a risk of brain tissue particles being transferred v i a the blood flow to heart and lungs or even in the whole carcass. This contamination risk is actually assessed to be low, but a continuing leakage of Central Nervous System (CNS material from the captive bolt aperture in the further slaughter process may lead to direct and indirect contamination of carcass, meat and equipment. Therefore alternative stunning methods like electrical stunning or concussion stunning are discussed. A further critical point is the treatment of the head. When the head is removed, the spinal cord is cut with a knife. There is a danger of cross contamination due to spinal protein that may adhere to the knife and because of liquid cerebralis, which leaks from the foramen occipitale magnum. Further head cleaning with hand-held hoses following skinning also includes the danger of cross contamination from cleaning water or aerosol. Therefore measures regarding the safe handling of head and harvesting of head meat are proposed. The most critical point in terms of contamination of the meat surface with SRM is the currently common practise of sawing the spine vertically in the middle with hand-guided belt-type saws. A m i x t u r e of sawing residues and rinsing water (“sawing sludge” collects in the housing of the saw, and if it contains infectious material this leads to contamination of the subsequent carcasses. The most promising

  15. Current status of spent fuel disposal program in Taiwan, Republic of China

    International Nuclear Information System (INIS)

    Soong, K.L.; Liu, S.J.

    1989-01-01

    In the year of 1988, Taiwan has completed a two-year preliminary study and began in late 1988 a second term for the final disposal of spent fuel program. The research conducted in the first phase was mainly concentrated on the reviews of international studies and domestic geological literatures, set-up of siting criteria, and pertinent engineering analysis of a repository. Taiwan is an area of complex and unstable geological structures, abundant ground water and high density of population. Favorable host rocks under consideration for permanent waste disposal are thick shales and mudstones, metamorphosed rocks of mesozoic basement, solidified quartzite and mesozoic granitic gneiss. The analysis of heat transfer for hypothetical case studies indicate that the temperature rises in the repository systems would be well below the proposed maximum admissible temperatures. The repository size would be less than 2 km 2 when appropriate period for surface storage of spent fuel is satisfied. A probabilistic risk analysis also demonstrates that the presence of faulting and other tectonic instabilities characterize Taiwan's disadvantages for geological disposal of nuclear waste

  16. Current status of radiation safety of disposal facility in the Republic of Moldova and measures of its improvement

    International Nuclear Information System (INIS)

    Zaharia, G.

    2000-01-01

    The infrastructure and waste management safety in the Republic of Moldova is presented. The current situation in the waste disposal facility is described. The radioactive waste inventory shows a total activity of 16.4 TBq. The radiological survey of soils at the CRWDF show a significant increase of the contamination by 226 Ra and 90 Sr at depths 3 - 5.5 m, considered as an accidental situation provoked by the disintegration of the facility protective walls. Measures for the prevention of further contamination and ground water are discussed. Construction of a new radioactive waste shallow land disposal facility on the site combined with some engineering improvements of the site is considered the best solution. Some problems of the waste management in the country are presented

  17. Cavern disposal concepts for HLW/SF: assuring operational practicality and safety with maximum programme flexibility

    International Nuclear Information System (INIS)

    McKinley, Ian G.; Apted, Mick; Umeki, Hiroyuki; Kawamura, Hideki

    2008-01-01

    Most conventional engineered barrier system (EBS) designs for HLW/SF repositories are based on concepts developed in the 1970s and 1980s that assured feasibility with high margins of safety, in order to convince national decision makers to proceed with geological disposal despite technological uncertainties. In the interval since the advent of such 'feasibility designs', significant progress has been made in reducing technological uncertainties, which has lead to a growing awareness of other, equally important uncertainties in operational implementation and challenges regarding social acceptance in many new, emerging national repository programs. As indicated by the NUMO repository concept catalogue study (NUMO, 2004), there are advantages in reassessing how previous designs can be modified and optimised in the light of improved system understanding, allowing a robust EBS to be flexibly implemented to meet nation-specific and site-specific conditions. Full-scale emplacement demonstrations, particularly those carried out underground, have highlighted many of the practical issues to be addressed; e.g., handling of compacted bentonite in humid conditions, use of concrete for support infrastructure, remote handling of heavy radioactive packages in confined conditions, quality inspection, monitoring / ease of retrieval of emplaced packages and institutional control. The CAvern REtrievable (CARE) concept reduces or avoids such issues by emplacement of HLW or SF within multi-purpose transportation / storage / disposal casks in large ventilated caverns at a depth of several hundred metres. The facility allows the caverns to serve as inspectable stores for an extended period of time (up to a few hundred years) until a decision is made to close them. At this point the caverns are backfilled and sealed as a final repository, effectively with the same safety case components as conventional 'feasibility designs'. In terms of operational practicality an d safety, the CARE

  18. Current practices of construction waste reduction through 3R practice among contractors in malaysia: Case study in penang

    Science.gov (United States)

    Ng, L. S.; Tan, L. W.; Seow, T. W.

    2017-11-01

    The effectiveness of the implementation of construction waste reduction through 3R reflects the sustainability in construction waste management. Weak implementation of construction waste reduction through 3R among contractors will lead to unsustainable construction waste management. Increase in construction waste on landfills is critical especially on islands where land is very limited for solid waste disposal. This aim of this paper is to investigate current practice of construction waste reduction through 3R practice among contractors in Penang, Malaysia. The findings reported herein is based on feedbacks from 143 construction contractors of grade CIDB G7, G6 and G5 in Penang and experts from Penang Local Authority, CIDB in Penang and its Headquarters, National Solid Waste Management Department, and Headquarters of Solid Waste and Public Cleansing Management Corporation. Interviews and questionnaire surveys have been found that 3R practice is not mandatory in construction waste management in Penang. Only 39.8% construction contractors practiced 3R in managing their waste. Therefore, 3R practices should be emphasized in construction industry. Reducing wastes through 3R practices in construction industry is a way forward towards sustainable construction waste management especially in expanding the lifetime of landfill.

  19. Directions in low-level radioactive waste management. Low level-radioactive waste disposal: currently operating commercial facilities

    International Nuclear Information System (INIS)

    1983-09-01

    This publication discusses three commercial facilities that receive and dispose of low-level radioactive waste. The facilities are located in Barnwell, South Carolina; Beatty, Nevada; and Richland, Washington. All three facilities initiated operations in the 1960s. The three facilities have operated without such major problems as those which led to the closure of three other commercial disposal facilities located in the United States. The Beatty site could be closed in 1983 as a result of a Nevada Board of Health ruling that renewal of the site license would be inimical to public health and safety. The site remains open pending federal and state court hearings, which began in January 1983, to resolve the Board of Health ruling. The three sites may also be affected by NRC's 10 CFR Part 61 regulations, but the impact of those regulations, issued in December 1982, has not yet been assessed. This document provides detailed information on the history and current status of each facility. This information is intended, primarily, to assist state officials - executive, legislative, and agency - in planning for, establishing, and managing low-level waste disposal facilities. 12 references

  20. KS 20322007 Near-Surface Disposal Radioactive Waste - Code Of Practice

    International Nuclear Information System (INIS)

    Omondi, C.

    2017-01-01

    To provide a basis for the near-surface disposal of solid radioactive waste to ensures that there is no unacceptable risk to humans, other biota or the environment. Near-Surface Disposal is the disposal of radioactive waste in below or above the natural ground surface, within app. 30 m. The code deals with management aspects associated with radioactive waste disposal only, and is not intended to cover issues related to the production and use of radionuclides. The objective of waste disposal is to isolate radioactive waste in order to ensure that there is no unacceptable health risk to humans and no long-term unacceptable effect to the environment. Radiation protection annual effective dose for exposure of members of the public should not exceed 1 mSv/year and occupational exposure of 20 mSv/year

  1. Frequency of unsafe storage, use, and disposal practices of opioids among cancer patients presenting to the emergency department.

    Science.gov (United States)

    Silvestre, Julio; Reddy, Akhila; de la Cruz, Maxine; Wu, Jimin; Liu, Diane; Bruera, Eduardo; Todd, Knox H

    2017-12-01

    Approximately 75% of prescription opioid abusers obtain the drug from an acquaintance, which may be a consequence of improper opioid storage, use, disposal, and lack of patient education. We aimed to determine the opioid storage, use, and disposal patterns in patients presenting to the emergency department (ED) of a comprehensive cancer center. We surveyed 113 patients receiving opioids for at least 2 months upon presenting to the ED and collected information regarding opioid use, storage, and disposal. Unsafe storage was defined as storing opioids in plain sight, and unsafe use was defined as sharing or losing opioids. The median age was 53 years, 55% were female, 64% were white, and 86% had advanced cancer. Of those surveyed, 36% stored opioids in plain sight, 53% kept them hidden but unlocked, and only 15% locked their opioids. However, 73% agreed that they would use a lockbox if given one. Patients who reported that others had asked them for their pain medications (p = 0.004) and those who would use a lockbox if given one (p = 0.019) were more likely to keep them locked. Some 13 patients (12%) used opioids unsafely by either sharing (5%) or losing (8%) them. Patients who reported being prescribed more pain pills than required (p = 0.032) were more likely to practice unsafe use. Most (78%) were unaware of proper opioid disposal methods, 6% believed they were prescribed more medication than required, and 67% had unused opioids at home. Only 13% previously received education about safe disposal of opioids. Overall, 77% (87) of patients reported unsafe storage, unsafe use, or possessed unused opioids at home. Many cancer patients presenting to the ED improperly and unsafely store, use, or dispose of opioids, thus highlighting a need to investigate the impact of patient education on such practices.

  2. Approaches to LLW disposal site selection and current progress of host states

    International Nuclear Information System (INIS)

    Walsh, J.J.; Kerr, T.A.

    1990-11-01

    In accordance with the Low-Level Radioactive Waste Policy Amendments Act of 1985 and under the guidance of 10 CFR 61, States have begun entering into compacts to establish and operate regional disposal facilities for low-level radioactive waste. The progress a state makes in implementing a process to identify a specific location for a disposal site is one indication of the level of a state's commitment to meeting its responsibilities under Federal law and interstate compact agreements. During the past few years, several States have been engaged in site selection processes. The purpose of this report is to summarize the site selection approaches of some of the Host States (California, Michigan, Nebraska, New York, North Carolina, Texas, and Illinois), and their progress to date. An additional purpose of the report is to discern whether the Host States's site selection processes were heavily influenced by any common factors. One factor each state held in common was that political and public processes exerted a powerful influence on the site selection process at virtually every stage. 1 ref

  3. Survey of Current Best Practices for Diving in Contaminated Water

    National Research Council Canada - National Science Library

    Steigleman, W

    2002-01-01

    .... Navy divers operating in contaminated water. This survey attempted to identify the current best practices and equipment for diving in contaminated water, including personal protective equipment as well as hazard identification, diver training...

  4. 21 CFR 114.5 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 114.5 Section...) FOOD FOR HUMAN CONSUMPTION ACIDIFIED FOODS General Provisions § 114.5 Current good manufacturing practice. The criteria in §§ 114.10, 114.80, 114.83, 114.89, and 114.100, as well as the criteria in part...

  5. Current Practices in the Delivery of Undergraduate Exercise Physiology Content

    Science.gov (United States)

    Fisher, Michele M.

    2013-01-01

    The purpose of this study was to identify current practices for the delivery of exercise physiology content at the undergraduate level. An anonymous 22-item survey was sent to instructors of exercise physiology to collect information concerning the structure of course offerings and instructional practices. One hundred ten instructors responded to…

  6. China's current status and long-term outlook of nuclear power and radioactive waste disposal management

    International Nuclear Information System (INIS)

    Li, Zhidong

    2015-01-01

    This study identified the current status and long-term outlook of China's nuclear power development and radioactive waste disposal management after the 3.11 FUKUSHIMA accidents. China strengthened the actions for achieving nuclear power safety and cost efficiency as well as safety management of radioactive waste. It is a hard work to expand the capacity to 58 GW, the governmental target in 2020. The long-term development will strongly depend on the progress in safety management of nuclear power and radioactive waste and economic competitiveness. (author)

  7. Current status of preparing buffer/backfill block in HLW disposal abroad

    International Nuclear Information System (INIS)

    Yan Ming; Wang Xuewen; Zhang Huyuan

    2014-01-01

    There is an urgent need for China to commence the full-scale compaction test, resolving the preparation problem for buffer/backfill blocks when underground research laboratory project is planned for High Level Radioactive Waste (HLW) disposal. The foreign countries have some research about the preparation of buffer/backfill blocks in engineered barrier systems. The foreign research shows that installation of clay blocks with sector shape at waste pollution area is a feasible engineering method. Compacted clay blocks need to be cured in a cabinet with controlled temperature and humidity to avoid desiccation and surface powdering. A freeze mixing method, mixing powdered-ice and cooled bentonite, can be operated more easily and obtain more uniform hydration than the traditional mixing of water and bentonite. It is helpful to review and adsorb the foreign research results for the design of full-scale test of bentonite compaction. (authors)

  8. Current practice of incineration of low-level institutional radioactive waste

    International Nuclear Information System (INIS)

    Cooley, L.R.; McCampbell, M.R.; Thompson, J.D.

    1981-02-01

    During 1972, 142 medical and academic institutions were surveyed to assess the current practice of incineration of low-level radioactive waste. This was one activity carried out by the University of Maryland as part of a contract with EG and G Idaho, Inc., to site a radioactive waste incineration system. Of those surveyed, 46 (approximately 32%) were presently incinerating some type of radioactive waste. All were using controlled-air, multistage incinerators. Incinerators were most often used to burn animal carcasses and other biological wastes (96%). The average size unit had a capacity of 113 kg/h. Disposal of liquid scintillation vials posed special problems; eight institutions incinerated full scintillation vials and five incinerated scintillation fluids in bulk form. Most institutions (87%) used the incinerator to dispose of other wastes in addition to radioactive wastes. About half (20) of the institutions incinerating radioactive wastes reported shortcomings in their incineration process; those most often mentioned were: problems with liquid scintillation wastes, ash removal, melting glass, and visible smoke. Frequently cited reasons for incinerating wastes were: less expensive than shipping for commercial shallow land burial, volume reduction, convenience, and closure of existing disposal sites

  9. Prevention of healthcare-associated infections in general practice: Current practice and drivers for change in a French study

    Directory of Open Access Journals (Sweden)

    M Gignon

    2012-01-01

    Full Text Available Purpose: The fight against Healthcare-associated infections is a public health priority and a major challenge for the safety and quality of care. The objective was to assess hygiene in general practitioners′ (GPs′ office and identify barriers to and drivers for better practice. Materials and Methods: We performed a cross-sectional study in which a questionnaire was sent to a randomly selected, representative sample of 800 GPs. We used a self-administered questionnaire. The first part assessed current practice and the second part focused on barriers and motivating factors for better practice. We performed a descriptive statistical analysis of the responses to closed questions and a qualitative analysis of the responses to open-ended questions. Results: Only a third of the GPs were aware of the current guidelines. Disposable equipment was used by 31% of the GPs. For the remainder, only 38% complied with the recommended procedures for sterilisation or disinfection. Seventy-two percent of the GPs washed their hands between consultations in the office. A significant minority of physicians disregarded the guidelines by never wearing gloves to perform sutures (11%, treat wounds (10%, fit intrauterine devices (18% or perform injections (18%. The main barriers to good practice were the high cost of modifications and lack of time/space. Two third of the GPs did not intend to change their practices. The drivers for change were pressure from patients (4.8 on a scale of 1 to 7, inspection by the health authorities (4.8 and the fear of legal action (4.4. Conclusions: Our results show that there are significant differences between current practice and laid-down professional guidelines. Policies for improvement of hygiene must take into account barriers and motivating factors.

  10. A review of the disposal of miscellaneous radioactive wastes in the United Kingdom

    International Nuclear Information System (INIS)

    Hookway, B.

    1980-01-01

    Current practices in the United Kingdom for waste disposal from ''minor users'' of radioactive materials are reviewed. The regulation of the disposal of solid, liquid and airborne wastes is discussed. (H.K.)

  11. Patterns and correlates of solid waste disposal practices in Dar es ...

    African Journals Online (AJOL)

    USER

    collection. Key words: Solid waste, garbage, waste disposal, waste management, Multinomial Logit model. INTRODUCTION. Urbanization introduces society to a new, modern way of ..... Multinomial logistic estimation. .... The trend of using.

  12. Labelling of electronic cigarettes: regulations and current practice.

    Science.gov (United States)

    Buonocore, Federico; Marques Gomes, Ana C N; Nabhani-Gebara, Shereen; Barton, Stephen J; Calabrese, Gianpiero

    2017-01-01

    Over the past decade e-cigarettes have established themselves in the global market. E-cigarettes triggered much interest in relation to their content and efficacy as smoking cessation tools, but less attention has been paid to users and environmental safety warnings and guidance. Several regulations have been introduced to promote their safe handling and disposal. From May 2016, liquids and cartridges will be regulated by European Community Directives (ECDs) 2001/83/EC and 93/42/EEC, or 2014/40/EU if marketed as tobacco-related products. Currently, manufacturers and distributors must abide by the Chemical (Hazard Information and Packaging for Supply) Regulations 2009 (CHIP) or Classification, Labelling and Packaging Regulations (CLP), the latter replacing CHIP in June 2015. In this work, the compliance of marketed e-liquids and e-cigarettes with current European Union and UK legislations is assessed. E-liquids and e-cigarettes (21 and 9 brands, respectively) were evaluated. Evidence of non-compliance was found in relation to the CHIP/CLP toxic (13%) and environmental (37%) pictograms, tactile warning (23%), nominal amount of solution (30%), supplier contact telephone number and address (40%). None of the evaluated e-cigarettes displayed information on the correct disposal/recycling of batteries in line with the ECD 2006/66/EC. More stringent enforcement of regulations is needed to ensure not only the user's safety and awareness, but also the safeguarding of the environment. 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/.

  13. Current Best Practices for Preventing Asbestos Exposure Among Brake and Clutch Repair Workers

    Science.gov (United States)

    Covers concerns about asbestos exposure for mechanics, how to tell if asbestos brake or clutch components contain asbestos, work practices to follow, protecting yourself for home mechanics, disposal of waste that contains asbestos.

  14. Tank-connected food waste disposer systems--current status and potential improvements.

    Science.gov (United States)

    Bernstad, A; Davidsson, A; Tsai, J; Persson, E; Bissmont, M; la Cour Jansen, J

    2013-01-01

    An unconventional system for separate collection of food waste was investigated through evaluation of three full-scale systems in the city of Malmö, Sweden. Ground food waste is led to a separate settling tank where food waste sludge is collected regularly with a tank-vehicle. These tank-connected systems can be seen as a promising method for separate collection of food waste from both households and restaurants. Ground food waste collected from these systems is rich in fat and has a high methane potential when compared to food waste collected in conventional bag systems. The content of heavy metals is low. The concentrations of N-tot and P-tot in sludge collected from sedimentation tanks were on average 46.2 and 3.9 g/kg TS, equalling an estimated 0.48 and 0.05 kg N-tot and P-tot respectively per year and household connected to the food waste disposer system. Detergents in low concentrations can result in increased degradation rates and biogas production, while higher concentrations can result in temporary inhibition of methane production. Concentrations of COD and fat in effluent from full-scale tanks reached an average of 1068 mg/l and 149 mg/l respectively over the five month long evaluation period. Hydrolysis of the ground material is initiated between sludge collection occasions (30 days). Older food waste sludge increases the degradation rate and the risks of fugitive emissions of methane from tanks between collection occasions. Increased particle size decreases hydrolysis rate and could thus decrease losses of carbon and nutrients in the sewerage system, but further studies in full-scale systems are needed to confirm this. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Current earthquake engineering practice for Japanese nuclear power plants

    International Nuclear Information System (INIS)

    Hofmayer, C.H.; Park, Y.J.; Costello, J.F.

    1992-01-01

    This paper provides a brief overview of seismic research being conducted in Japan and describes USNRC efforts to understand Japanese seismic practice. Current earthquake engineering practice for Japanese nuclear power plants is descried in JEAG 4601-1987, ''Technical Guidelines for Aseismic Design of Nuclear Power Plants.'' The USNRC has sponsored BNL to translate this document into English. Efforts are underway to study and understand JEAG 4601-1987 and make the translation more readily available in the United States

  16. Enforcement Alert: Hazardous Waste Management Practices at Mineral Processing Facilities Under Scrutiny by U.S. EPA; EPA Clarifies 'Bevill Exclusion' Wastes and Establishes Disposal Standards

    Science.gov (United States)

    This is the enforcement alert for Hazardous Waste Management Practices at Mineral Processing Facilities Under Scrutiny by U.S. EPA; EPA Clarifies 'Bevill Exclusion' Wastes and Establishes Disposal Standards

  17. Overprescription of postoperative narcotics: a look at postoperative pain medication delivery, consumption and disposal in urological practice.

    Science.gov (United States)

    Bates, Cory; Laciak, Robert; Southwick, Andrew; Bishoff, Jay

    2011-02-01

    Prescription narcotic abuse is a significant social problem. Surplus medication following surgery is 1 source of prescription diversion. We assessed prescribing practices, consumption and disposal of prescribed narcotics after urological surgery. Surveys were administered to a 3-month consecutive sample of adult patients who underwent surgery performed by full and adjunct University of Utah Urology faculty. Surveys were performed 2 to 4 weeks postoperatively. With the exception of the investigators, prescribing physicians had no prior knowledge of the study. Data collected included perception of pain control, type and quantity of medication prescribed, quantity of leftover medication, refills needed, disposal instructions and surplus medication disposition. Overall 47% of 586 patients participated in the study. Hydrocodone was prescribed most commonly (63%), followed by oxycodone (35%), and 86% of the patients were satisfied with pain control. Of the dispensed narcotics 58% was consumed and 12% of patients requested refills. A total of 67% of patients had surplus medication from the initial prescription and 92% received no disposal instructions for surplus medication. Of those patients with leftover medication 91% kept the medication at home while 6% threw it in the trash, 2% flushed it down the toilet and less than 1% returned it to a pharmacy. Overprescription of narcotics is common and retained surplus medication presents a readily available source of opioid diversion. It appears that no entity on the prescribing or dispensing ends of prescription opioid delivery is fulfilling the responsibility to accurately educate patients on proper surplus medication disposal. Surgeons should analyze prescribing practices and consider decreasing the quantity of postoperative narcotics prescribed. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  18. Aspects of governance in the practical implementation of the concept of reversibility for deep geological disposal. Report no. 308

    International Nuclear Information System (INIS)

    Reaud, C.; Schieber, C.; Schneider, T.; Gadbois, S.; Heriard Dubreuil, G.

    2010-01-01

    The European project COWAM in Practice (CIP) was aimed to lead for three years (2007-2009) a process of monitoring, analyzing and evaluating the governance linked with radioactive waste management. This project, in cooperation with a research group and stakeholders, was conducted in parallel in 5 European countries (Spain, France, United Kingdom, Romania, Slovenia). In France, the issue of reversibility for a deep geological disposal was introduced in the Act of December 30, 1991 on the possible options to manage radioactive waste. The Act of June 28, 2006 relative to sustainable management of materials and radioactive waste confirmed the option, by calling for a reversible waste disposal facility in a deep geological formation to be designed. The main issue is no longer to justify the adoption of reversibility, but to investigate the practical procedures for its implementation. The French stakeholder Group 4 involved in the European project COWAM In Practice (CIP) had identified several subjects for investigation: - The different aspects associated with the practical implementation of reversible disposal: technical aspects, and aspects relative to monitoring, safety and expertise, in terms of legal, financial, administrative and political, etc. responsibility related to the notion of reversibility. - The stakes of governance related to the processes of assessment and decision-making - The roles of local stakeholders in these processes. The analysis conducted by CEPN in cooperation with the French stakeholder group, facilitated by Mutadis, showed that the practical implementation of reversibility aims to maintain a capacity of choice between three options: to continue to maintain the reversibility, to retrieve packages or to initiate the closure of all or part the disposal facility. Maintaining this choice in the long term implies setting up specific institutional, financial and decision-making systems,etc,. that need to be jointly developed in advance by all the

  19. Continuous infusion in haemophilia: current practice in Europe

    NARCIS (Netherlands)

    Batorova, A.; Holme, P.; Gringeri, A.; Richards, M.; Hermans, C.; Altisent, C.; Lopez-Fernández, M.; Fijnvandraat, K.

    2012-01-01

    . Continuous infusion (CI) of factor VIII (FVIII) is an effective method for replacement therapy in haemophilia. Recently, concerns have been raised regarding association of CI with the development of inhibitors. The aim of this study was to gain information on the current practices in Europe

  20. Clinical Supervision of Substance Abuse Counselors: Current and Preferred Practices.

    Science.gov (United States)

    Culbreth, John R.

    1999-01-01

    Reports on a national survey of substance abuse counselors (N=134) to learn their current and preferred supervision practices. Results suggests that substance abuse counselor are receiving supervision similar to other counselors. No preference was indicated for the sex of the supervisor, nor for the 12-step recovery experience. Counselors did…

  1. The Current Practices and Problems of School Based Supervision in ...

    African Journals Online (AJOL)

    The purpose of this study was to identify the current practice and problems of school based supervision in government primary schools of Jile Timuga Woreda of Oromia Zone. A descriptive survey design of research methodology was employed. Regarding sampling, there were 39 primary schools grouped in 10 cluster ...

  2. The Current Teacher Education Programs in Ethiopia: Reflection on Practice

    Science.gov (United States)

    Mekonnen, Geberew Tulu

    2017-01-01

    This study threw light on the current practice of Postgraduate Diploma in Teaching Program at Addis Ababa University, Ethiopia. The study focused on the enrolment, graduation and attrition proportion of Postgraduate Diploma in Teaching candidates in the year 2011 and 2015. The 2011 and 2015 academic years have been purposively selected because the…

  3. Human Factors Engineering: Current Practices and Development Needs in Finland

    Energy Technology Data Exchange (ETDEWEB)

    Savioja, Paula; Norros, Leena; Liinasuo, Marja; Laarni, Jari [VTT Technical Research Centre of Finland, Finland (Finland)

    2011-08-15

    This paper describes initial findings from a study concerning the practices and development needs of Human Factors Engineering (HFE) in Finland. HFE is increasing in importance as the Radiation and Nuclear Safety Authority Finland (STUK) is renewing the regulatory guidelines and the intention is to include requirements concerning HFE. The motivation for the paper is to discover how HFE is conducted currently in order to envision what should be aimed at when modifying requirements for design practices. In an interview with STUK it was discovered that current HFE practices encompass mainly activities related to control room modifications and as such namely verification and validation of new designs. The adoption of the entire HFE process in design and modification projects requires changes that include better integration of technical and Human Factors Engineering approaches. Boundary objects that mediate between different design disciplines are needed in order to enforce the stronger integration. Concept of operations (CONOPS) is suggested as a such boundary object.

  4. Curating research data a handbook of current practice

    CERN Document Server

    Johnston, Lisa R

    2017-01-01

    Curating Research Data, Volume Two: A Handbook of Current Practice guides you across the data lifecycle through the practical strategies and techniques for curating research data in a digital repository setting. The data curation steps for receiving, appraising, selecting, ingesting, transforming, describing, contextualizing, disseminating, and preserving digital research data are each explored, and then supplemented with detailed case studies written by more than forty international practitioners from national, disciplinary, and institutional data repositories. The steps in this volume detail the sequential actions that you might take to curate a data set from receiving the data (Step 1) to eventual reuse (Step 8). Data curators, archivists, research data management specialists, subject librarians, institutional repository managers, and digital library staff will benefit from these current and practical approaches to data curation.

  5. Solid medical waste: a cross sectional study of household disposal practices and reported harm in Southern Ghana.

    Science.gov (United States)

    Udofia, Emilia Asuquo; Gulis, Gabriel; Fobil, Julius

    2017-05-18

    Solid medical waste (SMW) in households is perceived to pose minimal risks to the public compared to SMW generated from healthcare facilities. While waste from healthcare facilities is subject to recommended safety measures to minimize risks to human health and the environment, similar waste in households is often untreated and co-mingled with household waste which ends up in landfills and open dumps in many African countries. In Ghana, the management of this potentially hazardous waste stream at household and community level has not been widely reported. The objective of this study was to investigate household disposal practices and harm resulting from SMW generated in households and the community. A cross-sectional questionnaire survey of 600 households was undertaken in Ga South Municipal Assembly in Accra, Ghana from mid-April to June, 2014. Factors investigated included socio-demographic characteristics, medication related practices, the belief that one is at risk of diseases associated with SMW, SMW disposal practices and reported harm associated with SMW at home and in the community. Eighty percent and 89% of respondents discarded unwanted medicines and sharps in household refuse bins respectively. A corresponding 23% and 35% of respondents discarded these items without a container. Harm from SMW in the household and in the community was reported by 5% and 3% of respondents respectively. Persons who believed they were at risk of diseases associated with SMW were nearly three times more likely to report harm in the household (OR 2.75, 95%CI 1.15-6.54). The belief that one can be harmed by diseases associated with SMW influenced reporting rates in the study area. Disposal practices suggest the presence of unwanted medicines and sharps in the household waste stream conferring on it hazardous properties. Given the low rates of harm reported, elimination of preventable harm might justify community intervention.

  6. Solid medical waste: a cross sectional study of household disposal practices and reported harm in Southern Ghana

    Directory of Open Access Journals (Sweden)

    Emilia Asuquo Udofia

    2017-05-01

    Full Text Available Abstract Background Solid medical waste (SMW in households is perceived to pose minimal risks to the public compared to SMW generated from healthcare facilities. While waste from healthcare facilities is subject to recommended safety measures to minimize risks to human health and the environment, similar waste in households is often untreated and co-mingled with household waste which ends up in landfills and open dumps in many African countries. In Ghana, the management of this potentially hazardous waste stream at household and community level has not been widely reported. The objective of this study was to investigate household disposal practices and harm resulting from SMW generated in households and the community. Methods A cross-sectional questionnaire survey of 600 households was undertaken in Ga South Municipal Assembly in Accra, Ghana from mid-April to June, 2014. Factors investigated included socio-demographic characteristics, medication related practices, the belief that one is at risk of diseases associated with SMW, SMW disposal practices and reported harm associated with SMW at home and in the community. Results Eighty percent and 89% of respondents discarded unwanted medicines and sharps in household refuse bins respectively. A corresponding 23% and 35% of respondents discarded these items without a container. Harm from SMW in the household and in the community was reported by 5% and 3% of respondents respectively. Persons who believed they were at risk of diseases associated with SMW were nearly three times more likely to report harm in the household (OR 2.75, 95%CI 1.15–6.54. Conclusion The belief that one can be harmed by diseases associated with SMW influenced reporting rates in the study area. Disposal practices suggest the presence of unwanted medicines and sharps in the household waste stream conferring on it hazardous properties. Given the low rates of harm reported, elimination of preventable harm might justify community

  7. Cost estimation for decommissioning: a review of current practice

    International Nuclear Information System (INIS)

    O'Sullivan, P.; Pescatore, C.

    2009-01-01

    inventory, decontamination and waste disposal. Several countries look for cost reduction possibilities through waste minimization processes. Consideration should be given to developing upgraded decommissioning management systems to deal with latest developments, data quality, completeness and safety, while offering flexibility in data processing and cost calculations. Regular interaction between system developers and users is necessary to develop the inventory and maintain user friendliness. Current good practices include the use of a standardised list of decommissioning activities, a strong quality-assurance programme, use of a dedicated decommissioning core group during the planning phase of decommissioning, and involvement of regulators and stakeholders in the drafting of decommissioning plans

  8. EIA systems in Nigeria: evolution, current practice and shortcomings

    International Nuclear Information System (INIS)

    Ogunba, Olusegun A.

    2004-01-01

    Amidst mounting criticism of Environmental Impact Assessments (EIAs) carried out in Nigeria under the three independent EIA systems--the EIA Decree 86 (1992), the Town and Country Planning Decree 88 (1992) and the Petroleum Act (1969)--the paper traces the evolution of Nigeria's systems and appraises current practice and shortcomings. The path of development of the systems was traced within the framework of Gibson's model of EIA evolution [Impact Assess. Proj. Apprais., 20 (3) 2002, 151-159], while current practice and shortcomings were explored in random interview surveys of consultant firms, approval authorities and the academia. It was seen that Gibson's four-stage model is not exactly representative of the Nigerian situation, and a more appropriate six-stage model was developed. It was also established that the current practices of the three EIA systems were at different stages of evolution: one of the EIA schemes (the Town and Country Planning Decree) has not evolved satisfactorily, while the other two EIA systems have produced intricate legislations and guidelines, but fall short of first-rate practice. The other discovery was that the simultaneous use of three independent systems creates unnecessary duplication of EIA preparation with considerable time and money costs. The paper advises that Nigeria can make substantial progress along the evolutionary path through a correction of observed system shortcomings and a merger of the three systems

  9. Australian survey on current practices for breast radiotherapy.

    Science.gov (United States)

    Dundas, Kylie L; Pogson, Elise M; Batumalai, Vikneswary; Boxer, Miriam M; Yap, Mei Ling; Delaney, Geoff P; Metcalfe, Peter; Holloway, Lois

    2015-12-01

    Detailed, published surveys specific to Australian breast radiotherapy practice were last conducted in 2002. More recent international surveys specific to breast radiotherapy practice include a European survey conducted in 2008/2009 and a Spanish survey conducted in 2009. Radiotherapy techniques continue to evolve, and the utilisation of new techniques, such as intensity-modulated radiation therapy (IMRT), is increasing. This survey aimed to determine current breast radiotherapy practices across Australia. An online survey was completed by 50 of the 69 Australian radiation therapy treatment centres. Supine tangential beam whole breast irradiation remains the standard of care for breast radiotherapy in Australia. A growing number of institutions are exploring prone positioning and IMRT utilisation. This survey demonstrated a wide variation in the benchmarks used to limit and report organ at risk doses, prescribed dose regimen, and post-mastectomy bolus practices. This survey also indicated, when compared with international literature, that there may be less interest in or uptake of external beam partial breast irradiation, prone positioning, simultaneous integrated boost and breath hold techniques. These are areas where further review and research may be warranted to ensure Australian patients are receiving the best care possible based on the best evidence available. This survey provides insight into the current radiotherapy practice for breast cancer in Australia. © 2015 The Royal Australian and New Zealand College of Radiologists.

  10. Sewage sludge: current legislation and final disposal; Fangos de depuracion: legislacion vigente y destino final

    Energy Technology Data Exchange (ETDEWEB)

    Taboas, R.; Fernandez-Couto, M. P.; Cancela, M. A.; Alvarez, E.

    2003-07-01

    This study gathers together information on the different types of sludge generated in the treatment of waste waters depending on where they come from in the treatment plant and on the kind of treatment to which they have been subjected (aerobic or anaerobic digestion). Current legislation is analysed and compared with the proposed new directive. A study is made of the possible uses to which such sludge might be put in farming and obtaining energy and several processes are presented that have so far been little developed. The article concludes by pointing out that in spite of the interest that exists in using the sludge in agricultural applications, the restrictions included in the draft of the new directive constitute a major challenge to the possibility of continuing to employ sludge in farming. (Author) 13 refs.

  11. Current trends in endodontic practice: emergency treatments and technological armamentarium.

    Science.gov (United States)

    Lee, Michelle; Winkler, Johnathon; Hartwell, Gary; Stewart, Jeffrey; Caine, Rufus

    2009-01-01

    The current clinical practice of endodontics includes the utilization of a variety of new technological advances and materials. The last comprehensive survey that compared treatment modalities used in endodontic practices was conducted in 1990. The purpose of the current survey was to determine the frequency with which these new endodontic technologies and materials are being used in endodontic practices today. An e-mail questionnaire was sent to the 636 active diplomates of the American Board of Endodontics with current e-mail addresses. Two hundred thirty-two diplomates responded for a response rate of 35%. Calcium hydroxide was found to be the most frequently used intracanal medicament for all cases diagnosed with necrotic pulps. Ibuprofen was the most frequently prescribed medication for pain, and penicillin was the most frequently prescribed antibiotic when an active infection was present. Eighty-two percent of the respondents are still incorporating hand files in some fashion during the cleansing and shaping phase of treatment. Lateral condensation and continuous wave were the most common methods used for obturation. Digital radiography was reported as being used by 72.5% of the respondents, whereas 45.3% reported using the microscope greater than 75% of the patient treatment. Ultrasonics was used by 97.8% of the respondents. It appears from the results that new endodontic technology is currently being used in the endodontic offices of those who responded to the survey.

  12. A Threat to the Environment from Practice of Drug Disposal in Thailand

    Directory of Open Access Journals (Sweden)

    Wiwat Arkaravichien

    2014-01-01

    Full Text Available Medicine contains active pharmaceutical ingredients which may do harm to the environment when dispersed into the environment. Once people have leftover medicines, if they discard them incorrectly, these medicines will contaminate the environment. This study determined how Thai villagers stored and disposed their medicines. A survey study of 331 subjects was conducted in 4 villages of Khon Kaen suburb by interviewing about what medications they stored, how they stored and how they managed their leftover medicines. The study showed that 89.4% of people kept some kind of drugs in their houses. Neuromuscular drugs were the most common group. The study revealed that there were leftover medicines at homes and they discarded them when unwanted. The most common method of discard was trashing in to rubbish bin. This method accounted for 81.4%, 64.6% and 66.6% of solid dosage form, liquid dosage form and external use drugs respectively. Liquid dosage forms were also put into the drainage system (7.4%. These disposal methods are discussed as non environmental friendly methods as the active pharmaceutical ingredients could eventually get into surface water and then may unconsciously get back to people through tap water and drinking water. This study alerts the concern for more appropriate means of drug disposal in Thailand.

  13. Concierge and Second-Opinion Radiology: Review of Current Practices.

    Science.gov (United States)

    Shaikh, Shehbaz; Bafana, Rounak; Halabi, Safwan S

    2016-01-01

    Radiology's core assets include the production, interpretation, and distribution of quality imaging studies. Second-opinion services and concierge practices in radiology aim to augment traditional services by providing patient-centered and physician-centered care, respectively. Patient centeredness enhances patients' understanding and comfort with their radiology tests and procedures and allows them to make better decisions about their health care. As the fee-for-service paradigm shifts to value-based care models, radiology practices have begun to diversify imaging service delivery and communication to coincide with the American College of Radiology Imaging 3.0 campaign. Physician-centered consultation allows for communication of evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for a specific clinical condition. There are disparate practice models and payment schema for the various second-opinion and concierge practices. This review article explores the current state and payment models of second-opinion and concierge practices in radiology. This review also includes a discussion on the benefits, roadblocks, and ethical issues that surround these novel types of practices. Copyright © 2015 Mosby, Inc. All rights reserved.

  14. Knowledge and Self-Reported Practice of Insulin Injection Device Disposal among Diabetes Patients in Gondar Town, Ethiopia: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Abebe Basazn Mekuria

    2016-01-01

    Full Text Available Background. Incorrect sharp disposal practices may expose the public to needle-stick injuries. The present study aimed at assessing the knowledge and practice of diabetic patients towards insulin injection device disposal in Gondar town, Ethiopia. Methods. A cross-sectional study was employed on insulin requiring diabetes patients who visited the diabetes clinic at Gondar University Referral Hospital (GURH from February 1 to March 28, 2016. Frequencies, percentages, and ANOVA (analysis of variance and Student’s t-test were used to analyze variables. Results. About half of the participants (49.5% had poor knowledge towards safe insulin injection waste disposal. More than two-thirds (80.7% of respondents had poor practice and 64.3% of respondents did not put insulin needle and lancets into the household garbage. 31% of respondents threw sharps on street when they travel outside. Respondents living in urban areas had a higher mean of knowledge and practice score than those who live in rural area. Conclusions. This study revealed that knowledge and practice of diabetic patients were low towards safe insulin injection waste disposal in study area. Healthcare providers should also be aware of safe disposing system and counsel patients on appropriate disposal of used syringes.

  15. Specialization and the Current Practices of General Surgeons

    Science.gov (United States)

    Decker, Marquita R; Dodgion, Christopher M; Kwok, Alvin C; Hu, Yue-Yung; Havlena, Jeff A; Jiang, Wei; Lipsitz, Stuart R; Kent, K Craig; Greenberg, Caprice C

    2014-01-01

    Background The impact of specialization on the practice of general surgery has not been characterized. Our goal was to assess general surgeons’ operative practices to inform surgical education and workforce planning. Study Design We examined the practices of general surgeons identified in the 2008 State Inpatient and Ambulatory Surgery Databases of the Healthcare Cost and Utilization Project (HCUP) for three US states. Operations were identified using ICD-9 and CPT codes linked to encrypted physician identifiers. For each surgeon, total operative volume and the percentage of practice comprised of their most common operation were calculated. Correlation was measured between general surgeons’ case volume and the number of other specialists in a health service area. Results There were 1,075 general surgeons who performed 240,510 operations in 2008. The mean operative volume for each surgeon was 224 annual procedures. General surgeons performed an average of 23 different types of operations. For the majority of general surgeons, their most common procedure comprised no more than 30% of total practice. The most common operations, ranked by the frequency that they appeared as general surgeons’ top procedure, included: cholecystectomy, colonoscopy, endoscopy, and skin excision. The proportion of general surgery practice comprised of endoscopic procedures inversely correlated with the number of gastroenterologists in the health service area (Rho = - 0.50, p = 0.005). Conclusions Despite trends toward specialization, the current practices of general surgeons remain heterogeneous. This indicates a continued demand for broad-based surgical education to allow future surgeons to tailor their practices to their environment. PMID:24210145

  16. Status and current spent fuel storage practices in the United States

    International Nuclear Information System (INIS)

    Lake, W.H.

    1999-01-01

    Brief discussions are presented on the history and state of spent fuel generation by utilities that comprise the United States commercial nuclear power industry, the current situation regarding the Federal government's nuclear waste policy, and evolving spent fuel storage practices. These evolving spent fuel storage practices are the result of private sector initiatives, but appear to be influenced by various external factors. The paper is not intended to provide a comprehensive appraisal of the storage initiatives being conducted by the private sector. The focus, instead, is on the Federal government's role and activities related to spent fuel management. Although the Federal government has adopted a policy calling for deep geological disposal of spent fuel, the US Congress has recently begun to consider expanding that policy to include a centralized interim storage facility. In the absence of such an expanded policy, the Department of Energy has performed some preliminary activities that would expedite development of a centralized interim storage facility, if Congress were to enact such a policy. The Department's current activities with regard to developing a centralized interim storage facility, which are consistent with the current policy, are described in the paper. The paper also describes two important technical development activities that have been conducted by the Department of Energy to support improved efficiency in spent fuel management. The Department's activities regarding development of a burnup credit methodology, and a dry transfer system are summarized. (author)

  17. Gender Perspective to Vedic Education: Current Practices in Nepal

    Directory of Open Access Journals (Sweden)

    Rajendra Raj Timilsina

    2016-10-01

    Full Text Available Vedic civilization has seen changes in its history- from Satya Yug to current Kali Yug. There were equal rights and duties of both men and women at the beginning. Interpretations of Veda, brought out of the Puranas and externalities made the status unequal. Sanatan Dharma, which is still mainstream of Hinduism, has been challenged by reformist Arya Samaj. As a result, there are interpretive differences as well as practices. Such differences can be seen in contemporary Nepal for the last 130 years. Continuing the differences, classicism has been reviving in the education. This revival also commenced with the same dualism. In this qualitative approach of exploration, two different gurukuls of girls have been observed and analyzed from the field for the purpose of exploring the recent practices. The observation was based on respective scriptures as well as experts' interviews. These data have analyzed the confronting practices on gender in Veda and rooted ideas in contemporary Nepal.

  18. Analysis of Current Supplier Relationship Management Practices: A Solution Proposal

    OpenAIRE

    Gomes Campelo Filho, Eulalio

    2009-01-01

    The work contributes with the existing literature by investigating current SRM practices. Based on the research, the author has designed an information system framework, which provides companies with an innovative SRM solution to manage their indirect material purchasing process through an environment that supports companies entire plan-to-order activities, including functionalities such as central data management, spend data management, e-sourcing and the usual e-procurement features.

  19. Remediation in Practicing Physicians: Current and Alternative Conceptualizations.

    Science.gov (United States)

    Bourgeois-Law, Gisèle; Teunissen, Pim W; Regehr, Glenn

    2018-04-24

    Suboptimal performance in practicing physicians is a decades-old problem. The lack of a universally accepted definition of remediation, the paucity of research on best remediation practices, and the ongoing controversy regarding the institutional responsibility for enacting and overseeing this activity suggests that the remediation of physicians is not merely a difficult problem to solve, but a problem that the community does not grapple with meaningfully. Undoubtedly, logistical and political considerations contribute to this state of affairs; however, other underlying conceptual issues may also play a role in the medical profession's difficulties in engaging with the challenges around remediation.Through a review of the medical education and other literatures, the authors examined current conceptualizations of both remediation itself and the individual being remediated, as well as how the culture of medicine influences these conceptions. The authors explored how conceptualizations of remediation and the surrounding culture might affect not only the medical community's ability to support, but also its willingness to engage with physicians in need of remediation.Viewing remediation as a means of supporting practice change-rather than as a means of redressing gaps in knowledge and skill-might be a useful alternative conceptualization, providing a good place to start exploring new avenues of research. However, moving forward will require more than simply a reconceptualizion of remediation; it will also necessitate a change in how the community views its struggling members and a change in the medical culture that currently positions professional autonomy as the foundational premise for individual practice improvement.

  20. Quality of the current low power and shutdown PSA practice

    International Nuclear Information System (INIS)

    Jang, Seung Cheol; Park, Jin Hee; Lim, Ho Gon; Kim, Tae Woon

    2004-01-01

    A probabilistic safety assessment (PSA) for the low-power and shutdown (LPSD) modes in a Korea standard nuclear power plant (KSNP) has been performed for the purpose of estimating the LPSD risk and identifying the vulnerabilities of LPSD operations. Both the operational experience and PSA results indicate that the risks from LPSD operations could be comparable with those from power operations. However, the application of the LPSD risk insights to risk-informed decision making has been slow to be adopted in practice. It is largely due to the question of whether the current LPSD PSA practice is appropriate for application to risk-informed decision making or not. Such a question has to do with the quality of the current LPSD PSA practice. In this paper, we have performed self-assessment of the KSNP LPSD PSA quality based on the ANS Standard (draft as of 13 Sep. 2002). The aims of the work are to find the LPSD PSA technical areas insufficient for application to risk-informed decision making and to efficiently allocate the limited research resources to improve the LPSD PSA model quality. Many useful findings regarding the current LPSD PSA quality are presented in this paper

  1. Current practice in airway management: A descriptive evaluation.

    Science.gov (United States)

    Kjonegaard, Rebecca; Fields, Willa; King, Major L

    2010-03-01

    Ventilator-associated pneumonia, a common complication of mechanical ventilation, could be reduced if health care workers implemented evidence-based practices that decrease the risk for this complication. To determine current practice and differences in practices between registered nurses and respiratory therapists in managing patients receiving mechanical ventilation. A descriptive comparative design was used. A convenience sample of 41 registered nurses and 25 respiratory therapists who manage critical care patients treated with mechanical ventilation at Sharp Grossmont Hospital, La Mesa, California, completed a survey on suctioning techniques and airway management practices. Descriptive and inferential statistics were used to analyze the data. Significant differences existed between nurses and respiratory therapists for hyperoxygenation before suctioning (P =.03). In the 2 groups, nurses used the ventilator for hyper-oxygenation more often, and respiratory therapists used a bag-valve device more often (P =.03). Respiratory therapists instilled saline (P <.001) and rinsed the closed system with saline after suctioning (P =.003) more often than nurses did. Nurses suctioned oral secretions (P <.001) and the nose of orally intubated patients (P =.01), brushed patients' teeth with a toothbrush (P<.001), and used oral swabs to clean the mouth (P <.001) more frequently than respiratory therapists did. Nurses and respiratory therapists differed significantly in the management of patients receiving mechanical ventilation. To reduce the risk of ventilator-associated pneumonia, both nurses and respiratory therapists must be consistent in using best practices when managing patients treated with mechanical ventilation.

  2. Disposal configuration options for future uses of greater confinement disposal at the Nevada Test Site

    International Nuclear Information System (INIS)

    Price, L.

    1994-09-01

    The US Department of Energy (DOE) is responsible for disposing of a variety of radioactive and mixed wastes, some of which are considered special-case waste because they do not currently have a clear disposal option. The DOE's Nevada Field Office contracted with Sandia National Laboratories to investigate the possibility of disposing of some of this special-case waste at the Nevada Test Site (NTS). As part of this investigation, a review of a near-surface and subsurface disposal options that was performed to develop alternative disposal configurations for special-case waste disposal at the NTS. The criteria for the review included (1) configurations appropriate for disposal at the NTS; (2) configurations for disposal of waste at least 100 ft below the ground surface; (3) configurations for which equipment and technology currently exist; and (4) configurations that meet the special requirements imposed by the nature of special-case waste. Four options for subsurface disposal of special-case waste are proposed: mined consolidated rock, mined alluvium, deep pits or trenches, and deep boreholes. Six different methods for near-surface disposal are also presented: earth-covered tumuli, above-grade concrete structures, trenches, below-grade concrete structures, shallow boreholes, and hydrofracture. Greater confinement disposal (GCD) in boreholes at least 100 ft deep, similar to that currently practiced at the GCD facility at the Area 5 Radioactive Waste Management Site at the NTS, was retained as the option that met the criteria for the review. Four borehole disposal configurations are proposed with engineered barriers that range from the native alluvium to a combination of gravel and concrete. The configurations identified will be used for system analysis that will be performed to determine the disposal configurations and wastes that may be suitable candidates for disposal of special-case wastes at the NTS

  3. Challenges of implementing fibromyalgia treatment guidelines in current clinical practice.

    Science.gov (United States)

    Arnold, Lesley M; Clauw, Daniel J

    2017-09-01

    The current diagnostic and treatment pathway for patients with fibromyalgia (FM) is lengthy, complex, and characterized by multiple physician visits with an average 2-year wait until diagnosis. It is clear that effective identification and appropriate treatment of FM remain a challenge in current clinical practice. Ideally, FM management involves a multidisciplinary approach with the preferable patient pathway originating in primary care but supported by a range of health care providers, including referral to specialist care when necessary. After the publication of individual clinical studies, high-quality reviews, and meta-analyses, recently published FM treatment guidelines have transitioned from an expert consensus to an evidence-based approach. Evidence-based guidelines provide a framework for ensuring early diagnosis and timely adoption of appropriate treatment. However, for successful outcomes, FM treatments must adopt a more holistic approach, which addresses more than just pain. Impact on the associated symptoms of fatigue and cognitive problems, sleep and mood disturbances, and lowered functional status are also important in judging the success of FM therapy. Recently published guidelines recommend the adoption of a symptom-based approach to guide pharmacologic treatment. Emerging treatment options for FM may be best differentiated on the basis of their effect on comorbid symptoms that are often associated with pain (e.g. sleep disturbance, mood, fatigue). The current review discusses the most recently published Canadian guidelines and the implications of the recent European League Against Rheumatism (EULAR) recommendations, with a focus on the challenges of implementing these guidelines in current clinical practice.

  4. Review of current research into soil decontamination and volume reduction techniques for purposes of transportation and disposal

    International Nuclear Information System (INIS)

    Haywood, F.F.

    1986-01-01

    In recent years, a number of soil decontamination studies have been carried out by investigators in the US and Canada. These investigations have included the segregation of potentially hazardous chemicals from uranium mill tailings, the use of various leaching agents for the selective removal of radium, thorium, and uranium from mine and mill tailings, the study of neutralization, fixation, and conditioning processes for tailings, the separation and removal of transuranium elements from contaminated soil and sediment, and finally studies of the cost effectiveness of various decontamination approaches. Remedial action programs for which soil decontamination may be an attractive alternative are those which include the cleanup of large open land areas since thousands of cubic years of material are generally involved. The practice of decontaminating or otherwise segregating contaminated and uncontaminated soil fractions before shipment to a final disposal site can only be done if it is economical to do so. This paper considers several techniques which have been reported in unclassified literature and includes a comparison of the authors' conclusions regarding the effectiveness of their investigations. The manuscript will include a comprehensive bibliography of references to techniques which appear to be feasible alternatives in remedial action programs

  5. Regulating the long-term safety of geological disposal of radioactive waste: practical issues and challenges

    International Nuclear Information System (INIS)

    2008-01-01

    Regulating the long-term safety of geological disposal of radioactive waste is a key part of making progress on the radioactive waste management issue. A survey of member countries has shown that differences exist both in the protection criteria being applied and in the methods for demonstrating compliance, reflecting historical and cultural differences between countries which in turn result in a diversity of decision-making approaches and frameworks. At the same time, however, these differences in criteria are unlikely to result in significant differences in long-term protection, as all the standards being proposed are well below levels at which actual effects of radiological exposure can be observed and a range of complementary requirements is foreseen. In order to enable experts from a wide range of backgrounds to debate the various aspects of these findings, the NEA organised an international workshop in November 2006 in Paris, France. Discussions focused on diversity in regulatory processes; the basis and tools for assuring long-term protection; ethical responsibilities of one generation to later generations and how these can be discharged; and adapting regulatory processes to the long time frames involved in implementing geological disposal. These proceedings include a summary of the viewpoints expressed as well as the 22 papers presented at the workshop. (author)

  6. Current Administrative court practice in the procedure of Public Procurement

    Directory of Open Access Journals (Sweden)

    Silvio Čović

    2017-01-01

    Full Text Available Under the current conditions of complex and difficult economic and social circumstances and given the comparative possibilities and economic effects, the system of public procurement which is firstly at a legal level regulated by the Public Procurement Act 8 (Zakon o javnoj nabavi of 2011 (further referred to as: PPA (ZN, is of particular importance for the entire legal, political and economic system of the Republic of Croatia. Public procurement in essence represents contracting the procurement of goods, works or services. The specifities of that system are comprised, above all, of regulation of entering contractual relations between the public and private sector. Therefore, this system in principle must be formal in order to protect equality of competitors in the public procurement procedure and also in the general interest. Appreciating the legal tradition and indigenous particularities, the author’s fundamental aims consisted of providing and analysing administrative court practice in the context of international legal acquis communautaire showing some legal regulation in practice of disputable aspects of the system of public procurement in Croatia and the doubts emerging from current administrative court practice.

  7. Recent trends and current practices for secondary processing of zinc and lead. Part II: zinc recovery from secondary sources.

    Science.gov (United States)

    Sahu, Kamala Kanta; Agrawal, Archana; Pandey, Banshi Dhar

    2004-08-01

    Almost all metallurgical processes are associated with the generation of wastes and residues that may be hazardous or non-hazardous in nature depending upon the criteria specified by institutions such as the US Environment Protection Agency, etc. Wastes containing heavy and toxic metals such as arsenic, cadmium, chromium, nickel, lead, copper, mercury, zinc, etc., that are present beyond permissible limits deemed to be treated or disposed of, and non-hazardous wastes can be utilized for metal recovery or safe disposal. Zinc is in growing demand all over the world. In India, a major amount of zinc is imported and therefore processing of zinc secondaries will assist in satisfying the gap between demand and supply to some extent. This report mainly focuses on the current practices and recent trends on the secondary processing of zinc. Attempts made by various laboratories to develop ecofriendly processes for the recovery of zinc from secondary raw materials are also described and discussed.

  8. Bimodal Programming: A Survey of Current Clinical Practice.

    Science.gov (United States)

    Siburt, Hannah W; Holmes, Alice E

    2015-06-01

    The purpose of this study was to determine the current clinical practice in approaches to bimodal programming in the United States. To be specific, if clinicians are recommending bimodal stimulation, who programs the hearing aid in the bimodal condition, and what method is used for programming the hearing aid? An 11-question online survey was created and sent via email to a comprehensive list of cochlear implant programming centers in the United States. The survey was sent to 360 recipients. Respondents in this study represented a diverse group of clinical settings (response rate: 26%). Results indicate little agreement about who programs the hearing aids, when they are programmed, and how they are programmed in the bimodal condition. Analysis of small versus large implant centers indicated small centers are less likely to add a device to the contralateral ear. Although a growing number of cochlear implant recipients choose to wear a hearing aid on the contralateral ear, there is inconsistency in the current clinical approach to bimodal programming. These survey results provide evidence of large variability in the current bimodal programming practices and indicate a need for more structured clinical recommendations and programming approaches.

  9. Cardioversion for atrial fibrillation in current European practice

    DEFF Research Database (Denmark)

    Hernández-Madrid, Antonio; Svendsen, Jesper Hastrup; Lip, Gregory Y.H.

    2013-01-01

    This survey was conducted to provide an insight into the current clinical practice regarding the use of cardioversion for atrial fibrillation (AF) in Europe. Responses were received from 57 centres across Europe, 71.9% of which were university hospitals. For electrical cardioversion, general...... anaesthesia was managed by an anaesthesiologist in 73.9% of centres and by a cardiologist in 37%. In the majority of centres, electrical cardioversion was performed using a biphasic defibrillator (85.1%). Antiarrhythmic drugs were routinely prescribed prior to electrical cardioversion by 54.3% of hospitals...

  10. Individual Performance Management: A Review of Current Practices

    Directory of Open Access Journals (Sweden)

    Ian O’ Boyle

    2013-05-01

    Full Text Available This paper provides a review of current practice in relation to individual performance management systems and process within the traditional business environment. There is a consensus that the role of the individual is central to the overall performance of any organization and how individual performances are managed and evaluated can have significant impacts on overall organizational success. Many organizations employ the traditional performance appraisal in order to monitor and assess individual employee performances. However, new approaches, such as 360-degree feedback have also become commonplace within the business environment. An analysis of each approach including benefits and challenges associated with each process is presented within this paper.

  11. Neuroimaging in refractory epilepsy. Current practice and evolving trends

    International Nuclear Information System (INIS)

    Ramli, N.; Rahmat, K.; Lim, K.S.; Tan, C.T.

    2015-01-01

    Highlights: • Neuroimaging is imperative in diagnostic work up and therapeutic assessment of refractory epilepsy. • Identification of epileptogenic zone on EEG, MRI and functional imaging improves the success of surgery. • High performance MRI greatly enhanced metabolic information and elucidate brain functions. • Optimisation of epilepsy protocols in structural and functional MRI are presented in this article. - Abstract: Identification of the epileptogenic zone is of paramount importance in refractory epilepsy as the success of surgical treatment depends on complete resection of the epileptogenic zone. Imaging plays an important role in the locating and defining anatomic epileptogenic abnormalities in patients with medically refractory epilepsy. The aim of this article is to present an overview of the current MRI sequences used in epilepsy imaging with special emphasis of lesion seen in our practices. Optimisation of epilepsy imaging protocols are addressed and current trends in functional MRI sequences including MR spectroscopy, diffusion tensor imaging and fusion MR with PET and SPECT are discussed

  12. Neuroimaging in refractory epilepsy. Current practice and evolving trends

    Energy Technology Data Exchange (ETDEWEB)

    Ramli, N. [Department of Biomedical Imaging, University Malaya Research Imaging Centre (Malaysia); Rahmat, K., E-mail: katt_xr2000@yahoo.com [Department of Biomedical Imaging, University Malaya Research Imaging Centre (Malaysia); Lim, K.S.; Tan, C.T. [Neurology Unit, Department of Medicine, University Malaya, Kuala Lumpur (Malaysia)

    2015-09-15

    Highlights: • Neuroimaging is imperative in diagnostic work up and therapeutic assessment of refractory epilepsy. • Identification of epileptogenic zone on EEG, MRI and functional imaging improves the success of surgery. • High performance MRI greatly enhanced metabolic information and elucidate brain functions. • Optimisation of epilepsy protocols in structural and functional MRI are presented in this article. - Abstract: Identification of the epileptogenic zone is of paramount importance in refractory epilepsy as the success of surgical treatment depends on complete resection of the epileptogenic zone. Imaging plays an important role in the locating and defining anatomic epileptogenic abnormalities in patients with medically refractory epilepsy. The aim of this article is to present an overview of the current MRI sequences used in epilepsy imaging with special emphasis of lesion seen in our practices. Optimisation of epilepsy imaging protocols are addressed and current trends in functional MRI sequences including MR spectroscopy, diffusion tensor imaging and fusion MR with PET and SPECT are discussed.

  13. Autopsy in Islam and current practice in Arab Muslim countries.

    Science.gov (United States)

    Mohammed, Madadin; Kharoshah, Magdy A

    2014-03-01

    Autopsy, or post-mortem examination, is the dissection of a dead body. It is performed for many reasons. Attitudes toward dead bodies vary with religious beliefs and cultural and geographical backgrounds. We have carried out an extensive literature review to determine the Islamic view and current practice of Autopsy, in at least four Arab countries which published their experiences. Several research articles have studied the history of Islamic Autopsy as well as the current situation and legal debates about it. The overwhelming conclusion is that data is lacking. More must be published from Arabic Muslim countries and more research done to correct misconceptions. We also recommend more application of non-invasive Autopsy. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  14. Extracorporeal membrane oxygenation: current clinical practice, coding, and reimbursement.

    Science.gov (United States)

    Schuerer, Douglas J E; Kolovos, Nikoleta S; Boyd, Kayla V; Coopersmith, Craig M

    2008-07-01

    Extracorporeal membrane oxygenation (ECMO) is a technique for providing life support for patients experiencing both pulmonary and cardiac failure by maintaining oxygenation and perfusion until native organ function is restored. ECMO is used routinely at many specialized hospitals for infants and less commonly for children with respiratory or cardiac failure from a variety of causes. Its usage is more controversial in adults, but select medical centers have reported favorable findings in patients with ARDS and other causes of severe pulmonary failure. ECMO is also rarely used as a rescue therapy in a small subset of adult patients with cardiac failure. This article will review the current uses and techniques of ECMO in the critical care setting as well as the evidence supporting its usage. In addition, current practice management related to coding and reimbursement for this intensive therapy will be discussed.

  15. Disposal of Pesticide Wastes as Implemented in A Proposed Code of Practice in Egypt

    International Nuclear Information System (INIS)

    Sherif El-Hamady, E.

    1999-01-01

    In the present study , an Egyptian Code of Practice for the safe use of pesticides on farms and holdings is suggested. The Code has to be issued for the purpose of providing practical guidance to citizens especially farmers and growers engaged in crop production or to the authorities of companies and plants manufacturing and formulating pesticides in Egypt

  16. Clinical exome sequencing reports: current informatics practice and future opportunities.

    Science.gov (United States)

    Swaminathan, Rajeswari; Huang, Yungui; Astbury, Caroline; Fitzgerald-Butt, Sara; Miller, Katherine; Cole, Justin; Bartlett, Christopher; Lin, Simon

    2017-11-01

    The increased adoption of clinical whole exome sequencing (WES) has improved the diagnostic yield for patients with complex genetic conditions. However, the informatics practice for handling information contained in whole exome reports is still in its infancy, as evidenced by the lack of a common vocabulary within clinical sequencing reports generated across genetic laboratories. Genetic testing results are mostly transmitted using portable document format, which can make secondary analysis and data extraction challenging. This paper reviews a sample of clinical exome reports generated by Clinical Laboratory Improvement Amendments-certified genetic testing laboratories at tertiary-care facilities to assess and identify common data elements. Like structured radiology reports, which enable faster information retrieval and reuse, structuring genetic information within clinical WES reports would help facilitate integration of genetic information into electronic health records and enable retrospective research on the clinical utility of WES. We identify elements listed as mandatory according to practice guidelines but are currently missing from some of the clinical reports, which might help to organize the data when stored within structured databases. We also highlight elements, such as patient consent, that, although they do not appear within any of the current reports, may help in interpreting some of the information within the reports. Integrating genetic and clinical information would assist the adoption of personalized medicine for improved patient care and outcomes. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Pediatric hospitalists: training, current practice, and career goals.

    Science.gov (United States)

    Freed, Gary L; Dunham, Kelly M

    2009-03-01

    To determine the range and frequency of experiences, clinical and nonclinical roles, training, work expectations, and career plans of practicing pediatric hospitalists. Mail survey study of a national sample of 530 pediatric hospitalists of whom 67% (N = 338) were from teaching hospitals, 71% (N = 374) were from children's hospitals, 43% (N = 230) were from freestanding children's hospitals, and 69% (N = 354) were from hospitals with >or=250 beds. The response rate was 84%. The majority (54%; N = 211) had been practicing as hospitalists for at least 3 years. Most reported that the pediatric inpatient unit (94%) and inpatient consultation service (51%) were a part of their regular clinical assignment. Most did not provide service in the normal newborn nursery (58%), subspecialty inpatient service (52%), transports (85%), outpatient clinics (66%), or as part of an emergency response team (53%). Many participated in quality improvement (QI) initiatives (84%) and practice guideline development (81%). This study provides the most comprehensive information available regarding the clinical and nonclinical roles, training, work expectations, and career plans of pediatric hospitalists. However, the field is currently a moving target; there is significant flux in the hospitalist workforce and variation in the roles of these professionals in their clinical and nonclinical work environment. (c) 2009 Society of Hospital Medicine.

  18. Figures in clinical trial reports: current practice & scope for improvement.

    Science.gov (United States)

    Pocock, Stuart J; Travison, Thomas G; Wruck, Lisa M

    2007-11-19

    Most clinical trial publications include figures, but there is little guidance on what results should be displayed as figures and how. To evaluate the current use of figures in Trial reports, and to make constructive suggestions for future practice. We surveyed all 77 reports of randomised controlled trials in five general medical journals during November 2006 to January 2007. The numbers and types of figures were determined, and then each Figure was assessed for its style, content, clarity and suitability. As a consequence, guidelines are developed for presenting figures, both in general and for each specific common type of Figure. Most trial reports contained one to three figures, mean 2.3 per article. The four main types were flow diagram, Kaplan Meier plot, Forest plot (for subgroup analyses) and repeated measures over time: these accounted for 92% of all figures published. For each type of figure there is a considerable diversity of practice in both style and content which we illustrate with selected examples of both good and bad practice. Some pointers on what to do, and what to avoid, are derived from our critical evaluation of these articles' use of figures. There is considerable scope for authors to improve their use of figures in clinical trial reports, as regards which figures to choose, their style of presentation and labelling, and their specific content. Particular improvements are needed for the four main types of figures commonly used.

  19. Figures in clinical trial reports: current practice & scope for improvement

    Directory of Open Access Journals (Sweden)

    Travison Thomas G

    2007-11-01

    Full Text Available Abstract Background Most clinical trial publications include figures, but there is little guidance on what results should be displayed as figures and how. Purpose To evaluate the current use of figures in Trial reports, and to make constructive suggestions for future practice. Methods We surveyed all 77 reports of randomised controlled trials in five general medical journals during November 2006 to January 2007. The numbers and types of figures were determined, and then each Figure was assessed for its style, content, clarity and suitability. As a consequence, guidelines are developed for presenting figures, both in general and for each specific common type of Figure. Results Most trial reports contained one to three figures, mean 2.3 per article. The four main types were flow diagram, Kaplan Meier plot, Forest plot (for subgroup analyses and repeated measures over time: these accounted for 92% of all figures published. For each type of figure there is a considerable diversity of practice in both style and content which we illustrate with selected examples of both good and bad practice. Some pointers on what to do, and what to avoid, are derived from our critical evaluation of these articles' use of figures. Conclusion There is considerable scope for authors to improve their use of figures in clinical trial reports, as regards which figures to choose, their style of presentation and labelling, and their specific content. Particular improvements are needed for the four main types of figures commonly used.

  20. International online survey to assess current practice in equine anaesthesia.

    Science.gov (United States)

    Wohlfender, F D; Doherr, M G; Driessen, B; Hartnack, S; Johnston, G M; Bettschart-Wolfensberger, R

    2015-01-01

    Multicentre Confidential Enquiries into Perioperative Equine Fatalities (CEPEF) have not been conducted since the initial CEPEF Phases 1-3, 20 years ago. To collect data on current practice in equine anaesthesia and to recruit participants for CEPEF-4. Online questionnaire survey. An online questionnaire was prepared and the link distributed internationally to veterinarians possibly performing equine anaesthesia, using emails, posters, flyers and an editorial. The questionnaire included 52 closed, semiclosed and open questions divided into 8 subgroups: demographic data, anaesthetist, anaesthesia management (preoperative, technical equipment, monitoring, drugs, recovery), areas of improvements and risks and motivation for participation in CEPEF-4. Descriptive statistics and Chi-squared tests for comparison of categorical variables were performed. A total of 199 questionnaires were completed by veterinarians from 14 different countries. Of the respondents, 43% worked in private hospitals, 36% in private practices and 21% in university teaching hospitals. In 40 institutions (23%) there was at least one diplomate of the European or American colleges of veterinary anaesthesia and analgesia on staff. Individual respondents reported routinely employ the following anaesthesia monitoring modalities: electrocardiography (80%), invasive arterial blood pressures (70%), pulse oximetry (60%), capnography (55%), arterial blood gases (47%), composition of inspired and expired gases (45%) and body temperature (35%). Drugs administered frequently or routinely as part of a standard protocol were: acepromazine (44%), xylazine (68%), butorphanol (59%), ketamine (96%), diazepam (83%), isoflurane (76%), dobutamine (46%), and, as a nonsteroidal anti-inflammatory drug, phenylbutazone (73%) or flunixin meglumine (66%). Recovery was routinely assisted by 40%. The main factors perceived by the respondents to affect outcome of equine anaesthesia were the preoperative health status of the

  1. Current neurotrauma treatment practice in secondary medical service centers

    International Nuclear Information System (INIS)

    Suehiro, Eiichi; Yoshino, Hiroko; Koizumi, Hiroyasu; Yoneda, Hiroshi; Suzuki, Michiyasu

    2011-01-01

    Despite neurotrauma treatment practices comprising a significant amount of neurosurgical work for secondary medical service centers, little attention has been placed on neurotrauma cases and evaluation of current neurotrauma treatment practices is limited. Therefore we investigated current neurotrauma practices in our hospital located in a Japanese suburban city. We analyzed 439 patients with traumatic brain injury (TBI) admitted to our hospital between April 2004 and October 2010. Patients were divided into three groups based on the Glasgow Coma Scale (GCS) score on admission: mild TBI (GCS 14-15) in 252 patients (57.4%), moderate TBI (GCS 9-13) in 116 patients (26.4%), and severe TBI (GCS 3-8) in 71 patients (16.2%). Age, gender, alcohol consumption, cause of injury, cranial CT findings, neurosurgical procedure, length of hospital stay, and clinical outcome were analyzed. The average age of the patients was 59.2 years old. Male patients comprised 65%. Alcohol consumption was reported in 81 cases (18.5%), most of them with moderate TBI. Fall (208 cases, 47.4%) was the most frequent cause of injury, followed by traffic accident (115 cases, 26.2%) and high fall (73 cases, 16.6%). Acute subdural hematoma (174 cases, 39.6%) was most frequently seen in cranial CT findings on admission, which significantly increased with severity. A neurosurgical procedure was performed for 70 cases (15.9%), of which 15 (6.0%) were mild TBI and 18 (15.5%) were moderate TBI. The average hospital stay was 20.8 days, which significantly increased with severity. The overall rate of favorable outcome was 82.7%, and mortality was 8.2%; outcome deteriorated with severity. Some mild and moderate TBI cases had deteriorated and required surgery or resulted in death. These findings suggest that cautious treatment is necessary even in mild to moderate TBI cases which are often encountered in secondary medical service centers. (author)

  2. Regulatory aspects and practices of low level radioactive waste disposal in France

    Energy Technology Data Exchange (ETDEWEB)

    Pellerin, P [CEA Centre d' Etudes Nucleaires de Cadarache, 13 - Saint-Paul-les-Durance (France). Service de Protection contre les Rayonnements

    1982-01-01

    For the use of radioactivity in medicine, universities and conventional industries as well as nuclear power generation in France, the licensing of the users is performed on the basis of competence certification, the justification of application, the responsibility of the users and the record of all discharge and waste. Radioprotection survey is a responsibility of specialized doctors and biologists. The procedure of obtaining the license when people want to use artificial radionuclides is explained. The ORIS has devoted to the production and distribution of radioisotopes. The delivery of major isotopes to medicine and industries as non-sealed sources and sealed sources is reported. The obligation of the users, the licensing of their gaseous and liquid discharge, and the provisory storage of solid wastes are described. The problems are the diversity of the nature of wastes, the specialization of the means of treating each type of wastes, the dispersion of waste producers and the low volume to pick up. The solution in France is the establishment of a national agency five years ago. The waste processing and disposal system in France is explained. Radioprotection is not only a question of science, but also of philosophy, moral, extreme wisdom, economy, politics and public judgement.

  3. Regulatory aspects and practices of low level radioactive waste disposal in France

    International Nuclear Information System (INIS)

    Pellerin, P.

    1982-01-01

    For the use of radioactivity in medicine, universities and conventional industries as well as nuclear power generation in France, the licensing of the users is performed on the basis of competence certification, the justification of application, the responsibility of the users and the record of all discharge and waste. Radioprotection survey is a responsibility of specialized doctors and biologists. The procedure of obtaining the license when people want to use artificial radionuclides is explained. The ORIS has devoted to the production and distribution of radioisotopes. The delivery of major isotopes to medicine and industries as non-sealed sources and sealed sources is reported. The obligation of the users, the licensing of their gaseous and liquid discharge, and the provisory storage of solid wastes are described. The problems are the diversity of the nature of wastes, the specialization of the means of treating each type of wastes, the dispersion of waste producers and the low volume to pick up. The solution in France is the establishment of a national agency five years ago. The waste processing and disposal system in France is explained. Radioprotection is not only a question of science, but also of philosophy, moral, extreme wisdom, economy, politics and public judgement. (Kako,I.)

  4. Soil Quality Impacts of Current South American Agricultural Practices

    Directory of Open Access Journals (Sweden)

    Ana B. Wingeyer

    2015-02-01

    Full Text Available Increasing global demand for oil seeds and cereals during the past 50 years has caused an expansion in the cultivated areas and resulted in major soil management and crop production changes throughout Bolivia, Paraguay, Uruguay, Argentina and southern Brazil. Unprecedented adoption of no-tillage as well as improved soil fertility and plant genetics have increased yields, but the use of purchased inputs, monocropping i.e., continuous soybean (Glycine max (L. Merr., and marginal land cultivation have also increased. These changes have significantly altered the global food and feed supply role of these countries, but they have also resulted in various levels of soil degradation through wind and water erosion, soil compaction, soil organic matter (SOM depletion, and nutrient losses. Sustainability is dependent upon local interactions between soil, climate, landscape characteristics, and production systems. This review examines the region’s current soil and crop conditions and summarizes several research studies designed to reduce or prevent soil degradation. Although the region has both environmental and soil resources that can sustain current agricultural production levels, increasing population, greater urbanization, and more available income will continue to increase the pressure on South American croplands. A better understanding of regional soil differences and quantifying potential consequences of current production practices on various soil resources is needed to ensure that scientific, educational, and regulatory programs result in land management recommendations that support intensification of agriculture without additional soil degradation or other unintended environmental consequences.

  5. Current Practices in Defining Seismic Input for Nuclear Facilities

    International Nuclear Information System (INIS)

    2015-05-01

    This report has been written in the framework of seismic subgroup of the OECD/NEA CSNI Working Group on Integrity and Ageing of Components and Structures (WGIAGE) to provide a brief review of current practices regarding the definition of the seismic input for design and reevaluation of nuclear power plants. It is taken for granted that, prior to conducting the seismic design of a nuclear facility, a seismic hazard analysis (SHA) has been conducted for the site where the facility is located. This provides some reference motions for defining those that will later be used as input for the dynamic analyses of the facility. The objective of the report is to clarify the current practices in various OECD Member States for defining the seismic input to be used in the dynamic calculations of NPPs, once the SHA results are already at hand. Current practices have been summarized for Canada, Czech Republic, Finland, France, Germany, Japan, Slovenia, South Korea, Spain, Sweden, The Netherlands, United Kingdom and United States. The main findings of the report are: a) The approaches followed by the regulatory bodies of OECD Member States differ substantially, certainly in relation with the consideration of site effects, but also in the probability level of the event that a nuclear facility should be required to withstand. b) In many countries a probabilistic approach is adopted for the design, in some cases combined with a deterministic one; in other cases, like France, Japan or South Korea, a deterministic approach is followed. c) The US and Japan have the more complete guidelines in relation with site effects. The former provide specific approaches for definition of the seismic input. The latter clearly recognizes the need to propagate the bedrock motion to foundation level, thereby introducing the site effect in some way. d) The definition of bedrock is very heterogeneous in the various countries, although this should not constitute a serious problem if the starting

  6. Study of deep ocean currents near the 3800-M low-level radioactive waste disposal site. May 1984-May 1986. Final report

    International Nuclear Information System (INIS)

    Casagrande, C.; Hamilton, P.

    1988-06-01

    The report presents the results of a two-year study of a U.S. 3800-m low-level radioactive waste-disposal site near the mouth of the Hudson Canyon. The program objectives were to describe the currents, including their source and variability, and deduce from the data the potential for, and direction of, transport of contaminants from the disposal area. The results show that the currents in the disposal area range in strength from a few to 62 cm/sec and are principally due to the presence of low-frequency topographic Rossby waves having periods of approximately two to four weeks. The currents generally flow towards the southwest, in line with the general topography of the mid-Atlantic region. The canyon acts to distort the southwest flow, resulting in currents below the canyon rim which are aligned with the canyon onshore-offshore axis. The direction of currents along the canyon axis appears to be determined by the proximity of both the Gulf Stream and the Western Boundary Undercurrent

  7. Typography and layout of technical reports - Survey of current practices

    Science.gov (United States)

    Pinelli, T. E.; Cordle, V. M.; Mccullough, R.

    1985-01-01

    As part of a review of the NASA Langley Research Center scientific and technical information program, 50 technical reports from industry, research institutions, and government agencies were systematically examined and analyzed to determine current usage and practice in regard to (1) typography, including composition method, type style, type size, and margin treatment; (2) graphic design, including layout and imposition of material on the page; and (3) physical media, including paper, ink, and binding methods. The results indicate that approximately 50 percent of the reports were typeset, 70 percent used Roman (serif) type, 80 percent used 10- or 11-point type for text, 60 percent used a ragged right-hand margin, slightly more than half used paragraph indentation, 75 percent used a single-column layout, 65 percent had one or more figures or tables placed perpendicular to (not aligned with) the text, and perfect binding was the most frequently used binding method.

  8. Local air quality management: some evidence of current practices

    Energy Technology Data Exchange (ETDEWEB)

    Beattie, Clare; Newton, Alex; Longhurst, Jim [University of the West of England, Air Quality Research Group, Bristol (United Kingdom)

    1998-12-01

    The recent legislative changes, notably the Environment Act 1995 and resultant National Air Quality Strategy have brought new powers and obligations to local authorities to reach specified air quality standards and objectives. Initially this will involve local authorities carrying out a review and assessment of air quality in their locality by December 1999. This paper will outline a project currently being undertaken within the University of the West of England investigating how this legislation is being put into practice and present the results from a nation-wide questionnaire survey of environmental health officers. The study found that local authorities are still at an early stage of the process. It seems probable that one possible barrier to the implementation of Air Quality Management will be communication and cooperation within local authorities. (Author)

  9. Current practice for diagnosis and management of silent atrial fibrillation

    DEFF Research Database (Denmark)

    Dobreanu, Dan; Svendsen, Jesper Hastrup; Lewalter, Thorsten

    2013-01-01

    for the diagnosis and management of silent AF. This survey is based on an electronic questionnaire sent to the European Heart Rhythm Association Research Network partners. Responses were received from 33 centres in 16 countries. The preferred screening methods for silent AF in patients with rhythm control...... for such patients. Most responders preferred rate control over rhythm control in patients with silent AF, although some favoured pulmonary vein isolation in young patients. However, oral anticoagulant therapy in patients at high thromboembolic risk was considered mandatory by most, provided that at least one......Although it is well known that silent atrial fibrillation (AF) is associated with morbidity and mortality rates similar to those of symptomatic AF, no specific strategy for screening and management of this form of AF has been advocated. The purpose of this survey was to identify current practices...

  10. Current best practice in the management of Turner syndrome

    Science.gov (United States)

    Shankar, Roopa Kanakatti; Backeljauw, Philippe F.

    2017-01-01

    Turner syndrome (TS) is characterized by partial or complete loss of the second X-chromosome in phenotypic females resulting in a constellation of clinical findings that may include lymphedema, cardiac anomalies, short stature, primary ovarian failure and neurocognitive difficulties. Optimizing health care delivery is important to enable these individuals achieve their full potential. We review the current best practice management recommendations for individuals with TS focusing on the latest consensus opinion in regard to genetic diagnosis, treatment of short stature, estrogen supplementation, addressing psychosocial issues, as well screening for other comorbidities. A multidisciplinary approach and a well-planned transition to adult follow-up care will improve health care delivery significantly for this population. PMID:29344338

  11. Healthcare waste management: current practices in selected healthcare facilities, Botswana.

    Science.gov (United States)

    Mbongwe, Bontle; Mmereki, Baagi T; Magashula, Andrew

    2008-01-01

    Healthcare waste management continues to present an array of challenges for developing countries, and Botswana is no exception. The possible impact of healthcare waste on public health and the environment has received a lot of attention such that Waste Management dedicated a special issue to the management of healthcare waste (Healthcare Wastes Management, 2005. Waste Management 25(6) 567-665). As the demand for more healthcare facilities increases, there is also an increase on waste generation from these facilities. This situation requires an organised system of healthcare waste management to curb public health risks as well as occupational hazards among healthcare workers as a result of poor waste management. This paper reviews current waste management practices at the healthcare facility level and proposes possible options for improvement in Botswana.

  12. REVIEW OF CURRENT PRACTICE IN CHARACTERIZATION AND MONITORING

    Energy Technology Data Exchange (ETDEWEB)

    M.A.Ebadian, Ph.D.

    2001-01-01

    Characterization and monitoring are important parts of environmental remediation of contaminated sites by the Department of Energy--Office of Environmental Management (DOE-EM). The actual remediation process often cannot begin or even be planned until characterization is complete. Monitoring is essential to verify the progress of remediation and of the waste stream. However, some contaminated sites are difficult, costly, or have a high exposure risk to personnel to characterize or monitor using the baseline technology or current practice. Therefore, development of new characterization and monitoring technologies is time-critical to remediate these sites. The main task of the Characterization, Monitoring, and Sensor Technology Crosscutting Program (CMST-CP) is to develop and deploy innovative characterization and monitoring technologies that improve performance and reduce personnel exposure, cost, and detection limits. However, to evaluate different proposals for new technologies to decide which ones to develop or deploy, it is necessary to compare their cost and performance to the baseline technology. The goal of this project is to facilitate the direct comparison of new technologies to the baseline technology by documenting the current practices for site characterization and monitoring at DOE sites and by presenting the information in an easy-to-use, concise database. The database will assist the CMST-CP and others in evaluating or designing new technologies by identifying the baseline technologies and describing their performance and cost. The purpose of this document is to report on the completion of this project and to describe the database. Section 2.0 describes the data assessment methodology. Section 3.0 presents the database and serves as a user manual. Section 4.0 lists the references used for each baseline technology in the database. The full references can be found in the Appendix.

  13. REVIEW OF CURRENT PRACTICE IN CHARACTERIZATION AND MONITORING

    International Nuclear Information System (INIS)

    Ebadian, M.A.

    2001-01-01

    Characterization and monitoring are important parts of environmental remediation of contaminated sites by the Department of Energy--Office of Environmental Management (DOE-EM). The actual remediation process often cannot begin or even be planned until characterization is complete. Monitoring is essential to verify the progress of remediation and of the waste stream. However, some contaminated sites are difficult, costly, or have a high exposure risk to personnel to characterize or monitor using the baseline technology or current practice. Therefore, development of new characterization and monitoring technologies is time-critical to remediate these sites. The main task of the Characterization, Monitoring, and Sensor Technology Crosscutting Program (CMST-CP) is to develop and deploy innovative characterization and monitoring technologies that improve performance and reduce personnel exposure, cost, and detection limits. However, to evaluate different proposals for new technologies to decide which ones to develop or deploy, it is necessary to compare their cost and performance to the baseline technology. The goal of this project is to facilitate the direct comparison of new technologies to the baseline technology by documenting the current practices for site characterization and monitoring at DOE sites and by presenting the information in an easy-to-use, concise database. The database will assist the CMST-CP and others in evaluating or designing new technologies by identifying the baseline technologies and describing their performance and cost. The purpose of this document is to report on the completion of this project and to describe the database. Section 2.0 describes the data assessment methodology. Section 3.0 presents the database and serves as a user manual. Section 4.0 lists the references used for each baseline technology in the database. The full references can be found in the Appendix

  14. Baby walkers--health visitors' current practice, attitudes and knowledge.

    Science.gov (United States)

    Kendrick, Denise; Illingworth, Rachel; Hapgood, Rhydian; Woods, Amanda J; Collier, Jacqueline

    2003-09-01

    Baby walkers are a commonly used item of nursery equipment. Between 12% and 50% of parents whose infant uses a walker report that their child has suffered a walker-related injury. Health visitors' knowledge, attitudes and practice with regard to walkers and related health education has not been explored so far. The aim of the study was to describe health visitors' knowledge of walkers and walker-related injuries, their attitudes towards walkers and current practice with regard to walker health education, and to examine the relationship between knowledge and attitudes and knowledge and practice. A survey was carried out with 64 health visitors prior to participation in a randomized controlled trial assessing the effectiveness of an educational package in reducing baby walker use. The response rate was 95%. Half of the health visitors always discussed walkers postnatally, most frequently at the 6-9 month check. Most did not usually discuss the frequency of walker-related injuries. Most had negative attitudes towards walkers, but believed that parents hold positive attitudes to them and that it is hard to persuade parents not to use them. Health visitors had a limited knowledge of walker use and walker-related injuries. Those giving advice on walkers most often had higher knowledge scores than those giving advice less often (P = 0.03). Those with higher knowledge scores held more negative attitudes towards walkers (rs = 0.29, P = 0.023) and believed parents to have more positive attitudes towards walkers (rs = -0.49, P negotiating alternatives to their use. The provision of audio-visual aids for discussing walkers might also be helpful.

  15. Emergency room management of ureteral calculi: current practices.

    Science.gov (United States)

    Phillips, Elizabeth; Kieley, Sam; Johnson, Elizabeth B; Monga, Manoj

    2009-06-01

    To evaluate current practice patterns in U.S. emergency departments (EDs) for the diagnosis, treatment, and counseling of patients with ureteral calculi. Hospital-based ED physicians were invited by e-mail to participate in a Survey-Monkey survey. E-mails were delivered in March 2008 by Direct Medical Data using a listserv provided by the American Medical Association. Of the e-mails sent, 173 e-mails were opened, and 135 physicians responded. Physicians were compensated with a $10 Amazon.com gift card. Ninety percent of ED physicians use noncontrast CT as their initial imaging modality, and 63% use alpha-blockers for medical expulsive therapy. Only 13% of evaluated EDs have guidelines for the management of renal colic, and only 58% of these guidelines that recommend the use of an alpha-blocker. Alpha-blocker use was more common with physicians who have been practicing fewer than 5 years (81%) compared with those with more than 10 years of experience (56%). The majority of physicians used ketorolac and morphine to achieve effective analgesia. Although the average responses concerning the chance of spontaneous stone passage for stones 4 mm (44%) were close to evidence-based values, great variation in the answers was noted (standard deviations: 12% and 22%, respectively). Indeed, 38% of respondents stated that stones 95% chance of passage. Twenty-eight percent of ED physicians would arrange follow-up with a primary care physician, while the remainder would arrange follow-up with a urologist. This study establishes a need for educational opportunities for ED physicians in the management of renal colic. The development of collaborative practice guidelines between urology and emergency medicine associations may be warranted.

  16. Renal biopsies in children: current practice and audit of outcomes.

    Science.gov (United States)

    Hussain, Farida; Mallik, Meeta; Marks, Stephen D; Watson, Alan R

    2010-02-01

    There is considerable variation in the way that children are prepared for and the techniques employed in a renal biopsy. There was national agreement between UK paediatric renal centres to review current practice and audit outcomes An initial questionnaire survey was undertaken and a 12-month prospective audit performed of renal biopsies against agreed standards for the number of needle passes, adequacy of biopsy material and complication rates. Eleven of 13 centres participated. Information leaflets are sent pre-biopsy in five centres with only one using play preparation. Six of 11 routinely perform biopsies as day-case (DC) procedures and 6 use general anaesthesia (GA). Real-time ultrasound is the favoured method in eight centres. Biopsies are performed by nephrologists only in four centres, nephrologists with radiologists in five and radiology alone in two. Of 531 biopsies (352 native), 31% were performed as a DC with 49% being done under GA. The standard for the number of passes of native kidneys (95%). The major complication rate was higher than the standard of practice with limited use of preparation materials and DC procedures. The results have stimulated constructive debate about preparation and indications for biopsy and training issues. The audit enables centres and individuals to monitor performance.

  17. Current nursing practice by hospital-based stoma specialist nurses.

    Science.gov (United States)

    Burch, Jennie

    Nurses frequently care for patients who have stomas. A common complication is sore peristomal skin (skin around the stoma). The study aim was to answer the research question: what is the current nursing practice for peristomal skin problems among UK stoma specialist nurses? The question was explored through investigation of descriptions, treatments and opinions of peristomal skin problems. Results were examined to ascertain if practice reflects the literature and if care was evidence-based. A questionnaire was posted in September 2009 to the stoma care nurses in all UK NHS hospitals (n=596). The proportion of completed or partially completed questionnaires was 15% (89 of 596). Most of the responding nurses held a stoma-related qualification (86%), a degree (55%) and had specialised in stoma care for over 5 years (67%). Respondents used erythema to describe sore skin (80%). Stoma powder (98%) and convex appliances (98%) were the most commonly used treatments. The most common cause of sore skin was appliance leakage (61%). The study population was deemed suitably qualified and experienced to answer the research question. Many responses were reflected in the literature (predominantly opinion articles), reflecting a degree of reliability and validity. It could be concluded that stoma specialist nurses can accurately assess and use stoma accessories to treat sore skin, but due to the paucity of research, the care cannot be defined as evidence-based. More research is needed to determine universally accepted definitions and treatments for sore peristomal skin.

  18. Approaches and practices related to hazardous waste management, processing and final disposal in germany and Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Passos, J.A.L.; Pereira, F.A.; Tomich, S. [CETREL S.A., Camacari, BA (Brazil)

    1993-12-31

    A general overview of the existing management and processing of hazardous wastes technologies in Germany and Brazil is presented in this work. Emphasis has been given to the new technologies and practices adopted in both countries, including a comparison of the legislation, standards and natural trends. Two case studies of large industrial hazardous waste sites are described. 9 refs., 2 figs., 9 tabs.

  19. Approaches and practices related to hazardous waste management, processing and final disposal in germany and Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Passos, J A.L.; Pereira, F A; Tomich, S [CETREL S.A., Camacari, BA (Brazil)

    1994-12-31

    A general overview of the existing management and processing of hazardous wastes technologies in Germany and Brazil is presented in this work. Emphasis has been given to the new technologies and practices adopted in both countries, including a comparison of the legislation, standards and natural trends. Two case studies of large industrial hazardous waste sites are described. 9 refs., 2 figs., 9 tabs.

  20. Biosafety in the Laboratory: Prudent Practices for the Handling and Disposal of Infectious Materials

    Science.gov (United States)

    1989-03-01

    psittacosis, lymphogranuloma animal disease diagnostic laboratory). Biosafety Level venereum (LGV), and trachoma are documented APPENDIX A I11 hazards and...127 see also Facilities Lymphogranuloma venereum , 110-111 Laboratory practices academic laboratories, 68-69 M Biosafety Level 1, 90 Biosafety Level

  1. Research on geological disposal: R and D concept on geological disposal

    International Nuclear Information System (INIS)

    1993-01-01

    The objective on geological disposal of high-level radioactive wastes are to ensure the long term radiological protection of the human and his environment in accordance with current internationally agreed radiation protection principles. The principle of geological disposal is to settle the high-level wastes in deep underground so as to isolate them from the human and his environment considering the existence of groundwater. Japan is currently in the stage of assessing technical feasibility of geological disposal to the extent practicable. In accordance with the AEC (Atomic Energy Commission) policy in 1989, PNC (Power Reactor and Nuclear Fuel Development Corporation) has conducted the research and development on geological disposal in three areas: 1) studies of geological environment, 2) research and development of disposal technology, and 3) performance assessment study. (author)

  2. Is dosimetry still a necessity in current dental practice?

    International Nuclear Information System (INIS)

    Reddy, S S; Rakesh, N; Clint, Joseph Ben; Sharma, Shivani; Chauhan, Pallavi

    2015-01-01

    Today, dentists have a wide range of imaging modalities to choose from, the film based techniques, digital techniques, and the recent introduction of 3D volumetric or cone beam computed tomography (CBCT). The inherent design features of the new generation dental x-ray equipment has significantly improved over the years with no evidence of substandard x-ray units in operation. In dental facilities radiological workload is comparatively low, newer radiation equipments and accessories follow safety guidelines and employ better radiation protection measures for the patient and the operator. Dentists’ knowledge and expertise in radiation protection measures is good, enabling them to carry out riskfree radiation procedures in their practice. Therefore, the present study is aimed at assessing the need for dosimeters in current dental scenario.‘Is there currently a significant risk from dental radiography to merit the use of personal dosimetery in dental practice.’Dental health professionals (Oral radiologists) and radiographic assistants of fourteen dental colleges in Karnataka state participated in this questionnaire study. The questionnaire consisted of the following questions—the make, type, year of manufacture of radiographic machines used in their setup, number of radiographs made per day in the institution, type of receptors used, number of personnel at risk for radiation exposure, radiation protection measures used, regular monitoring by personal dosimeters, equivalent dosage readings for the past 12 months and whether the reading of thermoluminescent dosimeters (TLD) for any personnel had exceeded the recommended exposure value in the last 3 years.Dosimetry records of the radiology staff in the last three years shows doses no more than 1.50 mSv per year. The various institutions’ dose (person mSv) was in the range of 3.70 mSv–3.90 mSv.Personal monitoring for Dentists can be omitted in the dental colleges since the estimated dose of oral radiologists

  3. Colostomy irrigation: current knowledge and practice of WOC nurses.

    Science.gov (United States)

    Cobb, Martha D; Grant, Marcia; Tallman, Nancy J; Wendel, Christopher S; Colwell, Janice; McCorkle, Ruth; Krouse, Robert S

    2015-01-01

    This study builds on the authors' previous studies that demonstrate that persons living with a colostomy who practice colostomy irrigation (CI) experience quality-of-life benefits. Studies also reveal that patients may not be taught about CI. The purpose of this study was to determine current knowledge, attitudes, and practices of WOC nurses on CI. The target population was ostomy nurses who were members of the Wound, Ostomy and Continence Nurse's Society. Nine hundred eighty-five nurses out of a possible pool of 4191 members responded, providing a response rate of 24%. Their average age was 53 years (range, 25-79 years). Respondents averaged 12 years' experience as a WOC nurse (range, 1-40 years) and 90% (n = 875) were certified. Participants practiced in a variety of settings, including acute and long-term care facilities, home health, and ambulatory clinics. They saw an average of 37 ± 60.5 (mean ± SD) ostomy patients per year (range, 0-1100). A 1-time online survey (SurveyMonkey) of members of the Wound, Ostomy and Continence Nurses (WOCN) Society was conducted. In addition to demographic and educational information, questions also included (1) CI advantages and disadvantages; (2) CI content routinely taught; (3) challenges in assisting patients to learn CI; and (4) where preparation was received for teaching this procedure. Nurses were asked whether they believe CI is evidence-based. More than half identified irrigation as an evidence-based practice (59%), but half indicated they do not routinely teach CI. Multiple factors correlated with nurses' decisions to teach CI, including years of experience (P = .03), specific CI education (P < .001), and considering the intervention evidence-based (P < .001). Factors influencing CI instruction are multifactorial; they include nurses' attitudes, experience base, education, medical indications, setting characteristics, and patient interest and physical abilities. Education on this procedure is urgently needed for

  4. Child obesity prevention in primary health care: investigating practice nurse roles, attitudes and current practices.

    Science.gov (United States)

    Robinson, Alison; Denney-Wilson, Elizabeth; Laws, Rachel; Harris, Mark

    2013-04-01

    Overweight and obesity affects approximately 20% of Australian pre-schoolers. The general practice nurse (PN) workforce has increased in recent years; however, little is known of PN capacity and potential to provide routine advice for the prevention of child obesity. This mixed methods pilot study aims to explore the current practices, attitudes, confidence and training needs of Australian PNs surrounding child obesity prevention in the general practice setting. PNs from three Divisions of General Practice in New South Wales were invited to complete a questionnaire investigating PN roles, attitudes and practices in preventive care with a focus on child obesity. A total of 59 questionnaires were returned (response rate 22%). Semi-structured qualitative interviews were also conducted with a subsample of PNs (n = 10). Questionnaire respondent demographics were similar to that of national PN data. PNs described preventive work as enjoyable despite some perceived barriers including lack of confidence. Number of years working in general practice did not appear to strongly influence nurses' perceived barriers. Seventy per cent of PNs were interested in being more involved in conducting child health checks in practice, and 85% expressed an interest in taking part in child obesity prevention training. Findings from this pilot study suggest that PNs are interested in prevention of child obesity despite barriers to practice and low confidence levels. More research is needed to determine the effect of training on PN confidence and behaviours in providing routine healthy life-style messages for the prevention of child obesity. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  5. Validation of analytical methods in GMP: the disposable Fast Read 102® device, an alternative practical approach for cell counting.

    Science.gov (United States)

    Gunetti, Monica; Castiglia, Sara; Rustichelli, Deborah; Mareschi, Katia; Sanavio, Fiorella; Muraro, Michela; Signorino, Elena; Castello, Laura; Ferrero, Ivana; Fagioli, Franca

    2012-05-31

    The quality and safety of advanced therapy products must be maintained throughout their production and quality control cycle to ensure their final use in patients. We validated the cell count method according to the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use and European Pharmacopoeia, considering the tests' accuracy, precision, repeatability, linearity and range. As the cell count is a potency test, we checked accuracy, precision, and linearity, according to ICH Q2. Briefly our experimental approach was first to evaluate the accuracy of Fast Read 102® compared to the Bürker chamber. Once the accuracy of the alternative method was demonstrated, we checked the precision and linearity test only using Fast Read 102®. The data were statistically analyzed by average, standard deviation and coefficient of variation percentages inter and intra operator. All the tests performed met the established acceptance criteria of a coefficient of variation of less than ten percent. For the cell count, the precision reached by each operator had a coefficient of variation of less than ten percent (total cells) and under five percent (viable cells). The best range of dilution, to obtain a slope line value very similar to 1, was between 1:8 and 1:128. Our data demonstrated that the Fast Read 102® count method is accurate, precise and ensures the linearity of the results obtained in a range of cell dilution. Under our standard method procedures, this assay may thus be considered a good quality control method for the cell count as a batch release quality control test. Moreover, the Fast Read 102® chamber is a plastic, disposable device that allows a number of samples to be counted in the same chamber. Last but not least, it overcomes the problem of chamber washing after use and so allows a cell count in a clean environment such as that in a Cell Factory. In a good manufacturing practice setting the disposable

  6. Validation of analytical methods in GMP: the disposable Fast Read 102® device, an alternative practical approach for cell counting

    Directory of Open Access Journals (Sweden)

    Gunetti Monica

    2012-05-01

    Cell Factory. In a good manufacturing practice setting the disposable cell counting devices will allow a single use of the count chamber they can then be thrown away, thus avoiding the waste disposal of vital dye (e.g. Trypan Blue or lysing solution (e.g. Tuerk solution.

  7. Investigating sources of pharmaceutical pollution: Survey of over-the-counter and prescription medication purchasing, use, and disposal practices among university students.

    Science.gov (United States)

    Vatovec, Christine; Van Wagoner, Emily; Evans, Corey

    2017-08-01

    Pharmaceutical pollution in surface waters poses a range of risks to public health and aquatic ecosystems. Consumers contribute to pharmaceutical pollution via use and disposal of medications, though data on such behaviors is limited. This paper investigates the purchasing, use, and disposal practices among a population that has been researched only minimally to date, yet will determine pharmaceutical pollution for decades to come: young adults represented by a university student population. We employed an online, 21-question survey to examine behaviors related to pharmaceuticals among students at the University of Vermont (n = 358). Results indicate that the majority of respondents had purchased medications in the previous 12 months (94%), and had leftover drugs (61%). Contrary to previous studies of older populations, only a small proportion of students had disposed of drugs (18%); municipal trash was the primary route of drug disposal (25%), and very few students disposed drugs via flushing (1%). Less than a quarter of students were aware of drug take-back programs (24%), and only 4% had ever used take-back services. These findings indicate that the university student population may be storing a large volume of unused drugs that will require future disposal. Increasing awareness of, access to, and participation in pro-environment pharmaceutical behaviors, such as purchasing over-the-counter medication in smaller quantities and utilizing drug take-back programs, could minimize future pharmaceutical pollution from this population. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Pharmacovigilance in oncology: evaluation of current practice and future perspectives.

    Science.gov (United States)

    Baldo, Paolo; De Paoli, Paolo

    2014-10-01

    Pharmacovigilance (PV), or drug safety monitoring, aims to improve patient safety through the detection and management of drug-related adverse reactions. It is implemented both by spontaneous reporting of adverse drug reactions (ADRs) and by careful detection of signals suggestive of drug toxicity. PV is an important clinical topic in clinical practice and pharmacotherapy, assuring the maintenance of a safe risk/benefit ratio throughout the commercial life cycle of a drug. We conducted a structured literature search on PubMed, Scopus, Cinahl and the Cochrane Library. We also performed manual searches in international databases of ADR individual reports to outline a structured profile on the topic. Our goal was to review key elements that affect safety monitoring of cancer drugs and their appropriate use, highlighting the strengths and weaknesses of PV in oncology. This paper provides an understanding of the methodologies used by PV in current clinical practice and particularly in cancer drug therapy; a focus upon reporting of ADRs by health professionals and patients; and a focus upon methods used by PV to detect new signals of risk/harm related to medicines utilization. To our knowledge, few articles focus upon the importance of PV and post-marketing surveillance of cancer drug therapies. Structured management of spontaneous reports of ADRs and data collection is essential to monitoring the safe use of drugs in this field in which pharmacotherapy is affected by high incidence of drug-related complications and by a narrow benefit/risk ratio. © 2014 John Wiley & Sons, Ltd.

  9. Survey on current practices for neurological prognostication after cardiac arrest.

    Science.gov (United States)

    Friberg, Hans; Cronberg, Tobias; Dünser, Martin W; Duranteau, Jacques; Horn, Janneke; Oddo, Mauro

    2015-05-01

    To investigate current practices and timing of neurological prognostication in comatose cardiac arrest patients. An anonymous questionnaire was distributed to the 8000 members of the European Society of Intensive Care Medicine during September and October 2012. The survey had 27 questions divided into three categories: background data, clinical data, decision-making and consequences. A total of 1025 respondents (13%) answered the survey with complete forms in more than 90%. Twenty per cent of respondents practiced outside of Europe. Overall, 22% answered that they had national recommendations, with the highest percentage in the Netherlands (>80%). Eighty-nine per cent used induced hypothermia (32-34 °C) for comatose cardiac arrest patients, while 11% did not. Twenty per cent had separate prognostication protocols for hypothermia patients. Seventy-nine per cent recognized that neurological examination alone is not enough to predict outcome and a similar number (76%) used additional methods. Intermittent electroencephalography (EEG), brain computed tomography (CT) scan and evoked potentials (EP) were considered most useful. Poor prognosis was defined as cerebral performance category (CPC) 3-5 (58%) or CPC 4-5 (39%) or other (3%). When prognosis was considered poor, 73% would actively withdraw intensive care while 20% would not and 7% were uncertain. National recommendations for neurological prognostication after cardiac arrest are uncommon and only one physician out of five uses a separate protocol for hypothermia treated patients. A neurological examination alone was considered insufficient to predict outcome in comatose patients and most respondents advocated a multimodal approach: EEG, brain CT and EP were considered most useful. Uncertainty regarding neurological prognostication and decisions on level of care was substantial. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Bioorganic Municipal Waste Management to Deploy a Sustainable Solid Waste Disposal Practice in China

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    The utilization of bioorganic municipal waste (BMW) is considered essentially for the further development of integrated waste management practice in China. Awareness and knowledge about the importance of BMW management and source separation of waste on household level, as a precondition for the implementation of an economically feasible integrated waste management infrastructure, were developed in Europe during the last decade. The Sino-German RRU-BMW Project is facilitating applied research investigations in 4 pilot areas in Shenyang to assess the population's behavior to develop the design criteria for appropriate process technologies and to provide the basis to adopt BMW management policy in China.

  11. Ecological models and pesticide risk assessment: current modeling practice.

    Science.gov (United States)

    Schmolke, Amelie; Thorbek, Pernille; Chapman, Peter; Grimm, Volker

    2010-04-01

    Ecological risk assessments of pesticides usually focus on risk at the level of individuals, and are carried out by comparing exposure and toxicological endpoints. However, in most cases the protection goal is populations rather than individuals. On the population level, effects of pesticides depend not only on exposure and toxicity, but also on factors such as life history characteristics, population structure, timing of application, presence of refuges in time and space, and landscape structure. Ecological models can integrate such factors and have the potential to become important tools for the prediction of population-level effects of exposure to pesticides, thus allowing extrapolations, for example, from laboratory to field. Indeed, a broad range of ecological models have been applied to chemical risk assessment in the scientific literature, but so far such models have only rarely been used to support regulatory risk assessments of pesticides. To better understand the reasons for this situation, the current modeling practice in this field was assessed in the present study. The scientific literature was searched for relevant models and assessed according to nine characteristics: model type, model complexity, toxicity measure, exposure pattern, other factors, taxonomic group, risk assessment endpoint, parameterization, and model evaluation. The present study found that, although most models were of a high scientific standard, many of them would need modification before they are suitable for regulatory risk assessments. The main shortcomings of currently available models in the context of regulatory pesticide risk assessments were identified. When ecological models are applied to regulatory risk assessments, we recommend reviewing these models according to the nine characteristics evaluated here. (c) 2010 SETAC.

  12. Basic reasons and the practice of using deep water-bearing levels for liquid radioactive waste disposal

    International Nuclear Information System (INIS)

    Spitsyn, V.I.; Pimenov, M.K.; Balukova, V.D.; Leontichuk, A.S.; Kokorin, I.N.; Yudin, F.P.; Rakov, N.A.

    1978-01-01

    Speculations are presented on the development and organization of liquid radioactive waste underground disposal in deep water-bearing levels completely isolated from other levels and the surface. Major requirements are formulated that are laid down to low-, moderate-and high-radioactive wastes subject to the disposal. Geological and hydrological conditions as well as the scheme and design features of pilot field facilities are described, where works on high-active waste disposal were started in 1972. In 1972 and 1973 450 and 1050 m 3 of the wastes (7.5 and 53 MCi) respecrespectively were disposed. The first results of the pilot disposal and the 3-year surveillance over the plate-collector condition and the performance of the facilities have reaffirmed the feasibility, medical and radiation safety and economic attractiveness of the disposal of wastes with up to 10-25 Ci/l specific activity

  13. Current UK practices in the management of subacromial impingement

    Science.gov (United States)

    Drury, Colin; Tait, Gavin R

    2015-01-01

    Background Controversy presently exists surrounding the management of patients with subacromial impingement. This study aims to highlight current UK practices in the management of these patients. Methods BESS members were invited to complete a questionnaire and responses were received from 157 consultant shoulder surgeons. Results Physiotherapy is an integral part of management for 93% of surgeons with a minimum period of 12 weeks being most popular prior to consideration of arthroscopic subacromial decompression. Subacromial steroid injection is used by 95% and 86% repeat this if the patient has failed to respond to a previous injection by the general practioner. From initial presentation, 77% felt there should be at least 3 months of conservative management before proceeding to surgery. Good but transient response to subacromial injection was considered the best predictor of good surgical outcome by 77%. The coracoacromial ligament is fully released by 78%, although there was greater variation in how aggressive surgeons were with acromioplasty. Most (59%) do not include the nontender acromioclavicular joint to any extent in routine acromioplasty. Hospital physiotherapy protocols are used by 63% for postoperative rehabilitation. Conclusions Variation exists in the management regimes offered to patients with subacromial impingement, but most employ a minimum period of 12 weeks of conservative management incorporating physiotherapy and at least 2 subacromial steriod injections. PMID:27582972

  14. Postoperative delirium in elderly citizens and current practice

    Directory of Open Access Journals (Sweden)

    Siddareddygari Velayudha Reddy

    2017-01-01

    Full Text Available Postoperative delirium (POD represents an acute brain dysfunction in the postsurgical period. Perioperative physicians caring for the older adults are familiar with the care of dysfunction of organs such as lungs, heart, liver, or kidney in the perioperative setting, but they are less familiar with management of brain dysfunction. As early detection and prompt treatment of inciting factors are utmost important to prevent or minimize the deleterious outcomes of delirium. The purpose of this review is to prepare perioperative physicians with a set of current clinical practice recommendations to provide optimal perioperative care of older adults, with a special focus on specific perioperative interventions that have been shown to prevent POD. On literature search in EMBASE, CINAHL, and PUBMED between January 2000 and September 2015 using search words delirium, POD, acute postoperative confusion, and brain dysfunction resulted in 9710 articles. Among them, 73 articles were chosen for review, in addition, National Institute for Health and Clinical Excellence guidelines, American Geriatric Society guidelines, hospital elderly life program-confusion assessment method training manual, New York geriatric nursing protocols, World Health Organization's International Classification of Diseases, 10th Revision classification of mental disorders, Food and Drug Administration requests boxed warnings on older class of antipsychotic drugs 2008 and delirium in Miller's text book of anesthesia were reviewed and relevant information presented in this article.

  15. Current safety practices in nano-research laboratories in China.

    Science.gov (United States)

    Zhang, Can; Zhang, Jing; Wang, Guoyu

    2014-06-01

    China has become a key player in the global nanotechnology field, however, no surveys have specifically examined safety practices in the Chinese nano-laboratories in depth. This study reports results of a survey of 300 professionals who work in research laboratories that handle nanomaterials in China. We recruited participants at three major nano-research laboratories (which carry out research in diverse fields such as chemistry, material science, and biology) and the nano-chemistry session of the national meeting of the Chinese Chemical Society. Results show that almost all nano-research laboratories surveyed had general safety regulations, whereas less than one third of respondents reported having nanospecific safety rules. General safety measures were in place in most surveyed nano-research laboratories, while nanospecific protective measures existed or were implemented less frequently. Several factors reported from the scientific literature including nanotoxicology knowledge gaps, technical limitations on estimating nano-exposure, and the lack of nano-occupational safety legislation may contribute to the current state of affairs. With these factors in mind and embracing the precautionary principle, we suggest strengthening or providing nanosafety training (including raising risk awareness) and establishing nanosafety guidelines in China, to better protect personnel in the nano-workplace.

  16. Current Continuing Professional Education Practice among Malaysian Nurses

    Directory of Open Access Journals (Sweden)

    Mei Chan Chong

    2014-01-01

    Full Text Available Nurses need to participate in CPE to update their knowledge and increase their competencies. This research was carried out to explore their current practice and the future general needs for CPE. This cross-sectional descriptive study involved registered nurses from government hospitals and health clinics from Peninsular Malaysia. Multistage cluster sampling was used to recruit 1000 nurses from four states of Malaysia. Self-explanatory questionnaires were used to collect the data, which were analyzed using SPSS version 16. Seven hundred and ninety-two nurses participated in this survey. Only 80% (562 of the nurses had engaged in CPE activities during the past 12 months. All attendance for the various activities was below 50%. Workshops were the most popular CPE activity (345, 43.6% and tertiary education was the most unpopular activity (10, 1.3%. The respondents did perceive the importance of future CPE activities for career development. Mandatory continuing professional education (MCPE is a key measure to ensure that nurses upgrade their knowledge and skills; however, it is recommended that policy makers and nurse leaders in the continuing professional development unit of health service facilities plan CPE activities to meet registered nurses’ (RNs needs and not simply organizational requirements.

  17. Gender relations and health research: a review of current practices

    Directory of Open Access Journals (Sweden)

    Bottorff Joan L

    2011-12-01

    Full Text Available Abstract Introduction The importance of gender in understanding health practices and illness experiences is increasingly recognized, and key to this work is a better understanding of the application of gender relations. The influence of masculinities and femininities, and the interplay within and between them manifests within relations and interactions among couples, family members and peers to influence health behaviours and outcomes. Methods To explore how conceptualizations of gender relations have been integrated in health research a scoping review of the existing literature was conducted. The key terms gender relations, gender interactions, relations gender, partner communication, femininities and masculinities were used to search online databases. Results Through analysis of this literature we identified two main ways gender relations were integrated in health research: a as emergent findings; and b as a basis for research design. In the latter, gender relations are included in conceptual frameworks, guide data collection and are used to direct data analysis. Conclusions Current uses of gender relations are typically positioned within intimate heterosexual couples whereby single narratives (i.e., either men or women are used to explore the influence and/or impact of intimate partner gender relations on health and illness issues. Recommendations for advancing gender relations and health research are discussed. This research has the potential to reduce gender inequities in health.

  18. Current UK practices in the management of subacromial impingement.

    Science.gov (United States)

    Bryceland, James K; Drury, Colin; Tait, Gavin R

    2015-07-01

    Controversy presently exists surrounding the management of patients with subacromial impingement. This study aims to highlight current UK practices in the management of these patients. BESS members were invited to complete a questionnaire and responses were received from 157 consultant shoulder surgeons. Physiotherapy is an integral part of management for 93% of surgeons with a minimum period of 12 weeks being most popular prior to consideration of arthroscopic subacromial decompression. Subacromial steroid injection is used by 95% and 86% repeat this if the patient has failed to respond to a previous injection by the general practioner. From initial presentation, 77% felt there should be at least 3 months of conservative management before proceeding to surgery. Good but transient response to subacromial injection was considered the best predictor of good surgical outcome by 77%. The coracoacromial ligament is fully released by 78%, although there was greater variation in how aggressive surgeons were with acromioplasty. Most (59%) do not include the nontender acromioclavicular joint to any extent in routine acromioplasty. Hospital physiotherapy protocols are used by 63% for postoperative rehabilitation. Variation exists in the management regimes offered to patients with subacromial impingement, but most employ a minimum period of 12 weeks of conservative management incorporating physiotherapy and at least 2 subacromial steriod injections.

  19. Current status of gas migration and swelling experiments using engineering scale model for immediate depth disposal in Japan

    International Nuclear Information System (INIS)

    Higashihara, Tomohiro; Ono, Makoto; Kawaragi, Chie; Saito, Shigeyuki

    2010-01-01

    In intermediate depth disposal facility of radioactive waste in Japan, waste is surrounded with bentonite layer to retard interaction of the waste and groundwater, because the bentonite layer saturated with the groundwater has very low hydraulic conductivity. On the other hand, it is important to confirm stability of barrier system for stress generated together with swelling of the bentonite and to understand effect of increase of gas pressure because of generation of hydrogen gas by corrosion of metallic waste. To understand and evaluate the swelling behavior of the bentonite layer, JNES carries out the experiment. In the experiments, we carry out the swelling experiment to examine the swelling behavior of the bentonite layer and the gas migration experiment to understand the gas migration behavior in the bentonite layer, using engineering scale model of the disposal facility. The swelling experiment has been in operation since June 2010. After this experiment, the gas migration experiment will start in July 2011. (orig.)

  20. Communication of Energy Efficiency Information to Remodelers: Lessons From Current Practice

    Energy Technology Data Exchange (ETDEWEB)

    Liaukus, C.

    2012-10-01

    The effective communication of energy efficiency and building science information to remodeling contractors is achieved through varying formats, timelines, and modes depending on who is delivering the information, who is intended to receive it, and what technical, intellectual,and time resources the recipients have at their disposal. Determining what type of communication is effective does not lend itself to a clearly quantifiable test but rather a qualitative one. That qualitative judgment can be supported by the research of current practices deemed effective for one or more of the following reasons: it has led to the successful completion of a certifying test or other evaluation, it has been widely used for the remodeling industry, it has been considered effective by a sampling of remodeling contractors, and/or it has proven effective in the field for the BARA team. These criteria were used to create a select list of communications to be further analyzed to determine why they are effective and how less successful formats or strategies can be revised for greater effectiveness.

  1. A practice of ultra-fine tailings disposal as filling material in a gold mine.

    Science.gov (United States)

    Deng, D Q; Liu, L; Yao, Z L; Song, K I-I L; Lao, D Z

    2017-07-01

    A practice of cemented backfill technology with ultra-fine tailings in a gold mine was comprehensively presented, and a series of tests were conducted in accordance with the peculiar properties of ultra-fine tailings and the mining technology conditions. The test results show that, the tailings from Shuiyindong Gold Mine have a great grinding fineness, with the average particle diameter 22.03 μm, in which the ultra-fine particles with the diameter below 20 μm occupying 66.13%. The analysis results of chemical components of tailings indicate that the content of SiO 2 is relatively low, i.e., 33.08%, but the total content of CaO, MgO and Al 2 O 3 is relatively high i.e., 36.5%. After the settlement of 4-6 h, the tailing slurry with the initial concentration of 40% has the maximum settling concentration of 54.692%, and the corresponding maximum settling unit weight is 1.497 g/cm 3 . During the field application, the ultra-fine tailings and PC32.5 cement were mixed with the cement-tailings ratios of 1:3-1:8, and the slurry concentration of 50 wt% was prepared. Using the slurry pump, the prepared cemented backfill slurries flowed into the goaf, and then the strength of the cemented backfill body met the mining technique requirements in Shuiyindong Gold Mine, where the ore body has a smooth occurrence, with the average thickness of approximately 2 m and the inclination angle ranging from 5 to 10°. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. 78 FR 4307 - Current Good Manufacturing Practice Requirements for Combination Products

    Science.gov (United States)

    2013-01-22

    ...-2009-N-0435] Current Good Manufacturing Practice Requirements for Combination Products AGENCY: Food and...) is issuing this regulation on the current good manufacturing practice (CGMP) requirements applicable... this subpart? (Sec. 4.2) D. What current good manufacturing practice requirements apply to my...

  3. 21 CFR 212.2 - What is current good manufacturing practice for PET drugs?

    Science.gov (United States)

    2010-04-01

    ..., holding, or distribution of PET drugs intended for human use. Current good manufacturing practice is... 21 Food and Drugs 4 2010-04-01 2010-04-01 false What is current good manufacturing practice for... HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR POSITRON EMISSION...

  4. Shifting currents: Progress, setbacks, and shifts in policy and practice

    Science.gov (United States)

    ,; Dunning, Charles; Robertson, Dale M.

    2016-01-01

    clean water future. More than a decade has passed since our first statewide WOW conversation and the report that captured recommendations from its participants: Waters of Wisconsin: The Future of Our Aquatic Ecosystems and Resources. Drawing from a diverse and growing set of stakeholders from across the state, the Wisconsin Academy initiated a new conversation in 2012 (known as WOW II) to assess progress in regard to our 2003 recommendations. We also sought to review the status of waters in Wisconsin today. The result of this renewed conversation is Shifting Currents: Progress, Setbacks, and Shifts in Policy and Practice. The new report assesses progress in brief, and explores in greater depth the continuing and emerging challenges to water quality, supply, and aquatic ecosystems in Wisconsin.In this report, we first review the context and frameworks for public decision-making about water and then examine some of the root causes—or “drivers”—and ecological stressors that underlie many of the symptoms we see in the form of pollution or ecosystem degradation in Wisconsin. This is followed by a summary of current water issues, many of which had been identified in the 2003 report and remain relevant today. We examine progress since 2003 but also setbacks, and discuss issues that we are likely to continue to face in the coming decades, including controlling agricultural runoff, mitigating climate change and grappling with its effects on the state’s waters, protecting groundwater from bacterial contamination and other pollutants, and preventing groundwater depletion. We also attempt to anticipate issues on the horizon. We offer a deeper look at some particular challenges, such as phosphorus pollution and groundwater contamination. We then consider the current decision-making framework and how it is shaping our capacity to respond to water challenges in Wisconsin. Finally, we offer recommendations and identify opportunities to safeguard Wisconsin’s waters in the

  5. Best practice in English Local Air Quality Management: principles illustrated by some examples of current practice

    Energy Technology Data Exchange (ETDEWEB)

    Beattie, C.I.; Ling, K.; Longhurst, J.W.S. [Univ. of the West of England, Faculty of Applied Sciences, Bristol (GB)] [and others

    1999-07-01

    The Local Air Quality Management (LAQM) process, a holistic approach to management, is well underway in England. The process aims to tackle air pollution problems from a variety of diverse sources, operating over different time scales and spatial areas. Although technical guidance from the Government has been published over the last two years, little guidance has been available for the management aspects of the process. Arguably, the management of air quality will be the crucial test of the LAQM process. Only by collaboration can technologies and policy actions, such as traffic management schemes, be put into effective action. The authors present an overview of the process, including a model of current LAQM procedures in the UK. Current practice is illustrated by way of results from a questionnaire survey of local authorities, health authorities and the Environment Agency and also by reference to specific examples from local authorities. (Author)

  6. Review and evaluation of principles used in the estimation of radiation doses associated with the practice of deepsea disposal of low-level radioactive waste

    International Nuclear Information System (INIS)

    Baker, D.A.; Templeton, W.L.; Soldat, J.K.

    1985-09-01

    The relevant national and international guidance concerning the estimation of radiological doses from the practice of deepsea disposal of radioactive waste was reviewed. The review includes the dose limitation guidance of the various national and international bodies, especially that of the International Commission on Radiological Protection (ICRP). Pathway modeling is discussed as well as the oceanographic models of the International Atomic Energy Agency (IAEA). Included in the discussion are the recommendations for the definition of high-level waste by the IAEA for use by the London Dumping Convention (LDC) in setting limits for ocean disposal of waste. An assessment of the ICRP's radiological protection system using the effective whole-body dose methodology is made. Present models, which should continue to be improved as the research data becomes available, do provide an adequate basis for regulatory authorities to decide whether authorization for a proposed disposal can be granted, since they provide a means of indicating whether maximum individual (critical groups) exposure limits are likely to be exceeded. However, new models and information are continuously being developed by the international community to assess ocean disposal of radioactive waste in comparison to land disposal and to compare one site against another. 47 refs., 2 figs., 4 tabs

  7. Sewage sludge disposal in Baden-Wuerttemberg. Current situation and outlook; Klaerschlammentsorgung in Baden-Wuerttemberg. Aktuelle Situation und Perspektiven

    Energy Technology Data Exchange (ETDEWEB)

    Sasse, H.; Karl, U.; Lonjaret, J.P.; Rentz, O. [Deutsch-Franzoesisches Inst. fuer Umweltforschung (DFIU), Univ. Karlsruhe (Thailand) (Germany)

    1998-12-01

    The deposition of sewage sludge at landfills will be subject to more stringent regulations from 2005 at the latest. Acceptance of its use in farming is also low. Nor can its shipping to other federal states be considered to be secure in the long term. Hence, alternative methods of disposal are discussed. (orig.) [Deutsch] Die Deponie von Klaerschlamm wird spaetestens ab 2005 erschwert werden. Auch die landwirtschaftliche Verwertung stoesst auf Akzeptanzprobleme. Auch die Verbringung aus Baden-Wuerttemberg heraus kann nicht als langfristig sicher betrachtet werden. Es werden deshalb alternative Beseitigungsmoeglichkeiten diskutiert. (orig.)

  8. Current status and future plan of research and development program related to geological disposal at CEN-SCK

    Energy Technology Data Exchange (ETDEWEB)

    Neerdael, Bernard; Put, Martin [Centre d`Etude de l`Energie Nucleaire, Mol (BBE)

    1994-12-31

    The studies at CEN-SCK related to the R and D of geological disposal are performed within the research unit `waste and disposal` which also deals with the characterization of waste packages and their compatibility with host clay. The in situ test program developed by the underground research facility is shown. The in situ corrosion and leaching test, the combined radiation/heating test CERBERUS, the in situ migration experiment and the geotechnical survey on the gallery structures and their surrounding clay have been continued, and the main achievements until mid 1993 are reported. New actions have been started since 1991 related to hydrogeological modeling, the migration of gas in clay and the `PARCLAY` demonstration test. Besides the periodic measurement of water level in hydrological observation well network, the critical review of the previous regional hydrological modeling has been carried out. Migration studies were extended to the permeation of hydrogen, and the MEGAS project of the modeling and experiment of gas migration was started. Four main experiments, ARCHIMEDES, PHEBUS, BACCHUS 2 and ATLAS, as the international efforts are explained. (K.I.).

  9. On the Current Measurement Practices in Agile Software Development

    OpenAIRE

    Javdani, Taghi; Zulzalil, Hazura; Ghani, Abdul Azim Abd; Sultan, Abu Bakar Md; Parizi, Reza Meimandi

    2013-01-01

    Agile software development (ASD) methods were introduced as a reaction to traditional software development methods. Principles of these methods are different from traditional methods and so there are some different processes and activities in agile methods comparing to traditional methods. Thus ASD methods require different measurement practices comparing to traditional methods. Agile teams often do their projects in the simplest and most effective way so, measurement practices in agile metho...

  10. Forensic Occupational Therapy in Canada: The Current State of Practice.

    Science.gov (United States)

    Chui, Adora L Y; Wong, Chantal Isabelle; Maraj, Sara A; Fry, Danielle; Jecker, Justine; Jung, Bonny

    2016-09-01

    Although occupational therapists have been practicing in forensic settings for many years, there is a paucity of literature regarding the nature of this practice in Canada. The purpose of this study was to describe the practices of Canadian occupational therapists in forensic mental health. An online survey was designed based on the Canadian Practice Process Framework. Following purposive and snowball sampling, responses were analysed with descriptive statistics and content analysis. Twenty-seven clinicians responded (56% response rate). Respondents indicated commonalities in workplaces, client caseloads and practice challenges. The outstanding need in Canada to demonstrate client outcomes through the use of evaluation instruments reflects those practice gaps identified internationally. Education, advocacy and research are critical areas for the development of Canadian forensic occupational therapy. Although findings heavily reflect one provincial context and may not be generalizable to nonhospital settings, a number of priority areas were identified. Future efforts should clarify the role of forensic occupational therapy to stakeholders, and validate their contributions through research that evaluates intervention efficacy and meaningful outcomes. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  11. [Description of current hypnosis practice in French university hospitals].

    Science.gov (United States)

    Chabridon, G; Nekrouf, N; Bioy, A

    2017-10-01

    Hypnosis is very fashionable as an entertainment through TV shows searching for new sensational experiences. What about its practice in the medical world? The aim of this article is to answer to this question. Therefore, we contacted every French University Hospital of each region to find out if hypnosis was practiced for the care of pain (hypnoanalgesia), for chirurgical procedures (hypnosedation) and in adult psychiatry care units (hypnotherapy). For this last practice, we also questioned the type of indications. All 30 of the French University Hospitals had replied by November 2015. Hypnoanalgesia is practiced by all and two-thirds offer hypnosedation. Hypnotherapy is practiced by 40 % of the University Hospitals, 91,7 % for anxiety disorders, 66,7 % for psychotraumatic care and 25 % for mood disorders. Therefore, hypnosis seems to have found its place in the care of pain and as an anesthetic to replace standard procedures. However, the use of hypnotherapy in psychiatry is less frequent, indications for its use being variable and not very consensual. Copyright © 2016 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  12. Menstrual Hygiene, Management, and Waste Disposal: Practices and Challenges Faced by Girls/Women of Developing Countries.

    Science.gov (United States)

    Kaur, Rajanbir; Kaur, Kanwaljit; Kaur, Rajinder

    2018-01-01

    Menstruation and menstrual practices still face many social, cultural, and religious restrictions which are a big barrier in the path of menstrual hygiene management. In many parts of the country especially in rural areas girls are not prepared and aware about menstruation so they face many difficulties and challenges at home, schools, and work places. While reviewing literature, we found that little, inaccurate, or incomplete knowledge about menstruation is a great hindrance in the path of personal and menstrual hygiene management. Girls and women have very less or no knowledge about reproductive tract infections caused due to ignorance of personal hygiene during menstruation time. In rural areas, women do not have access to sanitary products or they know very little about the types and method of using them or are unable to afford such products due to high cost. So, they mostly rely on reusable cloth pads which they wash and use again. Needs and requirements of the adolescent girls and women are ignored despite the fact that there are major developments in the area of water and sanitation. Women manage menstruation differently when they are at home or outside; at homes, they dispose of menstrual products in domestic wastes and in public toilets and they flush them in the toilets without knowing the consequences of choking. So, there should be a need to educate and make them aware about the environmental pollution and health hazards associated with them. Implementation of modern techniques like incineration can help to reduce the waste. Also, awareness should be created to emphasize the use of reusable sanitary products or the natural sanitary products made from materials like banana fibre, bamboo fibre, sea sponges, water hyacinth, and so on.

  13. Menstrual Hygiene, Management, and Waste Disposal: Practices and Challenges Faced by Girls/Women of Developing Countries

    Directory of Open Access Journals (Sweden)

    Rajanbir Kaur

    2018-01-01

    Full Text Available Menstruation and menstrual practices still face many social, cultural, and religious restrictions which are a big barrier in the path of menstrual hygiene management. In many parts of the country especially in rural areas girls are not prepared and aware about menstruation so they face many difficulties and challenges at home, schools, and work places. While reviewing literature, we found that little, inaccurate, or incomplete knowledge about menstruation is a great hindrance in the path of personal and menstrual hygiene management. Girls and women have very less or no knowledge about reproductive tract infections caused due to ignorance of personal hygiene during menstruation time. In rural areas, women do not have access to sanitary products or they know very little about the types and method of using them or are unable to afford such products due to high cost. So, they mostly rely on reusable cloth pads which they wash and use again. Needs and requirements of the adolescent girls and women are ignored despite the fact that there are major developments in the area of water and sanitation. Women manage menstruation differently when they are at home or outside; at homes, they dispose of menstrual products in domestic wastes and in public toilets and they flush them in the toilets without knowing the consequences of choking. So, there should be a need to educate and make them aware about the environmental pollution and health hazards associated with them. Implementation of modern techniques like incineration can help to reduce the waste. Also, awareness should be created to emphasize the use of reusable sanitary products or the natural sanitary products made from materials like banana fibre, bamboo fibre, sea sponges, water hyacinth, and so on.

  14. Attitudes and practices regarding disposal of liquid nuclear waste at Clinton Laboratories in the very early years: A historical analysis

    International Nuclear Information System (INIS)

    Stow, S.H.

    1996-02-01

    Many previously unreferenced documents show that the management and disposal of the liquid nuclear waste generated at Clinton Labs (which became ORNL after 1948) during the 1940s was performed with the highest degree of integrity and professionalism, contradicting today's perceptions. Even before construction of the laboratories in early 1943, professionals were making plans for the ''safe'' disposal of waste through treatment and dilution at medically prescribed levels into White Oak Creek and the Clinch River; concern for human health permeated all the disposal decisions. Chemical and physical treatment processes were used to remove as much of the activity as possible before release. Environmental and biological monitoring of the surface waters was instituted very early in the disposal history. Information learned at Clinton Labs with regard to waste disposal was transferred to Hanford. By the latter part of the 1940s, the scientists were formulating fairly sophisticated research programs for managing liquid waste and began research on the disposal of low-level solid waste. This historical analysis attempts to place the actions of the 1940s in proper perspective, drawing on the attentiveness and integrity of those who participated 50 years ago. Applying standards of the 1990s to actions in the 1940s must be done skilfully, carefully, and with the realization that those individuals were operating under extremely trying conditions, with minimal knowledge of radionuclide behavior

  15. 77 FR 16158 - Current Good Manufacturing Practice in Manufacturing, Processing, Packing, or Holding of Drugs...

    Science.gov (United States)

    2012-03-20

    .... FDA-1997-N-0518] (formerly 97N-0300) Current Good Manufacturing Practice in Manufacturing, Processing... labeling control provisions of the current good manufacturing practice (CGMP) regulations for human and... GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS 0 1. The authority citation for 21 CFR part...

  16. Waste management in ancient Greece from the Homeric to the Classical period: concepts and practices of waste, dirt, recycling and disposal

    OpenAIRE

    Lindenlauf, A.

    2000-01-01

    This doctoral thesis has two purposes. First, it develops a universally applicable model for the analysis of waste disposal and recycling practices. This model synthesises Schiffer's behavioural analysis of the formation processes of the archaeological record with the history, sociology and anthropology of conceptualisations of dirt. Second, it shows how this model may be applied to ancient Greece. In the tradition of material culture studies, it aims to challenge the entrenche...

  17. Current Practices In Infant Nutrition In Benin City, Nigeria ...

    African Journals Online (AJOL)

    Of the 780 mothers 432 (55.6%) had children who were less than 6 months while 348(44.6%) had older infants. About 98.0% of the mothers were practicing one form of breast-feeding or the other. The exclusive breastfeeding rate (EBR), predominant breastfeeding rate (PBR) and bottle-feed rates (BOTFR) were respectively ...

  18. Feedback matters current feedback practices in the EFL classroom

    CERN Document Server

    Reitbauer, Margit; Mercer, Sarah; Schumm-Fauster, Jennifer

    2013-01-01

    This varied collection of papers is concerned with feedback in the language learning context. With its blend of theoretical overviews, action research-based empirical studies and practical implications, this will be a valuable resource for all academics and practitioners concerned with generating feedback that matters.

  19. Teacher's current practices of teaching reading and grade four ...

    African Journals Online (AJOL)

    This study examined the practices and challenges of teaching reading strategies and ... Twelve grade 4 students were selected using simple random sampling ... The quantitative data disclosed lower student scores, while the qualitative data ... By Country · List All Titles · Free To Read Titles This Journal is Open Access.

  20. Equity crowdfunding in China : Current practice and important legal issues

    NARCIS (Netherlands)

    Li, Jing

    2017-01-01

    By studying two leading Chinese equity crowdfunding portals, namely, Renrentou and Zhongou8, this paper provides the very first empirical evidence on the practice and regulation of equity crowdfunding in China. In the case of Renrentou, I examine a hand-collected sample consisting of the investment

  1. Psychotherapy: a profile of current occupational therapy practice in Ontario.

    Science.gov (United States)

    Moll, Sandra E; Tryssenaar, Joyce; Good, Colleen R; Detwiler, Lisa M

    2013-12-01

    Psychotherapy can be an important part of psychosocial occupational therapy practice; however, it requires specialized training to achieve and maintain competence. Regulation varies by province, and in Ontario, occupational therapists were recently authorized to perform psychotherapy. The purpose of this study was to explore the psychotherapy practice, training, and support needs of Ontario occupational therapists. An online survey was sent to occupational therapists who had clients with mental health or chronic pain issues, asking about their expertise and support needs in relation to nine psychotherapy approaches. Of the 331 therapists who responded, there were variations in the nature and frequency of psychotherapy practice. Experienced therapists in outpatient settings were more likely to practice psychotherapy, and cognitive-behaviour therapy, motivational interviewing, and mindfulness were the most common approaches. Supervision and training varied, with many therapists interested in occupational therapy-specific training. Recommendations for a framework of support include education about the nature of psychotherapy, training and supervision guidelines, and advocacy for occupational therapy and psychotherapy.

  2. Current marketing practices in the nursing home sector.

    Science.gov (United States)

    Calhoun, Judith G; Banaszak-Holl, Jane; Hearld, Larry R

    2006-01-01

    Marketing is widely recognized as an essential business function across all industries, including healthcare. While many long-term care facilities adopted basic healthcare marketing practices and hired marketing staff by the early 1990s, a paucity of research on nursing home marketing exists in the literature. This study examines the extent to which nursing homes have developed more formulated marketing and related communication and promotional strategies as market competition has increased in this sector during the past two decades. In addition, we explored managers' perceptions of their control over marketing decision making, the impact of competition on the use of marketing practices, and areas for enhanced competitive positioning. Administrators from 230 nursing homes in 18 Southeastern Michigan counties were surveyed regarding (1) the adoption level of approximately 40 literature-based, best-practice marketing strategies; (2) the types of staff involved with the marketing function; and (3) their perception of their level of control over marketing functions and of local competition. Results from 101 (44 percent) survey participants revealed that although respondents viewed their markets as highly competitive, their marketing practices remained focused on traditional and relatively constrained practices. In relation to the importance of customer relationship management, the majority of the administrators reported intensive efforts being focused on residents and their families, referrers, and staff, with minimal efforts being extended to insurers and other types of payers. A significant positive relation was found between the intensity of marketing initiatives and the size of the facility (number of beds), whereas significant negative correlations were revealed in relation to occupancy and the perceived level of control over the function.

  3. Personal trainer demographics, current practice trends and common trainee injuries

    Directory of Open Access Journals (Sweden)

    Gregory R. Waryasz

    2016-10-01

    Full Text Available Increasing emphasis on maintaining a healthy lifestyle has led many individuals to seek advice on exercise from personal trainers. There are few studies to date that evaluate personal trainer education, practice trends, and injuries they have seen while training clients. A survey was distributed to personal trainers using Survey Monkey® (Palo Alto, CA, USA with 605 personal trainers accessing the survey. An exercise related bachelor’s degree was held by 64.2% of survey participants and a certification in personal training by 89.0%. The most common personal trainer certifications were from American College of Sports Medicine (59.2% and National Strength and Conditioning Association (28.9%. Only 2.9% of all personal trainers surveyed had no exercise-related bachelor’s degree and no personal trainer certification. The most common injuries seen by personal trainers during sessions were lumbar muscle strain (10.7%, rotator cuff tear/tendonitis (8.9%, shin splints (8.1%, ankle sprain (7.5%, and cervical muscle strain (7.4%. There is variability in the practices between different personal trainers when analyzing differences in collegiate education, personal trainer certifications, and strength and conditioning certifications. The clinical implication of the differences in practices is unknown as to the impact on injuries or exercise prescription effectiveness.

  4. Self-Assessment in Librarianship: Current Practices and Future Possibilities

    Directory of Open Access Journals (Sweden)

    Ania Dymarz

    2015-07-01

    Full Text Available The authors of this qualitative study set out to investigate self-assessment practices within the library profession. The researchers conducted semi-structured interviews with a purposeful sample of nine librarians coming from a range of library settings and possessing a diversity of library experience. Interviews were then transcribed and coded in NVIVO to identify emergent themes. This paper details some of the results of that study, highlighting motivations, limitations, and strategies with regard to self-assessment. The findings present a summary of a range of approaches to the practice of assessment as reported by the interviewees. One area of possible growth for our profession, as highlighted by the findings, is in the development of peer networks as a support for the individual practice of self-assessment. While the results of this small case study cannot be generalized, the authors hope these preliminary findings can open up the conversation around self-assessment both for individual librarians and for those librarians and managers working to shape their workplace culture.

  5. Personal Trainer Demographics, Current Practice Trends and Common Trainee Injuries

    Science.gov (United States)

    Waryasz, Gregory R.; Daniels, Alan H.; Gil, Joseph A.; Suric, Vladimir; Eberson, Craig P.

    2016-01-01

    Increasing emphasis on maintaining a healthy lifestyle has led many individuals to seek advice on exercise from personal trainers. There are few studies to date that evaluate personal trainer education, practice trends, and injuries they have seen while training clients. A survey was distributed to personal trainers using Survey Monkey® (Palo Alto, CA, USA) with 605 personal trainers accessing the survey. An exercise related bachelor’s degree was held by 64.2% of survey participants and a certification in personal training by 89.0%. The most common personal trainer certifications were from American College of Sports Medicine (59.2%) and National Strength and Conditioning Association (28.9%). Only 2.9% of all personal trainers surveyed had no exercise-related bachelor’s degree and no personal trainer certification. The most common injuries seen by personal trainers during sessions were lumbar muscle strain (10.7%), rotator cuff tear/tendonitis (8.9%), shin splints (8.1%), ankle sprain (7.5%), and cervical muscle strain (7.4%). There is variability in the practices between different personal trainers when analyzing differences in collegiate education, personal trainer certifications, and strength and conditioning certifications. The clinical implication of the differences in practices is unknown as to the impact on injuries or exercise prescription effectiveness. PMID:27761219

  6. Online Learning Integrity Approaches: Current Practices and Future Solutions

    Science.gov (United States)

    Lee-Post, Anita; Hapke, Holly

    2017-01-01

    The primary objective of this paper is to help institutions respond to the stipulation of the Higher Education Opportunity Act of 2008 by adopting cost-effective academic integrity solutions without compromising the convenience and flexibility of online learning. Current user authentication solutions such as user ID and password, security…

  7. Current problems of foreign practice-related educational psychology

    Directory of Open Access Journals (Sweden)

    A.D. Andreeva

    2012-09-01

    Full Text Available The article regards the questions of scientific-methodological provision of psychologist’s activity in an educational settlement which are urgent for the activity of practical educational psychologist in Russia as well. The presented information concerns the psychologist’s particular strands of work which can be both developing (development of ABM and psycho-correcting (reasons and forms of school phobias, bullying displays, lying. The ethical problems of psychologist’s work with families namely in case of the parent-child conflicts is also reviewed in the article.

  8. Sealed radionuclide sources - new technical specifications and current practice

    Energy Technology Data Exchange (ETDEWEB)

    Brabec, D

    1987-03-01

    Basic technical specifications are discussed valid in Czechoslovakia for sealed radionuclide sources, based on international ISO and CMEA standards. Described are the standardization of terminology, relationships of tests, testing methods, types of sealed sources and their applications, relations to Czechoslovak regulations on radiation protection and to IAEA specifications for radioactive material shipment, etc. Practical impact is shown of the introduction of the new standards governing sealed sources on the national economy, and the purpose is explained of various documents issued with sealed sources. (author). 2 figs., 45 refs.

  9. Revisiting reflexology: Concept, evidence, current practice, and practitioner training

    OpenAIRE

    Embong, Nurul Haswani; Soh, Yee Chang; Ming, Long Chiau; Wong, Tin Wui

    2015-01-01

    Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and th...

  10. Radioactive waste management policy in the UK of best practicable environmental options for waste disposal and storage

    International Nuclear Information System (INIS)

    Johnson, P.D.; Feates, F.S.

    1986-01-01

    The organisations which produce radioactive waste carry the direct responsibility for safe and effective management of the wastes and for meeting the costs. UK Nirex Ltd., the Nuclear Industry Radioactive Waste Executive, has been set up to develop and operate new disposal facilities. Individual producers of radioactive waste undertake research related to the treatment of their own wastes, and UK Nirex Ltd. commissions research related to the disposal facilities it wishes to develop. Whatever new disposal facilities are developed and used, UK Nirex Ltd. will have to show that any proposed facilities comply with the principles for assessment of proposals for the protection of the human environment issued by the Government Authorising Departments in 1984, and which incorporate basic radiological safety requirements

  11. What is current practice in soft tissue sarcoma grading?

    International Nuclear Information System (INIS)

    Golouh, R.; Bracko, M.

    2001-01-01

    Purpose. Most published grading systems of soft tissue sarcomas (STS) are somewhat subjective and it seems that there is no definite consensus among experts which of them is the most effective. The aim of this study was to collect data from practicing pathologists and to get some insight in the practice of STS grading. Subjects. A questionnaire was sent to 135 pathologists chosen randomly. Results. There were 88 responders from 30 countries from 5 continents. Most responders (85%) grade STS, more frequently in Europe than in non-European countries. Three-grade system is preferred by both European and non-European pathologists, who use it in almost 77% and 67%, respectively. They apply the criteria set by FNCLCC in 37.3%, by NCI in 24%, by Broders in 12% and by Markhede in 1.4%. In Europe, FNCLCC system is the most widely used. Beside classical histological criteria, other modern methods are applied by more than one half of the responders. Immunohistochemical evaluation of proliferation markers is the method most widely used, followed by molecular markers and DNA flow cytometry. Conclusion. The results of our study indicate that most pathologists consider histologic grade of STS as a valuable, however not completely satisfactory predictor of a patient's survival. (author)

  12. Postoperative electrolyte management: Current practice patterns of surgeons and residents.

    Science.gov (United States)

    Angarita, Fernando A; Dueck, Andrew D; Azouz, Solomon M

    2015-07-01

    Managing postoperative electrolyte imbalances often is driven by dogma. To identify areas of improvement, we assessed the practice pattern of postoperative electrolyte management among surgeons and residents. An online survey was distributed among attending surgeons and surgical residents at the University of Toronto. The survey was designed according to a systematic approach for formulating self-administered questionnaires. Questions addressed workload, decision making in hypothetical clinical scenarios, and improvement strategies. Of 232 surveys distributed, 156 were completed (response rate: 67%). The majority stated that junior residents were responsible for managing electrolytes at 13 University of Toronto-affiliated hospitals. Supervision was carried out predominately by senior residents (75%). Thirteen percent reported management went unsupervised. Approximately 59% of residents were unaware how often attending surgeons assessed patients' electrolytes. Despite the majority of residents (53.7%) reporting they were never given tools or trained in electrolyte replacement, they considered themselves moderately or extremely confident. The management of hypothetical clinical scenarios differed between residents and attending surgeons. The majority (50.5%) of respondents considered that an electrolyte replacement protocol is the most appropriate improvement strategy. Electrolyte replacement represents an important component of surgeons' workload. Despite reporting that formal training in electrolyte management is limited, residents consider themselves competent; however, their practice is highly variable and often differs from pharmacologic-directed recommendations. Optimizing how postoperative electrolytes are managed in surgical wards requires building a framework that improves knowledge, training, and limits unnecessary interventions. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Practical Application of Eddy Currents Generated by Wind

    International Nuclear Information System (INIS)

    Dirba, I; Kleperis, J

    2011-01-01

    When a conductive material is subjected to time-varying magnetic fluxes, eddy (Foucault) currents are generated in it and magnetic field of opposite polarity as the applied one arises. Due to the internal resistance of the conductive material, the eddy currents will be dissipated into heat (Joule heating). Conventional domestic water heaters utilize gas burners or electric resistance heating elements to heat the water in the tank and substantial part of the energy to use for it is wasted. In this paper the origin of electromagnetic induction heat generated by wind turbine in special heat exchange camera connected to water boiler is discussed and material evaluation performed using mathematical modelling (comparing the 2D finite element model with analytical and numerical calculation results).

  14. Practical Application of Eddy Currents Generated by Wind

    Science.gov (United States)

    Dirba, I.; Kleperis, J.

    2011-06-01

    When a conductive material is subjected to time-varying magnetic fluxes, eddy (Foucault) currents are generated in it and magnetic field of opposite polarity as the applied one arises. Due to the internal resistance of the conductive material, the eddy currents will be dissipated into heat (Joule heating). Conventional domestic water heaters utilize gas burners or electric resistance heating elements to heat the water in the tank and substantial part of the energy to use for it is wasted. In this paper the origin of electromagnetic induction heat generated by wind turbine in special heat exchange camera connected to water boiler is discussed and material evaluation performed using mathematical modelling (comparing the 2D finite element model with analytical and numerical calculation results).

  15. Practical Application of Eddy Currents Generated by Wind

    Energy Technology Data Exchange (ETDEWEB)

    Dirba, I; Kleperis, J, E-mail: imants.dirba@gmail.com [Institute of Solid State Physics of University of Latvia, 8 Kengaraga Street, Riga, LV-1063 (Latvia)

    2011-06-23

    When a conductive material is subjected to time-varying magnetic fluxes, eddy (Foucault) currents are generated in it and magnetic field of opposite polarity as the applied one arises. Due to the internal resistance of the conductive material, the eddy currents will be dissipated into heat (Joule heating). Conventional domestic water heaters utilize gas burners or electric resistance heating elements to heat the water in the tank and substantial part of the energy to use for it is wasted. In this paper the origin of electromagnetic induction heat generated by wind turbine in special heat exchange camera connected to water boiler is discussed and material evaluation performed using mathematical modelling (comparing the 2D finite element model with analytical and numerical calculation results).

  16. Trends in Mediation Analysis in Nursing Research: Improving Current Practice.

    Science.gov (United States)

    Hertzog, Melody

    2018-06-01

    The purpose of this study was to describe common approaches used by nursing researchers to test mediation models and evaluate them within the context of current methodological advances. MEDLINE was used to locate studies testing a mediation model and published from 2004 to 2015 in nursing journals. Design (experimental/correlation, cross-sectional/longitudinal, model complexity) and analysis (method, inclusion of test of mediated effect, violations/discussion of assumptions, sample size/power) characteristics were coded for 456 studies. General trends were identified using descriptive statistics. Consistent with findings of reviews in other disciplines, evidence was found that nursing researchers may not be aware of the strong assumptions and serious limitations of their analyses. Suggestions for strengthening the rigor of such studies and an overview of current methods for testing more complex models, including longitudinal mediation processes, are presented.

  17. Is current clinical practice modified about intraoperative breast irradiation?

    Science.gov (United States)

    Massa, Michela; Franchelli, Simonetta; Panizza, Renzo; Massa, Tiberio

    2016-04-01

    After the results obtained in the two randomized clinical trial, the ELIOT trial and the TARGIT-A trial, a heated debate is going on concerning the question of applying intraoperative radiotherapy (IORT) instead of postoperative whole breast irradiation (WBI) after breast conservative treatment. Currently, many centers are applying the IORT following the strict selection criteria dictated by the working groups American Society for Radiation Oncology (ASTRO) and Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) and monitoring the oncological outcome together with radiation toxicity on breast tissue. The clinical experience of the Geneva University Hospital regarding the use of the Intrabeam system is evaluated and compared with current evidences.

  18. Current practice in out-of-hospital cardiac arrest management

    DEFF Research Database (Denmark)

    Proclemer, Alessandro; Dobreanu, Dan; Pison, Laurent

    2012-01-01

    AIMS: The purpose of this EP wire is to examine clinical practice in the field of out-of-hospital cardiac arrest (OHCA) management, with special focus on in-hospital diagnostic and therapeutic strategies. METHODS AND RESULTS: Fifty-three European centres, all members of the EHRA-EP Research network......, completed the questions of the survey. A dedicated strategy for OHCA management is active in 85% of the centres. Shockable tachyarrhythmias such as initial OHCA rhythm are reported in >70% of the patients in 64% of the centres. In-hospital therapeutic hypothermia was applied in >50% of the patients in 53...... management strategy, including coronary angiography/PCI and implantable cardioverter defibrillator therapy, while therapeutic hypothermia appears to be underused....

  19. The Current State of Rural Neurosurgical Practice: An International Perspective.

    Science.gov (United States)

    Upadhyayula, Pavan S; Yue, John K; Yang, Jason; Birk, Harjus S; Ciacci, Joseph D

    2018-01-01

    Rural and low-resource areas have diminished capacity to care for neurosurgical patients due to lack of infrastructure, healthcare investment, and training programs. This review summarizes the range of rural neurosurgical procedures, novel mechanisms for delivering care, rapid training programs, and outcome differences across international rural neurosurgical practice. A comprehensive literature search was performed for English language manuscripts with keywords "rural" and "neurosurgery" using the National Library of Medicine PubMed database (01/1971-06/2017). Twenty-four articles focusing on rural non-neurosurgical practice were included. Time to care and/or surgery and shortage of trained personnel remain the strongest risk factors for mortality and poor outcome. Telemedicine consults to regional centers with neurosurgery housestaff have potential for increased timeliness of diagnosis/triage, improved time to surgery, and reductions in unnecessary transfers in remote areas. Mobile neurosurgery teams have been deployed with success in nations with large transport distances precluding initial transfers. Common neurosurgical procedures involve trauma mechanisms; accordingly, training programs for nonneurosurgery medical personnel on basic assessment and operative techniques have been successful in resource-deficient settings where neurosurgeons are unavailable. Protracted transport times, lack of resources/training, and difficulty retaining specialists are barriers to successful outcomes. Advances in telemedicine, mobile neurosurgery, and training programs for urgent operative techniques have been implemented efficaciously. Development of guidelines for paired partnerships between rural centers and academic hospitals, supplying surplus technology to rural areas, and rapid training of qualified local surgical personnel can create sustainable feed-forward programs for trainees and infrastructural solutions to address challenges in rural neurosurgery.

  20. Gastroesophageal reflux disease in pediatric practice: current topical issues

    Directory of Open Access Journals (Sweden)

    O.Yu. Bielousova

    2017-03-01

    Full Text Available In recent years, much attention has been paid to the upper digestive tract diseases in children, particularly gastroesophageal reflux disease, as a cause that has an impact on the quality of life, even in children of school age, and thereafter in young adults. Consequently, there are searches for optimization of early detection, new me-thods of non-invasive diagnosis, screening of this pathology in children’s population in order to determine persons with risk factors and to control disease development and complicated course, as well as searches for the formation of preventive activities algorithm. Scientists came to a consensus that all examinations, which are used in pediatric practice, must be maximally available, simple and non-invasive to the extent of child’s condition. The question about advisability of performing esophagogastroduodenoscopy for all patients with complaints of heartburn and with other symptoms of gastroesophageal reflux disease, the question relative to performing ultrasonography of the esophagus in children as an additional method of examination, usage of questionnaire in pediatric practice, formation of disease course prediction algorithm, and identification of preventive measures specific to every patient remain open. In order to explain their application, the developmental mechanisms of this pathology must be well-understood, and individual risk factors that may influence disease severity and disease course prediction, which occur in children in different periods of life, must be taken into account. Therefore, the goal of this research is to provide an overview of modern literature with reference to topical issues of clinical evidence, risk factors, diagnosis, prediction of gastroesophageal reflux disease course in children of different ages (regarding main causative and pathogenic factors, clinical evidence (esophageal and extra-esophageal, diagnostic methods and modern approaches to gastroesophageal reflux disease

  1. The current state of rural neurosurgical practice: An international perspective

    Directory of Open Access Journals (Sweden)

    Pavan S Upadhyayula

    2018-01-01

    Full Text Available Introduction: Rural and low-resource areas have diminished capacity to care for neurosurgical patients due to lack of infrastructure, healthcare investment, and training programs. This review summarizes the range of rural neurosurgical procedures, novel mechanisms for delivering care, rapid training programs, and outcome differences across international rural neurosurgical practice. Methods: A comprehensive literature search was performed for English language manuscripts with keywords “rural” and “neurosurgery” using the National Library of Medicine PubMed database (01/1971–06/2017. Twenty-four articles focusing on rural non-neurosurgical practice were included. Results: Time to care and/or surgery and shortage of trained personnel remain the strongest risk factors for mortality and poor outcome. Telemedicine consults to regional centers with neurosurgery housestaff have potential for increased timeliness of diagnosis/triage, improved time to surgery, and reductions in unnecessary transfers in remote areas. Mobile neurosurgery teams have been deployed with success in nations with large transport distances precluding initial transfers. Common neurosurgical procedures involve trauma mechanisms; accordingly, training programs for nonneurosurgery medical personnel on basic assessment and operative techniques have been successful in resource-deficient settings where neurosurgeons are unavailable. Conclusions: Protracted transport times, lack of resources/training, and difficulty retaining specialists are barriers to successful outcomes. Advances in telemedicine, mobile neurosurgery, and training programs for urgent operative techniques have been implemented efficaciously. Development of guidelines for paired partnerships between rural centers and academic hospitals, supplying surplus technology to rural areas, and rapid training of qualified local surgical personnel can create sustainable feed-forward programs for trainees and

  2. The Current State of Rural Neurosurgical Practice: An International Perspective

    Science.gov (United States)

    Upadhyayula, Pavan S.; Yue, John K.; Yang, Jason; Birk, Harjus S.; Ciacci, Joseph D.

    2018-01-01

    Introduction: Rural and low-resource areas have diminished capacity to care for neurosurgical patients due to lack of infrastructure, healthcare investment, and training programs. This review summarizes the range of rural neurosurgical procedures, novel mechanisms for delivering care, rapid training programs, and outcome differences across international rural neurosurgical practice. Methods: A comprehensive literature search was performed for English language manuscripts with keywords “rural” and “neurosurgery” using the National Library of Medicine PubMed database (01/1971–06/2017). Twenty-four articles focusing on rural non-neurosurgical practice were included. Results: Time to care and/or surgery and shortage of trained personnel remain the strongest risk factors for mortality and poor outcome. Telemedicine consults to regional centers with neurosurgery housestaff have potential for increased timeliness of diagnosis/triage, improved time to surgery, and reductions in unnecessary transfers in remote areas. Mobile neurosurgery teams have been deployed with success in nations with large transport distances precluding initial transfers. Common neurosurgical procedures involve trauma mechanisms; accordingly, training programs for nonneurosurgery medical personnel on basic assessment and operative techniques have been successful in resource-deficient settings where neurosurgeons are unavailable. Conclusions: Protracted transport times, lack of resources/training, and difficulty retaining specialists are barriers to successful outcomes. Advances in telemedicine, mobile neurosurgery, and training programs for urgent operative techniques have been implemented efficaciously. Development of guidelines for paired partnerships between rural centers and academic hospitals, supplying surplus technology to rural areas, and rapid training of qualified local surgical personnel can create sustainable feed-forward programs for trainees and infrastructural solutions to

  3. Teacher feedback during active learning: current practices in primary schools.

    Science.gov (United States)

    van den Bergh, Linda; Ros, Anje; Beijaard, Douwe

    2013-06-01

    Feedback is one of the most powerful tools, which teachers can use to enhance student learning. It appears difficult for teachers to give qualitatively good feedback, especially during active learning. In this context, teachers should provide facilitative feedback that is focused on the development of meta-cognition and social learning. The purpose of the present study is to contribute to the existing knowledge about feedback and to give directions to improve teacher feedback in the context of active learning. The participants comprised 32 teachers who practiced active learning in the domain of environmental studies in the sixth, seventh, or eighth grade of 13 Dutch primary schools. A total of 1,465 teacher-student interactions were examined. Video observations were made of active learning lessons in the domain of environmental studies. A category system was developed based on the literature and empirical data. Teacher-student interactions were assessed using this system. Results. About half of the teacher-student interactions contained feedback. This feedback was usually focused on the tasks that were being performed by the students and on the ways in which these tasks were processed. Only 5% of the feedback was explicitly related to a learning goal. In their feedback, the teachers were directing (rather than facilitating) the learning processes. During active learning, feedback on meta-cognition and social learning is important. Feedback should be explicitly related to learning goals. In practice, these kinds of feedback appear to be scarce. Therefore, giving feedback during active learning seems to be an important topic for teachers' professional development. © 2012 The British Psychological Society.

  4. Small Wind Turbine Applications: Current Practice in Colorado

    International Nuclear Information System (INIS)

    Green, Jim

    1999-01-01

    Numerous small wind turbines are being used by homeowners in Colorado. Some of these installations are quite recent while others date back to the federal tax-credit era of the early 1980s. Through visits with small wind turbine owners in Colorado, I have developed case studies of six small wind energy applications focusing on the wind turbine technology, wind turbine siting, the power systems and electric loads, regulatory issues, and motivations about wind energy. These case studies offer a glimpse into the current state-of-the-art of small-scale wind energy and provide some insight into issues affecting development of a wider market

  5. Technical support document for the surface disposal of sewage sludge. Final report

    International Nuclear Information System (INIS)

    1992-11-01

    The document provides the technical background and justification for the U.S. Environmental Protection Agency's (EPA) final regulation (40 CFR Part 503) covering the surface disposal of sewage sludge. The document summarizes current practices in land application and presents data supporting the risk assessment methodology used to derive human health and environmental risk-based limits for contaminants in sewage sludge placed on surface disposal sites. The management practices associated with surface disposal are outlined and the different pathways by which contaminants reach highly-exposed individuals (HEIs) through surface disposal are discussed

  6. Technical support document for the surface disposal of sewage sludge. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1992-11-01

    The document provides the technical background and justification for the U.S. Environmental Protection Agency's (EPA) final regulation (40 CFR Part 503) covering the surface disposal of sewage sludge. The document summarizes current practices in land application and presents data supporting the risk assessment methodology used to derive human health and environmental risk-based limits for contaminants in sewage sludge placed on surface disposal sites. The management practices associated with surface disposal are outlined and the different pathways by which contaminants reach highly-exposed individuals (HEIs) through surface disposal are discussed.

  7. NUMO-RMS: a practical requirements management system for the long-term management of the deep geological disposal project - 16304

    International Nuclear Information System (INIS)

    Ueda, Hiroyoshi; Suzuki, Satoru; Ishiguro, Katsuhiko; Oyamada, Kiyoshi; Yashio, Shoko; White, Matt; Wilmot, Roger

    2009-01-01

    NUMO (Nuclear Waste Management Organization of Japan) has the responsibility for implementing deep geological disposal of high-level (HLW) and transuranic (TRU) radioactive waste from the Japanese nuclear programme. A formal Requirements Management System (RMS) is planned to efficiently and effectively support the computerised implementation of the management strategy and the methodology required to drive the step-wise siting processes, and the following repository operational phase,. The RMS will help in the comprehensive management of the decision-making processes in the geological disposal project, in change management as the disposal system is optimised, in driving projects such as the R and D programme efficiently, and in maintaining structured records regarding past decisions, all of which lead to soundness of the project in terms of long-term continuity. The system is planned to have information handling and management functions using a database that includes the decisions/requirements in the programme under consideration, the way in which these are structured in terms of the decision-making process and other associated information. A two-year development programme is underway to develop and enhance an existing trial RMS to a practical system. Functions for change management, history management and association with the external timeline management system are being implemented in the system development work. The database format is being improved to accommodate the requirements management data relating to the facility design and to safety assessment of the deep geological repository. This paper will present an outline of the development work with examples to demonstrate the system's practicality. In parallel with the system/database developments, a case research of the use of requirements management in radioactive waste disposal projects was undertaken to identify key issues in the development of an RMS for radioactive waste disposal and specify a number of

  8. Robotic general surgery: current practice, evidence, and perspective.

    Science.gov (United States)

    Jung, M; Morel, P; Buehler, L; Buchs, N C; Hagen, M E

    2015-04-01

    Robotic technology commenced to be adopted for the field of general surgery in the 1990s. Since then, the da Vinci surgical system (Intuitive Surgical Inc, Sunnyvale, CA, USA) has remained by far the most commonly used system in this domain. The da Vinci surgical system is a master-slave machine that offers three-dimensional vision, articulated instruments with seven degrees of freedom, and additional software features such as motion scaling and tremor filtration. The specific design allows hand-eye alignment with intuitive control of the minimally invasive instruments. As such, robotic surgery appears technologically superior when compared with laparoscopy by overcoming some of the technical limitations that are imposed on the surgeon by the conventional approach. This article reviews the current literature and the perspective of robotic general surgery. While robotics has been applied to a wide range of general surgery procedures, its precise role in this field remains a subject of further research. Until now, only limited clinical evidence that could establish the use of robotics as the gold standard for procedures of general surgery has been created. While surgical robotics is still in its infancy with multiple novel systems currently under development and clinical trials in progress, the opportunities for this technology appear endless, and robotics should have a lasting impact to the field of general surgery.

  9. Participation in a Household Hazardous Waste Collection Drive and "Before" and "After" Public Knowledge and Disposal Practices: Champaign County.

    Science.gov (United States)

    Liebert, Roland J.

    The extent to which households use, store, and dispose of hazardous materials has become a matter of increasing concern but has been rarely assessed. This report provides an assessment of the first household hazardous materials publicity campaign and collection event held in Illinois. The report describes survey results concerning the state of…

  10. Gas Hydrate Investigations Using Pressure Core Analysis: Current Practice

    Science.gov (United States)

    Schultheiss, P.; Holland, M.; Roberts, J.; Druce, M.

    2006-12-01

    Recently there have been a number of major gas hydrate expeditions, both academic and commercially oriented, that have benefited from advances in the practice of pressure coring and pressure core analysis, especially using the HYACINTH pressure coring systems. We report on the now mature process of pressure core acquisition, pressure core handling and pressure core analysis and the results from the analysis of pressure cores, which have revealed important in situ properties along with some remarkable views of gas hydrate morphologies. Pressure coring success rates have improved as the tools have been modified and adapted for use on different drilling platforms. To ensure that pressure cores remain within the hydrate stability zone, tool deployment, recovery and on-deck handling procedures now mitigate against unwanted temperature rises. Core analysis has been integrated into the core transfer protocol and automated nondestructive measurements, including P-wave velocity, gamma density, and X-ray imaging, are routinely made on cores. Pressure cores can be subjected to controlled depressurization experiments while nondestructive measurements are being made, or cores can be stored at in situ conditions for further analysis and subsampling.

  11. Somatic cell nuclear transfer cloning: practical applications and current legislation.

    Science.gov (United States)

    Niemann, H; Lucas-Hahn, A

    2012-08-01

    Somatic cloning is emerging as a new biotechnology by which the opportunities arising from the advances in molecular genetics and genome analysis can be implemented in animal breeding. Significant improvements have been made in SCNT protocols in the past years which now allow to embarking on practical applications. The main areas of application of SCNT are: Reproductive cloning, therapeutic cloning and basic research. A great application potential of SCNT based cloning is the production of genetically modified (transgenic) animals. Somatic cell nuclear transfer based transgenic animal production has significant advances over the previously employed microinjection of foreign DNA into pronuclei of zygotes. This cell based transgenesis is compatible with gene targeting and allows both, the addition of a specific gene and the deletion of an endogenous gene. Efficient transgenic animal production provides numerous opportunities for agriculture and biomedicine. Regulatory agencies around the world have agreed that food derived from cloned animals and their offspring is safe and there is no scientific basis for questioning this. Commercial application of somatic cloning within the EU is via the Novel Food regulation EC No. 258/97. Somatic cloning raises novel questions regarding the ethical and moral status of animals and their welfare which has prompted a controversial discussion in Europe which has not yet been resolved. © 2012 Blackwell Verlag GmbH.

  12. Brachytherapy in Europe: philosophies, current practice and future directions

    International Nuclear Information System (INIS)

    Haworth, A.

    2000-01-01

    Full text: Five months sabbatical leave provided an opportunity to visit six radiotherapy centres in France, Holland and England. While brachytherapy philosophies and practices within each country were similar, there were considerable differences in attitudes between countries. The Institute Gustave Roussy, home of the Paris System and host for the French sector confirmed that the Paris System is still very much the preferred dosimetry method in this part of the world. Though their preference for low dose rate brachytherapy is still evident, high dose rate brachytherapy has found some applications but the rules of the Paris System are never far away and the words 'what about the hyperdose sleeve' are firmly implanted into this visitor's brain. The use of real time dosimetry for I-125 prostate brachytherapy at the Institute Curie (Paris) provided an interesting contrast to the standard pre and post implant dosimetry techniques commonly employed elsewhere. The two Dutch centres on the itinerary, in stark contrast to the traditional techniques seen in France, have applied the power of computers to investigate optimisation of the classic dosimetry systems and called on the analysis techniques (DVH, NTCP, TCP etc) now familiar to us all in external beam therapy. The Cookridge Hospital in England fitted somewhere between the French and Dutch centres. This centre showed how both modern and traditional techniques could be applied in an efficient way for a large variety of treatment sites. Copyright (2000) Australasian College of Physical Scientists and Engineers in Medicine

  13. Current Developments and Best Practice in Open and Distance Learning

    Directory of Open Access Journals (Sweden)

    Armando Rocha Trinidade

    2000-06-01

    Full Text Available Through the many documents regularly emitted by those dedicated to this activity, it is comparatively easy to describe factual developments in the field of open and distance education in different places in the world. However, it is much more difficult to produce judgements of value about their quality. Quality is a subjective rather than an absolute concept and may be examined from different analytical perspectives: consumers' satisfaction level, intrinsic value of scientific and technical content of learning materials, soundness of learning strategies, efficiency of organisation and procedures, adequate use of advanced technologies, reliability of student support mechanisms, etc.These parameters should be put into the context of specific objectives, nature of target populations and availability of different kinds of resources. In a specific geographic, social, economic and cultural situation a given set of solutions might be judged as adequate and deserving the qualification of "good practice," while in a different context it could be considered of rather poor quality.The selection of examples in this article is the sole responsibility of the authors: neither should the chosen cases be considered as clearly better than any other one, nor missing cases be interpreted as lack of appreciation or a negative judgement.Finally, the authors are aware of the risks of interpreting trends and trying to extrapolate them into the near future: readers should use their own judgement in accepting (or forcefully rejecting these projections.

  14. Revisiting reflexology: Concept, evidence, current practice, and practitioner training.

    Science.gov (United States)

    Embong, Nurul Haswani; Soh, Yee Chang; Ming, Long Chiau; Wong, Tin Wui

    2015-10-01

    Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and the training for reflexology practitioners. PubMed, SCOPUS, Google Scholar, and SpringerLink databases were utilized to search the following medical subject headings or keywords: foot massage, reflexology, foot reflexotherapy, reflexological treatment, and zone therapy. The articles published for the last 10 years were included. Previous systematic reviews failed to show concrete evidence for any specific effect of reflexology in any conditions. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided.

  15. Revisiting reflexology: Concept, evidence, current practice, and practitioner training

    Directory of Open Access Journals (Sweden)

    Nurul Haswani Embong

    2015-10-01

    Full Text Available Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and the training for reflexology practitioners. PubMed, SCOPUS, Google Scholar, and SpringerLink databases were utilized to search the following medical subject headings or keywords: foot massage, reflexology, foot reflexotherapy, reflexological treatment, and zone therapy. The articles published for the last 10 years were included. Previous systematic reviews failed to show concrete evidence for any specific effect of reflexology in any conditions. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided.

  16. Power Testing in Basketball: Current Practice and Future Recommendations.

    Science.gov (United States)

    Wen, Neal; Dalbo, Vincent J; Burgos, Bill; Pyne, David B; Scanlan, Aaron T

    2018-02-01

    Numerous foundational movements performed during basketball are predicated on underlying power-related attributes, including speed, change-of-direction, and jumping. Accordingly, fitness testing batteries for basketball have incorporated an assortment of linear speed tests, change-of-direction tests, and jump tests. However, due to the wide variety of testing options it is difficult for basketball practitioners to select appropriate testing protocols for the assessment of power-related attributes. As a result, there is a need to review the relevant literature to identify game-specific, power-related attributes important in basketball and the most appropriate tests available to assess power-related attributes for basketball practitioners. Therefore, the aims of this review were to: (1) identify essential power-related attributes important in basketball; (2) discuss the suitability of common and novel power-related tests; and (3) provide recommendations for future research and best practice approaches for basketball coaching staff. In this review, we propose a series of novel tests that are more targeted and specific to basketball movements including: (1) 5-m and 10-m linear sprints, (2) Modified Agility T-Test, (3) Change-of-Direction Deficit, (4) lateral bound, (5) Sargent jump, (6) one-step jump, and (7) isometric midthigh pull test. Improved testing of power-related attributes should enable basketball practitioners to develop targeted training plans for enhancing player performance.

  17. Overview of robotic colorectal surgery: Current and future practical developments

    Science.gov (United States)

    Roy, Sudipta; Evans, Charles

    2016-01-01

    Minimal access surgery has revolutionised colorectal surgery by offering reduced morbidity and mortality over open surgery, while maintaining oncological and functional outcomes with the disadvantage of additional practical challenges. Robotic surgery aids the surgeon in overcoming these challenges. Uptake of robotic assistance has been relatively slow, mainly because of the high initial and ongoing costs of equipment but also because of limited evidence of improved patient outcomes. Advances in robotic colorectal surgery will aim to widen the scope of minimal access surgery to allow larger and more complex surgery through smaller access and natural orifices and also to make the technology more economical, allowing wider dispersal and uptake of robotic technology. Advances in robotic endoscopy will yield self-advancing endoscopes and a widening role for capsule endoscopy including the development of motile and steerable capsules able to deliver localised drug therapy and insufflation as well as being recharged from an extracorporeal power source to allow great longevity. Ultimately robotic technology may advance to the point where many conventional surgical interventions are no longer required. With respect to nanotechnology, surgery may eventually become obsolete. PMID:26981188

  18. Disposal of radioactive wastes

    International Nuclear Information System (INIS)

    Dlouhy, Z.

    1982-01-01

    This book provides information on the origin, characteristics and methods of processing of radioactive wastes, as well as the philosophy and practice of their storage and disposal. Chapters are devoted to the following topics: radioactive wastes, characteristics of radioactive wastes, processing liquid and solid radioactive wastes, processing wastes from spent fuel reprocessing, processing gaseous radioactive wastes, fixation of radioactive concentrates, solidification of high-level radioactive wastes, use of radioactive wastes as raw material, radioactive waste disposal, transport of radioactive wastes and economic problems of radioactive wastes disposal. (C.F.)

  19. China's spent nuclear fuel management: Current practices and future strategies

    International Nuclear Information System (INIS)

    Zhou Yun

    2011-01-01

    Although China's nuclear power industry is relatively young and the management of its spent nuclear fuel is not yet a concern, China's commitment to nuclear energy and its rapid pace of development require detailed analyses of its future spent fuel management policies. The purpose of this study is to provide an overview of China's fuel cycle program and its reprocessing policy, and to suggest strategies for managing its future fuel cycle program. The study is broken into four sections. The first reviews China's current nuclear fuel cycle program and facilities. The second discusses China's current spent fuel management methods and the storage capability of China's 13 operational nuclear power plants. The third estimates China's total accumulated spent fuel, its required spent fuel storage from present day until 2035, when China expects its first commercialized fast neutron reactors to be operational, and its likely demand for uranium resources. The fourth examines several spent fuel management scenarios for the present period up until 2035; the financial cost and proliferation risk of each scenario is evaluated. The study concludes that China can and should maintain a reprocessing operation to meet its R and D activities before its fast reactor program is further developed. - Highlights: → This study provides an overview of China's fuel cycle program and its reprocessing policy.→ This study suggests strategies for managing its future fuel cycle program.→ China will experience no pressure to lessen the burden of spent fuel storage in the next 30 years.→ China should maintain sufficient reprocessing operations to meet its demands for R and D activities.→ China should actively invest on R and D activities of both fuel cycling and fast reactor programs.

  20. Provision of genetic services in Europe: current practices and issues.

    Science.gov (United States)

    Godard, Béatrice; Kääriäinen, Helena; Kristoffersson, Ulf; Tranebjaerg, Lisbeth; Coviello, Domenico; Aymé, Ségolène

    2003-12-01

    This paper examines the professional and scientific views on the social, ethical and legal issues that impact on the provision of genetic services in Europe. Many aspects have been considered, such as the definition and the aims of genetic services, their organization, the quality assessment, public education, as well as the partnership with patients support groups and the multicultural aspects. The methods was primarily the analysis of professional guidelines, legal frameworks and other documents related to the organization of genetic services, mainly from Europe, but also from USA and international organizations. Then, the method was to examine the background data emerging from an updated report produced by the Concerted Action on Genetic Services in Europe, as well as the issues debated by 43 experts from 17 European countries invited to an international workshop organized by the European Society of Human Genetics Public and Professional Policy Committee in Helsinki, Finland, 8 and 9 September 2000. Some conclusions were identified from the ESHG workshop to arrive at outlines for optimal genetic services. Participants were concerned about equal accessibility and effectiveness of clinical genetic services, quality assessment of services, professional education, multidisciplinarity and division of tasks as well as networking. Within European countries, adherence to the organizational principles of prioritization, regionalization and integration into related health services would maximize equal accessibility and effectiveness of genetic actions. There is a need for harmonization of the rules involved in financial coverage of DNA tests in order to make these available to all Europeans. Clear guidelines for the best practice will ensure that the provision of genetic services develops in a way that is beneficial to its customers, be they health professionals or the public, especially since the coordination of clinical, laboratory and research perspectives within a

  1. 76 FR 38399 - Assessing the Current Research, Policy, and Practice Environment in Public Health Genomics

    Science.gov (United States)

    2011-06-30

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [Docket Number CDC-2011-0008] Assessing the Current Research, Policy, and Practice Environment in Public Health... information helpful to assess the current research, policy, and practice environment in public health genomics...

  2. The mining sector of Liberia: current practices and environmental challenges.

    Science.gov (United States)

    Wilson, Samuel T K; Wang, Hongtao; Kabenge, Martin; Qi, Xuejiao

    2017-08-01

    Liberia is endowed with an impressive stock of mineral reserves and has traditionally relied on mining, namely iron ore, gold, and diamonds, as a major source of income. The recent growth in the mining sector has the potential to contribute significantly to employment, income generation, and infrastructure development. However, the development of these mineral resources has significant environmental impacts that often go unnoticed. This paper presents an overview of the Liberian mining sector from historical, current development, and economic perspectives. The efforts made by government to address issues of environmental management and sustainable development expressed in national and international frameworks, as well as some of the environmental challenges in the mining sector are analyzed. A case study was conducted on one of the iron ore mines (China Union Bong Mines Investment) to analyze the effects of the water quality on the local water environment. The results show that the analyzed water sample concentrations were all above the WHO and Liberia water standard Class I guidelines for drinking water. Finally the paper examines the application of water footprint from a life cycle perspective in the Liberian mining sector and suggests some policy options for water resources management.

  3. Grading of direct laryngoscopy. A survey of current practice.

    Science.gov (United States)

    Cohen, A M; Fleming, B G; Wace, J R

    1994-06-01

    One hundred and twenty anaesthetists (30 of each grade), from three separate regions, were interviewed as to how they recorded the appearance of laryngeal structures at direct laryngoscopy and about their knowledge of the commonly used numerical grading system. About two-thirds of anaesthetists surveyed (69.2%) used the numerical grading system, but of these, over half could not identify a 'grade 2' laryngoscopic appearance correctly. Of anaesthetists who did not use the numerical method, over half could not correctly state the difference between a 'grade 2' and a 'grade 3' laryngoscopic appearance. Over 40% of anaesthetists stated incorrectly that the grading should be made on the initial view, even when laryngeal pressure had been needed. Junior anaesthetists were more likely to use the numerical method of recording. The results show that there is unacceptable uncertainty and inaccuracy in the use of the numerical grading system by users as well as non-users, which makes the current routine clinical use of the numerical grading system unsatisfactory.

  4. Current practices in generation of small molecule new leads.

    Science.gov (United States)

    Goodnow, R A

    2001-01-01

    The current drug discovery processes in many pharmaceutical companies require large and growing collections of high quality lead structures for use in high throughput screening assays. Collections of small molecules with diverse structures and "drug-like" properties have, in the past, been acquired by several means: by archive of previous internal lead optimization efforts, by purchase from compound vendors, and by union of separate collections following company mergers. More recently, many drug discovery companies have established dedicated efforts to effect synthesis by internal and/or outsourcing efforts of targeted compound libraries for new lead generation. Although high throughput/combinatorial chemistry is an important component in the process of new lead generation, the selection of library designs for synthesis and the subsequent design of library members has evolved to a new level of challenge and importance. The potential benefits of screening multiple small molecule compound library designs against multiple biological targets offers substantial opportunity to discover new lead structures. Subsequent optimization of such compounds is often accelerated because of the structure-activity relationship (SAR) information encoded in these lead generation libraries. Lead optimization is often facilitated due to the ready applicability of high-throughput chemistry (HTC) methods for follow-up synthesis. Some of the strategies, trends, and critical issues central to the success of lead generation processes are discussed below. Copyright 2002 Wiley-Liss, Inc.

  5. Disposal safety

    International Nuclear Information System (INIS)

    Bartlett, J.W.

    International consensus does not seem to be necessary or appropriate for many of the issues concerned with the safety of nuclear waste disposal. International interaction on the technical aspects of disposal has been extensive, and this interaction has contributed greatly to development of a consensus technical infrastructure for disposal. This infrastructure provides a common and firm base for regulatory, political, and social actions in each nation

  6. Waste disposal

    International Nuclear Information System (INIS)

    Neerdael, B.; Marivoet, J.; Put, M.; Verstricht, J.; Van Iseghem, P.; Buyens, M.

    1998-01-01

    The primary mission of the Waste Disposal programme at the Belgian Nuclear Research Centre SCK/CEN is to propose, develop, and assess solutions for the safe disposal of radioactive waste. In Belgium, deep geological burial in clay is the primary option for the disposal of High-Level Waste and spent nuclear fuel. The main achievements during 1997 in the following domains are described: performance assessment, characterization of the geosphere, characterization of the waste, migration processes, underground infrastructure

  7. Municipal solid waste (MSW) as a renewable source of energy: current and future practices in China.

    Science.gov (United States)

    Cheng, Hefa; Hu, Yuanan

    2010-06-01

    With rapid economic growth and massive urbanization, China faces the problem of municipal solid waste (MSW) disposal and the pressing need for development of alternative energy. Waste-to-energy (WTE) incineration, which recovers energy from discarded MSW and produces electricity and/or steam for heating, is recognized as a renewable source of energy and is playing an increasingly important role in MSW management in China. This article provides an overview of the WTE industry, discusses the major challenges in expanding WTE incineration in China, namely, high capital and operational costs, equipment corrosion, air pollutant emissions, and fly ash disposal. A perspective on MSW as a renewable energy source in China is also presented. Currently, only approximately 13% of MSW generated in China is disposed in WTE facilities. With the significant benefits of environmental quality, the reduction of greenhouse gas (GHG) emissions, and government policies and financial incentives as a renewable energy source, WTE incineration industry is expected to experience significant growth in the coming decade and make greater contribution to supplying renewable energy in China. Copyright 2010 Elsevier Ltd. All rights reserved.

  8. Alternatives for definse waste-salt disposal

    International Nuclear Information System (INIS)

    Benjamin, R.W.; McDonell, W.R.

    1983-01-01

    Alternatives for disposal of decontaminated high-level waste salt at Savannah River were reviewed to estimate costs and potential environmental impact for several processes. In this review, the reference process utilizing intermediate-depth burial of salt-concrete (saltcrete) monoliths was compared with alternatives including land application of the decontaminated salt as fertilizer for SRP pine stands, ocean disposal with and without containment, and terminal storage as saltcake in existing SRP waste tanks. Discounted total costs for the reference process and its modifications were in the same range as those for most of the alternative processes; uncontained ocean disposal with truck transport to Savannah River barges and storage as saltcake in SRP tanks had lower costs, but presented other difficulties. Environmental impacts could generally be maintained within acceptable limits for all processes except retention of saltcake in waste tanks, which could result in chemical contamination of surrounding areas on tank collapse. Land application would require additional salt decontamination to meet radioactive waste disposal standards, and ocean disposal without containment is not permitted in existing US practice. The reference process was judged to be the only salt disposal option studied which would meet all current requirements at an acceptable cost

  9. Comparison of selected DOE and non-DOE requirements, standards, and practices for Low-Level Radioactive Waste Disposal

    International Nuclear Information System (INIS)

    Cole, L.; Kudera, D.; Newberry, W.

    1995-12-01

    This document results from the Secretary of Energy's response to Defense Nuclear Facilities Safety Board Recommendation 94--2. The Secretary stated that the US Department of Energy (DOE) would ''address such issues as...the need for additional requirements, standards, and guidance on low-level radioactive waste management. '' The authors gathered information and compared DOE requirements and standards for the safety aspects Of low-level disposal with similar requirements and standards of non-DOE entities

  10. Preliminary disposal limits, plume interaction factors, and final disposal limits

    Energy Technology Data Exchange (ETDEWEB)

    Flach, G. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2018-01-11

    In the 2008 E-Area Performance Assessment (PA), each final disposal limit was constructed as the product of a preliminary disposal limit and a plume interaction factor. The following mathematical development demonstrates that performance objectives are generally expected to be satisfied with high confidence under practical PA scenarios using this method. However, radionuclides that experience significant decay between a disposal unit and the 100-meter boundary, such as H-3 and Sr-90, can challenge performance objectives, depending on the disposed-of waste composition, facility geometry, and the significance of the plume interaction factor. Pros and cons of analyzing single disposal units or multiple disposal units as a group in the preliminary disposal limits analysis are also identified.

  11. Disposal Of Waste Matter

    International Nuclear Information System (INIS)

    Kim, Jeong Hyeon; Lee, Seung Mu

    1989-02-01

    This book deals with disposal of waste matter management of soiled waste matter in city with introduction, definition of waste matter, meaning of management of waste matter, management system of waste matter, current condition in the country, collect and transportation of waste matter disposal liquid waste matter, industrial waste matter like plastic, waste gas sludge, pulp and sulfuric acid, recycling technology of waste matter such as recycling system of Black clawson, Monroe and Rome.

  12. Measuring Infant and Young Child Complementary Feeding Practices: Indicators, Current Practice, and Research Gaps.

    Science.gov (United States)

    Ruel, Marie T

    2017-01-01

    The publication of the WHO Infant and Young Child Feeding (IYCF) indicators in 2008 equipped the nutrition and broader development community with an invaluable tool for measuring, documenting, and advocating for faster progress in improving these practices in low- and middle-income countries (LMICs). The indicators, with 5 of them focusing on complementary feeding (CF) practices, were originally designed for population level assessment, targeting, monitoring, and evaluation. This chapter takes stock of where we are with the existing CF indicators: it reviews how the indicators have been used, what we have learned, and what their strengths and limitations are, and it suggests a way forward. We find that the indicators have been used extensively for population level assessments and country comparisons, and to track progress. They have also been adopted by researchers in program impact evaluations and in research seeking to understand the determinants and consequences of poor CF practices for child growth and development outcomes. In addition to generating a wealth of knowledge and unveiling the severity of the global problem of poor CF practices in LMICs, the indicators have been an invaluable tool to raise awareness and call for urgent action on improving CF practices at scale. The indicators have strengths and limitations, which are summarized in this chapter. Although enormous progress has been achieved since the indicators were released in 2008, we feel it is time to reflect and revisit the CF indicators, improve them, develop new ones, and promote their appropriate use. Better indicators are critically important to stimulate action and investments in improving CF practices at scale. © 2017 Nestec Ltd., Vevey/S. Karger AG, Basel.

  13. European audit of current practice in diagnosis and treatment of childhood growth hormone deficiency

    DEFF Research Database (Denmark)

    Juul, Anders; Bernasconi, Sergio; Clayton, Peter E

    2002-01-01

    The present survey among members of the ESPE on current practice in diagnosis and treatment of growth hormone (GH) deficiency (GHD) is of great clinical relevance and importance in the light of the recently published guidelines for diagnosis and treatment of GHD by the Growth Hormone Research...... Society. We have found much conformity but also numerous discrepancies between the recommendations of the Growth Hormone Research Society and the current practice in Europe....

  14. Feeding practices of low-income mothers: how do they compare to current recommendations?

    OpenAIRE

    Power, Thomas G; Hughes, Sheryl O; Goodell, L Suzanne; Johnson, Susan L; Duran, J Andrea Jaramillo; Williams, Kimberly; Beck, Ashley D; Frankel, Leslie A

    2015-01-01

    Background Despite a growing consensus on the feeding practices associated with healthy eating patterns, few observational studies of maternal feeding practices with young children have been conducted, especially in low-income populations. The aim of this study was to provide such data on a low income sample to determine the degree to which observed maternal feeding practices compare with current recommendations. Methods Eighty low-income mothers and their preschool children were videotaped a...

  15. Low-level waste disposal technology

    International Nuclear Information System (INIS)

    Levin, G.B.

    1983-01-01

    A design has been proposed for a low-level radioactive waste disposal site that should provide the desired isolation under all foreseeable conditions. Although slightly more costly than current practices; this design provides additional reliability. This reliability is desirable to contribute to the closure of the fuel cycle and to demonstrate the responsible management of the uranium cycle by reestablishing confidence in the system

  16. Delivering Communication Strategy Training for People with Aphasia: What Is Current Clinical Practice?

    Science.gov (United States)

    Beckley, Firle; Best, Wendy; Beeke, Suzanne

    2017-01-01

    Background: Communication strategy training (CST) is a recognized part of UK speech and language therapists' (SLTs) role when working with a person with aphasia. Multiple CST interventions have been published but, to date, there are no published studies exploring clinical practice in this area. Aims: To investigate UK SLTs' current CST practices.…

  17. Globalization of Gerontology Education: Current Practices and Perceptions for Graduate Gerontology Education in the United States

    Science.gov (United States)

    Mwangi, Samuel M.; Yamashita, Takashi; Ewen, Heidi H.; Manning, Lydia K.; Kunkel, Suzanne R.

    2012-01-01

    The purpose of this study is to document current practices and understandings about globalization of gerontology education in the United States. Better understanding of aging requires international perspectives in global communities. However, little is known about how globalization of gerontology education is practiced in U.S. graduate-level…

  18. Critical Ethical Issues in Online Counseling: Assessing Current Practices with an Ethical Intent Checklist

    Science.gov (United States)

    Shaw, Holly E.; Shaw, Sarah F.

    2006-01-01

    The authors used a 16-item Ethical Intent Checklist, developed from the American Counseling Association's (1999) Ethical Standards for Internet Online Counseling, to assess the current practices of 88 online counseling Web sites. Results showed fewer than half of online counselors were following the accepted practice on 8 of the 16 items. Online…

  19. The Practice of School Psychology in Quebec English Schools: Current Challenges and Opportunities

    Science.gov (United States)

    Finn, Cindy A.

    2016-01-01

    In Quebec, school psychology is alive and well. This article outlines current challenges and opportunities related to the practice of psychology in Quebec English schools. Changes to the practice of psychology in Quebec over the last decade have had an impact on the delivery of psychological services in schools. Modifications of the admission…

  20. Technical guidelines for maintaining occupational exposures as low as practicable. Phase I. Summary of current practices

    International Nuclear Information System (INIS)

    Gilchrist, R.L.; Selby, J.M.; Wedlick, H.L.

    1978-08-01

    Reducing radiation exposures to as low as practicable is a principle that was first introduced in 1949. However, the recent controversy over the low-level effects of radiation has led the Department of Energy (DOE) to review its programs. One such review was conducted by the Pacific Northwest Laboratory to survey the implementation of the ALAP principle in the DOE laboratories. This report contains the results of that survey, performed in 18 major DOE installations. The DOE contractors were asked questions concerning the following eight major areas: management, operational health physics, design, dosimetry, instrumentation, training, risk/cost-benefit, and impact of the ALAP philosophy. The survey revealed several potential areas of concern, which are described in this report. These areas will be addressed in the forthcoming manual, A Guide to Reducing Radiation Exposures As Low As Practicable

  1. Application of radiotherapy for hepatocellular carcinoma in current clinical practice guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Rim, Chai Hong; Seong, Jin Sil [Dept. of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-09-15

    In oncologic practice, treatment guidelines provide appropriate treatment strategies based on evidence. Currently, many guidelines are used, including those of the European Association for the Study of the Liver and European Organization for Research and Treatment of Cancer (EASL-EORTC), National Comprehensive Cancer Network (NCCN), Asia-Pacific Primary Liver Cancer Expert (APPLE), and Korean Liver Cancer Study Group and National Cancer Centre (KLCSG-NCC). Although radiotherapy is commonly used in clinical practice, some guidelines do not accept it as a standard treatment modality. In this review, we will investigate the clinical practice guidelines currently used, and discuss the application of radiotherapy.

  2. Application of radiotherapy for hepatocellular carcinoma in current clinical practice guidelines

    International Nuclear Information System (INIS)

    Rim, Chai Hong; Seong, Jin Sil

    2016-01-01

    In oncologic practice, treatment guidelines provide appropriate treatment strategies based on evidence. Currently, many guidelines are used, including those of the European Association for the Study of the Liver and European Organization for Research and Treatment of Cancer (EASL-EORTC), National Comprehensive Cancer Network (NCCN), Asia-Pacific Primary Liver Cancer Expert (APPLE), and Korean Liver Cancer Study Group and National Cancer Centre (KLCSG-NCC). Although radiotherapy is commonly used in clinical practice, some guidelines do not accept it as a standard treatment modality. In this review, we will investigate the clinical practice guidelines currently used, and discuss the application of radiotherapy

  3. Current Status and Future Agenda for the Theory, Research, and Practice of Childhood Career Development

    Science.gov (United States)

    Schultheiss, Donna E. Palladino

    2008-01-01

    This article reviews the current status and a future agenda for childhood career development theory, research, and practice. The fragmented nature of the current state of the literature is noted, and a call is made for a reexamination and reconsideration of the childhood developmental pathways of life's work. It is suggested that the study of…

  4. Determining how much mixed waste will require disposal

    International Nuclear Information System (INIS)

    Kirner, N.P.

    1990-01-01

    Estimating needed mixed-waste disposal capacity to 1995 and beyond is an essential element in the safe management of low-level radioactive waste disposal capacity. Information on the types and quantities of mixed waste generated is needed by industry to allow development of treatment facilities and by states and others responsible for disposal and storage of this type of low-level radioactive waste. The design of a mixed waste disposal facility hinges on a detailed assessment of the types and quantities of mixed waste that will ultimately require land disposal. Although traditional liquid scintillation counting fluids using toluene and xylene are clearly recognized as mixed waste, characterization of other types of mixed waste has, however, been difficult. Liquid scintillation counting fluids comprise most of the mixed waste generated and this type of mixed waste is generally incinerated under the supplemental fuel provisions of the Resource Conservation and Recovery Act (RCRA) Because there are no Currently operating mixed waste land disposal facilities, it is impossible to make projections of waste requiring land disposal based on a continuation of current waste disposal practices. Evidence indicates the volume of mixed waste requiring land disposal is not large, since generators are apparently storing these wastes. Surveys conducted to date confirm that relatively small volumes of commercially generated mixed waste volume have relied heavily oil generators' knowledge of their wastes. Evidence exists that many generators are confused by the differences between the Atomic Energy Act and the Resource Conservation and Recovery Act (RCRA) on the issue of when a material becomes a waste. In spite of uncertainties, estimates of waste volumes requiring disposal can be made. This paper proposes an eight-step process for such estimates

  5. Waste disposal

    International Nuclear Information System (INIS)

    2005-01-01

    Radioactive waste, as a unavoidable remnant from the use of radioactive substances and nuclear technology. It is potentially hazardous to health and must therefore be managed to protect humans and the environment. The main bulk of radioactive waste must be permanently disposed in engineered repositories. Appropriate safety standards for repository design and construction are required along with the development and implementation of appropriate technologies for the design, construction, operation and closure of the waste disposal systems. As backend of the fuel cycle, resolving the issue of waste disposal is often considered as a prerequisite to the (further) development of nuclear energy programmes. Waste disposal is therefore an essential part of the waste management strategy that contributes largely to build confidence and helps decision-making when appropriately managed. The International Atomic Energy Agency provides assistance to Member States to enable safe and secure disposal of RW related to the development of national RWM strategies, including planning and long-term project management, the organisation of international peer-reviews for research and demonstration programmes, the improvement of the long-term safety of existing Near Surface Disposal facilities including capacity extension, the selection of potential candidate sites for different waste types and disposal options, the characterisation of potential host formations for waste facilities and the conduct of preliminary safety assessment, the establishment and transfer of suitable technologies for the management of RW, the development of technological solutions for some specific waste, the building of confidence through training courses, scientific visits and fellowships, the provision of training, expertise, software or hardware, and laboratory equipment, and the assessment of waste management costs and the provision of advice on cost minimisation aspects

  6. Report on radioactive waste disposal

    International Nuclear Information System (INIS)

    1993-01-01

    The safe management of radioactive wastes constitutes an essential part of the IAEA programme. A large number of reports and conference proceedings covering various aspects of the subject have been issued. The Technical Review Committee on Underground Disposal (February 1988) recommended that the Secretariat issue a report on the state of the art of underground disposal of radioactive wastes. The Committee recommended the need for a report that provided an overview of the present knowledge in the field. This report covers the basic principles associated with the state of the art of near surface and deep geological radioactive waste disposal, including examples of prudent practice, and basic information on performance assessment methods. It does not include a comprehensive description of the waste management programmes in different countries nor provide a textbook on waste disposal. Such books are available elsewhere. Reviewing all the concepts and practices of safe radioactive waste disposal in a document of reasonable size is not possible; therefore, the scope of this report has been limited to cover essential parts of the subject. Exotic disposal techniques and techniques for disposing of uranium mill tailings are not covered, and only brief coverage is provided for disposal at sea and in the sea-bed. The present report provides a list of references to more specialized reports on disposal published by the IAEA as well as by other bodies, which may be consulted if additional information is sought. 108 refs, 22 figs, 2 tabs

  7. Waste management in the Irkutsk Region, Siberia, Russia: Environmental assessment of current practice focusing on landfilling

    DEFF Research Database (Denmark)

    Starostina, Vlada; Damgaard, Anders; Rechberger, Helmut

    2014-01-01

    The municipal waste management system of the region of Irkutsk is described and a life cycle assessment (LCA) performed to assess the environmental performance of the system. Annually about 500 000 tons of waste are managed. The waste originates from three sources: household waste (27%), commercial...... waste (23%) and office & institutional waste (44%). Other waste of unknown composition constitutes 6%. Only 3% of the waste is recycled; 97% of the municipal waste is disposed of at the old Alexandrovsky landfill. The environmental impact from the current system is dominated by the landfill, which has...... no gas or leachate collection system. The global warming contribution is due to the emission of methane of the order of 420 000 tons CO2-equivalents per year. Collection and transport of the waste are insignificant compared with impacts from the landfill. As the old landfill runs out of capacity in a few...

  8. Current waste-management practices and operations at Oak Ridge National Laboratory, 1982

    Energy Technology Data Exchange (ETDEWEB)

    Eisenhower, B.M.; Oakes, T.W.; Coobs, J.H.; Weeter, D.W.

    1982-09-01

    The need for efficient management of industrial chemical wastes, especially those considered hazardous or radioactive, is receiving increased attention in the United States. During the past five years, several federal laws have addressed the establishment of stronger programs for the control of hazardous and residual wastes. At a facility such as Oak Ridge National Laboratory (ORNL), an efficient waste management program is an absolute necessity to ensure protection of human health and compliance with regulatory requirements addressing the treatment and disposal of hazardous, nonhazardous, and radioactive wastes. This report highlights the major regulatory requirements under which the Laboratory must operate and their impact on ORNL facilities. Individual waste streams, estimates of quantities of waste, and current waste management operations are discussed.

  9. Current waste-management practices and operations at Oak Ridge National Laboratory, 1982

    International Nuclear Information System (INIS)

    Eisenhower, B.M.; Oakes, T.W.; Coobs, J.H.; Weeter, D.W.

    1982-09-01

    The need for efficient management of industrial chemical wastes, especially those considered hazardous or radioactive, is receiving increased attention in the United States. During the past five years, several federal laws have addressed the establishment of stronger programs for the control of hazardous and residual wastes. At a facility such as Oak Ridge National Laboratory (ORNL), an efficient waste management program is an absolute necessity to ensure protection of human health and compliance with regulatory requirements addressing the treatment and disposal of hazardous, nonhazardous, and radioactive wastes. This report highlights the major regulatory requirements under which the Laboratory must operate and their impact on ORNL facilities. Individual waste streams, estimates of quantities of waste, and current waste management operations are discussed

  10. Addressing Prediabetes in Childhood Obesity Treatment Programs: Support from Research and Current Practice

    Science.gov (United States)

    Grow, H. Mollie; Fernandez, Cristina; Lukasiewicz, Gloria J.; Rhodes, Erinn T.; Shaffer, Laura A.; Sweeney, Brooke; Woolford, Susan J.; Estrada, Elizabeth

    2014-01-01

    Abstract Background: Type 2 diabetes mellitus (T2DM) and prediabetes have increased in prevalence among overweight and obese children, with significant implications for long-term health. There is little published evidence on the best approaches to care of prediabetes among overweight youth or the current practices used across pediatric weight management programs. Methods: This article reviews the literature and summarizes current practices for screening, diagnosis, and treatment of prediabetes at childhood obesity treatment centers. Findings regarding current practice were based on responses to an online survey from 28 pediatric weight management programs at 25 children's hospitals in 2012. Based on the literature reviewed, and empiric data, consensus support statements on prediabetes care and T2DM prevention were developed among representatives of these 25 children's hospitals' obesity clinics. Results: The evidence reviewed demonstrates that current T2DM and prediabetes diagnostic parameters are derived from adult-based studies with little understanding of clinical outcomes among youth. Very limited evidence exists on preventing progression of prediabetes. Some evidence suggests that a significant proportion of obese youth with prediabetes will revert to normoglycemia without pharmacological management. Evidence supports lifestyle modification for children with prediabetes, but further study of specific lifestyle changes and pharmacological treatments is needed. Conclusion: Evidence to guide management of prediabetes in children is limited. Current practice patterns of pediatric weight management programs show areas of variability in practice, reflecting the limited evidence base. More research is needed to guide clinical care for overweight youth with prediabetes. PMID:25055134

  11. Current Practices in Global/International Advanced Pharmacy Practice Experiences: Preceptor and Student Considerations.

    Science.gov (United States)

    Dornblaser, Emily K; Ratka, Anna; Gleason, Shaun E; Ombengi, David N; Tofade, Toyin; Wigle, Patricia R; Zapantis, Antonia; Ryan, Melody; Connor, Sharon; Jonkman, Lauren J; Ochs, Leslie; Jungnickel, Paul W; Abrons, Jeanine P; Alsharif, Naser Z

    2016-04-25

    The objective of this article is to describe the key areas of consideration for global/international advanced pharmacy practice experience (G/I APPE) preceptors, students and learning objectives. At the 2013 Annual Meeting of the American Association of Colleges of Pharmacy (AACP), the GPE SIG prepared and presented an initial report on the G/IAPPE initiatives. Round table discussions were conducted at the 2014 AACP Annual Meeting to document GPE SIG member input on key areas in the report. Literature search of PubMed, Google Scholar and EMBASE with keywords was conducted to expand this report. In this paper, considerations related to preceptors and students and learning outcomes are described. Preceptors for G/I APPEs may vary based on the learning outcomes of the experience. Student learning outcomes for G/I APPEs may vary based on the type of experiential site. Recommendations and future directions for development of G/IAPPEs are presented. Development of a successful G/I APPE requires significant planning and consideration of appropriate qualifications for preceptors and students.

  12. Unused and expired medications disposal practices in the community: a cross-sectional survey in Cheras, Malaysia

    Directory of Open Access Journals (Sweden)

    Omotayo Fatokun*, Ai Wei Chang, Wan Nah Ng, Thashini Nair, Vanitha Balakrishnan

    2011-09-01

    Full Text Available Irresponsible disposal of unused and expired medicationsmay lead to both environmental and public health hazards andhas been subject of several studies [1-3]. The presence ofpharmaceuticals and their respective metabolites in theaquatic environment has become a source for rising concern inrecent years and several studies [2,3 ] have shown that theexistence of these substances in waste water and drinkingwater [4] and they may be potentially harmful to aquatic life.Besides, risk to human life remained a concern [2]. Therefore,the objective of this study was to assess medication disposalpractices and environmental risks awareness of improperdisposal of medications among individuals in the community.A 9-item structured questionnaire was developed based onexisting literature [1-3]. Following a pre-test on ten people in acommunity shopping mall, the final questionnaire wasadministered face-to-face to a convenience sample of 200participants at different areas in two large shopping malls andsurrounding restaurants in Cheras, Kuala Lumpur, Malaysia.Findings demonstrate that Majority of participants (51.5%were male. In terms of ethnic distribution, the majority ofparticipants surveyed were Chinese (66.5%, followed byMalays (17.0% and Indians (15.5%. Majority of participants(47.5% were aged between 20-29 years old.

  13. Surveys of Current Teaching and Practice for Impressions for Complete Dentures.

    Science.gov (United States)

    Hussain, N; Jabbar, H; Hayati, M; Wu, J; Hyde, T P

    2018-03-08

    The 3 objectives are to assess current preferences for impressions for complete dentures, audit practice and compare practice to current UK teaching. Three surveys where undertaken; a survey of GDPs preferences, an audit of practice and a survey of teaching in UK dental schools. UK Universities advocate border moulded custom trays. In stated preferences, 99% of practitioners used custom trays for private practice; 67% for NHS work. In actual use, the audit found 91% practitioners in private practice used custom trays; in NHS practice 78% did so. The most widely taught materials were silicone (43%), alginate (29%), & zinc oxide eugenol paste (19%). In practitioners stated preferences, 97% of NHS and 53% of private dentists listed alginate as an option; however the audit showed only 74% (NHS) and 52% (private) actually used alginate, with 20% (NHS) and 48% (private) using silicone. Definitive impressions in custom trays are used by GDPs for both private and NHS work; they are universally taught at UK dental schools. Alginate is popular in NHS practice; however, silicone is more widely taught in UK Universities. The use of silicone materials for definitive impressions has increased since 1999. In UK private practice silicone usage is aligned in popularity with alginate. Copyright© 2018 Dennis Barber Ltd.

  14. Infective endocarditis prophylaxis: current practice trend among paediatric cardiologists: are we following the 2007 guidelines?

    Science.gov (United States)

    Naik, Ronak J; Patel, Neil R; Wang, Ming; Shah, Nishant C

    2016-08-01

    In 2007, the American Heart Association modified the infective endocarditis prophylaxis guidelines by limiting the use of antibiotics in patients with cardiac conditions associated with the highest risk of adverse outcomes after infective endocarditis. Our objective was to evaluate current practice for infective endocarditis prophylaxis among paediatric cardiologists. A web-based survey focussing on current practice, describing the use of antibiotics for infective endocarditis prophylaxis in various congenital and acquired heart diseases, was distributed via e-mail to paediatric cardiologists. The survey was kept anonymous and was distributed twice. Data from 253 participants were analysed. Most paediatric cardiologists discontinued infective endocarditis prophylaxis in patients with simple lesions such as small ventricular septal defect, patent ductus arteriosus, and bicuspid aortic valve without stenosis or regurgitation; however, significant disagreement persists in prescribing infective endocarditis prophylaxis in certain conditions such as rheumatic heart disease, Fontan palliation without fenestration, and the Ross procedure. Use of antibiotic prophylaxis in certain selected conditions for which infective endocarditis prophylaxis has been indicated as per the current guidelines varies from 44 to 83%. Only 44% follow the current guidelines exclusively, and 34% regularly discuss the importance of oral hygiene with their patients at risk for infective endocarditis. Significant heterogeneity still persists in recommending infective endocarditis prophylaxis for several cardiac lesions among paediatric cardiologists. More than half of the participants (56%) do not follow the current guidelines exclusively in their practice. Counselling for optimal oral health in patients at risk for infective endocarditis needs to be optimised in the current practice.

  15. Low-level-waste-disposal methodologies

    International Nuclear Information System (INIS)

    Wheeler, M.L.; Dragonette, K.

    1981-01-01

    This report covers the followng: (1) history of low level waste disposal; (2) current practice at the five major DOE burial sites and six commercial sites with dominant features of these sites and radionuclide content of major waste types summarized in tables; (3) site performance with performance record on burial sites tabulated; and (4) proposed solutions. Shallow burial of low level waste is a continuously evolving practice, and each site has developed its own solutions to the handling and disposal of unusual waste forms. There are no existing national standards for such disposal. However, improvements in the methodology for low level waste disposal are occurring on several fronts. Standardized criteria are being developed by both the Nuclear Regulatory Commission (NRC) and by DOE. Improved techniques for shallow burial are evolving at both commercial and DOE facilities, as well as through research sponsored by NRC, DOE, and the Environmental Protection Agency. Alternatives to shallow burial, such as deeper burial or the use of mined cavities is also being investigated by DOE

  16. Radioactive waste disposal and political aspects

    International Nuclear Information System (INIS)

    Blanc, M.

    1992-01-01

    The difficulties presented by the current atomic energy law for the nuclear waste disposal in Switzerland are shown. It is emphasised how important scientific information is in the political solutions for nuclear disposal

  17. 78 FR 11611 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Science.gov (United States)

    2013-02-19

    ... related to the proposed rule on ``Current Good Manufacturing Practice and Hazard Analysis and Risk-Based... . All comments should be identified with the title ``Current Good Manufacturing Practice and Hazard... rulemaking to modernize the regulation for ``Current Good Manufacturing Practice In Manufacturing, Packing...

  18. 78 FR 48636 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Science.gov (United States)

    2013-08-09

    ... collection related to the proposed rule, ``Current Good Manufacturing Practice and Hazard Analysis and Risk... period. These two proposals are related to the proposed rule ``Current Good Manufacturing Practice and... final extension of the comment period for the ``Current Good Manufacturing Practice and Hazard Analysis...

  19. The current state of abortion law and practice in Northern Ireland.

    Science.gov (United States)

    Daniels, Pauline; Campbell, Patricia; Clinton, Alison

    This paper reviews current abortion law and practice in Northern Ireland (NI). It explores the origins of NI's abortion law and its complexity in relation to current practice. It reviews issues relating to women seeking terminations in NI and Great Britain and reviews attempts by the Family Planning Association in NI to require the Department of Health, Social Services and Public Safety NI to clarify the current legal basis for termination of pregnancy and to provide guidance for health professionals engaged in this practice. The paper also discusses some of the issues surrounding abortion in NI and seeks to explain why this subject is causing controversy and debate, especially following a judicial review in February and Marie Stopes opening a termination service in Belfast.

  20. Goal setting practice in chronic low back pain. What is current practice and is it affected by beliefs and attitudes?

    Science.gov (United States)

    Gardner, Tania; Refshauge, Kathryn; McAuley, James; Hübscher, Markus; Goodall, Stephen; Smith, Lorraine

    2018-01-18

    Goal setting, led by the patient, is promising as an effective treatment for the management of chronic low back pain (CLBP); however, little is known about current practice. The aims of the study were to explore (1) current goal setting practice in CLBP among physiotherapists; (2) perceived barriers to goal setting in CLBP; and (3) relationship between clinician's attitudes and beliefs and goal setting practice. A cross-sectional observational survey. The majority of respondents used goal setting with the main aim of facilitating self-management. The greatest number of goals were set with 50% therapist/50% patient involvement. The most common perceived barriers to goal setting related to time constraints and lack of skill and confidence. A higher biomedical score for treatment orientation of the therapist was associated with a lower patient involvement score. Goal setting is common practice for CLBP and is perceived as a high priority. It is more often a collaboration between therapist and patient rather than patient-led with treatment orientation of the physiotherapist a predictor of patient involvement. Education of healthcare professionals needs to include better understanding of chronic pain to orient them away from a biomedical treatment approach, as well as to enhance skills in facilitating patient involvement in goal setting.

  1. Guidelines on current good radiopharmacy practice (cGRPP) in the preparation of radiopharmaceuticals

    International Nuclear Information System (INIS)

    Dumas, Cecile

    2010-07-01

    Preparation of radiopharmaceuticals for injection involves adherence to regulations on radiation protection as well as to appropriate rules of working under aseptic conditions, which are covered by these guidelines on Good Radiopharmacy Practice (GRPP). The handling of radiopharmaceuticals is potentially hazardous. The level of risk depends in particular upon the types of radiation emitted and the half-lives of the radioactive isotopes. Particular attention must be paid to the prevention of cross-contamination, and to waste disposal. A continuous assessment of the effectiveness of the Quality Assurance system is essential to prove that the procedures applied in the Radiopharmacy Department lead to the expected quality. Clinical trials with new radiopharmaceuticals should follow these regulations on cGRPP as well as the Guideline on Good Clinical Practice. As there is a considerable difference in complexity in preparing 'classical' radiopharmaceuticals in 'kit' procedures and producing radiopharmaceuticals by distinct chemical procedures (Positron Emission Tomography (PET) Radiopharmaceuticals, in house prepared radiopharmaceuticals including in house prepared kits) these guidelines have been divided in two parts (A and B) respecting these differences

  2. Assessment of current cybersecurity practices in the public domain : cyber indications and warnings domain.

    Energy Technology Data Exchange (ETDEWEB)

    Hamlet, Jason R.; Keliiaa, Curtis M.

    2010-09-01

    This report assesses current public domain cyber security practices with respect to cyber indications and warnings. It describes cybersecurity industry and government activities, including cybersecurity tools, methods, practices, and international and government-wide initiatives known to be impacting current practice. Of particular note are the U.S. Government's Trusted Internet Connection (TIC) and 'Einstein' programs, which are serving to consolidate the Government's internet access points and to provide some capability to monitor and mitigate cyber attacks. Next, this report catalogs activities undertaken by various industry and government entities. In addition, it assesses the benchmarks of HPC capability and other HPC attributes that may lend themselves to assist in the solution of this problem. This report draws few conclusions, as it is intended to assess current practice in preparation for future work, however, no explicit references to HPC usage for the purpose of analyzing cyber infrastructure in near-real-time were found in the current practice. This report and a related SAND2010-4766 National Cyber Defense High Performance Computing and Analysis: Concepts, Planning and Roadmap report are intended to provoke discussion throughout a broad audience about developing a cohesive HPC centric solution to wide-area cybersecurity problems.

  3. Economics of low-level radioactive waste disposal

    International Nuclear Information System (INIS)

    Schafer, J.; Jennrich, E.

    1983-01-01

    Regardless of who develops new low-level radioactive waste disposal sites or when, economics will play a role. To assist in this area the Department of Energy's Low-Level Radioactive Waste Management Program has developed a computer program, LLWECON, and data base for projecting disposal site costs. This program and its non-site specific data base can currently be used to compare the costs associated with various disposal site development, financing, and operating scenarios. As site specific costs and requirements are refined LLWECON will be able to calculate exact life cycle costs for each facility. While designed around shallow land burial, as practiced today, LLWECON is flexible and the input parameters discrete enough to be applicable to other disposal options. What the program can do is illustrated

  4. Globalization of Gerontology Education: Current Practices and Perceptions for Graduate Gerontology Education in the United States

    Science.gov (United States)

    MWANGI, SAMUEL M.; YAMASHITA, TAKASHI; EWEN, HEIDI H.; MANNING, LYDIA K.; KUNKEL, SUZANNE R.

    2013-01-01

    The purpose of this study is to document current practices and understandings about globalization of gerontology education in the United States. Better understanding of aging requires international perspectives in global communities. However, little is known about how globalization of gerontology education is practiced in U.S. graduate-level degree programs. The authors conducted qualitative interviews with representatives of the Association for Gerontology in Higher Education, the major national organization supporting higher education in gerontology, graduate program directors, and students. Although all respondents expressed their interest in globalizing gerontology education, actual practices are diverse. The authors discuss suggested conceptualization and strategies for globalizing gerontology education. PMID:22490075

  5. Current nuclear industry practices with regard to the integration of surveillances

    International Nuclear Information System (INIS)

    Stewart, M.; Smith, C.

    1992-04-01

    Commercial nuclear industry practices regarding the integration of technical specification (TS) surveillance and maintenance activities are identified in this report. A questionnaire was developed and used to obtain current industry practices from NRC Regional personnel and INEL engineers with utility experience. Some of these practices indicate that the scheduling of TS surveillance and maintenance items could be more effectively coordinated. Also, must utilities do not formally consider risk implications when they are scheduling maintenance. Methodologies and approaches for proposing and evaluating changes to improve the integration of TS surveillance and maintenance activities have been identified for planned future work

  6. Globalization of gerontology education: current practices and perceptions for graduate gerontology education in the United States.

    Science.gov (United States)

    Mwangi, Samuel M; Yamashita, Takashi; Ewen, Heidi H; Manning, Lydia K; Kunkel, Suzanne R

    2012-01-01

    The purpose of this study is to document current practices and understandings about globalization of gerontology education in the United States. Better understanding of aging requires international perspectives in global communities. However, little is known about how globalization of gerontology education is practiced in U.S. graduate-level degree programs. The authors conducted qualitative interviews with representatives of the Association for Gerontology in Higher Education, the major national organization supporting higher education in gerontology, graduate program directors, and students. Although all respondents expressed their interest in globalizing gerontology education, actual practices are diverse. The authors discuss suggested conceptualization and strategies for globalizing gerontology education.

  7. Waste Disposal

    International Nuclear Information System (INIS)

    Neerdael, B.; Marivoet, J.; Put, M.; B-Verstricht, J.; Van Iseghem, P.; Buyens, M.

    1998-01-01

    This contribution describes the main activities of the Waste and Disposal Department of the Belgian Nuclear Research Center SCK-CEN. Achievements in 1997 in three topical areas are reported on: performance assessments, waste forms/packages and near-and far field studies

  8. Solid waste disposal into salt mines

    International Nuclear Information System (INIS)

    Repke, W.

    1981-01-01

    The subject is discussed as follows: general introduction to disposal of radioactive waste; handling of solid nuclear waste; technology of final disposal, with specific reference to salt domes; conditioning of radioactive waste; safety barriers for radioactive waste; practice of final disposal in other countries. (U.K.)

  9. A Profile of Current Employee Training Practices in Selected Businesses and Industries in Southwest Virginia

    OpenAIRE

    Hundley, Katrina M.

    2003-01-01

    The purposes of this study were to (a) establish a profile of the current training practices of selected businesses and industries in Southwest Virginia; (b) identify the type of training methods these companies are choosing -- such as traditional classroom training or web-based training programs, and (c) identify how the training methods are selected. This profile established baseline data for current business and industry employee training programs. The population of this study include...

  10. Menstrual Hygiene, Management, and Waste Disposal: Practices and Challenges Faced by Girls/Women of Developing Countries

    OpenAIRE

    Rajanbir Kaur; Kanwaljit Kaur; Rajinder Kaur

    2018-01-01

    Menstruation and menstrual practices still face many social, cultural, and religious restrictions which are a big barrier in the path of menstrual hygiene management. In many parts of the country especially in rural areas girls are not prepared and aware about menstruation so they face many difficulties and challenges at home, schools, and work places. While reviewing literature, we found that little, inaccurate, or incomplete knowledge about menstruation is a great hindrance in the path of p...

  11. Rehabilitation of the Upper Extremity after Stroke: Current Practice As a Guide for Curriculum

    Directory of Open Access Journals (Sweden)

    Mylene Schriner PhD, OTR/L

    2014-01-01

    Full Text Available Stroke is the leading cause of disability in the United States and a top diagnosis for occupational therapy (OT services among neurological conditions. Academic programs teach OT students neurological frames of reference (FORs to provide a foundation for future practice. To meet accreditation standards, entry-level curricula must reflect current practice and evidence-based interventions. A survey of OT practitioners working in upper extremity stroke rehabilitation was conducted to investigate current clinical practice in a variety of treatment settings. Survey questions probed the use of motor rehabilitation techniques exclusive to one of six neurological FORs: Brunnstrom, Constraint-induced Movement Therapy, Neurodevelopmental Treatment, Proprioceptive Neuromuscular Facilitation, Rood, and Task-Oriented. Responses from 167 OT professionals indicated interventions representing all six FORs are currently being utilized in stroke rehabilitation. Techniques from the Task-Oriented and Neurodevelopmental Treatment approaches were used most frequently; however, the Rood–based techniques were used much less than interventions from the other FORs. No single neurological approach was found to dominate practice regardless of the number of years of experience in stroke rehabilitation or years since graduation from an entry-level program. A majority of participants appear to employ techniques from multiple approaches frequently, suggesting contemporary OT practice in upper extremity stroke rehabilitation is eclectic in nature.

  12. A Focus Group Study of Child Nutrition Professionals' Attitudes about Food Allergies and Current Training Practices

    Science.gov (United States)

    Lee, Yee Ming; Kwon, Junehee; Sauer, Kevin

    2014-01-01

    Purpose/Objectives: The purpose of this study was to explore child nutrition professionals' (CNPs) attitudes about food allergies, current practices of food allergy training, and operational issues related to food allergy training in school foodservice operations. Methods: Three focus groups were conducted with 21 CNPs with managerial…

  13. Assessment of Current Practice for Tank Testing of Small Marine Energy Devices

    DEFF Research Database (Denmark)

    Kofoed, Jens Peter; Frigaard, Peter

    Discussion Report. Equitable Testing and Evaluation of Marine Energy Extraction Devices in terms of Performance, Cost and Environmental Impact. The report is a contribution by Aalborg University (AAU) to the deliverable on Assessment of current practice for tank testing of small marine energy...

  14. Examining Current Beliefs, Practices and Barriers about Technology Integration: A Case Study

    Science.gov (United States)

    Hsu, Pi-Sui

    2016-01-01

    The purpose of this mixed-methods study was to examine the current beliefs, practices and barriers concerning technology integration of Kindergarten through Grade Six teachers in the midwestern United States. The three data collection methods were online surveys with 152 teachers as well as interviews and observations with 8 teachers. The findings…

  15. Cultural landscapes as heritage in Malaysia: Potentials, threats, and current practices

    NARCIS (Netherlands)

    Ahmad, R.

    2013-01-01

    The rural cultural landscape in Malaysia is relatively under-researched. The current heritage practices focus on built heritage as national heritage, which implies the everyday landscapes of the rural areas have been neglected as potential heritage and have received little attention from politicians

  16. Current Trends in Malaysian Higher Education and the Effect on Education Policy and Practice: An Overview

    Science.gov (United States)

    Grapragasem, Selvaraj; Krishnan, Anbalagan; Mansor, Azlin Norhaini

    2014-01-01

    Malaysia has evolved from a production-based to knowledge-based economy in order to stay relevant and compete in the global marketplace. Thus, the purpose of this article is to discuss current trends in Malaysian higher education and how these affect education policies and practices. Four main trends are discussed in this study: Globalization,…

  17. Vitamin D status of dairy cattle: Outcomes of current practices in the dairy industry

    Science.gov (United States)

    The need for vitamin D supplementation of dairy cattle has been known for the better part of the last century and is well-appreciated by dairy producers and nutritionists. Whether current recommendations and practices for supplemental vitamin D are meeting the needs of dairy cattle, however, is not...

  18. Mentoring and New Teacher Induction in the United States: A Review and Analysis of Current Practices

    Science.gov (United States)

    Bullough, Robert V., Jr.

    2012-01-01

    In this article, current practices were reviewed in mentoring and induction across three large states--New York, Texas, and California--and one small state, Utah. Patterns and trends are described in the United States, program results and evolving views of mentoring are discussed, gaps in the research literature are identified, and the future of…

  19. Cardioversion for atrial fibrillation in current European practice : results of the European Heart Rhythm Association survey

    NARCIS (Netherlands)

    Hernandez-Madrid, Antonio; Svendsen, Jesper Hastrup; Lip, Gregory Y. H.; Van Gelder, Isabelle C.; Dobreanu, Dan; Blomstrom-Lundqvist, Carina

    This survey was conducted to provide an insight into the current clinical practice regarding the use of cardioversion for atrial fibrillation (AF) in Europe. Responses were received from 57 centres across Europe, 71.9 of which were university hospitals. For electrical cardioversion, general

  20. Educating physicians in evidence based medicine: current practices and curricular strategies

    NARCIS (Netherlands)

    Maggio, L.A.

    2015-01-01

    Evidence based medicine (EBM) is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” The practice of EBM is an expectation of professional healthcare and requisite component in many medical school curricula. Yet, despite

  1. Interpersonal Relationships, Motivation, Engagement, and Achievement: Yields for Theory, Current Issues, and Educational Practice

    Science.gov (United States)

    Martin, Andrew J.; Dowson, Martin

    2009-01-01

    In this review, we scope the role of interpersonal relationships in students' academic motivation, engagement, and achievement. We argue that achievement motivation theory, current issues, and educational practice can be conceptualized in relational terms. Influential theorizing, including attribution theory, expectancy-value theory, goal theory,…

  2. Methane emissions from natural gas pipelines - current estimates, technologies and practices

    International Nuclear Information System (INIS)

    Lang, M.C.; Crook, L.

    1997-01-01

    Methane is the major component of natural gas. World-wide methane emissions from gas systems is estimated to be between 50 and 25 tera grams or about 5 percent of the world-wide total of anthropogenic methane emissions. Technologies and practices are described that are currently being used or are planned to be used in the US to both measure and/or reduce methane emissions from natural gas pipelines. One of the technologies that is described includes a high flow sampling instrument. One of the practices that is described is the current voluntary program conducted by the US Environmental Protection Agency called the Natural Gas Star program. This program supports research into best management practices, information sharing and technology transfer to promote methane emissions reductions profitably. (R.P.)

  3. Standard practice for examination of welds using the alternating current field measurement technique

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2007-01-01

    1.1 This practice describes procedures to be followed during alternating current field measurement examination of welds for baseline and service-induced surface breaking discontinuities. 1.2 This practice is intended for use on welds in any metallic material. 1.3 This practice does not establish weld acceptance criteria. 1.4 The values stated in either inch-pound units or SI units are to be regarded separately as standard. The values stated in each system might not be exact equivalents; therefore, each system shall be used independently of the other. 1.5 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.

  4. Current practice and views of neurologists on the transition from pediatric to adult care.

    Science.gov (United States)

    Oskoui, Maryam; Wolfson, Christina

    2012-12-01

    To describe the current practice and views of neurologists on transitioning patients from pediatric to adult care, a cross-sectional study of all pediatric and adult neurologists in the province of Quebec, Canada, was conducted. The response rate was 73% for pediatric and 49% for adult neurologists. Most pediatric neurologists do not have a patient transition program or policy in place. Although a transfer summary is commonly provided, critical information is often lacking. Nearly half of neurologists believed that patients experience a gap in care during the transition process, and most agreed that the transition process is often poorly coordinated, highlighting patient, family, and health care factors. Current practice does not follow existing consensus statements for transition of care with respect to timing, communication, and preparation, and many pediatric neurologists experience difficulty in finding an appropriate adult health care provider for their patients. Neurologists reported many challenges in the current transition of care process.

  5. Theoretical and practical program in the non-destructive testing by eddy currents - the first level

    International Nuclear Information System (INIS)

    Shaaban, H.I.; Addarwish, J.M.A.

    2014-11-01

    The testing using eddy currents is one of the non-destructive tests that use electromagnetic property as a basis for testing procedures, and there are many other ways to use this principle, including Remote Field Testing and the Magnetic Flux Leakage test. Eddy currents are electrical currents moving in a circular path, and took the name eddy of eddies that form when a liquid or gas is moving in a circular path because of objection obstacles to its track. They are generated in the material using a variable magnetic field. Non-destructive testing by eddy currents is a technique used for the detection of defects and interruptions in a material and it is a process that relies on the generation of small eddy currents in the material of the part to be examined, provided that this part is of an electrically conducting material. This technique and its scientific basis are explained in this book. Also the devices used in this technique and how to use these devices in details are explained. The book contains Twelve chapters: Introduction to non destructive testing - Engineering materials and its mechanical characteristics - Electrical and magnetic characteristics of engineering materials - Introduction to testing by eddy currents - Factors affecting eddy currents - Basis of electrical circuits used in eddy currents testing devices - Probes of eddy currents testing - Eddy currents testing devices (Theoretical) - Analysis of the examination results of testing by eddy currents: techniques and applications - Applications of testing by eddy currents - Eddy currents testing devices (Application) - Practical lessons for the first level in testing by eddy currents.

  6. Articulating current service development practices: a qualitative analysis of eleven mental health projects.

    Science.gov (United States)

    Jun, Gyuchan Thomas; Morrison, Cecily; Clarkson, P John

    2014-01-17

    The utilisation of good design practices in the development of complex health services is essential to improving quality. Healthcare organisations, however, are often seriously out of step with modern design thinking and practice. As a starting point to encourage the uptake of good design practices, it is important to understand the context of their intended use. This study aims to do that by articulating current health service development practices. Eleven service development projects carried out in a large mental health service were investigated through in-depth interviews with six operation managers. The critical decision method in conjunction with diagrammatic elicitation was used to capture descriptions of these projects. Stage-gate design models were then formed to visually articulate, classify and characterise different service development practices. Projects were grouped into three categories according to design process patterns: new service introduction and service integration; service improvement; service closure. Three common design stages: problem exploration, idea generation and solution evaluation - were then compared across the design process patterns. Consistent across projects were a top-down, policy-driven approach to exploration, underexploited idea generation and implementation-based evaluation. This study provides insight into where and how good design practices can contribute to the improvement of current service development practices. Specifically, the following suggestions for future service development practices are made: genuine user needs analysis for exploration; divergent thinking and innovative culture for idea generation; and fail-safe evaluation prior to implementation. Better training for managers through partnership working with design experts and researchers could be beneficial.

  7. Waste disposal

    CERN Multimedia

    2006-01-01

    We should like to remind you that you can have all commonplace, conventional waste (combustible, inert, wood, etc.) disposed of by the TS-FM Group. Requests for the removal of such waste should be made by contacting FM Support on tel. 77777 or by e-mail (Fm.Support@cern.ch). For requests to be acted upon, the following information must be communicated to FM Support: budget code to be debited for the provision and removal of the skip / container. type of skip required (1m3, 4 m3, 7 m3, 15 m3, 20 m3, 30 m3). nature of the waste to be disposed of (bulky objects, cardboard boxes, etc.). building concerned. details of requestor (name, phone number, department, group, etc.). We should also like to inform you that the TS-FM Group can arrange for waste to be removed from work-sites for firms under contract to CERN, provided that the prior authorisation of the CERN Staff Member in charge of the contract is obtained and the relevant disposal/handling charges are paid. You are reminded that the selective sorting o...

  8. Waste disposal

    CERN Multimedia

    2006-01-01

    We should like to remind you that you can have all commonplace, conventional waste (combustible, inert, wood, etc.) disposed of by the TS-FM Group. Requests for the removal of such waste should be made by contacting FM Support on tel. 77777 or by e-mail (Fm.Support@cern.ch). For requests to be acted upon, the following information must be communicated to FM Support: budget code to be debited for the provision and removal of the skip / container; type of skip required (1m3, 4 m3, 7 m3, 15 m3, 20 m3, 30 m3); nature of the waste to be disposed of (bulky objects, cardboard boxes, etc.); building concerned; details of requestor (name, phone number, department, group, etc.). We should also like to inform you that the TS-FM Group can arrange for waste to be removed from work-sites for firms under contract to CERN, provided that the prior authorisation of the CERN Staff Member in charge of the contract is obtained and the relevant disposal/handling charges are paid. You are reminded that the selective sorting...

  9. ICU nurses' oral-care practices and the current best evidence.

    Science.gov (United States)

    DeKeyser Ganz, Freda; Fink, Naomi Farkash; Raanan, Ofra; Asher, Miriam; Bruttin, Madeline; Nun, Maureen Ben; Benbinishty, Julie

    2009-01-01

    The purpose of this study was to describe the oral-care practices of ICU nurses, to compare those practices with current evidence-based practice, and to determine if the use of evidence-based practice was associated with personal demographic or professional characteristics. A national survey of oral-care practices of ICU nurses was conducted using a convenience sample of 218 practicing ICU nurses in 2004-05. The survey instrument included questions about demographic and professional characteristics and a checklist of oral-care practices. Nurses rated their perceived level of priority concerning oral care on a scale from 0 to 100. A score was computed representing the sum of 14 items related to equipment, solutions, assessments, and techniques associated with the current best evidence. This score was then statistically analyzed using ANOVA to determine differences of EBP based on demographic and professional characteristics. The most commonly used equipment was gauze pads (84%), followed by tongue depressors (55%), and toothbrushes (34%). Chlorhexidine was the most common solution used (75%). Less than half (44%) reported brushing their patients' teeth. The majority performed an oral assessment before beginning oral care (71%); however, none could describe what assessment tool was used. Only 57% of nurses reported documenting their oral care. Nurses rated oral care of intubated patients with a priority of 67+/-27.1. Wide variations were noted within and between units in terms of which techniques, equipment, and solutions were used. No significant relationships were found between the use of an evidence-based protocol and demographic and professional characteristics or with the priority given to oral care. While nurses ranked oral care a high priority, many did not implement the latest evidence into their current practice. The level of research utilization was not related to personal or professional characteristics. Therefore attempts should be made to encourage all

  10. Engineering geology of waste disposal

    International Nuclear Information System (INIS)

    Bentley, S.P.

    1996-01-01

    This volume covers a wide spectrum of activities in the field of waste disposal. These activities range from design of new landfills and containment properties of natural clays to investigation, hazard assessment and remediation of existing landfills. Consideration is given to design criteria for hard rock quarries when used for waste disposal. In addition, an entire section concerns the geotechnics of underground repositories. This covers such topics as deep drilling, in situ stress measurement, rock mass characterization, groundwater flows and barrier design. Engineering Geology of Waste Disposal examines, in detail, the active role of engineering geologists in the design of waste disposal facilities on UK and international projects. The book provides an authoritative mix of overviews and detailed case histories. The extensive spectrum of papers will be of practical value to those geologists, engineers and environmental scientists who are directly involved with waste disposal. (UK)

  11. Implications of current resident work-hour guidelines on the future practice of surgery in Canada.

    Science.gov (United States)

    Maruscak, Adam A; VanderBeek, Laura; Ott, Michael C; Kelly, Stephen; Forbes, Thomas L

    2012-01-01

    Work-hour restrictions have had a profound impact on surgical training. However, little is known of how work-hour restrictions may affect the future practice patterns of current surgical residents. The purpose of this study is to compare the anticipated career practice patterns of surgical residents who are training within an environment of work-hour restrictions with the current practice of faculty surgeons. An electronic survey was sent to all surgery residents and faculty at 2 Canadian university-affiliated medical centers. The survey consisted of questions regarding expected (residents) or current (faculty) practice patterns. A total of 149 residents and 125 faculty members completed the survey (50.3% and 52.3% response rates, respectively). A greater proportion of males were in the faculty cohort than in the resident group (77.6% vs 62.4%, p = 0.0003). More faculty than residents believed that work-hour restrictions have a negative impact on both residency education (40.8% vs 20.8%, p = 0.008) and preparation for a surgical career (56.8% vs 19.5%, p implications and might require larger surgical groups and reconsideration of resource allocation. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  12. Subproject L-045H 300 Area Treated Effluent Disposal Facility

    International Nuclear Information System (INIS)

    1991-06-01

    The study focuses on the project schedule for Project L-045H, 300 Area Treated Effluent Disposal Facility. The 300 Area Treated Effluent Disposal Facility is a Department of Energy subproject of the Hanford Environmental Compliance Project. The study scope is limited to validation of the project schedule only. The primary purpose of the study is to find ways and means to accelerate the completion of the project, thereby hastening environmental compliance of the 300 Area of the Hanford site. The ''300 Area'' has been utilized extensively as a laboratory area, with a diverse array of laboratory facilities installed and operational. The 300 Area Process Sewer, located in the 300 Area on the Hanford Site, collects waste water from approximately 62 sources. This waste water is discharged into two 1500 feet long percolation trenches. Current environmental statutes and policies dictate that this practice be discontinued at the earliest possible date in favor of treatment and disposal practices that satisfy applicable regulations

  13. The effect of recent amblyopia research on current practice in the UK.

    Science.gov (United States)

    Newsham, D

    2010-10-01

    Several studies have recently provided insights into how amblyopia may be most effectively managed. Despite the new evidence, a US study reported that a recent randomised controlled trial had made little influence on clinical practice. The aims of this research are to assess current practice of amblyopia management in the UK and to determine the comparability with the evidence-based recommendations. A questionnaire was constructed to assess current amblyopia management practice, particularly in relation to areas investigated by recent research and emailed to every head orthoptist within the UK. There was a great deal of variability in the amount of occlusion that was prescribed for moderate and severe amblyopia. Sixty per cent of clinicians indicated that the maximum they would prescribe was in excess of the 6 h recommended by research. Atropine was rarely recommended as a first-line treatment, with occlusion generally being considered to be more effective. Despite recommendations regarding education as a means of reducing non-compliance, only 39% of clinicians always gave written information, although various other methods of enhancing compliance were used. A period of refractive adaptation was allowed by most clinicians but often far less than recommended. The uptake of recent research evidence into clinical practice is sporadic and incomplete with one-third of respondents indicating that following the studies, they had made no changes whatsoever to their practice. This is similar to other areas of medicine; the reasons are likely to be varied, and is an area that would benefit from greater attention.

  14. A Snapshot Study of Current Practices among Sellers of Translation Services between Japanese and English

    Directory of Open Access Journals (Sweden)

    Dr. Stephen Crabbe

    2015-11-01

    Full Text Available A two-part study was launched in light of the Japan Translation Federation’s 2012 statement in its guide, 翻訳で失敗しないために翻訳発注の手引き [lit. For not getting it wrong with translation: a guide to ordering translation], that “外国語の文書を母国語に翻訳するのがプロの原則です” [lit. It is a fundamental principle that professional translators work into their native languages] (Japan Translation Federation, 2012, p. 15. The key goal is to gauge the extent to which this 2012 statement is reflected in current practices among the sellers and buyers of translation services between Japanese and English. In this paper, which describes the first part of the study, the focus is on the practices of sellers of translation services between Japanese and English: specifically, professional freelance translators. Twenty-four professional freelance translators completed an online questionnaire. The results of this questionnaire, first, suggest that current practices among sellers of translation services between Japanese and English are consistent with the Japan Translation Federation’s 2012 statement and, second, broadly support secondary literature on L1 translation (translation into the first language and L2 translation (translation into the second language. Whilst this is only a snapshot of current practices among sellers of translation services between Japanese and English, the overall results are informative. In the second, follow-up part of the study the focus will be on the current practices of buyers of translation services between Japanese and English.

  15. Economic analysis of alternative LLW disposal methods

    International Nuclear Information System (INIS)

    Foutes, C.E.; Queenan, C.J. III

    1987-01-01

    The Environmental Protection Agency (EPA) has evaluated the costs and benefits of alternative disposal technologies as part of its program to develop generally applicable environmental standards for the land disposal of low-level radioactive waste (LLW). Costs, population health effects and Critical Population Group (CPG) exposures resulting from alternative waste treatment and disposal methods were evaluated both in absolute terms and also relative to a base case (current practice). Incremental costs of the standard included costs for packaging, processing, transportation, and burial of waste. Benefits are defined in terms of reductions in the general population health risk (expected fatal cancers and genetic effects) evaluated over 10,000 years. A cost-effectiveness ratio, defined as the incremental cost per avoided health effect, was calculated for each alternative standard. The cost-effectiveness analysis took into account a number of waste streams, hydrogeologic and climatic region settings, and waste treatment and disposal methods. This paper describes the alternatives considered and preliminary results of the cost-effectiveness analysis. 15 references, 7 figures, 3 tables

  16. 78 FR 64425 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Science.gov (United States)

    2013-10-29

    ..., 507, and 579 [Docket No. FDA-2011-N-0922] Current Good Manufacturing Practice and Hazard Analysis and... requirements for current good manufacturing practice and hazard analysis and risk-based preventive controls for..., packing, or holding of animal food in two ways. First, it would create new current good manufacturing...

  17. 78 FR 69604 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Science.gov (United States)

    2013-11-20

    ... Federal Register of January 16, 2013 (78 FR 3646), entitled ``Current Good Manufacturing Practice and... a proposed rule entitled ``Current Good Manufacturing Practice and Hazard Analysis and Risk-Based..., 114, 117, 120, 123, 129, 179, and 211 [Docket No. FDA-2011-N-0920] RIN 0910-AG36 Current Good...

  18. Current practice and developmental efforts for leak detection in U.S. reactor primary systems

    International Nuclear Information System (INIS)

    Kupperman, D.S.; Claytor, T.N.

    1986-01-01

    Current leak detection practices in 74 operating nuclear reactors have been reviewed. Existing leak detection systems are adequate to ensure a leak-before-break scenario in most situations, but no currently available, single method combines optimal leakage detection sensitivity, leak-locating ability, and leakage measurement accuracy. Simply tightening current leakage limits may produce an unacceptably large number of unnecessary shutdowns. The use of commercially available acoustic monitoring systems or moisture-sensitive tape may improve leak detection capability at specific sites. However, neither of these methods currently provides source discrimination (e.g., to distinguish between leaks from pipe cracks and valves) or leak-rate information (a small leak may saturate the system). A field-implementable acoustic leak detection system is being developed to address these limitations. 5 refs.

  19. Current practice and developmental efforts for leak detection in US reactor primary systems

    International Nuclear Information System (INIS)

    Kupperman, D.S.; Claytor, T.N.

    1985-07-01

    Current leak detection practices in 74 operating nuclear reactors have been reviewed. Existing leak detection systems are adequate to ensure a leak-before-break scenario in most situations, but no currently available, single method combines optimal leakage detection sensitivity, leak-locating ability, and leakage measurement accuracy. Simply tightening current leakage limits may produce an unacceptably large number of unnecessary shutdowns. The use of commercially available acoustic monitoring systems or moisture-sensitive tape may improve leak detection capability at specific sites. However, neither of these methods currently provides source discrimination (e.g., to distinguish between leaks from pipe cracks and valves) or leak-rate information (a small leak may saturate the system). A field-implementable acoustic leak detection system is being developed to address these limitations. 5 refs., 3 figs

  20. Disposal options for radioactive waste

    International Nuclear Information System (INIS)

    Olivier, J.P.

    1991-01-01

    On the basis of the radionuclide composition and the relative toxicity of radioactive wastes, a range of different options are available for their disposal. Practically all disposal options rely on confinement of radioactive materials and isolation from the biosphere. Dilution and dispersion into the environment are only used for slightly contaminated gaseous and liquid effluents produced during the routine operation of nuclear facilities, such as power plants. For the bulk of solid radioactive waste, whatever the contamination level and decay of radiotoxicity with time are, isolation from the biosphere is the objective of waste disposal policies. The paper describes disposal approaches and the various techniques used in this respect, such as shallow land burial with minimum engineered barriers, engineered facilities built at/near the surface, rock cavities at great depth and finally deep geologic repositories for long-lived waste. The concept of disposing long-lived waste into seabed sediment layers is also discussed, as well as more remote possibilities, such as disposal in outer space or transmutation. For each of these disposal methods, the measures to be adopted at institutional level to reinforce technical isolation concepts are described. To the extent possible, some comments are made with regard to the applicability of such disposal methods to other hazardous wastes. (au)

  1. Modelling the dissolution of borosilicate glasses for radioactive waste disposal with the PHREEQE/GLASSOL code: theory and practice

    International Nuclear Information System (INIS)

    Curti, E.

    1991-02-01

    A model describing the corrosion kinetics of silicate glasses has been developed by Grambow in recent years. In this report, the theoretical background of the model is thoroughly discussed, and its practical use demonstrated. The main objectives were: 1) to test the validity of the basic assumptions on which the model relies, and 2) to assess whether it can be applied to the safety analysis of a Swiss final repository for high-level radioactive waste. Transition State Theory, a tool based on quantum mechanical principles, has been used by Grambow to derive a general kinetic equation for the corrosion of silicate glasses. This equation predicts successfully the observed dependence of the corrosion rate on the silicic acid concentration in solution according to a first order kinetics law. However, some parameters required by this equation are determined on the base of questionable assumptions. In particular, the simplistic surface complexation model used for the calculation of the free energy of the glass-water reaction yields, for the protonation of silicon on the glass surface, results which are not consistent with the experimental findings. Further, although the model predicts a unique value, common to all silicate glasses, for the activation energy of the rate-determining elementary reaction, leaching experiments conducted on a wide variety of glasses suggest that this quantity may vary by a factor 2. In its present form, the model is judged to be unsuitable for the safety analysis of the Swiss final repository. The reasons include: 1) the model neglects the potential effects of diffusive transport and silica sorption in a bentonite backfill on the glass corrosion kinetics, 2) the release of radionuclides can be only modelled assuming congruent dissolution, and 3) the magnitude of the final rates of corrosion, the parameter defining the maximal lifetime of the glass matrix, is still not known with sufficient precision. (author) figs., tabs., 27 refs

  2. Current state of information technology use in a US primary care practice-based research network.

    Science.gov (United States)

    Andrews, James E; Pearce, Kevin A; Sydney, Carey; Ireson, Carol; Love, Margaret

    2004-01-01

    To examine the current levels of information technology (IT) use in a primary care practice-based research network (PBRN) in order to inform future development of its infrastructure. Every primary care practitioner who is a member of the Kentucky Ambulatory Network (KAN),as well as the office managers of each practice. Practitioners included family practitioners, general practitioners, nurse practitioners and physician assistants. A cross-sectional study using two survey instruments: one for office managers and one for practitioners. The office manager survey included questions related to the current state of IT within the practice, plans for enhancement and general IT issues from the perspective of managing a practice. The practitioner survey was designed to measure current IT use and attitudes of primary care practitioners. Response rates for the surveys were 46% (n = 68) for the office managers and 51% (n = 116) for practitioners. All but one practice had internet access; however, 43% had only dial-up service. Only 21% of practitioners use an electronic medical record (EMR), with dollar cost being the barrier reported most frequently (58%). More than half of the office managers were either 'somewhat interested' (45%) or 'very interested' (17%) in a low-cost, standardised EMR that was, at the time, to be sponsored by the American Academy of Family Physicians. For practitioners, 71% were either 'somewhat' or 'very' interested in such a system. Responses to other IT issues are reported. While interest in enabling information technologies was high in KAN, adoption was variable, with use of several key technologies reported as low.The results suggest that research in this network that would be dependent on or enhanced by IT might be impeded and, generally, greater attention should be given to enhancing the IT infrastructure in primary care.

  3. FFTF disposable solid waste cask

    Energy Technology Data Exchange (ETDEWEB)

    Thomson, J. D.; Goetsch, S. D.

    1983-01-01

    Disposal of radioactive waste from the Fast Flux Test Facility (FFTF) will utilize a Disposable Solid Waste Cask (DSWC) for the transport and burial of irradiated stainless steel and inconel materials. Retrievability coupled with the desire for minimal facilities and labor costs at the disposal site identified the need for the DSWC. Design requirements for this system were patterned after Type B packages as outlined in 10 CFR 71 with a few exceptions based on site and payload requirements. A summary of the design basis, supporting analytical methods and fabrication practices developed to deploy the DSWC is provided in this paper.

  4. FFTF disposable solid waste cask

    International Nuclear Information System (INIS)

    Thomson, J.D.; Goetsch, S.D.

    1983-01-01

    Disposal of radioactive waste from the Fast Flux Test Facility (FFTF) will utilize a Disposable Solid Waste Cask (DSWC) for the transport and burial of irradiated stainless steel and inconel materials. Retrievability coupled with the desire for minimal facilities and labor costs at the disposal site identified the need for the DSWC. Design requirements for this system were patterned after Type B packages as outlined in 10 CFR 71 with a few exceptions based on site and payload requirements. A summary of the design basis, supporting analytical methods and fabrication practices developed to deploy the DSWC is provided in this paper

  5. Current practices in vestibular schwannoma management: a survey of American and Canadian neurosurgeons.

    Science.gov (United States)

    Fusco, Matthew R; Fisher, Winfield S; McGrew, Benjamin M; Walters, Beverly C

    2014-12-01

    Comprehensive therapy for vestibular schwannomas has changed dramatically over the past fifty years. Previously, neurosurgeons were most likely to treat these tumors via an independent surgical approach. Currently, many neurosurgeons treat vestibular schwannomas employing an interdisciplinary team approach with neuro-otologists and radiation oncologists. This survey aims to determine the current treatment paradigm for vestibular schwannomas among American and Canadian neurosurgeons, with particular attention to the utilization of a team approach to the surgical resection of these lesions. A seventeen part survey questionnaire was sent by electronic mail to residency trained members of the American Association of Neurological Surgeons currently practicing in Canada or the United States. Questions were divided into groups regarding physician background, overall practice history, recent practice history, opinions on treatment paradigms, and experience with an interdisciplinary team approach. Seven hundred and six responses were received. The vast majority of neurosurgeons surgically resect vestibular schwannomas as part of an interdisciplinary team (85.7%). Regional variations were observed in the use of an interdisciplinary team: 52.3% of responding neurosurgeons who surgically treat vestibular schwannomas without neuro-otologists currently practice in the South (no other region represented more than 15.4% of this group, p=0.02). Surgeons who have treated >50 vestibular schwannomas show a trend towards more frequent utilization of an interdisciplinary approach than less experienced surgeons, but this did not reach statistical significance. The majority of neurosurgeons in the United States and Canada surgically resect vestibular schwannomas via an interdisciplinary approach with the participation of a neuro-otologist. Neurosurgeons in the South appear more likely to surgically treat these tumors alone than neurosurgeons in other regions of the U.S. and Canada

  6. Small Business and Defense Acquisitions: A Review of Policies and Current Practices

    Science.gov (United States)

    2011-01-01

    Office of Management and Budget xviii Small Business and Defense Acquisitions: A Review of Policies and Current Practices PSC Product and Service Code...themselves as minority-owned, women-owned, veteran- owned, or small disadvantaged businesses . The resulting database gives sourcing managers a tool for...REPORT DATE 2011 2. REPORT TYPE 3. DATES COVERED 00-00-2011 to 00-00-2011 4. TITLE AND SUBTITLE Small Business and Defense Acquisitions: A

  7. Reporting Multiple Individual Injuries in Studies of Team Ball Sports: A Systematic Review of Current Practice

    OpenAIRE

    Fortington, Lauren V; van der Worp, Henk; van den Akker-Scheek, Inge; Finch, Caroline F

    2017-01-01

    Background To identify and prioritise targets for injury prevention efforts, injury incidence studies are widely reported. The accuracy and consistency in calculation and reporting of injury incidence is crucial. Many individuals experience more than one injury but multiple injuries are not consistently reported in sport injury incidence studies. Objective The aim of this systematic review was to evaluate current practice of how multiple injuries within individuals have been defined and repor...

  8. Surgical handover in an era of reduced working hours: an audit of current practice.

    Science.gov (United States)

    Shafiq-ur-Rehman; Mehmood, Sajid; Ahmed, Jamil; Razzaq, Muhammad Haroon; Khan, Shakeeb; Perry, Eugene Phillip

    2012-06-01

    To examine the current practice of handover and to record trainees' assessment of handover process. An audit study. Department of General Surgery, Scarborough General Hospital, Scarborough, United Kingdom, from January to April 2010. A paper-based questionnaire containing instruments pertaining to handover guidelines was disseminated to trainees on surgical on-call rota at the hospital. Trainees' responses regarding handover process including information transferred, designated location, duration, structure, senior supervision, awareness of guidelines, formal training, and rating of current handover practice were analysed. A total of 42 questionnaires were returned (response rate = 100%). The trainees included were; registrars 21% (n=9), core surgical trainees 38 % (n=16), and foundation trainees 41% (n=17). Satisfactory compliance (> 80% handover sessions) to RCS guidelines was observed for only five out of nine components. Ninety-five percent of hand over sessions took place at a designated place and two-third lasted less than 20-minutes. Computer generated handover sheet 57% (n=24) was the most commonly practised method of handover. Specialist registrar 69 % (n=29) remained the supervising person in majority of handover sessions. None of the respondents received formal teaching or training in handover, whereas only half of them 48% (n=20) were aware of handover guidelines. Twenty-one percent of the trainees expressed dissatisfaction with the current practice of handover. Current practice of surgical handover lacks structure despite a fair degree of compliance to RCS handover guidelines. A computerised-sheet based structured handover process, subjected to regular audit, would ensure patient safety and continuity of care.

  9. Management of Pediatric Delirium in Pediatric Cardiac Intensive Care Patients: An International Survey of Current Practices.

    Science.gov (United States)

    Staveski, Sandra L; Pickler, Rita H; Lin, Li; Shaw, Richard J; Meinzen-Derr, Jareen; Redington, Andrew; Curley, Martha A Q

    2018-06-01

    The purpose of this study was to describe how pediatric cardiac intensive care clinicians assess and manage delirium in patients following cardiac surgery. Descriptive self-report survey. A web-based survey of pediatric cardiac intensive care clinicians who are members of the Pediatric Cardiac Intensive Care Society. Pediatric cardiac intensive care clinicians (physicians and nurses). None. One-hundred seventy-three clinicians practicing in 71 different institutions located in 13 countries completed the survey. Respondents described their clinical impression of the occurrence of delirium to be approximately 25%. Most respondents (75%) reported that their ICU does not routinely screen for delirium. Over half of the respondents (61%) have never attended a lecture on delirium. The majority of respondents (86%) were not satisfied with current delirium screening, diagnosis, and management practices. Promotion of day/night cycle, exposure to natural light, deintensification of care, sleep hygiene, and reorientation to prevent or manage delirium were among nonpharmacologic interventions reported along with the use of anxiolytic, antipsychotic, and medications for insomnia. Clinicians responding to the survey reported a range of delirium assessment and management practices in postoperative pediatric cardiac surgery patients. Study results highlight the need for improvement in delirium education for pediatric cardiac intensive care clinicians as well as the need for systematic evaluation of current delirium assessment and management practices.

  10. Toward a more materialistic medicine: the value of authentic materialism within current and future medical practice.

    Science.gov (United States)

    Leder, Drew; Krucoff, Mitchell W

    2011-09-01

    Modern medicine is often accused by diverse critics of being "too materialistic" and therefore insufficiently holistic and effective. Yet, this critique can be misleading, dependent upon the ambiguous meanings of "materialism." The term can refer to the prevalence of financial concerns in driving medical practice. Alternatively, it can refer to "mechanistic materialism," the patient viewed as a body-machine. In each case, this article shows that this represents not authentic "materialism" at play, but a focus upon high-level abstractions. "Bottom-line" financial or diagnostic numbers can distract practitioners from the embodied needs of sick patients. In this sense, medical practice is not materialist enough. Through a series of clinical examples, this article explores how an authentic materialism would look in current and future practice. The article examines the use of prayer/comfort shawls at the bedside; hospitals and nursing homes redesigned as enriched healing environments; and a paradigmatic medical device--the implantable cardioverter defibrillator--as it might be presented to patients, in contrast to current practice.

  11. A review of current practices and the future for deep well injection in the upper Miocene Stevens sand, Kern County, California

    International Nuclear Information System (INIS)

    Kiser, S.C.; Chenot, D.W.

    1991-01-01

    Waste-water disposal is a major concern of the petroleum business, especially because of complications associated with many produced-water surface-impoundment percolation facilities. In the San Joaquin Valley, California, the current environmental regulations protecting the potentially usable groundwaters are stringent. the Stevens has significant potential as a disposal zone that may offer considerable capacity when the project is designed using proper geologic and engineering studies. The Stevens sands are well known for their oil-producing capabilities, however, not much has been published regarding its suitability as a zone for deep well injection. Conditions that make the Stevens potentially suitable include (1) adequate confinement providing geologic separation from the groundwater sources in the basin, (2) storage capacity, and (3) large areal extent. Because the search for acceptable disposal options is becoming critical, the current class II disposal options is becoming critical, the current class II disposal activities in the Stevens sands were reviewed and the areas offering the greatest future potential were identified. The authors then discuss class II disposal projects in Stevens sands in the West Bellevue and Midway Sunset oil fields and estimate the ultimate basin-wide disposal capacity of the Stevens

  12. radioactive waste disposal standards abroad

    International Nuclear Information System (INIS)

    Lu Yan; Xin Pingping; Wu Jian; Zhang Xue

    2012-01-01

    With the world focus on human health and environmental protection, the problem of radioactive waste disposal has gradually become a global issue, and the focus of attention of public. The safety of radioactive waste disposal, is not only related to human health and environmental safety, but also an important factor of affecting the sustainable development of nuclear energy. In recent years the formulation of the radioactive waste disposal standards has been generally paid attention to at home and abroad, and it has made great progress. In China, radioactive waste management standards are being improved, and there are many new standards need to be developed. The revised task of implement standards is very arduous, and there are many areas for improvement about methods and procedures of the preparation of standards. This paper studies the current situation of radioactive waste disposal standards of the International Atomic Energy Agency, USA, France, Britain, Russia, Japan, and give some corresponding recommendations of our radioactive waste disposal standards. (authors)

  13. Smartphone use in dermatology for clinical photography and consultation: Current practice and the law.

    Science.gov (United States)

    Abbott, Lisa M; Magnusson, Roger S; Gibbs, Emma; Smith, Saxon D

    2018-05-01

    Smartphones are rapidly changing the way doctors capture and communicate clinical information, particularly in highly visual specialties such as dermatology. An understanding of how and why smartphones are currently used in clinical practice is critical in order to evaluate professional and legal risks, and to formulate policies that enable safe use of mobile technologies for the maximal benefit of practitioners and patients. Australian dermatologists and dermatology trainees were surveyed on their current practices relating to clinical smartphone use. Of the 105 respondents, 101 provided useable results. The data show clinical smartphone use is common and frequent, with more than 50% of respondents sending and receiving images on their smartphones at least weekly. Clinical photographs were usually sent via multimedia message or email and were commonly stored on smartphones (46%). Security measures adopted to protect data were limited. There was inadequate documentation of consent for transmission of photographs and advice provided. Only 22% of respondents were aware of clear policies in their workplace regarding smartphone use, and a majority desired further education on digital image management. Given the frequency of use and the degree of importance placed on the ability to send and receive clinical images, clinical smartphone use will persist and will likely increase over time. Current practices are insufficient to comply with professional and legal obligations, and increase practitioners' vulnerability to civil and disciplinary proceedings. Further education, realistic policies and adequate software resources are critical to ensure protection of patients, practitioners and the reputation of the dermatological profession. © 2017 The Australasian College of Dermatologists.

  14. Disposal of radioactive waste. An overview of the principles involved

    International Nuclear Information System (INIS)

    1982-01-01

    Radioactive waste management strategies and practices have been reviewed in many publications. By and large these documents are technical in nature and they do not normally discuss the motives that determine which course of action should be taken. The present document concentrates on these less well defined aspects and is intended to provide a review of the philosophy underlying the current technical approach to the disposal of radioactive waste. Disposal is the final step in waste management and may be simply defined as a method of dealing with wastes for which there is no intention of retrieval

  15. Test result communication in primary care: a survey of current practice.

    Science.gov (United States)

    Litchfield, Ian; Bentham, Louise; Lilford, Richard; McManus, Richard J; Hill, Ann; Greenfield, Sheila

    2015-11-01

    The number of blood tests ordered in primary care continues to increase and the timely and appropriate communication of results remains essential. However, the testing and result communication process includes a number of participants in a variety of settings and is both complicated to manage and vulnerable to human error. In the UK, guidelines for the process are absent and research in this area is surprisingly scarce; so before we can begin to address potential areas of weakness there is a need to more precisely understand the strengths and weaknesses of current systems used by general practices and testing facilities. We conducted a telephone survey of practices across England to determine the methods of managing the testing and result communication process. In order to gain insight into the perspectives from staff at a large hospital laboratory we conducted paired interviews with senior managers, which we used to inform a service blueprint demonstrating the interaction between practices and laboratories and identifying potential sources of delay and failure. Staff at 80% of practices reported that the default method for communicating normal results required patients to telephone the practice and 40% of practices required that patients also call for abnormal results. Over 80% had no fail-safe system for ensuring that results had been returned to the practice from laboratories; practices would otherwise only be aware that results were missing or delayed when patients requested results. Persistent sources of missing results were identified by laboratory staff and included sample handling, misidentification of samples and the inefficient system for collating and resending misdirected results. The success of the current system relies on patients both to retrieve results and in so doing alert staff to missing and delayed results. Practices appear slow to adopt available technological solutions despite their potential for reducing the impact of recurring errors in the

  16. A survey of current practice of vascular surgeons in venous disease management.

    Science.gov (United States)

    Bush, Ruth L; Gloviczki, Peter

    2013-01-01

    Acute venous thromboembolism and chronic venous diseases are common conditions that affect a large proportion of the United States population. The diagnosis of venous disease has improved, and the treatment options have rapidly evolved over the past decade. To date, it is unclear to what extent vascular surgeons have become involved in the modern management of venous disorders. This survey was undertaken to explore the current interest and practice of vascular surgeons in the contemporary care of venous disease. A survey was administered via a web-based platform to active and candidate members of the Society for Vascular Surgery (SVS). The survey included 30 questions investigating the characteristics of venous surgeons and scope of venous practice. Open-ended questions were also included for commentary. A total of 1879 surveys were sent to SVS members nationwide, and 385 members participated (response rate of 20.5%). The participants were mostly men (89.6%) with 37.7% practicing in an academic setting and 59.2% in private practice. The respondents treated superficial veins (92.9%) and deep veins (85.8%) in clinical practice, with 89.9% having their own vascular laboratory. A wide spectrum of interventions for superficial (91.9%), deep (85.8%), and perforator veins (52.7% endovenous, 19.4% subfascial endoscopic perforator surgery) are being performed by respondents. Only 26.2% had learned endovenous thermal ablation in their training program; however, over 96% of those performing venous interventions utilized this technique. Overall, the majority (85.5%) devoted 50% or less of practice to venous disorders. Respondents indicated that limitations to expansion of vein practices mainly involved challenges with third party payers, local competition, and existing large volumes of arterial interventions needing to be performed. Despite the widespread incorporation of venous disease into current vascular practices, 66.1% are not members of the American Venous Forum (AVF

  17. Managing the Services Supply Chain in the Department of Defense: An Empirical Study of Current Management Practices

    National Research Council Canada - National Science Library

    Apte, Aruna U; Apte, Uday M; Rendon, Rene G

    2008-01-01

    .... Specifically, we studied the current management practices in such areas as life cycle approach, project management, organization/ management structure, and training provided to services acquisition personnel...

  18. Adolescents' physical activity is associated with previous and current physical activity practice by their parents

    Directory of Open Access Journals (Sweden)

    Diego Giulliano Destro Christofaro

    Full Text Available Abstract Objective: The purpose of this study was to determine whether parents' current and previous physical activity practice is associated with adolescents' physical activity. Methods: The sample was composed of 1231 adolescents (14-17 years, and 1202 mothers and 871 fathers were interviewed. Weight and height of the adolescents were measured. Self-reported parents' weight and height were obtained. The current and previous physical activity levels (Baecke's questionnaire of parents (during childhood and adolescence and adolescents' physical activity levels were obtained using a questionnaire. The magnitude of the associations between parent and adolescent physical activity levels was determined by binary logistic regression (adjusted by sex, age, and socioeconomic level of adolescents and education level of parents. Results: The current physical activity practice by parents was associated with adolescents' physical activity (p < 0.001. The physical activities reported by parents in their childhood and adolescence were also associated with higher physical activity levels among adolescents. Adolescents whose parents were both physically active in the past and present were six times (OR = 6.67 [CI = 1.94-22.79] more likely to be physically active compared to adolescents with no parents who were physically active in the past. Conclusions: The current and previous physical activities of parents were associated with higher levels of physical activity in adolescents, even after controlling for confounding factors.

  19. Adolescents' physical activity is associated with previous and current physical activity practice by their parents.

    Science.gov (United States)

    Christofaro, Diego Giulliano Destro; Andersen, Lars Bo; Andrade, Selma Maffei de; Barros, Mauro Virgílio Gomes de; Saraiva, Bruna Thamyres Ciccotti; Fernandes, Rômulo Araújo; Ritti-Dias, Raphael Mendes

    The purpose of this study was to determine whether parents' current and previous physical activity practice is associated with adolescents' physical activity. The sample was composed of 1231 adolescents (14-17 years), and 1202 mothers and 871 fathers were interviewed. Weight and height of the adolescents were measured. Self-reported parents' weight and height were obtained. The current and previous physical activity levels (Baecke's questionnaire) of parents (during childhood and adolescence) and adolescents' physical activity levels were obtained using a questionnaire. The magnitude of the associations between parent and adolescent physical activity levels was determined by binary logistic regression (adjusted by sex, age, and socioeconomic level of adolescents and education level of parents). The current physical activity practice by parents was associated with adolescents' physical activity (p<0.001). The physical activities reported by parents in their childhood and adolescence were also associated with higher physical activity levels among adolescents. Adolescents whose parents were both physically active in the past and present were six times (OR=6.67 [CI=1.94-22.79]) more likely to be physically active compared to adolescents with no parents who were physically active in the past. The current and previous physical activities of parents were associated with higher levels of physical activity in adolescents, even after controlling for confounding factors. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  20. The Current Landscape of Transitions of Care Practice Models: A Scoping Review.

    Science.gov (United States)

    Rochester-Eyeguokan, Charmaine D; Pincus, Kathleen J; Patel, Roshni S; Reitz, Shirley J

    2016-01-01

    Transitions of care (TOC) are a set of actions to ensure patient coordination and continuity of care as patients transfer between different locations or levels. During transitions associated with chronic or acute illness, vulnerable patients may be placed at risk with fragmented systems compromising their health and safety. In addition, poor care transitions also have an enormous impact on health care spending. The primary objective of this scoping review is to summarize the current landscape of practice models that deliver TOC services in the United States. The secondary objective is to use the information to characterize the current state of best practice models. A search of the PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Science, International Pharmaceutical Abstracts, National Center for Biotechnology Information at the U.S. National Library of Medicine, and Cochrane Library databases (January 1, 2000-April 13, 2015) for articles pertaining to TOC models, limited to U.S. studies published in the English language with human subjects, gleaned 1362 articles. An additional 26 articles were added from the gray literature. Articles meeting inclusion criteria underwent a second review and were categorized into four groups: background information, original TOC research articles not evaluating practice model interventions, original TOC research articles describing practice models, and systematic or Cochrane reviews. The reviewers met weekly to discuss the challenges and resolve disagreements regarding literature reviews with consensus before progressing. A total of 188 articles describing TOC practice models met the inclusion criteria. Despite the strengths of several quality TOC models, none satisfied all the components recommended by leading experts. Multimodal interventions by multidisciplinary teams appear to represent a best practice model for TOC to improve patient outcomes and reduce readmissions, but one size does not fit all

  1. Questioning current practice in brown bear, Ursus arctos, conservation in Europe that undervalues taxonomy

    Energy Technology Data Exchange (ETDEWEB)

    Gippoliti, S.

    2016-07-01

    The present paper highlights problems associated with the currently–accepted taxonomy of brown bear, Ursus arctos, and their consequences for conservation at the European level. The enormous morphological variability within Ursus arctos is not acknowledged in current taxonomy and conservation practice. Seven major clades are recognized in Ursus arctos by molecular researchers, and although Western Europe maintains most of the populations belonging to the relict Clade 1 brown bear lineage, no reference to this is made in current conservation policy. Furthermore, the tiny population of Apennine brown bears, characterized by unique skull morphology, is not even recognized as a distinct ESU (evolutionari significant unit) by current European legislation, nor is it included in the IUCN Red List. This may have serious consequences as brown bear conservation in Western Europe has been mainly based on restocking and reintroduction programs. (Author)

  2. Current Practices in Global/International Advanced Pharmacy Practice Experiences: Home/Host Country or Site/Institution Considerations.

    Science.gov (United States)

    Alsharif, Naser Z; Dakkuri, Adnan; Abrons, Jeanine P; Williams, Dennis; Ombengi, David N; Zheng, HaiAn; Al-Dahir, Sara; Tofade, Toyin; Gim, Suzanna; O'Connell, Mary Beth; Ratka, Anna; Dornblaser, Emily

    2016-04-25

    International outreach by schools and colleges of pharmacy is increasing. In this paper, we provide current practice guidelines to establish and maintain successful global/international advanced pharmacy practice experiences (G/I APPEs) with specific recommendations for home/host country and host site/institution. The paper is based on a literature review (2000-2014) in databases and Internet searches with specific keywords or terms. Educational documents such as syllabi and memoranda of understanding (MoUs) from pharmacy programs were also examined. In addition, a preliminary draft was developed and the findings and recommendations were reviewed in a 90-minute roundtable discussion at the 2014 American Association of Colleges of Pharmacy Annual Meeting. Recommendations for the host country include travel considerations (eg, passport, visa, air travel), safety, housing, transportation, travel alerts and warnings, health issues, and financial considerations. For the home country, considerations for establishment of G/I APPE site (eg, vetting process, MoU, site expectations) are described. The paper is a resource for development of new G/I APPEs and provides guidance for continuous quality improvement of partnerships focusing on G/I pharmacy education.

  3. Waste management and the land disposal restriction storage prohibition

    International Nuclear Information System (INIS)

    1992-05-01

    RCRA Sect. 3004(j) prohibits storage of wastes that have been prohibited from land disposal, unless that storage is for the purpose of accumulating sufficient quantities of hazardous wastes to facilitate proper recovery, treatment, or disposal. This requirement was incorporated as part of the Land Disposal Restriction (LDR) regulations. Under the LDR storage prohibition, facilities may only store restricted wastes in containers and tanks. As stated in the Third LDR rule, storage of prohibited waste is only allowed in non-land based storage units since land-based storage is a form of disposal. The EPA has recognized that generators and storers of radioactive mixed waste (RMW) may find it impossible to comply with storage prohibition in cases where no available treatment capacity exists. Additionally, under the current regulatory interpretation, there is no provision that would allow for storage of wastes for which treatment capacity and capability are not available, even where capacity is legitimately being developed. Under the LDR program, restricted wastes that are disposed of, or placed into storage before an LDR effective date, are not subject to the LDR requirements. However, if such wastes are removed from a storage or disposal site after the effective date, such wastes would be subject to LDR requirements. The purpose of this information brief is to clarify what waste management practices constitute removal from storage

  4. Determination of significance in Ecological Impact Assessment: Past change, current practice and future improvements

    Energy Technology Data Exchange (ETDEWEB)

    Briggs, Sam; Hudson, Malcolm D., E-mail: mdh@soton.ac.uk

    2013-01-15

    Ecological Impact Assessment (EcIA) is an important tool for conservation and achieving sustainable development. 'Significant' impacts are those which disturb or alter the environment to a measurable degree. Significance is a crucial part of EcIA, our understanding of the concept in practice is vital if it is to be effective as a tool. This study employed three methods to assess how the determination of significance has changed through time, what current practice is, and what would lead to future improvements. Three data streams were collected: interviews with expert stakeholders, a review of 30 Environmental Statements and a broad-scale survey of the United Kingdom Institute of Ecology and Environmental Management (IEEM) members. The approach taken in the determination of significance has become more standardised and subjectivity has become constrained through a transparent framework. This has largely been driven by a set of guidelines produced by IEEM in 2006. The significance of impacts is now more clearly justified and the accuracy with which it is determined has improved. However, there are limitations to accuracy and effectiveness of the determination of significance. These are the quality of baseline survey data, our scientific understanding of ecological processes and the lack of monitoring and feedback of results. These in turn are restricted by the limited resources available in consultancies. The most notable recommendations for future practice are the implementation of monitoring and the publication of feedback, the creation of a central database for baseline survey data and the streamlining of guidance. - Highlights: Black-Right-Pointing-Pointer The assessment of significance has changed markedly through time. Black-Right-Pointing-Pointer The IEEM guidelines have driven a standardisation of practice. Black-Right-Pointing-Pointer Currently limited by quality of baseline data and scientific understanding. Black-Right-Pointing-Pointer Monitoring

  5. Pediatric endocrine society survey of diabetes practices in the United States: What is the current state?

    Science.gov (United States)

    Guttmann-Bauman, I; Thornton, P; Adhikari, S; Reifschneider, K; Wood, M A; Hamby, T; Rubin, K

    2018-03-26

    The Practice Management Committee (PMC) of the Pediatric Endocrine Society (PES) conducted a survey of its membership in February/March, 2016 to assess the current state of pediatric diabetes care delivery across multiple practice types in the United States. The PES distributed an anonymous electronic survey (Survey Monkey) via email to its membership and requested that only one survey be completed for each practice. Ninety-three unique entries from the US were entered into analysis. Care is predominantly delivered by multidisciplinary teams, based at academic institutions (65.6%), with >85% of the provider types being physicians. Each 1.0 full time equivalent certified diabetes educators serves on average 367 diabetic youth. Fee-for-service remains the standard method of reimbursement with 57% of practices reporting financial loss. Survey respondents identified under-reimbursement as a major barrier to improving patient outcomes and lack of behavioral health (BH) providers as a key gap in services provided. Our survey reveals wide variation in all aspects of pediatric diabetes care delivery in the United States. Pediatric Endocrinologists responding to the survey identified a lack of resources and the current fee for service payment model as a major impediment to practice and the lack of integrated BH staff as a key gap in service. The respondents strongly support its organizations' involvement in the dissemination of standards for care delivery and advocacy for a national payment model aligned with chronic diabetes care in the context of our emerging value-based healthcare system. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Feeding practices of low-income mothers: how do they compare to current recommendations?

    Science.gov (United States)

    Power, Thomas G; Hughes, Sheryl O; Goodell, L Suzanne; Johnson, Susan L; Duran, J Andrea Jaramillo; Williams, Kimberly; Beck, Ashley D; Frankel, Leslie A

    2015-03-07

    Despite a growing consensus on the feeding practices associated with healthy eating patterns, few observational studies of maternal feeding practices with young children have been conducted, especially in low-income populations. The aim of this study was to provide such data on a low income sample to determine the degree to which observed maternal feeding practices compare with current recommendations. Eighty low-income mothers and their preschool children were videotaped at dinner in their homes. Mothers were chosen from a larger study to create a 2 X 2 X 2 design: maternal ethnicity (African American vs. Latina) by child gender by child weight status (healthy weight vs. overweight/obese). Observers coded videotapes for a range of maternal feeding strategies and other behaviors. Many mothers spent considerable time encouraging eating--often in spite of the child's insistence that he or she was finished. Mothers talked little about food characteristics, rarely referred to feelings of hunger and fullness, and made more attempts to enforce table manners than to teach eating skills. Latina mothers showed higher levels of teaching eating skills and encouraging their children to eat; African American mothers showed higher levels of enforcing table manners and getting children to clear their plates. Mothers of boys used more unelaborated commands and less questions/suggestions than mothers of girls. Finally, compared to mothers of overweight/obese children, mothers of healthy weight children showed higher levels of encouraging eating and lower levels of discouraging eating. Most of the mothers in this study did not engage in feeding practices that are consistent with current recommendations. They did this, despite the fact that they knew they were being observed. These results should be used to inform future research about the motivations behind mothers' feeding practices and the development of interventions by helping identify areas in greatest need of change.

  7. Investigating influences on current community pharmacy practice at micro, meso, and macro levels.

    Science.gov (United States)

    Hermansyah, Andi; Sainsbury, Erica; Krass, Ines

    The nature of Australian community pharmacy is continually evolving, raising the need to explore the current situation in order to understand the potential impact of any changes. Although community pharmacy has the potential to play a greater role in health care, it is currently not meeting this potential. To investigate the nature of the contemporary practice of community pharmacy in Australia and examine the potential missed opportunities for role expansion in health care. In-depth semi-structured interviews with a wide-range of key stakeholders within and beyond community pharmacy circles were conducted. Interviews were audio-recorded, transcribed verbatim and analyzed for emerging themes. Twenty-seven key informants across Eastern half of Australia were interviewed between December 2014 and August 2015. Several key elements of the current situation representing the social, economic and policy context of community pharmacy have been identified. These elements operate interdependently, influence micro, meso and macro levels of community pharmacy operation and are changing in the current climate. Community pharmacy has untapped potential in primary health care, but it has been slow to change to meet opportunities available in the current situation. As the current situation is complex, interrelated and dynamic with often unintended and unpredictable consequences, this paper suggests that policy makers to consider the micro, meso and macro levels of community pharmacy operation when making significant policy changes. The framework proposed in this study can be a helpful tool to analyze the processes operating at these three levels and their influences on practice. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. A revisit on the current practice of dispute resolution and ADR in the Malaysian construction industry

    Directory of Open Access Journals (Sweden)

    Mohd Suhaimi Mohd Danuri

    2012-06-01

    Full Text Available The current dispute resolution procedures available in the Malaysian construction industry are mainly litigation and arbitration. In addition, the alternative dispute resolutions (ADR, namely mediation and adjudication, have also been introduced as the other methods for resolving disputes. The objective of this study is to examine the current practice of dispute resolution and ADR available in the Malaysian construction industry. The aim of this paper is two-fold: to report the current practice of dispute resolution and ADR, and identify the attributes of successful implementation of both mechanisms based on the perceptions of the Malaysian construction industry players. From the jurisprudence point of view, this study looks into the law as it is, in relation to the current practice of dispute resolution and ADR, by showing how those findings can be used to explain why improvement is needed to promote a successful and well received dispute resolution and ADR, and what lessons can be learnt, towards the formulation of a more viable methods for the Malaysian construction industry. NVivo software has been used to manage and organise the complete interview transcripts and facilitate the data analysis process for this study. Literature review reveals a continuous development of dispute resolution and ADR in the Malaysian construction industry, while, globally the industry has not only embraced ADR but also spearheaded the development of innovative forms of dispute avoidance mechanism. The findings of interviews show that locally, apart from litigation, the common types of ADR are arbitration, mediation and ad hoc mechanism. The findings also lead to the discovery of the following attributes: faster, less procedural, cost effective and enforceable; regulation and government's support; professionalism and ethic; training; and facility, that may promote a successful implementation of dispute resolution and ADR in Malaysia.

  9. Improving medical students' knowledge of genetic disease: a review of current and emerging pedagogical practices

    Directory of Open Access Journals (Sweden)

    Wolyniak MJ

    2015-10-01

    Full Text Available Michael J Wolyniak,1 Lynne T Bemis,2 Amy J Prunuske2 1Department of Biology, Hampden-Sydney College, Hampden-Sydney, VA, 2Department of Biomedical Sciences, University of Minnesota Medical School, Duluth, MN, USA Abstract: Genetics is an essential subject to be mastered by health professional students of all types. However, technological advances in genomics and recent pedagogical research have changed the way in which many medical training programs teach genetics to their students. These advances favor a more experience-based education focused primarily on developing student's critical thinking skills. In this review, we examine the current state of genetics education at both the preclinical and clinical levels and the ways in which medical and pedagogical research have guided reforms to current and emerging teaching practices in genetics. We discover exciting trends taking place in which genetics is integrated with other scientific disciplines both horizontally and vertically across medical curricula to emphasize training in scientific critical thinking skills among students via the evaluation of clinical evidence and consultation of online databases. These trends will produce future health professionals with the skills and confidence necessary to embrace the new tools of medical practice that have emerged from scientific advances in genetics, genomics, and bioinformatics. Keywords: genetics education, medical genetics, pedagogical practice, active learning, problem-based learning

  10. Current Ketamine Practice: Results of the 2016 American Society of Pain Management Nursing Survey on Ketamine.

    Science.gov (United States)

    Klaess, Cynthia C; Jungquist, Carla R

    2018-06-01

    Ketamine is increasingly utilized for a variety of pain management challenges. Audience comments from a ketamine presentation at the 2015 American Society of Pain Management Nursing (ASPMN) Conference reflected wide variation in ketamine practices as well as barriers to use. The goal was to gain a greater understanding of ASPMN member practice patterns and barriers related to ketamine as adjunctive therapy for pain management. A questionnaire survey design was used. Respondents represented 35 states and 2 countries. The participants were 146 respondents from ASPMN membership (1,485 members). The survey was distributed by ASPMN on SurveyMonkey. Practice setting and ketamine administration practices were assessed with areas for comments. Results were reviewed using frequencies to describe responses and formatted into tables. Comments were individually reviewed and grouped into common themes. Administration of ketamine as an analgesic was reported by 63% of respondents. Continuous intravenous ketamine infusions were the most common route of administration (65%); however, wide variability in dosing and length of therapy was reported. A wide variety of practices and challenges related to ketamine utilization were noted. Numerous studies have indicated the analgesic benefits of ketamine in pain management. The lack of practice standardization has created challenges to its consistent use and outcome measurement. Additionally, the off-label use of ketamine for pain management creates its own unique challenges. However, given the current national climate with intense focus on pain management, interdisciplinary practitioners have an ideal opportunity to evaluate ketamine's use in a comprehensive approach to pain management. Copyright © 2018 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  11. Current and previous eating practices among women recovered from anorexia nervosa: a qualitative approach

    Directory of Open Access Journals (Sweden)

    Mariana Dimitrov Ulian

    2013-12-01

    Full Text Available OBJECTIVE: The aim of this study was to analyze qualitatively how women, who have recovered from anorexia nervosa, perceive and describe their current eating practices, as well as the ones developed during the eating disorder period. METHODS: Seven women were interviewed individually with the objective of investigating their eating practices, transition phases and all relevant aspects that somewhat contributed to the habit-forming; experiences, feelings and perceptions related to mealtime and the influence that food has had over the present subjects' life. The interviews were analyzed by the discourse of the collective subject method. RESULTS: The results brought up the following topics: a control; b concerns and feelings; c deprivation d beauty dictatorship; e eating competence; f importance of food; g food cacophony. CONCLUSIONS: What stands out is a multiplicity of eating practices, which during the eating disorder were similar to and characterized by restriction; however, after recovery, part of the subjects seem to have developed a higher eating competence, whereas others show a practice similar to the one acquired during the anorexia nervosa, such as the difficulty in realizing when they are satisfied and a feeling of discomfort when facing social interactions.

  12. A survey of current clinical practice in permanent and temporary prostate brachytherapy: 2010 update.

    Science.gov (United States)

    Buyyounouski, Mark K; Davis, Brian J; Prestidge, Bradley R; Shanahan, Thomas G; Stock, Richard G; Grimm, Peter D; Demanes, D Jeffrey; Zaider, Marco; Horwitz, Eric M

    2012-01-01

    To help establish patterns of care and standards of care of interstitial permanent low-dose-rate (LDR) and temporary high-dose-rate brachytherapy for prostate cancer and to compare the results with a similar 1998 American Brachytherapy Society (ABS) survey. A comprehensive questionnaire intended to survey specific details of current clinical brachytherapy practice was provided to the participants of the seventh ABS Prostate Brachytherapy School. Responses were tabulated and descriptive statistics are reported. Sixty-five brachytherapy practitioners responded to the survey. Eighty-nine percent (89%) of respondents performed LDR and 49% perform high-dose-rate brachytherapy. The median number of years of experience for LDR brachytherapists increased from 5 to 10 years over the course of the 12 years since the preceding survey. Compared with the first ABS, a smaller proportion of respondents received formal brachytherapy residency training (43% vs. 56%) or formal "hands-on" brachytherapy training (15% vs. 63%). There has been a marked decline in the utilization of the Mick applicator (Mick Radio-Nuclear Instruments, Inc., Mount Vernon, NY, USA) (60% vs. 28%) and an increase in the use of stranded seeds (40% vs. 11%). Compliance with postimplant dosimetry was higher in the 2010 survey. This survey does suggest an evolution in the practice of LDR brachytherapy since 1998 and aids in identifying aspects that require further progress or investigation. ABS guidelines and other practice recommendations appear to impact the practice of brachytherapy. Copyright © 2012 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  13. Gender trends in dental practice patterns. A review of current U.S. literature.

    Science.gov (United States)

    Dolan, T A

    1991-01-01

    This paper reviews three recent reports of national gender trends in dental practice patterns. Although the three independent cross-sectional studies were conducted at different points in time, used different sampling strategies, and used similar but independent survey instruments, findings were consistent across studies. In summary: Women dentists are less likely to be married and have fewer children. Women are more likely to assume child rearing and household responsibilities. Women are less likely to be practice owners. Women worked slightly fewer hours per week and weeks per year, and were more likely to take a leave of absence for illness or child rearing. However, women dentists demonstrate a far greater professional work commitment than was previously reported in the literature. Women earn significantly less income from the practice of dentistry, even after controlling for age, practice ownership, hours worked per week, and other personal characteristics. The most current "Gender Wage Gap" estimates range from 57.7% for specialists to 75.4% for general practitioners (8). delta.

  14. Emergency nurses' current practices and understanding of family presence during CPR.

    LENUS (Irish Health Repository)

    Madden, Eilis

    2012-02-03

    PURPOSE: To examine emergency nurses\\' current practices and understanding of family presence during CPR in the emergency department, Cork University Hospital, Republic of Ireland. METHOD: A quantitative descriptive design was used in the study. A questionnaire developed by ENA was distributed to emergency nurses working in a level I trauma emergency department at Cork University Hospital. The total sample number was 90, including all emergency nurses with at least 6 months\\' emergency nursing experience. RESULTS: Emergency nurses often took families to the bedside during resuscitation efforts (58.9%) or would do so if the opportunity arose (17.8%). A high percentage (74.4%) of respondents would prefer a written policy allowing the option of family presence during CPR. The most significant barrier to family witnessed resuscitation (FWR) was conflicts occurring within the emergency team. The most significant facilitator to FWR was a greater understanding of health care professionals on the benefits of FWR to patients and families, indicating the need for educational development. CONCLUSION: The findings of the study and previously published studies indicate the need for development of written polices and guidelines on the practice to meet the needs of patients, families, and staff by providing consistent, safe, and caring practices for all involved in the resuscitation process. Recommendations of the study include the development of a written policy and an educational programme on the safe implementation and practices of FWR.

  15. Management options for food production systems affected by a nuclear accident. Task 5: disposal of waste milk to sea

    International Nuclear Information System (INIS)

    Wilkins, B.; Woodman, R.; Nisbet, A.; Mansfield, P.

    2001-11-01

    In emergency exercises, discharge to sea is often put forward as a disposal option for waste milk, the intention being to use the outfalls for coolant water or liquid effluent at nuclear installations. However, so far the legislative constraints and the practical and scientific limitations of this option have not been fully considered. This report sets out the current legal position and evaluates the practicability of transporting milk from an affected farm to a suitable coastal facility for disposal. The effect of discharging milk into coastal water bodies has also been considered, bearing in mind that after a serious accident disposals could continue for several weeks

  16. Current thinking in qualitative research: evidence-based practice, moral philosophies, and political struggle.

    Science.gov (United States)

    Papadimitriou, Christina; Magasi, Susan; Frank, Gelya

    2012-01-01

    In this introduction to the special issue on current thinking in qualitative research and occupational therapy and science, the authors focus on the importance of rigorous qualitative research to inform occupational therapy practice. The authors chosen for this special issue reflect a "second generation of qualitative researchers" who are critical, theoretically sophisticated, methodologically productive, and politically relevant to show that working with disabled clients is political work. Three themes emerged across the articles included in this special issue: (1) recognizing and addressing social justice issues; (2) learning from clients' experiences; and (3) critically reframing occupational therapy's role. These themes can inform occupational therapy practice, research, and education to reflect a more client-centered and politically engaging approach. Copyright 2012, SLACK Incorporated.

  17. Disposable Landscapes

    Science.gov (United States)

    Kevin T. Smith

    2008-01-01

    Whether we are a traditionalist or on the cutting edge of landscape care, we need to take a deep breath and think about what we are trying to achieve, before we select a specific treatment or practice for tree care. We should measure that treatment or practice against what we know about the tree system. I say "system" because the recent years of Modern...

  18. 78 FR 24691 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Science.gov (United States)

    2013-04-26

    ... comments should be identified with the title ``Current Good Manufacturing Practice and Hazard Analysis and..., 114, 117, 120, 123, 129, 179, and 211 [Docket No. FDA-2011-N-0920] RIN 0910-AG36 Current Good Manufacturing Practice and Hazard Analysis and Risk- Based Preventive Controls for Human Food; Extension of...

  19. Trends in Dental Practice Sales and Associateships in the Current Economy

    Directory of Open Access Journals (Sweden)

    C. Steven Wolff

    2011-10-01

    Full Text Available Recent experiences would suggest that there is a significant discrepancy in the number of doctors retiring and transitioning their practices and the number of younger practitioners wishing to assume ownership and build a career. Peaks and valleys in dental school enrollment over the last forty years should have produced an abundance of retirement aged doctors wishing to place their practices on the market to a smaller pool of buyers. Such is currently not the case. Doctors in their sixties have experienced recent stock market downturns in 2000 and 2008, the “9-11” tragedy and a drop in both the value and liquidity of the housing market. The ready access to refinance or second mortgage funds may even find some doctors upside down on personal, vacation and investment real estate. All of this combined has had considerable negative impact on their net worth. Health care costs continue to increase and most dentists are personally responsible for their premiums. Combine all of this with the current low level of secure returns on invested capital along with a significant increase in life expectancy over the last two generations and many decide they are simply unable to retire as planned. The fear of running out of money is stronger than their will to pursue retirement. This article examines in some detail the reasons for this imbalance and the effects they are having on practice transitions, practice values and the market for associate employment. We will also explore what the future may hold for both retiring and new career doctors.

  20. Acute care patient portals: a qualitative study of stakeholder perspectives on current practices.

    Science.gov (United States)

    Collins, Sarah A; Rozenblum, Ronen; Leung, Wai Yin; Morrison, Constance Rc; Stade, Diana L; McNally, Kelly; Bourie, Patricia Q; Massaro, Anthony; Bokser, Seth; Dwyer, Cindy; Greysen, Ryan S; Agarwal, Priyanka; Thornton, Kevin; Dalal, Anuj K

    2017-04-01

    To describe current practices and stakeholder perspectives of patient portals in the acute care setting. We aimed to: (1) identify key features, (2) recognize challenges, (3) understand current practices for design, configuration, and use, and (4) propose new directions for investigation and innovation. Mixed methods including surveys, interviews, focus groups, and site visits with stakeholders at leading academic medical centers. Thematic analyses to inform development of an explanatory model and recommendations. Site surveys were administered to 5 institutions. Thirty interviews/focus groups were conducted at 4 site visits that included a total of 84 participants. Ten themes regarding content and functionality, engagement and culture, and access and security were identified, from which an explanatory model of current practices was developed. Key features included clinical data, messaging, glossary, patient education, patient personalization and family engagement tools, and tiered displays. Four actionable recommendations were identified by group consensus. Design, development, and implementation of acute care patient portals should consider: (1) providing a single integrated experience across care settings, (2) humanizing the patient-clinician relationship via personalization tools, (3) providing equitable access, and (4) creating a clear organizational mission and strategy to achieve outcomes of interest. Portals should provide a single integrated experience across the inpatient and ambulatory settings. Core functionality includes tools that facilitate communication, personalize the patient, and deliver education to advance safe, coordinated, and dignified patient-centered care. Our findings can be used to inform a "road map" for future work related to acute care patient portals. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  1. An examination of current stroke rehabilitation practice in Peru: Implications for interprofessional education.

    Science.gov (United States)

    McDonald, Cody L; Fuhs, Amy K; Kartin, Deborah

    2018-05-01

    This study aimed to better understand current clinical practice of rehabilitation professionals in Lima, Peru, and to explore the existence of and potential for interprofessional collaboration. A secondary purpose was to assess rehabilitation professionals' agreement with evidence-based stroke rehabilitation statements and confidence performing stroke rehabilitation tasks prior to and following an interprofessional stroke rehabilitation training. Current clinical practice for rehabilitation professionals in Peru differs from high-income counties like the United States, as physical therapists work with dysphagia and feeding, prosthetist orthotists serve a strictly technical role, and nurses have a limited role in rehabilitation. Additionally, while opportunity for future interprofessional collaboration within stroke rehabilitation exists, it appears to be discouraged by current health system policies. Pre- and post-training surveys were conducted with a convenience sample of 107 rehabilitation professionals in Peru. Survey response options included endorsement of professionals for rehabilitation tasks and a Likert scale of agreement and confidence. Training participants largely agreed with evidence-based stroke rehabilitation statements. Differences in opinion remained regarding the prevalence of dysphagia and optimal frequency of therapy post-stroke. Substantially increased agreement post-training was seen in favour of early initiation of stroke rehabilitation and ankle foot orthosis use. Participants were generally confident performing traditional profession-specific interventions and educating patients and families. Substantial increases were seen in respondents' confidence to safely and independently conduct bed to chair transfers and determine physiological stability. Identification of key differences in rehabilitation professionals' clinical practice in Peru is a first step toward strengthening the development of sustainable rehabilitation systems and

  2. Antidepressants during pregnancy: Guideline adherence and current practice amongst Dutch gynaecologists and midwives.

    Science.gov (United States)

    Molenaar, Nina M; Brouwer, Marlies E; Duvekot, Johannes J; Burger, Huibert; Knijff, Esther M; Hoogendijk, Witte J; Bockting, Claudi L H; de Wolf, G S; Lambregtse-van den Berg, Mijke P

    2018-06-01

    prescription rates of antidepressants during pregnancy range from 2-3% in The Netherlands to 6.2% in the USA. Inconclusive evidence about harms and benefits of antidepressants during pregnancy leads to variation in advice given by gynaecologists and midwives. The objective was to investigate familiarity with, and adherence to the Dutch multidisciplinary guideline on Selective Serotonin Reuptake Inhibitor (SSRI) use during pregnancy by gynaecologists and midwives in the Netherlands. an online survey was developed and send to Dutch gynaecologists and midwives. The survey consisted mainly of multiple-choice questions addressing guideline familiarity and current practice of the respondent. Also, caregiver characteristics associated with guideline adherence were investigated. a total of 178 gynaecologists and 139 midwives responded. Overall familiarity with the Dutch guideline was 92.7%. However, current practice and advice given to patients by caregivers differed substantially, both between gynaecologists and midwives as well as within both professions. Overall guideline adherence was 13.9%. Multivariable logistic regression showed that solely caregiver profession was associated with guideline adherence, with gynaecologists having a higher adherence rate (OR 2.10, 95%CI 1.02-4.33) than midwives. although reported familiarity with the guideline is high, adherence to the guideline is low, possibly resulting in advice to patients that is inconsistent with guidelines and unwanted variation in current practice. further implementation of the recommendations as given in the guideline should be stimulated. Additional research is needed to examine how gynaecologists and midwives can be facilitated to follow the recommendations of the clinical guideline on SSRI use during pregnancy. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Study on practical of eddy current testing of core and core support graphite components in HTTR

    International Nuclear Information System (INIS)

    Ishihara, Masahiro; Iyoku, Tatsuo; Ooka, Norikazu; Shindo, Yoshihisa; Kawae, Hidetoshi; Hayashi, Motomitsu; Kambe, Mamoru; Takahashi, Masaaki; Ide, Akira.

    1994-01-01

    Core and core support graphite components in the HTTR (High Temperature Engineering Test Reactor) are mainly made of nuclear-grade IG-110 and PGX graphites. Nondestructive inspection with Eddy Current Testing (ECT) is planned to be applied to these components. The method of ECT has been already established for metallic components, however, cannot be applied directly to the graphite ones, because the characteristics of graphite are quite different in micro-structure from those of metals. Therefore, ECT method and condition were studied for the application of the ECT to the graphite components. This paper describes the study on practical method and conditions of ECT for above mentioned graphite structures. (author)

  4. Closeout of uranium mines and mills: A review of current practices

    International Nuclear Information System (INIS)

    1997-04-01

    The present report is a first step in gathering information on the assessment and control of the long term (over a few centuries) impact of uranium mining and milling waste. Its intention is to outline several examples of worldwide experience. It contains summaries of current closeout practices which have not previously been presented in a singly publication. It is expected to provide necessary information to Member States to formulate meaningful decisions for adequately controlling impacts resulting from uranium mines and mills waste materials. The information contained herein may also be valuable as background material for developing relevant guidance in this subject area, for example within the IAEA Safety Standards Programme. Refs, figs, tabs

  5. Assessment of current practices in creating and using passwords as a control mechanism for information access

    Directory of Open Access Journals (Sweden)

    P. L. Wessels

    2007-11-01

    Full Text Available One of the critical issues in managing information within an organization is to ensure that proper controls exist and are applied in allowing people access to information. Passwords are used extensively as the main control mechanism to identify users wanting access to systems, applications, data files, network servers or personal information. In this article, the issues involved in selecting and using passwords are discussed and the current practices employed by users in creating and storing passwords to gain access to sensitive information are assessed. The results of this survey conclude that information managers cannot rely only on users to employ proper password control in order to protect sensitive information.

  6. Waste management, final waste disposal, fuel cycle

    International Nuclear Information System (INIS)

    Rengeling, H.W.

    1991-01-01

    Out of the legal poblems that are currently at issue, individual questions from four areas are dealt with: privatization of ultimate waste disposal; distribution of responsibilities for tasks in the field of waste disposal; harmonization and systematization of regulations; waste disposal - principles for making provisions for waste disposal - proof of having made provisions for waste disposal; financing and fees. A distinction has to be made between that which is legally and in particular constitutionally imperative or, as the case may be, permissible, and issues where there is room for political decision-making. Ultimately, the deliberations on the amendment are completely confined to the sphere of politics. (orig./HSCH) [de

  7. Commercial mixed waste treatment and disposal

    International Nuclear Information System (INIS)

    Vance, J.K.

    1994-01-01

    At the South Clive, Utah, site, Envirocare of Utah, Inc., (Envirocare), currently operates a commercial low-activity, low-level radioactive waste facility, a mixed waste RCRA Part B storage and disposal facility, and an 11e.(2) disposal facility. Envirocare is also in the process of constructing a Mixed Waste Treatment Facility. As the nation's first and only commercial treatment and disposal facility for such waste, the information presented in this segment will provide insight into their current and prospective operations

  8. Public acceptability of risk of radioactive waste disposal

    International Nuclear Information System (INIS)

    Millerd, W.H.

    1977-01-01

    A ''public interest'' viewpoint is presented on the disposal of radioactive wastes. Criteria for the development of disposal methods are needed. The current program to develop disposal sites and methods has become an experiment. The advantages and disadvantages of radwaste disposal as an ongoing experiment are discussed briefly

  9. Ocean Disposal Site Monitoring

    Science.gov (United States)

    EPA is responsible for managing all designated ocean disposal sites. Surveys are conducted to identify appropriate locations for ocean disposal sites and to monitor the impacts of regulated dumping at the disposal sites.

  10. Waste disposal: preliminary studies

    International Nuclear Information System (INIS)

    Carvalho, J.F. de.

    1983-01-01

    The problem of high level radioactive waste disposal is analyzed, suggesting an alternative for the final waste disposal from irradiated fuel elements. A methodology for determining the temperature field around an underground disposal facility is presented. (E.G.) [pt

  11. Getting emotional: historic and current changes in food consumption practices viewed through the lens of cultural theories

    OpenAIRE

    Sahakian, Marlyne

    2015-01-01

    Social practice theory has brought new perspectives to ‘sustainable consumption’ studies in terms of both conceptual developments and rich empirical research. One appealing and shared understanding is that practices change over time, suggesting that shifts away from current unsustainable practices toward more environmentally sound and socially just alternatives are possible. Much work has focused on how to recruit new practitioners to more ‘sustainable’ practices (Jack 2013; Plessz et al. 201...

  12. Practical considerations on the introduction of sacubitril/valsartan in clinical practice: Current evidence and early experience.

    Science.gov (United States)

    Farmakis, Dimitrios; Bistola, Vassiliki; Karavidas, Apostolos; Parissis, John

    2016-11-15

    The combination of neprilysin inhibitor sacubitril with the angiotensin II receptor 1 blocker valsartan is the first agent from the angiotensin receptor neprilysin inhibitors (ARNI) class authorized for clinical use in heart failure (HF) patients with reduced ejection fraction (HFrEF). Sacubitril/valsartan resulted in 20% reduction in the incidence rate of death or HF hospitalization compared to enalapril in symptomatic HFrEF patients in the seminal PARADIGM-HF trial. As a result, the recently updated European and American HF guidelines granted this agent a class IB indication for the treatment of ambulatory/chronic symptomatic HFrEF patients. However, translating the positive results of trials into true clinical benefit is often challenging. This is particularly true in the case of sacubitril/valsartan, as HF is a heterogeneous syndrome including many severely ill patients who are prone to decompensation, while this new agent comes to replace a cornerstone of current evidence-based HF therapy. In the present paper, we address a number of practical issues regarding the introduction of sacubitril/valsartan and propose an algorithm based on available evidence and early clinical experience. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Improving medical students' knowledge of genetic disease: a review of current and emerging pedagogical practices.

    Science.gov (United States)

    Wolyniak, Michael J; Bemis, Lynne T; Prunuske, Amy J

    2015-01-01

    Genetics is an essential subject to be mastered by health professional students of all types. However, technological advances in genomics and recent pedagogical research have changed the way in which many medical training programs teach genetics to their students. These advances favor a more experience-based education focused primarily on developing student's critical thinking skills. In this review, we examine the current state of genetics education at both the preclinical and clinical levels and the ways in which medical and pedagogical research have guided reforms to current and emerging teaching practices in genetics. We discover exciting trends taking place in which genetics is integrated with other scientific disciplines both horizontally and vertically across medical curricula to emphasize training in scientific critical thinking skills among students via the evaluation of clinical evidence and consultation of online databases. These trends will produce future health professionals with the skills and confidence necessary to embrace the new tools of medical practice that have emerged from scientific advances in genetics, genomics, and bioinformatics.

  14. Physicians' current practices and opportunities for DNA banking of dying patients with cancer.

    Science.gov (United States)

    Quillin, John M; Bodurtha, Joann N; Siminoff, Laura A; Smith, Thomas J

    2011-05-01

    The availability of genetic tests for cancer susceptibility is increasing. Current tests, however, have limited clinical sensitivity. Even when clinically valid tests are available, the genetic counseling and informed consent process might not be feasible for dying patients with cancer. DNA banking preserves the opportunity for future research or clinical testing and may provide critical opportunities for surviving relatives. This study explored the current practices and potential for DNA banking for cancer susceptibility among oncologists specializing in palliative care. Palliative care oncologists actively providing clinical care for dying patients with cancer were recruited for an online survey. Descriptive statistics for DNA banking practices, perceived qualification to recommend banking, and potential predictors were assessed. Data were collected from 49 physicians (37% recruitment rate). Eighty percent reported assessing at least some patients for genetic cancer susceptibility in the past 12 months. No participants reported banking DNA for patients in the past 12 months. Only 5% reported feeling at least somewhat qualified to order DNA banking. A Web-based risk assessment tool and genetic counselor on staff were perceived as the most helpful potential resources. Despite its potential, DNA banking is not being used by palliative care oncologists.

  15. Improving medical students’ knowledge of genetic disease: a review of current and emerging pedagogical practices

    Science.gov (United States)

    Wolyniak, Michael J; Bemis, Lynne T; Prunuske, Amy J

    2015-01-01

    Genetics is an essential subject to be mastered by health professional students of all types. However, technological advances in genomics and recent pedagogical research have changed the way in which many medical training programs teach genetics to their students. These advances favor a more experience-based education focused primarily on developing student’s critical thinking skills. In this review, we examine the current state of genetics education at both the preclinical and clinical levels and the ways in which medical and pedagogical research have guided reforms to current and emerging teaching practices in genetics. We discover exciting trends taking place in which genetics is integrated with other scientific disciplines both horizontally and vertically across medical curricula to emphasize training in scientific critical thinking skills among students via the evaluation of clinical evidence and consultation of online databases. These trends will produce future health professionals with the skills and confidence necessary to embrace the new tools of medical practice that have emerged from scientific advances in genetics, genomics, and bioinformatics. PMID:26604852

  16. The current practice of using multiple representations in year 4 science classrooms

    Science.gov (United States)

    Chuenmanee, Chanoknat; Thathong, Kongsak

    2018-01-01

    Multiple representations have been widely used as a reasoning tool for understanding complex scientific concepts. Thus this study attempted to investigate the current practice of using multiple representations on Year 4 science classrooms in terms of modes and levels which appear in curriculum documents, teaching plans, tasks and assessments, teaching practices, and students' behaviors. Indeed, documentary analysis, classroom observation, and interview were used as the data collection methods. First of all, Year 4 science documents were analyzed. Then classroom observation was used as a collecting method to seek what actually happen in the classroom. Finally, in-depth interviews were used to gather more information and obtain meaningful data. The finding reveals that many modes of verbal, visual, and tactile representations within three levels of representations are posed in Year 4 documents. Moreover, according to classroom observations and interviews, there are three main points of applying multiple representations into classrooms. First of all, various modes of representations were used, however, a huge number of them did not come together with the levels. The levels of representations, secondly, macroscopic and cellular levels were introduced into all classrooms while symbolic level was provided only in some classrooms. Finally, the connection of modes and levels pointed out that modes of representations were used without the considerations on the levels of them. So, it seems to be that teaching practice did not meet the aims of curriculum. Therefore, these issues were being considered in order to organize and design the further science lessons.

  17. Field Measurements at River and Tidal Current Sites for Hydrokinetic Energy Development: Best Practices Manual

    Energy Technology Data Exchange (ETDEWEB)

    Neary, Vincent S [ORNL; Gunawan, Budi [Oak Ridge National Laboratory (ORNL)

    2011-09-01

    In this report, existing data collection techniques and protocols for characterizing open channel flows are reviewed and refined to further address the needs of the MHK industry. The report provides an overview of the hydrodynamics of river and tidal channels, and the working principles of modern acoustic instrumentation, including best practices in remote sensing methods that can be applied to hydrokinetic energy site characterization. Emphasis is placed upon acoustic Doppler velocimeter (ADV) and acoustic-Doppler current profiler (ADCP) instruments, as these represent the most practical and economical tools for use in the MHK industry. Incorporating the best practices as found in the literature, including the parameters to be measured, the instruments to be deployed, the instrument deployment strategy, and data post-processing techniques. The data collected from this procedure aims to inform the hydro-mechanical design of MHK systems with respect to energy generation and structural loading, as well as provide reference hydrodynamics for environmental impact studies. The standard metrics and protocols defined herein can be utilized to guide field experiments with MHK systems.

  18. Evaluation and management of patients with peripheral artery disease by interventional radiologists: current practices.

    Science.gov (United States)

    Prince, Ethan A; Murphy, Timothy P; Dhangana, Raj; Soares, Gregory M; Ahn, Sun H; Dubel, Gregory J

    2008-05-01

    Traditionally, surgeons have served as primary consultants for patients with peripheral vascular disease for whom revascularization is considered. An important component of care for patients with peripheral artery disease (PAD) is risk factor management. The present study was undertaken to determine current management practices of interventional radiologists for patients with PAD and compare them to published data for vascular surgeons. If PAD patient management practices are similar, this would support direct referral of PAD patients who are considered for revascularization from primary care doctors to interventional radiologists. An online survey was administered to full members of the Society of Interventional Radiology with e-mail addresses on file. Filtering was done to examine and compare interactions among several responses. The margin of error for the survey was +/-2%, based on 95% CIs for the entire surveyed population (N=2,371). Seventy-five percent of respondents see PAD patients in ambulatory office settings. Only eight percent see themselves as the physician responsible for risk factor management, similar to reported results of vascular surgeons (10%). Other variables examined, such as frequency of inquiring about Framingham risk factors, indicate similar practices to those previously reported for vascular surgeons. For interventional radiologists who accept direct referrals for medical management of patients with PAD, disease management by interventional radiologists is similar to that previously reported for vascular surgeons. This supports the role of interventional radiologists who accept direct referrals of patients with PAD as primary consultants to primary care doctors.

  19. AC impedance behavior of a practical-size single-cell SOFC under DC current

    Energy Technology Data Exchange (ETDEWEB)

    Momma, Akihiko; Kaga, Yasuo; Takano, Kiyonami; Nozaki, Ken; Negishi, Akira; Kato, Ken; Kato, Tohru [Fuel Cell Group, Energy Electronics Institute, National Institute of Advanced Industrial Science and Technology, Umezono Tsukuba-shi, Ibaraki 305-8568 (Japan); Inagaki, Toru; Yoshida, Hiroyuki [Energy Use R and D Center, The Kansai Electric Power Company, Inc., 11-20 Nakoji, 3-Chome, Amagasaki, Hyogo 661-0974 (Japan); Hosoi, Kei; Hoshino, Koji; Akbay, Taner; Akikusa, Jun; Yamada, Masaharu; Chitose, Norihisa [Central Research Institute, Naka Research Center, Mitsubishi Materials Corp. 1002-14 Mukohyama, Naka-machi, Naka-gun, Ibaraki 311-0102 (Japan)

    2004-10-29

    AC impedance measurements were carried out using practical-size planar disc-type SOFC which employs lanthanum gallate as a solid electrolyte. The data were obtained under practical conditions of gas flow rate and DC current. Under these conditions, the gas conversion impedance (GCI), which originates from the change of the electromotive force (EMF) caused by the change in anodic gaseous concentrations along the flow direction, was observed in the low-frequency range of the data obtained. The overlapping impedance together with GCI on the low-frequency arc was also estimated. Experimentally obtained GCI was in good agreement with that calculated. It was concluded that GCI was predominant in the impedance data obtained under practical conditions. The shift of the high-frequency intercept in the complex impedance diagrams was shown to appear as a result of the change in the distribution of gaseous composition in the anode. The dependency of the low-frequency arc on temperature was also shown, and it was assumed that the overlapped impedance varies as the temperature changes. The validity of the impedance measurement, as a diagnostic means to evaluate the gas flow in SOFC stack, was suggested.

  20. Current Rehabilitation Practices for Children with Cerebral Palsy: Focus and Gaps.

    Science.gov (United States)

    Anaby, Dana; Korner-Bitensky, Nicol; Steven, Emma; Tremblay, Stephanie; Snider, Laurie; Avery, Lisa; Law, Mary

    2017-02-01

    To describe the focus of therapy practices in occupational and physical therapy for school-aged children with cerebral palsy, and better understand whether it is congruent with recommended practices. A Canada-wide Web-based survey was completed by 62 occupational and 61 physical therapists to identify problems, assessments, and treatment interventions for two case-based scenarios. Data were coded using the International Classification of Functioning, Disability and Health (ICF) definitions for "body functions and structure," "activity and participation," and "environment." Physical therapists, in comparison to occupational therapists, were more likely to select interventions classed in the "body functions and structure" category (34-42% and 18-20%, respectively). Both professions focused on "activity and participation" (34-61%) when identifying problems, assessing, and intervening; attention, however, was mainly directed towards task-oriented activities such as activities of daily living and mobility. Participation in leisure or community-based activities received less attention (2-15%). The environment received limited attention for problems and assessments (4-25%), though it was an important focus of intervention (19-37%). While body functions and structure are well-addressed, other ICF elements, specifically participation, are poorly integrated into practice. The emerging focus on the environment in therapy intervention, by modifying the context rather than changing aspects of the child, is consistent with current approaches and evidence. Knowledge translation implementation initiatives are recommended to bridge identified gaps.

  1. Current practice in software development for computational neuroscience and how to improve it.

    Science.gov (United States)

    Gewaltig, Marc-Oliver; Cannon, Robert

    2014-01-01

    Almost all research work in computational neuroscience involves software. As researchers try to understand ever more complex systems, there is a continual need for software with new capabilities. Because of the wide range of questions being investigated, new software is often developed rapidly by individuals or small groups. In these cases, it can be hard to demonstrate that the software gives the right results. Software developers are often open about the code they produce and willing to share it, but there is little appreciation among potential users of the great diversity of software development practices and end results, and how this affects the suitability of software tools for use in research projects. To help clarify these issues, we have reviewed a range of software tools and asked how the culture and practice of software development affects their validity and trustworthiness. We identified four key questions that can be used to categorize software projects and correlate them with the type of product that results. The first question addresses what is being produced. The other three concern why, how, and by whom the work is done. The answers to these questions show strong correlations with the nature of the software being produced, and its suitability for particular purposes. Based on our findings, we suggest ways in which current software development practice in computational neuroscience can be improved and propose checklists to help developers, reviewers, and scientists to assess the quality of software and whether particular pieces of software are ready for use in research.

  2. Current practice in software development for computational neuroscience and how to improve it.

    Directory of Open Access Journals (Sweden)

    Marc-Oliver Gewaltig

    2014-01-01

    Full Text Available Almost all research work in computational neuroscience involves software. As researchers try to understand ever more complex systems, there is a continual need for software with new capabilities. Because of the wide range of questions being investigated, new software is often developed rapidly by individuals or small groups. In these cases, it can be hard to demonstrate that the software gives the right results. Software developers are often open about the code they produce and willing to share it, but there is little appreciation among potential users of the great diversity of software development practices and end results, and how this affects the suitability of software tools for use in research projects. To help clarify these issues, we have reviewed a range of software tools and asked how the culture and practice of software development affects their validity and trustworthiness. We identified four key questions that can be used to categorize software projects and correlate them with the type of product that results. The first question addresses what is being produced. The other three concern why, how, and by whom the work is done. The answers to these questions show strong correlations with the nature of the software being produced, and its suitability for particular purposes. Based on our findings, we suggest ways in which current software development practice in computational neuroscience can be improved and propose checklists to help developers, reviewers, and scientists to assess the quality of software and whether particular pieces of software are ready for use in research.

  3. Assessment of current practice and barriers to antimicrobial prophylaxis in peritoneal dialysis patients.

    Science.gov (United States)

    Campbell, Denise J; Brown, Fiona G; Craig, Jonathan C; Gallagher, Martin P; Johnson, David W; Kirkland, Geoffrey S; Kumar, Subramanian K; Lim, Wai H; Ranganathan, Dwarakanathan; Saweirs, Walaa; Sud, Kamal; Toussaint, Nigel D; Walker, Rowan G; Williams, Lesley A; Yehia, Maha; Mudge, David W

    2016-04-01

    Existing Australasian and international guidelines outline antibiotic and antifungal measures to prevent the development of treatment-related infection in peritoneal dialysis (PD) patients. Practice patterns and rates of PD-related infection vary widely across renal units in Australia and New Zealand and are known to vary significantly from guideline recommendations, resulting in PD technique survival rates that are lower than those achieved in many other countries. The aim of this study was to determine if there is an association between current practice and PD-related infection outcomes and to identify the barriers and enablers to good clinical practice. This is a multicentre network study involving eight PD units in Australia and New Zealand, with a focus on adherence to guideline recommendations on antimicrobial prophylaxis in PD patients. Current practice was established by asking the PD unit heads to respond to a short survey about practice/protocols/policies and a 'process map' was constructed following a face-to-face interview with the primary PD nurse at each unit. The perceived barriers/enablers to adherence to the relevant guideline recommendations were obtained from the completion of 'cause and effect' diagrams by the nephrologist and PD nurse at each unit. Data on PD-related infections were obtained for the period 1 January 2011 to 31 December 2011. Perceived barriers that may result in reduced adherence to guideline recommendations included lack of knowledge, procedural lapses, lack of a centralized patient database, patients with non-English speaking background, professional concern about antibiotic resistance, medication cost and the inability of nephrologists and infectious diseases staff to reach consensus on unit protocols. The definitions of PD-related infections used by some units varied from those recommended by the International Society for Peritoneal Dialysis, particularly with exit-site infection (ESI). Wide variations were observed in the

  4. Probabilistic safety assessment in radioactive waste disposal

    International Nuclear Information System (INIS)

    Robinson, P.C.

    1987-07-01

    Probabilistic safety assessment codes are now widely used in radioactive waste disposal assessments. This report gives an overview of the current state of the field. The relationship between the codes and the regulations covering radioactive waste disposal is discussed and the characteristics of current codes is described. The problems of verification and validation are considered. (author)

  5. Relationship Between Current Substance Use and Unhealthy Weight Loss Practices Among Adolescents.

    Science.gov (United States)

    Vidot, Denise C; Messiah, Sarah E; Prado, Guillermo; Hlaing, WayWay M

    2016-04-01

    To determine the relationship between current substance use and unhealthy weight loss practices (UWLP) among 12-to-18 year olds. Participants were 12-to-18 year olds who completed the 2013 Youth Risk Behavior Survey in Florida (N = 5620). Current alcohol, tobacco, and marijuana use was self-reported based on last 30-day use. UWLP was defined based on self-report of at least one of three methods to lose weight in last 30-days: (1) ≥24 h of fasting, (2) diet pill use, and (3) laxative use/purging. The reference group included those with no reported UWLP. Logistic regression models adjusted for age, gender, race/ethnicity, academic performance, age-sex-specific body mass index percentiles, and perceived weight status were fitted to assess relationships between UWLP and current substance use. About 15 and 41 % of adolescents reported ≥1 UWLP and use of ≥1 substance in the last 30-days, respectively. Over half (60.1 %) of adolescents who reported substance use engaged in UWLP (p < 0.0001). The prevalence of current alcohol use (50.6 %) was the highest among those who reported UWLP, followed by marijuana (31.9 %), tobacco (19.7 %), and cocaine (10.5 %) use. Adolescents who reported current tobacco [adjusted odds ratio (AOR) 2.7, 95 % confidence interval (CI) 2.1-3.6], alcohol (AOR 2.2, 95 % CI 1.9-2.6), or marijuana (AOR 2.1, 95 % CI 1.7-2.5) use had significantly higher odds of UWLP compared to their non-user counterparts. This cross-sectional study shows that substance use and UWLP behaviors are likely to co-exist in adolescents. Further studies are necessary to determine the temporal relationship between substance use and UWLP. It is recommended that intervention programs for youth consider targeting these multiple health risk behaviors.

  6. Overview of nuclear waste disposal in space

    International Nuclear Information System (INIS)

    Rice, E.E.; Priest, C.C.

    1981-01-01

    One option receiving consideration by the Department of Energy (DOE) is the space disposal of certain high-level nuclear wastes. The National Aeronautics and Space Administration is assessing the space disposal option in support of DOE studies on alternatives for nuclear waste management. The space disposal option is viewed as a complement, since total disposal of fuel rods from commercial power plants is not considered to be economically practical with Space Shuttle technology. The space disposal of certain high-level wastes may, however, provide reduced calculated and perceived risks. The space disposal option in conjunction with terrestrial disposal may offer a more flexible and lower risk overall waste management system. For the space disposal option to be viable, it must be demonstrated that the overall long-term risks associated with this activity, as a complement to the mined geologic repository, would be significantly less than the long-term risk associated with disposing of all the high-level waste. The long-term risk benefit must be achieved within an acceptable short-term and overall program cost. This paper briefly describes space disposal alternatives, the space disposal destination, possible waste mixes and forms, systems and typical operations, and the energy and cost analysis

  7. Current Research and Statistical Practices in Sport Science and a Need for Change

    Directory of Open Access Journals (Sweden)

    Jake R. Bernards

    2017-11-01

    Full Text Available Current research ideologies in sport science allow for the possibility of investigators producing statistically significant results to help fit the outcome into a predetermined theory. Additionally, under the current Neyman-Pearson statistical structure, some argue that null hypothesis significant testing (NHST under the frequentist approach is flawed, regardless. For example, a p-value is unable to measure the probability that the studied hypothesis is true, unable to measure the size of an effect or the importance of a result, and unable to provide a good measure of evidence regarding a model or hypothesis. Many of these downfalls are key questions researchers strive to answer following an investigation. Therefore, a shift towards a magnitude-based inference model, and eventually a fully Bayesian framework, is thought to be a better fit from a statistical standpoint and may be an improved way to address biases within the literature. The goal of this article is to shed light on the current research and statistical shortcomings the field of sport science faces today, and offer potential solutions to help guide future research practices.

  8. Human resource aspects of antiretroviral treatment delivery models: current practices and recommendations.

    Science.gov (United States)

    Assefa, Yibeltal; Van Damme, Wim; Hermann, Katharina

    2010-01-01

    PURPOSE OF VIEW: To illustrate and critically assess what is currently being published on the human resources for health dimension of antiretroviral therapy (ART) delivery models. The use of human resources for health can have an effect on two crucial aspects of successful ART programmes, namely the scale-up capacity and the long-term retention in care. Task shifting as the delegation of tasks from higher qualified to lower qualified cadres has become a widespread practice in ART delivery models in low-income countries in recent years. It is increasingly shown to effectively reduce the workload for scarce medical doctors without compromising the quality of care. At the same time, it becomes clear that task shifting can only be successful when accompanied by intensive training, supervision and support from existing health system structures. Although a number of recent publications have focussed on task shifting in ART delivery models, there is a lack of accessible information on the link between task shifting and patient outcomes. Current ART delivery models do not focus sufficiently on retention in care as arguably one of the most important issues for the long-term success of ART programmes. There is a need for context-specific re-designing of current ART delivery models in order to increase access to ART and improve long-term retention.

  9. Improving Hospital Services Based on Patient Experience Data: Current Feedback Practices and Future Opportunities.

    Science.gov (United States)

    Kaipio, Johanna; Stenhammar, Hanna; Immonen, Susanna; Litovuo, Lauri; Axelsson, Minja; Lantto, Minna; Lahdenne, Pekka

    2018-01-01

    Patient feedback is considered important for healthcare organizations. However, measurement and analysis of patient reported data is useful only if gathered insights are transformed into actions. This article focuses on gathering and utilization of patient experience data at hospitals with the aim of supporting the development of patient-centered services. The study was designed to explore both current practices of collecting and utilizing patient feedback at hospitals as well as future feedback-related opportunities. Nine people working at different hierarchical levels of three university hospitals in Finland participated in in-depth interviews. Findings indicate that current feedback processes are poorly planned and inflexible. Some feedback data are gathered, but not systematically utilized. Currently, it is difficult to obtain a comprehensive picture of the situation. One future hope was to increase the amount of patient feedback to be able to better generalize and utilize the data. Based on the findings the following recommendations are given: attention to both patients' and healthcare staff's perspectives when collecting feedback, employing a coordinated approach for collecting and utilizing patient feedback, and organizational transformation towards a patient-centric culture.

  10. Cancer pain management in China: current status and practice implications based on the ACHEON survey

    Directory of Open Access Journals (Sweden)

    Xia Z

    2017-08-01

    Full Text Available Zhongjun Xia Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, ChinaPurpose: Cancer pain can seriously impact the quality of life (QoL of patients, and optimal management practices are therefore of paramount importance. The ACHEON survey queried physicians and patients from 10 Asian countries/regions to assess current clinical practices in cancer pain management in Asia. This study presents the data obtained for cancer pain management in mainland China, with an emphasis on practices related to opioid drugs.Materials and methods: In several tertiary hospitals across China, 250 patients experiencing cancer pain and 100 physicians were surveyed on questions designed to assess current cancer pain management practices and cancer pain impact on QoL.Results: The patient survey showed that 88% of patients reported moderate-to-severe cancer pain, with a median duration of 6 months. The physician survey showed that medical school/residency training with regard to cancer pain management was inadequate in ~80% of physicians. A total of 80% of physicians and 67.2% of patients reported that pain scale was used during pain assessment; 84% of physicians expressed that physician-perceived pain severity was not completely consistent with actual pain the patient experienced. Of the 147 patients who recalled the medication received, 83.7% were administered opioid prescriptions. Of the 240 patients who received treatment, 43.8% perceived the inadequacy of controlling pain. The primary barriers from physicians perceived to optimal pain management included patients’ fear of side effects (58%, patients’ fear of addiction (53%, patients’ reluctance to report pain (43%, physicians’ reluctance to prescribe (29%, physicians’ inadequacy of pain assessment (27% and excessive regulation of opioid analgesics (47%.Conclusion: Knowledge of cancer pain management should be strengthened among physicians. Quantitative pain assessment and principle-based pain

  11. Protocol for audit of current Filipino practice in rehabilitation of stroke inpatients.

    Science.gov (United States)

    Gonzalez-Suarez, Consuelo B; Dizon, Janine Margarita R; Grimmer, Karen; Estrada, Myrna S; Liao, Lauren Anne S; Malleta, Anne-Rochelle D; Tan, Ma Elena R; Marfil, Vero; Versales, Cristina S; Suarez, Jimah L; So, Kleon C; Uyehara, Edgardo D

    2015-01-01

    Stroke is one of the leading medical conditions in the Philippines. Over 500,000 Filipinos suffer from stroke annually. Provision of evidence-based medical and rehabilitation management for stroke patients has been a challenge due to existing environmental, social, and local health system issues. Thus, existing western guidelines on stroke rehabilitation were contextualized to draft recommendations relevant to the local Philippine setting. Prior to fully implementing the guidelines, an audit of current practice needs to be undertaken, thus the purpose of this audit protocol. A clinical audit of current practices in stroke rehabilitation in the Philippines will be undertaken. A consensus list of data items to be captured was identified by the audit team during a 2-day meeting in 2012. These items, including patient demographics, type of stroke, time to referral for rehabilitation management, length of hospital stay, and other relevant descriptors of stroke management were included as part of the audit. Hospitals in the Philippines will be recruited to take part in the audit activity. Recruitment will be via the registry of the Philippine Academy of Rehabilitation Medicine, where 90% of physiatrists (medical doctors specialized in rehabilitation medicine) are active members and are affiliated with various hospitals in the Philippines. Data collectors will be identified and trained in the audit process. A pilot audit will be conducted to test the feasibility of the audit protocol, and refinements to the protocol will be undertaken as necessary. The comprehensive audit process will take place for a period of 3 months. Data will be encoded using MS Excel(®). Data will be reported as means and percentages as appropriate. Subgroup analysis will be undertaken to look into differences and variability of stroke patient descriptors and rehabilitation activities. This audit study is an ambitious project, but given the "need" to conduct the audit to identify "gaps" in current

  12. Summary of the Environmental Impact Statement on the concept for disposal of Canada's nuclear fuel waste

    International Nuclear Information System (INIS)

    1994-01-01

    This is the Summary of the Environmental Impact Statement (EIS) prepared by Atomic Energy of Canada Limited (AECL) on the concept for disposal of Canada's nuclear fuel waste. The proposed concept is a method for geological disposal, based on a system of natural and engineered barriers. The EIS provides information requested by the Environmental Assessment Panel reviewing the disposal concept and presents AECL's case for the acceptability of the concept. The introductory chapter of this Summary provides background information on several topics related to nuclear fuel waste, including current storage practices for used fuel, the need for eventual disposal of nuclear fuel waste, the options for disposal, and the reasons for Canada's focus on geological disposal. Chapter 2 describes the concept for disposal of nuclear fuel waste. Because the purpose of implementing the concept would he to protect human health and the natural environment far into the future, we discuss the long-term performance of a disposal system and present a case study of potential effects on human health and the natural environment after the closure of a disposal facility. The effects and social acceptability of disposal would depend greatly on how the concept was implemented. Chapter 3 describes AECL's proposed approach to concept implementation. We discuss how the public would be involved in implementation; activities that would be undertaken to protect human health, the natural environment, and the socio-economic environment; and a case study of the potential effects of disposal before the closure of a disposal facility. The last chapter presents AECL's Conclusion, based on more than 15 years of research and development, that implementation of the disposal concept represents a means by which Canada can safely dispose of its nuclear fuel waste. This chapter also presents AECL's recommendation that Canada progress toward disposal of its nuclear fuel waste by undertaking the first stage of concept

  13. Current practices in treatment of female genital fistula: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Ruminjo Joseph

    2010-11-01

    Full Text Available Abstract Background Maternal outcomes in most countries of the developed world are good. However, in many developing/resource-poor countries, maternal outcomes are bleaker: Every year, more than 500,000 women die in childbirth, mostly in resource-poor countries. Those who survive often suffer from severe and long-term morbidities. One of the most devastating injuries is obstetric fistula, occurring most often in south Asia and sub-Saharan Africa. Fistula treatment and care are available in many countries across Africa and Asia, but there is a lack of reliable data around clinical factors associated with the success of fistula repair surgery. Most published research has been retrospective. While these studies have provided useful information about the care and treatment of fistula, they are limited by the design. This study was designed to identify practices in care that could lead to the design of prospective and randomized controlled trials. Methods Self-administered questionnaires were completed by 40 surgeons known to provide fistula treatment services in Africa and Asia at private and government hospitals. The questionnaire was divided into three parts to address the following issues: prophylactic use of antibiotics before, during, and after fistula surgery; urethral catheter management; and management practices for patients with urinary incontinence following fistula repair. Results The results provide a glimpse into current practices in fistula treatment and care across a wide swath of geographic, economic, and organizational considerations. There is consensus in treatment in some areas (routine use of prophylactic antibiotics, limited bed rest until the catheter is removed, nonsurgical treatment for postsurgical incontinence, while there are wide variations in practice in other areas (duration of catheter use, surgical treatments for postsurgical incontinence. These findings are based on a small sample and do not allow for recommending

  14. Current practices in treatment of female genital fistula: a cross sectional study.

    Science.gov (United States)

    Arrowsmith, Steven D; Ruminjo, Joseph; Landry, Evelyn G

    2010-11-10

    Maternal outcomes in most countries of the developed world are good. However, in many developing/resource-poor countries, maternal outcomes are bleaker: Every year, more than 500,000 women die in childbirth, mostly in resource-poor countries. Those who survive often suffer from severe and long-term morbidities. One of the most devastating injuries is obstetric fistula, occurring most often in south Asia and sub-Saharan Africa. Fistula treatment and care are available in many countries across Africa and Asia, but there is a lack of reliable data around clinical factors associated with the success of fistula repair surgery. Most published research has been retrospective. While these studies have provided useful information about the care and treatment of fistula, they are limited by the design. This study was designed to identify practices in care that could lead to the design of prospective and randomized controlled trials. Self-administered questionnaires were completed by 40 surgeons known to provide fistula treatment services in Africa and Asia at private and government hospitals. The questionnaire was divided into three parts to address the following issues: prophylactic use of antibiotics before, during, and after fistula surgery; urethral catheter management; and management practices for patients with urinary incontinence following fistula repair. The results provide a glimpse into current practices in fistula treatment and care across a wide swath of geographic, economic, and organizational considerations. There is consensus in treatment in some areas (routine use of prophylactic antibiotics, limited bed rest until the catheter is removed, nonsurgical treatment for postsurgical incontinence), while there are wide variations in practice in other areas (duration of catheter use, surgical treatments for postsurgical incontinence). These findings are based on a small sample and do not allow for recommending changes in clinical care, but they point to issues for

  15. [Materials/Biomaterials in Clinical Practice - a Short Review and Current Trends].

    Science.gov (United States)

    Bolle, T; Meyer, F; Walcher, F; Lohmann, C; Jockenhövel, S; Gries, T; Hoffmann, W

    2017-04-01

    Biomaterials play a major role in interventional medicine and surgery. However, the development of biomaterials is still in its early phases in spite of the huge progress made within the last decades. On the one hand, this is because our knowledge of the molecular and cellular processes associated with biomaterials is still increasing exponentially. On the other hand, a wide variety of advanced materials with highly interesting properties is being developed currently. This review provides a short introduction into the variety of materials in use as well as their application in interventional medicine and surgery. Also the importance of biomaterials for tissue engineering in the field of regenerative medicine and the functionalisation of biomaterials, including sterilisation methods are discussed. For the future, an even broader interdisciplinary scientific collaboration is necessary in order to develop novel biomaterials and facilitate their translation into clinical practice. Georg Thieme Verlag KG Stuttgart · New York.

  16. Biodiversity in environmental assessment-current practice and tools for prediction

    International Nuclear Information System (INIS)

    Gontier, Mikael; Balfors, Berit; Moertberg, Ulla

    2006-01-01

    Habitat loss and fragmentation are major threats to biodiversity. Environmental impact assessment and strategic environmental assessment are essential instruments used in physical planning to address such problems. Yet there are no well-developed methods for quantifying and predicting impacts of fragmentation on biodiversity. In this study, a literature review was conducted on GIS-based ecological models that have potential as prediction tools for biodiversity assessment. Further, a review of environmental impact statements for road and railway projects from four European countries was performed, to study how impact prediction concerning biodiversity issues was addressed. The results of the study showed the existing gap between research in GIS-based ecological modelling and current practice in biodiversity assessment within environmental assessment

  17. Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening

    DEFF Research Database (Denmark)

    Buckley, B S; Harreiter, J; Damm, P

    2012-01-01

    Background: Gestational diabetes mellitus is a potentially serious condition that affects many pregnancies and its prevalence is increasing. Evidence suggests early detection and treatment improves outcomes, but this is hampered by continued disagreement and inconsistency regarding many aspects...... of its diagnosis. Methods: The Vitamin D and Lifestyle Intervention for Gestational Diabetes Mellitus Prevention (DALI) research programme aims to promote pan-European standards in the detection and diagnosis of gestational diabetes and to develop effective preventive interventions. To provide...... an overview of the context within which the programme will be conducted and its findings interpreted, systematic searching and narrative synthesis have been used to identify and review the best available European evidence relating to the prevalence of gestational diabetes, current screening practices...

  18. Screening for developmental dysplasia of the hip: current practices in Ireland.

    LENUS (Irish Health Repository)

    O'Grady, M J

    2012-01-31

    OBJECTIVE: To ascertain the current approach to screen for developmental dysplasia of the hip in the Republic of Ireland. METHODS: Two-pronged prospective and retrospective study. (1) Postal questionnaire to consultant paediatricians responsible for the routine neonatal care of infants in the Irish Republic in June 2006. (2) Retrospective database review to identify infants undergoing radiological follow-up and their outcome. RESULTS: All maternity units surveyed responded. Most units (84%) were dependent on radiographs at 4-6 months for imaging hips, only two units primarily used ultrasound (10.5%). We estimate that neonatal hip examination is performed by an experienced examiner in less than 30% of routine newborn examinations. On retrospective analysis, 94% of radiographs performed were normal. CONCLUSIONS: The most effective interventions, selective ultrasound and examination by an experienced clinician are not widely practiced. There is a need for the development of national guidelines based on available resources.

  19. Current Knowledge and Practice of Pediatric Providers in Umbilical Cord Blood Banking.

    Science.gov (United States)

    Armstrong, Amy E; Fonstad, Rachel; Spellman, Stephen; Tullius, Zoe; Chaudhury, Sonali

    2018-02-01

    More than 35 000 umbilical cord blood (UCB) transplants have been performed worldwide, prompting the development of private and public banks to collect and store UCB cells. We hypothesized that pediatricians, who are uniquely poised to discuss UCB banking (UCBB) during prenatal or sibling visits, rarely do so. Through distribution of a 26-question electronic survey to general and subspecialty pediatric providers, we assessed baseline knowledge and conversations about UCBB. A total of 473 providers completed the survey; only 22% of physicians ever discussed UCBB with expectant parents. The majority responded that autologous UCB transplants were indicated in malignant (73%) and nonmalignant (61%) conditions; however, these are rare indications. Providers practicing >10 years were more likely to address UCBB ( P ≤ .001), whereas younger and female general pediatric providers were significantly less likely ( P < .001). Overall, pediatric providers rarely speak to families about UCBB, and we believe that they can be better informed to its current clinical utility.

  20. Myocardial perfusion imaging in Denmark: activity from 1997 to 2001 and current practice

    DEFF Research Database (Denmark)

    Petersen, Claus Leth; Kjaer, Andreas

    2003-01-01

    , and the survey thus covers all MPI performed in Denmark during the period in question. The number of MPI studies (examined patients) was 2,531 in 1997 (0.47 MPI/1,000/year) and 4,961 (0.93 MPI/1,000/year) in 2001, which is a doubling in activity in 5 years. Nineteen (95%) of the Danish departments performed MPI...... in 2001, and 14 (74%) of these reported that activity had increased over the past 5 years. MPI activity was unevenly distributed between hospitals and regions. In 2001, the university hospitals in the central Copenhagen region (capital) accounted for the highest MPI activity (2.00/1,000/year), while......A questionnaire was sent to all departments of nuclear medicine in Denmark (n=20) asking for details of myocardial perfusion imaging (MPI), including the number of patients examined each year from 1997 to 2001 and the current clinical and technical practice. All (100%) departments replied...

  1. Current best practice for the health surveillance of enzyme workers in the soap and detergent industry.

    Science.gov (United States)

    Nicholson, P J; Newman Taylor, A J; Oliver, P; Cathcart, M

    2001-03-01

    This study defines current best practice for the health surveillance of workers who are potentially exposed to enzymes in the manufacture of enzymatic detergent products. It is recommended that health surveillance is performed 6-monthly for the first 2 years and annually thereafter. The health surveillance programme should include a respiratory questionnaire to detect symptoms, assessment of lung function to detect pre-symptomatic changes and an immunological test to detect specific immunoglobulin E (IgE) to enzymes. The International Union Against Tuberculosis and Lung Disease respiratory questionnaire should be used since it has been validated extensively for detecting asthma. Operators should observe the American Thoracic Society performance criteria for spirometers and standardized procedures for conducting spirometry. Since current airborne monitoring techniques for enzymes do not detect short-duration peak exposures, the incidence of employee sensitizations remains the most reliable measure of the integrity of environmental control. The Pepys skin prick test has been validated as a sensitive, specific and practical test for detecting specific IgE to many inhalant allergens including enzymes. For newly sensitized workers, a multi-cause investigation should be conducted to identify potential sources of exposure. Group results of immunological test results assist in the evaluation of workplace control measures, and should be used to monitor the effectiveness of hygiene and engineering programmes and to help prioritize areas for improvement. Positive responses to a questionnaire or abnormal spirometry should be assessed further. Occupational asthma should be excluded in any case of adult-onset asthma that starts or deteriorates during working life. This is particularly important because an accurate diagnosis of occupational asthma with early avoidance of exposure to its cause can result in remission of symptoms and restoration of lung function.

  2. Anaesthetic specialist registrars in Ireland: current teaching practices and perceptions of their role as undergraduate teachers.

    LENUS (Irish Health Repository)

    Walsh, K

    2012-02-03

    BACKGROUND AND OBJECTIVES: Teaching is an important responsibility of non-consultant hospital doctors. In Ireland, specialist registrars (SpRs) in anaesthesia are contractually obliged to teach medical students, other doctors and nurses. Both medical students and fellow non-consultant hospital doctors attribute between 30 and 40% of their knowledge gain to non-consultant hospital doctors. METHODS: We carried out a confidential telephone survey of anaesthetic SpRs in Ireland regarding their current teaching practices and the perceptions of their role as undergraduate teachers. All the SpRs currently working in clinical practice in Ireland were eligible. RESULTS: Fifty-five of the 79 (70%) SpRs responded to the questionnaire. Only 7 (12.7%) of the respondents said they had been well trained as a teacher. The majority of the respondents stated that they would attend a learning-to-teach course\\/workshop if one was available, and felt that such a course would improve their ability as a teacher. Only 8 (14.5%) agreed that adequate emphasis is placed on commitment to teaching in the assessment of SpRs, both by individual departments and by the College of Anaesthetists. Anaesthetic SpRs in Ireland spend a considerable amount of time each day teaching undergraduate medical students, the majority (68.9%) stated that they had inadequate time to prepare for teaching. CONCLUSION: The majority of the respondents stated that they enjoy teaching, feel that they play an important role in undergraduate teaching but have inadequate time to prepare for teaching. An adequate emphasis is not placed on their commitment to teaching.

  3. Current Cytology Practices in Korea: A Nationwide Survey by the Korean Society for Cytopathology

    Directory of Open Access Journals (Sweden)

    Eun Ji Oh

    2017-11-01

    Full Text Available Background Limited data are available on the current status of cytology practices in Korea. This nationwide study presents Korean cytology statistics from 2015. Methods A nationwide survey was conducted in 2016 as a part of the mandatory quality-control program by the Korean Society for Cytopathology. The questionnaire was sent to 208 medical institutions performing cytopathologic examinations in Korea. Individual institutions were asked to submit their annual cytology statistical reports and gynecologic cytology-histology correlation data for 2015. Results Responses were obtained from 206 medical institutions including 83 university hospitals, 87 general hospitals, and 36 commercial laboratories. A total of 8,284,952 cytologic examinations were performed in 2015, primarily in commercial laboratories (74.9%. The most common cytology specimens were gynecologic samples (81.3%. Conventional smears and liquid-based cytology were performed in 6,190,526 (74.7% and 2,094,426 (25.3% cases, respectively. The overall diagnostic concordance rate between cytologic and histologic diagnoses of uterine cervical samples was 70.5%. Discordant cases were classified into three categories: category A (minimal clinical impact, 17.4%, category B (moderate clinical impact, 10.2%, and category C (major clinical impact, 1.9%. The ratio of atypical squamous cells of undetermined significance to squamous intraepithelial lesion was 1.6 in university hospitals, 2.9 in general hospitals, and 4.9 in commercial laboratories. Conclusions This survey reveals the current status and trend of cytology practices in Korea. The results of this study can serve as basic data for the establishment of nationwide cytopathology policies and quality improvement guidelines in Korean medical institutions.

  4. A survey of current practices in management of Hirschsprung′s disease in Nigeria

    Directory of Open Access Journals (Sweden)

    Abdulrasheed A. Nasir

    2014-01-01

    Full Text Available Background: Although there are several modalities of treatment for Hirschsprung′s disease (HD, there are presently no clear guidelines on treatment of the condition by paediatric surgeons in Nigeria. This survey determines the current approach to treatment among Nigerian paediatric surgeons and should help in establishing a consensus and guidelines for care in this and similar setting. Materials and Methods: An online questionnaire was designed using survey Monkey ® to determine current clinical and operative management of patients with HD by consultant paediatric surgeons practicing in the Nigeria. The paediatric surgeons were notified by E-mail, which included a link to the survey on survey Monkey ® . The survey was also administered at the 12 th annual meeting of Association of Paediatric Surgeons of Nigeria in September, 2013, to capture those who did not complete the online survey. Thirty-one paediatric surgeons from 21 different tertiary paediatric surgery centres completed the survey. Results: Sixteen (52% respondents see up to 20% of their patients with HD in the neonatal period. Twenty-six (84% respondents do routine barium enema. Twenty six (84% respondents do full thickness rectal biopsy under general anaesthesia (GA. There was no consistency in operative techniques, with transabominal Swenson′s operation being practiced by 17 (57% respondents and 11 (37% transanal endorectal pull through. 14 (45% do pull through at any age. 12 (39% respondents do more than half of their patient as primary pull through. Conclusion: Full thickness rectal biopsy under GA is still the vogue with variations in the surgical technique for management of Hirshsprung′s disease in Nigeria. Primary pull through procedures is becoming increasingly popular. There′s a need for Paediatric Surgeons in Nigeria to come up with a guideline on management of HD, to guide trainees and other surgeons in the care of these patients.

  5. Current practice and recommendations in UK epilepsy monitoring units. Report of a national survey and workshop.

    Science.gov (United States)

    Hamandi, Khalid; Beniczky, Sandor; Diehl, Beate; Kandler, Rosalind H; Pressler, Ronit M; Sen, Arjune; Solomon, Juliet; Walker, Matthew C; Bagary, Manny

    2017-08-01

    Inpatient video-EEG monitoring (VEM) is an important investigation in patients with seizures or blackouts, and in the pre-surgical workup of patients with epilepsy. There has been an expansion in the number of Epilepsy Monitoring Units (EMU) in the UK offering VEM with a necessary increase in attention on quality and safety. Previous surveys have shown variation across centres on issues including consent and patient monitoring. In an effort to bring together healthcare professionals in the UK managing patients on EMU, we conducted an online survey of current VEM practice and held a one-day workshop convened under the auspices of the British Chapter of the ILAE. The survey and workshop aimed to cover all aspects of VEM, including pre-admission, consent procedures, patient safety, drug reduction and reinstatement, seizure management, staffing levels, ictal testing and good data recording practice. This paper reports on the findings of the survey, the workshop presentations and workshop discussions. 32 centres took part in the survey and there were representatives from 22 centres at the workshop. There was variation in protocols, procedures and consent processes between units, and levels of observation of monitored patients. Nevertheless, the workshop discussion found broad areas of agreement on points. A survey and workshop of UK epilepsy monitoring units found that some variability in practice is inevitable due to different local arrangements and patient groups under investigation. However, there were areas of clear consensus particularly in relation to consent and patient safety that can be applied to most units and form a basis for setting minimum standards. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  6. Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening.

    LENUS (Irish Health Repository)

    Buckley, B S

    2011-12-12

    Background:  Gestational diabetes mellitus is a potentially serious condition that affects many pregnancies and its prevalence is increasing. Evidence suggests early detection and treatment improves outcomes, but this is hampered by continued disagreement and inconsistency regarding many aspects of its diagnosis. Methods:  The Vitamin D and Lifestyle Intervention for Gestational Diabetes Mellitus Prevention (DALI) research programme aims to promote pan-European standards in the detection and diagnosis of gestational diabetes and to develop effective preventive interventions. To provide an overview of the context within which the programme will be conducted and its findings interpreted, systematic searching and narrative synthesis have been used to identify and review the best available European evidence relating to the prevalence of gestational diabetes, current screening practices and barriers to screening. Results:  Prevalence is most often reported as 2-6% of pregnancies. Prevalence may be lower towards the Northern Atlantic seaboard of Europe and higher in the Southern Mediterranean seaboard. Screening practice and policy is inconsistent across Europe, hampered by lack of consensus on testing methods, diagnostic glycaemic thresholds and the value of routine screening. Poor clinician awareness of gestational diabetes, its diagnosis and local clinical guidelines further undermine detection of gestational diabetes. Conclusions:  Europe-wide agreement on screening approaches and diagnostic standards for gestational diabetes could lead to better detection and treatment, improved outcomes for women and children and a strengthened evidence base. There is an urgent need for well-designed research that can inform decisions on best practice in gestational diabetes mellitus screening and diagnosis. © 2011 The Authors. Diabetic Medicine© 2011 Diabetes UK.

  7. Cervical spine trauma radiographs: Swimmers and supine obliques; an exploration of current practice

    Energy Technology Data Exchange (ETDEWEB)

    Fell, Michael, E-mail: michael.fell@mkgeneral.nhs.u [Milton Keynes General Hospital, Radiology Standing Way, Eaglestone, Milton Keynes, Buckinghamshire MK6 5LD (United Kingdom)

    2011-02-15

    The study objectives were: to investigate current cervical spine radiographic imaging practices in conscious adult patients with suspected neck injury; reasons behind variation and consideration of dose estimates were explored. Comparison with a previous survey has been made. Questionnaires were sent to superintendent radiographers responsible for accident and emergency X-ray departments in English trusts with over 8500 emergency admissions per year, with a response rate of 97% (n = 181/186). Departmental cervical spine imaging protocols were reported by 82% of respondents. None use fewer than the three standard projections; if the cervicothoracic junction (C7/T1), is not adequately demonstrated 87% use swimmers projections, 9% supine obliques, 3% CT alone. Following projectional radiography, 97% perform CT. A significant (p = 0.018) increase was found since 1999 in CT use once the swimmers projection fails; fewer now use obliques at this point, continuing with CT instead. No significant difference (p = 0.644) was found in choice of first supplementary radiographs; despite British Trauma Society's recommendation to undertake supine obliques, swimmers remain the most widespread technique. An 85% response rate (n = 103/121) completed a second questionnaire, exploring reasons behind the various practices. Several reported a perceived difficulty in interpreting oblique radiographs, some a concern over high dose of the swimmers. Numerous issues affect the acquisition of cervical spine radiographs. Patient radiation dose should be a major consideration in selection of technique. A potential need for training in interpretation of obliques is highlighted. Specific guidelines for optimum projections should be researched, and protocols issued to ensure best practice.

  8. A survey of current clinical practice of permanent prostate brachytherapy in the United States

    International Nuclear Information System (INIS)

    Prestidge, Bradley R.; Prete, James J.; Buchholz, Thomas A.; Friedland, Jay L.; Stock, Richard G.; Grimm, Peter D.; Bice, William S.

    1998-01-01

    Purpose: To help establish standards of care for transperineal interstitial permanent prostate brachytherapy (TIPPB) by obtaining data regarding current clinical practice among the most experienced TIPPB brachytherapists in the United States. Methods and Materials: The 70 brachytherapists who performed the greatest number of TIPPB cases in 1995 in the U.S. were surveyed. Each received a comprehensive four page questionnaire that included sections on training and experience, patient and isotope selection criteria, manpower, technique, and follow-up. Thirty-five (50%) surveys were ultimately returned after three mailings and follow-up phone calls. The cumulative experience of the 35 respondents represented approximately 45% of the total TIPPB volume in the U.S. for 1995. Respondents included 29 from the private sector and six from academic programs. Results: The median physician experience with TIPPB was reported as 4.9 years. Each performed an average of 73 TIPPB procedures in 1995 (range 40-300). This represented an increase in volume for most (74%) of the respondents. Sixty-three percent of the respondents attended a formal training course, 54% had TIPPB-specific residency training, and 31% had been proctored (16 had received two or more types of training experience). The most commonly reported selection criteria for implant alone was on Gleason score ≤7, PSA 125 I prescribed to 120 Gy (75%) or 103 Pd to 90 Gy (50%). Sixty percent reported using a Mick applicator, 46% prefer using preloaded needles, and (11%) use both techniques. Real-time imaging was usually performed with ultrasound (94%); most included fluoroscopy (60%). Definitions of PSA control varied widely. Conclusions: TIPPB clinical practice in the U.S. demonstrates similarities in technique, but differences in patient selection and definitions of biochemical control. It is, therefore, incumbent on those beginning TIPPB programs to carefully review the specific practice details of those institutions

  9. Educating for collaborative practice: an interpretation of current achievements and thoughts for future directions.

    Science.gov (United States)

    Hudson, Judith Nicky; Croker, Anne

    2018-01-01

    The Edinburgh Declaration, developed in 1998 as a pledge to alter the character of medical education to more effectively meet the needs of society, included a recommendation to increase the opportunity for joint learning between health and health-related professions, as part of the training for teamwork. This article acknowledges achievements since the Declaration in relation to this recommendation, using an umbrella term for the phenomenon, 'educating for collaborative practice', and presents a perspective framed as a series of questions to encourage reflection on future directions. A literature interpretation, informed by philosophical hermeneutics, was conducted using text sets comprising reports and reviews from a section of the international literature since 1988. The interpretation involved: engaging with meanings as presented in the chosen texts; making iterative returns to the texts to explore emerging understanding; and ensuring parts of our understanding from particular texts were fused with complete understanding of the texts as a whole. A lens of appreciative inquiry facilitated acknowledgement of what has been achieved, while being curious about how it could be. Interpretation of the selected literature revealed notable achievements. Areas for further consideration were identified in relation to three themes: establishing shared understanding AND purpose behind use of terminology; being a conduit AND sharing responsibility for change; exploring ways of doing things AND ensuring ongoing inclusivity. Interpreting the current literature on 'educating for collaborative practice' has generated questions for reflection on how it may be otherwise. Readers are encouraged to embrace the tensions inherent in unanswered questions, providing space for communication, initiative and diversity of thought. An ongoing dialogue with the literature is proposed, asking whether educating students for a collective identity in settings where they are learning for and with

  10. Current practices in corrosion, surface characterization, and nickel leach testing of cardiovascular metallic implants.

    Science.gov (United States)

    Nagaraja, Srinidhi; Di Prima, Matthew; Saylor, David; Takai, Erica

    2017-08-01

    In an effort to better understand current test practices and improve nonclinical testing of cardiovascular metallic implants, the Food and Drug Administration (FDA) held a public workshop on Cardiovascular Metallic Implants: corrosion, surface characterization, and nickel leaching. The following topics were discussed: (1) methods used for corrosion assessments, surface characterization techniques, and nickel leach testing of metallic cardiovascular implant devices, (2) the limitations of each of these in vitro tests in predicting in vivo performance, (3) the need, utility, and circumstances when each test should be considered, and (4) the potential testing paradigms, including acceptance criteria for each test. In addition to the above topics, best practices for these various tests were discussed, and knowledge gaps were identified. Prior to the workshop, discussants had the option to provide feedback and information on issues relating to each of the topics via a voluntary preworkshop assignment. During the workshop, the pooled responses were presented and a panel of experts discussed the results. This article summarizes the proceedings of this workshop and background information provided by workshop participants. Published 2016. This article is a U.S. Government work and is in the public domain in the USA. J Biomed Mater Res Part B: Appl Biomater, 105B: 1330-1341, 2017. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  11. Coliform Bacteria Monitoring in Fish Systems: Current Practices in Public Aquaria.

    Science.gov (United States)

    Culpepper, Erin E; Clayton, Leigh A; Hadfield, Catherine A; Arnold, Jill E; Bourbon, Holly M

    2016-06-01

    Public aquaria evaluate coliform indicator bacteria levels in fish systems, but the purpose of testing, testing methods, and management responses are not standardized, unlike with the coliform bacteria testing for marine mammal enclosures required by the U.S. Department of Agriculture. An online survey was sent to selected aquaria to document current testing and management practices in fish systems without marine mammals. The information collected included indicator bacteria species, the size and type of systems monitored, the primary purpose of testing, sampling frequency, test methods, the criteria for interpreting results, corrective actions, and management changes to limit human exposure. Of the 25 institutions to which surveys were sent, 19 (76%) responded. Fourteen reported testing for fecal indicator bacteria in fish systems. The most commonly tested indicator species were total (86%) and fecal (79%) coliform bacteria, which were detected by means of the membrane filtration method (64%). Multiple types and sizes of systems were tested, and the guidelines for testing and corrective actions were highly variable. Only three institutions performed additional tests to confirm the identification of indicator organisms. The results from this study can be used to compare bacterial monitoring practices and protocols in fish systems, as an aid to discussions relating to the accuracy and reliability of test results, and to help implement appropriate management responses. Received August 23, 2015; accepted December 29, 2015.

  12. Current Trends in the Studies of Allelochemicals for Their Application in Practice

    Directory of Open Access Journals (Sweden)

    Arsen V.Viter

    2015-06-01

    Full Text Available The allelochemicals have been largely used in agriculture, forestry, landscape design and ornamental plant growing for many decades. However, there is a lack of the comprehensive studies, where existing publications are analyzed and synthesized with regards to the theoretic aspects for such usage. The objective of this paper was to systemize the advances in the research on allelochemicals’ application in practice. Numerous novel methodological propositions have risen recently. We classified them into the physical, chemical, biological, biotechnological and cropgrowing approaches. The allelochemicals consist of the wide diversity of the substances according to their chemical nature. Among these substances we outlined, firstly, the unidentified plant exudates and the products of green manuring, secondly, the chemically characterized or purified substances, which include alcohols, organic acids, aliphatic compounds, aromatic, alicyclic and nitrogen-contain organic compounds. Several groups of the biotic sources of allelochemicals were described: dicotyledonous and monocotyledonous plants, particularly under their colonization by non-pathogenic strains of Fusarium oxysporum, marine flora and fungi, which exhibit the herbicidal activity. Different targets of the allelochemical application were listed in the paper and they were categorized into several groups: higher flora, animals, unicellular and multi-cellular fungi. We concluded that there is lack of the modern multifaceted knowledge bases for the information about the allelochemical application. Those knowledge bases must be useful in order to choose the appropriate biological method for solving each particular problem of plant cultivation. To that end we systemized the results of current investigation about the usage of allelochemicals in practice.

  13. Classification and disposal of radioactive wastes

    International Nuclear Information System (INIS)

    Kocher, D.C.

    1990-01-01

    This paper reviews the historical development in the U.S. of definitions and requirements for permanent disposal of different classes of radioactive waste. We first consider the descriptions of different waste classes that were developed prior to definitions in laws and regulations. These descriptions usually were not based on requirements for permanent disposal but, rather, on the source of the waste and requirements for safe handling and storage. We then discuss existing laws and regulations for disposal of different waste classes. Current definitions of waste classes are largely qualitative, and thus somewhat ambiguous, and are based primarily on the source of the waste rather than the properties of its radioactive constituents. Furthermore, even though permanent disposal is clearly recognized as the ultimate goal of radioactive water management, current laws and regulations do not associated the definitions of different waste classes with requirement for particular disposal systems. Thus, requirements for waste disposal essentially are unaffected by ambiguities in the present waste classification system

  14. Early surgery versus optimal current step-up practice for chronic pancreatitis (ESCAPE): design and rationale of a randomized trial

    NARCIS (Netherlands)

    Ahmed Ali, U.; Issa, Y.; Bruno, M.J.; Goor, H. van; Santvoort, H.C. van; Busch, O.R.; Dejong, C.H.; Nieuwenhuijs, V.B.; Eijck, C.H. van; Dullemen, H.M. van; Fockens, P.; Siersema, P.D.; Gouma, D.J.; Hooft, J.E. van; Keulemans, Y.; Poley, J.W.; Timmer, R.; Besselink, M.G.; Vleggaar, F.P.; Wilder-Smith, O.H.G.; Gooszen, H.G.; Dijkgraaf, M.G.; Boermeester, M.A.; et al.,

    2013-01-01

    BACKGROUND: In current practice, patients with chronic pancreatitis undergo surgical intervention in a late stage of the disease, when conservative treatment and endoscopic interventions have failed. Recent evidence suggests that surgical intervention early on in the disease benefits patients in

  15. Early surgery versus optimal current step-up practice for chronic pancreatitis (ESCAPE): Design and rationale of a randomized trial

    NARCIS (Netherlands)

    U. Ahmed Ali (Usama); Y. Issa (Yama); M.J. Bruno (Marco); H. van Goor (Harry); H.C. van Santvoort (Hjalmar); O.R.C. Busch (Olivier); C.H. Dejong (Cees); V.B. Nieuwenhuijs (Vincent); C.H.J. van Eijck (Casper); H.M. van Dullemen (Hendrik); P. Fockens (Paul); P.D. Siersema (Peter); D.J. Gouma (Dirk); J.E. van Hooft (Jeanin); Y. Keulemans (Yolande); J.-W. Poley (Jan-Werner); R. Timmer (Robin); M.G. Besselink (Marc); F.P. Vleggaar (Frank); O.H. Wilder-Smith (O.); H.G. Gooszen (Hein); M.G.W. Dijkgraaf (Marcel); M.A. Boermeester (Marja)

    2013-01-01

    textabstractBackground: In current practice, patients with chronic pancreatitis undergo surgical intervention in a late stage of the disease, when conservative treatment and endoscopic interventions have failed. Recent evidence suggests that surgical intervention early on in the disease benefits

  16. European Communication Monitor: Current developments, issues and tendencies of the professional practice of public relations in Europe

    NARCIS (Netherlands)

    Moreno, A.; Zerfass, A.; Tench, R.; Verčič, D.; Verhoeven, P.

    2009-01-01

    The European Communication Monitor (ECM) research explores the current developments for communications disciplines, practices and instruments. It is an extensive research project to monitor trends in communication management, analyse the changing framework for the profession driven by European

  17. Early surgery versus optimal current step-up practice for chronic pancreatitis (ESCAPE) : design and rationale of a randomized trial

    NARCIS (Netherlands)

    Ali, Usama Ahmed; Issa, Yama; Bruno, Marco J.; van Goor, Harry; van Santvoort, Hjalmar; Busch, Olivier R. C.; Dejong, Cornelis H. C.; Nieuwenhuijs, Vincent B.; van Eijck, Casper H.; van Dullemen, Hendrik M.; Fockens, Paul; Siersema, Peter D.; Gouma, Dirk J.; van Hooft, Jeanin E.; Keulemans, Yolande; Poley, Jan W.; Timmer, Robin; Besselink, Marc G.; Vleggaar, Frank P.; Wilder-Smith, Oliver H.; Gooszen, Hein G.; Dijkgraaf, Marcel G. W.; Boermeester, Marja A.

    2013-01-01

    Background: In current practice, patients with chronic pancreatitis undergo surgical intervention in a late stage of the disease, when conservative treatment and endoscopic interventions have failed. Recent evidence suggests that surgical intervention early on in the disease benefits patients in

  18. Current issues in dental practice management. Part 1. The importance of shared values.

    Science.gov (United States)

    Newsome, Philip R H

    2003-04-01

    There can be few who would argue with the notion that the nature of dental practice in the United Kingdom has changed dramatically over the last couple of decades. A variety of factors, including new clinical techniques, growing consumerism, a much greater awareness of health-related and well-being issues in the public at large, as well as a marked deregulation within the dental profession, the development of vocational training and recently mandatory lifelong learning, the growing number of females working in the profession, and an increasing reluctance of young dentists to finance dental practices have all combined to create an environment which has enabled and encouraged a move away from traditional forms of dental care delivery. Instead, there has been considerable growth in independently-funded practice and a commensurate growth in the number of practices operating under a corporate body umbrella of one form or another. Currently there are 27 corporate bodies registered with the General Dental Council (GDC) with the likelihood of more in the future given the proposed GDC review. This will no doubt take into consideration European law, under which the restriction within the Dentist's Act on the number of corporate bodies is likely to be untenable. Although they still have only a small share of the dental market--with 4% of all dentists in the UK in 1999--they have expanded rapidly from a small base. The data available at the time the paper was written indicate that the global total of fees earned from dentistry in the UK in the financial year 2001/2002 was almost 3 billion Pounds, of which 1.9 billion Pounds (64%) came from NHS fees and 1.1 billion Pounds (36%) from private fees. Of this 1.9 billion Pounds received in NHS fees in 2001/2002, 0.55 billion Pounds were paid by patients who were not exempt from charges, bringing the total amount actually paid out of patients' pockets for dental treatment to 1.65 billion Pounds. Compare these figures with 1996

  19. Health impact assessment in Latin American countries: Current practice and prospects

    International Nuclear Information System (INIS)

    Pereira, Carlos A.R.; Périssé, André R.S.; Knoblauch, Astrid M.; Utzinger, Jürg; Hacon, Sandra de Souza

    2017-01-01

    Background: With the objective to avoid and mitigate potential adverse health impacts of projects, programmes and policies, health impact assessment (HIA) offers an opportunity for disease prevention and health promotion. Although HIA has gained importance over the past two decades, it is unclear whether and to what extent HIA practice has been established and institutionalised in Latin America. To address this issue, the current practice and prospects of HIA in Latin America was assessed in the peer-reviewed literature and existing guidelines. Methodology: The peer-reviewed literature was systematically searched using five electronic databases until February 2016. Studies were included on a set of pre-defined criteria. The search was carried out in English, French, Portuguese and Spanish. Additionally, a search for HIA guidelines used in Latin American countries and territories was performed by means of a Google search and on websites of government departments and institutions that may promote HIA. Results: The search yielded 167 hits in the peer-reviewed literature of which 17 articles met inclusion criteria. Only four peer-reviewed articles described prospective HIAs and four featured a discussion of the HIA approach. The remaining nine articles presented health impact evaluations. Most studies were published only recently, after 2012 (88%). Seven HIA guideline documents were identified, two of which were country-specific (i.e. Brazil and Mexico) and the remaining five addressed HIA at the regional level. Conclusions: This study confirmed the paucity of literature pertaining to HIA implementation, as well as HIA guidelines in Latin America. Mexico, Brazil and Cuba have the longest track record in scientific literature and guidelines on HIA. In order to better understand current barriers and limitations to practice and institutionalisation of HIA in Latin American countries, a broad discussion among policy makers, academic institutions and HIA practitioners is

  20. Current biomedical waste management practices and cross-infection control procedures of dentists in India.

    Science.gov (United States)

    Singh, Balendra Pratap; Khan, Suleman A; Agrawal, Neeraj; Siddharth, Ramashanker; Kumar, Lakshya

    2012-06-01

    To investigate the knowledge, attitudes and behaviour of dentists working in dental clinics and dental hospitals regarding biomedical waste management and cross-infection control. A national survey was conducted. Self-administered questionnaires were sent to 800 dentists across India. A total of 494 dentists responded, giving a response rate of 61.8%. Of these, 228 of 323 (70.6%) general dentists reported using boiling water as a sterilising medium and 339 (68.6%) dentists reported disposing of hazardous waste such as syringes, blades and ampoules in dustbins and emptying these into municipal corporation bins. Dentists should undergo continuing education programmes on biomedical waste management and infection control guidelines. Greater cooperation between dental clinics and hospitals and pollution control boards is needed to ensure the proper handling and disposal of biomedical waste. © 2012 FDI World Dental Federation.

  1. Aspects of governance in the practical implementation of the concept of reversibility for deep geological disposal. Report no. 308; Stockage geologique de dechets radioactifs: mise en oeuvre pratique du concept de reversibilite et gouvernance. Rapport no. 308

    Energy Technology Data Exchange (ETDEWEB)

    Reaud, C.; Schieber, C.; Schneider, T.; Gadbois, S.; Heriard Dubreuil, G.

    2010-07-01

    The European project COWAM in Practice (CIP) was aimed to lead for three years (2007-2009) a process of monitoring, analyzing and evaluating the governance linked with radioactive waste management. This project, in cooperation with a research group and stakeholders, was conducted in parallel in 5 European countries (Spain, France, United Kingdom, Romania, Slovenia). In France, the issue of reversibility for a deep geological disposal was introduced in the Act of December 30, 1991 on the possible options to manage radioactive waste. The Act of June 28, 2006 relative to sustainable management of materials and radioactive waste confirmed the option, by calling for a reversible waste disposal facility in a deep geological formation to be designed. The main issue is no longer to justify the adoption of reversibility, but to investigate the practical procedures for its implementation. The French stakeholder Group 4 involved in the European project COWAM In Practice (CIP) had identified several subjects for investigation: - The different aspects associated with the practical implementation of reversible disposal: technical aspects, and aspects relative to monitoring, safety and expertise, in terms of legal, financial, administrative and political, etc. responsibility related to the notion of reversibility. - The stakes of governance related to the processes of assessment and decision-making - The roles of local stakeholders in these processes. The analysis conducted by CEPN in cooperation with the French stakeholder group, facilitated by Mutadis, showed that the practical implementation of reversibility aims to maintain a capacity of choice between three options: to continue to maintain the reversibility, to retrieve packages or to initiate the closure of all or part the disposal facility. Maintaining this choice in the long term implies setting up specific institutional, financial and decision-making systems,etc,. that need to be jointly developed in advance by all the

  2. A practical approach to the disposal of highly toxic and long-lived spent nuclear fuel waste between Venus and Earth

    International Nuclear Information System (INIS)

    Ehricke, K.A.

    1983-01-01

    Extraterrestrial disposal, while not the only alternative, nevertheless assures definite and irreversible removal of the most toxic and long-lived waste from the biosphere. The disposal 'site' should lie at minimum safe transfer energy level. Primary candidate is the space between Venus and Earth. The number of propulsion phases should be a minimum, preferably only one. Lunar gravity assist can be helpful to achieve higher inclination of the heliocentric orbit relative to the ecliptic. Solidified spent fuel isotopes and actinides, sufficient to reduce the residual terrestrial waste to the radiation level of natural uranium deposits after 30 to 40 yr instead of 1000 to 1500 yr, is deposited into heliocentric orbits. Transportation systems, requirements, costs and the associated socio-economic benefit potentials of an environmentally more benign and a more vigorous nuclear power generation program are presented. Prior to solidification, an interim storage of 10 yr, following removal from the reactor, may be required. The Shuttle, with one Orbiter modified as Nuclear Waste Carrying Orbiter and an out of near-Earth orbit booster, provides a safe and economic transportation system at disposal mission costs from surface to disposal orbit of less than 0.5 cents/kWhe or <= 0.1 cent/kWhe depending on level of orbital operations. Details are discussed. (author)

  3. Ethical aspects in connection with the disposal of radioactive wastes

    International Nuclear Information System (INIS)

    Boetsch, W.

    2003-01-01

    The progress of modern natural and technological science and their far-reaching consequences affecting the distant future require increasingly practice-oriented ethical concepts. In the discussions about responseable acting, the question of the ethical tenability of nuclear energy nowadays takes a special position. Above all the problem of the disposal of radioactive wastes - the effects of which on the distant future have to be prognosticated - is controversially discussed in society. The Federal Ministry for the Environment, Nature Conservation and Nuclear Safety (BMU) commissioned Gesellschaft fuer Anlagen- und Reaktorsicherheit mbH (GRS) in the context of the project ''Disposal of radioactive wastes in the context of ethical objectives'' to summarise the current national and international status of ethical aspects in connection with the disposal of radioactive wastes. One aim of this report is to derive criteria to form the basis of a comprehensive discussion of the ethical aspects of the disposal of radioactive wastes. These criteria are to describe, as far as possible, all content-related aspects that result from radioactive waste disposal. The issues in this report resulting from the opinions, comments and publications presented are to serve as a basis for an experts' meeting at which the important ethical criteria concerning the responsible management of radioactive waste disposal are to be discussed at an interdisciplinary level with all those involved. The results of this report are based on an investigation which gathered the available national and international statements, principles, and criteria relating to the ethical aspects of the disposal of radioactive wastes and to sustainable development in the context of the technological impact assessment up to beginning of 2000. In the meantime, the debate in Germany has become somewhat more pragmatic, i. a. due to the work of the research group ''Arbeitskreis Auswahlverfahren Endlagerstandorte (AkEnd)'' and

  4. Black Truffle Harvesting in Spanish Forests: Trends, Current Policies and Practices, and Implications on its Sustainability

    Science.gov (United States)

    Garcia-Barreda, Sergi; Forcadell, Ricardo; Sánchez, Sergio; Martín-Santafé, María; Marco, Pedro; Camarero, J. Julio; Reyna, Santiago

    2018-04-01

    The European black truffle is a mycorrhizal fungus native to Spanish Mediterranean forests. In most Spanish regions it was originally commercially harvested in the second half of the 20th century. Experts agree that wild truffle yields suffered a sharp decline during the 1970s and 1980s. However, official statistics for Spanish harvest are scarce and seemingly conflicting, and little attention has been paid to the regime for the exploitation of truffle-producing forests and its implications on the sustainability of this resource. Trends in harvest from 1969 to 2013 and current harvesting practices were analyzed as a case study, taking into account that Spain is a major truffle producer worldwide, but at the same time truffles have only recently been exploited. The available statistical sources, which include an increasing proportion of cultivated truffles since the mid-1990s, were explored, with estimates from Truffle Harvesters Federation showing higher consistency. Statistical sources were then compared with proxies for wild harvest (rents from truffle leases in public forests) to corroborate time trends in wild harvesting. Results suggest that black truffle production is recovering in recent years thanks to plantations, whereas wild harvest is still declining. The implications of Spanish legal and institutional framework on sustainability of wild truffle use are reviewed. In the current scenario, the decline of wild harvest is likely to continue and eventually make commercial harvesting economically unattractive, thus aggravating sustainability issues. Strengthening of property rights, rationalization of harvesting pressure, forest planning and involvement of public stakeholders are proposed as corrective measures.

  5. Previous management practices for naturally occurring radionuclide wastes: current radiological status

    International Nuclear Information System (INIS)

    Goldsmith, W.A.; Crawford, D.J.; Haywood, F.F.; Leggett, R.Q.

    1979-01-01

    Many installations used during the early days of the United States atomic energy program have been released in recent years for unrestricted private uses. These installations include lands and buildings used for the storage of radioactive wastes resulting from refining and processing of uranium and thorium. Waste management practices at these sites in the 1940's and 1950's were not conducted with today's emphasis on as-low-as-reasonably-achievable (ALARA) principles. Consequently, many of these older waste storage areas are contaminated with naturally occurring radionuclides in concentrations which are orders of magnitude greater than those found ordinarily in the earth's crust. current and potential elevated human exposures at fifteen of these sites are due primarily to radon daughters and external-gamma radiation. A wide variety of exposure conditions may be found at these sites - ranging from slightly above background to more than thirty times the guidelines recommended for the public. Remedial actions are contemplated for a number of these sites where contamination levels or radiaion exposures exceed current guidelines

  6. High- and Low-Load Resistance Training: Interpretation and Practical Application of Current Research Findings.

    Science.gov (United States)

    Fisher, James; Steele, James; Smith, Dave

    2017-03-01

    Our current state of knowledge regarding the load (lighter or heavier) lifted in resistance training programmes that will result in 'optimal' strength and hypertrophic adaptations is unclear. Despite this, position stands and recommendations are made based on, we propose, limited evidence to lift heavier weights. Here we discuss the state of evidence on the impact of load and how it, as a single variable, stimulates adaptations to take place and whether evidence for recommending heavier loads is available, well-defined, currently correctly interpreted or has been overlooked. Areas of discussion include electromyography amplitude, in vivo and in vitro methods of measuring hypertrophy, and motor schema and skill acquisition. The present piece clarifies to trainers and trainees the impact of these variables by discussing interpretation of synchronous and sequential motor unit recruitment and revisiting the size principle, poor agreement between whole-muscle cross-sectional area (CSA) and biopsy-determined changes in myofibril CSA, and neural adaptations around task specificity. Our opinion is that the practical implications of being able to self-select external load include reducing the need for specific facility memberships, motivating older persons or those who might be less confident using heavy loads, and allowing people to undertake home- or field-based resistance training intervention strategies that might ultimately improve exercise adherence.

  7. Inhaled therapies in patients with moderate COPD in clinical practice: current thinking

    Science.gov (United States)

    Ariel, Amnon; Altraja, Alan; Belevskiy, Andrey; Boros, Piotr W; Danila, Edvardas; Fležar, Matjaz; Koblizek, Vladimir; Fridlender, Zvi G; Kostov, Kosta; Krams, Alvils; Milenkovic, Branislava; Somfay, Attila; Tkacova, Ruzena; Tudoric, Neven; Ulmeanu, Ruxandra; Valipour, Arschang

    2018-01-01

    COPD is a complex, heterogeneous condition. Even in the early clinical stages, COPD carries a significant burden, with breathlessness frequently leading to a reduction in exercise capacity and changes that correlate with long-term patient outcomes and mortality. Implementation of an effective management strategy is required to reduce symptoms, preserve lung function, quality of life, and exercise capacity, and prevent exacerbations. However, current clinical practice frequently differs from published guidelines on the management of COPD. This review focuses on the current scientific evidence and expert opinion on the management of moderate COPD: the symptoms arising from moderate airflow obstruction and the burden these symptoms impose, how physical activity can improve disease outcomes, the benefits of dual bronchodilation in COPD, and the limited evidence for the benefits of inhaled corticosteroids in this disease. We emphasize the importance of maximizing bronchodilation in COPD with inhaled dual-bronchodilator treatment, enhancing patient-related outcomes, and enabling the withdrawal of inhaled corticosteroids in COPD in well-defined patient groups. PMID:29317810

  8. Survey of current Swiss pig feeding practices and potential for ammonia emission reduction

    OpenAIRE

    Spring, P.; Bracher, A.

    2017-01-01

    Controlling potentially harmful and polluting emissions from farms is important in the developed world, where legislation exists in many countries limiting emissions such as ammonia and controlling how manure is disposed of from intensive farming operations. In Switzerland, there are legal agreements concerning controls of ammonia emissions, most especially from farms. Ammonia production from pig farms can be controlled by dietary intervention, such as reducing protein levels, which in turn r...

  9. Communication of Energy Efficiency Information to Remodelers. Lessons From Current Practice

    Energy Technology Data Exchange (ETDEWEB)

    Liaukus, C. [Building Media and the Building America Retrofit Alliance (BARA), Wilmington, DE (United States)

    2012-10-01

    The effective communication of energy efficiency and building science information to remodeling contractors is achieved through varying formats, timelines, and modes depending on who is delivering the information, who is intended to receive it, and what technical, intellectual, and time resources the recipients have at their disposal. This report reviews communications that are deemed effective, and selects a group to be further analyzed to determine why they are effective and how less successful formats or strategies can be revised for greater effectiveness.

  10. Protocol for audit of current Filipino practice in rehabilitation of stroke inpatients

    Directory of Open Access Journals (Sweden)

    Gonzalez-Suarez CB

    2015-03-01

    Full Text Available Consuelo B Gonzalez-Suarez,1–3 Janine Margarita R Dizon,2,3 Karen Grimmer,3 Myrna S Estrada,4 Lauren Anne S Liao,1 Anne-Rochelle D Malleta,5 Ma Elena R Tan,6 Vero Marfil,6 Cristina S Versales,1 Jimah L Suarez,5 Kleon C So,1 Edgardo D Uyehara6 1University of Santo Tomas Hospital, University of Santo Tomas, 2University of Santo Tomas, Manila, Philippines; 3International Centre for Allied Health Evidence, University of South Australia, City East Campus, North Terrace, Adelaide, SA, Australia; 4De La Salle University Hospital, Cavite, Dasmariñas, 5Philippine Orthopedic Center, 6Veterans’ Memorial Medical Center, Quezon City, Philippines Background: Stroke is one of the leading medical conditions in the Philippines. Over 500,000 Filipinos suffer from stroke annually. Provision of evidence-based medical and rehabilitation management for stroke patients has been a challenge due to existing environmental, social, and local health system issues. Thus, existing western guidelines on stroke rehabilitation were contextualized to draft recommendations relevant to the local Philippine setting. Prior to fully implementing the guidelines, an audit of current practice needs to be undertaken, thus the purpose of this audit protocol.Methods: A clinical audit of current practices in stroke rehabilitation in the Philippines will be undertaken. A consensus list of data items to be captured was identified by the audit team during a 2-day meeting in 2012. These items, including patient demographics, type of stroke, time to referral for rehabilitation management, length of hospital stay, and other relevant descriptors of stroke management were included as part of the audit. Hospitals in the Philippines will be recruited to take part in the audit activity. Recruitment will be via the registry of the Philippine Academy of Rehabilitation Medicine, where 90% of physiatrists (medical doctors specialized in rehabilitation medicine are active members and are affiliated

  11. Factors influencing the current practice of self-medication consultations in Eastern Indonesian community pharmacies: a qualitative study.

    Science.gov (United States)

    Brata, Cecilia; Fisher, Colleen; Marjadi, Brahmaputra; Schneider, Carl R; Clifford, Rhonda M

    2016-05-13

    Research has shown that the current practice of pharmacy staff when providing self-medication consultations in Indonesia is suboptimal. To improve the performance of pharmacy staff when providing self-medication consultations in community pharmacies, the factors that influence current practice need to be understood. The aim of this study is to identify the factors that influence current practice of pharmacy staff when handling self-medication consultations in Eastern Indonesian community pharmacies. Fifteen in-depth interviews were conducted with pharmacists, pharmacy technicians, pharmacy owners, and counter attendants. Thematic analysis was used to generate findings. The current practice of pharmacy staff when handling self-medication consultations is directly influenced by the professionalism of pharmacy staff and patient responses to the consultations. These factors are in turn affected by the organisational context of the pharmacy and the external pharmacy environment. The organisational context of the pharmacy includes staffing, staff affordability, and the availability of time and facilities in which to provide consultations. The external pharmacy environment includes the number of trained pharmacy staff in the research setting, the relevance of pharmacy education to the needs of pharmacy practice, the support offered by the Indonesian Pharmacists Association, a competitive business environment, and the policy environment. Complex and inter-related factors influence the current practice of pharmacy staff when providing self-medication consultations in community pharmacies in this research setting. Multiple strategies will be required to improve consultation practices.

  12. Evaluation of the current practices of noise-induced hearing loss (NIHL) awareness training in the South African mining industry

    CSIR Research Space (South Africa)

    Edwards, AL

    2015-01-01

    Full Text Available This study aimed to evaluate the current practices in relation to best practice criteria and make recommendations for improvements to noise-induced hearing loss (NIHL) awareness training in the South African mining industry. A survey tool based...

  13. Continuous improvement in the Netherlands: A survey-based study into the current practices of continuous improvement

    NARCIS (Netherlands)

    Middel, H.G.A.; op de Weegh, S.; Gieskes, J.F.B.; Schuring, R.W.

    2004-01-01

    Continuous Improvement is a well-known and consolidated concept in literature and practice and is considered vital in today¿s business environment. In 2003 a survey, as part of the international CINet survey, has been performed in the Netherlands in order to gain insight into the current practices

  14. Current clinical nutrition practices in critically ill patients in Latin America: a multinational observational study.

    Science.gov (United States)

    Vallejo, Karin Papapietro; Martínez, Carolina Méndez; Matos Adames, Alfredo A; Fuchs-Tarlovsky, Vanessa; Nogales, Guillermo Carlos Contreras; Paz, Roger Enrique Riofrio; Perman, Mario Ignacio; Correia, Maria Isabel Toulson Davisson; Waitzberg, Dan Linetzky

    2017-08-25

    Malnutrition in critically ill adults in the intensive care unit (ICU) is associated with a significantly elevated risk of mortality. Adequate nutrition therapy is crucial to optimise outcomes. Currently, there is a paucity of such data in Latin America. Our aims were to characterise current clinical nutrition practices in the ICU setting in Latin America and evaluate whether current practices meet caloric and protein requirements in critically ill patients receiving nutrition therapy. We conducted a cross-sectional, retrospective, observational study in eight Latin American countries (Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, Panama, and Peru). Eligible patients were critically ill adults hospitalised in the ICU and receiving enteral nutrition (EN) and/or parenteral nutrition (PN) on the Screening Day and the previous day (day -1). Caloric and protein balance on day -1, nutritional status, and prescribed nutrition therapy were recorded. Multivariable logistic regression analysis was performed to identify independent predictors of reaching daily caloric and protein targets. The analysis included 1053 patients from 116 hospitals. Evaluation of nutritional status showed that 74.1% of patients had suspected/moderate or severe malnutrition according to the Subjective Global Assessment. Prescribed nutrition therapy included EN alone (79.9%), PN alone (9.4%), and EN + PN (10.7%). Caloric intake met >90% of the daily target in 59.7% of patients on day -1; a caloric deficit was present in 40.3%, with a mean (±SD) daily caloric deficit of -688.8 ± 455.2 kcal. Multivariable logistic regression analysis showed that combined administration of EN + PN was associated with a statistically significant increase in the probability of meeting >90% of daily caloric and protein targets compared with EN alone (odds ratio, 1.56; 95% confidence interval, 1.02-2.39; p = 0.038). In the ICU setting in Latin America, malnutrition was highly prevalent and caloric

  15. Shared Decision-Making in Oncology - A Qualitative Analysis of Healthcare Providers' Views on Current Practice.

    Science.gov (United States)

    Frerichs, Wiebke; Hahlweg, Pola; Müller, Evamaria; Adis, Christine; Scholl, Isabelle

    2016-01-01

    Despite an increased awareness of shared decision-making (SDM) and its prominent position on the health policy agenda, its implementation in routine care remains a challenge in Germany. In order to overcome this challenge, it is important to understand healthcare providers' views regarding SDM and to take their perspectives and opinions into account in the development of an implementation program. The present study aimed at exploring a) the attitudes of different healthcare providers regarding SDM in oncology and b) their experiences with treatment decisions in daily practice. A qualitative study was conducted using focus groups and individual interviews with different healthcare providers at the University Cancer Center Hamburg, Germany. Focus groups and interviews were audio-recorded, transcribed and analyzed using conventional content analysis and descriptive statistics. N = 4 focus groups with a total of N = 25 participants and N = 17 individual interviews were conducted. Attitudes regarding SDM varied greatly between the different participants, especially concerning the definition of SDM, the attitude towards the degree of patient involvement in decision-making and assumptions about when SDM should take place. Experiences on how treatment decisions are currently made varied. Negative experiences included time and structural constraints, and a lack of (multidisciplinary) communication. Positive experiences comprised informed patients, involvement of relatives and a good physician-patient relationship. The results show that German healthcare providers in oncology have a range of attitudes that currently function as barriers towards the implementation of SDM. Also, their experiences on how decision-making is currently done reveal difficulties in actively involving patients in decision-making processes. It will be crucial to take these attitudes and experiences seriously and to subsequently disentangle existing misconceptions in future implementation programs.

  16. The disposal of radioactive waste

    International Nuclear Information System (INIS)

    Ormai, P.

    2006-01-01

    The first part shows different ways of 'producing' radioactive wastes, defines the wastes of small, medium and high activity and gives estimation on the quantity of the necessary capacities of waste disposal facilities. The modern radioactive waste disposal that is the integrated processing of the form of waste, the package, the technical facility and the embedding geological environment that guarantee the isolation together. Another factor is the lifetime of radioactive waste which means that any waste containing long lifetime waste in higher concentration than 400-4000 kBq/kg should be disposed geologically. Today the centre of debate disposal of radioactive waste is more social than technical. For this reason not only geological conditions and technical preparations, but social discussions and accepting communities are needed in selecting place of facilities. Now, the focus is on long term temporary disposal of high activity wastes, like burnt out heating elements. The final part of the paper summarizes the current Hungarian situation of disposal of radioactive wastes. (T-R.A.)

  17. Disposal of Radioactive Waste. Specific Safety Requirements

    International Nuclear Information System (INIS)

    2011-01-01

    This publication establishes requirements applicable to all types of radioactive waste disposal facility. It is linked to the fundamental safety principles for each disposal option and establishes a set of strategic requirements that must be in place before facilities are developed. Consideration is also given to the safety of existing facilities developed prior to the establishment of present day standards. The requirements will be complemented by Safety Guides that will provide guidance on good practice for meeting the requirements for different types of waste disposal facility. Contents: 1. Introduction; 2. Protection of people and the environment; 3. Safety requirements for planning for the disposal of radioactive waste; 4. Requirements for the development, operation and closure of a disposal facility; 5. Assurance of safety; 6. Existing disposal facilities; Appendices.

  18. Current practice patterns and knowledge among gynecologic surgeons of InterStim® programming after implantation.

    Science.gov (United States)

    Hobson, Deslyn T G; Gaskins, Jeremy T; Frazier, LaTisha; Francis, Sean L; Kinman, Casey L; Meriwether, Kate V

    2017-10-03

    The objective of this study was to describe surgeons' current practices in InterStim® programming after initial implantation and their knowledge of programming parameters. We hypothesized that surgeons performing their own reprogramming would have increased knowledge. We administered a written survey to attendees at the Society of Gynecologic Surgeons Scientific Meeting and analyzed those on which surgeons indicated they offer InterStim® care. The survey queried surgeon characteristics, experience with InterStim® implantation and programming, and clinical opinions regarding reprogramming and tested six knowledge-based questions about programming parameters. Correct response to all six questions was the primary outcome. One hundred and thirty-five of 407 (33%) attendees returned the survey, of which 99 met inclusion criteria. Most respondents (88 of 99; 89%) were between 36 and 60 years, 27 (73%) were women, 76 (77%) practiced in a university setting, and 76 (77%) were trained in Female Pelvic Medicine and Reconstructive Surgery (FPMRS). Surgeons who had InterStim® programming training were more likely to perform their own programming [15/46 (32%) vs 6/47 (13%), p = 0.03]. Most answered all knowledge-based questions correctly (62/90, 69%); no surgeon characteristics were significantly associated with this outcome. Most surgeons cited patient comfort (71/80, 89%) and symptom relief (64/80, 80%) as important factors when reprogramming, but no prevalent themes emerged on how and why surgeons change certain programming parameters. Surgeons who had formal InterStim® programming training are more likely to perform programming themselves. No surgeon characteristic was associated with improved programming knowledge. We found that surgeons prioritize patient comfort and symptoms when deciding to reprogram.

  19. Physiotherapy for plantar fasciitis: a UK-wide survey of current practice.

    Science.gov (United States)

    Grieve, Rob; Palmer, Shea

    2017-06-01

    To identify how United Kingdom (UK) physiotherapists currently diagnose, assess and manage plantar fasciitis in routine practice. Online questionnaire survey. Practising physiotherapists across the UK who treat patients with plantar fasciitis. Physiotherapists were approached via 'interactive Chartered Society of Physiotherapy (CSP)' online networks and an email database of clinical educators in South West England. An online questionnaire was developed by reviewing similar existing physiotherapy surveys and consultation with experienced musculoskeletal researchers/clinicians. Descriptive statistics were used to analyse the data. 285 physiotherapists responded, with 257 complete survey responses. Pain on palpation and early morning pain were the most common diagnostic criteria, with some physiotherapists using no formal test criteria. Advice (237/257, 92%), plantar fasciitis pathology education (207/257, 81%) and general stretching exercises (189/257, 74%) were most routinely used. Prefabricated orthotics, custom made orthotics and night splints were seldom always used. For the manual therapy approach, the most frequently used modalities were massage, myofascial release, specific soft tissue mobilisations and myofascial trigger point therapy. Commonly used outcome measures were pain assessment, functional tests and range of movement. Physiotherapists appeared to follow most of the established diagnostic criteria for PF, but have not followed established outcome measure guidelines. Advice as well as education with an emphasis on self-management including calf/hamstring stretching was the most commonly reported treatment approach. There was uncertainty whether this approach accurately reflected clinical practice used throughout the UK, owing to potential response bias/unknown response rate and the low number of patients with PF treated by the respondents. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  20. Design and analysis of group-randomized trials in cancer: A review of current practices.

    Science.gov (United States)

    Murray, David M; Pals, Sherri L; George, Stephanie M; Kuzmichev, Andrey; Lai, Gabriel Y; Lee, Jocelyn A; Myles, Ranell L; Nelson, Shakira M

    2018-06-01

    The purpose of this paper is to summarize current practices for the design and analysis of group-randomized trials involving cancer-related risk factors or outcomes and to offer recommendations to improve future trials. We searched for group-randomized trials involving cancer-related risk factors or outcomes that were published or online in peer-reviewed journals in 2011-15. During 2016-17, in Bethesda MD, we reviewed 123 articles from 76 journals to characterize their design and their methods for sample size estimation and data analysis. Only 66 (53.7%) of the articles reported appropriate methods for sample size estimation. Only 63 (51.2%) reported exclusively appropriate methods for analysis. These findings suggest that many investigators do not adequately attend to the methodological challenges inherent in group-randomized trials. These practices can lead to underpowered studies, to an inflated type 1 error rate, and to inferences that mislead readers. Investigators should work with biostatisticians or other methodologists familiar with these issues. Funders and editors should ensure careful methodological review of applications and manuscripts. Reviewers should ensure that studies are properly planned and analyzed. These steps are needed to improve the rigor and reproducibility of group-randomized trials. The Office of Disease Prevention (ODP) at the National Institutes of Health (NIH) has taken several steps to address these issues. ODP offers an online course on the design and analysis of group-randomized trials. ODP is working to increase the number of methodologists who serve on grant review panels. ODP has developed standard language for the Application Guide and the Review Criteria to draw investigators' attention to these issues. Finally, ODP has created a new Research Methods Resources website to help investigators, reviewers, and NIH staff better understand these issues. Published by Elsevier Inc.

  1. Current practices related to family presence during acute deterioration in adult emergency department patients.

    Science.gov (United States)

    Youngson, Megan J; Currey, Judy; Considine, Julie

    2017-11-01

    To explore the characteristics of and interactions between clinicians, patients and family members during management of the deteriorating adult patient in the emergency department. Previous research into family presence during resuscitation has identified many positive outcomes when families are included. However, over the last three decades the epidemiology of acute clinical deterioration has changed, with a decrease in in-hospital cardiac arrests and an increase in acute clinical deterioration. Despite the decrease in cardiac arrests, research related to family presence continues to focus on care during resuscitation rather than care during acute deterioration. Descriptive exploratory study using nonparticipatory observation. Five clinical deterioration episodes were observed within a 50-bed, urban, Australian emergency department. Field notes were taken using a semistructured tool to allow for thematic analysis. Presence, roles and engagement describe the interactions between clinicians, family members and patients while family are present during a patient's episode of deterioration. Presence was classified as no presence, physical presence and therapeutic presence. Clinicians and family members moved through primary, secondary and tertiary roles during patients' deterioration episode. Engagement was observed to be superficial or deep. There was a complex interplay between presence, roles and engagement with each influencing which form the other could take. Current practices of managing family during episodes of acute deterioration are complex and multifaceted. There is fluid interplay between presence, roles and engagement during a patient's episode of deterioration. This study will contribute to best practice, provide a strong foundation for clinician education and present opportunities for future research. © 2017 John Wiley & Sons Ltd.

  2. A discussion of current issues and concepts in the practice of skull-photo/craniofacial superimposition.

    Science.gov (United States)

    Gordon, G M; Steyn, M

    2016-05-01

    A recent review paper on cranio-facial superimposition (CFS) stated that "there have been specific conceptual variances" from the original methods used in the practice of skull-photo superimposition, leading to poor results as far as accuracy is concerned. It was argued that the deviations in the practice of the technique have resulted in the reduced accuracies (for both failure to include and failure to exclude) that are noted in several recent studies. This paper aims to present the results from recent research to highlight the advancement of skull-photo/cranio-facial superimposition, and to discuss some of the issues raised regarding deviations from original techniques. The evolving methodology of CFS is clarified in context with the advancement of technology, forensic science and specifically within the field of forensic anthropology. Developments in the skull-photo/cranio-facial superimposition techniques have largely focused on testing reliability and accuracy objectively. Techniques now being employed by forensic anthropologists must conform to rigorous scientific testing and methodologies. Skull-photo/cranio-facial superimposition is constantly undergoing accuracy and repeatability testing which is in line with the principles of the scientific method and additionally allows for advancement in the field. Much of the research has indicated that CFS is useful in exclusion which is consistent with the concept of Popperian falsifiability - a hypothesis and experimental design which is falsifiable. As the hypothesis is disproved or falsified, another evolves to replace it and explain the new observations. Current and future studies employing different methods to test the accuracy and reliability of skull-photo/cranio-facial superimposition will enable researchers to establish the contribution the technique can have for identification purposes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. Current and Best Practices of Genetic Testing for Maturity Onset Diabetes of the Young: Views of Professional Experts

    NARCIS (Netherlands)

    van der Zwaag, A.M.; Weinreich, S.S.; Bosma, A.R.; Rigter, T.; Losekoot, M.; Henneman, L.; Cornel, M.C.

    2015-01-01

    Aims: Currently, many patients with maturity onset diabetes of the young (MODY) are undiagnosed or misdiagnosed with type 1 or 2 diabetes. This study aims to assess professional experts' views on factors which may influence the current practice of genetic testing for MODY and to explore next steps

  4. The relevance of the early history of probability theory to current risk assessment practices in mental health care.

    Science.gov (United States)

    Large, Matthew

    2013-12-01

    Probability theory is at the base of modern concepts of risk assessment in mental health. The aim of the current paper is to review the key developments in the early history of probability theory in order to enrich our understanding of current risk assessment practices.

  5. Radioactive waste disposal

    International Nuclear Information System (INIS)

    Petit, J.C.

    1998-04-01

    A deep gap, reflecting a persisting fear, separates the viewpoints of the experts and that of the public on the issue of the disposal of nuclear WASTES. The history of this field is that of the proliferation with time of spokesmen who pretend to speak in the name of the both humans and non humans involved. Three periods can be distinguished: 1940-1970, an era of contestation and confusion when the experts alone represents the interest of all; 1970-1990, an era of contestation and confusion when spokespersons multiply themselves, generating the controversy and the slowing down of most technological projects; 1990-, an era of negotiation, when viewpoints, both technical and non technical, tend to get closer and, let us be optimistic, leading to the overcome of the crisis. We show that, despite major differences, the options and concepts developed by the different actors are base on two categories of resources, namely Nature and Society, and that the consensus is built up through their 'hydridation'. we show in this part that the perception of nuclear power and, in particular of the underground disposal of nuclear wastes, involves a very deep psychological substrate. Trying to change mentalities in the domain by purely scientific and technical arguments is thus in vain. The practically instinctive fear of radioactivity, far from being due only to lack of information (and education), as often postulated by scientists and engineers, is rooted in archetypical structures. These were, without doubt, reactivated in the 40 s by the traumatizing experience of the atomic bomb. In addition, anthropological-linked considerations allow us to conclude that he underground disposal of wastes is seen as a 'rape' and soiling of Mother Earth. This contributes to explaining, beyond any rationality, the refusal of this technical option by some persons. However, it would naturally be simplistic and counter-productive to limit all controversy in this domain to these psychological aspects

  6. Low level waste disposal

    International Nuclear Information System (INIS)

    Barthoux, A.

    1985-01-01

    Final disposal of low level wastes has been carried out for 15 years on the shallow land disposal of the Manche in the north west of France. Final participant in the nuclear energy cycle, ANDRA has set up a new waste management system from the production center (organization of the waste collection) to the disposal site including the setting up of a transport network, the development of assessment, additional conditioning, interim storage, the management of the disposal center, records of the location and characteristics of the disposed wastes, site selection surveys for future disposals and a public information Department. 80 000 waste packages representing a volume of 20 000 m 3 are thus managed and disposed of each year on the shallow land disposal. The disposal of low level wastes is carried out according to their category and activity level: - in tumuli for very low level wastes, - in monoliths, a concrete structure, of the packaging does not provide enough protection against radioactivity [fr

  7. Family medicine practice in Saudi Arabia: The current situation and Proposed Strategic Directions Plan 2020.

    Science.gov (United States)

    Al-Khaldi, Yahia M; Al-Ghamdi, Essam A; Al-Mogbil, Tariq I; Al-Khashan, Hesham I

    2017-01-01

    The objectives of this study were to assess the current situation of the teaching and training of undergraduate and postgraduate programs in family medicine in KSA, assess the current practice of family medicine, and draw a roadmap to achieve Saudi vision 2020. This study was conducted with the support and collaboration of the Primary Health Care Department of the Ministry of Health, Saudi Arabia, and World Health Organization (EMRO) in November 2015. Based on the literature review of previous studies conducted for similar purposes, relevant questionnaires were developed. These consisted of four forms, each of which was directed at a different authority to achieve the above-mentioned objectives. Data of all questionnaires were coded, entered, and analyzed using SPSS version 16. There are 2282 primary health-care centers (PHCCs), 60% of which are in rural areas. More than half of the PHCCs have a laboratory and more than one-third have a Radiology Department. Out of the 6107 physicians, 636 are family physicians (10%). All medical colleges have a family medicine department with a total staff of 170 medical teachers. Thirteen departments run family medicine courses of 4-8 weeks' duration for students. Fourteen colleges have internship programs in family medicine and four colleges have postgraduate centers for family medicine (27%). There are 95 training centers for Saudi Board (Saudi Board of Family Medicine [SBFM]) and 68 centers for Saudi Diploma (Saudi Diploma of Family Medicine [SDFM]). The total number of trainers was 241, while the total trainees were 756 in SBFM and 137 in SDFM. This survey showed that there is a shortage of qualified family physicians in all health sectors in Saudi Arabia as a result of the lack of a strategic plan for the training of family physicians. A national strategic plan with specific objectives and an explicit budget are necessary to deal with this shortage and improve the quality of health-care services at PHCCs.

  8. Biological variation in musculoskeletal injuries: current knowledge, future research and practical implications.

    Science.gov (United States)

    Collins, Malcolm; September, Alison V; Posthumus, Michael

    2015-12-01

    Evidence from familial and genetic association studies have reported that DNA sequence variants play an important role, together with non-genetic factors, in the aetiology of both exercise-associated and occupational-associated acute and chronic musculoskeletal soft tissue injuries. The associated variants, which have been identified to date, may contribute to the interindividual variation in the structure and, by implication, mechanical properties of the collagen fibril and surrounding matrix within musculoskeletal soft tissues, as well as their response to mechanical loading and other stimuli. Future work should focus on the establishment of multidisciplinary international consortia for the identification of biologically relevant variants involved in modulating injury risk. These consortia will improve the limitations of the published hypothesis-driven genetic association studies, since they will allow resources to be pooled in recruiting large well-characterised cohorts required for whole-genome screening. Finally, clinicians and coaches need to be aware that many direct-to-consumer companies are currently marketing genetic tests directly to athletes without it being requested by an appropriately qualified healthcare professional, and without interpretation alongside other clinical indicators or lifestyle factors. These specific genetic tests are premature and are not necessarily required to evaluate susceptibility to musculoskeletal soft tissue injury. Current practice should rather consider susceptibility through known risk factors such as a positive family history of a specific injury, a history of other tendon and/or ligament injuries and participation in activities associated with the specific musculoskeletal injuries. Potential susceptible athletes may then be individually managed to reduce their risk profile. 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/

  9. Australian general practitioners’ current practice for chronic kidney disease (CKD detection and management

    Directory of Open Access Journals (Sweden)

    Marie Ludlow

    2017-06-01

    Full Text Available Background Guidelines for early detection of chronic kidney disease (CKD emphasise regular testing of kidney health in high-risk individuals. However, evidence suggests that CKD is not being adequately detected or appropriately managed in primary care. Aims Assess Australian general practitioners’ (GP current practice in relation to CKD detection and management. Methods This was a cross-sectional study utilising a random sample of GPs identified by interrogation of the national online telephone directory, and stratified by geographical location. Data collection occurred between October 2014 and January 2015. Of 2,815 eligible contacts, the final response rate was 23 per cent. Results Of the 656 respondents, over 90 per cent assessed kidney health at least annually in people with diabetes or high blood pressure, and 71 per cent correctly assessed kidney health every 3–6 months in a patient with Stage 3b CKD. The tests most commonly used to assess kidney health were serum creatinine (with eGFR, blood pressure and urine albumin creatinine ratio. The most commonly reported CKD management strategies were ‘blood pressure reduction using pharmacological agents’ (81 per cent and ‘glycaemic control if diabetes present’ (64 per cent. Knowledge testing highlighted that 32 per cent of respondents were not able to correctly identify how to properly assess absolute cardiovascular risk, and this was significantly more common in more experienced GPs (p=0.003. Conclusion The results indicate that Australian GPs are mainly practising in accordance with current guidelines for detection and management of patients with CKD, but with room for improvement in some areas

  10. Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review

    Directory of Open Access Journals (Sweden)

    Patrícia do Carmo Silva Parreira

    2014-03-01

    Full Text Available Questions: Is Kinesio Taping more effective than a sham taping/placebo, no treatment or other interventions in people with musculoskeletal conditions? Is the addition of Kinesio Taping to other interventions more effective than other interventions alone in people with musculoskeletal conditions? Design: Systematic review of randomised trials. Participants: People with musculoskeletal conditions. Intervention: Kinesio Taping was compared with sham taping/placebo, no treatment, exercises, manual therapy and conventional physiotherapy. Outcome measures: Pain intensity, disability, quality of life, return to work, and global impression of recovery. Results: Twelve randomised trials involving 495 participants were included in the review. The effectiveness of the Kinesio Taping was tested in participants with: shoulder pain in two trials; knee pain in three trials; chronic low back pain in two trials; neck pain in three trials; plantar fasciitis in one trial; and multiple musculoskeletal conditions in one trial. The methodological quality of eligible trials was moderate, with a mean of 6.1 points on the 10-point PEDro Scale score. Overall, Kinesio Taping was no better than sham taping/placebo and active comparison groups. In all comparisons where Kinesio Taping was better than an active or a sham control group, the effect sizes were small and probably not clinically significant or the trials were of low quality. Conclusion: This review provides the most updated evidence on the effectiveness of the Kinesio Taping for musculoskeletal conditions. The current evidence does not support the use of this intervention in these clinical populations. PROSPERO registration: CRD42012003436. [Parreira PdCS, Costa LdCM, Hespanhol Junior LC, Lopes AD, Costa LOP (2014 Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review. Journal of Physiotherapy 60: 31–39

  11. Prevention of Backover Fatalities in Highway Work Zones: A Synthesis of Current Practices and Recommendations

    Directory of Open Access Journals (Sweden)

    Wei Fan

    2014-12-01

    Full Text Available The purpose of this paper is to synthesize current practices and procedures on the prevention of backing fatalities in highway work zones. First, general work zone safety hazards are reviewed, particularly blind areas are identified. Second, engineering controls currently in use are examined and explained to help understand what steps can be taken to prevent future backing fatalities. Third, administrative controls (including signalers, drivers, and workers-on-foot training are also discussed. Fourth, existing technology controls are reviewed for use in aiding equipment operators in identifying when pedestrian personnel are in dangerous areas around their equipment (i.e., back-up camera, radar. Fifth, recommendations are made based on the comprehensive review of the backover fatality prevention techniques in construction work zones and the conducted testing results of several commercially available systems. Recommendations on engineering and technology controls are discussed, with detailed information such as improving internal traffic control plans, and integrating technology with traffic control plans. Information and drawings are provided to illustrate how to design work zones, and the internal traffic flow diagrams are created using the integrated technology available, and site specific characteristics. The drawings represent examples of using different types of technology, in different scenarios using the proper legend, as well as using the proper general and technology notes to help explain the traffic control plan, ensuring that full comprehension is made. Recommendations on administrative controls are also given such as how to conduct safety meetings, electing safety officers, how to set regulations and guidelines for workers, and how to handle training. Training should be used as a backover fatality prevention method for pedestrian workers, flaggers, spotters, and equipment operators. Finally, a summary and discussion of future research

  12. Screening mammography among nursing home residents in the United States: Current guidelines and practice.

    Science.gov (United States)

    Mack, Deborah S; Epstein, Mara M; Dubé, Catherine; Clark, Robin E; Lapane, Kate L

    2018-06-04

    United States (US) guidelines regarding when to stop routine breast cancer screening remain unclear. No national studies to-date have evaluated the use of screening mammography among US long-stay nursing home residents. This cross-sectional study was designed to identify prevalence, predictors, and geographic variation of screening mammography among that population in the context of current US guidelines. Screening mammography prevalence, identified with Physician/Supplier Part B claims and stratified by guideline age classification (65-74, ≥75 years), was estimated for all women aged ≥65 years residing in US Medicare- and Medicaid- certified nursing homes (≥1 year) with an annual Minimum Data Set (MDS) 3.0 assessment, continuous Medicare Part B enrollment, and no clinical indication for screening mammography as of 2011 (n = 389,821). The associations between resident- and regional- level factors, and screening mammography, were estimated by crude and adjusted prevalence ratios from robust Poisson regressions clustered by facility. Women on average were 85.4 (standard deviation ±8.1) years old, 77.9% were disabled, and 76.3% cognitively impaired. Screening mammography prevalence was 7.1% among those aged 65-74 years (95% Confidence Interval (CI): 6.8%-7.3%) and 1.7% among those ≥75 years (95% CI, 1.7%-1.8%), with geographic variation observed. Predictors of screening in both age groups included race, cognitive impairment, frailty, hospice, and some comorbidities. These results shed light on the current screening mammography practices in US nursing homes. Thoughtful consideration about individual screening recommendations and the implementation of more clear guidelines for this special population are warranted to prevent overscreening. Copyright © 2018 Elsevier Inc. All rights reserved.

  13. Current good manufacturing practice production of an oncolytic recombinant vesicular stomatitis viral vector for cancer treatment.

    Science.gov (United States)

    Ausubel, L J; Meseck, M; Derecho, I; Lopez, P; Knoblauch, C; McMahon, R; Anderson, J; Dunphy, N; Quezada, V; Khan, R; Huang, P; Dang, W; Luo, M; Hsu, D; Woo, S L C; Couture, L

    2011-04-01

    Vesicular stomatitis virus (VSV) is an oncolytic virus currently being investigated as a promising tool to treat cancer because of its ability to selectively replicate in cancer cells. To enhance the oncolytic property of the nonpathologic laboratory strain of VSV, we generated a recombinant vector [rVSV(MΔ51)-M3] expressing murine gammaherpesvirus M3, a secreted viral chemokine-binding protein that binds to a broad range of mammalian chemokines with high affinity. As previously reported, when rVSV(MΔ51)-M3 was used in an orthotopic model of hepatocellular carcinoma (HCC) in rats, it suppressed inflammatory cell migration to the virus-infected tumor site, which allowed for enhanced intratumoral virus replication leading to increased tumor necrosis and substantially prolonged survival. These encouraging results led to the development of this vector for clinical translation in patients with HCC. However, a scalable current Good Manufacturing Practice (cGMP)-compliant manufacturing process has not been described for this vector. To produce the quantities of high-titer virus required for clinical trials, a process that is amenable to GMP manufacturing and scale-up was developed. We describe here a large-scale (50-liter) vector production process capable of achieving crude titers on the order of 10(9) plaque-forming units (PFU)/ml under cGMP. This process was used to generate a master virus seed stock and a clinical lot of the clinical trial agent under cGMP with an infectious viral titer of approximately 2 × 10(10) PFU/ml (total yield, 1 × 10(13) PFU). The lot has passed all U.S. Food and Drug Administration-mandated release testing and will be used in a phase 1 clinical translational trial in patients with advanced HCC.

  14. French surface disposal experience. The disposal of large waste

    International Nuclear Information System (INIS)

    Dutzer, Michel; Lecoq, Pascal; Duret, Franck; Mandoki, Robert

    2006-01-01

    More than 90 percent of the volume of radioactive waste that are generated in France can be managed in surface disposal facilities. Two facilities are presently operated by ANDRA: the Centre de l'Aube disposal facility that is dedicated to low and intermediate short lived waste and the Morvilliers facility for very low level waste. The Centre de l'Aube facility was designed at the end of the years 1980 to replace the Centre de la Manche facility that ended operation in 1994. In order to achieve as low external exposure as possible for workers it was decided to use remote handling systems as much as possible. Therefore it was necessary to standardize the types of waste containers. But taking into account the fact that these waste were conditioned in existing facilities, it was not possible to change a major part of existing packages. As a consequence, 6 mobile roofs were constructed to handle 12 different types of waste packages in the disposal vaults. The scope of Centre de l'Aube was mainly to dispose operational waste. However some packages, as 5 or 10 m 3 metallic boxes, could be used for larger waste generated by decommissioning activities. The corresponding flow was supposed to be small. After the first years of operations, it appeared interesting to develop special procedures to dispose specific large waste in order to avoid external exposure costly cutting works in the generating facilities. A 40 m 3 box and a large remote handling device were disposed in vaults that were currently used for other types of packages. Such a technique could not be used for the disposal of vessel heads that were replaced in 55 pressurised water power reactors. The duration of disposal and conditioning operation was not compatible with the flow of standard packages that were delivered in the vaults. Therefore a specific type of vault was designed, including handling and conditioning equipment. The first pressure vessel head was delivered on the 29 of July 2004, 6 heads have been

  15. On the Need for Rethinking Current Practice that Highlights Goal Achievement Risk in an Enterprise Context.

    Science.gov (United States)

    Aven, Eyvind; Aven, Terje

    2015-09-01

    This article addresses the issue of how performance and risk management can complement each other in order to enhance the management of an enterprise. Often, we see that risk management focuses on goal achievements and not the enterprise risk related to its activities in the value chain. The statement "no goal, no risk" is a common misconception. The main aim of the article is to present a normative model for describing the links between performance and risk, and to use this model to give recommendations on how to best structure and plan the management of an enterprise in situations involving risk and uncertainties. The model, which has several novel features, is based on the interaction between different types of risk management (enterprise risk management, task risk management, and personal risk management) and a structure where the enterprise risk management overrules both the task and personal risk management. To illustrate the model we use the metaphor of a ship, where the ship is loaded with cash-generating activities and has a direction over time determined by the overall strategic objectives. Compared to the current enterprise risk management practice, the model and related analysis are founded on a new perspective on risk, highlighting knowledge and uncertainties beyond probabilities. © 2015 Society for Risk Analysis.

  16. Current contraceptive management in Australian general practice: an analysis of BEACH data.

    Science.gov (United States)

    Mazza, Danielle; Harrison, Christopher; Taft, Angela; Brijnath, Bianca; Britt, Helena; Hobbs, Melissa; Stewart, Kay; Hussainy, Safeera

    2012-07-16

    To determine current contraceptive management by general practitioners in Australia. Analysis of data from a random sample of 3910 Australian GPs who participated in the Bettering the Evaluation and Care of Health (BEACH) survey, a continuous cross-sectional survey of GP activity, between April 2007 and March 2011. Consultations with female patients aged 12-54 years that involved all forms of contraception were analysed. GP and patient characteristics associated with the management of contraception; types of contraception used; rates of encounters involving emergency contraception. Increased age, ethnicity, Indigenous status and holding a Commonwealth Health Care Card were significantly associated with low rates of encounters involving management of contraception. The combined oral contraceptive pill was the most frequently prescribed method of contraception, with moderate prescription of long-acting reversible contraception (LARC), especially among women aged 34-54 years. Rates of consultations concerned with emergency contraception were low, but involved high rates of counselling, advice or education (48%) compared with encounters for general contraception (> 20%). A shift towards prescribing LARC, as recommended in clinical guidelines, has yet to occur in Australian general practice. Better understanding of patient and GP perspectives on contraceptive choices could lead to more effective contraceptive use.

  17. Current End-of-Life Care Needs and Care Practices in Acute Care Hospitals

    Directory of Open Access Journals (Sweden)

    Amy J. Thurston

    2011-01-01

    Full Text Available A descriptive-comparative study was undertaken to examine current end-of-life care needs and practices in hospital. A chart review for all 1,018 persons who died from August 1, 2008 through July 31, 2009 in two full-service Canadian hospitals was conducted. Most decedents were elderly (73.8% and urbanite (79.5%, and cancer was the most common diagnosis (36.2%. Only 13.8% had CPR performed at some point during this hospitalization and 8.8% had CPR immediately preceding death, with 87.5% having a DNR order and 30.8% providing an advance directive. Most (97.3% had one or more life-sustaining technologies in use at the time of death. These figures indicate, when compared to those in a similar mid-1990s Canadian study, that impending death is more often openly recognized and addressed. Technologies continue to be routinely but controversially used. The increased rate of end-stage CPR from 2.9% to 8.8% could reflect a 1994+ shift of expected deaths out of hospital.

  18. Current status of information literacy instruction practices in medical libraries of Pakistan.

    Science.gov (United States)

    Ullah, Midrar; Ameen, Kanwal

    2014-10-01

    The research explored the current practices of information literacy (IL) instruction in medical libraries of Pakistan. A semi-structured questionnaire was mailed to the head librarians of all 114 academic medical libraries in Pakistan. It investigated the types of IL instruction provided, topics covered, methods of delivery and assessment, level of integration in the curriculum, and level of collaboration with teaching staff. The study revealed that 74% of the respondents had offered some types of IL instruc