Identifying barriers to and facilitators of tuberculosis contact investigation in Kampala, Uganda: a behavioral approach.

Science.gov (United States)

Ayakaka, Irene; Ackerman, Sara; Ggita, Joseph M; Kajubi, Phoebe; Dowdy, David; Haberer, Jessica E; Fair, Elizabeth; Hopewell, Philip; Handley, Margaret A; Cattamanchi, Adithya; Katamba, Achilles; Davis, J Lucian

2017-03-09

The World Health Organization recommends routine household tuberculosis contact investigation in high-burden countries but adoption has been limited. We sought to identify barriers to and facilitators of TB contact investigation during its introduction in Kampala, Uganda. We collected cross-sectional qualitative data through focus group discussions and interviews with stakeholders, addressing three core activities of contact investigation: arranging household screening visits through index TB patients, visiting households to screen contacts and refer them to clinics, and evaluating at-risk contacts coming to clinics. We analyzed the data using a validated theory of behavior change, the Capability, Opportunity, and Motivation determine Behavior (COM-B) model, and sought to identify targeted interventions using the related Behavior Change Wheel implementation framework. We led seven focus-group discussions with 61 health-care workers, two with 21 lay health workers (LHWs), and one with four household contacts of newly diagnosed TB patients. We, in addition, performed 32 interviews with household contacts from 14 households of newly diagnosed TB patients. Commonly noted barriers included stigma, limited knowledge about TB among contacts, insufficient time and space in clinics for counselling, mistrust of health-center staff among index patients and contacts, and high travel costs for LHWs and contacts. The most important facilitators identified were the personalized and enabling services provided by LHWs. We identified education, persuasion, enablement, modeling of health-positive behaviors, incentivization, and restructuring of the service environment as relevant intervention functions with potential to alleviate barriers to and enhance facilitators of TB contact investigation. The use of a behavioral theory and a validated implementation framework provided a comprehensive approach for systematically identifying barriers to and facilitators of TB contact

Electron tunneling across a tunable potential barrier

International Nuclear Information System (INIS)

Mangin, A; Anthore, A; Rocca, M L Della; Boulat, E; Lafarge, P

2009-01-01

We present an experiment where the elementary quantum electron tunneling process should be affected by an independent gate voltage parameter. We have realized nanotransistors where the source and drain electrodes are created by electromigration inducing a nanometer sized gap acting as a tunnel barrier. The barrier potential shape is in first approximation considered trapezoidal. The application of a voltage to the gate electrode close to the barrier region can in principle affect the barrier shape. Simulations of the source drain tunnel current as a function of the gate voltage predict modulations as large as one hundred percent. The difficulty of observing the predicted behaviour in our samples might be due to the peculiar geometry of the realized tunnel junction.

Reflectionlessness, kurtosis and top curvature of potential barriers

International Nuclear Information System (INIS)

Ahmed, Zafar

2006-01-01

Apart from the rectangular barrier, other barriers having a single maximum generally display reflectivity, R(E), as a smoothly decreasing function of energy. We conjecture that symmetric potential barriers with a single maximum entail zeros or sharp minima in R(E) provided they have either their coefficient of kurtosis lying in the range (1.8, 3.0), or their top curvature as zero, or both

Use of participant focus groups to identify barriers and facilitators to worksite exercise therapy adherence in randomized controlled trials involving firefighters

Directory of Open Access Journals (Sweden)

Mayer JM

2013-03-01

Full Text Available John M Mayer,1 James L Nuzzo,1 Simon Dagenais2 1School of Physical Therapy and Rehabilitation Sciences, College of Medicine, University of South Florida, Tampa, FL, 2Palladian Health, West Seneca, NY, USA Background: Firefighters are at increased risk for back injuries, which may be mitigated through exercise therapy to increase trunk muscle endurance. However, long-term adherence to exercise therapy is generally poor, limiting its potential benefits. Focus groups can be used to identify key barriers and facilitators to exercise adherence among study participants. Objective: To explore barriers and facilitators to worksite exercise therapy adherence among firefighters to inform future randomized controlled trials (RCTs. Methods: Participants enrolled in a previous RCT requiring twice-weekly worksite exercise therapy for 24 weeks were asked to take part in moderated focus group discussions centered on eight open-ended questions related to exercise adherence. Responses were analyzed qualitatively using a social ecological framework to identify key intrapersonal, interpersonal, and institutional barriers and potential facilitators to exercise adherence. Results: A total of 27 participants were included in the four focus group discussions, representing 50% of those assigned to a worksite exercise therapy group in the previous RCT, in which only 67% of scheduled exercise therapy sessions were completed. Lack of self-motivation was cited as the key intrapersonal barrier to adherence, while lack of peer support was the key interpersonal barrier reported, and lack of time to exercise during work shifts was the key institutional barrier identified. Conclusion: Focus group discussions identified both key barriers and potential facilitators to increase worksite exercise therapy adherence among firefighters. Future studies should consider educating and reminding participants about the benefits of exercise, providing individual and group incentives based on

Estimates for diffusion barriers and atomic potentials in MGO

International Nuclear Information System (INIS)

Skala, L.; Kenkre, V.M.

1991-01-01

In this paper, as part of a program of investigation of microwave sintering, self-consistent CNDO/2 calculations are presented for diffusion barriers and potentials for the motion of interstitial atoms and vacancies in MgO. Clusters of 30 atoms are used in the calculations. Activation energies, diffusion barriers, shape of the potentials and electron densities are obtained

Comparative studies for different proximity potentials applied to sub-barrier fusion reactions

Energy Technology Data Exchange (ETDEWEB)

Zhang, G.L. [Beihang University, School of Physics and Nuclear Energy Engineering, Beijing (China); Beihang University, Key Laboratory of Micro-Nano Measurement-Manipulation and Physics (Ministry of Education), Beijing (China); Qu, W.W. [Medical College of Soochow University, School of Radiation Medicine and Protection, Soochow (China); Guo, M.F.; Qian, J.Q. [Beihang University, School of Physics and Nuclear Energy Engineering, Beijing (China); Zhang, H.Q. [China Institute of Atomic Energy, Beijing (China); Wolski, R. [Henryk Niewodniczanski Institute of Nuclear Physics PAS, Cracow (Poland)

2016-02-15

Coulomb barrier heights calculated by using 14 different versions of proximity potentials are studied and applied for experimental data of fusion in terms of a recently proposed energy scaling approach. The results show that the descriptions of proximity potentials 77 and 88 for the barrier heights seem to be closest to the values required by the systematics. On the basis of proximity potential 77, the parameterized formulas of the barrier height and radius are obtained. These formulas can calculate the barrier positions and barrier heights reasonably well within the error, respectively. Thus it provides a simple and direct way to calculate the barrier positions and barrier heights for heavy-ion fusion reactions. (orig.)

Identifying and responding to barriers impacting women educators ...

African Journals Online (AJOL)

Drawing on these reflections, this article explores the notion of academic citizenship as it relates to the status and practice of these five educators who teach at various institutions of higher education in Southern Africa. The article is divided into two parts. a) Part 1 identifies the barriers impacting the participants. It draws on ...

Identifying Multilevel Barriers to Tobacco Intervention in Postdoctoral Dental Education.

Science.gov (United States)

Albert, David A; Bruzelius, Emilie; Ward, Angela; Gordon, Judith S

2016-04-01

The aims of this mixed-methods study were to assess tobacco treatment behaviors among residents and faculty in dental specialty postdoctoral programs and to explore factors in training and practice related to tobacco treatment education. Surveys and focus groups were conducted with a convenience sample of participants at three postdoctoral residency programs in New York City. Surveys assessed tobacco cessation training and behaviors. Focus groups explored barriers to implementing tobacco cessation treatment in educational settings. Data were collected between May and December 2013. Among the 160 faculty and residents identified as potentially eligible for the study, 60 were invited by program directors to participate, and 50 subsequently completed the survey and participated in a focus group (response rate of 31.3%). Survey results indicated high levels of asking patients about tobacco use and advising patients to quit. In contrast, specific tobacco cessation assistance and follow-up care occurred less frequently. There were statistically significant differences in tobacco cessation intervention across the specialties surveyed, but not between residents and faculty. Focus group comments were grouped into three broad areas: clinician factors, organizational support, and structural and contextual factors. Focus group results indicated that participants experienced significant organizational and structural barriers to learning about and providing tobacco treatment. Participants from each specialty indicated that multi-level barriers impeded their provision of evidence-based tobacco cessation interventions in postdoctoral educational settings. They suggested that didactic education should be reinforced by organizational- and systems-level changes to facilitate comprehensive tobacco education and effective cessation treatment in future dental practice.

Renewable energy costs, potentials, barriers: Conceptual issues

International Nuclear Information System (INIS)

Verbruggen, Aviel; Fischedick, Manfred; Moomaw, William; Weir, Tony; Nadai, Alain; Nilsson, Lars J.; Nyboer, John; Sathaye, Jayant

2010-01-01

Renewable energy can become the major energy supply option in low-carbon energy economies. Disruptive transformations in all energy systems are necessary for tapping widely available renewable energy resources. Organizing the energy transition from non-sustainable to renewable energy is often described as the major challenge of the first half of the 21st century. Technological innovation, the economy (costs and prices) and policies have to be aligned to achieve full renewable energy potentials, and barriers impeding that growth need to be removed. These issues are also covered by IPCC's special report on renewable energy and climate change to be completed in 2010. This article focuses on the interrelations among the drivers. It clarifies definitions of costs and prices, and of barriers. After reviewing how the third and fourth assessment reports of IPCC cover mitigation potentials and commenting on definitions of renewable energy potentials in the literature, we propose a consistent set of potentials of renewable energy supplies.

Identifying and intervening on barriers to healthcare access among members of a small Korean community in the southern USA.

Science.gov (United States)

Rhodes, Scott D; Song, Eunyoung; Nam, Sang; Choi, Sarah J; Choi, Seungyong

2015-04-01

We used community-based participatory research (CBPR) to explore barriers to healthcare access and utilization and identify potentially effective intervention strategies to increase access among members of the Korean community in North Carolina (NC). Our CBPR partnership conducted 8 focus groups with 63 adult Korean immigrants in northwest NC and 15 individual in-depth interviews and conducted an empowerment-based community forum. We identified 20 themes that we organized into four domains, including practical barriers to health care, negative perceptions about care, contingencies for care, and provider misconceptions about local needs. Forum attendees identified four strategies to improve Korean community health. Despite the implementation of the Patient Protection and Affordable Care Act (ACA), many Korean community members will continue to remain uninsured, and among those who obtain insurance, many barriers will remain. It is imperative to ensure the health of this highly neglected and vulnerable community. Potential strategies include the development of (1) low-literacy materials to educate members of the Korean community about how to access healthcare services, (2) lay health advisor programs to support navigation of service access and utilization, (3) church-based programming, and (4) provider education to reduce misconceptions about Korean community needs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Renewable energy in South Africa: Potentials, barriers and options for support

International Nuclear Information System (INIS)

Pegels, Anna

2010-01-01

The challenge of transforming entire economies is enormous; even more so if a country is as fossil fuel based and emission intensive as South Africa. However, in an increasingly carbon constrained world and already now facing climate change impacts South Africa has to reduce greenhouse gas emissions intensity soon and decidedly. The South African electricity sector is a vital part of the economy and at the same time contributes most to the emissions problem. First steps have been taken by the South African government to enhance energy efficiency and promote renewable energy, however, they fail to show large-scale effects. This paper seeks to identify the relevant barriers to renewable energy investments and, based on experience from other countries, provide policy recommendations. The major barrier identified in the paper is based on the economics of renewable energy technologies, i.e. their cost and risk structures, two main factors in investment planning. As a solution, the South African government introduced several renewable energy support measures, such as a feed-in tariff. The paper discusses the potential and possible shortcomings of this and other existing support schemes and identifies complementing measures on a national scale.

Renewable energy in South Africa. Potentials, barriers and options for support

Energy Technology Data Exchange (ETDEWEB)

Pegels, Anna [German Development Institute/Deutsches Institut fuer Entwicklungspolitik, Tulpenfeld 6, 53113 Bonn (Germany)

2010-09-15

The challenge of transforming entire economies is enormous; even more so if a country is as fossil fuel based and emission intensive as South Africa. However, in an increasingly carbon constrained world and already now facing climate change impacts South Africa has to reduce greenhouse gas emissions intensity soon and decidedly. The South African electricity sector is a vital part of the economy and at the same time contributes most to the emissions problem. First steps have been taken by the South African government to enhance energy efficiency and promote renewable energy, however, they fail to show large-scale effects. This paper seeks to identify the relevant barriers to renewable energy investments and, based on experience from other countries, provide policy recommendations. The major barrier identified in the paper is based on the economics of renewable energy technologies, i.e. their cost and risk structures, two main factors in investment planning. As a solution, the South African government introduced several renewable energy support measures, such as a feed-in tariff. The paper discusses the potential and possible shortcomings of this and other existing support schemes and identifies complementing measures on a national scale. (author)

Renewable energy in South Africa: Potentials, barriers and options for support

Energy Technology Data Exchange (ETDEWEB)

Pegels, Anna, E-mail: anna.pegels@die-gdi.d [German Development Institute/Deutsches Institut fuer Entwicklungspolitik, Tulpenfeld 6, 53113 Bonn (Germany)

2010-09-15

The challenge of transforming entire economies is enormous; even more so if a country is as fossil fuel based and emission intensive as South Africa. However, in an increasingly carbon constrained world and already now facing climate change impacts South Africa has to reduce greenhouse gas emissions intensity soon and decidedly. The South African electricity sector is a vital part of the economy and at the same time contributes most to the emissions problem. First steps have been taken by the South African government to enhance energy efficiency and promote renewable energy, however, they fail to show large-scale effects. This paper seeks to identify the relevant barriers to renewable energy investments and, based on experience from other countries, provide policy recommendations. The major barrier identified in the paper is based on the economics of renewable energy technologies, i.e. their cost and risk structures, two main factors in investment planning. As a solution, the South African government introduced several renewable energy support measures, such as a feed-in tariff. The paper discusses the potential and possible shortcomings of this and other existing support schemes and identifies complementing measures on a national scale.

A Rising Female Empire? : Exploring the potential barriers women face in achieving leadership positions in the humanitarian sector

OpenAIRE

Eriksson, Lina Elisabeth

2015-01-01

This research aims to explore how women and men view and perceive potential barriers to women achieving leadership positions in the humanitarian sector. Female leadership is so far an under-researched area within the humanitarian sector, so it is unknown whether females encounter any barriers in accessing and attaining leadership positions. Three categories were identified; identity, perception and challenges through which the views and barriers are explored. Semi-structured interviews were c...

Building America Guidance for Identifying and Overcoming Code, Standard, and Rating Method Barriers

Energy Technology Data Exchange (ETDEWEB)

Cole, Pamala C.; Halverson, Mark A.

2013-09-01

The U.S. Department of Energy’s (DOE) Building America program implemented a new Codes and Standards Innovation (CSI) Team in 2013. The Team’s mission is to assist Building America (BA) research teams and partners in identifying and resolving conflicts between Building America innovations and the various codes and standards that govern the construction of residences. A CSI Roadmap was completed in September, 2013. This guidance document was prepared using the information in the CSI Roadmap to provide BA research teams and partners with specific information and approaches to identifying and overcoming potential barriers to Building America (BA) innovations arising in and/or stemming from codes, standards, and rating methods. For more information on the BA CSI team, please email: CSITeam@pnnl.gov

A survey to identify barriers of implementing an antibiotic checklist.

Science.gov (United States)

van Daalen, F V; Geerlings, S E; Prins, J M; Hulscher, M E J L

2016-04-01

A checklist is an effective implementation tool, but addressing barriers that might impact on the effectiveness of its use is crucial. In this paper, we explore barriers to the uptake of an antibiotic checklist that aims to improve antibiotic use in daily hospital care. We performed an online questionnaire survey among medical specialists and residents with various professional backgrounds from nine Dutch hospitals. The questionnaire consisted of 23 statements on anticipated barriers hindering the uptake of the checklist. Furthermore, it gave the possibility to add comments. We included 219 completed questionnaires (122 medical specialists and 97 residents) in our descriptive analysis. The top six anticipated barriers included: (1) lack of expectation of improvement of antibiotic use, (2) lack of expected patients' satisfaction by checklist use, (3) lack of feasibility of the checklist, (4) negative previous experiences with other checklists, (5) the complexity of the antibiotic checklist and (6) lack of nurses' expectation of checklist use. Remarkably, 553 comments were made, mostly (436) about the content of the checklist. These insights can be used to improve the specific content of the checklist and to develop an implementation strategy that addresses the identified barriers.

7Li breakup polarization potential at near barrier energies

International Nuclear Information System (INIS)

Lubian, J. . E-mail lubian@if.uff.br; Correa, T.; Paes, B.; Figueira, J.M.; Abriola, D.; Fernandez Niello, J.O.; Arazi, A.; Capurro, O.A.; de Barbara, E.; Marti, G.V.; Martinez Heinmann, D.; Negri, A.E.; Pacheco, A.J.; Padron, I.; Gomes, P.R.S.

2007-01-01

Inelastic and one neutron transfer cross sections at energies around the Coulomb barrier were used to derive dynamic polarization potential (DPP) for the 7 Li + 27 Al system. The DPP due to breakup, obtained in a simple way, indicates that its real part is repulsive at near barrier energies

Influence of the potential well and the potential barrier on the density distribution of confined-model fluids

CERN Document Server

Lee, B H; Lee, C H; Seong Baek Seok

2000-01-01

A density functional perturbative approximation, which is based on the density functional expansion of the one-particle direct correlation function of model fluids with respect to the bulk density, has been employed to investigate the influence of the potential well and the potential barrier on the density behavior of confined-model fluids. The mean spherical approximation has been used to calculate the two-particle direct correlation function of the model fluids. At lower densities, the density distributions are strongly affected by the barrier height and the well depth of the model potential, the contribution from the short-range repulsive part being especially important. However, the effects of the barrier height and the well depth of the model potential decrease with increasing bulk density. The calculated results also show that in the region where the effect of the wall-fluid interaction is relatively weak, the square-barrier part of the model potential leads to a nonuniformity in the density distributio...

Universal potential-barrier penetration by initially confined wave packets

International Nuclear Information System (INIS)

Granot, Er'el; Marchewka, Avi

2007-01-01

The dynamics of an initially sharp-boundary wave packet in the presence of an arbitrary potential barrier is investigated. It is shown that the penetration through the barrier is universal in the sense that it depends only on the values of the wave function and its derivatives at the boundary. The dependence on the derivatives vanishes at long distances from the barrier, where the dynamics is governed solely by the initial value of the wave function at the boundary

Universal potential-barrier penetration by initially confined wave packets

Science.gov (United States)

Granot, Er'El; Marchewka, Avi

2007-07-01

The dynamics of an initially sharp-boundary wave packet in the presence of an arbitrary potential barrier is investigated. It is shown that the penetration through the barrier is universal in the sense that it depends only on the values of the wave function and its derivatives at the boundary. The dependence on the derivatives vanishes at long distances from the barrier, where the dynamics is governed solely by the initial value of the wave function at the boundary.

Identifying the barriers and enablers to palliative care nurses' recognition and assessment of delirium symptoms: a qualitative study.

Science.gov (United States)

Hosie, Annmarie; Lobb, Elizabeth; Agar, Meera; Davidson, Patricia M; Phillips, Jane

2014-11-01

Delirium is underrecognized by nurses, including those working in palliative care settings where the syndrome occurs frequently. Identifying contextual factors that support and/or hinder palliative care nurses' delirium recognition and assessment capabilities is crucial, to inform development of clinical practice and systems aimed at improving patients' delirium outcomes. The aim of the study was to identify nurses' perceptions of the barriers and enablers to recognizing and assessing delirium symptoms in palliative care inpatient settings. A series of semistructured interviews, guided by critical incident technique, were conducted with nurses working in Australian palliative care inpatient settings. A hypoactive delirium vignette prompted participants' recall of delirium and identification of the perceived factors (barriers and enablers) that impacted on their delirium recognition and assessment capabilities. Thematic content analysis was used to analyze the qualitative data. Thirty participants from nine palliative care services provided insights into the barriers and enablers of delirium recognition and assessment in the inpatient setting that were categorized as patient and family, health professional, and system level factors. Analysis revealed five themes, each reflecting both identified barriers and current and/or potential enablers: 1) value in listening to patients and engaging families, 2) assessment is integrated with care delivery, 3) respecting and integrating nurses' observations, 4) addressing nurses' delirium knowledge needs, and 5) integrating delirium recognition and assessment processes. Supporting the development of palliative care nursing delirium recognition and assessment practice requires attending to a range of barriers and enablers at the patient and family, health professional, and system levels. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Applying the Theoretical Domains Framework to identify barriers and targeted interventions to enhance nurses' use of electronic medication management systems in two Australian hospitals.

Science.gov (United States)

Debono, Deborah; Taylor, Natalie; Lipworth, Wendy; Greenfield, David; Travaglia, Joanne; Black, Deborah; Braithwaite, Jeffrey

2017-03-27

Medication errors harm hospitalised patients and increase health care costs. Electronic Medication Management Systems (EMMS) have been shown to reduce medication errors. However, nurses do not always use EMMS as intended, largely because implementation of such patient safety strategies requires clinicians to change their existing practices, routines and behaviour. This study uses the Theoretical Domains Framework (TDF) to identify barriers and targeted interventions to enhance nurses' appropriate use of EMMS in two Australian hospitals. This qualitative study draws on in-depth interviews with 19 acute care nurses who used EMMS. A convenience sampling approach was used. Nurses working on the study units (N = 6) in two hospitals were invited to participate if available during the data collection period. Interviews inductively explored nurses' experiences of using EMMS (step 1). Data were analysed using the TDF to identify theory-derived barriers to nurses' appropriate use of EMMS (step 2). Relevant behaviour change techniques (BCTs) were identified to overcome key barriers to using EMMS (step 3) followed by the identification of potential literature-informed targeted intervention strategies to operationalise the identified BCTs (step 4). Barriers to nurses' use of EMMS in acute care were represented by nine domains of the TDF. Two closely linked domains emerged as major barriers to EMMS use: Environmental Context and Resources (availability and properties of computers on wheels (COWs); technology characteristics; specific contexts; competing demands and time pressure) and Social/Professional Role and Identity (conflict between using EMMS appropriately and executing behaviours critical to nurses' professional role and identity). The study identified three potential BCTs to address the Environmental Context and Resources domain barrier: adding objects to the environment; restructuring the physical environment; and prompts and cues. Seven BCTs to address Social

Study on fusion potential barrier in heavy ion reactions based on the dynamical model

International Nuclear Information System (INIS)

Tian Junlong; Wu Xizhen; Li Zhuxia; Wang Ning; Liu Fuhu

2004-01-01

Based on an improved quantum molecular dynamics model the static and dynamic potential in the entrance channel of synthesis of superheavy nuclei are studied. The dependence of the static potential (and driving potential) on mass-asymmetry is obtained. From this study authors find out that the mass-symmetric system seems to be difficult to fuse and the fusing system with the largest driving potential could be the optimal choice of the projectile-target combination. By comparing the static potential barrier with the dynamic one authors find that the latter one is lower than former one obviously, and that the dynamical potential barrier is entrance energy dependent. The maximum and minimum of dynamic potential barriers approach to the diabatic (sudden approximation) and the adiabatic static potential barriers, respectively

Moving Towards Sustainable Food Consumption : Identifying Barriers to Sustainable Student Diets

OpenAIRE

Ede, James; Graine, Sophia; Rhodes, Chris

2011-01-01

Adopting more sustainable consumption habits has been identified as a necessary step in the progression towards a sustainable society. In the area of sustainable consumption, personal food behaviour represents a strong leverage point. University students have been identified as a strategic audience; habits established during this transformative period can track forward into later life. This study seeks to identify the barriers inhibiting students from eating more sustainably. Perceived benefi...

Identifying Barriers and Pathways to Success for Renewable Energy Development on American Indian Lands

Energy Technology Data Exchange (ETDEWEB)

Necefer, Len Edward [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Univ. of Arizona, Tucson, AZ (United States); Jones, Thomas Elisha [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Carnegie Mellon Univ., Pittsburgh, PA (United States)

2016-11-01

American Indian tribes possess lands rich with renewable energy (RE) resources. Tribes have great potential and need to develop these resources, yet face a host of barriers that continue to impede development. Understanding these challenges as well as the pathways that can be taken to overcome them may facilitate more economic development to meet community needs and better position tribes to play a role in securing a low-carbon energy future for the United States. This paper presents the results of an expert elicitation of 24 tribal energy experts from federal, tribal, academic, and private industry backgrounds to identify barriers and opportunities for federally recognized tribes in the lower 48 states. Experts identified a number of unique challenges facing tribes including financing and funding, infrastructure, tribal leadership and staff, state-level influence, and partnerships. Cultural factors were seen only to be of concern with large-scale development. Tribal sovereignty is a significant motivation for RE development and has yet to be fully realized. Cultural considerations are critical to the success of future projects; smaller residential and community-scale projects may be a better fit. Improving partnerships between tribes and the private sector can increase RE deployment and overcome historical distrust. States can have a double-ended influence on projects within tribal lands through taxation.

A qualitative case study to identify possible barriers that limit effective elementary science education

Science.gov (United States)

Foster, Donald Carey

The purpose of this case study was to identify barriers that limit the effectiveness of elementary teachers in the teaching of science. It is of the utmost urgency that barriers be first identified, so that possible solutions can be explored to bring about the improvement of elementary science education. This urgency has been imposed by the scheduled national testing of students in science by 2007, as mandated by the No Child Left Behind Act of 2001. Using qualitative case study methods, the researcher conducted interviews with 8 elementary teachers from two schools within one school district who taught 3rd, 4th, and 5th grade. These interviews were designed to gain insight into barriers these elementary teachers perceived as factors limiting their effectiveness in teaching science and preparing students for high-stakes testing. Barriers in the areas of teacher background, typical teaching day, curriculum, inservices, and legislative influences were explored. This study concluded that the barriers explored do have a substantial negative affect on the teaching and learning of science in the elementary grades. Specifically, the barriers revealed in this study include the limited science background of elementary teachers, inadequate class time devoted to science, non-comprehensive curriculum, ineffective or lack of inservice training, and pressures from legislated mandates. But it is also clear that these barriers are so intertwined that one cannot remove these barriers one at a time. It will take a collective effort from all involved, including legislators, administrators, teachers, parents, and students, to alleviate these barriers and discover effective solutions to improve elementary science education.

Identifying real and perceived barriers to therapeutic education programs for individuals with inflammatory arthritis.

Science.gov (United States)

Bain, Lorna; Sangrar, Ruheena; Bornstein, Carolyn; Lukmanji, Sara; Hapuhennedige, Sandani; Thorne, Carter; Beattie, Karen A

2016-09-01

Therapeutic Education Programs (TEPs) grounded in self-management principles have been shown to improve quality of life of patients with chronic conditions and reduce patient-related healthcare costs. Though these programs are becoming more readily available, patients often experience barriers in participating. This study sought to identify barriers faced by inflammatory arthritis (IA) patients in attending a TEP and understand how patients overcame perceived barriers. A mixed-method study design was used. Questionnaires were distributed to individuals with IA who were invited to attend a TEP between 2010 and 2013. Respondents were those that chose not to attend (group A), individuals who attended ≤4 of 10 sessions (group B), individuals who attended ≥5 of 10 sessions prior to May 2013 (group C), and individuals who attended ≥5 of 10 sessions from June 2013 to November 2013 (group D). Individuals in group D were also invited to participate in focus groups to discuss how they had overcome perceived barriers. Real barriers identified by individuals in groups A and B included time, distance, and cost associated with attendance. Individuals who overcame perceived barriers (groups C and D) discussed strategies they used to do so. Aspects of the overall program experience and access to clinic and program also contributed to patients being able to overcome barriers. Time, distance, and cost are external barriers that prevented individuals from utilizing self-management education opportunities. These barriers were overcome if and when individuals had resources available to them. Readiness for behavior change also influenced commitment to participate in the program.

Load management for refrigeration systems: Potentials and barriers

Energy Technology Data Exchange (ETDEWEB)

Grein, Arne, E-mail: a.grein@tu-berlin.de [University of Technology Berlin, Institute for Energy Technology, Department of Energy Systems, Einsteinufer 25 (TA8), 10587 Berlin (Germany); Pehnt, Martin [Institute for Energy and Environmental Research Heidelberg (ifeu), Wilckensstr. 3, 69120 Heidelberg (Germany)

2011-09-15

As a strategy to deal with the increasing intermittent input of renewable energy sources in Germany, the adaptation of power consumption is complementary to power-plant regulation, grid expansion and physical energy storage. One demand sector that promises strong returns for load management efforts is cooling and refrigeration. In these processes, thermal inertia provides a temporal buffer for shifting and adjusting the power consumption of cooling systems. We have conducted an empirical investigation to obtain a detailed and time-resolved bottom-up analysis of load management for refrigeration systems in the city of Mannheim, Germany. We have extrapolated our results to general conditions in Germany. Several barriers inhibit the rapid adoption of load management strategies for cooling systems, including informational barriers, strict compliance with legal cooling requirements, liability issues, lack of technical experience, an inadequate rate of return and organizational barriers. Small commercial applications of refrigeration in the food-retailing and cold storage in hotels and restaurants are particularly promising starting points for intelligent load management. When our results are applied to Germany, suitable sectors for load management have theoretical and achievable potential values of 4.2 and 2.8 GW, respectively, amounting to about 4-6% of the maximum power demand in Germany. - Highlights: > Potential and barriers for implementation of load shifting for refrigeration. > Empirical investigation for time-resolved bottom-up analysis in Mannheim, Germany. > Suitable sectors and further recommendations for introducing load management.> Extrapolation of results from local to national level.

Load management for refrigeration systems: Potentials and barriers

International Nuclear Information System (INIS)

Grein, Arne; Pehnt, Martin

2011-01-01

As a strategy to deal with the increasing intermittent input of renewable energy sources in Germany, the adaptation of power consumption is complementary to power-plant regulation, grid expansion and physical energy storage. One demand sector that promises strong returns for load management efforts is cooling and refrigeration. In these processes, thermal inertia provides a temporal buffer for shifting and adjusting the power consumption of cooling systems. We have conducted an empirical investigation to obtain a detailed and time-resolved bottom-up analysis of load management for refrigeration systems in the city of Mannheim, Germany. We have extrapolated our results to general conditions in Germany. Several barriers inhibit the rapid adoption of load management strategies for cooling systems, including informational barriers, strict compliance with legal cooling requirements, liability issues, lack of technical experience, an inadequate rate of return and organizational barriers. Small commercial applications of refrigeration in the food-retailing and cold storage in hotels and restaurants are particularly promising starting points for intelligent load management. When our results are applied to Germany, suitable sectors for load management have theoretical and achievable potential values of 4.2 and 2.8 GW, respectively, amounting to about 4-6% of the maximum power demand in Germany. - Highlights: → Potential and barriers for implementation of load shifting for refrigeration. → Empirical investigation for time-resolved bottom-up analysis in Mannheim, Germany. → Suitable sectors and further recommendations for introducing load management.→ Extrapolation of results from local to national level.

Potential and barrier study. Energy efficiency of Norwegian homes; Potensial- og barrierestudie. Energieffektivisering av norske boliger

Energy Technology Data Exchange (ETDEWEB)

NONE

2012-07-01

Enova has identified potentials and barriers for energy efficiency in Norwegian buildings. This report summarizes the results of this work. Efficient energy in buildings is important to ensure that future economic activity and growth can occur in a way that reduces the possibilities for an environmentally and economically sound development. (eb)

Review of potential subsurface permeable barrier emplacement and monitoring technologies

International Nuclear Information System (INIS)

Riggsbee, W.H.; Treat, R.L.; Stansfield, H.J.; Schwarz, R.M.; Cantrell, K.J.; Phillips, S.J.

1994-02-01

This report focuses on subsurface permeable barrier technologies potentially applicable to existing waste disposal sites. This report describes candidate subsurface permeable barriers, methods for emplacing these barriers, and methods used to monitor the barrier performance. Two types of subsurface barrier systems are described: those that apply to contamination.in the unsaturated zone, and those that apply to groundwater and to mobile contamination near the groundwater table. These barriers may be emplaced either horizontally or vertically depending on waste and site characteristics. Materials for creating permeable subsurface barriers are emplaced using one of three basic methods: injection, in situ mechanical mixing, or excavation-insertion. Injection is the emplacement of dissolved reagents or colloidal suspensions into the soil at elevated pressures. In situ mechanical mixing is the physical blending of the soil and the barrier material underground. Excavation-insertion is the removal of a soil volume and adding barrier materials to the space created. Major vertical barrier emplacement technologies include trenching-backfilling; slurry trenching; and vertical drilling and injection, including boring (earth augering), cable tool drilling, rotary drilling, sonic drilling, jetting methods, injection-mixing in drilled holes, and deep soil mixing. Major horizontal barrier emplacement technologies include horizontal drilling, microtunneling, compaction boring, horizontal emplacement, longwall mining, hydraulic fracturing, and jetting methods

What do patients choose to tell their doctors? Qualitative analysis of potential barriers to reattributing medically unexplained symptoms.

Science.gov (United States)

Peters, Sarah; Rogers, Anne; Salmon, Peter; Gask, Linda; Dowrick, Chris; Towey, Maria; Clifford, Rebecca; Morriss, Richard

2009-04-01

Despite both parties often expressing dissatisfaction with consultations, patients with medically unexplained symptoms (MUS) prefer to consult their general practitioners (GPs) rather than any other health professional. Training GPs to explain how symptoms can relate to psychosocial problems (reattribution) improves the quality of doctor-patient communication, though not necessarily patient health. To examine patient experiences of GPs' attempts to reattribute MUS in order to identify potential barriers to primary care management of MUS and improvement in outcome. Qualitative study. Patients consulting with MUS whose GPs had been trained in reattribution. A secondary sample of patients of control GPs was also interviewed to ascertain if barriers identified were specific to reattribution or common to consultations about MUS in general. Thematic analysis of in-depth interviews. Potential barriers include the complexity of patients' problems and patients' judgements about how to manage their presentation of this complexity. Many did not trust doctors with discussion of emotional aspects of their problems and chose not to present them. The same barriers were seen amongst patients whose GPs were not trained, suggesting the barriers are not particular to reattribution. Improving GP explanation of unexplained symptoms is insufficient to reduce patients' concerns. GPs need to (1) help patients to make sense of the complex nature of their presenting problems, (2) communicate that attention to psychosocial factors will not preclude vigilance to physical disease and (3) ensure a quality of doctor-patient relationship in which patients can perceive psychosocial enquiry as appropriate.

Quasibound states in graphene quantum-dot nanostructures generated by concentric potential barrier rings

International Nuclear Information System (INIS)

Jiang Zhao-Tan; Yu Cheng-Long; Dong Quan-Li

2012-01-01

We study the quasibound states in a graphene quantum-dot structure generated by the single-, double-, and triple-barrier electrostatic potentials. It is shown that the strongest quasibound states are mainly determined by the innermost barrier. Specifically, the positions of the quasibound states are determined by the barrier height, the number of the quasibound states is determined by the quantum-dot radius and the angular momentum, and the localization degree of the quasibound states is influenced by the width of the innermost barrier, as well as the outside barriers. Furthermore, according to the study on the double- and triple-barrier quantum dots, we find that an effective way to generate more quasibound states with even larger energy level spacings is to design a quantum dot defined by many concentric barriers with larger barrier-height differences. Last, we extend our results into the quantum dot of many barriers, which gives a complete picture about the formation of the quasibound states in the kind of graphene quantum dot created by many concentric potential barrier rings. (rapid communication)

Na+/K+-ATPase α1 identified as an abundant protein in the blood-labyrinth barrier that plays an essential role in the barrier integrity.

Directory of Open Access Journals (Sweden)

Yue Yang

2011-01-01

Full Text Available The endothelial-blood/tissue barrier is critical for maintaining tissue homeostasis. The ear harbors a unique endothelial-blood/tissue barrier which we term "blood-labyrinth-barrier". This barrier is critical for maintaining inner ear homeostasis. Disruption of the blood-labyrinth-barrier is closely associated with a number of hearing disorders. Many proteins of the blood-brain-barrier and blood-retinal-barrier have been identified, leading to significant advances in understanding their tissue specific functions. In contrast, capillaries in the ear are small in volume and anatomically complex. This presents a challenge for protein analysis studies, which has resulted in limited knowledge of the molecular and functional components of the blood-labyrinth-barrier. In this study, we developed a novel method for isolation of the stria vascularis capillary from CBA/CaJ mouse cochlea and provided the first database of protein components in the blood-labyrinth barrier as well as evidence that the interaction of Na(+/K(+-ATPase α1 (ATP1A1 with protein kinase C eta (PKCη and occludin is one of the mechanisms of loud sound-induced vascular permeability increase.Using a mass-spectrometry, shotgun-proteomics approach combined with a novel "sandwich-dissociation" method, more than 600 proteins from isolated stria vascularis capillaries were identified from adult CBA/CaJ mouse cochlea. The ion transporter ATP1A1 was the most abundant protein in the blood-labyrinth barrier. Pharmacological inhibition of ATP1A1 activity resulted in hyperphosphorylation of tight junction proteins such as occludin which increased the blood-labyrinth-barrier permeability. PKCη directly interacted with ATP1A1 and was an essential mediator of ATP1A1-initiated occludin phosphorylation. Moreover, this identified signaling pathway was involved in the breakdown of the blood-labyrinth-barrier resulting from loud sound trauma.The results presented here provide a novel method for

IDENTIFYING AND ANALYZING THE TRANSIENT AND PERMANENT BARRIERS FOR BIG DATA

Directory of Open Access Journals (Sweden)

SARFRAZ NAWAZ BROHI

2016-12-01

Full Text Available Auspiciously, big data analytics had made it possible to generate value from immense amounts of raw data. Organizations are able to seek incredible insights which assist them in effective decision making and providing quality of service by establishing innovative strategies to recognize, examine and address the customers’ preferences. However, organizations are reluctant to adopt big data solutions due to several barriers such as data storage and transfer, scalability, data quality, data complexity, timeliness, security, privacy, trust, data ownership, and transparency. Despite the discussion on big data opportunities, in this paper, we present the findings of our in-depth review process that was focused on identifying as well as analyzing the transient and permanent barriers for adopting big data. Although, the transient barriers for big data can be eliminated in the near future with the advent of innovative technical contributions, however, it is challenging to eliminate the permanent barriers enduringly, though their impact could be recurrently reduced with the efficient and effective use of technology, standards, policies, and procedures.

l-dependent potential barriers and superdeformed states

International Nuclear Information System (INIS)

Gherghescu, R.A.; Royer, G.

1999-01-01

The macroscopic-microscopic energy of rotating nuclei moving in the fusion-like deformation valley has been determined within a generalized liquid drop model including the nuclear proximity energy, the two-center shell model and the Strutinsky method. The l-dependent potential barriers of the 84 Zr, 132 Ce, 152 Dy and 192 Hg nuclei have been determined. A first minimum having a pure microscopic origin and lodging the normally deformed states, progressively disappears with increasing angular momenta. The microscopic and macroscopic energies contribute to generate a second minimum where superdeformed states may survive. It becomes progressively the lowest one at intermediate spins. At still higher angular momenta, the minimum moves towards the foot of the external fission barrier leading to macroscopic hyper-deformed quasi-molecular states. (authors)

Barriers to installing innovative energy systems in existing housing stock identified

NARCIS (Netherlands)

Hoppe, Thomas

2013-01-01

Several barriers to upgrading existing social housing with innovative energy systems (IES) have been identified by a study of eight large-scale renovation projects in the Netherlands. These include a lack of trust between stakeholders, opposition from tenants on grounds of increased costs or delays,

Oculocutaneous albinism: identifying and overcoming barriers to vision care in a Nigerian population.

Science.gov (United States)

Udeh, N N; Eze, B I; Onwubiko, S N; Arinze, O C; Onwasigwe, E N; Umeh, R E

2014-06-01

To assess eye care service utilization, and identify access barriers in a south-eastern Nigerian albino population. The study was a population-based, cross-sectional survey conducted in Enugu state between August, 2011 and January, 2012. Using the data base of the state's Albino Foundation and tailored awareness creation, persons living with albinism were identified and recruited at two study centres. Data on participants' socio-demographics, perception of vision, visual needs, previous eye examination and or low vision assessment, use of glasses or low vision devices were collected. Reasons for non-utilisation of available vision care services were also obtained. Descriptive and comparative statistics were performed. A p low vision assessment and none--0.0% had used low vision device. Of the participants, 82.4% reported previous eye examination, 33.3% had not used spectacles previously, despite the existing need. Ignorance--88.9% and poor access--8.5% were the main barriers to uptake of vision care services. In Enugu, Nigeria, there is poor awareness and low utilization of vision care services among people with albinism. The identified barriers to vision care access are amenable to awareness creation and logistic change in the provision of appropriate vision care services.

Identifying barriers to recovery from work related upper extremity disorders: use of a collaborative problem solving technique.

Science.gov (United States)

Shaw, William S; Feuerstein, Michael; Miller, Virginia I; Wood, Patricia M

2003-08-01

Improving health and work outcomes for individuals with work related upper extremity disorders (WRUEDs) may require a broad assessment of potential return to work barriers by engaging workers in collaborative problem solving. In this study, half of all nurse case managers from a large workers' compensation system were randomly selected and invited to participate in a randomized, controlled trial of an integrated case management (ICM) approach for WRUEDs. The focus of ICM was problem solving skills training and workplace accommodation. Volunteer nurses attended a 2 day ICM training workshop including instruction in a 6 step process to engage clients in problem solving to overcome barriers to recovery. A chart review of WRUED case management reports (n = 70) during the following 2 years was conducted to extract case managers' reports of barriers to recovery and return to work. Case managers documented from 0 to 21 barriers per case (M = 6.24, SD = 4.02) within 5 domains: signs and symptoms (36%), work environment (27%), medical care (13%), functional limitations (12%), and coping (12%). Compared with case managers who did not receive the training (n = 67), workshop participants identified more barriers related to signs and symptoms, work environment, functional limitations, and coping (p Problem solving skills training may help focus case management services on the most salient recovery factors affecting return to work.

Paving the Way to Successful Implementation: Identifying Key Barriers to Use of Technology-Based Therapeutic Tools for Behavioral Health Care.

Science.gov (United States)

Ramsey, Alex; Lord, Sarah; Torrey, John; Marsch, Lisa; Lardiere, Michael

2016-01-01

This study aimed to identify barriers to use of technology for behavioral health care from the perspective of care decision makers at community behavioral health organizations. As part of a larger survey of technology readiness, 260 care decision makers completed an open-ended question about perceived barriers to use of technology. Using the Consolidated Framework for Implementation Research (CFIR), qualitative analyses yielded barrier themes related to characteristics of technology (e.g., cost and privacy), potential end users (e.g., technology literacy and attitudes about technology), organization structure and climate (e.g., budget and infrastructure), and factors external to organizations (e.g., broadband accessibility and reimbursement policies). Number of reported barriers was higher among respondents representing agencies with lower annual budgets and smaller client bases relative to higher budget, larger clientele organizations. Individual barriers were differentially associated with budget, size of client base, and geographic location. Results are discussed in light of implementation science frameworks and proactive strategies to address perceived obstacles to adoption and use of technology-based behavioral health tools.

Aptamer nanomedicine for cancer therapeutics: barriers and potential for translation.

Science.gov (United States)

Lao, Yeh-Hsing; Phua, Kyle K L; Leong, Kam W

2015-03-24

Aptamer nanomedicine, including therapeutic aptamers and aptamer nanocomplexes, is beginning to fulfill its potential in both clinical trials and preclinical studies. Especially in oncology, aptamer nanomedicine may perform better than conventional or antibody-based chemotherapeutics due to specificity compared to the former and stability compared to the latter. Many proof-of-concept studies on applying aptamers to drug delivery, gene therapy, and cancer imaging have shown promising efficacy and impressive safety in vivo toward translation. Yet, there remains ample room for improvement and critical barriers to be addressed. In this review, we will first introduce the recent progress in clinical trials of aptamer nanomedicine, followed by a discussion of the barriers at the design and in vivo application stages. We will then highlight recent advances and engineering strategies proposed to tackle these barriers. Aptamer cancer nanomedicine has the potential to address one of the most important healthcare issues of the society.

On the (DE-) stabilization of quantum mechanical binding by potential barriers

International Nuclear Information System (INIS)

Hogreve, H.

1994-04-01

Stabilization and destabilization effects caused by adding or rising a potential barrier are studied for a simple one-dimensional quantum system. Calculating the motion of the corresponding S-matrix poles for varying barrier width and height, this reveals the scenario for the transition between bound, virtual and resonance states. Our results show that the presence of a barrier leads to nonanalyticity of the ground state with respect to the involved coupling constants. Furthermore, for increasing barrier width the size of the virtual regime shrinks drastically, so that it might be hardly detectable in many practical situations. (author). 15 refs, 5 figs

Effects of continuous feedback on households’ electricity consumption: Potentials and barriers

International Nuclear Information System (INIS)

Nilsson, Andreas; Bergstad, Cecilia Jakobsson; Thuvander, Liane; Andersson, David; Andersson, Kristin; Meiling, Pär

2014-01-01

Highlights: • Two studies on conservation behaviours using in home-displays are presented. • No significant effects on electricity consumption were found. • Display feedback does not necessarily contribute to lower electricity use. • Interviews conclude that different types of feedback techniques should be combined. • Two important barriers are difficulties to understand the display and a lack of interest. - Abstract: Two field experiments were carried out to study (a) the effects on energy savings of continuous visual feedback via in-home displays, and (b) the motives for responding or not. In study 1, 40 participants living in separate or semi-detached houses in two different towns participated. All participants received a questionnaire and a list of possible energy saving measures. Households were then randomly assigned to an experimental condition (display) or a control condition (no display). In study 2, 32 households in rented apartments participated. No significant differences between the conditions were found for either of the studies. In study 2, semi-structured interviews were conducted among nine of the households. Through an analysis of interview transcripts barriers were identified explaining why the feedback intervention was not sufficient to change behaviour and reduce consumption. The barriers experienced indicate that there is a risk of overconfidence in IHDs. For the development of energy policies and more wide-scale implementation, it is important to be aware of the potential obstacles to success

The escape of brownian particle over potential barriers

International Nuclear Information System (INIS)

Zhong Yunxiao

1985-01-01

A convenient method is introduced to calculate the rate of escape of Brownian particle over potential barriers by exact solution of Smoluchowskian equation. This method is applied to calculate the nuclear fission probabilities. The results for four different cases are compared with the results of other theories

Li breakup polarization potential at near barrier energies

International Nuclear Information System (INIS)

Lubian, F. J.; Correa, T.; Gomes, P.R.S.; Paes, B; Figueira, J. M.; Abriola, D.; Fernandez, J. O.; Capurro, O. A.; Marti, G.V.; Martinez, D.; Heimann; Negri, A.; Pacheco, A. J.; Padron, I.

2007-01-01

Inelastic and one neutron transfer cross sections at energies around the Coulomb barrier were used to derive dynamic polarization potential (DPP) for the 7 Li + 27 Al system. The DPP due to breakup, obtained in a simple way, indicates that its real part is repulsive at nearbarrier energies. (Author)

Tunneling effect on double potential barriers GaAs and PbS

Science.gov (United States)

Prastowo, S. H. B.; Supriadi, B.; Ridlo, Z. R.; Prihandono, T.

2018-04-01

A simple model of transport phenomenon tunnelling effect through double barrier structure was developed. In this research we concentrate on the variation of electron energy which entering double potential barriers to transmission coefficient. The barriers using semiconductor materials GaAs (Galium Arsenide) with band-gap energy 1.424 eV, distance of lattice 0.565 nm, and PbS (Lead Sulphide) with band gap energy 0.41 eV distance of lattice is 18 nm. The Analysisof tunnelling effect on double potentials GaAs and PbS using Schrodinger’s equation, continuity, and matrix propagation to get transmission coefficient. The maximum energy of electron that we use is 1.0 eV, and observable from 0.0025 eV- 1.0 eV. The shows the highest transmission coefficient is0.9982 from electron energy 0.5123eV means electron can pass the barriers with probability 99.82%. Semiconductor from materials GaAs and PbS is one of selected material to design semiconductor device because of transmission coefficient directly proportional to bias the voltage of semiconductor device. Application of the theoretical analysis of resonant tunnelling effect on double barriers was used to design and develop new structure and combination of materials for semiconductor device (diode, transistor, and integrated circuit).

Validating the Modified Drug Adherence Work-Up (M-DRAW) Tool to Identify and Address Barriers to Medication Adherence.

Science.gov (United States)

Lee, Sun; Bae, Yuna H; Worley, Marcia; Law, Anandi

2017-09-08

Barriers to medication adherence stem from multiple factors. An effective and convenient tool is needed to identify these barriers so that clinicians can provide a tailored, patient-centered consultation with patients. The Modified Drug Adherence Work-up Tool (M-DRAW) was developed as a 13-item checklist questionnaire to identify barriers to medication adherence. The response scale was a 4-point Likert scale of frequency of occurrence (1 = never to 4 = often). The checklist was accompanied by a GUIDE that provided corresponding motivational interview-based intervention strategies for each identified barrier. The current pilot study examined the psychometric properties of the M-DRAW checklist (reliability, responsiveness and discriminant validity) in patients taking one or more prescription medication(s) for chronic conditions. A cross-sectional sample of 26 patients was recruited between December 2015 and March 2016 at an academic medical center pharmacy in Southern California. A priming question that assessed self-reported adherence was used to separate participants into the control group of 17 "adherers" (65.4%), and into the intervention group of nine "unintentional and intentional non-adherers" (34.6%). Comparable baseline characteristics were observed between the two groups. The M-DRAW checklist showed acceptable reliability (13 item; alpha = 0.74) for identifying factors and barriers leading to medication non-adherence. Discriminant validity of the tool and the priming question was established by the four-fold number of barriers to adherence identified within the self-selected intervention group compared to the control group (4.4 versus 1.2 barriers, p tool will include construct validation.

Potential corridors and barriers for plague spread in central Asia

Science.gov (United States)

2013-01-01

Background Plague (Yersinia pestis infection) is a vector-borne disease which caused millions of human deaths in the Middle Ages. The hosts of plague are mostly rodents, and the disease is spread by the fleas that feed on them. Currently, the disease still circulates amongst sylvatic rodent populations all over the world, including great gerbil (Rhombomys opimus) populations in Central Asia. Great gerbils are social desert rodents that live in family groups in burrows, which are visible on satellite images. In great gerbil populations an abundance threshold exists, above which plague can spread causing epizootics. The spatial distribution of the host species is thought to influence the plague dynamics, such as the direction of plague spread, however no detailed analysis exists on the possible functional or structural corridors and barriers that are present in this population and landscape. This study aims to fill that gap. Methods Three 20 by 20 km areas with known great gerbil burrow distributions were used to analyse the spatial distribution of the burrows. Object-based image analysis was used to map the landscape at several scales, and was linked to the burrow maps. A novel object-based method was developed – the mean neighbour absolute burrow density difference (MNABDD) – to identify the optimal scale and evaluate the efficacy of using landscape objects as opposed to square cells. Multiple regression using raster maps was used to identify the landscape-ecological variables that explain burrow density best. Functional corridors and barriers were mapped using burrow density thresholds. Cumulative resistance of the burrow distribution to potential disease spread was evaluated using cost distance analysis. A 46-year plague surveillance dataset was used to evaluate whether plague spread was radially symmetric. Results The burrow distribution was found to be non-random and negatively correlated with Greenness, especially in the floodplain areas. Corridors and

Parent-identified barriers to pediatric health care: a process-oriented model.

Science.gov (United States)

Sobo, Elisa J; Seid, Michael; Reyes Gelhard, Leticia

2006-02-01

To further understand barriers to care as experienced by health care consumers, and to demonstrate the importance of conjoining qualitative and quantitative health services research. Transcripts from focus groups conducted in San Diego with English- and Spanish-speaking parents of children with special health care needs. Participants were asked about the barriers to care they had experienced or perceived, and their strategies for overcoming these barriers. Using elementary anthropological discourse analysis techniques, a process-based conceptual model of the parent experience was devised. The analysis revealed a parent-motivated model of barriers to care that enriched our understanding of quantitative findings regarding the population from which the focus group sample was drawn. Parent-identified barriers were grouped into the following six temporally and spatially sequenced categories: necessary skills and prerequisites for gaining access to the system; realizing access once it is gained; front office experiences; interactions with physicians; system arbitrariness and fragmentation; outcomes that affect future interaction with the system. Key to the successful navigation of the system was parents' functional biomedical acculturation; this construct likens the biomedical health services system to a cultural system within which all parents/patients must learn to function competently. Qualitative analysis of focus group data enabled a deeper understanding of barriers to care--one that went beyond the traditional association of marker variables with poor outcomes ("what") to reveal an understanding of the processes by which parents experience the health care system ("how,"why") and by which disparities may arise. Development of such process-oriented models furthers the provision of patient-centered care and the creation of interventions, programs, and curricula to enhance such care. Qualitative discourse analysis, for example using this project's widely applicable

Spin-dependent scattering by a potential barrier on a nanotube

International Nuclear Information System (INIS)

Abranyos, Yonatan; Gumbs, Godfrey; Fekete, Paula

2010-01-01

The electron spin effects on the surface of a nanotube have been considered through the spin-orbit interaction (SOI), arising from the electron confinement on the surface of the nanotube. This is of the same nature as the Rashba-Bychkov SOI at a semiconductor heterojunction. We estimate the effect of disorder within a potential barrier on the transmission probability. Using a continuum model, we obtain analytic expressions for the spin-split energy bands for electrons on the surface of nanotubes in the presence of SOI. First we calculate analytically the amplitudes of scattering from a potential barrier located around the axis of the nanotube into spin-dependent states. The effect of disorder on the scattering process is included phenomenologically and induces a reduction in the transition probability. We analyze the relative role of SOI and disorder in the transmission probability which depends on the angular and linear momentum of the incoming particle, and its spin orientation. Finally we demonstrate that in the presence of disorder, perfect transmission may not be achieved for finite barrier heights.

Reflection at a complex potential barrier in the semiclassical theory of scattering

International Nuclear Information System (INIS)

Avishai, Y.; Knoll, J.

1976-01-01

The reflection of spherical waves at a complex potential barrier is discussed in the semiclassical approximation. We study the complex WKB method and the Uniform Approximation in the special case of weakly absorptive barriers, typical of surface transparent optical potentials used in heavy-ion reactions. It is found that the complex WKB results lead to a very accurate cross-section despite their inaccuracy in the most important phase shifts. Thereby, the amazing stamina of the WKB has been confirmed once more. (orig.) [de

Heavy-ion optical potential for sub-barrier fusion deduced from a dispersion relation

International Nuclear Information System (INIS)

Kim, B.T.; Kim, H.C.; Park, K.E.

1988-01-01

The heavy-ion energy-dependent optical potentials for the 16 O+ 208 Pb system are deduced from a dispersion relation. These potentials are used to analyze the elastic scattering, fusion, and spin distributions of compound nuclei for the system in a unified way based on the direct reaction theory. It turns out that the energy dependence of the optical potential is essential in explaining the data at near- and sub-barrier energies. The real part of the energy-dependent optical potential deduced was also used in calculating the elastic and fusion cross sections by the conventional barrier penetration model using an incoming wave boundary condition. The predictions of the elastic scattering, fusion cross sections, and the spin distributions of compound nuclei are not satisfactory compared with those from the direct reaction approach. It seems to originate from the fact that this model neglects absorption around the Coulomb barrier region

Barrier potential design criteria in multiple-quantum-well-based solar-cell structures

Science.gov (United States)

Mohaidat, Jihad M.; Shum, Kai; Wang, W. B.; Alfano, R. R.

1994-01-01

The barrier potential design criteria in multiple-quantum-well (MQW)-based solar-cell structures is reported for the purpose of achieving maximum efficiency. The time-dependent short-circuit current density at the collector side of various MQW solar-cell structures under resonant condition was numerically calculated using the time-dependent Schroedinger equation. The energy efficiency of solar cells based on the InAs/Ga(y)In(1-y)As and GaAs/Al(x)Ga(1-x)As MQW structues were compared when carriers are excited at a particular solar-energy band. Using InAs/Ga(y)In(1-y)As MQW structures it is found that a maximum energy efficiency can be achieved if the structure is designed with barrier potential of about 450 meV. The efficiency is found to decline linearly as the barrier potential increases for GaAs/Al(x)Ga(1-x)As MQW-structure-based solar cells.

Tests of potential functional barriers for laminated multilayer food packages. Part I: Low molecular weight permeants.

Science.gov (United States)

Simal-Gándara, J; Sarria-Vidal, M; Koorevaar, A; Rijk, R

2000-08-01

The advent of the functional barrier concept in food packaging has brought with it a requirement for fast tests of permeation through potential barrier materials. In such tests it would be convenient for both foodstuffs and materials below the functional barrier (sub-barrier materials) to be represented by standard simulants. By means of inverse gas chromatography, liquid paraffin spiked with appropriate permeants was considered as a potential simulant of sub-barrier materials based on polypropylene (PP) or similar polyolefins. Experiments were performed to characterize the kinetics of the permeation of low molecular weight model permeants (octene, toluene and isopropanol) from liquid paraffin, through a surrogate potential functional barrier (25 microns-thick oriented PP) into the food stimulants olive oil and 3% (w/v) acetic acid. These permeation results were interpreted in terms of three permeation kinetic models regarding the solubility of a particular model permeant in the post-barrier medium (i.e. the food simulant). The results obtained justify the development and evaluation of liquid sub-barrier simulants that would allow flexible yet rigorous testing of new laminated multilayer packaging materials.

Validating the Modified Drug Adherence Work-Up (M-DRAW Tool to Identify and Address Barriers to Medication Adherence

Directory of Open Access Journals (Sweden)

Sun Lee

2017-09-01

Full Text Available Barriers to medication adherence stem from multiple factors. An effective and convenient tool is needed to identify these barriers so that clinicians can provide a tailored, patient-centered consultation with patients. The Modified Drug Adherence Work-up Tool (M-DRAW was developed as a 13-item checklist questionnaire to identify barriers to medication adherence. The response scale was a 4-point Likert scale of frequency of occurrence (1 = never to 4 = often. The checklist was accompanied by a GUIDE that provided corresponding motivational interview-based intervention strategies for each identified barrier. The current pilot study examined the psychometric properties of the M-DRAW checklist (reliability, responsiveness and discriminant validity in patients taking one or more prescription medication(s for chronic conditions. A cross-sectional sample of 26 patients was recruited between December 2015 and March 2016 at an academic medical center pharmacy in Southern California. A priming question that assessed self-reported adherence was used to separate participants into the control group of 17 “adherers” (65.4%, and into the intervention group of nine “unintentional and intentional non-adherers” (34.6%. Comparable baseline characteristics were observed between the two groups. The M-DRAW checklist showed acceptable reliability (13 item; alpha = 0.74 for identifying factors and barriers leading to medication non-adherence. Discriminant validity of the tool and the priming question was established by the four-fold number of barriers to adherence identified within the self-selected intervention group compared to the control group (4.4 versus 1.2 barriers, p < 0.05. The current study did not investigate construct validity due to small sample size and challenges on follow-up with patients. Future testing of the tool will include construct validation.

Parametric enhancement of the tunneling transmission through a potential barrier

International Nuclear Information System (INIS)

Tanaka, Masatoshi; Iwata, Giiti.

1992-01-01

A possibility of indicated of enhancing the tunneling transmission of particle incident on a potential barrier with the aid of an auxiliary potential parametrically in resonance with incident particles. For a simple auxiliary potential, a train of two-step square wells, examples are presented in which the ratio of the transmission coefficients with and without the auxiliary potential can be very large, e.g. (2n + 1) 2L , where n is the positive integer and L the number of the period of the auxiliary potential. (author)

Effect of a two-dimensional potential on the rate of thermally induced escape over the potential barrier

International Nuclear Information System (INIS)

Han, S.; Lapointe, J.; Lukens, J.E.

1992-01-01

The thermally induced escape rate of a particle trapped in a two-dimensional (2D) potential well has been investigated through experiment and numerical simulations. The measurements were performed on a special type of superconducting quantum interference device (SQUID) which has 2 degrees of freedom. The energies associated with the motion perpendicular to (transverse) and along (longitudinal) the escape direction are quite different: the ratio between the transverse and longitudinal small oscillation frequencies is ω t /ω l ∼7. The SQUID's parameters, which were used to determine the potential shape and energy scales were all independently determined. All data were obtained under conditions for which the 2D thermal activation (TA) model is expected to be valid. The results were found in good agreement with the theoretical prediction. The measured thermal activation energy is found to be the same as the barrier height calculated from the independently determined potential parameters. No evidence of apparent potential barrier enhancement recently reported in a similar system was found. In addition, the results of our numerical simulations suggest that the region in which the 2D thermal activation model is applicable may be extended to barriers as low as ΔU∼k BT

Evidence-based dentistry for planning restorative treatments: barriers and potential solutions.

Science.gov (United States)

Afrashtehfar, K I; Eimar, H; Yassine, R; Abi-Nader, S; Tamimi, F

2017-11-01

Evidence-based dentistry (EBD) can help provide the best treatment option for every patient, however, its implementation in restorative dentistry is very limited. This study aimed at assessing the barriers preventing the implementation of EBD among dental undergraduate and graduate students in Montreal, and explore possible solutions to overcome these barriers. A cross-sectional survey was conducted by means of a paper format self-administrated questionnaire distributed among dental students. The survey assessed the barriers and potential solutions for implementation of an evidence-based practice. Sixty-one students completed the questionnaire. Forty-one percent of respondents found evidence-based literature to be the most reliable source of information for restorative treatment planning, however, only 16% used it. They considered that finding reliable information was difficult and they sometimes encountered conflicting information when consulting different sources. Dental students had positive attitudes towards the need for better access to evidence-based literature to assist learning and decision making in restorative treatment planning and to improve treatment outcomes. Even for dentists trained in EBD, online searching takes too much time, and even though it can provide information of better quality than personal intuition, it might not be enough to identify the best available evidence. Even though dental students are aware of the importance of EBD in restorative dentistry they rarely apply the concept, mainly due to time constraints. For this reason, implementation of EBD would probably require faster access to evidence-based knowledge. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Barriers and Incentives to Potential Adoption of Biofuels Crops by Smallholder Farmers in the Eastern Cape Province, South Africa

OpenAIRE

Cheteni, Priviledge; Mushunje, Abbyssinia; Taruvinga, Amon

2014-01-01

The main objective of this study was to identify barriers and incentives that influence the potential adoption of biofuel crops by smallholder farmers. The study utilized a semi-structured questionnaire to record responses from 129 smallholder farmers that were identified through a snowballing sampling technique. The respondents were from the Oliver Tambo and Chris Hani District Municipalities in the Eastern Cape Province, South Africa. A Heckman two-step model was applied to analyze the dat...

Identifying Facilitators and Barriers to Physical Activity for Adults with Down Syndrome

Science.gov (United States)

Mahy, J.; Shields, N.; Taylor, N. F.; Dodd, K. J.

2010-01-01

Background: Adults with Down syndrome are typically sedentary, and many do not participate in the recommended levels of physical activity per week. The aim of this study was to identify the facilitators and barriers to physical activity for this group. Method: Semi-structured interviews were conducted to elicit the views of adults with Down…

Potential barriers to the use of health services among ethnic minorities : a review

NARCIS (Netherlands)

Scheppers, E.; van Dongen, E.; Dekker, J.; Geertzen, J.; Dekker, J.

Background. Ethnic minority patients seem to be confronted with barriers when using health services. Yet, care providers are often oblivious to these barriers, although they may share to some extent the burden of responsibility for them. In order to enlighten care providers, as to the potential

Generalization of Kramer's formula: Fission over a multidimensional potential barrier

International Nuclear Information System (INIS)

Jing-Shang, Z.; Weidenmueller, H.A.

1983-01-01

We generalize Kramers's rate expression for diffusion over a potential barrier to the case of a diffusion problem for n degrees of freedom. These can be thought of as the shape degrees of freedom of a fissioning nucleus. We present our formula for the fission width and discuss its dependence on the parameters: the mass tensor, the friction tensor, and the shape of the potential landscape

Electronic transport for armchair graphene nanoribbons with a potential barrier

International Nuclear Information System (INIS)

Ben-Hu, Zhou; Ben-Liang, Zhou; Guang-Hui, Zhou; Zi-Gang, Duan

2010-01-01

This paper studies the electronic transport property through a square potential barrier in armchair-edge graphene nanoribbon (AGNR). Using the Dirac equation with the continuity condition for wave functions at the interfaces between regions with and without a barrier, we calculate the mode-dependent transmission probability for both semiconducting and metallic AGNRs, respectively. It is shown that, by some numerical examples, the transmission probability is generally an oscillating function of the height and range of the barrier for both types of AGNRs. The main difference between the two types of systems is that the magnitude of oscillation for the semiconducting AGNR is larger than that for the metallic one. This fact implies that the electronic transport property for AGNRs depends sensitively on their widths and edge details due to the Dirac nature of fermions in the system

Electronic transport for armchair graphene nanoribbons with a potential barrier

International Nuclear Information System (INIS)

Zhou Benliang; Zhou Benhu; Liao Wenhu; Zhou Guanghui

2010-01-01

We theoretically investigate the electronic transport properties through a rectangular potential barrier embedded in armchair-edge graphene nanoribbons (AGNRs) of various widths. Using the Landauer formula and Dirac equation with the continuity conditions for all segments of wave functions at the interfaces between regions inside and outside the barrier, we calculate analytically the conductance and Fano factor for the both metallic and semiconducting AGNRs, respectively. It is shown that, by some numerical examples, at Dirac point the both types of AGNRs own a minimum conductance associated with the maximum Fano factor. The results are discussed and compared with the previous relevant works.

Animal Study Registries: Results from a Stakeholder Analysis on Potential Strengths, Weaknesses, Facilitators, and Barriers.

Science.gov (United States)

Wieschowski, Susanne; Silva, Diego S; Strech, Daniel

2016-11-01

Publication bias in animal research, its extent, its predictors, and its potential countermeasures are increasingly discussed. Recent reports and conferences highlight the potential strengths of animal study registries (ASRs) in this regard. Others have warned that prospective registration of animal studies could diminish creativity, add administrative burdens, and complicate intellectual property issues in translational research. A literature review and 21 international key-informant interviews were conducted and thematically analyzed to develop a comprehensive matrix of main- and subcategories for potential ASR-related strengths, weaknesses, facilitators, and barriers (SWFBs). We identified 130 potential SWFBs. All stakeholder groups agreed that ASRs could in various ways improve the quality and refinement of animal studies while allowing their number to be reduced, as well as supporting meta-research on animal studies. However, all stakeholder groups also highlighted the potential for theft of ideas, higher administrative burdens, and reduced creativity and serendipity in animal studies. Much more detailed reasoning was captured in the interviews than is currently found in the literature, providing a comprehensive account of the issues and arguments around ASRs. All stakeholder groups highlighted compelling potential strengths of ASRs. Although substantial weaknesses and implementation barriers were highlighted as well, different governance measures might help to minimize or even eliminate their impact. Such measures might include confidentiality time frames for accessing prospectively registered protocols, harmonized reporting requirements across ASRs, ethics reviews, lab notebooks, and journal submissions. The comprehensive information gathered in this study could help to guide a more evidence-based debate and to design pilot tests for ASRs.

Animal Study Registries: Results from a Stakeholder Analysis on Potential Strengths, Weaknesses, Facilitators, and Barriers.

Directory of Open Access Journals (Sweden)

Susanne Wieschowski

2016-11-01

Full Text Available Publication bias in animal research, its extent, its predictors, and its potential countermeasures are increasingly discussed. Recent reports and conferences highlight the potential strengths of animal study registries (ASRs in this regard. Others have warned that prospective registration of animal studies could diminish creativity, add administrative burdens, and complicate intellectual property issues in translational research. A literature review and 21 international key-informant interviews were conducted and thematically analyzed to develop a comprehensive matrix of main- and subcategories for potential ASR-related strengths, weaknesses, facilitators, and barriers (SWFBs. We identified 130 potential SWFBs. All stakeholder groups agreed that ASRs could in various ways improve the quality and refinement of animal studies while allowing their number to be reduced, as well as supporting meta-research on animal studies. However, all stakeholder groups also highlighted the potential for theft of ideas, higher administrative burdens, and reduced creativity and serendipity in animal studies. Much more detailed reasoning was captured in the interviews than is currently found in the literature, providing a comprehensive account of the issues and arguments around ASRs. All stakeholder groups highlighted compelling potential strengths of ASRs. Although substantial weaknesses and implementation barriers were highlighted as well, different governance measures might help to minimize or even eliminate their impact. Such measures might include confidentiality time frames for accessing prospectively registered protocols, harmonized reporting requirements across ASRs, ethics reviews, lab notebooks, and journal submissions. The comprehensive information gathered in this study could help to guide a more evidence-based debate and to design pilot tests for ASRs.

Stakeholders identify similar barriers but different strategies to facilitate return-to-work: A vignette of a worker with an upper extremity condition.

Science.gov (United States)

Peters, Susan E; Truong, Anthony P; Johnston, Venerina

2018-01-01

Stakeholders involved in the return-to-work (RTW) process have different roles and qualificationsOBJECTIVE:To explore the perspectives of Australian stakeholders of the RTW barriers and strategies for a worker with an upper extremity condition and a complex workers' compensation case. Using a case vignette, stakeholders were asked to identify barriers and recommend strategies to facilitate RTW. Content analysis was performed on the open-ended responses. The responses were categorised into RTW barriers and strategies using the biopsychosocial model. Pearson's Chi Square and ANOVA were performed to establish group differences. 621 participants (488 healthcare providers (HCPs), 62 employers, 55 insurers and 16 lawyers) identified 36 barriers (31 modifiable): 4 demographic; 8 biological; 15 psychological and 9 social barriers. 484 participants reported 16 RTW strategies: 4 biological; 6 psychological and 6 social strategies. 'Work relationship stressors' (83.4%) and 'Personal relationship stressors' (64.7%) were the most frequently nominated barriers. HCPs most frequently nominated 'Pain management' (49.6%), while employers, insurers and lawyers nominated 'RTW planning/Suitable duties programs' (40.5%; 42.9%; 80%). Stakeholders perceived similar barriers for RTW but recommended different strategies. Stakeholders appeared to be more proficient in identifying barriers than recommending strategies. Future research should focus on tools to both identify RTW barriers and direct intervention.

Barrier Coatings for Refractory Metals and Superalloys

Energy Technology Data Exchange (ETDEWEB)

SM Sabol; BT Randall; JD Edington; CJ Larkin; BJ Close

2006-02-23

In the closed working fluid loop of the proposed Prometheus space nuclear power plant (SNPP), there is the potential for reaction of core and plant structural materials with gas phase impurities and gas phase transport of interstitial elements between superalloy and refractory metal alloy components during service. Primary concerns are surface oxidation, interstitial embrittlement of refractory metals and decarburization of superalloys. In parallel with kinetic investigations, this letter evaluates the ability of potential coatings to prevent or impede communication between reactor and plant components. Key coating requirements are identified and current technology coating materials are reviewed relative to these requirements. Candidate coatings are identified for future evaluation based on current knowledge of design parameters and anticipated environment. Coatings were identified for superalloys and refractory metals to provide diffusion barriers to interstitial transport and act as reactive barriers to potential oxidation. Due to their high stability at low oxygen potential, alumina formers are most promising for oxidation protection given the anticipated coolant gas chemistry. A sublayer of iridium is recommended to provide inherent diffusion resistance to interstitials. Based on specific base metal selection, a thin film substrate--coating interdiffusion barrier layer may be necessary to meet mission life.

Barrier Coatings for Refractory Metals and Superalloys

International Nuclear Information System (INIS)

SM Sabol; BT Randall; JD Edington; CJ Larkin; BJ Close

2006-01-01

In the closed working fluid loop of the proposed Prometheus space nuclear power plant (SNPP), there is the potential for reaction of core and plant structural materials with gas phase impurities and gas phase transport of interstitial elements between superalloy and refractory metal alloy components during service. Primary concerns are surface oxidation, interstitial embrittlement of refractory metals and decarburization of superalloys. In parallel with kinetic investigations, this letter evaluates the ability of potential coatings to prevent or impede communication between reactor and plant components. Key coating requirements are identified and current technology coating materials are reviewed relative to these requirements. Candidate coatings are identified for future evaluation based on current knowledge of design parameters and anticipated environment. Coatings were identified for superalloys and refractory metals to provide diffusion barriers to interstitial transport and act as reactive barriers to potential oxidation. Due to their high stability at low oxygen potential, alumina formers are most promising for oxidation protection given the anticipated coolant gas chemistry. A sublayer of iridium is recommended to provide inherent diffusion resistance to interstitials. Based on specific base metal selection, a thin film substrate--coating interdiffusion barrier layer may be necessary to meet mission life

Developing leadership as a trainee- opportunities, barriers and potential improvements.

Science.gov (United States)

Doherty, Rachel; Lawson, Sara; Mc Laughlin, Laura; Donaghy, Grainne; Courtney, Julia; Gardiner, Keith

2018-05-01

The General Medical Council explicitly state that doctors completing training should demonstrate capabilities in leadership and teamwork. 1 However, most trainees receive little formal training in leadership. In March 2017, at the Faculty of Medical Leadership and Management (FMLM) Northern Ireland Regional Conference, a workshop on developing leadership skills as a trainee was hosted and the views of doctors in training regarding current opportunities, potential barriers and improvements were sought. In Northern Ireland presently there are a number of opportunities available for trainees to gain experience in leadership - both by learning through observation and learning through experience. These range from informal activities which do not require significant time commitment to focused, immersive leadership experiences such as ADEPT (Achieve Develop Explore Programme for Trainees) 2 , and the Royal College of Physicians' Chief Registrar scheme. 3 Several barriers to developing leadership have been identified, including limited understanding of what constitutes leadership, a lack of senior support and little formal recognition for trainees leading teams. Time pressures, frequently rotating jobs, limited resources and difficulty upscaling can also undermine the sustainability of improvement and other leadership projects. Incorporating awareness of and training in leadership skills, as well as greater engagement with senior leaders and managers, at an early stage in training could promote understanding and encourage trainees. Formalising leadership roles within training posts may improve experience. Deaneries and Trusts can also enable leadership opportunities by facilitating study leave, raising awareness amongst supervisors, and providing career enhancing incentives for interested trainees.

Identifying Barriers in Implementing Outcomes-Based Assessment Program Review: A Grounded Theory Analysis

Science.gov (United States)

Bresciani, Marilee J.

2011-01-01

The purpose of this grounded theory study was to identify the typical barriers encountered by faculty and administrators when implementing outcomes-based assessment program review. An analysis of interviews with faculty and administrators at nine institutions revealed a theory that faculty and administrators' promotion, tenure (if applicable),…

Identifying barriers to remaining physically active after rehabilitation: differences in perception between physical therapists and older adult patients.

Science.gov (United States)

Zalewski, Kathryn; Alt, Carlynn; Arvinen-Barrow, Monna

2014-06-01

Cross-sectional study. To describe readiness for change and barriers to physical activity in older adults and to contrast perceptions of physical therapists and patients using the Barriers to Being Active Quiz. Regular physical activity is vital to recovery after discharge from physical therapy. Physical therapists are positioned to support change in physical activity habits for those transitioning to home care. Understanding of readiness for change and barriers to physical activity could optimize recovery. Thirteen physical therapists enrolled in the study and invited patients who met the inclusion criteria to enroll (79 patients enrolled). The physical therapists provided the ICD-9 code, the physical therapist diagnosis, and completed the Barriers to Being Active Quiz as they perceived their patients would. The enrolled patients provided demographics and filled out the Satisfaction With Life Scale, the stages-of-change scale for physical activity, and the Barriers to Being Active Quiz. Patients were predominantly in the early stages of readiness for change. Both patients and physical therapists identified lack of willpower as the primary barrier to physical activity. Patients identified lack of willpower and social influence as critical barriers more often than physical therapists, whereas physical therapists identified fear of injury and lack of time more often than their patients did. Differences between physical therapists and their patients were noted for fear of injury (z = 2.66, P = .008) and lack of time (z = 3.46, P = .001). The stage of change for physical activity impacted perception of social influence (χ2 = 9.64, Pbarriers to physical activity may allow physical therapists to better tailor intervention strategies to impact physical activity behavior change.

Identification of potential biomarkers for gut barrier failure in broiler chickens

Directory of Open Access Journals (Sweden)

Juxing eChen

2015-05-01

Full Text Available The objective of the present study was to identify potential biomarkers for gut barrier failure in chickens. A total of 144 day-of-hatch Ross 308 male broiler chickens were housed in 24 battery cages with 6 chicks per cage. Cages were randomly assigned to either a control group (CON or gut barrier failure (GBF group. During the first 13 d, birds in CON or GBF groups were fed a common corn-soy starter diet. On d 14, CON chickens were switched to a corn grower diet and GBF chickens were switched to rye-wheat-barley grower diet. In addition, on d 21, GBF chickens were orally challenged with a coccidiosis vaccine. At d 21 and d 28, birds were weighed by cage and feed intake was recorded to calculate feed conversion ratio. At d 28, one chicken from each cage was euthanized to collect intestinal samples for morphometric analysis, blood for serum, and intestinal mucosa scrapings for gene expression. Overall performance and feed efficiency was severely affected (P < 0.05 by a GBF model when compared with CON group at d 21 and d 28. Duodenum of GBF birds had wider villi, longer crypt depth, and higher crypt depth/villi height ratio than CON birds. Similarly, GBF birds had longer crypt depth in jejunum and ileum when compared with CON birds. An increase (P <0.05 in serum endotoxin, α1-acid glycoprotein (AGP, as well as interleukin (IL-8, IL-1β, transforming growth factor (TGF-β4 and fatty-acid-binding protein (FABP 6 mRNA levels were increased in GBF birds compared to CON; however, FABP2 mRNA levels were decreased (P <0.05 in GBF birds compared to CON. Occludin was numerically reduced by 24% (P = 0.107 and mucin 2 (MUC2 was reduced by 29 % (P = 0.088 in GBF birds compared to CON birds. The results from the present study suggest that serum endotoxin and AGP, as well as, gene expression of FABP2, FABP6, IL-8, IL-1β and TGF-β4 in mucosa may work as potential biomarkers for gut barrier health in chickens.

Clinical trial regulation in Argentina: overview and analysis of regulatory framework, use of existing tools, and researchers' perspectives to identify potential barriers.

Science.gov (United States)

White, Lauren; Ortiz, Zulma; Cuervo, Luis G; Reveiz, Ludovic

2011-11-01

To review and analyze the regulatory framework of clinical trial registration, use of existing tools (publicly accessible national/international registration databases), and users' perspectives to identify possible barriers to registration compliance by sponsors and researchers in Argentina. Internationally registered trials recruiting patients in Argentina were found through clincialtrials.gov and the International Clinical Trial Registration Platform (ICTRP) and compared with publically available clinical trials registered through the National Administration of Drugs, Foods, and Medical Devices (ANMAT). A questionnaire addressing hypothesized attitudinal, knowledge-related, idiomatic, technical, economic, and regulatory barriers that could discourage or impede registration of clinical trials was developed, and semi-structured, in-depth interviews were conducted with a purposively selected sample of researchers (investigators, sponsors, and monitors) in Argentina. A response rate of 74.3% (n = 29) was achieved, and 27 interviews were ultimately used for analysis. Results suggested that the high proportion of foreign-sponsored or multinational trials (64.8% of all protocols approved by ANMAT from 1994-2006) may contribute to a communication gap between locally based investigators and foreign-based administrative officials. A lack of knowledge about available international registration tools and limited awareness of the importance of registration were also identified as limiting factors for local investigators and sponsors. To increase compliance and promote clinical trial registration in Argentina, national health authorities, sponsors, and local investigators could take the following steps: implement a grassroots educational campaign to improve clinical trial regulation, support local investigator-sponsor-initiated clinical trials, and/or encourage local and regional scientific journal compliance with standards from the International Committee of Medical Journal

Barriers to guideline-compliant psoriasis care: analyses and concepts.

Science.gov (United States)

Eissing, L; Radtke, M A; Zander, N; Augustin, M

2016-04-01

Despite the availability of effective therapeutics and evidence-based treatment guidelines, a substantial proportion of patients with moderate-to-severe psoriasis does not receive appropriate care. This under-provision of health care may cause further worsening of health, remarkable limitations of the patient's quality of life, and indirect costs for the health care system. In order to provide guideline-compliant care for every psoriasis patient, it is important to identify barriers obstructing optimal care. Studies have identified various barriers on the physician's and on the patient's side; however, respective studies approached only single barriers, and not all of them in the context of psoriasis. Other publications that describe barriers systematically did not focus on psoriasis either. The objective of this literature review was to identify barriers and facilitators, based on studies analysing quality of care and single barriers, resulting in a comprehensive model of causal factors. Our analyses revealed three categories of barriers - patient-related, physician-related and external factors: On the patient side, we found non-adherence to therapies to be an important barrier, often in close association with psychiatric factors. Barriers on the physician's side predominantly are incomplete knowledge of the guidelines as well as the complexity of psoriasis comorbidity. In some countries, payment for patients with complex disease status is poor and inconsistent reimbursement regulations potentially interfere with optimal care. The current analysis indicates that most barriers are interdependent. Thus, measures approaching related barriers simultaneously are required. To improve care for psoriasis patients, further studies systematically addressing all potentially relevant barriers in conjoint are needed. © 2015 European Academy of Dermatology and Venereology.

Effect of the δ-potential on spin-dependent electron tunneling in double barrier semiconductor heterostructure

Science.gov (United States)

Chandrasekar, L. Bruno; Gnanasekar, K.; Karunakaran, M.

2018-06-01

The effect of δ-potential was studied in GaAs/Ga0.6Al0·4As double barrier heterostructure with Dresselhaus spin-orbit interaction. The role of barrier height and position of the δ- potential in the well region was analysed on spin-dependent electron tunneling using transfer matrix method. The spin-separation between spin-resonances on energy scale depends on both height and position of the δ- potential, whereas the tunneling life time of electrons highly influenced by the position of the δ- potential and not on the height. These results might be helpful for the fabrication of spin-filters.

Designing Caregiver-Implemented Shared-Reading Interventions to Overcome Implementation Barriers

Science.gov (United States)

Logan, Jessica R.; Damschroder, Laura

2015-01-01

Purpose This study presents an application of the theoretical domains framework (TDF; Michie et al., 2005), an integrative framework drawing on behavior-change theories, to speech-language pathology. Methods A multistep procedure was used to identify barriers affecting caregivers' implementation of shared-reading interventions with their children with language impairment (LI). The authors examined caregiver-level data corresponding to implementation issues from two randomized controlled trials and mapped these to domains in the TDF as well as empirically validated behavior-change techniques. Results Four barriers to implementation were identified as potentially affecting caregivers' implementation: time pressures, reading difficulties, discomfort with reading, and lack of awareness of benefits. These were mapped to 3 TDF domains: intentions, beliefs about capabilities, and skills. In turn, 4 behavior-change techniques were identified as potential vehicles for affecting these domains: reward, feedback, model, and encourage. An ongoing study is described that is determining the effects of these techniques for improving caregivers' implementation of a shared-reading intervention. Conclusions A description of the steps to identifying barriers to implementation, in conjunction with an ongoing experiment that will explicitly determine whether behavior-change techniques affect these barriers, provides a model for how implementation science can be used to identify and overcome implementation barriers in the treatment of communication disorders. PMID:26262941

Quantifying family dissemination and identifying barriers to communication of risk information in Australian BRCA families.

Science.gov (United States)

Healey, Emma; Taylor, Natalie; Greening, Sian; Wakefield, Claire E; Warwick, Linda; Williams, Rachel; Tucker, Kathy

2017-12-01

PurposeRecommendations for BRCA1 and BRCA2 mutation carriers to disseminate information to at-risk relatives pose significant challenges. This study aimed to quantify family dissemination, to explain the differences between fully informed families (all relatives informed verbally or in writing) and partially informed families (at least one relative uninformed), and to identify dissemination barriers.MethodsBRCA1 and BRCA2 mutation carriers identified from four Australian hospitals (n=671) were invited to participate in the study. Distress was measured at consent using the Kessler psychological distress scale (K10). A structured telephone interview was used to assess the informed status of relatives, geographical location of relatives, and dissemination barriers. Family dissemination was quantified, and fully versus partially informed family differences were examined. Dissemination barriers were thematically coded and counted.ResultsA total of 165 families participated. Information had been disseminated to 81.1% of relatives. At least one relative had not been informed in 52.7% of families, 4.3% were first-degree relatives, 27.0% were second-degree relatives, and 62.0% were cousins. Partially informed families were significantly larger than fully informed families, had fewer relatives living in close proximity, and exhibited higher levels of distress. The most commonly recorded barrier to dissemination was loss of contact.ConclusionLarger, geographically diverse families have greater difficulty disseminating BRCA mutation risk information to all relatives. Understanding these challenges can inform future initiatives for communication, follow-up and support.

Potential and barrier study. Energy efficiency of Norwegian homes; Potensial- og barrierestudie. Energieffektivisering av norske boliger

Energy Technology Data Exchange (ETDEWEB)

Mjoenes, Christian; Pettersen, Folke Vogn Haug; Kristoffersen, Bjoerge Sandberg; Birkeland, Bjoern Mangor; Essen, Jan von; Haarberg; Karl Johan

2012-01-15

On behalf of Enova SF, Prognosesenteret AS and Entelligens AS carried out a potential and barrier study of energy efficiency of the Norwegian housing stock. The study made use of newer and known studies of the Norwegian housing stock, known and documented barriers to energy efficiency, and new and extensive studies of several topics which have only been partially or never explored before. Through unique analysis and a case-based approach, it revealed a real energy efficiency potential in Norwegian homes with known technology and revealed representativeness, relevance, strength and extent of the barriers that prevent that one can realize most of the technical energy efficiency potential in the Norwegian housing stock. (eb)

Investigation of the potential barrier lowering for quasi-ballistic transport in short channel MOSFETs

International Nuclear Information System (INIS)

Lee, Jaehong; Kwon, Yongmin; Ji, Junghwan; Shin, Hyungcheol

2011-01-01

In this paper, the quasi-ballistic carrier transport in short channel MOSFETs is investigated from the point of potential barrier lowering. To investigate the ballistic characteristic of transistors, we extracted the channel backscattering coefficient and the ballistic ratio from experimental data obtained by RF C-V and DC I-V measurements. Two factors that modulate the potential barrier height, besides the gate bias, are considered in this work: the drain bias (V DS ) and the channel doping concentration (N A ). We extract the critical length by calculating the potential drop in the channel region and conclude that the drain bias and the channel doping concentration affect the quasi-ballistic carrier transport.

Electronic tunneling through a potential barrier on the surface of a topological insulator

Science.gov (United States)

Zhou, Benliang; Zhou, Benhu; Zhou, Guanghui

2016-12-01

We investigate the tunneling transport for electrons on the surface of a topological insulator (TI) through an electrostatic potential barrier. By using the Dirac equation with the continuity conditions for all segments of wave functions at the interfaces between regions inside and outside the barrier, we calculate analytically the transmission probability and conductance for the system. It is demonstrated that, the Klein paradox can also been observed in the system same as in graphene system. Interestingly, the conductance reaches the minimum value when the incident electron energy is equal to the barrier strength. Moreover, with increasing barrier width, the conductance turns up some tunneling oscillation peaks, and larger barrier strength can cause lower conductance, shorter period but larger oscillation amplitude. The oscillation amplitude decreases as the barrier width increases, which is similar as that of the system consisting of the compressive uniaxial strain applied on a TI, but somewhat different from that of graphene system where the oscillation amplitude is a constant. The findings here imply that an electrostatic barrier can greatly influence the electron tunneling transport of the system, and may provide a new way to realize directional filtering of electrons.

Securing the Future of Cultural Heritage by Identifying Barriers to and Strategizing Solutions for Preservation under Changing Climate Conditions

Directory of Open Access Journals (Sweden)

Sandra Fatorić

2017-11-01

Full Text Available Climate change challenges cultural heritage management and preservation. Understanding the barriers that can impede preservation is of paramount importance, as is developing solutions that facilitate the planning and management of vulnerable cultural resources. Using online survey research, we elicited the opinions of diverse experts across southeastern United States, a region with cultural resources that are particularly vulnerable to flooding and erosion from storms and sea level rise. We asked experts to identify the greatest challenges facing cultural heritage policy and practice from coastal climate change threats, and to identify strategies and information needs to overcome those challenges. Using content analysis, we identified institutional, technical and financial barriers and needs. Findings revealed that the most salient barriers included the lack of processes and preservation guidelines for planning and implementing climate adaptation actions, as well as inadequate funding and limited knowledge about the intersection of climate change and cultural heritage. Experts perceived that principal needs to overcome identified barriers included increased research on climate adaptation strategies and impacts to cultural heritage characteristics from adaptation, as well as collaboration among diverse multi-level actors. This study can be used to set cultural heritage policy and research agendas at local, state, regional and national scales.

Identifying barriers to glycemic control in patients with type 2 diabetes after completion of an accredited education program.

Science.gov (United States)

Gildea, Chris M; Lantaff, Wendy M; Olenik, Nicole L

The objective of this study was to identify patient-perceived barriers to achieving A1C targets after receiving instruction in an accredited diabetes education program. Qualitative research using semistructured interviews and thematic analyses. One pharmacist-run diabetes center located within an independent community pharmacy in a suburban region of southern Indiana. A total of 17 participants between the ages of 41-78 were interviewed in March and April 2016. Not applicable. Patient-perceived barriers to attaining glycemic control after completion of a pharmacist-taught diabetes self-management education (DSME) program accredited by the American Association of Diabetes Educators. Participants reported a variety of perceived barriers to glycemic control subsequent to the receipt of structured education. Seven major themes emerged: 1) health care provider factors; 2) self-identified indiscretions; 3) psychological barriers and poor social support; 4) knowledge deficits; 5) personal injury or adverse drug events; 6) time constraints and competing life demands; and 7) financial constraints. Participants reported a variety of perceived barriers to achieving A1C targets after completing DSME. Incorporation of solutions and coping mechanisms to these barriers into diabetes education programs may help patients attain glycemic control. Other factors may require individualized attention outside of DSME in follow-up episodes of diabetes care. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

IEA Wind Task 32: Wind Lidar Identifying and Mitigating Barriers to the Adoption of Wind Lidar

Directory of Open Access Journals (Sweden)

Andrew Clifton

2018-03-01

Full Text Available IEA Wind Task 32 exists to identify and mitigate barriers to the adoption of lidar for wind energy applications. It leverages ongoing international research and development activities in academia and industry to investigate site assessment, power performance testing, controls and loads, and complex flows. Since its initiation in 2011, Task 32 has been responsible for several recommended practices and expert reports that have contributed to the adoption of ground-based, nacelle-based, and floating lidar by the wind industry. Future challenges include the development of lidar uncertainty models, best practices for data management, and developing community-based tools for data analysis, planning of lidar measurements and lidar configuration. This paper describes the barriers that Task 32 identified to the deployment of wind lidar in each of these application areas, and the steps that have been taken to confirm or mitigate the barriers. Task 32 will continue to be a meeting point for the international wind lidar community until at least 2020 and welcomes old and new participants.

Identifying and prioritizing barriers to implementation of smart energy city projects in Europe: An empirical approach

International Nuclear Information System (INIS)

Mosannenzadeh, Farnaz; Di Nucci, Maria Rosaria; Vettorato, Daniele

2017-01-01

Successful implementation of smart energy city projects in Europe is crucial for a sustainable transition of urban energy systems and the improvement of quality of life for citizens. We aim to develop a systematic classification and analysis of the barriers hindering successful implementation of smart energy city projects. Through an empirical approach, we investigated 43 communities implementing smart and sustainable energy city projects under the Sixth and Seventh Framework Programmes of the European Union. Validated through literature review, we identified 35 barriers categorized in policy, administrative, legal, financial, market, environmental, technical, social, and information-and-awareness dimensions. We prioritized these barriers, using a novel multi-dimensional methodology that simultaneously analyses barriers based on frequency, level of impact, causal relationship among barriers, origin, and scale. The results indicate that the key barriers are lacking or fragmented political support on the long term at the policy level, and lack of good cooperation and acceptance among project partners, insufficient external financial support, lack of skilled and trained personnel, and fragmented ownership at the project level. The outcome of the research should aid policy-makers to better understand and prioritize implementation barriers to develop effective action and policy interventions towards more successful implementation of smart energy city projects. - Highlights: • A solid empirical study on the implementation of European smart energy city projects. • We found 35 barriers in nine dimensions; e.g. policy, legal, financial, and social. • We suggested a new multi-dimensional methodology to prioritize barriers. • Lacking or fragmented political support on the long term is a key barrier. • We provided insights for action for project coordinators and policy makers.

Barriers to pediatric pain management: a nursing perspective.

Science.gov (United States)

Czarnecki, Michelle L; Simon, Katherine; Thompson, Jamie J; Armus, Cheryl L; Hanson, Tom C; Berg, Kristin A; Petrie, Jodie L; Xiang, Qun; Malin, Shelly

2011-09-01

This study describes strategies used by the Joint Clinical Practice Council of Children's Hospital of Wisconsin to identify barriers perceived as interfering with nurses' (RNs) ability to provide optimal pain management. A survey was used to ascertain how nurses described optimal pain management and how much nurses perceived potential barriers as interfering with their ability to provide that level of care. The survey, "Barriers to Optimal Pain management" (adapted from Van Hulle Vincent & Denyes, 2004), was distributed to all RNs working in all patient care settings. Two hundred seventy-two surveys were returned. The five most significant barriers identified were insufficient physician (MD) orders, insufficient MD orders before procedures, insufficient time to premedicate patients before procedures, the perception of a low priority given to pain management by medical staff, and parents' reluctance to have patients receive pain medication. Additional barriers were identified through narrative comments. Information regarding the impact of the Acute Pain Service on patient care, RNs' ability to overcome barriers, and RNs' perception of current pain management practices is included, as are several specific interventions aimed at improving or ultimately eliminating identified barriers. Copyright © 2011 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

A tool for identifying potential Eucalyptus nitens seed orchard sites ...

African Journals Online (AJOL)

Shy seed production in orchards of Eucalyptus nitens is a major barrier to the deployment of genetic gain in South African plantations. A machine learning method was used to identify optimal sites for the establishment of E. nitens seed orchards within the plantation forestry landscape of the summer rainfall region of South ...

Identifying Communication Barriers to Colorectal Cancer Screening Adherence among Appalachian Kentuckians.

Science.gov (United States)

Bachman, Audrey Smith; Cohen, Elisia L; Collins, Tom; Hatcher, Jennifer; Crosby, Richard; Vanderpool, Robin C

2017-08-18

Utilizing data from 40 in-depth interviews, this article identifies both barriers and facilitators to colorectal screening guideline adherence among Appalachian Kentucky adults recruited through a community-based research network. Key findings identify (a) varying levels of knowledge about screening guidelines, (b) reticence to engage in screening processes, and (c) nuanced communication with healthcare providers and family members regarding screening adherence. What participants knew about the screening process was often derived from personal stories or recalled stories from family members about their screening experiences. Reticence to engage in screening processes reflected reports of cumbersome preparation, privacy issues, embarrassment, medical mistrust, fear of receiving a cancer diagnosis, and lack of symptoms. Participants cited many ways to enhance patient-centered communication, and the findings from this study have implications for health communication message design and communication strategies for healthcare practices in Appalachian Kentucky clinics.

Developing a questionnaire to identify perceived barriers for implementing the Dutch physical therapy COPD clinical practice guideline.

Science.gov (United States)

van der Wees, Philip J; Zagers, Cor A M; de Die, Sara E; Hendriks, Erik J M; Nijhuis-van der Sanden, Maria W G; de Bie, Rob A

2013-05-01

Clinical practice guidelines have been developed to assist healthcare practitioners in clinical decision making. Publication of clinical practice guidelines does not automatically lead to their uptake and barrier identification has been recognized as an important step in implementation planning. This study aimed at developing a questionnaire to identify perceived barriers for implementing the Dutch COPD guideline for physical therapists and its recommended measurement instruments. An overall questionnaire, based on two existing questionnaires, was constructed to identify barriers and facilitators for implementing the COPD guideline. The construct of the questionnaire was assessed in a cross-sectional study among 246 chest physical therapists. Factor analysis was conducted to explore underlying dimensions. Psychometric properties were analyzed using Cronbach's alpha. Barriers and facilitators were assessed using descriptive statistics. Some 139 physical therapists (57%) responded. Factor analysis revealed 4-factor and 5-factor solutions with an explained variance of 36% and 39% respectively. Cronbach's alpha of the overall questionnaire was 0.90, and varied from 0.66 to 0.92 for the different factors. Underlying domains of the 5-factor solution were characterized as: attitude towards using measurement instruments, knowledge and skills of the physical therapist, applicability of the COPD guideline, required investment of time & money, and patient characteristics. Physical therapists showed a positive attitude toward using the COPD guideline. Main barriers for implementation were required time investment and financial constraints. The construct of the questionnaire revealed relevant underlying domains for the identification of barriers and facilitators for implementing the COPD guideline. The questionnaire allowed for tailoring to the target group and may be used across health care professionals as basis for in-depth analysis of barriers to specific recommendations in

Knowledge sharing in Chinese hospitals identifying sharing barriers in traditional Chinese and Western medicine collaboration

CERN Document Server

Zhou, Lihong

2015-01-01

This book aims to identify, understand and qualify barriers to the patient-centred knowledge sharing (KS) in interprofessional practice of Traditional Chinese Medicine (TCM) and Western Medicine (WM) healthcare professionals in Chinese hospitals.  This collaboration is particularly crucial and unique to China since, contrary to Western practice, these two types of professionals actually work together complimentary in the same hospital. This study adopted a Grounded Theory approach as the overarching methodology to guide the analysis of the data collected in a single case-study design.  A public hospital in central China was selected as the case-study site, at which 49 informants were interviewed by using semi-structured and evolving interview scripts.  The research findings point to five categories of KS barriers: contextual influences, hospital management, philosophical divergence, Chinese healthcare education and interprofessional training.  Further conceptualising the research findings, it is identifie...

Provider-identified barriers and facilitators to implementing a supported employment program in spinal cord injury.

Science.gov (United States)

Cotner, Bridget A; Ottomanelli, Lisa; O'Connor, Danielle R; Trainor, John K

2018-06-01

In a 5-year study, individual placement and support (IPS) significantly increased employment rate of United States Veterans with spinal cord injury (SCI), a historically underemployed population. In a follow-up study, data on barriers and facilitators to IPS implementation were identified. Over 24 months of implementation, 82 key medical and vocational staff underwent semi-structured interviews (n = 130). Interviews were digitally recorded and qualitatively analyzed (ATLAS.ti v0.7) using a constant comparative method to generate themes. Some barriers to implementation occurred throughout the study, such as Veterans' lack of motivation and providers' difficulty integrating vocational and medical rehabilitation. Other barriers emerged at specific stages, for example, early barriers included a large geographic service area and a large patient caseload, and late barriers included need for staff education. Facilitators were mostly constant throughout implementation and included leadership support and successful integration of vocational staff into the medical care team. Implementation strategies need to be adjusted as implementation progresses and matures. The strategies that succeeded in this setting, which were situated in a real-world context of providing IPS as a part of SCI medical care, may inform implementation of IPS for other populations with physical disabilities. Implications for Rehabilitation Key facilitators to IPS in SCI implementation are integrating vocational staff with expertise in IPS and SCI on clinical rehabilitation teams and providing leadership support. Ongoing barriers to IPS in SCI include patient specific and program administration factors such as caseload size and staffing patterns. Varying implementation strategies are needed to address barriers as they arise and facilitate successful implementation.

Scattering of a two skyrmion configuration on potential holes or barriers in a model Landau-Lifshitz equation

International Nuclear Information System (INIS)

Collins, J C; Zakrzewski, W J

2009-01-01

The dynamics of a baby-skyrmion configuration, in a model Landau-Lifshitz equation, was studied in the presence of various potential obstructions. The baby-skyrmion configuration was constructed from two Q = 1 hedgehog solutions to the baby-skyrme model in (2+1) dimensions. The potential obstructions were created by introducing a new term into the Lagrangian which resulted in a localized inhomogeneity in the potential terms' coefficient. In the barrier system, the normal circular path was deformed as the skyrmions traversed the barrier. During the same period, it was seen that the skyrmions sped up as they went over the barrier. For critical values of the barrier height and width, the skyrmions were no longer bound and were free to separate. In the case of a potential hole, the baby skyrmions no longer formed a bound state and moved asymptotically along the axis of the hole. It is shown how to modify the definition of the angular momentum to include the effects of the obstructions, so that it is conserved

Families' perceived benefits of home visits for managing paediatric obesity outweigh the potential costs and barriers.

Science.gov (United States)

Gehring, Nicole D; Ball, Geoff D C; Perez, Arnaldo; Holt, Nicholas L; Neuman, Daniel; Spence, Nicholas; Mercier, Laura; Jetha, Mary

2018-02-01

Home visits have successfully been used to deliver various health services, but what role could they play in paediatric weight management? Low treatment initiation and high attrition prompted our multidisciplinary paediatric weight management clinic to investigate how families perceived the benefits and barriers of home visits. We focused on children with obesity aged 2-17 who were enrolled in our tertiary-level clinic in Alberta, Canada. None had received a home visit. The families were interviewed face-to-face from October 2015 to October 2016, and we used a qualitative description methodological framework and manifest content analysis. The parents were the main interviewees. Of the 56 families, 89% were interested in a home visit, 82% wanted support from a dietician and 54% from an exercise specialist. The perceived benefits of home visits included comprehensive assessment (95%), convenience (86%), tailored care (29%) and family involvement (13%), while the costs and barriers included clinicians' potential judgmental attitudes (30%), loss of privacy (19%) and distractions (10%). Some thought clinicians would find home visits inconvenient (25%), with bureaucratic challenges (14%) and sustainability issues (5%). Families felt home visits were a convenient option for managing paediatric obesity and identified important benefits and barriers that could guide such interventions. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

IEA Wind Task 32: Wind lidar identifying and mitigating barriers to the adoption of wind lidar

DEFF Research Database (Denmark)

Clifton, Andrew; Clive, Peter; Gottschall, Julia

2018-01-01

IEA Wind Task 32 exists to identify and mitigate barriers to the adoption of lidar for wind energy applications. It leverages ongoing international research and development activities in academia and industry to investigate site assessment, power performance testing, controls and loads, and complex...... flows. Since its initiation in 2011, Task 32 has been responsible for several recommended practices and expert reports that have contributed to the adoption of ground-based, nacelle-based, and floating lidar by the wind industry. Future challenges include the development of lidar uncertainty models......, best practices for data management, and developing community-based tools for data analysis, planning of lidar measurements and lidar configuration. This paper describes the barriers that Task 32 identified to the deployment of wind lidar in each of these application areas, and the steps that have been...

Material Barriers to Diffusive Mixing

Science.gov (United States)

Haller, George; Karrasch, Daniel

2017-11-01

Transport barriers, as zero-flux surfaces, are ill-defined in purely advective mixing in which the flux of any passive scalar is zero through all material surfaces. For this reason, Lagrangian Coherent Structures (LCSs) have been argued to play the role of mixing barriers as most repelling, attracting or shearing material lines. These three kinematic concepts, however, can also be defined in different ways, both within rigorous mathematical treatments and within the realm of heuristic diagnostics. This has lead to a an ever-growing number of different LCS methods, each generally identifying different objects as transport barriers. In this talk, we examine which of these methods have actual relevance for diffusive transport barriers. The latter barriers are arguably the practically relevant inhibitors in the mixing of physically relevant tracers, such as temperature, salinity, vorticity or potential vorticity. We demonstrate the role of the most effective diffusion barriers in analytical examples and observational data. Supported in part by the DFG Priority Program on Turbulent Superstructures.

Potential and barrier study. Passive house and near-zero energy buildings; Potensial- og barrierestudie. Passivhus og naer nullenergibygninger

Energy Technology Data Exchange (ETDEWEB)

NONE

2012-07-01

The main conclusion from the analysis is that the barriers to realize both passive and near zero-energy buildings are significant. In addition to being a mere economic assessment indicates that 30-70% of the technical potential is not profitable depending on energy price levels, the barriers is reducing the economic potential with approximately another half as a realistic market potential.(eb)

Superluminal tunneling of a relativistic half-integer spin particle through a potential barrier

Directory of Open Access Journals (Sweden)

Nanni Luca

2017-11-01

Full Text Available This paper investigates the problem of a relativistic Dirac half-integer spin free particle tunneling through a rectangular quantum-mechanical barrier. If the energy difference between the barrier and the particle is positive, and the barrier width is large enough, there is proof that the tunneling may be superluminal. For first spinor components of particle and antiparticle states, the tunneling is always superluminal regardless the barrier width. Conversely, the second spinor components of particle and antiparticle states may be either subluminal or superluminal depending on the barrier width. These results derive from studying the tunneling time in terms of phase time. For the first spinor components of particle and antiparticle states, it is always negative while for the second spinor components of particle and antiparticle states, it is always positive, whatever the height and width of the barrier. In total, the tunneling time always remains positive for particle states while it becomes negative for antiparticle ones. Furthermore, the phase time tends to zero, increasing the potential barrier both for particle and antiparticle states. This agrees with the interpretation of quantum tunneling that the Heisenberg uncertainty principle provides. This study’s results are innovative with respect to those available in the literature. Moreover, they show that the superluminal behaviour of particles occurs in those processes with high-energy confinement.

Barriers and strategies for identifying and managing risk factors of cardiovascular diseases in levels of preventing, screening, and treating

Directory of Open Access Journals (Sweden)

Saber Azami Aghdash

2015-11-01

Full Text Available Introduction: Cardiovascular diseases (CVD are of the main causes of mortality in the world and impose a heavy economic, social, and health burden on society. Therefore, the objective of this study was to determine the barriers and strategies for identifying and managing risk factors of CVD in levels of preventing, screening, and treating. Methods: During present qualitative study with phenomenological approach, 60 subjects of cardiologists, nurses, patients, and their relatives were selected based on purposive sampling from educational-medical cardiothoracic subspecialty centers. Data were collected using an open-ended questionnaire and was extracted and analyzed with content analysis method. Results: Barriers were divided into three groups of individual barriers (low awareness, delay in referring for treatment and screening, incorrect beliefs, and not caring about health, socio-economic barriers (high costs, lack of resources, mental and psychological pressures, and health care barriers (non-alignment of doctors, being therapy-oriented, managerial and planning weaknesses, and lack of health care facilities. The most important presenting strategies are: providing public educations, improving family physician program, reduction of costs, cooperation of patients, and using functional indices to evaluate and improve the quality of services. Conclusion: Low awareness of people, high costs of services, lack of health care facilities, socio-cultural problems of people, and delay in referring of people, for treatment and screening are of the most important barriers of proper identifying and managing risk factors of CVD. Strategies provided in this study to overcome these barriers could be used.

The Fuel Efficiency of Maritime Transport. Potential for improvement and analysis of barriers

Energy Technology Data Exchange (ETDEWEB)

Faber, J.; Nelissen, D.; Smit, M. [CE Delft, Delft (Netherlands); Behrends, B. [Marena Ltd., s.l. (United Kingdom); Lee, D.S. [Manchester Metropolitan University, Machester (United Kingdom)

2012-02-15

There is significant potential to improve the fuel efficiency of ships and thus contribute to reducing greenhouse gas emissions from maritime transport. It has long been recognised that this potential is not being fully exploited, owing to the existence of non-market barriers. This report analyses the barriers to implementing fuel efficiency improvements, and concludes that the most important of these are the split incentive between ship owners and operators, a lack of trusted data on new technologies, and transaction costs associated with evaluating measures. As a result, in practice about a quarter of the cost-effective abatement potential is unavailable. There are several ways to overcome these barriers. The split incentive can - to some extent - be overcome by providing more detailed information on the fuel efficiency of vessels, making due allowance for operational profiles. This would allow fuel consumption to be more accurately projected and a larger share of efficiency benefits to accrue to ship owners, thus increasing the return on investment in fuel-saving technologies. This would also require changes to standard charter parties. The credibility of information on new technologies can be improved through intensive collaboration between suppliers of new technologies and shipping companies. In order to overcome risk, government subsidies could provide an incentive. This could have the additional benefit that governments could require publication of results.

Identifying the barriers and enablers in the implementation of the New Zealand and Australian Antenatal Corticosteroid Clinical Practice Guidelines

Directory of Open Access Journals (Sweden)

E. L. Mc Goldrick

2016-10-01

Full Text Available Abstract Background The ineffective implementation of evidence based practice guidelines can mean that the best health outcomes are not achieved. This study examined the barriers and enablers to the uptake and implementation of the new bi-national (Australia and New Zealand antenatal corticosteroid clinical practice guidelines among health professionals, using the Theoretical Domains Framework. Methods Semi-structured interviews or online questionnaires were conducted across four health professional groups and three district health boards in Auckland, New Zealand. The questions were constructed to reflect the 14 behavioural domains from the Theoretical Domains Framework. Relevant domains were identified by the presence of conflicting beliefs within a domain; the frequency of beliefs; and the likely strength of the impact of a belief on the behaviour using thematic analysis. The influence of health professional group and organisation on the different barriers and enablers identified were explored. Results Seventy-three health professionals completed either a semi-structured interview (n = 35 or on-line questionnaire (n = 38. Seven behavioural domains were identified as overarching enablers: belief about consequences; knowledge; social influences; environmental context and resource; belief about capabilities; social professional role and identity; and behavioural regulation. Five behavioural domains were identified as overarching barriers: environmental context and resources; knowledge; social influences; belief about consequences; and social professional role and identity. Differences in beliefs between individual health professional groups were identified within the domains: belief about consequences; social professional role and identity; and emotion. Organisational differences were identified within the domains: belief about consequences; social influences; and belief about capabilities. Conclusion This study has identified some of the

Potential barrier heights at metal on oxygen-terminated diamond interfaces

Energy Technology Data Exchange (ETDEWEB)

Muret, P., E-mail: pierre.muret@neel.cnrs.fr; Traoré, A.; Maréchal, A.; Eon, D. [Inst. NEEL, Univ. Grenoble Alpes, F-38042 Grenoble, France and CNRS, Inst. NEEL, F-38042 Grenoble (France); Pernot, J. [Univ. Grenoble Alpes, Inst. NEEL, F-38042 Grenoble, (France); CNRS, Inst. NEEL, F-38042 Grenoble, (France); Institut Universitaire de France, 103 Boulevard Saint-Michel, F-75005 Paris (France); Pinero, J. C.; Villar, M. P.; Araujo, D., E-mail: daniel.araujo@uca.es [Dpto. Ciencias de los Materiales, Universidad de Cádiz, 11510 Puerto Real (Cádiz) (Spain)

2015-11-28

Electrical properties of metal-semiconductor (M/SC) and metal/oxide/SC structures built with Zr or ZrO{sub 2} deposited on oxygen-terminated surfaces of (001)-oriented diamond films, comprised of a stack of lightly p-doped diamond on a heavily doped layer itself homoepitaxially grown on an Ib substrate, are investigated experimentally and compared to different models. In Schottky barrier diodes, the interfacial oxide layer evidenced by high resolution transmission electron microscopy and electron energy losses spectroscopy before and after annealing, and barrier height inhomogeneities accounts for the measured electrical characteristics until flat bands are reached, in accordance with a model which generalizes that by Tung [Phys. Rev. B 45, 13509 (1992)] and permits to extract physically meaningful parameters of the three kinds of interface: (a) unannealed ones, (b) annealed at 350 °C, (c) annealed at 450 °C with the characteristic barrier heights of 2.2–2.5 V in case (a) while as low as 0.96 V in case (c). Possible models of potential barriers for several metals deposited on well defined oxygen-terminated diamond surfaces are discussed and compared to experimental data. It is concluded that interface dipoles of several kinds present at these compound interfaces and their chemical evolution due to annealing are the suitable ingredients that are able to account for the Mott-Schottky behavior when the effect of the metal work function is ignored, and to justify the reverted slope observed regarding metal work function, in contrast to the trend always reported for all other metal-semiconductor interfaces.

Identifying non-technical skills and barriers for improvement of teamwork in cardiac arrest teams

DEFF Research Database (Denmark)

Andersen, P.O.; Jensen, Michael Kammer; Lippert, A.

2010-01-01

Background: The application of non-technical skills (NTSs) in health care has previously been described in other health-care educational programmes. NTSs are behavioural principles such as leadership, task distribution and communication. The aim of this study was to identify NTSs suitable...... for improving team performance in multi-professional cardiac arrest teams, and to describe barriers to the use and implementation of such NTSs by using a qualitative method. Methods: Individual semi-structured interviews were conducted with 11 Danish Advanced Life Support instructors during the period April...... 2006 to November 2006. Interviews were focussed on barriers and recommendations for teamwork in the cardiac arrest team, optimal policy for improvement of resuscitation training and clinical practice, use of cognitive aids and adoption of European Resuscitation Council (ERC) Guidelines 2005. Interviews...

Modeling connectivity to identify current and future anthropogenic barriers to movement of large carnivores: A case study in the American Southwest.

Science.gov (United States)

McClure, Meredith L; Dickson, Brett G; Nicholson, Kerry L

2017-06-01

This study sought to identify critical areas for puma ( Puma concolor ) movement across the state of Arizona in the American Southwest and to identify those most likely to be impacted by current and future human land uses, particularly expanding urban development and associated increases in traffic volume. Human populations in this region are expanding rapidly, with the potential for urban centers and busy roads to increasingly act as barriers to demographic and genetic connectivity of large-bodied, wide-ranging carnivores such as pumas, whose long-distance movements are likely to bring them into contact with human land uses and whose low tolerance both for and from humans may put them at risk unless opportunities for safe passage through or around human-modified landscapes are present. Brownian bridge movement models based on global positioning system collar data collected during bouts of active movement and linear mixed models were used to model habitat quality for puma movement; then, a wall-to-wall application of circuit theory models was used to produce a continuous statewide estimate of connectivity for puma movement and to identify pinch points, or bottlenecks, that may be most at risk of impacts from current and future traffic volume and expanding development. Rugged, shrub- and scrub-dominated regions were highlighted as those offering high quality movement habitat for pumas, and pinch points with the greatest potential impacts from expanding development and traffic, although widely distributed, were particularly prominent to the north and east of the city of Phoenix and along interstate highways in the western portion of the state. These pinch points likely constitute important conservation opportunities, where barriers to movement may cause disproportionate loss of connectivity, but also where actions such as placement of wildlife crossing structures or conservation easements could enhance connectivity and prevent detrimental impacts before they occur.

Identifying barriers to chronic disease reporting in Chicago Public Schools: a mixed-methods approach.

Science.gov (United States)

Rivkina, Victoria; Tapke, David E; Cardenas, Lilliana D; Harvey-Gintoft, Blair; Whyte, Stephanie A; Gupta, Ruchi S

2014-12-06

Chronic disease among school-aged children is a public health concern, particularly for asthma and food allergy. In Chicago Public Schools (CPS), rates of asthma and food allergy among students are underreported. The aim of this study was to determine the barriers to chronic disease reporting as experienced by CPS parents and school nurses. A mixed-methods approach included focus groups and key informant interviews with parents and school nurses, and a cross-sectional survey was completed by parents. Qualitative data analysis was performed and survey data were analyzed to determine the significant demographic and knowledge variables associated with successfully completing the reporting process. The three main barriers identified were 1) a lack of parental process knowledge; 2) limited communication from schools; and 3) insufficient availability of school nurses. Parents were significantly more likely to successfully complete the reporting process if they knew about special accommodations for chronic diseases, understood the need for physician verification, and/or knew the school nurse. These findings suggest that increasing parental knowledge of the reporting process will allow schools to better identify and manage their students' chronic conditions. A parent-focused intervention informed by these results has been completed.

Energy shift and conduction-to-valence band transition mediated by a time-dependent potential barrier in graphene

Science.gov (United States)

Chaves, Andrey; da Costa, D. R.; de Sousa, G. O.; Pereira, J. M.; Farias, G. A.

2015-09-01

We investigate the scattering of a wave packet describing low-energy electrons in graphene by a time-dependent finite-step potential barrier. Our results demonstrate that, after Klein tunneling through the barrier, the electron acquires an extra energy which depends on the rate of change of the barrier height with time. If this rate is negative, the electron loses energy and ends up as a valence band state after leaving the barrier, which effectively behaves as a positively charged quasiparticle.

Novel Active Learning Experiences for Students to Identify Barriers to Independent Living for People with Disabilities.

Science.gov (United States)

McArthur, Polly; Burch, Lillian; Moore, Katherine; Hodges, Mary Sue

2016-07-01

This article describes interactive learning about independent living for people with disabilities and features the partnership of the College of Nursing and a Center for Independent Living (CIL). Using qualitative descriptive approach, students' written reflections were analyzed. Through "Xtreme Challenge," 82 undergraduate nursing students participated in aspects of independent living as well as identifying barriers. Students were engaged and learned to consider the person before the disability. Moreover, students valued the activity leaders' openness, which facilitated understanding the point of view of a person with disability. The value of partnership was evident as it allowed students to participate in active learning, which led to growth in the affective domain. Students became aware of potential education resources through the CIL. This article will guide educators in designing experiences that teach nursing care at the individual, family, and community level for people living with disabilities. © 2015 Association of Rehabilitation Nurses.

A survey to identify barriers of implementing an antibiotic checklist

NARCIS (Netherlands)

van Daalen, F. V.; Geerlings, S. E.; Prins, J. M.; Hulscher, M. E. J. L.

2016-01-01

A checklist is an effective implementation tool, but addressing barriers that might impact on the effectiveness of its use is crucial. In this paper, we explore barriers to the uptake of an antibiotic checklist that aims to improve antibiotic use in daily hospital care. We performed an online

Complex energy eigenvalues of a linear potential with a parabolical barrier

International Nuclear Information System (INIS)

Malherbe, J.B.

1978-01-01

The physical meaning and restrictions of complex energy eigenvalues are briefly discussed. It is indicated that a quasi-stationary phase describes an idealised disintegration system. Approximate resonance-eigenvalues of the one dimensional Schrodinger equation with a linear potential and parabolic barrier are calculated by means of Connor's semiclassical method. This method is based on the generalized WKB-method of Miller and Good. The results obtained confirm the correctness of a model representation which explains the unusual distribution of eigenvalues by certain other linear potentials in a complex energy level [af

Identifying and Overcoming Barriers to Effective Consideration of Human and Organisational Factors in Event Analysis and Root Cause Analysis. Workshop Proceedings, September 21-22, 2009, Paris, France

International Nuclear Information System (INIS)

2011-01-01

Nuclear licensees must have effective processes for learning from operating experience in order to manage safety, secure continuous improvement and defend against the potential for repeat events. These processes include root cause analysis (RCA) to identify the underlying causes of events and mechanisms to learn from these analyses and to implement improvements. Correctly identifying and correcting the causes of events will allow lessons to be learned and shared with others in the industry. The treatment of Human and Organisational Factors (HOF) in RCA is of special interest to WGHOF. It is estimated that approximately 60-80% of events in the nuclear industry can be attributed to human and organisational factors. Although the importance of correctly identifying the HOF causes is understood, there is still a tendency for the analysis to focus solely on the technical issues of the event. The history of prominent events across the major hazards sector shows that HOF lessons often fail to be learned. A NEA/CSNI special experts meeting entitled 'Identification of Barriers to Analyzing and Identifying Human and Organisational Factors in Root Cause Analysis' was held at the NEA Headquarters in Paris, France on September 21-22, 2009. A total of 17 participants from 10 countries representing licensee organisations, regulators, international organisations and an independent consultant attended the meeting. The meeting was structured to allow for small group discussions during which a number of themes were explored, followed by plenary discussion. There were also four papers presented which complemented the discussion themes. As set out in the objectives of this work, the participants identified barriers to the effective treatment of HOF in RCA and recommendations to mitigate the effects of these barriers. Many of the barriers and recommendations identified relate to the RCA process in general, not specifically to the treatment of HOF in the RCA process. This is logical, for

Scattering and pair production by a potential barrier

International Nuclear Information System (INIS)

Nikishov, A.I.

2004-01-01

Scattering and electron-positron pair production by a one-dimensional electric barrier is considered in the framework of the S-matrix formalism. The solution of the Dirac equation are classified according to frequency sign. The Bogolyubov transformations relating the in- and out-states are given. It is shown that the norm of a solution of the wave equation is determined by the largest amplitude of its asymptotic form when x 3 → ±∞. For the Sauter-type potential we give the explicit expressions for the complete in- and out-sets of orthonormalized wave functions. It is noted that in principle virtual vacuum processes in external field influence the phase of the wave function of the scattered particle [ru

Quantum mechanical streamlines. I - Square potential barrier

Science.gov (United States)

Hirschfelder, J. O.; Christoph, A. C.; Palke, W. E.

1974-01-01

Exact numerical calculations are made for scattering of quantum mechanical particles hitting a square two-dimensional potential barrier (an exact analog of the Goos-Haenchen optical experiments). Quantum mechanical streamlines are plotted and found to be smooth and continuous, to have continuous first derivatives even through the classical forbidden region, and to form quantized vortices around each of the nodal points. A comparison is made between the present numerical calculations and the stationary wave approximation, and good agreement is found between both the Goos-Haenchen shifts and the reflection coefficients. The time-independent Schroedinger equation for real wavefunctions is reduced to solving a nonlinear first-order partial differential equation, leading to a generalization of the Prager-Hirschfelder perturbation scheme. Implications of the hydrodynamical formulation of quantum mechanics are discussed, and cases are cited where quantum and classical mechanical motions are identical.

Some Danish experience with product-service systems and their potentials and barriers to sustainable development

DEFF Research Database (Denmark)

Jørgensen, Michael Søgaard

2003-01-01

This paper is one of the first attempts to scan the Danish experience with product-service systems and analyse the experiences with respect to potentials and barriers to sustainable development, i.e. reduced resource consumption and reduced environmental impact. The scan shows a variety of product-service-systems......: some have been around for many years and have not be set up for sustainability purposes, while others are rather new and are attempts to contribute to a more sustainable development. Some of the systems identified are so to say born as product-service-systems (like food catering), while others have...... been developed from being a product system into being a product-service-systems in order to support the marketing of more environmental friendly products....

Quantum tunneling through a very narrow triangular potential barrier exact and WKB solution

International Nuclear Information System (INIS)

Ballo, P.; Harmatha, L.

2011-01-01

We have investigated the quantum-mechanical transmission of an electron in narrow potential barrier. It has been shown that application of WKB approximation could give enormous error if the slope of potential is rapid. Edification of this work is that unreasonable application of numerical approximations without the deep knowledge of theory should give wrong result. This we should remember every second, every day. (authors)

Smart parking barrier

KAUST Repository

Alharbi, Abdulrazaq M.

2016-05-06

Various methods and systems are provided for smart parking barriers. In one example, among others, a smart parking barrier system includes a movable parking barrier located at one end of a parking space, a barrier drive configured to control positioning of the movable parking barrier, and a parking controller configured to initiate movement of the parking barrier, via the barrier drive. The movable parking barrier can be positioned between a first position that restricts access to the parking space and a second position that allows access to the parking space. The parking controller can initiate movement of the movable parking barrier in response to a positive identification of an individual allowed to use the parking space. The parking controller can identify the individual through, e.g., a RFID tag, a mobile device (e.g., a remote control, smartphone, tablet, etc.), an access card, biometric information, or other appropriate identifier.

Effect of nanodimensional polyethylenimine layer on surface potential barriers of hybrid structures based on silicon single crystal

Science.gov (United States)

Malyar, Ivan V.; Gorin, Dmitry A.; Stetsyura, Svetlana V.

2013-01-01

In this report we present the analysis of I-V curves for MIS-structures like silicon substrate / nanodimensional polyelectrolyte layer / metal probe (contact) which is promising for biosensors, microfluidic chips, different devices of molecular electronics, such as OLEDs, solar cells, where polyelectrolyte layers can be used to modify semiconductor surface. The research is directed to investigate the contact phenomena which influence the resulting signal of devices mentioned above. The comparison of I-V characteristics of such structures measured by scanning tunnel microscopy (contactless technique) and using contact areas deposited by thermal evaporation onto the organic layer (the contact one) was carried out. The photoassisted I-V measurements and complex analysis based on Simmons and Schottky models allow one to extract the potential barriers and to observe the changes of charge transport in MIS-structures under illumination and after polyelectrolyte adsorption. The direct correlation between the thickness of the deposited polyelectrolyte layer and both equilibrium tunnel barrier and Schottky barrier height was observed for hybrid structures with polyethylenimine. The possibility of control over the I-V curves of hybrid structure and the height of the potential barriers (for different charge transports) by illumination was confirmed. Based on experimental data and complex analysis the band diagrams were plotted which illustrate the changes of potential barriers for MIS-structures due to the polyelectrolyte adsorption and under the illumination.

Barriers to healthcare for transgender individuals.

Science.gov (United States)

Safer, Joshua D; Coleman, Eli; Feldman, Jamie; Garofalo, Robert; Hembree, Wylie; Radix, Asa; Sevelius, Jae

2016-04-01

Transgender persons suffer significant health disparities and may require medical intervention as part of their care. The purpose of this manuscript is to briefly review the literature characterizing barriers to healthcare for transgender individuals and to propose research priorities to understand mechanisms of those barriers and interventions to overcome them. Current research emphasizes sexual minorities' self-report of barriers, rather than using direct methods. The biggest barrier to healthcare reported by transgender individuals is lack of access because of lack of providers who are sufficiently knowledgeable on the topic. Other barriers include: financial barriers, discrimination, lack of cultural competence by providers, health systems barriers, and socioeconomic barriers. National research priorities should include rigorous determination of the capacity of the US healthcare system to provide adequate care for transgender individuals. Studies should determine knowledge and biases of the medical workforce across the spectrum of medical training with regard to transgender medical care; adequacy of sufficient providers for the care required, larger social structural barriers, and status of a framework to pay for appropriate care. As well, studies should propose and validate potential solutions to address identified gaps.

ICTs for rural development: potential applications and barriers involved

Directory of Open Access Journals (Sweden)

Anastasia Stratigea

2013-03-01

Full Text Available Rural policy nowadays is at the heart of the policy discussion in many countries all over the world, in the effort to address and effectively support the specific needs and opportunities of rural places and their population in the new era. Along these lines, the focus of the present paper is twofold: on the one hand it attempts to shed light on the role of ICTs and their applications as enabling tools empowering rural development; while on the other hand it explores the barriers appearing towards the adoption and use of ICTs in rural regions. In such a context, it firstly places emphasis on the evolving new rural development paradigm. Then, the range and potential of ICTs applications is explored, that can serve the implementation of the new policy paradigm in rural regions. It follows a discussion on the steps that are needed in order to develop value-added ICTs applications in rural regions and the barriers appearing in the adoption and use of ICTs in these regions. Finally, are presented some issues of policy concern in respect to the adoption and use of ICTs in a rural development perspective.

Communicating with disabled children when inpatients: barriers and facilitators identified by parents and professionals in a qualitative study.

Science.gov (United States)

Sharkey, Siobhan; Lloyd, Claire; Tomlinson, Richard; Thomas, Eleanor; Martin, Alice; Logan, Stuart; Morris, Christopher

2016-06-01

Communication is a fundamental part of health care, but can be more difficult with disabled children. Disabled children are more frequently admitted to hospital than other children. To explore experiences of ward staff and families to identify barriers and facilitators to effective communication with disabled children whilst inpatients. This was an exploratory qualitative study. We consulted 25 staff working on paediatric wards and 15 parents of disabled children recently admitted to those wards. We had difficulty in recruiting children and evaluating their experiences. Data were collected through interviews and focus groups. A thematic analysis of the data supported by the Framework Approach was used to explore experiences and views about communication. Emerging themes were subsequently synthesised to identify barriers and facilitators to good communication. Barriers to communication included time, professionals not prioritising communication in their role and poor information sharing between parents and professionals. Facilitators included professionals building rapport with a child, good relationships between professionals and parents, professionals having a family-centred approach, and the use of communication aids. Communication with disabled children on the ward was perceived as less than optimal. Parents are instrumental in the communication between their children and professionals. Although aware of the importance of communication with disabled children, staff perceived time pressures and lack of priority given to communicating directly with the child as major barriers. © 2014 John Wiley & Sons Ltd.

Moderated mediation to identify the knowledge stocks, learning flows and barriers at a Dutch telecom operator

NARCIS (Netherlands)

de Schryver, Tom; Rosendaal, Bas

2013-01-01

Drawing on the 4I-model of Crossan et al. (1999), we have identified the knowledge stocks, learning flows and barriers at a Dutch telecom operator by means of moderated mediation. In this company, the strategic relevant knowledge stocks move in the same direction and many processes support their

Barriers to female sex addiction treatment in the UK.

Science.gov (United States)

Dhuffar, Manpreet K; Griffiths, Mark D

2016-12-01

Background Over the last 20 years, behavioral addictions (e.g., addictions to gambling, playing video games, work, etc.) have become more accepted among both public and scientific communities. Addiction to sex is arguably a more controversial issue, but this does not take away from the fact that some individuals seek professional help for problematic excessive sex, irrespective of how the behavior is conceptualized. Empirical evidence suggests that among treatment seekers, men are more likely than women to seek help for sex addiction (SA). Methods Using the behavioral addiction literature and the authors' own expertise in researching female SA, this paper examines potential barriers to the treatment for female sex addicts. Results Four main types of barriers for female sex addicts not seeking treatment were identified. These comprised (a) individual barriers, (b) social barriers, (c) research barriers, and (d) treatment barriers. Conclusions Further research is needed to either confirm or disconfirm the identified barriers that female sex addicts face when seeking treatment, and if conformation is found, interested stakeholders should provide better awareness and/or see ways in which such barriers can be overcome to aid better uptake of SA services.

Examining emergency department communication through a staff-based participatory research method: identifying barriers and solutions to meaningful change.

Science.gov (United States)

Cameron, Kenzie A; Engel, Kirsten G; McCarthy, Danielle M; Buckley, Barbara A; Mercer Kollar, Laura Min; Donlan, Sarah M; Pang, Peter S; Makoul, Gregory; Tanabe, Paula; Gisondi, Michael A; Adams, James G

2010-12-01

We test an initiative with the staff-based participatory research (SBPR) method to elicit communication barriers and engage staff in identifying strategies to improve communication within our emergency department (ED). ED staff at an urban hospital with 85,000 ED visits per year participated in a 3.5-hour multidisciplinary workshop. The workshop was offered 6 times and involved: (1) large group discussion to review the importance of communication within the ED and discuss findings from a recent survey of patient perceptions of ED-team communication; (2) small group discussions eliciting staff perceptions of communication barriers and best practices/strategies to address these challenges; and (3) large group discussions sharing and refining emergent themes and suggested strategies. Three coders analyzed summaries from group discussions by using latent content and constant comparative analysis to identify focal themes. A total of 127 staff members, including attending physicians, residents, nurses, ED assistants, and secretaries, participated in the workshop (overall participation rate 59.6%; range 46.7% to 73.3% by staff type). Coders identified a framework of 4 themes describing barriers and proposed interventions: (1) greeting and initial interaction, (2) setting realistic expectations, (3) team communication and respect, and (4) information provision and delivery. The majority of participants (81.4%) reported that their participation would cause them to make changes in their clinical practice. Involving staff in discussing barriers and facilitators to communication within the ED can result in a meaningful process of empowerment, as well as the identification of feasible strategies and solutions at both the individual and system levels. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Barriers and Facilitators to Central Venous Catheter Insertion: A Qualitative Study.

Science.gov (United States)

Cameron, Kenzie A; Cohen, Elaine R; Hertz, Joelle R; Wayne, Diane B; Mitra, Debi; Barsuk, Jeffrey H

2018-03-14

The aims of the study were to identify perceived barriers and facilitators to central venous catheter (CVC) insertion among healthcare providers and to understand the extent to which an existing Simulation-Based Mastery Learning (SBML) program may address barriers and leverage facilitators. Providers participating in a CVC insertion SBML train-the-trainer program, in addition to intensive care unit nurse managers, were purposively sampled from Veterans Administration Medical Centers located in geographically diverse areas. We conducted semistructured interviews to assess perceptions of barriers and facilitators to CVC insertion. Deidentified transcripts were analyzed using a grounded theory approach and the constant comparative method. We subsequently mapped identified barriers and facilitators to our SBML curriculum to determine whether or not the curriculum addresses these factors. We interviewed 28 providers at six Veterans Administration Medical Centers, identifying the following five overarching factors of perceived barriers to CVC insertion: (1) equipment, (2) personnel/staff, (3) setting or organizational context, (4) patient or provider, and (5) time-related barriers. Three overarching factors of facilitators emerged: (1) equipment, (2) personnel, and (3) setting or organizational context facilitators. The SBML curriculum seems to address most identified barriers, while leveraging many facilitators; building on the commonly identified facilitator of nursing staff contribution by expanding the curriculum to explicitly include nurse involvement could improve team efficiency and organizational culture of safety. Many identified facilitators (e.g., ability to use ultrasound, personnel confidence/competence) were also identified as barriers. Evidence-based SBML programs have the potential to amplify these facilitators while addressing the barriers by providing an opportunity to practice and master CVC insertion skills.

Origin of methyl torsional potential barrier – An overview

Indian Academy of Sciences (India)

Unknown

The effect of skeletal flexing on the picture of barrier .... views to explain the origin of the barrier to this rotation have been proposed, but none of .... molecule, a model is always advantageous to predict the barrier and its cause in a given.

Translational safety biomarkers of colonic barrier integrity in the rat.

Science.gov (United States)

Erkens, Tim; Bueters, Ruud; van Heerden, Marjolein; Cuyckens, Filip; Vreeken, Rob; Goeminne, Nick; Lammens, Lieve

2018-05-20

The intestinal barrier controls intestinal permeability, and its disruption has been associated with multiple diseases. Therefore, preclinical safety biomarkers monitoring barrier integrity are essential during the development of drugs targeting the intestines, particularly if starting treatment early after onset of disease. Classical toxicology endpoints are not sensitive enough and therefore our objective was to identify non-invasive markers enabling early in vivo detection of colonic barrier perturbation. Male Sprague-Dawley rats were dosed intracolonically via the rectum, using sodium caprate or ibuprofen as tool compounds to alter barrier integrity. Several potentially translational biomarkers and probe molecules related to permeability, inflammation or tissue damage were evaluated, using various analytical platforms, including immunoassays, targeted metabolomics and highly sensitive ultra-performance liquid chromatography-tandem mass spectrometry. Several markers were identified that allow early in vivo detection of colonic barrier integrity changes, before histopathological evidence of tissue damage. The most promising permeability markers identified were plasma fluorescein isothiocyanate-dextran 4000 and a lactulose/mannitol/sucralose mixture in urine. These markers showed maximum increases over 100-fold or approximately 10-50-fold, respectively. Intracolonic administration of the above probe molecules outperformed oral administration and inflammatory or other biomarkers, such as α 2 -macroglobulin, calprotectin, cytokines, prostaglandins and a panel of metabolic molecules to identify early and subtle changes in barrier integrity. However, optimal timing of probe administration and sample collection is important for all markers evaluated. Inclusion of these probe molecules in preclinical toxicity studies might aid in risk assessment and the design of a clinical biomarker plan, as several of these markers have translational potential. Copyright © 2018 John

Barriers to renewable energy penetration. A framework for analysis

DEFF Research Database (Denmark)

Painuly, Jyoti P.

2001-01-01

Renewable energy has the potential to play an important role in providing energy with sustainability to the vast populations in developing countries who as yet have no access to clean energy. Although economically viable fur several applications, renewable energy has not been able to realise its...... potential due to several barriers to its penetration. A framework has been developed in this paper to identify the barriers to renewable energy penetration acid to suggest measures to overcome them. (C) 2001 Elsevier Science Ltd. All rights reserved....

Barriers and facilitators of mental health screening in pregnancy.

Science.gov (United States)

Kingston, Dawn; Austin, Marie-Paule; Heaman, Maureen; McDonald, Sheila; Lasiuk, Gerri; Sword, Wendy; Giallo, Rebecca; Hegadoren, Kathy; Vermeyden, Lydia; van Zanten, Sander Veldhuyzen; Kingston, Joshua; Jarema, Karly; Biringer, Anne

2015-11-01

Access to mental health services during pregnancy is most commonly mobilized through formal mental health screening. However, few studies to date have identified barriers and facilitators that affect pregnant women's responses to mental health screening. The objective was to identify barriers and facilitators that influence pregnant women's responses to the screening process and factors associated with their identification. This multi-site, cross-sectional survey recruited pregnant women >16 years of age who spoke/read English in Alberta, Canada. Main outcomes were barriers and facilitators of mental health screening. Descriptive statistics were generated to identify the most common barriers and facilitators and multivariable logistic regression models were conducted to determine factors associated with barriers and facilitators. Study participation rate was 92% (460/500). Women's most common barriers were: significant others normalizing their emotional difficulties; desiring to handle mental health problems on their own; preferring to discuss feelings with significant others; and not knowing what emotions were 'normal'. Women who identified these barriers were more likely not to have been treated previously for mental illness, were primiparous, and could not be completely honest with their provider. Main facilitators were provider characteristics (sensitive, interested), reassurance that mental healthcare is a part of routine prenatal care, hearing that other women have emotional problems during pregnancy and knowing that help was available. The sample comprised largely Caucasian, well-educated, and partnered women, which limits generalizability of the findings. Personal and stigma-related barriers influence pregnant women's responses to mental health screening. Efforts to minimize barriers and enhance facilitators should be explored as potential strategies for optimizing prenatal mental health screening. Copyright © 2015 Elsevier B.V. All rights reserved.

Identifying Barriers to Delivering the Awakening and Breathing Coordination, Delirium, and Early Exercise/Mobility Bundle to Minimize Adverse Outcomes for Mechanically Ventilated Patients: A Systematic Review.

Science.gov (United States)

Costa, Deena Kelly; White, Matthew R; Ginier, Emily; Manojlovich, Milisa; Govindan, Sushant; Iwashyna, Theodore J; Sales, Anne E

2017-08-01

Improved outcomes are associated with the Awakening and Breathing Coordination, Delirium, and Early exercise/mobility bundle (ABCDE); however, implementation issues are common. As yet, no study has integrated the barriers to ABCDE to provide an overview of reasons for less successful efforts. The purpose of this review was to identify and catalog the barriers to ABCDE delivery based on a widely used implementation framework, and to provide a resource to guide clinicians in overcoming barriers to implementation. We searched MEDLINE via PubMed, CINAHL, and Scopus for original research articles from January 1, 2007, to August 31, 2016, that identified barriers to ABCDE implementation for adult patients in the ICU. Two reviewers independently reviewed studies, extracted barriers, and conducted thematic content analysis of the barriers, guided by the Consolidated Framework for Implementation Research. Discrepancies were discussed, and consensus was achieved. Our electronic search yielded 1,908 articles. After applying our inclusion/exclusion criteria, we included 49 studies. We conducted thematic content analysis of the 107 barriers and identified four classes of ABCDE barriers: (1) patient-related (ie, patient instability and safety concerns); (2) clinician-related (ie, lack of knowledge, staff safety concerns); (3) protocol-related (ie, unclear protocol criteria, cumbersome protocols to use); and, not previously identified in past reviews, (4) ICU contextual barriers (ie, interprofessional team care coordination). We provide the first, to our knowledge, systematic differential diagnosis of barriers to ABCDE delivery, moving beyond the conventional focus on patient-level factors. Our analysis offers a differential diagnosis checklist for clinicians planning ABCDE implementation to improve patient care and outcomes. Copyright © 2017 American College of Chest Physicians. All rights reserved.

Women with physical disability and the mammogram: An observational study to identify barriers and facilitators

International Nuclear Information System (INIS)

Poulos, Ann; Balandin, Susan; Llewellyn, Gwynnyth; McCarthy, Louella; Dark, Leigha

2011-01-01

Purpose: To identify barriers and facilitators experienced by women with physical disability having a mammogram. Method: Direct observation of the mammography procedure for women with a range of physical disability at screening facilities of BreastScreen NSW Australia. Results: A volunteer sample of 13 women with varying degrees of physical disability participated in the study. The outcomes suggested that many barriers for women with physical disability can be ameliorated by environmental adaptations and guidelines for both radiographers and women. Some women however cannot be screened successfully, or can be screened only with a level of trauma and/or pain which militates against their continuation within the screening program. This study has identified physical limitations which preclude a successful outcome, those which increase the discomfort/pain of the procedure and aspects of the procedure which can be improved to minimise the experience of discomfort/pain. Conclusion: From the outcomes of the study the development of a decision tool is indicated as a method of providing information for women with physical disability and their doctors as to the likelihood of a successful outcome to participation in mammography screening.

Women with physical disability and the mammogram: An observational study to identify barriers and facilitators

Energy Technology Data Exchange (ETDEWEB)

Poulos, Ann, E-mail: ann.poulos@sydney.edu.a [University of Sydney, Faculty of Health Sciences, Discipline of Medical Radiation Sciences, PO Box 170, Lidcombe, NSW 1825 (Australia); Balandin, Susan [University of Sydney, Faculty of Health Sciences, Discipline of Speech Pathology, PO Box 170, Lidcombe, NSW 1825 (Australia); Avdeling for helse- og sosialfag, Hogskolen i Molde, Postboks 2110, 6402 Molde (Norway); Llewellyn, Gwynnyth; McCarthy, Louella [University of Sydney, Faculty of Health Sciences, Discipline of Occupational Therapy, PO Box 170, Lidcombe, NSW 1825 (Australia); Dark, Leigha [University of Sydney, Faculty of Health Sciences, Discipline of Speech Pathology, PO Box 170, Lidcombe, NSW 1825 (Australia)

2011-02-15

Purpose: To identify barriers and facilitators experienced by women with physical disability having a mammogram. Method: Direct observation of the mammography procedure for women with a range of physical disability at screening facilities of BreastScreen NSW Australia. Results: A volunteer sample of 13 women with varying degrees of physical disability participated in the study. The outcomes suggested that many barriers for women with physical disability can be ameliorated by environmental adaptations and guidelines for both radiographers and women. Some women however cannot be screened successfully, or can be screened only with a level of trauma and/or pain which militates against their continuation within the screening program. This study has identified physical limitations which preclude a successful outcome, those which increase the discomfort/pain of the procedure and aspects of the procedure which can be improved to minimise the experience of discomfort/pain. Conclusion: From the outcomes of the study the development of a decision tool is indicated as a method of providing information for women with physical disability and their doctors as to the likelihood of a successful outcome to participation in mammography screening.

Identifying a motor proficiency barrier for meeting physical activity guidelines in children.

Science.gov (United States)

De Meester, An; Stodden, David; Goodway, Jacqueline; True, Larissa; Brian, Ali; Ferkel, Rick; Haerens, Leen

2018-01-01

This study examined the existence of a threshold level (proficiency barrier) of actual motor competence (MC) below which a child is not likely to attain 60min of moderate-to-vigorous physical activity (MVPA) per day. A cross-sectional study. Actual MC was assessed in 326 children (48.5% boys; age=9.50±1.24years) using the Test of Gross Motor Development-2; MVPA was measured with ActiGraph GT3X+accelerometers. Perceived MC, included as a potential mediating variable, was assessed with the Self-Perception Profile for Children. Binary logistic (mediation) regression analyses controlling for sex and a chi-squared test were used to gain insight into the relationship between (the levels of) actual MC and the percentage of children meeting the MVPA guideline. Actual MC significantly predicted the percentage of children meeting the guideline (B=.03, SE=.01, p<.001), even when controlling for sex. Perceived MC did not mediate this relationship. Children with high actual MC (65-100 percentile) were 2.46 (p=.003) times more likely to meet the guideline than children with low actual MC (0-27 percentile). The present study demonstrates the potential impact of low MC on children's MVPA levels and suggests evidence for the existence of a proficiency barrier for meeting MVPA guidelines. Almost 90% of the children whose actual MC is below the 'average' threshold do not meet the MVPA guideline. As more children with higher levels of actual MC meet the guideline than their less competent peers, it is crucial to provide opportunities to sufficiently develop children's actual MC. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Identifying Facilitators and Barriers for Patient Safety in a Medicine Label Design System Using Patient Simulation and Interviews

DEFF Research Database (Denmark)

Dieckmann, Peter; Clemmensen, Marianne Hald; Sørensen, Trine Kart

2016-01-01

Objectives Medicine label design plays an important role in improving patient safety. This study aimed at identifying facilitators and barriers in a medicine label system to prevent medication errors in clinical use by health care professionals. Methods The study design is qualitative and explora......Objectives Medicine label design plays an important role in improving patient safety. This study aimed at identifying facilitators and barriers in a medicine label system to prevent medication errors in clinical use by health care professionals. Methods The study design is qualitative...... of the system and some inconsistencies (different meaning of colors) posed challenges, when considered with the actual application context, in which there is little time to get familiar with the design features. Conclusions For optimizing medicine labels and obtaining the full benefit of label design features...

Barriers to accessing radiation therapy in Canada: a systematic review

International Nuclear Information System (INIS)

Gillan, Caitlin; Briggs, Kaleigh; Pazos, Alejandro Goytisolo; Maurus, Melanie; Harnett, Nicole; Catton, Pamela; Wiljer, David

2012-01-01

Radiation therapy (RT) is effective treatment for curing and palliating cancer, yet concern exists that not all Canadians for whom RT is indicated receive it. Many factors may contribute to suboptimal use of RT. A review of recent Canadian literature was undertaken to identify such barriers. MEDLINE, CINAHL, and EMBase databases were used to search keywords relating to barriers to accessing or utilizing RT in Canada. Collected abstracts were reviewed independently. Barriers identified in relevant articles were categorized as relating to the health systems, patient socio-demographic, patient factors, or provider factors contexts and thematic analysis performed for each context. 535 unique abstracts were collected. 75 met inclusion criteria. 46 (61.3%) addressed multiple themes. The most cited barriers to accessing RT when indicated were patient age (n = 26, 34.7%), distance to treatment centre (n = 23, 30.7%), wait times (n = 22, 29.3%), and lack of physician understanding about the use of RT (n = 16, 21.6%). Barriers to RT are reported in many areas. The role of provider factors and the lack of attention to patient fears and mistrust as potential barriers were unexpected findings demanding further attention. Solutions should be sought to overcome identified barriers facilitating more effective cancer care for Canadians

Prescriber barriers and enablers to minimising potentially inappropriate medications in adults: a systematic review and thematic synthesis.

Science.gov (United States)

Anderson, Kristen; Stowasser, Danielle; Freeman, Christopher; Scott, Ian

2014-12-08

To synthesise qualitative studies that explore prescribers' perceived barriers and enablers to minimising potentially inappropriate medications (PIMs) chronically prescribed in adults. A qualitative systematic review was undertaken by searching PubMed, EMBASE, Scopus, PsycINFO, CINAHL and INFORMIT from inception to March 2014, combined with an extensive manual search of reference lists and related citations. A quality checklist was used to assess the transparency of the reporting of included studies and the potential for bias. Thematic synthesis identified common subthemes and descriptive themes across studies from which an analytical construct was developed. Study characteristics were examined to explain differences in findings. All healthcare settings. Medical and non-medical prescribers of medicines to adults. Prescribers' perspectives on factors which shape their behaviour towards continuing or discontinuing PIMs in adults. 21 studies were included; most explored primary care physicians' perspectives on managing older, community-based adults. Barriers and enablers to minimising PIMs emerged within four analytical themes: problem awareness; inertia secondary to lower perceived value proposition for ceasing versus continuing PIMs; self-efficacy in regard to personal ability to alter prescribing; and feasibility of altering prescribing in routine care environments given external constraints. The first three themes are intrinsic to the prescriber (eg, beliefs, attitudes, knowledge, skills, behaviour) and the fourth is extrinsic (eg, patient, work setting, health system and cultural factors). The PIMs examined and practice setting influenced the themes reported. A multitude of highly interdependent factors shape prescribers' behaviour towards continuing or discontinuing PIMs. A full understanding of prescriber barriers and enablers to changing prescribing behaviour is critical to the development of targeted interventions aimed at deprescribing PIMs and reducing the

Electron optics with magnetic vector potential barriers in graphene

International Nuclear Information System (INIS)

Ghosh, Sankalpa; Sharma, Manish

2009-01-01

An analysis of electron transport in graphene in the presence of various arrangements of delta-function like magnetic barriers is presented. The motion through one such barrier gives an unusual non-specular refraction leading to asymmetric transmission. The symmetry is restored by putting two such barriers in opposite directions side by side. Periodic arrangements of such barriers can be used as Bragg reflectors whose reflectivity has been calculated using a transfer matrix formalism. Such Bragg reflectors can be used to make resonant cavities. We also analyze the associated band structure for the case of infinite periodic structures. (fast track communication)

Potential facilitators and barriers to adopting standard treatment guidelines in clinical practice.

Science.gov (United States)

Sharma, Sangeeta; Pandit, Ajay; Tabassum, Fauzia

2017-04-18

Purpose The purpose of this paper is to assess medicines information sources accessed by clinicians, if sources differed in theory and practice and to find out the barriers and facilitators to effective guideline adoption. Design/methodology/approach In all, 183 doctors were surveyed. Barriers and facilitators were classified as: communication; potential adopters; innovation; organization characteristics and environmental/social/economic context. Findings Most of the clinicians accessed multiple information sources including standard treatment guidelines, but also consulted seniors/colleagues in practice. The top three factors influencing clinical practice guideline adoption were innovation characteristics, environmental context and individual characteristics. The respondents differed in the following areas: concerns about flexibility offered by the guideline; denying patients' individuality; professional autonomy; insights into gaps in current practice and evidence-based practice; changing practices with little or no benefit. Barriers included negative staff attitudes/beliefs, guideline integration into organizational structures/processes, time/resource constraints. Fearing third parties (government and insurance companies) restricting medicines reimbursement and poor liability protection offered by the guidelines emerged as the barriers. Facilitators include aligning organizational structures/processes with the innovation; providing leadership support to guide diffusion; increasing awareness and enabling early innovation during pre/in-service training, with regular feedback on outcomes and use. Practical implications Guideline adoption in clinical practice is partly within doctors' control. There are other key prevailing factors in the local context such as environmental, social context, professional and organizational culture affecting its adoption. Organizational policy and accreditation standards necessitating adherence can serve as a driver. Originality

Anti-collimation of ballistic electrons by a potential barrier

Science.gov (United States)

Coleridge, P. T.; Taylor, R. P.; Sachrajda, A. S.; Adams, J. A.

1994-03-01

A pair of Quantum Point Contacts separated by a continuous barrier have been fabricated using the surface gate technique. Transport measurements for each component of this system and for various combinations have shown both additive and non-additive behaviour. The results are explained by a combination of reflection by the barrier of electrons collimated by the Quantum Point Contacts and transport by diffusion across the barrier.

Identifying the Correlates and Barriers of Future Planning among Parents of Individuals with Intellectual and Developmental Disabilities

Science.gov (United States)

Burke, Meghan; Arnold, Catherine; Owen, Aleksa

2018-01-01

Although individuals with intellectual and developmental disabilities (IDD) are living longer lives, fewer than half of parents of individuals with IDD conduct future planning. The correlates and barriers to future planning must be identified to develop targeted interventions to facilitate future planning. In this study, 388 parents of individuals…

A new barrier potential and alpha-decay half-lives of even–even nuclei in the 82⩽Z⩽92 regime

Energy Technology Data Exchange (ETDEWEB)

Hassanabadi, Hasan [Physics Department, Shahrood University of Technology, Shahrood (Iran, Islamic Republic of); Javadimanesh, ELham, E-mail: elham_javadimanesh89@yahoo.com [Department of Basic Sciences, Shahrood Branch, Islamic Azad University, Shahrood (Iran, Islamic Republic of); Zarrinkamar, Saber [Department of Basic Sciences, Garmsar Branch, Islamic Azad University, Garmsar (Iran, Islamic Republic of)

2013-05-15

The alpha-decay half-life in a nuclear reaction is mainly affected by the penetration probability, which itself depends on the choice of the barrier potential. Here, we propose a new barrier potential to investigate the alpha-decay half-lives in the even–even nuclei from {sup 178}Po to {sup 238}U. The obtained results are motivating.

The Barriers to High-Quality Inpatient Pain Management: A Qualitative Study.

Science.gov (United States)

Lin, Richard J; Reid, M Carrington; Liu, Lydia L; Chused, Amy E; Evans, Arthur T

2015-09-01

The current literature suggests deficiencies in the quality of acute pain management among general medical inpatients. The aim of this qualitative study is to identify potential barriers to high-quality acute pain management among general medical inpatients at an urban academic medical center during a 2-year period. Data are collected using retrospective chart reviews, survey questionnaires, and semistructured, open-ended interviews of 40 general medical inpatients who have experienced pain during their hospitalization. Our results confirm high prevalence and disabling impacts of pain and significant patient- and provider-related barriers to high-quality acute pain management. We also identify unique system-related barriers such as time delay and pain management culture. Efforts to improve the pain management experience of general medical inpatients will need to address all these barriers. © The Author(s) 2014.

Identifying common barriers and facilitators to linkage and retention in chronic disease care in western Kenya

Directory of Open Access Journals (Sweden)

Beth Rachlis

2016-08-01

Full Text Available Abstract Background Sub-Saharan Africa is increasingly being challenged in providing care and treatment for chronic diseases, both communicable and non-communicable. In order to address the challenges of linkage to and retention in chronic disease management, there is the need to understand the factors that can influence engagement in care. We conducted a qualitative study to identify barriers and facilitators to linkage and retention in chronic care for HIV, tuberculosis (TB and Hypertension (HTN as part of the Academic Model Providing Access to Healthcare (AMPATH program in western Kenya. Methods In-depth interviews and focus group discussions were conducted July 2012-August 2013. Study participants were purposively sampled from three AMPATH clinics and included patients within the AMPATH program receiving HIV, TB, and HTN care, as well as caregivers of children with HIV, community leaders, and healthcare providers. A set of interview guides were developed to explore perceived barriers and facilitators to chronic disease management, particularly related to linkage to and retention in HIV, TB and HTN care. Data were coded and various themes were identified. We organized the concepts and themes generated using the Andersen-Newman Framework of Health Services Utilization. Results A total of 235 participants including 110 individuals living with HIV (n = 50, TB (n = 39, or HTN (n = 21; 24 caregivers; 10 community leaders; and 62 healthcare providers participated. Barriers and facilitators were categorized as predisposing characteristics, enabling resources and need factors. Many of the facilitators and barriers reported in this study were consistently reported across disease categories including personal drive, patient-provider relationships and the need for social and peer support. Conclusions Our findings provide insight into the individual as well as broader structural factors that can deter or encourage linkage and retention that

Overcoming regulatory barriers: DOE environmental technology development program

International Nuclear Information System (INIS)

Kurtyka, B.M.; Clodfelter-Schumack, K.; Evans, T.T.

1995-01-01

The potential to improve environmental conditions via compliance or restoration is directly related to the ability to produce and apply innovative technological solutions. However, numerous organizations, including the US General Accounting Office (GAO), the EPA National Advisory Council for Environmental Policy and Technology (NACEPT), the DOE Environmental Management Advisory Board (EMAB), and the National Science and Technology Council (NSTC) have determined that significant regulatory barriers exist that inhibit the development and application of these technologies. They have noted the need for improved efforts in identifying and rectifying these barriers for the purpose of improving the technology development process, providing innovative alternatives, and enhancing the likelihood of technology acceptance by all. These barriers include, among others, regulator and user bias against ''unknown/unproven'' technologies; multi-level/multi-media permit disincentives; potential liability of developers and users for failed implementation; wrongly defined or inadequate data quality objectives: and lack of customer understanding and input. The ultimate goal of technology development is the utilization of technologies. This paper will present information on a number of regulatory barriers hindering DOE's environmental technology development program and describe DOE efforts to address these barriers

Exponential dependence of potential barrier height on biased voltages of inorganic/organic static induction transistor

International Nuclear Information System (INIS)

Zhang Yong; Yang Jianhong; Cai Xueyuan; Wang Zaixing

2010-01-01

The exponential dependence of the potential barrier height φ c on the biased voltages of the inorganic/organic static induction transistor (SIT/OSIT) through a normalized approach in the low-current regime is presented. It shows a more accurate description than the linear expression of the potential barrier height. Through the verification of the numerical calculated and experimental results, the exponential dependence of φ c on the applied biases can be used to derive the I-V characteristics. For both SIT and OSIT, the calculated results, using the presented relationship, are agreeable with the experimental results. Compared to the previous linear relationship, the exponential description of φ c can contribute effectively to reduce the error between the theoretical and experimental results of the I-V characteristics. (semiconductor devices)

Josephson-like currents in graphene for arbitrary time-dependent potential barriers

OpenAIRE

Savel'ev, Sergey E.; Hausler, Wolfgang; Hanggi, Peter

2011-01-01

From the exact solution of the Dirac-Weyl equation we find unusual currents j_y running in y-direction parallel to a time-dependent scalar potential barrier W(x,t) placed upon a monolayer of graphene, even for vanishing momentum component p_y. In their sine-like dependence on the phase difference of wave functions, describing left and right moving Dirac fermions, these currents resemble Josephson currents in superconductors, including the occurance of Shapiro steps at certain frequencies of p...

Identifying and Overcoming Critical Barriers to Widespread Second Use of PEV Batteries

Energy Technology Data Exchange (ETDEWEB)

Neubauer, J. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Smith, K. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Wood, E. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Pesaran, A. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2015-02-01

Both the market penetration of plug-in electric vehicles (PEVs) and deployment of grid-connected energy storage systems are presently restricted by the high cost of batteries. Battery second use (B2U) strategies--in which a single battery first serves an automotive application, then is redeployed into a secondary market--could help address both issues by reducing battery costs to the primary (automotive) and secondary (electricity grid) users. This study investigates the feasibility of and major barriers to the second use of lithium-ion PEV batteries by posing and answering the following critical B2U questions: 1. When will used automotive batteries become available, and how healthy will they be? 2. What is required to repurpose used automotive batteries, and how much will it cost? 3. How will repurposed automotive batteries be used, how long will they last, and what is their value? Advanced analysis techniques are employed that consider the electrical, thermal, and degradation response of batteries in both the primary (automotive) and secondary service periods. Second use applications are treated in detail, addressing operational requirements, economic value, and market potential. The study concludes that B2U is viable and could provide considerable societal benefits due to the large possible supply of repurposed automotive batteries and substantial remaining battery life following automotive service. However, the only identified secondary market large enough to consume the supply of these batteries (utility peaker plant replacement) is expected to be a low margin market, and thus B2U is not expected to affect the upfront cost of PEVs.

Evaluation of the potential of PV noise barrier technology for electricity production and market share. Final report

International Nuclear Information System (INIS)

Goetzberger, A.; Kleiss, G.; Castello, S.; Hille, G.; Reise, C.; Wiemken, E.; Betcke, J.W.H.; Van Dijk, V.A.P.; Pearsall, N.; Hynes, K.; Gaidddon, B.; Nordmann, T.; Froelich, A.

1999-06-01

The analysis of existing and planned noise barriers along rails and roads has been carried out by the national partners together with national authorities, which are experts and responsible for the required data. The methodical approach of this study includes the set-up of a grid along longitude and latitudes with 1 by 1 degrees for Germany, Italy, France, United Kingdom and 0.5 by 0.5 degrees for the Netherlands and Switzerland. For each degree the length and orientation of rails and roads, the existing and planned noise barriers are registered and grouped according to their orientations. The solar radiation is based on data of a METEONORM data set. This includes the solar radiation on horizontal orientation as well as various inclination angles for all possible orientations. Moreover, possible shading has been considered. The technical specifications of noise barriers (PVNB) are based on the comprehensive knowledge of TNC GmbH and TNC AG with various plants realised. Technologies have been considered for both state-of-the-art and innovative concepts such as bifacial PVNB. In bifacial PVNB the PV-module is mounted vertically on both sides and is used at the same time as noise reflecting material. Installed PV power and produced electricity have been calculated for: 1. theoretical potential 2. technical potential 3. short-term resp. European extrapolated potential 4. anticipated potential 5. EU-member assessment The result of this study confirms the current activities to implement PV on noise barriers as an important share in the PV market.The report is subdivided into two volumes: Volume 1 contains the main topics and results, and Volume 2 contains additional information on the solar radiation, typical concepts as an excerpt of the various potentials and all country maps with the required explanations. 95 refs

Identifying facilitators and barriers for implementation of interprofessional education: Perspectives from medical educators in the Netherlands.

Science.gov (United States)

de Vries-Erich, Joy; Reuchlin, Kirsten; de Maaijer, Paul; van de Ridder, J M Monica

2017-03-01

Patient care and patient safety can be compromised by the lack of interprofessional collaboration and communication between healthcare providers. Interprofessional education (IPE) should therefore start during medical training and not be postponed until after graduation. This case study explored the current situation in the Dutch context and interviewed experts within medical education and with pioneers of successful best practices to learn more about their experiences with IPE. Data analysis started while new data were still collected, resulting in an iterative, constant comparative process. Using a strengths, weaknesses, opportunities, and threats (SWOT) analysis framework, we identified barriers and facilitators such as lack of a collective professional language, insufficient time or budget, stakeholders' resistance, and hierarchy. Opportunities and strengths identified were developing a collective vision, more attention for patient safety, and commitment of teachers. The facilitators and barriers relate to the organisational level of IPE and the educational content and practice. In particular, communication, cohesiveness, and support are influenced by these facilitators. An adequate identification of the SWOT elements in the current situation could prove beneficial for a successful implementation of IPE within the healthcare educational system.

Barriers to participation in mental health research: are there specific gender, ethnicity and age related barriers?

Directory of Open Access Journals (Sweden)

Howard Louise

2010-12-01

Full Text Available Abstract Background It is well established that the incidence, prevalence and presentation of mental disorders differ by gender, ethnicity and age, and there is evidence that there is also differential representation in mental health research by these characteristics. The aim of this paper is to a review the current literature on the nature of barriers to participation in mental health research, with particular reference to gender, age and ethnicity; b review the evidence on the effectiveness of strategies used to overcome these barriers. Method Studies published up to December 2008 were identified using MEDLINE, PsycINFO and EMBASE using relevant mesh headings and keywords. Results Forty-nine papers were identified. There was evidence of a wide range of barriers including transportation difficulties, distrust and suspicion of researchers, and the stigma attached to mental illness. Strategies to overcome these barriers included the use of bilingual staff, assistance with travel, avoiding the use of stigmatising language in marketing material and a focus on education about the disorder under investigation. There were very few evaluations of such strategies, but there was evidence that ethnically matching recruiters to potential participants did not improve recruitment rates. Educational strategies were helpful and increased recruitment. Conclusion Mental health researchers should consider including caregivers in recruitment procedures where possible, provide clear descriptions of study aims and describe the representativeness of their sample when reporting study results. Studies that systematically investigate strategies to overcome barriers to recruitment are needed.

Safety assessment of discharge chute isolation barrier preparation and installation

International Nuclear Information System (INIS)

Meichle, R.H.

1994-01-01

This analysis examines activities associated with the installation of isolation barriers in the K Basins at the Hanford Reservation. This revision adds evaluation of barrier drops on stored fuel and basin floor, identifies fuel which will be moved and addresses criticality issues with sludge. The safety assessment is made for the activities for the preparation and installation of the discharge chute isolation barriers. The safety assessment includes a hazard assessment and comparisons of potential accidents/events to those addressed by the current safety basis documentation. No significant hazards were identified. An evaluation against the USQ evaluation questions was made and the determination made that the activities do not represent a USQ. Hazard categorization techniques were used to provide a basis for readiness review classifications

Quantum tunneling time of a Bose-Einstein condensate traversing through a laser-induced potential barrier

International Nuclear Information System (INIS)

Duan Zhenglu; Fan Bixuan; Yuan Chunhua; Zhang Weiping; Cheng Jing; Zhu Shiyao

2010-01-01

We theoretically study the effect of atomic nonlinearity on the tunneling time in the case of an atomic Bose-Einstein condensate (BEC) traversing the laser-induced potential barrier. The atomic nonlinearity is controlled to appear only in the region of the barrier by employing the Feshbach resonance technique to tune interatomic interaction in the tunneling process. Numerical simulation shows that the atomic nonlinear effect dramatically changes the tunneling behavior of the BEC matter wave packet and results in the violation of the Hartman effect and the occurrence of negative tunneling time.

Identifying climate risk perceptions, information needs, and barriers to information exchange among public land managers.

Science.gov (United States)

Peters, Casey B; Schwartz, Mark W; Lubell, Mark N

2018-03-01

Meeting ecosystem management challenges posed by climate change requires building effective communication channels among researchers, planners and practitioners to focus research on management issues requiring new knowledge. We surveyed resource managers within two regions of the western United States regions to better understand perceived risks and vulnerabilities associated with climate change and barriers to obtaining and using relevant climate science information in making ecosystem management decisions. We sought to understand what types of climate science information resource managers find most valuable, and the formats in which they prefer to receive climate science information. We found broad concern among natural resource managers in federal agencies that climate change will make it more difficult for them to achieve their management goals. Primary barriers to incorporating climate science into planning are distributed among challenges identifying, receiving, and interpreting appropriate science and a lack of direction provided by agency leadership needed to meaningfully use this emerging science in resource planning. Copyright © 2017 Elsevier B.V. All rights reserved.

Identifying barriers to mental health system improvements: an examination of community participation in assertive community treatment programs

Directory of Open Access Journals (Sweden)

Wakefield Patricia A

2011-11-01

Full Text Available Abstract Background Integrating the best available evidence into program standards is essential if system-wide improvements in the delivery of community-based mental health services are to be achieved. Since the beginning of the Assertive Community Treatment (ACT program movement, program standards have included a role for the community. In particular, ACT program standards have sought to ensure that members of the local community are involved in governance and that former clients participate in service delivery as "Peer Support Specialists". This paper reports on the extent to which ACT program standards related to community participation have been implemented and identifies barriers to full compliance. Methods Qualitative and quantitative data were collected through a telephone survey of ACT Program Coordinators in Ontario, Canada, using a census sample of the existing 66 ACT programs. A thematic approach to content analysis was used to analyze respondents' qualitative comments. Quantitative data were analyzed using SPSS 16.0 and included means, frequencies, independent t-tests and Pearson Correlations. Results An 85% response rate was achieved. Of the 33 program standards, the two that received the lowest perceived compliance ratings were the two standards directly concerning community participation. Specifically, the standard to have a functioning Community Advisory Body and the standard requiring the inclusion of a Peer Support Specialist. The three major themes that emerged from the survey data with respect to the barriers to fully implementing the Community Advisory Body were: external issues; standard related issues; and, organizational/structural related issues. The three major themes concerning barriers to implementing the Peer Support Specialist role were: human resource related issues; organizational/structural related issues; and, standard related issues. Conclusions The reasons for low compliance of ACT programs with community

Regulatory Monitoring of Fortified Foods: Identifying Barriers and Good Practices

Science.gov (United States)

Rowe, Laura A; Vossenaar, Marieke; Garrett, Greg S

2015-01-01

While fortification of staple foods and condiments has gained enormous global traction, poor performance persists throughout many aspects of implementation, most notably around the critical element of regulatory monitoring, which is essential for ensuring foods meet national fortification standards. Where coverage of fortified foods is high, limited nutritional impact of fortification programs largely exists due to regulatory monitoring that insufficiently identifies and holds producers accountable for underfortified products. Based on quality assurance data from 20 national fortification programs in 12 countries, we estimate that less than half of the samples are adequately fortified against relevant national standards. In this paper, we outline key findings from a literature review, key informant interviews with 11 fortification experts, and semi-quantitative surveys with 39 individuals from regulatory agencies and the food fortification industry in 17 countries on the perceived effectiveness of regulatory monitoring systems and barriers to compliance against national fortification standards. Findings highlight that regulatory agencies and industry disagree on the value that enforcement mechanisms have in ensuring compliance against standards. Perceived political risk of enforcement and poorly resourced inspectorate capacity appear to adversely reinforce each other within an environment of unclear legislation to create a major hurdle for improving overall compliance of fortification programs against national standards. Budget constraints affect the ability of regulatory agencies to create a well-trained inspector cadre and improve the detection and enforcement of non-compliant and underfortified products. Recommendations to improve fortification compliance include improving technical capacity; ensuring sustained leadership, accountability, and funding in both the private and the public sectors; and removing political barriers to ensure consistent detection of

Ground-Source Heat Pumps. Overview of Market Status, Barriers to Adoption, and Options for Overcoming Barriers

Energy Technology Data Exchange (ETDEWEB)

Goetzler, William [Navigant Consulting, Inc., Chicago, IL (United States); Zogg, Robert [Navigant Consulting, Inc., Chicago, IL (United States); Lisle, Heather [Navigant Consulting, Inc., Chicago, IL (United States); Burgos, Javier [Navigant Consulting, Inc., Chicago, IL (United States)

2009-02-03

February 2009 final report submitted to DOE by Navigant Consulting, Inc. This report summarizes the status of ground-source heat pump (GSHP) technology and market penetration globally, estimates the energy saving potential of GSHPs in the U.S., identifies key market barriers that are inhibiting wider market adoption of GSHPs, and recommends initiatives that can be implemented or facilitated by the DOE to accelerate market adoption.

Fusion barriers in heavy ion collisions

International Nuclear Information System (INIS)

Zhu Long; Su Jun; Xie Wenjie; Guo Chenchen; Zhang Donghong; Zhang Fengshou

2014-01-01

Study of fusion barrier is very important for people to better understand fusion reactions. In this paper the Improved Isospin-dependent Quantum Molecular Dynamics (ImIQMD) model is introduced firstly. Then the shell correction effects, energy dependence, isospin effects and orientation effects of fusion barrier are studied. The fusion barriers for the fusion reactions "4"0Ca + "4"0Ca, "4"8Ca + "2"0"8Pb, "4"8Ca + "2"0"4Pb and "1"6O + "1"5"4Sm are extracted. The negative shell correction energies lower potential barriers of a certain reaction. A complex phenomenon of energy dependence is observed. It is also found that incident energy dependence of the barrier radius and barrier height shows opposite behaviors. The Coulomb potential shows weak energy dependence when distance of two colliding nuclei is lower than the touching distance. The isospin effects of the potential barrier are investigated. The orientation effects of the potential barrier are also discussed for the system "1"6O + "1"5"4Sm. (authors)

Understanding low levels of physical activity in people with intellectual disabilities : A systematic review to identify barriers and facilitators

NARCIS (Netherlands)

Bossink, Leontien; van der Putten, Annette; Vlaskamp, Carla

2017-01-01

Background: People with intellectual disabilities (ID) undertake extremely low levels of physical activity. Aims: To enhance understanding concerning low levels of physical activity in people with ID, this study has three aims: (1) to identify barriers to and facilitators of physical activity in

Calculation of multidimensional potential energy surfaces for even-even transuranium nuclei: systematic investigation of the triaxiality effect on the fission barrier

Science.gov (United States)

Chai, Qing-Zhen; Zhao, Wei-Juan; Liu, Min-Liang; Wang, Hua-Lei

2018-05-01

Static fission barriers for 95 even-even transuranium nuclei with charge number Z = 94–118 have been systematically investigated by means of pairing self-consistent Woods-Saxon-Strutinsky calculations using the potential energy surface approach in multidimensional (β 2, γ, β 4) deformation space. Taking the heavier 252Cf nucleus (with the available fission barrier from experiment) as an example, the formation of the fission barrier and the influence of macroscopic, shell and pairing correction energies on it are analyzed. The results of the present calculated β 2 values and barrier heights are compared with previous calculations and available experiments. The role of triaxiality in the region of the first saddle is discussed. It is found that the second fission barrier is also considerably affected by the triaxial deformation degree of freedom in some nuclei (e.g., the Z=112–118 isotopes). Based on the potential energy curves, general trends of the evolution of the fission barrier heights and widths as a function of the nucleon numbers are investigated. In addition, the effects of Woods-Saxon potential parameter modifications (e.g., the strength of the spin-orbit coupling and the nuclear surface diffuseness) on the fission barrier are briefly discussed. Supported by National Natural Science Foundation of China (11675148, 11505157), the Project of Youth Backbone Teachers of Colleges and Universities of Henan Province (2017GGJS008), the Foundation and Advanced Technology Research Program of Henan Province (162300410222), the Outstanding Young Talent Research Fund of Zhengzhou University (1521317002) and the Physics Research and Development Program of Zhengzhou University (32410017)

Barriers and enablers to physical activity participation in patients with COPD: a systematic review.

Science.gov (United States)

Thorpe, Olivia; Johnston, Kylie; Kumar, Saravana

2012-01-01

Physical activity (PA) has been shown to improve symptoms in people with chronic obstructive pulmonary disease (COPD). Despite the high health and financial costs, the uptake of management strategies, particularly participation in PA and pulmonary rehabilitation (PR), are low. The review objective here was to identify potential barriers and enablers, which people with COPD report being associated with their participation in PA programs, including PR. A systematic search was undertaken to identify studies (published Jan 2000 to Aug 2011) reporting any barriers and enablers experienced by people with COPD regarding participation in PA and PR. Methodological quality of the studies was appraised using McMaster critical appraisal tools. A narrative summary of findings was undertaken reporting on individual study characteristics, country of origin, participants, and potential barriers and enablers. Eleven studies (8 qualitative and 3 quantitative) met the inclusion criteria for this systematic review. Several methodological issues (small sampling, poor description of data collection and analysis, issues with generalizability of the research findings) were common among included studies. Barriers identified included changing health status, personal issues, lack of support, external factors, ongoing smoking, and program-specific barriers. Enablers identified included social support, professional support, personal drivers, personal benefit, control of condition, specific goals, and program-specific enablers. The findings from this review may assist health professionals, patients, care givers and the wider community to develop effective strategies to promote participation in PA and PR among people with COPD.

Magnetic properties and potential barrier between crystallites model of MgGa2-xFexO4 ceramics

Directory of Open Access Journals (Sweden)

V. A. dos S. Ribeiro

Full Text Available Abstract The aim of this work was to investigate the magnetic properties and the electrical conductivity temperature dependence associated to the potential barrier between the crystallites model. Gallium and magnesium containing spinel ceramic has low magnetic coercivity and high electrical resistivity. MgGa2-xFexO4 samples (x= 0.01, 0.05, 0.15, 0.25, 0.35 were prepared by solid-state method and sintered at 800 °C for 8 h. X-ray diffraction analysis confirmed the formation of a single phase with compact cubic spinel structure. The magnetic measurements show that the saturation magnetization and remanence of all samples increased with increasing iron concentration. The coercive field decreased up to the concentration x= 0.15, and above x= 0.25 it was observed an increase in the coercive field. Through electrical characterization it was found that the samples presented highly insulating behavior for x= 0.01, and further increase in x above 0.15 gives a semiconductor behavior compatible with the potential barrier between the crystallites model, i.e. fulfills the condition L/2 > LD (crystallite size L in comparison with the Debye length LD, and the conduction is limited by potential barriers between the crystallites.

Perceived barriers to the regionalization of adult critical care in the United States: a qualitative preliminary study

Directory of Open Access Journals (Sweden)

Rubenfeld Gordon D

2008-11-01

Full Text Available Abstract Background Regionalization of adult critical care services may improve outcomes for critically ill patients. We sought to develop a framework for understanding clinician attitudes toward regionalization and potential barriers to developing a tiered, regionalized system of care in the United States. Methods We performed a qualitative study using semi-structured interviews of critical care stakeholders in the United States, including physicians, nurses and hospital administrators. Stakeholders were identified from a stratified-random sample of United States general medical and surgical hospitals. Key barriers and potential solutions were identified by performing content analysis of the interview transcriptions. Results We interviewed 30 stakeholders from 24 different hospitals, representing a broad range of hospital locations and sizes. Key barriers to regionalization included personal and economic strain on families, loss of autonomy on the part of referring physicians and hospitals, loss of revenue on the part of referring physicians and hospitals, the potential to worsen outcomes at small hospitals by limiting services, and the potential to overwhelm large hospitals. Improving communication between destination and source hospitals, provider education, instituting voluntary objective criteria to become a designated referral center, and mechanisms to feed back patients and revenue to source hospitals were identified as potential solutions to some of these barriers. Conclusion Regionalization efforts will be met with significant conceptual and structural barriers. These data provide a foundation for future research and can be used to inform policy decisions regarding the design and implementation of a regionalized system of critical care.

Barriers Inhibiting Inquiry-Based Science Teaching and Potential Solutions: Perceptions of Positively Inclined Early Adopters

Science.gov (United States)

Fitzgerald, Michael; Danaia, Lena; McKinnon, David H.

2017-07-01

In recent years, calls for the adoption of inquiry-based pedagogies in the science classroom have formed a part of the recommendations for large-scale high school science reforms. However, these pedagogies have been problematic to implement at scale. This research explores the perceptions of 34 positively inclined early-adopter teachers in relation to their implementation of inquiry-based pedagogies. The teachers were part of a large-scale Australian high school intervention project based around astronomy. In a series of semi-structured interviews, the teachers identified a number of common barriers that prevented them from implementing inquiry-based approaches. The most important barriers identified include the extreme time restrictions on all scales, the poverty of their common professional development experiences, their lack of good models and definitions for what inquiry-based teaching actually is, and the lack of good resources enabling the capacity for change. Implications for expectations of teachers and their professional learning during educational reform and curriculum change are discussed.

Potential and barriers for biogas production in Denmark at widely expanded organic farming with focus on the soil carbon content; Potentiale og barrierer for biogasproduktion i Danmark ved omfattende oekologisk jordbrug med fokus paa dyrkningsjordens kulstofforhold

Energy Technology Data Exchange (ETDEWEB)

Buch Salomonsen, K.

2000-06-01

The Ph.D. thesis describes the influence from continued expansion of organic farming systems to the potential for energy production from biogas in Denmark. The project analyses the consequence from three categories of barriers: 1) Practical barriers, 2) The attitude of organic farmers, and 3) Agricultural biological problems. Economic and political barriers are not examined. When the barriers can be quantified, they are included in the calculation of the maximum biogas potential. When not, the implications of barriers are expressed qualitatively. It has been a particular goal to provide new information on whether agricultural biological problems are a barrier to biogas production in organic farming systems. One important question in this connection is whether biogas production has a negative influence on the soil carbon content compared to composting. This question is investigated by an experiment. The project is based on technical and natural science disciplines, with an interdisciplinary basis ranging over energy planning, agricultural science, microbiology, and crop, and animal operation. (au)

Quantum damped oscillator II: Bateman's Hamiltonian vs. 2D parabolic potential barrier

International Nuclear Information System (INIS)

Chruscinski, Dariusz

2006-01-01

We show that quantum Bateman's system which arises in the quantization of a damped harmonic oscillator is equivalent to a quantum problem with 2D parabolic potential barrier known also as 2D inverted isotropic oscillator. It turns out that this system displays the family of complex eigenvalues corresponding to the poles of analytical continuation of the resolvent operator to the complex energy plane. It is shown that this representation is more suitable than the hyperbolic one used recently by Blasone and Jizba

Barriers to the Implementation of Strategic Corporate Social Responsibility in Shipping

Directory of Open Access Journals (Sweden)

Kum Fai Yuen, PhD Candidate

2016-03-01

Full Text Available Strategic corporate social responsibility (CSR involves the voluntary practice of social and environment activities to satisfy firms’ stakeholders, with the intention of generating profits. Companies, especially those within the shipping industry, often face challenges when implementing strategic CSR. The paper therefore, seeks to identify, rank, and discuss the barriers to the implementation of strategic CSR in shipping. A list of barriers was first identified from reviewing the literature. Subsequently, a survey was administered to 600 shipping companies in Singapore and the collected data were analysed using structural equation modelling. The results showed that factors relating to lack of resources, lack of strategic vision, lack of measurement system, high regulatory standards, and low willingness to pay for CSR are significant barriers to implementing strategic CSR in shipping. The findings imply that the practice of strategic CSR is contingent on both the firm's macro-environment and micro-environment, albeit to a lesser extent. Understanding these potential barriers can help companies avoid or overcome these barriers and improve their chances of successfully implementing strategic CSR.

Barriers to Breast and Cervical Cancer Screening in Singapore: a Mixed Methods Analysis.

Science.gov (United States)

Malhotra, Chetna; Bilger, Marcel; Liu, Joy; Finkelstein, Eric

2016-01-01

In order to increase breast and cervical cancer screening uptake in Singapore, women's perceived barriers to screening need to be identified and overcome. Using data from both focus groups and surveys, we aimed to assess perceived barriers and motivations for breast and cervical cancer screening. We conducted 8 focus groups with 64 women, using thematic analysis to identify overarching themes related to women's attitudes towards screening. Based on recurring themes from focus groups, several hypotheses regarding potential barriers and motivations to screen were generated and tested through a national survey of 801 women aged 25-64. Focus group participants had misconceptions related to screening, believing that the procedures were painful. Cost was an issue, as well as efficacy and fatalism. By identifying barriers to and motivators for screening through a mixed-method design that has both nuance and external validity, this study offers valuable suggestions to policymakers to improve breast and cervical cancer screening uptake in Singapore.

Transmission through a potential barrier in Luttinger liquids with a topological spin gap

Science.gov (United States)

Kainaris, Nikolaos; Carr, Sam T.; Mirlin, Alexander D.

2018-03-01

We study theoretically the transport of the one-dimensional single-channel interacting electron gas through a strong potential barrier in the parameter regime where the spin sector of the low-energy theory is gapped by interaction (Luther-Emery liquid). There are two distinct phases of this nature, of which one is of particular interest as it exhibits nontrivial interaction-induced topological properties. Focusing on this phase and using bosonization and an expansion in the tunneling strength we calculate the conductance through the barrier as a function of the temperature as well as the local density of states (LDOS) at the barrier. Our main result concerns the mechanism of bound-state-mediated tunneling. The characteristic feature of the topological phase is the emergence of protected zero-energy bound states with fractional spin located at the impurity position. By flipping this fractional spin, single electrons can tunnel across the impurity even though the bulk spectrum for spin excitations is gapped. This results in a finite LDOS below the bulk gap and in a nonmonotonic behavior of the conductance. The system represents an important physical example of an interacting symmetry-protected topological phase, which combines features of a topological spin insulator and a topological charge metal, in which the topology can be probed by measuring transport properties.

Identifying Knowledge Sharing Barriers in the Collaboration of Traditional and Western Medicine Professionals in Chinese Hospitals: A Case Study

Science.gov (United States)

Zhou, Lihong; Nunes, Miguel Baptista

2012-01-01

This paper reports on a research project that aims at identifying knowledge sharing (KS) barriers between traditional and western medicine practitioners co-existing and complementing each other in Chinese healthcare organisations. The study focuses on the tacit aspects of patient knowledge, rather than the traditional technical information shared…

Cosmetic dermatologic surgical training in US dermatology residency programs: identifying and overcoming barriers.

Science.gov (United States)

Bauer, Bruce; Williams, Erin; Stratman, Erik J

2014-02-01

The public and other medical specialties expect dermatologists who offer cosmetic dermatology services to provide competent care. There are numerous barriers to achieving cosmetic dermatology competency during residency. Many dermatology residents enter the workforce planning to provide cosmetic services. If a training gap exists, this may adversely affect patient safety. To identify resources available for hands-on cosmetic dermatology training in US dermatology residency training programs and to assess program director (PD) attitudes toward cosmetic dermatology training during residency and strategies, including discounted pricing, used by training programs to overcome barriers related to resident-performed cosmetic dermatology procedures. An online survey in academic dermatology practices among PDs of US dermatology residency programs. Frequency of cosmetic dermatology devices and injectables used for dermatology resident hands-on cosmetic dermatology training, categorizing PD attitudes toward cosmetic dermatology training during residency and describing residency-related discounted pricing models. Responses from PDs were received from 53 of 114 (46%) US dermatology residency programs. All but 3 programs (94%) offered hands-on cosmetic dermatology training using botulinum toxin, and 47 of 53 (89%) provided training with hyaluronic acid fillers. Pulsed dye lasers represented the most common laser use experienced by residents (41 of 52 [79%]), followed by Q-switched Nd:YAG (30 of 52 [58%]). Discounted procedures were offered by 32 of 53 (60%) programs, with botulinum toxin (30 of 32 [94%]) and fillers (27 of 32 [84%]) most prevalent and with vascular lasers (17 of 32 [53%]) and hair removal lasers (12 of 32 [38%]) less common. Various discounting methods were used. Only 20 of 53 (38%) PDs believed that cosmetic dermatology should be a necessary aspect of residency training; 14 of 52 (27%) PDs thought that residents should not be required to perform any cosmetic

Energy consumption and CO2 emissions of industrial process technologies. Saving potentials, barriers and instruments

International Nuclear Information System (INIS)

Fleiter, Tobias; Schlomann, Barbara; Eichhammer, Wolfgang

2013-01-01

Which contribution can the increase of energy efficiency achieve in the industry energy for the energy transition in Germany? To answer this question a model-based analysis of existing energy efficiency potentials of the energy-intensive industries is performed, which account for about 70% of the total energy demand of the industry. Based on this industry for each sector are instruments proposed for the implementation of the calculated potential and to overcome the existing barriers. [de

The Use of Online Posts to Identify Barriers to and Facilitators of HIV Pre-exposure Prophylaxis (PrEP) Among Men Who Have Sex with Men: A Comparison to a Systematic Review of the Peer-Reviewed Literature.

Science.gov (United States)

Hannaford, Alisse; Lipshie-Williams, Madeleine; Starrels, Joanna L; Arnsten, Julia H; Rizzuto, Jessica; Cohen, Phillip; Jacobs, Damon; Patel, Viraj V

2018-04-01

Pre-exposure prophylaxis (PrEP) remains an under-utilized HIV prevention tool among men who have sex with men (MSM). To more comprehensively elucidate barriers and facilitators to PrEP use among US MSM, we conducted a systematic review of peer-reviewed published articles and content analysis of online posts about PrEP. We searched peer-reviewed databases (Medline, Web of Science, Google Scholar) using MESH headings and keywords about PrEP and/or HIV prevention from 2005 to 2015. We included original studies among MSM in the US that reported on barriers, facilitators, or other factors related to PrEP use. We also searched online posts and associated comments (news articles, opinion pieces, blogs and other social media posts) in diverse venues (Facebook, Slate Outward, Huffington Post Gay Voices, Queerty, and My PrEP Experience blog) to identify posts about PrEP. We used content analysis to identify themes and compare potential differences between the peer-reviewed literature and online posts. We identified 25 peer-reviewed articles and 28 online posts meeting inclusion criteria. We identified 48 unique barriers and 46 facilitators to using PrEP. These 94 themes fit into six overarching categories: (1) access (n = 14), (2) attitudes/beliefs (n = 24), (3) attributes of PrEP (n = 13), (4) behaviors (n = 11), (5) sociodemographic characteristics (n = 8), and (6) social network (n = 6). In all categories, analysis of online posts resulted in identification of a greater number of unique themes. Thirty-eight themes were identified in the online posts that were not identified in the peer-reviewed literature. We identified barriers and facilitators to PrEP in online posts that were not identified in a systematic review of the peer-reviewed literature. By incorporating data both from a systematic review of peer-reviewed articles and from online posts, we have identified salient and novel information about barriers to and facilitators of PrEP use. Traditional

Deactivation of SCR catalysts by potassium: A study of potential alkali barrier materials

DEFF Research Database (Denmark)

Olsen, Brian Kjærgaard; Kügler, Frauke; Castellino, Francesco

2017-01-01

The use of coatings in order to protect vanadia based SCR catalysts against potassium poisoning has been studied by lab- and pilot-scale experiments. Three-layer pellets, consisting of a layer ofa potential coating material situated between layers of fresh and potassium poisoned SCR catalyst, were...... the coating process. Potassium had to some extent penetrated the MgO coat, and SEM analysis revealed it to be rather thick and fragile. Despite these observations, the coating did protect the SCR catalyst against potassium poisoning to some degree, leaving promise of further optimization....... used to test the ability of the barrier layer to block the diffusion of potassium across the pellet. Of MgO, sepiolite and Hollandite manganese oxide, MgO was the most effective potassium barrier, and no potassium was detected in the MgO layer upon exposure to SCR conditions for 7 days. Two monoliths...

On the generalized Hartman effect for symmetric double-barrier point potentials

International Nuclear Information System (INIS)

Lee, Molly A; Manzoni, Luiz A; Nyquist, Erik A; Lunardi, José T

2015-01-01

We consider the scattering of a non-relativistic particle by a symmetrical arrangement of two identical barriers in one-dimension, with the barriers given by the well-known four-parameter family of point interactions. We calculate the phase time and the stationary Salecker-Wigner-Peres clock time for the particular cases of a double δ and a double δ' barrier and investigate the off-resonance behavior of these time scales in the limit of opaque barriers, addressing the question of emergence of the generalized Hartman effect

GPs' use of problem solving therapy for depression: a qualitative study of barriers to and enablers of evidence based care

Directory of Open Access Journals (Sweden)

Gunn Jane

2007-04-01

Full Text Available Abstract Background Depression is a major health concern, predominantly treated by general practitioners (GPs. Problem solving therapy (PST is recognised as an effective treatment for depression that is not widely used by GPs. This research aims to explore barriers and enablers that may influence GPs use of this treatment. Method Qualitative methodology was used including individual and focus group interviews of GPs, PST experts and consumers. Analysis was undertaken using the Theory of Planned Behaviour (TPB as a framework. Results A spectrum of potential influences, on GPs' use of PST emerged. Both barriers and enablers were identified. PST was perceived as being close to current practice approaches and potentially beneficial to both doctor and patient. In addition to a broadly positive attitude to PST, expressed by those with previous experience of its use, potential solutions to perceived barriers emerged. By contrast some GPs expressed fear that the use of PST would result in loss of doctor control of consultations and associated potential adverse patient outcomes. Patient expectations, which emerged as not always coinciding with GPs' perception of those expectations, were identified as a potential influence on GPs' decision concerning adoption of PST. In addition specific factors, including GP skill and confidence, consultation time constraints and technical issues related to PST were noted as potential concerns. Conclusion This research contributes to our knowledge of the factors that may influence GPs' decisions regarding use of PST as a treatment for depression. It recognises both barriers and enablers. It suggests that for many GPs, PST is viewed in a positive light, providing encouragement to those seeking to increase the provision of PST by GPs. In identifying a number of potential barriers, along with associated options to address many of these barriers, it provides insights which may assist in the planning of GP training in PST.

Barriers To Successful Implementation of STEM Education

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James A. Ejiwale

2013-05-01

Full Text Available The implementation of STEM education in schools across the globe is to prepare the future workforce with strong scientific and mathematical backgrounds to enhance skills development across STEM disciplines. However, for STEM education to achieve its goals and objectives, addressing the barriers to STEM education should start by fixing the problems at the elementary, junior and senior high school levels; the grassroots and potential feeders to colleges and universities. Since many nations including the United States of America is in dire need of the workforce with adequate preparation in science and mathematics to help address the nation’s economy that is in shambles, the barriers to its successful implementation should be identified and addressed. In this paper, (a the definition of STEM education and (b some barriers to successful implementation of STEM education are discussed and elaborated.

Health professional's perceptions of and potential barriers to smoking cessation care: a survey study at a dental school hospital in Japan

Directory of Open Access Journals (Sweden)

Makiishi Takemi

2010-12-01

Full Text Available Abstract Background Smoking is currently accepted as a well-established risk factor for many oral diseases such as oral cancer and periodontal disease. Provision of smoking cessation care to patients with oral problems is a responsibility of health care professionals, particularly dentists and dental hygienists. This study examined the smoking-related perceptions and practices of dental school hospital-based health professionals in Japan. Findings A cross-sectional study design was used. The sample was formed from dentists, dental hygienists, physicians and nurses of a dental school hospital in Tokyo, Japan (n = 93, 72%. Participants were asked to complete an 11-item questionnaire assessing demographic variables and smoking history, provision of smoking cessation advice or care, attitudes about smoking cessation, and perceived barrier(s to smoking cessation care. Eighteen percent of participants reported being current smokers and 15% reported being ex-smokers, with higher smoking rates reported by dentists compared with other health professionals (p = 0.0199. While recognizing the importance of asking patients about their smoking status, actual provision of smoking cessation advice or care by participants was relatively insufficient. Interventions such as 'assess willingness to make a quit attempt' and 'assist in quit attempt' were implemented for less than one-quarter of their patients who smoke. Non-smokers were more likely to acknowledge the need for increased provision in smoking cessation care by oral health professionals. 'Lack of knowledge and training' was identified as a central barrier to smoking cessation care, followed by 'few patients willing to quit'. Conclusions A need for further promotion of smoking cessation activities by the health professionals was identified. The findings also suggest that dentists and dental hygienists, while perceiving a role in smoking care, do require training in the provision of smoking cessation care

Barriers to free antiretroviral treatment access among kothi-identified men who have sex with men and aravanis (transgender women) in Chennai, India.

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Chakrapani, Venkatesan; Newman, Peter A; Shunmugam, Murali; Dubrow, Robert

2011-12-01

The Indian government provides free antiretroviral treatment (ART) for people living with HIV. To assist in developing policies and programs to advance equity in ART access, we explored barriers to ART access among kothis (men who have sex with men [MSM] whose gender expression is feminine) and aravanis (transgender women, also known as hijras) living with HIV in Chennai. In the last quarter of 2007, we conducted six focus groups and four key-informant interviews. Data were explored using framework analysis to identify categories and derive themes. We identified barriers to ART access at the family/social-level, health care system-level, and individual-level; however, we found these barriers to be highly interrelated. The primary individual-level barrier was integrally linked to the family/social and health care levels: many kothis and aravanis feared serious adverse consequences if their HIV-positive status were revealed to others. Strong motivations to keep one's HIV-positive status and same-sex attraction secret were interconnected with sexual prejudice against MSM and transgenders, and HIV stigma prevalent in families, the health care system, and the larger society. HIV stigma was present within kothi and aravani communities as well. Consequences of disclosure, including rejection by family, eviction from home, social isolation, loss of subsistence income, and maltreatment (although improving) within the health care system, presented powerful disincentives to accessing ART. Given the multi-level barriers to ART access related to stigma and discrimination, interventions to facilitate ART uptake should address multiple constituencies: the general public, health care providers, and the kothi and aravani communities. India needs a national policy and action plan to address barriers to ART access at family/social, health care system, and individual levels for aravanis, kothis, other subgroups of MSM and other marginalized groups.

Evidentiary requirements to identify potentially acceptable sites (PAS) in crystalline rock

International Nuclear Information System (INIS)

Comella, P.A.; Smith, B.H.

1985-01-01

This report contains information on the evidentiary requirements to identify potentially acceptable sites in crystalline rock for waste disposal. Topics addressed include: chronology, key regulatory assumptions, statutory framework for identifying potentially acceptable sites, application of 10 disqualifiers, consideration of favorable and potentially adverse conditions, a composite favorability analysis, and a proposed outline for PAS identification decision document

Workplace barriers encountered by employed persons with systemic sclerosis.

Science.gov (United States)

Poole, Janet L; Anwar, Sahar; Mendelson, Cindy; Allaire, Saralynn

2016-01-01

Systemic sclerosis (SSc) is an auto-immune connective tissue disease characterized by fibrosis of skin, blood vessels, and internal organs that results in significant disability. To identify the work barriers faced by people with systemic sclerosis (SSc) in maintaining employment. Thirty-six people with SSc who were working more than 8 hours per week completed the Work Experience Survey, which contains lists of potential work barriers, including the ability to travel to and from work; get around at work; perform essential job functions, including physical, cognitive, and task-related activities; work with others; and manage work conditions. Thirty-three participants completed and returned the questionnaires, most of whom were female, and working full time and in professional careers. Principal disease symptoms included fatigue, Raynaud's phenomenon, esophageal involvement, and leg or hand/wrist pain. All participants reported some barriers with a mean of 18 barriers per participant. At least three quarters of participants cited outside temperature (82%), cold temperatures inside the workplace (76%), and household work (76%), as barriers. The next most common barriers were using both hands (64%), arranging and taking part in social activities (64%), being able to provide self-care (61%) and working 8 hours (58%). Participants reported a wide range of barriers, from cold temperatures, to physical job, fatigue related, and non-workplace demands, in maintaining the worker role. The barriers reflect the disease symptoms they reported. Identifying workplace barriers facilitates the creation of job accommodations or adaptations that will allow people with SSc to continue working.

[On Atomic Nuclear Fusion Processes at Low-Temperatures. An Enhancement of the Probability of Transition through a Potential Barrier Due to the So-Called Barrier Anti-Zeno Effect].

Science.gov (United States)

Namiot, V A

2016-01-01

It is known that in quantum mechanics the act of observing the experiment can affect the experimental findings in some cases. In particular, it happens under the so-called Zeno effect. In this work it is shown that in contrast to the "standard" Zeno-effect where the act of observing a process reduces the probability of its reality, an inverse situation when a particle transmits through a potential barrier (a so-called barrier anti-Zeno effect) can be observed, the observation of the particle essentially increases the probability of its transmission through the barrier. The possibility of using the barrier anti-Zeno effect is discussed to explain paradoxical results of experiments on "cold nuclear fusion" observed in various systems including biological ones. (According to the observers who performed the observations, the energy generation, which could not be explained by any chemical processes, as well as the change in the isotope and even element composition of the studied object may occur in these systems.

Born to roam? Surveying cat owners in Tasmania, Australia, to identify the drivers and barriers to cat containment.

Science.gov (United States)

McLeod, Lynette J; Hine, Donald W; Bengsen, Andrew J

2015-12-01

Free-roaming domestic cats, Felis catus, are a major public nuisance in neighbourhoods across the world, and have been linked to biodiversity loss and a host of community health problems. Owners who let their cats roam, also place their cats at risk of serious injury. One management strategy that is gaining considerable support involves encouraging cat owners to contain their pets within their property. Contemporary behaviour change models highlight the importance of identifying drivers and barriers that encourage and discourage target behaviours such as cat containment. Results from a random dial phone survey of 356 cat owners in northern Tasmania identified four distinct cat containment profiles: owners who contained their cat all the time, owners who only contained their cat at night, owners who sporadically contained their cat with no set routine, and owners who made no attempt to contain their pet. Our results indicated that cat-owners' decisions to contain or not contain their cats were guided by a range of factors including owners' beliefs about their ability to implement an effective containment strategy and their views about the physical and psychological needs of their cats. The results are discussed in terms of improving the behavioural effectiveness of cat containment interventions by selecting appropriate behavioural change tools for the identified drivers and barriers, and developing targeted engagement strategies and messaging. Copyright © 2015 Elsevier B.V. All rights reserved.

Identifying barriers to the availability and use of Magnesium Sulphate Injection in resource poor countries: a case study in Zambia.

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Ridge, Anna L; Bero, Lisa A; Hill, Suzanne R

2010-12-16

Pre-eclampsia and eclampsia are serious complications of pregnancy and major causes of maternal mortality and morbidity worldwide. According to systematic reviews and WHO guidelines magnesium sulphate injection (MgSO4) should be the first -line treatment for severe pre-eclampsia and eclampsia. Studies have shown that this safe and effective medicine is unavailable and underutilized in many resource poor countries. The objective of this study was to identify barriers to the availability and use of MgSO4 in the Zambian Public Health System. A 'fishbone' (Ishikawa) diagram listing probable facilitators to the availability and use of MgSO4 identified from the literature was used to develop an assessment tool. Barriers to availability and use of MgSO4 were assessed at the regulatory/government, supply, procurement, distribution, health facility and health professional levels. The assessment was completed during August 2008 using archival data, and observations at a pragmatic sample of health facilities providing obstetric services in Lusaka District, Zambia. The major barrier to the availability of MgSO4 within the public health system in Zambia was lack of procurement by the Ministry of Health. Other barriers identified included a lack of demand by health professionals at the health centre level and a lack of in-service training in the use of MgSO4. Where there was demand by obstetricians, magnesium sulphate injection was being procured from the private sector by the hospital pharmacy despite not being registered and licensed for use for the treatment of severe pre-eclampsia and eclampsia by the national Pharmaceutical Regulatory Authority. The case study in Zambia highlights the complexities that underlie making essential medicines available and used appropriately. The fishbone diagram is a useful theoretical framework for illustrating the complexity of translating research findings into clinical practice. A better understanding of the supply system and of the pattern

Integrating Religion and Spirituality into Counselor Education: Barriers and Strategies

Science.gov (United States)

Adams, Christopher M.; Puig, Ana; Baggs, Adrienne; Wolf, Cheryl Pence

2015-01-01

Despite a professionally recognized need for training in religion/spirituality, literature indicates that religious and spirituality issues continue to be inconsistently addressed in counselor education. Ten experts were asked to identify potential barriers to integrating religion and spirituality into counselor education and indicate strategies…

Robust global identifiability theory using potentials--Application to compartmental models.

Science.gov (United States)

Wongvanich, N; Hann, C E; Sirisena, H R

2015-04-01

This paper presents a global practical identifiability theory for analyzing and identifying linear and nonlinear compartmental models. The compartmental system is prolonged onto the potential jet space to formulate a set of input-output equations that are integrals in terms of the measured data, which allows for robust identification of parameters without requiring any simulation of the model differential equations. Two classes of linear and non-linear compartmental models are considered. The theory is first applied to analyze the linear nitrous oxide (N2O) uptake model. The fitting accuracy of the identified models from differential jet space and potential jet space identifiability theories is compared with a realistic noise level of 3% which is derived from sensor noise data in the literature. The potential jet space approach gave a match that was well within the coefficient of variation. The differential jet space formulation was unstable and not suitable for parameter identification. The proposed theory is then applied to a nonlinear immunological model for mastitis in cows. In addition, the model formulation is extended to include an iterative method which allows initial conditions to be accurately identified. With up to 10% noise, the potential jet space theory predicts the normalized population concentration infected with pathogens, to within 9% of the true curve. Copyright © 2015 Elsevier Inc. All rights reserved.

Barrier cell sheath formation

International Nuclear Information System (INIS)

Kesner, J.

1980-04-01

The solution for electrostatic potential within a simply modeled tandem mirror thermal barrier is seen to exhibit a sheath at each edge of the cell. The formation of the sheath requires ion collisionality and the analysis assmes that the collisional trapping rate into the barrier is considerably slower than the barrier pump rate

Facilitators and barriers to non-medical prescribing - A systematic review and thematic synthesis.

Science.gov (United States)

Graham-Clarke, Emma; Rushton, Alison; Noblet, Timothy; Marriott, John

2018-01-01

Non-medical prescribing has the potential to deliver innovative healthcare within limited finances. However, uptake has been slow, and a proportion of non-medical prescribers do not use the qualification. This systematic review aimed to describe the facilitators and barriers to non-medical prescribing in the United Kingdom. The systematic review and thematic analysis included qualitative and mixed methods papers reporting facilitators and barriers to independent non-medical prescribing in the United Kingdom. The following databases were searched to identify relevant papers: AMED, ASSIA, BNI, CINAHL, EMBASE, ERIC, MEDLINE, Open Grey, Open access theses and dissertations, and Web of Science. Papers published between 2006 and March 2017 were included. Studies were quality assessed using a validated tool (QATSDD), then underwent thematic analysis. The protocol was registered with PROSPERO (CRD42015019786). Of 3991 potentially relevant identified studies, 42 were eligible for inclusion. The studies were generally of moderate quality (83%), and most (71%) were published 2007-2012. The nursing profession dominated the studies (30/42). Thematic analysis identified three overarching themes: non-medical prescriber, human factors, and organisational aspects. Each theme consisted of several sub-themes; the four most highly mentioned were 'medical professionals', 'area of competence', 'impact on time' and 'service'. Sub-themes were frequently interdependent on each other, having the potential to act as a barrier or facilitator depending on circumstances. Addressing the identified themes and subthemes enables strategies to be developed to support and optimise non-medical prescribing. Further research is required to identify if similar themes are encountered by other non-medical prescribing groups than nurses and pharmacists.

Identifying Barriers and Facilitators at Affect Community Pharmacists' Ability to Engage Children in Medication Counseling: A Pilot Study

Science.gov (United States)

Alexander, Dayna S.; Schleiden, Loren J.; Carpenter, Delesha M.

2017-01-01

OBJECTIVES This study aimed to describe the barriers and facilitators that influence community pharmacists' ability to provide medication counseling to pediatric patients. METHODS Semistructured interviews (n = 16) were conducted with pharmacy staff at 3 community pharmacies in 2 Eastern states. The interview guide elicited pharmacy staff experiences interacting with children and their perceived barriers and facilitators to providing medication counseling. Transcripts were reviewed for accuracy and a codebook was developed for data analysis. NVivo 10 was used for content analysis and identifying relevant themes. RESULTS Ten pharmacists and 6 pharmacy technicians were interviewed. Most participants were female (69%), aged 30 to 49 years (56%), with ≥5 years of pharmacy practice experience. Eight themes emerged as barriers to pharmacists' engaging children in medication counseling, the most prevalent being the child's absence during medication pickup, the child appearing to be distracted or uninterested, and having an unconducive pharmacy environment. Pharmacy staff noted 7 common facilitators to engaging children, most importantly, availability of demonstrative and interactive devices/technology, pharmacist demeanor and communication approach, and having child-friendly educational materials. CONCLUSIONS Findings suggest that pharmacy personnel are rarely able to engage children in medication counseling because of the patient's absence during medication pickup; however, having child-friendly materials could facilitate interactions when the child is present. These findings can inform programs and interventions aimed at addressing the barriers pharmacists encounter while educating children about safe and appropriate use of medicines. PMID:29290741

Inter- and Intrapersonal Barriers to Living Donor Kidney Transplant among Black Recipients and Donors.

Science.gov (United States)

Davis, LaShara A; Grogan, Tracy M; Cox, Joy; Weng, Francis L

2017-08-01

End-stage renal disease (ESRD) is more common among Blacks, but Blacks are less likely to receive a live donor kidney transplant (LDKT). The objective of this study is to identify barriers and coping mechanisms that Black LDKT recipients and donors experienced while receiving or donating a kidney. A qualitative study was conducted using structured interviews. Thematic analysis was used for data interpretation. All 20 participants identified as Black, with two participants identifying themselves as multiracial. The mean age for the 14 recipients was 60, and the average age for the 6 living donors was 47. Themes emerging from the data suggest both recipients and donors faced barriers in the LDKT experience. Recipients faced barriers associated with their denial and avoidance of the severity of their ESRD, their desire to maintain the privacy of their health status, and their refusal to approach potential donors. Donors encountered negative responses from others about the donors' desire to donate and the initial refusal of recipients to accept a LDKT offer. Recipients identified faith as a coping mechanism, while donors identified normalization of donation as their method of coping. Various types of social support helped donors and recipients navigate the transplant process. Black LDKT recipients and donors must overcome barriers prior to receiving or donating a kidney. Most of these barriers arise from communication and interactions with others that are either lacking or undesirable. Future interventions to promote LDKT among Blacks may benefit by specifically targeting these barriers.

Barriers, facilitators, and potential strategies for increasing HPV vaccination: A statewide assessment to inform action

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Kathleen B. Cartmell

2018-06-01

Full Text Available Objective: The objective was to investigate how state level strategies in South Carolina could maximize HPV vaccine uptake. Design: An environmental scan identified barriers, facilitators, and strategies for improving HPV vaccination in South Carolina. Interviews were conducted with state leaders from relevant organizations such as public health agencies, medical associations, K-12 schools, universities, insurers, and cancer advocacy organizations. A thematic content analysis design was used. Digital interview files were transcribed, a data dictionary was created and data were coded using the data dictionary. Results: Thirty four interviews were conducted with state leaders. Barriers to HPV vaccination included lack of HPV awareness, lack of provider recommendation, HPV vaccine concerns, lack of access and practice-level barriers. Facilitators included momentum for improving HPV vaccination, school-entry Tdap requirement, pharmacy-based HPV vaccination, state immunization registry, HEDIS measures and HPV vaccine funding. Strategies for improving HPV vaccination fell into three categories: 1 addressing lack of awareness about the importance of HPV vaccination among the public and providers; 2 advocating for policy changes around HPV vaccine coverage, vaccine education, and pharmacy-based vaccination; and 3 coordination of efforts. Discussion: A statewide environmental scan generated a blueprint for action to be used to improve HPV vaccination in the state. Keywords: HPV, HPV vaccines, Cervical cancer, Prevention, Health systems, Barriers, Facilitators, Strategies, South Carolina

Evaluation of barriers and resilience to improve organizational performance in nuclear power plants

Energy Technology Data Exchange (ETDEWEB)

Nelson, P. F.; Martin del Campo, C., E-mail: pnelson_007@yahoo.com [UNAM, Facultad de Ingenieria, Departamento de Sistemas Energeticos, Paseo Cuauhnahuac 8532, Jiutepec 62550, Morelos (Mexico)

2014-10-15

In this study, several models are built from the information contained in the Condition Reports from the Corrective Action Program ar a nuclear power plant. Condition Reports are seen as indications of organizational stress levels with consequential Condition Reports being further evidence of organizational resilience being exceeded. Also contained in this paper is an examination of methods used to assess organizational resilience thresholds to preclude consequential events, based on examination of the number and severity of the Condition Reports. In combination with PSA risk insights, it is possible to identify risk significant procedures and their corresponding risk significant steps. Leading indicators can be used to identify the need for installing a barrier or defense to reduce human errors in a nuclear power plant. These indicators are developed from the Corrective Action Program data by detecting increases in events. Organizational barriers can then be identified to improve performance. The resulting identified barriers are evaluated to rank the value of each possible barrier, and determine the best barrier(s) to implement. The tool described in this paper is designed to provide a systematic approach to identify areas where improvements in organizational effectiveness best reduce the likelihood of consequential events. Due to the uncertainty of many of the factors that influence the performance of humans in nuclear power plant activities, we propose using Bayesian networks to identify sources of organizational errors leading to consequential events. This study, using actual nuclear power plant data, includes a method for data processing and highlights some potential uses of Bayesian networks for improving organizational effectiveness in the nuclear power industry. (Author)

Evaluation of barriers and resilience to improve organizational performance in nuclear power plants

International Nuclear Information System (INIS)

Nelson, P. F.; Martin del Campo, C.

2014-10-01

In this study, several models are built from the information contained in the Condition Reports from the Corrective Action Program ar a nuclear power plant. Condition Reports are seen as indications of organizational stress levels with consequential Condition Reports being further evidence of organizational resilience being exceeded. Also contained in this paper is an examination of methods used to assess organizational resilience thresholds to preclude consequential events, based on examination of the number and severity of the Condition Reports. In combination with PSA risk insights, it is possible to identify risk significant procedures and their corresponding risk significant steps. Leading indicators can be used to identify the need for installing a barrier or defense to reduce human errors in a nuclear power plant. These indicators are developed from the Corrective Action Program data by detecting increases in events. Organizational barriers can then be identified to improve performance. The resulting identified barriers are evaluated to rank the value of each possible barrier, and determine the best barrier(s) to implement. The tool described in this paper is designed to provide a systematic approach to identify areas where improvements in organizational effectiveness best reduce the likelihood of consequential events. Due to the uncertainty of many of the factors that influence the performance of humans in nuclear power plant activities, we propose using Bayesian networks to identify sources of organizational errors leading to consequential events. This study, using actual nuclear power plant data, includes a method for data processing and highlights some potential uses of Bayesian networks for improving organizational effectiveness in the nuclear power industry. (Author)

Barriers to Use of Family Planning Methods Among Heterosexual Mexican Couples.

Science.gov (United States)

Arias, María Luisa Flores; Champion, Jane Dimmitt; Soto, Norma Elva Sáenz; Tovar, Marlene; Dávila, Sandra Paloma Esparza

2017-05-01

Family planning has become increasingly important as a fundamental component of sexual health and as such is offered via public health systems worldwide. Identification of barriers to use of family planning methods among heterosexual couples living in Mexico is indicated to facilitate access to family planning methods. Barriers to family planning methods were assessed among Mexican heterosexual, sexually active males and females of reproductive age, using a modified Spanish version of the Barriers to the Use of Family Planning Methods scale (Cronbach's alpha = .89, subscales ranging from .53 to .87). Participants were recruited via convenience sampling in ambulatory care clinics within a metropolitan area in Central Mexico. Participants included 52 heterosexual couples aged 18-35 years (N = 104). Sociodemographic comparisons by gender identified older age and higher education, income, and numbers of sexual partners among men than women. More men (50%) than women (25%) were currently using family planning methods; however, 80% overall indicated intentions for its use. Overall, male condoms were used and intended for use most often by men than women. Significant gender-specific differences were found, with men (71.15%) reporting no family planning barriers, whereas women (55.66%) reported barriers including low socioeconomic status, medical concerns, and stigma. The modified Spanish translation demonstrated usefulness for measuring barriers to family planning methods use in Mexico among heterosexual males and females of reproductive age. Barriers identified by Mexican women in this study may be addressed to reduce potential barriers to family planning among Mexican populations.

Barriers to Banking - Towards an Inclusive Banking Environment in South Africa.

Science.gov (United States)

Martinson, Estelle; Martinson, Johannes

2016-01-01

A recent study in South Africa on the barriers to banking which involved customers in three disability groups namely mobility, hearing and vision has highlighted that currently banking in South Africa is not accessible. Customers with a disability are unable to independently use banking services across a wide range of channels. Exclusion from something as fundamental as managing their own financial affairs raise serious human rights concerns and requires committed action from decision-makers to address this. The fact that solutions to all of the identified barriers have been successfully implemented in banks in other parts of the world for many years emphasize that this is not a technical challenge. While some solutions require complex or expensive changes such as removing physical access barriers and ensuring that digital channels meet internationally accepted standards of accessibility, there are many simple and low-cost solutions which can be implemented immediately and would make a world of difference to these customers and their experience of banking. One key barrier which emerged in all the focus groups and surveys is attitudinal barriers - staff who are unwilling to assist, impatient, interact with the customer's assistant instead of directly with them and lack basic skills on how to interact with someone who has a disability. A comprehensive framework of banking was used to identify a wide range of barriers. The barriers were classified as attitudinal, barriers to physical access, digital access barriers, barriers to information, communication barriers and some generic concerns such as safe evacuation during emergencies and alternative authentication. Both the barriers and the solutions where ranked by participants. From a theoretical perspective, the benefit of a customer-centric approach to understanding these barriers and the innovation potential of a Universal Design approach is affirmed by this study.

Barriers to accessing urethroplasty.

Science.gov (United States)

Consolo, Michael J; Syed, Kirin K; Robison, Christopher; McFadden, Jacob; Shalowitz, David I; Brown, Gordon A; Sussman, David O; Figler, Bradley D

2016-01-01

Urethroplasty is an effective treatment for men with anterior urethral strictures, but is utilized less frequently than ineffective treatments such as internal urethrotomy. We sought to identify provider-level barriers to urethroplasty. An anonymous online survey was emailed to all Mid-Atlantic American Urological Association members. Six scenarios in which urethroplasty was the most appropriate treatment were presented. Primary outcome was recommendation for urethroplasty in ≥ three clinical scenarios. Other factors measured include practice zip code, urethroplasty training, and proximity to a urethroplasty surgeon. Multivariate logistic regression identified factors associated with increased likelihood of urethroplasty recommendation. Of 670 members emailed, 109 (16%) completed the survey. Final analysis included 88 respondents. Mean years in practice was 17.2. Most respondents received formal training in urethroplasty: 43 (49%) in residency, 5 (6%) in fellowship, and 10 (11%) in both; 48 respondents (55%) had a urethroplasty surgeon in their practice, whereas 18 (20%) had a urethroplasty surgeon within 45 minutes of his or her primary practice location. The only covariate that was associated with an increased likelihood of recommending urethroplasty in ≥ three scenarios was formal urethroplasty training. Most members (68%) reported no barriers to referring patients for urethroplasty; the most common barriers cited were long distance to urethroplasty surgeon (n 5 13, 15%) and concern about complications (n 5 8, 9%). Urethroplasty continues to be underutilized in men with anterior urethral strictures, potentially due to lack of knowledge dissemination and access to a urethroplasty surgeon. Appropriate urethroplasty utilization may increase with greater exposure to urethroplasty in training.

Edible moisture barriers: how to assess of their potential and limits in food products shelf-life extension?

Science.gov (United States)

Bourlieu, C; Guillard, V; Vallès-Pamiès, B; Guilbert, S; Gontard, N

2009-05-01

Control of moisture transfer inside composite food products or between food and its environment remains today a major challenge in food preservation. A wide rage of film-forming compounds is now available and facilitates tailoring moisture barriers with optimized functional properties. Despite these huge potentials, a realistic assessment of the film or coating efficacy is still critical. Due to nonlinear water sorption isotherms, water-dependent diffusivities, and variations of physical state, modelling transport phenomena through edible barriers is complex. Water vapor permeability can hardly be considered as an inherent property of films and only gives a relative indication of the barrier efficacy. The formal or mechanistic models reported in literature that describe the influence of testing conditions on the barrier properties of edible films are reviewed and discussed. Most of these models have been validated on a narrow range of conditions. Conversely, few original predictive models based on Fick's Second Law have been developed to assess shelf-life extension of food products including barriers. These models, assuming complex and realistic hypothesis, have been validated in various model foods. The development of nondestructive methods of moisture content measurement should speed up model validation and allow a better comprehension of moisture transfer through edible films.

The Future of Basic Science in Academic Surgery: Identifying Barriers to Success for Surgeon-scientists.

Science.gov (United States)

Keswani, Sundeep G; Moles, Chad M; Morowitz, Michael; Zeh, Herbert; Kuo, John S; Levine, Matthew H; Cheng, Lily S; Hackam, David J; Ahuja, Nita; Goldstein, Allan M

2017-06-01

The aim of this study was to examine the challenges confronting surgeons performing basic science research in today's academic surgery environment. Multiple studies have identified challenges confronting surgeon-scientists and impacting their ability to be successful. Although these threats have been known for decades, the downward trend in the number of successful surgeon-scientists continues. Clinical demands, funding challenges, and other factors play important roles, but a rigorous analysis of academic surgeons and their experiences regarding these issues has not previously been performed. An online survey was distributed to 2504 members of the Association for Academic Surgery and Society of University Surgeons to determine factors impacting success. Survey results were subjected to statistical analyses. We also reviewed publicly available data regarding funding from the National Institutes of Health (NIH). NIH data revealed a 27% decline in the proportion of NIH funding to surgical departments relative to total NIH funding from 2007 to 2014. A total of 1033 (41%) members responded to our survey, making this the largest survey of academic surgeons to date. Surgeons most often cited the following factors as major impediments to pursuing basic investigation: pressure to be clinically productive, excessive administrative responsibilities, difficulty obtaining extramural funding, and desire for work-life balance. Surprisingly, a majority (68%) did not believe surgeons can be successful basic scientists in today's environment, including departmental leadership. We have identified important barriers that confront academic surgeons pursuing basic research and a perception that success in basic science may no longer be achievable. These barriers need to be addressed to ensure the continued development of future surgeon-scientists.

Vehicle barrier systems

International Nuclear Information System (INIS)

Sena, P.A.

1986-01-01

The ground vehicle is one of the most effective tools available to an adversary force. Vehicles can be used to penetrate many types of perimeter barriers, transport equipment and personnel rapidly over long distances, and deliver large amounts of explosives directly to facilities in suicide missions. The function of a vehicle barrier system is to detain or disable a defined threat vehicle at a selected distance from a protected facility. Numerous facilities are installing, or planning to install, vehicle barrier systems and many of these facilities are requesting guidance to do so adequately. Therefore, vehicle barriers are being evaluated to determine their stopping capabilities so that systems can be designed that are both balanced and capable of providing a desired degree of protection. Equally important, many of the considerations that should be taken into account when establishing a vehicle barrier system have been identified. These considerations which pertain to site preparation, barrier selection, system integration and operation, and vehicle/barrier interaction, are discussed in this paper

Barriers to breast cancer screening among a sample of Egyptian females

Directory of Open Access Journals (Sweden)

Heba M. Mamdouh

2014-01-01

Full Text Available Background: Breast cancer (BC is usually diagnosed in late stages in countries with limited resources. Early detection of BC is likely to improve the outcome of the disease for women in these areas. Objective: The aim of this study was to understand the possible personal, economic, and systems barriers to BC screening in a sample of Egyptian women. Materials and Methods: A cross-sectional study was conducted in family health centers representing the seven districts of Alexandria governorate, Egypt. A total of 612 women were randomly selected from the chosen centers. Results: In this sample of Egyptian women, the most frequently identified potential barriers to BC screening were the following: 81.8% would not seek care until they were ill, 77% were unwilling to have a mammogram until it was recommended by the doctor, 71.4% blamed the, lack of privacy, 69.2% thought that medical checkups were not worthwhile, and 64.6% blamed the cost of services. The study further revealed that women of lower education, women in the lower income category, women who did not do paid work, those who had poor knowledge of the risks of BC, and women with no family history of BC were more likely to perceive different screening barriers compared with their counterparts. Conclusion: Many potential personal, economic, and health system barriers were identified. Addressing these barriers by increasing the awareness of BC and dealing with the misconceptions that the women have can help the policy makers to design more culturally relevant strategies to motivate women to utilize screening services.

CAPILLARY BARRIERS IN UNSATURATED FRACTURED ROCKS OF YUCCA MOUNTAIN, NEVADA

International Nuclear Information System (INIS)

Wu, Y.S.; Zhang, W.; Pan, L.; Hinds, J.; Bodvarsson, G.

2000-01-01

This work presents modeling studies investigating the effects of capillary barriers on fluid-flow and tracer-transport processes in the unsaturated zone of Yucca Mountain, Nevada, a potential site for storing high-level radioactive waste. These studies are designed to identify factors controlling the formation of capillary barriers and to estimate their effects on the extent of possible large-scale lateral flow in unsaturated fracture rocks. The modeling approach is based on a continuum formulation of coupled multiphase fluid and tracer transport through fractured porous rock. Flow processes in fractured porous rock are described using a dual-continuum concept. In addition, approximate analytical solutions are developed and used for assessing capillary-barrier effects in fractured rocks. This study indicates that under the current hydrogeologic conceptualization of Yucca Mountain, strong capillary-barrier effects exist for significantly diverting moisture flow

Barriers for realisation of energy savings in buildings; Barrierer for realisering af energibesparelser i bygninger

Energy Technology Data Exchange (ETDEWEB)

Jensen, O.M.

2004-07-01

Many years' efforts within the energy labelling area have shown large saving potentials in heating and use of electricity in buildings. At the same time it has been proved that these saving potentials, even when economically advantageous, only are cashed to a limited extent. The reason to this is ascribed to barriers that meet the individual building owner who wants to start saving energy. Most barriers are known and a lot of these have been sought overcome for some time. The questions are how many barriers still exist, have new barriers arisen and the character of these barriers. On this background the objective of this survey has been to concretize and study the barriers, which are blocking reasonable energy savings. Focus has especially been on barriers for realisation of heating savings, but through a general evaluation of energy savings of barriers other forms of energy saving methods have been taken into consideration. Special interest has been directed towards houses, typically one family houses, which are affected by the Energy Labelling Scheme. The concept barriers include all kinds of barriers, also barriers that not are acknowledged as barriers by the individual house owner, or that on closer inspection turn out to be something else than actual barriers. This note suggests an alternative inertia model, in order to create an idea of the inertness characteristic of the many house owners who understand the message but fail to act on it. (BA)

Understanding barriers to implementation of an adaptive land management program

Science.gov (United States)

Jacobson, S.K.; Morris, J.K.; Sanders, J.S.; Wiley, E.N.; Brooks, M.; Bennetts, R.E.; Percival, H.F.; Marynowski, S.

2006-01-01

The Florida Fish and Wildlife Conservation Commission manages over 650,000 ha, including 26 wildlife management and environmental areas. To improve management, they developed an objective-based vegetation management (OBVM) process that focuses on desired conditions of plant communities through an adaptive management framework. Our goals were to understand potential barriers to implementing OBVM and to recommend strategies to overcome barriers. A literature review identified 47 potential barriers in six categories to implementation of adaptive and ecosystem management: logistical, communication, attitudinal, institutional, conceptual, and educational. We explored these barriers through a bureau-wide survey of 90 staff involved in OBVM and personal interviews with area managers, scientists, and administrators. The survey incorporated an organizational culture assessment instrument to gauge how institutional factors might influence OBVM implementation. The survey response rate was 69%. Logistics and communications were the greatest barriers to implementing OBVM. Respondents perceived that the agency had inadequate resources for implementing OBVM and provided inadequate information. About one-third of the respondents believed OBVM would decrease their job flexibility and perceived greater institutional barriers to the approach. The 43% of respondents who believed they would have more responsibility under OBVM also had greater attitudinal barriers. A similar percentage of respondents reported OBVM would not give enough priority to wildlife. Staff believed that current agency culture was hierarchical but preferred a culture that would provide more flexibility for adaptive management and would foster learning from land management activities. In light of the barriers to OBVM, we recommend the following: (1) mitigation of logistical barriers by addressing real and perceived constraints of staff, funds, and other resources in a participatory manner; (2) mitigation of

Getting what they need when they need it. Identifying barriers to information needs of family caregivers to manage dementia-related behavioral symptoms.

Science.gov (United States)

Werner, Nicole E; Stanislawski, Barbara; Marx, Katherine A; Watkins, Daphne C; Kobayashi, Marissa; Kales, Helen; Gitlin, Laura N

2017-02-22

Consumer health informatics (CHI) such as web-based applications may provide the platform for enabling the over 15 million family caregivers of patients with Alzheimer's Disease or related dementias the information they need when they need it to support behavioral symptom management. However, for CHI to be successful, it is necessary that it be designed to meet the specific information needs of family caregivers in the context in which caregiving occurs. A sociotechnical systems approach to CHI design can help to understand the contextual complexities of family caregiving and account for those complexities in the design of CHI for family caregivers. This study used a sociotechnical systems approach to identify barriers to meeting caregivers' information needs related to the management of dementia-related behavioral symptoms, and to derive design implications that overcome barriers for caregiver-focused web-based platforms. We have subsequently used these design implications to inform the development of a web-based platform, WeCareAdvisor,TM which provides caregivers with information and an algorithm by which to identify and manage behavioral symptoms for which they seek management strategies. We conducted 4 focus groups with family caregivers (N=26) in a Midwestern state. Qualitative content analysis of the data was guided by a sociotechnical systems framework. We identified nine categories of barriers that family caregivers confront in obtaining needed information about behavioral symptom management from which we extrapolated design implications for a web-based platform. Based on interactions within the sociotechnical system, three critical information needs were identified: 1) timely access to information, 2) access to information that is tailored or specific to caregiver's needs and contexts, and 3) usable information that can directly inform how caregivers' manage behaviors. The sociotechnical system framework is a useful approach for identifying information

Quantum damped oscillator II: Bateman’s Hamiltonian vs. 2D parabolic potential barrier

Science.gov (United States)

Chruściński, Dariusz

2006-04-01

We show that quantum Bateman’s system which arises in the quantization of a damped harmonic oscillator is equivalent to a quantum problem with 2D parabolic potential barrier known also as 2D inverted isotropic oscillator. It turns out that this system displays the family of complex eigenvalues corresponding to the poles of analytical continuation of the resolvent operator to the complex energy plane. It is shown that this representation is more suitable than the hyperbolic one used recently by Blasone and Jizba.

Recent results from TMX-U thermal barrier experiments

International Nuclear Information System (INIS)

Molvik, A.W.; Allen, S.; Barter, J.

1984-01-01

The Tandem Mirror Experiment-Upgrade (TMX-U) device was designed to study plasma confinement in a tandem mirror with thermal barriers. Previously the author reported improved axial confinement with high end-plug potentials, consistent with thermal barrier operation. Now, the existence of thermal barriers in TMX-U confirmed by measuring the axial potential profile. Specifically, measured the change in energy of a 5-keV deuterium neutral beam that is injected nearly parallel to the axis and is ionized between the barrier and the central cell. The authors found that the barrier potential is lower than the central cell potential, as required for a thermal barrier. The peak potential is at least 2.4 keV, as determined from the minimum energy of end loss ions. In addition, radial transport is reduced by the use of floating and electrodes that map to concentric cylinders in the central cell. Sloshing ions continue to be microstable

Barriers to renewable energy development: A case study of large-scale wind energy in Saskatchewan, Canada

International Nuclear Information System (INIS)

Richards, Garrett; Noble, Bram; Belcher, Ken

2012-01-01

Renewable energy is receiving increased attention as a viable alternative to non-renewable electrical generation, however, meeting global energy demands will require a more ambitious renewable energy program than is currently the case. There have been several reviews of potential technological, economic, social, or public barriers and solutions to renewable energy investment. Although important, there is also need for multi-dimensional analyses of these barriers and identification of the most significant underlying barriers if viable solutions are to be developed. In this paper we apply a theoretical framework to examine stakeholder's perceptions and understanding of the barriers to wind energy development in Saskatchewan, Canada. We identify and examine the most significant underlying barriers to investment in renewable energy and the interactions between those barriers. Results show a number of perceived barriers to wind energy investment, however, these barriers can be explained in large part by knowledge barriers, if not disagreement over whether the current level of investment in wind energy is sufficient. We show that barriers to renewable energy cannot be explained solely by technological, social, political, or economic factors in isolation, and that a multi-dimensional approach, identifying and explaining the underlying sources of these barriers, is necessary to develop viable solutions. - Highlights: ► Meeting future wind energy objectives requires an ambitious investment program. ► A framework is applied to identify and explain perceived barriers to wind energy. ► Stakeholders perceived technological and political barriers as the most significant. ► These could be explained by knowledge barriers and complacency with the status quo. ► Even with additional investment these underlying barriers will constrain progress.

Older adults are mobile too!Identifying the barriers and facilitators to older adults' use of mHealth for pain management.

Science.gov (United States)

Parker, Samantha J; Jessel, Sonal; Richardson, Joshua E; Reid, M Cary

2013-05-06

Mobile health (mHealth) is a rapidly emerging field with the potential to assist older adults in the management of chronic pain (CP) through enhanced communication with providers, monitoring treatment-related side effects and pain levels, and increased access to pain care resources. Little is currently known, however, about older adults' attitudes and perceptions of mHealth or perceived barriers and facilitators to using mHealth tools to improve pain management. We conducted six focus groups comprised of 41 diverse older adults (≥60 years of age) with CP. Participants were recruited from one primary care practice and two multiservice senior community day-visit centers located in New York City that serve older adults in their surrounding neighborhoods. Focus group discussions were recorded and transcribed, and transcriptions were analyzed using direct content analysis to identify and quantify themes. Focus group discussions generated 38 individual themes pertaining to the use of mHealth to help manage pain and pain medications. Participants had low prior use of mHealth (5% of participants), but the vast majority (85%) were highly willing to try the devices. Participants reported that mHealth devices might help them reach their healthcare provider more expeditiously (27%), as well as help to monitor for falls and other adverse events in the home (15%). Barriers to device use included concerns about the cost (42%) and a lack of familiarity with the technology (32%). Facilitators to device use included training prior to device use (61%) and tailoring devices to the functional needs of older adults (34%). This study suggests that older adults with CP are interested and willing to use mHealth to assist in the management of pain. Participants in our study reported important barriers that medical professionals, researchers, and mHealth developers should address to help facilitate the development and evaluation of age-appropriate, and function-appropriate, m

Modelling intelligence-led policing to identify its potential

NARCIS (Netherlands)

Hengst-Bruggeling, M. den; Graaf, H.A.L.M. de; Scheepstal, P.G.M. van

2014-01-01

lntelligence-led policing is a concept of policing that has been applied throughout the world. Despite some encouraging reports, the effect of intelligence-led policing is largely unknown. This paper presents a method with which it is possible to identify intelligence-led policing's potential to

Identifying barriers to the availability and use of Magnesium Sulphate Injection in resource poor countries: A case study in Zambia

Directory of Open Access Journals (Sweden)

Hill Suzanne R

2010-12-01

Full Text Available Abstract Background Pre-eclampsia and eclampsia are serious complications of pregnancy and major causes of maternal mortality and morbidity worldwide. According to systematic reviews and WHO guidelines magnesium sulphate injection (MgSO4 should be the first -line treatment for severe pre-eclampsia and eclampsia. Studies have shown that this safe and effective medicine is unavailable and underutilized in many resource poor countries. The objective of this study was to identify barriers to the availability and use of MgSO4 in the Zambian Public Health System. Methods A 'fishbone' (Ishikawa diagram listing probable facilitators to the availability and use of MgSO4 identified from the literature was used to develop an assessment tool. Barriers to availability and use of MgSO4 were assessed at the regulatory/government, supply, procurement, distribution, health facility and health professional levels. The assessment was completed during August 2008 using archival data, and observations at a pragmatic sample of health facilities providing obstetric services in Lusaka District, Zambia. Results The major barrier to the availability of MgSO4 within the public health system in Zambia was lack of procurement by the Ministry of Health. Other barriers identified included a lack of demand by health professionals at the health centre level and a lack of in-service training in the use of MgSO4. Where there was demand by obstetricians, magnesium sulphate injection was being procured from the private sector by the hospital pharmacy despite not being registered and licensed for use for the treatment of severe pre-eclampsia and eclampsia by the national Pharmaceutical Regulatory Authority. Conclusions The case study in Zambia highlights the complexities that underlie making essential medicines available and used appropriately. The fishbone diagram is a useful theoretical framework for illustrating the complexity of translating research findings into clinical

Barriers to adopting and implementing local-level tobacco control policies.

Science.gov (United States)

Satterlund, Travis D; Cassady, Diana; Treiber, Jeanette; Lemp, Cathy

2011-08-01

Although California communities have been relatively successful in adopting and implementing a wide range of local tobacco control policies, the process has not been without its setbacks and barriers. Little is known about local policy adoption, and this paper examines these processes related to adopting and implementing outdoor smoke-free policies, focusing on the major barriers faced by local-level tobacco control organizations in this process. Ninety-six projects funded by the California Tobacco Control Program submitted final evaluation reports pertaining to an outdoor smoking objective, and the reports from these projects were analyzed. The barriers were grouped in three primary areas: politically polarizing barriers, organizational barriers, and local political orientation. The barriers identified in this study underscore the need for an organized action plan in adopting local tobacco policy. The authors also suggest potential strategies to offset the barriers, including: (1) having a "champion" who helps to carry an objective forward; (2) tapping into a pool of youth volunteers; (3) collecting and using local data as a persuasive tool; (4) educating the community in smoke-free policy efforts; (5) working strategically within the local political climate; and (6) demonstrating to policymakers the constituent support for proposed policy.

Implementation of renewable energy technologies - Opportunities and barriers. Egypt country study

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-07-01

The project used case studies of renewable energy implementation projects to analyse the reasons for success or failure of specific projects or technologies. In particular the study aimed to identify possibilities for 'removing' the main barriers and thus 'promoting' increased implementation of (RETs), and to 'generalise' the experiences from the case studies and produce results that can be disseminated and utilized further in a planned second phase. The specific objectives for Egypt Country Study were: 1) To determine, on the basis of analysis of the past experience, the barriers against implementation of RETs in Egypt, and to identify the favourable conditions and actions required for such implementation. 2) To apply the knowledge gained and results of the analysis of past projects for a detailed analysis of barriers to a chosen set of potential RETs implementation projects with view to success. 3) To identify specific RET projects for implementation including necessary actions to overcome identified barriers. The case study revealed that; for Domestic Solar Water Heating (DSWH) the main barriers are; the economic barriers followed by the awareness / information barriers, then the Technical and Institution barriers. For the PV rural electrification, the most important barriers are; the economic and financial barriers, the awareness and information barriers then the technical barriers. For the large-scale biogas systems, the main barriers are the institution and capacity, economic, policy and awareness / information respectively. According to the project results the main actions that could be taken to overcome the barriers and make use of the available opportunities are: Economic / Financial: 1) Creation of new financial schemes for the RETs applications components and systems. 2) Reducing the taxes and duties for the components and / or materials needed for Renewable Energy (RE) systems. 3) More government-supported market incentives to encourage further

Implementation of renewable energy technologies - Opportunities and barriers. Egypt country study

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-07-01

The project used case studies of renewable energy implementation projects to analyse the reasons for success or failure of specific projects or technologies. In particular the study aimed to identify possibilities for 'removing' the main barriers and thus 'promoting' increased implementation of (RETs), and to 'generalise' the experiences from the case studies and produce results that can be disseminated and utilized further in a planned second phase. The specific objectives for Egypt Country Study were: 1) To determine, on the basis of analysis of the past experience, the barriers against implementation of RETs in Egypt, and to identify the favourable conditions and actions required for such implementation. 2) To apply the knowledge gained and results of the analysis of past projects for a detailed analysis of barriers to a chosen set of potential RETs implementation projects with view to success. 3) To identify specific RET projects for implementation including necessary actions to overcome identified barriers. The case study revealed that; for Domestic Solar Water Heating (DSWH) the main barriers are; the economic barriers followed by the awareness / information barriers, then the Technical and Institution barriers. For the PV rural electrification, the most important barriers are; the economic and financial barriers, the awareness and information barriers then the technical barriers. For the large-scale biogas systems, the main barriers are the institution and capacity, economic, policy and awareness / information respectively. According to the project results the main actions that could be taken to overcome the barriers and make use of the available opportunities are: Economic / Financial: 1) Creation of new financial schemes for the RETs applications components and systems. 2) Reducing the taxes and duties for the components and / or materials needed for Renewable Energy (RE) systems. 3) More government-supported market incentives

Barriers and facilitators to implementing a patient-centered model of contraceptive provision in community health centers.

Science.gov (United States)

Politi, Mary C; Estlund, Amy; Milne, Anne; Buckel, Christina M; Peipert, Jeffrey F; Madden, Tessa

2016-01-01

The Contraceptive CHOICE Project developed a patient-centered model for contraceptive provision including: (1) structured, evidence-based counseling; (2) staff and health care provider education; and (3) removal of barriers such as cost and multiple appointments to initiate contraception. In preparation for conducting a research study of the CHOICE model in three community health settings, we sought to identify potential barriers and facilitators to implementation. Using a semi-structured interview guide guided by a framework of implementation research, we conducted 31 qualitative interviews with female patients, staff, and health care providers assessing attitudes, beliefs, and barriers to receiving contraception. We also asked about current contraceptive provision and explored organizational practices relevant to implementing the CHOICE model. We used a grounded theory approach to identify major themes. Many participants felt that current contraceptive provision could be improved by the CHOICE model. Potential facilitators included agreement about the necessity for improved contraceptive knowledge among patients and staff; importance of patient-centered contraceptive counseling; and benefits to same-day insertion of long-acting reversible contraception (LARC). Potential barriers included misconceptions about contraception held by staff and providers; resistance to new practices; costs associated with LARC; and scheduling challenges required for same-day insertion of LARC. In addition to staff and provider training, implementing a patient-centered model of contraceptive provision needs to be supplemented by strategies to manage patient and system-level barriers. Community health center staff, providers, and patients support patient-centered contraceptive counseling to improve contraception provision if organizations can address these barriers.

Polymers for subterranean containment barriers for underground storage tanks (USTs)

International Nuclear Information System (INIS)

Heiser, J.H.; Colombo, P.; Clinton, J.

1992-12-01

The US Department of Energy (DOE) set up the Underground Storage Tank Integrated Demonstration Program (USTID) to demonstrate technologies for the retrieval and treatment of tank waste, and closure of underground storage tanks (USTs). There are more than 250 underground storage tanks throughout the DOE complex. These tanks contain a wide variety of wastes including high level, low level, transuranic, mixed and hazardous wastes. Many of the tanks have performed beyond the designed lifetime resulting in leakage and contamination of the local geologic media and groundwater. To mitigate this problem it has been proposed that an interim subterranean containment barrier be placed around the tanks. This would minimize or prevent future contamination of soil and groundwater in the event that further tank leakages occur before or during remediation. Use of interim subterranean barriers can also provide sufficient time to evaluate and select appropriate remediation alternatives. The DOE Hanford site was chosen as the demonstration site for containment barrier technologies. A panel of experts for the USTID was convened in February, 1992, to identify technologies for placement of subterranean barriers. The selection was based on the ability of candidate grouts to withstand high radiation doses, high temperatures and aggressive tank waste leachates. The group identified and ranked nine grouting technologies that have potential to place vertical barriers and five for horizontal barriers around the tank. The panel also endorsed placement technologies that require minimal excavation of soil surrounding the tanks

Potential solver for sloshing-ion thermal barriers

International Nuclear Information System (INIS)

Boghosian, B.M.; Campbell, R.B.; Gilmore, J.M.

1981-01-01

The quasineutrality equations at points (a) and (b) in a sloshing-ion thermal barrier are derived and an algorithm for their solution is given. The solution technique is sufficiently reliable and efficient to be used in a fluid code where it must be invoked at each time step. Circumstances under which the equations admit multiple solutions are noted and discussed

Barriers and Facilitators to Implementing the HEADS-ED: A Rapid Screening Tool for Pediatric Patients in Emergency Departments.

Science.gov (United States)

MacWilliams, Kate; Curran, Janet; Racek, Jakub; Cloutier, Paula; Cappelli, Mario

2017-12-01

This study sought to identify barriers and facilitators to the implementation of the HEADS-ED, a screening tool appropriate for use in the emergency department (ED) that facilitates standardized assessments, discharge planning, charting, and linking pediatric mental health patients to appropriate community resources. A qualitative theory-based design was used to identify barriers and facilitators to implementing the HEADS-ED tool. Focus groups were conducted with participants recruited from 6 different ED settings across 2 provinces (Ontario and Nova Scotia). The Theoretical Domains Framework was used as a conceptual framework to guide data collection and to identify themes from focus group discussions. The following themes spanning 12 domains were identified as reflective of participants' beliefs about the barriers and facilitators to implementing the HEADS-ED tool: knowledge, skills, beliefs about capabilities, social professional role and identity, optimism, beliefs about consequences, reinforcement, environmental context and resources, social influences, emotion, behavioral regulation and memory, and attention and decision process. The HEADS-ED has the potential to address the need for better discharge planning, complete charting, and standardized assessments for the increasing population of pediatric mental health patients who present to EDs. This study has identified potential barriers and facilitators, which should be considered when developing an implementation plan for adopting the HEADS-ED tool into practice within EDs.

Barriers to outdoor physical activity in wintertime among Somali youth.

Science.gov (United States)

Rothe, Elizabeth; Holt, Christina; Kuhn, Celine; McAteer, Timothy; Askari, Isabella; O'Meara, Mary; Sharif, Abdimajid; Dexter, William

2010-10-01

To identify barriers to outdoor physical activity in winter among Somali youth in Maine. Despite the many proven health benefits of physical activity among children, such as cardiovascular fitness and health status as an adult, there has been a decrease in physical activity among children in recent years. Specifically, children who are of low socio-economic status or are from communities where many immigrants are at increased risk for developing obesity. Immigrants are also less likely to be physically active. There are many potential barriers to wintertime physical activity among Somali youth in Maine, such as lack of financial resources, transportation, proper winter clothing, and appropriate knowledge of winter safety, and language and cultural barriers. For females, different attire required for outdoor activity may be a barrier. Somali parents and children were recruited from Portland, Maine to participate in focus groups led by a trained facilitator with a Somali translator and cultural broker. Transcripts were coded using NVIVO software to identify barriers to physical activity among Somali youth outside in winter. Eight focus groups were conducted. Sixty-one Somali community members were recruited. Participants felt outdoor physical activity is important, but note that it is decreased in winter. Barriers to outdoor activity in winter cited by focus group participants were lack of resources, health concerns, gender barriers for females, and knowledge barriers. Concern over lack of supervision while children play outside was also cited. This study revealed many of the underlying beliefs, barriers and cultural issues that impact Somali families' intention to be active and ability to be active outdoors in winter. These findings can be used to generate research hypotheses and public health interventions regarding outdoor physical activity among Somali youth.

Speeding up the first-passage for subdiffusion by introducing a finite potential barrier

International Nuclear Information System (INIS)

Palyulin, Vladimir V; Metzler, Ralf

2014-01-01

We show that for a subdiffusive continuous time random walk with scale-free waiting time distribution the first-passage dynamics on a finite interval can be optimized by introduction of a piecewise linear potential barrier. Analytical results for the survival probability and first-passage density based on the fractional Fokker–Planck equation are shown to agree well with Monte Carlo simulations results. As an application we discuss an improved design for efficient translocation of gradient copolymers compared to homopolymer translocation in a quasi-equilibrium approximation. (fast track communications)

Trench Safety–Using a Qualitative Approach to Understand Barriers and Develop Strategies to Improve Trenching Practices

Science.gov (United States)

FLYNN, MICHAEL A.; SAMPSON, JULIE M.

2015-01-01

Despite efforts to ensure workplace safety and health, injuries and fatalities related to trenching and excavation remain alarmingly high in the construction industry. Because properly installed trenching protective systems can potentially reduce the significant number of trenching fatalities, there is clearly a need to identify the barriers to the use of these systems and to develop strategies to ensure these systems are utilized consistently. The current study reports on the results of focus groups with construction workers and safety management personnel to better understand these barriers and to identify solutions. The results suggest several factors, from poor planning to pressures from experienced workers and supervisors, which present barriers to safe trenching practices. Based on the results, it is recommended that safety trainings incorporate unique messages for new workers, experienced workers and management in an effort to motivate each group to work safely as well as provide them with solutions to overcome the identified barriers. PMID:26550006

Modeling approaches for concrete barriers used in low-level waste disposal

International Nuclear Information System (INIS)

Seitz, R.R.; Walton, J.C.

1993-11-01

A series of three NUREGs and several papers addressing different aspects of modeling performance of concrete barriers for low-level radioactive waste disposal have been prepared previously for the Concrete Barriers Research Project. This document integrates the information from the previous documents into a general summary of models and approaches that can be used in performance assessments of concrete barriers. Models for concrete degradation, flow, and transport through cracked concrete barriers are discussed. The models for flow and transport assume that cracks have occurred and thus should only be used for later times in simulations after fully penetrating cracks are formed. Most of the models have been implemented in a computer code. CEMENT, that was developed concurrently with this document. User documentation for CEMENT is provided separate from this report. To avoid duplication, the reader is referred to the three previous NUREGs for detailed discussions of each of the mathematical models. Some additional information that was not presented in the previous documents is also included. Sections discussing lessons learned from applications to actual performance assessments of low-level waste disposal facilities are provided. Sensitive design parameters are emphasized to identify critical areas of performance for concrete barriers, and potential problems in performance assessments are also identified and discussed

Nature of potential barrier in (Ca 1/4,Cu 3/4)TiO 3 polycrystalline perovskite

Science.gov (United States)

Marques, V. P. B.; Bueno, P. R.; Simões, A. Z.; Cilense, M.; Varela, J. A.; Longo, E.; Leite, E. R.

2006-04-01

The nonohmic electrical features of (Ca 1/4,Cu 3/4)TiO 3 perovskite ceramics, which have very strong gigantic dielectric is believed originate from potential barriers at the grain boundaries. In the present study, we used the admittance and impedance spectroscopy technique to investigate (Ca 1/4,Cu 3/4)TiO 3 perovskite ceramics with low nonohmic electrical properties. The study was conducted under two different conditions: on as-sintered ceramics and on ceramics thermally treated in an oxygen-rich atmosphere. The results confirm that thermal treatment in oxygen-rich atmospheres influence the nonohmic properties. Annealing at oxygen-rich atmospheres improve the nonohmic behavior and annealing at oxygen-poor atmospheres decrease the nonohmic properties, a behavior already reported for common metal oxide nonohmic devices and here firstly evidenced for the (Ca 1/4,Cu 3/4)TiO 3 perovskite related materials. The results show that oxygen also influences the capacitance values at low frequencies, a behavior that is indicative of the Schottky-type nature of the potential barrier.

Barriers to the adoption of energy-conserving technologies in the textile industry

Energy Technology Data Exchange (ETDEWEB)

Evans, A.R.; Zussman, S.K.

1979-09-01

An overview of the textile industry and a discussion of energy-conserving technologies currently available at the pilot-demonstration stage are presented. Existing and potential barriers to the adoption of these technologies in the textile industry identified are: economic; technical acceptance; conflict between commitments of capital for compliance with environmental and health regulations and for investment in energy conservation measures; and a lack of information and technical expertise. Possible measures to eliminate barriers to the implementation of energy-conserving technologies are discussed. (MCW)

A framework for understanding semi-permeable barrier effects on migratory ungulates

Science.gov (United States)

Sawyer, Hall; Kauffman, Matthew J.; Middleton, Arthur D.; Morrison, Thomas A.; Nielson, Ryan M.; Wyckoff, Teal B.

2013-01-01

1. Impermeable barriers to migration can greatly constrain the set of possible routes and ranges used by migrating animals. For ungulates, however, many forms of development are semi-permeable, and making informed management decisions about their potential impacts to the persistence of migration routes is difficult because our knowledge of how semi-permeable barriers affect migratory behaviour and function is limited. 2. Here, we propose a general framework to advance the understanding of barrier effects on ungulate migration by emphasizing the need to (i) quantify potential barriers in terms that allow behavioural thresholds to be considered, (ii) identify and measure behavioural responses to semi-permeable barriers and (iii) consider the functional attributes of the migratory landscape (e.g. stopovers) and how the benefits of migration might be reduced by behavioural changes. 3. We used global position system (GPS) data collected from two subpopulations of mule deer Odocoileus hemionus to evaluate how different levels of gas development influenced migratory behaviour, including movement rates and stopover use at the individual level, and intensity of use and width of migration route at the population level. We then characterized the functional landscape of migration routes as either stopover habitat or movement corridors and examined how the observed behavioural changes affected the functionality of the migration route in terms of stopover use. 4. We found migratory behaviour to vary with development intensity. Our results suggest that mule deer can migrate through moderate levels of development without any noticeable effects on migratory behaviour. However, in areas with more intensive development, animals often detoured from established routes, increased their rate of movement and reduced stopover use, while the overall use and width of migration routes decreased. 5. Synthesis and applications. In contrast to impermeable barriers that impede animal movement

Barriers' and policies' analysis of China's building energy efficiency

International Nuclear Information System (INIS)

Zhang, Yurong; Wang, Yuanfeng

2013-01-01

With the rapid economic growth and the improvement of people's living standards, China's building energy consumption has kept rising during the past 15 years. Under the effort of the Chinese government and the society, China's building energy efficiency has made certain achievements. However, the implementation of building energy efficiency in China is still far from its potential. Based on the analysis of the existing policies implemented in China, the article concluded that the most essential and the most effective ways to promote building energy efficiency is the government's involvement as well as economic and financial incentives. In addition, the main barriers in the process of promoting building energy efficiency in China are identified in six aspects. It has been found that the legal system and administrative issues constitute major barriers, and the lack of financial incentives and the mismatching of market mechanism also hamper the promotion of building energy efficiency. Finally, in view of the existing policies and barriers analysis, three corresponding policy proposals are presented. -- Highlights: •The existing policies implemented in China from three aspects are presented and analysed. •The Government's involvement is the most essential effective way to promote building-energy efficiency. •Six aspects of barriers in promoting building energy efficiency in China are identified. •The legal system and administrative issues constitute the major barriers. •Three policy proposals to further promote building energy efficiency in China are proposed

Barriers to Herbal Medicine Research in Nigeria; Researcher's ...

African Journals Online (AJOL)

This paper presents the barriers to herbal medicine research in Nigeria. This is with a view to formulating appropriate strategies that would be deployed to overcome the identified barriers to herbal medicine research. The paper therefore identified and discussed some of these inherent barriers such as the standardization of ...

Barriers to Optimal Pain Management in Aged Care Facilities: An Australian Qualitative Study.

Science.gov (United States)

Veal, Felicity; Williams, Mackenzie; Bereznicki, Luke; Cummings, Elizabeth; Thompson, Angus; Peterson, Gregory; Winzenberg, Tania

2018-04-01

Up to 80% of residents in aged care facilities (ACFs) experience pain, which is often suboptimally managed. The purpose of this study was to characterize pain management in ACFs and identify the barriers to optimal pain management. This exploratory descriptive qualitative study used semistructured interviews in five Southern Tasmania, Australian ACFs. Interviewees included 23 staff members (18 nurses and 5 facility managers) and were conducted from September to November 2015. Interviews included questions about how pain was measured or assessed, what happened if pain was identified, barriers to pain management, and potential ways to overcome these barriers. Interviewees noted that there were no formal requirements regarding pain assessment at the ACFs reviewed; however, pain was often informally assessed. Staff noted the importance of adequate pain management for the residents' quality of life and employed both nonpharmacologic and pharmacologic techniques to reduce pain when identified. The barriers to optimal pain management included difficulty identifying and assessing pain, residents' resistance to reporting pain and/or taking medications, and communication barriers between the nursing staff and GPs. Staff interviewed were dedicated to managing residents' pain effectively; however, actions in a number of areas could improve resident outcomes. These include a more consistent approach to documenting pain in residents' progress notes and improving nurse-GP communications to ensure that new or escalating pain is identified and expedient changes can be made to the resident's management. Additionally, resident, family, nurse, and carer education, conducted within the facilities on a regular basis, could help improve the pain management of residents. Copyright © 2017. Published by Elsevier Inc.

Barriers to efficiency improvement and fuel switching in Karnataka, India

International Nuclear Information System (INIS)

Reddy, A.

1991-01-01

Implementing energy efficiency changes requires a wide range measures. Improvements, therefore, require actions at the lowest level of the consumer, through the highest level of the global agencies. Due to the multiplicity of participants, however, barriers to achieving these improvements can arise at every level. The major barriers to improving energy efficiency in developing countries are defined and paths to overcome these challenges are identified. Topics of discussion include: energy consumers; end-use equipment manufacturers; end-use equipment providers; energy carrier producers and distributors; actual/potential cogenerators; financial institutions; government; and international, multilateral and industrialized country funding/aid agencies

Potential of kaolin-based particle film barriers for Formosan subterranean termite (Isoptera: Rhinotermitidae) control

Science.gov (United States)

Wiltz, B.A.; Woodson, W.D.; Puterka, G.J.

2010-01-01

Effects of three particle film products on Formosan subterranean termites, Coptotermes formosanus Shiraki, were evaluated in feeding, tunneling, and contact assays. The particle films, hydrophobic M96-018 and hydrophilic Surround and Surround WP are based on the inert clay mineral kaolin. In 2-week long no-choice feeding tests, significant mortality occurred only with M96-018-coated wood. When a choice was provided, M96-018 and Surround were consumed at higher rates than untreated wood. Surround WP did not differ from controls in either test. In the tunneling assay termites were given the option of crossing a kaolin-sand mixture to reach an alternate food source. After 3-weeks, rates of 1% and 5% M96-018 provided an effective barrier to Formosan termite tunneling, while termites were not stopped by rates as high as 20% Surround and Surround WP. Dust treatments of all three formulations caused significant increases in mortality within 24 h, with mortality rates ranging from 72.0 - 97.3% within 72 h of treatment. The particle films were most effective when moisture levels were low, suggesting that desiccation was the mechanism for mortality. All particle films showed potential for use in above ground applications while hydrophobic M06-018 has the most potential as a soil barrier to subterranean termites.

PS-109 Barriers and facilitators to implementing drug changes caused by drug tenders and shortages

DEFF Research Database (Denmark)

Rishøj, Rikke Mie; Christrup, Lona Louring; Clemmensen, Marianne H

2015-01-01

. Purpose To identify barriers and facilitators for implementing drug changes due to drug tenders and shortages in Danish public hospitals. Material and methods Six focus group interviews were conducted at three hospitals in different regions of the country. At each hospital two focus group interviews were...... thematically through content analysis. Results Barriers Identified included: frequent changes of labelling, packages and drug names. Furthermore, implementing drug changes requires extra resources and finance. Technologies such as computerised physician order entry and barcode scanning systems were perceived...... as potential facilitators, but also as barriers in cases where the quality and implementation of the systems were not adequate. Facilitators included: hospital pharmacy services and lower drug prices. Furthermore recommendations on generic prescription, optimisation of the tendering process and support...

A GIS methodology to identify potential corn stover collection locations

Energy Technology Data Exchange (ETDEWEB)

Haddad, Monica A. [Department of Community and Regional Planning, 583 College of Design, Iowa State University, Ames, IA 50011-3095 (United States); Anderson, Paul F. [Department of Landscape Architecture, 481 College of Design, Iowa State University, Ames, IA 50011 (United States); Department of Agronomy, 481 College of Design, Iowa State University, Ames, IA 50011 (United States)

2008-12-15

In this study, we use geographic information systems technology to identify potential locations in a Midwestern region for collection and storage of corn stover for use as biomass feedstock. Spatial location models are developed to identify potential collection sites along an existing railroad. Site suitability analysis is developed based on two main models: agronomic productivity potential and environmental costs. The analysis includes the following steps: (1) elaboration of site selection criteria; (2) identification of the study region and service area based on transportation network analysis; (3) reclassification of input spatial layers based on common scales; (4) overlaying the reclassified spatial layers with equal weights to generate the two main models; and (5) overlaying the main models using different weights. A pluralistic approach is adopted, presenting three different scenarios as alternatives for the potential locations. Our results suggest that there is a significant subset of potential sites that meet site selection criteria. Additional studies are needed to evaluate potential sites through field visits, assess economic and social costs, and estimate the proportion of corn producers willing to sell and transport corn stover to collection facilities. (author)

Merging electricity and environment politics of Hong Kong: Identifying the barriers from the ways that sustainability is defined

International Nuclear Information System (INIS)

Lo, Alex Y.H.

2008-01-01

The present paper presents a study of the electricity policy of Hong Kong in an environmental-political context. Through a critical review of the policy structure and rationale, it identifies the barriers to developing a truly sustainable electricity policy system and is expected to shed light on the forthcoming electricity market reform in the territory. The barriers stem from the path-dependent institutional set-ups that restrict a timely transformation of the roles of the actors. And this is coupled with the government's treatment that does not look beyond these structural constraints, overly appreciating scientific and economic rationalities than communicative actions. The author is of the view that these are intensified by the sharp changes in the local political economy. Positive signs of change are dampened by the minimal progress in democratic development in the near future and the extension of the power companies' monopolist status that will ruin the 'trust' between the stakeholders compounding the guilt of those rigid regulatory constraints

Heavy-ion fusion: Channel-coupling effects, the barrier penetration model, and the threshold anomaly for heavy-ion potentials

International Nuclear Information System (INIS)

Satchler, G.R.; Nagarajan, M.A.; Lilley, J.S.; Thompson, I.J.

1987-01-01

We study the formal structure of the influence of channel coupling on near- and sub-barrier fusion. The reduction to a one-channel description is studied, with emphasis on the channel-coupling effects being manifest primarily as an energy dependence (the ''threshold anomaly'') of the real nuclear potential. The relation to the barrier penetration model is examined critically. The results of large-scale coupled-channel calculations are used as ''data'' to illustrate the discussion. Particular emphasis is placed on the importance of reproducing correctly the partial-wave (or ''spin'') distributions. The simple barrier penetration model is found to be adequate to exhibit the strong enhancements due to channel couplings when the threshold anomaly is taken into account, although there may be important corrections due to the long-ranged peripheral absorption, especially from Coulomb excitation. copyright 1987 Academic Press, Inc

How Barriers to Collaboration Prevent Progress in Demand for Knowledge

DEFF Research Database (Denmark)

Goduscheit, René Chester; Knudsen, Mette Præst

2015-01-01

(RTOs) as potential mediators of collaboration between SMEs and universities. On the basis of a unique sample consisting of 151 SMEs, RTOs and universities from seven countries, the differences across dyads of potential collaborations are identified. In particular, the article finds that both firms...... and universities with collaboration experience with the other partner in general perceive higher barriers than inexperienced firms or universities. In terms of the mediating role of RTOs, the article illustrates that universities perceive lower barriers when collaborating with RTOs than with SMEs. A similar...... tendency to a mediating role of RTOs can be found among the SMEs' perception of university collaboration. Finally, the analysis shows that the knowledge institutions perceive the SMEs as very important collaboration partners, but the same sense of importance is not shared by the SMEs regarding...

The willingness to participate in health research studies of individuals with Turkish migration backgrounds: barriers and resources.

Science.gov (United States)

Dingoyan, D; Schulz, H; Mösko, M

2012-06-01

Lower participation rates of ethnic minorities in health research studies and potential participation barriers are commonly reported. Four semi-structured focus groups of individuals with Turkish migration backgrounds living in Germany were conducted to identify potential participation barriers. Documented statements and superscripted presentation cards by the participants were evaluated with a qualitative content analysis. The following eight potential reasons for the lower participation rates were identified: role of women, lack of knowledge, lack of interest, German-Turkish interactions, mistrust, anxiety, data privacy protection and benefits of the study. Additionally, the following recruitment strategies to enhance participation rates were found: public relations, especially word-of-mouth promotion and contacting Turkish key figures, (non-) tangible incentives and trust building through transparent communication of the project and its conditions. The findings provide a wide range of potential participation barriers and implications that should be considered to enhance the participation rates of minority populations. The willingness to participate in health research studies can be increased through particular efforts, which should be tailored to the recruitment of the underrepresented target population. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Clinician-scientists in Canada: barriers to career entry and progress.

Directory of Open Access Journals (Sweden)

Bryn Lander

Full Text Available BACKGROUND: Clinician-scientists play an important role in translating between research and clinical practice. Significant concerns about a decline in their numbers have been raised. Potential barriers for career entry and progress are explored in this study. METHODS: Case-study research methods were used to identify barriers perceived by clinician-scientists and their research teams in two Canadian laboratories. These perceptions were then compared against statistical analysis of data from Canadian Institutes of Health Research (CIHR databases on grant and award performance of clinician-scientists and non-clinical PhDs for fiscal years 2000 to 2008. RESULTS: Three main barriers were identified through qualitative analysis: research training, research salaries, and research grants. We then looked for evidence of these barriers in the Canada-wide statistical dataset for our study period. Clinician-scientists had a small but statistically significant higher mean number of degrees (3.3 than non-clinical scientists (3.2, potentially confirming the perception of longer training times. But evidence of the other two barriers was equivocal. For example, while overall growth in salary awards was minimal, awards to clinician-scientists increased by 45% compared to 6.3% for non-clinical PhDs. Similarly, in terms of research funding, awards to clinician-scientists increased by more than 25% compared with 5% for non-clinical PhDs. However, clinician-scientist-led grants funded under CIHR's Clinical thematic area decreased significantly from 61% to 51% (p-value<0.001 suggesting that clinician-scientists may be shifting their attention to other research domains. CONCLUSION: While clinician-scientists continue to perceive barriers to career entry and progress, quantitative results suggest improvements over the last decade. Clinician-scientists are awarded an increasing proportion of CIHR research grants and salary awards. Given the translational importance of

Education, implementation, and policy barriers to greater integration of palliative care: A literature review.

Science.gov (United States)

Aldridge, Melissa D; Hasselaar, Jeroen; Garralda, Eduardo; van der Eerden, Marlieke; Stevenson, David; McKendrick, Karen; Centeno, Carlos; Meier, Diane E

2016-03-01

Early integration of palliative care into the management of patients with serious disease has the potential to both improve quality of life of patients and families and reduce healthcare costs. Despite these benefits, significant barriers exist in the United States to the early integration of palliative care in the disease trajectory of individuals with serious illness. To provide an overview of the barriers to more widespread palliative care integration in the United States. A literature review using PubMed from 2005 to March 2015 augmented by primary data collected from 405 hospitals included in the Center to Advance Palliative Care's National Palliative Care Registry for years 2012 and 2013. We use the World Health Organization's Public Health Strategy for Palliative Care as a framework for analyzing barriers to palliative care integration. We identified key barriers to palliative care integration across three World Health Organization domains: (1) education domain: lack of adequate education/training and perception of palliative care as end-of-life care; (2) implementation domain: inadequate size of palliative medicine-trained workforce, challenge of identifying patients appropriate for palliative care referral, and need for culture change across settings; (3) policy domain: fragmented healthcare system, need for greater funding for research, lack of adequate reimbursement for palliative care, and regulatory barriers. We describe the key policy and educational opportunities in the United States to address and potentially overcome the barriers to greater integration of palliative care into the healthcare of Americans with serious illness. © The Author(s) 2015.

Recruitment barriers in a randomized controlled trial from the physicians' perspective – A postal survey

Directory of Open Access Journals (Sweden)

Karrer Werner

2009-03-01

Full Text Available Abstract Background The feasibility of randomized trials often depends on successful patient recruitment. Although numerous recruitment barriers have been identified it is unclear which of them complicate recruitment most. Also, most surveys have focused on the patients' perspective of recruitment barriers whereas the perspective of recruiting physicians has received less attention. Therefore, our aim was to conduct a postal survey among recruiting physicians of a multi-center trial to weigh barriers according to their impact on recruitment. Methods We identified any potential recruitment barriers from the literature and from our own experience with a multi-center trial of respiratory rehabilitation in patients with chronic obstructive pulmonary disease. We developed and pilot-tested a self-administered questionnaire where recruiting physicians were asked to express their agreement with statements about recruitment barriers on a Likert-type scale from 1 (full agreement with statement = very substantial recruitment barrier to 7 (no agreement with statement = no recruitment barrier. Results 38 of 55 recruiting physicians returned questionnaires (69% response rate, of which 35 could be analyzed (64% useable response rate. Recruiting physicians reported that "time constraints" (median agreement of 3, interquartile range 2–5 had the most negative impact on recruitment followed by "difficulties including identified eligible patients" (median agreement of 5, IQR 3–6. Other barriers such as "trial design barriers", "lack of access to treatment", "individual barriers of recruiting physicians" or "insufficient training of recruiting physicians" were perceived to have little or no impact on patient recruitment. Conclusion Physicians perceived time constraints as the most relevant recruitment barrier in a randomized trial. To overcome recruitment barriers interventions, that are affordable for both industry- and investigator-driven trials, need to be

A consistent derivation of the real and imaginary parts of the heavy ion potential below and above the Coulomb barrier

International Nuclear Information System (INIS)

Vinh Mau, N.

1987-03-01

In a model including approximately a large set of non elastic channels, the real and imaginary potentials are consistently derived. The anomaly of the real potential which sharply increases in the vicinity of the Coulomb barrier where the imaginary potential is strongly reduced is studied in 16 0+ 40 Ca and 16 O+ 208 Pb systems. The results on the imaginary potential are discussed and compared to our previous calculation

Microscopic calculation of sub-barrier fusion cross section and barrier distribution using M3Y-type forces

International Nuclear Information System (INIS)

Ismail, M.; Ramadan, Kh.A.

2000-01-01

The heavy-ion (HI) potential between spherical and deformed nuclei is derived using an M3Y-type nucleon-nucleon (NN) interaction. The calculation of the exchange part of the HI potential was improved by using a finite-range NN exchange force instead of the zero-range pseudo-potential which is usually used in deriving the potential between deformed nuclei. We consider an 154 Sm- 16 O nuclear pair as an example to show the effect of finite range on the nucleus-nucleus potential for different deformation parameters and at different orientation angles of the deformed target nucleus. We calculated the fusion cross section and the barrier distribution in the WKB approximation and studied their dependence on the orientation and deformation of the target nucleus. The variations found due to improving the exchange part enhance the fusion cross section below the Coulomb barrier by a factor of about four. It has been found that both the cross section and the barrier distribution are very sensitive to the deformation parameters at energies below the Coulomb barrier. (author)

Microscopic calculation of sub-barrier fusion cross section and barrier distribution using M3Y-type forces

Energy Technology Data Exchange (ETDEWEB)

Ismail, M.; Ramadan, Kh.A. [Physics Department, Faculty of Science, Cairo University, Giza (Egypt)

2000-10-01

The heavy-ion (HI) potential between spherical and deformed nuclei is derived using an M3Y-type nucleon-nucleon (NN) interaction. The calculation of the exchange part of the HI potential was improved by using a finite-range NN exchange force instead of the zero-range pseudo-potential which is usually used in deriving the potential between deformed nuclei. We consider an {sup 154}Sm-{sup 16}O nuclear pair as an example to show the effect of finite range on the nucleus-nucleus potential for different deformation parameters and at different orientation angles of the deformed target nucleus. We calculated the fusion cross section and the barrier distribution in the WKB approximation and studied their dependence on the orientation and deformation of the target nucleus. The variations found due to improving the exchange part enhance the fusion cross section below the Coulomb barrier by a factor of about four. It has been found that both the cross section and the barrier distribution are very sensitive to the deformation parameters at energies below the Coulomb barrier. (author)

Review of durability of cementitious engineered barriers in repository environments

International Nuclear Information System (INIS)

Parrott, L.J.; Lawrence, C.D.

1992-01-01

This report is concerned with the durability of cementitious engineered barriers in a repository for low and intermediate level nuclear waste. Following the introduction the second section of the review identifies the environmental conditions associated with a deep, hard rock repository for ILW and LLW that are relevant to the durability of cementitious barriers. Section three examines the microstructure and macrostructure of cementitious materials and considers the physical and chemical processes of radionuclide immobilization. Potential repository applications and compositions of cementitious materials are reviewed in Section four. The main analysis of durability is dealt with in Section five. The different types of cementitious barrier are considered separately and their most probable modes of degradation are analysed. Concluding remarks that highlight critical technical matters are given in Section six. (author)

Potential Pathways for CNS Drug Delivery Across the Blood-Cerebrospinal Fluid Barrier

OpenAIRE

Strazielle, Nathalie; Ghersi-Egea, Jean-Fran?ois

2016-01-01

The blood-brain interfaces restrict the cerebral bioavailability of pharmacological compounds. Various drug delivery strategies have been developed to improve drug penetration into the brain. Most strategies target the microvascular endothelium forming the blood-brain barrier proper. Targeting the blood-cerebrospinal fluid (CSF) barrier formed by the epithelium of the choroid plexuses in addition to the blood-brain barrier may offer added-value for the treatment of central nervous system dise...

Contaminant containment using polymer gel barriers

NARCIS (Netherlands)

Darwish, M.I.M.; Rowe, R.K.; Maarel, van der J.R.C.; Pel, L.; Huinink, H.P.; Zitha, P.L.J.

2004-01-01

Polymer gels are well known in the oil industry, but their potential for use as barriers to contaminant transport has not previously received significant study. As a first step, this paper examines the potential for a polyelectrolyte gel to serve as a barrier to the migration of sodium chloride. Two

Assessment of skin barrier function and biochemical changes of ex vivo human skin in response to physical and chemical barrier disruption.

Science.gov (United States)

Döge, Nadine; Avetisyan, Araks; Hadam, Sabrina; Pfannes, Eva Katharina Barbosa; Rancan, Fiorenza; Blume-Peytavi, Ulrike; Vogt, Annika

2017-07-01

Topical dermatotherapy is intended to be used on diseased skin. Novel drug delivery systems even address differences between intact and diseased skin underlining the need for pre-clinical assessment of different states of barrier disruption. Herein, we studied how short-term incubation in culture media compared to incubation in humidified chambers affects human skin barrier function and viability. On both models we assessed different types and intensities of physical and chemical barrier disruption methods with regard to structural integrity, biophysical parameters and cytokine levels. Tissue degeneration and proliferative activity limited the use of tissue cultures to 48h. Viability is better preserved in cultured tissue. Tape-stripping (50×TS) and 4h sodium lauryl sulfate (SLS) pre-treatment were identified as highly reproducible and effective procedures for barrier disruption. Transepidermal water loss (TEWL) values reproducibly increased with the intensity of disruption while sebum content and skin surface pH were of limited value. Interleukin (IL)-6/8 and various chemokines and proteases were increased in tape-stripped skin which was more pronounced in SLS-treated skin tissue extracts. Thus, albeit limited to 48h, cultured full-thickness skin maintained several barrier characteristics and responded to different intensities of barrier disruption. Potentially, these models can be used to assess pre-clinically the efficacy and penetration of anti-inflammatory compounds. Copyright © 2016 Elsevier B.V. All rights reserved.

Motivational readiness for active commuting by university students: incentives and barriers.

Science.gov (United States)

Cole, Rachel; Leslie, Eva; Donald, Maria; Cerin, Ester; Neller, Anne; Owen, Neville

2008-12-01

Walking for transport can contribute significantly to health-enhancing physical activity. We examined the associations of stages of motivational readiness for active transport with perceived barriers and incentives to walking to and from university among students. Mail-back surveys were completed by 781 students in a regional university in south-east Queensland. They identified one of eight options on motivational readiness for active commuting, which were then classified as: pre-contemplation; contemplation-preparation; or, action-maintenance. Open-ended questions were used to identify relevant barriers and incentives. Logistic regressions were used to examine the barriers and incentives that distinguished between those at different stages of motivational readiness. Barriers most frequently reported were long travel distances, inconvenience and time constraints. Incentives most frequently reported were shorter travel distance, having more time, supportive infrastructure and better security. Those not considering active commuting (pre-contemplation) were significantly more likely to report shorter travel distance as an incentive compared to those in contemplation-preparation. Those in contemplation-preparation were significantly more likely to report lack of motivation, inadequate infrastructure, shorter travel distance and inconvenience as barriers; and, having more time, supportive infrastructure, social support and incentive programs as encouragement. Different barriers and incentives to walking to or from university exist for students in the different stages of motivational readiness for active commuting. Interventions targeted specifically to stage of motivational readiness may be potentially helpful in increasing activity levels, through active transport.

Implementing a novel dance intervention in rehabilitation: perceived barriers and facilitators.

Science.gov (United States)

Demers, Marika; Thomas, Aliki; Wittich, Walter; McKinley, Patricia

2015-01-01

To identify clinicians' perceptions regarding the facilitators and barriers to the use of dance in rehabilitation. This study used a qualitative descriptive design. Three focus groups were conducted with clinicians across three purposively selected rehabilitation centers. Data were analyzed using thematic content analysis. Fourteen allied health-care professionals (six occupational therapists, six physical therapists, and two social workers) with previous dance experience participated in this study. Four main themes emerged from the analysis representing the personal and organizational factors influencing on the implementation of dance interventions: (1) Clinician's dance experience and training, (2) Interest and personal beliefs towards using dance as a potential intervention, (3) Support from the organization of the institution, and (4) Available resources. Although each site was different, the main factors acting as barriers and facilitators were similar for all three sites. The identification of the barriers and facilitators to implementing dance in rehabilitation is the first step to support the translation of knowledge about dance. A tailored approach designed for clinicians and managers should address the main barriers to knowledge use about dance, as a potential rehabilitation modality for individuals with disabilities. Personal and organizational factors can act simultaneously as barriers and facilitators to the implementation of a dance intervention. Lack of time for professional development and lack of support from the organization are the main barriers to the uptake of knowledge about dance in rehabilitation. A knowledge translation strategy addressing the barriers to knowledge use is helpful for clinicians and managers facilitating the implementation of dance in rehabilitation settings.

Observation of ion confining potential enhancement due to thermal barrier potential formation and its scaling law in the tandem mirror GAMMA 10

International Nuclear Information System (INIS)

Cho, Teruji; Nakashima, Yousuke; Foote, J.H.

1987-01-01

In the tandem mirror GAMMA 10, (i) the enhancement of the ion confining potential, φ c , only during the period of the thermal barrier potential φ b -formation, has been observed first by using not only end-loss-analysers (ELA's) of GAMMA 10 but an end-loss-ion-spectrometer (ELIS) installed from TMX-U. This results in strong end-loss-ion plugging with increased central cell density. (ii) The first experimental observation of the φ c vs φ b -scaling law is obtained, where φ c increases with φ b . This scaling law is consistently interpreted by Cohen's theories of the weak-ECH and the strong-ECH in the plug region. (iii) Good agreement of the plug potential measured with the ELA's and the ELIS is achieved. (author)

Barriers and facilitators of prostate cancer screening among Filipino men in Hawaii.

Science.gov (United States)

Conde, Francisco A; Landier, Wendy; Ishida, Dianne; Bell, Rose; Cuaresma, Charlene F; Misola, Jane

2011-03-01

To examine perceptions, attitudes, and beliefs regarding barriers and facilitators to prostate cancer screening, and to identify potential interventional strategies to promote prostate cancer screening among Filipino men in Hawaii. Exploratory, qualitative. Community-based settings in Hawaii. 20 Filipino men age 40 years or older. Focus group discussions were tape recorded and transcribed, and content analysis was performed for emergent themes. Perceptions regarding prostate cancer, barriers and facilitators to prostate cancer screening, and culturally relevant interventional strategies. Perceptions of prostate cancer included fatalism, hopelessness, and dread. Misconceptions regarding causes of prostate cancer, such as frequency of sexual activity, were identified. Barriers to prostate cancer screening included lack of awareness of the need for screening, reticence to seek health care when feeling well, fear of cancer diagnosis, financial issues, time constraints, and embarrassment. Presence of urinary symptoms, personal experience with family or friends who had cancer, and receiving recommendations from a healthcare provider regarding screening were facilitators for screening. Potential culturally relevant interventional strategies to promote prostate cancer screening included screening recommendations from healthcare professionals and cancer survivors; radio or television commercials and newspaper articles targeting the Filipino community; informational brochures in Tagalog, Ilocano, or English; and interactive, educational forums facilitated by multilingual Filipino male healthcare professionals. Culturally relevant interventions are needed that address barriers to prostate cancer screening participation and misconceptions about causes of prostate cancer. Findings provide a foundation for future research regarding development of interventional strategies to promote prostate cancer screening among Filipino men.

Barriers to treatment for older adults seeking psychological therapy.

Science.gov (United States)

Wuthrich, Viviana M; Frei, Jacqueline

2015-07-01

Older adults with mental health disorders underutilize mental health services more than other adults. While there are well known general barriers to help seeking across the population, specific barriers for older adults include difficulties with transportation, beliefs that it is normal to be anxious and depressed in old age, and beliefs by referrers that psychological therapy is less likely to be effective. This study examined barriers related to identifying the need for help, seeking help and participating in therapy in a clinical population of older adults. Sixty older adults (aged 60-79 years) with comorbid anxiety and unipolar mood disorders completed barriers to treatment questionnaires before and after psychological group treatment, as well as measures of cognitive ability, anxiety, depression, and quality of life at baseline. The greatest barriers to help seeking related to difficulties identifying the need for help, with 50% of the sample reporting their belief that their symptoms were normal as a major barrier. Other major barriers identified were related to: self-reliance, cost of treatment, and fear of medication replicating previous findings. The main barriers reported for difficulties in continuing therapy included not finding therapy helpful, cost of treatment, and thinking that the therapist did not understand their issues. The main barriers identified related to issues with identifying the need to seek help. More attention is needed to educate older adults and professionals about the need for, and effectiveness of, psychological therapies for older adults with anxiety and depression to reduce this barrier to help seeking.

Identifying Barriers and Enablers in the Dietary Management of Type 2 Diabetes in M'Bour, Senegal.

Science.gov (United States)

Foley, Evan; BeLue, Rhonda

2017-07-01

The purpose of this study was to identify cultural enablers and barriers to dietary management of type 2 diabetes in M'Bour, Senegal. This qualitative study used the PEN-3 cultural model to explore diabetes dietary management within a cultural framework. Content analysis identified emergent themes based on the PEN-3 model. Forty-one individuals completed interviews. Themes reflecting ways that culture affects adherence to the diabetic diet included (a) having a different diet or eating separately from the communal family plate creates feelings of social isolation; (b) forgoing the diabetic diet sometimes occurs so that family members have enough food; (c) reducing servings of traditional foods feels like abandoning culture; and (d) women being responsible for preparing food, while men typically manage money for purchasing food yet do not provide input on what food is purchased. Results suggest that educating family units on the dietary management of diabetes may be more effective than individual education.

A qualitative study into the perceived barriers of accessing healthcare among a vulnerable population involved with a community centre in Romania.

Science.gov (United States)

George, Siân; Daniels, Katy; Fioratou, Evridiki

2018-04-03

Minority vulnerable communities, such as the European Roma, often face numerous barriers to accessing healthcare services, resulting in negative health outcomes. Both these barriers and outcomes have been reported extensively in the literature. However, reports on barriers faced by European non-Roma native communities are limited. The "Health Care Access Barriers" (HCAB) model identifies pertinent financial, structural and cognitive barriers that can be measured and potentially modified. The present study thus aims to explore the barriers to accessing healthcare for a vulnerable population of mixed ethnicity from a charity community centre in Romania, as perceived by the centre's family users and staff members, and assess whether these reflect the barriers identified from the HCAB model. Eleven community members whose children attend the centre and seven staff members working at the centre participated in face-to-face semi-structured interviews, exploring personal experiences and views on accessing healthcare. The interviews were transcribed and analysed using an initial deductive and secondary inductive approach to identify HCAB themes and other emerging themes and subthemes. Identified themes from both groups aligned with HCAB's themes of financial, structural and cognitive barriers and emergent subthemes important to the specific population were identified. Specifically, financial barriers related mostly to health insurance and bribery issues, structural barriers related mostly to service availability and accessibility, and cognitive barriers related mostly to healthcare professionals' attitudes and discrimination and the vulnerable population's lack of education and health literacy. A unique theme of psychological barriers emerged from both groups with associated subthemes of mistrust, hopelessness, fear and anxiety of this vulnerable population. The current study highlights healthcare access barriers to a vulnerable non-Roma native population involved with a

Barriers to promote cardiovascular health in community pharmacies: a systematic review.

Science.gov (United States)

Alonso-Perales, María Del Mar; Lasheras, Berta; Beitia, Guadalupe; Beltrán, Idoia; Marcos, Beatriz; Núñez-Córdoba, Jorge M

2017-06-01

Community pharmacists play an important role in the provision of health promotion services, and community pharmacies are considered as a potentially ideal site for cardiovascular health promotion. Information based on a systematic review of barriers to promoting cardiovascular health in community pharmacy is currently lacking. We have sought to identify the most important barriers to cardiovascular health promotion in the community pharmacy. We have systematically searched PubMed and International Pharmaceutical Abstracts for a period of 15 years from 1 April 1998 to 1 April 2013, contacted subject experts and hand-searched bibliographies. We have included peer-reviewed articles, with English abstracts in the analysis, if they reported community pharmacists' perceptions of the barriers to cardiovascular health promotion activities in a community pharmacy setting. Two reviewers have independently extracted study characteristics and data. We identified 24 studies that satisfy the eligibility criteria. The main barriers to cardiovascular health promotion in the community pharmacy included pharmacist-related factors; practice site factors; financial factors; legal factors; and patient-related factors. This review will help to provide reliable evidence for health promotion practitioners of the barriers to promoting cardiovascular health in the community pharmacy setting. This knowledge is valuable for the improvement of cardiovascular health promotion in this setting and guiding future research. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Combining measures of dispersal to identify conservation strategies in fragmented landscapes.

Science.gov (United States)

Leidner, Allison K; Haddad, Nick M

2011-10-01

Understanding the way in which habitat fragmentation disrupts animal dispersal is key to identifying effective and efficient conservation strategies. To differentiate the potential effectiveness of 2 frequently used strategies for increasing the connectivity of populations in fragmented landscapes-corridors and stepping stones-we combined 3 complimentary methods: behavioral studies at habitat edges, mark-recapture, and genetic analyses. Each of these methods addresses different steps in the dispersal process that a single intensive study could not address. We applied the 3 methods to the case study of Atrytonopsis new species 1, a rare butterfly endemic to a partially urbanized stretch of barrier islands in North Carolina (U.S.A.). Results of behavioral analyses showed the butterfly flew into urban and forested areas, but not over open beach; mark-recapture showed that the butterfly dispersed successfully through short stretches of urban areas (5 km) were a dispersal barrier, but shorter stretches of urban areas (≤5 km) were not. Although results from all 3 methods indicated natural features in the landscape, not urbanization, were barriers to dispersal, when we combined the results we could determine where barriers might arise: forests restricted dispersal for the butterfly only when there were long stretches with no habitat. Therefore, urban areas have the potential to become a dispersal barrier if their extent increases, a finding that may have gone unnoticed if we had used a single approach. Protection of stepping stones should be sufficient to maintain connectivity for Atrytonopsis new species 1 at current levels of urbanization. Our research highlights how the use of complementary approaches for studying animal dispersal in fragmented landscapes can help identify conservation strategies. ©2011 Society for Conservation Biology.

Barriers to the future

Energy Technology Data Exchange (ETDEWEB)

Massey, C T

1986-09-01

Opportunities for the British coal industry seem vast yet there are still barriers to progress. Seven areas are identified and discussed: mining mobility (for example, longwall mining systems are rigid and inflexible compared with American stall and pillar working); mine structure (many mines are more suitable to pit ponies than to large pieces of equipment); financial barriers (Government requires the industry to break even in 1987/88); personnel barriers (less specialization, better use of skills); safety barriers (increased use of remote control, ergonomics and robotics to protect workers); microelectronic management (nationalization has cushioned management from the market place; there is a need for a more multidisciplinary approach to the industry); and legal barriers (most legislation in the past has been in response to accidents; legislation external to the industry but affecting it is more fundamental).

Structural and Socio-cultural Barriers to Prenatal Care in a US Marshallese Community.

Science.gov (United States)

Ayers, Britni L; Purvis, Rachel S; Bing, Williamina Ioanna; Rubon-Chutaro, Jellesen; Hawley, Nicola L; Delafield, Rebecca; Adams, Ingrid K; McElfish, Pearl Anna

2018-02-22

Objectives Pacific Islanders are disproportionately burdened by poorer perinatal health outcomes with higher rates of pre-term births, low birth weight babies, infant mortality, and inadequate or no prenatal care. The aim of this study is to examine Marshallese mothers' beliefs, perceptions, and experiences of prenatal care and to identify potential barriers. Methods Three focus groups were conducted with Marshallese mothers, who were 18 years or older, and living in Arkansas. Focus groups focused on mothers' beliefs, perceptions, and experiences of prenatal care. A thematic qualitative analysis was conducted to identify salient themes within the data. Results The results demonstrated that negotiating health insurance, transportation, and language barriers were all major structural barriers that constrain prenatal care. The social-cultural barriers that emerged included a lack of understanding of the importance of seeking early and consistent prenatal care, as well as how to navigate the healthcare process. The more complicated challenges that emerged were the feelings of shame and embarrassment due to the perception of their age or being unmarried during pregnancy not being acceptable in American culture. Furthermore, the participants described perceived discrimination from prenatal care providers. Lastly, the participants described fear as a barrier to seeking out prenatal care. Conclusions for Practice This study identified both structural and socio-cultural barriers that can be incorporated into suggestions for policy makers to aid in alleviating maternal health disparities among Pacific Islander women. Further research is needed to address the Marshallese mothers' perceived discrimination from maternal health care providers.

[Barriers for the implementation of cognitive services in Spanish community pharmacies].

Science.gov (United States)

Gastelurrutia, Miguel Angel; Fernández-Llimos, Fernando; Benrimoj, Shalom I; Castrillon, Carla Cristina; Faus, María José

2007-09-01

To identify and assess barriers for dissemination, implementation, and sustainability of different cognitive services in Spanish community pharmacies. Qualitative study through semi-structured interviews followed by a descriptive analysis. Two groups of experts related to Spanish community pharmacy were chosen. One with 15 community pharmacists with a relevant professional activity, while the other group (n=18) was related to pharmacy strategists. The lack of university clinical oriented learning, lack of pharmacists' attitude towards change and some uncertainty over their professional future were identified as barriers at the pharmacists' level. In relation to pharmacy as an organization the lack of clear messages by their leaders and the small volume of Spanish pharmacies were identified as barriers. In the category of pharmacy profession, the current reimbursement system, the lack of university clinical education, and the lack of leadership by current representative organizations were the barriers found. The lack of real involvement by health authorities, the lack of knowledge about the objectives of pharmacy cognitive services, and the lack of demand of these services by patients where also identified as barriers. Finally, 12 barriers were identified and grouped into 6 categories. These barriers fit in with the barriers identified in other countries.

Barriers to Implementing Evidence-Based Intrapartum Care: A Descriptive Exploratory Qualitative Study.

Science.gov (United States)

Iravani, Mina; Janghorbani, Mohsen; Zarean, Ellahe; Bahrami, Masod

2016-02-01

Evidence based practice is an effective strategy to improve the quality of obstetric care. Identification of barriers to adaptation of evidence-based intrapartum care is necessary and crucial to deliver high quality care to parturient women. The current study aimed to explore barriers to adaptation of evidence-based intrapartum care from the perspective of clinical groups that provide obstetric care in Iran. This descriptive exploratory qualitative research was conducted from 2013 to 2014 in fourteen state medical training centers in Iran. Participants were selected from midwives, specialists, and residents of obstetrics and gynecology, with a purposive sample and snowball method. Data were collected through face-to-face semi-structured in-depth interviews and analyzed according to conventional content analysis. Data analysis identified twenty subcategories and four main categories. Main categories included barriers were related to laboring women, persons providing care, the organization environment and health system. The adoption of evidence based intrapartum care is a complex process. In this regard, identifying potential barriers is the first step to determine and apply effective strategies to encourage the compliance evidence based obstetric care and improves maternity care quality.

Observation of potential barriers on barium strontium titanate PTCR ceramics by electrostatic force microscopy

International Nuclear Information System (INIS)

Manfredini, J.P.; Paulin Filho, P.I.; Gheno, S.M.

2011-01-01

A composition of PTCR ceramic based in barium titanate with isovalent replacement of part of barium by strontium using lanthanum and manganese as additives was investigated. The transition temperature, typical of these materials, was shifted below the room temperature by the presence of strontium, whose behavior was detected by tests of DC resistivity and impedance spectroscopy. The observation of potential barriers at grain boundaries was possible through the technique of electrostatic force microscopy (EFM). The results also showed the presence of space charges in regions inside grains, possibly at subgrain boundaries. (author)

What are the barriers to initiating end-of-life conversations with patients in the last year of life?

Science.gov (United States)

Travers, Alice; Taylor, Vanessa

2016-09-02

Improving end of life care is a national imperative. Unsatisfactory care persists particularly in acute hospitals, with shortcomings, variability in communication and advance care planning identified as fundamental issues. This review explored the literature to identify what is known about the barriers to initiating end-of-life conversations with patients from the perspective of doctors and nurses in the acute hospital setting. Six electronic databases were searched for potentially relevant records published between 2008 and 2015. Studies were included if the authors reported on barriers to discussing end of life with families or patients as described by doctors or nurses in hospital settings, excluding critical care. Of 1267 potentially relevant records, 12 were included in the review. Although there is limited high-quality evidence available, several barriers were identified. Recurrent themes within the literature related to a lack of education and training, difficulty in prognostication, cultural differences and perceived reluctance of the patient or family. This study illustrated that, in addressing barriers to communication, consideration needs to be extended to include how to embed good communication practice between patients and health professionals into the culture of this setting. Board level commitment is required to raise awareness of, and familiarity with, policies and protocols concerning communication and end-of-life care. Communication training should include practical skills and tools, opportunities to explore the personal beliefs of practitioners and managing their emotions, opportunities to analyse the local organisational (physical and social environment) and team barriers.

Merging electricity and environment politics of Hong Kong: Identifying the barriers from the ways that sustainability is defined

Energy Technology Data Exchange (ETDEWEB)

Lo, Alex Y.H. [Department of Geography, The University of Hong Kong, Hui Oi Chow Science Building, Pokfulam Road, Hong Kong SAR (China)

2008-04-15

The present paper presents a study of the electricity policy of Hong Kong in an environmental-political context. Through a critical review of the policy structure and rationale, it identifies the barriers to developing a truly sustainable electricity policy system and is expected to shed light on the forthcoming electricity market reform in the territory. The barriers stem from the path-dependent institutional set-ups that restrict a timely transformation of the roles of the actors. And this is coupled with the government's treatment that does not look beyond these structural constraints, overly appreciating scientific and economic rationalities than communicative actions. The author is of the view that these are intensified by the sharp changes in the local political economy. Positive signs of change are dampened by the minimal progress in democratic development in the near future and the extension of the power companies' monopolist status that will ruin the 'trust' between the stakeholders compounding the guilt of those rigid regulatory constraints. (author)

Magnetic properties and potential barrier between crystallites model of MgGa{sub 2-x}Fe{sub x}O{sub 4} ceramics

Energy Technology Data Exchange (ETDEWEB)

Ribeiro, V.A. dos S.; Rubinger, R.M.; Oliveira, A.F.; Mendonca, C.S.P.; Silva, M.R. da, E-mail: vanderalkmin@gmail.com, E-mail: rero@unifei.edu.br, E-mail: adhimarflavio@unifei.edu.br, E-mail: sales.claudiney21@gmail.com, E-mail: mrsilva@unifei.edu.br [Universidade Federal de Itajuba (UNIFEI), MG (Brazil). Instituto de Fisica e Quimica

2016-10-15

The aim of this work was to investigate the magnetic properties and the electrical conductivity temperature dependence associated to the potential barrier between the crystallites model. Gallium and magnesium containing spinel ceramic has low magnetic coercivity and high electrical resistivity. MgGa{sub 2-x}Fe{sub x}O{sub 4} samples (x= 0.01, 0.05, 0.15, 0.25, 0.35) were prepared by solid-state method and sintered at 800 °C for 8 h. X-ray diffraction analysis confirmed the formation of a single phase with compact cubic spinel structure. The magnetic measurements show that the saturation magnetization and remanence of all samples increased with increasing iron concentration. The coercive field decreased up to the concentration x= 0.15, and above x= 0.25 it was observed an increase in the coercive field. Through electrical characterization it was found that the samples presented highly insulating behavior for x= 0.01, and further increase in x above 0.15 gives a semiconductor behavior compatible with the potential barrier between the crystallites model, i.e. fulfills the condition L/2 > L{sub D} (crystallite size L in comparison with the Debye length L{sub D}), and the conduction is limited by potential barriers between the crystallites. (author)

A cluster expansion model for predicting activation barrier of atomic processes

International Nuclear Information System (INIS)

Rehman, Tafizur; Jaipal, M.; Chatterjee, Abhijit

2013-01-01

We introduce a procedure based on cluster expansion models for predicting the activation barrier of atomic processes encountered while studying the dynamics of a material system using the kinetic Monte Carlo (KMC) method. Starting with an interatomic potential description, a mathematical derivation is presented to show that the local environment dependence of the activation barrier can be captured using cluster interaction models. Next, we develop a systematic procedure for training the cluster interaction model on-the-fly, which involves: (i) obtaining activation barriers for handful local environments using nudged elastic band (NEB) calculations, (ii) identifying the local environment by analyzing the NEB results, and (iii) estimating the cluster interaction model parameters from the activation barrier data. Once a cluster expansion model has been trained, it is used to predict activation barriers without requiring any additional NEB calculations. Numerical studies are performed to validate the cluster expansion model by studying hop processes in Ag/Ag(100). We show that the use of cluster expansion model with KMC enables efficient generation of an accurate process rate catalog

Psychological Barriers to Behavior Change: How to indentify the barriers that inhibit change

OpenAIRE

Olson, James M.

1992-01-01

Adopting a healthy lifestyle often requires changing patterns of behavior. This article describes three categories of psychological barriers to behavior change: those that prevent the admission of a problem, those that interfere with initial attempts to change behavior, and those that make long-term change difficult. Strategies are identified that family physicians can use to overcome the barriers.

Identifying product development crises: The potential of adaptive heuristics

DEFF Research Database (Denmark)

Münzberger, C.; Stingl, Verena; Oehmen, Josef

2017-01-01

This paper introduces adaptive heuristics as a tool to identify crises in design projects and highlights potential applications of these heuristics as decision support tool for crisis identification. Crises may emerge slowly or suddenly, and often have ambiguous signals. Thus the identification...... for the application of heuristics in design sciences. To achieve this, the paper compares crises to 'business as usual', and presents sixteen indicators for emerging crises. These indicators are potential cues for adaptive heuristics. Specifically three adaptive heuristics, One-single-cue, Fast-and-Frugal-Trees...

Alpha-induced instabilities in tandem thermal barriers

Energy Technology Data Exchange (ETDEWEB)

Kammash, T.; Galbraith, D.L.

1987-01-01

A major premise in the operation of Tandem Mirror reactors is that the fusion reactions take place in the central cell only. The alpha particles generated by the Deuterium-Tritium (DT) fusions, along with other ions, will however pass from the central cell to the thermal barriers and return to the central cell as a result of reflection by the potential hills that exist by the plugs' side of these barriers. This streaming motion gives rise to electrostatic and electomagnetic instabilities which could detract from the barrier's function as a thermal insulator. The number density and streaming velocity of these passing particles are dictated by the electrostatic potential variation and the magnetic field structure in these regions. It is shown that, in the absence of alphas, barriers with deep potential depression are less susceptible to electrostatic instabilities while particularly vulnerable to unstable electromagnetic modes. In the presence of alphas, especially the fast alphas whose mean energy is significantly larger than the barrier potentials they see, (which is twice as high as that seen by the ions) both types of modes become unstable.

A Conditionally Integrable Bi-confluent Heun Potential Involving Inverse Square Root and Centrifugal Barrier Terms

Science.gov (United States)

Ishkhanyan, Tigran A.; Krainov, Vladimir P.; Ishkhanyan, Artur M.

2018-05-01

We present a conditionally integrable potential, belonging to the bi-confluent Heun class, for which the Schrödinger equation is solved in terms of the confluent hypergeometric functions. The potential involves an attractive inverse square root term x-1/2 with arbitrary strength and a repulsive centrifugal barrier core x-2 with the strength fixed to a constant. This is a potential well defined on the half-axis. Each of the fundamental solutions composing the general solution of the Schrödinger equation is written as an irreducible linear combination, with non-constant coefficients, of two confluent hypergeometric functions. We present the explicit solution in terms of the non-integer order Hermite functions of scaled and shifted argument and discuss the bound states supported by the potential. We derive the exact equation for the energy spectrum and approximate that by a highly accurate transcendental equation involving trigonometric functions. Finally, we construct an accurate approximation for the bound-state energy levels.

Reducing Barriers to Care in the Office-Based Health Care Setting for Children With Autism.

Science.gov (United States)

Bultas, Margaret W; McMillin, Stephen Edward; Zand, Debra H

2016-01-01

The purpose of this survey-design research study was to evaluate the usefulness of a researcher-developed tool designed to improve office-based health care services and to assess the barriers and resources affecting office-based health care services for children with autism spectrum disorder. Fifty-four health care providers (HCPs) and 59 parents participated in the study. HCPs reported child behaviors, communication, and fears as barriers to providing care, whereas parents reported child behavior, sensory issues, and feelings of a disconnect with the HCP as barriers. HCPs identified the parent as a key resource. Parent-identified resources included provider adaptations to the patient, including slowing down the delivery of care and environmental adaptations to the office. In addition, both HCPs and parents indicated that the researcher-developed tool would be useful in reducing barriers during the HCE. Reducing barriers and improving health care interactions during delivery of care for children with autism spectrum disorder has the potential to improve health outcomes. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Barriers to evidence-based medicine: a systematic review.

Science.gov (United States)

Sadeghi-Bazargani, Homayoun; Tabrizi, Jafar Sadegh; Azami-Aghdash, Saber

2014-12-01

Evidence-based medicine (EBM) has emerged as an effective strategy to improve health care quality. The aim of this study was to systematically review and carry out an analysis on the barriers to EBM. Different database searching methods and also manual search were employed in this study using the search words ('evidence-based' or 'evidence-based medicine' or 'evidence-based practice' or 'evidence-based guidelines' or 'research utilization') and (barrier* or challenge or hinder) in the following databases: PubMed, Scopus, Web of Knowledge, Cochrane library, Pro Quest, Magiran, SID. Out of 2592 articles, 106 articles were finally identified for study. Research barriers, lack of resources, lack of time, inadequate skills, and inadequate access, lack of knowledge and financial barriers were found to be the most common barriers to EBM. Examples of these barriers were found in primary care, hospital/specialist care, rehabilitation care, medical education, management and decision making. The most common barriers to research utilization were research barriers, cooperation barriers and changing barriers. Lack of resources was the most common barrier to implementation of guidelines. The result of this study shows that there are many barriers to the implementation and use of EBM. Identifying barriers is just the first step to removing barriers to the use of EBM. Extra resources will be needed if these barriers are to be tackled. © 2014 John Wiley & Sons, Ltd.

How Can Medical Students Add Value? Identifying Roles, Barriers, and Strategies to Advance the Value of Undergraduate Medical Education to Patient Care and the Health System.

Science.gov (United States)

Gonzalo, Jed D; Dekhtyar, Michael; Hawkins, Richard E; Wolpaw, Daniel R

2017-09-01

As health systems evolve, the education community is seeking to reimagine student roles that combine learning with meaningful contributions to patient care. The authors sought to identify potential stakeholders regarding the value of student work, and roles and tasks students could perform to add value to the health system, including key barriers and associated strategies to promote value-added roles in undergraduate medical education. In 2016, 32 U.S. medical schools in the American Medical Association's (AMA's) Accelerating Change in Education Consortium met for a two-day national meeting to explore value-added medical education; 121 educators, systems leaders, clinical mentors, AMA staff leadership and advisory board members, and medical students were included. A thematic qualitative analysis of workshop discussions and written responses was performed, which extracted key themes. In current clinical roles, students can enhance value by performing detailed patient histories to identify social determinants of health and care barriers, providing evidence-based medicine contributions at the point-of-care, and undertaking health system research projects. Novel value-added roles include students serving as patient navigators/health coaches, care transition facilitators, population health managers, and quality improvement team extenders. Six priority areas for advancing value-added roles are student engagement, skills, and assessments; balance of service versus learning; resources, logistics, and supervision; productivity/billing pressures; current health systems design and culture; and faculty factors. These findings provide a starting point for collaborative work to positively impact clinical care and medical education through the enhanced integration of value-added medical student roles into care delivery systems.

Antibody Arrays Identify Potential Diagnostic Markers of Hepatocellular Carcinoma

Directory of Open Access Journals (Sweden)

Brian J. Peter

2008-01-01

Full Text Available Hepatocellular carcinoma (HCC is the third leading cause of cancer deaths worldwide. Effective treatment of HCC patients is hampered by the lack of sensitive and specific diagnostic markers of HCC. Alpha-fetoprotein (AFP, the currently used HCC marker, misses 30%–50% of HCC patients, who therefore remain undiagnosed and untreated. In order to identify novel diagnostic markers that can be used individually or in combination with AFP, we used an antibody array platform to detect the levels of candidate proteins in the plasma of HCC patients (n = 48 and patients with chronic hepatitis B or C viral infections (n = 19 (both of which are the major risk factors of HCC. We identified 7 proteins that significantly differentiate HCC patients from hepatitis patients (p < 0.05 (AFP, CTNNB, CSF1, SELL, IGFBP6, IL6R, and VCAM1.Importantly, we also identified 8 proteins that significantly differentiate HCC patients with ‘normal’ levels of AFP (<20 ng/ml from hepatitis patients (p < 0.05 (IL1RN, IFNG, CDKN1A, RETN, CXCL14, CTNNB, FGF2, and SELL. These markers are potentially important complementary markers to AFP. Using an independent immunoassay method in an independent group of 23 HCC patients and 22 hepatitis patients, we validated that plasma levels of CTNNB were significantly higher in the HCC group (p = 0.020. In conclusion, we used an antibody array platform to identify potential circulating diagnostic markers of HCC, some of which may be valuable when used in combination with AFP. The clinical utility of these newly identified HCC diagnostic markers needs to be systematically evaluated.

Potential Strategies to Address the Major Clinical Barriers Facing Stem Cell Regenerative Therapy for Cardiovascular Disease: A Review.

Science.gov (United States)

Nguyen, Patricia K; Neofytou, Evgenios; Rhee, June-Wha; Wu, Joseph C

2016-11-01

Although progress continues to be made in the field of stem cell regenerative medicine for the treatment of cardiovascular disease, significant barriers to clinical implementation still exist. To summarize the current barriers to the clinical implementation of stem cell therapy in patients with cardiovascular disease and to discuss potential strategies to overcome them. Information for this review was obtained through a search of PubMed and the Cochrane database for English-language studies published between January 1, 2000, and July 25, 2016. Ten randomized clinical trials and 8 systematic reviews were included. One of the major clinical barriers facing the routine implementation of stem cell therapy in patients with cardiovascular disease is the limited and inconsistent benefit observed thus far. Reasons for this finding are unclear but may be owing to poor cell retention and survival, as suggested by numerous preclinical studies and a small number of human studies incorporating imaging to determine cell fate. Additional studies in humans using imaging to determine cell fate are needed to understand how these factors contribute to the limited efficacy of stem cell therapy. Treatment strategies to address poor cell retention and survival are under investigation and include the following: coadministration of immunosuppressive and prosurvival agents, delivery of cardioprotective factors packaged in exosomes rather than the cells themselves, and use of tissue-engineering strategies to provide structural support for cells. If larger grafts are achieved using these strategies, it will be imperative to carefully monitor for the potential risks of tumorigenicity, immunogenicity, and arrhythmogenicity. Despite important achievements to date, stem cell therapy is not yet ready for routine clinical implementation. Significant research is still needed to address the clinical barriers outlined herein before the next wave of large clinical trials is under way.

Electron transmission through a periodically driven graphene magnetic barrier

Energy Technology Data Exchange (ETDEWEB)

Biswas, R., E-mail: rbiswas.pkc@gmail.com [Department of Physics, P. K. College, Contai, Purba Medinipur, West Bengal – 721401 (India); Maiti, S. [Ajodhya Hills G.S.A.T High School, Ajodhya, Purulia, West Bengal – 723152 (India); Mukhopadhyay, S. [Purulia Zilla School, Dulmi Nadiha, Purulia, West Bengal – 723102 (India); Sinha, C. [Department of Physics, P. K. College, Contai, Purba Medinipur, West Bengal – 721401 (India); Department of Theoretical Physics, Indian Association for the Cultivation of Science, Jadavpur – 700032 (India)

2017-05-10

Electronic transport through graphene magnetic barriers is studied theoretically in presence of an external time harmonic scalar potential in the framework of non-perturbative Landau–Floquet Formalism. The oscillating field mostly suppresses the transmission for rectangular magnetic barrier structure and exhibits the Fano resonance for multiphoton processes due to the presence of bound state inside the barrier. While, for a pair of delta function barriers of larger separation, the oscillating potential suppresses the usual Fabry–Perot oscillations in the transmission and a new type of asymmetric Fano resonance is noted for smaller separation, occurring due to extended states between the barriers. - Highlights: • Tunnelling of the Dirac Fermions through oscillating pure magnetic barriers is reported for the first time. • The high energy transmission through a graphene magnetic barrier is suppressed by the application of time periodic modulation. • Suppression of the Fabry Perot transmission is noted due to the application of an external time harmonic potential. • Two kinds of the Fano resonances are noted in transmission through a pair of modulated δ-function magnetic barriers.

Perceptions regarding strategic and structural entry barriers

NARCIS (Netherlands)

Lutz, C.H.M.; Kemp, R.G.M.; Dijkstra, S.G.

2010-01-01

This article uses factor analysis to identify the underlying dimensions of strategic and structural entry barriers. We find that, in the perception of firms, both types of barriers are important and that the effectiveness of strategic barriers depends on attributes of the market structure. Based on

Perceptions regarding strategic and structural entry barriers

NARCIS (Netherlands)

Lutz, Clemens H. M.; Kemp, Ron G. M.; Dijkstra, S. Gerhard

This article uses factor analysis to identify the underlying dimensions of strategic and structural entry barriers. We find that, in the perception of firms, both types of barriers are important and that the effectiveness of strategic barriers depends on attributes of the market structure. Based on

Benchmarking the interactions among barriers in third-party logistics implementation

DEFF Research Database (Denmark)

Diabat, A.; Khreishah, A.; Govindan, Kannan

2013-01-01

Purpose: The purpose of this paper is to analyze the interaction among some of the major barriers that may hinder the implementation of third-party logistics (TPL) in manufacturing industries. Design/methodology/approach: This paper uses an interpretive structural modeling (ISM) methodology...... to analyze the interactions among the barriers. Findings: It is beneficial for the management of any firm to be aware of significant barriers and to diagnose those that could be integral to the organization's future survival. Many works have focused on identifying barriers for TPL implementation, but a model...... for such barriers is lacking. This paper attempts to develop a model for the barriers using an ISM methodology and analyzes the mutual interactions among the barriers. The model differentiates between the barriers so that driving barriers, which can intensify other barriers, and dependent barriers are identified...

Potential Pathways for CNS Drug Delivery Across the Blood-Cerebrospinal Fluid Barrier

Science.gov (United States)

Strazielle, Nathalie; Ghersi-Egea, Jean-François

2016-01-01

The blood-brain interfaces restrict the cerebral bioavailability of pharmacological compounds. Various drug delivery strategies have been developed to improve drug penetration into the brain. Most strategies target the microvascular endothelium forming the blood-brain barrier proper. Targeting the blood-cerebrospinal fluid (CSF) barrier formed by the epithelium of the choroid plexuses in addition to the blood-brain barrier may offer added-value for the treatment of central nervous system diseases. For instance, targeting the CSF spaces, adjacent tissue, or the choroid plexuses themselves is of interest for the treatment of neuroinflammatory and infectious diseases, cerebral amyloid angiopathy, selected brain tumors, hydrocephalus or neurohumoral dysregulation. Selected CSF-borne materials seem to reach deep cerebral structures by mechanisms that need to be understood in the context of chronic CSF delivery. Drug delivery through both barriers can reduce CSF sink action towards parenchymal drugs. Finally, targeting the choroid plexus-CSF system can be especially relevant in the context of neonatal and pediatric diseases of the central nervous system. Transcytosis appears the most promising mechanism to target in order to improve drug delivery through brain barriers. The choroid plexus epithelium displays strong vesicular trafficking and secretory activities that deserve to be explored in the context of cerebral drug delivery. Folate transport and exosome release into the CSF, plasma protein transport, and various receptor-mediated endocytosis pathways may prove useful mechanisms to exploit for efficient drug delivery into the CSF. This calls for a clear evaluation of transcytosis mechanisms at the blood-CSF barrier, and a thorough evaluation of CSF drug delivery rates. PMID:27464721

Retrofitting the Low Impact Development Practices into Developed Urban areas Including Barriers and Potential Solution

Science.gov (United States)

Shafique, Muhammad; Kim, Reeho

2017-06-01

Low impact development (LID)/green infrastructure (GI) practices have been identified as the sustainable practices of managing the stormwater in urban areas. Due to the increasing population, most of the cities are more developing which results in the change of natural area into impervious areas (roads, buildings etc.). Moreover, urbanization and climate change are causing many water-related problems and making over cities unsafe and insecure. Under these circumstances, there is a need to introduce new stormwater management practices into developed cities to reduce the adverse impacts of urbanization. For this purpose, retrofitting low impact development practices demands more attention to reduce these water-related problems and trying to make our cities sustainable. In developed areas, there is a little space is available for the retrofitting of LID practices for the stormwater management. Therefore, the selection of an appropriate place to retrofitting LID practices needs more concern. This paper describes the successfully applied retrofitting LID practices around the globe. It also includes the process of applying retrofitting LID practices at the suitable place with the suitable combination. Optimal places for the retrofitting of different LID practices are also mentioned. This paper also highlights the barriers and potential solutions of retrofitting LID practices in urban areas.

Retrofitting the Low Impact Development Practices into Developed Urban areas Including Barriers and Potential Solution

Directory of Open Access Journals (Sweden)

Shafique Muhammad

2017-06-01

Full Text Available Low impact development (LID/green infrastructure (GI practices have been identified as the sustainable practices of managing the stormwater in urban areas. Due to the increasing population, most of the cities are more developing which results in the change of natural area into impervious areas (roads, buildings etc.. Moreover, urbanization and climate change are causing many water-related problems and making over cities unsafe and insecure. Under these circumstances, there is a need to introduce new stormwater management practices into developed cities to reduce the adverse impacts of urbanization. For this purpose, retrofitting low impact development practices demands more attention to reduce these water-related problems and trying to make our cities sustainable. In developed areas, there is a little space is available for the retrofitting of LID practices for the stormwater management. Therefore, the selection of an appropriate place to retrofitting LID practices needs more concern. This paper describes the successfully applied retrofitting LID practices around the globe. It also includes the process of applying retrofitting LID practices at the suitable place with the suitable combination. Optimal places for the retrofitting of different LID practices are also mentioned. This paper also highlights the barriers and potential solutions of retrofitting LID practices in urban areas.

Explicating perceived barriers to mammography for the USCREEN project: concerns about breast implants, faith violations, and perceived recommendations.

Science.gov (United States)

Jensen, Jakob D; Ratcliff, Chelsea; Weaver, Jeremy; Krakow, Melinda M; Payton, William; Loewen, Sherrie

2015-11-01

In line with the health belief model, perceived barriers have proven to be a key determinant of intentions to screen for breast cancer. The standard measure of perceived barriers to breast cancer screening is an 11 item scale developed by Victoria Champion. However, perceived barriers emerge and change over time, and Champion's perceived barriers scale was last revised in 1999. Moreover, the original scale did not address barriers which may be more pronounced in particular populations, such as congruity of action with faith. As part of the Utah Screening Project, a sample of women 40-74 (N = 341, Mage = 51.19, SD = 8.11) were recruited from four Utah counties in 2014 to complete a survey. The results revealed that the four new perceived barrier items explained 6.4 % of intentions to screen, above and beyond other predictors. In addition to barriers identified in past research, the current study identified several novel barriers including (a) concerns about negative effects to breast implants, (b) perceived conflict with faith, and the (c) perception that mammography is no longer recommended. The new perceived barriers items are useful to researchers interested in exploring barriers not addressed by the original instrument. The barriers also suggest potential belief-based targets and channels (e.g., plastic surgery clinics, faith-based interventions) for delivering mammography interventions.

Barriers to cancer screening in Hmong Americans: the influence of health care accessibility, culture, and cancer literacy.

Science.gov (United States)

Lee, Hee Yun; Vang, Suzanne

2010-06-01

Hmong Americans face high cancer mortality rates even in comparison to their Asian American counterparts, and report low utilization of cancer screenings. To date, no study has been conducted on the cultural barriers this population faces in undergoing cancer screenings. A systematic review of the literature was conducted to examine the existing knowledge regarding the barriers to cancer screening for Hmong Americans. Potential barriers were identified from this examination to include: health access factors (type of health insurance, ethnicity of provider, low English proficiency, and years spent in the U.S.); cultural factors (belief in the spiritual etiology of diseases, patriarchal values, modesty, and mistrust of the western medical system); and cancer literacy factors (cancer and prevention illiteracy). Based on this review, potential cultural and ethnic group-specific prevention strategies and cancer health policies are discussed to address these barriers and enhance screening behavior among the Hmong.

A Learner Perspective on Barriers to E-Learning

Science.gov (United States)

Becker, Karen; Newton, Cameron; Sawang, Sukanlaya

2013-01-01

This study aims to identify and categorize barriers to e-learning adoption and the relative impact of those barriers on learners. It contributes to the understanding of learner perceptions of barriers, the different types of barriers and their relative importance. This study used a quantitative methodology grounded in previous literature. The…

Delivering an evidence-based outdoor journey intervention to people with stroke: Barriers and enablers experienced by community rehabilitation teams

Directory of Open Access Journals (Sweden)

Middleton Sandy

2010-01-01

Full Text Available Abstract Background Transferring knowledge from research into practice can be challenging, partly because the process involves a change in attitudes, roles and behaviour by individuals and teams. Helping teams to identify then target potential barriers may aid the knowledge transfer process. The aim of this study was to identify barriers and enablers, as perceived by allied health professionals, to delivering an evidence-based (Level 1 outdoor journey intervention for people with stroke. Methods A qualitative design and semi-structured interviews were used. Allied health professionals (n = 13 from two community rehabilitation teams were interviewed, before and after receiving feedback from a medical record audit and attending a training workshop. Interviews allowed participants to identify potential and actual barriers, as well as enablers to delivering the intervention. Qualitative data were analysed using theoretical domains described by Michie and colleagues. Results Two barriers to delivery of the intervention were the social influence of people with stroke and their family, and professionals' beliefs about their capabilities. Other barriers included professionals' knowledge and skills, their role identity, availability of resources, whether professionals remembered to provide the intervention, and how they felt about delivering the intervention. Enablers to delivering the intervention included a belief that they could deliver the intervention, a willingness to expand and share professional roles, procedures that reminded them what to do, and feeling good about helping people with stroke to participate. Conclusions This study represents one step in the quality improvement process. The interviews encouraged reflection by staff. We obtained valuable data which have been used to plan behaviour change interventions addressing identified barriers. Our methods may assist other researchers who need to design similar behaviour change interventions.

A comparison of freeway median crash frequency, severity, and barrier strike outcomes by median barrier type.

Science.gov (United States)

Russo, Brendan J; Savolainen, Peter T

2018-08-01

Median-crossover crashes are among the most hazardous events that can occur on freeways, often resulting in severe or fatal injuries. The primary countermeasure to reduce the occurrence of such crashes is the installation of a median barrier. When installation of a median barrier is warranted, transportation agencies are faced with the decision among various alternatives including concrete barriers, beam guardrail, or high-tension cable barriers. Each barrier type differs in terms of its deflection characteristics upon impact, the required installation and maintenance costs, and the roadway characteristics (e.g., median width) where installation would be feasible. This study involved an investigation of barrier performance through an in-depth analysis of crash frequency and severity data from freeway segments where high-tension cable, thrie-beam, and concrete median barriers were installed. A comprehensive manual review of crash reports was conducted to identify crashes in which a vehicle left the roadway and encroached into the median. This review also involved an examination of crash outcomes when a barrier strike occurred, which included vehicle containment, penetration, or re-direction onto the travel lanes. The manual review of crash reports provided critical supplementary information through narratives and diagrams not normally available through standard fields on police crash report forms. Statistical models were estimated to identify factors that affect the frequency, severity, and outcomes of median-related crashes, with particular emphases on differences between segments with varying median barrier types. Several roadway-, traffic-, and environmental-related characteristics were found to affect these metrics, with results varying across the different barrier types. The results of this study provide transportation agencies with important guidance as to the in-service performance of various types of median barrier. Copyright © 2018 Elsevier Ltd. All rights

Barriers to Pelvic Floor Physical Therapy Regarding Treatment of High-Tone Pelvic Floor Dysfunction.

Science.gov (United States)

Zoorob, Dani; Higgins, Margaret; Swan, Kimberly; Cummings, Jennifer; Dominguez, Sarah; Carey, Erin

Chronic pelvic pain is a prevalent and debilitating condition with a wide range of etiologies. An estimated 30% to 70% of chronic pelvic cases involve musculoskeletal component pain including high-tone pelvic floor dysfunction (HTPFD). Pelvic floor physical therapy has been shown to be a beneficial treatment for HTPFD, yet many patients do not have access to this treatment. The objective of this study was to identify the barriers preventing patients from following through with the first-line management, physical therapy. Participants with a diagnosis of HTPFD (n = 154) were identified from the list of referrals sent from the obstetrics and gynecology department to an affiliated PFPT center. Participants were contacted and asked to complete a phone survey addressing demographics and perceived barriers to care. Responses were collected in REDCap. Univariate and bivariate analyses were performed using a statistical analysis software. Seventy surveys were completed. The top barriers identified by participants were financial constraints (51.4%), perceived lack of utility (37.1%), time constraints (30.0%), and travel issues (18.6%); 84.4% of participants had 1 or more comorbid pain condition. Whereas 51.4% expressed some level of anxiety regarding the PFPT option, only 9.6% of participants did not start treatment because of fear of treatment. The majority of treatment barriers identified were concrete restraints, with insurance noncoverage and time constraints being the top issues. A fair number of participants expressed anxiety about the treatment or felt they received unclear explanations of the treatment. These are areas in which providers can potentially alleviate some barriers to care.

Conductance and refraction across a Barrier in Phosphorene

Science.gov (United States)

Dahal, Dipendra; Gumbs, Godfrey

The transmission coefficient and ballistic conductance for monolayer black phosphorene is calculated when a potential step or square barrier is present. The Landauer-B¨uttiker formalism is employed in our calculations of the conductance. We obtain the refractive index for the step potential barrier when an incident beam of electron travel along different paths so as to observe what role the anisotropy of the energy bands plays. Numerical results are presented for various potential heights and barrier widths and these are compared with those for gapless and gapped graphene.

Origin of methyl torsional potential barrier – An overview

Indian Academy of Sciences (India)

Unknown

This paper presents the evolution of views on methyl internal rotation ... recognized in the early years of quantum theory.1 Since then, detailed experimental and ..... C−C bond in the methyl conjugated molecules is an important factor for barrier.

Identifying gaps, barriers, and solutions in implementing pressure ulcer prevention programs.

Science.gov (United States)

Jankowski, Irene M; Nadzam, Deborah Morris

2011-06-01

Patients continue to suffer from pressure ulcers (PUs), despite implementation of evidence-based pressure ulcer (PU) prevention protocols. In 2009, Joint Commission Resources (JCR) and Hill-Rom created the Nurse Safety Scholar-in-Residence (nurse scholar) program to foster the professional development of expert nurse clinicians to become translators of evidence into practice. The first nurse scholar activity has focused on PU prevention. Four hospitals with established PU programs participated in the PU prevention implementation project. Each hospital's team completed an inventory of PU prevention program components and provided copies of accompanying documentation, along with prevalence and incidence data. Site visits to the four participating hospitals were arranged to provide opportunities for more in-depth analysis and support. Following the initial site visit, the project team at each hospital developed action plans for the top three barriers to PU program implementation. A series of conference calls was held between the site visits. Pressure Ulcer Program Gaps and Recommendations. The four hospitals shared common gaps in terms of limitations in staff education and training; lack of physician involvement; limited involvement of unlicensed nursing staff; lack of plan for communicating at-risk status; and limited quality improvement evaluations of bedside practices. Detailed recommendations were identified for addressing each of these gaps. these Recommendations for eliminating gaps have been implemented by the participating teams to drive improvement and to reduce hospital-acquired PU rates. The nurse scholars will continue to study implementation of best practices for PU prevention.

Barriers to healthy eating: Findings from the focus groups with older people and children/adolescents

DEFF Research Database (Denmark)

Kazbare, Laura; Bech-Larsen, Tino

or potential behavioural change in terms of healthier eating, discussing pre-selected healthy and unhealthy food categories. The revised Social Cognitive Theory was used as a theoretical framework. Results: The study suggests that the main obstacles to change can be grouped into motivational and implementation......), "liking" remains the main food choice criterion, including the healthy foods. Conclusion: The study presented a number of barriers to healthy eating identified by older people and children/adolescents. Based on the results of the study, further investigations should be undertaken in this area...... barriers. The motivational barriers are unwillingness to change eating habits, satisfaction with current diets and misconception about their healthiness; relatively low health consciousness and unwillingness to become excessively health-oriented. Implementation barriers include remembering the change...

Study and comparison of some methods for calculating the transmission factor of a potential barrier in quantum mechanics (1963); Etude et comparaison de quelques methodes de calcul du facteur de transmission d'une barriere de potentiel en mecanique quantique (1963)

Energy Technology Data Exchange (ETDEWEB)

Jamet, P [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1964-07-01

The author formulates two accurate methods for the calculation of the transmission coefficient of a one-dimensional potential barrier. The principles of these methods are. expressed in a symmetrical form with respect to the two sides of the potential barrier; this constitutes a proof of the fact that the transmission coefficient is path direction independent. The numerical application is carried out on several examples and the results are compared to those provided by the WKB method. (author) [French] L'auteur formule deux methodes exactes pour calculer le coefficient de transmission d'une barriere de potentiel unidimensionnelle. Les principes de ces methodes s'enoncent sous forme symetrique par rapport aux deux cotes de la barriere de potentiel, ce qui constitue une demonstration du fait que le coefficient de transmission est independant du sens de parcours. L'application numerique est faite sur quelques exemples et les resultats sont compares a ceux fournis par la methode B KW. (auteur)

Self-efficacy and barriers to disaster evacuation in Hong Kong.

Science.gov (United States)

Newnham, Elizabeth A; Balsari, Satchit; Lam, Rex Pui Kin; Kashyap, Shraddha; Pham, Phuong; Chan, Emily Y Y; Patrick, Kaylie; Leaning, Jennifer

2017-12-01

To investigate specific challenges to Hong Kong's capacity for effective disaster response, we assessed perceived barriers to evacuation and citizens' self-efficacy. Global positioning system software was used to determine random sampling locations across Hong Kong, weighted by population density. The resulting sample of 1023 participants (46.5% female, mean age 40.74 years) were invited to complete questionnaires on emergency preparedness, barriers to evacuation and self-efficacy. Latent profile analysis and multinomial logistic regression were used to identify self-efficacy profiles and predictors of profile membership. Only 11% of the sample reported feeling prepared to respond to a disaster. If asked to evacuate in an emergency, 41.9% of the sample cited significant issues that would preclude them from doing so. Self-efficacy was negatively associated with barriers to disaster response so that participants reporting higher levels of self-efficacy cited fewer perceived barriers to evacuation. Hong Kong has established effective strategies for emergency response, but concerns regarding evacuation and mobilisation remain. The findings indicate that improving self-efficacy for disaster response has potential to increase evacuation readiness.

Identifying potential kidney donors using social networking web sites.

Science.gov (United States)

Chang, Alexander; Anderson, Emily E; Turner, Hang T; Shoham, David; Hou, Susan H; Grams, Morgan

2013-01-01

Social networking sites like Facebook may be a powerful tool for increasing rates of live kidney donation. They allow for wide dissemination of information and discussion and could lessen anxiety associated with a face-to-face request for donation. However, sparse data exist on the use of social media for this purpose. We searched Facebook, the most popular social networking site, for publicly available English-language pages seeking kidney donors for a specific individual, abstracting information on the potential recipient, characteristics of the page itself, and whether potential donors were tested. In the 91 pages meeting inclusion criteria, the mean age of potential recipients was 37 (range: 2-69); 88% were US residents. Other posted information included the individual's photograph (76%), blood type (64%), cause of kidney disease (43%), and location (71%). Thirty-two percent of pages reported having potential donors tested, and 10% reported receiving a live-donor kidney transplant. Those reporting donor testing shared more potential recipient characteristics, provided more information about transplantation, and had higher page traffic. Facebook is already being used to identify potential kidney donors. Future studies should focus on how to safely, ethically, and effectively use social networking sites to inform potential donors and potentially expand live kidney donation. © 2013 John Wiley & Sons A/S.

Barriers to Mammography among Inadequately Screened Women

Science.gov (United States)

Stoll, Carolyn R. T.; Roberts, Summer; Cheng, Meng-Ru; Crayton, Eloise V.; Jackson, Sherrill; Politi, Mary C.

2015-01-01

Mammography use has increased over the past 20 years, yet more than 30% of women remain inadequately screened. Structural barriers can deter individuals from screening, however, cognitive, emotional, and communication barriers may also prevent mammography use. This study sought to identify the impact of number and type of barriers on mammography…

Faculty Perceptions about Barriers to Active Learning

Science.gov (United States)

Michael, Joel

2007-01-01

Faculty may perceive many barriers to active learning in their classrooms. Four groups of participants in a faculty development workshop were asked to list their perceived barriers to active learning. Many of the problems identified were present on more than one list. The barriers fall into three categories: student characteristics, issues…

Uses and evaluation methods of potential hydrogen permeation barriers for nuclear reactor materials

International Nuclear Information System (INIS)

Noga, J.O.; Piercy, G.R.; Bowker, J.T.

1985-07-01

This report summarizes results on the use of coatings as hydrogen permeation barriers on nuclear reactor component materials. Two classes of base materials were considered, exothermic hydrogen absorbers and endothermic hydrogen absorbers. The results of the tests indicate that substantial reductions in the amount of hydrogen absorbed by a metal can be achieved through the use of hydrogen permeation barrier coatings. Gold was determined to provide an effective hydrogen permeation barrier on Zr-2-1/2 Nb pressure tube material. Tin was determined to be a suitable hydrogen permeation barrier when applied on AISI 410 stainless steel and iron. Both gas phase and electrochemical permeation techniques were used to determine hydrogen permeabilities through coatings and base materials

Identifying motivators and barriers to older community-dwelling people participating in resistance training: A cross-sectional study.

Science.gov (United States)

Burton, Elissa; Lewin, Gill; Pettigrew, Simone; Hill, Anne-Marie; Bainbridge, Liz; Farrier, Kaela; Langdon, Trish; Airey, Phil; Hill, Keith D

2017-08-01

Participation rates of older people in resistance training (RT) are low despite increasing research showing many health benefits. To increase the number of older people participating in RT it is important to know what would motivate people to become involved, what motivates those who participate to continue, and the factors preventing many older people from commencing participation. To investigate these issues, a questionnaire was mailed to three groups of older people: (1) those receiving home care services, (2) members of a peak non-government seniors' organisation and (3) those participating in a specific gym-based RT programme. In total, 1327 questionnaires were returned (response rate = 42.5%). To feel good physically and mentally were the main reasons motivating participation among all three groups, and falls prevention was identified as an important motivator for the home care respondents. Pain, injury and illness were the main barriers to participating, or continuing to participate. However, medical advice was a factor influencing participation commencement. The results suggest organisations providing RT programmes for older people should tailor the promotion and delivery of programmes to address key motivators and barriers specific to each group to increase the proportion of older people initiating and continuing to engage in RT.

Perceived barriers to care and provider gender preferences among veteran men who have experienced military sexual trauma: a qualitative analysis.

Science.gov (United States)

Turchik, Jessica A; McLean, Caitlin; Rafie, Samantha; Hoyt, Tim; Rosen, Craig S; Kimerling, Rachel

2013-05-01

Research suggests that there may be unique barriers to accessing care among men who have experienced sexual trauma. The primary goal of the current research was to elucidate potential barriers to accessing military sexual trauma (MST)-related care for male veterans. A secondary goal was to explore whether veterans have preferences regarding the gender of clinicians providing MST-related care. Qualitative analyses were used to examine data collected from semistructured interviews conducted with 20 male veterans enrolled in Veterans Health Administration care who reported MST but who had not received any MST-related mental health care. Veterans identified a number of potential barriers, with the majority of reported barriers relating to issues of stigma and gender. Regarding provider gender preferences, veterans were mixed, with 50% preferring a female provider, 25% a male provider, and 25% reporting no gender preference. These preliminary data suggest that stigma, gender, and knowledge-related barriers may exist for men regarding seeking MST-related care. Interventions to address potential barriers, such as outreach interventions and providing gender-specific psychoeducation, may increase access to care for male veterans who report MST. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Return-to-work barriers for workers with contact dermatitis.

Science.gov (United States)

Holness, D Linn

2003-12-01

There is little information available regarding barriers to return-to-work (RTW) in workers with contact dermatitis. The purpose of this study was to survey occupational health and safety personnel to determine their perceptions regarding RTW barriers for workers with contact dermatitis. The study was conducted during an occupational health and safety research conference attended by stakeholders from labour, management, injured workers, government, safety associations, occupational health and safety practitioners and researchers. The attendees were presented with 3 pictures of varying degrees of work-related hand contact dermatitis and were asked to list the 3 key barriers or challenges in RTW for individuals with contact dermatitis. 21 individuals completed the survey. Issues identified in descending order of frequency were concern of ongoing dermatitis, ability to do the job safely, appearance, ability to accommodate, personal protective equipment, fear that the rash was contagious, workplace attitudes and pain. While some of these issues are potentially common to RTW situations in general, others are more specific to health problems which have a visible manifestation. Increased awareness of and attention to these possible barriers to RTW may lead to better RTW outcomes.

A concept mapping approach to identifying the barriers to implementing an evidence-based sports injury prevention programme.

Science.gov (United States)

Donaldson, Alex; Callaghan, Aisling; Bizzini, Mario; Jowett, Andrew; Keyzer, Patrick; Nicholson, Matthew

2018-01-20

Understanding the barriers to programme use is important to facilitate implementation of injury prevention programmes in real-word settings. This study investigated the barriers to coaches of adolescent female soccer teams, in Victoria, Australia, implementing the evidence-based FIFA 11+ injury prevention programme. Concept mapping with data collected from 19 soccer coaches and administrators. Brainstorming generated 65 statements as barriers to 11+ implementation. After the statements were synthesised and edited, participants sorted 59 statements into groups (mean, 6.2 groups; range, 3-10 groups). Multidimensional scaling and hierarchical cluster analysis identified a six-cluster solution: Lack of 11+ knowledge among coaches (15 statements), Lack of player enjoyment and engagement (14), Lack of link to football-related goals (11), Lack of facilities and resources (8), Lack of leadership (6) and Lack of time at training (5). Statements in the 'Lack of 11+ knowledge among coaches' cluster received the highest mean importance (3.67 out of 5) and feasibility for the Football Federation to address (3.20) rating. Statements in the 'Lack of facilities and resources' cluster received the lowest mean importance rating (2.23), while statements in the 'Lack of time at training' cluster received the lowest mean feasibility rating (2.19). A multistrategy, ecological approach to implementing the 11+-with specific attention paid to improving coach knowledge about the 11+ and how to implement it, linking the 11+ to the primary goal of soccer training, and organisational leadership-is required to improve the uptake of the 11+ among the targeted coaches. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Caspase-14 Expression Impairs Retinal Pigment Epithelium Barrier Function: Potential Role in Diabetic Macular Edema

Directory of Open Access Journals (Sweden)

Selina Beasley

2014-01-01

Full Text Available We recently showed that caspase-14 is a novel molecule in retina with potential role in accelerated vascular cell death during diabetic retinopathy (DR. Here, we evaluated whether caspase-14 is implicated in retinal pigment epithelial cells (RPE dysfunction under hyperglycemia. The impact of high glucose (HG, 30 mM D-glucose on caspase-14 expression in human RPE (ARPE-19 cells was tested, which showed significant increase in caspase-14 expression compared with normal glucose (5 mM D-glucose + 25 mM L-glucose. We also evaluated the impact of modulating caspase-14 expression on RPE cells barrier function, phagocytosis, and activation of other caspases using ARPE-19 cells transfected with caspase-14 plasmid or caspase-14 siRNA. We used FITC-dextran flux assay and electric cell substrate impedance sensing (ECIS to test the changes in RPE cell barrier function. Similar to HG, caspase-14 expression in ARPE-19 cells increased FITC-dextran leakage through the confluent monolayer and decreased the transcellular electrical resistance (TER. These effects of HG were prevented by caspase-14 knockdown. Furthermore, caspase-14 knockdown prevented the HG-induced activation of caspase-1 and caspase-9, the only activated caspases by HG. Phagocytic activity was unaffected by caspase-14 expression. Our results suggest that caspase-14 contributes to RPE cell barrier disruption under hyperglycemic conditions and thus plays a role in the development of diabetic macular edema.

Mucus as a Barrier to Drug Delivery

DEFF Research Database (Denmark)

Bøgh, Marie; Nielsen, Hanne Mørck

2015-01-01

Viscoelastic mucus lines all mucosal surfaces of the body and forms a potential barrier to mucosal drug delivery. Mucus is mainly composed of water and mucins; high-molecular weight glycoproteins forming an entangled network. Consequently, mucus forms a steric barrier and due to its negative charge...... barrier to drug delivery. Current knowledge of mucus characteristics and barrier properties, as achieved by state-of-the-art methodologies, is the topic of this MiniReview emphasizing the gastrointestinal mucus and an overall focus on oral drug delivery. Cell culture-based in vitro models are well......, studies of peptide and protein drug diffusion in and through mucus and studies of mucus-penetrating nanoparticles are included to illustrate the mucus as a potentially important barrier to obtain sufficient bioavailability of orally administered drugs, and thus an important parameter to address...

Motivators and barriers for paediatricians discharging patients.

Science.gov (United States)

Turbitt, Erin; Kunin, Marina; Gafforini, Sarah; Freed, Gary L

2017-07-01

The aim of this study was to identify motivators and barriers that paediatricians face when discharging patients from outpatient specialty care. A questionnaire was administered to outpatient care paediatricians in Victoria working in one of five speciality public hospital clinics. Questions focused on how important various motivators and barriers were in respondents' decision to discharge a patient from their clinic. Nearly all (91%, n=74) paediatricians invited to participate provided responses. The factor influencing the greatest proportion of paediatricians in their decision to discharge patients back to primary care was the potential that patients may not receive the required care from a GP. The next most highly rated barrier was that it is too complicated to arrange discharge; rated as a very important influence by one-third of paediatricians (33%, n=24). Improvements to the discharge process may encourage more paediatricians to discharge patients back to their GP, therefore freeing up appointment slots. This in turn could reduce waiting times for paediatric outpatient clinics in Victoria. The concern from paediatricians that patients may not receive the required care from a GP warrants attention and should be further investigated.

Geophysical characterization of subsurface barriers

International Nuclear Information System (INIS)

Borns, D.J.

1995-08-01

An option for controlling contaminant migration from plumes and buried waste sites is to construct a subsurface barrier of a low-permeability material. The successful application of subsurface barriers requires processes to verify the emplacement and effectiveness of barrier and to monitor the performance of a barrier after emplacement. Non destructive and remote sensing techniques, such as geophysical methods, are possible technologies to address these needs. The changes in mechanical, hydrologic and chemical properties associated with the emplacement of an engineered barrier will affect geophysical properties such a seismic velocity, electrical conductivity, and dielectric constant. Also, the barrier, once emplaced and interacting with the in situ geologic system, may affect the paths along which electrical current flows in the subsurface. These changes in properties and processes facilitate the detection and monitoring of the barrier. The approaches to characterizing and monitoring engineered barriers can be divided between (1) methods that directly image the barrier using the contrasts in physical properties between the barrier and the host soil or rock and (2) methods that reflect flow processes around or through the barrier. For example, seismic methods that delineate the changes in density and stiffness associated with the barrier represents a direct imaging method. Electrical self potential methods and flow probes based on heat flow methods represent techniques that can delineate the flow path or flow processes around and through a barrier

Barriers to return to work after burn injuries.

Science.gov (United States)

Esselman, Peter C; Askay, Shelley Wiechman; Carrougher, Gretchen J; Lezotte, Dennis C; Holavanahalli, Radha K; Magyar-Russell, Gina; Fauerbach, James A; Engrav, Loren H

2007-12-01

To identify barriers to return to work after burn injury as identified by the patient. A cohort study with telephone interview up to 1 year. Hospital-based burn centers at 3 national sites. Hospitalized patients (N=154) meeting the American Burn Association criteria for major burn injury, employed at least 20 hours a week at the time of injury, and with access to a telephone after discharge. Patients were contacted via telephone every 2 weeks up to 4 months, then monthly up to 1 year after discharge. A return to work survey was used to identify barriers that prevented patients from returning to work. A graphic rating scale determined the impact of each barrier. By 1 year, 79.7% of patients returned to work. Physical and wound issues were barriers early after discharge. Although physical abilities continued to be a significant barrier up to 1 year, working conditions (temperature, humidity, safety) and psychosocial factors (nightmares, flashbacks, appearance concerns) became important issues in those with long-term disability. The majority of patients return to work after a burn injury. Although physical and work conditions are important barriers, psychosocial issues need to be evaluated and treated to optimize return to work.

Instantaneous Tunneling Flight Time for Wavepacket Transmission through Asymmetric Barriers.

Science.gov (United States)

Petersen, Jakob; Pollak, Eli

2018-04-12

The time it takes a particle to tunnel through the asymmetric Eckart barrier potential is investigated using Gaussian wavepackets, where the barrier serves as a model for the potential along a chemical reaction coordinate. We have previously shown that the, in principle experimentally measurable, tunneling flight time, which determines the time taken by the transmitted particle to traverse the barrier, vanishes for symmetric potentials like the Eckart and square barrier [ Petersen , J. ; Pollak , E. J. Phys. Chem. Lett. 2017 , 9 , 4017 ]. Here we show that the same result is obtained for the asymmetric Eckart barrier potential, and therefore, the zero tunneling flight time seems to be a general result for one-dimensional time-independent potentials. The wavepacket dynamics is simulated using both an exact quantum mechanical method and a classical Wigner prescription. The excellent agreement between the two methods shows that quantum coherences are not important in pure one-dimensional tunneling and reinforces the conclusion that the tunneling flight time vanishes.

Permeability Barrier Generation in the Martian Lithosphere

Science.gov (United States)

Schools, Joe; Montési, Laurent

2015-11-01

Permeability barriers develop when a magma produced in the interior of a planet rises into the cooler lithosphere and crystallizes more rapidly than the lithosphere can deform (Sparks and Parmentier, 1991). Crystallization products may then clog the porous network in which melt is propagating, reducing the permeability to almost zero, i.e., forming a permeability barrier. Subsequent melts cannot cross the barrier. Permeability barriers have been useful to explain variations in crustal thickness at mid-ocean ridges on Earth (Magde et al., 1997; Hebert and Montési, 2011; Montési et al., 2011). We explore here under what conditions permeability barriers may form on Mars.We use the MELTS thermodynamic calculator (Ghiorso and Sack, 1995; Ghiorso et al., 2002; Asimow et al., 2004) in conjunction with estimated Martian mantle compositions (Morgan and Anders, 1979; Wänke and Dreibus, 1994; Lodders and Fegley, 1997; Sanloup et al., 1999; Taylor 2013) to model the formation of permeability barriers in the lithosphere of Mars. In order to represent potential past and present conditions of Mars, we vary the lithospheric thickness, mantle potential temperature (heat flux), oxygen fugacity, and water content.Our results show that permeability layers can develop in the thermal boundary layer of the simulated Martian lithosphere if the mantle potential temperature is higher than ~1500°C. The various Martian mantle compositions yield barriers in the same locations, under matching variable conditions. There is no significant difference in barrier location over the range of accepted Martian oxygen fugacity values. Water content is the most significant influence on barrier development as it reduces the temperature of crystallization, allowing melt to rise further into the lithosphere. Our lower temperature and thicker lithosphere model runs, which are likely the most similar to modern Mars, show no permeability barrier generation. Losing the possibility of having a permeability

Barriers and Facilitators of Prostate Cancer Screening among Filipino Men in Hawai’i

Science.gov (United States)

Conde, Francisco A.; Landier, Wendy; Ishida, Dianne; Bell, Rose; Cuaresma, Charlene F.; Misola, Jane

2013-01-01

Purpose/Objectives To examine perceptions, attitudes, and beliefs regarding barriers and facilitators to prostate cancer screening, and to identify potential interventional strategies to promote prostate cancer screening among Filipino men in Hawai’i. Design Exploratory, qualitative. Setting Community-based settings in Hawai’i. Sample 20 Filipino men, 40 years old or older Methods Focus group discussions were tape-recorded, transcribed, and content analysis performed for emergent themes. Main Research Variables Perceptions regarding prostate cancer, barriers and facilitators to prostate cancer screening, and culturally-relevant interventional strategies Findings Perceptions of prostate cancer included fatalism, hopelessness, and dread. Misconceptions regarding causes of prostate cancer, such as frequency of sexual activity, were identified. Barriers to prostate cancer screening included lack of awareness of the need for screening, reticence to seek healthcare when feeling well, fear of cancer diagnosis, financial issues, time constraints, and embarrassment. Presence of urinary symptoms, personal experience with family or friend who had cancer, and receiving recommendations from a healthcare provider regarding screening were facilitators for screening. Potential culturally-relevant interventional strategies to promote prostate cancer screening included screening recommendations from health professionals and cancer survivors; radio/television commercials and newspaper articles targeted to the Filipino community; informational brochures in Tagalog, Ilocano and/or English; and interactive, educational forums facilitated by Filipino multilingual, male healthcare professionals. Conclusions Culturally-relevant interventions are needed that address barriers to prostate cancer screening participation and misconceptions about causes of prostate cancer. Implications for Nursing Findings provide a foundation for future research regarding development of interventional

SME's perceptions regarding strategic and structural entry barriers

NARCIS (Netherlands)

Lutz, Clemens; Kemp, Ron; Dijkstra, S. Gerhard

2007-01-01

Abstract Extant literature discusses a large number of different entry barriers that may hamper market efficiency or entrepreneurial activity. In practice several of these barriers cohere and stem from the same root. Factor analysis is used to identify the underlying dimensions of these barriers. 7

Barriers to discharge in an acute care medical teaching unit: a qualitative analysis of health providers’ perceptions

Directory of Open Access Journals (Sweden)

Okoniewska B

2015-02-01

Full Text Available Barbara Okoniewska,1 Maria Jose Santana,1 Horacio Groshaus,2 Svetlana Stajkovic,3 Jennifer Cowles,4 David Chakrovorty,5 William A Ghali1 1Department of Community Health Sciences, W21C Research and Innovation Centre, Institute of Public Health, 2Department of Internal Medicine, University of Calgary, 3Community Based Practice, 4Foothills Medical Centre, 5Department of Quality and Healthcare Improvement, Alberta Health Services, Calgary, AB, Canada Background: The complex process of discharging patients from acute care to community care requires a multifaceted interaction between all health care providers and patients. Poor communication in a patient’s discharge can result in post hospital adverse events, readmission, and mortality. Because of the gravity of these problems, discharge planning has been emphasized as a potential solution. The purpose of this paper is to identify communication barriers to effective discharge planning in an acute care unit of a tertiary care center and to suggest solutions to these barriers. Methods: Health care providers provided comments to a single open-ended question: “What are the communication barriers between the different health care providers that limit an effective discharge of patients from Unit 36?” We conducted qualitative thematic analysis by identifying themes related to communication barriers affecting a successful discharge process. Results: Three broad themes related to barriers to the discharge process were identified: communication, lack of role clarity and lack of resources. We also identified two themes for opportunities for improvement, ie, structure and function of the medical team and need for leadership. Conclusion: While it was evident that poor communication was an overarching barrier identified by health care providers, other themes emerged. In an effort to increase inter-team communication, “bullet rounds”, a condensed form of discharge rounds, were introduced to the medical

IDENTIFYING AND ANALYZING THE TRANSIENT AND PERMANENT BARRIERS FOR BIG DATA

OpenAIRE

SARFRAZ NAWAZ BROHI; MERVAT ADIB BAMIAH; MUHAMMAD NAWAZ BROHI

2016-01-01

Auspiciously, big data analytics had made it possible to generate value from immense amounts of raw data. Organizations are able to seek incredible insights which assist them in effective decision making and providing quality of service by establishing innovative strategies to recognize, examine and address the customers’ preferences. However, organizations are reluctant to adopt big data solutions due to several barriers such as data storage and transfer, scalability, data quality, data c...

Access to Strong Opioid Analgesics in the Context of Legal and Regulatory Barriers in Eleven Central and Eastern European Countries.

Science.gov (United States)

Vranken, Marjolein J M; Mantel-Teeuwisse, Aukje K; Schutjens, Marie-Hélène D B; Scholten, Willem K; Jünger, Saskia; Medic, Dr Rer; Leufkens, Hubert G M

2018-04-06

In 2011-2013, >95% of the global opioid analgesics consumption occurred in three regions, accounting for 15% of the world population. Despite abundant literature on barriers to access, little is known on the correlation between actual access to opioid analgesics and barriers to access, including legal and regulatory barriers. This study aimed to evaluate the correlation between access to strong opioid analgesics and barriers to access in national legislation and regulations in 11 central and eastern European countries that participated in the Access to Opioid Medication in Europe (ATOME) project. Two variables were contrasted to assess their correlation: the country level of access to strong opioid analgesics indicated by the Adequacy of Consumption Measure (ACM) and the number of potential legal and regulatory barriers identified by an external review of legislation and regulations. A linear correlation was evaluated using a squared linear correlation coefficient. Evaluation of the correlation between the ACM and the number of potential barriers produces an R 2 value of 0.023 and a correlation plot trend line gradient of -0.075, indicating no correlation between access to strong opioid analgesics and the number of potential barriers in national legislation and regulations in the countries studied. No correlation was found, which indicates that other factors besides potential legal and regulatory barriers play a critical role in withholding prescribers and patients essential pain medication in the studied countries. More research is needed toward better understanding of the complex interplay of factors that determine access to strong opioid analgesics.

Exploring physiotherapists' experiences of implementing a cognitive behavioural approach for managing low back pain and identifying barriers to long-term implementation.

Science.gov (United States)

Richmond, Helen; Hall, Amanda M; Hansen, Zara; Williamson, Esther; Davies, David; Lamb, Sarah E

2018-03-01

Our objectives were two-fold: (i) to describe physiotherapists' experiences of implementing a cognitive behavioural approach (CBA) for managing low back pain (LBP) after completing an extensive online training course (iBeST), and (ii) to identify how iBeST could be enhanced to support long-term implementation before scale up for widespread use. We conducted semi-structured interviews with 11 physiotherapists from six National Health Service departments in the Midlands, Oxfordshire and Derbyshire. Questions centred on (i) using iBeST to support implementation, (ii) what barriers they encountered to implementation and (iii) what of information or resources they required to support sustained implementation. Interviews were transcribed and thematically analysed using NVivo. Themes were categorised using the Theoretical Domains Framework (TDF). Evidence-based techniques were identified using the behaviour change technique taxonomy to target relevant TDF domains. Three themes emerged from interviews: anxieties about using a CBA, experiences of implementing a CBA, and sustainability for future implementation of a CBA. Themes crossed multiple TDF domains and indicated concerns with knowledge, beliefs about capabilities and consequences, social and professional roles, social influences, emotion, and environmental context and resources. We identified evidence-based strategies that may support sustainable implementation of a CBA for LBP in a physiotherapy setting. This study highlighted potential challenges for physiotherapists in the provision of evidence-based LBP care within the current UK NHS. Using the TDF provided the foundation to develop a tailored, evidence-based, implementation intervention to support long term use of a CBA by physiotherapists managing LBP within UK NHS outpatient departments. Copyright © 2017 Chartered Society of Physiotherapy. All rights reserved.

Identifying and Overcoming Barriers to Diabetes Management in the Elderly: An Intervention Study

National Research Council Canada - National Science Library

Munshi, Medha

2008-01-01

.... The interventions are now being implemented with help of a geriatric life specialist (GLS). Intervention by GDT includes focused strategies to overcome barriers in the areas of clinical care, education, social environment, and finances...

Investigating the Potential Barrier Function of Nanostructured Materials Formed in Engineered Barrier Systems (EBS) Designed for Nuclear Waste Isolation.

Science.gov (United States)

Cuevas, Jaime; Ruiz, Ana Isabel; Fernández, Raúl

2018-02-21

Clay and cement are known nano-colloids originating from natural processes or traditional materials technology. Currently, they are used together as part of the engineered barrier system (EBS) to isolate high-level nuclear waste (HLW) metallic containers in deep geological repositories (DGR). The EBS should prevent radionuclide (RN) migration into the biosphere until the canisters fail, which is not expected for approximately 10 3  years. The interactions of cementitious materials with bentonite swelling clay have been the scope of our research team at the Autonomous University of Madrid (UAM) with participation in several European Union (EU) projects from 1998 up to now. Here, we describe the mineral and chemical nature and microstructure of the alteration rim generated by the contact between concrete and bentonite. Its ability to buffer the surrounding chemical environment may have potential for further protection against RN migration. © 2018 The Chemical Society of Japan & Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Identification of barriers to medication adherence in a Latino population.

Science.gov (United States)

Compton, Sheryl; Haack, Sally; Phillips, Charles R

2010-12-01

Barriers to medication adherence may present differently in diverse patient populations. Because of changing U.S. demographics, health care providers will be required to identify alternative strategies for managing increasingly diverse patient populations. This pilot project identified barriers that may hinder medication adherence in a Latino population. The results of the survey may identify trends in barriers allowing for the development of interventions aimed at improving medication adherence. The study used a convenience sample of Spanish-labeled prescriptions that had not been picked up from a community pharmacy after a 2-week period to identify study subjects. Patients were contacted by phone and surveyed regarding reasons for not picking up their prescription medication. The 24-item survey instrument consisted of demographic and medication-related questions, reasons for, and associated barriers with failure to pick up medications. The most common classes of medications patients failed to pick up were chronic medications. More than 90% of the patients thought that the medication in question was helpful to them, and nearly 80% thought that the medicine was still needed. Patients cited communication issues (ie, content matter, such as when the prescription was ready), logistics, and limited hours of pharmacy operation as the primary barriers in picking up their medications, whereas nearly 40% failed to identify any barriers. Barriers identified by patients that could be improved included confusion regarding when their prescription was ready and limited hours of pharmacy operation. Most of the patients were comfortable using the American health care system. The barriers to medication adherence identified did not appear to be the result of cultural influences. This could be because the community pharmacy had bilingual staff and interpreters available for patient education and prescription processing. Alternative methods are needed to further identify reasons for

A qualitative study to understand the barriers and enablers in implementing an enhanced recovery after surgery program.

Science.gov (United States)

Pearsall, Emily A; Meghji, Zahida; Pitzul, Kristen B; Aarts, Mary-Anne; McKenzie, Marg; McLeod, Robin S; Okrainec, Allan

2015-01-01

Explore the barriers and enablers to adoption of an Enhanced Recovery after Surgery (ERAS) program by the multidisciplinary perioperative team responsible for the care of elective colorectal surgical patients. ERAS programs include perioperative interventions that when used together have led to decreased length of stay while increasing patient recovery and satisfaction. Despite the known benefits of ERAS programs, uptake remains slow. Semistructured interviews were conducted with general surgeons, anesthesiologists, and ward nurses at 7 University of Toronto-affiliated hospitals to identify potential barriers and enablers to adoption of 18 ERAS interventions. Grounded theory was used to thematically analyze the transcribed interviews. Nineteen general surgeons, 18 anesthesiologists, and 18 nurses participated. The mean time of each interview was 18 minutes. Lack of manpower, poor communication and collaboration, resistance to change, and patient factors were cited by most as barriers. Discipline-specific issues were identified although most related to resistance to change. Overall, interviewees were supportive of implementation of a standardized ERAS program and agreed that a standardized guideline based on best evidence; standardized order sets; and education of the staff, patients, and families are essential. Multidisciplinary perioperative staff supported the implementation of an ERAS program at the University of Toronto-affiliated hospitals. However, major barriers were identified, including the need for patient education, increased communication and collaboration, and better evidence for ERAS interventions. Identifying these barriers and enablers is the first step toward successfully implementing an ERAS program.

Caring for people with dementia in hospital: findings from a survey to identify barriers and facilitators to implementing best practice dementia care.

Science.gov (United States)

Tropea, Joanne; LoGiudice, Dina; Liew, Danny; Roberts, Carol; Brand, Caroline

2017-03-01

Best practice dementia care is not always provided in the hospital setting. Knowledge, attitudes and motivation, practitioner behavior, and external factors can influence uptake of best practice and quality care. The aim of this study was to determine hospital staff perceived barriers and enablers to implementing best practice dementia care. A 17-item survey was administered at two Australian hospitals between July and September 2014. Multidisciplinary staff working in the emergency departments and general medical wards were invited to participate in the survey. The survey collected data about the respondents' current role, work area, and years of experience, their perceived level of confidence and knowledge in dementia care and common symptoms of dementia, barriers and enablers to implementing best practice dementia care, job satisfaction in caring for people with dementia, and to rate the hospital's capacity and available resources to support best practice dementia care. A total of 112 survey responses were received. The environment, inadequate staffing levels and workload, time, and staff knowledge and skills were identified as barriers to implementing best practice dementia care. Most respondents rated their knowledge of dementia care and common symptoms of dementia, and confidence in recognizing whether a person has dementia, as moderate or high dementia. Approximately, half the respondents rated access to training and equipment as low or very low. The survey findings highlighted hospital staff perceived barriers to implementing best practice dementia care that can be used to inform locally tailored improvement interventions.

SPARQL-enabled identifier conversion with Identifiers.org.

Science.gov (United States)

Wimalaratne, Sarala M; Bolleman, Jerven; Juty, Nick; Katayama, Toshiaki; Dumontier, Michel; Redaschi, Nicole; Le Novère, Nicolas; Hermjakob, Henning; Laibe, Camille

2015-06-01

On the semantic web, in life sciences in particular, data is often distributed via multiple resources. Each of these sources is likely to use their own International Resource Identifier for conceptually the same resource or database record. The lack of correspondence between identifiers introduces a barrier when executing federated SPARQL queries across life science data. We introduce a novel SPARQL-based service to enable on-the-fly integration of life science data. This service uses the identifier patterns defined in the Identifiers.org Registry to generate a plurality of identifier variants, which can then be used to match source identifiers with target identifiers. We demonstrate the utility of this identifier integration approach by answering queries across major producers of life science Linked Data. The SPARQL-based identifier conversion service is available without restriction at http://identifiers.org/services/sparql. © The Author 2015. Published by Oxford University Press.

SPARQL-enabled identifier conversion with Identifiers.org

Science.gov (United States)

Wimalaratne, Sarala M.; Bolleman, Jerven; Juty, Nick; Katayama, Toshiaki; Dumontier, Michel; Redaschi, Nicole; Le Novère, Nicolas; Hermjakob, Henning; Laibe, Camille

2015-01-01

Motivation: On the semantic web, in life sciences in particular, data is often distributed via multiple resources. Each of these sources is likely to use their own International Resource Identifier for conceptually the same resource or database record. The lack of correspondence between identifiers introduces a barrier when executing federated SPARQL queries across life science data. Results: We introduce a novel SPARQL-based service to enable on-the-fly integration of life science data. This service uses the identifier patterns defined in the Identifiers.org Registry to generate a plurality of identifier variants, which can then be used to match source identifiers with target identifiers. We demonstrate the utility of this identifier integration approach by answering queries across major producers of life science Linked Data. Availability and implementation: The SPARQL-based identifier conversion service is available without restriction at http://identifiers.org/services/sparql. Contact: sarala@ebi.ac.uk PMID:25638809

Identifying Barriers in the Use of Electronic Health Records in Hawai‘i

Science.gov (United States)

Hamamura, Faith D; Hughes, Kira

2017-01-01

Hawai‘i faces unique challenges to Electronic Health Record (EHR) adoption due to physician shortages, a widespread distribution of Medically Underserved Areas and Populations (MUA/P), and a higher percentage of small independent practices. However, research on EHR adoption in Hawai‘i is limited. To address this gap, this article examines the current state of EHR in Hawai‘i, the barriers to adoption, and the future of Health Information Technology (HIT) initiatives to improve the health of Hawai‘i's people. Eight focus groups were conducted on Lana‘i, Maui, Hawai‘i Island, Kaua‘i, Moloka‘i, and O‘ahu. In these groups, a total of 51 diverse health professionals were asked about the functionality of EHR systems, barriers to use, facilitators of use, and what EHRs would look like in a perfect world. Responses were summarized and analyzed based on constant comparative analysis techniques. Responses were then clustered into thirteen themes: system compatibility, loss of productivity, poor interface, IT support, hardware/software, patient factors, education/training, noise in the system, safety, data quality concerns, quality metrics, workflow, and malpractice concerns. Results show that every group mentioned system compatibility. In response to these findings, the Health eNet Community Health Record initiative — which allows providers web-based access to patient health information from the patient's provider network— was developed as a step toward alleviating some of the barriers to sharing information between different EHRs. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) legislation will introduce a new payment model in 2017 that is partially based on EHR utilization. Therefore, more research should be done to understand EHR adoption and how this ruling will affect providers in Hawai‘i. PMID:28435756

Barriers and facilitators to recruitment of South Asians to health research: a scoping review

Science.gov (United States)

Frimer, Leora; Janssen, Patricia A; Lamers, Yvonne

2017-01-01

Objectives People of South Asian ethnicity are under-represented in health research studies. The objectives of this scoping review were to examine the barriers and facilitators to recruitment of South Asians to health research studies and to describe strategies for improving recruitment. Design Scoping review Methods Using the Arksey and O’Malley framework for scoping reviews, we comprehensively searched electronic databases (MEDLINE via PubMed, Cochrane Library, CINAHL and PsycINFO). Studies that identified barriers and facilitators to recruitment, or recruitment strategies for South Asian populations were included. Recruitment barriers, facilitators and strategies were grouped thematically and summarised narratively. Synthesis Of 1846 potentially relevant articles, 15 met the inclusion criteria and were included in the thematic synthesis. Multiple facilitators and barriers to enrolment of South Asians in health research studies were identified; these most commonly related to logistical challenges, language and cultural barriers, concerns about adverse consequences of participating and mistrust of research. Several actionable strategies were discussed, the most common being engagement of South Asian communities, demonstration of cultural competency, provision of incentives and benefits, language sensitivity through the use of translators and translated materials and the development of trust and personal relationships. Conclusion There is a growing awareness of the barriers and facilitators to recruitment of South Asian participants to health research studies. Knowledge of effective recruitment strategies and implementation during the grant funding stages may reduce the risk of poor recruitment and representation of South Asians. PMID:28576896

BENCHMARKING THE INTERACTIONS AMONG BARRIERS IN DAIRY SUPPLY CHAIN: AN ISM APPROACH

Directory of Open Access Journals (Sweden)

Rahul S Mor

2018-06-01

Full Text Available The purpose of this paper is to explore the key barriers in dairy supply chain and to analyze their interactions in the context of Indian dairy industry. A total of eight barriers have been identified through literature review and the opinions of an expert team consisting of managerial and technical experts from dairy industry and academics. A questionnaire has been developed for identified barriers and responses were collected from select dairy industries located at northern India. Interpretive structure modeling (ISM is used to analyze the interactions among barriers and to propose a structural model. Further, the importance of barriers is determined based on their driving and dependence power using MICMAC analysis. The ISM-based model allocates to 'traceability, unbalanced production line, over-processing' as key barriers, 'wastages and high production downtime' comes next. MICMAC analysis depicts one autonomous barrier, one dependent barrier and six linkage barriers. The ISM-based model and MICMAC analysis will support the decision makers in dairy industry for planning their supply chain activities in an efficient way by managing the identified barriers.

Barriers and motivators to blood and cord blood donations in young African-American women.

Science.gov (United States)

Grossman, Brenda; Watkins, Andre R; Fleming, Faye; Debaun, Michael R

2005-03-01

The primary aim of this study was to assess potential barriers and motivators to blood and cord blood donation among African-American women. A telephone survey of African-American women, ages 18-30 years, in the St. Louis metropolitan area was performed. The survey was administered by trained telemarketing personnel using a Computer-Assisted Direct Interview (CADI) system. One hundred sixty-two women were surveyed. Common barriers to blood donation were inconvenience of donor sites (19%), fear of needles (16%), and too much time required to donate (15%). Potential motivators were increasing awareness of need for blood (43%), increasing the number of convenient donor locations (19%), and encouragement by spiritual leaders to have blood drives at their church (17%). Lack of awareness was the only identified barrier to cord blood donation. Most women surveyed (88%) indicated that they definitely or probably would donate cord blood. Strategies to increase the proportion of African-American blood and cord blood donations may include educating potential donors about the process and benefits of donation to particular patient populations and engaging church leadership in supporting blood and cord blood donations.

A cross-cultural investigation into the dimensional structure and stability of the Barriers to Research and Utilization Scale (BARRIERS Scale).

Science.gov (United States)

Williams, Brett; Brown, Ted; Costello, Shane

2015-10-24

It is important that scales exhibit strong measurement properties including those related to the investigation of issues that impact evidence-based practice. The validity of the Barriers to Research Utilization Scale (BARRIERS Scale) has recently been questioned in a systematic review. This study investigated the dimensional structure and stability of the 28 item BARRIERS Scale when completed by three groups of participants from three different cross-cultural environments. Data from the BARRIERS Scale completed by 696 occupational therapists from Australia (n = 137), Taiwan (n = 413), and the United Kingdom (n = 144) were analysed using principal components analysis, followed by Procrustes Transformation. Poorly fitting items were identified by low communalities, cross-loading, and theoretically inconsistent primary loadings, and were systematically removed until good fit was achieved. The cross-cultural stability of the component structure of the BARRIERS Scale was examined. A four component, 19 item version of the BARRIERS Scale emerged that demonstrated an improved dimensional fit and stability across the three participant groups. The resulting four components were consistent with the BARRIERS Scale as originally conceptualised. Findings from the study suggest that the four component, 19 item version of the BARRIERS Scale is a robust and valid measure for identifying barriers to research utilization for occupational therapists in paediatric health care settings across Australia, United Kingdom, and Taiwan. The four component 19 item version of the BARRIERS Scale exhibited good dimensional structure, internal consistency, and stability.

Doctors' perspectives on the barriers to appropriate prescribing in older hospitalized patients: A qualitative study.

LENUS (Irish Health Repository)

Cullinan, S

2014-11-18

Older patients commonly suffer from multimorbidites and take multiple medications. As a result, these patients are more vulnerable to potentially inappropriate prescribing (PIP). PIP in older patients may result in adverse drug events and hospitalisations. However, little has been done to identify why PIP occurs. The objectives of this study were; (1) to identify hospital doctors\\' perceptions as to why PIP occurs, (2) to identify the barriers to addressing the issues identified, and (3) to determine which intervention types would be best suited to improving prescribing.

10 CFR 63.115 - Requirements for multiple barriers.

Science.gov (United States)

2010-01-01

... Requirements for multiple barriers. Demonstration of compliance with § 63.113(a) must: (a) Identify those design features of the engineered barrier system, and natural features of the geologic setting, that are... 10 Energy 2 2010-01-01 2010-01-01 false Requirements for multiple barriers. 63.115 Section 63.115...

Barriers to glaucoma case finding as perceived by optometrists in Ireland.

Science.gov (United States)

Barrett, Catriona; O'Brien, Colm; Butler, John S; Loughman, James

2018-01-01

This research was designed to provide an in-depth exploration of the perceptions of optometrists relating to the challenges of glaucoma case finding in the Irish health-care system. A survey was developed, piloted and distributed for anonymous completion by optometrists registered to practise in Ireland. The survey included 10 five-level Likert items exploring potential barriers to glaucoma detection and a free-text box for participants to comment more broadly. One hundred and ninety-nine optometrists (27 per cent of registrants) responded to the survey. Among the barriers identified, there was notable agreement (71 per cent) with the need for extra training on glaucoma detection. Logistic regression showed that optometrists without postgraduate qualifications were more likely to agree with the need for extra training (OR 3.2, 95 per cent CI 1.3-8.1). Respondents largely agreed (61 per cent) that patient unwillingness to pay additional fees for supplementary glaucoma-specific tests was also a barrier. Appointment times of less than 30 minutes were significantly associated with six of the 10 proposed barriers to glaucoma detection. A logistic regression analysis (n = 179) confirmed that the time allotted per appointment was a significant predictor of the agreement time of optometrists as a barrier (χ 2 [1] = 13.52, p glaucoma indicates that optometrists wishing to increase their scope of practice in the new legislative environment in Ireland may more actively seek training in areas of interest. The responses also indicate a lack of funding for the level of diagnostic testing required for accurate glaucoma diagnosis. Recent increases in the state's eye examination fees look likely to address the identified time and financial barriers to glaucoma detection in Ireland. Future work should look to analyse the effects of increased funding on optometric case finding for glaucoma. © 2017 Optometry Australia.

Engineered barrier system and waste package design concepts for a potential geologic repository at Yucca Mountain

International Nuclear Information System (INIS)

Short, D.W.; Ruffner, D.J.; Jardine, L.J.

1991-10-01

We are using an iterative process to develop preliminary concept descriptions for the Engineered Barrier System and waste-package components for the potential geologic repository at Yucca Mountain. The process allows multiple design concepts to be developed subject to major constraints, requirements, and assumptions. Involved in the highly interactive and interdependent steps of the process are technical specialists in engineering, metallic and nonmetallic materials, chemistry, geomechanics, hydrology, and geochemistry. We have developed preliminary design concepts that satisfy both technical and nontechnical (e.g., programmatic or policy) requirements

Large magnetocurrents in double-barrier tunneling transistors

International Nuclear Information System (INIS)

Lee, J.H.; Jun, K.-I.; Shin, K.-H.; Park, S.Y.; Hong, J.K.; Rhie, K.; Lee, B.C.

2005-01-01

Magnetic tunneling transistors (MTT) with double tunneling barriers are fabricated. The structure of the transistor is AFM/FM/I/FM/I/FM/AFM, and ferromagnetic layers serve as the emitter, base and collector. This double-barrier tunneling transistor (DBTT) has an advantage of controlling the potential between the base and collector, compared to the Schottky-barrier-based base and collector of MTT. We found that the collector current density of DBTT is at least 10 3 times larger than that of conventional MTT, since tunneling through AlO x barrier provides much larger current density than that through Schottky barrier

Assessment of Barriers to Providing Introductory Pharmacy Practice Experiences (IPPEs in the Hospital Setting

Directory of Open Access Journals (Sweden)

Matthew J Gibson

2016-07-01

Full Text Available Objectives: The primary objective of the study is to identify the barriers to providing Introductory Pharmacy Practice Experiences (IPPEs in the hospital setting. Methods: Potential barriers to IPPEs were identified via literature review and interviews with current IPPE preceptors from various institutions. Based on this information, an electronic survey was developed and distributed to IPPE preceptors in order to assess student, preceptor, logistical and college or school of pharmacy related barriers that potentially exist for providing IPPE in the hospital setting. Results: Sixty-eight of the 287 eligible survey respondents (24% completed the electronic survey. Seventy-six percent of respondents agreed or strongly agreed that available time was a barrier to precepting IPPE students even though a majority of respondents reported spending a third or more of their day with an IPPE student when on rotation. Seventy-three percent of respondents disagreed or strongly disagreed that all preceptors have consistent performance expectations for students, while just 46% agreed or strongly agreed that they had adequate training to precept IPPEs. Sixty-five percent of respondents agreed that IPPE students have the ability to be a participant in patient care and 70% of preceptors believe that IPPE students should be involved in patient care. Conclusions: Conducting IPPEs in the institutional setting comes with challenges. Based on the results of this study, experiential directors and colleges/schools of pharmacy could make a positive impact on the quality and consistency of IPPEs by setting student expectations and training preceptors on appropriate and consistent expectations for students.   Type: Original Research

Barriers Approach to Innovation in Academic Libraries

Directory of Open Access Journals (Sweden)

Fu-Hsuan Chuang

2016-11-01

Full Text Available Innovation in academic libraries is not a brand new issue. Academic libraries can benefit from successful innovation, since innovation is a key contributor to gaining and sustaining competitive advantage for survival. Building on two case studies, 28 participants from leadership teams to practitioners are involved, the qualitative findings identified the specific two types of barriers that academic libraries face by applying a barriers approach to innovation, that’s, environmental and organizational barriers. Especially, seven dimensions of two types of barriers to innovation are found.

Maternally Perceived Barriers to and Facilitators of Establishing and Maintaining Tooth-Brushing Routines with Infants and Preschoolers

Directory of Open Access Journals (Sweden)

Sarah Elison

2014-07-01

Full Text Available Establishing effective toothbrushing routines using fluoridated toothpaste in infancy has been suggested as important to dental health throughout childhood and into adulthood. However, previous studies have revealed a number of potential barriers to, and facilitators of caregivers ability to establish early dyadic toothbrushing routines with pre-schoolers. However, as yet no qualitative research has been conducted to ascertain potential barriers and facilitators of the earliest dyadic toothbrushing in infancy, and nor has any previous research specifically focused on how novice mothers of first-born infants and preschoolers manage this task. This study therefore outlines findings from a qualitative interview study with first-time mothers of children aged 24–30 months (n = 16 exploring perceived barriers to and facilitators of early dyadic toothbrushing routines with infants and preschoolers. A number of key themes were identified from interview transcripts and an ‘ecological’ approach conceptualised maternally perceived barriers to and facilitators of dyadic toothbrushing. Proximal influences were found to be located within the caregiver-child relationship (‘micro-system’, including parental cognitions (e.g., PSE, parental behaviours (e.g., parenting practices and infant and preschooler temperament and behaviours (e.g., tantrums. Distal factors were also identified as relevant to the establishment and maintenance of these routines, such as social support (‘exosystem’ and family history of tooth-brushing (‘chronosystem’.

Barriers and Facilitators of Partner Treatment of Chlamydia: A Qualitative Investigation with Prescribers and Community Pharmacists

Directory of Open Access Journals (Sweden)

Helen Wood

2018-02-01

Full Text Available Chlamydia trachomatis is the most frequently-notified sexually transmitted infection in Australia. Effective and timely partner treatment of chlamydia is essential to reduce overall prevalence and the burden of infection. Currently in most of Australia, the only avenue for partner treatment of chlamydia (“standard partner therapy” is a tedious, and often inconvenient, process. The barriers and facilitators of standard partner therapy, and newer models of accelerated partner therapy (APT, need to be identified in the Australian setting. Additionally, the potential role of community pharmacists need to be explored. Semi-structured interview guides for two key stakeholder groups (prescribers and pharmacists were developed and piloted. Eleven prescribers (general practitioners, sexual health clinicians and nurse practitioners and twelve pharmacists practicing in the Perth metropolitan region were interviewed. Key reported barriers to standard partner therapy were lack of or delayed chlamydia testing. Key facilitators included ability to test and educate sexual partner. Key barriers for APT included prescribers’ legal responsibility and potential for medication-related adverse effects. Healthcare provider consultation and chlamydia testing were seen as potential facilitators of APT. Pharmacists were receptive to the idea of expanding their role in chlamydia treatment, however, barriers to privacy must be overcome in order to be acceptable to prescribers and pharmacists.

Enershield : energy saving air barriers

Energy Technology Data Exchange (ETDEWEB)

Hallihan, D. [Enershield Industries Ltd., Edmonton, AB (Canada)

2008-07-01

Enershield Industries is a leader in air barrier technology and provides solution for the Canadian climate. This presentation described the advantages of air barriers and the impact of rising energy costs. An air barrier is used to separate areas of differing environments and makes existing building systems more efficient. This presentation discussed how an air barrier works. It also identified how Enershield Industries calculates energy savings. It described air barrier applications and those who use barrier technology. These include the commercial and industrial sector as well as the personnel and retail sector. Barrier technology can be used for cold storage; vehicle and equipment washes; food processing; and environmental separation. Features and benefits such as the ability to create seal, acoustic insulation, and long term durability were also discussed. Last, the presentation addressed model selection and design criteria issues. Design criteria that were presented included a discussion of acoustic installation, articulating nozzles, scroll cased fans, and structural frame. Other design criteria presented were galvanized frames, telescopic sliders, and off the shelf parts. It was concluded that the ability to reduce energy consumption and enhance employee/client comfort is beneficial to the employer as well as to the employee. figs.

Richards Barrier LA Reference Design Feature Evaluation

International Nuclear Information System (INIS)

N.E. Kramer

1999-01-01

The Richards Barrier is one of the design features of the repository to be considered for the License Application (LA), Richards was a soil scientist who first described the diversion of moisture between two materials with different hydrologic properties. In this report, a Richards Barrier is a special type of backfill with a fine-grained material (such as sand) overlaying a coarse-grained material (such as gravel). Water that enters an emplacement drift will first encounter the fine-grained material and be transported around the coarse-grained material covering the waste package, thus protecting the waste package from contact with most of the groundwater. The objective of this report is to discuss the benefits and liabilities to the repository by the inclusion of a Richards Barrier type backfill in emplacement drifts. The Richards Barrier can act as a barrier to water flow, can reduce the waste package material dissolution rate, limit mobilization of the radionuclides, and can provide structural protection for the waste package. The scope of this report is to: (1) Analyze the behavior of barrier materials following the intrusion of groundwater for influxes of 1 to 300 mm per year. The report will demonstrate diversion of groundwater intrusions into the barrier over an extended time period when seismic activity and consolidation may cause the potential for liquefaction and settlement of the Richards Barrier. (2) Review the thermal effects of the Richards Barrier on material behavior. (3) Analyze the effect of rockfall on the performance of the Richards Barrier and the depth of the barrier required to protect waste packages under the barrier. (4) Review radiological and heating conditions on placement of multiple layers of the barrier. Subsurface Nuclear Safety personnel will perform calculations to determine the radiation reduction-time relationship and shielding capacity of the barrier. (5) Evaluate the effects of ventilation on cooling of emplacement drifts and

Barriers to the implementation and uptake of simulation-based training programs in general surgery: a multinational qualitative study.

Science.gov (United States)

Hosny, Shady G; Johnston, Maximilian J; Pucher, Philip H; Erridge, Simon; Darzi, Ara

2017-12-01

Despite evidence demonstrating the advantages of simulation training in general surgery, it is not widely integrated into surgical training programs worldwide. The aim of this study was to identify barriers and facilitators to the implementation and uptake of surgical simulation training programs. A multinational qualitative study was conducted using semi-structured interviews of general surgical residents and experts. Each interview was audio recorded, transcribed verbatim, and underwent emergent theme analysis. All data were anonymized and results pooled. A total of 37 individuals participated in the study. Seventeen experts (Program Directors and Surgical Attendings with an interest in surgical education) and 20 residents drawn from the United States, Canada, United Kingdom, France, and Japan were interviewed. Barriers to simulation-based training were identified based on key themes including financial cost, access, and translational benefit. Participants described cost (89%) and access (76%) as principal barriers to uptake. Common facilitators included a mandatory requirement to complete simulation training (78%) and on-going assessment of skills (78%). Participants felt that simulation training could improve patient outcomes (76%) but identified a lack of evidence to demonstrate benefit (38%). There was a consensus that simulation training has not been widely implemented (70%). There are multiple barriers to the implementation of surgical simulation training programs, however, there is agreement that these programs could potentially improve patient outcomes. Identifying these barriers enable the targeted use of facilitators to deliver simulation training programs. Copyright © 2017 Elsevier Inc. All rights reserved.

Quantum coherence in the reflection of above barrier wavepackets

Science.gov (United States)

Petersen, Jakob; Pollak, Eli

2018-02-01

The quantum phenomenon of above barrier reflection is investigated from a time-dependent perspective using Gaussian wavepackets. The transition path time distribution, which in principle is experimentally measurable, is used to study the mean flight times ⟨t⟩R and ⟨t⟩T associated with the reflection and the transmission over the barrier paying special attention to their dependence on the width of the barrier. Both flight times, and their difference Δt, exhibit two distinct regimes depending on the ratio of the spatial width of the incident wavepacket and the length of the barrier. When the ratio is larger than unity, the reflection and transmission dynamics are coherent and dominated by the resonances above the barrier. The flight times ⟨t⟩R/T and the flight time difference Δt oscillate as a function of the barrier width (almost in phase with the transmission probability). These oscillations reflect a momentum filtering effect related to the coherent superposition of the reflected and transmitted waves. For a ratio less than unity, the barrier reflection and transmission dynamics are incoherent and the oscillations are absent. The barrier width which separates the coherent and incoherent regimes is identified analytically. The oscillatory structure of the time difference Δt as a function of the barrier width in the coherent regime is absent when considered in terms of the Wigner phase time delays for reflection and transmission. We conclude that the Wigner phase time does not correctly describe the temporal properties of above barrier reflection. We also find that the structure of the reflected and transmitted wavepackets depends on the coherence of the process. In the coherent regime, the wavepackets can have an overlapping peak structure, but the peaks are not fully resolved. In the incoherent regime, the wavepackets split in time into distinct separated Gaussian like waves, each one reflecting the number of times the wavepacket crosses the barrier

Developing a survey of barriers and facilitators to recruitment in randomized controlled trials

Directory of Open Access Journals (Sweden)

Kaur Geetinder

2012-11-01

Full Text Available Abstract Background Recruitment to randomized controlled trials is known to be challenging. It is important to understand and identify predictors of good or poor accrual to a clinical trial so that appropriate strategies can be put in place to overcome these problems and facilitate successful trial completion. We have developed a survey tool to establish the recruitment experience of clinical teams regarding facilitators and barriers to recruitment in a clinical trial and describe herein the method of developing the questionnaire. Methods A literature search was conducted to identify studies that have explored facilitators and barriers to recruitment, and a list of potential factors affecting recruitment to a clinical trial was generated. These factors were categorized in terms relating to the (i trial, (ii site, (iii patient, (iv clinical team, (v information and consent and (vi study team. A list was provided for responders to grade these factors as weak, intermediate or strong facilitators or barriers to recruitment. Results A web-based survey questionnaire was developed. This survey was designed to establish the recruitment experience of clinical teams with regard to the perceived facilitators and barriers to recruitment, to identify strategies applied to overcome these problems, and to obtain suggestions for change in the organization of future trials. The survey tool can be used to assess the recruitment experience of clinical teams in a single/multicenter trial in any clinical setting or speciality involving adults or children either in an ongoing trial or at trial completion. The questionnaire is short, easy to administer and to complete, with an estimated completion time of 11 minutes. Conclusions We have presented a robust methodology for developing this survey tool that provides an evidence-based list of potential factors that can affect recruitment to a clinical trial. We recommend that all clinical trialists should consider using

Why is it not working? Identifying barriers to the therapy of paediatric obesity in an intercultural setting.

Science.gov (United States)

Ciupitu, Carmen Cristina; Babitsch, Birgit

2011-06-01

Given the high overweight prevalence among children with a migration background in Germany, this paper describes barriers to the treatment of paediatric obesity in a specialized clinic providing services to an ethnically diverse population. In a cross-sectional mixed-method design, a two-week participant observation was followed by a cultural competence survey among the healthcare professionals employed at the clinic. The present study revealed barriers related to all categories of social actors involved in the therapy process. A major difficulty encountered by providers when working with ethnically diverse patients was the lack of mutual understanding, often associated with language barriers. Language barriers were most prevalent between providers and ethnically diverse mothers. Targeted education programs for adults (particularly women) with a migration background and cultural competence training for healthcare providers are needed in Germany. Special attention should be paid to scheduling appointments and enhancing patients' engagement in the therapy process.

Barrier inhomogeneities limited current and 1/f noise transport in GaN based nanoscale Schottky barrier diodes

Science.gov (United States)

Kumar, Ashutosh; Heilmann, M.; Latzel, Michael; Kapoor, Raman; Sharma, Intu; Göbelt, M.; Christiansen, Silke H.; Kumar, Vikram; Singh, Rajendra

2016-01-01

The electrical behaviour of Schottky barrier diodes realized on vertically standing individual GaN nanorods and array of nanorods is investigated. The Schottky diodes on individual nanorod show highest barrier height in comparison with large area diodes on nanorods array and epitaxial film which is in contrast with previously published work. The discrepancy between the electrical behaviour of nanoscale Schottky diodes and large area diodes is explained using cathodoluminescence measurements, surface potential analysis using Kelvin probe force microscopy and 1ow frequency noise measurements. The noise measurements on large area diodes on nanorods array and epitaxial film suggest the presence of barrier inhomogeneities at the metal/semiconductor interface which deviate the noise spectra from Lorentzian to 1/f type. These barrier inhomogeneities in large area diodes resulted in reduced barrier height whereas due to the limited role of barrier inhomogeneities in individual nanorod based Schottky diode, a higher barrier height is obtained. PMID:27282258

Revival of cloaking effect in a driven bilayer graphene vector barrier

Science.gov (United States)

Maiti, S.; Panigrahi, A.; Biswas, R.; Sinha, C.

2018-05-01

Transmission profiles in bilayer graphene are studied theoretically through a rectangular vector potential (magnetic) barrier with and without the presence of an oscillatory potential. Unlike the electrostatic barrier, the Fano resonances (FR) are noted in the transmission spectra both for normal and glancing incidences due to non-conservation of chirality for a static vector barrier. The results for normal incidence indicate that the cloaking effect is a manifestation of the chirality conservation in charge transport through bilayer graphene scalar barriers. It is also noted that the aforesaid FR for a static vector barrier might disappear (photon induced electronic cloaking effect) due to the predominant photon exchange processes in presence of an external oscillating potential. The study of Fano resonances in transmission spectrum is in high demand in respect of localization of charge carriers in graphene nano structures for its potential applications in digital device fabrications.

A House Full of Trap Doors. Identifying barriers to resilient drylands in the toolbox of pastoral development

Science.gov (United States)

Krätli, Saverio; Kaufmann, Brigitte; Roba, Hassan; Hiernaux, Pierre; Li, Wenjun; Easdale, Marcos H.; Huelsebusch, Christian

2016-04-01

The theoretical understanding of drylands and pastoral systems has long undergone a U-turn from the initial perspective rooted in classical ecology. The shift has hinged on the way to represent asymmetric variability, from a disturbance in an ecosystem that naturally tends towards uniformity and stability, to a constitutive part of a dynamic ecosystem. Operationalising the new reversed perspective, including the need to update the methodological infrastructure to plan around drylands and pastoral development, remains a challenge. Underlying assumptions about stability and uniformity, that are a legacy of equilibrium thinking, remain embedded in the toolbox of pastoral development, starting from the technical language to talk about the subject. This effectively gets in the way of operationalizing state of the art understanding of pastoral systems and the drylands. Unless these barriers are identified, unpacked and managed, even the present calls for increasing the rigour and intensity of data collection - for example as part of the ongoing global process to revise and improve agricultural data - cannot deliver a realistic representation of pastoral systems in statistics and policy making. This contribution presents the case for understanding variability as an asset, and provides a range of examples of methodological barriers, including classifications of livestock systems, scale of observation, key parameters in animal production, indicators in the measurement of ecological efficiency, concepts of ecological fragility, natural resources, and pastoral risk. The need to update this legacy is a pressing challenge for policy makers concerned with both modernisation and resilience in the drylands.

Demand-side mitigation options of the agricultural sector: potential, barriers and ways forward

Directory of Open Access Journals (Sweden)

Brunelle Thierry

2017-01-01

Full Text Available This paper reviews the potential and barriers of demand-side mitigation options in the agricultural sector based on the recent academic literature and on a survey conducted on a sample of 788 respondents living in France. The mitigation potential of such measures as reducing losses in the food supply chain and shifting diets toward less animal products is estimated to be particularly high, higher, in particular, than supply-side mitigation options. However, to ensure that these measures do not entail a reduction in protein intake, these estimations should consider both caloric and protein units, and take into account the digestibility differentials between protein sources. Our survey shows that people are relatively reluctant to eat more sustainably, preferring to reduce their emissions in other areas such as housing or equipment. This relative reluctance is mainly due to individual perceptions linked to health concerns, taste or habits. Some obstacles could easily be overcome through well-designed policies aiming to, for example, advertise a lower consumption of red meat for health benefits. National governments are, however, rather inactive on this topic, leaving the initiative to the civil society.

The blood-tendon barrier: identification and characterisation of a novel tissue barrier in tendon blood vessels

Directory of Open Access Journals (Sweden)

C Lehner

2016-05-01

Full Text Available Tissue barriers function as “gate keepers” between different compartments (usually blood and tissue and are formed by specialised membrane-associated proteins, localising to the apicolateral plasma membrane domain of epithelial and endothelial cells. By sealing the paracellular space, the free diffusion of solutes and molecules across epithelia and endothelia is impeded. Thereby, tissue barriers contribute to the establishment and maintenance of a distinct internal and external environment, which is crucial during organ development and allows maintenance of an organ-specific homeostatic milieu. So far, various epithelial and endothelial tissue barriers have been described, including the blood-brain barrier, the blood-retina barrier, the blood-testis barrier, the blood-placenta barrier, and the cerebrospinal fluid (CSF-brain barrier, which are vital for physiological function and any disturbance of these barriers can result in severe organ damage or even death. Here, we describe the identification of a novel barrier, located in the vascular bed of tendons, which we term the blood-tendon barrier (BTB. By using immunohistochemistry, transmission electron microscopy, and tracer studies we demonstrate the presence of a functional endothelial barrier within tendons restricting the passage of large blood-borne molecules into the surrounding tendon tissue. We further provide in vitro evidence that the BTB potentially contributes to the creation of a distinct internal tissue environment impacting upon the proliferation and differentiation of tendon-resident cells, effects which might be fundamental for the onset of tendon pathologies.

Self-organization and forcing templates in coastal barrier response to storms

Science.gov (United States)

Lazarus, E.

2015-12-01

When a storm event pushes water up and over a coastal barrier, cross-shore flow transports sediment from the barrier face to the back-barrier environment. This natural physical process is called "overwash", and "washover" is the sedimentary deposit it forms. Overwash and washover support critical coastal habitats, and enable barriers to maintain their height and width relative to rising sea level. On developed barrier coasts, overwash constitutes a natural hazard, which sea-level rise will exacerbate. Overwash is also a prerequisite for barrier breaching and coastal flooding. Predicting occurrence and characteristics of overwash and washover has significant societal value. Hazard models typically assume that pre-storm barrier morphology determines how the barrier changes during a storm. However, classic work has documented the absence of a relationship between pre/post-storm topography in some cases, and has also identified rhythmic patterns in washover alongshore. Previous explanations for these spatial patterns have looked to forcing templates, forms that get imprinted in the barrier shape. An alternative explanation is that washover patterns self-organize, emerging from feedbacks between water flow and sediment transport. Self-organization and forcing templates are often framed as mutually exclusive, but patterns likely form across a continuum of conditions. Here, I use data from a new physical experiment to suggest that spatial patterns in washover can self-organize within the limit of a forcing template of some critical "strength", beyond which pre/post-storm morphologies are highly correlated. Quantifying spatial patterns in washover deposits opens exciting questions regarding coastal morphodynamic response to storms. Measurement of relative template strength over extended spatial (and temporal) scales has the potential to improve hazard assessment and prediction, particularly where template strength is low and self-organization dominates barrier change.

Computing the Free Energy Barriers for Less by Sampling with a Coarse Reference Potential while Retaining Accuracy of the Target Fine Model.

Science.gov (United States)

Plotnikov, Nikolay V

2014-08-12

Proposed in this contribution is a protocol for calculating fine-physics (e.g., ab initio QM/MM) free-energy surfaces at a high level of accuracy locally (e.g., only at reactants and at the transition state for computing the activation barrier) from targeted fine-physics sampling and extensive exploratory coarse-physics sampling. The full free-energy surface is still computed but at a lower level of accuracy from coarse-physics sampling. The method is analytically derived in terms of the umbrella sampling and the free-energy perturbation methods which are combined with the thermodynamic cycle and the targeted sampling strategy of the paradynamics approach. The algorithm starts by computing low-accuracy fine-physics free-energy surfaces from the coarse-physics sampling in order to identify the reaction path and to select regions for targeted sampling. Thus, the algorithm does not rely on the coarse-physics minimum free-energy reaction path. Next, segments of high-accuracy free-energy surface are computed locally at selected regions from the targeted fine-physics sampling and are positioned relative to the coarse-physics free-energy shifts. The positioning is done by averaging the free-energy perturbations computed with multistep linear response approximation method. This method is analytically shown to provide results of the thermodynamic integration and the free-energy interpolation methods, while being extremely simple in implementation. Incorporating the metadynamics sampling to the algorithm is also briefly outlined. The application is demonstrated by calculating the B3LYP//6-31G*/MM free-energy barrier for an enzymatic reaction using a semiempirical PM6/MM reference potential. These modifications allow computing the activation free energies at a significantly reduced computational cost but at the same level of accuracy compared to computing full potential of mean force.

Piezotronically modified double Schottky barriers in ZnO varistors.

Science.gov (United States)

Raidl, Nadine; Supancic, Peter; Danzer, Robert; Hofstätter, Michael

2015-03-25

Double Schottky barriers in ZnO are modified piezotronically by the application of mechanical stresses. New effects such as the enhancement of the potential barrier height and the increase or decrease of the natural barrier asymmetry are presented. Also, an extended model for the piezotronic modification of double Schottky barriers is given. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Barriers to clinical adoption of next generation sequencing: Perspectives of a policy Delphi panel

Directory of Open Access Journals (Sweden)

Donna A. Messner

2016-09-01

Full Text Available This research aims to inform policymakers by engaging expert stakeholders to identify, prioritize, and deliberate the most important and tractable policy barriers to the clinical adoption of next generation sequencing (NGS. A 4-round Delphi policy study was done with a multi-stakeholder panel of 48 experts. The first 2 rounds of online questionnaires (reported here assessed the importance and tractability of 28 potential barriers to clinical adoption of NGS across 3 major policy domains: intellectual property, coverage and reimbursement, and FDA regulation. We found that: 1 proprietary variant databases are seen as a key challenge, and a potentially intractable one; 2 payer policies were seen as a frequent barrier, especially a perceived inconsistency in standards for coverage; 3 relative to other challenges considered, FDA regulation was not strongly perceived as a barrier to clinical use of NGS. Overall the results indicate a perceived need for policies to promote data-sharing, and a desire for consistent payer coverage policies that maintain reasonably high standards of evidence for clinical utility, limit testing to that needed for clinical care decisions, and yet also flexibly allow for clinician discretion to use genomic testing in uncertain circumstances of high medical need.

A systematic review of barriers to medication adherence in the elderly: looking beyond cost and regimen complexity.

Science.gov (United States)

Gellad, Walid F; Grenard, Jerry L; Marcum, Zachary A

2011-02-01

Medication nonadherence is a common problem among the elderly. To conduct a systematic review of the published literature describing potential nonfinancial barriers to medication adherence among the elderly. The PubMed and PsychINFO databases were searched for articles published in English between January 1998 and January 2010 that (1) described "predictors," "facilitators," or "determinants" of medication adherence or that (2) examined the "relationship" between a specific barrier and adherence for elderly patients (ie, ≥65 years of age) in the United States. A manual search of the reference lists of identified articles and the authors' files and recent review articles was conducted. The search included articles that (1) reviewed specific barriers to medication adherence and did not solely describe nonmodifiable predictors of adherence (eg, demographics, marital status), (2) were not interventions designed to address adherence, (3) defined adherence or compliance and specified its method of measurement, and (4) involved US participants only. Nonsystematic reviews were excluded, as were studies that focused specifically on people who were homeless or substance abusers, or patients with psychotic disorders, tuberculosis, or HIV infection, because of the unique circumstances that surround medication adherence for each of these populations. Nine studies met inclusion criteria for this review. Four studies used pharmacy records or claims data to assess adherence, 2 studies used pill count or electronic monitoring, and 3 studies used other methods to assess adherence. Substantial heterogeneity existed among the populations studied as well as among the measures of adherence, barriers addressed, and significant findings. Some potential barriers (ie, factors associated with nonadherence) were identified from the studies, including patient-related factors such as disease-related knowledge, health literacy, and cognitive function; drug-related factors such as adverse

A Survey to Assess Barriers to Urban Teaching Careers

Science.gov (United States)

Creasey, Gary; Mays, Jennifer; Lee, Robert; D'Santiago, Verenice

2016-01-01

The "Urban Teaching Barriers" survey was created to assess barriers to urban teaching careers. Pre-service teachers (N = 377) completed this instrument, along with questionnaires that assessed urban teaching intentions and urban teaching self-efficacy. Six barrier domains were identified that tapped concerns over (a) lack of resources,…

Barriers to colorectal cancer screening in community health centers: A qualitative study

Directory of Open Access Journals (Sweden)

Fletcher Robert H

2008-02-01

Full Text Available Abstract Background Colorectal cancer screening rates are low among disadvantaged patients; few studies have explored barriers to screening in community health centers. The purpose of this study was to describe barriers to/facilitators of colorectal cancer screening among diverse patients served by community health centers. Methods We identified twenty-three outpatients who were eligible for colorectal cancer screening and their 10 primary care physicians. Using in-depth semi-structured interviews, we asked patients to describe factors influencing their screening decisions. For each unscreened patient, we asked his or her physician to describe barriers to screening. We conducted patient interviews in English (n = 8, Spanish (n = 2, Portuguese (n = 5, Portuguese Creole (n = 1, and Haitian Creole (n = 7. We audiotaped and transcribed the interviews, and then identified major themes in the interviews. Results Four themes emerged: 1 Unscreened patients cited lack of trust in doctors as a barrier to screening whereas few physicians identified this barrier; 2 Unscreened patients identified lack of symptoms as the reason they had not been screened; 3 A doctor's recommendation, or lack thereof, significantly influenced patients' decisions to be screened; 4 Patients, but not their physicians, cited fatalistic views about cancer as a barrier. Conversely, physicians identified competing priorities, such as psychosocial stressors or comorbid medical illness, as barriers to screening. In this culturally diverse group of patients seen at community health centers, similar barriers to screening were reported by patients of different backgrounds, but physicians perceived other factors as more important. Conclusion Further study of these barriers is warranted.

BSN completion barriers, challenges, incentives, and strategies.

Science.gov (United States)

Duffy, Marie T; Friesen, Mary Ann; Speroni, Karen Gabel; Swengros, Diane; Shanks, Laura A; Waiter, Pamela A; Sheridan, Michael J

2014-04-01

The objectives of this study were to explore RN perceptions regarding barriers/challenges and incentives/supports for BSN completion and identify recommendations to increase RN BSN completion. The Institute of Medicine's 2011 The Future of Nursing report recommended the proportion of RNs with a BSN increase to 80% by 2020. This qualitative study included 41 RNs who participated in 1 of 6 focus groups based on their BSN completion status. Primary themes were sacrifices, barriers/challenges, incentives/supports, value, how to begin, and pressure. Primary BSN completion barriers/challenges were work-life balance and economic issues. Incentives/supports identified were financial compensation, assistance from employer and academic institution, and encouragement from family. Institutional strategies recommended for increasing BSN completion rates were improved access to education and financial support facilitated by collaboration between hospitals and academic institutions. Exploring RN barriers/challenges and incentives/supports for BSN completion can lead to implementation of institutional strategies, such as tuition reimbursement and academic collaboration.

Gene expression profile identifies potential biomarkers for human intervertebral disc degeneration.

Science.gov (United States)

Guo, Wei; Zhang, Bin; Li, Yan; Duan, Hui-Quan; Sun, Chao; Xu, Yun-Qiang; Feng, Shi-Qing

2017-12-01

The present study aimed to reveal the potential genes associated with the pathogenesis of intervertebral disc degeneration (IDD) by analyzing microarray data using bioinformatics. Gene expression profiles of two regions of the intervertebral disc were compared between patients with IDD and controls. GSE70362 containing two groups of gene expression profiles, 16 nucleus pulposus (NP) samples from patients with IDD and 8 from controls, and 16 annulus fibrosus (AF) samples from patients with IDD and 8 from controls, was downloaded from the Gene Expression Omnibus database. A total of 93 and 114 differentially expressed genes (DEGs) were identified in NP and AF samples, respectively, using a limma software package for the R programming environment. Gene Ontology (GO) function enrichment analysis was performed to identify the associated biological functions of DEGs in IDD, which indicated that the DEGs may be involved in various processes, including cell adhesion, biological adhesion and extracellular matrix organization. Pathway enrichment analysis using the Kyoto Encyclopedia of Genes and Genomes (KEGG) demonstrated that the identified DEGs were potentially involved in focal adhesion and the p53 signaling pathway. Further analysis revealed that there were 35 common DEGs observed between the two regions (NP and AF), which may be further regulated by 6 clusters of microRNAs (miRNAs) retrieved with WebGestalt. The genes in the DEG‑miRNA regulatory network were annotated using GO function and KEGG pathway enrichment analysis, among which extracellular matrix organization was the most significant disrupted biological process and focal adhesion was the most significant dysregulated pathway. In addition, the result of protein‑protein interaction network modules demonstrated the involvement of inflammatory cytokine interferon signaling in IDD. These findings may not only advance the understanding of the pathogenesis of IDD, but also identify novel potential

Identifying potentially cost effective chronic care programs for people with COPD

NARCIS (Netherlands)

L.M.G. Steuten (Lotte); K.M.M. Lemmens (Karin); A.P. Nieboer (Anna); H.J.M. Vrijhoef (Hubertus)

2009-01-01

textabstractObjective: To review published evidence regarding the cost effectiveness of multi-component COPD programs and to illustrate how potentially cost effective programs can be identified. Methods: Systematic search of Medline and Cochrane databases for evaluations of multicomponent disease

Implementation of renewable technologies - Opportunities and barriers. Zimbabwe country study

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-07-01

Renewable Energy Technologies (RETS) have over the years become an integral part of the energy supply chain in most developed countries. Recent projections show that 13.5% of the world's primary energy supply comes from renewable and this figure has an aggregated annual growth rate of 16%. Wind has the highest annual growth rate of 22% while the least annual growth rate of 2% is for hydropower. The main push for renewable like wind in the OECD countries are environmental concerns and the business aspect in power generation. The situation is however completely different in Africa, where the thrust for RETs is developmental based. Although the continent has abundant renewable energy resources like solar, biomass, wind and hydro potential, they have remained largely unexploited. Several efforts have been made to help African countries like Zimbabwe to exploit such resources. The main objectives of this country study included review of Zimbabwe's development of past RETs, establish barriers related lessons learnt from such projects and currently running RETs projects, identify barriers experienced by other projects and then select a few barrier removal projects and then develop them with the help of all stake holders in the country. The methodology of this study involved a review of past RETs projects to establish barriers faced and barriers related lessons learnt. An examination of the policy instruments related to RETs was done to establish how they promote the dissemination of the technologies as well as their adequacy. A survey of all possible RETs projects in the country was carried out and in this survey the end-users were visited and interviewed by the research team. An initial workshop, which was attended by all stake holders, was held in November 1999. An Advisory committee on RETs in Zimbabwe was then set up comprising of various stake holders from government, the private sector, research institutions, interviewed end-users and the NGO community

Barriers and facilitators among health professionals in primary care to prevention of cardiometabolic diseases: a systematic review.

NARCIS (Netherlands)

Wandell, P.E.; Waard, A.K.M. de; Holzmann, M.J.; Gornitzki, C.; Lionis, C.; Wit, N.J. de; Søndergaard, J.; Sønderlund, A.L.; Král, N.; Seifert, B.; Korevaar, J.C.; Schellevis, F.G.; Carlsson, A.C.

2018-01-01

The aim of this study is to identify potential facilitators and barriers for health care professionals to undertake selective prevention of cardiometabolic diseases (CMD) in primary health care. We developed a search string for Medline, Embase, Cinahl and PubMed. We also screened reference lists of

Integrated control of the wastewater system – potentials and barriers

DEFF Research Database (Denmark)

Mollerup, Ane Loft; Grum, Morten; Muschalla, Dirk

2013-01-01

Applying integrated control to a sewer system and wastewater treatment plant often leads to additional benefits for both systems when compared to controlling them independently. However, barriers such as a lack of incentive for utilities to put this type of control in place mean that in practice...

Evaluation of engineered barriers at the Idaho National Engineering and Environmental Laboratory

International Nuclear Information System (INIS)

Bhatt, R.N.; Porro, I.

1998-03-01

Subsurface Disposal (SDA) of the Radioactive Waste Management Complex serves as the low level waste burial ground at the Idaho National Engineering and Environmental Laboratory (INEEL). The low level wastes are buried in trenches, pits, and soil vaults in surficial sediments. A closure/post-closure plan must be written prior to closure of the SDA. The closure plan for the facility must include a design for an engineered barrier closure cover that will meet all applicable regulatory requirements. This paper describes the approach being followed at the INEEL to choose an appropriate cover design for the SDA closure. Regulatory requirements and performance objectives potentially applicable to closure of the SDA were identified. Technical issues related to SDA closure were identified from a literature search of previous arid site engineered barrier studies and from previous SDA closure cover evaluations. Five engineered barrier conceptual design alternatives were identified: (1) a bio/capillary barrier cover, (2) a thin soil cover, (3) a thick soil cover, (4) a Resource Conservation and Recovery Act cover, and (5) a concrete sealed surface cover. Two of these designs were chosen for in situ hydraulic testing, rather than all five, in order to maximize the amount of information generated relative to projected project costs. Testing of these two cover designs provides data to quantify hydrologic model input parameters and for verification of site specific hydrologic models for long term closure cover performance evaluation and detailed analysis of closure cover alternatives. The specific objectives of the field tests are to determine the water balance for the two covers over several years and to determine cover soil physical and hydraulic properties

Exome sequencing of a large family identifies potential candidate genes contributing risk to bipolar disorder.

Science.gov (United States)

Zhang, Tianxiao; Hou, Liping; Chen, David T; McMahon, Francis J; Wang, Jen-Chyong; Rice, John P

2018-03-01

Bipolar disorder is a mental illness with lifetime prevalence of about 1%. Previous genetic studies have identified multiple chromosomal linkage regions and candidate genes that might be associated with bipolar disorder. The present study aimed to identify potential susceptibility variants for bipolar disorder using 6 related case samples from a four-generation family. A combination of exome sequencing and linkage analysis was performed to identify potential susceptibility variants for bipolar disorder. Our study identified a list of five potential candidate genes for bipolar disorder. Among these five genes, GRID1(Glutamate Receptor Delta-1 Subunit), which was previously reported to be associated with several psychiatric disorders and brain related traits, is particularly interesting. Variants with functional significance in this gene were identified from two cousins in our bipolar disorder pedigree. Our findings suggest a potential role for these genes and the related rare variants in the onset and development of bipolar disorder in this one family. Additional research is needed to replicate these findings and evaluate their patho-biological significance. Copyright © 2017 Elsevier B.V. All rights reserved.

Implementation of renewable energy technology - Opportunities and barriers. Summary of country studies

Energy Technology Data Exchange (ETDEWEB)

Painuly, J.P.; Fenhann, J.V.

2002-07-01

The project was launched to identify barriers to the implementation of renewable energy technologies (RETs) and explore measures to overcome the identified barriers. National institutions in Egypt, Ghana and Zimbabwe carried out the country studies based on the basic methodological framework provided by the UNEP Centre. The objectives of the project included strengthening institutional capacity for analysis and implementation of RET projects in the participating countries and bring out experiences on RETs barriers and removal measures for dissemination so that others can benefit from the knowledge so gained. An important highlight of the studies was involvement of stake holders in the process of identification of barriers and measures to remove them. A preliminary identification of relevant RETs for their countries was done by the country teams in the initial stage of the project. After that, national workshops involving various stake holders were held between July and September 1999 to discuss the RETs and barriers to their implementation. Based on the discussions, a few important RETs were identified for more detailed study. PV systems for rural electrification, solar water heating systems and large-scale biogas system were identified and analysed for barriers in the Egypt country study. Economic, information and policy barriers were identified as major barriers for these technologies. Solar water pumps, biogas and small hydro were the focus of study in Ghana. In this case also, economic, information and policy barriers were found to be the important barriers for the selected technologies. In the case of Zimbabwe, focus was on identification of primary and secondary barriers to RETs dissemination. The primary barriers included lack of capacity to develop proposals, lack of information for policy making and framework for information dissemination. The study concluded that the secondary barriers as seen and experienced by the stake holders are due to primary

Projecting the range of potential future climate change as an aid in the assessment of the effectiveness of the Hanford Site Permanent Isolation Barrier

Energy Technology Data Exchange (ETDEWEB)

Petersen, K.L.

1993-10-01

The Hanford Site Permanent Isolation Barrier Development Program was organized to develop an in-place disposal capability for low-level nuclear waste for the US Department of Energy at the Hanford Site in south-eastern Washington. Layered earthen and engineered barriers are being developed by Westinghouse Hanford Company and the Pacific Northwest Laboratory that will function in what is presently a semiarid environment (annual precipitation 150 mm) for at least 1,000 yr by limiting the infiltration of water through the waste. The Long-Term Climate Change Task is one of several key barrier tasks. Based on the recommendation of a panel of internationally recognized climate and modeling experts, climatic data for this task is being acquired in a step-wise and multi-disciplinary manner. The specific research strategy includes literature review and specialized studies to obtain pollen-derived climatic reconstruction, documented historic weather patterns, and Global Circulation Model output of potential future climate changes related to both the greenhouse effect and the cycling into the next ice age. The specific goals of the task are to: (1) obtain defensible probabilistic projections of the long-term climate variability in the Hanford Site region at many different time scales into the future, (2) develop several test case climate scenarios that bracket the range of potential future climate, and (3) use the climate scenarios both to test and to model protective barrier performance.

An automated technique to identify potential inappropriate traditional Chinese medicine (TCM) prescriptions.

Science.gov (United States)

Yang, Hsuan-Chia; Iqbal, Usman; Nguyen, Phung Anh; Lin, Shen-Hsien; Huang, Chih-Wei; Jian, Wen-Shan; Li, Yu-Chuan

2016-04-01

Medication errors such as potential inappropriate prescriptions would induce serious adverse drug events to patients. Information technology has the ability to prevent medication errors; however, the pharmacology of traditional Chinese medicine (TCM) is not as clear as in western medicine. The aim of this study was to apply the appropriateness of prescription (AOP) model to identify potential inappropriate TCM prescriptions. We used the association rule of mining techniques to analyze 14.5 million prescriptions from the Taiwan National Health Insurance Research Database. The disease and TCM (DTCM) and traditional Chinese medicine-traditional Chinese medicine (TCMM) associations are computed by their co-occurrence, and the associations' strength was measured as Q-values, which often referred to as interestingness or life values. By considering the number of Q-values, the AOP model was applied to identify the inappropriate prescriptions. Afterwards, three traditional Chinese physicians evaluated 1920 prescriptions and validated the detected outcomes from the AOP model. Out of 1920 prescriptions, 97.1% of positive predictive value and 19.5% of negative predictive value were shown by the system as compared with those by experts. The sensitivity analysis indicated that the negative predictive value could improve up to 27.5% when the model's threshold changed to 0.4. We successfully applied the AOP model to automatically identify potential inappropriate TCM prescriptions. This model could be a potential TCM clinical decision support system in order to improve drug safety and quality of care. Copyright © 2016 John Wiley & Sons, Ltd.

Barriers to patient portal access among veterans receiving home-based primary care: a qualitative study.

Science.gov (United States)

Mishuris, Rebecca G; Stewart, Max; Fix, Gemmae M; Marcello, Thomas; McInnes, D Keith; Hogan, Timothy P; Boardman, Judith B; Simon, Steven R

2015-12-01

Electronic, or web-based, patient portals can improve patient satisfaction, engagement and health outcomes and are becoming more prevalent with the advent of meaningful use incentives. However, adoption rates are low, particularly among vulnerable patient populations, such as those patients who are home-bound with multiple comorbidities. Little is known about how these patients view patient portals or their barriers to using them. To identify barriers to and facilitators of using My HealtheVet (MHV), the United States Department of Veterans Affairs (VA) patient portal, among Veterans using home-based primary care services. Qualitative study using in-depth semi-structured interviews. We conducted a content analysis informed by grounded theory. Fourteen Veterans receiving home-based primary care, surrogates of two of these Veterans, and three home-based primary care (HBPC) staff members. We identified five themes related to the use of MHV: limited knowledge; satisfaction with current HBPC care; limited computer and Internet access; desire to learn more about MHV and its potential use; and value of surrogates acting as intermediaries between Veterans and MHV. Despite their limited knowledge of MHV and computer access, home-bound Veterans are interested in accessing MHV and using it as an additional point of care. Surrogates are also potential users of MHV on behalf of these Veterans and may have different barriers to and benefits from use. © 2014 John Wiley & Sons Ltd.

Using the ecological framework to identify barriers and enablers to implementing Namaste Care in Canada's long-term care system.

Science.gov (United States)

Hunter, Paulette V; Kaasalainen, Sharon; Froggatt, Katherine A; Ploeg, Jenny; Dolovich, Lisa; Simard, Joyce; Salsali, Mahvash

2017-10-01

Higher acuity of care at the time of admission to long-term care (LTC) is resulting in a shorter period to time of death, yet most LTC homes in Canada do not have formalized approaches to palliative care. Namaste Care is a palliative care approach specifically tailored to persons with advanced cognitive impairment who are living in LTC. The purpose of this study was to employ the ecological framework to identify barriers and enablers to an implementation of Namaste Care. Six group interviews were conducted with families, unlicensed staff, and licensed staff at two Canadian LTC homes that were planning to implement Namaste Care. None of the interviewees had prior experience implementing Namaste Care. The resulting qualitative data were analyzed using a template organizing approach. We found that the strongest implementation enablers were positive perceptions of need for the program, benefits of the program, and fit within a resident-centred or palliative approach to care. Barriers included a generally low resource base for LTC, the need to adjust highly developed routines to accommodate the program, and reliance on a casual work force. We conclude that within the Canadian LTC system, positive perceptions of Namaste Care are tempered by concerns about organizational capacity to support new programming.

The low internal rotation barriers of halogenated toluenes: Rotational spectrum of 2,4-difluorotoluene

Science.gov (United States)

Nair, K. P. Rajappan; Herbers, Sven; Obenchain, Daniel A.; Grabow, Jens-Uwe; Lesarri, Alberto

2018-02-01

The rotational spectrum of 2,4-difluorotoluene in the region 5-25 GHz has been studied by pulsed supersonic jet using Fourier transform microwave spectroscopy. The tunneling splitting due to the methyl internal rotation in the ground torsional state could be unambiguously identified and the threefold (V3) potential barrier hindering the internal rotation of the methyl top was determined as 2.80144 (82) kJ/mol. The ground-state rotational parameters for the parent and seven 13C isotopic species in natural abundance were determined with high accuracy, including all quartic centrifugal distortion constants. The electric dipole moment μ = 1.805(42) D was obtained from Stark effect measurements. The molecular structure was derived using the substitution (rs) method. Supporting ab initio (MP2) calculations provided comparative values for the potential barrier and molecular parameters.

Barriers and facilitators to implementing the Baby-Friendly hospital initiative in neonatal intensive care units.

Science.gov (United States)

Benoit, Britney; Semenic, Sonia

2014-01-01

To explore manager, educator, and clinical leader perceptions of barriers and facilitators to implementing Baby-Friendly practice in the neonatal intensive care unit (NICU). Qualitative, descriptive design. Two university-affiliated level-III NICUs in Canada. A purposive sample of 10 medical and nursing managers, nurse educators, lactation consultants, and neonatal nurse practitioners. In-depth, semistructured interviews transcribed and analyzed using qualitative content analysis. Participants valued breastfeeding and family-centered care yet identified numerous contextual barriers to Baby-Friendly care including infant health status, parent/infant separation, staff workloads and work patterns, gaps in staff knowledge and skills, and lack of continuity of breastfeeding support. Facilitators included breastfeeding education, breastfeeding champions, and interprofessional collaboration. Despite identifying numerous barriers, participants recognized the potential value of expanding the Baby-Friendly Hospital Initiative (BFHI) to the NICU setting. Recommendations include promoting BFHI as a facilitator of family-centered care, interdisciplinary staff education, increasing access to lactation consultants, and establishing a group of NICU champions dedicated to BFHI implementation. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

A home monitoring program including real-time wireless home spirometry in idiopathic pulmonary fibrosis: a pilot study on experiences and barriers.

Science.gov (United States)

Moor, C C; Wapenaar, M; Miedema, J R; Geelhoed, J J M; Chandoesing, P P; Wijsenbeek, M S

2018-05-29

In idiopathic pulmonary fibrosis (IPF), home monitoring experiences are limited, not yet real-time available nor implemented in daily care. We evaluated feasibility and potential barriers of a new home monitoring program with real-time wireless home spirometry in IPF. Ten patients with IPF were asked to test this home monitoring program, including daily home spirometry, for four weeks. Measurements of home and hospital spirometry showed good agreement. All patients considered real-time wireless spirometry useful and highly feasible. Both patients and researchers suggested relatively easy solutions for the identified potential barriers regarding real-time home monitoring in IPF.

[Implementing daily physical education in primary school - potentials and barriers from the involved actor's point of view].

Science.gov (United States)

Sterdt, E; Liersch, S; Henze, V; Röbl, M; Suermann, T; Krauth, C; Walter, U

2015-04-01

The objective was to determine to what extent daily physical education can be implemented in primary schools, what barriers exist and how to overcome the mentioned barriers. Moreover, it was analysed to what extent daily physical education is accepted by teachers, external trainers, parents and students. Semi-structured interviews with parents (n=7), teachers (n=5) and external trainers (n=6) of the intervention schools. The intervention students (n=44) were surveyed within focus groups. All surveyed groups appraised the implementation of daily school sports as successful. The cooperation between the schools and the sports club should be maintained during a comprehensive implementation of daily physical education. Besides an improved lessons quality teachers and external trainers reported an improved social behaviour of the children. Parents perceived positive effects on the child development. All groups believe that daily physical education increases the enjoyment of children in sports. As a certain barrier a lack of resources (e. g., facilities, equipment, financial resources) in the schools were mentioned. The cooperation between the schools and the sports club proved to be an applicable model to implement daily physical education. The combination of teachers and external trainers can contribute to a higher lesson quality. Considering the perceived potentials of daily physical education by all surveyed groups, a comprehensive implementation of systematic daily physical activity promotion in the primary school setting should be tapped more strongly in future. © Georg Thieme Verlag KG Stuttgart · New York.

Advanced house air-barrier systems

Energy Technology Data Exchange (ETDEWEB)

Lee, R.K. [Natural Resources Canada, Ottawa, ON (Canada)

1996-08-01

Air barrier systems used in modern Canadian airtight homes were discussed. The Advanced Houses Program sets its airtightness requirements at 1.5 air changes per hour at 50 Pascals pressure difference (ACH{sub 5}0). In recent tests of 10 houses, it was suggested that a better airtightness level was attainable with average airtightness of about 1.0 ACH{sub 5}0. Six of the homes tested did not use the traditional polyethylene approach. Two of the houses used the airtight drywall approach, one used a foam system, and three used exterior air barriers. The advantages and disadvantages of each system was described, including cost effectiveness, cost reduction, performance and installation advantages. The confusion between an air barrier and a vapour diffusion retarder was explained. Exterior air barriers showed the greatest potential for meeting airtightness requirements at reasonable cost. 5 refs., 3 tabs.

Method for identifying drivers, barriers and synergies related to the deployment of a CO2 pipeline network : A case study for the Iberian Peninsula and Morocco

NARCIS (Netherlands)

Berghout, Niels; Cabal, Helena; Gouveia, João Pedro; van den Broek, Machteld; Faaij, André

2015-01-01

This paper provides a method to identify drivers, barriers and synergies (DBS) related to the deployment of a CO2 pipeline network. The method was demonstrated for the West Mediterranean region (WMR) (i.e. Spain, Portugal and Morocco). The method comprises a literature review, analysis of

Do stigma and other perceived barriers to mental health care differ across Armed Forces?

Science.gov (United States)

Gould, Matthew; Adler, Amy; Zamorski, Mark; Castro, Carl; Hanily, Natalie; Steele, Nicole; Kearney, Steve; Greenberg, Neil

2010-01-01

Summary Objectives Military organizations are keen to address barriers to mental health care yet stigma and barriers to care remain little understood, especially potential cultural differences between Armed Forces. The aim of this study was to compare data collected by the US, UK, Australian, New Zealand and Canadian militaries using Hoge et al.'s perceived stigma and barriers to care measure (Combat duty in Iraq and Afghanistan, mental health problems and barriers to care. New Engl J Med 2004;351:13–22). Design Each member country identified data sources that had enquired about Hoge et al.'s perceived stigma and perceived barriers to care items in the re-deployment or immediate post-deployment period. Five relevant statements were included in the study. Setting US, UK Australian, New Zealand and Canadian Armed Forces. Results Concerns about stigma and barriers to care tended to be more prominent among personnel who met criteria for a mental health problem. The pattern of reported stigma and barriers to care was similar across the Armed Forces of all five nations. Conclusions Barriers to care continue to be a major issue for service personnel within Western military forces. Although there are policy, procedural and cultural differences between Armed Forces, the nations studied appear to share some similarities in terms of perceived stigma and barriers to psychological care. Further research to understand patterns of reporting and subgroup differences is required. PMID:20382906

Barriers to implement green supply chain management in automobile industry using interpretive structural modeling technique: An Indian perspective

Directory of Open Access Journals (Sweden)

Sunil Luthra

2011-07-01

Full Text Available Purpose: Green Supply Chain Management (GSCM has received growing attention in the last few years. Most of the automobile industries are setting up their own manufacturing plants in competitive Indian market. Due to public awareness, economic, environmental or legislative reasons, the requirement of GSCM has increased.  In this context, this study aims to develop a structural model of the barriers to implement GSCM in Indian automobile industry.Design/methodology/approach: We have identified various barriers and contextual relationships among the identified barriers. Classification of barriers has been carried out based upon dependence and driving power with the help of MICMAC analysis. In addition to this, a structural model of barriers to implement GSCM in Indian automobile industry has also been put forward using Interpretive Structural Modeling (ISM technique. Findings: Eleven numbers of relevant barriers have been identified from literature and subsequent discussions with experts from academia and industry. Out of which, five numbers of barriers have been identified as dependent variables; three number of barriers have been identified as the driver variables and three number of barriers have been identified as the linkage variables. No barrier has been identified as autonomous variable. Four barriers have been identified as top level barriers and one bottom level barrier. Removal of these barriers has also been discussed.Research limitations/implications: A hypothetical model of these barriers has been developed based upon experts’ opinions. The conclusions so drawn may be further modified to apply in real situation problem. Practical implications: Clear understanding of these barriers will help organizations to prioritize better and manage their resources in an efficient and effective way.Originality/value: Through this paper we contribute to identify the barriers to implement GSCM in Indian automobile industry and to prioritize them

Should we quit our jobs? Challenges, barriers and recommendations for interdisciplinary energy research

International Nuclear Information System (INIS)

Schuitema, Geertje; Sintov, Nicole D.

2017-01-01

Many plea for a better integration of social sciences in energy research, which would imply more comprehensive interdisciplinary energy research. We argue that in order to achieve this, institutional barriers and research challenges need to be recognised and addressed. We identify six challenges and barriers, and provide recommendations for working towards solutions. We conclude that to engage in interdisciplinary research implies extra costs and fewer rewards for all researchers, particularly early and mid-career academics. We propose a new conceptualisation of practices and incentive structures among academic institutions, funding agencies, and publication outlets, and urge all energy researchers to join this debate. - Highlights: • Interdisciplinary energy research currently does not reach its full potential. • Social sciences are underutilised in energy research. • Barriers and challenges need to be addressed to stimulate interdisciplinary energy research. • High costs and small rewards for interdisciplinary (early and mid-career) researchers.

Dimensional Analysis of Psychosocial Barriers to Prevention of Early Childhood Caries Among Recent Immigrants

Directory of Open Access Journals (Sweden)

Arnaldo Perez

2014-06-01

Full Text Available The objective of this article is to define the underlying dimensions of psychosocial barriers to obtaining and providing dental care for young children among recent immigrants. Fifteen focus groups were conducted with 99 primary caregivers from African, South Asian, and Chinese recent immigrants. A secondary analysis of identified barriers using dimensional analysis methodology was performed to determine dimensions and properties of barriers. The analysis continued until irreducible properties were found or emerging dimensions were not relevant to the study. Identified dimensions were associated with barriers and individuals. Type, number, level, objectiveness, nature, and impact were barrier-related; awareness and controllability were individual-related dimensions. Type refers to barriers themselves. Number and level indicate the amount and location of barriers, respectively. Objectiveness refers to the extent that perceived barrier reflects reality and nature indicates its intrinsic characteristic. Impact concerns behaviors, goals, and outcomes compromised by barriers. Awareness alludes to the extent that individuals are aware of the barriers and controllability explains how much control people perceive to have over barriers. Identified dimensions are useful for better understanding and addressing existing barriers to children’s optimal oral health.

Development of dry barriers for containment and remediation at waste sites

International Nuclear Information System (INIS)

Thomson, B.M.; Morris, C.E.; Ankeny, M.D.

1994-01-01

This paper describes a concept in which dry air is injected into an unsaturated formation to reduce the soil moisture content, referred to here as a dry (or sometimes tensiometric) barrier. The objective is to reduce the hydraulic conductivity of the unsaturated media to the point where liquid phase transport becomes negligible, thereby achieving containment. The concept could be applied in subsurface formations to provide containment from a leaking facility, or it could be incorporated into a cover design to provide redundancy for a capillary barrier. The air injection process could in principle be coupled with a vacuum extraction system to recover soil vapors, which would then provide a remediation process that would be appropriate if volatile organic compounds were present. Work to date has consisted of a combined theoretical, laboratory, and field research investigation. The objective of this research was to demonstrate the technical feasibility of the dry barrier concept by identifying the parameters which determine its effectiveness. Based on the results obtained for the experimental and theoretical studies, feasibility analyses were prepared for as a modification for a landfill cover design to prevent infiltration from atmospheric precipitation and for potential application of dry barriers to achieve subsurface containment and removal of volatile constituents. These analyses considered the technical as well as the economic aspects of the dry barrier concept

Potential Motivators and Barriers for Encouraging Health Screening for Cardiovascular Disease Among Latino Men in Rural Communities in the Northwestern United States.

Science.gov (United States)

Lee, Moon J; Sobralske, Mary C; Fackenthall, Chelane

2016-04-01

Cardiovascular disease (CVD) is the leading cause of death across all races and ethnicities. In particular, Latino men suffer disproportionately from conditions that lead to CVD such as hypertension, high cholesterol, and diabetes. There are easy and inexpensive ways to screen for certain cardiovascular conditions, yet Latino men are not benefiting from these. It is important to identify motivators and barriers to screening among this population. The purpose of this qualitative, descriptive study was to determine what motivates Latino men to participate in health screening for diabetes, high blood pressure, and high cholesterol. Self-identified Latino men (n = 17) were interviewed following a community health screening targeting Latinos. Individual semi-structured interviews were conducted in either Spanish or English after giving written consent. Trained interpreters were used for Spanish interviews. Emerging themes include motivating factors and barriers to participate in screening. Data findings direct future studies and provide culturally meaningful and relevant strategies to reduce health disparities.

Monitoring the environment and human sentiment on the Great Barrier Reef: Assessing the potential of collective sensing.

Science.gov (United States)

Becken, Susanne; Stantic, Bela; Chen, Jinyan; Alaei, Ali Reza; Connolly, Rod M

2017-12-01

With the growth of smartphone usage the number of social media posts has significantly increased and represents potentially valuable information for management, including of natural resources and the environment. Already, evidence of using 'human sensor' in crises management suggests that collective knowledge could be used to complement traditional monitoring. This research uses Twitter data posted from the Great Barrier Reef region, Australia, to assess whether the extent and type of data could be used to Great Barrier Reef organisations as part of their monitoring program. The analysis reveals that large amounts of tweets, covering the geographic area of interest, are available and that the pool of information providers is greatly enhanced by the large number of tourists to this region. A keyword and sentiment analysis demonstrates the usefulness of the Twitter data, but also highlights that the actual number of Reef-related tweets is comparatively small and lacks specificity. Suggestions for further steps towards the development of an integrative data platform that incorporates social media are provided. Copyright © 2017 Elsevier Ltd. All rights reserved.

Identifying the barriers to conducting outcomes research in integrative health care clinic settings - a qualitative study

Directory of Open Access Journals (Sweden)

Findlay-Reece Barbara

2010-01-01

Full Text Available Abstract Background Integrative health care (IHC is an interdisciplinary blending of conventional medicine and complementary and alternative medicine (CAM with the purpose of enhancing patients' health. In 2006, we designed a study to assess outcomes that are relevant to people using such care. However, we faced major challenges in conducting this study and hypothesized that this might be due to the lack of a research climate in these clinics. To investigate these challenges, we initiated a further study in 2008, to explore the reasons why IHC clinics are not conducting outcomes research and to identify strategies for conducting successful in-house outcomes research programs. The results of the latter study are reported here. Methods A total of 25 qualitative interviews were conducted with key participants from 19 IHC clinics across Canada. Basic content analysis was used to identify key themes from the transcribed interviews. Results Barriers identified by participants fell into four categories: organizational culture, organizational resources, organizational environment and logistical challenges. Cultural challenges relate to the philosophy of IHC, organizational leadership and practitioner attitudes and beliefs. Participants also identified significant issues relating to their organization's lack of resources such as funding, compensation, infrastructure and partnerships/linkages. Environmental challenges such as the nature of a clinic's patient population and logistical issues such as the actual implementation of a research program and the applicability of research data also posed challenges to the conduct of research. Embedded research leadership, integration of personal and professional values about research, alignment of research activities and clinical workflow processes are some of the factors identified by participants that support IHC clinics' ability to conduct outcomes research. Conclusions Assessing and enhancing the broader

Barriers to providing maternity care to women with physical disabilities: Perspectives from health care practitioners.

Science.gov (United States)

Mitra, Monika; Smith, Lauren D; Smeltzer, Suzanne C; Long-Bellil, Linda M; Sammet Moring, Nechama; Iezzoni, Lisa I

2017-07-01

Women with physical disabilities are known to experience disparities in maternity care access and quality, and communication gaps with maternity care providers, however there is little research exploring the maternity care experiences of women with physical disabilities from the perspective of their health care practitioners. This study explored health care practitioners' experiences and needs around providing perinatal care to women with physical disabilities in order to identify potential drivers of these disparities. We conducted semi-structured telephone interviews with 14 health care practitioners in the United States who provide maternity care to women with physical disabilities, as identified by affiliation with disability-related organizations, publications and snowball sampling. Descriptive coding and content analysis techniques were used to develop an iterative code book related to barriers to caring for this population. Public health theory regarding levels of barriers was applied to generate broad barrier categories, which were then analyzed using content analysis. Participant-reported barriers to providing optimal maternity care to women with physical disabilities were grouped into four levels: practitioner level (e.g., unwillingness to provide care), clinical practice level (e.g., accessible office equipment like adjustable exam tables), system level (e.g., time limits, reimbursement policies), and barriers relating to lack of scientific evidence (e.g., lack of disability-specific clinical data). Participants endorsed barriers to providing optimal maternity care to women with physical disabilities. Our findings highlight the needs for maternity care practice guidelines for women with physical disabilities, and for training and education regarding the maternity care needs of this population. Copyright © 2016 Elsevier Inc. All rights reserved.

An Insight into Communication Barriers between Bank Managers and their Customers.

Science.gov (United States)

Golen, Steven

1987-01-01

The study attempted to identify specific industry-related communication problems of bank managers. A questionnaire was completed by 193 managers identifying perceived communication barriers and relative importance of each. Resistance to change and tendency not to listen were considered serious barriers. (CH)

Overcoming Branding Barriers in Nonprofit, Private Colleges and Universities

Science.gov (United States)

Chyr, Fred

2017-01-01

Purpose: The purpose of this Delphi study was to explore the views of experts in the field of nonprofit private colleges and universities in the United States to define branding and identify current barriers to branding, to discover how those barriers can be overcome, and to determine what barriers to branding are likely to occur 5 years in the…

Natural and Synthetic Barriers to Immobilize Radionuclides

International Nuclear Information System (INIS)

Um, W.

2011-01-01

The experiments of weathering of glass waste form and the reacted sediments with simulated glass leachates show that radionuclide sequestration can be significantly enhanced by promoting the formation of secondary precipitates. In addition, synthetic phosphate-bearing nanoporous material exhibits high stability at temperature and has a very high K d value for U(VI) removal. Both natural and synthetic barrier materials can be used as additional efficient adsorbents for retarding transport of radionuclides for various contaminated waste streams and waste forms present at U. S. Department of Energy clean-up sites and the proposed geologic radioactive waste disposal facility. In the radioactive waste repository facility, natural or synthetic materials are planned to be used as a barrier material to immobilize and retard radionuclide release. The getter material can be used to selectively scavenge the radionuclide of interest from a liquid waste stream and subsequently incorporate the loaded getters in a cementitious or various monolithic waste forms. Also, the getter material is to reduce the release of radionuclides from monolithic waste forms. Also, the getter material is to reduce the release of radionuclides from monolithic waste forms. Also, the getter material is to reduce the release of radionuclides form monolithic waste forms by being emplaced as a backfill barrier material around the wastes or waste form to minimize the potential around the wastes or waste form to minimize the potential hazard of leached radioactive wastes. The barrier material should be highly efficient to sequester radionuclides and possess physical and chemical stability for long-term exposure to severe weathering conditions. Because potential leaching of radionuclides depends on various environmental and weathering conditions of the near-field repository, the barrier materials must be durable and not disintegrate under a range of moisture, temperature, pressure, radiation, Eh, ph. and

Regulatory analysis for the use of underground barriers at the Hanford Site tank farms

International Nuclear Information System (INIS)

Hampsten, K.L.

1994-01-01

Sixty-seven of the single-shell tanks at the Hanford Site, Richland, Washington, are assumed to have leaked in the past. Some of the waste retrieval options being considered, such as past-practice sluicing (a process that uses hot water to dislodge waste for subsequent removal by pumping), have the potential for increasing releases of dangerous waste from these tanks. Underground barrier systems are being evaluated as a method to mitigate releases of tank waste to the soil and groundwater that may occur during retrieval activities. The following underground barrier system options are among those being evaluated to determine whether their construction at the Single-Shell Tank Farms is viable. (1) A desiccant barrier would be created by circulating air through the subsurface soil to lower and then maintain the water saturation below the levels required for liquids to flow. (2) An injected materials barrier would be created by injecting materials such as grout or silica into the subsurface soils to form a barrier around and under a given tank or tank farm. (3) A cryogenic barrier would be created by freezing subsurface soils in the vicinity of a tank or tank farm. An analysis is provided of the major regulatory requirements that may impact full scale construction and operation of an underground barrier system and a discussion of factors that should be considered throughout the barrier selection process, irrespective of the type of underground barrier system being considered. However, specific barrier systems will be identified when a given regulation will have significant impact on a particular type of barrier technology. Appendix A provides a matrix of requirements applicable to construction and operation of an underground barrier system

Nonlinear absorption coefficient and relative refraction index change for an asymmetrical double δ-doped quantum well in GaAs with a Schottky barrier potential

International Nuclear Information System (INIS)

Rojas-Briseño, J.G.; Martínez-Orozco, J.C.; Rodríguez-Vargas, I.; Mora-Ramos, M.E.; Duque, C.A.

2013-01-01

In this work we are reporting the energy level spectrum for a quantum system consisting of an n-type double δ-doped quantum well with a Schottky barrier potential in a Gallium Arsenide matrix. The calculated states are taken as the basis for the evaluation of the linear and third-order nonlinear contributions to the optical absorption coefficient and to the relative refractive index change, making particular use of the asymmetry of the potential profile. These optical properties are then reported as a function of the Schottky barrier height (SBH) and the separation distance between the δ-doped quantum wells. Also, the effects of the application of hydrostatic pressure are studied. The results show that the amplitudes of the resonant peaks are of the same order of magnitude of those obtained in the case of single δ-doped field effect transistors; but tailoring the asymmetry of the confining potential profile allows the control the resonant peak positions

Nonlinear absorption coefficient and relative refraction index change for an asymmetrical double δ-doped quantum well in GaAs with a Schottky barrier potential

Energy Technology Data Exchange (ETDEWEB)

Rojas-Briseño, J.G.; Martínez-Orozco, J.C.; Rodríguez-Vargas, I. [Unidad Académica de Física, Universidad Autónoma de Zacatecas, Calzada Solidaridad esquina con Paseo la Bufa S/N, C.P. 98060, Zacatecas, Zac. (Mexico); Mora-Ramos, M.E. [Facultad de Ciencias, Universidad Autónoma del Estado de Morelos, Av. Universidad 1001, CP 62209, Cuernavaca, Morelos (Mexico); Instituto de Física, Universidad de Antioquia, AA 1226, Medellín (Colombia); Duque, C.A., E-mail: cduque@fisica.udea.edu.co [Instituto de Física, Universidad de Antioquia, AA 1226, Medellín (Colombia)

2013-09-01

In this work we are reporting the energy level spectrum for a quantum system consisting of an n-type double δ-doped quantum well with a Schottky barrier potential in a Gallium Arsenide matrix. The calculated states are taken as the basis for the evaluation of the linear and third-order nonlinear contributions to the optical absorption coefficient and to the relative refractive index change, making particular use of the asymmetry of the potential profile. These optical properties are then reported as a function of the Schottky barrier height (SBH) and the separation distance between the δ-doped quantum wells. Also, the effects of the application of hydrostatic pressure are studied. The results show that the amplitudes of the resonant peaks are of the same order of magnitude of those obtained in the case of single δ-doped field effect transistors; but tailoring the asymmetry of the confining potential profile allows the control the resonant peak positions.

Barriers to Quality Care for Dying Patients in Rural Communities

Science.gov (United States)

Van Vorst, Rebecca F.; Crane, Lori A.; Barton, Phoebe Lindsey; Kutner, Jean S.; Kallail, K. James; Westfall, John M.

2006-01-01

Context: Barriers to providing optimal palliative care in rural communities are not well understood. Purpose: To identify health care personnel's perceptions of the care provided to dying patients in rural Kansas and Colorado and to identify barriers to providing optimal care. Methods: An anonymous self-administered survey was sent to health care…

Spontaneous swallowing frequency has potential to identify dysphagia in acute stroke.

Science.gov (United States)

Crary, Michael A; Carnaby, Giselle D; Sia, Isaac; Khanna, Anna; Waters, Michael F

2013-12-01

Spontaneous swallowing frequency has been described as an index of dysphagia in various health conditions. This study evaluated the potential of spontaneous swallow frequency analysis as a screening protocol for dysphagia in acute stroke. In a cohort of 63 acute stroke cases, swallow frequency rates (swallows per minute [SPM]) were compared with stroke and swallow severity indices, age, time from stroke to assessment, and consciousness level. Mean differences in SPM were compared between patients with versus without clinically significant dysphagia. Receiver operating characteristic curve analysis was used to identify the optimal threshold in SPM, which was compared with a validated clinical dysphagia examination for identification of dysphagia cases. Time series analysis was used to identify the minimally adequate time period to complete spontaneous swallow frequency analysis. SPM correlated significantly with stroke and swallow severity indices but not with age, time from stroke onset, or consciousness level. Patients with dysphagia demonstrated significantly lower SPM rates. SPM differed by dysphagia severity. Receiver operating characteristic curve analysis yielded a threshold of SPM≤0.40 that identified dysphagia (per the criterion referent) with 0.96 sensitivity, 0.68 specificity, and 0.96 negative predictive value. Time series analysis indicated that a 5- to 10-minute sampling window was sufficient to calculate spontaneous swallow frequency to identify dysphagia cases in acute stroke. Spontaneous swallowing frequency presents high potential to screen for dysphagia in acute stroke without the need for trained, available personnel.

Spontaneous Swallowing Frequency [Has Potential to] Identify Dysphagia in Acute Stroke

Science.gov (United States)

Carnaby, Giselle D; Sia, Isaac; Khanna, Anna; Waters, Michael

2014-01-01

Background and Purpose Spontaneous swallowing frequency has been described as an index of dysphagia in various health conditions. This study evaluated the potential of spontaneous swallow frequency analysis as a screening protocol for dysphagia in acute stroke. Methods In a cohort of 63 acute stroke cases swallow frequency rates (swallows per minute: SPM) were compared to stroke and swallow severity indices, age, time from stroke to assessment, and consciousness level. Mean differences in SPM were compared between patients with vs. without clinically significant dysphagia. ROC analysis was used to identify the optimal threshold in SPM which was compared to a validated clinical dysphagia examination for identification of dysphagia cases. Time series analysis was employed to identify the minimally adequate time period to complete spontaneous swallow frequency analysis. Results SPM correlated significantly with stroke and swallow severity indices but not with age, time from stroke onset, or consciousness level. Patients with dysphagia demonstrated significantly lower SPM rates. SPM differed by dysphagia severity. ROC analysis yielded a threshold of SPM ≤ 0.40 which identified dysphagia (per the criterion referent) with 0.96 sensitivity, 0.68 specificity, and 0.96 negative predictive value. Time series analysis indicated that a 5 to 10 minute sampling window was sufficient to calculate spontaneous swallow frequency to identify dysphagia cases in acute stroke. Conclusions Spontaneous swallowing frequency presents high potential to screen for dysphagia in acute stroke without the need for trained, available personnel. PMID:24149008

Coastal Barrier Resource Areas, Barrier Islands and Spits; s44gbb89; Barrier Beaches as defined by RI CRMC were barrier beaches as defined by RI CRMC were identified on quad maps and manually digitized from tablets, Published in 1989, 1:24000 (1in=2000ft) scale, Rhode Island and Providence Plantations.

Data.gov (United States)

NSGIC State | GIS Inventory — Coastal Barrier Resource Areas dataset current as of 1989. Barrier Islands and Spits; s44gbb89; Barrier Beaches as defined by RI CRMC were barrier beaches as defined...