WorldWideScience

Sample records for integrated refuse management

  1. Integrated solid waste management in Japan

    Energy Technology Data Exchange (ETDEWEB)

    1993-10-01

    The Japanese, through a combination of public policy, private market conditions, a geographic necessity, practice integrated municipal solid waste (MSW) management. The approach of MSW management in Japan is as follows: The basic concept of refuse treatment consists of recycling discharged refuse into usable resources, reusing such resources as much as possible, and then treating or disposing of the usable portion into a sanitary condition. Considering the difficulty of procuring land or seaside areas for such purpose as a refuse disposal site, it will be necessary to minimize the volume of refuse collected for treatment or disposal.

  2. The right to physical integrity and informed refusal: Just how far does a patient’s right to refuse medical treatment go?

    Directory of Open Access Journals (Sweden)

    Annelize Nienaber

    2016-11-01

    Full Text Available The article presents a legal analysis of the right to physical integrity as guaranteed by the South African Constitution, 1996, and the subsequent right of a competent adult person to refuse medical treatment under South African law. We consider whether the right to refuse treatment is an absolute right and very briefly reflect on the application of the constitutional limitations clause to this right. Instances in which patients’ right to physical integrity is limited by factors, which detract from (patient autonomy, are considered: these represent a limitation of their right to refuse medical treatment. We conclude that forced medical interventions, for the most part, are not desirable but, indeed, necessary in some narrowly defined circumstances. When a person makes a decision to refuse a medical intervention, which may seem unusual or may be perceived as irrational, it does not mean that person does not warrant the protection of the constitution and the courts. Provided that the patient makes an informed refusal while of sound mind, generally there is no reason to discredit his/her decision, difficult as it may be for others to accept. At all times the right to bodily integrity is pivotal in any health-related context and should not be lightly disregarded.

  3. [Refusal of care faced by case manager from elderly persons in complex situation: cross perspectives].

    Science.gov (United States)

    Corvol, A; Balard, F; Moutel, G; Somme, D

    2014-01-01

    Case management is a new professional field in France. It is addressed to elderly persons living in community whose situation is regarded as particularly complex. Case managers have to assess needs and coordinate necessary services. One common criteria of complexity is refusal of care. The objective of this study is to compare the words of users with those of case managers about refusal of care, in order to understand its meaning, professionals' attitudes and ethical challenges. Two researchers have cooperated on this qualitative research: the first one, anthropologist, interviewed 19 individuals, and 11 of their caregivers. The second one, geriatrician and researcher in medical ethics, lead four focus groups gathering a total of 18 case managers. Refusal of care often is the result of the will of preserving one's identity, compromised by illness. Individuals seek control on their life. Facing this behaviour, case managers try to secure the individual, by establishing a personal relationship that respects their choices, even if care has to be delayed. Refusal of care may sometimes disclose a desire to vanish, in front of which professionals meet their own limits. To recognise an elderly person that refuses care as a unique individual who can make choices secure his identity, and allow him to change. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  4. The right to physical integrity and informed refusal: Just how far does ...

    African Journals Online (AJOL)

    Provided that the patient makes an informed refusal while of sound mind, generally ... At all times the right to bodily integrity is pivotal in any health-related context and should ... choices regarding the body in an autonomous and independent.

  5. 30 CFR 77.215-3 - Refuse piles: certification.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles: certification. 77.215-3 Section... COAL MINES Surface Installations § 77.215-3 Refuse piles: certification. (a) Within 180 days following written notification by the District Manager that a refuse pile can present a hazard, the person owning...

  6. 30 CFR 77.215-2 - Refuse piles; reporting requirements.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles; reporting requirements. 77.215-2... COAL MINES Surface Installations § 77.215-2 Refuse piles; reporting requirements. (a) The proposed location of a new refuse pile shall be reported to and acknowledged in writing by the District Manager...

  7. Factors related to treatment refusal in Taiwanese cancer patients.

    Science.gov (United States)

    Chiang, Ting-Yu; Wang, Chao-Hui; Lin, Yu-Fen; Chou, Shu-Lan; Wang, Ching-Ting; Juang, Hsiao-Ting; Lin, Yung-Chang; Lin, Mei-Hsiang

    2015-01-01

    Incidence and mortality rates for cancer have increased dramatically in the recent 30 years in Taiwan. However, not all patients receive treatment. Treatment refusal might impair patient survival and life quality. In order to improve this situation, we proposed this study to evaluate factors that are related to refusal of treatment in cancer patients via a cancer case manager system. This study analysed data from a case management system during the period from 2010 to 2012 at a medical center in Northern Taiwan. We enrolled a total of 14,974 patients who were diagnosed with cancer. Using the PRECEDE Model as a framework, we conducted logistic regression analysis to identify independent variables that are significantly associated with refusal of therapy in cancer patients. A multivariate logistic regression model was also applied to estimate adjusted the odds ratios (ORs) with 95% confidence intervals (95%CI). A total of 253 patients (1.69%) refused treatment. The multivariate logistic regression result showed that the high risk factors for refusal of treatment in cancer patient included: concerns about adverse effects (prefuse treatment have poor survival. The present study provides evidence of factors that are related to refusal of therapy and might be helpful for further application and improvement of cancer care.

  8. Clean Cities Niche Market Overview: Refuse Haulers (Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    Shea, S.

    2011-09-01

    Refuse haulers are ideal for the adoption of alternative fuels and advanced vehicle technologies. By using fuels like natural gas, propane, or biodiesel, and technologies like hybrid electric and hydraulic hybrid systems, the refuse-hauling sector could substantially decrease its petroleum use and greenhouse gas emissions. Fleet managers should explore the benefits of the fuels and technologies available, as well as the individual fleet needs, before adoption.

  9. Pervasive refusal syndrome. Three German cases provide further illustration.

    Science.gov (United States)

    Jans, Thomas; Ball, Juliane; Preiss, Maike; Haberhausen, Michael; Warnke, Andreas; Renner, Tobias J

    2011-09-01

    Pervasive refusal syndrome (PRS) has been proposed as a new diagnostic entity among child and adolescent psychiatric disorders. It is characterized by a cluster of life-threatening symptoms including refusal of hood intake, decreased or complete lack of mobilization, and lack of communication as well as retreat from normal life activities. Active refusal to accept help as well as neglect of personal care have been core features of PRS in the limited number of cases reported in the last decade. There have, however; been cases with predominantly passive resistance, indicating the possibility that there may be a continuum from active refusal to passive resistance within PRS. Postulating this continuum allows for the integration of "depressive devitalization" -- a refusal syndrome mainly characterized by passive resistance -- into the concept of PRS. Here, three case vignettes of adolescent patients with PRS are presented. The patients' symptomatology can be allocated on this continuum of PRS. PRS and dissociative disorders are compared in greater detail and contrasted within this discussion of differential diagnoses at the poles of such a continuum. PRS is a useful diagnosis for cases involving symptoms of predominating refusal and retreat which cannot satisfactorily be classified by existing diagnostic categories, and which can mostly clearly be separated from dissociative disorder.

  10. [Refusal of treatments by an adult cancer patient].

    Science.gov (United States)

    Dauchy, Sarah; Faivre, Jean-Christophe; Block, Véronique; Metzger, Maude; Salleron, Julia; Charles, Cécile; Adam, Virginie

    2018-03-01

    Refusal of treatment questions the treatment's adequacy as well as the quality of the care relationship. A rigorous analysis of these situations is necessary in order to respect the patient's fundamental right to decide for him/herself while preventing a potential loss of chance. This paper proposes practical guidelines for assessment and management of the refusal of treatment by adult cancer patients. The French Association for Supportive Care in Cancer and the French Society for Psycho-Oncology formed a task force that applied a consensus methodology to draft guidelines. We propose five guidelines: (1) be informed of the conditions most often associated with refusal of treatment so as to reinforce adequate support measures; (2) understand the complexity of the process of refusal and accurately identify what is precisely refused; (3) apply an approach of systematic analysis to refusal, to try and increase the possibilities of finding an agreement while reinforcing the respect of the patient's position; (4) establish a legal procedure to address refusal of treatment that safeguards the stakeholders when no accord can be found; and (5) know the indications for ethical collective decision-making. A systematic assessment procedure of treatment refusal is necessary in order to ensure that all the physical, psychological and contextual aspects of it are taken into account, and to provide patients with the best treatment possible. The setting of good care relationship, the improvement of communication skills training and of comprehensive multidisciplinary care are all crucial elements in the prevention of these situations. Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  11. Caregivers who refuse preventive care for their children: the relationship between immunization and topical fluoride refusal.

    Science.gov (United States)

    Chi, Donald L

    2014-07-01

    The aim of this study was to examine caregivers' refusal of preventive medical and dental care for children. Prevalence rates of topical fluoride refusal based on dental records and caregiver self-reports were estimated for children treated in 3 dental clinics in Washington State. A 60-item survey was administered to 1024 caregivers to evaluate the association between immunization and topical fluoride refusal. Modified Poisson regression models were used to estimate prevalence rate ratios (PRRs). The prevalence of topical fluoride refusal was 4.9% according to dental records and 12.7% according to caregiver self-reports. The rate of immunization refusal was 27.4%. In the regression models, immunization refusal was significantly associated with topical fluoride refusal (dental record PRR = 1.61; 95% confidence interval [CI] = 1.32, 1.96; P refuse both immunizations and topical fluoride (P refusal of immunizations is associated with topical fluoride refusal. Future research should identify the behavioral and social factors related to caregiver refusal of preventive care with the goal of developing multidisciplinary strategies to help caregivers make optimal preventive care decisions for children.

  12. A narrative review of studies of refusal of psychotropic medication in acute inpatient psychiatric care.

    Science.gov (United States)

    Owiti, J A; Bowers, L

    2011-09-01

    This paper offers a narrative review of the 22 studies of medication refusal in acute psychiatry. Because of varied definitions of medication refusal, diverse methodologies and few rigorous studies, it has not been possible to draw firm conclusions on the average rate of refusal of psychotropic medications in acute psychiatry. However, it is clear that medication refusal is common and leads to poor outcomes characterized by higher rates of seclusion, restraint, threats of, and actual, assaults and longer hospitalizations. There are no statistically significant differences between refusers and acceptors in gender, marital status and preadmission living arrangements. Although no firm conclusions on the influence of ethnicity, status at admission and diagnosis on refusal, the refusers are more likely to have higher number of previous hospitalizations and history of prior refusal. The review indicates that staff factors such as the use of temporary staff, lack of confidence in ward staff and ineffective ward structure are associated with higher rates of medication refusal. Comprehensive knowledge of why, and how, patients refuse medication is lacking. Research on medication refusal is still fragmented, of variable methodological quality and lacks an integrating model. © 2011 Blackwell Publishing.

  13. 8. European sewage and refuse symposium. Documentation

    International Nuclear Information System (INIS)

    1990-01-01

    The subject of the 8. European Sewage and Refuse Symposium is covered under the following headings: collection and control in sewers, industrial waste water management, pretreatment, combined treatment, special cases, industrial waste water sludges disposal and the European waste business. (orig./BBR)

  14. Is clinician refusal to treat an emerging problem in injury compensation systems?

    Science.gov (United States)

    Brijnath, Bianca; Mazza, Danielle; Kosny, Agnieszka; Bunzli, Samantha; Singh, Nabita; Ruseckaite, Rasa; Collie, Alex

    2016-01-01

    Objective The reasons that doctors may refuse or be reluctant to treat have not been widely explored in the medical literature. To understand the ethical implications of reluctance to treat there is a need to recognise the constraints of doctors working in complex systems and to consider how these constraints may influence reluctance. The aim of this paper is to illustrate these constraints using the case of compensable injury in the Australian context. Design Between September and December 2012, a qualitative investigation involving face-to-face semistructured interviews examined the knowledge, attitudes and practices of general practitioners (GPs) facilitating return to work in people with compensable injuries. Setting Compensable injury management in general practice in Melbourne, Australia. Participants 25 GPs who were treating, or had treated a patient with compensable injury. Results The practice of clinicians refusing treatment was described by all participants. While most GPs reported refusal to treat among their colleagues in primary and specialist care, many participants also described their own reluctance to treat people with compensable injuries. Reasons offered included time and financial burdens, in addition to the clinical complexities involved in compensable injury management. Conclusions In the case of compensable injury management, reluctance and refusal to treat is likely to have a domino effect by increasing the time and financial burden of clinically complex patients on the remaining clinicians. This may present a significant challenge to an effective, sustainable compensation system. Urgent research is needed to understand the extent and implications of reluctance and refusal to treat and to identify strategies to engage clinicians in treating people with compensable injuries. PMID:26792215

  15. Clinical Characteristics of the Suicide Attempters Who Refused to Participate in a Suicide Prevention Case Management Program

    OpenAIRE

    Park, Soyoung; Choi, Kyoung Ho; Oh, Youngmin; Lee, Hae-Kook; Kweon, Yong-Sil; Lee, Chung Tai; Lee, Kyoung-Uk

    2015-01-01

    Case management interventions for suicide attempters aimed at helping adjust their social life to prevent reattempts have high nonparticipation and dropout rates. We analyzed the clinical characteristics of the group who refused to participate in the suicide prevention program in Korea. A total of 489 patients with a suicide attempt who visited Uijeongbu St. Mary's Hospital, the Catholic University of Korea, from December 2009 to December 2013 were analyzed. All patients were divided into the...

  16. Legislation and refusal of blood transfusion by a minor Jehovah-Witness in Belgium.

    Science.gov (United States)

    Deneyer, M; Matthys, D; Ramet, J; Michel, L; Holsters, D; Vandenplas, Y

    2011-01-01

    The refusal of blood transfusion by Jehovah's Witnesses in critical situations constitutes an ethical and juridical dilemma. The refusal to receive blood products by Jehovah's Witnesses is based on biblical verses. Recurring arguments to sustain this refusal regard the right to self-determination and the right to freedom of faith. If minors are involved, the problem is rendered even more difficult as the parental authority over young children needs to be taken into account. When adolescents are concerned, the situation if even more ambiguous since adolescents might be considered as mature enough to provide autonomous consent. On the basis of three cases, the most frequent bottlenecks that can come up in paediatric emergency services are highlighted: (1) the refusal of a blood transfusion by the parents of a young child; (2) the refusal by an adolescent and (3) prior refusal based on a "No Blood"-document. Regarding minors, the law on patients' rights in Belgium contains safety mechanisms concerning the preservation of physical integrity. Therefore, a key responsibility has been assigned to the physician. A step-by-step plan and a synoptic diagram are presented.

  17. Autonomy, religious values, and refusal of lifesaving medical treatment.

    Science.gov (United States)

    Wreen, M J

    1991-09-01

    The principal question of this paper is: Why are religious values special in refusal of lifesaving medical treatment? This question is approached through a critical examination of a common kind of refusal of treatment case, one involving a rational adult. The central value cited in defence of honouring such a patient's refusal is autonomy. Once autonomy is isolated from other justificatory factors, however, possible cases can be imagined which cast doubt on the great valuational weight assigned it by strong anti-paternalists. This weight is sufficient, in their estimation, to justify honouring the patient's refusal. There is thus a tension between the strong anti-paternalist's commitment to the sufficiency of autonomy and our intuitions respecting such cases. Attempts can be made to relieve this tension, such as arguing that patients aren't really rational in the circumstances envisaged, or that other values, such as privacy or bodily integrity, if added to autonomy, are sufficient to justify an anti-paternalistic stance. All such attempts fail, however. But what does not fail is the addition of religious freedom, freedom respecting a patient's religious beliefs and values. Why religious freedom reduces the tension is then explained, and the specialness of religious beliefs and values examined.

  18. Identification and characteristics of vaccine refusers

    OpenAIRE

    Wei, Feifei; Mullooly, John P; Goodman, Mike; McCarty, Maribet C; Hanson, Ann M; Crane, Bradley; Nordin, James D

    2009-01-01

    Abstract Background This study evaluated the utility of immunization registries in identifying vaccine refusals among children. Among refusers, we studied their socioeconomic characteristics and health care utilization patterns. Methods Medical records were reviewed to validate refusal status in the immunization registries of two health plans. Racial, education, and income characteristics of children claiming refusal were collected based on the census tract of each child. Health care utilizat...

  19. Is clinician refusal to treat an emerging problem in injury compensation systems?

    Science.gov (United States)

    Brijnath, Bianca; Mazza, Danielle; Kosny, Agnieszka; Bunzli, Samantha; Singh, Nabita; Ruseckaite, Rasa; Collie, Alex

    2016-01-20

    The reasons that doctors may refuse or be reluctant to treat have not been widely explored in the medical literature. To understand the ethical implications of reluctance to treat there is a need to recognise the constraints of doctors working in complex systems and to consider how these constraints may influence reluctance. The aim of this paper is to illustrate these constraints using the case of compensable injury in the Australian context. Between September and December 2012, a qualitative investigation involving face-to-face semistructured interviews examined the knowledge, attitudes and practices of general practitioners (GPs) facilitating return to work in people with compensable injuries. Compensable injury management in general practice in Melbourne, Australia. 25 GPs who were treating, or had treated a patient with compensable injury. The practice of clinicians refusing treatment was described by all participants. While most GPs reported refusal to treat among their colleagues in primary and specialist care, many participants also described their own reluctance to treat people with compensable injuries. Reasons offered included time and financial burdens, in addition to the clinical complexities involved in compensable injury management. In the case of compensable injury management, reluctance and refusal to treat is likely to have a domino effect by increasing the time and financial burden of clinically complex patients on the remaining clinicians. This may present a significant challenge to an effective, sustainable compensation system. Urgent research is needed to understand the extent and implications of reluctance and refusal to treat and to identify strategies to engage clinicians in treating people with compensable injuries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. The Refusal of Palliative Radiation in Metastatic Non-Small Cell Lung Cancer and Its Prognostic Implications.

    Science.gov (United States)

    Stavas, Mark J; Arneson, Kyle O; Ning, Matthew S; Attia, Albert A; Phillips, Sharon E; Perkins, Stephanie M; Shinohara, Eric T

    2015-06-01

    Patients with metastatic non-small cell lung cancer (NSCLC) have limited survival. Population studies have evaluated the impact of radiation refusal in the curative setting; however, no data exist concerning the prognostic impact of radiation refusal in the palliative care setting. To investigate the patterns of radiation refusal in newly diagnosed patients with metastatic NSCLC. Patients with Stage IV NSCLC diagnosed between 1988 and 2010 were identified in the Surveillance, Epidemiology, and End Results database. Univariate and multivariate analyses were used to identify predictors for refusal of radiation and the impact of radiation and refusal on survival in the palliative setting. A total of 285,641 patients were initially included in the analysis. Palliative radiation was recommended in 42% and refused by 3.1% of patients. Refusal rates remained consistent across included years of study. On multivariate analysis, older, nonblack/nonwhite, unmarried females were more likely to refuse radiation (P refusing radiation was three months vs. five months for those receiving radiation and two months for those whom radiation was not recommended. Patients with metastatic NSCLC who refuse recommended palliative radiation have a poor survival. Radiation refusal or the recommendation against treatment can serve as a trigger for integrating palliative care services sooner and contributes greatly to prognostic awareness. Further investigation into this survival difference and the factors behind refusal are warranted. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  1. Sustaining private sector participation (PSP) in solid waste management in Lagos, Nigeria, a developing country

    Energy Technology Data Exchange (ETDEWEB)

    Adebola, G. [Richbol Environmental Services Ltd., Lagos (Nigeria)

    2000-07-01

    Solid waste management in Lagos, Nigeria includes refuse collection and transportation to a landfill site. Disposal of the refuse and maintenance of the landfill site is also included in this task which, in the past was always a responsibility of the Government Agencies at the local level as a social service. This service has recently been privatised in the name of Private Sector Participation (PSP) in domestic refuse collection and disposal. As a new operator in about 23 wards in the ongoing PSP of domestic refuse, Richbol Environmental Ltd., recognized the enormous effort that government will have to make to sustain PSP in solid waste management. Governments can maintain control through re-orientation, legislation, enforcement, strengthening the PSP operators, integrating existing operators, and monitoring the activities of PSP operators. This paper presented a brief overview of the institutional changes that solid waste management has undergone in Lagos since 1977. It was emphasized that integrated waste management is extremely capital intensive. An integrated PSP can be a long term solution to waste management in developing, cash poor countries. The economic importance of PSP lies in the fact that it will reduce government expenditure and will also create a healthier environment and provide employment opportunities for thousands of employees and contribute to the gross domestic product of the country. 5 refs., 3 tabs., 1 fig.

  2. Knowledge-based fault diagnosis system for refuse collection vehicle

    International Nuclear Information System (INIS)

    Tan, CheeFai; Juffrizal, K.; Khalil, S. N.; Nidzamuddin, M. Y.

    2015-01-01

    The refuse collection vehicle is manufactured by local vehicle body manufacturer. Currently; the company supplied six model of the waste compactor truck to the local authority as well as waste management company. The company is facing difficulty to acquire the knowledge from the expert when the expert is absence. To solve the problem, the knowledge from the expert can be stored in the expert system. The expert system is able to provide necessary support to the company when the expert is not available. The implementation of the process and tool is able to be standardize and more accurate. The knowledge that input to the expert system is based on design guidelines and experience from the expert. This project highlighted another application on knowledge-based system (KBS) approached in trouble shooting of the refuse collection vehicle production process. The main aim of the research is to develop a novel expert fault diagnosis system framework for the refuse collection vehicle

  3. Knowledge-based fault diagnosis system for refuse collection vehicle

    Energy Technology Data Exchange (ETDEWEB)

    Tan, CheeFai; Juffrizal, K.; Khalil, S. N.; Nidzamuddin, M. Y. [Centre of Advanced Research on Energy, Universiti Teknikal Malaysia Melaka, Hang Tuah Jaya, Durian Tunggal, Melaka (Malaysia)

    2015-05-15

    The refuse collection vehicle is manufactured by local vehicle body manufacturer. Currently; the company supplied six model of the waste compactor truck to the local authority as well as waste management company. The company is facing difficulty to acquire the knowledge from the expert when the expert is absence. To solve the problem, the knowledge from the expert can be stored in the expert system. The expert system is able to provide necessary support to the company when the expert is not available. The implementation of the process and tool is able to be standardize and more accurate. The knowledge that input to the expert system is based on design guidelines and experience from the expert. This project highlighted another application on knowledge-based system (KBS) approached in trouble shooting of the refuse collection vehicle production process. The main aim of the research is to develop a novel expert fault diagnosis system framework for the refuse collection vehicle.

  4. School Refusal: Clinical Features, Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Kayhan Bahali

    2010-12-01

    Full Text Available Children regularly and voluntarily go to school in order to fulfill the expectations of society from them to continue their education or schooling. School continuation has been made compulsory by laws. Nonetheless, contrary to popular belief, for some children it is distressing to go to school. These children have difficulty continuing school and/or refuse to go to school. Today school refusal is defined as a child’s inability to continue school for reasons, such as anxiety and depression. The prevalence of school refusal has been reported to be approximately 1% in school-age children and 5% in child psychiatry samples. The prevalence of school refusal is similar among boys and girls. School refusal can occur at any time throughout the child’s academic life and at all socio-economic levels. School refusal is considered a symptom rather than a clinical diagnosis and can manifest itself as a sign of many psychiatric disorders, with anxiety disorders predominant. Separation anxiety disorder, generalized anxiety disorder, social phobia, specific phobia, and adjustment disorder with anxiety symptoms are the most common disorders co-occurring with school refusal. While separation anxiety disorder is associated with school refusal in younger children, other anxiety disorders, especially phobias, are associated with school refusal in adolescents. Children who have parents with psychiatric disorders have a higher incidence of school refusal, and psychiatric disorders are more frequently seen in adult relatives of children with school refusal, which supports a significant role of genetic and environmental factors in th etiology of school refusal. School refusal is a emergency state for child mental health. As it leads to detrimental effects in the short term and the long term, it should be regarded as a serious problem. The long-lasting follow-up studies of school refusing children have revealed that these children have a higher incidence of

  5. Integrated management systems

    CERN Document Server

    Bugdol, Marek

    2015-01-01

    Examining the challenges of integrated management, this book explores the importance and potential benefits of using an integrated approach as a cross-functional concept of management. It covers not only standardized management systems (e.g. International Organization for Standardization), but also models of self-assessment, as well as different types of integration. Furthermore, it demonstrates how processes and systems can be integrated, and how management efficiency can be increased. The major part of this book focuses on management concepts which use integration as a key tool of management processes (e.g. the systematic approach, supply chain management, virtual and network organizations, processes management and total quality management). Case studies, illustrations, and tables are also provided to exemplify and illuminate the content, as well as examples of successful and failed integrations. Providing a particularly useful resource to managers and specialists involved in the improvement of organization...

  6. 33 CFR 401.89 - Transit refused.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Transit refused. 401.89 Section... TRANSPORTATION SEAWAY REGULATIONS AND RULES Regulations General § 401.89 Transit refused. (a) An officer may refuse to allow a vessel to transit when, (1) The vessel is not equipped in accordance with §§ 401.5 to...

  7. The Legal Ethical Backbone of Conscientious Refusal

    DEFF Research Database (Denmark)

    Munthe, Christian; Nielsen, Morten Ebbe Juul

    2017-01-01

    This article analyzes the idea of a legal right to conscientious refusal for healthcare professionals from a basic legal ethical standpoint, using refusal to perform tasks related to legal abortion (in cases of voluntary employment) as a case in point. The idea of a legal right to conscientious...... refusal is distinguished from ideas regarding moral rights or reasons related to conscientious refusal, and none of the latter are found to support the notion of a legal right. Reasons for allowing some sort of room for conscientious refusal for healthcare professionals based on the importance of cultural...... identity and the fostering of a critical atmosphere might provide some support, if no countervailing factors apply. One such factor is that a legal right to healthcare professionals’ conscientious refusal must comply with basic legal ethical tenets regarding the rule of law and equal treatment...

  8. Understanding treatment refusal among adults presenting for HIV-testing in Soweto, South Africa: a qualitative study.

    Science.gov (United States)

    Katz, Ingrid T; Dietrich, Janan; Tshabalala, Gugu; Essien, Thandekile; Rough, Kathryn; Wright, Alexi A; Bangsberg, David R; Gray, Glenda E; Ware, Norma C

    2015-04-01

    HIV treatment initiatives have focused on increasing access to antiretroviral therapy (ART). There is growing evidence, however, that treatment availability alone is insufficient to stop the epidemic. In South Africa, only one third of individuals living with HIV are actually on treatment. Treatment refusal has been identified as a phenomenon among people who are asymptomatic, however, factors driving refusal remain poorly understood. We interviewed 50 purposively sampled participants who presented for voluntary counseling and testing in Soweto to elicit a broad range of detailed perspectives on ART refusal. We then integrated our core findings into an explanatory framework. Participants described feeling "too healthy" to start treatment, despite often having a diagnosis of AIDS. This subjective view of wellness was framed within the context of treatment being reserved for the sick. Taking ART could also lead to unintended disclosure and social isolation. These data provide a novel explanatory model of treatment refusal, recognizing perceived risks and social costs incurred when disclosing one's status through treatment initiation. Our findings suggest that improving engagement in care for people living with HIV in South Africa will require optimizing social integration and connectivity for those who test positive.

  9. Cubicle Refusal in Norwegian Dairy Herds

    Directory of Open Access Journals (Sweden)

    Myren HJ

    2001-03-01

    Full Text Available In order to survey the behaviour of choosing the alley area instead of a cubicle as a lying place (cubicle refusal, a questionnaire was sent to the 273 dairy farms in Norway known to keep cows in cubicle housing systems. Sixty-six percent of the farmers contacted were included in the study. The median herd size was 18 cows (range 7–118. More than 85% of the herds had sheds providing one or more cubicles per cow. The mean herd occurrence of cubicle refusal was 6%, but showed great variation (range 0–55%. Regression analysis showed a significant association between rearing heifers in slatted floor pens and an increased cubicle refusal occurrence (p = 0.02, R2 = 0.05, while herd size, use of litter, or cubicle-to-animal ratio were not found to be associated with cubicle refusal. The practice of rearing heifers in slatted floor pens accounted for about one half of the observed cubicle refusal (etiologic fraction = 0.51.

  10. 30 CFR 77.215-4 - Refuse piles; abandonment.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles; abandonment. 77.215-4 Section 77... MINES Surface Installations § 77.215-4 Refuse piles; abandonment. When a refuse pile is to be abandoned... refuse pile shall be abandoned in accordance with a plan submitted by the operator and approved by the...

  11. Hospital wastes management containing in radioactive refusals

    International Nuclear Information System (INIS)

    Campi, F.

    1999-01-01

    In large hospitals, featuring a nuclear medicine department, diagnostic examinations and metabolic therapies are performed using an amount of radio drugs per day averaging around some hundreds mCi. Part of these drugs are disposed in the conventional patient related waste and collected within the hospital itself. Before directing the wastes to the disposal, it is necessary verify that they do not contain radioactive materials. This article refers a study on the possibility to perform this verification by means of an automatic radio-metric system, in order to improve the efficiency, the speed and the safety of the control. Measures devoted to determined the minimum detectable activities for the main radionuclides used in the hospitals have been executed, and it has been designed a comprehensive device able to operate automatically, and unattended by any operator, the selection of radioactive refusals [it

  12. 30 CFR 816.83 - Coal mine waste: Refuse piles.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Coal mine waste: Refuse piles. 816.83 Section... ACTIVITIES § 816.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 816.81, the... drainage may not be diverted over the outslope of the refuse piles. Runoff from the areas above the refuse...

  13. 30 CFR 817.83 - Coal mine waste: Refuse piles.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Coal mine waste: Refuse piles. 817.83 Section... ACTIVITIES § 817.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 817.81, the... drainage may not be diverted over the outslope of the refuse pile. Runoff from areas above the refuse pile...

  14. The Legal Ethical Backbone of Conscientious Refusal.

    Science.gov (United States)

    Munthe, Christian; Nielsen, Morten Ebbe Juul

    2017-01-01

    This article analyzes the idea of a legal right to conscientious refusal for healthcare professionals from a basic legal ethical standpoint, using refusal to perform tasks related to legal abortion (in cases of voluntary employment) as a case in point. The idea of a legal right to conscientious refusal is distinguished from ideas regarding moral rights or reasons related to conscientious refusal, and none of the latter are found to support the notion of a legal right. Reasons for allowing some sort of room for conscientious refusal for healthcare professionals based on the importance of cultural identity and the fostering of a critical atmosphere might provide some support, if no countervailing factors apply. One such factor is that a legal right to healthcare professionals' conscientious refusal must comply with basic legal ethical tenets regarding the rule of law and equal treatment, and this requirement is found to create serious problems for those wishing to defend the idea under consideration. We conclude that the notion of a legal right to conscientious refusal for any profession is either fundamentally incompatible with elementary legal ethical requirements, or implausible because it undermines the functioning of a related professional sector (healthcare) or even of society as a whole.

  15. 21 CFR 211.50 - Sewage and refuse.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Sewage and refuse. 211.50 Section 211.50 Food and... CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Buildings and Facilities § 211.50 Sewage and refuse. Sewage, trash, and other refuse in and from the building and immediate premises shall be...

  16. Medication Refusal: Resident Rights, Administration Dilemma.

    Science.gov (United States)

    Haskins, Danielle R; Wick, Jeannette Y

    2017-12-01

    Occasionally, residents actively or passively refuse to take medications. Residents may refuse medication for a number of reasons, including religious beliefs, dietary restrictions, misunderstandings, cognitive impairment, desire to self-harm, or simple inconvenience. This action creates a unique situation for pharmacists and long-term facility staff, especially if patients have dementia. Residents have the legal right to refuse medications, and long-term care facilities need to employ a process to resolve disagreement between the health care team that recommends the medication and the resident who refuses it. In some cases, simple interventions like selecting a different medication or scheduling medications in a different time can address and resolve the resident's objection. If the medical team and the resident cannot resolve their disagreement, often an ethics consultation is helpful. Documenting the resident's refusal to take any or all medications, the health care team's actions and any other outcomes are important. Residents' beliefs may change over time, and the health care team needs to be prepared to revisit the issue as necessary.

  17. Legal briefing: conscience clauses and conscientious refusal.

    Science.gov (United States)

    Pope, Thaddeus Mason

    2010-01-01

    This issue's "Legal Briefing" column covers legal developments pertaining to conscience clauses and conscientious refusal. Not only has this topic been the subject of recent articles in this journal, but it has also been the subject of numerous public and professional discussions. Over the past several months, conscientious refusal disputes have had an unusually high profile not only in courthouses, but also in legislative and regulatory halls across the United States. Healthcare providers' own moral beliefs have been obstructing and are expected to increasingly obstruct patients' access to medical services. For example, some providers, on ethical or moral grounds, have denied: (1) sterilization procedures to pregnant patients, (2) pain medications in end-of-life situations, and (3) information about emergency contraception to rape victims. On the other hand, many healthcare providers have been forced to provide medical treatment that is inconsistent with their moral beliefs. There are two fundamental types of conscientious objection laws. First, there are laws that permit healthcare workers to refuse providing - on ethical, moral, or religious grounds healthcare services that they might otherwise have a legal or employer-mandated obligation to provide. Second, there are laws directed at forcing healthcare workers to provide services to which they might have ethical, moral, or religious objections. Both types of laws are rarely comprehensive, but instead target: (1) certain types of healthcare providers, (2) specific categories of healthcare services, (3) specific patient circumstances, and (4) certain conditions under which a right or obligation is triggered. For the sake of clarity, I have grouped recent legal developments concerning conscientious refusal into eight categories: 1. Abortion: right to refuse 2. Abortion: duty to provide 3. Contraception: right to refuse 4. Contraception: duty to provide 5. Sterilization: right to refuse 6. Fertility, HIV, vaccines

  18. 30 CFR 77.214 - Refuse piles; general.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles; general. 77.214 Section 77.214... Installations § 77.214 Refuse piles; general. (a) Refuse piles constructed on or after July 1, 1971, shall be..., tipples, or other surface installations and such piles shall not be located over abandoned openings or...

  19. Problems and prospects of refuse disposal in nigerian urban centres ...

    African Journals Online (AJOL)

    Refuse disposal is one of the major environmental problems that developing ... The problem of waste management has two parts, that of collection and that of disposal. ... Disposal methods such as dumping sites, incineration, recycling, shipping ... citizenry has roles to play in adopting more suitable solutions to this problem.

  20. Coal refuse reclamation project

    Energy Technology Data Exchange (ETDEWEB)

    Zellmer, S.D.

    1979-04-06

    A 13.8 ha abandoned coal refuse site in southwestern Illinois was reclaimed by recontouring the refuse material and covering it with a minimum 30 cm of soil. The reclamation procedure included determination of the site's final land use, collection of preconstruction environmental data, and development and implementation of engineering plans. The project is demonstrating methods that can be used to reclaim abandoned coal refuse sites, and a multidisciplinary approach is being used to evaluate postconstruction environmental and economic effects of the reclamation effort. Surface water quality has shown significant improvement and plant cover is becoming established on the site. Soil microbial populations are developing and wildlife habitats are forming. The economic value of the site and adjacent properties has increased substantially and the area's aesthetic value has been enhanced. This project is providing valuable design data for future reclamation efforts of this type.

  1. Management of Older Inpatients Who Refuse Nonpsychiatric Medication Within Birmingham and Solihull Mental Health NHS Foundation Trust: Audit.

    Science.gov (United States)

    Umotong, Eno

    2016-12-01

    The effects of poor medication compliance are well documented and include increased morbidity, early mortality, and financial costs to the society. According to national guidelines, when a competent patient refuses medication, the doctor on duty has a responsibility to ensure the patient understands their proposed course of action. The aims of this audit were to evaluate whether this consultation was taking place within older in-patient units across Birmingham and Solihull Mental Health NHS Foundation Trust when patients refuse nonpsychiatric medicines. Poor compliance was defined as more than five refusals of a nonpsychiatric medication over a 4-week period. A discussion with the duty doctor occurred in 75% of cases (27/36), which resulted in a change in prescription or compliance in 59% (16/27 patients). After patient refusal of medication, a consultation with the duty doctor is likely to improve compliance and uncover salient issues particularly in regards to capacity and drug suitability.

  2. Personal values and cancer treatment refusal

    NARCIS (Netherlands)

    Evert van Leeuwen; Marli Huijer

    2000-01-01

    This pilot study explores the reasons patients have for refusing chemotherapy, and the ways oncologists respond to them. Our hypothesis, generated from interviews with patients and oncologists, is that an ethical approach that views a refusal as an autonomous choice, in which patients are informed

  3. 30 CFR 77.215-1 - Refuse piles; identification.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles; identification. 77.215-1 Section... COAL MINES Surface Installations § 77.215-1 Refuse piles; identification. A permanent identification marker, at least six feet high and showing the refuse pile identification number as assigned by the...

  4. 30 CFR 77.215 - Refuse piles; construction requirements.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles; construction requirements. 77.215... COAL MINES Surface Installations § 77.215 Refuse piles; construction requirements. (a) Refuse deposited on a pile shall be spread in layers and compacted in such a manner so as to minimize the flow of air...

  5. 25 CFR 135.23 - Refusal of water delivery.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Refusal of water delivery. 135.23 Section 135.23 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES CONSTRUCTION ASSESSMENTS, CROW... District § 135.23 Refusal of water delivery. The right is reserved to refuse the delivery of water to any...

  6. "No Thank You, We'd Rather Not": The Rights and Policies of Daily Newspapers Relating to Refusals to Accept Advertising.

    Science.gov (United States)

    Utt, Sandra H.; Pasternack, Steve

    A study investigated the types of advertisements newspapers refuse as well as the attitudes of advertising managers about guidelines and laws concerning advertising refusal. Newspapers were selected from the "1985 Editor and Publisher Yearbook" using a systematic probability sampling method, and questionnaires were mailed to advertising…

  7. 25 CFR 135.6 - Refusal of water delivery.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Refusal of water delivery. 135.6 Section 135.6 Indians... INDIAN IRRIGATION PROJECT Charges Assessed Against Irrigation District Lands § 135.6 Refusal of water delivery. The right is reserved to the United States to refuse the delivery of water to each of the said...

  8. Project Startup: Evaluating the Performance of Hydraulic Hybrid Refuse Vehicles

    Energy Technology Data Exchange (ETDEWEB)

    2015-09-01

    The Fleet Test and Evaluation Team at the National Renewable Energy Laboratory (NREL) is evaluating the in-service performance of 10 next-generation hydraulic hybrid refuse vehicles (HHVs), 8 previous-generation HHVs, and 8 comparable conventional diesel vehicles operated by Miami-Dade County's Public Works and Waste Management Department in southern Florida. The HHVs under study - Autocar E3 refuse trucks equipped with Parker Hannifin's RunWise Advanced Series Hybrid Drive systems - can recover as much as 70 percent of the energy typically lost during braking and reuse it to power the vehicle. NREL's evaluation will assess the performance of this technology in commercial operation and help Miami-Dade County determine the ideal routes for maximizing the fuel-saving potential of its HHVs.

  9. Ignition processes in the refuse bed of a refuse incineration plant. Gomi shokyakuro ni okeru gomi sonai no chakka katei

    Energy Technology Data Exchange (ETDEWEB)

    Goromaru, T; Onishi, K; Iwakawa, N; Yoshikuni, N [Fukuoka Univ., Fukuoka, (Japan)

    1990-03-01

    The ignition process was studied in this paper, which was particularly connected with the drying process of refuse in the statical characteristics of refuse incinerators. Because of variety in refuse forms to be supplied to the incinerators, a physical model was composed, assuming that refuse was the layers of piled up refuse elements with uniform forms, and the ignition curves of the layers were drawn on the basis of the above model after a mathematical model was formed. The upper part of the curves was altered so that it suits to actual endothermic and heat velocity distribution on the assumption of temperature distribution in the incinerators at their inlet side. No particular alteration was made in their middle part, then the ignition curves were changed to almost straight lines inclined downward. Unburnt and refuse under firing were wrapped by ash and uncombustibles, so the lower part of the curves was only studied as a imaginary solid model by the two methods of finite element method and simple analytical one, and conversion was made into equivalent reduction in combustion temperature. 15 refs., 7 figs., 2 tabs.

  10. School Refusal

    Science.gov (United States)

    Wimmer, Mary

    2008-01-01

    School attendance is an ongoing concern for administrators, particularly in middle level and high school. Frequent absences affect student learning, test scores, and social development. Absenteeism is often the result of emotional disorders, such as anxiety or depression. Administrators who understand the causes of school refusal behavior and are…

  11. 20 CFR 401.70 - Appeals of refusals to correct records or refusals to allow access to records.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Appeals of refusals to correct records or refusals to allow access to records. 401.70 Section 401.70 Employees' Benefits SOCIAL SECURITY... also inform you that you have a right to file a statement of disagreement with the decision. Your...

  12. DEVELOPMENT AND DEMONSTRATION OF INTEGRATED CARBON RECOVERY SYSTEMS FROM FINE COAL PROCESSING WASTE

    Energy Technology Data Exchange (ETDEWEB)

    Y.P. Chugh; D. Patil; A. Patwardhan; R.Q. Honaker; B.K. Parekh; D. Tao; Latif Khan

    2000-07-01

    The project involves the development of an efficient, environmentally friendly system for the economical recovery of carbon from fine-coal refuse ponds. The project will be conducted in two phases. Phase I was involved in the development and evaluation of process equipment and techniques to be used in carbon recovery, product dewatering and reconstitution, and refuse management. Phase II will integrate the various units into a continuously operating circuit that will be demonstrated at a site selected based on the results presented in this study.

  13. Integrated nursery pest management

    Science.gov (United States)

    R. Kasten Dumroese

    2012-01-01

    What is integrated pest management? Take a look at the definition of each word to better understand the concept. Two of the words (integrated and management) are relatively straightforward. Integrated means to blend pieces or concepts into a unified whole, and management is the wise use of techniques to successfully accomplish a desired outcome. A pest is any biotic (...

  14. Differences between "refusers" and "non-refusers" in a psychological study.

    NARCIS (Netherlands)

    Hoogstraten, J.; Vorst, H.C.M.

    1972-01-01

    Administered the ABV (Amsterdam Biographical Questionnaire) and the LOS (Leadership Concept Scale) to 98 students. The directions indicated that the Ss need not comply with the requirement to complete the LOS. 21 Ss failed to avail themselves of this permission and were labeled "refusers" (A). Their

  15. Integral consideration of integrated management systems

    International Nuclear Information System (INIS)

    Frauenknecht, Stefan; Schmitz, Hans

    2010-01-01

    Aim of the project for the NPPs Kruemmel and Brunsbuettel (Vattenfall) is the integral view of the business process as basis for the implementation and operation of management systems in the domains quality, safety and environment. The authors describe the integral view of the business processes in the frame of integrated management systems with the focus nuclear safety, lessons learned in the past, the concept of a process-based controlling system and experiences from the practical realization.

  16. Primary care pediatricians' perceptions of vaccine refusal in europe.

    Science.gov (United States)

    Grossman, Zachi; van Esso, Diego; Del Torso, Stefano; Hadjipanayis, Adamos; Drabik, Anna; Gerber, Andreas; Miron, Dan

    2011-03-01

    An electronic survey assessing primary care pediatricians' estimations and practices regarding parents' vaccination refusal was sent to 395 members of the European Academy of Pediatrics Research in Ambulatory Setting network, with a response rate of 87%. Of respondents who vaccinate in the clinic, 93% estimated the total vaccine refusal rate as refusing parents.

  17. Persian Speakers' Use of Refusal Strategies across Politeness Systems

    Science.gov (United States)

    Salmani Nodoushan, Mohammad Ali

    2016-01-01

    This study aimed at investigating the preferred refusal strategies in Persian. 3047 refusals collected by 108 field workers as well as 376 refusals collected through face to face interviews were analyzed and classified according to the descriptions proposed by Liao (1994) and Liao and Bresnahan (1996). The frequencies of the resulting direct and…

  18. 19 CFR 12.114 - Release or refusal of delivery.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Release or refusal of delivery. 12.114 Section 12... delivery. If the completed Notice of Arrival directs the port director to release the shipment of... directs the port director to refuse delivery of the shipment, the shipment shall be refused delivery and...

  19. NREL Evaluates Performance of Hydraulic Hybrid Refuse Vehicles

    Energy Technology Data Exchange (ETDEWEB)

    2015-09-01

    This highlight describes NREL's evaluation of the in-service performance of 10 next-generation hydraulic hybrid refuse vehicles (HHVs), 8 previous-generation (model year 2013) HHVs, and 8 comparable conventional diesel vehicles operated by Miami-Dade County's Public Works and Waste Management Department in southern Florida. Launched in March 2015, the on-road portion of this 12-month evaluation focuses on collecting and analyzing vehicle performance data - fuel economy, maintenance costs, and drive cycles - from the HHVs and the conventional diesel vehicles. The fuel economy of heavy-duty vehicles, such as refuse trucks, is largely dependent on the load carried and the drive cycles on which they operate. In the right applications, HHVs offer a potential fuel-cost advantage over their conventional counterparts. This advantage is contingent, however, on driving behavior and drive cycles with high kinetic intensity that take advantage of regenerative braking. NREL's evaluation will assess the performance of this technology in commercial operation and help Miami-Dade County determine the ideal routes for maximizing the fuel-saving potential of its HHVs. Based on the field data, NREL will develop a validated vehicle model using the Future Automotive Systems Technology Simulator, also known as FASTSim, to study the impacts of route selection and other vehicle parameters. NREL is also analyzing fueling and maintenance data to support total-cost-of-ownership estimations and forecasts. The study aims to improve understanding of the overall usage and effectiveness of HHVs in refuse operation compared to similar conventional vehicles and to provide unbiased technical information to interested stakeholders.

  20. The Secret Drama at the Patient's Bedside-Refusal of Treatment Because of the Practitioner's Ethnic Identity: The Medical Staff 's Point of View.

    Science.gov (United States)

    Popper-Giveon, Ariela; Keshet, Yael

    2018-04-01

    Patients' refusal of treatment based on the practitioner's ethnic identity reveals a clash of values: neutrality in medicine versus patient-centered care. Taking the Israeli-Palestinian conflict into account, this article aims at examining Israeli health care professionals' points of view concerning patients' refusal of treatment because of a practitioner's ethnic identity. Fifty in-depth interviews were conducted with 10 managers and 40 health care professionals, Jewish and Arab, employed at 11 public hospitals. Most refusal incidents recorded are unidirectional: Jewish patients refusing to be treated by Arab practitioners. Refusals are usually directed toward nurses and junior medical staff members, especially if recognizable as religious Muslims. Refusals are often initiated by the patients' relatives and occur more frequently during periods of escalation in the conflict. The structural competency approach can be applied to increase awareness of the role of social determinants in shaping patients' ethnic-based treatment refusals and to improve the handling of such incidents.

  1. Denitrification capacity of bioreactors filled with refuse at different landfill ages

    International Nuclear Information System (INIS)

    Chen Yingxu; Wu Songwei; Wu Weixiang; Sun Hua; Ding Ying

    2009-01-01

    The denitrification capacity of refuse at different landfill ages in bioreactor landfill system was studied. Three reactors filled with 1-year-old refuse (R1), 6-year-old refuse (R6) and 11-year-old refuse (R11), respectively, were operated in the experiment. Nitrate solution (1000 mg NO 3 - -N L -1 ) was added into each reactor. The results showed that the reactors were all able to consume nitrate. However, 1-year-old refuse in R1 had both a higher nitrate reduction rate and concentration of N 2 . In addition, vertical differences in nitrate removal along the depth of R1 were observed. The bottom-layer refuse and the middle-layer refuse both showed higher efficiency in nitrate depletion than the top layer. Furthermore, N 2 O accumulation was found in R11 with the concentration up to 19.3% of the released gas. These results suggested that 1-year-old refuse, which was partly degraded, was more suitable to use as denitrification medium.

  2. 36 CFR 1002.14 - Sanitation and refuse.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Sanitation and refuse. 1002.14 Section 1002.14 Parks, Forests, and Public Property PRESIDIO TRUST RESOURCE PROTECTION, PUBLIC USE AND RECREATION § 1002.14 Sanitation and refuse. (a) The following are prohibited: (1) Disposing of...

  3. Conscientious objection and refusal to provide reproductive healthcare: a White Paper examining prevalence, health consequences, and policy responses.

    Science.gov (United States)

    Chavkin, Wendy; Leitman, Liddy; Polin, Kate

    2013-12-01

    Global Doctors for Choice-a transnational network of physician advocates for reproductive health and rights-began exploring the phenomenon of conscience-based refusal of reproductive healthcare as a result of increasing reports of harms worldwide. The present White Paper examines the prevalence and impact of such refusal and reviews policy efforts to balance individual conscience, autonomy in reproductive decision making, safeguards for health, and professional medical integrity. The White Paper draws on medical, public health, legal, ethical, and social science literature published between 1998 and 2013 in English, French, German, Italian, Portuguese, and Spanish. Estimates of prevalence are difficult to obtain, as there is no consensus about criteria for refuser status and no standardized definition of the practice, and the studies have sampling and other methodologic limitations. The White Paper reviews these data and offers logical frameworks to represent the possible health and health system consequences of conscience-based refusal to provide abortion; assisted reproductive technologies; contraception; treatment in cases of maternal health risk and inevitable pregnancy loss; and prenatal diagnosis. It concludes by categorizing legal, regulatory, and other policy responses to the practice. Empirical evidence is essential for varied political actors as they respond with policies or regulations to the competing concerns at stake. Further research and training in diverse geopolitical settings are required. With dual commitments toward their own conscience and their obligations to patients' health and rights, providers and professional medical/public health societies must lead attempts to respond to conscience-based refusal and to safeguard reproductive health, medical integrity, and women's lives. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  4. Characteristics and Outcomes of Elderly Patients Refused to ICU

    Directory of Open Access Journals (Sweden)

    María-Consuelo Pintado

    2013-01-01

    Full Text Available Background. There are few data regarding the process of deciding which elderly patients are refused to ICU admission, their characteristics, and outcome. Methods. Prospective longitudinal observational cohort study. We included all consecutive patients older than 75 years, who were evaluated for admission to but were refused to treatment in ICU, during 18 months, with 12-month followup. We collected demographic data, ICU admission/refusal reasons, previous functional and cognitive status, comorbidity, severity of illness, and hospital and 12-month mortality. Results. 338 elderly patients were evaluated for ICU admission and 88 were refused to ICU (26%. Patients refused because they were “too ill to benefit” had more comorbidity and worse functional and mental situation than those admitted to ICU; there were no differences in illness severity. Hospital mortality rate of the whole study cohort was 36.3%, higher in patients “too ill to benefit” (55.6% versus 35.8%, P<0.01, which also have higher 1-year mortality (73.7% versus 42.5%, P<0.01. High comorbidity, low functional status, unavailable ICU beds, and age were associated with refusal decision on multivariate analysis. Conclusions. Prior functional status and comorbidity, not only the age or severity of illness, can help us more to make the right decision of admitting or refusing to ICU patients older than 75 years.

  5. [Perioperative management of Jehovah's Witness patients. Special consideration of religiously motivated refusal of allogeneic blood transfusion].

    Science.gov (United States)

    Habler, O; Voss, B

    2010-04-01

    The religious organization of Jehovah's Witnesses numbers more than 7 million members worldwide, including 165,000 members in Germany. Although Jehovah's Witnesses strictly refuse the transfusion of allogeneic red blood cells, platelets and plasma, Jehovah's Witness patients may nevertheless benefit from modern therapeutic concepts including major surgical procedures without facing an excessive risk of death. The present review describes the perioperative management of surgical Jehovah's Witness patients aiming to prevent fatal anemia and coagulopathy. The cornerstones of this concept are 1) education of the patient about blood conservation techniques generally accepted by Jehovah's Witnesses, 2) preoperative optimization of the cardiopulmonary status and correction of preoperative anemia and coagulopathy, 3) perioperative collection of autologous blood, 4) minimization of perioperative blood loss and 5) utilization of the organism's natural anemia tolerance and its acute accentuation in the case of life-threatening anemia.

  6. 36 CFR 2.14 - Sanitation and refuse.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Sanitation and refuse. 2.14 Section 2.14 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR RESOURCE PROTECTION, PUBLIC USE AND RECREATION § 2.14 Sanitation and refuse. (a) The following are...

  7. Refusal of Curative Radiation Therapy and Surgery Among Patients With Cancer

    International Nuclear Information System (INIS)

    Aizer, Ayal A.; Chen, Ming-Hui; Parekh, Arti; Choueiri, Toni K.; Hoffman, Karen E.; Kim, Simon P.; Martin, Neil E.; Hu, Jim C.; Trinh, Quoc-Dien; Nguyen, Paul L.

    2014-01-01

    Purpose: Surgery and radiation therapy represent the only curative options for many patients with solid malignancies. However, despite the recommendations of their physicians, some patients refuse these therapies. This study characterized factors associated with refusal of surgical or radiation therapy as well as the impact of refusal of recommended therapy on patients with localized malignancies. Methods and Materials: We used the Surveillance, Epidemiology, and End Results program to identify a population-based sample of 925,127 patients who had diagnoses of 1 of 8 common malignancies for which surgery and/or radiation are believed to confer a survival benefit between 1995 and 2008. Refusal of oncologic therapy, as documented in the SEER database, was the primary outcome measure. Multivariable logistic regression was used to investigate factors associated with refusal. The impact of refusal of therapy on cancer-specific mortality was assessed with Fine and Gray's competing risks regression. Results: In total, 2441 of 692,938 patients (0.4%) refused surgery, and 2113 of 232,189 patients (0.9%) refused radiation, despite the recommendations of their physicians. On multivariable analysis, advancing age, decreasing annual income, nonwhite race, and unmarried status were associated with refusal of surgery, whereas advancing age, decreasing annual income, Asian American race, and unmarried status were associated with refusal of radiation (P<.001 in all cases). Refusal of surgery and radiation were associated with increased estimates of cancer-specific mortality for all malignancies evaluated (hazard ratio [HR], 2.80, 95% confidence interval [CI], 2.59-3.03; P<.001 and HR 1.97 [95% CI, 1.78-2.18]; P<.001, respectively). Conclusions: Nonwhite, less affluent, and unmarried patients are more likely to refuse curative surgical and/or radiation-based oncologic therapy, raising concern that socioeconomic factors may drive some patients to forego potentially life

  8. Refusal of Curative Radiation Therapy and Surgery Among Patients With Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Aizer, Ayal A., E-mail: aaaizer@partners.org [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Chen, Ming-Hui [Department of Statistics, University of Connecticut, Storrs, Connecticut (United States); Parekh, Arti [Boston University School of Medicine, Boston, Massachusetts (United States); Choueiri, Toni K. [Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Harvard Medical School, Boston, Massachusetts (United States); Hoffman, Karen E. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Kim, Simon P. [Department of Urology, Mayo Clinic, Rochester, Minnesota (United States); Martin, Neil E. [Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Harvard Medical School, Boston, Massachusetts (United States); Hu, Jim C. [Department of Urology, University of California, Los Angeles, California (United States); Trinh, Quoc-Dien [Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec (Canada); Nguyen, Paul L. [Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Harvard Medical School, Boston, Massachusetts (United States)

    2014-07-15

    Purpose: Surgery and radiation therapy represent the only curative options for many patients with solid malignancies. However, despite the recommendations of their physicians, some patients refuse these therapies. This study characterized factors associated with refusal of surgical or radiation therapy as well as the impact of refusal of recommended therapy on patients with localized malignancies. Methods and Materials: We used the Surveillance, Epidemiology, and End Results program to identify a population-based sample of 925,127 patients who had diagnoses of 1 of 8 common malignancies for which surgery and/or radiation are believed to confer a survival benefit between 1995 and 2008. Refusal of oncologic therapy, as documented in the SEER database, was the primary outcome measure. Multivariable logistic regression was used to investigate factors associated with refusal. The impact of refusal of therapy on cancer-specific mortality was assessed with Fine and Gray's competing risks regression. Results: In total, 2441 of 692,938 patients (0.4%) refused surgery, and 2113 of 232,189 patients (0.9%) refused radiation, despite the recommendations of their physicians. On multivariable analysis, advancing age, decreasing annual income, nonwhite race, and unmarried status were associated with refusal of surgery, whereas advancing age, decreasing annual income, Asian American race, and unmarried status were associated with refusal of radiation (P<.001 in all cases). Refusal of surgery and radiation were associated with increased estimates of cancer-specific mortality for all malignancies evaluated (hazard ratio [HR], 2.80, 95% confidence interval [CI], 2.59-3.03; P<.001 and HR 1.97 [95% CI, 1.78-2.18]; P<.001, respectively). Conclusions: Nonwhite, less affluent, and unmarried patients are more likely to refuse curative surgical and/or radiation-based oncologic therapy, raising concern that socioeconomic factors may drive some patients to forego potentially life

  9. Clinical practice guidelines of the French Association for Supportive Care in Cancer and the French Society for Psycho-oncology: refusal of treatment by adults afflicted with cancer.

    Science.gov (United States)

    Faivre, J C; Adam, V; Block, V; Metzger, M; Salleron, J; Dauchy, S

    2017-11-01

    The study's purpose was to develop practical guidelines for assessment and management of refusal of treatment by adults afflicted with cancer. The French Association for Supportive Care in Cancer and the French Society for Psycho-oncology gathered a task force that applied a consensus methodology to draft guidelines studied predisposing situations, the diagnosis, regulatory aspects, and the management of refusal of treatment by adults afflicted with cancer. We propose five guidelines: (1) be aware of the conditions/profiles of patients most often associated with refusal of treatment so as to adequately underpin the care and support measures; (2) understand the complexity of the process of refusal and knowing how to accurately identify the type and the modalities of the refused treatments; (3) apply a way to systematically analyze refusal, thereby promoting progression from a situation of disaccord toward a consensual decision; (4) devise procedures, according to the legal context, to address refusal of treatment that safeguards the stakeholders in situations of sustained disaccord; and (5) know the indications for ethical collective decision-making. The quality of the relationship between patients and health professionals, and the communication between them are essential components involved in reaching a point of consent or refusal of treatment. A process of systematic analysis of refusal is recommended as the only way to ensure that all of the physiological, psychological, and contextual elements that are potentially involved are taken into account.

  10. Information Security Management - Part Of The Integrated Management System

    Science.gov (United States)

    Manea, Constantin Adrian

    2015-07-01

    The international management standards allow their integrated approach, thereby combining aspects of particular importance to the activity of any organization, from the quality management systems or the environmental management of the information security systems or the business continuity management systems. Although there is no national or international regulation, nor a defined standard for the Integrated Management System, the need to implement an integrated system occurs within the organization, which feels the opportunity to integrate the management components into a cohesive system, in agreement with the purpose and mission publicly stated. The issues relating to information security in the organization, from the perspective of the management system, raise serious questions to any organization in the current context of electronic information, reason for which we consider not only appropriate but necessary to promote and implement an Integrated Management System Quality - Environment - Health and Operational Security - Information Security

  11. Refusal Skill Ability: An Examination of Adolescent Perceptions of Effectiveness

    Science.gov (United States)

    Nichols, Tracy R.; Birnel, Sara; Graber, Julia A.; Brooks-Gunn, Jeanne; Botvin, Gilbert J.

    2010-01-01

    This pilot study examined whether refusal assertion as defined by a proven drug prevention program was associated with adolescent perceptions of effectiveness by comparing two sets of coded responses to adolescent videotaped refusal role-plays (N = 63). The original set of codes was defined by programmatic standards of refusal assertion and the…

  12. 47 CFR 73.4005 - Advertising-refusal to sell.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Advertising-refusal to sell. 73.4005 Section 73.4005 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES RADIO BROADCAST SERVICES Rules Applicable to All Broadcast Stations § 73.4005 Advertising—refusal to sell. See 412...

  13. Integrating fire management analysis into land management planning

    Science.gov (United States)

    Thomas J. Mills

    1983-01-01

    The analysis of alternative fire management programs should be integrated into the land and resource management planning process, but a single fire management analysis model cannot meet all planning needs. Therefore, a set of simulation models that are analytically separate from integrated land management planning models are required. The design of four levels of fire...

  14. Pipeline integrity management

    Energy Technology Data Exchange (ETDEWEB)

    Guyt, J.; Macara, C.

    1997-12-31

    This paper focuses on some of the issues necessary for pipeline operators to consider when addressing the challenge of managing the integrity of their systems. Topics are: Definition; business justification; creation and safeguarding of technical integrity; control and deviation from technical integrity; pipelines; pipeline failure assessment; pipeline integrity assessment; leak detection; emergency response. 6 figs., 3 tabs.

  15. Refusal of curative radiation therapy and surgery among patients with cancer.

    Science.gov (United States)

    Aizer, Ayal A; Chen, Ming-Hui; Parekh, Arti; Choueiri, Toni K; Hoffman, Karen E; Kim, Simon P; Martin, Neil E; Hu, Jim C; Trinh, Quoc-Dien; Nguyen, Paul L

    2014-07-15

    Surgery and radiation therapy represent the only curative options for many patients with solid malignancies. However, despite the recommendations of their physicians, some patients refuse these therapies. This study characterized factors associated with refusal of surgical or radiation therapy as well as the impact of refusal of recommended therapy on patients with localized malignancies. We used the Surveillance, Epidemiology, and End Results program to identify a population-based sample of 925,127 patients who had diagnoses of 1 of 8 common malignancies for which surgery and/or radiation are believed to confer a survival benefit between 1995 and 2008. Refusal of oncologic therapy, as documented in the SEER database, was the primary outcome measure. Multivariable logistic regression was used to investigate factors associated with refusal. The impact of refusal of therapy on cancer-specific mortality was assessed with Fine and Gray's competing risks regression. In total, 2441 of 692,938 patients (0.4%) refused surgery, and 2113 of 232,189 patients (0.9%) refused radiation, despite the recommendations of their physicians. On multivariable analysis, advancing age, decreasing annual income, nonwhite race, and unmarried status were associated with refusal of surgery, whereas advancing age, decreasing annual income, Asian American race, and unmarried status were associated with refusal of radiation (PRefusal of surgery and radiation were associated with increased estimates of cancer-specific mortality for all malignancies evaluated (hazard ratio [HR], 2.80, 95% confidence interval [CI], 2.59-3.03; Prefuse curative surgical and/or radiation-based oncologic therapy, raising concern that socioeconomic factors may drive some patients to forego potentially life-saving care. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Microbial ecology of coal mine refuse

    Energy Technology Data Exchange (ETDEWEB)

    Cameron, R. E.; Miller, R. M.

    1977-01-01

    Baseline microbial and ecological studies of samples obtained from two abandoned coal mine refuse sites in the State of Illinois indicate that the unfavorable nature of refuse materials can be a very limiting factor for survival and growth of organisms. Despite the ''foothold'' obtained by some microorganisms, especially acidophilic fungi and some acidotolerant algae, the refuse materials should be amended or ameliorated to raise the pH, provide needed nutrients, especially nitrogen, and provide biodegradable organic matter, both for physical and biological purposes. Finally, the role of microbial populations, responses, and interactions in acid mine wastes must be put into larger perspective. Acid mine drainage amounts to over 4 million tons per year of acidity from active and abandoned mines. Microorganisms appear to be significantly responsible for this problem, but they also can play a beneficial and significant role in the amelioration or alleviation of this detrimental effect as abandoned mines are reclaimed and returned to useful productivity.

  17. Elemental composition of suspended particles released in refuse incineration

    International Nuclear Information System (INIS)

    Mamuro, Tetsuo; Mizohata, Akira

    1979-01-01

    Suspended particles released in refuse incineration were subjected to multielement analysis by means of instrumental neutron activation method and energy dispersive X-ray fluorescence spectrometry. The analytical results were compared with the elemental concentrations observed in the urban atmosphere, and the contribution of the refuse incineration to the urban atmosphere was roughly estimated. Greenberg et al. pointed out on the basis of their analyses that the refuse incineration can account for major portions of the Zn, Cd and Sb observed on urban aerosols. According to our results, the contribution of the refuse incineration for Zn, Cd and Sb is not negligible, but not so serious as in U.S.A. big cities. In Japan big cities there must be other more important sources of these elements. (author)

  18. Process for producing a fuel suitable for degassing from refuse

    Energy Technology Data Exchange (ETDEWEB)

    Sulzberger, J

    1975-11-20

    Utilization of the heat energy of refuse in waste incineration plants is time-consuming and expensive due to high investment and operation costs. The inventor recommends to process the refuse to a sterile, handy and storable fuel. For this propose the refuse should be crushed, kneaded and pressed. The briquettes produced in this way should be dried.

  19. Autonomy, religious values, and refusal of lifesaving medical treatment.

    OpenAIRE

    Wreen, M J

    1991-01-01

    The principal question of this paper is: Why are religious values special in refusal of lifesaving medical treatment? This question is approached through a critical examination of a common kind of refusal of treatment case, one involving a rational adult. The central value cited in defence of honouring such a patient's refusal is autonomy. Once autonomy is isolated from other justificatory factors, however, possible cases can be imagined which cast doubt on the great valuational weight assign...

  20. 14 CFR 121.586 - Authority to refuse transportation.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Authority to refuse transportation. 121.586 Section 121.586 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... transportation. (a) No certificate holder may refuse transportation to a passenger on the basis that, because the...

  1. Situation testing: the case of health care refusal.

    Science.gov (United States)

    Després, C; Couralet, P-E

    2011-04-01

    Situation testing to assess physicians' refusal to provide healthcare is increasingly used in research studies. This paper aims to explain the relevance and limits of this method. Conducted in 2008-2009, this study was designed to assess the rate of healthcare refusal among several categories of private practitioners toward patients covered by the French public means-tested complementary health insurance (CMUc) when they requested a first appointment by phone. The other objectives were to study the determinants of healthcare refusal and assess the method. The study was conducted on a representative sample of Paris-based dentists and physicians in five categories: general practitioners, medical gynecologists, ophthalmologists, radiologists, and dentists. The method was based on two protocols. In the first scenario, an actor pretended to be a CMUc beneficiary and, in the second one, he did not give information about his health coverage but hinted at a low socioeconomic status. The two protocols were compared and procedures checking the relation between refusal and CMUc coverage were implemented in each of them. In the scenario in which the patient declared being a CMUc beneficiary, the results showed different refusal rates depending on the type of practitioner, physician, or dentist, their specialty, and whether or not, they charge more than the standard set fee. In the second scenario, refusal rates were much lower. The comparison of the two protocols seems to confirm the existence of discrimination based on CMUc affiliation rather than patients' socioeconomic status. The discussion presents the limits of situation testing, which remains an experimental instrument because it does not observe reality but reveals behaviors in situation. The findings cannot be extrapolated and are limited in time. The statistical analysis is only valid if the procedure followed is precise and applied consistently using a preset scenario. In addition, the discriminatory nature of the

  2. [Refusal of nursing care, the legal perspective].

    Science.gov (United States)

    Fisman, Jérôme

    2016-10-01

    The refusal of nursing care forms part of the freedom offered to anyone wanting to refuse, consciously and knowingly, any form of nursing care such as washing, the taking of medication or hospitalisation. However, limits are fixed by law as well as by case law. Are we totally free in the expression of our will? Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  3. Alternative Fuels Data Center: Virginia Cleans up With Natural Gas Refuse

    Science.gov (United States)

    Trucks Virginia Cleans up With Natural Gas Refuse Trucks to someone by E-mail Share Alternative Fuels Data Center: Virginia Cleans up With Natural Gas Refuse Trucks on Facebook Tweet about Alternative Fuels Data Center: Virginia Cleans up With Natural Gas Refuse Trucks on Twitter Bookmark Alternative

  4. Integrated data management for RODOS

    International Nuclear Information System (INIS)

    Abramowicz, K.; Koschel, A.; Rafat, M.; Wendelgass, R.

    1995-12-01

    The report presents the results of a feasibility study on an integrated data organisation and management in RODOS, the real-time on-line decision support system for off-site nuclear emergency management. The conceptual design of the functional components of the integrated data management are described taking account of the software components and the operation environment of the RODOS system. In particular, the scheme architecture of a database integration manager for accessing and updating a multi-database system is discussed in detail under a variety of database management aspects. Furthermore, the structural design of both a simple knowledge database and a real-time database are described. Finally, some short comments on the benefits and disadvantages of the proposed concept of data integration in RODOS are given. (orig.) [de

  5. Patient refusal for regional anesthesia in elderly orthopedic population: A cross-sectional survey at a tertiary care hospital.

    Science.gov (United States)

    Salam, Asma Abdus; Afshan, Gauhar

    2016-01-01

    Improvements in pain management techniques in the last decade have had a major impact on the practice of orthopedic surgeries, for example, total hip arthroplasty and total knee arthroplasty. Although there are a number of treatment options for postoperative pain, a gold standard has not been established. In our institution, both general anesthesia and regional anesthesia (RA), are being offered to the elderly orthopedic population but RA is not frequently accepted by elderly population. The objective of this study was to determine the frequency of various reasons for refusal of RA in elderly patients undergoing orthopedic surgeries. A prospective study conducted over a period of 1 year, had 549 patients with ages above 60 years who underwent different types of elective orthopedic procedures 182 patients who refused RA were interviewed according to a structured questionnaire designed to assess the reasons of refusal. Most common reason for the refusal of RA was surgeon's choice (38.5%), whereas 20.3% of the patients were unaware about the RA. There was a significant association between female gender and refusing RA due to backache (17.2%) and fear of being awake during the operation (24.1%) respectively. This survey showed that the main reasons among elderly female population were the fear of remaining awake and backache. However, overall it was the surgeon's choice which made patients refuse RA, and the anesthesiologists were the main source of information.

  6. School Refusal: Assessment and Intervention within School Settings.

    Science.gov (United States)

    Wimmer, Mary B.

    Anxiety-based school refusal occurs in 2% of school-age children. The reasons why they refuse to go school range from mental illness and learning problems to general defiance and a desire for attention. Early identification and multi-faceted assessment and interventions are critical to addressing the problem. This book offers concise, practical…

  7. Risk factors associated with treatment refusal in lung cancer.

    Science.gov (United States)

    Suh, Won Na; Kong, Kyoung Ae; Han, Yeji; Kim, Soo Jung; Lee, Su Hwan; Ryu, Yon Ju; Lee, Jin Hwa; Shim, Sung Shine; Kim, Yookyung; Chang, Jung Hyun

    2017-09-01

    The incidence of lung cancer is increasing with longer life expectancy. Refusal of active treatment for cancer is prone to cause patients to experience more severe symptoms and shorten survival. The purpose of this study was to define the factors related to refusal or abandonment of active therapy in lung cancer. We retrospectively reviewed the data of 617 patients from medical records from 2010 to 2014. Two groups were formed: 149 patients who refused anti-cancer treatment and allowed only palliative care were classified into the non-treatment group, while the remaining 468 who received anti-cancer treatment were classified into the treatment group. The groups differed significantly in age, employment, relationship status, number of offspring, educational status, body mass index, presence of chest and systemic symptoms, Charlson Comorbidity Index, Eastern Cooperative Oncology Group score, and tumor node metastasis stage ( P refusal of cancer treatment. Individual factors, such as old age, low educational status, low weight, and poor performance status can influence refusal of cancer treatment in patients with lung cancer, and should be considered prior to consultation with patients. © 2017 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

  8. When does food refusal require professional intervention?

    OpenAIRE

    Dovey, Terence M.; Farrow, Claire V.; Martin, Clarissa I.; Isherwood, Elaine; Halford, Jason C.G.

    2009-01-01

    Food refusal can have the potential to lead to nutritional deficiencies, which increases the risk of a variety of communicable and non-communicable diseases. Deciding when food refusal requires professional intervention is complicated by the fact that there is a natural and appropriate stage in a child's development that is characterised by increased levels of rejection of both previously accepted and novel food items. Therefore, choosing to intervene is difficult, which if handled badly can ...

  9. Integrated Work Management: Overview, Course 31881

    Energy Technology Data Exchange (ETDEWEB)

    Simpson, Lewis Edward [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-06-30

    Integrated work management (IWM) is the process used for formally implementing the five-step process associated with integrated safety management (ISM) and integrated safeguards and security management (ISSM) at Los Alamos National Laboratory (LANL). IWM also directly supports the LANL Environmental Management System (EMS). IWM helps all workers and managers perform work safely and securely and in a manner that protects people, the environment, property, and the security of the nation. The IWM process applies to all work activities at LANL, from working in the office to designing experiments to assembling and detonating explosives. The primary LANL document that establishes and describes IWM requirements is Procedure (P) 300, Integrated Work Management.

  10. Refusal of medical treatment in the pediatric emergency service: analysis of reasons and aspects.

    Science.gov (United States)

    Gündüz, Ramiz Coşkun; Halil, Halit; Gürsoy, Cüneyt; Çifci, Atilla; Özgün, Seher; Kodaman, Tuğba; Sönmez, Mehtap

    2014-01-01

    Refusal of treatment for acutely ill children is still an important problem in the emergency service. When families refuse medical treatment for their acutely ill children, healthcare professionals may attempt to provide information and negotiate with the family concerning treatment refusal and its possible adverse outcomes, and request consent for refusal of medical treatment. There is insufficient data about refusal of treatment in our country. The purpose of this study was to analyze the causes of treatment refusal in the pediatric emergency service. We collected data recorded on informed consent forms. During a 2-year-study period, 215 patients refused treatment recommended by acute health care professionals. The majorty of patients were in the 0-2 year age group. Hospitalization was the type of treatment most commonly refused; restrictions regarding family members staying with their children during hospitalization and admission to another hospital were the major reasons for refusal of treatment. Clarifying the reasons for treatment refusal may help us to overcome deficiencies, improve conditions, resolve problems and build confidence between healthcare providers and service users, increasing users' satisfaction in the future.

  11. Current status of research on school refusal

    Directory of Open Access Journals (Sweden)

    Cándido J. Inglés

    2015-06-01

    Full Text Available School refusal behavior refers to the avoidance of a child attending school and/or persistent difficulty staying in the classroom throughout the school day. Based on a review of the scientific literature, the aim of this study is to describe the current state of research on school refusal, differentiating between the findings and progress made in Spain from those achieved in the international field. For this purpose, the significance of this phenomenon, in addition to associated risk factors and variables, will be reviewed in the child and youth population. In turn, the commonly used assessment methods and most recommended treatment proposals, mainly based on cognitive behavioral therapy, are discussed. The results reveal several gaps and subjects for debate in some areas of knowledge about school refusal behavior, with differences being found between Spanish and international studies. In conclusion, future studies and challenges in this field are required.

  12. Refusal to medical interventions.

    Science.gov (United States)

    Palacios, G; Herreros, B; Pacho, E

    2014-10-01

    Refusal to medical interventions is the not acceptance, voluntary and free, of an indicated medical intervention. What the physician should do in case of refusal? It is understandable that the rejection of a validated medical intervention is difficult to accept by the responsible physician when raises the conflict protection of life versus freedom of choice. Therefore it is important to follow some steps to incorporate the most relevant aspects of the conflict. These steps include: 1) Give complete information to patients, informing on possible alternatives, 2) determine whether the patient can decide (age, competency and level of capacity), 3) to ascertain whether the decision is free, 4) analyze the decision with the patient, 5) to persuade, 6) if the patient kept in the rejection decision, consider conscientious objection, 7) take the decision based on the named criteria, 8) finally, if the rejection is accepted, offer available alternatives. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  13. Medication refusal in children with oppositional defiant disorder or conduct disorder and comorbid attention-deficit/hyperactivity disorder: medication history and clinical correlates.

    Science.gov (United States)

    Demidovich, Mark; Kolko, David J; Bukstein, Oscar G; Hart, Jonathan

    2011-02-01

    Abstract Objective: This study examines the characteristics of 96 children with attention-deficit/hyperactivity disorder (ADHD) and their families who refused a recommendation for medication as part of their treatment for disruptive disorders. The ADHD cases were taken from a sample of 139 youth (age 6-11) who were recruited for a clinical trial that compared the administration of a modular psychosocial treatment in an outpatient clinic or community settings. Medication management was an optional treatment module for children with ADHD in both conditions. Children who were (vs. were not) taking medication at intake, and children who accepted (vs. refused) medication recommendations during the study were compared on diagnostic and clinical measures related to child, school, parent, and family domains of functioning. Parents of 30% of the children refused study medication for ADHD. Parental medication acceptability and intake correlated highly with both medication history and study refusal of medication. Increased parental self-efficacy and emotional support for their youth correlated with medication refusal. No demographics and few child or school factors were associated with medication refusal. Medication use was associated with reductions in some key ADHD symptoms, but did not affect disruptive behaviors as did the psychosocial interventions. Medication refusers remain poorly understood but certain correlates, such as parental self-efficacy, parental emotional support for their youth, and medication acceptability, warrant further evaluation.

  14. Racial and Ethnic Disparities in Parental Refusal of Consent in a Large, Multisite Pediatric Critical Care Clinical Trial.

    Science.gov (United States)

    Natale, Joanne E; Lebet, Ruth; Joseph, Jill G; Ulysse, Christine; Ascenzi, Judith; Wypij, David; Curley, Martha A Q

    2017-05-01

    To evaluate whether race or ethnicity was independently associated with parental refusal of consent for their child's participation in a multisite pediatric critical care clinical trial. We performed a secondary analyses of data from Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE), a 31-center cluster randomized trial of sedation management in critically ill children with acute respiratory failure supported on mechanical ventilation. Multivariable logistic regression modeling estimated associations between patient race and ethnicity and parental refusal of study consent. Among the 3438 children meeting enrollment criteria and approached for consent, 2954 had documented race/ethnicity of non-Hispanic White (White), non-Hispanic Black (Black), or Hispanic of any race. Inability to approach for consent was more common for parents of Black (19.5%) compared with White (11.7%) or Hispanic children (13.2%). Among those offered consent, parents of Black (29.5%) and Hispanic children (25.9%) more frequently refused consent than parents of White children (18.2%, P refuse consent. Parents of children offered participation in the intervention arm were more likely to refuse consent than parents in the control arm (OR 2.15, 95% CI 1.37-3.36, P care clinical trial. Ameliorating this racial disparity may improve the validity and generalizability of study findings. ClinicalTrials.gov: NCT00814099. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Refusing The Choice: Balancing Life and Work

    Science.gov (United States)

    Brooks, J.

    2012-12-01

    The Choice The intellect of man is forced to choose perfection of the life, or of the work, And if it take the second must refuse A heavenly mansion, raging in the dark. When all that story's finished, what's the news? In luck or out the toil has left its mark: That old perplexity an empty purse, Or the day's vanity, the night's remorse. William Butler Yeats William Yeats put forward The Choice that I feel too many scientists feel they must make. Too often, many choose to leave science. How do we refuse this choice and find balance between life and our careers? While I don't know the answer, I will share choices that have lead to not perfection but satisfaction in science careers and lives. The role of mentors, supportive spouses, the luck of the job, and flexibility in research directions have all contributed to being able to refuse to choose.

  16. Integrated supply chain risk management

    OpenAIRE

    Riaan Bredell; Jackie Walters

    2007-01-01

    Integrated supply chain risk management (ISCRM) has become indispensable to the theory and practice of supply chain management. The economic and political realities of the modern world require not only a different approach to supply chain management, but also bold steps to secure supply chain performance and sustainable wealth creation. Integrated supply chain risk management provides supply chain organisations with a level of insight into their supply chains yet to be achieved. If correctly ...

  17. Patient Experience Of Provider Refusal Of Medicaid Coverage And Its Implications.

    Science.gov (United States)

    Bhandari, Neeraj; Shi, Yunfeng; Jung, Kyoungrae

    2016-01-01

    Previous studies show that many physicians do not accept new patients with Medicaid coverage, but no study has examined Medicaid enrollees' actual experience of provider refusal of their coverage and its implications. Using the 2012 National Health Interview Survey, we estimate provider refusal of health insurance coverage reported by 23,992 adults with continuous coverage for the past 12 months. We find that among Medicaid enrollees, 6.73% reported their coverage being refused by a provider in 2012, a rate higher than that in Medicare and private insurance by 4.07 (p<.01) and 3.68 (p<.001) percentage points, respectively. Refusal of Medicaid coverage is associated with delaying needed care, using emergency room (ER) as a usual source of care, and perceiving current coverage as worse than last year. In view of the Affordable Care Act's (ACA) Medicaid expansion, future studies should continue monitoring enrollees' experience of coverage refusal.

  18. Integrated Work Management: PIC, Course 31884

    Energy Technology Data Exchange (ETDEWEB)

    Simpson, Lewis Edward [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-09-08

    The person-in-charge (PIC) plays a key role in the integrated work management (IWM) process at Los Alamos National Laboratory (LANL, or the Laboratory) because the PIC is assigned responsibility and authority by the responsible line manager (RLM) for the overall validation, coordination, release, execution, and closeout of a work activity in accordance with IWM. This course, Integrated Work Management: PIC (Course 31884), describes the PIC’s IWM roles and responsibilities. This course also discusses IWM requirements that the PIC must meet. For a general overview of the IWM process, see self-study Course 31881, Integrated Work Management: Overview. For instruction on the preparer’s role, see self-study Course 31883, Integrated Work Management: Preparer.

  19. Business process management and IT management: The missing integration

    DEFF Research Database (Denmark)

    Rahimi, Fatemeh; Møller, Charles; Hvam, Lars

    2016-01-01

    of IT on process innovations, the association between business process management and IT management is under-explored. Drawing on a literature analysis of the capabilities of business process and IT governance frameworks and findings from a case study, we propose the need for horizontal integration between the two......The importance of business processes and the centrality of IT to contemporary organizations' performance calls for a specific focus on business process management and IT management. Despite the wide scope of business process management covering both business and IT domains, and the profound impact...... management functions to enable strategic and operational business - IT alignment. We further argue that the role of IT in an organization influences the direction of integration between the two functions and thus the choice of integration mechanisms. Using case study findings, we propose...

  20. Integrated supply chain risk management

    Directory of Open Access Journals (Sweden)

    Riaan Bredell

    2007-11-01

    Full Text Available Integrated supply chain risk management (ISCRM has become indispensable to the theory and practice of supply chain management. The economic and political realities of the modern world require not only a different approach to supply chain management, but also bold steps to secure supply chain performance and sustainable wealth creation. Integrated supply chain risk management provides supply chain organisations with a level of insight into their supply chains yet to be achieved. If correctly applied, this process may optimise management decision-making and assist in the protection and enhancement of shareholder value.

  1. Integrated Work Management: FOD/RLM, Course 31882

    Energy Technology Data Exchange (ETDEWEB)

    Simpson, Lewis Edward [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-08-07

    The facility operations director (FOD) and responsible line manager (RLM) play leadership and functional roles in the integrated work management (IWM) process at Los Alamos National Laboratory (LANL). This course, Integrated Work Management: FOD/RLM (COURSE 31882), describes the IWM roles and responsibilities of the FOD and the RLM; it also discusses IWM requirements that must be met by the FOD and the RLM. Before taking this course, you may want to take COURSE 31881, Integrated Work Management: Overview. This self-study course would be particularly helpful if you are unfamiliar with the IWM process. You should also read Procedure (P) 300, Integrated Work Management. This course briefly covers the roles of the preparer and person in charge (PIC). For more in-depth instruction on the preparer’s role, see COURSE 31883, Integrated Work Management: Preparer. For instruction on the PIC’s role, see COURSE 31884, Integrated Work Management: PIC.

  2. Parental refusal of life-saving treatments for adolescents: Chinese familism in medical decision-making re-visited.

    Science.gov (United States)

    Hui, Edwin

    2008-06-01

    This paper reports two cases in Hong Kong involving two native Chinese adolescent cancer patients (APs) who were denied their rights to consent to necessary treatments refused by their parents, resulting in serious harm. We argue that the dynamics of the 'AP-physician-family-relationship' and the dominant role Chinese families play in medical decision-making (MDM) are best understood in terms of the tendency to hierarchy and parental authoritarianism in traditional Confucianism. This ethic has been confirmed and endorsed by various Chinese writers from Mainland China and Hong Kong. Rather than giving an unqualified endorsement to this ethic, based more on cultural sentimentalism than rational moral reasoning, we warn that a strong familism in MDM, which deprives 'weak' family members of rights, represents the less desirable elements of this tradition, against which healthcare professionals working in this cultural milieu need to safeguard. Specifically for APs, we suggest that parental authority and family integrity should be re-interpreted in terms of parental responsibility and the enhancement of children's interests respectively, as done in the West. This implies that when parents refuse to consent to necessary treatment and deny their adolescent children's right to consent, doctors, as the only remaining advocates of the APs' interest, have the duty to inform the state, which can override parental refusal to enable the doctors to fulfill their professional and moral obligations. In so doing the state exercises its 'parens patriae' power to defend the defenseless in society and the integrity of the medical profession.

  3. Configuration Management Program - a part of Integrated Management System

    International Nuclear Information System (INIS)

    Mancev, Bogomil; Yordanova, Vanja; Nenkova, Boyka

    2014-01-01

    The recently issued International Atomic Energy Agency (IAEA) publications (GS-R-3, GS-G-3.1 and GS-G-3.5) regarding Management Systems for Facilities and Activities define requirements for creation, introduction, evaluation and continuously improvement of the Management System, which unifies the safety, health, environment, security, quality and economic elements. According to GS-R-3 the Integrated Management System is based on defined processes identified in the enterprises: Managing, Basic and Supporting processes. At implementation of their activities, the organizations often apply other standards in their interrelations with suppliers and the parties concerned - ISO 9001:2008, ISO 14001:2004 and OHSAS 18001:2007, regarding quality, environment and occupational health and safety management. The integration of the standards of both series ensure the observance of the common management principles that reflect the best practices of management as leadership, participation of the people, process approach, continuously improvement, systematical approach to the management and approach based on facts used at the making decisions. The main objective of the Integrated Management System introduction is to ensure safety considering the influence of all additional impacts taken together. The Integrated Management System is based on the process approach at implementation of the activities in nuclear power plant. The transition to the process oriented approach require long period of time, during which the distribution of the responsibilities is optimized up to the level that will satisfy the requirements, reach and maintain the stipulated objectives. The Configuration Management (CM) is an integrated management process by means of which conformity between design requirements, physical configuration and the plant documentation is ascertained and maintained during the entire life cycle of the facility. Processes within configuration management are not isolated, but are part of

  4. Academic Self-Attributions for Success and Failure in Mathematics and School Refusal

    Science.gov (United States)

    Gonzálvez, Carolina; Sanmartín, Ricardo; Vicent, María; Inglés, Cándido J.; Aparicio-Flores, M. Pilar; García-Fernández, José M.

    2018-01-01

    The aim of this research is twofold: to analyze the mean differences scores in mathematic self-attributions based on school refusal and to verify its predictive capability on high scores in school refusal. The Sydney Attribution Scale and the School Refusal Assessment Scale-Revised were administered to 1078 Spanish students (50.8% boys) aged…

  5. [The refusal of nursing care by the families].

    Science.gov (United States)

    Curchod, Claude; Fisher, Marion

    2016-10-01

    Caregiving is complex. While it is not easy to admit that the process can be refused by the patient, it is no easier when it is refused by the patient's family. Accepting this fact is however an essential stage in the relational and care processes. The family must therefore be supported by professionals in order to be able to make an enlightened choice. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  6. INTEGRATIVE AUGMENTATION OF STANDARDIZED MANAGEMENT SYSTEMS

    Directory of Open Access Journals (Sweden)

    Stanislav Karapetrovic

    2008-03-01

    Full Text Available The development, features and integrating abilities of different international standards related to management systems are discussed. A group of such standards that augment the performance of quality management systems in organizations is specifically focused on. The concept, characteristics and an illustrative example of one augmenting standard, namely ISO 10001, are addressed. Integration of standardized augmenting systems, both by themselves and within the overall management system, is examined. It is argued that, in research and practice alike, integrative augmentation represents the future of standardized quality and other management systems.

  7. Delay and refusal of human papillomavirus vaccine for girls, national immunization survey-teen, 2010.

    Science.gov (United States)

    Dorell, Christina; Yankey, David; Jeyarajah, Jenny; Stokley, Shannon; Fisher, Allison; Markowitz, Lauri; Smith, Philip J

    2014-03-01

    Human papillomavirus (HPV) vaccine coverage among girls is low. We used data reported by parents of 4103 girls, 13 to 17 years old, to assess associations with, and reasons for, delaying or refusing HPV vaccination. Sixty-nine percent of parents neither delayed nor refused vaccination, 11% delayed only, 17% refused only, and 3% both delayed and refused. Eighty-three percent of girls who delayed only, 19% who refused only, and 46% who both delayed and refused went on to initiate the vaccine series or intended to initiate it within the next 12 months. A significantly higher proportion of parents of girls who were non-Hispanic white, lived in households with higher incomes, and had mothers with higher education levels, delayed and/or refused vaccination. The most common reasons for nonvaccination were concerns about lasting health problems from the vaccine, wondering about the vaccine's effectiveness, and believing the vaccine is not needed.

  8. Refusal of emergency caesarean section in Ireland: a relational approach.

    Science.gov (United States)

    Wade, Katherine

    2014-01-01

    This article examines the issue of emergency caesarean section refusal. This raises complex legal and ethical issues surrounding autonomy, capacity, and the right to refuse treatment. In Ireland, the situation is complicated further by the constitutional right to life of the unborn. While cases involving caesarean section refusal have occurred in other jurisdictions, a case of this nature has yet to be reported in Ireland. This article examines possible ways in which the interaction of a woman's right to refuse treatment and the right to life of the unborn could be approached in Ireland in the context of caesarean section refusal. The central argument of the article is that the liberal individualistic approach to autonomy evident in the caesarean section cases in England and Wales is difficult to apply in the Irish context, due to the conflicting constitutional rights of the woman and foetus. Thus, alternative visions of autonomy which take the interests and rights of others into account in medical decision-making are examined. In particular, this article focuses on the concept of relational consent, as developed by Alasdair Maclean and examines how such an approach could be applied in the context of caesarean section refusal in Ireland. The article explains why this approach is particularly appropriate and identifies mechanisms through which such a theory of consent could be applied. It is argued that this approach enhances a woman's right to autonomy, while at the same time allows the right to life of the unborn to be defended.

  9. Central Nervous System Disease, Education, and Race Impact Radiation Refusal in Pediatric Cancer Patients.

    Science.gov (United States)

    Patel, Chirayu G; Stavas, Mark; Perkins, Stephanie; Shinohara, Eric T

    2017-07-01

    To investigate the determinants of radiation therapy refusal in pediatric cancer, we used the Surveillance, Epidemiology, and End Results registry to identify 24,421 patients who met the eligibility criteria, diagnosed between 1974 and 2012. Patients had any stage of cancer, were aged 0 to 19, and received radiation therapy or refused radiation therapy when it was recommended. One hundred twenty-eight patients (0.52%) refused radiation therapy when it was recommended. Thirty-two percent of patients who refused radiation therapy ultimately died from their cancer, at a median of 7 months after diagnosis (95% confidence interval, 3-11 mo), as compared with 29.0% of patients who did not refuse radiation therapy died from their cancer, at a median of 17 months after diagnosis (95% confidence interval, 17-18 mo). On multivariable analysis, central nervous system (CNS) site, education, and race were associated with radiation refusal. The odds ratio for radiation refusal for patients with CNS disease was 1.62 (P=0.009) as compared with patients without CNS disease. For patients living in a county with ≥10% residents having less than ninth grade education, the odds ratio for radiation refusal was 1.71 (P=0.008) as compared with patients living in a county with education. Asian, Pacific Islander, Alaska Native, and American Indian races had an odds ratio of 2.12 (P=0.002) for radiation refusal as compared with black or white race. Although the radiation refusal rate in the pediatric cancer population is low, we show that CNS site, education level, and race are associated with a significant difference in radiation refusal.

  10. Perceived Quality of Informed Refusal Process: A Cross-Sectional Study from Iranian Patients' Perspectives.

    Science.gov (United States)

    Farzandipour, Mehrdad; Sheikhtaheri, Abbas; Sadeqi Jabali, Monireh

    2015-12-01

    Patients have the right to refuse their treatment; however, this refusal should be informed. We evaluated the quality of the informed refusal process in Iranian hospitals from patients' viewpoints. To this end, we developed a questionnaire that covered four key aspects of the informed refusal process including; information disclosure, voluntariness, comprehension, and provider-patient relationship. A total of 284 patients who refused their treatment from 12 teaching hospitals in the Isfahan Province, Iran, were recruited and surveyed to produce a convenience sample. Patients' perceptions about the informed refusal process were scored and the mean scores of the four components were calculated. The findings showed that the practice of information disclosure (9.6 ± 6.4 out of 22 points) was perceived to be moderate, however, comprehension (2.3 ± 1.4 out of 4 points), voluntariness (8.7 ± 1.5 out of 12 points) and provider-patient relationship (10.2 ± 5.2 out of 16 points) were perceived to be relatively good. We found that patients, who refused their care before any treatment had commenced, reported a lower quality of information disclosure and voluntariness. Patients informed by nurses and those who had not had a previous related admission, reported lower scores for comprehension and relationship. In conclusion, the process of obtaining informed refusal was relatively satisfactory except for levels of information disclosure. To improve current practices, Iranian patients need to be better informed about; different treatment options, consequences of treatment refusal, costs of not continuing treatment and follow-ups after refusal. Developing more informative refusal forms is needed. © 2014 John Wiley & Sons Ltd.

  11. Heroin refusal self-efficacy and preference for medication-assisted treatment after inpatient detoxification.

    Science.gov (United States)

    Kenney, Shannon R; Bailey, Genie L; Anderson, Bradley J; Stein, Michael D

    2017-10-01

    An individual's self-efficacy to refuse using heroin in high-risk situations is believed to minimize the likelihood for relapse. However, among individuals completing inpatient heroin detoxification, perceived refusal self-efficacy may also reduce one's perceived need for medication-assisted treatment (MAT), an effective and recommended treatment for opioid use disorder. In the current study, we examined the relationship between heroin refusal self-efficacy and preference for MAT following inpatient detoxification. Participants (N=397) were interviewed at the start of brief inpatient opioid detoxification. Multiple logistic regression was used to estimate the adjusted association of background characteristics, depressed mood, and perceived heroin refusal self-efficacy with preference for MAT. Controlling for other covariates, depressed mood and lower perceived refusal self-efficacy were associated with a significantly greater likelihood of expressing preference for MAT (versus no MAT). Perceived ability to refuse heroin after leaving detox is inversely associated with a heroin user's desire for MAT. An effective continuum of care model may benefit from greater attention to patient's perceived refusal self-efficacy during detoxification which may impact preference for MAT and long-term recovery. Copyright © 2017. Published by Elsevier Ltd.

  12. Sodium bicarbonate effects on the anaerobic digestion of refuse

    Energy Technology Data Exchange (ETDEWEB)

    Kasali, G.B.; Senior, E.; Watson-Craik, I.A. (Strathclyde Univ., Glasgow (UK). Dept. of Applied Physics)

    1989-01-01

    Laboratory column and bottle cultures were used to examine the efficacy of NaHCO{sub 3}additions (1%, 2.5% and 5% w/v) to promote the solid-state refuse fermentation. Buffering capacity increase, by addition of 2.5% NaHCO{sub 3}, equivalent to 84 mg NaHCO{sub 3} g dry weight refuse{sup -1}, promoted both acidogenesis and methanogenesis, with the latter accelerating by a factor of six, compared with glass-distilled water controls. Increased addition, with 5% NaHCO{sub 3}, however, mediated partial suppression of methanogenesis and acidogenesis with cation toxicity the most likely cause. Promotion of the refuse fermentation by NaHCO{sub 3} addition, therefore, necessitates careful control of the concentration applied. (author).

  13. A plea for uniform European definitions for organ donor potential and family refusal rates.

    Science.gov (United States)

    Jansen, Nichon E; Haase-Kromwijk, Bernadette J J M; van Leiden, Hendrik A; Weimar, Willem; Hoitsma, Andries J

    2009-11-01

    Conversion of potential organ donors to actual donors is negatively influenced by family refusals. Refusal rates differ strongly among countries. Is it possible to compare refusal rates in order to be able to learn from countries with the best practices? We searched in the literature for reviews of donor potential and refusal rates for organ donation in intensive care units. We found 14 articles pertinent to this study. There is an enormous diversity among the performed studies. The definitions of potential organ donors and family refusal differed substantially. We tried to re-calculate the refusal rates. This method failed because of the influence caused by the registered will on donation in the Donor Register. We therefore calculated the total refusal rate. This strategy was also less satisfactory considering possible influence of the legal consent system on the approach of family. Because of lack of uniform definitions, we can conclude that the refusal rates for organ donation can not be used for a sound comparison among countries. To be able to learn from well-performing countries, it is necessary to establish uniform definitions regarding organ donation and registration of all intensive care deaths.

  14. Integral control for population management.

    Science.gov (United States)

    Guiver, Chris; Logemann, Hartmut; Rebarber, Richard; Bill, Adam; Tenhumberg, Brigitte; Hodgson, Dave; Townley, Stuart

    2015-04-01

    We present a novel management methodology for restocking a declining population. The strategy uses integral control, a concept ubiquitous in control theory which has not been applied to population dynamics. Integral control is based on dynamic feedback-using measurements of the population to inform management strategies and is robust to model uncertainty, an important consideration for ecological models. We demonstrate from first principles why such an approach to population management is suitable via theory and examples.

  15. INTEGRATED HSEQ MANAGEMENT SYSTEMS: DEVELOPMENTS AND TRENDS

    OpenAIRE

    Osmo Kauppila; Janne Härkönen; Seppo Väyrynen

    2015-01-01

    The integration of health and safety, environmental and quality (HSEQ) management systems has become a current topic in the 21st century, as the need for systems thinking has grown along with the number of management system standards. This study aims to map current developments and trends in integrated HSEQ management. Three viewpoints are taken: the current state of the main HSEQ management standards, research literature on integrated management systems (IMS), and a case study of an industry...

  16. Effect of bio-column composed of aged refuse on methane abatement--a novel configuration of biological oxidation in refuse landfill.

    Science.gov (United States)

    Han, Dan; Zhao, Youcai; Xue, Binjie; Chai, Xiaoli

    2010-01-01

    An experimental bio-column composed of aged refuse was installed around the exhaust pipe as a new way to mitigate methane in refuse landfill. One of the objectives of this work was to assess the effect of aged refuse thickness in bio-column on reducing CH4 emissions. Over the study period, methane oxidation was observed at various thicknesses, 5 cm (small size), 10 cm (middle size) and 15 cm (large size), representing one to three times of pipeline diameters. The middle and large size both showed over 90% methane conversion, and the highest methane conversion rate of above 95% occurred in the middle-size column cell. Michaelis-Menten equation addressed the methanotrophs diffusion in different layers of the bio-columns. Maximum methanotrophic activity (Vmax) measured at the three thicknesses ranged from 6.4 x 10(-3) to 15.6 x 10(-3) units, and the half-saturation value (K(M)) ranged from 0.85% to 1.67%. Both the highest Vmax and K(M) were observed at the middle-size of the bio-column, as well as the largest methanotrophs population, suggesting a significant efficiency of methane mitigation happened in the optimum zone with greatest affinity and methanotrophic bacteria activities. Therefore, bio-column is a potential style for methane abatement in landfill, and the aged refuse both naturally formed and artificially placed in the column plays a critical role in CH4 emission.

  17. Social Skills, Competence, and Drug Refusal Efficacy as Predictors of Adolescent Alcohol Use.

    Science.gov (United States)

    Scheier, Lawrence M.; Botvin, Gilbert J.; Diaz, Tracy; Griffin, Kenneth W.

    1999-01-01

    Examines the extent to which assertiveness and related social skills, personal competence, and refusal efficacy predict alcohol involvement in adolescents. Males were at higher risk for poor refusal skills and reported higher alcohol involvement. Youth characterized by poor social skill development reported lower refusal efficacy, lower grades,…

  18. Considerations on Integrating Risk and Quality Management

    Directory of Open Access Journals (Sweden)

    Maria POPESCU

    2011-03-01

    Full Text Available This paper aims to highlight the links between risk management and quality management and to study the possibility of their integrated approach. The study reviews the evolution of risk approach within organizations and stresses the need to increase the effectiveness of this approach by incorporating risk management methodology in the quality management system. Starting from this idea, the authors present the current state of risk approach into quality management, basic rules of integrated quality-risk management and major difficulties which may arise in the implementation of integrated quality–risk systems.

  19. Intelligent Integrated System Health Management

    Science.gov (United States)

    Figueroa, Fernando

    2012-01-01

    Intelligent Integrated System Health Management (ISHM) is the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system (Management: storage, distribution, sharing, maintenance, processing, reasoning, and presentation). Presentation discusses: (1) ISHM Capability Development. (1a) ISHM Knowledge Model. (1b) Standards for ISHM Implementation. (1c) ISHM Domain Models (ISHM-DM's). (1d) Intelligent Sensors and Components. (2) ISHM in Systems Design, Engineering, and Integration. (3) Intelligent Control for ISHM-Enabled Systems

  20. Refusal of Emergency Medical Treatment: Case Studies and Ethical Foundations.

    Science.gov (United States)

    Marco, Catherine A; Brenner, Jay M; Kraus, Chadd K; McGrath, Norine A; Derse, Arthur R

    2017-11-01

    Informed consent is an important component of emergency medical treatment. Most emergency department patients can provide informed consent for treatment upon arrival. Informed consent should also be obtained for emergency medical interventions that may entail significant risk. A related concept to informed consent is informed refusal of treatment. Patients may refuse emergency medical treatment during their evaluation and treatment. This article addresses important considerations for patients who refuse treatment, including case studies and discussion of definitions, epidemiology, assessment of decisional capacity, information delivery, medicolegal considerations, and alternative care plans. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  1. Managing IT Integration Risk in Acquisitions

    DEFF Research Database (Denmark)

    Henningsson, Stefan; Kettinger, William J.

    2016-01-01

    The article discusses a framework for evaluating risk of information technology (IT) integration in acquisitions. Topics include the use of the experience of serial acquirer Trelleborg AB to show the merits of the framework for managing the risk and to determine low-risk acquisitions......, the importance of managing IT integration risk, and various risk areas for acquisition IT integration....

  2. Assessment of musculoskeletal load in refuse collectors

    Directory of Open Access Journals (Sweden)

    Zbigniew W. Jóźwiak

    2013-08-01

    Full Text Available Background: The aim of this work was to assess the load on the musculoskeletal system and its effects in the collectors of solid refuse. The rationale behind this study was to formulate proposals how to reduce excessive musculoskeletal load in this group of workers. Material and Methods: The study group comprised 15 refuse collectors aged 25 to 50 years. Data about the workplace characteristics and subjective complaints of workers were collected by the free interview and questionnaire. During the survey the photorecording of the workpostures, the distance and velocity by GPS recorders, measurements of forces necessary to move containers, energy expenditure (lung ventilation method, workload estimation using the Firstbeat system and REBA method and stadiometry were done. Results: The distance walked daily by the collectors operating in terms of 2 to 3 in urban areas was about 15 km, and in rural areas about 18 km. The most frequent musculoskeletal complaints concerned the feet (60% subjects, knees, wrists and shoulders (over 40% subjects. After work-shift all examined workers had vertebral column shorter by 10 to 14 mm (11.4 mm mean. Conclusions: The results of our study show that the refuse collectors are subjected to a very high physical load because of the work organization and the way it is performed. To avoid adverse health effects and overload it is necessary to undertake ergonomic interventions, involving training of workers to improve the way of their job performance, active and passive leisure, technical control of the equipment and refuse containers, as well as the renegotiation of contracts with clients, especially those concerning non-standard containers. Med Pr 2013;64(4:507–519

  3. Geomorphic reclmation of a coal refuse pile

    Science.gov (United States)

    Hopkinson, L. C.; Quaranta, J.

    2017-12-01

    Geomorphic reclamation is a technique that may offer opportunities to improve mine reclamation in Central Appalachia. The design approach is based on constructing a steady-state, mature landform condition and takes into account the long-term climatic conditions, soil types, terrain grade, and vegetation. Geomorphic reclamation has been applied successfully in semi-arid regions but has not yet been applied in Central Appalachia. This work describes a demonstration study where geomorphic landforming techniques are being applied to a coarse coal refuse pile in southern West Virginia, USA. The reclamation design includes four geomorphic watersheds that radially drain runoff from the pile. Each watershed has one central draining channel and incorporates compound slope profiles similarly to naturally eroded slopes. Planar slopes were also included to maintain the impacted area. The intent is to alter the hydrology to decrease water quality treatment costs. The excavation cut and fill volumes are comparable to those of more conventional refuse pile reclamation designs. If proven successful then this technique can be part of a cost-effective solution to improve water quality at active and future refuse facilities, abandoned mine lands, bond forfeiture sites, landfills, and major earthmoving activities within the region.

  4. Refusal of hemodialysis by hospitalized chronic kidney disease patients in Pakistan.

    Science.gov (United States)

    Shafi, Salman Tahir; Saleem, Mohammad; Anjum, Roshina; Abdullah, Wajid; Shafi, Tahir

    2018-01-01

    In Pakistan, patients with chronic kidney disease (CKD) are commonly diagnosed at a late stage. There is little information about the refusal of hemodialysis by hospitalized CKD patients who need hemodialysis (HD) and reasons for acceptance and refusal among these patients. All patients with Stage V CKD who had medical indications to undergo HD and were hospitalized at a tertiary care facility over a six-month period were invited to participate in this study. Patients were surveyed regarding acceptance or refusing of HD and reasons for their decisions. Demographic, socioeconomic, and clinical characteristics of patients were compared between patients who accepted or refused HD. A total of 125 patients were included in the study. The mean age of the patients was 47.9 ±12.1 years. The mean duration of diagnosis of CKD was 2.5 ± 0.6 months. Of all patients, 72 (57.6%) agreed to do HD and 53 (42.4%) refused HD. Patients with arteriovenous fistula in place (27.1 vs. 9.1%, P 0.02) and those in the middle- or higher-income group (64.4% vs. 38.6%, p = 0.03) were more willing to undergo HD. Trust in doctor's advice (86.1%) was the most common reason for acceptance of HD. Frequency of HD per week (52.8%), lifelong and permanent nature of HD (50.9%), advice by family members or friends (37.7%), perception of poor quality of life on HD (35.8%), and fear of HD needles and complications during HD (33.9%) were the most common reasons for refusal. Refusal of HD is common among hospitalized CKD patients with medical indications to undergo HD, especially in lower income group.

  5. Integrated parasite management

    DEFF Research Database (Denmark)

    Clausen, Jesper Hedegaard; Madsen, Henry; Van, Phan Thi

    2015-01-01

    communities at risk through mass drug administration. However, we argue that treatment alone will not reduce the risk from eating infected fish and that sustainable effective control must adopt an integrated FZT control approach based on education, infrastructure improvements, and management practices...... that target critical control points in the aquaculture production cycle identified from a thorough understanding of FZT and host biology and epidemiology. We present recommendations for an integrated parasite management (IPM) program for aquaculture farms.......Fishborne zoonotic trematodes (FZT) are an emerging problem and there is now a consensus that, in addition to wild-caught fish, fish produced in aquaculture present a major food safety risk, especially in Southeast Asia where aquaculture is important economically. Current control programs target...

  6. Predictors of intensive care unit refusal in French intensive care units: a multiple-center study.

    Science.gov (United States)

    Garrouste-Orgeas, Maité; Montuclard, Luc; Timsit, Jean-François; Reignier, Jean; Desmettre, Thibault; Karoubi, Philippe; Moreau, Delphine; Montesino, Laurent; Duguet, Alexandre; Boussat, Sandrine; Ede, Christophe; Monseau, Yannick; Paule, Thierry; Misset, Benoit; Carlet, Jean

    2005-04-01

    To identify factors associated with granting or refusing intensive care unit (ICU) admission, to analyze ICU characteristics and triage decisions, and to describe mortality in admitted and refused patients. Observational, prospective, multiple-center study. Four university hospitals and seven primary-care hospitals in France. None. Age, underlying diseases (McCabe score and Knaus class), dependency, hospital mortality, and ICU characteristics were recorded. The crude ICU refusal rate was 23.8% (137/574), with variations from 7.1% to 63.1%. The reasons for refusal were too well to benefit (76/137, 55.4%), too sick to benefit (51/137, 37.2%), unit too busy (9/137, 6.5%), and refusal by the family (1/137). In logistic regression analyses, two patient-related factors were associated with ICU refusal: dependency (odds ratio [OR], 14.20; 95% confidence interval [CI], 5.27-38.25; p refused patients, and 1.03 (95% CI, 0.28-1.75) for later-admitted patients. ICU refusal rates varied greatly across ICUs and were dependent on both patient and organizational factors. Efforts to define ethically optimal ICU admission policies might lead to greater homogeneity in refusal rates, although case-mix variations would be expected to leave an irreducible amount of variation across ICUs.

  7. Managing harvest and habitat as integrated components

    Science.gov (United States)

    Osnas, Erik; Runge, Michael C.; Mattsson, Brady J.; Austin, Jane E.; Boomer, G. S.; Clark, R. G.; Devers, P.; Eadie, J. M.; Lonsdorf, E. V.; Tavernia, Brian G.

    2014-01-01

    In 2007, several important initiatives in the North American waterfowl management community called for an integrated approach to habitat and harvest management. The essence of the call for integration is that harvest and habitat management affect the same resources, yet exist as separate endeavours with very different regulatory contexts. A common modelling framework could help these management streams to better understand their mutual effects. Particularly, how does successful habitat management increase harvest potential? Also, how do regional habitat programmes and large-scale harvest strategies affect continental population sizes (a metric used to express habitat goals)? In the ensuing five years, several projects took on different aspects of these challenges. While all of these projects are still on-going, and are not yet sufficiently developed to produce guidance for management decisions, they have been influential in expanding the dialogue and producing some important emerging lessons. The first lesson has been that one of the more difficult aspects of integration is not the integration across decision contexts, but the integration across spatial and temporal scales. Habitat management occurs at local and regional scales. Harvest management decisions are made at a continental scale. How do these actions, taken at different scales, combine to influence waterfowl population dynamics at all scales? The second lesson has been that consideration of the interface of habitat and harvest management can generate important insights into the objectives underlying the decision context. Often the objectives are very complex and trade-off against one another. The third lesson follows from the second – if an understanding of the fundamental objectives is paramount, there is no escaping the need for a better understanding of human dimensions, specifically the desires of hunters and nonhunters and the role they play in conservation. In the end, the compelling question is

  8. INTEGRATED HSEQ MANAGEMENT SYSTEMS: DEVELOPMENTS AND TRENDS

    Directory of Open Access Journals (Sweden)

    Osmo Kauppila

    2015-06-01

    Full Text Available The integration of health and safety, environmental and quality (HSEQ management systems has become a current topic in the 21st century, as the need for systems thinking has grown along with the number of management system standards. This study aims to map current developments and trends in integrated HSEQ management. Three viewpoints are taken: the current state of the main HSEQ management standards, research literature on integrated management systems (IMS, and a case study of an industry-led HSEQ cluster in Northern Finland. The results demonstrate that some of the most prominent current trends are the harmonization of the high level structure of management systems by ISO, the evaluation of IMS, accounting for the supply chain in HSEQ issues, and sustainability and risk management. The results of the study can be used by practitioners to get a view of the current state of HSEQ management systems and their integration, and by researchers to seek out potential directions for HSEQ and IMS related research.

  9. 76 FR 29796 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Refuse...

    Science.gov (United States)

    2011-05-23

    ... for OMB Review; Comment Request; Refuse Piles and Impounding Structures, Recordkeeping and Reporting... Administration (MSHA) sponsored information collection request (ICR) titled, ``Refuse Piles and Impounding... to submit annual reports and certification on refuse piles and impoundments to the agency and to keep...

  10. Psychotropic Medication Refusal: Reasons and Patients′ Perception at a Secure Forensic Psychiatric Treatment Centre

    Directory of Open Access Journals (Sweden)

    Olajide O Adelugba

    2016-01-01

    Full Text Available Poor adherence to prescribed medication regimens can undermine the effectiveness of medications. This study was conducted to determine the demographic profile of forensic psychiatric inpatients refusing medications and to identify the reasons for refusal. Data were collected through interviews using a questionnaire including Drug Attitude Inventory-10. Medication refusal was more common among Aboriginals (68%, n = 34 than Caucasians (32%, n = 16 and was highest among the patients 21-30 years of age (44%, n = 22. Antisocial personality disorder and substance use disorder featured prominently among patients refusing medications. The main reasons for medication refusal were inconvenience (34%, n = 17 followed by side effects (22%, n = 11, ineffective medication (20%, n = 10, illness-related (16%, n = 8, and no reasons (8%, n = 6. Antipsychotic medications topped the list of the major classes of medications refused followed by Antidepressants and Mood Stabilizers.

  11. Management of area-wide integrated pest management programmes that integrate the sterile insect technique

    International Nuclear Information System (INIS)

    Dyck, V.A.; Vreysen, M.J.B.; Reyes Flores, J.; Regidor Fernandez, E.E.; Teruya, T.; Barnes, B.; Gomez Riera, P.; Lindquist, D.; Loosjes, M.

    2005-01-01

    Effective management of area-wide integrated pest management (AW-IPM) programmes that integrate the sterile insect technique (SIT) is key to success. Programme planning includes collection of baseline data and a feasibility assessment. The optimal management structure is where the programme can be implemented effectively and flexibly, independent of government politics, bureaucracy, and even corruption that impede timely goal achievement. Ideally, programmes include both public and private management, and require strong and steady financial support. Governments and donors are the most common sources of funds, but a mixture of public, community, and private funds is now the trend. Interrupted cash flow severely restrains programme performance. Physical support of programme operations must be reliable, and led by a maintenance professional. It is essential to have full-time, well-paid, and motivated staff led by a programme manger with technical and management experience. Programme failure is usually due to poor management and inadequate public support, and not to poor technology. (author)

  12. 29 CFR 1977.22 - Employee refusal to comply with safety rules.

    Science.gov (United States)

    2010-07-01

    ... WILLIAMS-STEIGER OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970 Some Specific Subjects § 1977.22 Employee refusal to comply with safety rules. Employees who refuse to comply with occupational safety and health... Section 1977.22 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH...

  13. Integrated project management type contracts

    International Nuclear Information System (INIS)

    Heisler, S.I.

    1975-01-01

    The concept of integrated project management represents a single source to which the owner can turn for all project management functions excepting for those relating to outside parties such as site purchase, personnel selection etc. Other functions such as design, procurement, construction management, schedule and cost control, quality assurance/quality control are usually handled by the integrated project manager as the agent of the owner. The arrangement is flexible and the responsibilities can be varied to suit the size and experience of the owner. Past experience in the United States indicates an increase in the trend toward IPM work and it appears that overseas this trend is developing also. (orig./RW) [de

  14. Renewed mer model of integral management

    Directory of Open Access Journals (Sweden)

    Janko Belak

    2015-12-01

    Full Text Available Background: The research work on entrepreneurship, enterprise's policy and management, which started in 1992, successfully continued in the following years. Between 1992 and 2011, more than 400 academics and other researchers have participated in research work (MER research program whose main orientation has been the creation of their own model of integral management. Results: In past years, academics (researchers and authors of published papers from Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Byelorussia, Canada, the Czech Republic, Croatia, Estonia, France, Germany, Hungary, Italy, Poland, Romania, Russia, the Slovak Republic, Slovenia, Switzerland, Ukraine, and the US have cooperated in MER programs, coming from more than fifty institutions. Thus, scientific doctrines of different universities influenced the development of the MER model which is based on both horizontal and vertical integration of the enterprises' governance and management processes, instruments and institutions into a consistently operating unit. Conclusions: The presented MER model is based on the multi-layer integration of governance and management with an enterprise and its environment, considering the fundamental desires for the enterprises' existence and, thus, their quantitative as well as qualitative changes. The process, instrumental, and institutional integrity of the governance and management is also the initial condition for the implementation of all other integration factors.

  15. Refusal of Treatment by Mentally Competent Patient: The Choice of Doctor-Patient Relationship Models

    Directory of Open Access Journals (Sweden)

    Andrei M. Beliaev

    2010-01-01

    Full Text Available Introduction: In modern medicine professional relationship between the clinician and the patient is patient-centered. Patients become actively involved in the treatment decision making process and are encouraged to express their health-related preferences. Some patients may, however, refuse a favorable risk/benefit ratio treatment. This manuscript presents three cases of refusal of treatment by mentally competent surgical patients and discusses differences in their management. Conclusion: To achieve the best medical outcome for patients who possess the Actual Understanding test of mental competence clinicians use the deliberate model of medical professional relationship. For patients demonstrating the Understanding test of mental competence and wishing to utilize their health-related preferences physicians are obliged to deploy the interpretive model of doctor-patient relationship. In mentally competent patients with an illness-induced acute psychological regression the interpretive model of doctor-patient relationship as an initial strategy and cognitive behavior therapy can be useful in modifying treatment rejecting behavior and improving medical outcome.

  16. A plea for uniform European definitions for organ donor potential and family refusal rates.

    NARCIS (Netherlands)

    Jansen, N.E.; Haase-Kromwijk, B.J.; Leiden, H.A. van; Weimar, W.; Hoitsma, A.J.

    2009-01-01

    Conversion of potential organ donors to actual donors is negatively influenced by family refusals. Refusal rates differ strongly among countries. Is it possible to compare refusal rates in order to be able to learn from countries with the best practices? We searched in the literature for reviews of

  17. Integrated crisis management exercises

    International Nuclear Information System (INIS)

    Callen, R.B.; DeHart, R.E.

    1994-01-01

    This paper describes some of the steps that Mobil has taken to enhance their crisis management capability and to improve their readiness. The approach stretches from the individual plant level to Mobil's Corporate offices in Fairfax, Virginia. Some of the lessons learned from several integrated crisis management exercises are outlined and some areas where additional industry co-operation in crisis management could pay dividends are suggested

  18. Integrated management of waterbirds: Beyond the conventional

    Science.gov (United States)

    Erwin, R.M.; Parsons, Katharine C.; Brown, Stephen C.; Erwin, R. Michael; Czech, Helen A.; Coulson, John C.

    2002-01-01

    Integrated waterbird management over the past few decades has implicitly referred to methods for managing wetlands that usually attempt to enhance habitat for taxonomic groups such as shorebirds and wading birds, in addition to waterfowl, the traditional focus group. Here I describe five elements of integration in management: taxonomic, spatial, temporal, population and habitat, and multiple-use management objectives. Spatial integration simply expands the scale of management concern. Rather than emphasizing management on a very limited number of impoundments or wetlands in small refuges or wildlife management areas, the vision is beginning to shift to connectivity within larger landscapes on the order of many square kilometers as telemetry data on daily and seasonal movements for many species become available. Temporal integration refers to the potential for either simultaneous management for waterbirds and commercial 'crops' (e.g., crayfish and rice) or for temporally-staggered management such as row crop production in spring-summer growing seasons and waterbird management on fallow fields in the non-growing (winter) season. Integrating population dynamics with habitats has become a major research focus over the past decade. Identifying which wetlands are ?sources? or ?sinks? for specific populations provides managers with critical information about effective management. Further, the applications of spatially explicit population models place heavy demands on researchers to identify use patterns for breeding and dispersing individuals by age, sex, and reproductive class. Population viability analysis models require much the same information. Finally, multiple-use management integration refers to trying to optimize the uses of wetlands, when only one (perhaps secondary) use may include waterbird management. Depending upon the ownership and primary land use of a particular parcel of land containing wetlands and/or water bodies, managing for waterbirds may be an

  19. The Impact of Refuse Dump sites on the Physico-chemical and ...

    African Journals Online (AJOL)

    The Impact of Refuse Dump sites on the Physico-chemical and Microbial Properties of ground Water in some selected areas. ... Journal of Agricultural Research and Development. Journal Home ... The pollution effect of refuse dumps on the quality of wells at Ojota, Lagos, Apete, Ibadan and Odopetu, Akure were studied.

  20. Learned Helplessness and Learning Goals: Role played in School Refusal. A Study on Italian Students.

    Directory of Open Access Journals (Sweden)

    Luana Sorrenti

    2016-08-01

    Full Text Available Literature on school refusal has shown a link between school refusal and poor school performance. However, there has been little investigation into the individual underlying factors, and specifically factors directly related to the learning process, such as the learning goals of students and their expectations of success and/or failure. The main purpose of the present study is to investigate the influence of Learned Helplessness (LH and learning goals on school refusal. We hypothesized that LH and learning goals exert a unique role in predicting school refusal above and beyond the roles of academic achievement, age, and gender. The sample consisted of 201 Italian students with an average age of 11.93, with both low (57.2 % of students and high (42.8 % academic achievement. School refusal, LH, and learning goals were measured by means of questionnaires. The results confirm the hypothesis of this study; in fact, we found that learning goals and, above all, LH play a more predictive role of school refusal than academic achievement. These results extend previous studies on school refusal and, for the first time, they provide additional knowledge about this problem, analyzing the relationship between school refusal, learning goals, and LH, still neglected in the literature. Implications on the psychological well-being of students are discussed.

  1. Risk taking and refusal assertiveness in a longitudinal model of alcohol use among inner-city adolescents.

    Science.gov (United States)

    Epstein, J A; Griffin, K W; Botvin, G J

    2001-09-01

    Risk taking and refusal assertiveness have been shown to be important determinants of adolescent alcohol use. However, it remains unclear whether youth predisposed to risk taking would be less likely to assertively refuse. This study examined the relationships among risk taking, refusal assertiveness, and alcohol use in a sample of inner-city minority students (N = 1,459), using a cross-lagged longitudinal structural equation model. Data collectors administered the questionnaire to students following a standardized protocol during a 40-min class period. Based on the tested model, risk taking was more stable over time than refusal assertiveness. Furthermore, high risk takers reported less frequent subsequent refusal assertiveness, and less frequent refusal assertiveness predicted greater drinking. A predisposition toward risk taking appears to be an enduring characteristic that is associated with low refusal assertiveness and increased alcohol use. These findings suggest that alcohol prevention programs that emphasize refusal skills training may be less effective for high risk takers. But programs that focus on enhancing competence or reducing normative expectations for peer alcohol use might be more effective for high risk-taking youth.

  2. Y-12 Integrated Materials Management System

    Energy Technology Data Exchange (ETDEWEB)

    Alspaugh, D. H.; Hickerson, T. W.

    2002-06-03

    The Integrated Materials Management System, when fully implemented, will provide the Y-12 National Security Complex with advanced inventory information and analysis capabilities and enable effective assessment, forecasting and management of nuclear materials, critical non-nuclear materials, and certified supplies. These capabilities will facilitate future Y-12 stockpile management work, enhance interfaces to existing National Nuclear Security Administration (NNSA) corporate-level information systems, and enable interfaces to planned NNSA systems. In the current national nuclear defense environment where, for example, weapons testing is not permitted, material managers need better, faster, more complete information about material properties and characteristics. They now must manage non-special nuclear material at the same high-level they have managed SNM, and information capabilities about both must be improved. The full automation and integration of business activities related to nuclear and non-nuclear materials that will be put into effect by the Integrated Materials Management System (IMMS) will significantly improve and streamline the process of providing vital information to Y-12 and NNSA managers. This overview looks at the kinds of information improvements targeted by the IMMS project, related issues, the proposed information architecture, and the progress to date in implementing the system.

  3. Integrated solid waste management in megacities

    Directory of Open Access Journals (Sweden)

    M.A. Abdoli

    2016-05-01

    Full Text Available Rapid urbanization and industrialization, population growth and economic growth in developing countries make management of municipal solid waste more complex comparing with developed countries. Furthermore, the conventional municipal solid waste management approach often is reductionists, not tailored to handle complexity. Therefore, the need to a comprehensive and multi-disciplinary approach regarding the municipal solid waste management problems is increasing. The concept of integrated solid waste management is accepted for this aim all over the world. This paper analyzes the current situation as well as opportunities and challenges regarding municipal solid waste management in Isfahan according to the integrated solid waste management framework in six aspects: environmental, political/legal, institutional, socio-cultural, financial/economic, technical and performance aspects. Based on the results obtained in this analysis, the main suggestions for future integrated solid waste management of Isfahan are as i promoting financial sustainability by taking the solid waste fee and reducing the expenses through the promoting source collection of recyclable materials, ii improving compost quality and also marketing the compost products simultaneously, iii promoting the private sector involvements throughout the municipal solid waste management system.

  4. Y-12 Integrated Materials Management System

    International Nuclear Information System (INIS)

    Alspaugh, D. H.; Hickerson, T. W.

    2002-01-01

    The Integrated Materials Management System, when fully implemented, will provide the Y-12 National Security Complex with advanced inventory information and analysis capabilities and enable effective assessment, forecasting and management of nuclear materials, critical non-nuclear materials, and certified supplies. These capabilities will facilitate future Y-12 stockpile management work, enhance interfaces to existing National Nuclear Security Administration (NNSA) corporate-level information systems, and enable interfaces to planned NNSA systems. In the current national nuclear defense environment where, for example, weapons testing is not permitted, material managers need better, faster, more complete information about material properties and characteristics. They now must manage non-special nuclear material at the same high-level they have managed SNM, and information capabilities about both must be improved. The full automation and integration of business activities related to nuclear and non-nuclear materials that will be put into effect by the Integrated Materials Management System (IMMS) will significantly improve and streamline the process of providing vital information to Y-12 and NNSA managers. This overview looks at the kinds of information improvements targeted by the IMMS project, related issues, the proposed information architecture, and the progress to date in implementing the system

  5. Advantages and Limitations of Integrated Management System: the Theoretical Viewpoint

    Directory of Open Access Journals (Sweden)

    Agota Giedrė Raišienė

    2013-08-01

    Full Text Available Purpose. The goal of the paper is to discuss the potential benefits and to highlight the drawbacks of integrated management system for organizations that seek to improve management process.Methodology. Methods of the research were used: analysis of a scientific and special literature that presents the requirements, models and results of integrated management systems studies, and analysis of statistical data to assess actuality of integrated management systems for enterprises in Lithuania.Findings. Summarizing research findings, it should be stated that the implementation of management system integration should be based on provision of social responsibility and holistic approach to the organization. It requires the long-term united efforts of leaders in a strategic hierarchical level and high organizational maturity to ensure the fluency of the running stages of planning management system integration, preparing documentations, implementing and realizing integrated management system. Also it is necessary to purify the conception of integrated management system in organizational context. Theoretical analysis of integrated management systems show, that all of the management systems can not be well integrated in principle. They can only be partly integrated and coordinated. A need to question the level of integration of management systems is very important as in scientific discourse as in practice. It is important to mark, that the number of organizations, that seek to optimize management processes by implementing the integrated management systems is rapidly increasing in Lithuania, too. It shows that benefit associated with integration of management systems is apprehensible in Lithuania. Advantages of integrated management systems can certainly become even stronger if scientists and practicians join their forces in search of methods of organizational management development.Research limitations. The research limitations related to a lack of

  6. Bonus Point System for Refuse Classification and Sustainable Development: A Study in China

    Directory of Open Access Journals (Sweden)

    Shijie Guo

    2017-09-01

    Full Text Available The rapid growth of household waste not only endangers the environment and people’s health, but also limits social and economic development. The effective sorting and recycling of garbage can control this problem. Adopting a semi-quantitative case study method, our researchers investigated the effect of a bonus point system for refuse classification that improves the accuracy of refuse classification and the residents’ environment awareness. In the system, residents will receive some gifts after sorting the garbage correctly. We also investigated the attitudes of residents and companies towards this novel system. Our researchers employed various methods to analyze garbage-sorting data, questionnaires completed by residents, and interview records. The results show that use of a bonus point system affects the management of domestic waste by improving the accuracy and enhancing the awareness of garbage sorting. Overall, residents support the system and benefit from it, which increases participation and consciousness of environmental protection. However, continuous publicity and coordination of various policies are required to promote the wide-range implementation and sustainable development of this system.

  7. I-15 integrated corridor management system : project management plan.

    Science.gov (United States)

    2011-06-01

    The Project Management Plan (PMP) assists the San Diego ICM Team by defining a procedural framework for : management and control of the I-15 Integrated Corridor Management Demonstration Project, and development and : deployment of the ICM System. The...

  8. Microbial ecology studies at two coal mine refuse sites in Illinois

    Energy Technology Data Exchange (ETDEWEB)

    Miller, R. M.; Cameron, R. E.

    1978-01-01

    An investigation was made of the microflora associated with coal refuse at two abandoned mines in the midwestern United States. Information was gathered for both the edaphic and the biotic composition of the refuse material. Emphasis was placed on heterotrophic and autotrophic components as to numbers, kinds, and physiological groups. The presence of chemolithotrophs was also investigated. The relationship between abiotic and biotic components in regard to distribution of bacteria, fungi, and algae is discussed. Information presented in this report will be utilized in assessing trends and changes in microbial numbers and composition related to manipulations of the edaphic and biotic ecosystem components associated with reclamation of the refuse piles.

  9. Advantages and Limitations of Integrated Management System: the Theoretical Viewpoint

    Directory of Open Access Journals (Sweden)

    Agota Giedrė Raišienė

    2011-08-01

    Full Text Available Purpose. The goal of the paper is to discuss the potential benefits and to highlight the drawbacks of integrated management system for organizations that seek to improve management process.Methodology. Methods of the research were used: analysis of a scientific and special literature that presents the requirements, models and results of integrated management systems studies, and analysis of statistical data to assess actuality of integrated management systems for enterprises in Lithuania.Findings. Summarizing research findings, it should be stated that the implementation of management system integration should be based on provision of social responsibility and holistic approach to the organization. It requires the long-term united efforts of leaders in a strategic hierarchical level and high organizational maturity to ensure the fluency of the running stages of planning management system integration, preparing documentations, implementing and realizing integrated management system. Also it is necessary to purify the conception of integrated management system in organizational context. Theoretical analysis of integrated management systems show, that all of the management systems can not be well integrated in principle. They can only be partly integrated and coordinated. A need to question the level of integration of managementsystems is very important as in scientific discourse as in practice. It is important to mark, that the number of organizations, that seek to optimize management processes by implementing the integrated management systems is rapidly increasing in Lithuania, too. It shows that benefit associated with integration of management systems is apprehensible in Lithuania. Advantages of integrated management systems can certainly become even stronger if scientists and practicians join their forces in search of methods of organizational management development.Research limitations. The research limitations related to a lack of integrated

  10. Multidisciplinary management--an opportunity for service integration.

    Science.gov (United States)

    Cameron, M

    1997-01-01

    The management team of the future will enter an environment requiring facilitation, participation, clinical, and empowerment skills. Those individuals who possess a clinical orientation as well as business expertise will be sought to manage multidisciplinary units. The rapid changes in the health-care environment have forced organizations to restructure their operations. To achieve quality care, customer satisfaction, cost-effectiveness, and efficiency, service integration across the organization will be required. As we approach the 21st century, this standard will evolve until "all levels are managing patient care." Some of the restructuring trends occurring in the health-care industry have been collaboration service integration, management consolidation, and job elimination. The emphasis for the multidisciplinary manager of the future will include integrating the professional and clinical services, managing information, building community partnerships, promoting physician collaboration, and managing the change process. A model organization in the next century will move toward a people-oriented system with inclusion and empowerment initiatives. Service integration will affect all organizations, but the disciplines within the Clinical Support System will be the most affected. Future opportunities of leadership will exist for pathologists, nurses, or medical technologists as the professional silos of managers and clinicians continue to crumble.

  11. Integrated Project Management System description

    International Nuclear Information System (INIS)

    1987-03-01

    The Uranium Mill Tailings Remedial Action (UMTRA) Project is a Department of Energy (DOE) designated Major System Acquisition (MSA). To execute and manage the Project mission successfully and to comply with the MSA requirements, the UMTRA Project Office (''Project Office'') has implemented and operates an Integrated Project Management System (IPMS). The Project Office is assisted by the Technical Assistance Contractor's (TAC) Project Integration and Control (PIC) Group in system operation. Each participant, in turn, provides critical input to system operation and reporting requirements. The IPMS provides a uniform structured approach for integrating the work of Project participants. It serves as a tool for planning and control, workload management, performance measurement, and specialized reporting within a standardized format. This system description presents the guidance for its operation. Appendices 1 and 2 contain definitions of commonly used terms and abbreviations and acronyms, respectively. 17 figs., 5 tabs

  12. Integrated management system

    International Nuclear Information System (INIS)

    Florescu, N.

    2003-01-01

    A management system is developed in order to reflect the needs of the business and to ensure that the objectives of the organization will be achieved. The process model and each individual process within the system then needs to identify the drives or requirements from external customers and stakeholders, regulations, and standards such as ISO and 50-C-Q. The processes are then developed to address these drivers. Developing the process in this way makes it fully integrated and capable of incorporating any new requirements. The International Standard (ISO 9000:2000) promotes the adoption of a process approach when developing, implementing and improving the effectiveness of a quality management system to enhance customer satisfaction by meeting customer requirements. The IAEA Code recognizes that the entire work is a process which can be planned, assessed and improved. For an organization to function effectively, numerous linked activities have to be identified and managed. By definition a process is an activity that using resources and taking into account all the constraints imposed executes the necessary operations which transform the inputs in outcomes. Running a system of processes within an organization, identification of the interaction between the processes and their management can be referred to as a 'process approach'. The advantage of such an approach is the ensuring of the ongoing control over the linkage between the individual processes composing the system as well as over their combination and interaction. Developing a management system implies: identification of the process which delivers Critical Success Factor (CSFs) of the business; identifying the support processes enabling the CSFs to be accomplished; identifying the processes that deliver the business fundamentals. An integrated management system should include all activities not only those related to Quality, Health and Safety. When developing an IMS it is necessary to identify all of the drivers

  13. Integrated Data Management Processes Expedite Common Data Management Tasks in Autism Research

    OpenAIRE

    Farach, Frank; Sinanis, Naralys; Hawthorne, Julie; Agnew, Henry; Schantz, Tricia; Jensen, Bill; Rozenblit, Leon

    2013-01-01

    We compare the efficiency of (1) just-in-time data management, in which data are cleaned prior to each analysis, and (2) integrated data management, in which data are centralized, cleaned up front, and made available via a query interface. Integrated data management was associated with faster completion of data management requests.

  14. Can children aged 12 years or more refuse life-saving treatment ...

    African Journals Online (AJOL)

    The best interests of the child are paramount, and should the child unreasonably refuse to consent to life-saving treatment, the Minister of Social Development may give consent for such treatment in terms of the Children's Act. Otherwise, should a parent, guardian, caregiver or healthcare provider believe that such a refusal ...

  15. Assessment and management of ecological integrity: Chapter 12

    Science.gov (United States)

    Kwak, Thomas J.; Freeman, Mary C.

    2010-01-01

    Assessing and understanding the impacts of human activities on aquatic ecosystems has long been a focus of ecologists, water resources managers, and fisheries scientists. While traditional fisheries management focused on single-species approaches to enhance fish stocks, there is a growing emphasis on management approaches at community and ecosystem levels. Of course, as fisheries managers shift their attention from narrow (e.g., populations) to broad organizational scales (e.g., communities or ecosystems), ecological processes and management objectives become more complex. At the community level, fisheries managers may strive for a fish assemblage that is complex, persistent, and resilient to disturbance. Aquatic ecosystem level objectives may focus on management for habitat quality and ecological processes, such as nutrient dynamics, productivity, or trophic interactions, but a long-term goal of ecosystem management may be to maintain ecological integrity. However, human users and social, economic, and political demands of fisheries management often result in a reduction of ecological integrity in managed systems, and this conflict presents a principal challenge for the modern fisheries manager. The concepts of biotic integrity and ecological integrity are being applied in fisheries science, natural resource management, and environmental legislation, but explicit definitions of these terms are elusive. Biotic integrity of an ecosystem may be defined as the capability of supporting and maintaining an integrated, adaptive community of organisms having a species composition, diversity, and functional organization comparable to that of a natural habitat of the region (Karr and Dudley 1981). Following that, ecological integrity is the summation of chemical, physical, and biological integrity. Thus, the concept of ecological integrity extends beyond fish and represents a holistic approach for ecosystem management that is especially applicable to aquatic systems. The

  16. Integrated Work Management: Preparer, Course 31883

    Energy Technology Data Exchange (ETDEWEB)

    Simpson, Lewis Edward [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-08-07

    The preparer (also called the “planner”) plays a key role in the integrated work management (IWM) process at Los Alamos National Laboratory (LANL). This course, Integrated Work Management: Preparer (COURSE 31883), describes the IWM roles and responsibilities of the preparer. This course also discusses IWM requirements that must be met by the preparer.

  17. 37 CFR 1.295 - Review of decision finally refusing to publish a statutory invention registration.

    Science.gov (United States)

    2010-07-01

    ... dissatisfied with the final refusal to publish a statutory invention registration for reasons other than... refunded if the final refusal to publish a statutory invention registration for reasons other than... refusing to publish a statutory invention registration. 1.295 Section 1.295 Patents, Trademarks, and...

  18. Implementation of integrated management system

    International Nuclear Information System (INIS)

    Gaspar Junior, Joao Carlos A.; Fonseca, Victor Zidan da

    2007-01-01

    In present day exist quality assurance system, environment, occupational health and safety such as ISO9001, ISO14001 and OHSAS18001 and others standards will can create. These standards can be implemented and certified they guarantee one record system, quality assurance, documents control, operational control, responsibility definition, training, preparing and serve to emergency, monitoring, internal audit, corrective action, continual improvement, prevent of pollution, write procedure, reduce costs, impact assessment, risk assessment , standard, decree, legal requirements of municipal, state, federal and local scope. These procedure and systems when isolate applied cause many management systems and bureaucracy. Integration Management System reduce to bureaucracy, excess of documents, documents storage and conflict documents and easy to others standards implementation in future. The Integrated Management System (IMS) will be implemented in 2007. INB created a management group for implementation, this group decides planing, works, policy and advertisement. Legal requirements were surveyed, internal audits, pre-audits and audits were realized. INB is partially in accordance with ISO14001, OSHAS18001 standards. But very soon, it will be totally in accordance with this norms. Many studies and works were contracted to deal with legal requirements. This work have intention of show implementation process of ISO14001, OHSAS18001 and Integrated Management System on INB. (author)

  19. Children with pervasive refusal.

    OpenAIRE

    Lask, B; Britten, C; Kroll, L; Magagna, J; Tranter, M

    1991-01-01

    Four children are described with a potentially life threatening condition manifested by profound and pervasive refusal to eat, drink, walk, talk, or care for themselves in any way over a period of several months. The multiplicity and severity of the symptoms in these children do not fit comfortably into any existing diagnostic category. Long term and highly skilled nursing and psychiatric care is required to help these children to recover. The possible causes of this syndrome are discussed.

  20. Improving integration for integrated coastal zone management: an eight country study.

    Science.gov (United States)

    Portman, M E; Esteves, L S; Le, X Q; Khan, A Z

    2012-11-15

    Integrated coastal zone management (ICZM) is a widely accepted approach for sustainable management of the coastal environment. ICZM emphasizes integration across sectors, levels of government, uses, stakeholders, and spatial and temporal scales. While improving integration is central to progress in ICZM, the role of and the achievement of integration remain understudied. To further study these two points, our research analyzes the performance of specific mechanisms used to support ICZM in eight countries (Belgium, India, Israel, Italy, Portugal, Sweden, UK, and Vietnam). The assessment is based on a qualitative comparative analysis conducted through the use of two surveys. It focuses on five ICZM mechanisms (environmental impact assessment; planning hierarchy; setback lines; marine spatial planning, and regulatory commission) and their role in improving integration. Our findings indicate that certain mechanisms enhance specific types of integration more effectively than others. Environmental impact assessment enhances science-policy integration and can be useful to integrate knowledge across sectors. Planning hierarchy and regulatory commissions are effective mechanisms to integrate policies across government levels, with the latter also promoting public-government integration. Setback lines can be applied to enhance integration across landscape units. Marine spatial planning is a multi-faceted mechanism with the potential to promote all types of integration. Policy-makers should adopt the mechanisms that are suited to the type of integration needed. Results of this study also contribute to evidence-based coastal management by identifying the most common impediments related to the mechanisms of integration in the eight studied countries. Copyright © 2012 Elsevier B.V. All rights reserved.

  1. Chemical reagent and process for refuse disposal

    International Nuclear Information System (INIS)

    Somerville, R.B.; Fan, L.T.

    1989-01-01

    A process for treating refuse by mixing them with a reactive chemical and a puzzolana-type material. Said chemical includes a retarding agent which modifies the viscosity and an accelerating agent. (author)

  2. 49 CFR 219.213 - Unlawful refusals; consequences.

    Science.gov (United States)

    2010-10-01

    ... inconsistent with the employee's health, whether such refusal was made in good faith and based on medical..., as appropriate, also consider the following: (1) Whether the railroad made a good faith determination...

  3. Biometric identification with high frequency electrocardiogram: Unregistered user refusal method and performance evaluation.

    Science.gov (United States)

    Kyoso, Masaki

    2015-08-01

    As a new modality for biometric identification, electrocardiogram-based identification technique has been developed. We proposed a technique with high frequency component of electrocardiogram (HFECG) in QRS segment. In this report, an unregistered user refusal algorithm was combined with the artificial neural network based waveform classifier. The refusal function was realized by simple thresholding technique. HFECGs from twenty collaborators were used for supervised learning. Twenty HFECGs from the same collaborators were tested and false acceptance rate (FAR) and false rejection rate (FRR) were evaluated. Ten HFECGs from other collaborators were also tested to find unregistered user refusal performance. The results show that FAR and FRR in the registrants can be kept within 1%, however, unregistered user refusal performance was not acceptable under the same condition.

  4. Behavioural treatment of severe food refusal in five toddlers with developmental disabilities

    NARCIS (Netherlands)

    Moor, J.M.H. de; Didden, H.C.M.; Korzilius, H.P.L.M.

    2007-01-01

    BACKGROUND: Young children with developmental disabilities are at risk of food refusal. In case of severe food refusal, children are being fed by nasal or gastrostomy tube. Behavioural treatment may be effective in establishing oral food intake. METHODS: A behavioural treatment package was

  5. Behavioral treatment of severe food refusal in five toddlers with developmental disabilities

    NARCIS (Netherlands)

    Moor, J.M.H. de; Didden, H.C.M.; Korzilius, H.P.L.M.

    2007-01-01

    Background Young children with developmental disabilities are at risk of food refusal. In case of severe food refusal, children are being fed by nasal or gastrostomy tube. Behavioural treatment may be effective in establishing oral food intake. Methods A behavioural treatment package was

  6. Behavioural treatment of severe food refusal in five toddlers with developmental disabilities.

    NARCIS (Netherlands)

    Moor, J.M.H. de; Didden, R.; Korzilius, H.P.L.M.

    2007-01-01

    BACKGROUND: Young children with developmental disabilities are at risk of food refusal. In case of severe food refusal, children are being fed by nasal or gastrostomy tube. Behavioural treatment may be effective in establishing oral food intake. METHODS: A behavioural treatment package was

  7. Integrated environment, safety, and health management system description

    International Nuclear Information System (INIS)

    Zoghbi, J. G.

    2000-01-01

    The Integrated Environment, Safety, and Health Management System Description that is presented in this document describes the approach and management systems used to address integrated safety management within the Richland Environmental Restoration Project

  8. Integrated waste management - Looking beyond the solid waste horizon

    International Nuclear Information System (INIS)

    Seadon, J.K.

    2006-01-01

    Waste as a management issue has been evident for over four millennia. Disposal of waste to the biosphere has given way to thinking about, and trying to implement, an integrated waste management approach. In 1996 the United Nations Environmental Programme (UNEP) defined 'integrated waste management' as 'a framework of reference for designing and implementing new waste management systems and for analysing and optimising existing systems'. In this paper the concept of integrated waste management as defined by UNEP is considered, along with the parameters that constitute integrated waste management. The examples used are put into four categories: (1) integration within a single medium (solid, aqueous or atmospheric wastes) by considering alternative waste management options (2) multi-media integration (solid, aqueous, atmospheric and energy wastes) by considering waste management options that can be applied to more than one medium (3) tools (regulatory, economic, voluntary and informational) and (4) agents (governmental bodies (local and national), businesses and the community). This evaluation allows guidelines for enhancing success: (1) as experience increases, it is possible to deal with a greater complexity; and (2) integrated waste management requires a holistic approach, which encompasses a life cycle understanding of products and services. This in turn requires different specialisms to be involved in the instigation and analysis of an integrated waste management system. Taken together these advance the path to sustainability

  9. Integrated Computer System of Management in Logistics

    Science.gov (United States)

    Chwesiuk, Krzysztof

    2011-06-01

    This paper aims at presenting a concept of an integrated computer system of management in logistics, particularly in supply and distribution chains. Consequently, the paper includes the basic idea of the concept of computer-based management in logistics and components of the system, such as CAM and CIM systems in production processes, and management systems for storage, materials flow, and for managing transport, forwarding and logistics companies. The platform which integrates computer-aided management systems is that of electronic data interchange.

  10. Integrated management systems

    DEFF Research Database (Denmark)

    Jørgensen, Tine Herreborg; Remmen, Arne; Mellado, M. Dolores

    2006-01-01

    Different approaches to integration of management systems (ISO 9001, ISO 14001, OHSAS 18001 and SA 8000) with various levels of ambition have emerged. The tendency of increased compatibility between these standards has paved the road for discussions of, how to understand the different aspects of ...

  11. Responding to the refusal of care in the emergency department.

    Science.gov (United States)

    Nelson, Jennifer; Venkat, Arvind; Davenport, Moira

    2014-01-01

    The emergency department (ED) serves as the primary gateway for acute care and the source of health care of last resort. Emergency physicians are commonly expected to rapidly assess and treat patients with a variety of life-threatening conditions. However, patients do refuse recommended therapy, even when the consequences are significant morbidity and even mortality. This raises the ethical dilemma of how emergency physicians and ED staff can rapidly determine whether patient refusal of treatment recommendations is based on intact decision-making capacity and how to respond in an appropriate manner when the declining of necessary care by the patient is lacking a basis in informed judgment. This article presents a case that illustrates the ethical tensions raised by the refusal of life-sustaining care in the ED and how such situations can be approached in an ethically appropriate manner.

  12. [Maternal refusal to consent to a cesarean delivery, stillbirth].

    Science.gov (United States)

    Defline, A; Obadia, M; El Djerbi, A; Plevy, P; Lepercq, J

    2014-01-01

    The doctor-lawyer perspective that we discuss is a maternal refusal to consent to a cesarean delivery for a fetal indication in June 2011. Despite repeated information of the risks during a three-week hospitalization for pre-eclampsia, after being assured of the proper understanding of the seriousness of the situation by the patient and spouse, and after consideration to transfer to another hospital, the reiterated refusal led to a late fetal extraction resulting in term stillbirth. Copyright © 2013. Published by Elsevier Masson SAS.. All rights reserved.

  13. Integrated Urban Water Quality Management

    DEFF Research Database (Denmark)

    Rauch, W.; Harremoës, Poul

    1995-01-01

    The basic features of integrated urban water quality management by means of deterministic modeling are outlined. Procedures for the assessment of the detrimental effects in the recipient are presented as well as the basic concepts of an integrated model. The analysis of a synthetic urban drainage...... system provides useful information for water quality management. It is possible to identify the system parameters that contain engineering significance. Continuous simulation of the system performance indicates that the combined nitrogen loading is dominated by the wastewater treatment plant during dry...

  14. Jehovah's Witnesses and autonomy: honouring the refusal of blood transfusions.

    Science.gov (United States)

    Bock, Gregory L

    2012-11-01

    This paper explores the scriptural and theological reasons given by Jehovah's Witnesses (JWs) to refuse blood transfusions. Julian Savulescu and Richard W Momeyer argue that informed consent should be based on rational beliefs and that the refusal of blood transfusions by JWs is irrational, but after examining the reasons given by JWs, I challenge the claim that JW beliefs are irrational. I also question whether we should give up the traditional notion of informed consent.

  15. Food refusal in prisoners: a communication or a method of self-killing? The role of the psychiatrist and resulting ethical challenges.

    Science.gov (United States)

    Brockman, B

    1999-12-01

    Food refusal occurs for a variety of reasons. It may be used as a political tool, as a method of exercising control over others, at either the individual, family or societal level, or as a method of self-harm, and occasionally it indicates possible mental illness. This article examines the motivation behind hunger strikes in prisoners. It describes the psychiatrist's role in assessment and management of prisoners by referring to case examples. The paper discusses the assessment of an individual's competence to commit suicide by starvation, legal restraints to intervention, practical difficulties and associated ethical dilemmas. Anecdotal evidence suggests that most prisoners who refuse food are motivated by the desire to achieve an end rather than killing themselves, and that hunger-strike secondary to mental illness is uncommon. Although rarely required, the psychiatrist may have an important contribution to make in the management of practical and ethical difficulties.

  16. Supply chain integration, risk management and manufacturing flexibility

    DEFF Research Database (Denmark)

    Chaudhuri, Atanu; Boer, Harry; Taran, Yariv

    2018-01-01

    , respectively, and manufacturing flexibility. Design/methodology/approach – Using hierarchical regression, data are analyzed from a sample of 343 manufacturing plants in Asia collected in 2013-2014 as part of the International Manufacturing Strategy Survey (IMSS VI). Findings – Internal integration and supply......Purpose – The purpose of this paper is to investigate the impact of internal integration, external integration and supply chain risk management on manufacturing flexibility, and the moderating effect of supply chain risk management on the relationships between internal and external integration...... chain risk management have a direct effect on manufacturing flexibility. Supply chain risk management moderates the relationship between external integration and flexibility. Research limitations/implications – Further research is needed to generalize beyond the flexibility performance of discrete...

  17. Using a Nonaversive Procedure to Decrease Refusals.

    Science.gov (United States)

    Spooner, Fred; And Others

    1990-01-01

    A nonaversive technique was used to teach a severely handicapped woman to decrease her refusals. The technique employed precision teaching via precise daily measurement strategies, environmental analysis, and a focus on building appropriate behavior. (JDD)

  18. Research on monitoring and management information integration technique in waste treatment and management

    International Nuclear Information System (INIS)

    Kong Jinsong; Yu Ren; Mao Wei

    2013-01-01

    The integration of the waste treatment process and the device status monitoring information and management information is a key problem required to be solved in the information integration of the waste treatment and management. The main content of the monitoring and management information integration is discussed in the paper. The data exchange techniques, which are based on the OPC, FTP and data push technology, are applied to the different monitoring system respectively, according to their development platform, to realize the integration of the waste treatment process and device status monitoring information and management information in a waste treatment center. (authors)

  19. What happens after a request for euthanasia is refused? Qualitative interviews with patients, relatives and physicians.

    Science.gov (United States)

    Pasman, H Roeline W; Willems, Dick L; Onwuteaka-Philipsen, Bregje D

    2013-09-01

    Obtaining in-depth information from both patient and physician perspectives about what happens after a request for euthanasia or physician-assisted suicide (EAS) is refused. In-depth interviews with nine patients whose EAS request was refused and seven physicians of these patients, and with three relatives of patients who had died after a request was refused and four physicians of these patients. Interviews were conducted at least 6 months after the refusal. A wish to die remained in all patients after refusal, although it sometimes diminished. In most cases patient and physician stopped discussing this wish, and none of the physicians had discussed plans for the future with the patient or evaluated the patient's situation after their refusal. Physicians were aware of patients' continued wish to die. Patients who are refused EAS may subsequently be silent about a wish to die without abandoning it. Open communication about wishes to die is important, even outside the context of EAS, because if people feel unable to talk about them, their quality of life may be further diminished. Follow up appointments after refusal could give patients the opportunity to discuss their feelings and physicians to support them. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  20. The integrity management cycle as a business process

    Energy Technology Data Exchange (ETDEWEB)

    Ackhurst, Trent B.; Peverelli, Romina P. [PIMS - Pipeline Integrity Management Specialists of London Ltd. (United Kingdom).

    2009-07-01

    It is a best-practice Oil and Gas pipeline integrity and reliability technique to apply integrity management cycles. This is conforms to the business principles of continuous improvement. This paper examines the integrity management cycle - both goals and objectives and subsequent component steps - from a business perspective. Traits that businesses require, to glean maximum benefit from such a cycle, are highlighted. A case study focuses upon an integrity and reliability process developed to apply to pipeline operators. installations. This is compared and contrasted to the pipeline integrity management cycle to underline both cycles. consistency with the principles of continuous improvement. (author)

  1. Prevention of formation of acid drainage from high-sulfur coal refuse by inhibition of iron- and sulfur-oxidizing microorganisms. II. Inhibition in run of mine refuse under simulated field conditions

    Energy Technology Data Exchange (ETDEWEB)

    Dugan, P.R.

    1987-01-01

    The combination of sodium lauryl sulfate and benzoic acid effectively inhibits iron- and sulfur-oxidizing bacteria in coal refuse and prevents the conversion of iron pyrite to sulfate, ferric iron, and sulfuric acid, thereby significantly reducing the formation of acidic drainage from coal refuse. The inhibitors were effective in a concentration of 1.1. mg/kg refuse, and data indicate that the SLS was in excess of the concentration required. The treatment was compatible with the use of lime for neutralization of acid present prior to inhibition of its formation.

  2. Integrated management systems in the nuclear field

    International Nuclear Information System (INIS)

    Beckmerhagen, I.A.; Berg, H.P.; Karapetrovic, S.V.; Willborn, W.O.

    2005-01-01

    In the last years several internationally accepted standards such as the ISO 9000 and ISO 14000 series and other function-specific management systems standards have been developed. At the same time, it has become imperative for organisations to continuously improve their overall quality, environmental and safety performance. Therefore, the need to create integrated management systems is of growing importance to enable an easier handling of the different management systems. This paper has two main objectives. The first one is to address the key issues in the underlying theory of integrated management systems including benefits and limits, the second one is to illustrate the importance of an integrated (in particular safety) management system and the experience feedback providing examples from different areas and different organisations in the nuclear field. (orig.)

  3. Correlates of Inconsistent Refusal of Unprotected Sex among Armenian Female Sex Workers

    Directory of Open Access Journals (Sweden)

    Karine Markosyan

    2014-01-01

    Full Text Available This cross-sectional study assessed the prevalence and correlates of inconsistent refusal of unprotected sex among female sex workers (FSWs in Armenia. One hundred and eighteen street-based FSWs between the ages of 20 and 52 completed a questionnaire assessing FSWs’ demographic, psychosocial, and behavioral characteristics. A total of 52.5% (n=62 of FSWs reported inconsistent refusal of unprotected sex with clients in the past 3 months. Logistic regression analysis controlling for participants’ age and education revealed that perceiving more barriers toward condom use (AOR = 1.1; P<0.01, reporting more types of abuse (AOR = 2.1; P<0.01, and setting lower fees for service (AOR = 0.9; P=0.02 significantly predicted inconsistent refusal of unprotected sex. HIV-risk-reduction behavioral interventions tailored to FSWs working in Yerevan Armenia should address the factors identified in this study toward the goal of enhancing refusal of unprotected sex and ultimately preventing acquisition of sexually transmitted infections (STIs including HIV.

  4. Integrated Risk Management Within NASA Programs/Projects

    Science.gov (United States)

    Connley, Warren; Rad, Adrian; Botzum, Stephen

    2004-01-01

    As NASA Project Risk Management activities continue to evolve, the need to successfully integrate risk management processes across the life cycle, between functional disciplines, stakeholders, various management policies, and within cost, schedule and performance requirements/constraints become more evident and important. Today's programs and projects are complex undertakings that include a myriad of processes, tools, techniques, management arrangements and other variables all of which must function together in order to achieve mission success. The perception and impact of risk may vary significantly among stakeholders and may influence decisions that may have unintended consequences on the project during a future phase of the life cycle. In these cases, risks may be unintentionally and/or arbitrarily transferred to others without the benefit of a comprehensive systemic risk assessment. Integrating risk across people, processes, and project requirements/constraints serves to enhance decisions, strengthen communication pathways, and reinforce the ability of the project team to identify and manage risks across the broad spectrum of project management responsibilities. The ability to identify risks in all areas of project management increases the likelihood a project will identify significant issues before they become problems and allows projects to make effective and efficient use of shrinking resources. By getting a total team integrated risk effort, applying a disciplined and rigorous process, along with understanding project requirements/constraints provides the opportunity for more effective risk management. Applying an integrated approach to risk management makes it possible to do a better job at balancing safety, cost, schedule, operational performance and other elements of risk. This paper will examine how people, processes, and project requirements/constraints can be integrated across the project lifecycle for better risk management and ultimately improve the

  5. Integrated Health Management Definitions

    Data.gov (United States)

    National Aeronautics and Space Administration — The Joint Army Navy NASA Air Force Modeling and Simulation Subcommittee's Integrated Health Management panel was started about 6 years ago to help foster...

  6. Integrated Co-management of Lakes through Beach Management Units

    OpenAIRE

    Goverment of Uganda; Department for International Development (DFID) of the UK Government

    2007-01-01

    Metadata only record In 1999, the Integrated Co-management of Lakes through Beach Management Units project was started in an effort to implement a new approach to the management of lake resources in Uganda. The main components of this plan involved decentralization, local community management, and improving the livelihood of the poor. In order to finance the management of these areas, the Beach Management Units (BMU's) are charging user fees to those individuals who obtain benefit from the...

  7. Impact of interventions for patients refusing emergency medical services transport.

    Science.gov (United States)

    Alicandro, J; Hollander, J E; Henry, M C; Sciammarella, J; Stapleton, E; Gentile, D

    1995-06-01

    To evaluate the effect of a documentation checklist and on-line medical control contact on ambulance transport of out-of-hospital patients refusing medical assistance. Consecutive patients served by four suburban ambulance services who initially refused emergency medical services (EMS) transport to the hospital were prospectively enrolled. In phase 1 (control phase), all patients who initially refused medical attention or transport had an identifying data card completed. In phase 2 (documentation phase), out-of-hospital providers completed a similar data card that contained a checklist of high-risk criteria for a poor outcome if not transported. In phase 3 (intervention phase), a data card similar to that used in phase 2 was completed, and on-line medical control was contacted for all patients with high-risk criteria who refused transport. The primary endpoint was the percentage of patients transported to the hospital. A total of 361 patients were enrolled. Transport rate varied by phase: control, 17 of 144 (12%); documentation, 11 of 150 (7%); and intervention, 12 of 67 (18%) (chi-square, p = 0.023). Transport of high-risk patients improved with each intervention: control, two of 60 (3%); documentation, seven of 70 (10%); and intervention, 12 of 34 (35%) (chi-square, p = 0.00003). Transport of patients without high-risk criteria decreased with each intervention: control, 15 of 84 (18%); documentation, four of 80 (5%); and intervention, 0 of 33 (0%) (p = 0.0025). Of the 28 patients for whom medical control was contacted, 12 (43%) were transported to the hospital, and only three of these 12 patients (25%) were released from the ED. Contact with on-line medical control increased the likelihood of transport of high-risk patients who initially refused medical assistance. The appropriateness of the decreased transport rate of patients not meeting high-risk criteria needs further evaluation.

  8. Refusal of dialysis amongst patients of chronic kidney disease (CKD)

    International Nuclear Information System (INIS)

    Anees, M.; Khan, J.A.

    2014-01-01

    This study was conducted to determine the refusal of dialysis amongst patients of chronic kidney disease presenting for the first time for dialysis in uremic condition. Study Design: Cross sectional Study. Place and Duration of the Study: Outpatient department of Nephrology, Mayo Hospital, Lahore from 1 st Jan 2012 to 31 st December 2012. Patients and Methods: Patients of CKD due to any cause presenting with uremia for the first time for dialysis were included in the study. History and physical examination was done and demographic data was collected in pre designed form. Patients were offered for dialysis while explaining to them the advantages of getting and disadvantages of not getting dialysis. Patient's response on the offer was recorded and the reason for the refusal were noted. Results: According to the criteria 150 patients were included in the study. Most of the patients were male 92 (61.3%) and illiterate 78 (52.0%). Major cause of CKD was diabetes mellitus 58 (38.7%) followed by hypertension 38 (25.3%). Mean age of the patients was 42.59 ± 13.72 year and income of themost of the patients 126 (84%) was less than US$100/-month. Most of the patients 126 (77.0%) were asked about the need of dialysis in less than three months, 61 (41.3%) offered for the first time and amongst them 85 (54.0%) were offered dialysis already. Majority of the patients 101 (67.3%) refused dialysis when it was offered to them for the first time. Major reason of the refusal was fear of dialysis procedure in 76 (76%) patients followed by treatment by spiritual 14 (14%) and alternative ways and others 11 (11 %). Middle age persons refused dialysis significantly. (author)

  9. Microbial community structure of leaf-cutter ant fungus gardens and refuse dumps.

    Science.gov (United States)

    Scott, Jarrod J; Budsberg, Kevin J; Suen, Garret; Wixon, Devin L; Balser, Teri C; Currie, Cameron R

    2010-03-29

    Leaf-cutter ants use fresh plant material to grow a mutualistic fungus that serves as the ants' primary food source. Within fungus gardens, various plant compounds are metabolized and transformed into nutrients suitable for ant consumption. This symbiotic association produces a large amount of refuse consisting primarily of partly degraded plant material. A leaf-cutter ant colony is thus divided into two spatially and chemically distinct environments that together represent a plant biomass degradation gradient. Little is known about the microbial community structure in gardens and dumps or variation between lab and field colonies. Using microbial membrane lipid analysis and a variety of community metrics, we assessed and compared the microbiota of fungus gardens and refuse dumps from both laboratory-maintained and field-collected colonies. We found that gardens contained a diverse and consistent community of microbes, dominated by Gram-negative bacteria, particularly gamma-Proteobacteria and Bacteroidetes. These findings were consistent across lab and field gardens, as well as host ant taxa. In contrast, dumps were enriched for Gram-positive and anaerobic bacteria. Broad-scale clustering analyses revealed that community relatedness between samples reflected system component (gardens/dumps) rather than colony source (lab/field). At finer scales samples clustered according to colony source. Here we report the first comparative analysis of the microbiota from leaf-cutter ant colonies. Our work reveals the presence of two distinct communities: one in the fungus garden and the other in the refuse dump. Though we find some effect of colony source on community structure, our data indicate the presence of consistently associated microbes within gardens and dumps. Substrate composition and system component appear to be the most important factor in structuring the microbial communities. These results thus suggest that resident communities are shaped by the plant degradation

  10. Adaptive and integrated water management

    NARCIS (Netherlands)

    Pahl-Wostl, C.; Kabat, P.; Möltgen, J.

    2007-01-01

    Sustainable water management is a key environmental challenge of the 21st century. Developing and implementing innovative management approaches and how to cope with the increasing complexity and uncertainties was the theme of the first International Conference on Adaptive and Integrated Water

  11. Networking of integrated pest management

    NARCIS (Netherlands)

    Lamichhane, Jay Ram; Aubertot, Jean Noël; Begg, Graham; Birch, Andrew Nicholas E.; Boonekamp, Piet; Dachbrodt-Saaydeh, Silke; Hansen, Jens Grønbech; Hovmøller, Mogens Støvring; Jensen, Jens Erik; Jørgensen, Lise Nistrup; Kiss, Jozsef; Kudsk, Per; Moonen, Anna Camilla; Rasplus, Jean Yves; Sattin, Maurizio; Streito, Jean Claude; Messéan, Antoine

    2016-01-01

    Integrated pest management (IPM) is facing both external and internal challenges. External challenges include increasing needs to manage pests (pathogens, animal pests and weeds) due to climate change, evolution of pesticide resistance as well as virulence matching host resistance. The complexity

  12. Blood Transfusion in Children: The Refusal of Jehovah’s Witness Parents’

    Science.gov (United States)

    Conti, Adelaide; Capasso, Emanuele; Casella, Claudia; Fedeli, Piergiorgio; Salzano, Francesco Antonio; Policino, Fabio; Terracciano, Lucia; Delbon, Paola

    2018-01-01

    Abstract In Italy, both parents have parental responsibility; as a general principle they have the power to give or withhold consent to medical procedures on their children, including consent for blood transfusion; however these rights are not absolute and exist only to promote the welfare of children. Methods The Authors discuss ethical and legal framework for Jehovah’s Witness parents’ refusal of blood transfusion in Italy. They searched national judgments concerning Jehovah’s Witness parents’ refusal of blood transfusion – and related comments – in national legal databases and national legal journals, and literature on medical literature databases. Results In the case of Jehovah’s Witness parents’ refusal of blood transfusion for their child, Italian Courts adopt measures that prevents the parents from exercise their parental responsibility not in the child’s best interest. Discussion In the event that refusal by the parents, outside of emergency situations, exposes the child’s health to serious risk, health workers must proceed by notifying the competent authority, according also to the Italian Code of Medical Ethics. Conclusion When the patient is a minor, the child’s best interest always come first. PMID:29666843

  13. Mental health consequences of abortion and refused abortion.

    Science.gov (United States)

    Watter, W W

    1980-02-01

    There is no scientific evidence to support the hypothesis put forth by Dr. Philip Ney in a recent article published in the Canadian Journal of Psychiatry that induced abortion is associated with an increase in child abuse. There are, however, numerous studies which support the contention that mandatory motherhood adversely affects the mental health of both the mother and the offspring. Studies conducted in Sweden, Scotland, and Czechoslovakia revealed that women who were refused abortions frequently experienced serious psychosocial difficulties for long periods of time following abortion refusal. Case controlled follow-up studies, conducted in Sweden and Czechoslovakia, of offspring born to women who were refused abortions demonstrated that a higher proportion of the unwanted children required psychiatric services, engaged in criminal behavior, and did less well in school than the controlled children. These studies have implications for the current Canadian law which permits a woman to obtain an abortion if pregnancy continuation will endanger her health. In view of the above statistical evidence, and the fact that mortality and morbidity are known to be lower for abortion than for childbirth, any person who denies a woman the right to have an abortion is increasing the risk that the health of the woman will be endangered. By law, therefore, all abortion requests should be honored.

  14. THE PLACE OF OCCUPATIONAL HEALTH AND SAFETY MANAGEMENT SYSTEM IN THE INTEGRATED MANAGEMENT SYSTEM

    Directory of Open Access Journals (Sweden)

    Piotr Kafel

    2016-06-01

    Full Text Available The purpose of this paper is to analyze the place of occupational health and safety management system (OHSMS within the integrated management system. Implementation aspects of management systems are discussed, namely the different management system standards used for registration, for example ISO 14001, ISO 9001, OHSAS 18001, ISO 27001, the order in which they were implemented, the time required for each implementation, as well as the scope of integration of these management system standards into a single Integrated Management System and the level of integration. In order to do so, some of the results of a survey carried out in 81 organizations registered to at least two management systems selected from popular international standards, e.g.: ISO 9001, ISO 14001, OHSAS 18001, ISO/IEC 27001, ISO 22000 were used. OHSMS is not the system that is implemented as a first one. Usually it is implemented after or simultaneously with ISO 9001 and ISO 14001 standards. Time of implementation of MSSs in second and further round of implementation is shorter than during the implementation of first standards. There is a higher level of integration of implemented management standards in organizations where one of the standards in OHSMS, than in a companies without OHSMS. The paper analyses those sequences of management systems implementation of safety management systems with other system, that allow organizations to achieve higher levels of integration and presents a possible pattern for the companies initiating the integration process.

  15. Pipeline four-dimension management is the trend of pipeline integrity management in the future

    Energy Technology Data Exchange (ETDEWEB)

    Shaohua, Dong; Feifan; Zhongchen, Han [China National Petroleum Corporation (CNPC), Beijing (China)

    2009-07-01

    Pipeline integrity management is essential for today's operators to operate their pipelines safety and cost effectively. The latest developments of pipeline integrity management around the world are involved with change of regulation, industry standard and innovation of technology. And who know the trend of PIM in the future, which can be answered in the paper. As a result, the concept of P4DM was set up firstly in the world. The paper analyzed the pipeline HSE management, pipeline integrity management (PIM) and asset integrity management (AIM), the problem of management was produced, and also the Pipeline 4-dimension Management (P4DM) theory was brought forward. According to P4DM, from the hierarchy of P4DM, the management elements, fields, space and time was analyzed. The main content is P4DM integrate the space geography location and time, control and manage the pipeline system in whole process, anywhere and anytime. It includes the pipeline integrity, pipeline operation and emergency, which is integrated by IT system. It come true that the idea, solution, technology, organization, manager alternately intelligently control the process of management. What the paper talks about included the definition of pipeline 4D management, the research develop of P4DM, the theory of P4DM, the relationship between P4DM and PIM, the technology basis of P4DM, how to perform the P4DM and conclusion. The P4DM was produced, which provide the development direction of PIM in the future, and also provide the new ideas for PetroChina in the field of technology and management. (author)

  16. Using Descriptive Assessment in the Treatment of Bite Acceptance and Food Refusal

    Science.gov (United States)

    Casey, Sean D.; Perrin, Christopher J.; Lesser, Aaron D.; Perrin, Stefanie H.; Casey, Cheryl L.; Reed, Gregory K.

    2009-01-01

    The feeding behaviors of two children who maintained failure to thrive diagnoses and displayed food refusal are assessed in their homes. Descriptive assessments are used to identify schedules of consequence provided by each child's care providers for bite acceptance and food refusal behaviors. Assessments reveal rich schedules of praise and access…

  17. Bioethics and religious bodies: refusal of blood transfusions in Germany.

    Science.gov (United States)

    Rajtar, Małgorzata

    2013-12-01

    The refusal of medical treatment is a recurrent topic in bioethical debates and Jehovah's Witnesses often constitute an exemplary case in this regard. The refusal of a potentially life-saving blood transfusion is a controversial choice that challenges the basic medical principle of acting in patients' best interests and often leads physicians to adopt paternalistic attitudes toward patients who refuse transfusion. However, neither existing bioethical nor historical and social sciences scholarship sufficiently addresses experiences of rank-and-file Witnesses in their dealings with the health care system. This article draws on results of a nine-month (2010, 2011-2012) ethnographic research on the relationship between religious, legal, ethical, and emotional issues emerging from the refusal of blood transfusions by Jehovah's Witnesses in Germany (mainly in Berlin). It shows how bioethical challenges are solved in practice by some German physicians and what they perceive to be the main goal of biomedicine: promoting the health or broadly understood well-being of patients. I argue that two different understandings of the concept of autonomy are at work here: autonomy based on reason and autonomy based on choice. The first is privileged by German physicians in line with a Kantian philosophical tradition and constitutional law; the second, paradoxically, is utilized by Jehovah's Witnesses in their version of the Anglo-Saxon Millian approach. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. PENATAAN RUANG LAUT BERDASARKAN INTEGRATED COASTAL MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Dina Sunyowati

    2008-10-01

    Full Text Available The planning of coastal spatial arrangement must be put in the valid spatial planning system. Law Number 26 of 2007 on Spatial Planning and it is in fact related with land spatial planning, although that ocean and air spatial management will be arranged in separate law. The legal for coastal zone management is determined by using the principles of integrated coastal management by focusing on area or zone authority system. The integrated of coastal zones management regulations should be followed by the planning of coastal spatial arrange­ment. Therefore, certain synchronization at coastal zones governance is very important issue since by integrating and coordinating other related regulations and therefore conflict of norm can be minimized in the spatial planning coastal zone.

  19. Are they really refusing to travel? A qualitative study of prehospital records

    Directory of Open Access Journals (Sweden)

    Christopher Sarah

    2006-09-01

    Full Text Available Abstract Background Refusal by the patient to travel after calling an emergency ambulance may lead to a preventable waste of scarce resources if it can be shown that an alternative more appropriate response could be employed. A greater understanding is required of the reasons behind 'refusal to travel' (RTT in order to find appropriate solutions to address this issue. We sought to investigate the reasons why patients refuse to travel following emergency call-out in a rural county. Methods Written records made by ambulance crews for patients (n = 397 who were not transported to hospital following an emergency call-out during October 2004 were retrospectively analysed. Results Twelve main themes emerged for RTT which included non injury or minor injury, falls and recovery after treatment on scene; other themes included alternative supervision, follow-up and treatment arrangements or patients arranging their own transport. Importantly, only 8% of the sample was recorded by ambulance crews as truly refusing to travel against advice. Conclusion A system that facilitates standardised recording of RTT information including social reasons for non-transportation needs to be designed. 'Refused to travel' disclaimers need to reflect instances when crew and patient are satisfied that not going to hospital is the right outcome. These recommendations should be considered within the context of the plans for widening the role of ambulance services.

  20. Renouncement of renal replacement therapy: withdrawal and refusal

    Directory of Open Access Journals (Sweden)

    José Andrade Moura Neto

    Full Text Available Abstract Renouncement of renal replacement therapy (RRT is a medical dilemma. This review covers the concept, the magnitude, the prognosis, and discusses strategies and management approaches about this subject in patients with CKD and AKI. Evidence suggests that refusal is more frequent and carries a more guarded prognosis than withdrawal of RRT. When RRT is not expected to be beneficial in terms of survival or quality of life, conservative treatment and palliative care are alternatives. We review the historical evolution of guidelines about renouncement of RRT and palliative care, and highlight the absence of specific recommendations in Brazil. However renouncement of RRT may be ethically and legally accepted in Brazil, as the right to a dignified death. Longer life expectancy, economic pressures, and greater awareness will require a more detailed discussion about indications and sustainable use of RRT, and possibly the elaboration of national guidelines.

  1. Knowledge and information management for integrated water resource management

    Science.gov (United States)

    Watershed information systems that integrate data and analytical tools are critical enabling technologies to support Integrated Water Resource Management (IWRM) by converting data into information, and information into knowledge. Many factors bring people to the table to participate in an IWRM fra...

  2. Basic principles, contents, and benefits of an integrated management system

    International Nuclear Information System (INIS)

    Schwarzin, Juergen

    2010-01-01

    The basic principles and contents of an integrated management system are presented. The report focuses on the benefits and the experience accumulated in using an integrated management system. Integrated management systems are characterized by 2 features in particular: - On the one hand, by a system holistically controlling and describing all processes within a company which are necessary to achieve the company policy and company goals as defined. - On the other hand, it combines in one integrated management system various different aspects (such as quality, environmental protection, and safety) and the resulting requirements. Successful implementation of an integrated management system requires a clear commitment by company management to the integrated management system serving as a management tool. Implementation must be assigned the appropriate importance in the company. It must not be viewed as an instrument preserving 'status quo.' Instead, it must be seen as a tool for long-term improvement of the company. Application of the integrated management system minimizes the probability of occurrence of events, but is not able to reduce it to zero. (orig.)

  3. Integrated solid waste management in Germany

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-07-01

    This report covers Germany`s experience with integrated solid waste management programs. The municipal solid waste practices of four cities include practices and procedures that waste facility managers with local or state governments may consider for managing their own day-to-day operations.

  4. Integrated management system laying a foundation for excellence

    Energy Technology Data Exchange (ETDEWEB)

    Brissette, S.; Vincent, D. [Bruce Power, Tiverton, Ontario (Canada)], E-mail: Derek.VINCENT@brucepower.com

    2009-07-01

    Integration in its simplest form involves seamless coordination between organizational elements such as organization structure, processes, systems and documents. This paper discusses the concept of integration in regards to managed systems and examines practical issues of marrying evolving standards to organizational design and overall governance. Bruce Power's experience in developing its Management System into a more integrated approach is described. Leadership sponsorship of an integrated programmatic approach using a Governance, Oversight, Support and Perform (GOSP) model of accountability framework within the Management System has been a critical success factor in Bruce Power's journey towards achieving operational excellence. (author)

  5. Integrated management system laying a foundation for excellence

    International Nuclear Information System (INIS)

    Brissette, S.; Vincent, D.

    2009-01-01

    Integration in its simplest form involves seamless coordination between organizational elements such as organization structure, processes, systems and documents. This paper discusses the concept of integration in regards to managed systems and examines practical issues of marrying evolving standards to organizational design and overall governance. Bruce Power's experience in developing its Management System into a more integrated approach is described. Leadership sponsorship of an integrated programmatic approach using a Governance, Oversight, Support and Perform (GOSP) model of accountability framework within the Management System has been a critical success factor in Bruce Power's journey towards achieving operational excellence. (author)

  6. Integrating workflow and project management systems for PLM applications

    Directory of Open Access Journals (Sweden)

    Fabio Fonseca Pereira de Paula

    2008-07-01

    Full Text Available The adoption of Product Life-cycle Management Systems (PLMs concept is fundamental to improve the product development, mainly to small and medium enterprises (SMEs. One of the challenges is the integration between project management and product data management functions. The paper presents an analysis of the potential integration strategies for a specifics product data management system (SMARTEAM and a project management system (Microsoft Project, which are commonly used for SMEs. Finally the article presents some considerations about the study of Project Management solutions in SMB’s companies, considering the PLM approach. Key-words: integration, project management (PM, workflow, PDM, PLM.

  7. Insulin therapy refusal among type II diabetes mellitus patients in Kubang Pasu district, Kedah, Malaysia

    Science.gov (United States)

    Tan, Wei Leong; Asahar, Siti Fairus; Harun, Noor Liani

    2015-01-01

    INTRODUCTION Diabetes mellitus is a rising non-communicable disease in Malaysia. Insulin therapy refusal is a challenge for healthcare providers, as it results in delayed insulin initiation. This study was conducted to determine the prevalence of insulin therapy refusal and its associated factors. METHODS This cross-sectional study was conducted at seven public health clinics in Kubang Pasu district of Kedah, Malaysia, from March to October 2012. A newly developed and validated questionnaire was used and participants were selected via systematic random sampling. Only patients diagnosed with type II diabetes mellitus (T2DM) and under the public health clinic care in Kubang Pasu were included in the study. Multiple logistic regression was used to study the association between insulin therapy refusal and its associated factors. RESULTS There were 461 respondents and the response rate was 100%. Among these 461 patients with T2DM, 74.2% refused insulin therapy. The most common reason given for refusal was a lack of confidence in insulin injection (85.4%). Multiple logistic regression revealed that respondents who had secondary education were 55.0% less likely to refuse insulin therapy than those who had primary education or no formal education (adjusted odds ratio [OR] 0.45, 95% confidence interval [CI] 0.25–0.82, p = 0.009). There was also a significant inverse association between glycated haemoglobin (HbA1c) level and insulin therapy refusal (adjusted OR 0.87, 95% CI 0.76–1.00, p = 0.047). CONCLUSION Insulin therapy refusal is common in Kubang Pasu. Educational status and HbA1c level should be taken into consideration when counselling patients on insulin therapy initiation. PMID:25532511

  8. Marketization of refuse collection in Denmark

    DEFF Research Database (Denmark)

    Busck, Ole Gunni

    2006-01-01

      Danish municipalities' outsourcing and contracting of refuse collection are framed by a complex set of ideologies and objectives, besides regulation. Both at EU-level and at national level extreme demands for marketization of the public sector are counter-weighed by demands for social and envir......  Danish municipalities' outsourcing and contracting of refuse collection are framed by a complex set of ideologies and objectives, besides regulation. Both at EU-level and at national level extreme demands for marketization of the public sector are counter-weighed by demands for social...... and environmental considerations associated with the superior goal of sustainable development. In the EU regulative complex developments in normative and legal regulation of social and environmental requirements to member-states' performance have co-existed with tough requirements to ensure open competition...... in public authorities contracting. In the latest edition of the procurement directive it has been clarified that public authorities' commitment of private service-providers to social and environmental requirements by contracting is perfectly legitimate. At national level the municipalities when contracting...

  9. How to justify enforcing a Ulysses contract when Ulysses is competent to refuse.

    Science.gov (United States)

    Davis, John K

    2008-03-01

    Sometimes the mentally ill have sufficient mental capacity to refuse treatment competently, and others have a moral duty to respect their refusal. However, those with episodic mental disorders may wish to precommit themselves to treatment, using Ulysses contracts known as "mental health advance directives." How can health care providers justify enforcing such contracts over an agent's current, competent refusal? I argue that providers respect an agent's autonomy not retrospectively--by reference to his or her past wishes-and not merely synchronically--so that the agent gets what he or she wants right now-but diachronically and prospectively, acting so that the agent can shape his or her circumstances as the agent wishes over time, for the agent will experience the consequences of providers' actions over time. Mental health directives accomplish this, so they are a way of respecting the agent's autonomy even when providers override the agent's current competent refusal.

  10. [Tuberculosis and refusal of treatment: resorting to legislation on serious health threats].

    Science.gov (United States)

    Bouvet, R; Le Gueut, M

    2013-06-01

    Clinicians are regularly confronted with the question of refusal of treatment from patients with tuberculosis. For several years, the French public health authorities have been studying the possibility of compelling treatment or isolation, but no plan has been implemented even though European and American experiences have shown the effectiveness of restrictive measures. Neither the statutory exceptions to the principle of consent to medical treatment nor the conditions of implementation of "required care" allow legally binding measures against patients refusing care or isolation. The legislation on serious health threats has recently been applied to the situation of a refusal of treatment in the context of tuberculosis. It allowed the patient to be ordered to observe prescribed care and the possibility of forced isolation in the event of breach of this order. The legislation on serious health threats is a response to the question of refusal of treatment from patients with tuberculosis. However the opinion of the legal authority as to its necessity and proportionality to the risk remains unknown. Copyright © 2013 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  11. Childhood vaccine refusal and hesitancy intentions in Croatia: insights from a population-based study.

    Science.gov (United States)

    Repalust, Anja; Šević, Sandra; Rihtar, Stanko; Štulhofer, Aleksandar

    2017-10-01

    Considering that programmatic data suggest a recent rise in vaccine refusal in Croatia, this study, first of its kind in Southeast Europe, aimed to estimate the prevalence, and sociodemographic, and sociocultural determinants of childhood vaccine refusal and hesitancy (CVRH) intentions among Croatian adults. Multi-stage stratified population-based survey included 1000 individuals aged 18-88 years (M age  = 47.7, SD = 17.8), of whom 51.7% were women. The outcome, a categorical indicator, distinguished among individuals who would approve vaccinating their children (vaccine accepting), those who would approve some but not all vaccines (vaccine hesitant), and those who would refuse vaccination (vaccine refusing). A sizeable minority of participants was characterized by childhood vaccine refusal (10.6%) and hesitancy intentions (19.5%). In a multivariate assessment controlling for parenthood, the odds of vaccine hesitancy were significantly increased by a younger age (AOR = 1.96-3.03, p Croatia. Following the social contagion model, future research should move beyond individual-level approach and take into account social interaction and social network effects.

  12. Global challenges in integrated coastal zone management

    DEFF Research Database (Denmark)

    integration of data and information in policy and management, combining expertise from nature and social science, to reach a balanced and sustainable development of the coastal zone. This important book comprises the proceedings of The International Symposium on Integrated Coastal Zone Management, which took....../mitigation to change in coastal systems Coastal governance Linking science and management Comprising a huge wealth of information, this timely and well-edited volume is essential reading for all those involved in coastal zone management around the globe. All libraries in research establishments and universities where...

  13. Integrated coastal management in Uruguay

    International Nuclear Information System (INIS)

    2011-01-01

    Integrated coastal management in Uruguay Carmelo includes the following areas-Nueva Palmira challenges and opportunities for local development in a context of large-scale industrial (Conchillas Uruguay), coastal management and stream Arroyo Solis Solis Chico Grande, Punta Colorada and Punta Negra, Maldonado Province Arroyo Valizas and sustainable tourism.

  14. Integrated Natural Resource Management in the Highlands of ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    1 janv. 2012 ... Integrated Natural Resource Management in the Highlands of Eastern Africa: ... goal of implementing an integrated approach to natural resource ... and the International Water Management Institute in Addis Ababa, Ethiopia.

  15. Outcomes of nighttime refusal of admission to the intensive care unit: The role of the intensivist in triage.

    Science.gov (United States)

    Hinds, Nicholas; Borah, Amit; Yoo, Erika J

    2017-06-01

    To compare outcomes of patients refused medical intensive care unit (MICU) admission overnight to those refused during the day and to examine the impact of the intensivist in triage. Retrospective, observational study of patients refused MICU admission at an urban university hospital. Of 294 patients, 186 (63.3%) were refused admission overnight compared to 108 (36.7%) refused during the day. Severity-of-illness by the Mortality Probability Model was similar between the two groups (P=.20). Daytime triage refusals were more likely to be staffed by an intensivist (P=.01). After risk-adjustment, daytime refusals had a lower odds of subsequent ICU admission (OR 0.46, 95% CI 0.22-0.95, P=.04) than patients triaged at night. There was no evidence for interaction between time of triage and intensivist staffing of the patient (P=.99). Patients refused MICU admission overnight are more likely to be later admitted to an ICU than patients refused during the day. However, the mechanism for this observation does not appear to depend on the intensivist's direct evaluation of the patient. Further investigation into the clinician-specific effects of ICU triage and identification of potentially modifiable hospital triage practices will help to improve both ICU utilization and patient safety. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Integrated therapy safety management system.

    Science.gov (United States)

    Podtschaske, Beatrice; Fuchs, Daniela; Friesdorf, Wolfgang

    2013-09-01

    The aim is to demonstrate the benefit of the medico-ergonomic approach for the redesign of clinical work systems. Based on the six layer model, a concept for an 'integrated therapy safety management' is drafted. This concept could serve as a basis to improve resilience. The concept is developed through a concept-based approach. The state of the art of safety and complexity research in human factors and ergonomics forms the basis. The findings are synthesized to a concept for 'integrated therapy safety management'. The concept is applied by way of example for the 'medication process' to demonstrate its practical implementation. The 'integrated therapy safety management' is drafted in accordance with the six layer model. This model supports a detailed description of specific work tasks, the corresponding responsibilities and related workflows at different layers by using the concept of 'bridge managers'. 'Bridge managers' anticipate potential errors and monitor the controlled system continuously. If disruptions or disturbances occur, they respond with corrective actions which ensure that no harm results and they initiate preventive measures for future procedures. The concept demonstrates that in a complex work system, the human factor is the key element and final authority to cope with the residual complexity. The expertise of the 'bridge managers' and the recursive hierarchical structure results in highly adaptive clinical work systems and increases their resilience. The medico-ergonomic approach is a highly promising way of coping with two complexities. It offers a systematic framework for comprehensive analyses of clinical work systems and promotes interdisciplinary collaboration. © 2013 The Authors. British Journal of Clinical Pharmacology © 2013 The British Pharmacological Society.

  17. Integrated Natural Resource Management in the Highlands of ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2012-01-01

    Jan 1, 2012 ... Book cover Integrated Natural Resource Management in the ... with the common goal of implementing an integrated approach to natural resource ... and the International Water Management Institute in Addis Ababa, Ethiopia.

  18. Vaccine refusal - what we need to know.

    Science.gov (United States)

    Succi, Regina Célia de Menezes

    2018-04-12

    Opposition to vaccines is not a new event, and appeared soon after the introduction of the smallpox vaccine in the late 18th century. The purpose of this review is to educate healthcare professionals about vaccine hesitancy and refusal, its causes and consequences, and make suggestions to address this challenge. A comprehensive and non-systematic search was carried out in the PubMed, LILACS, and ScieLo databases from 1980 to the present day, using the terms "vaccine refusal," "vaccine hesitancy," and "vaccine confidence." The publications considered as the most relevant by the author were critically selected. The beliefs and arguments of the anti-vaccine movements have remained unchanged in the past two centuries, but new social media has facilitated the dissemination of information against vaccines. Studies on the subject have intensified after 2010, but the author did not retrieve any published studies to quantify this behavior in Brazil. The nomenclature on the subject (vaccine hesitancy) was standardized by the World Health Organization in 2012. Discussions have been carried out on the possible causes of vaccine hesitancy and refusal, as well as on the behavior of families and health professionals. Proposals for interventions to decrease public doubts, clarify myths, and improve confidence in vaccines have been made. Guides for the health care professional to face the problem are emerging. The healthcare professional is a key element to transmit information, resolve doubts and increase confidence in vaccines. They must be prepared to face this new challenge. Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  19. Waste management - an integral part of environmental management systems

    Energy Technology Data Exchange (ETDEWEB)

    Hamm, Ulrich

    1998-12-01

    To consider waste as a resource instead of an annoyance with which the management has to cope with, has become an unavoidable task for modern managers. The task the management has to take to secure competitiveness in an environment of rising complexity of production processes and further increasing legal requirements, is to manage waste as much as other recourses are managed. Waste has to be considered an aspect of planning and decision process just as business plans or logistics are. Main themes discussed in this publication comprise waste management, implementation of waste management as an integral part of environmental management systems, and management approach to waste - the results. 4 figs.

  20. Management systems for high reliability organizations. Integration and effectiveness; Managementsysteme fuer Hochzuverlaessigkeitsorganisationen. Integration und Wirksamkeit

    Energy Technology Data Exchange (ETDEWEB)

    Mayer, Michael

    2015-03-09

    The scope of the thesis is the development of a method for improvement of efficient integrated management systems for high reliability organizations (HRO). A comprehensive analysis of severe accident prevention is performed. Severe accident management, mitigation measures and business continuity management are not included. High reliability organizations are complex and potentially dynamic organization forms that can be inherently dangerous like nuclear power plants, offshore platforms, chemical facilities, large ships or large aircrafts. A recursive generic management system model (RGM) was development based on the following factors: systemic and cybernetic Asepcts; integration of different management fields, high decision quality, integration of efficient methods of safety and risk analysis, integration of human reliability aspects, effectiveness evaluation and improvement.

  1. INTEGRATION OF ENVIRONMENTAL MANAGEMENT SYSTEM

    OpenAIRE

    Tomescu Ada Mirela

    2012-01-01

    The relevance of management as significant factor of business activity can be established on various management systems. These will help to obtain, organise, administrate, evaluate and control particulars: information, quality, environmental protection, health and safety, various resources (time, human, finance, inventory etc). The complexity of nowadays days development, forced us to think ‘integrated’. Sustainable development principles require that environment management policies and p...

  2. Managing for Organizational Integrity.

    Science.gov (United States)

    Paine, Lynn Sharp

    1994-01-01

    Compliance-based ethics programs focus on prevention, detection, and punishment. Companies should adopt an integrity-based approach to ethics management that combines a concern for the law with an emphasis on managerial responsibility for ethical behavior. (JOW)

  3. Integrated, regional approach to risk management of industrial systems

    International Nuclear Information System (INIS)

    Chakraborty, S.

    1992-01-01

    This paper focuses on the following four main issues: (1) necessity for an integrated, regional approach to risk management of industrial systems; (2) principles of risk management; (3) integrated approach and overall methodology; and (4) implementation of risk management strategies on a regional basis. The U.N. Interagency project on risk management for large industrial areas, which is a pioneer type of international initiative for an integrated approach to risk management, is discussed in this context. Another encouraging activity for further development of overall methodologies for risk management is the ongoing project on the risk and safety of technical systems at the Swiss Federal Institute of Technology in Aurich. The concept of integral risk management takes into account multidimensional factors including technical, economic, political, social, and ethical considerations to allow a well-balanced decision-making process

  4. 24 CFR 3282.354 - Submittal of false information or refusal to submit information.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Submittal of false information or... ENFORCEMENT REGULATIONS Primary Inspection Agencies § 3282.354 Submittal of false information or refusal to submit information. The submittal of false information or the refusal to submit information required...

  5. Integrated ageing management of Atucha NPP

    International Nuclear Information System (INIS)

    Ranalli, Juan M.; Marchena, Martin H.; Zorrilla, Jorge R.; Antonaccio, Elvio E.; Brenna, Pablo; Yllanez, Daniela; Cruz, Gerardo Vera de la; Luraschi, Carlos; Sabransky, Mario

    2013-01-01

    Atucha NPP is a two PHWR unit site located in Lima, Province of Buenos Aires, 120 km north of Buenos Aires, Argentina. Until recent, the site was split in Atucha I NPP, a 350 MW pressure vessel heavy water reactor in operation since 1974; and Atucha II, a similar design reactor, twice as big as Atucha I finishing a delayed construction. With the start-up of Atucha II and aiming to integrate the management of the plants, the Utility (Nucleolectrica Argentina Sociedad Anonima - NASA) has reorganized its operation units. Within this reorganization, an Ageing Management Department has been created to cope with all ageing issues of both Atucha I and II units. The Atomic Energy Commission of Argentina (Comision Nacional de Energia Atomica - CNEA) is a state-owned R and D organization that; among other functions such as designing and building research reactors, developing uranium mining and supplying radioisotopes to the medical market; is in charge of providing support and technological update to all Argentinean NPPs. The Ageing Management Department of Atucha NPP and the Ageing Management Division of CNEA has formed a joint working group in order to set up an Integrated Ageing Management Program for Atucha NPP following IAEA guidelines. In the present work a summary of the activities, documental structure and first outputs of the Integrated Ageing Management Program of Atucha NPP is presented. (author)

  6. Integrated Ageing Management of Atucha NPP

    International Nuclear Information System (INIS)

    Ranalli, J.M.; Marchena, M.H.; Zorrilla, J.R.; Sabransky, M.

    2012-01-01

    Atucha NPP is a two PHWR unit site located in Lima, Province of Buenos Aires, 120 km north of Buenos Aires, Argentina. Until recent, the site was split in Atucha I NPP, a 350 MW pressure vessel heavy water reactor in operation since 1974; and Atucha II, a similar design reactor twice as big as Atucha I finishing a delayed construction . With the start-up of Atucha II and aiming to integrate the management of the plants, the Utility (Nucleolectrica Argentina Sociedad Anonima - NASA) has reorganized its operation units. Within this reorganization, an Ageing Management Department has been created to cope with all ageing issues of both Atucha I and II units. The Atomic Energy Commission of Argentina (Comision Nacional de Energia Atomica - CNEA) is a state-owned R and D organization that; among other functions such as designing and building research reactors, developing uranium mining and supplying radioisotopes to the medical market; is in charge of providing support and technological update to all Argentinean NPPs. The Ageing Management Department of Atucha NPP and the Ageing Management Division of CNEA has formed a joint working group in order to set up an Integrated Ageing Management Program for Atucha NPP following IAEA guidelines. In the present work a summary of the activities, documental structure and first outputs of the Integrated Ageing Management Program of Atucha NPP is presented. (author)

  7. Integrated ageing management of Atucha NPP

    Energy Technology Data Exchange (ETDEWEB)

    Ranalli, Juan M.; Marchena, Martin H.; Zorrilla, Jorge R.; Antonaccio, Elvio E.; Brenna, Pablo; Yllanez, Daniela; Cruz, Gerardo Vera de la; Luraschi, Carlos, E-mail: ranalli@cnea.gov.ar [Gerencia Coordinacion Proyectos CNEA-NASA, Comision Nacional de Energia Atomica, Buenos Aires (Argentina); Sabransky, Mario, E-mail: msabransky@na-sa.com.ar [Departamento Gestion de Envejecimiento, Central Nuclear Atucha I-II Nucleoelectrica Argentina S.A., Provincia de Buenos Aires (Argentina)

    2013-07-01

    Atucha NPP is a two PHWR unit site located in Lima, Province of Buenos Aires, 120 km north of Buenos Aires, Argentina. Until recent, the site was split in Atucha I NPP, a 350 MW pressure vessel heavy water reactor in operation since 1974; and Atucha II, a similar design reactor, twice as big as Atucha I finishing a delayed construction. With the start-up of Atucha II and aiming to integrate the management of the plants, the Utility (Nucleolectrica Argentina Sociedad Anonima - NASA) has reorganized its operation units. Within this reorganization, an Ageing Management Department has been created to cope with all ageing issues of both Atucha I and II units. The Atomic Energy Commission of Argentina (Comision Nacional de Energia Atomica - CNEA) is a state-owned R and D organization that; among other functions such as designing and building research reactors, developing uranium mining and supplying radioisotopes to the medical market; is in charge of providing support and technological update to all Argentinean NPPs. The Ageing Management Department of Atucha NPP and the Ageing Management Division of CNEA has formed a joint working group in order to set up an Integrated Ageing Management Program for Atucha NPP following IAEA guidelines. In the present work a summary of the activities, documental structure and first outputs of the Integrated Ageing Management Program of Atucha NPP is presented. (author)

  8. [Nursing ethics in the face of the refusal of nursing care].

    Science.gov (United States)

    Dauchy, Sarah; Charles, Cécile; Vérotte, Nelly; Block, Véronique; Adam, Virginie

    2016-10-01

    Caregivers can find themselves faced with a refusal of nursing care. A number of questions are then raised. While it is firstly important to understand the reasons for this refusal and what is at stake for the patient, there are a number of nursing strategies in place, not least of all dialogue and analysis. The role of the multi-disciplinary team is essential in such situations. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  9. Power management techniques for integrated circuit design

    CERN Document Server

    Chen, Ke-Horng

    2016-01-01

    This book begins with the premise that energy demands are directing scientists towards ever-greener methods of power management, so highly integrated power control ICs (integrated chip/circuit) are increasingly in demand for further reducing power consumption. * A timely and comprehensive reference guide for IC designers dealing with the increasingly widespread demand for integrated low power management * Includes new topics such as LED lighting, fast transient response, DVS-tracking and design with advanced technology nodes * Leading author (Chen) is an active and renowned contributor to the power management IC design field, and has extensive industry experience * Accompanying website includes presentation files with book illustrations, lecture notes, simulation circuits, solution manuals, instructors manuals, and program downloads.

  10. INTEGRATION OF ENVIRONMENTAL MANAGEMENT SYSTEM

    Directory of Open Access Journals (Sweden)

    Tomescu Ada Mirela

    2012-07-01

    Full Text Available The relevance of management as significant factor of business activity can be established on various management systems. These will help to obtain, organise, administrate, evaluate and control particulars: information, quality, environmental protection, health and safety, various resources (time, human, finance, inventory etc. The complexity of nowadays days development, forced us to think ‘integrated’. Sustainable development principles require that environment management policies and practices are not good in themselves but also integrate with all other environmental objectives, and with social and economic development objectives. The principles of sustainable development involve that environment management policies and practices. These are not sound in them-self but also integrate with all other environmental objectives, and with social and economic development objectives. Those objectives were realized, and followed by development of strategies to effects the objective of sustainable development. Environmental management should embrace recent change in the area of environmental protection, and suit the recently regulations of the field -entire legal and economic, as well as perform management systems to meet the requirements of the contemporary model for economic development. These changes are trailed by abandon the conventional approach of environmental protection and it is replaced by sustainable development (SD. The keys and the aims of Cleaner Productions (CP are presented being implemented in various companies as a non-formalised environmental management system (EMS. This concept is suggested here as a proper model for practice where possible environmental harmful technologies are used -e.g. Rosia Montana. Showing the features and the power of CP this paper is a signal oriented to involve the awareness of policy-makers and top management of diverse Romanian companies. Many companies in European countries are developing

  11. ASPECTS OF INTEGRATION MANAGEMENT METHODS

    Directory of Open Access Journals (Sweden)

    Artemy Varshapetian

    2015-10-01

    Full Text Available For manufacturing companies to succeed in today's unstable economic environment, it is necessary to restructure the main components of its activities: designing innovative product, production using modern reconfigurable manufacturing systems, a business model that takes into account the global strategy and management methods using modern management models and tools. The first three components are discussed in numerous publications, for example, (Koren, 2010 and is therefore not considered in the article. A large number of publications devoted to the methods and tools of production management, for example (Halevi, 2007. On the basis of what was said in the article discusses the possibility of the integration of only three methods have received in recent years, the most widely used, namely: Six Sigma method - SS (George et al., 2005 and supplements its-Design for six sigm? - DFSS (Taguchi, 2003; Lean production transformed with the development to the "Lean management" and further to the "Lean thinking" - Lean (Hirano et al., 2006; Theory of Constraints, developed E.Goldratt - TOC (Dettmer, 2001. The article investigates some aspects of this integration: applications in diverse fields, positive features, changes in management structure, etc.

  12. Integrated Procurement Management System, Version II

    Science.gov (United States)

    Collier, L. J.

    1985-01-01

    Integrated Procurement Management System, Version II (IPMS II) is online/ batch system for collecting developing, managing and disseminating procurementrelated data at NASA Johnson Space Center. Portions of IPMS II adaptable to other procurement situations.

  13. Wernicke-Korsakoff Syndrome as a Consequence of Delusional Food Refusal: A Case Study.

    Science.gov (United States)

    Hargrave, David D; Schroeder, Ryan W; Heinrichs, Robin J; Baade, Lyle E

    2015-12-01

    Wernicke-Korsakoff syndrome is caused by thiamine (vitamin B1) deficiency, typically resulting from malnutrition secondary to chronic alcohol abuse. Less often, other conditions can lead to malnutrition and Wernicke-Korsakoff syndrome. We describe a 35-year-old man who developed Wernicke-Korsakoff syndrome with a typical neurologic and neuropsychological presentation after somatic delusions led him to refuse to eat. Cases like his serve to heighten awareness of the interplay between psychiatric and neurologic conditions, their sometimes atypical pathogenesis, and the value to primary care providers of consulting with psychiatrists, neurologists, and neuropsychologists when managing patients with possible Wernicke-Korsakoff syndrome.

  14. Innovation Management in Emerging Technology Ventures – The Concept of an Integrated Idea Management

    DEFF Research Database (Denmark)

    Brem, Alexander; Voigt, K.-I.

    2007-01-01

    , development and sales. Here especially, differentiating potentials are offered for emerging technology ventures. But it is important that idea and innovation management are integrated during the building-up stage while internal and external network structures are still manageable and often consist...... of the managers' and founders' personal contacts. Hence, the earlier an integrated idea management is implemented, the greater is the probability of high numbers of successful innovations.......For decades, suggestion systems have been used to include employees in the innovation process. However, in order to gather superior ideas, integrating external stakeholders is critical to the innovation success. Within this paper, the authors derive a sophisticated model of an integrated idea...

  15. Integrating the autonomous subsystems management process

    Science.gov (United States)

    Ashworth, Barry R.

    1992-01-01

    Ways in which the ranking of the Space Station Module Power Management and Distribution testbed may be achieved and an individual subsystem's internal priorities may be managed within the complete system are examined. The application of these results in the integration and performance leveling of the autonomously managed system is discussed.

  16. 9 CFR 93.806 - Animals refused entry.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Animals refused entry. 93.806 Section 93.806 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE EXPORTATION AND IMPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS IMPORTATION OF...

  17. Refusal to pay electricity bill is illegal

    International Nuclear Information System (INIS)

    Hermann, H.P.

    1979-01-01

    Pursuant to a judgement passed by the Lower Court of Hamburg, the author discusses probable legal arguments justifying the refusal to pay one's electricity bill, the so-called electricity bill boycott. Following an analysis of the power supply contract and of the content and the limits of the fundamental right of freedom of conscience, as well as of the concept of free enterprise and of the legal effect of licenses under the nuclear law, his point of view stated in the article is to agree with the decision of the court saying that the operation of a nuclear power plant licensed under the nuclear law does not mean an infringement of the right of freedom of conscience. It can further not be accepted to let people refuse to pay their electricity bill by referring to the right of freedom of speech, by alleging conduct against public policy on the part of the public utilities, or by referring to the right of opposition. (HSCH) [de

  18. Integrated management system - management standards evolution and the IAEA new approach

    International Nuclear Information System (INIS)

    Oliveira, Dirceu Paulo de; Zouain, Desiree Moraes

    2007-01-01

    The management standards application began in military and nuclear areas towards the end of Second World War, when some westerns countries developed quality standards to improve their means to assess suppliers' conditions to assure their products conformance, which was increasingly complex and required a higher degree of reliability. Afterwards, the quality standards application was extended to the consumer market focused on consumers' requirements satisfaction. Coming along the society crescent concern about quality of life, other management standards were developed, such as those dealing with environmental and sustainable development, occupational health and safety, social accountability and so on. As a consequence, the management process became complex. The management system integrated form approach makes possible the compatibility of distinct and complementary interests from several functions and disciplines involved and supply the absence of the organizations' holistic approach. According to this integrated management approach, the Agency - 'International Atomic Energy Agency' (IAEA) - decided to review the structure of the 50-C-Q standard - 'Quality Assurance for Safety in Nuclear Power Plants and Other Nuclear Installations', from 1996, publishing in 2006 the new GS-R-3 standard - 'The Management System for Facilities and Activities - Safety Requirements'. This work presents a brief evolution of management standards and integrated management approach, showing the Agency's new vision concerning this issue with the GS-R-3 standard publication. (author)

  19. School refusal associated with separation anxiety disorder; an adolescent case report

    Directory of Open Access Journals (Sweden)

    Mustafa Yasin Irmak

    2016-12-01

    Full Text Available In literature, there are lots of studies about separation anxiety disorder (SAD and school refusal. Of the patients in these studies, it is generally known to child age group. In this paper, we aimed to draw attention to an adolescent patient with SAD who admitted to our clinic with complaint of school refusal and there is SAD under his unwillingness to go to school. [J Contemp Med 2016; 6(4.000: 357-360

  20. 21 CFR 515.21 - Refusal to approve a medicated feed mill license application.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Refusal to approve a medicated feed mill license... SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS MEDICATED FEED MILL LICENSE Administrative Actions on Licenses § 515.21 Refusal to approve a medicated feed mill license application. (a) The...

  1. Nuclear importation, exportation and production within the framework of the law of the communities or zones of integration

    International Nuclear Information System (INIS)

    Bertone, L.

    1986-01-01

    The article starts from the hypothesis that a harmonisation of regulations concerning the international commerce of nuclear technology would be more useful, if in a first period it is managed on the level of communities (Euratom) or integration zones (ALADI). European and South-American regulations as well as certain aspects of the North-South-cooperation are presented. As yet, a universal cooperation in the field of nuclear material is refused. (CW) [de

  2. Project management plan : Dallas Integrated Corridor Management (ICM) demonstration project.

    Science.gov (United States)

    2010-12-01

    The Dallas Integrated Corridor Management System Demonstration Project is a multi-agency, de-centralized operation which will utilize a set of regional systems to integrate the operations of the corridor. The purpose of the Dallas ICM System is to im...

  3. 49 CFR 655.49 - Refusal to submit to a drug or alcohol test.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Refusal to submit to a drug or alcohol test. 655... TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS Types of Testing § 655.49 Refusal to submit to a drug or alcohol test. (a) Each...

  4. Refuse derived soluble bio-organics enhancing tomato plant growth and productivity

    Energy Technology Data Exchange (ETDEWEB)

    Sortino, Orazio [Dipartimento di Scienze Agronomiche Agrochimiche e delle Produzioni Animali, Universita degli Studi di Catania, Via Valdisavoia 5, 95123 Catania (Italy); Dipasquale, Mauro [Dipartimento di Chimica, Universita di Torino, Via P. Giuria 7, 10125 Torino (Italy); Montoneri, Enzo, E-mail: enzo.montoneri@unito.it [Dipartimento di Chimica, Universita di Torino, Via P. Giuria 7, 10125 Torino (Italy); Tomasso, Lorenzo; Perrone, Daniele G. [Dipartimento di Chimica, Universita di Torino, Via P. Giuria 7, 10125 Torino (Italy); Vindrola, Daniela; Negre, Michele; Piccone, Giuseppe [Dipartimento di Valorizzazione e Protezione delle Risorse Agroforestali, Universita di Torino, Via L. da Vinci 44, 10095 Grugliasco (Italy)

    2012-10-15

    Highlights: Black-Right-Pointing-Pointer Municipal bio-wastes are a sustainable source of bio-based products. Black-Right-Pointing-Pointer Refuse derived soluble bio-organics promote chlorophyll synthesis. Black-Right-Pointing-Pointer Refuse derived soluble bio-organics enhance plant growth and fruit ripening rate. Black-Right-Pointing-Pointer Sustainable chemistry exploiting urban refuse allows sustainable development. Black-Right-Pointing-Pointer Chemistry, agriculture and the environment benefit from biowaste technology. - Abstract: Municipal bio-refuse (CVD), containing kitchen wastes, home gardening residues and public park trimmings, was treated with alkali to yield a soluble bio-organic fraction (SBO) and an insoluble residue. These materials were characterized using elemental analysis, potentiometric titration, and 13C NMR spectroscopy, and then applied as organic fertilizers to soil for tomato greenhouse cultivation. Their performance was compared with a commercial product obtained from animal residues. Plant growth, fruit yield and quality, and soil and leaf chemical composition were the selected performance indicators. The SBO exhibited the best performance by enhancing leaf chlorophyll content, improving plant growth and fruit ripening rate and yield. No product performance-chemical composition relationship could be assessed. Solubility could be one reason for the superior performance of SBO as a tomato growth promoter. The enhancement of leaf chlorophyll content is discussed to identify a possible link with the SBO photosensitizing properties that have been demonstrated in other work, and thus with photosynthetic performance.

  5. Refuse derived soluble bio-organics enhancing tomato plant growth and productivity

    International Nuclear Information System (INIS)

    Sortino, Orazio; Dipasquale, Mauro; Montoneri, Enzo; Tomasso, Lorenzo; Perrone, Daniele G.; Vindrola, Daniela; Negre, Michele; Piccone, Giuseppe

    2012-01-01

    Highlights: ► Municipal bio-wastes are a sustainable source of bio-based products. ► Refuse derived soluble bio-organics promote chlorophyll synthesis. ► Refuse derived soluble bio-organics enhance plant growth and fruit ripening rate. ► Sustainable chemistry exploiting urban refuse allows sustainable development. ► Chemistry, agriculture and the environment benefit from biowaste technology. - Abstract: Municipal bio-refuse (CVD), containing kitchen wastes, home gardening residues and public park trimmings, was treated with alkali to yield a soluble bio-organic fraction (SBO) and an insoluble residue. These materials were characterized using elemental analysis, potentiometric titration, and 13C NMR spectroscopy, and then applied as organic fertilizers to soil for tomato greenhouse cultivation. Their performance was compared with a commercial product obtained from animal residues. Plant growth, fruit yield and quality, and soil and leaf chemical composition were the selected performance indicators. The SBO exhibited the best performance by enhancing leaf chlorophyll content, improving plant growth and fruit ripening rate and yield. No product performance-chemical composition relationship could be assessed. Solubility could be one reason for the superior performance of SBO as a tomato growth promoter. The enhancement of leaf chlorophyll content is discussed to identify a possible link with the SBO photosensitizing properties that have been demonstrated in other work, and thus with photosynthetic performance.

  6. An environmentally sustainable decision model for urban solid waste management

    International Nuclear Information System (INIS)

    Costi, P.; Minciardi, R.; Robba, M.; Rovatti, M.; Sacile, R.

    2004-01-01

    The aim of this work is to present the structure and the application of a decision support system (DSS) designed to help decision makers of a municipality in the development of incineration, disposal, treatment and recycling integrated programs. Specifically, within a MSW management system, several treatment plants and facilities can generally be found: separators, plants for production of refuse derived fuel (RDF), incinerators with energy recovery, plants for treatment of organic material, and sanitary landfills. The main goal of the DSS is to plan the MSW management, defining the refuse flows that have to be sent to recycling or to different treatment or disposal plants, and suggesting the optimal number, the kinds, and the localization of the plants that have to be active. The DSS is based on a decision model that requires the solution of a constrained non-linear optimization problem, where some decision variables are binary and other ones are continuous. The objective function takes into account all possible economic costs, whereas constraints arise from technical, normative, and environmental issues. Specifically, pollution and impacts, induced by the overall solid waste management system, are considered through the formalization of constraints on incineration emissions and on negative effects produced by disposal or other particular treatments

  7. DKIST facility management system integration

    Science.gov (United States)

    White, Charles R.; Phelps, LeEllen

    2016-07-01

    The Daniel K. Inouye Solar Telescope (DKIST) Observatory is under construction at Haleakalā, Maui, Hawai'i. When complete, the DKIST will be the largest solar telescope in the world. The Facility Management System (FMS) is a subsystem of the high-level Facility Control System (FCS) and directly controls the Facility Thermal System (FTS). The FMS receives operational mode information from the FCS while making process data available to the FCS and includes hardware and software to integrate and control all aspects of the FTS including the Carousel Cooling System, the Telescope Chamber Environmental Control Systems, and the Temperature Monitoring System. In addition it will integrate the Power Energy Management System and several service systems such as heating, ventilation, and air conditioning (HVAC), the Domestic Water Distribution System, and the Vacuum System. All of these subsystems must operate in coordination to provide the best possible observing conditions and overall building management. Further, the FMS must actively react to varying weather conditions and observational requirements. The physical impact of the facility must not interfere with neighboring installations while operating in a very environmentally and culturally sensitive area. The FMS system will be comprised of five Programmable Automation Controllers (PACs). We present a pre-build overview of the functional plan to integrate all of the FMS subsystems.

  8. Integrating incident investigation into the management system

    International Nuclear Information System (INIS)

    Peterson, E.E.

    1992-01-01

    In the last 10 yr, the size and frequency of incidents affecting the communities and environment surrounding chemical processing facilities has increased. The chemical process industry, which has always concerned itself with the safety of its facilities, has responded by committing to stricter standards of operation and management. A critical element of these management practices is the use of a structured incident investigation program. Many facilities have implemented and disciplined themselves to perform good investigation of incidents. However, most of these facilities maintain incident investigation as part of their safety management programs. This allows the process to be disconnected from the management system that deals with the day-to-day business of the facility. The first step of integration is understanding the objectives and functions of the management system into which the integration is to occur. To begin, a common definition of management is needed. Management, for the purposes of this discussion, is defined as the system of activities used to control, coordinate, and improve the flow of work within a facility or organization. This definition refers to several concepts that need further development in order to understand how incident investigation can be integrated into a management system, including (a) flow of work, (b) control, and (c) improvement. Application can be made to the nuclear industry

  9. Nuclear Plant Integrated Outage Management

    International Nuclear Information System (INIS)

    Gerstberger, C. R.; Coulehan, R. J.; Tench, W. A.

    1992-01-01

    This paper is a discussion of an emerging concept for improving nuclear plant outage performance - integrated outage management. The paper begins with an explanation of what the concept encompasses, including a scope definition of the service and descriptions of the organization structure, various team functions, and vendor/customer relationships. The evolvement of traditional base scope services to the integrated outage concept is addressed and includes discussions on changing customer needs, shared risks, and a partnership approach to outages. Experiences with concept implementation from a single service in 1984 to the current volume of integrated outage management presented in this paper. We at Westinghouse believe that the operators of nuclear power plants will continue to be aggressively challenged in the next decade to improve the operating and financial performance of their units. More and more customers in the U. S. are looking towards integrated outage as the way to meet these challenges of the 1990s, an arrangement that is best implemented through a long-term partnering with a single-source supplier of high quality nuclear and turbine generator outage services. This availability, and other important parameters

  10. Integration of Standardized Management Systems: A Dilemma?

    Directory of Open Access Journals (Sweden)

    Manuel Ferreira Rebelo

    2015-06-01

    Full Text Available The growing proliferation of management systems standards (MSSs, and their individualized implementation, is a real problem faced by organizations. On the other hand, MSSs are aimed at improving efficiency and effectiveness of organizational responses in order to satisfy the requirements, needs and expectations of the stakeholders. Each organization has its own identity and this is an issue that cannot be neglected; hence, two possible approaches can be attended. First, continue with the implementation of individualized management systems (MSs; or, integrate the several MSSs versus related MSs into an integrated management system (IMS. Therefore, in this context, organizations are faced with a dilemma, as a result of the increasing proliferation and diversity of MSSs. This paper takes into account the knowledge gained through a case study conducted in the context of a Portuguese company and unveils some of the advantages and disadvantages of integration. A methodology is also proposed and presented to support organizations in developing and structuring the integration process of their individualized MSs, and consequently minimize problems that are generators of inefficiencies, value destruction and loss of competitiveness. The obtained results provide relevant information that can support Top Management decision in solving that dilemma and consequently promote a successful integration, including a better control of business risks associated to MSSs requirements and enhancing sustainable performance, considering the context in which organizations operate.

  11. Why do some women refuse to allow male residents to perform pelvic exams?

    Science.gov (United States)

    Rifkin, Julie I; Shapiro, Howard; Regensteiner, Judith G; Stotler, Jeanne K; Schmidt, Betty

    2002-10-01

    Many women who receive medical care in residency training clinics refuse to allow male residents to perform their pelvic exams. This study was conducted to identify which women were most likely to refuse and to learn their reasons for refusing. From January to March 1997, a questionnaire was given to all women entering a Tri-County Health office and a Planned Parenthood clinic, both in the Denver, Colorado, metropolitan area, who consented to participate in the study. Data from the questionnaire were analyzed using a statistical software package. A total of 1,437 women entered the clinics during the study period. Of these patients, 1,078 consented to complete the questionnaire. Seven of these 1,078 women did not complete the questionnaire. Women who did not know the training level of the resident performing the pelvic exam were more likely to refuse than were women who knew the training level of the resident (p =.001), but many women preferred a female physician regardless of the physician's training level. Fifty-eight percent said they would allow a male resident to observe a female attending physician perform the exam, compared with 36% who said they would allow a male resident to observe if the attending physician was a man. Common statements from those who would refuse were: "I am just more comfortable with a female," "Women do not want men to examine their private body parts," and "Women explain things better." A woman's knowledge of the resident's training level correlates with her willingness to have a pelvic exam performed by a male resident. Women who said they would refuse a pelvic exam performed by a male resident gave specific reasons for their decision.

  12. Management of small digital collections with Omeka: the MoRE experience (A Museum of REfused and unrealised art projects

    Directory of Open Access Journals (Sweden)

    Alberto Salarelli

    2016-11-01

    Full Text Available This article examines the main features of Omeka, a free and open source CMS (Content Management System for online digital collections developed by the Roy Rosenzweig Center for History and New Media at George Mason University. Omeka presents very interesting features: first, a remarkable ease of use that, however, does not affect its multiple functions; secondly, it provides tools to create, in an innovative way, virtual exhibitions for archives, libraries and museums in order to promote their collections on the web; thirdly, its extreme adaptability to collection size: in fact Omeka is used by large and celebrated institutions such as the New York Public Library and Europeana, but also by many small initiatives including MoRE (A Museum of REfused and unrealized art projects. Specifically, the second part of the article describes, in brief, the objectives and characteristics of this virtual museum dedicated to contemporary unrealized artworks; it is an experimental project, still under development, devised by a working group of the University of Parma (Italy, who found in Omeka the most suitable IT solution to collect and expose these unique museum materials.

  13. 30 CFR 253.50 - How can MMS refuse or invalidate my OSFR evidence?

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false How can MMS refuse or invalidate my OSFR... can MMS refuse or invalidate my OSFR evidence? (a) If MMS determines that any OSFR evidence you submit... acceptable evidence without being subject to civil penalty under § 253.51. (b) MMS may immediately and...

  14. Integrated Rural-Urban Water Management for Climate Based ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    There are serious short- and long-term consequences on human health, physical assets, economic ... To work, adaptive climate-proof integrated urban water management must extend throughout the whole catchment, an approach known as integrated water resource management. ... Careers · Contact Us · Site map.

  15. Comparing the quality of life in insulin recipient and refusal patients with type 2 diabetes.

    Science.gov (United States)

    Khalili, Mitra; Sabouhi, Fakhri; Abazari, Parvaneh; Aminorroaya, Ashraf

    2016-01-01

    Better control of blood sugar and reduction of diabetes complications through insulin therapy could convince people to choose this method. However, patients might refuse insulin therapy due to its painful injection, limitations in daily activities, and hypoglycemia. Thus, insulin therapy could have both positive and negative effects on patients' quality of life (QOL). Therefore, the aim of this study was to compare the QOL of insulin recipient and insulin refusal patients with type 2 diabetes. This study was a descriptive and comparative research conducted on 126 patients; 63 were insulin recipients and 63 had refused insulin therapy. Participants were under the care of the Endocrine and Metabolism Research Center of Isfahan, Iran. Data were gathered using the Diabetes Quality of Life (DQOL) questionnaire. In this tool, higher scores indicated lower QOL in patients. Data were analyzed using independent t-test, analysis of covariance, Mann-Whitney, Chi-square, and Pearson and Spearman's correlation. There was a significant difference (P refusal patients (mean = 1.74, SD = 0.41) in terms of mean QOL score. In addition, men and participants with higher educational levels reported a better QOL (P refusal patients had a better QOL. It seems that QOL is associated with the acceptance or refusal of insulin therapy. Therefore, enhancement of QOL could be related to all aspects of the disease, especially its treatment method and solving the therapeutic problems.

  16. Groundwater/Vadose Zone Integration Project Management Plan

    International Nuclear Information System (INIS)

    Hughes, M. C.

    1999-01-01

    This Project Management Plan (PMP) defines the authorities, roles, and responsibilities of the US Department of Energy (DOE), Richland Operations Office (RL) and those contractor organizations participating in the Hanford Site' s Groundwater/Vadose Zone (GW/VZ) Integration Project. The PMP also describes the planning and control systems, business processes, and other management tools needed to properly and consistently conduct the Integration Project scope of work

  17. Implementing Integrated River Basin Management in China

    Directory of Open Access Journals (Sweden)

    Dorri G. J. te Boekhorst

    2010-06-01

    Full Text Available This paper examines the role of the World Wildlife Fund for Nature China as policy entrepreneur in China. It illustrates the ways in which the World Wildlife Fund for Nature is active in promoting integrated river basin management in the Yangtze River basin and how the efforts at basin level are matched with the advice of the China Council for International Cooperation on Environment and Development task force on integrated river basin management to the national government of China. This article demonstrates that the World Wildlife Fund for Nature uses various strategies of different types to support a transition process towards integrated river basin management. Successful deployment of these strategies for change in environmental policy requires special skills, actions, and attitudes on the part of the policy entrepreneur, especially in China, where the government has a dominant role regarding water management and the position of policy entrepeneurs is delicate.

  18. Analysis of fouling in refuse waste incinerators

    NARCIS (Netherlands)

    Beek, van M.C.; Rindt, C.C.M.; Wijers, J.G.; Steenhoven, van A.A.

    2001-01-01

    Gas-side fouling of waste-heat-recovery boilers, caused mainly by the deposition of particulate matter, reduces the heat transfer in the boiler. The fouling as observed on the tube bundles in the boiler of a Dutch refuse waste incinerator varied from thin and powdery for the economizer to thick and

  19. Use for refuse of shale carbonization

    Energy Technology Data Exchange (ETDEWEB)

    1917-09-25

    A process is disclosed for using the refuse from the carbonization of bituminous shales in the preparation of light building material, characterized in that the pulverized material is mixed wet with a light filler, formed in a mold, and burned with or without the addition of clay or with the addition of binding and preserving material, preparing the mold from the pulverized material in the cold.

  20. A Study on the Perception of Jordanian EFL Learners’ Pragmatic Transfer of Refusals

    Directory of Open Access Journals (Sweden)

    Ibrahim Fathi Huwari

    2015-02-01

    Full Text Available This study investigates the perception of Jordanian EFL learners’ (JEFL pragmatic transfer of refusal strategies in terms of contextual and cultural factors. Data were collected using a discourse completion test (DCT and a scaled-response questionnaire (SRQ to elicit perception data from the participants. Data from the SRQ were analyzed based on the speaker’s right to refuse the initiating act. Findings revealed that the right the speaker has to refuse the initiating act was assigned high ratings by the three groups (i.e., M > 3.00 in all social categories. Individually, however, the groups displayed the rating value differently where the AEL1 group’s perception of the speaker’s right was relatively higher than that of the JEFL and JAL1 groups in all the social categories. The JEFL participants’ negative pragmatic transfer criteria were met in the first and third social categories. The study concludes with a discussion of important directions for future research. Keywords: Perception, Refusal, Pragmatic transfer, Pragmalinguistic transfer, Sociopragmatic transfer

  1. Role of plant pathology in integrated pest management.

    Science.gov (United States)

    Jacobsen, B J

    1997-01-01

    Integrated Pest Management (IPM) is a paradigm that is widely adopted by all pest control disciplines but whose early definitions and philosophical basis belong to entomologists. Plant pathology research and extension work has historically emphasized integration of several control strategies and fits both historical and modern definitions of IPM. While the term IPM has been used only sparingly in the phytopathology literature, the integrated disease management strategies emphasized are now considered to be at the forefront of ecologically based or biointensive pest management. While IPM is broadly endorsed by crop protection disciplines, farmers, other agriculturalists, and consumers, the potential for Integrated Pest Management has not been fully realized. Most IPM programs reflect a package of tools and decision aids for individual crop insect, weed, nematode, and plant disease management. IPM programs that integrate all types of pests with the agroecosystem, crop growth and loss models still await the formation of interdisciplinary teams focusing on growers needs. Lack of funding for both discipline and interdisciplinary developmental research and implementation is responsible for the paucity of comprehensive IPM programs for the majority of the U.S. crop acreage. This review explores the origins and evolution of the IPM paradigm and reviews efforts to achieve the body of knowledge and implementation structure to achieve IPM's full potential.

  2. An audit of consent refusals in clinical research at a tertiary care center in India

    Directory of Open Access Journals (Sweden)

    S J Thaker

    2015-01-01

    Full Text Available Background and Rationale: Ensuring research participants′ autonomy is one of the core ethical obligations of researchers. This fundamental principle confers on every participant the right to refuse to take part in clinical research, and the measure of the number of consent refusals could be an important metric to evaluate the quality of the informed consent process. This audit examined consent refusals among Indian participants in clinical studies done at our center. Materials and Methods: The number of consent refusals and their reasons in 10 studies done at our center over a 5-year period were assessed. The studies were classified by the authors according to the type of participant (healthy vs patients, type of sponsor (investigator-initiated vs pharmaceutical industry, type of study (observational vs interventional, level of risk [based on the Indian Council of Medical Research (ICMR "Ethical Guidelines for Biomedical Research on Human Participants"], available knowledge of the intervention being studied, and each patient′s disease condition. Results: The overall consent refusal rate was 21%. This rate was higher among patient participants [23.8% vs. healthy people (14.9%; P = 0.002], in interventional studies [33.6% vs observational studies (7.5%; P < 0.0001], in pharmaceutical industry-sponsored studies [34.7% vs investigator-initiated studies (7.2%; P < 0.0001], and in studies with greater risk (P < 0.0001. The most common reasons for consent refusals were multiple blood collections (28%, inability to comply with the study protocol (20%, and the risks involved (20%. Conclusion: Our audit suggests the adequacy and reasonable quality of the informed consent process using consent refusals as a metric.

  3. Risk and Work Configuration Management as a Function of Integrated Safety Management

    International Nuclear Information System (INIS)

    Lana Buehrer; Michele Kelly; Fran Lemieux; Fred Williams

    2007-01-01

    National Security Technologies, LLC (NSTec), has established a work management program and corresponding electronic Facilities and Operations Management Information System (e-FOM) to implement Integrated Safety Management (ISM). The management of work scopes, the identification of hazards, and the establishment of implementing controls are reviewed and approved through electronic signatures. Through the execution of the program and the implementation of the electronic system, NSTec staff work within controls and utilize feedback and improvement process. The Integrated Work Control Manual further implements the five functions of ISM at the Activity level. By adding the Risk and Work Configuration Management program, NSTec establishes risk acceptance (business and physical) for liabilities within the performance direction and work management processes. Requirements, roles, and responsibilities are specifically identified in the program while e-FOM provides the interface and establishes the flowdown from the Safety Chain to work and facilities management processes to company work-related directives, and finally to Subject Matter Expert concurrence. The Program establishes, within the defined management structure, management levels for risk identification, risk mitigation (controls), and risk acceptance (business and physical) within the Safety Chain of Responsibility. The Program also implements Integrated Safeguards and Security Management within the NSTec Safety Chain of Responsibility. Once all information has been entered into e-FOM, approved, and captured as data, the information becomes searchable and sortable by hazard, location, organization, mitigating controls, etc

  4. [Refusal of care by a HIV-positive adolescent: role of the cross-cultural approach].

    Science.gov (United States)

    Bouaziz, Nora; Titia Rizzi, Alice

    The refusal of treatment is frequent in human immunodeficiency virus-positive adolescents. The clinical history of a teenage girl presenting severe immunodepression secondary to the virus, a depressive disorder and a refusal of treatment, illustrates the benefit of combined paediatric, child psychiatric and cross-cultural care as proposed by the Cochin-Paris Adolescent Centre. Working on the meaning of the refusal was a prerequisite for the construction of a care project forming part of a life project, as the psychopathological work could only begin once somatic care ensuring the patient's protection was in place. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  5. Application of contemporary integrated manufacture systems to nuclear power plants management

    International Nuclear Information System (INIS)

    Zhou Gang; Wang Lushuai; Tang Yaoyang

    2005-01-01

    In order to improve the safety, economy and reliability of the operation of a nuclear power plant (NPP), a novel integrated management method is proposed based on the 'integration' concept of the computer and contemporary integrated manufacture systems (CIMS). The design of integrated management system for NPP is studied. In the design of this system, information integration method based on the database and product data management (PDM) technology is adopted. In order to design and integrated management system satisfying the needs of NPP management, all activities of NPP are divided into different categories according to its characteristics. There are subsystems under the general management system to conduct the management work of different categories. All subsystems are interrelated in the environment of CIMS, but relatively independent. The application of CIMS to NPP provides a new way for scientific management of NPP, and makes the best of human, material and information resources. (authors)

  6. Integrated Pest Management (IPM)

    Science.gov (United States)

    Repellents Rodenticides Other types of pesticides Disponible en español Integrated Pest Management (IPM) IPM Company: IPM is the Key - Oregon State University Extension Service Last updated May 11, 2018 Related Insecticides Natural and Biological Pesticides Repellents Rodenticides Other types of pesticides Disponible en

  7. Managed care, vertical integration strategies and hospital performance.

    Science.gov (United States)

    Wang, B B; Wan, T T; Clement, J; Begun, J

    2001-09-01

    The purpose of this study is to examine the association of managed care with hospital vertical integration strategies, as well as to observe the relationships of different types of vertical integration with hospital efficiency and financial performance. The sample consists of 363 California short-term acute care hospitals in 1994. Linear structure equation modeling is used to test six hypotheses derived from the strategic adaptation model. Several organizational and market factors are controlled statistically. Results suggest that managed care is a driving force for hospital vertical integration. In terms of performance, hospitals that are integrated with physician groups and provide outpatient services (backward integration) have better operating margins, returns on assets, and net cash flows (p < 0.01). These hospitals are not, however, likely to show greater productivity. Forward integration with a long-term-care facility, on the other hand, is positively and significantly related to hospital productivity (p < 0.001). Forward integration is negatively related to financial performance (p < 0.05), however, opposite to the direction hypothesized. Health executives should be responsive to the growth of managed care in their local market and should probably consider providing more backward integrated services rather than forward integrated services in order to improve the hospital's financial performance in today's competitive health care market.

  8. Theoretical framework of integrated strategic performance management system

    OpenAIRE

    Mitrović, Zorica; Todorović, Marija; Bjelica, Dragan

    2015-01-01

    The aim of this paper is to present a conceptual model of the integrated strategic performance management system. This model is conceptual framework designed as a result of research that shows significant benefits of integrated application of strategic management and performance management in organizations. The framework consists of five steps: establishing a planning system, establishing of performance measurement system, establishing an accountability system, establishing of the knowledge m...

  9. Understanding Excessive School Absenteeism as School Refusal Behavior

    Science.gov (United States)

    Dube, Shanta R.; Orpinas, Pamela

    2009-01-01

    Understanding excessive absenteeism is important to ameliorating the negative outcomes associated with the behavior. The present study examined behavioral reinforcement profiles of school refusal behavior: negative reinforcement (avoidance) and positive reinforcement (gaining parental attention or receiving tangible benefits from not attending…

  10. School Refusal Behavior: Classification, Assessment, and Treatment Issues.

    Science.gov (United States)

    Lee, Marcella I.; Miltenberger, Raymond G.

    1996-01-01

    Discusses diagnostic and functional classification, assessment, and treatment approaches for school refusal behavior. Diagnostic classification focuses on separation anxiety disorder, specific phobia, social phobia, depression, and truancy. Functional classification focuses on the maintaining consequences of the behavior, such as avoidance of…

  11. Managing racial integration in South African public schools: In ...

    African Journals Online (AJOL)

    The paper explores what racial integration is. Furthermore, it scrutinises how racial integration is currently managed in South African Public schools. The main argument of the paper defends a deliberative conception of managing racial integration in South African public schools. In light of this, there is some form of hope to ...

  12. Integrated groundwater data management

    Science.gov (United States)

    Fitch, Peter; Brodaric, Boyan; Stenson, Matt; Booth, Nathaniel; Jakeman, Anthony J.; Barreteau, Olivier; Hunt, Randall J.; Rinaudo, Jean-Daniel; Ross, Andrew

    2016-01-01

    The goal of a data manager is to ensure that data is safely stored, adequately described, discoverable and easily accessible. However, to keep pace with the evolution of groundwater studies in the last decade, the associated data and data management requirements have changed significantly. In particular, there is a growing recognition that management questions cannot be adequately answered by single discipline studies. This has led a push towards the paradigm of integrated modeling, where diverse parts of the hydrological cycle and its human connections are included. This chapter describes groundwater data management practices, and reviews the current state of the art with enterprise groundwater database management systems. It also includes discussion on commonly used data management models, detailing typical data management lifecycles. We discuss the growing use of web services and open standards such as GWML and WaterML2.0 to exchange groundwater information and knowledge, and the need for national data networks. We also discuss cross-jurisdictional interoperability issues, based on our experience sharing groundwater data across the US/Canadian border. Lastly, we present some future trends relating to groundwater data management.

  13. Integrated management system: The integration of ISO 9001, ISO 14001, OHSAS 18001 and ISO 31000

    Science.gov (United States)

    Muzaimi, Hafizzudin; Chew, Boon Cheong; Hamid, Syaiful Rizal

    2017-03-01

    The implementation of integrated management system (IMS) for better quality management has become a preference for many organizations. This can be seen as many organizations used the combination of quality ISO 9001, an environment ISO 14001 and occupational health and safety management system OHSAS 18001 as a core for the IMS that largely implemented. Besides, the linked between quality management with risk management system need to be identified as the management system that enhance the effectiveness of IMS. Therefore, the risk management system ISO 31000 also presented as a part of integration. In nowadays competitive environment, the increasing pressure and needs from customer or stakeholders make it compulsory for the organization to propose the new system and standards. This paper presents and discusses about the benefit of integration, the management system components that can be converged and the implementation approach. A series of interview was conducted through in-depth interviews with 8 experts in this field, while data collected were analyzed qualitatively. The results consist of 16 factors of IMS implementation that have been identified and the use of PDCA approach for an effective implementation of IMS. As a conclusion, the paper proposes the integration of four management systems (ISO 9001, ISO 14001, OHSAS 18001 and ISO 31000) and on how the IMS can be used to structure the process of management for quality management towards sustainability practices in the organization.

  14. [Refusal of care in the intensive care: how makes decision?].

    Science.gov (United States)

    Borel, M; Veber, B; Villette-Baron, K; Hariri, S; Dureuil, B; Hervé, C

    2009-11-01

    Decision-making bringing to an admission or not in intensive care is complex. The aim of this study is to analyze with an ethical point of view the making decision process leading to the refusal and its consequences. It is proposed a setting in prospect through the principles of beneficence, non-maleficience, respect for autonomy, justice, and the Leonetti law. Prospective study in surgical reanimation at the University Hospital of Rouen over 9 months (November 2007-September 2008). Systematic collection for each non-admitted patient of the general characters, the methods of decision making, immediate becoming and within 48 h Constitution of two groups: patients for whom an admission in intensive care could be an unreasonable situation of obstinacy, and patients for whom an admission in reanimation would not be about unreasonable if it occurred. One hundred and fifty situations were analyzed. The potentially unreasonable character of an admission does not involve necessarily a refusal of care in intensive care. The question of the lack of place and equity in the access to the care is real but relative according to the typology of the patients. The research of the respect of the autonomy of the patient is difficult but could be facilitated. The Leonetti law does not appear to be able to be a framework with the situation of refusal of care in intensive care. It is not a question of going towards a systematic admission in intensive care of any patient proposed, but to make sure that so if there is a refusal, it is carried out according to a step ethically acceptable.

  15. Vaccination Confidence and Parental Refusal/Delay of Early Childhood Vaccines.

    Directory of Open Access Journals (Sweden)

    Melissa B Gilkey

    Full Text Available To support efforts to address parental hesitancy towards early childhood vaccination, we sought to validate the Vaccination Confidence Scale using data from a large, population-based sample of U.S. parents.We used weighted data from 9,354 parents who completed the 2011 National Immunization Survey. Parents reported on the immunization history of a 19- to 35-month-old child in their households. Healthcare providers then verified children's vaccination status for vaccines including measles, mumps, and rubella (MMR, varicella, and seasonal flu. We used separate multivariable logistic regression models to assess associations between parents' mean scores on the 8-item Vaccination Confidence Scale and vaccine refusal, vaccine delay, and vaccination status.A substantial minority of parents reported a history of vaccine refusal (15% or delay (27%. Vaccination confidence was negatively associated with refusal of any vaccine (odds ratio [OR] = 0.58, 95% confidence interval [CI], 0.54-0.63 as well as refusal of MMR, varicella, and flu vaccines specifically. Negative associations between vaccination confidence and measures of vaccine delay were more moderate, including delay of any vaccine (OR = 0.81, 95% CI, 0.76-0.86. Vaccination confidence was positively associated with having received vaccines, including MMR (OR = 1.53, 95% CI, 1.40-1.68, varicella (OR = 1.54, 95% CI, 1.42-1.66, and flu vaccines (OR = 1.32, 95% CI, 1.23-1.42.Vaccination confidence was consistently associated with early childhood vaccination behavior across multiple vaccine types. Our findings support expanding the application of the Vaccination Confidence Scale to measure vaccination beliefs among parents of young children.

  16. Treatment for School Refusal among Children and Adolescents: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Maynard, Brandy R.; Heyne, David; Brendel, Kristen Esposito; Bulanda, Jeffery J.; Thompson, Aaron M.; Pigott, Terri D.

    2018-01-01

    Objective: School refusal is a psychosocial problem associated with adverse short- and long-term consequences for children and adolescents. The authors conducted a systematic review and meta-analysis to examine the effects of psychosocial treatments for children and adolescents with school refusal. Method: A comprehensive search process was used…

  17. Obstetric Patients Who Select and Those Who Refuse Medical Students' Participation in Their Care.

    Science.gov (United States)

    Magrane, Diane; And Others

    1994-01-01

    A survey of 222 obstetrics patients assisted by medical clerkship students from the University of Vermont and 78 who refused student participation found privacy the primary motivation for refusal and a desire to contribute to students' education a primary reason for accepting student participation. Patients frequently erroneously anticipated the…

  18. Consent and assessment of capacity to decide or refuse treatment.

    Science.gov (United States)

    Simpson, Owena

    Consent protects the right of patients to decide what happens to them. Before any medical intervention, adults must give valid consent, which must be voluntary, informed and given free of undue influence. When consent is being obtained, patients must be informed about the intervention, why it is being done and its risks; information they are given must be recorded. Every effort should be made to explain the issues in terms that the patient can understand and by providing support and aids to communicate. Consent can be expressed, where patients say they consent or put it in writing, or implied, where a healthcare professional infers from their behaviour that they consent. While different types of consent are valid, some are evidence of stronger proof in court that valid consent has been given. Competent adults have the right to refuse treatment, regardless of the reasons they give for refusal and even if the refusal will result in death; clinicians must respect their decision. In some circumstances-such as when an unconscious person is admitted as an emergency-healthcare professionals can make decisions on behalf of patients, and must do so in patients' best interests.

  19. Parental psychological symptoms and familial risk factors of children and adolescents who exhibit school refusal.

    Science.gov (United States)

    Bahali, K; Tahiroglu, A Y; Avci, A; Seydaoglu, G

    2011-12-01

    To assess the levels of psychological symptoms in the parents of children with school refusal and determine the familial risk factors in its development. This study was performed on 55 pairs of parents who had children exhibiting school refusal and were compared with a control group. A socio-demographic data form, the Beck Depression Inventory, the State-Trait Anxiety Inventory, and the Symptom Checklist-90 revised were applied to these parents. Parents of the school refusal group had higher anxiety and depression scores than the controls. Among the risk factors for school refusal, physical punishment by the parents, a history of organic disease in the parents or children, and a history of psychiatric disorders in the parents or other relatives were found to be significant. Depending on genetic and environmental factors, parents with psychiatric disorders appeared to be associated with development of psychiatric disorders in their children. Moreover, psychiatric disorders in parents negatively affected the treatment of their children and adolescents who exhibited school refusal. It is therefore vital to treat psychiatric disorders of parents with the children having psychiatric disorders, and thus increase parent participation in their children's therapeutic process.

  20. Integrating School-Based and Therapeutic Conflict Management Models at School.

    Science.gov (United States)

    D'Oosterlinck, Franky; Broekaert, Eric

    2003-01-01

    Explores the possibility of integrating school-based and therapeutic conflict management models, comparing two management models: a school-based conflict management program, "Teaching Students To Be Peacemakers"; and a therapeutic conflict management program, "Life Space Crisis Intervention." The paper concludes that integration might be possible…

  1. Rape myth acceptance and rape acknowledgment: The mediating role of sexual refusal assertiveness.

    Science.gov (United States)

    Newins, Amie R; Wilson, Laura C; White, Susan W

    2018-05-01

    Unacknowledged rape, defined as when an individual experiences an event that meets a legal or empirical definition of rape but the individual does not label it as such, is prevalent. Research examining predictors of rape acknowledgment is needed. Sexual assertiveness may be an important variable to consider, as an individual's typical behavior during sexual situations may influence rape acknowledgment. To assess the indirect effect of rape myth acceptance on rape acknowledgment through sexual refusal assertiveness, an online survey of 181 female rape survivors was conducted. The indirect effects of two types of rape myths (He didn't mean to and Rape is a deviant event) were significant and positive. Specifically, acceptance of these two rape myths was negatively related to sexual refusal assertiveness, which was negatively associated with likelihood of rape acknowledgment. The results of this study indicate that sexual refusal assertiveness is associated with lower likelihood of rape acknowledgment among rape survivors. As a result, it appears that, under certain circumstances, women high in rape myth acceptance may be more likely to acknowledge rape when it results in decreased sexual refusal assertiveness. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Development and improvement of the integrated system of management

    Directory of Open Access Journals (Sweden)

    Lukmanova Inessa Galeevna

    2014-07-01

    Full Text Available Integrated management system construction can be considered a way that transforms using business processes and information resources into final construction products. Autonomous system of quality management, environmental, health and safety organizations introduction usually lead to the accumulation of duplicate documents, which increase the time spent on processing and analysis as well as increase the financial costs of maintaining the operation of each of them separately. System integration allows reducing these costs and entailing the most obvious benefits: reduced volumes of documents; reduction of time spent on analysis; reducing the cost of audit and certification; involvement of all the employees of the organization; productivity growth; increasing the attractiveness for consumers; reducing the burden on administrative and executive devices; ensuring a high level of flexibility in the organization's management system in case of internal and external changes. Integration of quality management systems, environmental management and safety management systems, production and safety led to the possibility to establish such integrated management system in developing building companies, which allows establishing a unified management system, as an element of management of organization. The main drawback of the currently used standards and specifications is the lack of flexibility of their application, as well as the basic principles and approaches to their implementation. Thus, knowing about what the system should be, but not knowing how to create it, many organizations have to operate without methodological support. Absence of mandatory standards concerning integration of management systems creates opportunities for the existence of multiple options for interaction systems. Economic effects on the integrated management system is formed from three sources: the reduction of production costs by improving product quality and reducing defects and

  3. Magnetometric Studies of Catalyst Refuses in Nanocarbon Materials

    Directory of Open Access Journals (Sweden)

    Eklund Peter

    2008-01-01

    Full Text Available AbstractIt is shown that magnetometry can be employed as an effective tool to control the content of a ferromagnetic constituent in nanocarbon materials. We propose a thermochemical treatment protocol to achieve extensive cleaning of the source nanocarbon materials from ferromagnetic refuses.

  4. [Refusal of personal hygiene care and nursing responsibility].

    Science.gov (United States)

    Peyé, Anne

    2013-03-01

    Situations of patients refusing personal hygiene care are frequent. Sources of difficulties and questioning for caregivers, they can lead to maltreatment. In order to avoid this pitfall, it is essential to support the teams in their approach around representations of caregiving and nursing responsibility.

  5. Integrated Simulation Of Supply Chain Management

    Directory of Open Access Journals (Sweden)

    N.Manikandan

    2013-06-01

    Full Text Available Nowadays, manufacturers face the challenge of reducing manufacturing cycle time, delivery lead time and inventory reduction. Every organization has its own objectives and its own way of decision making processes. Because of the conflictions among the objectives of each organization and non-integrated decision making processes, there has been a need for a new mechanism, which help to resolve those conflictions and to integrate processes. In the early 1990s, management is a process of integrating and utilizing suppliers, manufacturers, warehouses and retailers, so that goods are produced and delivered at the right quantities and at the right time while minimizing costs as well as satisfying customer requirements. Managing the entire supply chain becomes a key factor for the successful business. Organizations now realize that non-integrated manufacturing processes, nonintegrated distribution processes and poor relationships with suppliers and customers are in adequate for their success. The supply chain areas are affected by the organization’s plan. The organization plan’s impact on the supply chain areas cannot be predicted before its execution. Simulation paves way to evaluate the performance of plans before the execution of the plan. This paper describes the effort of developing a simulation model for the supply chain management in an industry. This article discusses the requirement of supply chain simulation modeling.

  6. Risk Informed Structural Systems Integrity Management

    DEFF Research Database (Denmark)

    Nielsen, Michael Havbro Faber

    2017-01-01

    The present paper is predominantly a conceptual contribution with an appraisal of major developments in risk informed structural integrity management for offshore installations together with a discussion of their merits and the challenges which still lie ahead. Starting point is taken in a selected...... overview of research and development contributions which have formed the basis for Risk Based Inspection Planning (RBI) as we know it today. Thereafter an outline of the methodical basis for risk informed structural systems integrity management, i.e. the Bayesian decision analysis is provided in summary....... The main focus is here directed on RBI for offshore facilities subject to fatigue damages. New ideas and methodical frameworks in the area of robustness and resilience modeling of structural systems are then introduced, and it is outlined how these may adequately be utilized to enhance Structural Integrity...

  7. Integrated Management System Incorporating Quality Management and Management of Environment, Health and Occupational Safety

    International Nuclear Information System (INIS)

    Manchev, B.; Nenkova, B.; Tomov, E.

    2012-01-01

    Risk Engineering Ltd is a Bulgarian private company founded in 1990 to provide engineering and consulting services applicable to each and every field of the energy sector. Since its establishment Risk Engineering Ltd develops, implement and apply a System for quality assurance, certified for the first time by BVQI (now Bureau Veritas Certification) in 1999 for conformity with the standard ISO 9001:1994. Later on, in connection with the revision of the standards of ISO 9000 series and introduction of the standard ISO 9001:2000 a Quality Management System in conformity with the standard ISO 9001:2000 was developed, introduced and certified. At present, Risk Engineering Ltd has got developed, documented, introduced and certified by Lloyd's Register Quality Assurance (LRQA) Quality Management System in compliance with ISO 9001:2008 on the process approach basis. On this basis and including the requirements of the ISO 14001:2004 (regarding the environment) and OHSAS 18001:2007 (regarding the health and occupational safety), Risk Engineering Ltd has developed and introduced Integrated Management System aim at achieving and demonstrating good results regarding protection of the environment, health and occupational safety. The processes under control by the Integrated Management System and applicable at the company are divided in two general types: A) Management processes: Strategic management and Management of the human resources. B) Processes describing the main activities: design/development process; project management; management of industrial projects and technical infrastructure project; construction, installation, repair and operation of power industry facilities; commercial activities and marketing; investigation of energy efficiency of industrial systems and certification of buildings regarding energy efficiency; consulting activity in the field of industry and energy as well as consultant in accordance with the Law of the Spatial Planning; management of the

  8. The geo-environmental design of a coal refuse impoundment in Illinois

    International Nuclear Information System (INIS)

    Ripp, B.J.

    1997-01-01

    The coal refuse impoundment discussed was one of the first permitted under new regulatory standards within the State of Illinois. The new standards go beyond the geotechnial stability of the structure and must address the groundwater quality of the area and the impact of the impoundment on the groundwater system. The geotechnial design of the coal refuse impoundment dam and associated structures had its own particular challenges such as: 1) the construction of the structure over mined workings; 2) the close proximity of seismically active fault zones; and 3) the embankment configuration being controlled by the material balance of the mine refuse. The implementation of the groundwater protection plan included: 1) incorporating the groundwater quality standards and sampling protocols of several state agencies while the standards were being drafted; 2) sampling of the potential sources of groundwater impact; 3) establishing background levels; and 4) establishing the groundwater class. An initial groundwater transport model was developed and used as the basis for recommending a groundwater monitoring design in place of constructing a soil or synthetic liner. 15 refs., 2 figs., 3 tabs

  9. Refuses and delays in the transportation by ship of radioactive material

    International Nuclear Information System (INIS)

    Xavier, Clarice; Sobreira, Ana Celia

    2011-01-01

    Some Class 7 materials can only be transported by ship, making that load and unload activities can be done in a port. In the Brazil, the port of Santos posses the most volume of cargo manipulation, and cargoes which contain radioactive material are always present with all manipulation requisites according to applicable regulations. The transport and manipulation operations of radioactive material are performed in accordance with national and international requisites but, some individuals posses yet a high risk perception according to our experience, involving members of Brazilian port authorities, the Navy and cargoes handlers at the ports. So, exist yet a high quantity of refuses and delays during the transport by ship. Therefore, a communication strategy was developed and applied, to inform the risk perception, supplying information on the very principles of ionizing radiation, legislation and uses of radiation, and so, diminishing the quantity of refuses and delays. From that initial communication strategy on, it becomes evident the necessity of training and conscience making a movement for the problem of refuses and delays be diminished

  10. Integrating fire management into land management planning for west-side forests

    Science.gov (United States)

    Peter D. Teensma

    1996-01-01

    Fire management's integration into land management planning is critical to the successful management of nearly all wildland ecosystems, including westside forests, which lie west of the Cascade crest in Oregon and the northern coastal ranges in California. Restoration and maintenance of fire as an ecosystem process is critical to retention of biological diversity...

  11. 25 CFR 171.420 - Can I dispose of sewage, trash, or other refuse on a BIA irrigation project?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Can I dispose of sewage, trash, or other refuse on a BIA... AND WATER IRRIGATION OPERATION AND MAINTENANCE Irrigation Facilities § 171.420 Can I dispose of sewage, trash, or other refuse on a BIA irrigation project? No. Sewage, trash, or other refuse are considered...

  12. The Impact of Age and Sex on the Refusal Strategies Used by Iranian EFL Learners

    Directory of Open Access Journals (Sweden)

    Shohreh Shahpouri Arani

    2013-05-01

    Full Text Available One major problem for non-native speakers is using refusals and because of this, second language teachers and others who communicate in that language should have the cultural differences in mind. When the interlocutors say “no” to a request or invitation, either directly or indirectly, they use speech act of refusalRefusal is considered a face threatening act, as there exists a kind of contradiction in it and is always realized indirectly. Thus, a high level of pragmatic competence is needed to realize it. The aim of this study is to find out whether the age and sex of Iranian learners have any effect on their used refusal strategies and if the existence of such an effect was demonstrated which group is more native like in terms of content and form of used strategies. To achieve this end, graduated students (male/female of different age, sex and different fields of study were selected. Three groups of participants participated in this study. The first group includes 30 American English Speakers (A.E.S. The second group consists of participants whose ages were between 22-29 and the third group was a group of 30 participants of both sexes who speak English as a second language (sex is the only variable under study in this group. Using a Discourse Completion Test (DCT, a number of refusal situations were collected, responded by participants and analyzed. The results revealed that the age and sex of EFL learners does not have any significant effect on using refusal strategies.

  13. Othermotherwork: "Testimonio" and the Refusal of Historical Trauma

    Science.gov (United States)

    Vega, Christine

    2018-01-01

    This paper is an "ofrenda" (offering), a "testimonio" (testimony) of the healing power of reconstituting severed relationships and reconstructing agentic creation stories in the pathology of soul-wounds where pictures and "cuentos" serve to mend genealogical traumas. This paper is a refusal of neglecting traumas, it…

  14. Predicting risk of school refusal: Examining the incremental role of trait EI beyond personality and emotion regulation

    Directory of Open Access Journals (Sweden)

    Filippello Pina

    2018-01-01

    Full Text Available Research has not yet been deepened in the link between personality factors and risk of school refusal. Furthermore, previous studies fail to verify the direct relation between trait EI and the risk of school refusal. The present study examined personality traits, emotion regulation and trait EI for the contributory role they may play in predicting the risk of school refusal. The sample consisted of 311 participants, 112 males (36% and 199 females (64% with an average age of 14.19 (SD = .60, from a high school in the city of Messina (Sicily, Italy. Results show that the risk of school refusal is positively related to neuroticism and maladaptive emotion regulation strategies, while it is negatively related to the extroversion, agreeableness and conscientiousness and trait EI. Moreover, trait EI can be considered as a strong incremental negative predictor of risk of school refusal over and above personality traits and emotion regulation.

  15. Export channel pricing management for integrated solutions

    OpenAIRE

    Roine, Henna; Sainio, Liisa-Maija; Saarenketo, Sami

    2012-01-01

    This article studies systems integrators' export channel pricing management for integrated solutions. We find support from our empirical case study for the notion that a systems integrator's export channel pricing strategy is multidimensional and dependent on international pricing environment and partner characteristics and that export partnerships have unique implications on a systems integrator's pricing process. The results show that giving up pricing control in export channel context may ...

  16. Integrated pest management and weed management in the United States and Canada.

    Science.gov (United States)

    Owen, Micheal D K; Beckie, Hugh J; Leeson, Julia Y; Norsworthy, Jason K; Steckel, Larry E

    2015-03-01

    There is interest in more diverse weed management tactics because of evolved herbicide resistance in important weeds in many US and Canadian crop systems. While herbicide resistance in weeds is not new, the issue has become critical because of the adoption of simple, convenient and inexpensive crop systems based on genetically engineered glyphosate-tolerant crop cultivars. Importantly, genetic engineering has not been a factor in rice and wheat, two globally important food crops. There are many tactics that help to mitigate herbicide resistance in weeds and should be widely adopted. Evolved herbicide resistance in key weeds has influenced a limited number of growers to include a more diverse suite of tactics to supplement existing herbicidal tactics. Most growers still emphasize herbicides, often to the exclusion of alternative tactics. Application of integrated pest management for weeds is better characterized as integrated weed management, and more typically integrated herbicide management. However, adoption of diverse weed management tactics is limited. Modifying herbicide use will not solve herbicide resistance in weeds, and the relief provided by different herbicide use practices is generally short-lived at best. More diversity of tactics for weed management must be incorporated in crop systems. © 2014 Society of Chemical Industry.

  17. Design of an integrated information management system for safe management of radioactive waste

    International Nuclear Information System (INIS)

    Son, Dong Chan; Hong, Suk Young; An, Kyoung Il

    2003-05-01

    An integrated data management system for the safe management of radioactive waste and spent fuel in Korea is developed to collect basic information, provide the framework for national regulation, and improve national competition and efficiency in the management of radioactive waste and spent fuel. This system can also provide public access to information such as a statistical graphs and integrated data from various waste generators to meet increased public needs and interests. Objectives can be summarized as: the five principles (independence, openness, clearance, efficiency and reliance) of safety regulation can be realized. Public understanding and reliance on the safety of spent fuel and radioactive waste management can be promoted by providing reliable information. Ensure an openness within the international nuclear community and efficiently support international agreements among contracting parties by operating safe and efficient management of spent fuel and radioactive waste (IAEA joint convention on the safety of spent fuel management and on the safety of radioactive waste management). The system can compensate for the imperfections in safe regulation of radioactive waste and spent fuel management related to waste generation, storage and disposal, and make it possible to holistic control. Re-organize the basic framework of KINS's intermediate and long term research organization and trends, regarding waste management policy is to integrate safe management and unit safe disposal

  18. Design of an integrated information management system for safe management of radioactive waste

    Energy Technology Data Exchange (ETDEWEB)

    Son, Dong Chan; Hong, Suk Young; An, Kyoung Il [Daesang Information Technology Co., Ltd., Seoul (Korea, Republic of)] (and others)

    2003-05-15

    An integrated data management system for the safe management of radioactive waste and spent fuel in Korea is developed to collect basic information, provide the framework for national regulation, and improve national competition and efficiency in the management of radioactive waste and spent fuel. This system can also provide public access to information such as a statistical graphs and integrated data from various waste generators to meet increased public needs and interests. Objectives can be summarized as: the five principles (independence, openness, clearance, efficiency and reliance) of safety regulation can be realized. Public understanding and reliance on the safety of spent fuel and radioactive waste management can be promoted by providing reliable information. Ensure an openness within the international nuclear community and efficiently support international agreements among contracting parties by operating safe and efficient management of spent fuel and radioactive waste (IAEA joint convention on the safety of spent fuel management and on the safety of radioactive waste management). The system can compensate for the imperfections in safe regulation of radioactive waste and spent fuel management related to waste generation, storage and disposal, and make it possible to holistic control. Re-organize the basic framework of KINS's intermediate and long term research organization and trends, regarding waste management policy is to integrate safe management and unit safe disposal.

  19. INNOVATION DEVELOPMENT MANAGEMENT IN VERTICALLY INTEGRATED HOLDING COMPANY

    Directory of Open Access Journals (Sweden)

    Natalya T. Uspenskaja

    2015-01-01

    Full Text Available The trend towards production consolidation and integration processes taking place both in the Russian and global economies leads to development of business associations, with a holding company being the most common form inRussiaand around the globe. The evidence in favor of the formation of holding companies is that they can benefit from the scale (bulk purchasing, centralized stuff training; in the global capital and exports markets they can be more effective than smaller businesses and, if non-profitable, a loss-making structure is easier to liquidate than the entire company; holding companies and associations can be an effective defender from political interference. As the importance of the well-functioning and harmonized procedure for the companies’ integration will increase (especially in the context of Russian business, where specific features of many areas of the production system imply the use of holding oligopolies as the most effective form of market structures, there is a need in their more profound study and, in particular, in the analysis of the most important technologies of the general integration procedure. The article outlines the relevance of innovative development management of vertically integrated holding systems, lists principles of innovative activity management and considers the features of innovation management of a vertically integrated holding company. The objective of the research is to study theoretical and practical aspects of innovative development management in vertically integrated holding systems. The object of research is management structures in innovative holding companies. While working on the article, the following methods of economic research were used: abstract and logical method, empirical method, method of expert evaluations, as well as methods of structural and functional and statistical analysis. 

  20. Improve data integration performance by employing metadata management utility

    Energy Technology Data Exchange (ETDEWEB)

    Wei, M.; Sung, A.H. [New Mexico Petroleum Recovery Research Center, Socorro, NM (United States)

    2005-07-01

    This conference paper explored ways of integrating petroleum and exploration data obtained from different sources in order to provide more comprehensive data for various analysis purposes and to improve the integrity and consistency of integrated data. This paper proposes a methodology to enhance oil and gas industry data integration performance by cooperating data management utilities in Microsoft SQL Server database management system (DBMS) for small scale data integration without support of commercial software. By semi-automatically capturing metadata, data sources are investigated in detail, data quality problems are partially cleansed, and the performance of data integration is improved. 20 refs., 7 tabs., 1 fig.

  1. Pediatric Depression: When Does Parental Refusal for Treatment Constitute Medical Neglect?

    Science.gov (United States)

    Shapiro, Michael

    2018-06-01

    Depression is a common disorder in youth, and 10% to 15% of individuals have a lifetime prevalence by 18 years of age. Youth who receive treatment typically have a positive outcome, but many remain undiagnosed and untreated. 1 There is a dearth of literature on parental refusal to consent to treatment for pediatric depression and the circumstances under which such refusal could be considered medical neglect. In general, it appears that mental health diagnoses are rarely reported in cases of medical neglect. 2 . Copyright © 2018 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  2. [Professionals' training and refusal of nursing care].

    Science.gov (United States)

    Bay, Corinne

    2016-10-01

    A patient's refusal of nursing care concerns the caregivers. Future professionals must be prepared for it and student nurses are trained to deal with such situations. It is also important to empower patients and support them in their choice. This article presents the example of the Haute École Robert Schuman in Libramont, Belgium. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  3. Social Cultivation of Vaccine Refusal and Delay among Waldorf (Steiner) School Parents.

    Science.gov (United States)

    Sobo, Elisa J

    2015-09-01

    U.S. media reports suggest that vastly disproportionate numbers of un- and under-vaccinated children attend Waldorf (private alternative) schools. After confirming this statistically, I analyzed qualitative and quantitative vaccination-related data provided by parents from a well-established U.S. Waldorf school. In Europe, Waldorf-related non-vaccination is associated with anthroposophy (a worldview foundational to Waldorf education)—but that was not the case here. Nor was simple ignorance to blame: Parents were highly educated and dedicated to self-education regarding child health. They saw vaccination as variously unnecessary, toxic, developmentally inappropriate, and profit driven. Some vaccine caution likely predated matriculation, but notable post-enrollment refusal increases provided evidence of the socially cultivated nature of vaccine refusal in the Waldorf school setting. Vaccine caution was nourished and intensified by an institutionalized emphasis on alternative information and by school community norms lauding vaccine refusal and masking uptake. Implications for intervention are explored. © 2015 by the American Anthropological Association.

  4. Integrating cost management and work management concepts for operations

    International Nuclear Information System (INIS)

    Vanditmars, C.

    1995-01-01

    Development of B C Gas Utility Limited's integrated work and cost management system was described, with emphasis on cost management without reliance on the financial systems, and standard costing and operational side benefits. The objectives of the system were identified as dynamic monitoring and control, and local empowerment. The concept underlying the two systems was explained in detail. In the case of the work management system the ability to manage all work in operations areas was stressed, along with its universal availability. Other benefits expected included improved resource utilization, improved productivity, better control of cost, improved revenue generation, superior customer service, a simplified financial system, and improved employee motivation through empowerment

  5. Comparing the quality of life in insulin recipient and refusal patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Mitra Khalili

    2016-01-01

    Conclusions: Results showed that insulin refusal patients had a better QOL. It seems that QOL is associated with the acceptance or refusal of insulin therapy. Therefore, enhancement of QOL could be related to all aspects of the disease, especially its treatment method and solving the therapeutic problems.

  6. Integrated software system for low level waste management

    International Nuclear Information System (INIS)

    Worku, G.

    1995-01-01

    In the continually changing and uncertain world of low level waste management, many generators in the US are faced with the prospect of having to store their waste on site for the indefinite future. This consequently increases the set of tasks performed by the generators in the areas of packaging, characterizing, classifying, screening (if a set of acceptance criteria applies), and managing the inventory for the duration of onsite storage. When disposal sites become available, it is expected that the work will require re-evaluating the waste packages, including possible re-processing, re-packaging, or re-classifying in preparation for shipment for disposal under the regulatory requirements of the time. In this day and age, when there is wide use of computers and computer literacy is at high levels, an important waste management tool would be an integrated software system that aids waste management personnel in conducting these tasks quickly and accurately. It has become evident that such an integrated radwaste management software system offers great benefits to radwaste generators both in the US and other countries. This paper discusses one such approach to integrated radwaste management utilizing some globally accepted radiological assessment software applications

  7. Use of wet FGD material for revegetation of an abandoned acidic coal refuse pile

    International Nuclear Information System (INIS)

    Mafi, S.; Stehouwer, R.C.

    1996-01-01

    Wet FGD material has a neutralizing potential of 15% CaCO 3 . These properties may make it a beneficial amendment for revegetation of hyper-acidic coal refuse. In greenhouse and field experiments, coal refuse (pH = 2.5) was amended with wet FGD (300, 500, and 700 tons/acre). Amendment with FGD was as effective as agricultural lime (AL) in increasing refuse pH and decreasing soluble Al and Fe. Addition of compost to the FGD further increased pH and decreased soluble Al and Fe. Downward transport of Ca was greater with FGD than AL, but FGD did not increase leachate concentrations of S. Amendment with FGD increased refuse, leachate and plant tissue concentrations of B. Other trace elements were not increased by FGD. In the greenhouse, plant growth was similar with AL and FGD except during the first three months when AL produced more growth than FGD. The initial growth suppression by FGD was likely due to high soluble salts, and possibly by high B concentrations. During the first year of the field experiment plant growth was greater with FGD than with AL. In both the field and greenhouse experiments compost increased plant growth when combined with FGD. These experiments show revegetation of toxic coal refuse and improvement in drainage water quality is possible by amendment with FGD. Revegetation success will be improved by combined amendment with FGD and compost

  8. The GENiC architecture for integrated data centre energy management

    NARCIS (Netherlands)

    Pesch, D.; McGibney, A.; Sobonski, P.; Rea, S.; Scherer, Th.; Chen, L.; Engbersen, T.; Mehta, D.; O'Sullivan, B.; Pages, E.; Townley, J.; Kasinathan, Dh.; Torrens, J.I.; Zavrel, V.; Hensen, J.L.M.

    2015-01-01

    We present an architecture for integrated data centre energy management developed in the EC funded GENiC project. The architecture was devised to create a platform that can integrate functions for workload management, cooling, power management and control of heat recovery for future, highly

  9. IM (Integrity Management) software must show flexibility to local codes

    Energy Technology Data Exchange (ETDEWEB)

    Brors, Markus [ROSEN Technology and Research Center GmbH (Germany); Diggory, Ian [Macaw Engineering Ltd., Northumberland (United Kingdom)

    2009-07-01

    There are many internationally recognized codes and standards, such as API 1160 and ASME B31.8S, which help pipeline operators to manage and maintain the integrity of their pipeline networks. However, operators in many countries still use local codes that often reflect the history of pipeline developments in their region and are based on direct experience and research on their pipelines. As pipeline companies come under increasing regulatory and financial pressures to maintain the integrity of their networks, it is important that operators using regional codes are able to benchmark their integrity management schemes against these international standards. Any comprehensive Pipeline Integrity Management System (PIMS) software package should therefore not only incorporate industry standards for pipeline integrity assessment but also be capable of implementing regional codes for comparison purposes. This paper describes the challenges and benefits of incorporating one such set of regional pipeline standards into ROSEN Asset Integrity Management Software (ROAIMS). (author)

  10. Integrating the radioactive waste management system into other management systems

    International Nuclear Information System (INIS)

    Silva, Ana Cristina Lourenco da; Nunes Neto, Carlos Antonio

    2007-01-01

    Radioactive waste management is to be included in the Integrated Management System (IMS) which pursues the continuous improvement of the company's quality, occupational safety and health, and environment protection processes. Radioactive waste management is based on the following aspects: optimization of human and material resources for execution of tasks, including the provision of a radiation protection supervisor to watch over the management of radioactive waste; improved documentation (management plan and procedures); optimization of operational levels for waste classification and release; maintenance of generation records and history through a database that facilitates traceability of information; implementation of radioactive waste segregation at source (source identification, monitoring and decontamination) activities intended to reduce the amount of radioactive waste; licensing of initial storage site for radioactive waste control and storage; employee awareness training on radioactive waste generation; identification and evaluation of emergency situations and response planning; implementation of preventive maintenance program for safety related items; development and application of new, advanced treatment methodologies or systems. These aspects are inherent in the concepts underlying quality management (establishment of administrative controls and performance indicators), environment protection (establishment of operational levels and controls for release), occupational health and safety (establishment of operational controls for exposure in emergency and routine situations and compliance with strict legal requirements and standards). It is noted that optimizing the addressed aspects of a radioactive waste management system further enhances the efficiency of the Integrated Management System for Quality, Environment, and Occupational Safety and Health. (author)

  11. An Integrated Knowledge Management System

    Directory of Open Access Journals (Sweden)

    Vasile Mazilescu

    2014-11-01

    Full Text Available The aim of this paper is to present a Knowledge Management System based on Fuzzy Logic (FLKMS, a real-time expert system to meet the challenges of the dynamic environment. The main feature of our integrated shell FLKMS is that it models and integrates the temporal relationships between the dynamic of the evolution of an economic process with some fuzzy inferential methods, using a knowledge model for control, embedded within the expert system’s operational knowledge base.

  12. Energy efficacy used to score organic refuse pretreatment processes for hydrogen anaerobic production.

    Science.gov (United States)

    Ruggeri, Bernardo; Luongo Malave, Andrea C; Bernardi, Milena; Fino, Debora

    2013-11-01

    The production of hydrogen through Anaerobic Digestion (AD) has been investigated to verify the efficacy of several pretreatment processes. Three types of waste with different carbon structures have been tested to obtain an extensive representation of the behavior of the materials present in Organic Waste (OW). The following types of waste were selected: Sweet Product Residue (SPR), i.e., confectionary residue removed from the market after the expiration date, Organic Waste Market (OWM) refuse from a local fruit and vegetable market, and Coffee Seed Skin (CSS) waste from a coffee production plant. Several pretreatment processes have been applied, including physical, chemical, thermal, and ultrasonic processes and a combination of these processes. Two methods have been used for the SPR to remove the packaging, manual (SPR) and mechanical (SPRex). A pilot plant that is able to extrude the refuse to 200atm was utilized. Two parameters have been used to score the different pretreatment processes: efficiency (ξ), which takes into account the amount of energy produced in the form of hydrogen compared with the available energy embedded in the refuse, and efficacy (η), which compares the efficiency obtained using the pretreated refuse with that obtained using the untreated refuse. The best result obtained for the SPR was the basic pretreatment, with η=6.4, whereas the thermal basic pretreatment gave the highest value, η=17.0 for SPRex. The best result for the OWM was obtained through a combination of basic/thermal pretreatments with η=9.9; lastly, the CSS residue with ultrasonic pretreatment produced the highest quantity of hydrogen, η=5.2. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Science of Integrated Approaches to Natural Resources Management

    Science.gov (United States)

    Tengberg, Anna; Valencia, Sandra

    2017-04-01

    To meet multiple environmental objectives, integrated programming is becoming increasingly important for the Global Environmental Facility (GEF), the financial mechanism of the multilateral environmental agreements, including the United Nations Convention to Combat Desertification (UNCCD). Integration of multiple environmental, social and economic objectives also contributes to the achievement of the Sustainable Development Goals (SDGs) in a timely and cost-effective way. However, integration is often not well defined. This paper therefore focuses on identifying key aspects of integration and assessing their implementation in natural resources management (NRM) projects. To that end, we draw on systems thinking literature, and carry out an analysis of a random sample of GEF integrated projects and in-depth case studies demonstrating lessons learned and good practices in addressing land degradation and other NRM challenges. We identify numerous challenges and opportunities of integrated approaches that need to be addressed in order to maximise the catalytic impact of the GEF during problem diagnosis, project design, implementation and governance. We highlight the need for projects to identify clearer system boundaries and main feedback mechanisms within those boundaries, in order to effectively address drivers of environmental change. We propose a theory of change for Integrated Natural Resources Management (INRM) projects, where short-term environmental and socio-economic benefits will first accrue at the local level. Implementation of improved INRM technologies and practices at the local level can be extended through spatial planning, strengthening of innovation systems, and financing and incentive mechanisms at the watershed and/or landscape/seascape level to sustain and enhance ecosystem services at larger scales and longer time spans. We conclude that the evolving scientific understanding of factors influencing social, technical and institutional innovations and

  14. An investigation on the fuel savings potential of hybrid hydraulic refuse collection vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Bender, Frank A., E-mail: bender@isys.uni-stuttgart.de; Bosse, Thomas; Sawodny, Oliver

    2014-09-15

    Highlights: • Driving cycle acquisition in a refuse collection vehicle. • Vehicle modeling and validation for numerical simulations based on the measured driving cycle. • Fuel consumption analysis for a conventional diesel vehicle and a hybrid hydraulic vehicle. - Abstract: Refuse trucks play an important role in the waste collection process. Due to their typical driving cycle, these vehicles are characterized by large fuel consumption, which strongly affects the overall waste disposal costs. Hybrid hydraulic refuse vehicles offer an interesting alternative to conventional diesel trucks, because they are able to recuperate, store and reuse braking energy. However, the expected fuel savings can vary strongly depending on the driving cycle and the operational mode. Therefore, in order to assess the possible fuel savings, a typical driving cycle was measured in a conventional vehicle run by the waste authority of the City of Stuttgart, and a dynamical model of the considered vehicle was built up. Based on the measured driving cycle and the vehicle model including the hybrid powertrain components, simulations for both the conventional and the hybrid vehicle were performed. Fuel consumption results that indicate savings of about 20% are presented and analyzed in order to evaluate the benefit of hybrid hydraulic vehicles used for refuse collection.

  15. An investigation on the fuel savings potential of hybrid hydraulic refuse collection vehicles

    International Nuclear Information System (INIS)

    Bender, Frank A.; Bosse, Thomas; Sawodny, Oliver

    2014-01-01

    Highlights: • Driving cycle acquisition in a refuse collection vehicle. • Vehicle modeling and validation for numerical simulations based on the measured driving cycle. • Fuel consumption analysis for a conventional diesel vehicle and a hybrid hydraulic vehicle. - Abstract: Refuse trucks play an important role in the waste collection process. Due to their typical driving cycle, these vehicles are characterized by large fuel consumption, which strongly affects the overall waste disposal costs. Hybrid hydraulic refuse vehicles offer an interesting alternative to conventional diesel trucks, because they are able to recuperate, store and reuse braking energy. However, the expected fuel savings can vary strongly depending on the driving cycle and the operational mode. Therefore, in order to assess the possible fuel savings, a typical driving cycle was measured in a conventional vehicle run by the waste authority of the City of Stuttgart, and a dynamical model of the considered vehicle was built up. Based on the measured driving cycle and the vehicle model including the hybrid powertrain components, simulations for both the conventional and the hybrid vehicle were performed. Fuel consumption results that indicate savings of about 20% are presented and analyzed in order to evaluate the benefit of hybrid hydraulic vehicles used for refuse collection

  16. [Remaining a caregiver in the face of a refusal of nursing care].

    Science.gov (United States)

    Blanchard, Karine; Ménard, Rachel; Corvol, Aline

    2016-10-01

    Caregivers working with elderly people often find themselves in a difficult position when faced with the refusal of nursing care, whether or not the patient presents cognitive disorders. The nurses from the mobile geriatrics team of Rennes university hospital are regularly asked to help the caregiving teams in such situations. Refusals may concern washing, medication, eating, moving to an armchair, the organisation of physical aids or human assistance after discharge or transfer to a nursing home. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  17. Treatment guidelines for primary nonretentive encopresis and stool toileting refusal.

    Science.gov (United States)

    Kuhn, B R; Marcus, B A; Pitner, S L

    1999-04-15

    Nonretentive encopresis refers to inappropriate soiling without evidence of fecal constipation and retention. This form of encopresis accounts for up to 20 percent of all cases. Characteristics include soiling accompanied by daily bowel movements that are normal in size and consistency. An organic cause for nonretentive encopresis is rarely identified. The medical assessment is usually normal, and signs of constipation are noticeably absent. A full developmental and behavioral assessment should be made to establish that the child is ready for intervention to correct encopresis and to identify any barriers to success, particularly disruptive behavior problems. Successful interventions depend on the presence of soft, comfortable bowel movements and addressing toilet refusal behavior. Daily scheduled positive toilet sits are recommended. Incentives may be used to reinforce successful defecation during these sits. A plan for management of stool withholding should be agreed on by the parents/caretakers and the family physician before intervention.

  18. Strategie di rifuto in Italiano: uno studio etnografico (Refusal Strategies in Italian: An Ethnographic Study).

    Science.gov (United States)

    Frescura, Marina

    1997-01-01

    After reviewing previous research on speech acts, this article describes a study that analyzed the behavior of speakers of standard Italian in refusing an offer of food. The importance of "face" is explained, and the refusal strategies are classified into four categories: explicit, tactical, decisive, and conclusive. (CFM)

  19. Integrated Approach to User Account Management

    Science.gov (United States)

    Kesselman, Glenn; Smith, William

    2007-01-01

    IT environments consist of both Windows and other platforms. Providing user account management for this model has become increasingly diffi cult. If Microsoft#s Active Directory could be enhanced to extend a W indows identity for authentication services for Unix, Linux, Java and Macintosh systems, then an integrated approach to user account manag ement could be realized.

  20. The tortoise shell Integrated Coastal Management in Galapagos

    OpenAIRE

    Polit Arguello, Victor Manuel

    2013-01-01

    The current work aims to examine the legal framework for Integrated Coastal Management for Archipelago de Galapagos. It examines the content of ICM at the internal level in order to find if there is a standard for appropriate Integrated Management of Coastal Zones. Also it aims to define whether the ratification of UNCLOS by the government of Ecuador should affect the implementation of such framework.

  1. Integrated Solution Support System for Water Management

    NARCIS (Netherlands)

    Kassahun, A.; Blind, M.; Krause, A.U.M.; Roosenschoon, O.R.

    2008-01-01

    Solving water management problems involves technical, social, economic, political and legal challenges and thus requires an integrated approach involving people from different backgrounds and roles. The integrated approach has been given a prominent role within the European Union¿s Water Framework

  2. Insulin therapy refusal among type II diabetes mellitus patients in Kubang Pasu district, the state of Kedah, Malaysia.

    Science.gov (United States)

    Tan, Wei Leong; Asahar, Siti Fairus; Harun, Noor Liani

    2015-04-01

    Diabetes mellitus is a rising non-communicable disease in Malaysia. Insulin therapy refusal is a great challenge for healthcare providers, as it results in delayed insulin initiation. This study was conducted to determine the prevalence of insulin therapy refusal and its associated factors. This cross sectional study was conducted at seven public health clinics in Kubang Pasu district, Malaysia, from March to October 2012. A newly developed and validated questionnaire was used and participants were selected via systematic random sampling. Only patients diagnosed with type II diabetes mellitus (T2DM) and under the public health clinic care in Kubang Pasu were included in the study. Multiple logistic regressions were used to study the association between insulin therapy refusal and its associated factors. There were 461 respondents and the response rate was 100%. Among these 461 patients with T2DM, 74.2% refused insulin therapy. The most common reason given for refusal was a lack of confidence in insulin injection (85.4%). Multiple logistic regression revealed that respondents who had secondary education were 55.0% less likely to refuse insulin therapy than those who had primary or no formal education (p = 0.009, adjusted odds ratio [OR] = 0.45, 95% confidence interval [CI] = 0.25-0.82). There was also a significant inverse association between glycated haemoglobin (HbA1c) and insulin therapy refusal (p = 0.047, adjusted OR = 0.87, 95% CI = 0.76-1.00). Insulin therapy refusal is common in Kubang Pasu. Education status and HbA1c should be taken into consideration when counselling patients on insulin therapy initiation.

  3. Toward population management in an integrated care model.

    Science.gov (United States)

    Maddux, Franklin W; McMurray, Stephen; Nissenson, Allen R

    2013-01-01

    Under the Patient Protection and Affordable Care Act of 2010, accountable care organizations (ACOs) will be the primary mechanism for achieving the dual goals of high-quality patient care at managed per capita costs. To achieve these goals in the newly emerging health care environment, the nephrology community must plan for and direct integrated delivery and coordination of renal care, focusing on population management. Even though the ESRD patient population is a complex group with comorbid conditions that may confound integration of care, the nephrology community has unique experience providing integrated care through ACO-like programs. Specifically, the recent ESRD Management Demonstration Project sponsored by the Centers for Medicare & Medicaid Services and the current ESRD Prospective Payment System with it Quality Incentive Program have demonstrated that integrated delivery of renal care can be accomplished in a manner that provides improved clinical outcomes with some financial margin of savings. Moving forward, integrated renal care will probably be linked to provider performance and quality outcomes measures, and clinical integration initiatives will share several common elements, namely performance-based payment models, coordination of communication via health care information technology, and development of best practices for care coordination and resource utilization. Integration initiatives must be designed to be measured and evaluated, and, consistent with principles of continuous quality improvement, each initiative will provide for iterative improvements of the initiative. © 2013 S. Karger AG, Basel.

  4. Conscientious refusals and reason-giving.

    Science.gov (United States)

    Marsh, Jason

    2014-07-01

    Some philosophers have argued for what I call the reason-giving requirement for conscientious refusal in reproductive healthcare. According to this requirement, healthcare practitioners who conscientiously object to administering standard forms of treatment must have arguments to back up their conscience, arguments that are purely public in character. I argue that such a requirement, though attractive in some ways, faces an overlooked epistemic problem: it is either too easy or too difficult to satisfy in standard cases. I close by briefly considering whether a version of the reason-giving requirement can be salvaged despite this important difficulty. © 2013 John Wiley & Sons Ltd.

  5. 7 CFR 319.8-26 - Material refused entry.

    Science.gov (United States)

    2010-01-01

    ... Plant Protection Act (7 U.S.C. 7714 and 7731). Neither the Department of Agriculture nor the inspector... 7 Agriculture 5 2010-01-01 2010-01-01 false Material refused entry. 319.8-26 Section 319.8-26 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION...

  6. Planning construction of integrative schedule management for nuclear power project

    International Nuclear Information System (INIS)

    Zeng Zhenglin; Wang Wenying; Peng Fei

    2012-01-01

    This paper introduces the planning construction of integrative schedule management for Nuclear Power Project. It details schedule management system and the requirement of schedulers and the mode of three schedule management flats. And analysis it combing with the implementation of construction water and all special schedules before FCD to further propose the improving and researching direction for the integrative schedule management. (authors)

  7. Intellectual capital management as the integral part of enterprise’s management

    OpenAIRE

    Аліна Олександрівна Осаул

    2016-01-01

    The main levels of the enterprise’s intellectual capital management are analyzed in the article. The distinctive peculiarities of the enterprise’s intellectual capital management are mentioned. Goals and benefits of the intellectual management system are determined. The ways of their improvement are pointed out. Implicit and explicit knowledge as an important integral intellectual capital resources are divided and characterized

  8. Why parents refuse childhood vaccination: a qualitative study using online focus groups

    Science.gov (United States)

    2013-01-01

    Background In high income countries, vaccine-preventable diseases have been greatly reduced through routine vaccination programs. Despite this success, many parents question, and a small proportion even refuse vaccination for their children. As no qualitative studies have explored the factors behind these decisions among Dutch parents, we performed a study using online focus groups. Methods In total, eight online focus groups (n = 60) which included Dutch parents with at least one child, aged 0–4 years, for whom they refused all or part of the vaccinations within the National Immunization Program (NIP). A thematic analysis was performed to explore factors that influenced the parents’ decisions to refuse vaccination. Results Refusal of vaccination was found to reflect multiple factors including family lifestyle; perceptions about the child’s body and immune system; perceived risks of disease, vaccine efficacy, and side effects; perceived advantages of experiencing the disease; prior negative experience with vaccination; and social environment. The use of online focus groups proved to be an effective qualitative research method providing meaningful data. Conclusion Information provided by the NIP turned out to be insufficient for this group of parents. More trust in the NIP and deliberate decisions might result from increased parental understanding of lifestyle and disease susceptibility, the impact of vaccinations on the immune system, and the relative risks of diseases and their vaccines. The public health institute should also inform parents that the NIP is recommended but non-mandatory. PMID:24341406

  9. Managing Key Risks in Post-Merger IS Integration

    DEFF Research Database (Denmark)

    Alaranta, Mar; Mathiassen, L

    2014-01-01

    Mergers and acquisitions (M&A) require organizations to blend together different information system (IS) configurations. Unfortunately, less than 50 percent of M&A's achieve their goals, with IS integration being a major problem. Here, the authors offer a framework to help managers prepare for......, analyze, and mitigate risks during post-merger IS integration. They identify key risks relating to IS integration content, process, and context, and present five strategies for mitigating those risks. Their framework aims to help managers proactively reduce the impact of adverse events. Adopting...... the framework supported by their templates is straightforward and the time and resources required are minimal. When properly executed, adoption increases the likelihood of successful merger outcomes; the framework is thus a valuable addition to the management tool box and can be applied in collaboration...

  10. THE MANAGEMENT ACCOUNTING TOOLS AND THE INTEGRATED REPORTING

    Directory of Open Access Journals (Sweden)

    Gabriel JINGA

    2015-04-01

    Full Text Available During the recent years the stakeholders are asking for other pieces of information to be published along with the financial one, such as risk reporting, intangibles, social and environmental accounting. The type of corporate reporting which incorporates the elements enumerated above is the integrated reporting. In this article, we argue that the information disclosed in the integrated reports is prepared by the management accounting, not only by the financial accounting. Thus, we search for the management accounting tools which are used by the companies which prepare integrated reports. In order to do this, we analytically reviewed all the reports available on the website of a selected company. Our results show that the company is using most of the management accounting tools mentioned in the literature review part.

  11. CORPORATIVE MOTIVES ON IMPLEMENTATION OF INTEGRATED MANAGEMENT SYSTEM (IMS

    Directory of Open Access Journals (Sweden)

    Dragan Rajkovic

    2009-09-01

    Full Text Available Integration of management systems for quality, environment, health and risk management as well as corporative social responsibilities is workable corporative approach to reduce costs, effective use of resources, higher motivation of employees and better fulfillment of requirements of social engagements and stakeholders. This paper presents contents of literature and review of a company motives on integrated management system (IMS implementation, namely factors affecting the IMS implementation.

  12. Integration of operational research and environmental management

    NARCIS (Netherlands)

    Bloemhof - Ruwaard, J.M.

    1996-01-01


    The subject of this thesis is the integration of Operational Research and Environmental Management. Both sciences play an important role in the research of environmental issues. Part I describes a framework for the interactions between Operational Research and Environmental Management.

  13. Integrated Financial Management Program

    Science.gov (United States)

    Pho, Susan

    2004-01-01

    Having worked in the Employees and Commercial Payments Branch of the Financial Management Division for the past 3 summers, I have seen the many changes that have occurred within the NASA organization. As I return each summer, I find that new programs and systems have been adapted to better serve the needs of the Center and of the Agency. The NASA Agency has transformed itself the past couple years with the implementation of the Integrated Financial Management Program (IFMP). IFMP is designed to allow the Agency to improve its management of its Financial, Physical, and Human Resources through the use of multiple enterprise module applications. With my mentor, Joseph Kan, being the branch chief of the Employees and Commercial Payments Branch, I have been exposed to several modules, such as Travel Manager, WebTads, and Core Financial/SAP, which were implemented in the last couple of years under the IFMP. The implementation of these agency-wide systems has sometimes proven to be troublesome. Prior to IFMP, each NASA Center utilizes their own systems for Payroll, Travel, Accounts Payable, etc. But with the implementation of the Integrated Financial Management Program, all the "legacy" systems had to be eliminated. As a result, a great deal of enhancement and preparation work is necessary to ease the transformation from the old systems to the new. All this work occurs simultaneously; for example, e-Payroll will "go live" in several months, but a system like Travel Manager will need to have information upgraded within the system to meet the requirements set by Headquarters. My assignments this summer have given me the opportunity to become involved with such work. So far, I have been given the opportunity to participate in projects resulting from a congressional request, several bankcard reconciliations, updating routing lists for Travel Manager, updating the majordomo list for Travel Manager approvers and point of contacts, and a NASA Headquarters project involving

  14. Integrating adaptive management and ecosystem services concepts to improve natural resource management: Challenges and opportunities

    Science.gov (United States)

    Epanchin-Niell, Rebecca S.; Boyd, James W.; Macauley, Molly K.; Scarlett, Lynn; Shapiro, Carl D.; Williams, Byron K.

    2018-05-07

    Executive Summary—OverviewNatural resource managers must make decisions that affect broad-scale ecosystem processes involving large spatial areas, complex biophysical interactions, numerous competing stakeholder interests, and highly uncertain outcomes. Natural and social science information and analyses are widely recognized as important for informing effective management. Chief among the systematic approaches for improving the integration of science into natural resource management are two emergent science concepts, adaptive management and ecosystem services. Adaptive management (also referred to as “adaptive decision making”) is a deliberate process of learning by doing that focuses on reducing uncertainties about management outcomes and system responses to improve management over time. Ecosystem services is a conceptual framework that refers to the attributes and outputs of ecosystems (and their components and functions) that have value for humans.This report explores how ecosystem services can be moved from concept into practice through connection to a decision framework—adaptive management—that accounts for inherent uncertainties. Simultaneously, the report examines the value of incorporating ecosystem services framing and concepts into adaptive management efforts.Adaptive management and ecosystem services analyses have not typically been used jointly in decision making. However, as frameworks, they have a natural—but to date underexplored—affinity. Both are policy and decision oriented in that they attempt to represent the consequences of resource management choices on outcomes of interest to stakeholders. Both adaptive management and ecosystem services analysis take an empirical approach to the analysis of ecological systems. This systems orientation is a byproduct of the fact that natural resource actions affect ecosystems—and corresponding societal outcomes—often across large geographic scales. Moreover, because both frameworks focus on

  15. Development and implementation of integrated management system

    International Nuclear Information System (INIS)

    Tomov, E.; Nenkova, B.

    2013-01-01

    Risk Engineering Ltd is a private Bulgarian company in the field of scientific technical consultancy and engineering services, established in 1990. The aim of this report is to present the experience of Risk Engineering Ltd. in the development, implementation and operation of an integrated management system. The process of implementation of the system was completed at the end of 2011. In January 2012, the Risk Engineering Integrated Management System was certified by Lloyd's Register for compliance with standards ISO 9001:2008, ISO 140001:2004 and BS OHSAS 18001:2007

  16. Refuse derived fuel incineration: Fuel gas monitoring and analysis

    International Nuclear Information System (INIS)

    Ranaldi, E.; Coronidi, M.; De Stefanis, P.; Di Palo, C.; Zagaroli, M.

    1993-11-01

    Experience and results on refuse derived fuel (selected from municipal solid wastes) incineration are reported. The study involved the investigation of inorganic compounds (heavy metals, acids and toxic gases) emissions, and included feeding materials and incineration residues characterization and mass balance

  17. Total Quality Management and Organizational Behavior Management: An Integration for Continual Improvement.

    Science.gov (United States)

    Mawhinney, Thomas C.

    1992-01-01

    The history and main features of organizational behavior management (OBM) are compared and integrated with those of total quality management (TQM), with emphasis on W.E. Deming's 14 points and OBM's operant-based approach to performance management. Interventions combining OBM, TQM, and statistical process control are recommended. (DB)

  18. The development of pipeline integrity management in the world and practice in China

    Energy Technology Data Exchange (ETDEWEB)

    Shaohua, Dong; Qing, Wang; Feifan [China National Petroleum Corporation (CNPC), Beijing (China)

    2009-07-01

    The paper analyzed the pipeline integrity management latest development, and the relationship among HSE management, pipeline integrity management (PIM) and asset integrity management (AIM). CNPC is a pioneer of China industry on implementation of pipeline integrity management by using latest developed technologies such as in-line inspection, GIS, Risk assessment and advanced repair technologies, and it is typical model of PIM in China pipeline who supply the gas to whole Beijing city. With smart pigging inspection and implementation of GIS and EAM(enterprise assets management) system on two thousand kilometers of Shaanxi-Beijing gas pipeline BHGC is able to manage pipeline integrity in five areas which include pipe materials safety, nature and geotechnical hazards management, coating and corrosion protection, stationing and associated facilities maintenance, and underground gas storage integrity. This paper presents latest achievement of BHGC in their pipeline integrity programs. (author)

  19. A Review of Ocean Management and Integrated Resource Management Programs from Around the World

    OpenAIRE

    , Seaplan

    2018-01-01

    This draft report is one of several prepared under contract to the Massachusetts Ocean Partnership (MOP) to support the Massachusetts Executive Office of Energy and Environmental Affairs (EOEEA) in its development of the integrated coastal ocean management plan mandated by the Massachusetts Oceans Act of 2008. The purpose of this report was to inventory and review ocean management and integrated resource management programs from around the world, including the United States, Europe, Australia...

  20. Information for Child Care Providers about Pesticides/Integrated Pest Management

    Science.gov (United States)

    Learn about pesticides/integrated pest management, the health effects associated with exposure to pests and pesticides, and the steps that can be taken to use integrated pest management strategies in childcare facilities.

  1. Invitation Refusals in Cameroon French and Hexagonal French

    Science.gov (United States)

    Farenkia, Bernard Mulo

    2015-01-01

    Descriptions of regional pragmatic variation in French are lacking to date the focus has been on a limited range of speech acts, including apologies, requests, compliments and responses to compliments. The present paper, a systematic analysis of invitation refusals across regional varieties of French, is designed to add to the research on…

  2. Wife beating refusal among women of reproductive age in urban and rural Ethiopia.

    Science.gov (United States)

    Gurmu, Eshetu; Endale, Senait

    2017-03-16

    Wife beating is the most common and widespread form of intimate partner violence in Ethiopia. It results in countless severe health, socio-economic and psychological problems and has contributed to the violation of human rights including the liberty of women to enjoy conjugal life. The main purpose of this study is to assess the levels and patterns of wife beating refusal and its associated socio-cultural and demographic factors in rural and urban Ethiopia. The 2011 Ethiopian Demographic and Health Survey (EDHS) data based on 11,097 and 5287 women in the reproductive age group (i.e. 15-49 years) living in rural and urban areas, respectively,were used in this study. Cronbach's alpha was used to assess the internal consistency of the measure of women's attitudes towards wife beating. The Statistical Package for Social Sciences was applied to analyze the data. A binary logistic regression model was fitted to identify variables that significantly predict respondents' refusal of wife beating. Separate analysis by a place of residence was undertaken as attitude towards wife beating vary between rural and urban areas. The likelihood of refusing wife beating in Ethiopia was significantly higher among urban women (54.2%) than rural women (24.5%). Although there was a significant variations in attitude towards refusing wife beating among different regions in Ethiopia, increasing educational level, high access to media, age of respondents were associated with high level of refusal of wife beating. In contrast, rural residence, being in marital union, high number of living children, being followers of some religions (Muslim followers in urban and Protestants in rural) were associated with low level of refusal of wife beating. The findings of this study reveal that wife beating in Ethiopia is a function of demographic and socio-cultural factors among which age and educational attainment of respondents, number of living children, religious affiliation, marital commitment and

  3. What happens after a request for euthanasia is refused? Qualitative interviews with patients, relatives and physicians

    NARCIS (Netherlands)

    Pasman, H.R.W.; Willems, D.L.; Onwuteaka-Philipsen, B.D.

    2013-01-01

    Objective: Obtaining in-depth information from both patient and physician perspectives about what happens after a request for euthanasia or physician-assisted suicide (EAS) is refused. Methods: In-depth interviews with nine patients whose EAS request was refused and seven physicians of these

  4. The role of business information management in advanced integrated environmental management systems

    DEFF Research Database (Denmark)

    Ulhøi, John Parm

    2000-01-01

    investments in the individual company. Secondly, based on the above, to calculate and assess some typical quantifiable savings, e.g. on energy and raw materials, over a period of four years (after the implementation of the integrated environmental management system). In line with other similar investigations......, the study shows that the implementation of systematic and integrated environmental management systems results in significant savings. This supports the general, albeit rarely tested, hypothesis that it pays to be an environmentally responsible enterprise....

  5. Integrated disease management: a critical review of foreign and Portuguese experience.

    Science.gov (United States)

    Coelho, Anabela; Leone, Cláudia; Ribeiro, Vanessa; Sá Moreira, Pedro; Dussault, Gilles

    2014-01-01

    The present article reviews findings from empirical evaluations of integrated disease management programmes. The objective is to provide insights on integration levels, priority interventions and their effect on patient outcomes. The literature review identified 1 251 articles, published from 2006 to 2011. Upon a detailed screening 61 articles were selected for bibliometric analysis and critical discussion. Among several findings, it can be noted that United States of America is the country with the highest amount of published evidence on the subject under study. The most frequently referred disease is diabetes mellitus and the main reported issue of integrated disease management is self-management support. The majority of the studies were developed and exclusively managed by managed care organizations, organized family doctors or hospitals. From a total of 360 interventions reported in studies, patient interventions are the most frequently used across all disease groups, followed by professional interventions. To monitor the effectiveness of the disease programmes, the most frequently used outcomes are patient physiological measures, service use and patient health status. Every country has its own way to implement the integrated disease management strategy. The focus of practice lies on patient empowerment, particularly through self-management. Physiological measures and service use are the outcomes with the highest rate of assessment, which are also the indicators that show higher impact among all integrated disease management programmes. The Portuguese health care system still faces challenges in the coordination and integration of care for patients with chronic disease thus improvements at integrated disease management programmes should be incorporate.

  6. Using remote sensing to inform integrated coastal zone management

    CSIR Research Space (South Africa)

    Roberts, W

    2010-06-01

    Full Text Available TO INFORM INTERGRATED COASTAL ZONE MANAGEMENT GISSA Western Cape Regional Meeting Wesley Roberts & Melanie Luck-Vogel 2 June 2010 CSIR NRE Ecosystems Earth Observation Group What is Integrated Coastal Zone Management? Integrated coastal management... D1D1 B a n d 1 Band 2 Quick theory of CVA Magnitude Direction ( ) ( )22 xaxbyaybM ?+?= Quadrant 1 (++) Accretion Quadrant 2 (-+) Quadrant 4 (+-) Quadrant 3 (--) Erosion CVA Results & Conclusions ? Change in image time series...

  7. Understanding the antecedents of Korean high school students' drinking refusal self-efficacy: parental influence, peer influence, and behavior.

    Science.gov (United States)

    Jang, Su Ahn; Cho, Namauk; Yoo, Jina

    2011-12-29

    The current study examined the factors that influence Korean adolescents' drinking refusal self-efficacy, which is known to be associated with alcohol use and drinking intentions. Specifically, this study considered parental monitoring, parent-child communication satisfaction, peer influence, and prior alcohol use as possible antecedents of Korean high school students' drinking refusal self-efficacy. High school students (n = 538) in South Korea responded to the current study. The data revealed that parent-child communication satisfaction facilitated parental monitoring, and these factors indirectly predicted adolescents' drinking behavior through peer influence. We also found that prior drinking, parental monitoring, and peer influence were directly associated with drinking refusal self-efficacy, and the self-efficacy, in turn, was associated with drinking intentions. These results not only suggest that drinking refusal self-efficacy are related to drinking behavior and intentions, but they also provide a theoretical explanation for how parental and peer influences are associated with adolescents' drinking refusal self-efficacy.

  8. Integrating Records Management (RM) and Information Technology (IT)

    Energy Technology Data Exchange (ETDEWEB)

    NUSBAUM,ANNA W.; CUSIMANO,LINDA J.

    2000-03-02

    Records Managers are continually exploring ways to integrate their services with those offered by Information Technology-related professions to capitalize on the advantages of providing customers a total solution to managing their records and information. In this day and age, where technology abounds, there often exists a fear on the part of records management that this integration will result in a loss of identity and the focus of one's own mission - a fear that records management may become subordinated to the fast-paced technology fields. They need to remember there is strength in numbers and it benefits RM, IT, and the customer when they can bring together the unique offerings each possess to reach synergy for the benefit of all the corporations. Records Managers, need to continually strive to move ''outside the records management box'', network, expand their knowledge, and influence the IT disciplines to incorporate the concept of ''management'' into their customer solutions.

  9. Informed consent for the administration of an intravenous contrast agent: importance and determinants of patient refusal

    International Nuclear Information System (INIS)

    Martel, J.; Garcia-Diaz, J. D.

    1999-01-01

    We proposed to determine the proportion of patients who refuse to undergo intravenous contrast administration and the factors that influence their refusal. Our series consisted of 442 patients who were supposed to undergo imaging studies involving the intravenous injection of an iodine contrast. In a personal interview, the patients were issued a questionnaire specifically designed for this study. The following parameters were recorded: sex, age, inpatient or outpatient status, medical history available, person who informed them about the procedure, person signing the informed consent (patient or other) , highest academic degree, attitude toward receiving the information and degree of concern after reading and signing the consent form. In our series 8.6% of the patients (95% confidence interval: 6-11.2) refused to sign the informed consent form. In addition, there were a number of patients who delayed the procedure or hindered the daily work schedule by some other means. When the relationship between each of the variables studied and refusal to sign the consent form was assessed, significant associations were observed between the latter and the academic level of the patient, his or her degree of concern and having received the information from a trained person. There was also a nearly significant trend toward the association between refusal and the patient's background. Relatively few patients refuse to sign the informed consent to receive intravenous contrast administration but this negative decision interferes with the health care practice. It is possible to identify certain correctable factors that influence the patient in this respect. (Author) 13 refs

  10. The impacts of coal refuse/fly ash bulk bends on water quality and plant growth

    Energy Technology Data Exchange (ETDEWEB)

    Stewar, B.R.; Daniels, W.L. [Virginia Polytechnic Institute and State Univ., Blacksburg, VA (United States)

    1995-09-01

    There is considerable interest in the beneficial reuse of coal fly ash as a soil amendment on coal refuse piles. One method of application would be to blend the coal refuse and the fly ash before deposition in a refuse pile. A field experiment was initiated to measure the effects of bulk blending fly ash with coal refuse on water quality and plant growth parameters. Fly ash (class F) from three sources were used in the experiment. Two of the fly ashes were acidic and the third was alkaline. Trenches were excavated in a coal refuse pile to a depth of 2 m and the refuse was blended with fly ash and then returned to the trench. In other plots the ash was applied as a surface amendment. A treatment of a bulk blend of 5% (w/w) rock phosphate was also included in the experiment. Large volume lysimeters were installed in some trenches to collect the leachates. The fly ash treatments appear to improve the quality of the leachates when compared to the leachates from the untreated plots. The fly ash amended treatments have lower leachate concentrations of Fe and Al. Initially the fly ash treatments showed high levels of leachate B, however those levels have decreased with time. Millet (Setaria italica) yields from the first year of the experiment were highest n the alkaline fly ash and rock phosphate blended plots. In the second growing season, the two bulk blends with alkaline fly ash had the highest yields. In the third growing season all treatments had higher yield levels than the untreated control plots. The positive effects of the fly ash on leachate quality were attributed to the alkalinity of the ash, and the increase in yield was attributed to the increases in water holding capacity due to fly ash treatments.

  11. Making Sense of Iconic Symbols: A Study of Preschool Children Conducting a Refuse-Sorting Task

    Science.gov (United States)

    Ljung-Djärf, Agneta; Åberg-Bengtsson, Lisbeth; Ottosson, Torgny; Beach, Dennis

    2015-01-01

    This article is part of a larger project focusing upon explanatory illustrations that children encounter in pre- and primary school education. The research questions concerned (a) how preschool children make sense of iconic symbols when placing items of refuse on illustrations of refuse bins in a sorting task and (b) what stumbling blocks they…

  12. 13 CFR 115.18 - Refusal to issue further guarantees; suspension and termination of PSB status.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Refusal to issue further guarantees; suspension and termination of PSB status. 115.18 Section 115.18 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION SURETY BOND GUARANTEE Provisions for All Surety Bond Guarantees § 115.18 Refusal to issue further guarantees; suspension...

  13. 75 FR 4565 - Federal Acquisition Regulation; Submission for OMB Review; Right of First Refusal of Employment

    Science.gov (United States)

    2010-01-28

    .... Please cite OMB Control No. 9000-0114, Right of First Refusal of Employment, in all correspondence. Dated... ADMINISTRATION [OMB Control No. 9000-0114] Federal Acquisition Regulation; Submission for OMB Review; Right of... previously approved information collection requirement concerning right of first refusal of employment. A...

  14. [Participation refusal by probands in an epidemiologic long-term study--sociodemographic, clinical and psychometric findings].

    Science.gov (United States)

    Franz, M; Schepank, H; Wirth, T; Schellberg, D

    1992-11-01

    Usually little is known about probands who participated in an epidemiological longitudinal field survey but refused participation in follow-up investigations. For reasons of data protection and on account of the fact that investigative instruments used in longterm field surveys or panel studies are more focused on well defined issues (opinions, attitudes, assessment of behaviors) and less on personality variables, differentiated statements on probands who explicitly refused cooperation can hardly be made. In our epidemiological longitudinal field study on prevalence and course of psychogenic disorders we have a different situation. Within the limits of our study we had the unique opportunity to gain far-reaching information on probands who refused to participate in preceding investigations in regard to sociodemographic, psychometric and clinical variables. The clientele of refusers we present in our paper mainly comprises elderly, married, rather obsessive-compulsive structured, lower-class females. According to our data interactive aspects are equally responsible for reduced cooperativeness. The significance of our findings for the planning and carrying out of epidemiological longitudinal field surveys is discussed.

  15. Review of the potential for utilizing washery refuse in N. S. W. and Queensland

    Energy Technology Data Exchange (ETDEWEB)

    Sullivan, K M

    1977-06-01

    The growing importance attached to the environment, coupled with the increasing quantities of coal refuse resulting from expanded coal production has highlighted the problem of coal refuse disposal and provided the necessary impetus to find uses for the by-product, which will eventually be regarded as a fuel and engineering material rather than a waste. Potential areas of use will be as a fuel; as a potential fuel replacement and raw material additive for brick manufacture; as a raw material for lightweight aggregate manufacture; as a construction material; for agricultural purposes, or a number of other areas of special use. The successful marketing of coal refuse will depend on an in-depth technical market analysis being carried out, followed by practical research and a comprehensive product examination and identification program being undertaken.

  16. Fundamental aspects of municipal refuse generated in Beirut and Tripoli: field studies 1994-1996

    International Nuclear Information System (INIS)

    Ayoub, G.M.; Acra, A.; Abdallah, R.; Merhebi, F.

    1996-01-01

    This study presents socio-economic survey on collection and analysis of data pertaining to the municipal refuse generated in Beirut and Tripoli, Two big cities of Lebanon.Although the collection process applied in Beirut has progressed immensely in the past two years, the unsatisfactory methods of disposal that have been employed until now has an impact on the environment:marine environment as well as the air pollution becoming problems in the city of Beirut. In this respect, solid wastes characterization and generation rates in both cities of Beirut and Tripoli are presented. Mapping of refuse collection and disposal services in the two cities is described. Sources of refuse like hospitals, industries, household,...are enumerated. Recycling potentials of plastics, paper and cardboard, glass wastes, metallic wastes, textile wastes are described

  17. Design of the Hospital Integrated Information Management System Based on Cloud Platform.

    Science.gov (United States)

    Aijing, L; Jin, Y

    2015-12-01

    At present, the outdated information management style cannot meet the needs of hospital management, and has become the bottleneck of hospital's management and development. In order to improve the integrated management of information, hospitals have increased their investment in integrated information management systems. On account of the lack of reasonable and scientific design, some hospital integrated information management systems have common problems, such as unfriendly interface, poor portability and maintainability, low security and efficiency, lack of interactivity and information sharing. To solve the problem, this paper carries out the research and design of a hospital information management system based on cloud platform, which can realize the optimized integration of hospital information resources and save money.

  18. Co-Leadership - A Management Solution for Integrated Health and Social Care.

    Science.gov (United States)

    Klinga, Charlotte; Hansson, Johan; Hasson, Henna; Sachs, Magna Andreen

    2016-05-23

    Co-leadership has been identified as one approach to meet the managerial challenges of integrated services, but research on the topic is limited. In the present study, co-leadership, practised by pairs of managers - each manager representing one of the two principal organizations in integrated health and social care services - was explored. To investigate co-leadership in integrated health and social care, identify essential preconditions in fulfilling the management assignment, its operationalization and impact on provision of sustainable integration of health and social care. Interviews with eight managers exercising co-leadership were analysed using directed content analysis. Respondent validation was conducted through additional interviews with the same managers. Key contextual preconditions were an organization-wide model supporting co-leadership and co-location of services. Perception of the management role as a collective activity, continuous communication and lack of prestige were essential personal and interpersonal preconditions. In daily practice, office sharing, being able to give and take and support each other contributed to provision of sustainable integration of health and social care. Co-leadership promoted robust management by providing broader competence, continuous learning and joint responsibility for services. Integrated health and social care services should consider employing co-leadership as a managerial solution to achieve sustainability.

  19. Ground Operations Autonomous Control and Integrated Health Management

    Science.gov (United States)

    Daniels, James

    2014-01-01

    The Ground Operations Autonomous Control and Integrated Health Management plays a key role for future ground operations at NASA. The software that is integrated into this system is called G2 2011 Gensym. The purpose of this report is to describe the Ground Operations Autonomous Control and Integrated Health Management with the use of the G2 Gensym software and the G2 NASA toolkit for Integrated System Health Management (ISHM) which is a Computer Software Configuration Item (CSCI). The decision rationale for the use of the G2 platform is to develop a modular capability for ISHM and AC. Toolkit modules include knowledge bases that are generic and can be applied in any application domain module. That way, there's a maximization of reusability, maintainability, and systematic evolution, portability, and scalability. Engine modules are generic, while application modules represent the domain model of a specific application. Furthermore, the NASA toolkit, developed since 2006 (a set of modules), makes it possible to create application domain models quickly, using pre-defined objects that include sensors and components libraries for typical fluid, electrical, and mechanical systems.

  20. Concept of operations : Dallas Integrated Corridor Management (ICM) demonstration project.

    Science.gov (United States)

    2010-06-01

    This concept of operations (Con Ops) for the US-75 Integrated Corridor Management (ICM) Program has been developed as part of the US : Department of Transportation Integrated Corridor Management Initiative, which is an innovative research initiative ...

  1. Integrated Foreign Exchange Risk Management

    DEFF Research Database (Denmark)

    Aabo, Tom; Høg, Esben; Kuhn, Jochen

    Empirical research has focused on export as a proxy for the exchange rate exposure and the use of foreign exchange derivatives as the instrument to deal with this exposure. This empirical study applies an integrated foreign exchange risk management approach with a particular focus on the role...

  2. Integrating school-based and therapeutic conflict management models at schools.

    Science.gov (United States)

    D'Oosterlinck, Franky; Broekaert, Eric

    2003-08-01

    Including children with emotional and behavioral needs in mainstream school systems leads to growing concern about the increasing number of violent and nonviolent conflicts. Schools must adapt to this evolution and adopt a more therapeutic dimension. This paper explores the possibility of integrating school-based and therapeutic conflict management models and compares two management models: a school-based conflict management program. Teaching Students To Be Peacemakers; and a therapeutic conflict management program, Life Space Crisis Intervention. The authors conclude that integration might be possible, but depends on establishing a positive school atmosphere, the central position of the teacher, and collaborative and social learning for pupils. Further implementation of integrated conflict management models can be considered but must be underpinned by appropriate scientific research.

  3. An Implentation Methodology for Integrated Resource Management in Urban Water Planning

    Science.gov (United States)

    Ebrahimi, G.; Thurm, B.; Klein, D. R.; Öberg, G.

    2014-12-01

    Urban water management requires innovative and integrative approaches to improve sustainability in cities keeping in touch with science progress. Integrated Resource Management (IRM) is one of these strategies and has been developed to integrate various natural and human resources. However, it is becoming increasingly clear that it is challenging to move from vision to implementation. The aim of this paper is to identify strengths and weaknesses of IRM and analyze if the approach might facilitate implementation of sustainability objectives in the water management field. A literature review was performed on peer-reviewed papers that were identified through Google Scholar search for the term 'Integrated Resource Management'. It was found that IRM has been used in a number of contexts such as urban planning, forestry, and management of waste and livestock. Significant implementation challenges are highlighted in the literature. Based on the lessons learned in many different fields, from forestry to communication sciences, important characteristics of IRM approach were found such as the need for adequate governance and strong leaderships, stakeholder's involvement, the learning process and the critical need of appropriate evaluation criteria. We conclude developing an implementation methodology and presenting several recommendations to implement IRM in urban management. While Integrated Water Resource Management (IWRM) is recognized as a fruitful approach to achieve sustainable water management, this study suggests that a shift toward Integrated Resource Management (IRM) can be beneficial as it is designed to facilitate consideration of the interrelationships between various natural and human resources.

  4. Continuous improvement of the BNFL transport integrated management system

    International Nuclear Information System (INIS)

    Hale, J.A.

    1998-01-01

    The integrated Management System of BNFL Transport and Pacific Nuclear Transport Limited (PNTL) is subject to continuous improvement by the application of established improvement techniques adopted by BNFL. The technique currently being used is the application of a Total Quality Management (TQM) philosophy, involving the identification of key processes, benchmarking against existing measures, initiating various improvement projects and applying process changes within the Company. The measurement technique being used is based upon the European Foundation for Quality Management Model (EFQM). A major initiative was started in 1996 to include the requirements of the Environmental Management Systems standard ISO 14001 within the existing integrated management system. This resulted in additional activities added to the system, modification to some existing activities and additional training for personnel. The system was audited by a third party certification organisation, Lloyds Register Quality Assurance (LRQA), during 1997. This paper describes the arrangements to review and update the integrated management system of BNFL Transport and PNTL to include the requirements of the environmental standard ISO 14001 and it also discusses the continuous improvement process adopted by BNFL Transport. (authors)

  5. Project Management Data Retrieval and Integration (PMDRI) Application

    Data.gov (United States)

    Department of Veterans Affairs — The Project Management Data Retrieval and Integration Database (PMDRI) is a system that presents data from the VA Financial Management System(FMS) in a structured...

  6. Integrating Process Management with Archival Management Systems: Lessons Learned

    Directory of Open Access Journals (Sweden)

    J. Gordon Daines, III

    2009-03-01

    Full Text Available The Integrated Digital Special Collections (INDI system is a prototype of a database-driven, Web application designed to automate and manage archival workflow for large institutions and consortia. This article discusses the how the INDI project enabled the successful implementation of a process to manage large technology projects in the Harold B. Lee Library at Brigham Young University. It highlights how the scope of these technology projects is set and how the major deliverables for each project are defined. The article also talks about how the INDI system followed the process and still failed to be completed. It examines why the process itself is successful and why the INDI project failed. It further underscores the importance of process management in archival management systems.

  7. Bacteria and Acidic Drainage from Coal Refuse: Inhibition by Sodium Lauryl Sulfate and Sodium Benzoate

    OpenAIRE

    Dugan, Patrick R.; Apel, William A.

    1983-01-01

    The application of an aqueous solution of sodium lauryl sulfate and sodium benzoate to the surface of high-sulfur coal refuse resulted in the inhibition of iron-and sulfur-oxidizing chemoautotrophic bacteria and in the decrease of acidic drainage from the refuse, suggesting that acid drainage can be abated in the field by inhibiting iron- and sulfur-oxidizing bacteria.

  8. Herpes labialis and Nigerian dental health care providers: knowledge, attitudes, behaviors, and refusal to treat.

    Science.gov (United States)

    Azodo, Clement Chinedu; Umoh, Agnes O

    2015-09-15

    The few existing studies on herpes labialis among health care workers have been predominantly among non-dental health care workers. The purpose of this study was to determine Nigerian dental health care providers' knowledge of, attitudes toward, preventive behaviors for, and refusal to treat patients with herpes labialis. This cross-sectional study was conducted among final-year dental students at the University of Benin, dental house officers, and residents at the University of Benin Teaching Hospital, Benin City, Nigeria. Data collection was via a self-administered questionnaire. Bivariate statistics and logistic regression were used to relate the dependent and independent variables. Of the 120 questionnaires distributed, 110 were completed and returned, giving a 91.7% retrieval rate. However, 15 of the returned questionnaires were discarded because they were improperly completed, leaving a total of 95 questionnaires for final analysis in this study. The majority of participants were over 28 years old (54.7%), male (67.4%), unmarried (66.3%), and postgraduate dental health care providers (51.6%). Less than half (43.2%) of participants demonstrated adequate overall knowledge of herpes labialis. About one-tenth (10.5%) and more than three-quarters (87.4%) of participants reported a positive attitude and performance of adequate preventive behaviors, respectively. A total of 16.8% of participants reported a high tendency to refuse treatment to patients with herpes labialis. Although not statistically significant, young, unmarried, male undergraduate participants reported a greater likelihood to refuse treatment to herpes labialis patients. We found a statistically significant positive correlation between attitude and refusal to treat patients with herpes labialis. However, marital status and the attitude of participants toward these patients emerged as the determinants for refusal to treat patients with herpes labialis. Data from this study revealed a high level of

  9. Economic Exposure and Integrated Risk Management

    OpenAIRE

    Miller, Kent D.

    1994-01-01

    Most corporate risk management research focuses on particular risk exposures to the exclusion of other interrelated exposures. By contrast, this study models corporate risk exposures using a multivariate approach integrating the distinct exposures of interest to finance and strategy researchers. The paper addresses the implications of multivariate modeling for corporate risk management, some key methodological issues arising in empirical estimation of corporate economic exposrues, and direc...

  10. The Management of Law Firms Using Business Process Management, Document Management and Web Services Integration

    OpenAIRE

    Roxana Maria Petculet

    2012-01-01

    The aim of this paper is to present the technical solution implemented in the present context for the management of law firms. The informational system consists of the automation of business processes using a BPM engine and electronic archiving using a DMS. The communication between the two modules is made by invoking web services. The whole system integrates modules like: project management, contract management, invoice management, collection, CRM, reporting.

  11. Integrated economic management. Principal aspects and future

    International Nuclear Information System (INIS)

    2004-01-01

    Now that five years have passed (1999-2003) since the Owner Companies decided to merge the Asco and Vandellos-II nuclear power plants, we believe that, for Integrated Management through a single AIE, it is timely and advisable to describe the key issues of the process implemented to optimize economic results, always in accordance with the Policies of Nuclear Safety, Quality and Environment, Prevention, Human Factors and Availability, and we emphasize the following as essential elements: The Corporate Model; strategic/Operating Plans; integrated Economic Management Model SIE; Rationalization of the organizational structure, Continuous Training; Analysis of Processes and Procedures. (Author)

  12. An integration architecture for knowledge management system and business process management system

    NARCIS (Netherlands)

    Jung, J.; Choi, I.; Song, M.S.

    2007-01-01

    Recently, interests in the notion of process-oriented knowledge management (PKM) from academia and industry have been significantly increased. Comprehensive research and development requirements along with a cogent framework, however, have not been proposed for integrating knowledge management (KM)

  13. Predictors of condom use and refusal among the population of Free State province in South Africa.

    Science.gov (United States)

    Chandran, Thoovakkunon Moorkoth; Berkvens, Dirk; Chikobvu, Perpetual; Nöstlinger, Christiana; Colebunders, Robert; Williams, Brian Gerard; Speybroeck, Niko

    2012-05-28

    This study investigated the extent and predictors of condom use and condom refusal in the Free State province in South Africa. Through a household survey conducted in the Free Sate province of South Africa, 5,837 adults were interviewed. Univariate and multivariate survey logistic regressions and classification trees (CT) were used for analysing two response variables 'ever used condom' and 'ever refused condom'. Eighty-three per cent of the respondents had ever used condoms, of which 38% always used them; 61% used them during the last sexual intercourse and 9% had ever refused to use them. The univariate logistic regression models and CT analysis indicated that a strong predictor of condom use was its perceived need. In the CT analysis, this variable was followed in importance by 'knowledge of correct use of condom', condom availability, young age, being single and higher education. 'Perceived need' for condoms did not remain significant in the multivariate analysis after controlling for other variables. The strongest predictor of condom refusal, as shown by the CT, was shame associated with condoms followed by the presence of sexual risk behaviour, knowing one's HIV status, older age and lacking knowledge of condoms (i.e., ability to prevent sexually transmitted diseases and pregnancy, availability, correct and consistent use and existence of female condoms). In the multivariate logistic regression, age was not significant for condom refusal while affordability and perceived need were additional significant variables. The use of complementary modelling techniques such as CT in addition to logistic regressions adds to a better understanding of condom use and refusal. Further improvement in correct and consistent use of condoms will require targeted interventions. In addition to existing social marketing campaigns, tailored approaches should focus on establishing the perceived need for condom-use and improving skills for correct use. They should also incorporate

  14. Predictors of condom use and refusal among the population of Free State province in South Africa

    Directory of Open Access Journals (Sweden)

    Chandran Thoovakkunon

    2012-05-01

    Full Text Available Abstract Background This study investigated the extent and predictors of condom use and condom refusal in the Free State province in South Africa. Methods Through a household survey conducted in the Free Sate province of South Africa, 5,837 adults were interviewed. Univariate and multivariate survey logistic regressions and classification trees (CT were used for analysing two response variables ‘ever used condom’ and ‘ever refused condom’. Results Eighty-three per cent of the respondents had ever used condoms, of which 38% always used them; 61% used them during the last sexual intercourse and 9% had ever refused to use them. The univariate logistic regression models and CT analysis indicated that a strong predictor of condom use was its perceived need. In the CT analysis, this variable was followed in importance by ‘knowledge of correct use of condom’, condom availability, young age, being single and higher education. ‘Perceived need’ for condoms did not remain significant in the multivariate analysis after controlling for other variables. The strongest predictor of condom refusal, as shown by the CT, was shame associated with condoms followed by the presence of sexual risk behaviour, knowing one’s HIV status, older age and lacking knowledge of condoms (i.e., ability to prevent sexually transmitted diseases and pregnancy, availability, correct and consistent use and existence of female condoms. In the multivariate logistic regression, age was not significant for condom refusal while affordability and perceived need were additional significant variables. Conclusions The use of complementary modelling techniques such as CT in addition to logistic regressions adds to a better understanding of condom use and refusal. Further improvement in correct and consistent use of condoms will require targeted interventions. In addition to existing social marketing campaigns, tailored approaches should focus on establishing the perceived need

  15. SELECTED REQUIREMENTS OF INTEGRATED MANAGEMENT SYSTEMS BASED ON PAS 99 SPECIFICATION

    Directory of Open Access Journals (Sweden)

    Paweł Nowicki

    2013-03-01

    Full Text Available The aim this research was to analyze the ways of integration of management systems in food sector. The study involved the documentation, audits, corrective and preventive actions and management's review phases described in the specification PAS 99, which is one of common elements of integrated management systems. Four organizations were selected for the study. The organizations had introduced and certified at least two standardized management systems. It was assumed that the investigated organizations should have implemented the HACCP system. Studies were conducted as a case study. The employees responsible for the functioning of management systems were interviewed in all four organizations. The study was conducted in the form of in-depth interviews based on pre-prepared script. The scenario was developed based on the PAS 99 guideline. The process of integration of management systems implemented in the studied companies reveals the full compliance of an integrated management system with PASS 99 in the policy area.

  16. Law for the Integral Management of Waste No. 8839

    International Nuclear Information System (INIS)

    2010-01-01

    The Law for Integral Waste Management No. 8839 was enacted in Costa Rica in 2010. The purpose of this law has been to regulate the integral management of residues and the efficient use of the resources, through the planning and execution of regulatory actions, operational, financial, administrative, educational, environmental and healthy of monitoring and evaluation [es

  17. Integrated Constructed Wetlands (ICW) for livestock wastewater management.

    Science.gov (United States)

    Harrington, Rory; McInnes, Robert

    2009-11-01

    Social, economic and environmental coherence is sought in the management of livestock wastewater. Wetlands facilitate the biogeochemical processes that exploit livestock wastewater and provide opportunities to achieve such coherence and also to deliver on a range of ecosystem services. The Integrated Constructed Wetland (ICW) concept integrates three inextricably linked objectives: water quantity and quality management, landscape-fit to improve aesthetic site values and enhanced biodiversity. The synergies derived from this explicit integration allow one of the key challenges for livestock management to be addressed. An example utilizing twelve ICW systems from a catchment on the south coast of Ireland demonstrates that over an eight year period mean reduction of total and soluble phosphorus (molybdate reactive phosphorus) exceeded 95% and the mean removal of ammonium-N exceeded 98%. This paper reviews evidence regarding the capacity of ICWs to provide a coherent and sustainable alternative to conventional systems.

  18. Nuclear power plant Angra integrated enterprise management system

    International Nuclear Information System (INIS)

    Andrade, Ronaldo Barata de

    2009-01-01

    The characteristics and peculiarities of the Nuclear Power Plant ANGRA 3 enterprise, amongst which its technical complexity, the size of the project and of the supplies of goods and services contracted for for the Brazilian and foreign scopes, the variety of contractors and participants involved in the implementation, associated with the need of integrated management of all the activities of the enterprise, requires the setting of standardized criteria and procedures to be adopted by the enterprise Project Management Team and by all involved ELETRONUCLEAR (ETN) Units, Suppliers and Contractors for Brazilian and foreign goods and services for the execution of the activities related to overall enterprise planning. These criteria and procedures aim at covering the five Project Management Process Groups: Initiating Process Group, Planning Process Group, Execution Process Group, Monitoring and Controlling Process Group and Closing Process Group. For the ANGRA 3 enterprise, ETN developed the Integrated Enterprise Management System - INTEGRA, being the software 'Primavera Enterprise Project Management' a fundamental part of this system. The aim of this paper is to describe the main concepts involving the ANGRA 3 enterprise management, and the integration between the processes, including all disciplines in all phases of the enterprise life cycle, such as: Nuclear and Environmental Licensing, Infrastructure, National and Foreign Engineering, National and Import Supplies, Civil Works, Electromechanical Erection, Commissioning. (author)

  19. Auditing supports the integration of management systems in the nuclear industry

    International Nuclear Information System (INIS)

    Beckmerhagen, I.A.; Berg, H.P.; Karapetrovic, S.V.; Willborn, W.O.

    2004-01-01

    Integration of function-specific management systems in organizations is rapidly becoming a topic of interest for managers and auditors alike. This is mainly due to the proliferation of management system standards that foster compliance with the stated criteria for quality, environmental, occupational health and safety, social responsibility and other function-specific aspects of performance. While most of the available literature on this topic focuses on the integration of standards, there is comparatively little information available on how to actually build an integrated system internally. This paper hypothesizes that, besides using audits for the implementation of the available procedures, audits can provide an excellent basis for these integration efforts. Therefore the prerequisites, strategies and resources necessary for an effective audit in support of integrated management systems are discussed. The paper also describes how audits are used to improve a combined quality and safety management system at the repository of radioactive waste in Morsleben (Germany). (authors)

  20. Feasibility of landfill gas as a liquefied natural gas fuel source for refuse trucks.

    Science.gov (United States)

    Zietsman, Josias; Bari, Muhammad Ehsanul; Rand, Aaron J; Gokhale, Bhushan; Lord, Dominique; Kumar, Sunil

    2008-05-01

    The purpose of this paper is to develop a methodology to evaluate the feasibility of using landfill gas (LFG) as a liquefied natural gas (LNG) fuel source for heavy-duty refuse trucks operating on landfills. Using LFG as a vehicle fuel can make the landfills more self-sustaining, reduce their dependence on fossil fuels, and reduce emissions and greenhouse gases. Acrion Technologies Inc. in association with Mack Trucks Inc. developed a technology to generate LNG from LFG using the CO2 WASH process. A successful application of this process was performed at the Eco Complex in Burlington County, PA. During this application two LNG refuse trucks were operated for 600 hr each using LNG produced from gases from the landfill. The methodology developed in this paper can evaluate the feasibility of three LFG options: doing nothing, electricity generation, and producing LNG to fuel refuse trucks. The methodology involved the modeling of several components: LFG generation, energy recovery processes, fleet operations, economic feasibility, and decision-making. The economic feasibility considers factors such as capital, maintenance, operational, and fuel costs, emissions and tax benefits, and the sale of products such as surplus LNG and food-grade carbon dioxide (CO2). Texas was used as a case study. The 96 landfills in Texas were prioritized and 17 landfills were identified that showed potential for converting LFG to LNG for use as a refuse truck fuel. The methodology was applied to a pilot landfill in El Paso, TX. The analysis showed that converting LFG to LNG to fuel refuse trucks proved to be the most feasible option and that the methodology can be applied for any landfill that considers this option.

  1. Integrating Sustainable Development into Operations Management Courses

    Science.gov (United States)

    Fredriksson, Peter; Persson, Magnus

    2011-01-01

    Purpose: It is widely acknowledged that aspects of sustainable development (SD) should be integrated into higher level operations management (OM) education. The aim of the paper is to outline the experiences gained at Chalmers University of Technology in Sweden from integrating aspects of SD into OM courses. Design/methodology/approach: The paper…

  2. Distribution Integrity Management Plant (DIMP)

    Energy Technology Data Exchange (ETDEWEB)

    Gonzales, Jerome F. [Los Alamos National Laboratory

    2012-05-07

    This document is the distribution integrity management plan (Plan) for the Los Alamos National Laboratory (LANL) Natural Gas Distribution System. This Plan meets the requirements of 49 CFR Part 192, Subpart P Distribution Integrity Management Programs (DIMP) for the LANL Natural Gas Distribution System. This Plan was developed by reviewing records and interviewing LANL personnel. The records consist of the design, construction, operation and maintenance for the LANL Natural Gas Distribution System. The records system for the LANL Natural Gas Distribution System is limited, so the majority of information is based on the judgment of LANL employees; the maintenance crew, the Corrosion Specialist and the Utilities and Infrastructure (UI) Civil Team Leader. The records used in this report are: Pipeline and Hazardous Materials Safety Administration (PHMSA) 7100.1-1, Report of Main and Service Line Inspection, Natural Gas Leak Survey, Gas Leak Response Report, Gas Leak and Repair Report, and Pipe-to-Soil Recordings. The specific elements of knowledge of the infrastructure used to evaluate each threat and prioritize risks are listed in Sections 6 and 7, Threat Evaluation and Risk Prioritization respectively. This Plan addresses additional information needed and a method for gaining that data over time through normal activities. The processes used for the initial assessment of Threat Evaluation and Risk Prioritization are the methods found in the Simple, Handy Risk-based Integrity Management Plan (SHRIMP{trademark}) software package developed by the American Pipeline and Gas Agency (APGA) Security and Integrity Foundation (SIF). SHRIMP{trademark} uses an index model developed by the consultants and advisors of the SIF. Threat assessment is performed using questions developed by the Gas Piping Technology Company (GPTC) as modified and added to by the SHRIMP{trademark} advisors. This Plan is required to be reviewed every 5 years to be continually refined and improved. Records

  3. Pediatric transplantation using hearts refused on the basis of donor quality.

    Science.gov (United States)

    Bailey, Leonard L; Razzouk, Anees J; Hasaniya, Nahidh W; Chinnock, Richard E

    2009-06-01

    There is always more demand than supply of organs in pediatric heart transplantation. Yet, potential donor organs are regularly declined for a variety of reasons, among them donor organ quality as determined by United Network for Organ Sharing (UNOS) refusal code 830 or its equivalent. For the study group institutional and UNOS databases (July 2000 to December 2008) were reviewed to examine outcomes of pediatric heart transplantation using donor hearts that had been previously refused one or more times because of organ quality. Variation between outcomes of this cohort and recipients who received primarily offered heart grafts in a single institution was analyzed. In 29 recipients, transplantation or retransplantation was with heart grafts previously declined on the basis of quality. Recovery distances (p actuarial survival was 74% +/- 10.5%. At the present time, 24 of the 29 recipients (83%) are alive. These results do not vary statistically from those experienced by 84 recipients of 86 primarily offered donor organs during the same time. Despite longer distance recovery (ie, longer graft cold ischemic times), outcomes of pediatric heart transplantation using donor heart grafts refused on the basis of organ quality are highly competitive. Pediatric donor hearts should seldom be declined on the basis of organ quality (UNOS code 830).

  4. Emissions from co-combustion of wood and household refuse

    International Nuclear Information System (INIS)

    Zhang, X.J.; Peterson, F.

    1996-01-01

    An investigation was carried out on the emissions produced in a 20 kW experimental boiler burning a combination of wood and household refuse. The wood content ranged form 10 to 50%. Direct sampling with Tenax adsorbent was used to cover a range of volatile organic compounds (VOCs). The measurements also included unburned hydrocarbons, carbon monoxide, carbon dioxide, oxygen and flue gas temperature. Combustion and emission parameters were recorded continuously with a multi-point data logger. VOCs were analyzed by gas chromatography and mass spectrometer (GC/MS). The main emphasis was placed on the effect of wood on VOC emissions. The results showed that as the wood content increased from 10 to 50%, there was a roughly linear increase in emissions of total VOCs. Carbon monoxide and unburned hydrocarbon emissions also increased. These results suggest that household refuse is a good substitute for wood as a boiler fuel, as it has a similar calorific value but fewer emissions. (Author)

  5. Bacteria and Acidic Drainage from Coal Refuse: Inhibition by Sodium Lauryl Sulfate and Sodium Benzoate

    Science.gov (United States)

    Dugan, Patrick R.; Apel, William A.

    1983-01-01

    The application of an aqueous solution of sodium lauryl sulfate and sodium benzoate to the surface of high-sulfur coal refuse resulted in the inhibition of iron-and sulfur-oxidizing chemoautotrophic bacteria and in the decrease of acidic drainage from the refuse, suggesting that acid drainage can be abated in the field by inhibiting iron- and sulfur-oxidizing bacteria. PMID:16346347

  6. Space station operations task force. Panel 4 report: Management integration

    Science.gov (United States)

    1987-01-01

    The Management Integration Panel of the Space Station Operations Task Force was chartered to provide a structure and ground rules for integrating the efforts of the other three panels and to address a number of cross cutting issues that affect all areas of space station operations. Issues addressed include operations concept implementation, alternatives development and integration process, strategic policy issues and options, and program management emphasis areas.

  7. Thinking through Moments of Sexual Refusal in "Looking for Alibrandi" and "The Rage in Placid Lake"

    Science.gov (United States)

    Clarke, Kyra

    2016-01-01

    This paper explores two scenarios in which young women refuse the sexual advances of young men in the films "Looking for Alibrandi" and "The Rage in Placid Lake." The paper highlights the heteronormative nature of education around refusing sex, which reinstates gendered stereotypes of masculine as active and feminine as…

  8. The nexus between integrated natural resources management and integrated water resources management in southern Africa

    Science.gov (United States)

    Twomlow, Stephen; Love, David; Walker, Sue

    The low productivity of smallholder farming systems and enterprises in the drier areas of the developing world can be attributed mainly to the limited resources of farming households and the application of inappropriate skills and practices that can lead to the degradation of the natural resource base. This lack of development, particularly in southern Africa, is of growing concern from both an agricultural and environmental perspective. To address this lack of progress, two development paradigms that improve land and water productivity have evolved, somewhat independently, from different scientific constituencies. One championed by the International Agricultural Research constituency is Integrated Natural Resource Management (INRM), whilst the second championed predominantly by Environmental and Civil Engineering constituencies is Integrated Water Resources Management (IWRM). As a result of similar objectives of working towards the millennium development goals of improved food security and environmental sustainability, there exists a nexus between the constituencies of the two paradigms, particularly in terms of appreciating the lessons learned. In this paper lessons are drawn from past INRM research that may have particular relevance to IWRM scientists as they re-direct their focus from blue water issues to green water issues, and vice-versa. Case studies are drawn from the management of water quality for irrigation, green water productivity and a convergence of INRM and IWRM in the management of gold panning in southern Zimbabwe. One point that is abundantly clear from both constituencies is that ‘one-size-fits-all’ or silver bullet solutions that are generally applicable for the enhancement of blue water management/formal irrigation simply do not exist for the smallholder rainfed systems.

  9. Integrated Data for Improved Asset Management

    Science.gov (United States)

    2016-05-26

    The objective of this research is to demonstrate the potential benefits for agency-wide data integration for VDOT asset management. This objective is achieved through an example application that requires information distributed across multiple databa...

  10. Transitional paternalism: how shared normative powers give rise to the asymmetry of adolescent consent and refusal.

    Science.gov (United States)

    Manson, Neil C

    2015-02-01

    In many jurisdictions, adolescents acquire the right to consent to treatment; but in some cases their refusals - e.g. of life-saving treatment - may not be respected. This asymmetry of adolescent consent and refusal seems puzzling, even incoherent. The aim here is to offer an original explanation, and a justification, of this asymmetry. Rather than trying to explain the asymmetry in terms of a variable standard of competence - where the adolescent is competent to consent to, but not refuse, certain interventions - the account offered here focuses more closely on the normative power to render actions permissible. Where normative powers are shared they can readily give rise to an asymmetry between consent and refusal. We then turn to why it is justifiable that normative powers be shared in adolescence. Transitional paternalism holds that the acquisition of normative powers by competent adolescents should not be an instant one, achieved in a single step, but that there should be a transitional period where paternalistic protection is rolled back, but not entirely withdrawn until a later date. Transitional paternalism could be implemented without generating the asymmetry between consent and refusal but, it is argued, the asymmetric version of transitional paternalism is to be preferred insofar as it offers a greater respect for the adolescent's decisions than the symmetrical alternative. © 2014 John Wiley & Sons Ltd.

  11. Integrated Climate Smart Flood Management for Accra, Ghana ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Home · What we do ... The research team will use evidence to develop an integrated climate smart flood management framework to support policymaking. ... The Ministry of Environment, Science, Technology, and Innovation will manage the ...

  12. Integrated groundwater management: An overview of concepts and challenges

    Science.gov (United States)

    Jakeman, Anthony J.; Barreteau, Olivier; Hunt, Randall J.; Rinaudo, Jean-Daniel; Ross, Andrew; Jakeman, Anthony J.; Barreteau, Olivier; Hunt, Randall J.; Rinaudo, Jean-Daniel; Ross, Andrew

    2016-01-01

    Managing water is a grand challenge problem and has become one of humanity’s foremost priorities. Surface water resources are typically societally managed and relatively well understood; groundwater resources, however, are often hidden and more difficult to conceptualize. Replenishment rates of groundwater cannot match past and current rates of depletion in many parts of the world. In addition, declining quality of the remaining groundwater commonly cannot support all agricultural, industrial and urban demands and ecosystem functioning, especially in the developed world. In the developing world, it can fail to even meet essential human needs. The issue is: how do we manage this crucial resource in an acceptable way, one that considers the sustainability of the resource for future generations and the socioeconomic and environmental impacts? In many cases this means restoring aquifers of concern to some sustainable equilibrium over a negotiated period of time, and seeking opportunities for better managing groundwater conjunctively with surface water and other resource uses. However, there are many, often-interrelated, dimensions to managing groundwater effectively. Effective groundwater management is underpinned by sound science (biophysical and social) that actively engages the wider community and relevant stakeholders in the decision making process. Generally, an integrated approach will mean “thinking beyond the aquifer”, a view which considers the wider context of surface water links, catchment management and cross-sectoral issues with economics, energy, climate, agriculture and the environment. The aim of the book is to document for the first time the dimensions and requirements of sound integrated groundwater management (IGM). The primary focus is on groundwater management within its system, but integrates linkages beyond the aquifer. The book provides an encompassing synthesis for researchers, practitioners and water resource managers on the concepts and

  13. Ergonomics Integration Omproving Production Process Management in Enterprises of Latvia

    OpenAIRE

    Henrijs Kaļķis

    2013-01-01

    Dotoral thesis ERGONOMICS INTEGRATION IMPROVING PRODUCTION PROCESS MANAGEMENT IN ENTERPRISES OF LATVIA ANNOTATION Ergonomics integration in process management has great significance in organisations` growth of productivity. It is a new approach to entrepreneurship and business strategy, where ergonomic aspects and values are taken into account in ensuring the effective process management and profitability of enterprises. This study is aimed at solution of the problem of e...

  14. The Integrated Mode Management Interface

    Science.gov (United States)

    Hutchins, Edwin

    1996-01-01

    Mode management is the processes of understanding the character and consequences of autoflight modes, planning and selecting the engagement, disengagement and transitions between modes, and anticipating automatic mode transitions made by the autoflight system itself. The state of the art is represented by the latest designs produced by each of the major airframe manufacturers, the Boeing 747-400, the Boeing 777, the McDonnell Douglas MD-11, and the Airbus A320/A340 family of airplanes. In these airplanes autoflight modes are selected by manipulating switches on the control panel. The state of the autoflight system is displayed on the flight mode annunciators. The integrated mode management interface (IMMI) is a graphical interface to autoflight mode management systems for aircraft equipped with flight management computer systems (FMCS). The interface consists of a vertical mode manager and a lateral mode manager. Autoflight modes are depicted by icons on a graphical display. Mode selection is accomplished by touching (or mousing) the appropriate icon. The IMMI provides flight crews with an integrated interface to autoflight systems for aircraft equipped with flight management computer systems (FMCS). The current version is modeled on the Boeing glass-cockpit airplanes (747-400, 757/767). It runs on the SGI Indigo workstation. A working prototype of this graphics-based crew interface to the autoflight mode management tasks of glass cockpit airplanes has been installed in the Advanced Concepts Flight Simulator of the CSSRF of NASA Ames Research Center. This IMMI replaces the devices in FMCS equipped airplanes currently known as mode control panel (Boeing), flight guidance control panel (McDonnell Douglas), and flight control unit (Airbus). It also augments the functions of the flight mode annunciators. All glass cockpit airplanes are sufficiently similar that the IMMI could be tailored to the mode management system of any modern cockpit. The IMMI does not replace the

  15. Lime helps establish crownvetch on coal-breaker refuse

    Science.gov (United States)

    Miroslaw M. Czapowskyj; Edward A. Sowa

    1976-01-01

    A study was begun in 1965 to determine the effect of lime fertilizer, and mulch on the establishment and growth of crownvetch crowns planted on anthracite coal-breaker refuse. After 7 years the lime application had by far the strongest effect. Both 2.5 and 5.0 tons per acre increased survival and ground cover manyfold, and both treatments were equally beneficial from...

  16. [Refusal of care and respect of the body].

    Science.gov (United States)

    Bernard, Marie-Fleur

    Patients receive numerous care procedures which they may refuse for physical and/or psychological reasons, even if, sometimes, the consequences for them can be dramatic. Faced with this situation, caregivers are helpless. Only ethical reflection centred on their responsibility and their humanity can guide them towards the suitable attitude to adopt. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  17. Correlates of HIV testing refusal among emergency department patients in the opt-out testing era.

    Science.gov (United States)

    Setse, Rosanna W; Maxwell, Celia J

    2014-05-01

    Opt-out HIV screening is recommended by the CDC for patients in all healthcare settings. We examined correlates of HIV testing refusal among urban emergency department (ED) patients. Confidential free HIV screening was offered to 32,633 ED patients in an urban tertiary care facility in Washington, DC, during May 2007-December 2011. Demographic differences in testing refusals were examined using χ(2) tests and generalized linear models. HIV testing refusal rates were 47.7 % 95 % CI (46.7-48.7), 11.7 % (11.0-12.4), 10.7 % (10.0-11.4), 16.9 % (15.9-17.9) and 26.9 % (25.6-28.2) in 2007, 2008, 2009, 2010 and 2011 respectively. Persons 33-54 years of age [adjusted prevalence ratio (APR) 1.42, (1.36-1.48)] and those ≥ 55 years [APR 1.39 (1.31-1.47)], versus 33-54 years; and females versus males [APR 1.07 (1.02-1.11)] were more likely to refuse testing. Opt-out HIV testing is feasible and sustainable in urban ED settings. Efforts are needed to encourage testing among older patients and women.

  18. Integrating environment health and safety management at Petro-Canada

    International Nuclear Information System (INIS)

    Raymond, G.

    1993-01-01

    Petro-Canada has developed a tool to integrate, measure, and improve its management systems of environment, health, and safety (EH ampersand S). This tool, called the Total Loss Management System, is described in the areas of general management issues, policies and procedures, evaluations, organization, stewardship, issue management, and performance measures. Petro-Canada's policies on occupational health and safety are consistent with its environmental policy, being structured in the same way. An integrated audit system is used to cover health, safety, industrial hygiene, reliability, environment, and risk management. EH ampersand S matters are integrated at the corporate level in a separate department. Regional divisions review EH ampersand S performance every month, incidents are discussed, and preventive measures are taken as necessary. Regional performances are combined every quarter for ultimate presentation to the Petro-Canada board. New or emerging issues that may affect divisions are assigned an issue sponsor, a member of divisional management who makes sure the issue receives the resources necessary to study and define its impact. Examples of issues include soil contamination, process hazard management, and benzene exposure limits. Performance measures flow from the corporate environment and occupational health and safety policies, and come in two types: those that measure activities to improve performance and those that measure the outcome of the activities

  19. Integrated information and logistics management, quality management and firm performance of pork processing industry in China

    NARCIS (Netherlands)

    Han, J.; Trienekens, J.H.; Omta, S.W.F.

    2009-01-01

    Purpose – This paper seeks to discuss the interactions amongst integrated information technology (IT), integrated logistics management, quality management practices and firm performance of pork processors in China. Design/methodology/approach – A conceptual framework was developed by examining the

  20. INTEGRATED SAFETY MANAGEMENT SYSTEM IN AIR TRAFFIC SERVICES

    Directory of Open Access Journals (Sweden)

    Volodymyr Kharchenko

    2014-06-01

    Full Text Available The article deals with the analysis of the researches conducted in the field of safety management systems.Safety management system framework, methods and tools for safety analysis in Air Traffic Control have been reviewed.Principles of development of Integrated safety management system in Air Traffic Services have been proposed.

  1. 49 CFR 195.452 - Pipeline integrity management in high consequence areas.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Pipeline integrity management in high consequence... Management § 195.452 Pipeline integrity management in high consequence areas. (a) Which pipelines are covered... that could affect a high consequence area, including any pipeline located in a high consequence area...

  2. Effects of top management involvement in integrated marketing communications

    Directory of Open Access Journals (Sweden)

    Nina Hočevar

    2007-12-01

    Full Text Available There is scarce empirical evidence in the academic literature of how top management involvement influences the degree of integrated marketing communications. At the same time, some authors believe that this relationship should be explored more extensively.In this paper we present one possible approach to investigating the relationship between top management involvement and the degree of integrated marketing communications. Our research established that a greater involvement of top management in marketing communications could be associated with a higher degree of IMC. Investigating the relationship between management and IMC is indeed at a very early stage. We suggest that this study has provided a basis for future research on the relationship between top management involvement in marketing communications and the degree of IMC.

  3. Integrated management system implementation strategy for PUSPATI TRIGA Reactor

    International Nuclear Information System (INIS)

    Phongsakorn Prak Tom; Shaharum Ramli; Mohamad Azman Che Mat Isa; Shahirah Abdul Rahman; Mohd Zaid Mohamed; Mat Zin Mat Husin; Nurfazila Husain; Mohamad Puad Abu

    2012-01-01

    Integrated Management System (IMS) designed to fulfil the requirements integrates safety, health, environmental, security, quality and economic elements. PUSPATI TRIGA Reactor (RTP) is currently implementing the Quality Assurance Program (QAP) and looking toward implementation of IMS. This paper discussed the implementation strategy of IMS for RTP. There are nine steps of IMS implementation strategy. In implementation of IMS, Gantt chart is useful project management tool in managing the project frame work. IMS is intended as a tool to enable the continuous development of safety culture and achieve higher safety levels. (author)

  4. [School refusal and dropping out of school: positioning regarding a Swiss perspective].

    Science.gov (United States)

    Walitza, Susanne; Melfsen, Siebke; Della Casa, André; Schneller, Lena

    2013-01-01

    This article deals with refusal to attend school and dropping out of school from the point of view of child and adolescent psychiatry and psychology, in German speaking countries and from the perspective of Swiss schools and their administrative bodies. General epidemiological data on refusal to attend school show that approximately 5% of children and adolescents are likely to try to avoid attending school at some point. There is very little data available on the frequency of school drop-out. In the past two years (2011 and 2012), approximately 2% of all patients seen for the first time at the department of Child and Adolescent Psychiatry, University Zurich, were referred because of failure to attend school, making this phenomenon one of the most common reasons for referral in child and adolescent psychiatry. After a discussion of the epidemiology, symptomatology, causes and its risk factors, the article presents examples drawn from practice and guidelines for intervention in cases of refusal to attend school, and discusses ways of preventing school drop-out from the point of view of schools, hospitals and bodies such as educational psychology services in Switzerland.

  5. Integrated Services Management System (ISMS): A management and decision making tool

    Energy Technology Data Exchange (ETDEWEB)

    Barber, D.S.; Brockman, D.L.; Buxton, L.D. [and others

    1995-10-01

    This document provides information concerning the Integrated Services Management System (ISMS) that was developed for the Laboratories Services Division during the period February 1994 through May 1995. ISMS was developed as a formal method for centralized management of programs within the Division. With minor modifications, this system can be adapted for management of all overhead functions at SNL or for sector level program management. Included in this document are the reasons for the creation of this system as well as the resulting benefits. The ISMS consists of six interlinked processes; Issues Management, Task/Activity Planning, Work Decision, Commitment Management, Process/Project Management, and Performance Assessment. Those processes are described in detail within this document. Additionally, lessons learned and suggestions for future improvements are indicated.

  6. Toward integrated design of waste management technologies

    International Nuclear Information System (INIS)

    Carnes, S.A.; Wolfe, A.K.

    1994-01-01

    Implementation of waste management technologies has been hindered by the intervention of diverse interests. Relying on a perceived history of inadequate and improper management, operations, and technological design, critics have stymied the implementation of scientifically and governmentally approved technologies and facilities, leading to a critical shortage of hazardous, mixed, and radioactive waste management capacity. The research and development (R ampersand D) required to identify technologies that are simultaneously (1) scientifically valid, (2) economically sound, and (3) publicly acceptable must necessarily address, in an integrated and interdisciplinary manner, these three criteria and how best to achieve the integration of stakeholders early in the technology implementation process (i.e., R ampersand D, demonstration, and commercialization). The goal of this paper is to initiate an identification of factors likely to render radioactive and hazardous waste management technologies publicly acceptable and to provide guidance on how technological R ampersand D might be revised to enhance the acceptability of alternative waste management technologies. Principal among these factors are the equitable distribution of costs, risks, and benefits of waste management policies and technologies, the equitable distribution of authority for making waste management policy and selecting technologies for implementation, and the equitable distribution of responsibility for resolving waste management problems. Stakeholder participation in assessing the likely distribution of these factors and mitigative mechanisms to enhance their equitable distribution, together with stakeholder participation in policy and technology R ampersand D, as informed by stakeholder assessments, should enhance the identification of acceptable policies and technologies

  7. Integrated corridor management : phase I, concept development and foundational research. Task 3.4, identify integrated corridor management institutional strategies and administration

    Science.gov (United States)

    2006-04-12

    Task 3 involves overall foundational research to further the understanding of various aspects of Integrated Corridor Management (ICM) and to identify integration issues needed to evaluate the feasibility of the ICM initiative. The focus of Task 3.4 a...

  8. Integrated Pest Management: A Curriculum for Early Care and Education Programs

    Science.gov (United States)

    California Childcare Health Program, 2011

    2011-01-01

    This "Integrated Pest Management Toolkit for Early Care and Education Programs" presents practical information about using integrated pest management (IPM) to prevent and manage pest problems in early care and education programs. This curriculum will help people in early care and education programs learn how to keep pests out of early…

  9. Constructive and Destructive Aspects of Refusal from Communication

    Directory of Open Access Journals (Sweden)

    Marianna A. Gulyaeva

    2016-12-01

    Full Text Available The article investigates the phenomenon of refusal from communication in terms of its positive and negative impact, both on the communicative process, and interpersonal relationships in general. It has been analyzed several aspects of the failure to communicate with positive communication position. The identification of constructive or destructive potential was carried out on the basis of three parameters such as productivity/ unproductive conflict resolution with the help of avoiding communication, the choice of an optimum way of non-communication and its role in the communication process on the basis of the functions performed by them. Failure to communicate is often perceived negatively and is considered an inefficient form of communication, so it does not allow to solve interpersonal conflicts. This article discusses the circumstances where refusal from communication advocates an effective way to avoid conflict. In situations where the termination of communication is inevitable, a fundamental factor for the positive, harmonious form of communication acts interrupting the communication process. Functioning in the communicative space, failure to communicate can either destroy an interaction and relationship between the partners, and regulate the communication process by guiding in the right direction, coordinating the behavior of communication.

  10. [Refusal of care in the intensive care: how makes decision?].

    OpenAIRE

    Borel , Marie; Veber , Benoit; Villette-Baron , Karen; Hariri , S.; Dureuil , Bertrand; Hervé , Christian

    2009-01-01

    International audience; It is not a question of going towards a systematic admission in intensive care of any patient proposed, but to make sure that so if there is a refusal, it is carried out according to a step ethically acceptable.

  11. Design Integration of Facilities Management

    DEFF Research Database (Denmark)

    Jensen, Per Anker

    2009-01-01

    One of the problems in the building industry is a limited degree of learning from experiences of use and operation of existing buildings. Development of professional facilities management (FM) can be seen as the missing link to bridge the gap between building operation and building design....... Strategies, methods and barriers for the transfer and integration of operational knowledge into the design process are discussed. Multiple strategies are needed to improve the integration of FM in design. Building clients must take on a leading role in defining and setting up requirements and procedures...... on literature studies and case studies from the Nordic countries in Europe, including research reflections on experiences from a main case study, where the author, before becoming a university researcher, was engaged in the client organization as deputy project director with responsibility for the integration...

  12. IMPLEMENTATION OF INTEGRAL SYSTEM OF QUALITY MANAGEMENT IN TOURISM

    Directory of Open Access Journals (Sweden)

    Vidoje Vujic

    2007-12-01

    Full Text Available Theory and practice have corroborated the need and usefulness of an integral approach to quality management in tourist destinations, since the destination and its touristic offer define a number of disparate participants and interested parties. An integral system of quality management is one of the models of touristic management that with the implementation of contemporary principles strives to achieve business excellence and competitory advantage. The paper determines and projects the need and importance of implementing an integral system and accordingly seeks to form a model for its development. By studying the oneness of the whole we have established the dependence and firm connections between particular norms and elements, and by analyzing them in this paper we describe the structure and associated characteristics of the whole.

  13. Development and design of an integrated information management system for safe management of radioactive waste

    Energy Technology Data Exchange (ETDEWEB)

    Son, Dong Chan; Hong, Suk Young; An, Kyoung Il [Daesang Information Technology Co., Ltd., Seoul (Korea, Republic of)

    2004-05-15

    An integrated data management system for the safe management of radioactive waste and spent fuel in Korea is developed to collect basic information, provide the framework for national regulation, and improve national competition and efficiency in the management of radioactive waste and spent fuel. This system can also provide public access to information such as a statistical graphs and integrated data from various waste generators to meet increased public needs and interests. Objectives can be summarized as; the five principles (independence, openness, clearance, efficiency and reliance) of safety regulation can be realized. Public understanding and reliance on the safety of spent fuel and radioactive waste management can be promoted by providing reliable information. Ensure an openness within the international nuclear community and efficiently support international agreements among contracting parties by operating safe and efficient management of spent fuel and radioactive waste (IAEA joint convention on the safety of spent fuel management and on the safety of radioactive waste management). The system can compensate for the imperfections In safe regulation of radioactive waste and spent fuel management related to waste generation, storage and disposal, and make it possible to holistic control. Re-organize the basic framework of KINS's intermediate and long term research organization and trends, regarding waste management policy is to integrate safe management and unit safe disposal.

  14. Development and design of an integrated information management system for safe management of radioactive waste

    International Nuclear Information System (INIS)

    Son, Dong Chan; Hong, Suk Young; An, Kyoung Il

    2004-05-01

    An integrated data management system for the safe management of radioactive waste and spent fuel in Korea is developed to collect basic information, provide the framework for national regulation, and improve national competition and efficiency in the management of radioactive waste and spent fuel. This system can also provide public access to information such as a statistical graphs and integrated data from various waste generators to meet increased public needs and interests. Objectives can be summarized as; the five principles (independence, openness, clearance, efficiency and reliance) of safety regulation can be realized. Public understanding and reliance on the safety of spent fuel and radioactive waste management can be promoted by providing reliable information. Ensure an openness within the international nuclear community and efficiently support international agreements among contracting parties by operating safe and efficient management of spent fuel and radioactive waste (IAEA joint convention on the safety of spent fuel management and on the safety of radioactive waste management). The system can compensate for the imperfections In safe regulation of radioactive waste and spent fuel management related to waste generation, storage and disposal, and make it possible to holistic control. Re-organize the basic framework of KINS's intermediate and long term research organization and trends, regarding waste management policy is to integrate safe management and unit safe disposal

  15. The moderating role of risk-taking tendency and refusal assertiveness on social influences in alcohol use among inner-city adolescents.

    Science.gov (United States)

    Epstein, Jennifer A; Botvin, Gilbert J

    2002-07-01

    Many etiological models of adolescent alcohol use concentrate on the main effects of risk and protective factors. This study examined the moderating influence of risk-taking tendency and refusal assertiveness on perceived friends' drinking as associated with alcohol use among inner-city adolescents. Participants (N = 2,400; 54% female) completed questionnaires that included measures of risk-taking tendency, refusal assertiveness, perceived friends' drinking and alcohol use (drinking frequency, drinking amount and drunkenness). Main effects for perceived friends' drinking, risk-taking tendency and refusal assertiveness were found for all three drinking measures, consistent with prior work. Furthermore, significant interactions were found between (1) risk-taking tendency and perceived friends' drinking and (2) refusal assertiveness and perceived friends' drinking. High risk-taking tendency and low refusal assertiveness increased the impact of perceived friends' drinking on alcohol use among inner-city adolescents. This suggests that these factors are important components in preventing alcohol use.

  16. Integrated pest management - an overview and update

    Science.gov (United States)

    Thomas D. Landis; R. Kasten Dumroese

    2014-01-01

    Integrated pest management, better known as IPM, is a familiar term for those of us working in forest, conservation, and native plant nurseries. An almost synonymous concept is "holistic pest management" that has been the topic of chapters in recent Agriculture Handbooks that would be useful to growers of native plants (see Landis and others 2009; Landis and...

  17. Comparative Study on Characteristics and Potential of Rice Straws and Dry Leaves as a Binder in Refuse Derived Fuel (RDF)

    International Nuclear Information System (INIS)

    Zulhafizal Othman; Lias, K.; Hashim, N.H.; Clement, F.N.

    2013-01-01

    Integrated waste management systems are one of the greatest challenges in order to develop the green environment. In this research, two types of binder were chosen in producing of Refuse Derived Fuel (RDF) which is rice straws and dry leaves. The objective of the research is to identify which types of binder that can give the optimum performance. This two binder was mixed with paper and plastic waste with controlled mixing ratio which is 3:1 (ratio 1), 3:1.5(ratio 2) and 3:2 (ratio 3). In order to identify the optimum ratio of RDF, 45 number of samples was prepared and their properties such as moisture content, carbon content, sulfur content, chlorine content and calorific value were evaluated. Result indicated that samples with rice straw as a binder give the optimum result with the ratio of 3:1. The optimum values of the carbon content is 50.9 %, moisture content is 5.5 %, chlorine content is 0.0 %, sulfur content is 2.1 % and calorific value is 29.0 MJ/ kg. Hence, rice straws shows a great potential to be used as binder in production of RDF. (author)

  18. Corporate Motivation for Integrated Management System Implementation, Why do Firms Engage in Integration of Management Systems: A Literature Review & Research Agenda

    NARCIS (Netherlands)

    Asif, M.; Asif, M.; de Bruijn, E.J.; Fisscher, O.A.M.

    2008-01-01

    Integration of management systems such as for quality, environment, occupational health and safety, risk management, and corporate social responsibilities is a viable organisational approach to cost reduction, efficient utilization of resources, greater motivation of employees, and better compliance

  19. Integral system of management quality - company quality assurance

    International Nuclear Information System (INIS)

    Dimitrovski, Aleksandar

    1999-01-01

    Integral System of Management Quality is imposed as a solution which in the future will be applied in the companies more frequently, provoked from the needs for solving management quality, working conditions, ecology, safety at work, way of leaving, etc. (Original)

  20. INTEGRATED WATERSHED MANAGEMENT: PRINCIPLES AND PRACTICE. Book Review

    Science.gov (United States)

    Through a wide range of information and topics, Integrated Watershed Management Principles and Practice shows how involved the watershed management planning process can be. The book is informative, and the author obviously has researched the subject thoroughly. The book's case...

  1. Integrated nutrients management for 'desi' cotton

    International Nuclear Information System (INIS)

    Qazi, M.A.; Akram, M.; Ahmad, N.; Khattak, M.A.

    2007-01-01

    Intensive cropping with no return of crop residues and other organic inputs result in the loss of soil organic matter (SOM) and nutrient supply in (Desi) cotton-wheat cropping system in Pakistan. For appraisal of problem and finding solution to sustainability, we evaluated six treatments comprised of two fertilizer doses and three management techniques over a period of three years (2003-05) monitoring their effects on seed cotton yield and soil fertility. The techniques included chemical fertilizers, municipal solid waste manure (MSWM) integrated with chemical fertilizers in 1:4 ratios with, and without pesticides. The results revealed that cotton yields. Were enhanced by 19% due to site-specific fertilizer dose over conventional dose. Ignoring weeds control by means of herbicided application resulted in 5% decrease of seed cotton yield in IPNM technique positive effect of MSWM integration was noted on soil test phosphorus and SOM. Site-specific fertilizer application and integrated plant nutrient management by MSWM proved their suitability as the techniques not only improve soil quality in terms of sustained levels of organic matter and phosphorus but also provide a safe way of waste disposal. (author)

  2. Supply Chain Management and Sustainability: Procrastinating Integration in Mainstream Research

    Directory of Open Access Journals (Sweden)

    Marisa P. de Brito

    2010-03-01

    Full Text Available Research has pointed out opportunities and research agendas to integrate sustainability issues with supply chain and operations management. However, we find that it is still not mainstream practice to systematically take a sustainability approach in tackling supply chain and operations management issues. In this paper, we make use of behavioral theory to explain the current lack of integration. We conclude through abductive reasoning that the reasons for procrastinating integration of sustainability in supply chain and operations management research are the conflicting nature of the task and the inherent context, which is the focus on operations rather than environmental or social issues.

  3. An investigation on the fuel savings potential of hybrid hydraulic refuse collection vehicles.

    Science.gov (United States)

    Bender, Frank A; Bosse, Thomas; Sawodny, Oliver

    2014-09-01

    Refuse trucks play an important role in the waste collection process. Due to their typical driving cycle, these vehicles are characterized by large fuel consumption, which strongly affects the overall waste disposal costs. Hybrid hydraulic refuse vehicles offer an interesting alternative to conventional diesel trucks, because they are able to recuperate, store and reuse braking energy. However, the expected fuel savings can vary strongly depending on the driving cycle and the operational mode. Therefore, in order to assess the possible fuel savings, a typical driving cycle was measured in a conventional vehicle run by the waste authority of the City of Stuttgart, and a dynamical model of the considered vehicle was built up. Based on the measured driving cycle and the vehicle model including the hybrid powertrain components, simulations for both the conventional and the hybrid vehicle were performed. Fuel consumption results that indicate savings of about 20% are presented and analyzed in order to evaluate the benefit of hybrid hydraulic vehicles used for refuse collection. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. The innovation and practice of management improved by integration management information system in nuclear enterprise

    International Nuclear Information System (INIS)

    Zhang Fan; Cheng Lihong; Li Qisheng; Ge Zhengfa

    2012-01-01

    This article expounds that Hunan Taohuajiang Nuclear Power Company generally programs the route of company's core business and implements its integration through referencing the experience of informationization construction of other enterprises at the beginning of the foundation of this company, and summarizes the experience of system construction and analyses the innovation and signification of the integrative management information system to the nu- clear power enterprise management from data unified, resources sharing and business electronic and the management improvement of this company. (authors)

  5. [Anorexia and refusal to eat in the elderly].

    Science.gov (United States)

    Hazif-Thomas, Cyril; Thomas, Philippe

    2016-01-01

    The question of the links between anorexia and the refusal to eat in the elderly is often the cause of major difficulties with regard to therapeutic strategies within caregiving teams. Likewise, few studies have been carried out into the diachronic links between teenage anorexia and that of the elderly. The role of the multi-disciplinary team is essential. Copyright © 2015. Published by Elsevier Masson SAS.

  6. Integrated tracking, classification, and sensor management theory and applications

    CERN Document Server

    Krishnamurthy, Vikram; Vo, Ba-Ngu

    2012-01-01

    A unique guide to the state of the art of tracking, classification, and sensor management. This book addresses the tremendous progress made over the last few decades in algorithm development and mathematical analysis for filtering, multi-target multi-sensor tracking, sensor management and control, and target classification. It provides for the first time an integrated treatment of these advanced topics, complete with careful mathematical formulation, clear description of the theory, and real-world applications. Written by experts in the field, Integrated Tracking, Classification, and Sensor Management provides readers with easy access to key Bayesian modeling and filtering methods, multi-target tracking approaches, target classification procedures, and large scale sensor management problem-solving techniques.

  7. [Management, quality of health and occupational safety and hospital organization: is integration possible?].

    Science.gov (United States)

    Corrao, Carmela Romana Natalina

    2011-01-01

    The evolution of the national and European legislation has progressively transformed the working environments into organized environments. Specific models for its management are being proposed, which should be integrated into general management strategies. In the case of hospitals this integration should consider the peculiar organizational complexity, where the management of the occupational risk needs to be integrated with clinical risk management and economic risk management. Resources management should also consider that Occupational Medicine has not a direct monetary benefit for the organisation, but only indirect health consequences in terms of reduction of accidents and occupational diseases. The deep and simultaneous analysis of the current general management systems and the current management methods of occupational safety and health protection allows one to hyphotesise a possible integration between them. For both of them the Top Management is the main responsible of the quality management strategies and the use of specific documents in the managerial process, such as the document of risks evaluation in the occupational management and the quality manual in the general management, is of paramount importance. An integrated management has also the scope to pursue a particular kind of quality management, where ethics and job satisfaction are innovative, as established by recent European guidelines, management systems and national legislations.

  8. RISK MANAGEMENT: AN INTEGRATED APPROACH TO RISK MANAGEMENT AND ASSESSMENT

    Directory of Open Access Journals (Sweden)

    Szabo Alina

    2012-12-01

    Full Text Available Purpose: The objective of this paper is to offer an overview over risk management cycle by focusing on prioritization and treatment, in order to ensure an integrated approach to risk management and assessment, and establish the ‘top 8-12’ risks report within the organization. The interface with Internal Audit is ensured by the implementation of the scoring method to prioritize risks collected from previous generated risk report. Methodology/approach: Using evidence from other research in the area and the professional expertise, this article outlines an integrated approach to risk assessment and risk management reporting processes, by separating the risk in two main categories: strategic and operational risks. The focus is on risk prioritization and scoring; the final output will comprise a mix of strategic and operational (‘top 8-12’ risks, which should be used to establish the annual Internal Audit plan. Originality/value: By using an integrated approach to risk assessment and risk management will eliminate the need for a separate Internal Audit risk assessment over prevailing risks. It will reduce the level of risk assessment overlap by different functions (Tax, Treasury, Information System over the same risk categories as a single methodology, is used and will align timings of risk assessment exercises. The risk prioritization by usage of risk and control scoring criteria highlights the combination between financial and non-financial impact criteria allowing risks that do not naturally lend themselves to a financial amount to be also assessed consistently. It is emphasized the usage of score method to prioritize the risks included in the annual audit plan in order to increase accuracy and timelines.

  9. [Application of supply chain integration management of medical consumables].

    Science.gov (United States)

    Zhang, Jian

    2013-07-01

    This paper introduces the background, the content, the information management system of material supply chain integration management and the consumables management process. The system helps to expand the selection of hospital supplies varieties, to reduce consumables management costs, to improve the efficiency of supplies, to ensure supplies safety, reliability and traceability.

  10. Ways to Say No: Refusal Skill Strategies among Urban Adolescents

    Science.gov (United States)

    Nichols, Tracy R.; Graber, Julia A.; Brooks-Gunn, Jeanne; Botvin, Gilbert J.

    2006-01-01

    Objectives: To examine associations among adolescents' generated verbal strategies (ie, Simple No, Declarative Statements, Excuse, Alternatives) and underlying nonverbal assertiveness in 2 refusal situations: smoking and shoplifting. Methods: Sixth-grade urban minority students (N = 454) participated in videotaped role-play assessments of peer…

  11. Integrated Guidelines for Management of Alloy 600 Locations

    Energy Technology Data Exchange (ETDEWEB)

    Na, Kyung-Hwan; Chung, Hansub; Yang, Jun-Seog; Lee, Kyoung-Soo [KHNP-Central Research Institute, Daejeon (Korea, Republic of)

    2015-05-15

    The locations experiencing PWSCC include steam generator tubes, pressurizer instrumental nozzles, control rod driving mechanism(CRDM) penetration nozzles, reactor outlet nozzles, and bottom mounted instrumental(BMI) nozzles. Korea Hydro and Nuclear Power Co.(KHNP) has developed integrated guidelines for management of alloy 600 locations and the guidelines are under review by the regulator. The guidelines consist of alloy 600 location database, inspection program, maintenance/preventive maintenance method, and finally water chemistry management for PWSCC mitigation. In this paper, the detailed contents are presented. The integrated guidelines collected all relevant information on the management of alloy 600 locations. This information may be useful for establishing the most effective preventive maintenance strategies by prioritization in addition to maintenance strategies. Table II summarize maintenance strategies for alloy 600 locations.

  12. The 5C model: A new approach to asset integrity management

    International Nuclear Information System (INIS)

    Rahim, Yousif; Refsdal, Ingbjorn; Kenett, Ron S.

    2010-01-01

    As organizations grow more complex in operation and more global in scope, assets and technical integrity become key success factors. A company's asset integrity business process needs to be mapped in order to 1) provide a proper overview of operation and business processes, 2) identify all critical interfaces and 3) ensure that all gaps and overlaps in processes are eliminated. Achieving asset integrity requires companies to sustain their activities and identify the hazards, weaknesses and objectives of their strategic assets. Technical integrity emphasizes a complete overview of technical conditions and related information, and the ability of the companies to document the technical state of its assets. It is based on an integrated view of the current state of operations, and the identification of all critical interfaces, in order to ensure that all gaps and unnecessary overlaps in processes are eliminated. Companies look increasingly at their asset integrity management system as a means to extend the life of their assets, beyond the original design conditions and production capacity. Establishing an asset integrity management system requires the documentation of the company's technical integrity management, a strategy and the processes for carrying it out, identifying gaps; selecting corrective interventions and conducting follow up actions. The paper discusses various aspects of asset integrity management, including its planning and implementation. We begin with an introduction to asset technical integrity, provide some theoretical backgrounds, present a model we call 5C and conclude with a summary and discussion.

  13. Integrating Medical Supply as Part of the Army's Single Integrated Materiel Manager Concept--Why or why Not?

    National Research Council Canada - National Science Library

    Baxter, Shelia

    1998-01-01

    .... To achieve the goal of seamless logistics integration capabilities, one concept is to establish a Single Integrated Materiel Manager for the Army which envisions integrating all such functions...

  14. Integrated online energy and battery life management for hybrid long haulage truck

    NARCIS (Netherlands)

    Pham, H.T.; Kessels, J.T.B.A.; Bosch, van den P.P.J.; Huisman, R.G.M.

    2014-01-01

    Battery lifetime management plays an important role for successful commercializing hybrid electric vehicles. This paper aims at integrating the battery lifetime management into the energy management system of a heavy-duty hybrid electric truck. The developed strategy called Integrated Energy

  15. Structural Integrity Management for Fixed Offshore Platforms in Malaysia

    OpenAIRE

    Narayanan Sambu Potty; Mohammad Kabir B. Mohd Akram

    2009-01-01

    Structural Integrity Management (SIM) is important for the protection of offshore crew, environment, business assets and company and industry reputation. API RP 2A contained guidelines for assessment of existing platforms mostly for the Gulf of Mexico (GOM). ISO 19902 SIM framework also does not specifically cater for Malaysia. There are about 200 platforms in Malaysia with 90 exceeding their design life. The Petronas Carigali Sdn Bhd (PCSB) uses the Asset Integrity Management ...

  16. Carbon-13 nuclear magnetic resonance spectroscopic characterization of humic substances from municipal refuse decomposing in a landfill

    International Nuclear Information System (INIS)

    Newman, R.H.; Theng, B.K.G.; Filip, Z.

    1987-01-01

    Municipal refuse was disposed of in simulated landfills and left for periods of more than 20 months. Three different 40 m 3 systems of disposals were studied, namely (i) where the refuse was compacted, (ii) where it was mixed with sewage sludge and left uncompacted, and (iii) where it was compacted with sewage sludge. At 2, 6, 12 and 20 months, the humic substances were extracted from each system, purified, and characterised by cross-polarisation 13 C NMR spectroscopy with 'magic-angle' sample spinning. The areas under the various signals were related to carbon percentages in different structural categories. The aromaticity of the humic acids increased with time of decomposition; those from refuse mixed with sewage sludge were particularly high in phenolic content. A signal at 174 p.p.m., assigned primarily to secondary amide linkages, reached maximum strength after 6 to 12 months decomposition. The carbohydrate contents of the humic acids showed only small variations as decomposition progressed. Polymethylene chains in lipids, particularly for the uncompacted system, accounted for a diminishing fraction of total carbon as time of refuse disposal increased. The spectrum of a soil humic acid showed features similar to those observed in spectra of humic acids derived from refuse, but the signals were less well resolved. 19 refs.; 8 figs.; 3 tabs

  17. Reward and Cognition: Integrating Reinforcement Sensitivity Theory and Social Cognitive Theory to Predict Drinking Behavior.

    Science.gov (United States)

    Hasking, Penelope; Boyes, Mark; Mullan, Barbara

    2015-01-01

    Both Reinforcement Sensitivity Theory and Social Cognitive Theory have been applied to understanding drinking behavior. We propose that theoretical relationships between these models support an integrated approach to understanding alcohol use and misuse. We aimed to test an integrated model in which the relationships between reward sensitivity and drinking behavior (alcohol consumption, alcohol-related problems, and symptoms of dependence) were mediated by alcohol expectancies and drinking refusal self-efficacy. Online questionnaires assessing the constructs of interest were completed by 443 Australian adults (M age = 26.40, sd = 1.83) in 2013 and 2014. Path analysis revealed both direct and indirect effects and implicated two pathways to drinking behavior with differential outcomes. Drinking refusal self-efficacy both in social situations and for emotional relief was related to alcohol consumption. Sensitivity to reward was associated with alcohol-related problems, but operated through expectations of increased confidence and personal belief in the ability to limit drinking in social situations. Conversely, sensitivity to punishment operated through negative expectancies and drinking refusal self-efficacy for emotional relief to predict symptoms of dependence. Two pathways relating reward sensitivity, alcohol expectancies, and drinking refusal self-efficacy may underlie social and dependent drinking, which has implications for development of intervention to limit harmful drinking.

  18. Integrating the traditional and the modern conflict management ...

    African Journals Online (AJOL)

    The study examines the modalities for integrating traditional and modern conflict management strategies in Nigeria using an analysis of relevant documents as well as Black's Social Control Theory and Thomas-Kilmann's Model of Conflict Management. The successful amalgamation of diverse groups has radically shifted ...

  19. SYSTEMS FOR IMPROVEMENT OF BUSINESS INTEGRATED MANAGEMENT PROCESSES IN PORTS

    Directory of Open Access Journals (Sweden)

    Pavle Popovic

    2017-03-01

    Full Text Available Based on test results obtained so far, the objective relating to modern scientific methods and approaches has been defined with the intention to develop model which defines new management system integration model, by adopting necessary practical terms of real systems that most frequently circulate in maritime practice in the field of integrated management systems (IMS in terms of safety and security of vessels and ports. The subject of research is maritime, particularly port services, by way of defining internal and external advantages through adopting integrated management systems. The research will be conducted through theoretical and applied assessments of case study analyses using example of the Port of Kotor H.Co.

  20. RISK MANAGEMENT: AN INTEGRATED APPROACH TO RISK MANAGEMENT AND ASSESSMENT

    OpenAIRE

    Szabo Alina

    2012-01-01

    Purpose: The objective of this paper is to offer an overview over risk management cycle by focusing on prioritization and treatment, in order to ensure an integrated approach to risk management and assessment, and establish the ‘top 8-12’ risks report within the organization. The interface with Internal Audit is ensured by the implementation of the scoring method to prioritize risks collected from previous generated risk report. Methodology/approach: Using evidence from other research in ...

  1. Implementing Integrated Multicultural Instructional Design in Management Education

    Science.gov (United States)

    Schultz, Jennifer L.; Higbee, Jeanne L.

    2011-01-01

    This purpose of this paper is to summarize the principles of integrated multicultural instructional design (IMID; Higbee, Goff, & Schultz, in press; Higbee, Schultz, & Goff, 2010) and present specific strategies for incorporating IMID in management education. The primary goal of IMID is to promote the integration of multicultural content…

  2. Integrated Hydrographical Basin Management. Study Case - Crasna River Basin

    Science.gov (United States)

    Visescu, Mircea; Beilicci, Erika; Beilicci, Robert

    2017-10-01

    Hydrographical basins are important from hydrological, economic and ecological points of view. They receive and channel the runoff from rainfall and snowmelt which, when adequate managed, can provide fresh water necessary for water supply, irrigation, food industry, animal husbandry, hydrotechnical arrangements and recreation. Hydrographical basin planning and management follows the efficient use of available water resources in order to satisfy environmental, economic and social necessities and constraints. This can be facilitated by a decision support system that links hydrological, meteorological, engineering, water quality, agriculture, environmental, and other information in an integrated framework. In the last few decades different modelling tools for resolving problems regarding water quantity and quality were developed, respectively water resources management. Watershed models have been developed to the understanding of water cycle and pollution dynamics, and used to evaluate the impacts of hydrotechnical arrangements and land use management options on water quantity, quality, mitigation measures and possible global changes. Models have been used for planning monitoring network and to develop plans for intervention in case of hydrological disasters: floods, flash floods, drought and pollution. MIKE HYDRO Basin is a multi-purpose, map-centric decision support tool for integrated hydrographical basin analysis, planning and management. MIKE HYDRO Basin is designed for analyzing water sharing issues at international, national and local hydrographical basin level. MIKE HYDRO Basin uses a simplified mathematical representation of the hydrographical basin including the configuration of river and reservoir systems, catchment hydrology and existing and potential water user schemes with their various demands including a rigorous irrigation scheme module. This paper analyzes the importance and principles of integrated hydrographical basin management and develop a case

  3. Organizational learning in developing the integrated quality management

    Directory of Open Access Journals (Sweden)

    Juhani Anttila

    2018-04-01

    Full Text Available High quality is organizations’ competitive advantage. It is beneficial to base this on professional approach, and basic concepts and definitions with scientific foundation. The necessary main concepts consist of quality, quality management, quality improvement and quality assurance. Organizations' top management is responsible of the quality management decisions and implementations. The present practical situation is fragmented and the implementations are most often based on the instrumental means of the different methodological schools, which is confusing and detrimental to the understanding and usefulness of the concept of quality management. It is not beneficial to build a special system for quality management by only following the requirements of the general standard. This cannot ensure competitive business advantage. In this article, we present an alternative approach that is a natural practical way to realize quality management as the teleological solution, Quality Integration, in which the general and specific quality concepts, principles and methodology are embedded within the normal business management activities. Our Quality Integration is based on the thinking of organizational learning. Its framework covers both running the current business and improving the overall business performance. This model has been used as the thinking framework in practical organizational cases since 1990’s. As the business circumstances change constantly, the organization must be constantly ready to renew through both small and radical changes. This change also receives resistance, and the development takes place according to a multi-phase process towards the new integration and requires a proper recognition and decisions. Principles of the organizational learning can help organizations in a consistent way. Evaluation of the overall organizational performance is an important quality management practice and should take into account performance enablers

  4. A SURVEY ON INDIAN EXPERIENCE ON INTEGRATED MANAGEMENT STANDARDS (IMS

    Directory of Open Access Journals (Sweden)

    H. Khanna

    2009-09-01

    Full Text Available Adoption of management systems standards is a key issue in manufacturing industry in India. Following the global trend quality and environmental issues are gaining importance. However the number of ISO 14001 certified companies are much less in India as compared to ISO 9001. The integration of ISO 14001 with ISO 9001 may help companies to sustain competitive advantage and overcome disappointments with quality standards and in turn encourage companies to adopt good environmental practices. The aim of this research is to study the implementation of integrated management standards (IMS by the manufacturing organizations in India. The different aspects of integration and benefits of IMS implementation are analyzed. This r esearch is based on empirical study carried out in Indian manufacturing firms, involving the application of a questionnaire. This questionnaire was tested on 50 manufacturing companies in India. The study reveals that focus on stakeholders; top management commitment and training are critical success factors for implementation of IMS. The main benefits of integration are discussed. The small sample size is one of the major limitations of this study. The paper informs the managers in manufacturing organizations and practitioners of management system standards especially in developing countries about IMS and will enable them to adopt IMS in future so that those organizations may not implement multiple and overlapping MSS(Management System Standards.

  5. Integrated emergency management in KKG

    International Nuclear Information System (INIS)

    Kluegel, J.U.; Plank, H.

    2007-01-01

    The development and introduction of emergency measures in Switzerland was mainly characterized by the evaluation of international experience and by systematic analysis of beyond-design basis accidents within the framework of plant-specific probabilistic safety analyses. As early as in the mid-eighties, the Swiss regulatory authority demanded that measures be taken against severe accidents, and periodically added more detailed requirements, most recently in 2000 when the introduction of Severe Accident Management Guidelines (SMAG) was demanded for power operation as well as operation in the non-power mode. The SMAG were introduced at the Goesgen nuclear power station within a project in the period between 2003 and 2005. For this purpose, a concept of integrated emergency management was developed which is based on updates of the proven emergency manual. One important aspect of this integrative concept is the distinction between preventive and mitigating procedures by defining appropriate criteria. The findings made in the implementation phase of the project include the realization that the introduction of procedures dealing with severe accidents also requires the ability to develop new ways of thinking and acting in accident management. This implies the awareness that procedures covering severe accidents must be applied much more flexibly and in the light of the situation than regulations covering fault conditions. Also possibilities to simulate severe accidents were created within the project both for the development of procedures and for training plant operators and members of the emergency staff. (orig.)

  6. Co-Leadership – A Management Solution for Integrated Health and Social Care

    Directory of Open Access Journals (Sweden)

    Charlotte Klinga

    2016-05-01

    Full Text Available Introduction: Co-leadership has been identified as one approach to meet the managerial challenges of integrated services, but research on the topic is limited. In the present study, co-leadership, practised by pairs of managers – each manager representing one of the two principal organizations in integrated health and social care services – was explored. Aim: To investigate co-leadership in integrated health and social care, identify essential preconditions in fulfilling the management assignment, its operationalization and impact on provision of sustainable integration of health and social care. Method: Interviews with eight managers exercising co-leadership were analysed using directed content analysis. Respondent validation was conducted through additional interviews with the same managers. Results: Key contextual preconditions were an organization-wide model supporting co-leadership and co-location of services. Perception of the management role as a collective activity, continuous communication and lack of prestige were essential personal and interpersonal preconditions. In daily practice, office sharing, being able to give and take and support each other contributed to provision of sustainable integration of health and social care.  Conclusion and discussion: Co-leadership promoted robust management by providing broader competence, continuous learning and joint responsibility for services. Integrated health and social care services should consider employing co-leadership as a managerial solution to achieve sustainability.

  7. Managing the tensions in integrating global organisations : The role of performance management systems

    NARCIS (Netherlands)

    Busco, C.; Giovannoni, E.; Scapens, R.W.

    The paper explores the role of performance management systems (PMSs) in integrating global organisations (GOs). It investigates the ways in which the diverse entities that comprise a GO can be co-ordinated and integrated to achieve a global unity of effort, while leaving space for local adaptation,

  8. Refusal of recommended maternity care: Time to make a pact with women?

    Science.gov (United States)

    Jenkinson, Bec; Kruske, Sue; Kildea, Sue

    2018-03-28

    The right to refuse medical treatment can be contentious in maternity care. Professional guidance for midwives and obstetricians emphasises informed consent and respect for patient autonomy, but there is little guidance available to clinicians about the appropriate clinical responses when women decline recommended care. We propose a comprehensive, woman-centred, systems-level framework for documentation and communication with the goal of supporting women, clinicians and health services in situations of maternal refusal. We term this the Personalised Alternative Care and Treatment framework. The Personalised Alternative Care and Treatment framework addresses Australian policy, practice, education and professional issues to underpin woman-centred care in the context of maternal refusal. It embeds Respectful Maternity Care in system-level maternity care policy; highlights the woman's role as decision maker about her maternity care; documents information exchanged with women; creates a 'living' plan that respects the woman's birth intentions and can be reviewed as circumstances change; enables communication between clinicians; permits flexible initiation pathways; provides for professional education for clinicians, and incorporates a mediation role to act as a failsafe. The Personalised Alternative Care and Treatment framework has the potential to meet the needs of women, clinicians and health services when pregnant women decline recommended maternity care. Copyright © 2018. Published by Elsevier Ltd.

  9. Integrated refinery waste management

    Energy Technology Data Exchange (ETDEWEB)

    Shieh, Y -S [ETG Environmental, Inc., Blue Bell, PA (US); Sheehan, W J [Separation and Recovery Systems, Inc., Irvine, CA (US)

    1992-01-01

    In response to the RCRA land ban regulations and TC rule promulgated by the U.S. Federal Environmental Protection Agency (EPA) in 1988-1990, an Integrated Refinery Waste Management (IRWM) program has been developed to provide cost-effective solutions to petroleum industry customers. The goal of IRWM is to provide technology based remediation treatment services to manage sludges and wastewaters generated from the oil refining processes, soils contaminated with petroleum distillates and groundwater contaminated with fuels. Resource recovery, volume reduction and waste minimization are the primary choices to mitigate environmental problems. Oil recovery has been performed through phase separation (such as centrifugation and filtration) and heating of heavy oils. Volume reduction is achieved by dewatering systems such as centrifuges and filter presses, and low temperature thermal treatment. Waste minimization can be accomplished by bioremediation and resource recovery through a cement kiln. (Author).

  10. Plant life management. Progress for structural integrity

    International Nuclear Information System (INIS)

    Solin, J.

    2003-03-01

    A joint project cluster of industry, VTT and other R and D suppliers is dealing with managing of lifetime of critical structures and components in energy and process industry. The research topics include systematic component lifetime management, data management, integrity and lifetime of pressure bearing components, non-destructive inspection, interactions of coolant and materials, environmentally assisted cracking and ageing of reactor internals. This Symposium is a compilation of selected papers describing an intermediate status of the projects after three years of research and development. (orig.)

  11. Competitiveness in organizational integrated computer system project management

    Directory of Open Access Journals (Sweden)

    Zenovic GHERASIM

    2010-06-01

    Full Text Available The organizational integrated computer system project management aims at achieving competitiveness by unitary, connected and personalised treatment of the requirements for this type of projects, along with the adequate application of all the basic management, administration and project planning principles, as well as of the basic concepts of the organisational information management development. The paper presents some aspects of organizational computer systems project management competitiveness with the specific reference to some Romanian companies’ projects.

  12. Integrated waste and water management system

    Science.gov (United States)

    Murray, R. W.; Sauer, R. L.

    1986-01-01

    The performance requirements of the NASA Space Station have prompted a reexamination of a previously developed integrated waste and water management system that used distillation and catalytic oxydation to purify waste water, and microbial digestion and incineration for waste solids disposal. This system successfully operated continuously for 206 days, for a 4-man equivalent load of urine, feces, wash water, condensate, and trash. Attention is given to synergisms that could be established with other life support systems, in the cases of thermal integration, design commonality, and novel technologies.

  13. INTEGRATED SUSTAINABLE MANGROVE FOREST MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Cecep Kusmana

    2015-07-01

    Full Text Available Mangrove forest as a renewable resource must be managed based on sustainable basis in which the benefits of ecological, economic and social from the forest have to equity concern in achieving the optimum forest products and services in fulfill the needs of recent generation without destruction of future generation needs and that does not undesirable effects on the physical and social environment. This Sustainable Forest Management (SFM practices needs the supporting of sustainability in the development of social, economic and environment (ecological sounds simultaneously, it should be run by the proper institutional and regulations. In operational scale, SFM need integration in terms of knowledge, technical, consultative of stakeholders, coordination among sectors and other stakeholders, and considerations of ecological inter-relationship in which mangroves as an integral part of both a coastal ecosystem and a watershed (catchment area. Some tools have been developed to measure the performent of SFM, such as initiated by ITTO at 1992 and followed by Ministry of Forestry of Indonesia (1993, CIFOR (1995, LEI (1999, FSC (1999, etc., however, the true nuance of SFM’s performance is not easy to be measured. 

  14. Electric equipment for Koto Refuse Incineration Plant; Tokyoto Koto seiso kojo muke denki setsubi

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-03-10

    Meidensha Corporation, intending to enter into refuse disposal business, delivered electric equipment to a Koto Refuse Incineration Plant, Koto Ward, Tokyo, and the facilities came into operation in October, 1998. The plant is the largest in Japan in terms of refuse processing capacity (1800t/day), and efforts are exerted to harmonize the plant with the surroundings, which involve pollution measures and a building that images a cruising yacht. The power receiving facility consists of a 66kV nominal two-circuit gas insulated switch and gas insulated transformer arranged in a space saving design. Heat from refuse incineration is fed to a steam turbine generator (yielding 50MW, the largest in Japan, with the surplus offered for sale after 15MW fed to loads in the site) and to neighboring facilities. For the suppression of fluctuations in voltage at the power receiving point, reactive power is subjected to control which is done by controlling the generator magnetic field system. An 11kV distribution system is provided to match the steam turbine generator voltage, and the voltage is stepped down to 6.6kV with the intermediary of a 23MVA gas insulated transformer. The power is fed to high voltage motors such as the one used for the induced draft fan, electric equipment in the buildings, power facilities in the plant, etc. A power monitoring board is provided in the central control room for general supervision over the power related facilities. (NEDO)

  15. Integrated project risk management of nuclear power projects

    International Nuclear Information System (INIS)

    Wang Xiaohui; Xu Yuanhui

    2001-01-01

    The concept and the features of risks in nuclear power projects are introduced, and in terms of nuclear power projects' own features, the Nuclear Power Project Integrated Risk Management Model is presented. The identification, estimation, evaluation, response plan development, control of risks and the theoretical basis of risk management are discussed. The model has feedback and control functions in order to control and manage the risks dynamically

  16. Understanding Organizational Memory from the Integrated Management Systems (ERP)

    OpenAIRE

    Gilberto Perez; Isabel Ramos

    2013-01-01

    With this research, in the form of a theoretical essay addressing the theme of Organizational Memory and Integrated Management Systems (ERP), we tried to present some evidence of how this type of system can contribute to the consolidation of certain features of Organizational Memory. From a theoretical review of the concepts of Human Memory, extending to the Organizational Memory and Information Systems, with emphasis on Integrated Management Systems (ERP) we tried to draw a parallel between ...

  17. the development of new generation of solid waste refuse incinerators

    African Journals Online (AJOL)

    Apart from town refuse, there are wastes from agriculturally based industries especially ... depends on careful control of the 3T's (time, temperature and turbulence). ... These activities cause serious public health risks ... The modifications to the old bottle incinerators were developed by carefully assessing the failure modes.

  18. 9 CFR 351.19 - Refusal of certification for specific lots.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Refusal of certification for specific lots. 351.19 Section 351.19 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION...

  19. Development of SFR Research and Integration Management System (S-RIMS)

    International Nuclear Information System (INIS)

    Cho, Chung Ho; Chang, Jin Wook; Kim, Young Gyun; Kim, Yeong Il

    2011-01-01

    Up to the present, the management of research and development (R and D) for a sodium cooled fast reactor (SFR) could be individually performed on each project without an organic relationship. However, a more systemic and effective integrated management of a project is required because the research and development environment is currently changing. Thus, we developed a Research and Integration Management System for SFR (S-RIMS) based on the enterprise project management (EPM) solution. The functional goals of the S-RIMS are as follows: 1. Provide data that show the progress and status of a project 2. Manage the design process and R and D products 3. Share the consistent design data between sub-projects

  20. CANDU plant life management - An integrated approach

    International Nuclear Information System (INIS)

    Hopkins, J.R.

    1998-01-01

    An integrated approach to plant life management has been developed for CANDU reactors. Strategies, methods, and procedures have been developed for assessment of critical systems structures and components and for implementing a reliability centred maintenance program. A Technology Watch program is being implemented to eliminate 'surprises'. Specific work has been identified for 1998. AECL is working on the integrated program with CANDU owners and seeks participation from other CANDU owners

  1. Free to become martyrs? The right to refuse medical treatment on religious grounds in a comparative perspective

    Directory of Open Access Journals (Sweden)

    Vincenzo Pacillo

    2016-09-01

     ABSTRACT: This study focuses on the right of patients to refuse medical treatments on religious grounds and on the (supposed right to the parents to refuse medical treatments on behalf of their children, emphasizing the links and connections between the freedom of religion, the right to self-determination and the right to refuse medical treatment based on religious motivations. After a comparison between the norms devoted to rule the exercise of these rights in the English (and Welsh and Italian legal systems, the article suggests that the approach of medical staff towards a Refusal of Medical Treatment on Religious Grounds ought to start an intercultural process. This process ought to be a cross-cultural dialogue devoted not only to translate medical language in a language which can be fully understood by the patient, but also to create a reciprocal comprehension between the (mainstream ethnocultural communication codes and instances of the staff and the (nondominant ethnocultural (and religious communication codes and instances of the patient (or of his/her parents.

  2. Research on integrated managing system based on CIMS for nuclear power plant safety

    International Nuclear Information System (INIS)

    Zhou Gang

    2006-01-01

    In order to improve safety, economy and reliability of operation for nuclear power plant (NPP), a novel integrated managing method was proposed based on the ideas of computer and contemporary integrated manufacturing system (CIMS). The application of CIMS to nuclear power plant safety management was researched. In order to design an integrated managing system to meet the needs of NPP safety management, all work related to nuclear safety is divided into different category according to its characters. On basis of this work, general integrated managing system was designed at first. Then subsystems were designed and every subsystem implements a category of nuclear safety management work. All subsystems are independent relatively on the one hand and are interrelated on other hand by global information system. (authors)

  3. Energy from refuse by bioconversion, fermentation and residue disposal processes

    Energy Technology Data Exchange (ETDEWEB)

    Pfeffer, J T; Liebman, J C

    1976-01-01

    Bioconversion of organic refuse to CH/sub 4/ by anaerobic fermentation is 1 mechanism by which the energy in urban waste can be reclaimed. Laboratory studies were made to determine the rate and amount of gas production at various operating temperatures. The dewatering characteristics of the spent fermentation slurry were evaluated. The spent solids can be dewatered to a sufficiently low moisture content such that incineration is self-sustaining. The incineration system was evaluated to determine the possible energy recovery from the spent cake. A process for treating the liquid blowdown from the system was developed. A mathematical simulation of the total system was constructed to evaluate performance under various operating conditions. A plant processing 908 tons of refuse/day will produce 3905 m/sup 3/ CH/sub 4//hr. Recovery of just CH/sub 4/ provides a 32.6% efficiency of energy recovery. This efficiency can be increased to 63.4% if steam from the incinerator can be sold.

  4. Right of a patient to refuse medical treatment: justification for judicial ...

    African Journals Online (AJOL)

    Nnamdi Azikiwe University Journal of International Law and Jurisprudence ... This paper discusses the right of a patient to refuse medical treatment and juxtaposes ... This is achieved by an expository review of relevant case law and scholarly ...

  5. When is it permissible to dismiss a family who refuses vaccines? Legal, ethical and public health perspectives.

    Science.gov (United States)

    Halperin, Beth; Melnychuk, Ryan; Downie, Jocelyn; Macdonald, Noni

    2007-12-01

    Although immunization is one of the most important health interventions of the 20th century, cases of infectious disease continue to occur. There are parents who refuse immunization for their children, creating a dilemma for the primary care physician who must consider the best interest of the individual child as well as that of the community. Some physicians, when faced with parents who refuse immunization on behalf of their children, choose to dismiss these families from their practice. Given the existing shortage of primary care physicians across Canada, this decision to dismiss families based on vaccine refusal has far-reaching implications. The present article explores this issue in the Canadian context from a legal, ethical and public health perspective.

  6. Ontario Hydro's integrated air management plan

    International Nuclear Information System (INIS)

    Kalvins, A.K.; Brown, D.; Camacho, F.; Howes, H.; Jantzi, B.; Lin, X.; Lui, P.; Melo, O.T.; Mortimer, W.P.; Reuber, B.

    1992-01-01

    Ontario Hydro is developing an integrated air management plan as a tool for comparing the environmental impacts of fossil-fuel power generation options. The goal is to relate equipment, location, emissions, and impacts and to identify the optimum way to manage the utility's fossil generation system in view of upcoming environmental regulations and public expectations. The eight steps of the plan are briefly described: definition of power generation scenarios (upgrading, conversion to natural gas, non-utility generation, alternative technologies); estimation of emissions for each generation and fuel option studied; identification of impact of air emissions on building materials, agriculture, forests, lakes, and fisheries; modelling of air emissions dispersion; quantification of damage to pollution receptors; quantification of full fuel cycle effects; and comparison of the scenarios. The scenario having the lowest overall environmental impact involved upgrading the existing fossil-fuel system with additional air emissions controls and two integrated gasification combined cycle plants. 9 refs., 3 figs., 3 tabs

  7. Factors influencing implementation of integrated management of ...

    African Journals Online (AJOL)

    intern

    implementation of health facility based Integrated Management of Childhood Illness ... community-owned resource persons (CORPs) to provide health education to care ... differing coverage of basic essential services such safe water supply, ...

  8. Individual- and regional-level determinants of human papillomavirus (HPV) vaccine refusal: the Ontario Grade 8 HPV vaccine cohort study.

    Science.gov (United States)

    Remes, Olivia; Smith, Leah M; Alvarado-Llano, Beatriz E; Colley, Lindsey; Lévesque, Linda E

    2014-10-08

    Studies on the determinants of human papillomavirus (HPV) vaccine use have generally focused on individual-level characteristics, despite the potentially important influence of regional-level characteristics. Therefore, we undertook a population-based, retrospective cohort study to identify individual- and regional-level determinants of HPV vaccine refusal (non-receipt) in Ontario's (Canada) Grade 8 HPV Immunization Program. Ontario's administrative health and immunization databases were used to identify girls eligible for free HPV vaccination in 2007-2011 and to ascertain individual-level characteristics of cohort members (socio-demographics, vaccination history, health care utilization, medical history). The social and material characteristics of the girl's region (health unit) were derived from the 2006 Canadian Census. Generalized estimating equations (binomial distribution, logit link) were used to estimate the population-average effects of individual- and regional-level characteristics on HPV vaccine refusal. Our cohort consisted of 144,047 girls, 49.3% of whom refused HPV vaccination. Factors associated with refusal included a previous diagnosis of Down's syndrome (OR = 1.37, 95% CI 1.16-1.63) or autism (OR = 1.60, 95% CI 1.34-1.90), few physician visits (OR = 1.45, 95% CI 1.35-1.55), and previous refusal of mandatory (OR = 2.23, 95% CI 2.07-2.40) and optional (OR = 3.96, 95% CI 3.87-4.05) vaccines. Refusal was highest among the lowest and highest income levels. Finally, a previous diagnosis of obesity and living in an area of high deprivation were associated with lower refusal (OR = 0.87, 95% CI 0.83-0.92 and OR = 0.82 95%, CI 0.79-0.86, respectively). Studies on HPV vaccine determinants should consider regional-level factors. Efforts to increase HPV vaccine acceptance should include vulnerable populations (such as girls of low income) and girls with limited contact with the healthcare system.

  9. Integrated Pest Management of the Southern Pine Beetle

    Science.gov (United States)

    Robert N. Coulson; Hannu Saarenmaa

    2011-01-01

    Integrated pest management (IPM) is the maintenance of destructive agents, including insects, at tolerable levels by the planned use of a variety of preventive, suppressive, or regulatory tactics and strategies that are ecologically and economically efficient and socially and politically acceptable. It is explicit that the actions taken are fully integrated into the...

  10. Integrated project management information systems: the French nuclear industry experience

    International Nuclear Information System (INIS)

    Jacquin, J.-C.; Caupin, G.-M.

    1990-01-01

    The article discusses the desirability of integrated project management systems within the French nuclear power industry. Change in demand for nuclear generation facilities over the last two decades has necessitated a change of policy concerning organization, cost and planning within the industry. Large corporate systems can benefit from integrating equipment and bulk materials tracking. Project management for the nuclear industry will, in future, need to incorporate computer aided design tools and project management information systems data bases as well as equipment and planning data. (UK)

  11. Integrated project management information systems: the French nuclear industry experience

    Energy Technology Data Exchange (ETDEWEB)

    Jacquin, J.-C.; Caupin, G.-M.

    1990-03-01

    The article discusses the desirability of integrated project management systems within the French nuclear power industry. Change in demand for nuclear generation facilities over the last two decades has necessitated a change of policy concerning organization, cost and planning within the industry. Large corporate systems can benefit from integrating equipment and bulk materials tracking. Project management for the nuclear industry will, in future, need to incorporate computer aided design tools and project management information systems data bases as well as equipment and planning data. (UK).

  12. A Framework for Integration of IVHM Technologies for Intelligent Integration for Vehicle Management

    Science.gov (United States)

    Paris, Deidre E.; Trevino, Luis; Watson, Mike

    2005-01-01

    As a part of the overall goal of developing Integrated Vehicle Health Management (IVHM) systems for aerospace vehicles, the NASA Faculty Fellowship Program (NFFP) at Marshall Space Flight Center has performed a pilot study on IVHM principals which integrates researched IVHM technologies in support of Integrated Intelligent Vehicle Management (IIVM). IVHM is the process of assessing, preserving, and restoring system functionality across flight and ground systems (NASA NGLT 2004). The framework presented in this paper integrates advanced computational techniques with sensor and communication technologies for spacecraft that can generate responses through detection, diagnosis, reasoning, and adapt to system faults in support of IIVM. These real-time responses allow the IIVM to modify the effected vehicle subsystem(s) prior to a catastrophic event. Furthermore, the objective of this pilot program is to develop and integrate technologies which can provide a continuous, intelligent, and adaptive health state of a vehicle and use this information to improve safety and reduce costs of operations. Recent investments in avionics, health management, and controls have been directed towards IIVM. As this concept has matured, it has become clear the IIVM requires the same sensors and processing capabilities as the real-time avionics functions to support diagnosis of subsystem problems. New sensors have been proposed, in addition, to augment the avionics sensors to support better system monitoring and diagnostics. As the designs have been considered, a synergy has been realized where the real-time avionics can utilize sensors proposed for diagnostics and prognostics to make better real-time decisions in response to detected failures. IIVM provides for a single system allowing modularity of functions and hardware across the vehicle. The framework that supports IIVM consists of 11 major on-board functions necessary to fully manage a space vehicle maintaining crew safety and mission

  13. PGPB's pipeline integrity management system

    Energy Technology Data Exchange (ETDEWEB)

    Urencio, Claudio; Sanchez, Luis; Moreno, Carlos [PGPB - Pemex Gas y Petroquimica Basica (Mexico)

    2005-07-01

    Pemex Gas has 12,134 km of natural gas transmission pipelines, 1,835 Km for LPG and 1,216 Km for basic petrochemicals. The must part of this infrastructure was built in the 70's and reaching their 35 years of operating life. To manage the integrity of the three systems, Pemex Gas has a portfolio of technological tools. This tools allow the Company to improves the decision taking, align the budget with their strategic goals, achieve efficient asset utilization, and increase the value generation. The process of integrity management starts with the risk evaluation on assets, with the use of a software called IAP (Integrity Assessment Program). This information is integrated to the SIIA (Assets Identification System). The results of both software are used to the construction of the Risk Atlas, which identifies graphically each pipeline segment, with their related risk and factors that influence their behavior. The Risk Atlas gives us information about the consequences to the people, environment and facilities, so we can design customized plans to prevent or mitigate emergencies. Finally a detailed analysis of the resulting information and scenarios simulations help us to determine the best investment projects that will minimize the risk through all our assets. (author)

  14. Management information system for cost-schedule integration control for nuclear power projects

    International Nuclear Information System (INIS)

    Liu Wei; Wang Yongqing; Tian Li

    2001-01-01

    Based on the project management experience abroad and at home, a cost-schedule integration control model was developed to improve nuclear power project management. The model integrates cost data with the scheduling data by unity coding to efficiently implement cost-schedule integration control on line. The software system architecture and database is designed and implemented. The system functions include estimating and forecasting dynamically cash flow, scheduling and evaluating deviation from the cost-schedule plan, etc. The research and development of the system should improve the architecture of computer integrated management information systems for nuclear power projects in China

  15. Disaster Management: AN Integral Part of Science & Technology System and Land Administration-Management System

    Science.gov (United States)

    Ghawana, T.; Zlatanova, S.

    2016-06-01

    Disaster management is a multidisciplinary field, which requires a general coordination approach as well as specialist approaches. Science and Technology system of a country allows to create policies and execution of technical inputs required which provide services for the specific types of disasters management. Land administration and management agencies, as the administrative and management bodies, focus more on the coordination of designated tasks to various agencies responsible for their dedicated roles. They get help from Scientific and technical inputs & policies which require to be implemented in a professional manner. The paper provides an example of such integration from India where these two systems complement each other with their dedicated services. Delhi, the Capital of India, has such a disaster management system which has lot of technical departments of government which are mandated to provide their services as Emergency Service Functionaries. Thus, it is shown that disaster management is a job which is an integral part of Science & Technology system of a country while being implemented primarily with the help of land administration and management agencies. It is required that new policies or mandates for the Science and technology organizations of government should give a primary space to disaster management

  16. Water management as a key component of integrated weed management

    Directory of Open Access Journals (Sweden)

    Antonio Berti

    2010-09-01

    Full Text Available Water management within the cropping system is a key factor for an integrated weed management. Soil moisture affects seed persistence and seed dormancy, thus influencing their germination, the establishment of seedlings as well as the competition at adult stage and the number, vitality and dormancy of the new seeds produced by the weeds. The interactions among water availability and competition are very complex and still not fully understood. A research effort in this sector should the be very relevant for the development of new approaches of weed management, such as “Ecological weed management”, aiming to reduce weed density and competitiveness and, in the medium term, to prevent undesired modifications of the weed flora.

  17. Weather information integration in transportation management center (TMC) operations.

    Science.gov (United States)

    2011-01-02

    This report presents the results of the third phase of an on-going FHWA study on weather integration in Transportation Management Center (TMC) operations. The report briefly describes the earlier phases of the integration study, summarizes the findin...

  18. Evolution of river management: up to integrated and beyond?

    NARCIS (Netherlands)

    Straatsma, M.W.; Nooij, R.J.W. de

    2010-01-01

    Integrated river management is heralded as the new style of river management, but it has been preceded by a number of previous styles, and is unlikely to be the last. This article presents the first analysis of the evolution of river management using Spiral Dynamics (SD). SD provides a growth

  19. Training plan : Dallas Integrated Corridor Management (ICM) demonstration project.

    Science.gov (United States)

    2013-01-01

    The Dallas Area Rapid Transit (DART) is leading the US 75 Integrated Corridor Management (ICM) Demonstration Project for the Dallas region. Coordinated corridor operations and management is predicated on being able to share transportation information...

  20. Test report : Dallas Integrated Corridor Management (ICM) demonstration project.

    Science.gov (United States)

    2015-05-01

    The Dallas Area Rapid Transit (DART) is leading the US 75 Integrated Corridor Management (ICM) : Demonstration Project for the Dallas region. Coordinated corridor operations and management is : predicated on being able to share transportation informa...

  1. Final report : Dallas Integrated Corridor Management (ICM) Demonstration Project.

    Science.gov (United States)

    2015-08-01

    The Dallas Area Rapid Transit (DART) is leading the US-75 Integrated Corridor Management (ICM) Demonstration Project for the Dallas region. Coordinated corridor operations and management is predicated on being able to share transportation information...

  2. Integrating research with management: The case of Katavi National ...

    African Journals Online (AJOL)

    Integrating research with management: The case of Katavi National Park, Tanzania. ... national park: (i) reduced water flow caused by local damming of the Katuma River, ... to both management and policy makers for tackling these problems.

  3. TWRS safety and technical integration risk management plan

    International Nuclear Information System (INIS)

    Fordham, R.A.

    1996-01-01

    The objectives of the Tank Waste Remediation System (TWRS) Safety and Technical Integration (STI) programmatic risk management program are to assess, analyze, and handle risks associated with TWRS STI responsibilities and to communicate information about the actions being taken and the results to enable decision making. The objective of this TWRS STI Risk Management Plan is to communicate a consistent approach to risk management that will be used by the organization

  4. INTEGRATION MECHANISMS OF IMPROVEMENT OF HUMAN RESOURCES MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Vera A. Akimenko

    2013-01-01

    Full Text Available In the current economic conditions, the efficiency of business processes of an organization is determined by the quality of the staff. Therefore, actual is the creation and application of new approaches to the management of human re-sources. The article presents a comparative analysis of management practices and their impact on the effectiveness of personnel management, the mechanism of their integration to improve the efficiency of the process.

  5. The Effect of Information Security Management on Organizational Processes Integration in Supply Chain

    Directory of Open Access Journals (Sweden)

    Mohsen Shafiei Nikabadi

    2012-03-01

    Full Text Available : The major purpose of this article was that how information security management has effect on supply chain integration and the effect of implementing "information security management system" on enhancing supplies chain integration. In this respect, current research was seeking a combination overview to these tow approaches (Information Security Management and Organizational Processes Integration by Enterprise Resources Planning System and after that determined factors of these two important issue by factor analysis. Researchers using a series of comments in the automotive experts (production planning and management and supply chain experts and caregivers car makers and suppliers in the first level and second level supply chain industry. In this way, it has been done that impact on how information security management processes enterprise supply chain integration with the help of statistical correlation analysis. The results of this investigation indicated effect of "information security management system" various dimensions that were coordination of information, prevent human errors and hardware, the accuracy of information and education for users on two dimensions of internal and external integration of business processes, supply chain and finally, it can increased integration of business processes in supply chain. At the end owing to quite these results, deployment of "information security management system" increased the integration of organizational processes in supply chain. It could be demonstrate with the consideration of relation of organizational integration processes whit the level of coordination of information, prevent errors and accuracy of information throughout the supply chain.

  6. Vegetation succession and soil infiltration characteristics under different aged refuse dumps at the Heidaigou opencast coal mine

    Directory of Open Access Journals (Sweden)

    Huang Lei

    2015-07-01

    Full Text Available Vegetation succession and soil infiltration characteristics under five different restoration models of refuse dumps including different-aged revegetated sites (1995, 1998, 2003 and 2005 in the northern, eastern and western open-pit coal mine dump and a reference site with native vegetation, which had never been damaged by coal mining activities on the Heidaigou Open Cut Coal Mine were studied. Changes in the plant species, soil properties and infiltration rates were evaluated at the different refuse dumps. The results indicated that the number of herbaceous species, plant cover, biomass, fine particles, and total N, P and SOM increased significantly with increasing site age. However, the number of shrub species decreased since revegetation, its cover increased from 17% to 41% initially and subsequently decreased to the present level of 4%. The natural vegetation community and the northern refuse dump had the highest cumulative infiltration rates of 3.96 and 2.89 cm s−1 in contrast to the eastern and western refuse dumps and the abandoned land, where the highest cumulative infiltration rates were 1.26, 1.04 and 0.88 cm s−1, respectively. A multiple linear regression analysis indicated that the infiltration rate was primarily determined by the silt percentage, SOM, plant coverage and the variation in soil bulk density. Our results provide new ideas regarding future soil erosion controls and sustainable development at open-pit coal mine refuse dumps.

  7. Development and Implementation of Integrated Pest Management in ...

    African Journals Online (AJOL)

    Nafiisah

    This paper reviews the status of Integrated Pest Management (IPM) research in. Mauritius and also reports on the successful cases of IPM implementation during ... Tool. Activity. Status. Source. Biological control. Introduce parasitoids .... 10 g sugar in 1 L of water) in plastic bottles as one option to manage fruit flies in.

  8. Integrating Security Risk Management into Business Process Management for the Cloud

    OpenAIRE

    Goettelmann , Elio; Mayer , Nicolas; Godart , Claude

    2014-01-01

    International audience; Security issues are still preventing wider adoption of cloud computing, especially for businesses which are handling sensitive information. Indeed, by outsourcing its information system (IS), a company can lose control over its infrastructure, its software or even its data. Therefore, new methods and tools need to be defined to respond to this challenge. In this paper we propose to integrate Security Risk Management approaches into Business Process Management to effect...

  9. A quality of life quandary: a framework for navigating parental refusal of treatment for co-morbidities in infants with underlying medical conditions.

    Science.gov (United States)

    Kunz, Sarah N; McAdams, Ryan M; Diekema, Douglas S; Opel, Douglas J

    2015-01-01

    Parental refusal of a recommended treatment is not an uncommon scenario in the neonatal intensive care unit. These refusals may be based upon the parents' perceptions of their child's projected quality of life. The inherent subjectivity of quality of life assessments, however, can exacerbate disagreement between parents and healthcare providers. We present a case of parental refusal of surgical intervention for necrotizing enterocolitis in an infant with Bartter syndrome and develop an ethical framework in which to consider the appropriateness of parental refusal based upon an infant's projected quality of life. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.

  10. AN ASSESSMENT OF THE INTEGRATED PEST MANAGEMENT ...

    African Journals Online (AJOL)

    Integrated Pest Management Collaborative Research Support Program) has been applying a farmer participatory IPM strategy at on-farm research sites in eastern Uganda since 1995. Following five years of project implementation an evaluation ...

  11. The use of coal refuse as construction aggregates; Utilizacion de los Esteriles de Carbon como Aridos en Construccion

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    The objective of this project was to carry out a study which would allow us to determine the nature and properties of coal refuse for its possible use as construction aggregates: roadbeds concrete, bituminous meagres, etc. and to establish criteria of acceptability, placing, and quality control. Two types of refuse, considered to be representative, were chosen (one black and one red) and various trials were performed at a grinding and classifying plant for the obtention of granular materials. The results of these trials determined the most appropriate plant treatment for each type of refuse and established the margin of acceptability, criteria of acceptability, and quality control tests to be applied to the materials obtained from coal refuse for use as construction aggregates. Laboratory testing with both types of refuse mixed with binders (cement, emulsions) were carried out. At the same time, real scale tests, through the construction of concrete slabs in local roads and in trial areas, using the proportions of aggregates and cement that are customary in the area, and also by varying the cement content, substituting it for airborne ash from the thermal La Pereda power station were also performed. From the results obtained, it can be deduced that coal refuse can be used as granular material for roadbeds in different ways: stabilised as gravel-cement, in the form of gravel emulsion, as gravel slag, or by itself. As far as its use in concrete manufacture, it is limited to marginal works. With regard to its decorative use in gardening, it is being used in various town halls in Asturias and Cantabria. (Author)

  12. Patient-related factors and circumstances surrounding decisions to forego life-sustaining treatment, including intensive care unit admission refusal.

    Science.gov (United States)

    Reignier, Jean; Dumont, Romain; Katsahian, Sandrine; Martin-Lefevre, Laurent; Renard, Benoit; Fiancette, Maud; Lebert, Christine; Clementi, Eva; Bontemps, Frederic

    2008-07-01

    To assess decisions to forego life-sustaining treatment (LST) in patients too sick for intensive care unit (ICU) admission, comparatively to patients admitted to the ICU. Prospective observational cohort study. A medical-surgical ICU. Consecutive patients referred to the ICU during a one-yr period. None. Of 898 triaged patients, 147 were deemed too well to benefit from ICU admission. Decisions to forego LST were made in 148 of 666 (22.2%) admitted patients and in all 85 patients deemed too sick for ICU admission. Independent predictors of decisions to forego LST at ICU refusal rather than after ICU admission were: age; underlying disease; living in an institution; preexisting cognitive impairment; admission for medical reasons; and acute cardiac failure, acute central neurologic illness, or sepsis. Hospital mortality after decisions to forego LST was not significantly different in refused and admitted patients (77.5% vs. 86.5%; p = .1). Decisions to forego LST were made via telephone in 58.8% of refused patients and none of the admitted patients. Nurses caring for the patient had no direct contact with the ICU physicians for 62.3% of the decisions in refused patients, whereas meetings between nurses and physicians occurred in 70.3% of decisions to forego LST in the ICU. Patients or relatives were involved in 28.2% of decisions to forego LST at ICU refusal compared with 78.4% of decisions to forego LST in ICU patients (p refused patients (vs. none of admitted patients) and were associated with less involvement of nurses and relatives compared with decisions in admitted patients. Further work is needed to improve decisions to forego LST made under the distinctive circumstances of triage.

  13. Steam gasification of tyre waste, poplar, and refuse-derived fuel: A comparative analysis

    International Nuclear Information System (INIS)

    Galvagno, S.; Casciaro, G.; Casu, S.; Martino, M.; Mingazzini, C.; Russo, A.; Portofino, S.

    2009-01-01

    In the field of waste management, thermal disposal is a treatment option able to recover resources from 'end of life' products. Pyrolysis and gasification are emerging thermal treatments that work under less drastic conditions in comparison with classic direct combustion, providing for reduced gaseous emissions of heavy metals. Moreover, they allow better recovery efficiency since the process by-products can be used as fuels (gas, oils), for both conventional (classic engines and heaters) and high efficiency apparatus (gas turbines and fuel cells), or alternatively as chemical sources or as raw materials for other processes. This paper presents a comparative study of a steam gasification process applied to three different waste types (refuse-derived fuel, poplar wood and scrap tyres), with the aim of comparing the corresponding yields and product compositions and exploring the most valuable uses of the by-products

  14. Understanding Treatment Refusal Among Adults Presenting for HIV-Testing in Soweto, South Africa: A Qualitative Study

    OpenAIRE

    Katz, Ingrid T.; Dietrich, Janan; Tshabalala, Gugu; Essien, Thandekile; Rough, Kathryn; Wright, Alexi A.; Bangsberg, David R.; Gray, Glenda E.; Ware, Norma C.

    2015-01-01

    HIV treatment initiatives have focused on increasing access to antiretroviral therapy (ART). There is growing evidence, however, that treatment availability alone is insufficient to stop the epidemic. In South Africa, only one third of individuals living with HIV are actually on treatment. Treatment refusal has been identified as a phenomenon among people who are asymptomatic, however, factors driving refusal remain poorly understood. We interviewed 50 purposively sampled participants who pre...

  15. Integrated solid waste management: a palliative to existing waste ...

    African Journals Online (AJOL)

    As a concept, Integrated Solid Waste Management (ISWM) is a sustainable ... on the perspective of consumers on waste generation, collection and disposal. ... to effective solid waste management in the case study area; non-sorting and ...

  16. Psychosocial Interventions for School Refusal with Primary and Secondary School Students: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Brandy Maynard

    2015-05-01

    Full Text Available BACKGROUND School refusal is a psychosocial problem characterized by a student’s difficulty attending school and, in many cases, substantial absence from school (Heyne & Sauter, 2013. It is often distinguished from truancy, in part because of the severe emotional distress associated with having to attend school and the absence of severe antisocial behavior. Truancy, on the other hand, is not typically associated with emotional distress and is commonly associated with severe externalizing behavior. The emotional distress associated with school refusal is often in the form of fear or anxiety, and sometimes in the form of depression. School refusal occurs for about 1-2% of young people, and estimates among clinically referred youth are considerably higher. There is substantial heterogeneity in both the presentation of school refusal and its associated risk factors. Significant adverse consequences may occur in the short- and long-term, including school dropout and problems with social adjustment. Family members and school staff are also affected by school refusal. The most commonly studied interventions for school refusal are behavioral approaches and cognitive-behavioral therapy (CBT. The overarching aim of these interventions is the reduction of the young person’s emotional distress and an increase in school attendance to help the young person follow a normal developmental pathway (Heyne & Sauter, 2013. Behavioral interventions include exposure-based interventions, relaxation training, and/or social skills training with the student, and contingency management procedures with the parents and school staff. CBT manuals additionally focus attention on the identification and modification of maladaptive cognition that may maintain the young person’s emotional distress and absenteeism. In some instances parent cognition is also targeted. Other interventions have been used to treat school refusal (e.g., psychodynamic treatment, family therapy

  17. Evaluation of low-level solid radioactive waste generated by a large hospital and disposed of with ordinary refuse

    International Nuclear Information System (INIS)

    Conte, L.; Pedroli, G.; Monciardini, M.; Bianchi, L.; Novario, R.; Beretta, A.

    1996-01-01

    In the Lombardy region some hospitals have recently been reported to the local authorities because of the presence of radioactivity in hospital refuse sent to the municipal tips for incineration. On various occasions the refuse collectors coming from the hospitals had to return with their refuse as traces of radioactivity were detected at the entrance to the tips equipped with monitoring systems. Hospitals administering radioactive substances for diagnostic or therapeutic purposes produce radioactive waste mainly in solid and liquid form. This waste is principally present in patient excreta and in contaminated materials. Radioactive waste present in patient excreta is normally disposed of through the sewage system provided that the concentration limits and annual activity stipulated by law are respected. The contaminated materials coming from the departments that carry out radioisotopic investigations and therapy with unsealed sources can be collected separately and sent to a tip after a period of storage to permit radioactive decay. However, part of the radioactive waste escapes all checks and inevitably mixes with normal refuse or with special hospital refuse that is not considered radioactive. This occurs in the case of: 1. excreta from patients who are not hospitalised after a radioisotopic investigation and materials contaminated by the excreta; 2. excreta from hospitalised patients which are eliminated outside the nuclear medicine and radiotherapy departments; 3. contaminated materials produced with unsealed sources in hospital departments other than those of nuclear medicine and radiotherapy; The waste indicated in point 1 is probably the main problem in ecological terms as the patients who are not hospitalised eliminate radioactive excreta into domestic sewage systems and can also contaminate materials that are disposed of with normal household refuse. In this case any solution to the problem would seriously affect diagnostic activities carried out in the

  18. INTEGRATED DOCUMENT MANAGEMENT SOLUTION FOR THE LOCAL GOVERNMENT

    Directory of Open Access Journals (Sweden)

    Nistor Razvan

    2013-07-01

    Full Text Available In this paper we present system analysis and design elements for the integrated document management solution at local governing authorities in the rural areas. While specifically dealing with the actual management of the Agricultural Register, an important primary unitary evidence document, we also keep a general character of the discussion, in order to argue for the generality of the proposed solution. Hence, for the identified and described problem space we propose an administrative and software infrastructure solution. This work is an empirical research in which our aim is primarily to identify key problems within the local governing authorities from several perspectives concerning the management of the Agricultural Register then to address those problems with an integrated document management system. For the proposed solution we give and argue the general system architecture and describe the key-mechanisms that support quality requirements. The relevance of this research concern is given by the impact of the actual Agricultural Register management on important stakeholders. This can be measured as the satisfaction felt by taxpayers and the performance of the local governing authorities, the Financial Administration, the Agency of Payments and Intervention in Agriculture and the Ministry of Agriculture and Rural Development. This work is also intended as a start-point for a new, modern thinking of the governing authorities in their pursue to improve public services. For this, in our work we highlight the importance of complete system analysis at all administrative levels as a main priority concern for all public managers. Our aim is the improvement of the public service by rising the awareness of the decision makers on the necessity of using integrated document management solutions for the provided services. Also, our work aims at increasing the efficiency with which nowadays, governing authorities invest public funds in various IT projects

  19. Integrated management of root-knot nematode (Meloidogyne ...

    African Journals Online (AJOL)

    Integrated management of root-knot nematode (Meloidogyne incognita) for tomato production and productivity. Bayuh Belay1* ... important food and cash crop of the farmers and is ...... some part of the research budget without any reservation.

  20. Strategic plan modelling by hospital senior administration to integrate diversity management.

    Science.gov (United States)

    Newhouse, John J

    2010-11-01

    Limited research suggests that some hospital senior administrators and chief executive officers (CEOs) have employed a strategic planning function to achieve diversity management practices. As the hospital industry struggles with how to integrate diversity practices to improve patient satisfaction, increase the quality of care and enhance clinical outcomes for minority populations, understanding the planning process involved in this endeavour becomes significant for senior hospital administrators. What is not well understood is what this strategic planning process represents and how it is applied to integrate diversity management. Scant research exists about the type of strategic models that hospital CEOs employ when they wish to reposition their organizations through diversity management. This study examines the strategic planning models used by senior administrators to integrate diversity management for an institutional-wide agenda. A qualitative survey process was used for CEOs in the states of New York, Pennsylvania, New Jersey and Delaware. The key research questions dealt with what type of strategic plan approach senior administrators used for integrating diversity management and what rationale they used to pursue this. Significant differences were reported between three types of strategic plan modelling used by CEOs. Also, when comparing past and current practices over time, such differences existed. The need to integrate diversity management is underscored by this study. How senior hospital administrators apply strategic plan models and what impact these approaches have represent the major implications that this study offers.